Univaried models in the series of temperature of the air

International Nuclear Information System (INIS)

Leon Aristizabal Gloria esperanza

2000-01-01

The theoretical framework for the study of the air's temperature time series is the theory of stochastic processes, particularly those known as ARIMA, that make it possible to carry out a univaried analysis. ARIMA models are built in order to explain the structure of the monthly temperatures corresponding to the mean, the absolute maximum, absolute minimum, maximum mean and minimum mean temperatures, for four stations in Colombia. By means of those models, the possible evolution of the latter variables is estimated with predictive aims in mind. The application and utility of the models is discussed

Comparison between the univariate and multivariate analysis on the partial characterization of the endoglucanase produced in the solid state fermentation by Aspergillus oryzae ATCC 10124.

Science.gov (United States)

de Brito, Aila Riany; Santos Reis, Nadabe Dos; Silva, Tatielle Pereira; Ferreira Bonomo, Renata Cristina; Trovatti Uetanabaro, Ana Paula; de Assis, Sandra Aparecida; da Silva, Erik Galvão Paranhos; Aguiar-Oliveira, Elizama; Oliveira, Julieta Rangel; Franco, Marcelo

2017-11-26

Endoglucanase production by Aspergillus oryzae ATCC 10124 cultivated in rice husks or peanut shells was optimized by experimental design as a function of humidity, time, and temperature. The optimum temperature for the endoglucanase activity was estimated by a univariate analysis (one factor at the time) as 50°C (rice husks) and 60°C (peanut shells), however, by a multivariate analysis (synergism of factors), it was determined a different temperature (56°C) for endoglucanase from peanut shells. For the optimum pH, values determined by univariate and multivariate analysis were 5 and 5.2 (rice husk) and 5 and 7.6 (peanut shells). In addition, the best half-lives were observed at 50°C as 22.8 hr (rice husks) and 7.3 hr (peanut shells), also, 80% of residual activities was obtained between 30 and 50°C for both substrates, and the pH stability was improved at 5-7 (rice hulls) and 6-9 (peanut shells). Both endoglucanases obtained presented different characteristics as a result of the versatility of fungi in different substrates.

Forecasting electricity spot-prices using linear univariate time-series models

International Nuclear Information System (INIS)

Cuaresma, Jesus Crespo; Hlouskova, Jaroslava; Kossmeier, Stephan; Obersteiner, Michael

2004-01-01

This paper studies the forecasting abilities of a battery of univariate models on hourly electricity spot prices, using data from the Leipzig Power Exchange. The specifications studied include autoregressive models, autoregressive-moving average models and unobserved component models. The results show that specifications, where each hour of the day is modelled separately present uniformly better forecasting properties than specifications for the whole time-series, and that the inclusion of simple probabilistic processes for the arrival of extreme price events can lead to improvements in the forecasting abilities of univariate models for electricity spot prices. (Author)

Regression Is a Univariate General Linear Model Subsuming Other Parametric Methods as Special Cases.

Science.gov (United States)

Vidal, Sherry

Although the concept of the general linear model (GLM) has existed since the 1960s, other univariate analyses such as the t-test and the analysis of variance models have remained popular. The GLM produces an equation that minimizes the mean differences of independent variables as they are related to a dependent variable. From a computer printout…

Association between chronic musculoskeletal pain and executive function in community-dwelling older adults.

Science.gov (United States)

Murata, S; Sawa, R; Nakatsu, N; Saito, T; Sugimoto, T; Nakamura, R; Misu, S; Ueda, Y; Ono, R

2017-11-01

We examined the association of chronic musculoskeletal pain with executive function in community-dwelling older adults. This cross-sectional study recruited 234 community-dwelling older adults in Japan (mean age: 72.7, women: 62.8%). Chronic musculoskeletal pain was defined as having moderate or more severe pain lasting ≥ 3 months. Executive function was assessed using the Digit Symbol Substitution Test (DSST), Trail Making Test (TMT) parts A and B, Letter Verbal Fluency Test (LVFT) and Category Verbal Fluency Test (CVFT). Prevalence of chronic musculoskeletal pain was 19% (n = 44). In the univariate analysis, the DSST and CVFT scores were significantly lower in the chronic musculoskeletal pain group than in the control group (DSST: chronic musculoskeletal pain group vs. control group, 40.2 vs. 45.4, respectively, p dwelling older adults. The association of chronic musculoskeletal pain with executive function requires further investigation. Our results suggest an association between moderate-severe chronic musculoskeletal pain and impairments of semantic fluency and processing speed in community-dwelling older adults. © 2017 European Pain Federation - EFIC®.

Self-determination and older people--a concept analysis.

Science.gov (United States)

Ekelund, Christina; Dahlin-Ivanoff, Synneve; Eklund, Kajsa

2014-03-01

Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

Comparison of different Methods for Univariate Time Series Imputation in R

OpenAIRE

Moritz, Steffen; Sardá, Alexis; Bartz-Beielstein, Thomas; Zaefferer, Martin; Stork, Jörg

2015-01-01

Missing values in datasets are a well-known problem and there are quite a lot of R packages offering imputation functions. But while imputation in general is well covered within R, it is hard to find functions for imputation of univariate time series. The problem is, most standard imputation techniques can not be applied directly. Most algorithms rely on inter-attribute correlations, while univariate time series imputation needs to employ time dependencies. This paper provides an overview of ...

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

Science.gov (United States)

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

2016-01-01

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

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

Science.gov (United States)

Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

2015-01-01

The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-03-01

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

Does cognitive decline decrease health utility value in older adult patients with cancer?

Science.gov (United States)

Akechi, Tatsuo; Aiki, Sayo; Sugano, Koji; Uchida, Megumi; Yamada, Atsuro; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Iida, Shinsuke; Okuyama, Toru

2017-05-01

Cognitive decline is common among older adults with cancer. The present study aimed to investigate the impact of cognitive decline on health utility value in older adults suffering from cancer. Consecutive patients aged 65 years or older with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Patients were asked to complete the EuroQoL-5 (EQ-5D) scale to measure health utility and the Mini-Mental State Examination to assess cognitive decline. The potential impact of cognitive decline was investigated with univariate analysis. A multivariate regression analysis was conducted to control for potential confounding factors. Complete data were obtained from 87 patients, 29% of whom had cognitive decline. The mean ± SE EQ-5D score for patients with cognitive decline was significantly lower than that for those without cognitive decline (0.67 ± 0.04 vs 0.79 ± 0.03, t = 2.38, P = 0.02). However, multiple regression analysis showed that cognitive decline was not significantly associated with EQ-5D scores. Female sex and lower performance scores (worse physical condition) were significantly associated with EQ-5D scores. Cognitive decline may be involved in decreased health utility value in older adult patients with cancer. However, this effect does not seem to be independent, and the patient's physical condition may be a relevant confounding factor. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

Unipedal stance testing as an indicator of fall risk among older outpatients.

Science.gov (United States)

Hurvitz, E A; Richardson, J K; Werner, R A; Ruhl, A M; Dixon, M R

2000-05-01

To test the hypothesis that a decreased unipedal stance time (UST) is associated with a history of falling among older persons. Fifty-three subjects underwent a standardized history and physical examination and three trials of timed unipedal stance. The electroneuromyography laboratories of tertiary care Veterans Administration and university hospitals. Ambulatory outpatients 50 years and older referred for electrodiagnostic studies. UST and fall histories during the previous year. Twenty subjects (38%) reported falling. Compared with the subjects who had not fallen, those who fell had a significantly shorter UST (9.6 [SD 11.6] vs 31.3 [SD 16.3] seconds, using the longest of the three trials, p risk of having fallen on univariate analysis and in a regression model (odds ratio 108; 95% confidence interval 3.8, >100; p falls. UST of falling, while a UST of > or = 30sec is associated with a low risk of falling.

Similarities and differences between older and young adult patients with celiac disease.

Science.gov (United States)

Kalkan, Çağdaş; Karakaya, Fatih; Soykan, Irfan

2017-11-01

Celiac disease is an autoimmune enteropathy with variable clinical symptoms. Elderly patients can have different manifestations from those of young patients. The aims of the present study were to investigate whether any differences or similarities exist between older and young patients with celiac disease with a special emphasis on concurrent autoimmune diseases. Celiac disease patients were stratified as older and younger patients. These two groups were then compared by means of clinical symptoms, laboratory parameters and concurrent autoimmune diseases. Factors associated with the presence of an autoimmune disease were identified by univariate and multivariate analysis. There were 66 older patients (mean age 67.7 ± 3.2 years, 50 women), and 277 younger patients (mean age 35.9 ± 11.7 years, 207 women). Of the 66 older patients, eight patients had gastrointestinal symptoms and 58 patients had extradigestive symptoms. In the younger group, the number of patients referred due to gastrointestinal symptoms was higher (8 [12.2%] vs 200 (72.2%), P celiac disease clinically, histologically and by means of laboratory parameters is different in older and young patients. Polyautoimmunity and multiple autoimmune syndrome are more common in older patients compared with younger patients. A biopsy score of Marsh score type, antinuclear antibody positivity, high serum anti-tissue transglutaminase immunoglobulin A level and low hemoglobin level were risk factors for having an autoimmune disease. Geriatr Gerontol Int 2017; 17: 2060-2067. © 2017 Japan Geriatrics Society.

Combinatorial bounds on the α-divergence of univariate mixture models

KAUST Repository

Nielsen, Frank; Sun, Ke

2017-01-01

We derive lower- and upper-bounds of α-divergence between univariate mixture models with components in the exponential family. Three pairs of bounds are presented in order with increasing quality and increasing computational cost. They are verified

Poor sleep quality is independently associated with physical disability in older adults.

Science.gov (United States)

Chien, Meng-Yueh; Chen, Hsi-Chung

2015-03-15

We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02-4.05). In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors. © 2014 American Academy of Sleep Medicine.

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

Science.gov (United States)

Krause, Neal

2011-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

A comparison between univariate probabilistic and multivariate (logistic regression) methods for landslide susceptibility analysis: the example of the Febbraro valley (Northern Alps, Italy)

Science.gov (United States)

Rossi, M.; Apuani, T.; Felletti, F.

2009-04-01

The aim of this paper is to compare the results of two statistical methods for landslide susceptibility analysis: 1) univariate probabilistic method based on landslide susceptibility index, 2) multivariate method (logistic regression). The study area is the Febbraro valley, located in the central Italian Alps, where different types of metamorphic rocks croup out. On the eastern part of the studied basin a quaternary cover represented by colluvial and secondarily, by glacial deposits, is dominant. In this study 110 earth flows, mainly located toward NE portion of the catchment, were analyzed. They involve only the colluvial deposits and their extension mainly ranges from 36 to 3173 m2. Both statistical methods require to establish a spatial database, in which each landslide is described by several parameters that can be assigned using a main scarp central point of landslide. The spatial database is constructed using a Geographical Information System (GIS). Each landslide is described by several parameters corresponding to the value of main scarp central point of the landslide. Based on bibliographic review a total of 15 predisposing factors were utilized. The width of the intervals, in which the maps of the predisposing factors have to be reclassified, has been defined assuming constant intervals to: elevation (100 m), slope (5 °), solar radiation (0.1 MJ/cm2/year), profile curvature (1.2 1/m), tangential curvature (2.2 1/m), drainage density (0.5), lineament density (0.00126). For the other parameters have been used the results of the probability-probability plots analysis and the statistical indexes of landslides site. In particular slope length (0 ÷ 2, 2 ÷ 5, 5 ÷ 10, 10 ÷ 20, 20 ÷ 35, 35 ÷ 260), accumulation flow (0 ÷ 1, 1 ÷ 2, 2 ÷ 5, 5 ÷ 12, 12 ÷ 60, 60 ÷27265), Topographic Wetness Index 0 ÷ 0.74, 0.74 ÷ 1.94, 1.94 ÷ 2.62, 2.62 ÷ 3.48, 3.48 ÷ 6,00, 6.00 ÷ 9.44), Stream Power Index (0 ÷ 0.64, 0.64 ÷ 1.28, 1.28 ÷ 1.81, 1.81 ÷ 4.20, 4.20 ÷ 9

Comparison of univariate and multivariate calibration for the determination of micronutrients in pellets of plant materials by laser induced breakdown spectrometry

International Nuclear Information System (INIS)

Batista Braga, Jez Willian; Trevizan, Lilian Cristina; Nunes, Lidiane Cristina; Aparecida Rufini, Iolanda; Santos, Dario; Krug, Francisco Jose

2010-01-01

The application of laser induced breakdown spectrometry (LIBS) aiming the direct analysis of plant materials is a great challenge that still needs efforts for its development and validation. In this way, a series of experimental approaches has been carried out in order to show that LIBS can be used as an alternative method to wet acid digestions based methods for analysis of agricultural and environmental samples. The large amount of information provided by LIBS spectra for these complex samples increases the difficulties for selecting the most appropriated wavelengths for each analyte. Some applications have suggested that improvements in both accuracy and precision can be achieved by the application of multivariate calibration in LIBS data when compared to the univariate regression developed with line emission intensities. In the present work, the performance of univariate and multivariate calibration, based on partial least squares regression (PLSR), was compared for analysis of pellets of plant materials made from an appropriate mixture of cryogenically ground samples with cellulose as the binding agent. The development of a specific PLSR model for each analyte and the selection of spectral regions containing only lines of the analyte of interest were the best conditions for the analysis. In this particular application, these models showed a similar performance, but PLSR seemed to be more robust due to a lower occurrence of outliers in comparison to the univariate method. Data suggests that efforts dealing with sample presentation and fitness of standards for LIBS analysis must be done in order to fulfill the boundary conditions for matrix independent development and validation.

A concept analysis of dignity for older adults.

Science.gov (United States)

Jacelon, Cynthia S; Connelly, Thomas W; Brown, Rana; Proulx, Kathy; Vo, Thuy

2004-10-01

Human dignity is an essential value of professional nursing education as well as a component of the American Nurses Association Code of Ethics. Nurses are exhorted to treat patients with dignity, and older adults want to be treated with dignity and die with dignity. Although dignity, particularly the dignity of older adults, is often discussed in the health care literature, its meaning is not always clear. The aim of this paper is to describe a concept analysis to develop a definition of dignity in older adults. Data were collected using a literature review and five focus groups composed of older adults. The literature provided data about professionals' ideas of dignity and the focus groups provided qualitative data about the nature of dignity in older people. The literature review and focus groups were carried out concurrently, followed by synthesis of the findings. Dignity is an inherent characteristic of being human, it can be subjectively felt as an attribute of the self, and is made manifest through behaviour that demonstrates respect for self and others. Dignity must be learned, and an individual's dignity is affected by the treatment received from others. A behavioural definition of dignity was constructed and this could provide the theoretical basis for nurses to develop interventions that foster dignity for older people.

Acceleration techniques in the univariate Lipschitz global optimization

Science.gov (United States)

Sergeyev, Yaroslav D.; Kvasov, Dmitri E.; Mukhametzhanov, Marat S.; De Franco, Angela

2016-10-01

Univariate box-constrained Lipschitz global optimization problems are considered in this contribution. Geometric and information statistical approaches are presented. The novel powerful local tuning and local improvement techniques are described in the contribution as well as the traditional ways to estimate the Lipschitz constant. The advantages of the presented local tuning and local improvement techniques are demonstrated using the operational characteristics approach for comparing deterministic global optimization algorithms on the class of 100 widely used test functions.

History of falls, gait, balance, and fall risks in older cancer survivors living in the community.

Science.gov (United States)

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with Pfalls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was Pfalls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (Pfalls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling.

Univariate decision tree induction using maximum margin classification

OpenAIRE

Yıldız, Olcay Taner

2012-01-01

In many pattern recognition applications, first decision trees are used due to their simplicity and easily interpretable nature. In this paper, we propose a new decision tree learning algorithm called univariate margin tree where, for each continuous attribute, the best split is found using convex optimization. Our simulation results on 47 data sets show that the novel margin tree classifier performs at least as good as C4.5 and linear discriminant tree (LDT) with a similar time complexity. F...

Which Frail Older People Are Dehydrated? The UK DRIE Study.

Science.gov (United States)

Hooper, Lee; Bunn, Diane K; Downing, Alice; Jimoh, Florence O; Groves, Joyce; Free, Carol; Cowap, Vicky; Potter, John F; Hunter, Paul R; Shepstone, Lee

2016-10-01

Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics. The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression. DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status. DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes. © 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.

Gender Differences in Performance of Script Analysis by Older Adults

Science.gov (United States)

Helmes, E.; Bush, J. D.; Pike, D. L.; Drake, D. G.

2006-01-01

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical…

Factors affecting institutionalization in older Hong Kong Chinese patients after recovery from acute medical illnesses.

Science.gov (United States)

Luk, James Ka Hay; Chiu, Patrick Ka Chun; Chu, Leung Wing

2009-01-01

Older patients with medical illnesses are at risk of institutionalization. The purpose of this study is to investigate the factors leading to institutionalization in older patients after recovery from medical illnesses. We studied 535 older patients in two convalescence hospitals in Hong Kong. Of them, 116 patients (21.7%) needed to move to nursing homes upon discharge. Univariate analysis showed that age, single/divorced/widowed status, longer length of stay, pressure sores, urinary incontinence, urinary catheterization, falls, dementia, diabetes mellitus, Barthel index (100), Elderly Mobility Score (EMS), Chinese version of the mini-mental state examination (C-MMSE) and albumin levels were significant factors associated with institutionalization. Multivariate analysis showed that being single/divorced/widowed (odds ratio=OR=2.74, 95% confidence interval=CI=1.36-5.53, p=0.0048), having urinary incontinence on discharge (OR=5.13, CI=2.66-10.6, p<0.001) and admission due to falls (OR=2.4, CI=1.03-5.57, p=0.04) were independent risk factors for nursing home admission. Higher admission EMS (OR=0.91, CI=0.84-0.97, p=0.009), admission C-MMSE (OR=0.93, CI=0.87-0.98, p=0.019), and discharge albumin levels (OR=0.93, CI=0.88-0.99, p=0.02) were independent protecting factors against nursing home admission. Knowledge of these factors can allow us to predict accommodation outcome and develop intervention strategy to reduce institutionalization in the older patients.

Drugs Related to Oropharyngeal Dysphagia in Older People.

Science.gov (United States)

Miarons, Marta; Campins, Lluís; Palomera, Elisabet; Serra-Prat, Mateu; Cabré, Mateu; Rofes, Laia

2016-10-01

Scientific evidence on the impact of medication on the physiology of swallowing is scarce and mainly based on clinical case reports. To evaluate the association between oropharyngeal dysphagia (OD) and chronic exposure to medication in older patients admitted to the acute geriatric unit (AGU) of a secondary hospital, we performed a retrospective cross-sectional study of 966 patients admitted to an AGU from 2008 to 2011. We reviewed (a) diagnosis of OD (assessed with the volume-viscosity swallow test, V- VST); (b) chronic patient medication classified by anatomical, therapeutic, chemical codes; and (c) demographic and clinical data. A univariate analysis was performed to determine which medications were associated with OD. A multivariate analysis adjusting for confounding clinical factors was performed to identify which of those medications were independently associated with OD. The age of patients included was 85.3 ± 6.37 years and 59.4 % were women. A total of 41.9 % presented OD. We found a possible protective effect of beta blocking agents on OD after the multivariate analysis (OR 0.54, 95 % CI 0.35-0.85). None of the categories of drugs was associated with an altered swallowing function after adjusting for confounding variables. The present study is the first one to widely investigate the association between drugs and OD, increasing understanding of their association. The role of beta blockers in OD needs to be further studied as their potentially beneficial effects on the swallowing function in older patients could help to prevent complications.

Effect Sizes for Research Univariate and Multivariate Applications

CERN Document Server

Grissom, Robert J

2011-01-01

Noted for its comprehensive coverage, this greatly expanded new edition now covers the use of univariate and multivariate effect sizes. Many measures and estimators are reviewed along with their application, interpretation, and limitations. Noted for its practical approach, the book features numerous examples using real data for a variety of variables and designs, to help readers apply the material to their own data. Tips on the use of SPSS, SAS, R, and S-Plus are provided. The book's broad disciplinary appeal results from its inclusion of a variety of examples from psychology, medicine, educa

Combinatorial bounds on the α-divergence of univariate mixture models

KAUST Repository

Nielsen, Frank

2017-06-20

We derive lower- and upper-bounds of α-divergence between univariate mixture models with components in the exponential family. Three pairs of bounds are presented in order with increasing quality and increasing computational cost. They are verified empirically through simulated Gaussian mixture models. The presented methodology generalizes to other divergence families relying on Hellinger-type integrals.

Characteristics of genomic signatures derived using univariate methods and mechanistically anchored functional descriptors for predicting drug- and xenobiotic-induced nephrotoxicity.

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Shi, Weiwei; Bugrim, Andrej; Nikolsky, Yuri; Nikolskya, Tatiana; Brennan, Richard J

2008-01-01

ABSTRACT The ideal toxicity biomarker is composed of the properties of prediction (is detected prior to traditional pathological signs of injury), accuracy (high sensitivity and specificity), and mechanistic relationships to the endpoint measured (biological relevance). Gene expression-based toxicity biomarkers ("signatures") have shown good predictive power and accuracy, but are difficult to interpret biologically. We have compared different statistical methods of feature selection with knowledge-based approaches, using GeneGo's database of canonical pathway maps, to generate gene sets for the classification of renal tubule toxicity. The gene set selection algorithms include four univariate analyses: t-statistics, fold-change, B-statistics, and RankProd, and their combination and overlap for the identification of differentially expressed probes. Enrichment analysis following the results of the four univariate analyses, Hotelling T-square test, and, finally out-of-bag selection, a variant of cross-validation, were used to identify canonical pathway maps-sets of genes coordinately involved in key biological processes-with classification power. Differentially expressed genes identified by the different statistical univariate analyses all generated reasonably performing classifiers of tubule toxicity. Maps identified by enrichment analysis or Hotelling T-square had lower classification power, but highlighted perturbed lipid homeostasis as a common discriminator of nephrotoxic treatments. The out-of-bag method yielded the best functionally integrated classifier. The map "ephrins signaling" performed comparably to a classifier derived using sparse linear programming, a machine learning algorithm, and represents a signaling network specifically involved in renal tubule development and integrity. Such functional descriptors of toxicity promise to better integrate predictive toxicogenomics with mechanistic analysis, facilitating the interpretation and risk assessment of

Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case–control study

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Kalava UR

2011-08-01

Full Text Available Usha R Kalava1, Stephen S Cha2, Paul Y Takahashi1,31Department of Internal Medicine, Division of Primary Care Internal Medicine, 2Department of Biostatistics, 3Kogod Center of Aging, Mayo Clinic, Rochester, MN, USABackground: Pressure ulcers are common among older adults, but knowledge about nutritional risk factors is still developing. Vitamin D deficiency is common in the elderly population and is required for normal skin proliferation. The role of vitamin D in pressure ulceration and wound healing is not known. The purpose of this case–control study was to determine the association between vitamin D levels and pressure ulceration in an older community-dwelling cohort.Methods: All cases and controls were community-dwelling elderly older than 60 years in a primary care panel in Olmsted County, MN. Pressure ulcer cases were defined clinically. The controls were age-matched and gender-matched to controls without pressure ulceration. The main exposure variable was 25-hydroxyvitamin D levels in both groups. The other exposure variable was the Charlson Comorbidity Index used to measure medical comorbidity. The analysis included univariate and conditional logistic regression for 25-hydroxyvitamin D levels.Results: The average (standard deviation age of the study participants with a pressure ulcer was 80.46 years (±8.67, and the average vitamin D level was 30.92 ng/mL (±12.46. In univariate analysis, Vitamin D deficiency (levels < 25 ng/mL was associated with pressure ulcers (odds ratio: 1.871, P = 0.0154. Comorbidities of the subjects calculated using the Charlson Comorbidity Index were also associated with pressure ulcers (odds ratio: 1.136, P < 0.001. In the final conditional logistical regression model, the association of Vitamin D and pressure ulcers became nonsignificant after adjustment for comorbid illness.Conclusion: Medical comorbidities increased the risk of pressure ulceration. Vitamin D deficiency was not an independent risk factor

Is leisure beneficial for older Korean immigrants? An interpretative phenomenological analysis

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Kim, Junhyoung; Moon, Sangjeong; Song, Jungsun

2016-01-01

Leisure is an important quality of life factor for older Korean immigrants. The purpose of this study was to explore leisure benefits associated with health among older Korean immigrants. A total of 18 individuals participated in the study. Using interpretative phenomenological analysis (IPA), three themes emerged from participants’ personal statements and experiences: (a) experiencing psychological benefits, (b) strengthening social connections, and (c) coping with acculturative stress. The findings indicate that leisure provided a context in which older Korean immigrants created an emotional and social support system that helped them to experience psychological and social benefits. This research suggested that older Korean immigrants used leisure as a coping mechanism that results in health and well-being. PMID:27914195

Is leisure beneficial for older Korean immigrants? An interpretative phenomenological analysis

Directory of Open Access Journals (Sweden)

Junhyoung Kim

2016-11-01

Full Text Available Leisure is an important quality of life factor for older Korean immigrants. The purpose of this study was to explore leisure benefits associated with health among older Korean immigrants. A total of 18 individuals participated in the study. Using interpretative phenomenological analysis (IPA, three themes emerged from participants’ personal statements and experiences: (a experiencing psychological benefits, (b strengthening social connections, and (c coping with acculturative stress. The findings indicate that leisure provided a context in which older Korean immigrants created an emotional and social support system that helped them to experience psychological and social benefits. This research suggested that older Korean immigrants used leisure as a coping mechanism that results in health and well-being.

Is leisure beneficial for older Korean immigrants? An interpretative phenomenological analysis.

Science.gov (United States)

Kim, Junhyoung; Moon, Sangjeong; Song, Jungsun

2016-01-01

Leisure is an important quality of life factor for older Korean immigrants. The purpose of this study was to explore leisure benefits associated with health among older Korean immigrants. A total of 18 individuals participated in the study. Using interpretative phenomenological analysis (IPA), three themes emerged from participants' personal statements and experiences: (a) experiencing psychological benefits, (b) strengthening social connections, and (c) coping with acculturative stress. The findings indicate that leisure provided a context in which older Korean immigrants created an emotional and social support system that helped them to experience psychological and social benefits. This research suggested that older Korean immigrants used leisure as a coping mechanism that results in health and well-being.

Serum Levels of ApoA1 and ApoA2 Are Associated with Cognitive Status in Older Men

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Ma, Cheng; Li, Jin; Bao, Zhijun; Ruan, Qingwei; Yu, Zhuowei

2015-01-01

Background. Advancing age, chronic inflammation, oxidative damage, and disorders of lipid metabolism are positively linked to the late-life cognitive impairment. Serum biomarkers may be associated with the cognitive status in older men. Methods. 440 old male subjects with different cognitive functions were recruited to investigate probable serum markers. Pearson Chi-Squared test, univariate analysis, and multivariate logistic regression analysis were performed to evaluate biomarkers which may be associated with cognitive status. Results. Levels of fundus atherosclerosis (AS) (P age (P age, AS levels, POD, IL-6, HDL-C, ApoA2, and ApoC2 were significantly related to cognitive status. Moreover, ApoA1 and ApoA2 were independently associated with cognitive impairment and late-life dementia. PMID:26682220

Sleep Apnea and Obstructive Airway Disease in Older Men: Outcomes of Sleep Disorders in Older Men Study.

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Zhao, Ying Y; Blackwell, Terri; Ensrud, Kristine E; Stone, Katie L; Omachi, Theodore A; Redline, Susan

2016-07-01

To evaluate the association between obstructive airway disease (OAD) and sleep apnea in older men. A community-based cross-sectional study of 853 community-dwelling older men (mean age 80.7 ± 4.1 years [range 73 to 90]) across 6 centers in the United States from the Outcomes of Sleep Disorders in Older Men Study. Sleep was objectively measured using full in-home polysomnography and lung function was objectively measured using spirometry. The association of OAD (pre-bronchodilator FEV1/FVC ratio sleep apnea (apnea-hypopnea index [AHI] ≥ 15 events/hour) was assessed using logistic regression. OAD and sleep apnea were identified in 111 (13.0%) and 247 (29.0%) men, respectively. In univariate analysis, participants with OAD had a lower AHI (mean ± SD; 8.7 ± 11.7 vs. 12.7 ± 13.8, P = 0.0009) and a lower prevalence of sleep apnea (14.4 vs. 31.1%, P = 0.0003) compared to participants without OAD. OAD remained independently associated with a lower odds of sleep apnea (odds ratio 0.30, 95% CI 0.16 to 0.55, P = 0.0001) after adjustment for demographics, body composition, smoking, and potential mediators (arousal index, time spent in rapid eye movement sleep). Individuals with OAD and sleep apnea (n = 16) had an increased arousal index and lower oxygen saturation level as compared to individuals with OAD alone (P values sleep apnea in a cohort of community-dwelling elderly men, and unexplained by differences in adiposity or sleep architecture. Although uncommon in this cohort, coexisting sleep apnea and OAD was associated with increased sleep fragmentation and nocturnal oxygen desaturation compared to OAD alone. © 2016 Associated Professional Sleep Societies, LLC.

The association between physical activity and social isolation in community-dwelling older adults.

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Robins, Lauren M; Hill, Keith D; Finch, Caroline F; Clemson, Lindy; Haines, Terry

2018-02-01

Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01-1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R 2 = 0.104). Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Healthcare professionals' perceptions of neglect of older people in Mexico: A qualitative secondary analysis.

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Caceres, Billy A; Bub, Linda; Negrete, Maria Isabel; Giraldo Rodríguez, Liliana; Squires, Allison P

2018-03-01

To describe healthcare professionals' perceptions of neglect of older people in Mexico. Mistreatment of older people, particularly neglect, has emerged as a significant public health concern worldwide. However, few studies have been conducted to examine neglect of older people in low- and middle-income countries. Most research has focused on estimating the prevalence of neglect in older populations with little emphasis on the perceptions of healthcare professionals and their role in addressing neglect of older people. Qualitative secondary analysis. The parent study consisted of nine focus groups conducted with healthcare professionals at five public hospitals in Mexico. The purpose of the parent study was to perform a needs assessment to determine the feasibility of adapting the Nurses Improving Care for Healthsystem Elders programme to Mexico. A qualitative secondary analysis with directed content analysis approach was used to extract data related to neglect of older people. A total of 89 participants representing healthcare professionals from several disciplines were interviewed. Three themes emerged: (i) The main point is not here; (ii) We feel hopeless; and (iii) We need preparation. Participants reported distress and hopelessness related to neglect of older people. Lack of community-based resources was noted as contributing to neglect. Increased education regarding care of older people for both caregivers and healthcare professionals and greater interdisciplinary collaboration were identified as potential solutions to combat neglect. Community-based services and resource allocation need to be re-evaluated to improve the care of older Mexicans. Interdisciplinary models of care should be developed to address concerns related to neglect of older people. Neglect negatively impacts healthcare professionals' ability to adequately care for older patients. There is a need to invest in community-based services and models of care to address these concerns. © 2017

A comparison of multivariate and univariate time series approaches to modelling and forecasting emergency department demand in Western Australia.

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Aboagye-Sarfo, Patrick; Mai, Qun; Sanfilippo, Frank M; Preen, David B; Stewart, Louise M; Fatovich, Daniel M

2015-10-01

To develop multivariate vector-ARMA (VARMA) forecast models for predicting emergency department (ED) demand in Western Australia (WA) and compare them to the benchmark univariate autoregressive moving average (ARMA) and Winters' models. Seven-year monthly WA state-wide public hospital ED presentation data from 2006/07 to 2012/13 were modelled. Graphical and VARMA modelling methods were used for descriptive analysis and model fitting. The VARMA models were compared to the benchmark univariate ARMA and Winters' models to determine their accuracy to predict ED demand. The best models were evaluated by using error correction methods for accuracy. Descriptive analysis of all the dependent variables showed an increasing pattern of ED use with seasonal trends over time. The VARMA models provided a more precise and accurate forecast with smaller confidence intervals and better measures of accuracy in predicting ED demand in WA than the ARMA and Winters' method. VARMA models are a reliable forecasting method to predict ED demand for strategic planning and resource allocation. While the ARMA models are a closely competing alternative, they under-estimated future ED demand. Copyright © 2015 Elsevier Inc. All rights reserved.

Stress assessment based on EEG univariate features and functional connectivity measures.

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Alonso, J F; Romero, S; Ballester, M R; Antonijoan, R M; Mañanas, M A

2015-07-01

The biological response to stress originates in the brain but involves different biochemical and physiological effects. Many common clinical methods to assess stress are based on the presence of specific hormones and on features extracted from different signals, including electrocardiogram, blood pressure, skin temperature, or galvanic skin response. The aim of this paper was to assess stress using EEG-based variables obtained from univariate analysis and functional connectivity evaluation. Two different stressors, the Stroop test and sleep deprivation, were applied to 30 volunteers to find common EEG patterns related to stress effects. Results showed a decrease of the high alpha power (11 to 12 Hz), an increase in the high beta band (23 to 36 Hz, considered a busy brain indicator), and a decrease in the approximate entropy. Moreover, connectivity showed that the high beta coherence and the interhemispheric nonlinear couplings, measured by the cross mutual information function, increased significantly for both stressors, suggesting that useful stress indexes may be obtained from EEG-based features.

Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

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Ismail, A.; Hassan, Noor I.

2013-09-01

Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

Gender differences in performance of script analysis by older adults.

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Helmes, E; Bush, J D; Pike, D L; Drake, D G

2006-12-01

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

Which DTW Method Applied to Marine Univariate Time Series Imputation

OpenAIRE

Phan , Thi-Thu-Hong; Caillault , Émilie; Lefebvre , Alain; Bigand , André

2017-01-01

International audience; Missing data are ubiquitous in any domains of applied sciences. Processing datasets containing missing values can lead to a loss of efficiency and unreliable results, especially for large missing sub-sequence(s). Therefore, the aim of this paper is to build a framework for filling missing values in univariate time series and to perform a comparison of different similarity metrics used for the imputation task. This allows to suggest the most suitable methods for the imp...

Perception of Spiritual Health: A Qualitative Content Analysis in Iranian Older Adults

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Zibad, Hosein Ajam; Foroughan, Mahshid; Shahboulaghi, Farahnaz Mohammadi; Rafiey, Hassan; Rassouli, Maryam

2017-01-01

The present study was performed with the aim to explain older people's perceptions of spiritual health. It was conducted using the conventional content analysis method. Twelve individuals aged 60 years or older with normal cognition participated in the study using purposive sampling. Data were collected by in-depth interviews. Data analysis…

Advertising Representations of Older People in the United Kingdom and Taiwan: A Comparative Analysis.

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Chen, Chin-Hui

2015-01-01

Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. © The Author(s) 2015.

Evaluation of in-line Raman data for end-point determination of a coating process: Comparison of Science-Based Calibration, PLS-regression and univariate data analysis.

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Barimani, Shirin; Kleinebudde, Peter

2017-10-01

A multivariate analysis method, Science-Based Calibration (SBC), was used for the first time for endpoint determination of a tablet coating process using Raman data. Two types of tablet cores, placebo and caffeine cores, received a coating suspension comprising a polyvinyl alcohol-polyethylene glycol graft-copolymer and titanium dioxide to a maximum coating thickness of 80µm. Raman spectroscopy was used as in-line PAT tool. The spectra were acquired every minute and correlated to the amount of applied aqueous coating suspension. SBC was compared to another well-known multivariate analysis method, Partial Least Squares-regression (PLS) and a simpler approach, Univariate Data Analysis (UVDA). All developed calibration models had coefficient of determination values (R 2 ) higher than 0.99. The coating endpoints could be predicted with root mean square errors (RMSEP) less than 3.1% of the applied coating suspensions. Compared to PLS and UVDA, SBC proved to be an alternative multivariate calibration method with high predictive power. Copyright © 2017 Elsevier B.V. All rights reserved.

Validated univariate and multivariate spectrophotometric methods for the determination of pharmaceuticals mixture in complex wastewater

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Riad, Safaa M.; Salem, Hesham; Elbalkiny, Heba T.; Khattab, Fatma I.

2015-04-01

Five, accurate, precise, and sensitive univariate and multivariate spectrophotometric methods were developed for the simultaneous determination of a ternary mixture containing Trimethoprim (TMP), Sulphamethoxazole (SMZ) and Oxytetracycline (OTC) in waste water samples collected from different cites either production wastewater or livestock wastewater after their solid phase extraction using OASIS HLB cartridges. In univariate methods OTC was determined at its λmax 355.7 nm (0D), while (TMP) and (SMZ) were determined by three different univariate methods. Method (A) is based on successive spectrophotometric resolution technique (SSRT). The technique starts with the ratio subtraction method followed by ratio difference method for determination of TMP and SMZ. Method (B) is successive derivative ratio technique (SDR). Method (C) is mean centering of the ratio spectra (MCR). The developed multivariate methods are principle component regression (PCR) and partial least squares (PLS). The specificity of the developed methods is investigated by analyzing laboratory prepared mixtures containing different ratios of the three drugs. The obtained results are statistically compared with those obtained by the official methods, showing no significant difference with respect to accuracy and precision at p = 0.05.

Association between multiple geriatric syndromes and life satisfaction in community-dwelling older adults: A nationwide study in Taiwan.

Science.gov (United States)

Yang, Deng-Chi; Lee, Jenq-Daw; Huang, Chi-Chang; Shih, Hsin-I; Chang, Chia-Ming

2015-01-01

Although previous studies have investigated the association between a single geriatric syndrome and life satisfaction in the older adults, the accumulated effects of multiple geriatric syndromes on life satisfaction remain unclear. We conducted a nationwide study by using data from the Taiwan Longitudinal Study on Aging database. A total of 2415 older adults were enrolled. Life satisfaction was evaluated according to the Life Satisfaction Index, and the geriatric syndromes included a depressive disorder, cognitive impairment, functional impairment, urine incontinence, pain, a fall, and polypharmacy. Other characteristics were age, sex, marital status, education level, self-rated health, and chronic diseases. Univariate analysis revealed that the older adults, who were illiterate, did not live with a partner, yet other issues such as stroke, malignancy, osteoarthritis, poor self-rated health, a depressive disorder, functional impairment, urine incontinence, or pain were associated with lower life satisfaction. In the multivariate regression model, the older adults who were male, illiterate, lived without a partner, had poor self-rated health, or had a depressive disorder were more likely to have lower life satisfaction. In addition, life satisfaction was unaffected in the older adults with only 1 geriatric syndrome, but among those with ≥2 geriatric syndromes, an increased number of geriatric syndromes were associated with lower life satisfaction. In addition to socio-demographic factors, cumulative effects of multiple geriatric syndromes might affect life satisfaction in the older adults. Further study of interventions for reducing geriatric syndromes to maintain life satisfaction is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta-Analysis.

Science.gov (United States)

Chang, Shu-Fang; Lin, Hsiang-Chun; Cheng, Chih-Ling

2018-06-06

This research explored the relationship between the stages of frailty and risk for hospitalization in older adults and evaluated the risk for hospitalization among the elderly in relation to various frailty assessment indexes. A systematic literature review and meta-analysis were carried out. A total of 32,998 older people, 8,666 of whom were hospitalized, were included in this study. Two of the researchers independently collected and reviewed the literature. The key search terms used were "frailty" or "frail," "hospitalization," and "older people" or "older" or "geriatric" or "senior." Data were recorded from January 2001 to July 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted for quality assessment. A systematic search was carried out using Embase and Scopus to analyze the collected literature. A meta-analysis was conducted on eight studies that discussed the relationship between frailty and hospitalization risk in older adults 65 years of age or older. The results showed that frail older people exhibited the highest risk for hospitalization, following by prefrail and robust older people. Next, different frailty assessment indicators were used to predict the risk for hospitalization among older people. All of these indexes also showed that older persons with frailty had the highest risk for hospitalization, followed by prefrail older people. Frailty is a vital issue in geriatric care and is a crucial factor in the hospitalization of older people. Frail older people were at the highest risk for hospitalization, following by prefrail and robust older people. Assessing frailty as early as possible can reduce the hospitalization risk among older people. Professional nursing staff should use frailty indicators in a timely fashion to assess the status of frailty in older people and should effectively develop frailty prevention strategies to decrease the risk for hospitalization and to enhance quality of life

Exploring the Knowledge Structure of Nursing Care for Older Patients With Delirium: Keyword Network Analysis.

Science.gov (United States)

Choi, Jung Eun; Kim, Mi So

2018-05-01

Prevention of delirium is considered a critical part of the agenda for patient safety and an indicator of healthcare quality for older patients. As the incidence rate of delirium for older patients has increased in recent years, there has been a significant expansion in knowledge relevant to nursing care. The purposes of this study were to analyze the knowledge structure and trends in nursing care for older adults with delirium based on a keyword network analysis, and to provide a foundation for future research. Data analysis showed that knowledge structure in this area consists of three themes of research: postoperative acute care for older patients with delirium, prevention of delirium for older patients in intensive care units, and safety management for the improvement of outcomes for patients with delirium. Through research trend analysis, we found that research on care for patients with delirium has achieved both quantitative and qualitative improvements over the last decades. Concerning future research, we propose the expansion of patient- and family-centered care, community care, specific nursing interventions, and the integration of new technology into care for patients with delirium. These results provide a reference framework for understanding and developing nursing care for older adults with delirium.

Cellulose I crystallinity determination using FT-Raman spectroscopy : univariate and multivariate methods

Science.gov (United States)

Umesh P. Agarwal; Richard S. Reiner; Sally A. Ralph

2010-01-01

Two new methods based on FT–Raman spectroscopy, one simple, based on band intensity ratio, and the other using a partial least squares (PLS) regression model, are proposed to determine cellulose I crystallinity. In the simple method, crystallinity in cellulose I samples was determined based on univariate regression that was first developed using the Raman band...

Biological characteristics and clinical outcome of triple negative primary breast cancer in older women - comparison with their younger counterparts.

Directory of Open Access Journals (Sweden)

Binafsha M Syed

Full Text Available Triple negative (ER, PgR and HER2 negative breast cancers (TNBCs are often considered as a poor prognostic phenotype. There is dearth of evidence showing the prevalence and biological behaviour of TNBCs in older women. This study aimed to analyse their biological characteristics in comparison with a well characterised younger series from a single centre with long term clinical follow-up. Over 37 years (1973-2010, 1,758 older (≥70 years women with early operable (<5 cm primary breast cancer were managed in a dedicated clinic and have complete clinical information available. Of these 813 patients underwent primary surgery and 575 had good quality tumour samples available for tissue microarray analysis using indirect immunohistochemistry. A total of 127 patients (22.1% had TNBCs and full biological analysis of 15 biomarkers was performed. The results were compared with those of their younger (<70 years counterparts 342 (18.9% from a previously characterised, consecutive series of primary breast cancer treated in the same unit (1986-1998. The 127 older patients with TNBCs showed lower rates of Ki67 and CK 7/8 positivity and high rates of bcl2 and CK18 positivity when compared with their younger counterparts (p<0.05. There was no significant difference in the long term clinical outcome between the two age groups, despite the fact that 47% of the younger patients had adjuvant chemotherapy, while none in the older cohort received such treatment. EGFR, axillary stage and pathological size showed prognostic significance in older women with TNBCs on univariate analysis. Despite not having received adjuvant chemotherapy, the older series had clinical outcome similar to the younger patients almost half of whom had chemotherapy. This appears to be related to other biomarkers (in addition to ER/PgR/HER2 eg Ki67, bcl2 and cytokeratins which have different expression patterns influencing prognosis.

Influence of psychosocial factors on the energy and protein intake of older people on dialysis.

Science.gov (United States)

Johansson, Lina; Hickson, Mary; Brown, Edwina A

2013-09-01

To explore the relationship between nutritional parameters and psychosocial factors in older people on dialysis. A cross-sectional observational study in prevalent older people on hemodialysis (HD) and peritoneal dialysis (PD). A secondary analysis from a quality of life study in older people (Broadening Options for Long-term Dialysis in the Elderly). One-hundred and six patients 65 years of age or older and on dialysis for at least 90 days were purposively recruited (HD patients matched to PD patients by age, sex, dialysis vintage, ethnicity and Index of Deprivation). Half were on HD, the mean age was 72.7 years, 72% were male, 92% were from a White ethnic background, and 26% had diabetes. The patients attended one visit at which they completed nutritional assessments (3-day food diary, subjective global assessment, handgrip strength, and body mass index) and questionnaires: Short Form-12 (SF-12), the Hospital Anxiety and Depression Scale (HADS), the Mini Mental State Exam, and social networks. The differences in nutritional parameters between patients on PD and HD were determined by univariate analyses, and the relationships between nutritional intake and demographic, clinical, and psychosocial variables were determined by multivariate analyses. There was no difference in the energy and protein intake and nutritional status between older people on HD and PD. For the whole sample, multivariate analyses found that lower energy intake was related to fewer social networks (P = .002) and lower SF-12 Physical Component Scale (PCS) scores (P = .021). A lower protein intake was related to worsening Index of Deprivation scores (P = .028) and an interaction between SF-12 PCS and presence of possible depression (P = .015). Energy and protein intake in older people (regardless of modality) appears to be independently associated with psychosocial variables. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study.

Science.gov (United States)

Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua

2015-01-01

The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people.

Science.gov (United States)

Chan, R; Leung, J; Woo, J; Kwok, T

2014-01-01

To examine the association of dietary protein intake with 4-year change in physical performance measures and muscle mass in Chinese community-dwelling older people aged 65 and older in Hong Kong. Prospective cohort study design. Hong Kong, People's of Republic of China. There were 2,726 (1411 male, 1315 female) community-dwelling older people aged 65 and older. Baseline total, animal and vegetable protein intakes were collected using a validated food frequency questionnaire. Relative protein intake expressed as g/kg body weight was calculated and divided into quartiles for data analysis. Baseline and 4-year physical performance measures (normal and narrow 6-meters walking speed and step length in a 6-meters walk) were measured and 4-year change in appendicular skeletal muscle mass (ASM) from baseline was assessed by dual-energy X-ray absorptiometry. Univariate analysis identified age and sex as significant factors associated with change in physical performance measures or ASM, thus adjustments for these factors were made for subsequent analysis of covariance. Median relative total protein intake was 1.3 g/kg body weight in men and 1.1 g/kg body weight in women. After adjustment for age and sex, relative total protein intake and animal protein intake were not associated with change in physical performance measures and ASM. In contrast, participants in the highest quartile (>0.72 g/kg body weight) of relative vegetable protein intake lost significantly less ASM over 4-year than those in the lowest quartile of relative vegetable protein intake (physical performance measures. Higher protein intake from vegetable source was associated with reduced muscle loss in Chinese community-dwelling older people in Hong Kong whereas no association between total and animal protein intake and subsequent decline in muscle mass or physical performance measures was observed in this sample.

Forecasting electric vehicles sales with univariate and multivariate time series models: The case of China.

Science.gov (United States)

Zhang, Yong; Zhong, Miner; Geng, Nana; Jiang, Yunjian

2017-01-01

The market demand for electric vehicles (EVs) has increased in recent years. Suitable models are necessary to understand and forecast EV sales. This study presents a singular spectrum analysis (SSA) as a univariate time-series model and vector autoregressive model (VAR) as a multivariate model. Empirical results suggest that SSA satisfactorily indicates the evolving trend and provides reasonable results. The VAR model, which comprised exogenous parameters related to the market on a monthly basis, can significantly improve the prediction accuracy. The EV sales in China, which are categorized into battery and plug-in EVs, are predicted in both short term (up to December 2017) and long term (up to 2020), as statistical proofs of the growth of the Chinese EV industry.

[Retrospective statistical analysis of clinical factors of recurrence in chronic subdural hematoma: correlation between univariate and multivariate analysis].

Science.gov (United States)

Takayama, Motoharu; Terui, Keita; Oiwa, Yoshitsugu

2012-10-01

Chronic subdural hematoma is common in elderly individuals and surgical procedures are simple. The recurrence rate of chronic subdural hematoma, however, varies from 9.2 to 26.5% after surgery. The authors studied factors of the recurrence using univariate and multivariate analyses in patients with chronic subdural hematoma We retrospectively reviewed 239 consecutive cases of chronic subdural hematoma who received burr-hole surgery with irrigation and closed-system drainage. We analyzed the relationships between recurrence of chronic subdural hematoma and factors such as sex, age, laterality, bleeding tendency, other complicated diseases, density on CT, volume of the hematoma, residual air in the hematoma cavity, use of artificial cerebrospinal fluid. Twenty-one patients (8.8%) experienced a recurrence of chronic subdural hematoma. Multiple logistic regression found that the recurrence rate was higher in patients with a large volume of the residual air, and was lower in patients using artificial cerebrospinal fluid. No statistical differences were found in bleeding tendency. Techniques to reduce the air in the hematoma cavity are important for good outcome in surgery of chronic subdural hematoma. Also, the use of artificial cerebrospinal fluid reduces recurrence of chronic subdural hematoma. The surgical procedures can be the same for patients with bleeding tendencies.

Nuisance forecasting. Univariate modelling and very-short-term forecasting of winter smog episodes; Immissionsprognose. Univariate Modellierung und Kuerzestfristvorhersage von Wintersmogsituationen

Energy Technology Data Exchange (ETDEWEB)

Schlink, U.

1996-12-31

The work evaluates specifically the nuisance data provided by the measuring station in the centre of Leipig during the period from 1980 to 1993, with the aim to develop an algorithm for making very short-term forecasts of excessive nuisances. Forecasting was to be univariate, i.e., based exclusively on the half-hourly readings of SO{sub 2} concentrations taken in the past. As shown by Fourier analysis, there exist three main and mutually independent spectral regions: the high-frequency sector (period < 12 hours) of unstable irregularities, the seasonal sector with the periods of 24 and 12 hours, and the low-frequency sector (period > 24 hours). After breaking the measuring series up into components, the low-frequency sector is termed trend component, or trend for short. For obtaining the components, a Kalman filter is used. It was found that smog episodes are most adequately described by the trend component. This is therefore more closely investigated. The phase representation then shows characteristic trajectories of the trends. (orig./KW) [Deutsch] In der vorliegende Arbeit wurden speziell die Immissionsdaten der Messstation Leipzig-Mitte des Zeitraumes 1980-1993 mit dem Ziel der Erstellung eines Algorithmus fuer die Kuerzestfristprognose von Ueberschreitungssituationen untersucht. Die Prognosestellung sollte allein anhand der in der Vergangenheit registrierten Halbstundenwerte der SO{sub 2}-Konzentration, also univariat erfolgen. Wie die Fourieranalyse zeigt, gibt es drei wesentliche und voneinander unabhaengige Spektralbereiche: Den hochfrequenten Bereich (Periode <12 Stunden) der instabilen Irregularitaeten, den saisonalen Anteil mit den Perioden von 24 und 12 Stunden und den niedrigfrequenten Bereich (Periode >24 Stunden). Letzterer wird nach einer Zerlegung der Messreihe in Komponenten als Trendkomponente (oder kurz Trend) bezeichnet. Fuer die Komponentenzerlegung wird ein Kalman-Filter verwendet. Es stellt sich heraus, dass Smogepisoden am deutlichsten

Receipt of maintenance therapy is most predictive of survival in older acute lymphoblastic leukemia patients treated with intensive induction chemotherapy regimens.

Science.gov (United States)

Landsburg, Daniel J; Stadtmauer, Edward; Loren, Alison; Goldstein, Steven; Frey, Noelle; Nasta, Sunita D; Porter, David L; Tsai, Donald E; Perl, Alexander E; Hexner, Elizabeth O; Luger, Selina

2013-08-01

While the prognosis for older adults diagnosed with acute lymphoblastic leukemia (ALL) is frequently poor, long-term survival can be achieved in patients treated with curative intent. We reviewed the outcomes of 37 patients age ≥60 treated at our institution with either DVP- or hyperCVAD-based chemotherapy regimens from 2003-2011. In this patient population, a complete response rate of 92%, relapse rate of 56% and median overall survival of 18.1 months was experienced. Univariate analysis revealed that receipt of maintenance therapy vs. no maintenance therapy was associated with a statistically-significant impact on overall survival (p = 0.001, HR 0.15 for death), while disease-related characteristics including high-risk white blood cell count at diagnosis and Philadelphia chromosome status as well as treatment-related factors including chemotherapy regimen or completion of intensive therapy were not. Many patients were unable to initiate or remain on maintenance therapy due to toxicities including infections and cytopenias. Our analysis reveals the benefit of prolonged therapy in the treatment of older adults with ALL as well as the high incidence of treatment-related toxicity experienced by these patients. Copyright © 2013 Wiley Periodicals, Inc.

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

Science.gov (United States)

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.

Lower bounds on the run time of the univariate marginal distribution algorithm on OneMax

DEFF Research Database (Denmark)

Krejca, Martin S.; Witt, Carsten

2017-01-01

The Univariate Marginal Distribution Algorithm (UMDA), a popular estimation of distribution algorithm, is studied from a run time perspective. On the classical OneMax benchmark function, a lower bound of Ω(μ√n + n log n), where μ is the population size, on its expected run time is proved...... values maintained by the algorithm, including carefully designed potential functions. These techniques may prove useful in advancing the field of run time analysis for estimation of distribution algorithms in general........ This is the first direct lower bound on the run time of the UMDA. It is stronger than the bounds that follow from general black-box complexity theory and is matched by the run time of many evolutionary algorithms. The results are obtained through advanced analyses of the stochastic change of the frequencies of bit...

Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department

DEFF Research Database (Denmark)

Bodilsen, Ann Christine; Hedegaard Klausen, Henrik; Petersen, Janne

2016-01-01

Objective: Mobility limitations relate to dependency in older adults. Identification of older patients with mobility limitations after hospital discharge may help stratify treatment and could potentially counteract dependency seen in older adults after hospitalization. We investigated the ability...... of four physical performance measures administered at hospital admission to identify older medical patients who manifest mobility limitations 30 days after discharge. Design: Prospective cohort study of patients (≥65 years) admitted to the emergency department for acute medical illness. During the first...... included. Of those, 128 (40%) patients had mobility limitations at follow-up. Univariate analyzes showed that each of the physical performance measures was strongly associated with mobility limitations at follow-up (handgrip strength(women), OR 0.86 (0.81–0.91), handgrip strength(men), OR 0.90 (0...

Wind Speed Prediction Using a Univariate ARIMA Model and a Multivariate NARX Model

Directory of Open Access Journals (Sweden)

Erasmo Cadenas

2016-02-01

Full Text Available Two on step ahead wind speed forecasting models were compared. A univariate model was developed using a linear autoregressive integrated moving average (ARIMA. This method’s performance is well studied for a large number of prediction problems. The other is a multivariate model developed using a nonlinear autoregressive exogenous artificial neural network (NARX. This uses the variables: barometric pressure, air temperature, wind direction and solar radiation or relative humidity, as well as delayed wind speed. Both models were developed from two databases from two sites: an hourly average measurements database from La Mata, Oaxaca, Mexico, and a ten minute average measurements database from Metepec, Hidalgo, Mexico. The main objective was to compare the impact of the various meteorological variables on the performance of the multivariate model of wind speed prediction with respect to the high performance univariate linear model. The NARX model gave better results with improvements on the ARIMA model of between 5.5% and 10. 6% for the hourly database and of between 2.3% and 12.8% for the ten minute database for mean absolute error and mean squared error, respectively.

R package imputeTestbench to compare imputations methods for univariate time series

OpenAIRE

Bokde, Neeraj; Kulat, Kishore; Beck, Marcus W; Asencio-Cortés, Gualberto

2016-01-01

This paper describes the R package imputeTestbench that provides a testbench for comparing imputation methods for missing data in univariate time series. The imputeTestbench package can be used to simulate the amount and type of missing data in a complete dataset and compare filled data using different imputation methods. The user has the option to simulate missing data by removing observations completely at random or in blocks of different sizes. Several default imputation methods are includ...

A concept analysis of oral hygiene care in dependent older adults.

Science.gov (United States)

Coker, Esther; Ploeg, Jenny; Kaasalainen, Sharon; Fisher, Anita

2013-10-01

To report a concept analysis of oral hygiene care. Oral hygiene care, as it is provided to older patients in hospital and long-term care settings by nurses and their delegates, has the potential to contribute to the oral health of patients while preventing aspiration pneumonia as well as periodontitis, which itself has been associated with several systemic diseases. However, the state of oral cleanliness in such patients tends to be poor and despite the existence of guidelines, nursing care practices may be inadequate and not reflective of recent advances in knowledge. Concept analysis. A search of electronic databases (2002-2012), use of internet search engines, and hand searching yielded an international data set of 66 research studies, reviews, and practice guidelines. The concept analysis method of Walker and Avant was used to explore the concept of oral hygiene care in the context of frail older patients. Oral hygiene care involves approaches informed by knowing the patient, inspecting the oral cavity, removing plaque, cleansing the oral tissues, decontaminating the oral cavity, using fluoride products and maintaining oral tissue moisture. Those attributes, along with their antecedents and consequences, form a conceptual framework from which a middle-range theory of nurse-administered oral hygiene care is derived that could be tested, evaluated, modified, and translated into practice. Clarity around the concept of oral hygiene care as a nursing intervention could enable nurses to impact oral health outcomes and possibly prevent systemic diseases in older patients. © 2013 Blackwell Publishing Ltd.

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

Science.gov (United States)

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

2017-01-01

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

E-hail (Rideshare) Knowledge, Use, Reliance, and Future Expectations among Older Adults.

Science.gov (United States)

Vivoda, Jonathon M; Harmon, Annie C; Babulal, Ganesh M; Zikmund-Fisher, Brian J

2018-05-01

The goals of this study were to explore e-hail (e.g., Uber/Lyft) knowledge, use, reliance, and future expectations among older adults. Specifically, we aimed to identify factors that were related to e-hail, and how older adults view this mode as a potential future transportation option. Data were collected from a sample of older adults using a pencil-and-paper mailed survey. Univariate, bivariate, and regression techniques were used to assess the relationships among e-hail and several demographic and other factors. Almost three-quarters of the sample (74%) reported no e-hail knowledge. Only 1.7% had used e-hail to arrange a ride,andonly 3.3% reported that they relied on e-hail for any of their transportation needs. Younger age, male gender, more education, higher transportation satisfaction, and discussing transportation options with others were all independently associated with greater e-hail knowledge. Male gender also predicted e-hail use. E-hail was the mode least relied upon by older adults. Current e-hail knowledge was the biggest predictor of anticipated future use. E-hail may be a viable future option for older adults who have limited or stopped driving. More exposure to e-hail and continued evolution of these services is required to overcome older adults' lower internet/smartphone use. Policies could be implemented at departments of motor vehicles to pair information or training on transportation alternatives (like e-hail) with elimination of driving privileges, or at doctors' offices, senior centers, or hospitals. Potential underlying reasons for the findings are also discussed.

Genome-wide Meta-analysis on the Sense of Smell Among US Older Adults

OpenAIRE

Dong, Jing; Yang, Jingyun; Tranah, Greg; Franceschini, Nora; Parimi, Neeta; Alkorta-Aranburu, Gorka; Xu, Zongli; Alonso, Alvaro; Cummings, Steven R.; Fornage, Myriam; Huang, Xuemei; Kritchevsky, Stephen; Liu, Yongmei; London, Stephanie; Niu, Liang

2015-01-01

Abstract Olfactory dysfunction is common among older adults and affects their safety, nutrition, quality of life, and mortality. More importantly, the decreased sense of smell is an early symptom of neurodegenerative diseases such as Parkinson disease (PD) and Alzheimer disease. However, the genetic determinants for the sense of smell have been poorly investigated. We here performed the first genome-wide meta-analysis on the sense of smell among 6252 US older adults of European descent from t...

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

Directory of Open Access Journals (Sweden)

Eugène Loos

2017-12-01

Full Text Available The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way older people are visually represented on websites of organizations for older people in seven European countries (Finland, UK, the Netherlands, Spain, Italy, Poland and Romania, using an analytical approached based on visual content analysis, inspired by the dimensional model of national cultural differences from the Hofstede model (1991; 2001; 2011. We used two out of the five Hofstede dimensions: Individualism/Collectivism (IDV and Masculinity/Femininity (MAS. The results demonstrated that in all seven countries older people are mostly visually represented as healthy/active, which reflects a dominant ‘ageing well’ discourse in Europe. The results also demonstrated that in most cases older people tend to be represented together with others, which is not consonant with the dominant ‘ageing well’ discourse in Europe. A last finding was that the visual representation of older people is in about half of the cases in line with these Hofstede dimensions. We discuss the implications of these findings claiming that the ‘ageing well’ discourse might lead to ‘visual ageism’. Organizations could keep this in mind while using pictures for their website or in other media and consider to use various kind of pictures, or to avoid using pictures of older people that stigmatize, marginalize or injure. They could look into the cultural situatedness and intersectional character of age relations and consider alternative strategies of both visibility and invisibility to talk with and about our ageing societies.

Diversity in Older Adults’ Use of the Internet: Identifying Subgroups Through Latent Class Analysis

Science.gov (United States)

van Boekel, Leonieke C; Peek, Sebastiaan TM; Luijkx, Katrien G

2017-01-01

Background As for all individuals, the Internet is important in the everyday life of older adults. Research on older adults’ use of the Internet has merely focused on users versus nonusers and consequences of Internet use and nonuse. Older adults are a heterogeneous group, which may implicate that their use of the Internet is diverse as well. Older adults can use the Internet for different activities, and this usage can be of influence on benefits the Internet can have for them. Objective The aim of this paper was to describe the diversity or heterogeneity in the activities for which older adults use the Internet and determine whether diversity is related to social or health-related variables. Methods We used data of a national representative Internet panel in the Netherlands. Panel members aged 65 years and older and who have access to and use the Internet were selected (N=1418). We conducted a latent class analysis based on the Internet activities that panel members reported to spend time on. Second, we described the identified clusters with descriptive statistics and compared the clusters using analysis of variance (ANOVA) and chi-square tests. Results Four clusters were distinguished. Cluster 1 was labeled as the “practical users” (36.88%, n=523). These respondents mainly used the Internet for practical and financial purposes such as searching for information, comparing products, and banking. Respondents in Cluster 2, the “minimizers” (32.23%, n=457), reported lowest frequency on most Internet activities, are older (mean age 73 years), and spent the smallest time on the Internet. Cluster 3 was labeled as the “maximizers” (17.77%, n=252); these respondents used the Internet for various activities, spent most time on the Internet, and were relatively younger (mean age below 70 years). Respondents in Cluster 4, the “social users,” mainly used the Internet for social and leisure-related activities such as gaming and social network sites. The

The contribution of postural balance analysis in older adult fallers: A narrative review.

Science.gov (United States)

Pizzigalli, L; Micheletti Cremasco, M; Mulasso, A; Rainoldi, A

2016-04-01

Falls are a serious health problem for older adults. Several studies have identified the decline of postural balance as one of the main risk factors for falls. Contrary to what may be believed, the capability of force platform measurements to predict falls remains uncertain. The focus of this narrative review is the identification of postural characteristics of older adults at risk of falling using both static and dynamic postural balance assessments. The literature analysis was conducted on Medline/PubMed. The search ended in May 2015. Centre of pressure (CoP) path length, CoP velocity and sway in medial lateral and anterior-posterior are the variables that distinguish older adult fallers from non-fallers. Recommendations to medical personnel on how to provide efficient balance training for older adults are offered, discussing the relevance and limitations of postural stability on static and dynamic board in falling risk prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Jason L Rucker

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

QRS complex detection based on continuous density hidden Markov models using univariate observations

Science.gov (United States)

Sotelo, S.; Arenas, W.; Altuve, M.

2018-04-01

In the electrocardiogram (ECG), the detection of QRS complexes is a fundamental step in the ECG signal processing chain since it allows the determination of other characteristics waves of the ECG and provides information about heart rate variability. In this work, an automatic QRS complex detector based on continuous density hidden Markov models (HMM) is proposed. HMM were trained using univariate observation sequences taken either from QRS complexes or their derivatives. The detection approach is based on the log-likelihood comparison of the observation sequence with a fixed threshold. A sliding window was used to obtain the observation sequence to be evaluated by the model. The threshold was optimized by receiver operating characteristic curves. Sensitivity (Sen), specificity (Spc) and F1 score were used to evaluate the detection performance. The approach was validated using ECG recordings from the MIT-BIH Arrhythmia database. A 6-fold cross-validation shows that the best detection performance was achieved with 2 states HMM trained with QRS complexes sequences (Sen = 0.668, Spc = 0.360 and F1 = 0.309). We concluded that these univariate sequences provide enough information to characterize the QRS complex dynamics from HMM. Future works are directed to the use of multivariate observations to increase the detection performance.

Same-sex partner bereavement in older women: an interpretative phenomenological analysis.

Science.gov (United States)

Ingham, Charlotte F A; Eccles, Fiona J R; Armitage, Jocelyn R; Murray, Craig D

2017-09-01

Due to the lack of existing literature, the current research explored experiences of same-sex partner bereavement in women over the age of 60. Semi-structured interviews were conducted with eight women. Transcripts were analysed using interpretative phenomenological analysis. Three themes were identified which elaborated the experiences of older women who had lost a same-sex partner: (1) being left alone encapsulated feelings of isolation and exclusion; (2) navigating visibility centred on how homophobia led to a lack of recognition of the women's grief; and (3) finding new places to be authentic related women's need for new relationships in which they could be themselves. The findings indicate that existing models of partner bereavement may provide useful frameworks when seeking to understand the experiences of older women who have lost their same-sex partners. The findings indicate that in addition to the experiences of partner bereavement noted in research with heterosexual widows, older women who lose same-sex partners may face particular challenges, which can impact upon psychological well-being and adjustment to loss. These challenges appear to result from past and current homophobic and heterosexist attitudes within the UK culture. A range of interventions at individual, group, health service, and societal levels may be beneficial in improving the psychological well-being of older women who lose a same-sex partner.

Neighborhood attributes security and solidarity promote the well-being of community-dwelling older people in the Netherlands.

Science.gov (United States)

Cramm, Jane M; Nieboer, Anna P

2014-07-01

To determine whether the neighborhood attributes solidarity and security positively affect the well-being of community-dwelling older people in the Netherlands after accounting for individual characteristics, and to test if a higher level of security in combination with a stronger sense of neighborhood solidarity results in a higher level of well-being. The study sample for the cross-sectional study consisted of 869 out of 2212 (39% response rate) independently-living older adults (aged >70 years) in 92 neighborhoods of Rotterdam. We fitted a hierarchical random-effects model to account for the structure of the study design: 869 older people (level 1) nested in 92 neighborhoods (level 2) in 10 districts (level 3). Neighborhood security and solidarity among neighbors varied significantly among the 10 districts. Univariate analyses showed that education, income, neighborhood security and solidarity within neighborhoods (all P ≤ 0.001) were significantly related to the well-being of community-dwelling older people. Multilevel analyses showed neighborhood security and solidarity within neighborhoods predicted the well-being of community-dwelling older people. Furthermore, a positive interaction effect was found between neighborhood security and solidarity within neighborhoods, and well-being of community-dwelling older people. Neighborhood security and solidarity among neighbors are important for the well-being of community-dwelling older people. Furthermore, neighborhoods with high levels of perceived security in combination with stronger solidarity among neighbors are especially beneficial to the well-being of community-dwelling older people. © 2013 Japan Geriatrics Society.

Diversity in Older Adults' Use of the Internet: Identifying Subgroups Through Latent Class Analysis.

Science.gov (United States)

van Boekel, Leonieke C; Peek, Sebastiaan Tm; Luijkx, Katrien G

2017-05-24

As for all individuals, the Internet is important in the everyday life of older adults. Research on older adults' use of the Internet has merely focused on users versus nonusers and consequences of Internet use and nonuse. Older adults are a heterogeneous group, which may implicate that their use of the Internet is diverse as well. Older adults can use the Internet for different activities, and this usage can be of influence on benefits the Internet can have for them. The aim of this paper was to describe the diversity or heterogeneity in the activities for which older adults use the Internet and determine whether diversity is related to social or health-related variables. We used data of a national representative Internet panel in the Netherlands. Panel members aged 65 years and older and who have access to and use the Internet were selected (N=1418). We conducted a latent class analysis based on the Internet activities that panel members reported to spend time on. Second, we described the identified clusters with descriptive statistics and compared the clusters using analysis of variance (ANOVA) and chi-square tests. Four clusters were distinguished. Cluster 1 was labeled as the "practical users" (36.88%, n=523). These respondents mainly used the Internet for practical and financial purposes such as searching for information, comparing products, and banking. Respondents in Cluster 2, the "minimizers" (32.23%, n=457), reported lowest frequency on most Internet activities, are older (mean age 73 years), and spent the smallest time on the Internet. Cluster 3 was labeled as the "maximizers" (17.77%, n=252); these respondents used the Internet for various activities, spent most time on the Internet, and were relatively younger (mean age below 70 years). Respondents in Cluster 4, the "social users," mainly used the Internet for social and leisure-related activities such as gaming and social network sites. The identified clusters significantly differed in age (PInternet

Risk Factors for Aspiration Pneumonia in Older Adults.

Directory of Open Access Journals (Sweden)

Toshie Manabe

Full Text Available Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76% who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL, and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p < 0.001, daily oxygen therapy (OR = 8.29, 95% CI: 4.39-15.65, feeding support dependency (OR = 8.10, 95% CI: 6.27-10.48, p < 0.001, and urinary catheterization (OR = 4.08, 95% CI: 2.81-5.91, p < 0.001. In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619, deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952, dehydration (OR = 8.019, 95% CI: 2.720-23.643, and dementia (OR = 1.618, 95% CI: 1.031-2.539.The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing

Interventions for addressing low balance confidence in older adults: a systematic review and meta-analysis.

Science.gov (United States)

Rand, Debbie; Miller, William C; Yiu, Jeanne; Eng, Janice J

2011-05-01

low balance confidence is a major health problem among older adults restricting their participation in daily life. to determine what interventions are most effective in increasing balance confidence in older adults. systematic review with meta-analysis of randomised controlled trials including at least one continuous end point of balance confidence. Studies, including adults 60 years or older without a neurological condition, were included in our study. the standardised mean difference (SMD) of continuous end points of balance confidence was calculated to estimate the pooled effect size with random-effect models. Methodological quality of trials was assessed using the Physical Therapy Evidence Database (PEDro) Scale. thirty studies were included in this review and a meta-analysis was conducted for 24 studies. Interventions were pooled into exercise (n = 9 trials, 453 subjects), Tai Chi (n = 5 trials, 468 subjects), multifactorial intervention (n = 10 trials, 1,233 subjects). Low significant effects were found for exercise and multifactorial interventions (SMD 0.22-0.31) and medium (SMD 0.48) significant effects were found for Tai Chi. Tai chi interventions are the most beneficial in increasing the balance confidence of older adults.

Mental health implications for older adults after natural disasters--a systematic review and meta-analysis.

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Parker, Georgina; Lie, David; Siskind, Dan J; Martin-Khan, Melinda; Raphael, Beverly; Crompton, David; Kisely, Steve

2016-01-01

Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.

Medication management strategies used by older adults with heart failure: A systems-based analysis.

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Mickelson, Robin S; Holden, Richard J

2017-09-01

Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.

MULTIVARIANT AND UNIVARIANT INTERGROUP DIFFERENCES IN THE INVESTIGATED SPECIFIC MOTOR SPACE BETWEEN RESPONDENTS JUNIORS AND SENIORS MEMBERS OF THE MACEDONIAN NATIONAL KARATE TEAM

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Kеnan Аsani

2013-07-01

Full Text Available The aim is to establish intergroup multivariant and univariant investigated differences in specific motor space between respondents juniors and seniors members of the Macedonian karate team. The sample of 30 male karate respondents covers juniors on 16,17 and seniors over 18 years.In the research were applied 20 specific motor tests. Based on Graph 1 where it is presented multivariant analysis of variance Manova and Anova can be noted that respondents juniors and seniors, although not belonging to the same population are not different in multivariant understudied area.W. lambda of .19, Rao-wool R - Approximation of 1.91 degrees of freedom df 1 = 20 and df 2 = 9 provides the level of significance of p =, 16. Based on univariant analysis for each variable separately can be seen that has been around intergroup statistically significant difference in seven SMAEGERI (kick in the sack with favoritism leg mae geri for 10 sec., SMAVASI (kick in the sack with favoritism foot mavashi geri by 10 sec., SUSIRO (kick in the sack with favoritism leg ushiro geri for 10 sec., SKIZAME (kick in the sack with favoritism hand kizame cuki for 10 sec., STAPNSR (taping with foot in sagital plane for 15 sec. SUDMNR (hitting a moving target with weaker hand and SUDMPN (hitting a moving target with favoritism foot of twenty applied manifest variables. There are no intergroup differences in multivariant investigated specific - motor space among the respondents juniors and seniors members of the Macedonian karate team. Based on univariant analysis for each variable separately can be seen that has been around intergroup statistically significant difference in seven SMAEGERI (kick in the sack with favoritism leg mae geri for 10 sec., SMAVASI (kick in the sack with favoritism foot mavashi geri by 10 sec., SUSIRO (kick in the sack with favoritism leg ushiro geri for 10 sec., SKIZAME (kick in the sack with favoritism hand kizame cuki for 10 sec., STAPNSR (taping with foot in

Constructing definitions of safety risks while nurses care for hospitalised older people: Secondary analysis of qualitative data.

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Dahlke, Sherry; Hall, Wendy A; Baumbusch, Jennifer

2017-09-01

The aim of this secondary qualitative descriptive analysis was to examine how nurses construct a definition of older peoples' safety risks and provide care while working within organisational contexts that are focused on diminishing patient risks. Numbers of older patients are increasing in acute hospital contexts-contexts that place their focus on patient safety. Nurses need to manage tensions between older peoples' risks, evidence-informed practice decisions, limited resources and organisational emphases on patient falls. To date, their practice dilemmas have not been well examined. A secondary qualitative descriptive analysis was conducted using data that were collected between June 2010 and May 2011 to examine nursing practice with hospitalised older people. All field notes and transcribed data were reviewed to generate themes representing 18 Registered Nurses' perceptions about safe care for hospitalised older people. The first author generated categories that described how nurses construct definitions of safety risks for older people. All authors engaged in an iterative analytic process that resulted in themes capturing nurses' efforts to provide care in limited resource environments while considering older peoples' safety risks. Nurses constructed definitions of patient safety risks in the context of institutional directives. Nurses provided care using available resources as efficiently as possible and accessing co-worker support. They also minimised the importance of older people's functional abilities by setting priorities for medically delegated tasks and immobilising their patients to reduce their risks. Nurses' definitions of patient risk, which were shaped by impoverished institutional resources and nurses' lack of valuing of functional abilities, contributed to suboptimal care for older adults. Nurses' definitions of risk as physical injury reduced their attention to patients' functional abilities, which nurses reported suffered declines as a result

Factors affecting mortality in older trauma patients-A systematic review and meta-analysis.

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Sammy, Ian; Lecky, Fiona; Sutton, Anthea; Leaviss, Joanna; O'Cathain, Alicia

2016-06-01

Major trauma in older people is a significant health burden in the developed world. The aging of the population has resulted in larger numbers of older patients suffering serious injury. Older trauma patients are at greater risk of death from major trauma, but the reasons for this are less well understood. The aim of this review was to identify the factors affecting mortality in older patients suffering major injury. A systematic review of Medline, Cinhal and the Cochrane database, supplemented by a manual search of relevant papers was undertaken, with meta-analysis. Multi-centre cohort studies of existing trauma registries that reported risk-adjusted mortality (adjusted odds ratios, AOR) in their outcomes and which analysed patients aged 65 and older as a separate cohort were included in the review. 3609 papers were identified from the electronic databases, and 28 from manual searches. Of these, 15 papers fulfilled the inclusion criteria. Demographic variables (age and gender), pre-existing conditions (comorbidities and medication), and injury-related factors (injury severity, pattern and mechanism) were found to affect mortality. The 'oldest old', aged 75 and older, had higher mortality rates than younger patients, aged 65-74 years. Older men had a significantly higher mortality rate than women (cumulative odds ratio 1.51, 95% CI 1.37-1.66). Three papers reported a higher risk of death in patients with pre-existing conditions. Two studies reported increased mortality in patients on warfarin (cumulative odds ratio 1.32, 95% CI 1.05-1.66). Higher mortality was seen in patients with lower Glasgow coma scores and systolic blood pressures. Mortality increased with increased injury severity and number of injuries sustained. Low level falls were associated with higher mortality than motor vehicle collisions (cumulative odds ratio 2.88, 95% CI 1.26-6.60). Multiple factors contribute to mortality risk in older trauma patients. The relation between these factors and

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

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

Visual classification of very fine-grained sediments: Evaluation through univariate and multivariate statistics

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Hohn, M. Ed; Nuhfer, E.B.; Vinopal, R.J.; Klanderman, D.S.

1980-01-01

Classifying very fine-grained rocks through fabric elements provides information about depositional environments, but is subject to the biases of visual taxonomy. To evaluate the statistical significance of an empirical classification of very fine-grained rocks, samples from Devonian shales in four cored wells in West Virginia and Virginia were measured for 15 variables: quartz, illite, pyrite and expandable clays determined by X-ray diffraction; total sulfur, organic content, inorganic carbon, matrix density, bulk density, porosity, silt, as well as density, sonic travel time, resistivity, and ??-ray response measured from well logs. The four lithologic types comprised: (1) sharply banded shale, (2) thinly laminated shale, (3) lenticularly laminated shale, and (4) nonbanded shale. Univariate and multivariate analyses of variance showed that the lithologic classification reflects significant differences for the variables measured, difference that can be detected independently of stratigraphic effects. Little-known statistical methods found useful in this work included: the multivariate analysis of variance with more than one effect, simultaneous plotting of samples and variables on canonical variates, and the use of parametric ANOVA and MANOVA on ranked data. ?? 1980 Plenum Publishing Corporation.

Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

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Kristensen, Dorte V; Sundler, Annelie J; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger K

2017-12-01

To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective. The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. A descriptive design with a qualitative inductive approach was used. Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication. © 2017 John Wiley & Sons Ltd.

When to perform urine cultures in respiratory syncytial virus-positive febrile older infants?

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Kaluarachchi, Dinushan; Kaldas, Virginia; Erickson, Evelyn; Nunez, Randolph; Mendez, Magda

2014-09-01

Respiratory syncytial virus (RSV) infections are associated with clinically significant rate of urinary tract infections (UTIs) in young infants. Previous research investigating RSV infections and UTIs has been performed mainly in infants younger than 2 to 3 months and has not focused on the risk of UTI in infants 3 to 12 months. This study aimed to assess the rate of UTIs in febrile RSV-positive older infants admitted as inpatients and identify predictors of UTI in febrile RSV-positive older infants. This is a retrospective comparative study of febrile RSV-positive infants 0 to 12 months of age admitted to the inpatient pediatric unit of Lincoln Medical and Mental Health Center, Bronx, from September through April 2006 to 2012. Infants 3 to 12 months were considered the cases, and infants 0 to 3 months were the comparative group. The rate of UTIs between the 2 groups was compared. Univariate tests and multiple logistic regression were used to identify demographic/clinical factors associated with UTI in febrile RSV-positive older infants. A total of 414 RSV-positive febrile infants were enrolled including 297 infants 3 to 12 months of age. The rate of UTI in older infants was 6.1% compared with 6.8% in infants younger than 3 months. Positive urinalysis finding was an independent predictor of UTI (P = 0.003) in older infants. All 11 boys with UTI were uncircumcised, and none of the 51 circumcised boys had UTI. Demographic (race, sex, and age) and clinical factors (temperature, white blood cell count, and absolute neutrophil count) were not associated with UTI. Febrile older infants who are RSV positive have a clinically significant rate of UTIs. It seems prudent to examine the urine of these older infants. Positive urinalysis finding was a predictive factor of UTI. Circumcised boys are at a decreased risk of UTI, compared with uncircumcised boys.

Using Structured Observation and Content Analysis to Explore the Presence of Older People in Public Fora in Developing Countries

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Geraldine Nosowska

2014-01-01

Full Text Available There is a lack of research on the everyday lives of older people in developing countries. This exploratory study used structured observation and content analysis to examine the presence of older people in public fora and considered the methods’ potential for understanding older people’s social integration and inclusion. Structured observation occurred of public social spaces in six cities each located in a different developing country and in one city in the United Kingdom, together with content analysis of the presence of people in newspaper pictures and on television in the selected countries. Results indicated that across all fieldwork sites and data sources, there was a low presence of older people, with women considerably less present than men in developing countries. There was variation across fieldwork sites in older people’s presence by place and time of day and in their accompanied status. The presence of older people in images drawn from newspapers was associated with the news/non-news nature of the source. The utility of the study’s methodological approach is considered, as is the degree to which the presence of older people in public fora might relate to social integration and inclusion in different cultural contexts.

Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias

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Felipe B. Schuch

Full Text Available Objective: To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT data. Methods: We conducted a meta-analysis of exercise in older adults, addressing limitations of previous works. RCTs of exercise interventions in older people with depression (≥ 60 years comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD (95% confidence interval [95%CI], meta-regressions, and trim, fill, and fail-safe number analyses were conducted. Results: Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 [95%CI -0.29 to -1.51], with a fail-safe number of 71 studies. Significant effects were found for 1 mixed aerobic and anaerobic interventions, 2 at moderate intensity, 3 that were group-based, 4 that utilized mixed supervised and unsupervised formats, and 5 in people without other clinical comorbidities. Conclusion: Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.

Self-worth therapy for depressive symptoms in older nursing home residents.

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Tsai, Yun-Fang; Wong, Thomas K S; Tsai, Hsiu-Hsin; Ku, Yan-Chiou

2008-12-01

The aim of this study is to report the effects of self-worth therapy on depressive symptoms of older nursing home residents. Depression in older people has become a serious healthcare issue worldwide. Pharmacological and non-pharmacological therapies have been shown to have inconsistent effects, and drug treatment can have important side-effects. A quasi-experimental design was used. Older people were sampled by convenience from residents of a nursing home in northern Taiwan between 2005 and 2006. To be included in the study participants had to: (i) have no severe cognitive deficits; (ii) test positive for depressive status and (iii) take the same anti-depressant medication in the previous 3 months and throughout the study. Participants in the experimental group (n = 31) received 30 minutes of one-to-one self-worth therapy on 1 day a week for 4 weeks. Control group participants (n = 32) received no therapy, but were individually visited by the same research assistant, who chatted with them for 30 minutes on 1 day/week for 4 weeks. Depressive status, cognitive status and functional status were measured at baseline, immediately after the intervention and 2 months later. Data were analysed by mean, standard deviations, t-test, chi-squared test and univariate anova. Self-worth therapy immediately decreased depressive symptoms relative to baseline, but not relative to control treatment. However, 2 months later, depressive symptoms were statistically significantly reduced relative to control. Self-worth therapy is an easily-administered, effective, non-pharmacological treatment with potential for decreasing depressive symptoms in older nursing home residents.

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

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

1997-02-01

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

Cognitive Strategies and Physical Activity in Older Adults: A Discriminant Analysis

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Nathalie André

2018-01-01

Full Text Available Background. Although a number of studies have examined sociodemographic, psychosocial, and environmental determinants of the level of physical activity (PA for older people, little attention has been paid to the predictive power of cognitive strategies for independently living older adults. However, cognitive strategies have recently been considered to be critical in the management of day-to-day living. Methods. Data were collected from 243 men and women aged 55 years and older living in France using face-to-face interviews between 2011 and 2013. Results. A stepwise discriminant analysis selected five predictor variables (age, perceived health status, barriers’ self-efficacy, internal memory, and attentional control strategies of the level of PA. The function showed that the rate of correct prediction was 73% for the level of PA. The calculated discriminant function based on the five predictor variables is useful for detecting individuals at high risk of lapses once engaged in regular PA. Conclusions. This study highlighted the need to consider cognitive functions as a determinant of the level of PA and, more specifically, those cognitive functions related to executive functions (internal memory and attentional control, to facilitate the maintenance of regular PA. These results are discussed in relation to successful aging.

High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults-A Systematic Review and Meta-Analysis.

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Verlaan, Sjors; Ligthart-Melis, Gerdien C; Wijers, Sander L J; Cederholm, Tommy; Maier, Andrea B; de van der Schueren, Marian A E

2017-05-01

Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other. A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini- Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa. In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Stereotype Threat Effects on Older Adults' Episodic and Working Memory: A Meta-Analysis.

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Armstrong, Bonnie; Gallant, Sara N; Li, Lingqian; Patel, Khushi; Wong, Brenda I

2017-08-01

Prior research has shown that exposure to negative age-based stereotype threat (ST) can undermine older adults' memory performance. The objective of the current meta-analysis was to examine the reliability and magnitude of ST effects on older adults' episodic and working memory performance-two forms of memory that typically show the greatest age-related declines. In addition, we examined potential moderators of age-based ST including type of ST manipulation, type and timing of memory task, participant age and education level. A total of 23 samples for episodic memory and 15 samples for working memory were derived from 19 published and 4 unpublished articles and analyzed in two separate meta-analyses. Analyses revealed a reliable effect of ST on both older adults' episodic (d = 0.373) and working memory performance (d = 0.253). Interestingly, the age-based ST effect was only significant when blatant ST manipulations were used with episodic memory tasks or when subtle ST manipulations were used with working memory tasks. Moreover, within episodic memory, the ST effect only reached significance for recall but not cued-recall or recognition performance, and for immediate but not delayed tests of memory. Neither age nor level of education moderated the association between ST and older adults' memory performance. These results highlight the vulnerability of both older adults' episodic and working memory performance to age-based ST. When measuring older adults' memory performance in a research context, we must therefore be wary of exposing participants to common stereotypes about aging and memory. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A meta-analysis of third wave mindfulness-based cognitive behavioral therapies for older people.

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Kishita, Naoko; Takei, Yuko; Stewart, Ian

2017-12-01

The aim of this study is to review the effectiveness of third wave mindfulness-based cognitive behavioral therapies (CBTs) for depressive or anxiety symptomatology in older adults across a wide range of physical and psychological conditions. Electronic literature databases were searched for articles, and random-effects meta-analysis was conducted. Ten studies met the inclusion criteria, of which nine reported the efficacy of interventions on depressive symptoms and seven on anxiety symptoms. Effect-size estimates suggested that mindfulness-based CBT is moderately effective on depressive symptoms in older adults (g = 0.55). The results demonstrated a similar level of overall effect size for anxiety symptoms (g = 0.58). However, there was a large heterogeneity, and publication bias was evident in studies reporting outcomes on anxiety symptoms, and thus, this observed efficacy for late-life anxiety may not be robust. The quality of the included studies varied. Only one study used an active psychological control condition. There were a limited number of studies that used an intent-to-treat (last observation carried forward method) analysis and reported appropriate methods for clinical trials (e.g., treatment-integrity reporting). Third wave mindfulness-based CBT may be robust in particular for depressive symptoms in older adults. We recommend that future studies (i) conduct randomized controlled trials with intent-to-treat to compare mindfulness-based CBT with other types of psychotherapy in older people and (ii) improve study quality by using appropriate methods for checking treatment adherence, randomization, and blinding of assessors. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Automatic Image Segmentation Using Active Contours with Univariate Marginal Distribution

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I. Cruz-Aceves

2013-01-01

Full Text Available This paper presents a novel automatic image segmentation method based on the theory of active contour models and estimation of distribution algorithms. The proposed method uses the univariate marginal distribution model to infer statistical dependencies between the control points on different active contours. These contours have been generated through an alignment process of reference shape priors, in order to increase the exploration and exploitation capabilities regarding different interactive segmentation techniques. This proposed method is applied in the segmentation of the hollow core in microscopic images of photonic crystal fibers and it is also used to segment the human heart and ventricular areas from datasets of computed tomography and magnetic resonance images, respectively. Moreover, to evaluate the performance of the medical image segmentations compared to regions outlined by experts, a set of similarity measures has been adopted. The experimental results suggest that the proposed image segmentation method outperforms the traditional active contour model and the interactive Tseng method in terms of segmentation accuracy and stability.

Restrictions of physical activity participation in older adults with disability: employing keyword network analysis.

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Koo, Kyo-Man; Kim, Chun-Jong; Park, Chae-Hee; Byeun, Jung-Kyun; Seo, Geon-Woo

2016-08-01

Older adults with disability might have been increasing due to the rapid aging of society. Many studies showed that physical activity is an essential part for improving quality of life in later lives. Regular physical activity is an efficient means that has roles of primary prevention and secondary prevention. However, there were few studies regarding older adults with disability and physical activity participation. The purpose of this current study was to investigate restriction factors to regularly participate older adults with disability in physical activity by employing keyword network analysis. Two hundred twenty-nine older adults with disability who were over 65 including aging with disability and disability with aging in type of physical disability and brain lesions defined by disabled person welfare law partook in the open questionnaire assessing barriers to participate in physical activity. The results showed that the keyword the most often used was 'Traffic' which was total of 21 times (3.47%) and the same proportion as in the 'personal' and 'economical'. Exercise was considered the most central keyword for participating in physical activity and keywords such as facility, physical activity, disabled, program, transportation, gym, discomfort, opportunity, and leisure activity were associated with exercise. In conclusion, it is necessary to educate older persons with disability about a true meaning of physical activity and providing more physical activity opportunities and decreasing inconvenience should be systematically structured in Korea.

Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients.

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Culley, Deborah J; Flaherty, Devon; Fahey, Margaret C; Rudolph, James L; Javedan, Houman; Huang, Chuan-Chin; Wright, John; Bader, Angela M; Hyman, Bradley T; Blacker, Deborah; Crosby, Gregory

2017-11-01

The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement. Patients were cognitively screened preoperatively using the Mini-Cog and demographic, medical, functional, and emotional/social data were gathered using standard instruments or review of the medical record. Outcomes included discharge to place other than home (primary outcome), delirium, in-hospital medical complications, hospital length-of-stay, 30-day emergency room visits, and mortality. Data were analyzed using univariate and multivariate analyses. Fifty of 211 (24%) patients screened positive for probable cognitive impairment (Mini-Cog less than or equal to 2). On age-adjusted multivariate analysis, patients with a Mini-Cog score less than or equal to 2 were more likely to be discharged to a place other than home (67% vs. 34%; odds ratio = 3.88, 95% CI = 1.58 to 9.55), develop postoperative delirium (21% vs. 7%; odds ratio = 4.52, 95% CI = 1.30 to 15.68), and have a longer hospital length of stay (hazard ratio = 0.63, 95% CI = 0.42 to 0.95) compared to those with a Mini-Cog score greater than 2. Many older elective orthopedic surgical patients have probable cognitive impairment preoperatively. Such impairment is associated with development of delirium postoperatively, a longer hospital stay, and lower likelihood of going home upon hospital discharge.

Genome-wide Meta-analysis on the Sense of Smell Among US Older Adults.

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Dong, Jing; Yang, Jingyun; Tranah, Greg; Franceschini, Nora; Parimi, Neeta; Alkorta-Aranburu, Gorka; Xu, Zongli; Alonso, Alvaro; Cummings, Steven R; Fornage, Myriam; Huang, Xuemei; Kritchevsky, Stephen; Liu, Yongmei; London, Stephanie; Niu, Liang; Wilson, Robert S; De Jager, Philip L; Yu, Lei; Singleton, Andrew B; Harris, Tamara; Mosley, Thomas H; Pinto, Jayant M; Bennett, David A; Chen, Honglei

2015-11-01

Olfactory dysfunction is common among older adults and affects their safety, nutrition, quality of life, and mortality. More importantly, the decreased sense of smell is an early symptom of neurodegenerative diseases such as Parkinson disease (PD) and Alzheimer disease. However, the genetic determinants for the sense of smell have been poorly investigated. We here performed the first genome-wide meta-analysis on the sense of smell among 6252 US older adults of European descent from the Atherosclerosis Risk in Communities (ARIC) study, the Health, Aging, and Body Composition (Health ABC) study, and the Religious Orders Study and the Rush Memory and Aging Project (ROS/MAP). Genome-wide association study analysis was performed first by individual cohorts and then meta-analyzed using fixed-effect models with inverse variance weights. Although no SNPs reached genome-wide statistical significance, we identified 13 loci with suggestive evidence for an association with the sense of smell (Pmeta < 1 × 10). Of these, 2 SNPs at chromosome 17q21.31 (rs199443 in NSF, P = 3.02 × 10; and rs2732614 in KIAA1267-LRRC37A, P = 6.65 × 10) exhibited cis effects on the expression of microtubule-associated protein tau (MAPT, 17q21.31) in 447 frontal-cortex samples obtained postmortem and profiled by RNA-seq (P < 1 × 10). Gene-based and pathway-enrichment analyses further implicated MAPT in regulating the sense of smell in older adults. Similar results were obtained after excluding participants who reported a physician-diagnosed PD or use of PD medications. In conclusion, we provide preliminary evidence that the MAPT locus may play a role in regulating the sense of smell in older adults and therefore offer a potential genetic link between poor sense of smell and major neurodegenerative diseases.

Insomnia and risk of dementia in older adults: Systematic review and meta-analysis.

Science.gov (United States)

de Almondes, Katie Moraes; Costa, Mônica Vieira; Malloy-Diniz, Leandro Fernandes; Diniz, Breno Satler

2016-06-01

There are cross-sectional evidences of an association between sleep disorders and cognitive impairment on older adults. However, there are no consensus by means of longitudinal studies data on the increased risk of developing dementia related to insomnia. We conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia in individuals with insomnia in population-based prospective cohort studies. Five studies of 5.242 retrieved references were included in the meta-analysis. We used the generic inverse variance method with a random effects model to calculate the pooled risk of dementia in older adults with insomnia. We assessed heterogeneity in the meta-analysis by means of the Q-test and I2 index. Study quality was assessed with the Newcastle-Ottawa Scale The results showed that Insomnia was associated with a significant risk of all-cause dementia (RR = 1.53 CI95% (1.07-2.18), z = 2.36, p = 0.02). There was evidence for significant heterogeneity in the analysis (q-value = 2.4, p < 0.001 I2 = 82%). Insomnia is associated with an increased risk for dementia. This results provide evidences that future studies should investigate dementia prevention among elderly individuals through screening and proper management of insomnia. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2015-02-01

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

A Java-based fMRI processing pipeline evaluation system for assessment of univariate general linear model and multivariate canonical variate analysis-based pipelines.

Science.gov (United States)

Zhang, Jing; Liang, Lichen; Anderson, Jon R; Gatewood, Lael; Rottenberg, David A; Strother, Stephen C

2008-01-01

As functional magnetic resonance imaging (fMRI) becomes widely used, the demands for evaluation of fMRI processing pipelines and validation of fMRI analysis results is increasing rapidly. The current NPAIRS package, an IDL-based fMRI processing pipeline evaluation framework, lacks system interoperability and the ability to evaluate general linear model (GLM)-based pipelines using prediction metrics. Thus, it can not fully evaluate fMRI analytical software modules such as FSL.FEAT and NPAIRS.GLM. In order to overcome these limitations, a Java-based fMRI processing pipeline evaluation system was developed. It integrated YALE (a machine learning environment) into Fiswidgets (a fMRI software environment) to obtain system interoperability and applied an algorithm to measure GLM prediction accuracy. The results demonstrated that the system can evaluate fMRI processing pipelines with univariate GLM and multivariate canonical variates analysis (CVA)-based models on real fMRI data based on prediction accuracy (classification accuracy) and statistical parametric image (SPI) reproducibility. In addition, a preliminary study was performed where four fMRI processing pipelines with GLM and CVA modules such as FSL.FEAT and NPAIRS.CVA were evaluated with the system. The results indicated that (1) the system can compare different fMRI processing pipelines with heterogeneous models (NPAIRS.GLM, NPAIRS.CVA and FSL.FEAT) and rank their performance by automatic performance scoring, and (2) the rank of pipeline performance is highly dependent on the preprocessing operations. These results suggest that the system will be of value for the comparison, validation, standardization and optimization of functional neuroimaging software packages and fMRI processing pipelines.

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

Science.gov (United States)

Bjelde, Kristine; Chromy, Barbara; Pankow, Debra

2008-12-01

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

Social change and birth cohort increase in loneliness among Chinese older adults: a cross-temporal meta-analysis, 1995-2011.

Science.gov (United States)

Yan, Zhimin; Yang, Xun; Wang, Lei; Zhao, Yuhan; Yu, Lin

2014-11-01

In China, rapid economic growth and increasing social problems constitute the two basic characteristics underlying contemporary social change. With dramatic social change, loneliness in older adults may have changed across birth cohorts, thus altering older adults' mental health. The present study aims to identify birth cohort changes in Chinese older adults' loneliness and the social indicators underlying these changes. Cross-temporal meta-analysis was utilized to investigate changes in Chinese older adults' loneliness from 1995 to 2011. We analyzed 25 studies (N = 13,280 adults; age ≥ 60 years) employing the University of California at Los Angeles Loneliness Scale. We correlated loneliness scores with social indicators and matched these correlations for three periods: ten years before the data collection, five years before data collection, and during the year of data collection. Loneliness levels in Chinese older adults have increased by 1.02 standard deviations from 1995 to 2011. Social indicators such as increased urbanization level, personal medical expenditure, divorce rate, the Gini coefficient, and unemployment rate significantly predicted loneliness in Chinese older adults. Decrease in social connectedness and increase in levels of health threat may be responsible for the observed increase in levels of loneliness. Cross-temporal meta-analysis revealed a birth cohort increase in loneliness among Chinese older adults. We conclude that changes in social connectedness and levels of health threat likely play an important role in predicting loneliness in the population of Chinese elderly adults.

Racial disparities in the development of breast cancer metastases among older women: a multilevel study.

Science.gov (United States)

Schootman, Mario; Jeffe, Donna B; Gillanders, William E; Aft, Rebecca

2009-02-15

Distant metastases are the most common and lethal type of breast cancer relapse. The authors examined whether older African American breast cancer survivors were more likely to develop metastases compared with older white women. They also examined the extent to which 6 pathways explained racial disparities in the development of metastases. The authors used 1992-1999 Surveillance, Epidemiology, and End Results (SEER) data with 1991-1999 Medicare data. They used Medicare's International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify metastases of respiratory and digestive systems, brain, bone, or other unspecified sites. The 6 pathways consisted of patient characteristics, tumor characteristics, type of treatment received, access to medical care, surveillance mammography use, and area-level characteristics (poverty rate and percentage African American) and were obtained from the SEER or Medicare data. Of the 35,937 women, 10.5% developed metastases. In univariate analysis, African American women were 1.61 times (95% confidence interval [CI], 1.54-1.83) more likely to develop metastasis than white women. In multivariate analysis, tumor grade, stage at diagnosis, and census-tract percentage African American explained why African American women were more likely to develop metastases than white women (hazard ratio, 0.84; 95% CI, 0.68-1.03). Interventions to reduce late-stage breast cancer among African Americans also may reduce racial disparities in subsequent increased risk of developing metastasis. African Americans diagnosed with high-grade breast cancer could be targeted to reduce their risk of metastasis. Future studies should identify specific reasons why the racial distribution in census tracts was associated with racial disparities in the risk of breast cancer metastases. (c) 2009 American Cancer Society.

Memory training interventions for older adults: a meta-analysis.

Science.gov (United States)

Gross, Alden L; Parisi, Jeanine M; Spira, Adam P; Kueider, Alexandra M; Ko, Jean Y; Saczynski, Jane S; Samus, Quincy M; Rebok, George W

2012-01-01

A systematic review and meta-analysis of memory training research was conducted to characterize the effect of memory strategies on memory performance among cognitively intact, community-dwelling older adults, and to identify characteristics of individuals and of programs associated with improved memory. The review identified 402 publications, of which 35 studies met criteria for inclusion. The overall effect size estimate, representing the mean standardized difference in pre-post change between memory-trained and control groups, was 0.31 standard deviations (SD; 95% confidence interval (CI): 0.22, 0.39). The pre-post training effect for memory-trained interventions was 0.43 SD (95% CI: 0.29, 0.57) and the practice effect for control groups was 0.06 SD (95% CI: 0.05, 0.16). Among 10 distinct memory strategies identified in studies, meta-analytic methods revealed that training multiple strategies was associated with larger training gains (p=0.04), although this association did not reach statistical significance after adjusting for multiple comparisons. Treatment gains among memory-trained individuals were not better after training in any particular strategy, or by the average age of participants, session length, or type of control condition. These findings can inform the design of future memory training programs for older adults.

Supporting frail older people and their family carers at home using information and communication technology: cost analysis.

Science.gov (United States)

Magnusson, Lennart; Hanson, Elizabeth

2005-09-01

This paper describes a cost analysis of a home-based support service for frail older people and their family carers in two municipalities in West Sweden and using information and communication technology. A key challenge facing nurse managers across Europe is an increasingly aged population, combined with reduced numbers of young adults of working age. New solutions are needed to provide quality, cost-effective community care services to frail older people and their family carers. A case study methodology involving five families was used, and included a detailed cost description of the technology-based service compared with usual services. Cost data were collected in June 2002. This work formed part of a larger project exploring the impact of a technology-based service known as, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). In addition to cost data, information was gathered on the quality of life of frail older people and their family carers, and the job satisfaction and work methods of nurses and other practitioners based in the community. The cost analysis comprised a description of the family and their caring situation, the perceived benefits of the telematic based support service and an assessment of its impact on the use of other care services. These analyses were carried out with the help of needs assessors who were known to the families, and nurses working in the ACTION call centre. All results were validated by the five participating families. Cost savings were achieved in all cases, and the benefits to older people and their carers were also considerable. As a result of the cost analysis and overall evaluation data, ACTION has been implemented as a mainstream service in the municipalities involved. Researchers, nurses, other practitioners and community care managers can work together with frail older people and their family carers to develop quality, cost-effective support services that reduce demands on staff

Same-sex partner bereavement in older women:an interpretative phenomenological analysis

OpenAIRE

Ingham, Charlotte; Eccles, Fiona Juliet Rosalind; Armitage, Jocelyn Rebecca; Murray, Craig David

2017-01-01

Objectives: Due to the lack of existing literature, the current research explored experiences of same-sex partner bereavement in women over the age of 60. Method: Semi-structured interviews were conducted with eight women. Transcripts were analysed using interpretative phenomenological analysis. Results: Three themes were identified which elaborated the experiences of older women who had lost a same-sex partner: (1) being left alone encapsulated feelings of isolation and exclusion; (2) naviga...

Residential patterns in older homeless adults: Results of a cluster analysis.

Science.gov (United States)

Lee, Christopher Thomas; Guzman, David; Ponath, Claudia; Tieu, Lina; Riley, Elise; Kushel, Margot

2016-03-01

Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n = 162), cohabited unstably with friends and family (n = 57), resided in multiple institutional settings (shelters, jails, transitional housing) (n = 88), or lived primarily in rental housing (recently homeless) (n = 43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after

New medical diagnoses and length of stay of acutely unwell older patients: Implications for funding models.

Science.gov (United States)

Basic, David; Khoo, Angela

2015-09-01

To examine the relationship between newly made medical diagnoses and length of stay (LOS) of acutely unwell older patients. Consecutive patients admitted under the care of four geriatricians were randomly allocated to a model development sample (n = 937) or a model validation sample (n = 855). Cox regression was used to model LOS. Variables considered for inclusion in the development model were established risk factors for LOS and univariate predictors from our dataset. Variables selected in the development sample were tested in the validation sample. A median of five new medical diagnoses were made during a median LOS of 10 days. New diagnoses predicted an increased LOS (hazard ratio 0.90, 95% confidence interval 0.88-0.92). Other significant predictors of increased LOS in both samples were malnutrition and frailty. Identification of new medical diagnoses may have implications for Diagnosis Related Groups-based funding models and may improve the care of older people. © 2015 AJA Inc.

Are religiousness and death attitudes associated with the wish to die in older people?

Science.gov (United States)

Bonnewyn, Anke; Shah, Ajit; Bruffaerts, Ronny; Demyttenaere, Koen

2016-03-01

A wish to die is common in older persons and is associated with increased mortality. Several risk factors have been identified, but the association between religiousness and a wish to die in older adults has been underexplored, and the association between death attitudes and the presence of a wish to die has not been investigated yet. The aim of this study is to explore the relationship between religiousness and death attitudes on the one hand and wish to die on the other hand, adjusting for clinical factors such as the presence of depression or somatic disorder. The sample comprised 113 older inpatients (from a psychiatric and somatic ward) with a mean age of 74 years. Psychiatric diagnoses were assessed by the Structured Clinical Interview for DSM-IV Disorders, and logistic regression analyses estimated the unique contribution of religiousness and death attitudes to the wish to die, controlling for socio-demographic variables, depressive disorder, and somatic symptoms. Both religiousness and death attitudes were associated with a wish to die in univariate models. Adding these variables in a multivariate logistic hierarchical model, death attitudes remained significant predictors but religiousness did not; 55% of the pseudovariance of the wish to die was explained by these variables, with an effective size of 0.89. Major depressive episode, somatic symptoms, Fear of Death, and Escape Acceptance were the most important predictors of the wish to die. This study suggests that how older adults perceive death partly determines whether they have a wish to die. There may be a clinical, patient-oriented benefit in discussing with older patients about how they perceive death, as this can play a role in the early detection (and prevention) of death or suicide ideation and associated behaviors in older adults.

Biomechanical analysis of effects of neuromusculoskeletal training for older adults on the likelihood of slip-induced falls.

OpenAIRE

Kim, Sukwon

2006-01-01

Overview of the Study Title Biomechanical Analysis for Effects of Neuromusculoskeletal Training for Older Adults on Outcomes of Slip-induced Falls. Research Objectives The objective of this study was to evaluate if neuromusculoskeletal training (i.e., weight and balance training) for older adults could reduce the likelihood of slip-induced fall accidents. The study focused on evaluating biomechanics among the elderly at pre- and post-training stages during processes associated w...

Univariate and multivariate forecasting of hourly solar radiation with artificial intelligence techniques

Energy Technology Data Exchange (ETDEWEB)

Sfetsos, A. [7 Pirsou Str., Athens (Greece); Coonick, A.H. [Imperial Coll. of Science Technology and Medicine, Dept. of Electrical and Electronic Engineering, London (United Kingdom)

2000-07-01

This paper introduces a new approach for the forecasting of mean hourly global solar radiation received by a horizontal surface. In addition to the traditional linear methods, several artificial-intelligence-based techniques are studied. These include linear, feed-forward, recurrent Elman and Radial Basis neural networks alongside the adaptive neuro-fuzzy inference scheme. The problem is examined initially for the univariate case, and is extended to include additional meteorological parameters in the process of estimating the optimum model. The results indicate that the developed artificial intelligence models predict the solar radiation time series more effectively compared to the conventional procedures based on the clearness index. The forecasting ability of some models can be further enhanced with the use of additional meteorological parameters. (Author)

Behavioral Observation and Microbiological Analysis of Older Adult Consumers' Cross-Contamination Practices in a Model Domestic Kitchen.

Science.gov (United States)

Evans, Ellen W; Redmond, Elizabeth C

2018-04-01

The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

Science.gov (United States)

Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Predictors of depressive symptoms in older Japanese primiparas at 1 month post-partum: A risk-stratified analysis.

Science.gov (United States)

Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Tamakoshi, Koji

2016-01-01

Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care. © 2015 Japan Academy of Nursing Science.

How do older adult drivers self-regulate? Characteristics of self-regulation classes defined by latent class analysis.

Science.gov (United States)

Bergen, Gwen; West, Bethany A; Luo, Feijun; Bird, Donna C; Freund, Katherine; Fortinsky, Richard H; Staplin, Loren

2017-06-01

Motor-vehicle crashes were the second leading cause of injury death for adults aged 65-84years in 2014. Some older drivers choose to self-regulate their driving to maintain mobility while reducing driving risk, yet the process remains poorly understood. Data from 729 older adults (aged ≥60years) who joined an older adult ride service program between April 1, 2010 and November 8, 2013 were analyzed to define and describe classes of driving self-regulation. Latent class analysis was employed to characterize older adult driving self-regulation classes using driving frequency and avoidance of seven driving situations. Logistic regression was used to explore associations between characteristics affecting mobility and self-regulation class. Three classes were identified (low, medium, and high self-regulation). High self-regulating participants reported the highest proportion of always avoiding seven risky driving situations and the lowest driving frequency followed by medium and low self-regulators. Those who were female, aged 80years or older, visually impaired, assistive device users, and those with special health needs were more likely to be high self-regulating compared with low self-regulating. Avoidance of certain driving situations and weekly driving frequency are valid indicators for describing driving self-regulation classes in older adults. Understanding the unique characteristics and mobility limitations of each class can guide optimal transportation strategies for older adults. Published by Elsevier Ltd.

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

Science.gov (United States)

Kurushima, Y; Silventoinen, K; Dokkedal, U; Skytthe, A; Mucci, L A; Christensen, K; Hjelmborg, J V B

2017-12-01

Tooth loss is a common health concern in older adults. We aimed to estimate the relative contributions of genetic and environmental factors to the variation in the number of teeth in middle-aged and older populations using a population-based cohort of Danish twins. The study included 5,269 Danish middle-aged or older twins who provided data on the number of teeth at baseline by structured interviews. The data were analyzed using univariate liability threshold modeling, stratified by sex and age, to estimate familial risk of tooth loss as well as estimates of heritability. In the whole cohorts, 23% of participants were edentate and 53% had retained 20 or more teeth. A statistical model including additive genetic factors and environmental factors partly shared by co-twins and partly unique to each individual twin gave the best statistical fit for the number of teeth in both age categories as well as in men and women. Overall, additive genetic factors explained 36% (95% confidence interval [CI]: 23% to 49%), common environmental factors 20% (95% CI: 9% to 31%), and unique environmental factors 44% (95% CI: 40% to 48%) of the total variation of the number of teeth. This study indicates that a substantial part of the variation in tooth loss is explained by genetic as well as environmental factors shared by co-twins. Our results implied that family background importantly affects tooth loss in both the middle-aged and the older populations. Family history is thus an important factor to take into account in dental health care.

Irrational ideas. Older vs. younger inpatients.

Science.gov (United States)

Hyer, L A; Jacobsen, R; Harrison, W R

1985-04-01

The relationship to age of irrational beliefs among psychiatric inpatients has not been explored using the rational-emotive model. This study addressed the following two questions: 1) Do older and younger psychiatric inpatients differ in irrational beliefs? 2) Do older depressives differ from older nondepressives in irrational beliefs? Upon admission to a large medical center, 58 younger (less than 45 years old) and 54 older (greater than 55 years old) subjects were assessed on a battery of psychological tests, including the Idea Inventory and the Beck Depression Inventory. Results showed that older and younger inpatients did not differ on irrational beliefs. Results also showed that older and younger groups of depressives did not differ on the irrationality scores. When a correlational analysis was used, depression was related to irrationality within the older group but not within the younger group.

Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey.

Science.gov (United States)

Doubova, Svetlana V; Pérez-Cuevas, Ricardo; Canning, David; Reich, Michael R

2015-07-21

While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). The study population comprised 18,847 older adults and 13,180 households that have an elderly member. The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (-8.1%, t-stat -2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET -11.3%, t-stat -3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET -1.9%, t-stat -2.178). Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant protective effect against lack of access and catastrophic expenditures compared with

Identification of fall risk factors in older adult emergency department patients.

Science.gov (United States)

Carpenter, Christopher R; Scheatzle, Mark D; D'Antonio, Joyce A; Ricci, Paul T; Coben, Jeffrey H

2009-03-01

Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6-month fall risk in community-dwelling older adults discharged from the emergency department (ED). This was a prospective observational study with a convenience sampling of noninstitutionalized elders presenting to an urban teaching hospital ED who did not require hospital admission. Interviews were conducted to determine the presence of fall risk factors previously described in non-ED populations. Subjects were followed monthly for 6 months through postcard or telephone contact to identify subsequent falls. Univariate and Cox regression analysis were used to determine the association of risk factors with 6-month fall incidence. A total of 263 patients completed the survey, and 161 (61%) completed the entire 6 months of follow-up. Among the 263 enrolled, 39% reported a fall in the preceding year, including 15% with more than one fall and 22% with injurious falls. Among those completing the 6 months of follow-up, 14% reported at least one fall. Cox regression analysis identified four factors associated with falls during the 6-month follow-up: nonhealing foot sores (hazard ratio [HR] = 3.71, 95% confidence interval [CI] = 1.73 to 7.95), a prior fall history (HR = 2.62, 95% CI = 1.32 to 5.18), inability to cut one's own toenails (HR = 2.04, 95% CI = 1.04 to 4.01), and self-reported depression (HR = 1.72, 95% CI = 0.83 to 3.55). Falls, recurrent falls, and injurious falls in community-dwelling elder ED patients being evaluated for non-fall-related complaints occur at least as frequently as in previously described outpatient cohorts. Nonhealing foot sores, self-reported depression, not clipping one's own toenails, and previous falls are all associated with falls after

Head Trauma from Falling Increases Subsequent Emergency Department Visits More Than Other Fall-Related Injuries in Older Adults.

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Southerland, Lauren T; Stephens, Julie A; Robinson, Shari; Falk, James; Phieffer, Laura; Rosenthal, Joseph A; Caterino, Jeffrey M

2016-04-01

To determine whether fall-related injuries affect return to the ED after the initial visit. Retrospective chart review. Academic Level 1 trauma center ED. Individuals aged 65 and older evaluated for a fall from standing height or less and discharged (N = 263, average age 77, 70% female). After institutional review board approval, electronic medical record data were queried. Univariate and multivariable logistic regression models were used to determine factors associated with risk of returning to the ED within 90 days. Injuries included fractures (45%, n = 117); head trauma (22%, n = 58); abrasions, lacerations, or contusions (34%, n = 88); and none (22%, n = 57). Emergency care was frequently required, with 13 (5%, 95% confidence interval (CI) = 2.3-7.6%) returning within 72 hours, 35 (13%, 95% CI = 9.2-17%] within 30 days, and 57 (22%, 95% CI = 17-27%) within 90 days. Univariately, the odds of returning to the ED within 90 days was more than two times as high for those with head trauma as for those without (odds ratio = 2.66). This remained significant in the multivariable model, which controlled for Charlson Comorbidity Index, fractures, soft tissue injuries, and ED observation unit use. More than one-third of older adults with minor head trauma from a fall will need to return to the ED in the following 90 days. These individuals should receive close attention from primary care providers. The link between minor head trauma and ED recidivism is a new finding. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

The evaluation of older patients with cervical cancer

Directory of Open Access Journals (Sweden)

Gao Y

2013-06-01

Full Text Available Ying Gao,1 Jin-lu Ma,1,* Fei Gao,2,* Li-ping Song11Department of Radiotherapy Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 2Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China *These authors contributed equally to this workObjective: The number of elderly patients being diagnosed with cervical cancer is increasing, and the outcome of cervical cancer related to age is controversial. We conducted a retrospective analysis in patients treated for advanced cervical cancer in order to investigate patient characteristics and prognosis of older patients.Methods: Medical records were collected of 159 patients with cervical cancer who had been treated with radiotherapy or combined radiotherapy and chemotherapy from January 2007 to January 2009. The patients were divided into two age groups: (1 patients ≥65 years old, and (2 patients <65 years old. There were 52 women in group 1, 107 in group 2. Prognosis, patient characteristics, treatment, and toxicities were evaluated.Results: With a median follow-up of 36.5 months, local control for groups 1 and 2 was 88.5% and 79.4%, respectively. Disease-free survival for the two groups was 71.2% and 67.3%; overall survival was 73.1% and 72.9%. As shown by univariate analyses, there was no statistically significant difference between the two groups (P > 0.05. Seventy-six patients had human papillomavirus (HPV at diagnosis (twelve women ≥65 years, 64 women ≤65 years; P = 0.000. Forty-two women tested positive for HPV 16, while 32 women tested positive for HPV 18 respectively. Pelvic and/or paraaortic lymph-node metastasis was found in 25 patients (eight in group 1, 17 in group 2; P = 0.960 on computed tomography scan. Of the 159 patients analyzed, sixteen patients (16/52 in group 1 received concurrent chemotherapy, while 96 (96/107 in group 2 completed that treatment.Conclusions: Cervical cancer has the same prognosis in old and

Global burden of road traffic accidents in older adults: A systematic review and meta-regression analysis.

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Ang, Boon Hong; Chen, Won Sun; Lee, Shaun Wen Huey

2017-09-01

This study aims to estimate the burden of road traffic accidents and death among older adults. A systematic literature review was conducted on 10 electronic databases for articles describing Road Traffic Accident(RTA) mortality in older adults until September 2016. A random-effects meta-regression analyses was conducted to estimate the pooled rates of road traffic accidents and death. A total 5018 studies were identified and 23 studies were included. Most of the reported older adults were aged between 60 and 74 years, with majority being male gender and sustained minor trauma due to Motor-Vehicle Collision (MVC). The overall pooled mortality rate was 14% (95% Confidence Interval, CI: 11%, 16%), with higher mortality rates in studies conducted in North America (15%, 95% CI: 12%, 18%) and older adults admitted to trauma centers (17%, 95% CI: 14%, 21%). Secondary analysis showed that the very elderly adults (aged >75years) and pedestrians had higher odds of mortality death (Odds Ratio, OR: 2.05, 95% CI: 1.25, 3.38; OR: 2.08, 95% CI: 1.63, 2.66, respectively). A new comprehensive trauma management guidelines tailored to older adults should be established in low and middle-income countries where such guidelines are still lacking. Copyright © 2017 Elsevier B.V. All rights reserved.

Volunteering by older adults and risk of mortality: a meta-analysis.

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Okun, Morris A; Yeung, Ellen WanHeung; Brown, Stephanie

2013-06-01

Organizational volunteering has been touted as an effective strategy for older adults to help themselves while helping others. Extending previous reviews, we carried out a meta-analysis of the relation between organizational volunteering by late-middle-aged and older adults (minimum age = 55 years old) and risk of mortality. We focused on unadjusted effect sizes (i.e., bivariate relations), adjusted effect sizes (i.e., controlling for other variables such as health), and interaction effect sizes (e.g., the joint effect of volunteering and religiosity). For unadjusted effect sizes, on average, volunteering reduced mortality risk by 47%, with a 95% confidence interval ranging from 38% to 55%. For adjusted effect sizes, on average, volunteering reduced mortality risk by 24%, with a 95% confidence interval ranging from 16% to 31%. For interaction effect sizes, we found preliminary support that as public religiosity increases, the inverse relation between volunteering and mortality risk becomes stronger. The discussion identifies several unresolved issues and directions for future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Modeling the potential risk factors of bovine viral diarrhea prevalence in Egypt using univariable and multivariable logistic regression analyses

Directory of Open Access Journals (Sweden)

Abdelfattah M. Selim

2018-03-01

Full Text Available Aim: The present cross-sectional study was conducted to determine the seroprevalence and potential risk factors associated with Bovine viral diarrhea virus (BVDV disease in cattle and buffaloes in Egypt, to model the potential risk factors associated with the disease using logistic regression (LR models, and to fit the best predictive model for the current data. Materials and Methods: A total of 740 blood samples were collected within November 2012-March 2013 from animals aged between 6 months and 3 years. The potential risk factors studied were species, age, sex, and herd location. All serum samples were examined with indirect ELIZA test for antibody detection. Data were analyzed with different statistical approaches such as Chi-square test, odds ratios (OR, univariable, and multivariable LR models. Results: Results revealed a non-significant association between being seropositive with BVDV and all risk factors, except for species of animal. Seroprevalence percentages were 40% and 23% for cattle and buffaloes, respectively. OR for all categories were close to one with the highest OR for cattle relative to buffaloes, which was 2.237. Likelihood ratio tests showed a significant drop of the -2LL from univariable LR to multivariable LR models. Conclusion: There was an evidence of high seroprevalence of BVDV among cattle as compared with buffaloes with the possibility of infection in different age groups of animals. In addition, multivariable LR model was proved to provide more information for association and prediction purposes relative to univariable LR models and Chi-square tests if we have more than one predictor.

Perceived stress and cognitive function in older adults: which aspect of perceived stress is important?

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Korten, Nicole C M; Comijs, Hannie C; Penninx, Brenda W J H; Deeg, Dorly J H

2017-04-01

Few studies examined the association between perceived stress and cognitive function in older adults. This study will examine which aspects of perceived stress especially impact cognitive function. Cross-sectional data of 1099 older adults between 64 and 100 years from the Longitudinal Aging Study Amsterdam were used. Perceived stress and its subscales perceived helplessness and perceived self-efficacy were measured with the Perceived Stress Scale. Cognitive function was assessed regarding memory, processing speed and executive function. Univariate and multivariate linear regression analyses were performed between the stress measures and the domains of cognitive function. Perceived stress was associated with worse processing speed, direct and delayed recall, semantic fluency and digit span backwards (range β = -0.10; -0.11; p cognitive function, also after adjustment for depressive symptoms or sense of mastery (range β = 0.10; 0.18; p cognitive functions. Perceived self-efficacy might be an important factor in reducing stress and the prevention of cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Sexual Homicide by Older Male Offenders.

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

2017-07-01

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

Childhood poverty and depressive symptoms for older adults in Mexico: a life-course analysis.

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Torres, Jacqueline M; Wong, Rebeca

2013-09-01

This study applies life-course theories of latent (direct), pathway (indirect) and conditional effects in an analysis of childhood poverty on later-life depressive symptoms among older adults in Mexico. Data are from the 2001 Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults born before 1951 (n = 8696). Respondents had a mean of 3.6 past-week depressive symptoms and 71% had no household sanitation facilities before age 10; this measure served as a proxy for childhood poverty. Childhood poverty is significantly related to scores on an adapted 9-item CES-D scale in the full model (b = 0.27, p Mexico's rapidly aging population as well as efforts for childhood poverty reduction and gains in education.

Childhood Poverty and Depressive Symptoms for Older Adults in Mexico: A Life-Course Analysis

Science.gov (United States)

Wong, Rebeca

2013-01-01

This study applies life-course theories of latent (direct), pathway (indirect) and conditional effects in an analysis of childhood poverty on later-life depressive symptoms among older adults in Mexico. Data are from the 2001 Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults born before 1951 (n=8696). Respondents had a mean of 3.6 past-week depressive symptoms and 71 % had no household sanitation facilities before age 10; this measure served as a proxy for childhood poverty. Childhood poverty is significantly related to scores on an adapted 9-item CES-D scale in the full model (b=0.27, pMexico’s rapidly aging population as well as efforts for childhood poverty reduction and gains in education. PMID:23783887

An exercise in model validation: Comparing univariate statistics and Monte Carlo-based multivariate statistics

International Nuclear Information System (INIS)

Weathers, J.B.; Luck, R.; Weathers, J.W.

2009-01-01

The complexity of mathematical models used by practicing engineers is increasing due to the growing availability of sophisticated mathematical modeling tools and ever-improving computational power. For this reason, the need to define a well-structured process for validating these models against experimental results has become a pressing issue in the engineering community. This validation process is partially characterized by the uncertainties associated with the modeling effort as well as the experimental results. The net impact of the uncertainties on the validation effort is assessed through the 'noise level of the validation procedure', which can be defined as an estimate of the 95% confidence uncertainty bounds for the comparison error between actual experimental results and model-based predictions of the same quantities of interest. Although general descriptions associated with the construction of the noise level using multivariate statistics exists in the literature, a detailed procedure outlining how to account for the systematic and random uncertainties is not available. In this paper, the methodology used to derive the covariance matrix associated with the multivariate normal pdf based on random and systematic uncertainties is examined, and a procedure used to estimate this covariance matrix using Monte Carlo analysis is presented. The covariance matrices are then used to construct approximate 95% confidence constant probability contours associated with comparison error results for a practical example. In addition, the example is used to show the drawbacks of using a first-order sensitivity analysis when nonlinear local sensitivity coefficients exist. Finally, the example is used to show the connection between the noise level of the validation exercise calculated using multivariate and univariate statistics.

An exercise in model validation: Comparing univariate statistics and Monte Carlo-based multivariate statistics

Energy Technology Data Exchange (ETDEWEB)

Weathers, J.B. [Shock, Noise, and Vibration Group, Northrop Grumman Shipbuilding, P.O. Box 149, Pascagoula, MS 39568 (United States)], E-mail: James.Weathers@ngc.com; Luck, R. [Department of Mechanical Engineering, Mississippi State University, 210 Carpenter Engineering Building, P.O. Box ME, Mississippi State, MS 39762-5925 (United States)], E-mail: Luck@me.msstate.edu; Weathers, J.W. [Structural Analysis Group, Northrop Grumman Shipbuilding, P.O. Box 149, Pascagoula, MS 39568 (United States)], E-mail: Jeffrey.Weathers@ngc.com

2009-11-15

The complexity of mathematical models used by practicing engineers is increasing due to the growing availability of sophisticated mathematical modeling tools and ever-improving computational power. For this reason, the need to define a well-structured process for validating these models against experimental results has become a pressing issue in the engineering community. This validation process is partially characterized by the uncertainties associated with the modeling effort as well as the experimental results. The net impact of the uncertainties on the validation effort is assessed through the 'noise level of the validation procedure', which can be defined as an estimate of the 95% confidence uncertainty bounds for the comparison error between actual experimental results and model-based predictions of the same quantities of interest. Although general descriptions associated with the construction of the noise level using multivariate statistics exists in the literature, a detailed procedure outlining how to account for the systematic and random uncertainties is not available. In this paper, the methodology used to derive the covariance matrix associated with the multivariate normal pdf based on random and systematic uncertainties is examined, and a procedure used to estimate this covariance matrix using Monte Carlo analysis is presented. The covariance matrices are then used to construct approximate 95% confidence constant probability contours associated with comparison error results for a practical example. In addition, the example is used to show the drawbacks of using a first-order sensitivity analysis when nonlinear local sensitivity coefficients exist. Finally, the example is used to show the connection between the noise level of the validation exercise calculated using multivariate and univariate statistics.

Evaluation of the efficiency of continuous wavelet transform as processing and preprocessing algorithm for resolution of overlapped signals in univariate and multivariate regression analyses; an application to ternary and quaternary mixtures

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Hegazy, Maha A.; Lotfy, Hayam M.; Mowaka, Shereen; Mohamed, Ekram Hany

2016-07-01

Wavelets have been adapted for a vast number of signal-processing applications due to the amount of information that can be extracted from a signal. In this work, a comparative study on the efficiency of continuous wavelet transform (CWT) as a signal processing tool in univariate regression and a pre-processing tool in multivariate analysis using partial least square (CWT-PLS) was conducted. These were applied to complex spectral signals of ternary and quaternary mixtures. CWT-PLS method succeeded in the simultaneous determination of a quaternary mixture of drotaverine (DRO), caffeine (CAF), paracetamol (PAR) and p-aminophenol (PAP, the major impurity of paracetamol). While, the univariate CWT failed to simultaneously determine the quaternary mixture components and was able to determine only PAR and PAP, the ternary mixtures of DRO, CAF, and PAR and CAF, PAR, and PAP. During the calculations of CWT, different wavelet families were tested. The univariate CWT method was validated according to the ICH guidelines. While for the development of the CWT-PLS model a calibration set was prepared by means of an orthogonal experimental design and their absorption spectra were recorded and processed by CWT. The CWT-PLS model was constructed by regression between the wavelet coefficients and concentration matrices and validation was performed by both cross validation and external validation sets. Both methods were successfully applied for determination of the studied drugs in pharmaceutical formulations.

Investigating univariate temporal patterns for intrinsic connectivity networks based on complexity and low-frequency oscillation: a test-retest reliability study.

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Wang, X; Jiao, Y; Tang, T; Wang, H; Lu, Z

2013-12-19

Intrinsic connectivity networks (ICNs) are composed of spatial components and time courses. The spatial components of ICNs were discovered with moderate-to-high reliability. So far as we know, few studies focused on the reliability of the temporal patterns for ICNs based their individual time courses. The goals of this study were twofold: to investigate the test-retest reliability of temporal patterns for ICNs, and to analyze these informative univariate metrics. Additionally, a correlation analysis was performed to enhance interpretability. Our study included three datasets: (a) short- and long-term scans, (b) multi-band echo-planar imaging (mEPI), and (c) eyes open or closed. Using dual regression, we obtained the time courses of ICNs for each subject. To produce temporal patterns for ICNs, we applied two categories of univariate metrics: network-wise complexity and network-wise low-frequency oscillation. Furthermore, we validated the test-retest reliability for each metric. The network-wise temporal patterns for most ICNs (especially for default mode network, DMN) exhibited moderate-to-high reliability and reproducibility under different scan conditions. Network-wise complexity for DMN exhibited fair reliability (ICC<0.5) based on eyes-closed sessions. Specially, our results supported that mEPI could be a useful method with high reliability and reproducibility. In addition, these temporal patterns were with physiological meanings, and certain temporal patterns were correlated to the node strength of the corresponding ICN. Overall, network-wise temporal patterns of ICNs were reliable and informative and could be complementary to spatial patterns of ICNs for further study. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Robust assignment of cancer subtypes from expression data using a uni-variate gene expression average as classifier

International Nuclear Information System (INIS)

Lauss, Martin; Frigyesi, Attila; Ryden, Tobias; Höglund, Mattias

2010-01-01

Genome wide gene expression data is a rich source for the identification of gene signatures suitable for clinical purposes and a number of statistical algorithms have been described for both identification and evaluation of such signatures. Some employed algorithms are fairly complex and hence sensitive to over-fitting whereas others are more simple and straight forward. Here we present a new type of simple algorithm based on ROC analysis and the use of metagenes that we believe will be a good complement to existing algorithms. The basis for the proposed approach is the use of metagenes, instead of collections of individual genes, and a feature selection using AUC values obtained by ROC analysis. Each gene in a data set is assigned an AUC value relative to the tumor class under investigation and the genes are ranked according to these values. Metagenes are then formed by calculating the mean expression level for an increasing number of ranked genes, and the metagene expression value that optimally discriminates tumor classes in the training set is used for classification of new samples. The performance of the metagene is then evaluated using LOOCV and balanced accuracies. We show that the simple uni-variate gene expression average algorithm performs as well as several alternative algorithms such as discriminant analysis and the more complex approaches such as SVM and neural networks. The R package rocc is freely available at http://cran.r-project.org/web/packages/rocc/index.html

Influence of microclimatic ammonia levels on productive performance of different broilers' breeds estimated with univariate and multivariate approaches.

Science.gov (United States)

Soliman, Essam S; Moawed, Sherif A; Hassan, Rania A

2017-08-01

Birds litter contains unutilized nitrogen in the form of uric acid that is converted into ammonia; a fact that does not only affect poultry performance but also has a negative effect on people's health around the farm and contributes in the environmental degradation. The influence of microclimatic ammonia emissions on Ross and Hubbard broilers reared in different housing systems at two consecutive seasons (fall and winter) was evaluated using a discriminant function analysis to differentiate between Ross and Hubbard breeds. A total number of 400 air samples were collected and analyzed for ammonia levels during the experimental period. Data were analyzed using univariate and multivariate statistical methods. Ammonia levels were significantly higher (p0.05) were found between the two farms in body weight, body weight gain, feed intake, feed conversion ratio, and performance index (PI) of broilers. Body weight; weight gain and PI had increased values (pbroiler breed. Ammonia emissions were positively (although weekly) correlated with the ambient relative humidity (r=0.383; p0.05). Test of significance of discriminant function analysis did not show a classification based on the studied traits suggesting that they cannot been used as predictor variables. The percentage of correct classification was 52% and it was improved after deletion of highly correlated traits to 57%. The study revealed that broiler's growth was negatively affected by increased microclimatic ammonia concentrations and recommended the analysis of broilers' growth performance parameters data using multivariate discriminant function analysis.

An Activation Likelihood Estimation Meta-Analysis Study of Simple Motor Movements in Older and Young Adults

Science.gov (United States)

Turesky, Ted K.; Turkeltaub, Peter E.; Eden, Guinevere F.

2016-01-01

The functional neuroanatomy of finger movements has been characterized with neuroimaging in young adults. However, less is known about the aging motor system. Several studies have contrasted movement-related activity in older versus young adults, but there is inconsistency among their findings. To address this, we conducted an activation likelihood estimation (ALE) meta-analysis on within-group data from older adults and young adults performing regularly paced right-hand finger movement tasks in response to external stimuli. We hypothesized that older adults would show a greater likelihood of activation in right cortical motor areas (i.e., ipsilateral to the side of movement) compared to young adults. ALE maps were examined for conjunction and between-group differences. Older adults showed overlapping likelihoods of activation with young adults in left primary sensorimotor cortex (SM1), bilateral supplementary motor area, bilateral insula, left thalamus, and right anterior cerebellum. Their ALE map differed from that of the young adults in right SM1 (extending into dorsal premotor cortex), right supramarginal gyrus, medial premotor cortex, and right posterior cerebellum. The finding that older adults uniquely use ipsilateral regions for right-hand finger movements and show age-dependent modulations in regions recruited by both age groups provides a foundation by which to understand age-related motor decline and motor disorders. PMID:27799910

The clinical identification of peripheral neuropathy among older persons.

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Richardson, James K

2002-11-01

To identify simple clinical rules for the detection of a diffuse peripheral neuropathy among older outpatients. Observational, blinded, controlled study. A tertiary-care electrodiagnostic laboratory and biomechanics laboratory. One hundred research subjects, 68 with electrodiagnostic evidence of peripheral neuropathy, between the ages of 50 and 80 years. Not applicable. One examiner, unaware of the results of electrodiagnostic testing, evaluated Achilles' and patellar reflexes, Romberg testing, semiquantified vibration, and position sense at the toe and ankle in all subjects, and unipedal stance time and the Michigan Diabetes Neuropathy Score in a subset of subjects. Significant group differences were present in all clinical measures tested. Three signs, Achilles' reflex (absent despite facilitation), vibration (128Hz tuning fork perceived for <10s), and position sense (<8/10 1-cm trials) at the toe, were the best predictors of peripheral neuropathy on both univariate and logistic regression (pseudo R(2)=.744) analyses. The presence of 2 or 3 signs versus 0 or 1 sign identified peripheral neuropathy with sensitivity, specificity, and positive and negative predictive values of 94.1%, 84.4%, 92.8%, and 87.1%, respectively. Values were similar among subgroups of subjects with and without diabetes mellitus. When other clinicians applied the technique to 12 more subjects, excellent interrater reliability regarding the presence of peripheral neuropathy (kappa=.833) and good to excellent interrater reliability for each sign (kappa range,.667-1.00) were shown. Among older persons, the presence of 2 or 3 of the 3 clinical signs strongly suggested electrodiagnostic evidence of a peripheral neuropathy, regardless of etiology. Age-related decline in peripheral nerve function need not be a barrier to the clinical recognition of a diffuse peripheral neuropathy among older persons. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of

Perceptions of exercise screening among older adults.

Science.gov (United States)

Stathokostas, Liza; Petrella, Andrea F M; Blunt, Wendy; Petrella, Robert J

2018-06-01

Prephysical activity screening is important for older adults' participating in physical activity. Unfortunately, many older adults face barriers to exercise participation and thus, may not complete proper physical activity screening. The purpose of this project was to conduct a thematic analysis of perceptions and experiences of community-dwelling older adults regarding prephysical activity screening (i.e., Get Active Questionnaire (GAQ) and a standardized exercise stress test). A convenience sample of adults (male n = 58, female n = 54) aged 75 ± 7 years living in the City of London, Ontario, Canada, was used. Participants completed a treadmill stress test and the GAQ at a research laboratory for community-based referrals. One week later, participants completed the GAQ again and were asked questions by a research assistant about their perceptions of the screening process. Thematic analysis of the responses was conducted. The results indicated that older adults view physical activity screening as acceptable, but not always necessary. Also, the experiences expressed by this sample of older adults indicated that physical activity screening can contribute to continued confidence (through reassurance) and can contribute to increased motivation (through yearly fitness results) in exercise participation. In conclusion, older adults may perceive screening as supportive in exercise adoption, if screening is simple, convenient, and supports older adults' motivation and confidence to exercise.

Survival benefit of radiotherapy to patients with small cell esophagus carcinoma: an analysis of Surveillance Epidemiology and End Results (SEER) data.

Science.gov (United States)

Song, Yaqi; Wang, Wanwei; Tao, Guangzhou; Zhu, Weiguo; Zhou, Xilei; Pan, Peng

2016-03-29

Small cell esophageal carcinoma (SCEC) is a rare malignant tumor. So far, few studies are found to research the effect of radiotherapy (RT) to it. This study is designed to explore the prognostic factors, and analyze survival benefit of RT to patients with SCEC. Patients with SCEC were more likely to be in female, older, higher disease stage than those with non-small cell esophageal carcinoma. RT was used in more than 50% SCEC patients. RT tended be reduced as the disease stage raise in SCEC. Univariate and multivariate analysis showed that age, year, disease stage, and RT were the prognostic factors of survival (P 0.05) and nearly 30% risks of death in distant stage (P > 0.05). SCEC patients between 1973 and 2012 were searched from the Surveillance Epidemiology and End Results (SEER) data. Clinical factors including age, year, sex, race, stage, surgery, and RT were summarized. Univariate and multivariate analysis were performed to explore the independent prognostic factors of SCEC. Cox regression survival analysis was performed to evaluate the effect of RT to SCEC based on different stages. Stage, age, year, and RT are independent prognostic factors of SCEC. Survival benefit of RT exists in any disease stage, but is only statistically significant in localized stage of SCEC.

Univariate time series modeling and an application to future claims amount in SOCSO's invalidity pension scheme

Science.gov (United States)

Chek, Mohd Zaki Awang; Ahmad, Abu Bakar; Ridzwan, Ahmad Nur Azam Ahmad; Jelas, Imran Md.; Jamal, Nur Faezah; Ismail, Isma Liana; Zulkifli, Faiz; Noor, Syamsul Ikram Mohd

2012-09-01

The main objective of this study is to forecast the future claims amount of Invalidity Pension Scheme (IPS). All data were derived from SOCSO annual reports from year 1972 - 2010. These claims consist of all claims amount from 7 benefits offered by SOCSO such as Invalidity Pension, Invalidity Grant, Survivors Pension, Constant Attendance Allowance, Rehabilitation, Funeral and Education. Prediction of future claims of Invalidity Pension Scheme will be made using Univariate Forecasting Models to predict the future claims among workforce in Malaysia.

Powerlessness of older people in Hong Kong: a political economy analysis.

Science.gov (United States)

Kam, Ping-kwong

2003-01-01

Gerontologists agree that old age can be associated with an increase in powerlessness both in the personal domain and in the social and political fields. This paper is an attempt to understand the concept of powerlessness in old age within a political economy theoretical framework. The paper argues that the powerlessness of older people is not biologically determined. Rather, it is socially constructed. It has its roots in the social, economic, and political structure of society. For this reason, the paper argues that (a) the capitalist economic system discriminates against and marginalizes older people in the labor market. The current unfavorable economic climate will make the economic situation of older people worse. (b) The residual welfare system does not counteract the unfavorable impact of the economic system. Rather, it deprives older people of the necessary financial resources and social service supports that would enable them to lead independent and dignified lives. (c) The authoritarian political system creates adverse conditions that make it very difficult for older people to participate in the decision-making process on issues that affect their lives, as well as on broader political issues that affect the whole of society. It is the interplay among these economic, social, and political forces in Hong Kong that creates the political economy of powerlessness in old age and prevents older people from using their powers to master and control their lives.

The portrayal of older people in television advertisements: a cross-cultural content analysis of the United States and South Korea.

Science.gov (United States)

Lee, Oungkwan; Kim, Bong-Chul; Han, Sangpil

2006-01-01

A cross-cultural content analysis of 2295 prime-time television ads--859 ads from the United States and 1436 ads from South Korea-was conducted to examine the differences in the portrayal of older people between U.S. and Korean ads. In two countries, the underrepresentation of older people in ads was found in terms of proportions of the actual population. The findings also showed that older people are more likely to play major roles in Korean television ads than in U.S. ads. In terms of the attributes of older people depicted in ads, differences between U.S. and Korean ads were also found. The results showed that Korean television ads are likely to more positively depict older people than American television ads are. These findings supported the basic assumption of cross-cultural advertising, in which the differences in cultural values between the two cultures are related to the differences in the contents of their advertisements. However, the problems of underrepresentation and stereotypes in the portrayal of older people were still identified both in Korean and U.S. prime-time television ads.

The relation between social network site usage and loneliness and mental health in community-dwelling older adults.

Science.gov (United States)

Aarts, S; Peek, S T M; Wouters, E J M

2015-09-01

Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults. Copyright © 2014 John Wiley & Sons, Ltd.

Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.

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Kojima, Gotaro

2015-12-01

Although multiple longitudinal studies have investigated frailty as a predictor of future falls, the results were mixed. Thus far, no systematic review or meta-analysis on this topic has been conducted. To review the evidence of frailty as a predictor of future falls among community-dwelling older people. Systematic review of literature and meta-analysis were performed using 6 electronic databases (Embase, Scopus, MEDLINE, CINAHL Plus, PsycINFO, and the Cochrane Library) searching for studies that prospectively examined risk of future fall risk according to frailty among community-dwelling older people published from 2010 to April 2015 with no language restrictions. Of 2245 studies identified through the systematic review, 11 studies incorporating 68,723 individuals were included in the meta-analysis. Among 7 studies reporting odds ratios (ORs), frailty and prefrailty were significantly associated with higher risk of future falls (pooled OR = 1.84, 95% confidence interval [95% CI] = 1.43-2.38, P dwelling older people despite various criteria used to define frailty. The future fall risk according to frailty seemed to be higher in men than in women. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Fall predictors in older cancer patients: a multicenter prospective study.

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

2014-12-15

In the older population falls are a common problem and a major cause of morbidity, mortality and functional decline. The etiology is often multifactorial making the identification of fall predictors essential for preventive measures. Despite this knowledge, data on falls within the older cancer population are limited. The objective of this study was to evaluate the occurrence of falls within 2 to 3 months after cancer treatment decision and to identify predictors of falls (≥1 fall) during follow-up. Older patients (70 years or more) with a cancer treatment decision were included. At baseline, all patients underwent geriatric screening (G8 and Flemish Triage Risk Screening Tool), followed by a geriatric assessment including living situation, activities of daily living (ADL), instrumental activities of daily living (IADL), fall history in the past 12 months, fatigue, cognition, depression, nutrition, comorbidities and polypharmacy. Questionnaires were used to collect follow-up (2-3 months) data. Univariate and multivariate analyses were performed to identify predictors for falls (≥1 fall) during follow-up. At baseline, 295 (31.5%) of 937 included patients reported at least one fall in the past 12 months with 88 patients (29.5%) sustaining a major injury. During follow-up (2-3 months), 142 (17.6%) patients fell, of whom 51.4% fell recurrently and 17.6% reported a major injury. Baseline fall history in the past 12 months (OR = 3.926), fatigue (OR = 0.380), ADL dependency (OR = 0.492), geriatric risk profile by G8 (OR = 0.471) and living alone (OR = 1.631) were independent predictors of falls (≥1 fall) within 2-3 months after cancer treatment decision. Falls are a serious problem among older cancer patients. Geriatric screening and assessment data can identify patients at risk for a fall. A patient with risk factors associated with falls should undergo further evaluation and intervention to prevent potentially injurious fall incidents.

Univariate Lp and ɭ p Averaging, 0 < p < 1, in Polynomial Time by Utilization of Statistical Structure

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John E. Lavery

2012-10-01

Full Text Available We present evidence that one can calculate generically combinatorially expensive Lp and lp averages, 0 < p < 1, in polynomial time by restricting the data to come from a wide class of statistical distributions. Our approach differs from the approaches in the previous literature, which are based on a priori sparsity requirements or on accepting a local minimum as a replacement for a global minimum. The functionals by which Lp averages are calculated are not convex but are radially monotonic and the functionals by which lp averages are calculated are nearly so, which are the keys to solvability in polynomial time. Analytical results for symmetric, radially monotonic univariate distributions are presented. An algorithm for univariate lp averaging is presented. Computational results for a Gaussian distribution, a class of symmetric heavy-tailed distributions and a class of asymmetric heavy-tailed distributions are presented. Many phenomena in human-based areas are increasingly known to be represented by data that have large numbers of outliers and belong to very heavy-tailed distributions. When tails of distributions are so heavy that even medians (L1 and l1 averages do not exist, one needs to consider using lp minimization principles with 0 < p < 1.

Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis.

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Cotten, Shelia R; Anderson, William A; McCullough, Brandi M

2013-02-28

Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults. The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction. One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60). After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores (P=.005). Going online was not associated with perceived social isolation (P=.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people (b=0.508, PInternet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities.

The Portrayal of Older People in Television Advertisements: A Cross-Cultural Content Analysis of the United States and South Korea

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Lee, Byoungkwan; Kim, Bong-Chul; Han, Sangpil

2006-01-01

A cross-cultural content analysis of 2,295 prime-time television ads--859 ads from the United States and 1,436 ads from South Korea--was conducted to examine the differences in the portrayal of older people between U.S. and Korean ads. In two countries, the underrepresentation of older people in ads was found in terms of proportions of the actual…

Measuring situational avoidance in older drivers: An application of Rasch analysis.

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Davis, Jessica; Conlon, Elizabeth; Ownsworth, Tamara; Morrissey, Shirley

2016-02-01

Situational avoidance is a form of driving self-regulation at the strategic level of driving behaviour. It has typically been defined as the purposeful avoidance of driving situations perceived as challenging or potentially hazardous. To date, assessment of the psychometric properties of existing scales that measure situational avoidance has been sparse. This study examined the contribution of Rasch analysis to the situational avoidance construct. Three hundred and ninety-nine Australian drivers (M=66.75, SD=10.14, range: 48-91 years) completed the Situational Avoidance Questionnaire (SAQ). Following removal of the item Parallel Parking, the scale conformed to a Rasch model, showing good person separation, sufficient reliability, little disordering of thresholds, and no evidence of differential item functioning by age or gender. The residuals were independent supporting the assumption of unidimensionality and in conforming to a Rasch model, SAQ items were found to be hierarchical or cumulative. Increased avoidance was associated with factors known to be related to driving self-regulation more broadly, including older age, female gender, reduced driving space and frequency, reporting a change in driving in the past five years and poorer indices of health (i.e., self-rated mood, vision and cognitive function). Overall, these results support the use of the SAQ as a psychometrically sound measure of situational avoidance. Application of Rasch analysis to this area of research advances understanding of the driving self-regulation construct and its practice by drivers in baby boomer and older adult generations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Detection of biomarkers for Hepatocellular Carcinoma using a hybrid univariate gene selection methods

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Abdel Samee Nagwan M

2012-08-01

Full Text Available Abstract Background Discovering new biomarkers has a great role in improving early diagnosis of Hepatocellular carcinoma (HCC. The experimental determination of biomarkers needs a lot of time and money. This motivates this work to use in-silico prediction of biomarkers to reduce the number of experiments required for detecting new ones. This is achieved by extracting the most representative genes in microarrays of HCC. Results In this work, we provide a method for extracting the differential expressed genes, up regulated ones, that can be considered candidate biomarkers in high throughput microarrays of HCC. We examine the power of several gene selection methods (such as Pearson’s correlation coefficient, Cosine coefficient, Euclidean distance, Mutual information and Entropy with different estimators in selecting informative genes. A biological interpretation of the highly ranked genes is done using KEGG (Kyoto Encyclopedia of Genes and Genomes pathways, ENTREZ and DAVID (Database for Annotation, Visualization, and Integrated Discovery databases. The top ten genes selected using Pearson’s correlation coefficient and Cosine coefficient contained six genes that have been implicated in cancer (often multiple cancers genesis in previous studies. A fewer number of genes were obtained by the other methods (4 genes using Mutual information, 3genes using Euclidean distance and only one gene using Entropy. A better result was obtained by the utilization of a hybrid approach based on intersecting the highly ranked genes in the output of all investigated methods. This hybrid combination yielded seven genes (2 genes for HCC and 5 genes in different types of cancer in the top ten genes of the list of intersected genes. Conclusions To strengthen the effectiveness of the univariate selection methods, we propose a hybrid approach by intersecting several of these methods in a cascaded manner. This approach surpasses all of univariate selection methods when

Sleep Duration and Patterns in Chinese Older Adults: a Comprehensive Meta-analysis.

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Lu, Li; Wang, Shi-Bin; Rao, Wen-Wang; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Zhang, Juan; Kou, Changgui; Jia, Fu-Jun; Xiang, Yu-Tao

2017-01-01

This meta-analysis examined the mean sleep duration and patterns in Chinese older adult population. A literature search was systematically conducted covering major English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure (CNKI), WanFang and SinoMed) databases. Data in studies with the mean and standard deviation of sleep duration and/or the proportion of short and long sleep durations in Chinese older adults were extracted and pooled using random-effects models. Subgroup analyses were conducted according to gender, region, area, survey time and sample size. A total of 36 studies with 150,616 subjects were included for analyses. The pooled mean sleep duration of 21 studies with available data was 6.82 hours/day (95% CI: 6.59-7.05 hours/day). The estimated proportions of sleep duration 8 hours/day) and 17.6% (95% CI: 12.4%-22.9%) (>9 hours/day). Given the adverse effects of unhealthy sleep patterns, health professionals should pay more attention to sleep patterns in this population in China.

An analysis on older driver's driving behavior by GPS tracking data: Road selection, left/right turn, and driving speed

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Yanning Zhao

2018-02-01

Full Text Available With the high older-related accident ratio and increasing population aging problem, understanding older drivers' driving behaviors has become more and more important for building and improving transportation system. This paper examines older driver's driving behavior which includes road selection, left/right turn and driving speed. A two-month experiment of 108 participants was carried out in Aichi Prefecture, Japan. Since apparently contradictory statements were often drawn in survey-based or simulators-based studies, this study collected not only drivers' basic information but also GPS data. Analysis of road selection demonstrates that older drivers are reluctant to drive on expressway not only in short trips but also in long trips. The present study did not find significant difference between older drivers and others while turning at the intersections. To investigate the impact factors on driving speed, a random-effects regression model is constructed with explanatory variables including age, gender, road types and the interaction terms between age and road types. Compared with other variables, it fails to find that age (60 years old or over has significant impact on driving speed. Moreover, the results reflect that older drivers drive even faster than others at particular road types: national road and ordinary municipal road. The results in this study are expected to help improve transportation planning and develop driving assistance systems for older drivers.

Acupoint Massage for Managing Cognitive Alterations in Older Adults: A Systematic Review and Meta-Analysis.

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Liu, Fang; Shen, Cuiling; Yao, Liqun; Li, Zhuangmiao

2018-06-01

Cognitive disorders pose a major problem in the aging population across the globe. Acupoint massage has been used to improve cognitive functions in older adults. In this study, the authors performed a meta-analysis to evaluate the usefulness of acupoint massage in preventing cognitive declines in older adults. The authors searched for randomized controlled trials (RCTs) reporting on the effectiveness of acupoint massage on cognition in older adults in the following literature databases: PubMed, MEDLINE, Embase, CINAHL, ScienceDirect, Foreign Medical Journal Service, Cochrane Library, VIP Information, Chinese National Knowledge Infrastructure, WANFANG, and Chinese Biomedical. Two reviewers independently extracted the data related to the study and participants' characteristics and the cognitive impairment outcomes. Only RCTs meeting the inclusion criteria were used in the present meta-analysis. Eight RCTs with 657 participants in total (age ≥60 years) were included. It is actually 8 for synthetic and 6 in the meta-analysis. The authors calculated the pooled estimates of the random effects of changes in the Mini-Mental State Examination to compare the groups with and without acupoint massage. The merged mean difference (MD) was 1.94 (95% confidence interval, C.I., [1.41-2.47], p < 0.00001) after 3 months of acupoint massage treatment and 3.04 (95% C.I. [2.43-3.64], p < 0.00001) after 6 months of treatment. They also calculated the merged MD of the Wechsler Memory Scale-Revised Chinese version after 6 months of acupoint massage. Visual Reproduction was 2.95 (95% C.I. [1.30-4.60], p = 0.0005), Associate Learning was 1.89 (95% C.I. [1.41-2.37], p < 0.00001), Logical Memory was 2.85 (95% C.I. [2.06-3.63], p < 0.00001), and Digit Span was 3.16 (95% C.I. [2.59-3.73], p < 0.00001). The Cochrane Handbook for Systematic Reviews of Interventions was used to rate the quality of the studies, which was moderate overall. The findings suggested that

Influence of microclimatic ammonia levels on productive performance of different broilers’ breeds estimated with univariate and multivariate approaches

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Soliman, Essam S.; Moawed, Sherif A.; Hassan, Rania A.

2017-01-01

Background and Aim: Birds litter contains unutilized nitrogen in the form of uric acid that is converted into ammonia; a fact that does not only affect poultry performance but also has a negative effect on people’s health around the farm and contributes in the environmental degradation. The influence of microclimatic ammonia emissions on Ross and Hubbard broilers reared in different housing systems at two consecutive seasons (fall and winter) was evaluated using a discriminant function analysis to differentiate between Ross and Hubbard breeds. Materials and Methods: A total number of 400 air samples were collected and analyzed for ammonia levels during the experimental period. Data were analyzed using univariate and multivariate statistical methods. Results: Ammonia levels were significantly higher (p0.05) were found between the two farms in body weight, body weight gain, feed intake, feed conversion ratio, and performance index (PI) of broilers. Body weight; weight gain and PI had increased values (pbroiler breed. Ammonia emissions were positively (although weekly) correlated with the ambient relative humidity (r=0.383; p0.05). Test of significance of discriminant function analysis did not show a classification based on the studied traits suggesting that they cannot been used as predictor variables. The percentage of correct classification was 52% and it was improved after deletion of highly correlated traits to 57%. Conclusion: The study revealed that broiler’s growth was negatively affected by increased microclimatic ammonia concentrations and recommended the analysis of broilers’ growth performance parameters data using multivariate discriminant function analysis. PMID:28919677

Clinical differences between younger and older adults with HIV/AIDS starting antiretroviral therapy in Uganda and Zimbabwe: a secondary analysis of the DART trial.

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Sujal M Parikh

Full Text Available Clinical and immunological data about HIV in older adults from low and middle income countries is scarce. We aimed to describe differences between younger and older adults with HIV starting antiretroviral therapy in two low-income African countries.HIV clinics in Uganda and Zimbabwe.Secondary exploratory cross-sectional analysis of the DART randomized controlled trial.Clinical and laboratory characteristics were compared between adults aged 18-49 years (younger and ≥ 50 years (older, using two exploratory multivariable logistic regression models, one with HIV viral load (measured in a subset pre-ART and one without.A total of 3316 eligible participants enrolled in DART were available for analysis; 219 (7% were ≥ 50 years and 1160 (35% were male. Across the two adjusted regression models, older adults had significantly higher systolic blood pressure, lower creatinine clearance and were consistently less likely to be females compared to younger adults with HIV. Paradoxically, the models separately suggested that older adults had statistically significant (but not clinically important higher CD4+ cell counts and higher plasma HIV-1 viral copies at initiation. Crude associations between older age and higher baseline hemoglobin, body mass index, diastolic blood pressure and lower WHO clinical stage were not sustained in the adjusted analysis.Our study found clinical and immunological differences between younger and older adults, in a cohort of Africans starting antiretroviral therapy. Further investigations should explore how these differences could be used to ensure equity in service delivery and affect outcomes of antiretroviral therapy.

Prognosis for medically treated elderly patients with coronary artery disease. Analysis by the cox model

International Nuclear Information System (INIS)

Furuno, Takashi; Yamasaki, Fumiyasu; Yabe, Toshikazu; Matsumura, Yoshihisa; Kitaoka, Hiroaki; Doi, Yoshinori

1997-01-01

The prognostic importance of age among well-known prognostic factors such as extent of coronary artery lesions, cardiac function, and myocardial ischemia was evaluated in 147 elderly patients with coronary artery disease aged 65 years or older who underwent dipyridamole perfusion scintigraphy and coronary angiography. After excluding 32 patients who initially underwent percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG), 115 patients who were initially treated medically were analysed by the Cox model for cardiac events during a mean follow-up period of 29±22 months. Among the 114 patients who were available for follow-up, nine patients (7.9%) had cardiac events, including five cardiac deaths and four non-fatal cardiac events (requiring PTCA or CABG). When the 114 patients were divided into three age-groups; 53 patients aged 65-69 years, 42 aged 70-74 years and 19 aged 75 years or older, the incidence of cardiac death was highest in those aged 75 years or older. Univariate analysis showed that age of 70 years or older (hazards ratio 15.15, p=0.004), scintigraphic diffuse slow washout (hazards ratio 8.77, p=0.002), and triple-vessel or left main trunk disease (hazards ratio 6.36, p=0.05) were important prognostic factors. Multivariate analysis showed that scintigraphic diffuse slow washout (hazards ratio 6.33, p=0.05), and triple-vessel or left main trunk disease (hazards ratio 11.94 p=0.05) were statistically significant as independent prognostic factors. However, when age of 70 years or older was included in the analysis, it showed higher hazards ratio (21.21, p=0.03) than that of scintigraphic diffuse slow washout (7.36) or triple-vessel or left main trunk disease (5.30). Age of 70 years or older may be a significant prognostic factor in elderly patients with coronary artery disease which has an equivalent importance to the extent of coronary lesions. (author)

[Analysis of the characteristics of the older adults with depression using data mining decision tree analysis].

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Park, Myonghwa; Choi, Sora; Shin, A Mi; Koo, Chul Hoi

2013-02-01

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Having Older Siblings Is Associated with Lower Rates of Depression, ADD/ADHD, Anxiety and Behavior Problems Among Children with ASD.

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Montes, Guillermo

2018-05-01

Objective Within the social determinants of mental health framework, this article investigated whether children with ASD who have older siblings are less likely to experience depression, anxiety, behavior problems or have ADD/ADHD after controlling for standard social determinants of mental health such as household income, parental education and adverse childhood experiences (ACEs). Methods Using the National Survey of Children's Health 2011-2012, children with ASD spectrum disorders (n = 1624) were categorized into three groups: only child, oldest child and has older siblings. Design corrected cross-tabulations, univariate and multivariate logistic regressions were estimated. Results The three groups of children with ASD were comparable in demographic characteristics (except age), ACEs, and parent-reported ASD severity. Children with ASD who had older siblings were significantly less likely to experience depression, anxiety or behavior problems. They were also less likely to have been diagnosed with ADD or ADHD. Adjusted odds ratios ranged from 0.12 to 0.53 indicating robust associations. Conclusions for Practice Children with ASD who have older siblings were less likely to have comorbid mental health disorders than other children with ASD. Conversely, oldest and only children with ASD were at increased risk for these disorders. Further research is needed to understand how this protection is conferred on children with ASD, and whether it can be adapted into interventions for only and oldest children with ASD.

Cross-Sectional Analysis of Neurocognitive Function, Retinopathy, and Retinal Thinning by Spectral-Domain Optical Coherence Tomography in Sickle Cell Patients.

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Oltra, Erica Z; Chow, Clement C; Wubben, Thomas; Lim, Jennifer I; Chau, Felix Y; Moss, Heather E

2016-01-01

The purpose was to examine the relationship between neurocognitive function and two distinct forms of retinopathy in sickle cell disease. Patients with sickle cell disease (n = 44, age range: 19-56 years, 70% female) were prospectively recruited for this cross-sectional study. Retinopathy was characterized by: (1) Presence of focal retinal thinning on spectral domain optical coherence tomography and (2) determination of the sickle retinopathy stage on funduscopic exam based on Goldberg classification. Neurocognitive function was assessed using the Philadelphia Brief Assessment of Cognition (PBAC), a validated test of cognition. Univariate and multivariate analyses for PBAC score outcomes were performed. Retinal thinning and retinopathy stage were primary variables of interest and age, gender, genotype, education, and history of stroke were covariates. Univariate analysis revealed associations with total PBAC score and age (P = 0.049), history of stroke (P = 0.04), and genotype (P retinopathy stage were not associated with each other in this sample. Neither the presence of focal retinal thinning nor degree of retinopathy was associated with total PBAC score in univariate or multivariate analyses. We find an association between lower cognitive function and older age, history of stroke and sickle cell genotype SS in patients with sickle cell disease. Our data do not provide evidence to support an association between cognitive function and retinopathy in sickle cell patients.

A Review of Smart House Analysis Methods for Assisting Older People Living Alone

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Veralia Gabriela Sanchez

2017-07-01

Full Text Available Smart Houses are a prominent field of research referring to environments adapted to assist people in their everyday life. Older people and people with disabilities would benefit the most from the use of Smart Houses because they provide the opportunity for them to stay in their home for as long as possible. In this review, the developments achieved in the field of Smart Houses for the last 16 years are described. The concept of Smart Houses, the most used analysis methods, and current challenges in Smart Houses are presented. A brief introduction of the analysis methods is given, and their implementation is also reported.

Becoming an Older Volunteer: A Grounded Theory Study

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Witucki Brown, Janet; Chen, Shu-li; Mefford, Linda; Brown, Allie; Callen, Bonnie; McArthur, Polly

2011-01-01

This Grounded Theory study describes the process by which older persons “become” volunteers. Forty interviews of older persons who volunteered for Habitat for Humanity were subjected to secondary content analysis to uncover the process of “becoming” a volunteer. “Helping out” (core category) for older volunteers occurs within the context of “continuity”, “commitment” and “connection” which provide motivation for volunteering. When a need arises, older volunteers “help out” physically and financially as health and resources permit. Benefits described as “blessings” of volunteering become motivators for future volunteering. Findings suggest that older volunteering is a developmental process and learned behavior which should be fostered in older persons by personally inviting them to volunteer. Intergenerational volunteering projects will allow older persons to pass on knowledge and skills and provide positive role modeling for younger volunteers. PMID:21994824

Becoming an Older Volunteer: A Grounded Theory Study

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Janet Witucki Brown

2011-01-01

Full Text Available This Grounded Theory study describes the process by which older persons “become” volunteers. Forty interviews of older persons who volunteered for Habitat for Humanity were subjected to secondary content analysis to uncover the process of “becoming” a volunteer. “Helping out” (core category for older volunteers occurs within the context of “continuity”, “commitment” and “connection” which provide motivation for volunteering. When a need arises, older volunteers “help out” physically and financially as health and resources permit. Benefits described as “blessings” of volunteering become motivators for future volunteering. Findings suggest that older volunteering is a developmental process and learned behavior which should be fostered in older persons by personally inviting them to volunteer. Intergenerational volunteering projects will allow older persons to pass on knowledge and skills and provide positive role modeling for younger volunteers.

Leadership in physical activity groups for older adults: a qualitative analysis.

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Estabrooks, Paul A; Munroe, Krista J; Fox, Elizabeth H; Gyurcsik, Nancy C; Hill, Jennie L; Lyon, Robert; Rosenkranz, Sara; Shannon, Vanessa R

2004-07-01

The purpose of this study was to determine whether a theory-based framework could be used to deductively identify and understand the characteristics of motivational leaders of physical activity groups for older adults. Participants were 23 older adults (mean age = 78.5 +/- 8.0 years, 65% women). An interview-guide approach was employed to elicit older adults' thoughts on important characteristics of physical activity group leaders. The data suggested that effective leaders are those whom the participants feel are properly qualified, are able to develop a personal bond with participants, and can use their knowledge and the group to demonstrate collective accomplishments. It was concluded that the findings could be used to extend the leadership activities beyond the traditional technical performance and individual feedback to include activities of social integration. Furthermore, the conceptual framework identified can serve as a valuable tool in guiding future researchers in their examination of leadership in physical activity groups for older adults. Copyright 2004 Human Kinetics Publishers, Inc.

Personality and Cognitive Decline in Older Adults: Data From a Longitudinal Sample and Meta-Analysis

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Terracciano, Antonio; Stephan, Yannick; Sutin, Angelina R.

2016-01-01

Objectives: Personality traits are associated with risk of dementia; less is known about their association with the trajectory of cognitive functioning. This research examines the association between the 5 major dimensions of personality and cognitive function and decline in older adulthood and includes a meta-analysis of published studies. Method: Personality traits, objective and subjective memory, and cognitive status were collected in a large national sample (N = 13,987) with a 4-year follow-up period. For each trait, the meta-analysis pooled results from up to 5 prospective studies to examine personality and change in global cognition. Results: Higher Neuroticism was associated with worse performance on all cognitive measures and greater decline in memory, whereas higher Conscientiousness and Openness were associated with better memory performance concurrently and less decline over time. All traits were associated with subjective memory. Higher Conscientiousness and lower Extraversion were associated with better cognitive status and less decline. Although modest, these associations were generally larger than that of hypertension, diabetes, history of psychological treatment, obesity, smoking, and physical inactivity. The meta-analysis supported the association between Neuroticism and Conscientiousness and cognitive decline. Discussion: Personality is associated with cognitive decline in older adults, with effects comparable to established clinical and lifestyle risk factors. PMID:25583598

Falls Prevention Education for Older Adults during and after Hospitalization: A Systematic Review and Meta-Analysis

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Lee, Den-Ching A.; Pritchard, Elizabeth; McDermott, Fiona; Haines, Terry P.

2014-01-01

Objectives: To assess the effectiveness of patient education in reducing falls, promoting behavioural change and the uptake of prevention activities in older adults during and after hospitalization. Design: Systematic review and meta-analysis. Methods: A systematic search of five health science databases was performed up to November 2012. Studies…

Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.

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Sherrington, Catherine; Michaleff, Zoe A; Fairhall, Nicola; Paul, Serene S; Tiedemann, Anne; Whitney, Julie; Cumming, Robert G; Herbert, Robert D; Close, Jacqueline C T; Lord, Stephen R

2017-12-01

Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. Update of a systematic review with random effects meta-analysis and meta-regression. Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016. We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group. 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, pexercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, pExercise also had a fall prevention effect in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I 2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I 2 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital. Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson

The Use of Univariate and Multivariate Analyses in the Geochemical Exploration, Ravanj Lead Mine, Delijan, Iran

Directory of Open Access Journals (Sweden)

Mostafa Nejadhadad

2017-11-01

Full Text Available A geochemical exploration program was applied to recognize the anomalous geochemical haloes at the Ravanj lead mine, Delijan, Iran. Sampling of unweathered rocks were undertaken across rock exposures on a 10 × 10 meter grid (n = 302 as well as the accessible parts of underground mine A (n = 42. First, the threshold values of all elements were determined using the cut-off values used in the exploratory data analysis (EDA method. Then, for further studies, elements with lognormal distributions (Pb, Zn, Ag, As, Cd, Co, Cu, Sb, S, Sr, Th, Ba, Bi, Fe, Ni and Mn were selected. Robustness against outliers is achieved by application of central log ratio transformation to address the closure problems with compositional data prior to principle components analysis (PCA. Results of these analyses show that, in the Ravanj deposit, Pb mineralization is characterized by a Pb-Ba-Ag-Sb ± Zn ± Cd association. The supra-mineralization haloes are characterized by barite and tetrahedrite in a Ba- Th- Ag- Cu- Sb- As- Sr association and sub-mineralization haloes are comprised of pyrite and tetrahedrite, probably reflecting a Fe-Cu-As-Bi-Ni-Co-Mo-Mn association. Using univariate and multivariate geostatistical analyses (e.g., EDA and robust PCA, four anomalies were detected and mapped in Block A of the Ravanj deposit. Anomalies 1 and 2 are around the ancient orebodies. Anomaly 3 is located in a thin bedded limestone-shale intercalation unit that does not show significant mineralization. Drilling of the fourth anomaly suggested a low grade, non-economic Pb mineralization.

Symptom distress in older adults following cancer surgery.

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Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

2013-01-01

Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Learning Choices, Older Australians and Active Ageing

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Boulton-Lewis, Gillian M.; Buys, Laurie

2015-01-01

This paper reports on the findings of qualitative, semistructured interviews conducted with 40 older Australian participants who either did or did not engage in organized learning. Phenomenology was used to guide the interviews and analysis to explore the lived learning experiences and perspectives of these older people. Their experiences of…

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

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Wu, Ya-Huei; Damnée, Souad; Kerhervé, Hélène; Ware, Caitlin; Rigaud, Anne-Sophie

2015-01-01

In a society where technology progresses at an exponential rate, older adults are often unaware of the existence of different kinds of information and communication technologies (ICTs). To bridge the gap, we launched a 2-year project, during which we conducted focus groups (FGs) with demonstrations of ICTs, allowing older adults to try them out and to share their opinions. This study aimed at investigating how participants perceived this kind of initiative and how they reacted to different kinds of ICTs. In total, 14 FGs were conducted with community-dwelling older adults, with a frequency of two FGs on the same topic once per trimester. Twenty-three older adults (four men and 19 women) attended at least one FG but only nearly half of them were regular attendants (ten participating in at least five sessions). Age of participants ranged from 63 years to 88 years, with a mean of 77.1 years. All of them had completed secondary education. The analyses of the data were performed according to inductive thematic analysis. Four overarching themes emerged from the analysis. The first concerned participants' motivation for and assessment of the project. The second theme identified the underlying factors of the "digital divide" between the younger and the older generations. The third theme concerned the factors of technology adoption among older adults. The fourth one identified participants' attitudes toward assistive ICTs, designed specifically for older adults ("gerontechnologies"). This project encouraging older adults to be informed about different kinds of ICTs was positively rated. With regard to ICTs, participants perceived a digital divide. The underlying factors are generation/cohort effects, cognitive and physical decline related to aging, and negative attitudes toward technologies. However, more and more older adults adopt different kinds of ICTs in order to fit in with the society. Concerning assistive ICTs, they manifested a lack of perceived need and usefulness

Presenteeism, stress resilience, and physical activity in older manual workers: a person-centred analysis.

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Thogersen-Ntoumani, Cecilie; Black, Julie; Lindwall, Magnus; Whittaker, Anna; Balanos, George M

2017-12-01

This study used a person-centred approach to explore typologies of older manual workers based on presenteeism, stress resilience, and physical activity. Older manual workers ( n  = 217; 69.1% male; age range 50-77; M age = 57.11 years; SD = 5.62) from a range of UK-based organisations, representing different manual job roles, took part in the study. A cross-sectional survey design was used. Based on the three input variables: presenteeism, stress resilience and physical activity, four distinct profiles were identified on using Latent Profile Analysis. One group ('High sport/exercise and well-functioning'; 5.50%) engaged in high levels of sport/exercise and exhibited low levels of stress resilience and all types of presenteeism. Another profile ('Physically burdened'; 9.70%) reported high levels of work and leisure-time physical activity, low stress resilience, as well as high levels of presenteeism due to physical and time demands. A 'Moderately active and functioning' group (46.50%) exhibited moderate levels on all variables. Finally, the fourth profile ('Moderately active with high presenteeism'; 38.20%) reported engaging in moderate levels of physical activity and had relatively high levels of stress resilience, yet also high levels of presenteeism. The profiles differed on work affect and health perceptions largely in the expected directions. There were no differences between the profiles in socio-demographics. These results highlight complex within-person interactions between presenteeism, stress resilience, and physical activity in older manual workers. The identification of profiles of older manual workers who are at risk of poor health and functioning may inform targeted interventions to help retain them in the workforce for longer.

Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey.

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Choi, Namkee

2011-04-20

Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only

Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol.

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Bosu, William K; Aheto, Justice M K; Zucchelli, Eugenio; Reilly, Siobhan

2017-10-04

The health of older persons has not been a major priority in many African countries. Hypertension is one of the common health problems of older persons. However, there is little information on the prevalence of hypertension in older adults in Africa. This is in spite of the fact that Africa has the highest age-standardized prevalence of hypertension in the world. We therefore present this protocol to conduct a systematic review and meta-analysis on the prevalence of hypertension and the level of its awareness among older persons living in Africa. Major databases (EMBASE, MEDLINE, Academic Search Complete, CINAHL, PsycINFO) and unpublished literature will be searched to identify population-based studies on hypertension in adults aged 50 years and older living in Africa. Eligible articles are those which use the 140/90-mmHg cutoff to diagnose hypertension and were published from 1980 to present. We will exclude subjects in restricted environments such as patients and refugees. Articles will be independently evaluated by two reviewers to determine if they meet the inclusion criteria. They will also evaluate the quality of included studies using a validated tool by Hoy and colleagues for prevalence studies. The main outcome is the prevalence of hypertension while the explanatory variables include demographic, socio-economic, dietary, lifestyle and behavioural factors. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the prevalence of hypertension in this population. The estimates of the prevalence, the risk factors and the level of awareness of hypertension could help in galvanizing efforts at prioritizing the cardiovascular health of older persons in Africa. PROSPERO CRD42017056474.

Autologous stem cell transplantation for patients aged 60 years or older with refractory or relapsed classical Hodgkin's lymphoma: a retrospective analysis from the French Society of Bone Marrow Transplantation and Cell Therapies (SFGM-TC).

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Stamatoullas, A; Brice, P; Gueye, M S; Mareschal, S; Chevallier, P; Bouabdallah, R; Nguyenquoc, S; Francois, S; Turlure, P; Ceballos, P; Monjanel, H; Bourhis, J-H; Guillerm, G; Mohty, M; Biron, P; Cornillon, J; Belhadj, K; Bonmati, C; Dilhuydy, M-S; Huynh, A; Bernard, M; Chrétien, M-L; Peffault de Latour, R; Tilly, H

2016-07-01

This report retrospectively analyzed the outcome of 91 patients aged 60 years or older with refractory/relapsed (R/R) classical Hodgkin's lymphoma (cHL) who underwent autologous stem cell transplantation (ASCT) between 1992 and 2013 and were reported to the French Society of Bone Marrow Transplantation and Cell Therapies registry. The median age at transplant was 63 years. The majority of patients exhibited disease chemosensitivity to salvage treatment (57 complete responses, 30 partial responses, 1 progressive disease and 3 unknown). The most frequent conditioning regimen consisted of BCNU, cytarabine, etoposide, melphalan (BEAM) chemotherapy (93%). With a median follow-up of 54 months, 5-year estimates of overall survival (OS) and progression free survival (PFS) for the entire group were 67 and 54%, respectively. Despite the missing data, in univariate analysis, the number of salvage chemotherapy lines (1-2 versus ⩾3) significantly influenced the OS, unlike the other prognostic factors (stage III-IV at relapse, disease status before ASCT and negative positron emission tomography (PET) scan) encountered in younger patients. In spite of its limitations, this retrospective study with a long-term follow-up suggests that ASCT is a valid treatment option for chemosensitive R/R cHL in selected elderly patients, with an acceptable rate of toxicity.

Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

NARCIS (Netherlands)

Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

NARCIS (Netherlands)

Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

2017-01-01

Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis.

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Lee, Seon Heui; Kim, Hee Sun

2017-02-01

Falls in older people are a common problem, often leading to considerable morbidity. However, the overall effect of exercise interventions on fall prevention in care facilities remains controversial. To evaluate the effectiveness of exercise interventions on the rate of falls and number of fallers in care facilities. A meta-analysis was conducted of randomized controlled trials published up to December 2014. Eight databases were searched including Ovid-Medline, Embase, CINAHL, Cochrane Library, KoreaMed, KMbase, KISS, and KisTi. Two investigators independently extracted data and assessed study quality. Twenty-one studies were selected, that included 5,540 participants. Fifteen studies included exercise as a single intervention, whereas the remaining six included exercise combined with two or more fall interventions tailored to each resident's fall risk (i.e., medication review, environmental modification or staff education). Meta-analysis showed that exercise had a preventive effect on the rate of falls (risk ratio [RR] 0.81, 95% CI 0.68-0.97). This effect was stronger when exercise combined with other fall interventions on the rate of falls (RR 0.61, 95% CI 0.52-0.72) and on the number of fallers (RR 0.85, 95% CI 0.77-0.95). Exercise interventions including balance training (i.e., gait, balance, and functional training; or balance and strength) resulted in reduced the rate of falls. Sensitivity analyses indicated that exercise interventions resulted in reduced numbers of recurrent fallers (RR 0.71, 95% CI 0.53-0.97). This review provides an important basis for developing evidence-based exercise intervention protocols for older people living in care facilities. Exercise programs, which are combined with tailored other fall interventions and challenge balance training to improve balance skills, should be applied to frail older people with functional limitations in institutional settings. © 2016 Sigma Theta Tau International.

Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people.

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Tomstad, Solveig; Dale, Bjørg; Sundsli, Kari; Saevareid, Hans Inge; Söderhamn, Ulrika

2017-12-01

To investigate the prevalence of individuals who often feel lonely among a sample of Norwegian older home-dwelling people aged ≥65 years old, as well as to identify any possible factors explaining their loneliness. Loneliness is known to be common among older people. To identify those older adults who are lonely, and to acquire knowledge about the complexity of their loneliness, is important to provide them with adequate help and support. This study employed a cross-sectional design. A questionnaire was mailed to a randomised sample of 6,033 older home-dwelling persons aged ≥65 years. A total of 2,052 persons returned the questionnaire and were included in the study. The questionnaire consisted of questions asking whether the subjects often felt lonely or not, as well as health-related and background questions and instruments to measure the participants' sense of coherence, mental problems, nutritional screening and self-care ability. The data were analysed using univariate and multivariate statistical methods. A total of 11.6% of the participants reported often feeling lonely. Six factors emerged to be independently associated with often feeling lonely among the respondents: Living alone, not being satisfied with life, having mental problems, a weak sense of coherence, not having contact with neighbours and being at risk for undernutrition. The study shows that often feeling lonely among older home-dwelling persons is a health-related problem that includes social, psychological and physical aspects. Moreover, these persons have limited resources to overcome feelings of loneliness. Lasting loneliness among older home-dwelling persons requires an overall, person-centred and time-consuming approach by nurses. Nurses with advanced knowledge on geriatric nursing may be required to offer appropriate care and support. Healthcare leaders and politicians should offer possibilities for adequate assessment, support and help. © 2017 John Wiley & Sons Ltd.

Older people in the information society

Directory of Open Access Journals (Sweden)

Aleksandra Marcinkiewicz-Wilk

2016-06-01

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

Frailty as a Predictor of Nursing Home Placement Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis.

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Kojima, Gotaro

Frailty has been recognized as a medical syndrome characterized by decreased physiological reserve and vulnerability to poor resolution of homeostasis. Frailty is common in nursing homes and as many as 90% of nursing home patients are frail or prefrail. Previous studies have examined frailty as a risk factor for nursing home placement and yielded inconsistent results. The current study aims to systematically review the literature and to conduct a meta-analysis to combine the risk measures to provide the evidence on frailty as a predictor of nursing home placement among community-dwelling older adults. A systematic literature search was performed in July 2015 using 6 databases (Scopus, Embase, CINAHL Plus, MEDLINE, PsycINFO, and the Cochrane Library). Any cohort studies examining associations between frailty and risk of subsequent nursing home placement among community-dwelling older adults published from 2000 to July 2015 were potentially eligible. The numbers of those who were admitted to nursing homes and who were not, according to frailty categories, were used to calculate pooled odds ratio (OR) using fixed-effect models. The included studies were assessed for heterogeneity, methodological quality, and publication bias. The systematic literature search and hand-search identified 885 potentially relevant studies, among which 5 studies including 3528 community-dwelling older adults were selected for this review. Meta-analyses were performed using data from these studies and showed that both frailty and prefrailty significantly predicted nursing home placement (5 studies: pooled OR = 5.58, 95% confidence interval [CI] = 2.94-10.60, P dwelling older adults. It is noteworthy that adherence to the exercise programs was high and adverse events were not reported in most of the trials. These findings suggest that physical exercise can potentially prevent or reverse frailty and may lead to decreased risks of nursing home placement in older adults. This systematic review

Roads not taken: A narrative positioning analysis of older adults' stories about missed opportunities.

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Blix, Bodil Hansen; Hamran, Torunn; Normann, Hans Ketil

2015-12-01

The point of departure for this article is narrative gerontology's conceptualization of life as storied and the assumption that identity development and meaning making do not cease at any age, but rather continue throughout life. We suggest that if identity construction is considered to be a lifelong project, narrative gerontology would benefit from applying analytical perspectives focused on the situated activity of narration. In this article, we apply a three-level positioning analysis to segments of interviews with two elderly Sami women concerning missed opportunities or roads not taken and, more specifically, to narrations about missed opportunities for education. We argue that such narrations should not necessarily be considered expressions of regret or processes of reconciliation but rather as pivotal in here-and-now identity constructions. Narrations about missed opportunities demonstrate that what narrators choose to insert into their life stories is chosen for a purpose and for an audience in a specific interpersonal and discursive context. We suggest that narrative gerontology would benefit from a broader focus on the diversity of sites of engagement in which older adults perform identity constructions. This shift implies moving beyond traditional studies of older adults' life stories and biographical narratives as related in the context of qualitative research interviews (of which the present study of Sami older adults' life stories is indeed an example). Copyright © 2015 Elsevier Inc. All rights reserved.

Labor Force Nonparticipation of Older People: United States, 1890-1970.

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Graney, Marshall J.; Cottam, Doris M.

1981-01-01

Analysis of U.S. census data provides evidence that decreased labor force participation of older people, 1980 to 1970, was due to the disproportionate growth in numbers of persons aged 65 or older and the growing economic dominance of industries that provide relatively few opportunities for older people's participation. (Author)

Guaranteed Bounds on Information-Theoretic Measures of Univariate Mixtures Using Piecewise Log-Sum-Exp Inequalities

KAUST Repository

Nielsen, Frank

2016-12-09

Information-theoreticmeasures, such as the entropy, the cross-entropy and the Kullback-Leibler divergence between two mixture models, are core primitives in many signal processing tasks. Since the Kullback-Leibler divergence of mixtures provably does not admit a closed-form formula, it is in practice either estimated using costly Monte Carlo stochastic integration, approximated or bounded using various techniques. We present a fast and generic method that builds algorithmically closed-form lower and upper bounds on the entropy, the cross-entropy, the Kullback-Leibler and the α-divergences of mixtures. We illustrate the versatile method by reporting our experiments for approximating the Kullback-Leibler and the α-divergences between univariate exponential mixtures, Gaussian mixtures, Rayleigh mixtures and Gamma mixtures.

A passion for gambling: a generation-specific conceptual analysis and review of gambling among older adults in Canada.

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Alberghetti, Alessandra; Collins, Patricia A

2015-06-01

The proliferation of gambling opportunities in Canada, coupled with an aging population, has led to an increased prevalence of gambling among older adults. Encouraged by this trend, gambling industries have modified their activities to attract and market to this group. Yet, older adults are not a homogeneous group. The life experiences, values, and attitudes shared by generations make a cohort-specific analysis of gambling among older adults a worthwhile pursuit. Drawing from the Dualistic Model of Passion (Vallerand et al. in J Pers Soc Psychol 85(4):756-767, 2003), we discuss the role of passion in shaping gambling behaviours, and the implications of a harmonious or obsessive passion on the benefits and risks to two distinct generations of older adults. Based on their generational attributes, we posit that members of the Silent Generation (those born between 1925 and 1942) stand to gain more from the benefits of recreational gambling, but also stand lose more from problem gambling, than their children's generation, the Baby Boomers (those born between 1942 and 1964). Preventative strategies to assist problem gambling seniors, along with recommendations for further research, are discussed.

A review of Smart House Analysis Methods for Assisting Older People Living Alone

OpenAIRE

Sanchez, Veralia Gabriela; Pfeiffer, Carlos; Skeie, Nils-Olav

2017-01-01

Smart Houses are a prominent field of research referring to environments adapted to assist people in their everyday life. Older people and people with disabilities would benefit the most from the use of Smart Houses because they provide the opportunity for them to stay in their home for as long as possible. In this review, the developments achieved in the field of Smart Houses for the last 16 years are described. The concept of Smart Houses, the most used analysis methods, and current challen...

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

Science.gov (United States)

Tatnall, Arthur

2014-01-01

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

Do Exercise Interventions Improve Participation in Life Roles in Older Adults? A Systematic Review and Meta-Analysis.

Science.gov (United States)

Beauchamp, Marla K; Lee, Annemarie; Ward, Rachel F; Harrison, Samantha M; Bain, Paul A; Goldstein, Roger S; Brooks, Dina; Bean, Jonathan F; Jette, Alan M

2017-10-01

The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence base for interventions to improve participation remains inconclusive. In particular, whether exercise interventions improve participation in life roles is unclear. The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles in older adults residing in the community. The PubMed, Embase, CINAHL, Cochrane, and PEDro databases were searched from inception through March 2015. Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults who were 60 years of age or older were included in this review. Teams of 2 investigators independently extracted data on participation. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The protocol was registered with Prospero (CRD42014014880). Eighteen randomized controlled trials with a total of 2,315 participants met the inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. A meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD = 0.03; 95% CI = -0.10 to 0.16). Subgroup analysis showed that exercise interventions lasting 12 months or more had a small positive effect on participation (SMD = 0.15; 95% CI = 0.02 to 0.28). Limitations included variability in definitions and measures of participation. In general, exercise interventions do not improve participation in life roles in older adults. The results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted. © 2017 American Physical Therapy

Univariate and multiple linear regression analyses for 23 single nucleotide polymorphisms in 14 genes predisposing to chronic glomerular diseases and IgA nephropathy in Han Chinese.

Science.gov (United States)

Wang, Hui; Sui, Weiguo; Xue, Wen; Wu, Junyong; Chen, Jiejing; Dai, Yong

2014-09-01

Immunoglobulin A nephropathy (IgAN) is a complex trait regulated by the interaction among multiple physiologic regulatory systems and probably involving numerous genes, which leads to inconsistent findings in genetic studies. One possibility of failure to replicate some single-locus results is that the underlying genetics of IgAN nephropathy is based on multiple genes with minor effects. To learn the association between 23 single nucleotide polymorphisms (SNPs) in 14 genes predisposing to chronic glomerular diseases and IgAN in Han males, the 23 SNPs genotypes of 21 Han males were detected and analyzed with a BaiO gene chip, and their associations were analyzed with univariate analysis and multiple linear regression analysis. Analysis showed that CTLA4 rs231726 and CR2 rs1048971 revealed a significant association with IgAN. These findings support the multi-gene nature of the etiology of IgAN and propose a potential gene-gene interactive model for future studies.

Motivators for physical activity among ambulatory nursing home older residents.

Science.gov (United States)

Chen, Yuh-Min; Li, Yueh-Ping

2014-01-01

The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

Pain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis.

Science.gov (United States)

Stubbs, Brendon; Binnekade, Tarik; Eggermont, Laura; Sepehry, Amir A; Patchay, Sandhi; Schofield, Pat

2014-01-01

To conduct a systematic review and meta-analysis to establish the association between pain and falls in community-dwelling older adults. Electronic databases from inception until March 1, 2013, including Cochrane Library, CINAHL, EBSCO, EMBASE, PubMed, and PsycINFO. Two reviewers independently conducted the searches and completed methodological assessment of all included studies. Studies were included that (1) focused on adults older than 60 years; (2) recorded falls over 6 or more months; and (3) identified a group with and without pain. Studies were excluded that included (1) participants with dementia or a neurologic condition (eg, stroke); (2) participants whose pain was caused by a previous fall; or (3) individuals with surgery/fractures in the past 6 months. One author extracted all data, and this was independently validated by another author. A total of 1334 articles were screened, and 21 studies met the eligibility criteria. Over 12 months, 50.5% of older adults with pain reported 1 or more falls compared with 25.7% of controls (Pfalling (odds ratio [OR]=1.56; 95% confidence interval [CI], 1.36-1.79; I(2)=53%). A subgroup meta-analysis incorporating studies that monitored falls prospectively established that the odds of falling were significantly higher in those with pain (n=4674; OR=1.71; 95% CI, 1.48-1.98; I(2)=0%). Foot pain was strongly associated with falls (n=691; OR=2.38; 95% CI, 1.62-3.48; I(2)=8%) as was chronic pain (n= 5367; OR=1.80; 95% CI, 1.56-2.09; I(2)=0%). Community-dwelling older adults with pain were more likely to have fallen in the past 12 months and to fall again in the future. Foot and chronic pain were particularly strong risk factors for falls, and clinicians should routinely inquire about these when completing falls risk assessments. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Growing older: a qualitative inquiry into the textured narratives of older, rural women.

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Terrill, Lauren; Gullifer, Judith

2010-07-01

This study explored experiences of eight rural, Anglo-Australian women aged between 65 and 75 using semi-structured interviews. Thematic analysis revealed three prominent themes: (a) the free and busy me highlights the increased freedom in later life enabling choices regarding activities the women would like to engage in; (b) the secret is being positive and pragmatic emphasizes the importance of adopting a pragmatic acceptance of growing older; and (c) narratives of growth and stagnation highlights the pursuit of growth among older women in order to enhance the current self. Findings emphasize the construction of later life as one of liberation, resilience and growth.

Interventions to Improve Medication Adherence among Older Adults: Meta-Analysis of Adherence Outcomes among Randomized Controlled Trials

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Conn, Vicki S.; Hafdahl, Adam R.; Cooper, Pamela S.; Ruppar, Todd M.; Mehr, David R.; Russell, Cynthia L.

2009-01-01

Purpose: This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. Design and Methods: Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge,…

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians.

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Shen, Yu-Tang; Radford, Kylie; Daylight, Gail; Cumming, Robert; Broe, Tony G A; Draper, Brian

2018-03-04

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies.

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians

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Yu-Tang Shen

2018-03-01

Full Text Available Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%, current late-life depression (18.1%, and suicidal ideation (11.1%. Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies.

Motivation to Learn among Older Adults in Taiwan

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Chang, Dian-Fu; Lin, Sung-Po

2011-01-01

This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of older adults. The finding revealed that the higher age or the lower education attainment of older adults, the lower their learning motivation. The…

Feelings of Gratitude Toward God Among Older Whites, Older African Americans, and Older Mexican Americans

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Krause, Neal

2011-01-01

The first goal of this study is to see if social relationships in the church influence feelings of gratitude toward God. The second goal is to assess the impact of race and ethnicity on this relationship. The data support the following hypotheses: (1) older people who go to church more often tend to receive more spiritual support from fellow church members; (2) older adults who receive more spiritual support at church will derive a deeper understanding of themselves and others; (3) older people who develop greater insight into themselves and others will derive a greater sense of religious meaning in life; and (4) older adults who develop a deeper sense of religious meaning in life will feel more grateful to God. The results also indicate that the study model explains how feelings of gratitude toward God arise among older blacks and whites, but not older Mexican Americans. PMID:23543840

Feelings of Gratitude Toward God Among Older Whites, Older African Americans, and Older Mexican Americans.

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Krause, Neal

2012-03-01

The first goal of this study is to see if social relationships in the church influence feelings of gratitude toward God. The second goal is to assess the impact of race and ethnicity on this relationship. The data support the following hypotheses: (1) older people who go to church more often tend to receive more spiritual support from fellow church members; (2) older adults who receive more spiritual support at church will derive a deeper understanding of themselves and others; (3) older people who develop greater insight into themselves and others will derive a greater sense of religious meaning in life; and (4) older adults who develop a deeper sense of religious meaning in life will feel more grateful to God. The results also indicate that the study model explains how feelings of gratitude toward God arise among older blacks and whites, but not older Mexican Americans.

Non-verbal communication of the residents living in homes for the older people in Slovenia.

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Zaletel, Marija; Kovacev, Asja Nina; Sustersic, Olga; Kragelj, Lijana Zaletel

2010-09-01

Aging of the population is a growing problem in all developed societies. The older people need more health and social services, and their life quality in there is getting more and more important. The study aimed at determining the characteristics of non-verbal communication of the older people living in old people's homes (OPH). The sample consisted of 267 residents of the OPH, aged 65-96 years, and 267 caregivers from randomly selected twenty-seven OPH. Three types of non-verbal communication were observed and analysed using univariate and multivariate statistical methods. In face expressions and head movements about 75% older people looked at the eyes of their caregivers, and about 60% were looking around, while laughing or pressing the lips together was rarely noticed. The differences between genders were not statistically significant while statistically significant differences among different age groups was observed in dropping the eyes (p = 0.004) and smiling (0.008). In hand gestures and trunk movements, majority of older people most often moved forwards and clenched fingers, while most rarely they stroked and caressed their caregivers. The differences between genders were statistically significant in leaning on the table (p = 0.001), and changing the position on the chair (0.013). Statistically significant differences among age groups were registered in leaning forwards (p = 0.006) and pointing to the others (p = 0.036). In different modes of speaking and paralinguistic signs almost 75% older people spoke normally, about 70% kept silent, while they rarely quarrelled. The differences between genders were not statistically significant while statistically significant differences among age groups was observed in persuasive speaking (p = 0.007). The present study showed that older people in OPH in Slovenia communicated significantly less frequently with hand gestures and trunk movements than with face expressions and head movements or different modes of speaking

Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis.

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Northey, Joseph Michael; Cherbuin, Nicolas; Pumpa, Kate Louise; Smee, Disa Jane; Rattray, Ben

2018-02-01

Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive. To determine if physical exercise is effective in improving cognitive function in this population. Systematic review with multilevel meta-analysis. Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016. Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function. The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; pcognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants. Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines. © 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.

Cohort analysis of older adults' travel patterns in Denmark

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Siren, Anu Kristiina; Haustein, Sonja

2012-01-01

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

Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults.

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Kim, Jihye; Yu, Areum; Choi, Bo Youl; Nam, Jung Hyun; Kim, Mi Kyung; Oh, Dong Hoon; Yang, Yoon Jung

2015-05-29

The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination-Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The "MFDF" dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the "WNC" dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44-0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults.

Health worry, physical activity participation, and walking difficulty among older adults: a mediation analysis.

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Li, Kin-Kit; Cardinal, Bradley J; Vuchinich, Samuel

2009-03-01

This study examined the effect of health worry (i.e., cognitive aspect of anxiety resulting from concern for health) on walking difficulty in a nationally representative sample (N = 7,527) of older adults (M age = 76.83 years). The study further tested whether physical activity mediates the effect of health worry on walking difficulty in a 6-year follow-up design. Results of a mediation analysis using structural equation modeling showed that people with a high degree of health worry engaged in less physical activity (beta = -.24, p < .001), and people who participated in less physical activity were more likely to report walking difficulty at the 6-year follow-up (beta = -.22, p < .001). There was a significant indirect effect from health worry to walking difficulty through physical activity (beta = .05, p < .001), controlling for demographic, psychosocial, and health related factors. Results suggested that inducing threat and worry may not be effective for physical activity promotion in the older population. More promising coping and regulation strategies are discussed.

Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies

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Zlateva Gergana

2010-11-01

Full Text Available Abstract Background Older patients are typically underrepresented in clinical trials of medications for chronic pain. A post hoc analysis of multiple clinical studies of pregabalin in patients with painful diabetic peripheral neuropathy (DPN or postherpetic neuralgia (PHN was conducted to evaluate the efficacy and safety of pregabalin in older patients. Methods Data from 11 double-blind, randomized, placebo-controlled clinical studies of pregabalin in patients with DPN or PHN were pooled. Efficacy outcomes included change in Daily Pain Rating Scale score, ≥30% and ≥50% responders, and endpoint pain score ≤3. Safety was based on adverse events (AEs. Primary efficacy was analyzed by analysis of covariance with terms for treatment, age category, protocol, baseline pain, and treatment-by-age category interaction. Results 2516 patients (white, n = 2344 [93.2%]; men, n = 1347 [53.5%]; PHN, n = 1003 [39.9%]; pregabalin, n = 1595 were included in the analysis. Patients were grouped by age: 18 to 64 years (n = 1236, 65 to 74 years (n = 766, and ≥75 years (n = 514. Baseline mean pain and sleep interference scores were comparable across treatment and age groups. Significant improvements in endpoint mean pain were observed for all pregabalin dosages versus placebo in all age groups (p ≤ 0.0009, except for the lowest dosage (150 mg/day in the youngest age group. Clinically meaningful pain relief, defined as ≥30% and ≥50% pain response, was observed in all age groups. The most common AEs were dizziness, somnolence, peripheral edema, asthenia, dry mouth, weight gain, and infections. The relative risks for these AEs increased with pregabalin dose, but did not appear related to older age or type of neuropathic pain. Conclusions Pregabalin (150-600 mg/day significantly reduced pain in older patients (age ≥65 years with neuropathic pain and improvements in pain were comparable to those observed in younger patients. Titration of pregabalin to the

Why Social Exclusion Persists among Older People in Australia

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Riyana Miranti

2015-07-01

Full Text Available The existing literature on social exclusion among older people, though relatively limited, suggests that disadvantage among older people is cumulative in nature. Some aspects of disadvantage starting at early life stages have long-term consequences. As such, older people with disadvantages may be subject to higher risks of persistent social exclusion. This article aims to improve understanding of social exclusion and its persistence among senior Australians in three ways. Firstly, the incidence of social exclusion among older people is analysed using selected indicators. Secondly, the study examines whether an older person experiencing social exclusion at one time is more likely to experience it again (persistence. Thirdly, it investigates what factors may be protecting older people from social exclusion. The analysis is conducted using the first eight waves of the Household, Income and Labour Dynamics in Australia (HILDA Survey. The sample of older people is disaggregated into a younger group (55–64 years at wave 1 and an older group (65+ years. The article suggests that higher education and income, as well as better health conditions and previous employment experiences, are important protective factors from social exclusion for older Australians.

Listening to Older Adult Parents of Adult Children with Mental Illness

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Smith, Judith R.

2012-01-01

This article uses qualitative research and narrative analysis to examine the experience of women age 55 and older who are parents caring for adult children with mental illness. Knowledge about the conflicts of older parents with dependent children is underdeveloped. In this study, analysis of women's stories about parenting in later life reveal…

The effect of gender on foot anthropometrics in older people.

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

2011-08-01

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

The Older Worker. Statistical Reports on Older Americans, No. 6.

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Chan, Teresita; Fowles, Donald G.

Trends in the labor force participation and unemployment of older workers were reviewed in a study. A declining rate of labor force participation by older men and a growth in participation by older women were noticed. Examination of labor force participation rates by race revealed a higher participation rate for minority women than for older white…

Slower Decline in C-Reactive Protein after an Inflammatory Insult Is Associated with Longer Survival in Older Hospitalised Patients.

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Maryam Barma

Full Text Available Enhancing biological resilience may offer a novel way to prevent and ameliorate disease in older patients. We investigated whether changes in C-reactive protein (CRP, as a dynamic marker of the acute inflammatory response to diverse stressors, may provide a way to operationalize the concept of resilience in older adults. We tested this hypothesis by examining whether such changes could predict prognosis by identifying which individuals are at greater risk of 6-month mortality.Analysis of prospective, routinely collected datasets containing data on hospitalization, clinical chemistry and rehabilitation outcomes for rehabilitation inpatients between 1999 and 2011. Maximum CRP response during acute illness and CRP recovery indices (time and slope of CRP decay to half maximum, and to <50mg/L if peak values were greater than 50mg/L was derived from biochemistry data. 6-month survival plots were conducted on quartiles of CRP recovery indices. Cox proportional hazards models were used to test univariate and multivariate predictors of 6-month mortality. Covariates included age, sex, number of medications, serum calcium, haemoglobin level, renal function, and the presence of previous myocardial infarction, stroke, chronic heart failure, COPD and diabetes.3723 patients, mean age 84 years, were included. 1535 (41% were male and 733 (20% died during six-month follow-up. The lower an individual's peak CRP reading, and the longer the time taken for their CRP to fall, the better their 6-month survival. The time for CRP to reach half of its maximum value was the best dynamic CRP index of survival (HR 0.93 per week, 95% CI 0.89 to 0.98; p = 0.004; this remained significant even after adjustment for maximum CRP level and covariates listed above.CRP recovery indices are associated with survival in older people; further work is required to explain differences in physiology between patients with a fast and slow CRP recovery.

Segmentation of Coronary Angiograms Using Gabor Filters and Boltzmann Univariate Marginal Distribution Algorithm

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Fernando Cervantes-Sanchez

2016-01-01

Full Text Available This paper presents a novel method for improving the training step of the single-scale Gabor filters by using the Boltzmann univariate marginal distribution algorithm (BUMDA in X-ray angiograms. Since the single-scale Gabor filters (SSG are governed by three parameters, the optimal selection of the SSG parameters is highly desirable in order to maximize the detection performance of coronary arteries while reducing the computational time. To obtain the best set of parameters for the SSG, the area (Az under the receiver operating characteristic curve is used as fitness function. Moreover, to classify vessel and nonvessel pixels from the Gabor filter response, the interclass variance thresholding method has been adopted. The experimental results using the proposed method obtained the highest detection rate with Az=0.9502 over a training set of 40 images and Az=0.9583 with a test set of 40 images. In addition, the experimental results of vessel segmentation provided an accuracy of 0.944 with the test set of angiograms.

Effects of programmed exercise on depressive symptoms in midlife and older women: A meta-analysis of randomized controlled trials.

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Pérez-López, Faustino R; Martínez-Domínguez, Samuel J; Lajusticia, Héctor; Chedraui, Peter

2017-12-01

To perform a systematic review and meta-analysis to clarify the effect of programmed exercise on depressive symptoms (DSs) in midlife and older women. We carried out a structured search of PubMed-Medline, Web of Science, Scopus, Embase, Cochrane Library and Scielo, from database inception through June 29, 2017, without language restriction. The search included the following terms: "depression", "depressive symptoms", "exercise", "physical activity", "menopause", and "randomized controlled trial" (RCTs) in midlife and older women. The US, UK and Australian Clinical Trials databases were also searched. We assessed randomized controlled trials (RCTs) that compared the effect of exercise for at least 6 weeks versus no intervention on DSs as the outcome (as defined by trial authors). Exercise was classified according to duration as "mid-term exercise intervention" (MTEI; lasting for 12 weeks to 4 months), and "long-term exercise intervention" (LTEI; lasting for 6-12 months). Mean changes (±standard deviations) in DSs, as assessed with different questionnaires, were extracted to calculate Hedges' g and then used as the effect size for meta-analysis. Standardized mean differences (SMDs) of DSs after intervention were pooled using a random-effects model. Eleven publications were included for analysis related to 1943 midlife and older women (age range 44-55 years minimum to 65.5±4.0 maximum), none of whom was using a hormone therapy. Seven MTEIs were associated with a significant reduction in DSs (SMD=-0.44; 95% CI -0.69, -0.18; p=0.0008) compared with controls. The reduction in DSs was also significant in six LTEIs (SMD=- 0.29; 95% CI -0.49; -0.09; p=0.005). Heterogeneity of effects among studies was moderate to high. Less perceived stress and insomnia (after exercise) were also found as secondary outcomes. Exercise of low to moderate intensity reduces depressive symptoms in midlife and older women. Copyright © 2017. Published by Elsevier B.V.

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

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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.

Reciprocal Benefits of Mass-Univariate and Multivariate Modeling in Brain Mapping: Applications to Event-Related Functional MRI, H215O-, and FDG-PET

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James R. Moeller

2006-01-01

Full Text Available In brain mapping studies of sensory, cognitive, and motor operations, specific waveforms of dynamic neural activity are predicted based on theoretical models of human information processing. For example in event-related functional MRI (fMRI, the general linear model (GLM is employed in mass-univariate analyses to identify the regions whose dynamic activity closely matches the expected waveforms. By comparison multivariate analyses based on PCA or ICA provide greater flexibility in detecting spatiotemporal properties of experimental data that may strongly support alternative neuroscientific explanations. We investigated conjoint multivariate and mass-univariate analyses that combine the capabilities to (1 verify activation of neural machinery we already understand and (2 discover reliable signatures of new neural machinery. We examined combinations of GLM and PCA that recover latent neural signals (waveforms and footprints with greater accuracy than either method alone. Comparative results are illustrated with analyses of real fMRI data, adding to Monte Carlo simulation support.

Noctural Enuresis as a Risk Factor for Falls in Older Community Dwelling Women with Urinary Incontinence.

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Pahwa, Avita K; Andy, Uduak U; Newman, Diane K; Stambakio, Hanna; Schmitz, Kathryn H; Arya, Lily A

2016-05-01

We determined the association of urinary symptoms with fall risk and physical limitations in older community dwelling women with urinary incontinence. We performed an in-depth assessment of daytime and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older community dwelling women with urinary incontinence who had not sought care for urinary symptoms. All assessments were performed in participant homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms to fall risk, physical function and physical performance. Of 37 women with a mean ± SD age of 74 ± 8.4 years who had urinary incontinence 48% were at high risk for falls. Nocturnal enuresis was reported by 50% of the women. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p = 0.04), worse lower limb function (p Women with nocturnal enuresis had significantly lower physical performance test scores than women without nocturnal enuresis (median 7, range 0 to 11 vs 9, range 1 to 12, p = 0.04). In a multivariable regression model including age, nocturnal enuresis episodes and physical function only physical function was associated with an increased fall risk (p women with urinary incontinence. It may serve as a marker of fall risk even in women who do not seek care for urinary symptoms. Interventions targeting upper and lower body physical function could potentially decrease the risk of falls in older women with urinary incontinence. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Neuropsychological benefits of stationary bike exercise and a cybercycle exergame for older adults with diabetes: an exploratory analysis.

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Anderson-Hanley, Cay; Arciero, Paul J; Westen, Sarah C; Nimon, Joseph; Zimmerman, Earl

2012-07-01

This quasi-experimental exploratory study investigated neuropsychological effects of exercise among older adults with diabetes mellitus (DM) compared with adults without diabetes (non-DM), and it examined the feasibility of using a stationary bike exergame as a form of exercise for older adults with and without diabetes. It is a secondary analysis that uses a small dataset from a larger randomized clinical trial (RCT) called the Cybercycle Study, which compared cognitive and physiological effects of traditional stationary cycling versus cybercycling. In the RCT and the secondary analysis, older adults living in eight independent living retirement facilities in the state of New York were enrolled in the study and assigned to exercise five times per week for 45 min per session (two times per week was considered acceptable for retention in the study) by using a stationary bicycle over the course of 3 months. They were randomly assigned to use either a standard stationary bicycle or a "cybercycle" with a video screen that displayed virtual terrains, virtual tours, and racing games with virtual competitors. For this secondary analysis, participants in the RCT who had type 2 DM (n = 10) were compared with age-matched non-DM exercisers (n = 10). The relationship between exercise and executive function (i.e., Color Trials 2, Digit Span Backwards, and Stroop C tests) was examined for DM and non-DM patients. Older adults with and without diabetes were able to use cybercycles successfully and complete the study, so the feasibility of this form of exercise for this population was supported. However, in contrast with the larger RCT, this small subset did not demonstrate statistically significant differences in executive function between the participants who used cybercycles and those who used stationary bikes with no games or virtual content on a video screen. Therefore, the study combined the two groups and called them "exercisers" and compared cognitive outcomes for DM versus

Predicting healthy lifestyle patterns among retirement age older adults in the WELL study: a latent class analysis of sex differences.

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Södergren, Marita; Wang, Wei Chun; Salmon, Jo; Ball, Kylie; Crawford, David; McNaughton, Sarah A

2014-01-01

The aim of this study was to identify subgroups of retirement age older adults with respect to their lifestyle patterns of eating, drinking, smoking, physical activity and TV viewing behaviors, and to examine the association between these patterns and socio-demographic covariates. The sample consisted of 3133 older adults aged 55-65 years from the Wellbeing, Eating and Exercise for a Long Life (WELL) study, 2010. This study used latent class analysis (stratified by sex), with a set of lifestyle indicators and including socio-demographic covariates. Statistical analyses were performed by generalized linear latent and mixed models in Stata. Two classes of lifestyle patterns were identified: Healthy (53% men and 72% women) and less healthy lifestyles. Physical activity, TV-viewing time, and fruit intake were good indicators distinguishing the "Healthier" class, whereas consumption of vegetables, alcohol (men) and fast food (women) could not clearly discriminate older adults in the two classes. Class membership was associated with education, body mass index, and self-rated health. This study contributes to the literature on lifestyle behaviors among older adults, and provides evidence that there are meaningful sex differences in lifestyle behaviors between subgroups of older adults. From a policy perspective, understanding indicators or "markers" of healthy and less healthy lifestyle patterns is important for identifying target groups for interventions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Pilot testing a digital pet avatar for older adults.

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Chi, Nai-Ching; Sparks, Olivia; Lin, Shih-Yin; Lazar, Amanda; Thompson, Hilaire J; Demiris, George

Social isolation in older adults is a major public health concern. An embodied conversational agent (ECA) has the potential to enhance older adults' social interaction. However, little is known about older adults' experience with an ECA. In this paper, we conducted a pilot study to examine the perceived acceptance and utility of a tablet-based conversational agent in the form of an avatar (termed "digital pet") for older adults. We performed secondary analysis of data collected from a study that employed the use of a digital pet in ten older adults' homes for three months. Most of the participants enjoyed the companionship, entertainment, reminders, and instant assistance from the digital pet. However, participants identified limited conversational ability and technical issues as system challenges. Privacy, dependence, and cost were major concerns. Future applications should maximize the agent's conversational ability and the system's overall usability. Our results can inform future designs of conversational agents for older adults, which need to include older adults as system co-designers to maximize usability and acceptance. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronic Diseases among Older Cancer Survivors

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Laura Deckx

2012-01-01

Full Text Available Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60 years with older non-cancer patients. Material and Methods. Each cancer patient (n=3835, mean age 72 was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis and longitudinally (incidence after diagnosis for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis. Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37 and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44, which were significantly more frequent (P<0.01 among older cancer compared to non-cancer patients. Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.

Social and productive activities and health among partnered older adults: A couple-level analysis.

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Lam, Jack; Bolano, Danilo

2018-04-16

We theorize and test the health of older adults as a result of their activity engagement, as well as a product of their spouse's engagement. We draw on 15 waves of couple-level data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Using responses of time engaged in nine different activities, we estimate Latent Class Models to describe activity profiles of partnered older adults. Given potential health selections into activity engagement, we lag older adults' activity engagement by one wave to examine its association with subsequent health. We then investigate associations between the lag of the spouse's activities with respondents' health, controlling for their own activity engagement at the previous wave. We find four activity profiles for men, and three for women. Respondents who were predominantly engaged in community activities generally report better subsequent health. Beyond their own activity engagement, for both older men and women, having a partner who was also community engaged associate with better subsequent health, though for older women, there were little differences between having a husband who was community engaged or inactive. Our findings highlight the value of considering activities of partnered older adults at the couple level. Copyright © 2018 Elsevier Ltd. All rights reserved.

Prevalence of Financial Fraud and Scams Among Older Adults in the United States: A Systematic Review and Meta-Analysis.

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Burnes, David; Henderson, Charles R; Sheppard, Christine; Zhao, Rebecca; Pillemer, Karl; Lachs, Mark S

2017-08-01

The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers. A valid estimate of elder financial fraud-scam prevalence is necessary as a foundation for research and prevention efforts. To estimate the prevalence of elder financial fraud-scam victimization in the United States based on a systematic review and meta-analysis. Multiple investigators independently screened titles and abstracts and reviewed relevant full-text records from PubMed, Medline, PsycINFO, Criminal Justice Abstracts, Social Work Abstracts, and AgeLine databases. To maximize the validity and generalizability of prevalence estimation, we restricted eligibility to general population-based studies (English speaking, 1990 onward) using state- or national-level probability sampling and collecting data directly from older adults. Information on elder financial fraud-scam prevalence and study-level characteristics was extracted independently by 2 investigators. Meta-analysis of elder financial fraud-scam prevalence used generalized mixed models with individual studies as levels of a random classification factor. We included 12 studies involving a total of 41 711 individuals in the meta-analysis. Overall pooled elder financial fraud-scam prevalence (up to 5-year period) across studies was 5.6% (95% confidence interval [CI] = 4.0%, 7.8%), with a 1-year period prevalence of 5.4% (95% CI = 3.2%, 7.6%). Studies using a series of questions describing specific fraud-scam events to measure victimization found a significantly higher prevalence (7.1%; 95% CI = 4.8%, 9.4%) than studies

A Course in Time Series Analysis

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Peña, Daniel; Tsay, Ruey S

2011-01-01

New statistical methods and future directions of research in time series A Course in Time Series Analysis demonstrates how to build time series models for univariate and multivariate time series data. It brings together material previously available only in the professional literature and presents a unified view of the most advanced procedures available for time series model building. The authors begin with basic concepts in univariate time series, providing an up-to-date presentation of ARIMA models, including the Kalman filter, outlier analysis, automatic methods for building ARIMA models, a

Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults

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Jihye Kim

2015-05-01

Full Text Available The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination–Korean version was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The “MFDF” dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the “WNC” dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44–0.94. The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults.

Incontinence and Nocturia in Older Adults After Hip Fracture: Analysis of a Secondary Outcome for a Parallel Group, Randomized Controlled Trial

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Enav Z. Zusman MSc

2017-05-01

Full Text Available Objective: To test the effect of a follow-up clinic on urinary incontinence (UI and nocturia among older adults with hip fracture. Method: Fifty-three older adults (≥65 years 3 to 12 months following hip fracture were enrolled and randomized to receive usual care plus the intervention (B4, or usual care (UC only. The B4 group received management by health professionals, with need-based referrals. UI, nocturia, and quality of life were measured with questionnaires at baseline, 6 months, and 12 months. Results: There were 48 participants included in this analysis, and at baseline, 44% of study participants self-reported UI. At final assessment, six out of 24 B4 participants and 12 out of 24 UC participants reported UI. Four out of five study participants reported nocturia at baseline; this did not decrease during the study. Discussion : Following hip fracture, many older adults report UI and most report nocturia. Health professionals should be aware of the high occurrence of urinary symptoms among older adults post hip fracture.

Portuguese Older Gay Men: Pathways to Family Integrity

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Filipa Daniela Marques

2016-08-01

Full Text Available Abstract Research in the field of older gay men remains scarce. This exploratory study examines older gay men's experiences in the construction of family integrity (versus disconnection and alienation. The family integrity approach is a developmental perspective that links ego integrity to a larger process of constructing meaning within the family system. The sample comprises ten participants (from 60 to 88 years old. A semi-structured interview was conducted and submitted to content analysis. The main findings suggest three experiences in older gay men's construction of family integrity: (i influence of homosexuality throughout life; (ii establishing a family of choice; (iii creating a legacy associated with homosexuality. Family integrity in older gay men seems to evolve from disclosure at a young age to making homosexuality a legacy in old age.

Vitamin D deficiency in older adults and its associated factors: a cross-sectional analysis of the Mexican Health and Aging Study.

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Carrillo-Vega, María Fernanda; García-Peña, Carmen; Gutiérrez-Robledo, Luis Miguel; Pérez-Zepeda, Mario Ulises

2017-12-01

Vitamin D deficiency was common in older adults from a country with adequate sun exposure. The variables associated with this deficiency provide insight into the next steps needed to characterize older adults with this deficiency and to treat it accordingly. The aim of this study was to describe the prevalence of and factors associated with vitamin D deficiency among Mexican older adults. This was a secondary analysis of the last wave of the Mexican Health and Aging Study. Vitamin D levels along with other biomarkers were obtained from a sub-sample of Mexican adults older than 60 years. Prevalence was described by sex and age group, and a multivariate analysis was performed to test the factors associated with this condition. Data from 1088 adults over the age of 60 years were analyzed. The mean serum vitamin D level was 23.1 ± 8.1 ng/mL and was significantly higher among men than women (25.6 ± 0.6 and 22.8 ± 0.5 ng/mL, respectively; p vitamin D deficiency, 65% of whom were women. Low 25-(OH)-vitamin D levels were associated with female sex (OR 1.74, 95% CI 1.59-2.42), current smoking (OR 2.21, 95% CI 1.47-3.39), education (OR 1.1, 95% CI 1.06-1.13), physical activity (OR 1.74, 95% CI 1.31-2.23), and high levels of glycated hemoglobin (OR 1.16, 95% CI 1.07-1.25). Vitamin D deficiency was highly prevalent in Mexican older adults and was associated with a number of factors, indicating the multifactorial causality of this deficiency.

Effect of Aerobic Training on Peak Oxygen Uptake Among Seniors Aged 70 or Older: A Meta-Analysis of Randomized Controlled Trials.

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Bouaziz, Walid; Kanagaratnam, Lukshe; Vogel, Thomas; Schmitt, Elise; Dramé, Moustapha; Kaltenbach, Georges; Geny, Bernard; Lang, Pierre Olivier

2018-01-02

Older adults undergo a progressive decline in cardiorespiratory fitness and functional capacity. This lower peak oxygen uptake (VO 2peak ) level is associated with increased risk of frailty, dependency, loss of autonomy, and mortality from all causes. Regular physical activity and particularly aerobic training (AT) have been shown to contribute to better and healthy aging. We conducted a meta-analysis to measure the exact benefit of AT on VO 2peak in seniors aged 70 years or older. A comprehensive, systematic database search for articles was performed in Embase, Medline, PubMed Central, Science Direct, Scopus, and Web of Science using key words. Two reviewers independently assessed interventional studies for potential inclusion. Ten randomized controlled trials (RCTs) were included totaling 348 seniors aged 70 years or older. Across the trials, no high risk of bias was measured and all considered open-label arms for controls. With significant heterogeneity between the RCTs (all p seniors were, respectively, 1.72 (95% CI: 0.34-3.10) and 1.47 (95% CI: 0.60-2.34). This meta-analysis confirms the AT-associated benefits on VO 2peak in healthy and unhealthy seniors.

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

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Wu YH

2015-01-01

Full Text Available Ya-Huei Wu,1,2 Souad Damnée,1,2 Hélène Kerhervé,1,2 Caitlin Ware,1,3 Anne-Sophie Rigaud1,2 1Department of Clinical Gerontology, Broca Hospital, Assistance Publique-Hôpitaux de Paris, 2Research Team 4468, Paris Descartes University, 3Centre de Recherche en Psychanalyse, Médicine et la Société, Paris Diderot University, Paris, France Purpose: In a society where technology progresses at an exponential rate, older adults are often unaware of the existence of different kinds of information and communication technologies (ICTs. To bridge the gap, we launched a 2-year project, during which we conducted focus groups (FGs with demonstrations of ICTs, allowing older adults to try them out and to share their opinions. This study aimed at investigating how participants perceived this kind of initiative and how they reacted to different kinds of ICTs.Patients and methods: In total, 14 FGs were conducted with community-dwelling older adults, with a frequency of two FGs on the same topic once per trimester. Twenty-three older adults (four men and 19 women attended at least one FG but only nearly half of them were regular attendants (ten participating in at least five sessions. Age of participants ranged from 63 years to 88 years, with a mean of 77.1 years. All of them had completed secondary education. The analyses of the data were performed according to inductive thematic analysis.Results: Four overarching themes emerged from the analysis. The first concerned participants’ motivation for and assessment of the project. The second theme identified the underlying factors of the “digital divide” between the younger and the older generations. The third theme concerned the factors of technology adoption among older adults. The fourth one identified participants’ attitudes toward assistive ICTs, designed specifically for older adults (“gerontechnologies”.Discussions and conclusion: This project encouraging older adults to be informed about

Depression and Mobility Among Older Adults in Mexico: ENSANUT 2012.

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Picazzo-Palencia, Esteban

2016-06-01

Depression among older people can be associated with limitations in physical mobility. The ENSANUT 2012 data set was used. A secondary data analysis was conducted on a total sample of 6,525 Mexicans 60 years and older. Findings indicate that depressive symptoms among older people derive from their limitations in mobility rather than from their age. In Mexico, the prevalence of major depressive disorders is higher among older adults than among the rest of the adults. Hence, as the prevalence of this problem grows, the need for appropriate mental health attention will increase in Mexico. © The Author(s) 2016.

Choice of Hemodialysis Access in Older Adults: A Cost-Effectiveness Analysis.

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Hall, Rasheeda K; Myers, Evan R; Rosas, Sylvia E; O'Hare, Ann M; Colón-Emeric, Cathleen S

2017-06-07

Although arteriovenous fistulas have been found to be the most cost-effective form of hemodialysis access, the relative benefits of placing an arteriovenous fistula versus an arteriovenous graft seem to be least certain for older adults and when placed preemptively. However, older adults' life expectancy is heterogeneous, and most patients do not undergo permanent access creation until after dialysis initiation. We evaluated cost-effectiveness of arteriovenous fistula placement after dialysis initiation in older adults as a function of age and life expectancy. Using a hypothetical cohort of patients on incident hemodialysis with central venous catheters, we constructed Markov models of three treatment options: ( 1 ) arteriovenous fistula placement, ( 2 ) arteriovenous graft placement, or ( 3 ) continued catheter use. Costs, utilities, and transitional probabilities were derived from existing literature. Probabilistic sensitivity analyses were performed by age group (65-69, 70-74, 75-79, 80-84, and 85-89 years old) and quartile of life expectancy. Costs, quality-adjusted life-months, and incremental cost-effectiveness ratios were evaluated for up to 5 years. The arteriovenous fistula option was cost effective compared with continued catheter use for all age and life expectancy groups, except for 85-89 year olds in the lowest life expectancy quartile. The arteriovenous fistula option was more cost effective than the arteriovenous graft option for all quartiles of life expectancy among the 65- to 69-year-old age group. For older age groups, differences in cost-effectiveness between the strategies were attenuated, and the arteriovenous fistula option tended to only be cost effective in patients with life expectancy >2 years. For groups for which the arteriovenous fistula option was not cost saving, the cost to gain one quality-adjusted life-month ranged from $2294 to $14,042. Among older adults, the cost-effectiveness of an arteriovenous fistula placed within the first

Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities.

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Church, Jody L; Haas, Marion R; Goodall, Stephen

2015-12-01

To evaluate the cost effectiveness of interventions designed to prevent falls and fall-related injuries among older people living in residential aged care facilities (RACFs) from an Australian health care perspective. A decision analytic Markov model was developed that stratified individuals according to their risk of falling and accounted for the risk of injury following a fall. The effectiveness of the interventions was derived from two Cochrane reviews of randomized controlled trials for falls/fall-related injury prevention in RACFs. Interventions were considered effective if they reduced the risk of falling or reduced the risk of injury following a fall. The interventions that were modelled included vitamin D supplementation, annual medication review, multifactorial intervention (a combination of risk assessment, medication review, vision assessment and exercise) and hip protectors. The cost effectiveness was calculated as the incremental cost relative to the incremental benefit, in which the benefit was estimated using quality-adjusted life-years (QALYs). Uncertainty was explored using univariate and probabilistic sensitivity analysis. Vitamin D supplementation and medication review both dominated 'no intervention', as these interventions were both more effective and cost saving (because of healthcare costs avoided). Hip protectors are dominated (less effective and more costly) by vitamin D and medication review. The incremental cost-effectiveness ratio (ICER) for medication review relative to vitamin D supplementation is AU$2442 per QALY gained, and the ICER for multifactorial intervention relative to medication review is AU$1,112,500 per QALY gained. The model is most sensitive to the fear of falling and the cost of the interventions. The model suggests that vitamin D supplementation and medication review are cost-effective interventions that reduce falls, provide health benefits and reduce health care costs in older adults living in RACFs.

In situ calibration using univariate analyses based on the onboard ChemCam targets: first prediction of Martian rock and soil compositions

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Fabre, C.; Cousin, A.; Wiens, R.C.; Ollila, A.; Gasnault, O.; Maurice, S.; Sautter, V.; Forni, O.; Lasue, J.; Tokar, R.; Vaniman, D.; Melikechi, N.

2014-01-01

Curiosity rover landed on August 6th, 2012 in Gale Crater, Mars and it possesses unique analytical capabilities to investigate the chemistry and mineralogy of the Martian soil. In particular, the LIBS technique is being used for the first time on another planet with the ChemCam instrument, and more than 75,000 spectra have been returned in the first year on Mars. Curiosity carries body-mounted calibration targets specially designed for the ChemCam instrument, some of which are homgeneous glasses and others that are fine-grained glass-ceramics. We present direct calibrations, using these onboard standards to infer elements and element ratios by ratioing relative peak areas. As the laser spot size is around 300 μm, the LIBS technique provides measurements of the silicate glass compositions representing homogeneous material and measurements of the ceramic targets that are comparable to fine-grained rock or soil. The laser energy and the auto-focus are controlled for all sequences used for calibration. The univariate calibration curves present relatively to very good correlation coefficients with low RSDs for major and ratio calibrations. Trace element calibration curves (Li, Sr, and Mn), down to several ppm, can be used as a rapid tool to draw attention to remarkable rocks and soils along the traverse. First comparisons to alpha-particle X-ray spectroscopy (APXS) data, on selected targets, show good agreement for most elements and for Mg# and Al/Si estimates. SiO 2 estimates using univariate cannot be yet used. Na 2 O and K 2 O estimates are relevant for high alkali contents, but probably under estimated due to the CCCT initial compositions. Very good results for CaO and Al 2 O 3 estimates and satisfactory results for FeO are obtained. - Highlights: • In situ LIBS univariate calibrations are done using the Curiosity onboard standards. • Major and minor element contents can be rapidly obtained. • Trace element contents can be used as a rapid tool along the

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

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

2017-08-01

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

Acute atomoxetine treatment of younger and older children with ADHD: A meta-analysis of tolerability and efficacy

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Vaughan Brigette S

2008-09-01

Full Text Available Abstract Background Atomoxetine is FDA-approved as a treatment of attention-deficit/hyperactivity disorder (ADHD in patients aged 6 years to adult. Among pediatric clinical trials of atomoxetine to date, six with a randomized, double-blind, placebo-controlled design were used in this meta-analysis. The purpose of this article is to describe and compare the treatment response and tolerability of atomoxetine between younger children (6–7 years and older children (8–12 years with ADHD, as reported in these six acute treatment trials. Methods Data from six clinical trials of 6–9 weeks duration were pooled, yielding 280 subjects, ages 6–7 years, and 860 subjects, ages 8–12 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-diagnosed ADHD. Efficacy was analyzed using the ADHD Rating Scale-IV (ADHD-RS, Conners' Parent Rating Scale-revised (CPRS-R:S, and the Clinical Global Impression of ADHD Severity (CGI-ADHD-S. Results Atomoxetine was superior to placebo in both age categories for mean (SD change in ADHD-RS total, total T, and subscale scores; 3 CPRS-R:S subscales; and CGI-ADHD-S from baseline. Although there were no significant treatment differentials between the age groups for these efficacy measures, the age groups themselves, regardless of treatment, were significantly different for ADHD-RS total (younger: ATX = -14.2 [13.8], PBO = -4.6 [10.4]; older: ATX = -15.4 [13.2], PBO = -7.3 [12.0]; p = .001, total T (younger: ATX = -15.2 [14.8], PBO = -4.9 [11.2]; older: ATX = -16.4 [14.6], PBO = -7.9 [13.1]; p = .003, and subscale scores (Inattentive: younger: ATX = -7.2 [7.5], PBO = -2.4 [5.7]; older: ATX = -8.0 [7.4], PBO = -3.9 [6.7]; p = .043; Hyperactive/Impulsive: younger: ATX = -7.0 [7.2], PBO = -2.1 [5.4]; older: ATX = -7.3 [7.0], PBO = -3.4 [6.3]; p Conclusion Atomoxetine is an effective and generally well-tolerated treatment of ADHD in both younger and older children as assessed by three

Comparative analysis of the first permanent molars caries prevalence in younger and older school children

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Stojković Branislava B.

2012-01-01

Full Text Available Introduction. The data on the health-condition of the first permanent molars among children in our region is scarce. Therefore, the need for more thorough analysis of the state of health of these teeth in the children from our region imposes itself, along with the need to determine the most critical period in which a significant increase in caries prevalence of these teeth takes place. Aim. The aim of the research was to perform a comparative analysis of the prevalence, average rate and structure of decay, missed and filled first permanent molars in the children of the younger school age in relation to those of the older school age. Material and methods. The research included 1.119 examinees, aged from 7 to 14 years. Examinees were divided into two groups according to their age: examinees of the younger school age and older school age. Dental check-up of the students was performed by means of a dental probe and mirror and the health condition of the examined teeth was registered by means of Klein-Palmer's DMF system. Results. The research determined high values of the examined parameters of the first permanent molars caries prevalence which increases with the age of the examinees. In the examinees of the age of 8, 9, and 10, statistically more significant values of the examined teeth caries prevalence parameters were registered, in relation to the examinees of seven years of age. In the examinees of the older school age, statistically significantly higher values were registered only for TCI and ACI and only in the examinees aged 14 in relation to the examinees aged 11. With the age, the percent of decay is decreases, while the percent of filled and extracted first permanent molars increases. Conclusion. Results show that the period between 7 and 10 years of age is the most critical and the most important period for the implementation of preventive-prophylactic measures aimed to preserve the health of the first permanent molars.

Challenges for Older Drivers in Urban, Suburban, and Rural Settings

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Rashmi P. Payyanadan

2018-03-01

Full Text Available Along with age-related factors, geographical settings—urban, suburban, and rural areas—also contribute to the differences in fatal crashes among older drivers. These differences in crash outcomes might be attributed to the various driving challenges faced by older drivers residing in different locations. To understand these challenges from the perspective of the older driver, a focus group study was conducted with drivers 65 and older from urban, suburban, and rural settings. Guided-group interviews were used to assess driving challenges, mobility options, opportunities for driver support systems (DSS, and alternate transportation needs. Content analysis of the interview responses resulted in four categories representing common challenges faced by older drivers across the settings: behavior of other drivers on the road, placement of road signs, reduced visibility of road signs due to age-related decline, and difficulties using in-vehicle technologies. Six categories involved location-specific challenges such as heavy traffic situations for urban and suburban drivers, and multi-destination trips for rural drivers. Countermeasures implemented by older drivers to address these challenges primarily involved route selection and avoidance. Technological advances of DSS systems provide a unique opportunity to support the information needs for route selection and avoidance preferences of drivers. Using the content analysis results, a framework was built to determine additional and modified DSS features to meet the specific challenges of older drivers in urban, suburban, and rural settings. These findings suggest that there is heterogeneity in the driving challenges and preferences of older drivers based on their location. Consequently, DSS technologies and vehicle automation need to be tailored to not only meet the driving safety and mobility needs of older drivers as a population, but also to their driving environment.

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

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Teresita M. Hogan

2014-07-01

Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

Cohort comparisons: emotional well-being among adolescents and older adults

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Momtaz, Yadollah Abolfathi; Hamid, Tengku Aizan; Ibrahim, Rahimah

2014-01-01

Background There are several negative stereotypes about older adults that have negatively influenced people’s attitude about aging. The present study compared emotional well-being between older adults and adolescents. Methods Data for this study came from 1,403 community-dwelling elderly persons and 1,190 secondary school students and were obtained from two national cross-sectional surveys. Emotional well-being was measured using the World Health Organization-Five Well-Being Index. Data analysis was conducted using a multivariate analysis of covariance with SPSS software version 20 (IBM Corporation, Armonk, NY, USA). Results Elderly people significantly scored higher levels of emotional well-being (mean, 62.3; standard deviation, 22.55) than younger people (mean, 57.9; standard deviation, 18.46; t, 5.32; P≤0.001). The findings from the multivariate analysis of covariance revealed a significant difference between older adults and younger people in emotional well-being [F(3, 2587)=120.21; P≤0.001; η2=0.122] after controlling for sex. Conclusion Contrary to negative stereotypes about aging, our findings show a higher level of emotional well-being among older adults compared with younger people. PMID:24872683

Risk Profiles for Falls among Older Adults: New Directions for Prevention

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William A. Satariano

2017-08-01

Full Text Available ObjectiveTo address whether neighborhood factors, together with older adults’ levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM analysis to conduct this descriptive analysis.MethodThis is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors were derived from GoM analysis.ResultsProfiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1; healthy older adults are likely to fall outdoors (Profile 2. Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.DiscussionNeighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.

The Digital Divide and urban older adults.

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

2010-01-01

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

Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis.

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Liu, Ping; Hao, Qiukui; Hai, Shan; Wang, Hui; Cao, Li; Dong, Birong

2017-09-01

The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I 2 =27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the

Leisure and religious activity participation and mental health: gender analysis of older adults in Nepal

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Kai Ichiro

2007-10-01

Full Text Available Abstract Background Involvement in activities has been found to be beneficial for improving quality of life and successful aging for older adults. Little is known, however, about the involvement in activities and depression of older adults in Asian developing countries. This study explores whether participation in leisure social and religious activities are related to depression and satisfaction with life in older adults of Nepal. Gender differences are also explored. Methods The study sample was derived from a survey which aimed to determine the intergenerational relationships between older adults and their married sons. A cross-sectional quantitative study of older adults sixty years and over in Nepal was conducted with face-to-face interviews using structured instruments. A convenience sample of 489 community dwelling older adults, 247 men and 242 women, were included in the study. The dependent variables, depression and satisfaction with life, were measured by the Geriatric Depression Scale (GDS and Satisfaction With Life Scale (SWLS respectively. Age, gender, marital status, education, perceived health, financial satisfaction, social support received and provided by older adults, and social activity were independent variables in the study. Results Saying prayers (B = -2.75; p Conclusion Specific activity participation was a significant correlate of lower levels of depression and higher levels of satisfaction with life among older adults in Nepal. The findings explore the need for further research on activity participation in developing countries so that it can be useful for health care practioners and those involved with the activities of aged populations in developing countries.

Perceptions of disaster preparedness among older people in South Korea.

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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.

Tolerability and outcomes of radiotherapy or chemoradiotherapy for rectal cancer in elderly patients aged 70 years and older

International Nuclear Information System (INIS)

Cai, Xin; Wu, Hongbin; Peng, Junjie; Zhu, Ji; Cai, Sanjun; Cai, Gang; Zhang, Zhen

2013-01-01

To assess the safety and outcomes of radiotherapy (RT) or chemoradiotherapy (CRT) in elderly patients (≥70) with rectal cancer. Elderly patients aged 70 and older with rectal cancer, who were treated with RT or CRT at a single institution, were retrospectively analyzed. Performance status (KPS and ECOG score) and comorbidity (Charlson comorbidity index) were calculated, and their correlation with treatment toxicity and overall survival were studied. Risk factors for overall survival were investigated using univariate and multivariate survival analysis. A total of 126 patients with locally advanced disease, local recurrence or synchronous metastasis were included, with a 3-year OS rate of 48.1%. Scheduled dosage of radiation was delivered to 69% of patients. Grade 3 toxicities occurred more often in patients treated with CRT versus RT. The occurrence of grade 3 toxicities was not related to KPS score, ECOG score, number of comorbidities, and Charlson score. Multivariate analysis found that only age and Charlson score were independent prognostic factors for predicting patients’ 3-year OS. The 3-year OS rate was significantly higher in patients with Charlson score <4 vs Charlson score ≥4 (71.1% vs. 26.4%, P=0.0003). Although toxicities may be significant, elderly patients with rectal cancer of varied stages can be safely treated with RT or CRT with careful monitoring and frequent modification of treatment. Except for patients’ age, Charlson comorbidity index may be helpful in assessing patients’ outcomes in elderly patients with rectal cancer

The issue of multiple univariate comparisons in the context of neuroelectric brain mapping: an application in a neuromarketing experiment.

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Vecchiato, G; De Vico Fallani, F; Astolfi, L; Toppi, J; Cincotti, F; Mattia, D; Salinari, S; Babiloni, F

2010-08-30

This paper presents some considerations about the use of adequate statistical techniques in the framework of the neuroelectromagnetic brain mapping. With the use of advanced EEG/MEG recording setup involving hundred of sensors, the issue of the protection against the type I errors that could occur during the execution of hundred of univariate statistical tests, has gained interest. In the present experiment, we investigated the EEG signals from a mannequin acting as an experimental subject. Data have been collected while performing a neuromarketing experiment and analyzed with state of the art computational tools adopted in specialized literature. Results showed that electric data from the mannequin's head presents statistical significant differences in power spectra during the visualization of a commercial advertising when compared to the power spectra gathered during a documentary, when no adjustments were made on the alpha level of the multiple univariate tests performed. The use of the Bonferroni or Bonferroni-Holm adjustments returned correctly no differences between the signals gathered from the mannequin in the two experimental conditions. An partial sample of recently published literature on different neuroscience journals suggested that at least the 30% of the papers do not use statistical protection for the type I errors. While the occurrence of type I errors could be easily managed with appropriate statistical techniques, the use of such techniques is still not so largely adopted in the literature. Copyright (c) 2010 Elsevier B.V. All rights reserved.

The association between the physical environment and the well-being of older people in residential care facilities: A multilevel analysis.

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Nordin, Susanna; McKee, Kevin; Wijk, Helle; Elf, Marie

2017-12-01

To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities. Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognized, more research is needed. A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted. Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument. Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being. Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Modern Attitudes Toward Older Adults in the Aging World: A Cross-Cultural Meta-Analysis.

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North, Michael S; Fiske, Susan T

2015-09-01

Prevailing beliefs suggest that Eastern cultures hold older adults in higher esteem than Western cultures do, due to stronger collectivist traditions of filial piety. However, in modern, industrialized societies, the strain presented by dramatic rises in population aging potentially threatens traditional cultural expectations. Addressing these competing hypotheses, a literature search located 37 eligible papers, comprising samples from 23 countries and 21,093 total participants, directly comparing Easterners and Westerners (as classified per U.N. conventions) in their attitudes toward aging and the aged. Contradicting conventional wisdom, a random-effects meta-analysis on these articles found such evaluations to be more negative in the East overall (standardized mean difference = -0.31). High heterogeneity in study comparisons suggested the presence of moderators; indeed, geographical region emerged as a significant moderating factor, with the strongest levels of senior derogation emerging in East Asia (compared with South and Southeast Asia) and non-Anglophone Europe (compared with North American and Anglophone Western regions). At the country level, multiple-moderator meta-regression analysis confirmed recent rises in population aging to significantly predict negative elder attitudes, controlling for industrialization per se over the same time period. Unexpectedly, these analyses also found that cultural individualism significantly predicted relative positivity-suggesting that, for generating elder respect within rapidly aging societies, collectivist traditions may backfire. The findings suggest the importance of demographic challenges in shaping modern attitudes toward elders-presenting considerations for future research in ageism, cross-cultural psychology, and even economic development, as societies across the globe accommodate unprecedented numbers of older citizens. (c) 2015 APA, all rights reserved).

Design of smart home sensor visualizations for older adults.

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Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

2014-07-24

Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date.CONCLUSIONS: Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

Design of smart home sensor visualizations for older adults.

Science.gov (United States)

Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

2014-01-01

Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date. Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

The Meaning of Older Adults' Peer Teaching: A Phenomenological Study

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Choi, Ilseon

2009-01-01

This study investigated older adults' peer teaching experiences at a Lifelong Learning Institute through interviews with eight teachers and observations of their classes. Thematic analysis revealed themes of peer-to-peer teaching, volunteer teaching, and explorative teaching. Discussion of the themes examines the meaning of older adults' peer…

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

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

2018-02-17

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

Real-time prediction of extreme ambient carbon monoxide concentrations due to vehicular exhaust emissions using univariate linear stochastic models

International Nuclear Information System (INIS)

Sharma, P.; Khare, M.

2000-01-01

Historical data of the time-series of carbon monoxide (CO) concentration was analysed using Box-Jenkins modelling approach. Univariate Linear Stochastic Models (ULSMs) were developed to examine the degree of prediction possible for situations where only a limited data set, restricted only to the past record of pollutant data are available. The developed models can be used to provide short-term, real-time forecast of extreme CO concentrations for an Air Quality Control Region (AQCR), comprising a major traffic intersection in a Central Business District of Delhi City, India. (author)

Greater BOLD variability in older compared with younger adults during audiovisual speech perception.

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Sarah H Baum

Full Text Available Older adults exhibit decreased performance and increased trial-to-trial variability on a range of cognitive tasks, including speech perception. We used blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI to search for neural correlates of these behavioral phenomena. We compared brain responses to simple speech stimuli (audiovisual syllables in 24 healthy older adults (53 to 70 years old and 14 younger adults (23 to 39 years old using two independent analysis strategies: region-of-interest (ROI and voxel-wise whole-brain analysis. While mean response amplitudes were moderately greater in younger adults, older adults had much greater within-subject variability. The greatly increased variability in older adults was observed for both individual voxels in the whole-brain analysis and for ROIs in the left superior temporal sulcus, the left auditory cortex, and the left visual cortex. Increased variability in older adults could not be attributed to differences in head movements between the groups. Increased neural variability may be related to the performance declines and increased behavioral variability that occur with aging.

Orthostatic hypotension and overall mortality in 1050 older patients of the outpatient comprehensive geriatric assessment unit.

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Freud, Tamar; Punchik, Boris; Kagan, Ella; Barzak, Alex; Press, Yan

2018-03-02

Orthostatic hypotension is a common problem in individuals aged ≥65 years. Its association with mortality is not clear. The aim of the present study was to evaluate associations between orthostatic hypotension and overall mortality in a sample of individuals aged ≥65 years who were seen at the Outpatient Comprehensive Geriatric Assessment Unit, Clalit Health Services, Beer-Sheva, Israel. Individuals who were evaluated in the Outpatient Comprehensive Geriatric Assessment Unit between January 2005 and December 2015, and who had data on orthostatic hypotension were included in the study. The database included sociodemographic characteristics, body mass index, functional and cognitive state, geriatric syndromes reached over the course of the assessment, and comorbidity. Data on mortality were also collected. The study sample included 1050 people, of whom 626 underwent comprehensive geriatric assessment and 424 underwent geriatric consultation. The mean age was 77.3 ± 5.4 years and 35.7% were men. Orthostatic hypotension was diagnosed in 294 patients (28.0%). In univariate analysis, orthostatic hypotension was associated with overall mortality only in patients aged 65-75 years (HR 1.5, 95% CI 1.07-2.2), but in the multivariate model this association disappeared. In older frail patients, orthostatic hypotension was not an independent risk factor for overall mortality. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

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Yamashita, Takashi; Noe, Douglas A.; Bailer, A. John

2012-01-01

Purpose of the Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors. Design and Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used.…

Age management in Slovenian enterprises: the viewpoint of older employees

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Jana Žnidaršič

2010-12-01

Full Text Available The main aim of this research is to highlight age management within Slovenian enterprises from the viewpoint of older employees by finding out what influences older employees to decide “should I stay or should I go”. The empirical research methodology is based on mixed strategy of approaching organizations (employees, which means that the quantitative (factor analysis, cluster analysis, correlation, regression, descriptive statistics and frequency distributions and qualitative parts (in-depth interviews analysis of research were conducted simultaneously. The results of the research indicate that there are in fact two groups of older employees, which can be referred to as “susceptible” and “insusceptible” in terms of how the employer can affect their decisions. “The unsusceptible” have already decided to retire as soon as possible and they cannot be influenced by any employer measure. On the other hand, “the susceptible” employees are sensitive to employers’ measures aimed at prolonging their working lives. Besides, a regression analysis confirmed a statistically significant correlation between the inclination towards extending one’s employment period and the susceptibility to the employer measures. It can thus be concluded that, through age management measures, an employer has an impact on an extended employment period of older employees. However, employers should be interested primarily in those employees who are inclined towards extending their working lives.

Nurses' understandings of suitable footwear for older people.

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

2013-01-01

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

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

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

2017-05-01

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

"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.

Predictors of suicidal ideation in older people: a decision tree analysis.

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Handley, Tonelle E; Hiles, Sarah A; Inder, Kerry J; Kay-Lambkin, Frances J; Kelly, Brian J; Lewin, Terry J; McEvoy, Mark; Peel, Roseanne; Attia, John R

2014-11-01

Suicide among older adults is a major public health issue worldwide. Although studies have identified psychological, physical, and social contributors to suicidal thoughts in older adults, few have explored the specific interactions between these factors. This article used a novel statistical approach to explore predictors of suicidal ideation in a community-based sample of older adults. Prospective cohort study. Participants aged 55-85 years were randomly selected from the Hunter Region, a large regional center in New South Wales, Australia. Baseline psychological, physical, and social factors, including psychological distress, physical functioning, and social support, were used to predict suicidal ideation at the 5-year follow-up. Classification and regression tree modeling was used to determine specific risk profiles for participants depending on their individual well-being in each of these key areas. Psychological distress was the strongest predictor, with 25% of people with high distress reporting suicidal ideation. Within high psychological distress, lower physical functioning significantly increased the likelihood of suicidal ideation, with high distress and low functioning being associated with ideation in 50% of cases. A substantial subgroup reported suicidal ideation in the absence of psychological distress; dissatisfaction with social support was the most important predictor among this group. The performance of the model was high (area under the curve: 0.81). Decision tree modeling enabled individualized "risk" profiles for suicidal ideation to be determined. Although psychological factors are important for predicting suicidal ideation, both physical and social factors significantly improved the predictive ability of the model. Assessing these factors may enhance identification of older people at risk of suicidal ideation. Copyright © 2014. Published by Elsevier Inc.

Implementing reverse mentoring to address social isolation among older adults.

Science.gov (United States)

Breck, Bethany M; Dennis, Cory B; Leedahl, Skye N

2018-07-01

Reverse mentoring is a means to address the social work Grand Challenge of social isolation. Among older adults, reverse mentoring can improve social connection by increasing the digital competence of older adults so they can use technology for social benefit, and by facilitating intergenerational connections with young adult mentors. In this paper, reverse mentoring is examined within an intergenerational program that serves older adults and utilizes the native technological knowledge and skills of young adults who mentor older adult participants. Qualitative data were collected through young adult mentor logs of each session, and through open-ended questions on the post-surveys collected from older adults and young adult mentors. Qualitative analysis revealed three themes related to social connection: (1) an increased sense of self-efficacy for older adults as they build confidence in technological use, and for young adults as they develop leadership skills through mentoring, (2) the breaking down of age-related stereotypes, and (3) intergenerational engagement and connection. The findings demonstrate that reverse mentoring can be used in various settings to decrease the social isolation of older adults by developing intergenerational connections and increasing older adult usage of technology.

Work Engagament of Older Employees

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Agnė Gaurylienė

2017-06-01

Full Text Available The aging of the labor force is observed in most developed and developing countries. The employment rate of older employees has been increasing every year and it appears to be not changed in the nearest future. The aging workforce is a serious challenge for organizations due to the prevailing stereotypical approach that older employees are less motivated, demonstrate lower labor productivity, they have more difficulties adopting new information, technologies and the lower ability to adapt to innovations. The aim of the paper is to investigate the impact of the work characteristics on the involvement in the work, the influence of employee’s characteristics on the work engagement, the influence of age and related factors on the involvement in the work and the relationship between age and achievements. The research is based on the analysis and synthesis of scientific literature, investigating to reveal the diversity of the concepts and methodologies and to systematize prevailing issues. The paper integrates the main researches in the field of older employees’ engagement and provides recommendations for future research.

Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross-sectional observational study.

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Okabe, Y; Takeuchi, K; Izumi, M; Furuta, M; Takeshita, T; Shibata, Y; Kageyama, S; Ganaha, S; Yamashita, Y

2017-02-01

The total number of natural teeth was related to swallowing function among older adults; however, limited information is available regarding the impact of occluding pairs of teeth on swallowing function. This study aimed to examine the association between posterior teeth occlusion and dysphagia risk in older nursing home residents. This cross-sectional study included 238 residents aged ≥60 years from eight nursing homes in Aso City, Japan. Swallowing function was evaluated using the modified water swallowing test (MWST); the primary outcome was dysphagia risk (MWST score ≤3). Posterior teeth occlusion was assessed using number of functional tooth units (FTUs), determined based on number and location of the remaining natural and artificial teeth on implant-supported, fixed or removable prostheses. Univariate and multivariate logistic regression analyses were performed to examine the association between posterior teeth occlusion and dysphagia risk, adjusted for the covariates of number of natural teeth, demographic characteristics, comorbidities, physical function, body mass index and cognitive function. Of the 238 subjects, 44 (18·5%) were determined to be at risk of dysphagia based on the MWST scores. The odds ratio (OR) of dysphagia risk decreased in subjects with higher total FTUs [OR = 0·92, 95% confidence interval (CI) 0·87-0·98]. After adjusting for covariates, this association remained significant (OR = 0·90, 95% CI 0·84-0·97). Loss of posterior teeth occlusion was independently associated with dysphagia risk in older nursing home residents. Maintaining and restoring posterior teeth occlusion may be an effective measure to prevent dysphagia. © 2016 John Wiley & Sons Ltd.

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

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Haque, Md Nuruzzaman

2016-01-01

Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different (p active ageing level. Implementation of an Integrated Active Ageing Package (IAAP), containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons' active ageing level in Thailand.

Home as a health promotion setting for older adults

DEFF Research Database (Denmark)

Mahler, Marianne; Sarvimäki, Anneli; Clancy, Anne

2014-01-01

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

Depressive symptoms among adolescents and older adults in Mexico City.

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Sánchez-García, Sergio; García-Peña, Carmen; González-Forteza, Catalina; Jiménez-Tapia, Alberto; Gallo, Joseph J; Wagner, Fernando A

2014-06-01

Determine the structure of depressive symptoms among adolescents and older adults through the person-centered approach of latent class analysis (LCA). The study is based on data from two independent samples collected in Mexico City (2,444 adolescents and 2,223 older adults) which included the revised version of the CES-D. The presence or absence of depressed mood (dysphoria), diminished pleasure (anhedonia), drastic change in weight, sleep problems, thinking and concentration difficulties, excessive or inappropriate guilt, fatigue, psychomotor agitation/retardation, and suicide ideation were used in LCA to determine the structure of depressive symptoms for adolescents and older adults. Adolescents reported higher excessive or inappropriate guilt compared to older adults, while older adults had higher proportions of anhedonia, sleep problems, fatigue, and psychomotor agitation/retardation. Similar proportions were found in other symptoms. The LCA analysis showed the best fit with four latent classes (LC): LC 1, "symptoms suggestive of major depressive episode (MDE)" with prevalence of 5.9 % (n = 144) and 10.3 % (n = 230) among adolescents and older adults, respectively; LC 2, "probable MDE symptoms" 18.2 % (n = 446) and 23.0 % (n = 512); LC 3, "possible MDE" 27.7 % (n = 676) and 21.8 % (n = 485); LC 4, "without significant depressive symptoms" 48.2 % (n = 1,178) and 44.8 % (n = 996). The differences in item thresholds between the two groups (adolescents vs. older adults) were statistically significant (Wald test = 255.684, df = 1, p depressive symptoms between adolescents and older adults that merit acknowledgment, further study, and consideration of their potential clinical and public health implications.

Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis.

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Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping

2015-05-28

Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis.

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

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

2015-12-01

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

Injury mechanisms, patterns and outcomes of older polytrauma patients—An analysis of the Dutch Trauma Registry

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Reininga, Inge H. F.; Pieske, Oliver; Lefering, Rolf; El Moumni, Mostafa; Wendt, Klaus

2018-01-01

Background Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. Methods Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18–59) and older (Group B: ages ≥60) polytrauma patients were compared. Differences in injury severity, trauma mechanism (only data for the year 2014), vital signs, injury patterns, ICU characteristics and hospital mortality were analyzed. Results Data of 25,304 polytrauma patients were analyzed. The older patients represented 47.8% of the polytrauma population. Trauma mechanism in the older patients was more likely to be a bicycle accident (A: 17%; B: 21%) or a low-energy fall (A: 13%; B: 43%). Younger polytrauma patients were more likely to have the worst scores on the Glasgow coma scale (EMV = 3, A: 20%, B: 13%). However, serious head injuries were seen more often in the older patients (A: 53%; B: 69%). The hospital mortality was doubled for the older polytrauma patients (19.8% vs. 9.6%). Conclusion Elderly are involved more often in polytrauma. Although injury severity did not differ between groups, the older polytrauma patients were at a higher risk of dying than their younger counterparts despite sustaining less high-energy accidents. PMID:29304054

Injury mechanisms, patterns and outcomes of older polytrauma patients-An analysis of the Dutch Trauma Registry.

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de Vries, Rob; Reininga, Inge H F; Pieske, Oliver; Lefering, Rolf; El Moumni, Mostafa; Wendt, Klaus

2018-01-01

Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18-59) and older (Group B: ages ≥60) polytrauma patients were compared. Differences in injury severity, trauma mechanism (only data for the year 2014), vital signs, injury patterns, ICU characteristics and hospital mortality were analyzed. Data of 25,304 polytrauma patients were analyzed. The older patients represented 47.8% of the polytrauma population. Trauma mechanism in the older patients was more likely to be a bicycle accident (A: 17%; B: 21%) or a low-energy fall (A: 13%; B: 43%). Younger polytrauma patients were more likely to have the worst scores on the Glasgow coma scale (EMV = 3, A: 20%, B: 13%). However, serious head injuries were seen more often in the older patients (A: 53%; B: 69%). The hospital mortality was doubled for the older polytrauma patients (19.8% vs. 9.6%). Elderly are involved more often in polytrauma. Although injury severity did not differ between groups, the older polytrauma patients were at a higher risk of dying than their younger counterparts despite sustaining less high-energy accidents.

Obesity and Sexuality Among Older Couples.

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Kwon, Soyoung; Schafer, Markus H

2016-04-01

We investigate whether obesity is associated with sexual activity, sexual frequency, and the range of sexual behaviors in heterosexual older couples. We assess to what extent associations between obesity and sexuality are explained by physical, psychological, and sexual health, and by relationship quality. We use data from 1,698 older adults in 849 partnered dyads in the 2010-2011 wave of the National Social Life, Health, and Aging Project and conduct couple-level analysis featuring women's and men's characteristics. Women's obesity-particularly at severe levels-is negatively associated with coupled sexual activity, and that the association is not mediated by hypothesized mediators. Men's obesity did not have any association with sexual activity. There was no significant difference between overweight and normal weight adults across all three sexuality measures. The growing number of older adults with high levels of body mass index, particularly women, may face certain difficulties in maintaining active sexual lives.

In situ calibration using univariate analyses based on the onboard ChemCam targets: first prediction of Martian rock and soil compositions

Energy Technology Data Exchange (ETDEWEB)

Fabre, C. [GeoRessources lab, Université de Lorraine, Nancy (France); Cousin, A.; Wiens, R.C. [Los Alamos National Laboratory, Los Alamos, NM (United States); Ollila, A. [University of NM, Albuquerque (United States); Gasnault, O.; Maurice, S. [IRAP, Toulouse (France); Sautter, V. [Museum National d' Histoire Naturelle, Paris (France); Forni, O.; Lasue, J. [IRAP, Toulouse (France); Tokar, R.; Vaniman, D. [Planetary Science Institute, Tucson, AZ (United States); Melikechi, N. [Delaware State University (United States)

2014-09-01

Curiosity rover landed on August 6th, 2012 in Gale Crater, Mars and it possesses unique analytical capabilities to investigate the chemistry and mineralogy of the Martian soil. In particular, the LIBS technique is being used for the first time on another planet with the ChemCam instrument, and more than 75,000 spectra have been returned in the first year on Mars. Curiosity carries body-mounted calibration targets specially designed for the ChemCam instrument, some of which are homgeneous glasses and others that are fine-grained glass-ceramics. We present direct calibrations, using these onboard standards to infer elements and element ratios by ratioing relative peak areas. As the laser spot size is around 300 μm, the LIBS technique provides measurements of the silicate glass compositions representing homogeneous material and measurements of the ceramic targets that are comparable to fine-grained rock or soil. The laser energy and the auto-focus are controlled for all sequences used for calibration. The univariate calibration curves present relatively to very good correlation coefficients with low RSDs for major and ratio calibrations. Trace element calibration curves (Li, Sr, and Mn), down to several ppm, can be used as a rapid tool to draw attention to remarkable rocks and soils along the traverse. First comparisons to alpha-particle X-ray spectroscopy (APXS) data, on selected targets, show good agreement for most elements and for Mg# and Al/Si estimates. SiO{sub 2} estimates using univariate cannot be yet used. Na{sub 2}O and K{sub 2}O estimates are relevant for high alkali contents, but probably under estimated due to the CCCT initial compositions. Very good results for CaO and Al{sub 2}O{sub 3} estimates and satisfactory results for FeO are obtained. - Highlights: • In situ LIBS univariate calibrations are done using the Curiosity onboard standards. • Major and minor element contents can be rapidly obtained. • Trace element contents can be used as a

Monitoring endemic livestock diseases using laboratory diagnostic data: A simulation study to evaluate the performance of univariate process monitoring control algorithms.

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Lopes Antunes, Ana Carolina; Dórea, Fernanda; Halasa, Tariq; Toft, Nils

2016-05-01

Surveillance systems are critical for accurate, timely monitoring and effective disease control. In this study, we investigated the performance of univariate process monitoring control algorithms in detecting changes in seroprevalence for endemic diseases. We also assessed the effect of sample size (number of sentinel herds tested in the surveillance system) on the performance of the algorithms. Three univariate process monitoring control algorithms were compared: Shewart p Chart(1) (PSHEW), Cumulative Sum(2) (CUSUM) and Exponentially Weighted Moving Average(3) (EWMA). Increases in seroprevalence were simulated from 0.10 to 0.15 and 0.20 over 4, 8, 24, 52 and 104 weeks. Each epidemic scenario was run with 2000 iterations. The cumulative sensitivity(4) (CumSe) and timeliness were used to evaluate the algorithms' performance with a 1% false alarm rate. Using these performance evaluation criteria, it was possible to assess the accuracy and timeliness of the surveillance system working in real-time. The results showed that EWMA and PSHEW had higher CumSe (when compared with the CUSUM) from week 1 until the end of the period for all simulated scenarios. Changes in seroprevalence from 0.10 to 0.20 were more easily detected (higher CumSe) than changes from 0.10 to 0.15 for all three algorithms. Similar results were found with EWMA and PSHEW, based on the median time to detection. Changes in the seroprevalence were detected later with CUSUM, compared to EWMA and PSHEW for the different scenarios. Increasing the sample size 10 fold halved the time to detection (CumSe=1), whereas increasing the sample size 100 fold reduced the time to detection by a factor of 6. This study investigated the performance of three univariate process monitoring control algorithms in monitoring endemic diseases. It was shown that automated systems based on these detection methods identified changes in seroprevalence at different times. Increasing the number of tested herds would lead to faster

Falls Risk Prediction for Older Inpatients in Acute Care Medical Wards: Is There an Interest to Combine an Early Nurse Assessment and the Artificial Neural Network Analysis?

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Beauchet, O; Noublanche, F; Simon, R; Sekhon, H; Chabot, J; Levinoff, E J; Kabeshova, A; Launay, C P

2018-01-01

Identification of the risk of falls is important among older inpatients. This study aims to examine performance criteria (i.e.; sensitivity, specificity, positive predictive value, negative predictive value and accuracy) for fall prediction resulting from a nurse assessment and an artificial neural networks (ANNs) analysis in older inpatients hospitalized in acute care medical wards. A total of 848 older inpatients (mean age, 83.0±7.2 years; 41.8% female) admitted to acute care medical wards in Angers University hospital (France) were included in this study using an observational prospective cohort design. Within 24 hours after admission of older inpatients, nurses performed a bedside clinical assessment. Participants were separated into non-fallers and fallers (i.e.; ≥1 fall during hospitalization stay). The analysis was conducted using three feed forward ANNs (multilayer perceptron [MLP], averaged neural network, and neuroevolution of augmenting topologies [NEAT]). Seventy-three (8.6%) participants fell at least once during their hospital stay. ANNs showed a high specificity, regardless of which ANN was used, and the highest value reported was with MLP (99.8%). In contrast, sensitivity was lower, with values ranging between 98.4 to 14.8%. MLP had the highest accuracy (99.7). Performance criteria for fall prediction resulting from a bedside nursing assessment and an ANNs analysis was associated with a high specificity but a low sensitivity, suggesting that this combined approach should be used more as a diagnostic test than a screening test when considering older inpatients in acute care medical ward.

Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study.

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Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

2017-05-30

Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. © 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.

Oral hygiene of hospitalised older patients with lower limb fracture.

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Ewan, Victoria; Newton, Julia L; Rushton, Steven; Walls, Angus W G

2016-11-01

good oral hygiene is important for eating, talking and improved quality of life, and is part of basic patient care, but there are few observational studies in hospitalised older patients. The aim of this study is to investigate dental plaque load in older patients over time in hospital. we examined the mouths of 93 patients with lower limb fracture prospectively at day 1, 7 and 14 after admission in a Newcastle upon Tyne Hospital. We assessed dental and denture plaque load, dry mouth symptoms and tooth number, along with demographic and frailty variables. We used univariate generalised linear modelling and mixed effects models to investigate associations between increased plaque and patient characteristics. in dentate patients, plaque score increased with time in hospital (P = 0.007, odds ratio (OR): 1.02; 95% confidence of interval (CI): 1.01-1.04). Frailty (P = 0.015, OR: 1.19; 95% CI: 1.04-1.37), dementia (P < 0.001, OR: 4.30; 95% CI: 2.03-9.12), residence in an institution (P < 0.001, OR: 4.61; 95% CI: 2.18-9.74), decreased mobility (P = 0.013, OR: 0.97; 95% CI: 0.96-0.99), but not Charlson comorbidity index (P = 0.102, OR: 1.08; 95% CI: 0.99-1.19), were associated with increased plaque scores at every time point. oral hygiene deteriorated in dentate patients in hospital. Plaque scores were significantly higher in patients who were more likely to be dependent on others for their oral hygiene. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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

2016-11-01

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

Impaired mobility, depressed mood, cognitive impairment and polypharmacy are independently associated with disability in older cancer outpatients: The prospective Physical Frailty in Elderly Cancer patients (PF-EC) cohort study.

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Pamoukdjian, Frederic; Aparicio, Thomas; Zelek, Laurent; Boubaya, Marouane; Caillet, Philippe; François, Veronique; de Decker, Laure; Lévy, Vincent; Sebbane, Georges; Paillaud, Elena

2017-05-01

To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer. The Physical Frailty in Elderly Cancer patients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted. Disability was defined as impairment in activities of daily living (ADL) and/or instrumental activities of daily living (IADL), simplified to four items. Univariate and multivariate logistic models of disabled patients were performed. The three final multivariate models were compared using the area under the receiver operating characteristic curve (AUC/ROC) of the logistic model. The mean age was 80.6years, and 51% of the patients were women with various types of cancer. The prevalence of disability was 67.6%. No oncologic factors (cancer site, cancer extension) were associated with disability. Impaired mobility, poor functional status, depressive mood, cognitive impairment and polypharmacy were independently associated with disability (PDisability was highly prevalent in older cancer outpatients before cancer treatment but was not associated with oncologic factors. Impaired mobility, depressed mood, cognitive impairment and polypharmacy were the geriatric variables significantly and independently associated with disability. Identifying these factors prior to cancer treatment could enable the implementation of corrective actions to improve patient autonomy before treatment and during follow-up. Copyright © 2017 Elsevier Ltd. All rights reserved.

"Heart trouble" and religious involvement among older white men and women.

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Thompson, Edward H; Killgore, Leslie; Connors, Heather

2009-09-01

Objective Few studies examine how older adults' health status affects spiritual and religious involvement. This study examined the effects of gender and poor cardiac health on older adults' ends, means, and quest religious motivations and frequency of private devotion. Method Longitudinal data (12 months between the T1 and T2 interviews) with 182 older adults sampled from a Northeast city were used to examine in a multivariate analysis of covariance whether gender and the existence of cardiac health problems at T1 affected older adults' spiritual and religious involvement at T2. Findings A gender and cardiac health condition interaction showed older men with heart trouble had more changes in religious involvement-they engaged in more religious doubt, prayed less, and were not as intrinsically oriented at T2. Discussion The findings strongly suggest that older men with heart trouble may maintain a masculine style and shun seeking divine help.

Perceived age discrimination in older adults.

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Rippon, Isla; Kneale, Dylan; de Oliveira, Cesar; Demakakos, Panayotes; Steptoe, Andrew

2014-05-01

to examine perceived age discrimination in a large representative sample of older adults in England. this cross-sectional study of over 7,500 individuals used data from the fifth wave of the English Longitudinal Study of Ageing (ELSA), a longitudinal cohort study of men and women aged 52 years and older in England. Wave 5 asked respondents about the frequency of five everyday discriminatory situations. Participants who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. Multivariable logistic regression analysis was used to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. approximately a third (33.3%) of all respondents experienced age discrimination, rising to 36.8% in those aged 65 and over. Perceived age discrimination was associated with older age, higher education, lower levels of household wealth and being retired or not in employment. The correlates of age discrimination across the five discriminatory situations were similar. understanding age discrimination is vital if we are to develop appropriate policies and to target future interventions effectively. These findings highlight the scale of the challenge of age discrimination for older adults in England and illustrate that those groups are particularly vulnerable to this form of discrimination.

ANALYSIS OF DNA DAMAGE AND REPAIR IN SKIN FIBROBLASTS OF INFANT AND OLDER CHILDREN USING THE IN VITRO ALKALINE COMET ASSAY

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ANALYSIS OF DNA DAMAGE AND REPAIR IN SKIN FIBROBLASTS OF INFANT AND OLDER CHILDREN USING THE IN VITRO ALKALINE COMET ASSAY, Alan H. Tennant1, Geremy W. Knapp1 and Andrew D. Kligerman1, 1Environmental Carcinogenesis Division, National Health and Environmental Effects Research Lab...

Outcome in hip fracture patients related to anemia at admission and allogeneic blood transfusion: an analysis of 1262 surgically treated patients

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Vochteloo Anne JH

2011-11-01

Full Text Available Abstract Background Anemia is more often seen in older patients. As the mean age of hip fracture patients is rising, anemia is common in this population. Allogeneic blood transfusion (ABT and anemia have been pointed out as possible risk factors for poorer outcome in hip fracture patients. Methods In the timeframe 2005-2010, 1262 admissions for surgical treatment of a hip fracture in patients aged 65 years and older were recorded. Registration was prospective from 2008 on. Anemic and non-anemic patients (based on hemoglobin level at admission were compared regarding clinical characteristics, mortality, delirium incidence, LOS, discharge to a nursing home and the 90-day readmission rate. Receiving an ABT, age, gender, ASA classification, type of fracture and anesthesia were used as possible confounders in multivariable regression analysis. Results The prevalence of anemia and the rate of ABT both were 42.5%. Anemic patients were more likely to be older and men and had more often a trochanteric fracture, a higher ASA score and received more often an ABT. In univariate analysis, the 3- and 12-month mortality rate, delirium incidence and discharge to a nursing home rate were significantly worse in preoperatively anemic patients. In multivariable regression analysis, anemia at admission was a significant risk factor for discharge to a nursing home and readmission Conclusions This study has demonstrated that anemia at admission and postoperative anemia needing an ABT (PANT were independent risk factors for worse outcome in hip fracture patients. In multivariable regression analysis, anemia as such had no effect on mortality, due to a rescue effect of PANT. In-hospital, 3- and 12-month mortality was negatively affected by PANT, with the main effect in the first 3 months postoperatively.

An examination of electronic health information privacy in older adults.

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Le, Thai; Thompson, Hilaire; Demiris, George

2013-01-01

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

Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

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Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

2013-01-01

Background Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Results Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (“fallers”). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21–4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Conclusions Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes. PMID:23825617

Daily Living Functioning, Social Engagement and Wellness of Older Adults

Directory of Open Access Journals (Sweden)

Noor Zainab

2017-08-01

Full Text Available AimThe present study aim to investigate the contributing role of daily living functioning and social engagement in enhancing wellness and various dimensions of wellness in older adults.MethodA correlational research was designed. Socio-demographic data was collected. Lawton Instrumental Activities of Daily Living, Lubben Social Network Scale, and Perceived Wellness Survey were administered on a sample of 112 participants, including 56 men and 56 women.ResultsA correlation analysis found positive correlations between daily living functioning, social engagement and wellness of older adults. The results of regression analysis concluded that both the daily living functioning and social engagement predicted wellness and domains of wellness as well.ConclusionThe obtained results indicate that older adults who are self-reliant lead a more satisfied life in old age and demonstrate to be more adjusted to the effects of aging.

"There's Not Enough Knowledge Out There": Examining Older Adults' Perceptions of Digital Technology Use and Digital Inclusion Classes.

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Betts, Lucy R; Hill, Rowena; Gardner, Sarah E

2017-10-01

Older adults' definitions of digital technology, and experiences of digital inclusion sessions, were examined using qualitative approaches. Seventeen older adults (aged between 54 and 85 years) participated in two focus groups that each lasted approximately 90 min to explore how older adults understood technology within their lived experience. Interpretative phenomenological analysis yielded two main themes: thirst for knowledge and a wish list for digital technology sessions. A separate content analysis was performed to identify what technology older adults identified as digital technology. This analysis revealed that the older adults most frequently defined digital technology as computers and telephones. The findings support the conclusions that this group of older adults, some of whom were "successful users," have a wide knowledge of digital technology, are interested in gaining more skills, and desire knowledge acquisition through personalized one-to-one learning sessions.

Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis.

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Okubo, Yoshiro; Schoene, Daniel; Lord, Stephen R

2017-04-01

To examine the effects of stepping interventions on fall risk factors and fall incidence in older people. Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015. Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors. Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, prisk ratio=0.51, 95% CI 0.38 to 0.68, pfalls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36-416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (pfalls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required. CRD42015017357. 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/.

Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai

OpenAIRE

Stephan Bandelow; Xin Xu; Shifu Xiao; Eef Hogervorst

2016-01-01

This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no p...

Independent older adults perspectives on oral health.

Science.gov (United States)

Khabra, K K; Compton, S M; Keenan, L P

2017-11-01

The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Older drivers' attitudes about instrument cluster designs in vehicles.

Science.gov (United States)

Owsley, Cynthia; McGwin, Gerald; Seder, Thomas

2011-11-01

Little is known about older drivers' preferences and attitudes about instrumentation design in vehicles. Yet visual processing impairments are common among older adults and could impact their ability to interface with a vehicle's dashboard. The purpose of this study is to obtain information from them about this topic, using focus groups and content analysis methodology. A trained facilitator led 8 focus groups of older adults. Discussion was stimulated by an outline relevant to dashboard interfaces, audiotaped, and transcribed. Using multi-step content analysis, a trained coder placed comments into thematic categories and coded comments as positive, negative, or neutral in meaning. Comments were coded into these categories: gauges, knobs/switches, interior lighting, color, lettering, symbols, location, entertainment, GPS, cost, uniformity, and getting information. Comments on gauges and knobs/switches represented half the comments. Women made more comments about getting information; men made more comments about uniformity. Positive and negative comments were made in each category; individual differences in preferences were broad. The results of this study will be used to guide the design of a population-based survey of older drivers about instrument cluster format, which will also examine how their responses are related to their visual processing capabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

Social networks of older adults living with HIV in Finland.

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Nobre, Nuno Ribeiro; Kylmä, Jari; Kirsi, Tapio; Pereira, Marco

2016-01-01

The aim of this study was to explore the social networks of older adults living with HIV. Interviews were conducted with nine individuals aged 50 or older living with HIV in Helsinki, Finland. Analysis of transcripts was analysed by inductive qualitative content analysis. Results indicated that these participants' networks tended to be large, including those both aware and unaware of the participants' health status. Analysis identified three main themes: large multifaceted social networks, importance of a support group, and downsizing of social networks. Support received appeared to be of great importance in coping with their health condition, especially since the time of diagnosis. Friends and family were the primary source of informal support. The majority of participants relied mostly on friends, some of whom were HIV-positive. Formal support came primarily from the HIV organisation's support group. In this study group, non-disclosure did not impact participants' well-being. In years to come, social networks of older adults living with HIV may shrink due to personal reasons other than HIV-disclosure. What is of primary importance is that healthcare professionals become knowledgeable about psychosocial issues of older adults living with HIV, identifying latent problems and developing adequate interventions in the early stages of the disease; this would help prevent social isolation and foster successful ageing with HIV.

Longitudinal Analysis of the Relationship Between Purposes of Internet Use and Well-being Among Older Adults.

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Szabo, Agnes; Allen, Joanne; Stephens, Christine; Alpass, Fiona

2018-04-23

There is support for the role of Internet use in promoting well-being among older people. However, there are also contradictory findings which may be attributed to methodological issues. First, research has focused on frequency of online activity rather than how engagement in different types of online activities may influence well-being. Secondly, previous studies have used either cross-sectional designs, which cannot elucidate causality or intervention designs with uncontrolled extraneous variables. In this longitudinal observational study, we test the indirect impact of online engagement for social, informational, and instrumental purposes on older adults' well-being via reducing loneliness and supporting social engagement. A population sample of 1,165 adults aged 60-77 (M = 68.22, SD = 4.42; 52.4% female) was surveyed over 3 waves. Using longitudinal mediation analysis with demographic controls, the indirect effects of types of Internet use on well-being through loneliness and social engagement were estimated. Participants engaged online for 3 purposes: social (e.g., connecting with friends/family), instrumental (e.g., banking), and informational (e.g., reading health-related information). Social use indirectly impacted well-being via decreased loneliness and increased social engagement. Informational and instrumental uses indirectly impacted well-being through engagement in a wider range of activities; however, were unrelated to loneliness. Findings highlight that Internet use can support older adults' well-being; however, not every form of engagement impacts well-being the same way. These findings will inform the focus of interventions which aim to promote well-being.

Application of Raman Spectroscopy and Univariate Modelling As a Process Analytical Technology for Cell Therapy Bioprocessing

Science.gov (United States)

Baradez, Marc-Olivier; Biziato, Daniela; Hassan, Enas; Marshall, Damian

2018-01-01

Cell therapies offer unquestionable promises for the treatment, and in some cases even the cure, of complex diseases. As we start to see more of these therapies gaining market authorization, attention is turning to the bioprocesses used for their manufacture, in particular the challenge of gaining higher levels of process control to help regulate cell behavior, manage process variability, and deliver product of a consistent quality. Many processes already incorporate the measurement of key markers such as nutrient consumption, metabolite production, and cell concentration, but these are often performed off-line and only at set time points in the process. Having the ability to monitor these markers in real-time using in-line sensors would offer significant advantages, allowing faster decision-making and a finer level of process control. In this study, we use Raman spectroscopy as an in-line optical sensor for bioprocess monitoring of an autologous T-cell immunotherapy model produced in a stirred tank bioreactor system. Using reference datasets generated on a standard bioanalyzer, we develop chemometric models from the Raman spectra for glucose, glutamine, lactate, and ammonia. These chemometric models can accurately monitor donor-specific increases in nutrient consumption and metabolite production as the primary T-cell transition from a recovery phase and begin proliferating. Using a univariate modeling approach, we then show how changes in peak intensity within the Raman spectra can be correlated with cell concentration and viability. These models, which act as surrogate markers, can be used to monitor cell behavior including cell proliferation rates, proliferative capacity, and transition of the cells to a quiescent phenotype. Finally, using the univariate models, we also demonstrate how Raman spectroscopy can be applied for real-time monitoring. The ability to measure these key parameters using an in-line Raman optical sensor makes it possible to have immediate

Application of Raman Spectroscopy and Univariate Modelling As a Process Analytical Technology for Cell Therapy Bioprocessing.

Science.gov (United States)

Baradez, Marc-Olivier; Biziato, Daniela; Hassan, Enas; Marshall, Damian

2018-01-01

Cell therapies offer unquestionable promises for the treatment, and in some cases even the cure, of complex diseases. As we start to see more of these therapies gaining market authorization, attention is turning to the bioprocesses used for their manufacture, in particular the challenge of gaining higher levels of process control to help regulate cell behavior, manage process variability, and deliver product of a consistent quality. Many processes already incorporate the measurement of key markers such as nutrient consumption, metabolite production, and cell concentration, but these are often performed off-line and only at set time points in the process. Having the ability to monitor these markers in real-time using in-line sensors would offer significant advantages, allowing faster decision-making and a finer level of process control. In this study, we use Raman spectroscopy as an in-line optical sensor for bioprocess monitoring of an autologous T-cell immunotherapy model produced in a stirred tank bioreactor system. Using reference datasets generated on a standard bioanalyzer, we develop chemometric models from the Raman spectra for glucose, glutamine, lactate, and ammonia. These chemometric models can accurately monitor donor-specific increases in nutrient consumption and metabolite production as the primary T-cell transition from a recovery phase and begin proliferating. Using a univariate modeling approach, we then show how changes in peak intensity within the Raman spectra can be correlated with cell concentration and viability. These models, which act as surrogate markers, can be used to monitor cell behavior including cell proliferation rates, proliferative capacity, and transition of the cells to a quiescent phenotype. Finally, using the univariate models, we also demonstrate how Raman spectroscopy can be applied for real-time monitoring. The ability to measure these key parameters using an in-line Raman optical sensor makes it possible to have immediate

Application of Raman Spectroscopy and Univariate Modelling As a Process Analytical Technology for Cell Therapy Bioprocessing

Directory of Open Access Journals (Sweden)

Marc-Olivier Baradez

2018-03-01

Full Text Available Cell therapies offer unquestionable promises for the treatment, and in some cases even the cure, of complex diseases. As we start to see more of these therapies gaining market authorization, attention is turning to the bioprocesses used for their manufacture, in particular the challenge of gaining higher levels of process control to help regulate cell behavior, manage process variability, and deliver product of a consistent quality. Many processes already incorporate the measurement of key markers such as nutrient consumption, metabolite production, and cell concentration, but these are often performed off-line and only at set time points in the process. Having the ability to monitor these markers in real-time using in-line sensors would offer significant advantages, allowing faster decision-making and a finer level of process control. In this study, we use Raman spectroscopy as an in-line optical sensor for bioprocess monitoring of an autologous T-cell immunotherapy model produced in a stirred tank bioreactor system. Using reference datasets generated on a standard bioanalyzer, we develop chemometric models from the Raman spectra for glucose, glutamine, lactate, and ammonia. These chemometric models can accurately monitor donor-specific increases in nutrient consumption and metabolite production as the primary T-cell transition from a recovery phase and begin proliferating. Using a univariate modeling approach, we then show how changes in peak intensity within the Raman spectra can be correlated with cell concentration and viability. These models, which act as surrogate markers, can be used to monitor cell behavior including cell proliferation rates, proliferative capacity, and transition of the cells to a quiescent phenotype. Finally, using the univariate models, we also demonstrate how Raman spectroscopy can be applied for real-time monitoring. The ability to measure these key parameters using an in-line Raman optical sensor makes it possible

Independence through social networks: bridging potential among older women and men.

Science.gov (United States)

Cornwell, Benjamin

2011-11-01

Most studies of older adults' social networks focus on their access to dense networks that yield access to social support. This paper documents gender differences in the extent to which older adults maintain a related, but distinct, form of social capital-bridging potential, which involves serving as a tie between two unconnected parties and thus boosts independence and control of everyday social life. I use egocentric social network data from a national sample of 3,005 older adults--collected in 2005-2006 by the National Social Life, Health, and Aging Project--to compare older men's and women's network bridging potential using multivariate regression analysis. Older women are more likely than older men to have bridging potential in their networks-between both kin and non-kin contacts. These gender differences increase with age. Older women are also more likely to have network members who are not connected to or monopolized by their spouse or partner. Some, but not all, of these gender differences are due to the fact that older women have larger social networks and maintain more ties to people outside of the household. These findings raise important questions about the relational advantages older women have over older men, including greater autonomy, and contradict stereotypes about women having more closely knit, kin-centered networks than men.

Influence of Weight Loss, Body Composition, and Lifestyle Behaviors on Plasma Adipokines: A Randomized Weight Loss Trial in Older Men and Women with Symptomatic Knee Osteoarthritis

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Gary D. Miller

2012-01-01

Full Text Available Objective. To investigate effects of weight loss on adipokines and health measures in obese older adults with symptomatic knee osteoarthritis. Methods. Participants were randomly assigned to either weight loss (WL (men: 12, women: 14 or weight stable (WS group (men: 12, women: 13. WL intervention included meal replacements and structured exercise training. Measurements of leptin, adiponectin, soluble leptin receptor, lifestyle behaviors, and body composition were collected at baseline and 6 months. Univariate analysis of covariance was performed on 6 month variables, and Spearman and partial correlations were made between variables. Results. Weight loss was 13.0% and 6.7% in WL for men and women, respectively. Women in WL had lower whole body and trunk fat than WS. The leptin : adiponectin ratio was lower for women in WL than WS at 6 months, with no group differences in adipokines for men. Leptin and free leptin index correlated with body fat in both genders at baseline. Interestingly, only women showed reductions in leptin (P<0.100 and correlations between the percentage change leptin and trunk fat and the percentage changes in free leptin index with total fat and trunk fat. Partial correlations between 6 month adipokines after adjustments for covariates and group/time period show potential multivariate influences. Conclusions. In the presence of an effective weight loss intervention in older obese adults, there are significant relationships between weight and fat loss and leptin in women, but not men, suggesting gender-specific features of adipokine metabolism in this age group.

a meta-analysis

Indian Academy of Sciences (India)

Chrissa G. Tsiara

2018-03-13

Mar 13, 2018 ... a meta-analysis of case–control studies was conducted. Univariate and ...... recent hepatitis C virus: potential benefit for ribavirin use in. HCV/HIV ... C/G polymorphism in breast pathologies and in HIV-infected patients.

Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey.

Science.gov (United States)

Orces, Carlos H

2013-01-01

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

Directory of Open Access Journals (Sweden)

Carlos H. Orces

2013-01-01

Full Text Available The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

Fatal traumatic brain injury in older adults in Austria 1980-2012: an analysis of 33 years.

Science.gov (United States)

Brazinova, Alexandra; Mauritz, Walter; Majdan, Marek; Rehorcikova, Veronika; Leitgeb, Johannes

2015-05-01

traumatic brain injury (TBI) is a significant public health problem. Developed countries report a significant increase of TBI in older adults in the past decades. The objective of this study was to investigate the changes in TBI-related mortality in older Austrians (65 years or older) between 1980 and 2012 (33 years) and to identify possible causes for these changes. data from Statistics Austria on mortality in Austria between 1980 and 2012 were screened and data on TBI-related mortality in adults aged 65 and older were extracted and analysed, based on the diagnostic codes of the International Classification of Diseases, 10th and 9th revision. Mortality rates were calculated for 5-year age groups; standardized mortality rates were calculated for the total. Mechanism of injury was analysed for all events, both sexes and individual age groups. between 1980 and 2012, 16,204 people aged 65 or older died from TBI in Austria; 61% of these were male. Fatal TBI cases and mortality rates increased in the oldest age groups (80 years or older). Half of the fatal TBI cases were caused by falls, 22% by traffic accidents and 17% by suicides. Rate of fall-related fatal TBI increased and rate of traffic accident-related fatal TBI decreased with age. preventive measures introduced in the past decades in the developed countries have contributed to a decrease in traffic injuries. However, falls in the older population are on the rise, mainly due to ageing of the population, throughout the reported period. It is important to take preventive measures to stop the epidemics of fall-related TBIs and fatalities in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Changes in disability in older adults with generalized radiographic osteoarthritis: A complex relationship with physical activity.

Science.gov (United States)

Tak, E C P M; van Meurs, J B; Bierma-Zeinstra, S M A; Hofman, A; Hopman-Rock, M

2017-12-01

The aim of the present study was to report on factors associated with changes in disability after 5 years, with a focus on physical activity (PA) in community-dwelling older adults with generalized radiographic osteoarthritis (GROA). Assessment of GROA (hand, knee, hip) and disability (Health Assessment Questionnaire) in the Rotterdam Study (cohort RS-1, N = 7,983; with GROA, n = 821). A good outcome at follow-up was defined as improved or mild disability, and a poor outcome as worsened or severe disability. Factors potentially associated with outcome were demographics, joint complaints, other chronic health problems or limitations (body mass index, number of chronic conditions, cognition), and level of different types of PA. Some of these assessments were repeated in between 1997 and 1999 (RS-3), and between 2002 and 2004 (RS-4). A total of 309 older adults with GROA and valid measures on RS-3 and RS-4 showed mild to moderate disability, with minor increases over 5 years (follow-up N = 287 RS-3 to RS-4). PA levels decreased with increasing disability, especially in sport and walking. PA was univariately associated with a better outcome at follow-up but when adjusted for other factors (higher age, having knee pain and stiffness, and having more than two other chronic conditions) was associated with negative changes in general and lower limb disability, although not with upper limb disability. This was the first study to report that community-dwelling older adults with GROA show moderate levels of disability, and that reduced levels of disability are associated with higher levels of PA, but when adjusted for other confounders this association is lost. Further research is needed to study the complex relationships between PA and other determinants of disability. Copyright © 2017 John Wiley & Sons, Ltd.

Depression in Older Adults

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

Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis.

Science.gov (United States)

Cheng, Feon W; Gao, Xiang; Bao, Le; Mitchell, Diane C; Wood, Craig; Sliwinski, Martin J; Smiciklas-Wright, Helen; Still, Christopher D; Rolston, David D K; Jensen, Gordon L

2017-07-01

To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. The conditional inference tree analysis, a data mining approach, was used to construct a risk stratification algorithm for developing functional limitation based on BMI and other potential risk factors for disability in 1,951 older adults without functional limitations at baseline (baseline age 73.1 ± 4.2 y). We also analyzed the data with multivariate stepwise logistic regression and compared the two approaches (e.g., cross-validation). Over a mean of 9.2 ± 1.7 years of follow-up, 221 individuals developed functional limitation. Higher BMI, age, and comorbidity were consistently identified as significant risk factors for functional decline using both methods. Based on these factors, individuals were stratified into four risk groups via the conditional inference tree analysis. Compared to the low-risk group, all other groups had a significantly higher risk of developing functional limitation. The odds ratio comparing two extreme categories was 9.09 (95% confidence interval: 4.68, 17.6). Higher BMI, age, and comorbid disease were consistently identified as significant risk factors for functional decline among older individuals across all approaches and analyses. © 2017 The Obesity Society.

Who uses nursing theory? A univariate descriptive analysis of five years' research articles.

Science.gov (United States)

Bond, A Elaine; Eshah, Nidal Farid; Bani-Khaled, Mohammed; Hamad, Atef Omar; Habashneh, Samira; Kataua', Hussein; al-Jarrah, Imad; Abu Kamal, Andaleeb; Hamdan, Falastine Rafic; Maabreh, Roqia

2011-06-01

Since the early 1950s, nursing leaders have worked diligently to build the Scientific Discipline of Nursing, integrating Theory, Research and Practice. Recently, the role of theory has again come into question, with some scientists claiming nurses are not using theory to guide their research, with which to improve practice. The purposes of this descriptive study were to determine: (i) Were nursing scientists' research articles in leading nursing journals based on theory? (ii) If so, were the theories nursing theories or borrowed theories? (iii) Were the theories integrated into the studies, or were they used as organizing frameworks? Research articles from seven top ISI journals were analysed, excluding regularly featured columns, meta-analyses, secondary analysis, case studies and literature reviews. The authors used King's dynamic Interacting system and Goal Attainment Theory as an organizing framework. They developed consensus on how to identify the integration of theory, searching the Title, Abstract, Aims, Methods, Discussion and Conclusion sections of each research article, whether quantitative or qualitative. Of 2857 articles published in the seven journals from 2002 to, and including, 2006, 2184 (76%) were research articles. Of the 837 (38%) authors who used theories, 460 (55%) used nursing theories, 377 (45%) used other theories: 776 (93%) of those who used theory integrated it into their studies, including qualitative studies, while 51 (7%) reported they used theory as an organizing framework for their studies. Closer analysis revealed theory principles were implicitly implied, even in research reports that did not explicitly report theory usage. Increasing numbers of nursing research articles (though not percentagewise) continue to be guided by theory, and not always by nursing theory. Newer nursing research methods may not explicitly state the use of nursing theory, though it is implicitly implied. © 2010 The Authors. Scandinavian Journal of Caring

Impact of Living Alone on Depressive Symptoms in Older Korean Widows

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Gyeong-Suk Jeon

2017-10-01

Full Text Available We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows, 65 years of age and older, who participated in the Living Profiles of Older People Survey (LPOPS. A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows.

Robotic and Sensor Technologies for Mobility in Older People.

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Penteridis, Lazaros; D'Onofrio, Grazia; Sancarlo, Daniele; Giuliani, Francesco; Ricciardi, Francesco; Cavallo, Filippo; Greco, Antonio; Trochidis, Ilias; Gkiokas, Alexander

2017-10-01

Maintaining independent mobility is fundamental to independent living and to the quality of life of older people. Robotic and sensor technologies may offer a lot of potential and can make a significant difference in the lives of older people and to their primary caregivers. The aim of this study was to provide a presentation of the methods that are used up till now for analysis and evaluation of human mobility utilizing sensor technologies and to give the state of the art in robotic platforms for supporting older people with mobility limitations. The literature was reviewed and systematic reviews of cohort studies and other authoritative reports were identified. The selection criteria included (1) patients with age ≥60 years; (2) patients with unstable gait, with or without recurrent falls; (3) patients with slow movements, short strides, and little trunk movement; (4) sensor technologies that are currently used for mobility evaluation; and (5) robotic technologies that can serve as a supporting companion for older people with mobility limitations. One hundred eighty-one studies published up until February 2017 were identified, of which 36 were included. Two categories of research were identified from the review regarding the robot and sensor technologies: (1) sensor technologies for mobility analysis and (2) robots for supporting older people with mobility limitations. Potential for robotic and sensor technologies can be taken advantage of for evaluation and support at home for elder persons with mobility limitations in an automated way without the need of the physical presence of any medical personnel, reducing the stress of caregivers.

Study of Ecotype and Sowing Date Interaction in Cumin (Cuminum cyminum L. using Different Univariate Stability Parameters

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J Ghanbari

2017-06-01

Full Text Available Introduction Cumin is one of the most important medicinal plants in Iran and today, it is in the second level of popularity between spices in the world after black pepper. Cumin is an aromatic plant used as flavoring and seasoning agent in foods. Cumin seeds have been found to possess significant biological and have been used for treatment of toothache, dyspepsia, diarrhoea, epilepsy and jaundice. Knowledge of GEI is advantageous to have a cultivar that gives consistently high yield in a broad range of environments and to increase efficiency of breeding program and selection of best genotypes. A genotype that has stable trait expression across environments contributes little to GEI and its performance should be more predictable from the main several statistical methods have been proposed for stability analysis, with the aim of explaining the information contained in the GEI. Regression technique was proposed by Finlay and Wilkinson (1963 and was improved by Eberhart and Russell (1966. Generally, genotype stability was estimated by the slope of and deviation from the regression line for each of the genotypes. This is a popular method in stability analysis and has been applied in many crops. Non-parametric methods (rank mean (R, standard deviation rank (SDR and yield index ratio (YIR, environmental variance (S2i and genotypic variation coefficient (CVi Wricke's ecovalence and Shukla's stability variance (Shukla, 1972 have been used to determine genotype-by-environment interaction in many studies. This study was aimed to evaluate the ecotype × sowing date interaction in cumin and to evaluation of genotypic response of cumin to different sowing dates using univariate stability parameters. Materials and Methods In order to study of ecotype × sowing date interaction, different cumin ecotypes: Semnan, Fars, Yazd, Golestan, Khorasan-Razavi, Khorasan-Shomali, Khorasan-Jonoubi, Isfahan and Kerman in 5 different sowing dates (26th December, 10th January

Older Adults and Alcohol

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

What works better for community-dwelling older people at risk to fall?: a meta-analysis of multifactorial versus physical exercise-alone interventions.

Science.gov (United States)

Petridou, Eleni Th; Manti, Eirini G; Ntinapogias, Athanasios G; Negri, Eva; Szczerbinska, Katarzyna

2009-08-01

To compare and quantify the effectiveness of multifactorial versus exercise-alone interventions in reducing recurrent falls among community-dwelling older people. A meta-analysis of recently published studies on fall prevention interventions was conducted. Measure of the overall effectiveness was the combined risk ratio for recurrent falls, whereas heterogeneity was explored via metaregression analyses. Ten of the 52 identified studies met the preset criteria and were included in the analysis. The exercise-alone interventions were about 5 times more effective compared to multifactorial ones. Short-term interventions, smaller samples, and younger age related to better outcomes. From cost-efficiency and public health perspectives, exercise-alone interventions can be considered valuable, as they are more likely to be implemented in countries with less resources. Further qualitative research is needed, however, to explore determinants of willingness to participate and comply with interventions aiming to prevent recurrent falls among older people.

Cancer in Older Adults

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

Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain

Directory of Open Access Journals (Sweden)

Cesar Calvo Lobo

2017-02-01

Full Text Available Background There is a high prevalence of non-specific shoulder pain associated with upper limb functional limitations in older adults. The purpose of this study was to determine the minimal clinically important differences (MCID of grip strength and pressure pain threshold (PPT in the upper limb between older adults with or without non-specific shoulder pain. Methods A case-control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE criteria. A sample of 132 shoulders (mean ± SD years with (n = 66; 76.04 ± 7.58 and without (n = 66; 75.05 ± 6.26 non-specific pain were recruited. The grip strength and PPT of the anterior deltoid and extensor carpi radialis brevis (ECRB muscles were assessed. Results There were statistically significant differences (mean ± SD; P-value for anterior deltoid PPT (2.51 ± 0.69 vs 3.68 ± 0.65, kg/cm2; P < .001, ECRB PPT (2.20 ± 0.60 vs 3.35 ± 0.38 kg/cm2; P < .001 and grip strength (20.78 ± 10.94 vs 24.63 ± 9.38 kg; P = .032 between shoulders with and without non-specific pain, respectively. Discussion The MCID of 1.17 kg/cm2, 1.15 kg/cm2 and 3.84 kg were proposed for anterior deltoid PPT, ECRB PPT and grip strength, respectively, to assess the upper limb of older adults with non-specific shoulder pain after treatment. In addition, univariate and multivariate (linear regression and regression trees analyses may be used to consider age distribution, sex, pain intensity, grip strength and PPT in older adults including clinical and epidemiological studies with non-specific shoulder pain.

Cost-Effectiveness Analysis of a Skin Awareness Intervention for Early Detection of Skin Cancer Targeting Men Older Than 50 Years.

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Gordon, Louisa G; Brynes, Joshua; Baade, Peter D; Neale, Rachel E; Whiteman, David C; Youl, Philippa H; Aitken, Joanne F; Janda, Monika

2017-04-01

To assess the cost-effectiveness of an educational intervention encouraging self-skin examinations for early detection of skin cancers among men older than 50 years. A lifetime Markov model was constructed to combine data from the Skin Awareness Trial and other published sources. The model incorporated a health system perspective and the cost and health outcomes for melanoma, squamous and basal cell carcinomas, and benign skin lesions. Key model outcomes included Australian costs (2015), quality-adjusted life-years (QALYs), life-years, and counts of skin cancers. Univariate and probabilistic sensitivity analyses were undertaken to address parameter uncertainty. The mean cost of the intervention was A$5,298 compared with A$4,684 for usual care, whereas mean QALYs were 7.58 for the intervention group and 7.77 for the usual care group. The intervention was thus inferior to usual care. When only survival gain is considered, the model predicted the intervention would cost A$1,059 per life-year saved. The likelihood that the intervention was cost-effective up to A$50,000 per QALY gained was 43.9%. The model was stable to most data estimates; nevertheless, it relies on the specificity of clinical diagnosis of skin cancers and is subject to limited health utility data for people with skin lesions. Although the intervention improved skin checking behaviors and encouraged men to seek medical advice about suspicious lesions, the overall costs and effects from also detecting more squamous and basal cell carcinomas and benign lesions outweighed the positive health gains from detecting more thin melanomas. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

How Do Formal Caregivers Experience the Sexuality of Older Adults? Beliefs and Attitudes Towards Older Adults’ Sexuality

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Ana Monteiro

2017-08-01

Full Text Available AimThe way caregivers experience the sexuality of older adults has implications to their identity and sexual manifestations. There are few studies that focus on the meaning of caring of older adults, taking into account their sexuality. This study aims to explore the experiences of formal caregivers (FC towards sexuality among older adults, and to obtain a description of their experiences.MethodComplete data were available from six caregivers working in a nursing home. We used a sociodemographic questionnaire and topic interview guide. The data was subjected to content analysis.ResultsThe most prevalent response of the interviewed participants for ‘beliefs about the interest in sexuality’ was ‘health limitations despite the desire’, for ‘observed behaviours related to sexual expression’ was ‘masturbation’, and for ‘reactions/behaviours due to the demonstration of sexual expression was ‘using humour”.ConclusionFuture educational and intervention programs in the institution should take into account our findings to improve their efficacy on discussing these issues and to ultimately promote sexual wellbeing.

Dental Care Utilization among North Carolina Rural Older Adults

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Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

2012-01-01

Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

Frailty as a Predictor of Alzheimer Disease, Vascular Dementia, and All Dementia Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.

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Kojima, Gotaro; Taniguchi, Yu; Iliffe, Steve; Walters, Kate

2016-10-01

To perform a systematic search of the literature for currently available evidence on frailty as a predictor of dementia and to conduct a meta-analysis to synthesize the pooled risk estimates among community-dwelling older people. A systematic review and meta-analysis. Embase, MEDLINE, CINAHL Plus, PsycINFO, and the Cochrane Library from 2000 to January 2016, and reference lists of relevant articles. Any studies that prospectively examined the incident risks of dementia with frailty among community-dwelling older people without language restriction. Of 2565 studies identified through the systematic review, 7 studies were included in this review. Of these, 4 studies reported hazard ratios (HR) of incident dementia for physical frailty defined by Cardiovascular Health Study criteria and were included in a meta-analysis. Frailty was a significant predictor of incident Alzheimer disease (4 studies: pooled HR = 1.28, 95% confidence interval (95% CI) = 1.00-1.63, P = .05), vascular dementia (2 studies: pooled HR 2.70, 95% CI 1.40-5.23, P = .003), and all dementia (3 studies: pooled HR 1.33, 95% CI 1.07-1.67, P = .01). Heterogeneity across the studies was low to modest (I(2) = 0%-51%). A random-effects meta-regression analysis showed that the female proportion of the cohort primarily mediated the association of frailty with Alzheimer disease (female proportion coefficient = 0.04, 95%CI = 0.01-0.08, P = .01). This systematic review and meta-analysis suggests that frailty was a significant predictor of Alzheimer disease, vascular dementia, and all dementia among community-dwelling older people. Frail women may have a higher risk of incident Alzheimer disease than frail men. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Forever young: Visual representations of gender and age in online dating sites for older adults.

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Gewirtz-Meydan, Ateret; Ayalon, Liat

2017-06-13

Online dating has become increasingly popular among older adults following broader social media adoption patterns. The current study examined the visual representations of people on 39 dating sites intended for the older population, with a particular focus on the visualization of the intersection between age and gender. All 39 dating sites for older adults were located through the Google search engine. Visual thematic analysis was performed with reference to general, non-age-related signs (e.g., facial expression, skin color), signs of aging (e.g., perceived age, wrinkles), relational features (e.g., proximity between individuals), and additional features such as number of people presented. The visual analysis in the present study revealed a clear intersection between ageism and sexism in the presentation of older adults. The majority of men and women were smiling and had a fair complexion, with light eye color and perceived age of younger than 60. Older women were presented as younger and wore more cosmetics as compared with older men. The present study stresses the social regulation of sexuality, as only heterosexual couples were presented. The narrow representation of older adults and the anti-aging messages portrayed in the pictures convey that love, intimacy, and sexual activity are for older adults who are "forever young."

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

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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.

The secrets of highly active older adults.

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Franke, Thea; Tong, Catherine; Ashe, Maureen C; McKay, Heather; Sims-Gould, Joanie

2013-12-01

Although physical activity is a recognized component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age (Manini & Pahor, 2009; Schutzer & Graves, 2004). In this article we examine the key factors that facilitate physical activity in highly active community-dwelling older adults. Using a strengths based approach, we examined the factors that facilitated physical activity in our sample of highly active older adults. Twenty-seven older adults participated in face-to face interviews. We extracted a sub-sample of 10 highly active older adults to be included in the analyses. Based on a framework analysis of our transcripts we identified three factors that facilitate physical activity in our sample, these include: 1) resourcefulness: engagement in self-help strategies such as self-efficacy, self-control and adaptability; 2) social connections: the presence of relationships (friend, neighborhood, institutions) and social activities that support or facilitate high levels of physical activity; and 3) the role of the built and natural environments: features of places and spaces that support and facilitate high levels of physical activity. Findings provide insight into, and factors that facilitate older adults' physical activity. We discuss implications for programs (e.g., accessible community centers, with appropriate programming throughout the lifecourse) and policies geared towards the promotion of physical activity (e.g., the development of spaces that facilitate both physical and social activities). © 2013.

Making working memory work: a meta-analysis of executive-control and working memory training in older adults.

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Karbach, Julia; Verhaeghen, Paul

2014-11-01

This meta-analysis examined the effects of process-based executive-function and working memory training (49 articles, 61 independent samples) in older adults (> 60 years). The interventions resulted in significant effects on performance on the trained task and near-transfer tasks; significant results were obtained for the net pretest-to-posttest gain relative to active and passive control groups and for the net effect at posttest relative to active and passive control groups. Far-transfer effects were smaller than near-transfer effects but were significant for the net pretest-to-posttest gain relative to passive control groups and for the net gain at posttest relative to both active and passive control groups. We detected marginally significant differences in training-induced improvements between working memory and executive-function training, but no differences between the training-induced improvements observed in older adults and younger adults, between the benefits associated with adaptive and nonadaptive training, or between the effects in active and passive control conditions. Gains did not vary with total training time. © The Author(s) 2014.

Association of Healthy Habits Beliefs and Mortality in Older Adults: A Longitudinal Analysis of the Mexican Health and Aging Study.

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Fernandez-Villa, Julio M; Marquez, David X; Sanchez-Garrido, Natalia; Perez-Zepeda, Mario U; Gonzalez-Lara, Mariana

2017-06-01

The aim of this article is to establish the association between beliefs about healthy habits and mortality in a group of Mexican older adults. This is an 11-year follow-up secondary analysis of the Mexican Health and Aging Study. There was a significant difference ( p healthy habits have the potential to improve health compared with those who did not. After adjustment for confounders, Cox regression models showed a hazard ratio (HR) of 0.17 (95% confidence interval [CI] [0.07, 0.38], p healthy habits. Although the mechanism is not completely clear, according to our results, believing that healthy habits can improve health was associated with lower rates of mortality. Further research should elucidate potential strategies for changing beliefs in older adults with the goal of improving their overall health.

Optimizing Tailored Health Promotion for Older Adults

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Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

2016-01-01

Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

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

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Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

2007-11-01

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

Relationships among sense of coherence, oral health status, nutritional status and care need level of older adults according to path analysis.

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Dewake, Nanae; Hamasaki, Tomoko; Sakai, Rie; Yamada, Shima; Nima, Yuko; Tomoe, Miki; Kakuta, Satoko; Iwasaki, Masanori; Soh, Inho; Shimazaki, Yoshihiro; Ansai, Toshihiro

2017-11-01

Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088. © 2017 Japan Geriatrics Society.

Cohort comparisons: emotional well-being among adolescents and older adults

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Momtaz YA

2014-05-01

Full Text Available Yadollah Abolfathi Momtaz,1 Tengku Aizan Hamid,1,2 Rahimah Ibrahim1,21Institute of Gerontology, 2Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaBackground: There are several negative stereotypes about older adults that have negatively influenced people's attitude about aging. The present study compared emotional well-being between older adults and adolescents.Methods: Data for this study came from 1,403 community-dwelling elderly persons and 1,190 secondary school students and were obtained from two national cross-sectional surveys. Emotional well-being was measured using the World Health Organization-Five Well-Being Index. Data analysis was conducted using a multivariate analysis of covariance with SPSS software version 20 (IBM Corporation, Armonk, NY, USA.Results: Elderly people significantly scored higher levels of emotional well-being (mean, 62.3; standard deviation, 22.55 than younger people (mean, 57.9; standard deviation, 18.46; t, 5.32; P≤0.001. The findings from the multivariate analysis of covariance revealed a significant difference between older adults and younger people in emotional well-being [F(3, 2587=120.21; P≤0.001; η2=0.122] after controlling for sex.Conclusion: Contrary to negative stereotypes about aging, our findings show a higher level of emotional well-being among older adults compared with younger people.Keywords: aged, ageism, emotional well-being, positive aging

Improving the performance of univariate control charts for abnormal detection and classification

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Yiakopoulos, Christos; Koutsoudaki, Maria; Gryllias, Konstantinos; Antoniadis, Ioannis

2017-03-01

Bearing failures in rotating machinery can cause machine breakdown and economical loss, if no effective actions are taken on time. Therefore, it is of prime importance to detect accurately the presence of faults, especially at their early stage, to prevent sequent damage and reduce costly downtime. The machinery fault diagnosis follows a roadmap of data acquisition, feature extraction and diagnostic decision making, in which mechanical vibration fault feature extraction is the foundation and the key to obtain an accurate diagnostic result. A challenge in this area is the selection of the most sensitive features for various types of fault, especially when the characteristics of failures are difficult to be extracted. Thus, a plethora of complex data-driven fault diagnosis methods are fed by prominent features, which are extracted and reduced through traditional or modern algorithms. Since most of the available datasets are captured during normal operating conditions, the last decade a number of novelty detection methods, able to work when only normal data are available, have been developed. In this study, a hybrid method combining univariate control charts and a feature extraction scheme is introduced focusing towards an abnormal change detection and classification, under the assumption that measurements under normal operating conditions of the machinery are available. The feature extraction method integrates the morphological operators and the Morlet wavelets. The effectiveness of the proposed methodology is validated on two different experimental cases with bearing faults, demonstrating that the proposed approach can improve the fault detection and classification performance of conventional control charts.

The effectiveness of behavioural therapy for the treatment of depression in older adults: a meta-analysis.

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Samad, Zara; Brealey, Stephen; Gilbody, Simon

2011-12-01

To systematically review the effectiveness of behavioural therapy in depressed older adults. Electronic databases were searched to July 2009. Reference lists of systematic reviews and identified studies from the search strategy were also screened. Randomised controlled trials (RCTs) of behavioural therapy compared with waiting list controls or other psychotherapies in older adults (aged ≥55 years) with clinical depression were included. One author independently identified studies for inclusion. Two authors extracted data and assessed the included studies for risk of bias. Estimates of depression were combined using a random effects model and the I(2) statistic to examine heterogeneity. Four RCTs were included in the meta-analysis. For post-treatment self-rated depression symptoms, behavioural therapy was not significantly more effective than a waiting list control [standardised mean difference (SMD) of -0.52, 95% confidence interval (CI) -1.35 to 0.30, p = 0.21, n = 117], cognitive therapy (SMD of 0.23, 95% CI -0.24 to 0.70, p = 0.33, n = 134) or brief psychodynamic therapy (SMD of -0.37, 95% CI -0.84 to 0.11, p = 0.13, n = 69). For post-treatment clinician-rated depression, behavioural therapy was not significantly more effective than cognitive therapy or brief psychodynamic therapy but was significantly more effective than a waiting list control (weighted mean difference (WMD) of -5.68, 95% CI -7.71 to -3.66, p depressed older adults appears to have comparable effectiveness with alternative psychotherapies. Further research is recommended with the need for larger sample sizes, more clarity on trial design and the intervention, longer term follow-up and concomitant economic evaluations. Copyright © 2011 John Wiley & Sons, Ltd.

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

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Louise Broderick

2015-04-01

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

Obesity Prevention in Older Adults.

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Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

2016-06-01

The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

Caregiving burden in foreign domestic workers caring for frail older adults in Singapore.

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Ha, Ngoc Huong Lien; Chong, Mei Sian; Choo, Robin Wai Munn; Tam, Wai Jia; Yap, Philip Lin Kiat

2018-03-21

Although foreign domestic workers (FDWs) play a significant role in caring for frail seniors in Singapore and are vulnerable to caregiving burden, there has been little research conducted hitherto. We explored caregiver burden and its determinants in this study. FDWs (N = 221, M age = 32.3, SD = 6.23) recruited from a hospital geriatric unit completed the Zarit Burden Interview (ZBI) administered in English, Bahasa Melayu, or Burmese. Univariate and multivariate regression were employed to investigate factors influencing caregiving burden in FDWs. Majority were Indonesians (60.0%), married (57.5%) with children (62.4%), with secondary-level education (59.7%), and providing care for >1 year (79.9%). Importantly, 25.1% reported physical health problems and 23.1% encountered language difficulties with employers. Univariate analysis revealed three significant factors associated with caregiving burden: nationality (p Indonesian and Burmese counterparts. The study highlights caregiver burden in FDWs and potential ways to alleviate it by empowering FDWs with dementia-specific caregiving skills, providing language training opportunities, and supporting particular FDW ethnic groups with more emotional and practical help.

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

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

2016-12-01

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

The divide within: Older active ICT users position themselves against different 'Others'.

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Kania-Lundholm, Magdalena; Torres, Sandra

2015-12-01

Although research into older people's internet usage patterns is rapidly growing, their understandings of digital technologies, particularly in relation to how these are informed by their understandings of aging and old age, remain unexplored. This is the case because research on older active ICT users tends to regard old age as an empirically interesting part of the life-course as opposed to a theoretically profuse source of information about why and how older people engage with digital technologies. This article explores - through focus group interviews with 30 older adults (aged 66-89) - the ways in which the social position of old age is used by older active ICT users in order to make sense of how and why they engage with these technologies. In this article, positioning theory is used to shed light on how the older people interviewed positioned themselves as 'active older users' in the interviews. The analysis brings to the fore the divide that older people themselves create as they discursively position themselves against different types of ICT users and non-users (young and old) when describing how and why they engage with digital technologies. Copyright © 2015 Elsevier Inc. All rights reserved.

Loss of Trust in the Neighborhood: The Experience of Older African Americans in Detroit.

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Fritz, Heather; Cutchin, Malcolm P; Cummins, Emily R

2018-02-19

Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue. We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 and older living in neighborhoods of varying quality in Detroit, Michigan. A subsample of (n = 20) older adults took photographs of bothersome aspects of their neighborhoods and participated in in-depth photo-elicitation interviews. Data were analyzed using a grounded theory approach. 'Loss of trust in the neighborhood' emerged as the core category to explain how older African Americans in our sample experienced neighborhood stressors in their daily lives. Loss of trust in physical, social, and institutional dimensions of the neighborhood contributed to the core category. The life course of neighborhoods and the trust placed in them appears to be intimately connected to the well-being of older African Americans. We therefore hypothesize that a fundamental pathway through which neighborhood stressors are experienced for older African Americans in U.S. 'Rust Belt' cities is the multifaceted loss of trust in the neighborhood.

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

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

2015-01-01

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

The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis.

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Li, Hui-Chi; Wang, Hsiu-Hung; Chou, Fan-Hao; Chen, Kuei-Min

2015-01-01

To conduct a systematic review and a meta-analysis of current studies to determine whether music therapy affects the cognitive function of older people. The databases surveyed include PsycINFO, PsycARTICLES, PubMed, MEDLINE, CINAHL, AgeLine, Cochrane Library, and the Chinese Electronic Periodical Services (CEPS) as well as the reference lists of the included studies. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for nonpharmacologic treatment was used to evaluate the literature. Music therapy intervention offered in nursing homes, hospitals, or communities. A total of 234 participants from 5 studies were assessed in the meta-analysis, with a mean age per study of 71.4 to 82.0 years. Cognitive outcome domains were analyzed in a systematic review. The short-term effects of music therapy in Mini-Mental State Examination data for meta-analysis were compiled. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference. Active music therapy comprising singing and other musical activities was generally determined to effect a significant improvement in the Mini-Mental State Examination according to individual retrieval studies. However, this study showed no significant improvement in the short-term effects of music therapy when all related studies in meta-analysis were combined. The pooled mean difference was 0.73 (95% confidence interval -0.07 to 1.54; Z = 1.79; P = .07) for using music therapy overall and 0.74 (95% confidence interval -0.08 to 1.56; Z = 1.76; P = .08) for using active music therapy. The findings of the meta-analysis indicate that the short-term effects of music therapy do not improve the cognitive function of older people. Future studies that utilize a good quality methodology with a long-term design and diversified active music therapy are recommended. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Pleiotropy analysis of quantitative traits at gene level by multivariate functional linear models.

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Wang, Yifan; Liu, Aiyi; Mills, James L; Boehnke, Michael; Wilson, Alexander F; Bailey-Wilson, Joan E; Xiong, Momiao; Wu, Colin O; Fan, Ruzong

2015-05-01

In genetics, pleiotropy describes the genetic effect of a single gene on multiple phenotypic traits. A common approach is to analyze the phenotypic traits separately using univariate analyses and combine the test results through multiple comparisons. This approach may lead to low power. Multivariate functional linear models are developed to connect genetic variant data to multiple quantitative traits adjusting for covariates for a unified analysis. Three types of approximate F-distribution tests based on Pillai-Bartlett trace, Hotelling-Lawley trace, and Wilks's Lambda are introduced to test for association between multiple quantitative traits and multiple genetic variants in one genetic region. The approximate F-distribution tests provide much more significant results than those of F-tests of univariate analysis and optimal sequence kernel association test (SKAT-O). Extensive simulations were performed to evaluate the false positive rates and power performance of the proposed models and tests. We show that the approximate F-distribution tests control the type I error rates very well. Overall, simultaneous analysis of multiple traits can increase power performance compared to an individual test of each trait. The proposed methods were applied to analyze (1) four lipid traits in eight European cohorts, and (2) three biochemical traits in the Trinity Students Study. The approximate F-distribution tests provide much more significant results than those of F-tests of univariate analysis and SKAT-O for the three biochemical traits. The approximate F-distribution tests of the proposed functional linear models are more sensitive than those of the traditional multivariate linear models that in turn are more sensitive than SKAT-O in the univariate case. The analysis of the four lipid traits and the three biochemical traits detects more association than SKAT-O in the univariate case. © 2015 WILEY PERIODICALS, INC.

Older peoples' perceptions of oral health: 'it's just not that simple'.

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McKenzie-Green, B; Giddings, L S; Buttle, L; Tahana, K

2009-02-01

Little is known about older persons' perceptions of oral health and oral health care. The purpose of this study was to explore the viewpoint of older adults' regarding their oral health care practices. A qualitative interpretive methodology was employed comprising three analytic levels: coding of data into concepts, analysis of concepts into themes, followed by an in-depth analysis of relationships within concepts and between themes. In-depth individual interviews were conducted with 19 participants aged 65 to 87 years. Older people's decision to access oral health care involves complex and personally meaningful strategies. A dental visit surfaces hopes and fears based on past and present experiences. Mouth and teeth are not merely objects of dental care; they represent a person's social and relational self. Age-related changes challenge the relational self as represented in societal ideal images of youth and perfection (the perfect smile). This study highlights older peoples' resilience and determination when faced with the dilemmas in accessing oral health care--it costs, personally as well as financially. Contrary to the assumption that older peoples' oral health status is related to neglect, rather for many, it is the result of the intersection of their history with technological advances. These findings challenge oral health care practitioners to be sensitive to the contexts affecting their older client's oral health care status. They do not 'just go' to the dentist; they bring with them their past dental experiences and their hopes for the future. It matters how one is treated at this vulnerable time.

Recruitment of older women: lessons learned from the Baltimore Hip Studies.

Science.gov (United States)

Resnick, Barbara; Concha, Betty; Burgess, Judy Graham; Fine, Mary Louise; West, Linda; Baylor, Karen; Nahm, Eun Shim; Buie, Verita Custis; Werner, Michelle; Orwig, Denise; Magaziner, Jay

2003-01-01

This study used a qualitative approach in which participants were asked to write about their experiences in recruiting older women into either one of two exercise intervention studies that are part of the Baltimore Hip Studies. The sample included 8 researcher nurses all women, White, and 42-53 years of age. Older adults, particularly older women, are less likely to participate in research studies when compared to their younger counterparts. The purpose of this study was to explore the techniques successfully used by research nurses in the Baltimore Hip Studies to recruit older women after hip fracture into exercise intervention studies. Data analysis was performed using basic content analysis (Crabtree & Miller, 1992; Miles & Huberman, 1984) "in vivo" coding (Dowd, 1991), or "grounded" coding (Glaser & Strauss, 1967), which involves using the informants' own words to capture a particular idea. A total of 16 codes were identified and reduced to nine themes. Seven themes focused on techniques that facilitated recruitment: (a) caring for individuals; (b) emphasizing benefits; (c) eliciting support from others; (d) being an expert; (e) using role models; (f) using good timing; and (g) giving good first impressions. The remaining two themes identified barriers to recruitment: (a) time commitment and (b) lack of support. Based on these themes, specific recruitment techniques are recommended. Ongoing research, however, is needed to establish the most effective recruitment procedures with older women.

Disentangling the health benefits of walking from increased exposure to falls in older people using remote gait monitoring and multi-dimensional analysis.

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Brodie, Matthew A; Okubo, Yoshiro; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Delbaere, Kim

2017-01-01

Falls and physical deconditioning are two major health problems for older people. Recent advances in remote physiological monitoring provide new opportunities to investigate why walking exercise, with its many health benefits, can both increase and decrease fall rates in older people. In this paper we combine remote wearable device monitoring of daily gait with non-linear multi-dimensional pattern recognition analysis; to disentangle the complex associations between walking, health and fall rates. One week of activities of daily living (ADL) were recorded with a wearable device in 96 independent living older people prior to completing 6 months of exergaming interventions. Using the wearable device data; the quantity, intensity, variability and distribution of daily walking patterns were assessed. At baseline, clinical assessments of health, falls, sensorimotor and physiological fall risks were completed. At 6 months, fall rates, sensorimotor and physiological fall risks were re-assessed. A non-linear multi-dimensional analysis was conducted to identify risk-groups according to their daily walking patterns. Four distinct risk-groups were identified: The Impaired (93% fallers), Restrained (8% fallers), Active (50% fallers) and Athletic (4% fallers). Walking was strongly associated with multiple health benefits and protective of falls for the top performing Athletic risk-group. However, in the middle of the spectrum, the Active risk-group, who were more active, younger and healthier were 6.25 times more likely to be fallers than their Restrained counterparts. Remote monitoring of daily walking patterns may provide a new way to distinguish Impaired people at risk of falling because of frailty from Active people at risk of falling from greater exposure to situations were falls could occur, but further validation is required. Wearable device risk-profiling could help in developing more personalised interventions for older people seeking the health benefits of walking

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

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Belgrave, Melita

2011-01-01

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

How life stressors influence modifiable lifestyle factors, depressive symptoms, and physical and mental health among Vietnamese older women?

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Dao-Tran, Tiet-Hanh; Anderson, Debra; Seib, Charrlotte

2017-06-29

Research has demonstrated that exposure to life stressors can influence health through a number of pathways. However, knowledge about the patterns of life stressors and their contributions to health in different populations is limited. Vietnamese older women have attracted little research to date in this area. This cross-sectional study used an interview-administered-questionnaire to collect data from 440 Vietnamese older women. Descriptive analysis was used to describe life stressors among Vietnamese older women. Binary analysis and Structural Equation Modelling statistical analysis were used to examine the influences of life stressors on modifiable lifestyle factors, depressive symptoms, physical and mental health among Vietnamese older women. Vietnamese older women in this study commonly reported the experience of losing a close person, including a baby/child, serious health or money problems, violence and disaster. Among the study participants, (1) exposure to more life stressors increased their depressive symptoms, and decreased their physical and mental health; (2) exposure to more life stressors also increased their physical health by increasing their physical activity levels. Life stressors influenced health among Vietnamese older women through different pathways. Interventions to manage stress and depressive symptoms are required for Vietnamese older women in the future.

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

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

2017-09-01

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

Systematic review of fall risk screening tools for older patients in acute hospitals.

Science.gov (United States)

Matarese, Maria; Ivziku, Dhurata; Bartolozzi, Francesco; Piredda, Michela; De Marinis, Maria Grazia

2015-06-01

To determine the most accurate fall risk screening tools for predicting falls among patients aged 65 years or older admitted to acute care hospitals. Falls represent a serious problem in older inpatients due to the potential physical, social, psychological and economic consequences. Older inpatients present with risk factors associated with age-related physiological and psychological changes as well as multiple morbidities. Thus, fall risk screening tools for older adults should include these specific risk factors. There are no published recommendations addressing what tools are appropriate for older hospitalized adults. Systematic review. MEDLINE, CINAHL and Cochrane electronic databases were searched between January 1981-April 2013. Only prospective validation studies reporting sensitivity and specificity values were included. Recommendations of the Cochrane Handbook of Diagnostic Test Accuracy Reviews have been followed. Three fall risk assessment tools were evaluated in seven articles. Due to the limited number of studies, meta-analysis was carried out only for the STRATIFY and Hendrich Fall Risk Model II. In the combined analysis, the Hendrich Fall Risk Model II demonstrated higher sensitivity than STRATIFY, while the STRATIFY showed higher specificity. In both tools, the Youden index showed low prognostic accuracy. The identified tools do not demonstrate predictive values as high as needed for identifying older inpatients at risk for falls. For this reason, no tool can be recommended for fall detection. More research is needed to evaluate fall risk screening tools for older inpatients. © 2014 John Wiley & Sons Ltd.

The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis.

Science.gov (United States)

Muir, Susan W; Gopaul, Karen; Montero Odasso, Manuel M

2012-05-01

cognitive impairment is an established fall risk factor; however, it is unclear whether a disease-specific diagnosis (i.e. dementia), measures of global cognition or impairments in specific cognitive domains (i.e. executive function) have the greatest association with fall risk. Our objective was to evaluate the epidemiological evidence linking cognitive impairment and fall risk. studies were identified through systematic searches of the electronic databases of MEDLINE, EMBASE, PyschINFO (1988-2009). Bibliographies of retrieved articles were also searched. A fixed-effects meta-analysis was performed using an inverse-variance method. twenty-seven studies met the inclusion criteria. Impairment on global measures of cognition was associated with any fall, serious injuries (summary estimate of OR = 2.13 (1.56, 2.90)) and distal radius fractures in community-dwelling older adults. Executive function impairment, even subtle deficits in healthy community-dwelling older adults, was associated with an increased risk for any fall (summary estimate of OR = 1.44 (1.20, 1.73)) and falls with serious injury. A diagnosis of dementia, without specification of dementia subtype or disease severity, was associated with risk for any fall but not serious fall injury in institution-dwelling older adults. the method used to define cognitive impairment and the type of fall outcome are both important when quantifying risk. There is strong evidence global measures of cognition are associated with serious fall-related injury, though there is no consensus on threshold values. Executive function was also associated with increased risk, which supports its inclusion in fall risk assessment especially when global measures are within normal limits.

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

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Bowen, Catherine E; Skirbekk, Vegard

2013-11-01

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

Using informatics to capture older adults' wellness.

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Demiris, George; Thompson, Hilaire J; Reeder, Blaine; Wilamowska, Katarzyna; Zaslavsky, Oleg

2013-11-01

The aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of older adults' wellness. A theoretical framework is presented that informs the design of a technology enhanced screening platform for wellness. We highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies (including a telehealth component to capture vital signs and customized questionnaires, a gait analysis component and cognitive assessment software) to assess the multiple aspects of wellness of older adults. A demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for older adults. Subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance, physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks. Data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness. Preliminary findings indicate that older adults are willing to participate in technology-enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers. Informatics can advance health care for older adults and support a holistic assessment of older adults' wellness. The described framework can support decision making, link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events. Copyright © 2011 Elsevier Ireland

Effects of Mat Pilates on Physical Functional Performance of Older Adults: A Meta-analysis of Randomized Controlled Trials.

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Bueno de Souza, Roberta Oliveira; Marcon, Liliane de Faria; Arruda, Alex Sandro Faria de; Pontes Junior, Francisco Luciano; Melo, Ruth Caldeira de

2018-06-01

The present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population. A search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases between February and March 2017. Only randomized controlled trials that were written in English, included subjects aged 60 yrs who used mat Pilates exercises, included a comparison (control) group, and reported performance-based measures of physical function (balance, flexibility, muscle strength, and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software. The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (standardized mean difference = 1.10, 95% confidence interval = 0.29-1.90), muscle strength (standardized mean difference = 1.13, 95% confidence interval = 0.30-1.96), flexibility (standardized mean difference = 1.22, 95% confidence interval = 0.39-2.04), and cardiorespiratory fitness (standardized mean difference = 1.48, 95% confidence interval = 0.42-2.54) of elderly subjects. There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals. Furthermore, high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

Automated Assessment of Left Ventricular Function and Mass Using Heart Deformation Analysis: Initial Experience in 160 Older Adults.

Science.gov (United States)

Lin, Kai; Collins, Jeremy D; Lloyd-Jones, Donald M; Jolly, Marie-Pierre; Li, Debiao; Markl, Michael; Carr, James C

2016-03-01

To assess the performance of automated quantification of left ventricular function and mass based on heart deformation analysis (HDA) in asymptomatic older adults. This study complied with Health Insurance Portability and Accountability Act regulations. Following the approval of the institutional review board, 160 asymptomatic older participants were recruited for cardiac magnetic resonance imaging including two-dimensional cine images covering the entire left ventricle in short-axis view. Data analysis included the calculation of left ventricular ejection fraction (LVEF), left ventricular mass (LVM), and cardiac output (CO) using HDA and standard global cardiac function analysis (delineation of end-systolic and end-diastolic left ventricle epi- and endocardial borders). The agreement between methods was evaluated using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). HDA had a shorter processing time than the standard method (1.5 ± 0.3 min/case vs. 5.8 ± 1.4 min/case, P HDA. There was a systemic bias toward lower LVEF (62.8% ± 8.3% vs. 69.3% ± 6.7%, P HDA compared to the standard technique. Conversely, HDA overestimated LVM (114.8 ± 30.1 g vs. 100.2 ± 29.0 g, P HDA has the potential to measure LVEF, CO, and LVM without the need for user interaction based on standard cardiac two-dimensional cine images. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

OpenAIRE

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

2014-01-01

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

Examining daily activity routines of older adults using workflow.

Science.gov (United States)

Chung, Jane; Ozkaynak, Mustafa; Demiris, George

2017-07-01

We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

Web Accessibility for Older Adults: A Comparative Analysis of Disability Laws.

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Yang, Y Tony; Chen, Brian

2015-10-01

Access to the Internet is increasingly critical for health information retrieval, access to certain government benefits and services, connectivity to friends and family members, and an array of commercial and social services that directly affect health. Yet older adults, particularly those with disabilities, are at risk of being left behind in this growing age- and disability-based digital divide. The Americans with Disabilities Act (ADA) was designed to guarantee older adults and persons with disabilities equal access to employment, retail, and other places of public accommodation. Yet older Internet users sometimes face challenges when they try to access the Internet because of disabilities associated with age. Current legal interpretations of the ADA, however, do not consider the Internet to be an entity covered by law. In this article, we examine the current state of Internet accessibility protection in the United States through the lens of the ADA, sections 504 and 508 of the Rehabilitation Act, state laws and industry guidelines. We then compare U.S. rules to those of OECD (Organisation for Economic Co-Operation and Development) countries, notably in the European Union, Canada, Japan, Australia, and the Nordic countries. Our policy recommendations follow from our analyses of these laws and guidelines, and we conclude that the biggest challenge in bridging the age- and disability-based digital divide is the need to extend accessibility requirements to private, not just governmental, entities and organizations. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Older people's experiences of dream coaching.

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Wadensten, Barbro

2009-12-01

Recalling and talking about dreams could initiate dream work among older people and provide an opportunity for self-confrontation and personal growth, which could in turn promote gerotranscendental development. The present article describes older people's opinions about participating in a dream-coaching group; it also briefly describes the theoretical foundation of dream coaching. The study aim was to investigate older people's experience of participating in a dream-coaching group based on Jungian psychology. A descriptive design was used. Retrospective interviews were explored using qualitative content analysis. The participants were satisfied with the arrangement of the dream-coaching groups. All participants believed that they had recalled their dreams and thought much more about their dreams during the period in which the dream-coaching group met. Three diverse appraisals of participating in a dream-coaching group, which had different effects on the participants, were identified: "An activity like any other activity," "An activity that led to deeper thoughts about the meaning of dreams," and "An activity that led to deeper thoughts both about the meaning of dreams and about how dreams can improve one's understanding of the life situation." It is possible to arrange dream-coaching groups for older people and could be a way to promote personal development using this type of intervention. The study provides some guidance as to how such a group could be organized, thus facilitating use of dream-coaching groups in gerontological care.

Understanding Older People's Readiness for Receiving Telehealth: Mixed-Method Study.

Science.gov (United States)

van Houwelingen, Cornelis Tm; Ettema, Roelof Ga; Antonietti, Michelangelo Gef; Kort, Helianthe Sm

2018-04-06

The Dutch Ministry of Health has formulated ambitious goals concerning the use of telehealth, leading to subsequent changes compared with the current health care situation, in which 93% of care is delivered face-to-face. Since most care is delivered to older people, the prospect of telehealth raises the question of whether this population is ready for this new way of receiving care. To study this, we created a theoretical framework consisting of 6 factors associated with older people's intention to use technology. The objective of this study was to understand community-dwelling older people's readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators. A mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people's intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people's actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2). In phase 1, a total of 256 people aged 65 years or older participated in the survey study (50.0% male; median age, 70 years; Q1-Q3: 67-76). Using a significance level of .05, we found seven significant associations regarding older people's perception of videoconferencing. Older people's (1) intention to use videoconferencing was predicted by their performance expectancy (odds ratio [OR] 1.26, 95% CI 1.13-1.39), effort expectancy (OR 1.23, 95% CI 1.07-1.39), and perceived privacy and security (OR 1.30, 95% CI 1.17-1.43); (2) their performance expectancy was predicted by their effort expectancy (OR 1.38, 95% CI 1.24-1.52); and (3) their effort expectancy was predicted by their self-efficacy (OR 1.55, 95% CI 1.42-1.68). In phase 2, a total of 6 men and 9

Neurobiological findings associated with high cognitive performance in older adults: a systematic review.

Science.gov (United States)

Borelli, Wyllians Vendramini; Schilling, Lucas Porcello; Radaelli, Graciane; Ferreira, Luciana Borges; Pisani, Leonardo; Portuguez, Mirna Wetters; da Costa, Jaderson Costa

2018-04-18

ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance. We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017. Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group. Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.

Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings.

Science.gov (United States)

Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

2014-09-01

To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.

Health literacy and the digital divide among older Americans.

Science.gov (United States)

Levy, Helen; Janke, Alexander T; Langa, Kenneth M

2015-03-01

Among the requirements for meaningful use of electronic medical records (EMRs) is that patients must be able to interact online with information from their records. However, many older Americans may be unprepared to do this, particularly those with low levels of health literacy. The purpose of the study was to quantify the relationship between health literacy and use of the Internet for obtaining health information among Americans aged 65 and older. We performed retrospective analysis of 2009 and 2010 data from the Health and Retirement Study, a longitudinal survey of a nationally representative sample of older Americans. Subjects were community-dwelling adults aged 65 years and older (824 individuals in the general population and 1,584 Internet users). Our analysis included measures of regular use of the Internet for any purpose and use of the Internet to obtain health or medical information; health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) and self-reported confidence filling out medical forms. Only 9.7% of elderly individuals with low health literacy used the Internet to obtain health information, compared with 31.9% of those with adequate health literacy. This gradient persisted after controlling for sociodemographic characteristics, health status, and general cognitive ability. The gradient arose both because individuals with low health literacy were less likely to use the Internet at all (OR = 0.36 [95% CI 0.24 to 0.54]) and because, among those who did use the Internet, individuals with low health literacy were less likely to use it to get health or medical information (OR = 0.60 [95% CI 0.47 to 0.77]). Low health literacy is associated with significantly less use of the Internet for health information among Americans aged 65 and older. Web-based health interventions targeting older adults must address barriers to substantive use by individuals with low health literacy, or risk exacerbating the

Active Ageing Level of Older Persons: Regional Comparison in Thailand

Directory of Open Access Journals (Sweden)

Md. Nuruzzaman Haque

2016-01-01

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

Shards of sorrow: Older men's accounts of their depression experience

Science.gov (United States)

Barker, Judith C.; Hinton, Ladson

2015-01-01

The experience of depression is diverse based on social locations and context. A sociological perspective building on masculinity, illness work, and the self provides a useful theoretical framework to understand how older men negotiate emotional suffering. This article examines older men's accounts of their depression experience from a social constructionist approach. This analysis is based on data from 77 in-depth interviews with depressed older men who participated in a larger mixed-method study, the Men's Health and Aging Study (MeHAS). We show how older men construct depression accounts in which they integrate biological and social factors associated with feeling a loss of control. This is experienced as a shamed masculine self given their inability to perform manhood acts, which leads them to severe social bonds. Men's accounts also shed light on how they resist the shaming of the masculine self by deploying two primary strategies: acting overtly masculine through aggressive behavior and by retracting from social interactions that may lead to feelings of shame. These strategies appear futile and they are only partially able to embrace alternative masculine values in line with roles as grandparents and older, wiser men. Depression in older men is characterized by an ongoing negotiation of limited statuses and roles given dominant conceptions of masculinity. PMID:25461856

To a Deeper Understanding of Loneliness amongst Older Irish Adults.

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Squires, Susan Elaine

2015-06-01

Loneliness can play a significant role in the wellbeing of older adults. This article describes a qualitative method for using case notes from the clinical records of older individuals in order to investigate the priority concerns spontaneously reported by older adults to deepen our understanding of both the context in which reported loneliness occurs in Ireland and the potential triggers. The participants in this study represent a cross-section of older adults who participated in the Technology Research for Independent Living Clinic (TRIL). Data were collected from participants through interviewer case notes at the TRIL centre in St James's hospital, Dublin. 624 participants (431 females; 193 males) ranging in age from 60-92 years (Mean 73 years, SD 7 years) took part in the study. All were community dwelling and provided consent. A thematic analysis from grounded theory was used to evaluate the case notes for each participant. Preliminary results highlight the richness of phenomenological experience to enhance our understanding of loneliness and provide an opportunity to better understand the precursors and variability that loneliness may take. In this study we found themes in the case note analysis linking social loneliness with self-imposed limitations on social engagement due to declining health while predominate themes for emotionally lonely focused on psychological issues of stress and anxiety associated with adverse life events. The results suggest the importance of case notes to inform clinical practice. Qualitative results provided insights into differing live events of older Irish adults, which help distinguish the causal differences between social and emotional loneliness.

Alcohol Use as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis

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Namkee G. Choi, PhD

2015-12-01

Full Text Available Introduction: Late middle-aged and older adults’ share of emergency department (ED visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Methods: Data came from the 2013 National Health Interview Survey’s Sample Adult file (n=15,713. Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/ moderate drinkers, and current heavy drinkers, chronic health and mental health status, and past-year ED visits as indicators. Results: LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/ mental health problems; Class 2 (21%; low-risk group consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Conclusion: Alcohol nonuse/use (and quantity of use and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex

Perception of the older adults regarding the practise of physical activity and healthy eating

OpenAIRE

de Rosso Krug, Rodrigo; Rodrigues Barbosa, Aline; Aita Monego, Estela; Ferreira de Mello, Ana Lúcia Schaefer; Francielle França, Vivian

2015-01-01

Objective: To understand the perception of regular physical activity and healthy eating among the older adults. Methods: This descriptive study (qualitative approach) included 36 older adults (69 to 91 years) residents in a rural community in southern Brazil. A semi-structured interview was used and the information were recorded, transcribed and interpreted (content analysis technique). Results: The following categories of analysis were identified: a) facilitators and barriers for the practis...

Student radiographers' attitudes toward the older patient – An intervention study

International Nuclear Information System (INIS)

Booth, L.; Kada, S.

2015-01-01

Purpose: To design, implement and evaluate the effect of an educational intervention on Norwegian student (diagnostic) radiographers' attitudes towards older people. Design: This study is part of a wider longitudinal study that will evaluate student radiographer attitudes towards the older patient as they progress through their training. In this phase an educational intervention, aimed at improving student radiographer attitudes towards the older person, was designed and implemented. What is reported here are the findings of a pre-test, post-test design that used the Kogan's attitudes towards older people scale to determine whether this intervention had any effect of student radiographer attitudes towards older people. Results: Overall students reported significantly more positive attitudes towards older people after intervention (p = 0.01). However, analysis of responses to individual questions reveals that this difference was not significant in all cases. Conclusion: The results of the present study suggest that an educational intervention can have a significant impact on student radiographer's attitudes towards older people. Whether this positive attitude remains throughout training, forms part of the wider basis for this study. - Highlights: • We designed an education intervention to improve Norwegian student radiographer attitudes towards older people. • Pre-intervention we found that these student radiographers generally had positive attitudes towards older people. • Post intervention the student radiographer's attitudes towards older people were significantly improved

Quantifying the magnitude of risk for balance impairment on falls in community-dwelling older adults: a systematic review and meta-analysis.

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Muir, Susan W; Berg, Katherine; Chesworth, Bert; Klar, Neil; Speechley, Mark

2010-04-01

To evaluate and summarize the evidence linking balance impairment as a risk factor for falls in community-dwelling older adults. Systematic review and meta-analysis. English language articles in MEDLINE, EMBASE, CINAHL (1988-2009), under keywords of accidental falls, aged, risk factors, and hip, radius, ulna, and humerus fractures; and bibliographies of retrieved articles. Community-dwelling older adults in a prospective study, at least 1-year duration, age more than 60 years, and samples not specific to a single disease-defined population were included. Sample size, inclusion/exclusion criteria, demographics, clinical balance measurement scale, type of fall outcome, method of fall ascertainment, length of follow-up, and odds ratio (OR) or risk ratio (RR) were extracted. Studies must have reported adjustment for confounders. Random effects meta-analysis to generate summary risk estimate was used. A priori evaluation of sources of heterogeneity was performed. Twenty-three studies met the selection criteria. A single summary measure could not be calculated because of the nonequivalence of the OR and RR, producing an overall fall risk of RR of 1.42 (1.08, 1.85) and OR of 1.98 (1.60, 2.46). Balance impairment imparts a moderate increase on fall risk in community-dwelling older adults. The type of fall outcome, the length of follow-up, and the balance measurement tool impact the magnitude of the association. Specific balance measurement scales were identified with associations for an increased fall risk, but further research is required to refine recommendations for their use in clinical practice. Copyright 2010 Elsevier Inc. All rights reserved.

Decadal analysis of deceased organ donation in Spain and the United States linking an increased donation rate and the utilization of older donors.

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Halldorson, Jeff; Roberts, John Paul

2013-09-01

After the foundation of the National Transplant Organization, Spanish rates of deceased donor donation rapidly outpaced US growth over the decade from 1989 to 1999. An analysis of the following decade, 1999-2009, demonstrated a markedly flattened growth curve for Spanish deceased donor organ procurement, which increased only 2.4% from 33.6 to 34.4 donors per million population (pmp). In comparison, over the same decade in the United States, the rate of deceased donation increased from 20.9 to 26.3 donors pmp (25.8%). An age group comparison demonstrated a much higher donation rate among older donors in Spain. For example, the number of donors older than 70 years increased from 3.8 to 8.8 pmp (a 132% increase), and they now constitute 25.4% of all Spanish organ donors. In contrast, the number of US donors older than 70 years increased from 1.0 to 1.3 pmp, and they constitute only 4.4% of total deceased donors. Over the same decade, the number of younger donors (15-30 years old) decreased from 6.6 to 2.5 pmp (a 62% decrease) in Spain, and this contrasted with a slightly increased US donation rate for the same age subgroup (a 15.5% increase from 5.8 to 6.7 pmp). Although older donors were more rarely used in the United States, growth in donation over the 2 decades (1989-2009) was strongly associated with the utilization of donors aged 65 or older (P < 0.01). United Network for Organ Sharing regions demonstrated significant differences in utilization rates for older donors. In conclusion, strategies aimed toward achieving US donation rates equivalent to the Spanish benchmark should target improved utilization rates for older donors in the United States instead of emulating elements of the Spanish organ procurement system. © 2013 American Association for the Study of Liver Diseases.

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

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

2017-09-01

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

Injury mechanisms, patterns and outcomes of older polytrauma patients : An analysis of the Dutch Trauma Registry

NARCIS (Netherlands)

de Vries, Rob; Reininga, Inge H. F.; Pieske, Oliver; Lefering, Rolf; El Moumni, Mostafa; Wendt, Klaus

2018-01-01

Background Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. Methods Data from

Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis

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Oster, Candice; Henderson, Julie; Lawn, Sharon; Reed, Richard; Dawson, Suzanne; Muir-Cochrane, Eimear; Fuller, Jeffrey

2016-01-01

Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people’s mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of ‘risk’, ‘ageing as decline/dependence’ and ‘healthy ageing’ were identified. Through these discourses, different neo-liberal governmental strategies are applied to ‘target’ groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people’s mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers. PMID:27147440

Transport-Related Social Exclusion amongst Older People in Rural Southwest England and Wales

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Shergold, Ian; Parkhurst, Graham

2012-01-01

Rural dwelling and older age are both associated with a higher risk of social exclusion, with accessibility identified as having an important facilitating role. The interactions between transport-related exclusion and older age, particularly in a rural context, are considered though analysis of quantitative and qualitative data collected from over…

Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

Science.gov (United States)

2014-01-01

Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

Older adults' intrinsic and extrinsic motivation toward physical activity.

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Dacey, Marie; Baltzell, Amy; Zaichkowsky, Len

2008-01-01

To examine how motives discriminate 3 physical activity levels of inactive, active, and sustained maintainers. Six hundred forty-five adults (M age = 63.8) completed stage-of-change and Exercise Motivations Inventory (EMI-2) scales. Exploratory factor analysis established psychometric properties of the EMI-2 suitable for older adults. Six factors emerged in the EMI-2: health and fitness, social/emotional benefits, weight management, stress management, enjoyment, and appearance. Enjoyment contributed most to differentiating activity levels. Moderators of age and gender were delineated. Intrinsic motivation and self-determined extrinsic motivation distinguish older adults' activity levels.

Complementary and alternative medicine use among older Australian women - a qualitative analysis

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McLaughlin Deirdre

2012-04-01

Full Text Available Abstract Background The use of complementary and alternative medicines (CAM among older adults is an emerging health issue, however little is known about older people's experiences of using CAM and the cultural, geographical and other determinants of CAM use in this population. This study used qualitative methods to explore older women's views of CAM and reasons for their use of CAM. Participants for the project were drawn from the Australian Longitudinal Study on Women's Health (ALSWH 1921-1926 birth cohort. Women who responded positively to a question about CAM use in Survey 5 (2008 of the ALSWH were invited to participate in the study. A total of 13 rural and 12 urban women aged between 83 and 88 years agreed to be interviewed. Results The women expressed a range of views on CAM which fell into three broad themes: "push" factors such as dissatisfaction with conventional health services, "pull" factors which emphasised the positive aspects of choice and self-care in health matters, and barriers to CAM use. Overall, the "push' factors did not play a major role in the decision to use CAM, rather this was driven by "pull" factors related to health care self-responsibility and being able to source positive information about types of CAM. A number of barriers were identified such as access difficulties associated with increased age, limited mobility and restricted transport options, as well as financial constraints. Conclusions CAM use among older women was unlikely to be influenced by aspects of conventional health care ("push factors", but rather was reflective of the personal beliefs of the women and members of their close social networks ("pull factors". While it was also apparent that there were differences between the rural and urban women in their use of CAM, the reasons for this were mainly due to the difficulties inherent in accessing certain types of CAM in rural areas.

Beyond 50. challenges at work for older nurses and allied health workers in rural Australia: a thematic analysis of focus group discussions

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Depczynski Julie C

2011-02-01

Full Text Available Abstract Background The health workforce in Australia is ageing, particularly in rural areas, where this change will have the most immediate implications for health care delivery and workforce needs. In rural areas, the sustainability of health services will be dependent upon nurses and allied health workers being willing to work beyond middle age, yet the particular challenges for older health workers in rural Australia are not well known. The purpose of this research was to identify aspects of work that have become more difficult for rural health workers as they have become older; and the age-related changes and exacerbating factors that contribute to these difficulties. Findings will support efforts to make workplaces more 'user-friendly' for older health workers. Methods Nurses and allied health workers aged 50 years and over were invited to attend one of six local workshops held in the Hunter New England region of NSW, Australia. This qualitative action research project used a focus group methodology and thematic content analysis to identify and interpret issues arising from workshop discussions. Results Eighty older health workers from a range of disciplines attended the workshops. Tasks and aspects of work that have become more difficult for older health workers in hospital settings, include reading labels and administering medications; hearing patients and colleagues; manual handling; particular movements and postures; shift work; delivery of babies; patient exercises and suturing. In community settings, difficulties relate to vehicle use and home visiting. Significant issues across settings include ongoing education, work with computers and general fatigue. Wider personal challenges include coping with change, balancing work-life commitments, dealing with attachments and meeting goals and expectations. Work and age-related factors that exacerbate difficulties include vision and hearing deficits, increasing tiredness, more complex

Beyond 50. Challenges at work for older nurses and allied health workers in rural Australia: a thematic analysis of focus group discussions.

Science.gov (United States)

Fragar, Lyn J; Depczynski, Julie C

2011-02-21

The health workforce in Australia is ageing, particularly in rural areas, where this change will have the most immediate implications for health care delivery and workforce needs. In rural areas, the sustainability of health services will be dependent upon nurses and allied health workers being willing to work beyond middle age, yet the particular challenges for older health workers in rural Australia are not well known. The purpose of this research was to identify aspects of work that have become more difficult for rural health workers as they have become older; and the age-related changes and exacerbating factors that contribute to these difficulties. Findings will support efforts to make workplaces more 'user-friendly' for older health workers. Nurses and allied health workers aged 50 years and over were invited to attend one of six local workshops held in the Hunter New England region of NSW, Australia. This qualitative action research project used a focus group methodology and thematic content analysis to identify and interpret issues arising from workshop discussions. Eighty older health workers from a range of disciplines attended the workshops. Tasks and aspects of work that have become more difficult for older health workers in hospital settings, include reading labels and administering medications; hearing patients and colleagues; manual handling; particular movements and postures; shift work; delivery of babies; patient exercises and suturing. In community settings, difficulties relate to vehicle use and home visiting. Significant issues across settings include ongoing education, work with computers and general fatigue. Wider personal challenges include coping with change, balancing work-life commitments, dealing with attachments and meeting goals and expectations. Work and age-related factors that exacerbate difficulties include vision and hearing deficits, increasing tiredness, more complex professional roles and a sense of not being valued in the

Meanings of television in older adults’ lives: an analysis of change and continuity in television viewing

NARCIS (Netherlands)

van der Goot, M.; Beentjes, J.W.J.; van Selm, M.

2012-01-01

Television viewing is an important leisure activity for older adults. The aim of the current study is to provide insight into the meanings of television in older adults' lives, by analysing change and continuity in their television viewing. A qualitative study was conducted that included in-depth

What's different about older people.

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Crome, Peter

2003-10-01

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

Friends, Depressive Symptoms, and Life Satisfaction Among Older Korean Americans.

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Roh, Soonhee; Lee, Yeon-Shim; Lee, Kyoung Hag; Shibusawa, Tazuko; Yoo, Grace J

2015-08-01

This study examined the interactive effects of social network support and depressive symptoms on life satisfaction among older Korean Americans (KAs). Using data from a sample of 200 elders in a large metropolitan area (M age = 72.50, SD = 5.15), hierarchical regression analysis was used to examine the interaction between social network support and depressive symptoms on life satisfaction among older KAs. After controlling for demographic variables, both social network support and depressive symptoms were identified as predictors for life satisfaction. Interaction effects indicated strong associations between higher social network support specifically from friends and lower depressive symptoms with higher levels of life satisfaction. Findings highlight the important role that friends play in terms of social network support for the mental health of older KAs, and the need for geriatric practitioners to monitor and assess the quality of social network support-including friendships-when working with older KAs.

Social network types among older Korean adults: Associations with subjective health.

Science.gov (United States)

Sohn, Sung Yun; Joo, Won-Tak; Kim, Woo Jung; Kim, Se Joo; Youm, Yoosik; Kim, Hyeon Chang; Park, Yeong-Ran; Lee, Eun

2017-01-01

With population aging now a global phenomenon, the health of older adults is becoming an increasingly important issue. Because the Korean population is aging at an unprecedented rate, preparing for public health problems associated with old age is particularly salient in this country. As the physical and mental health of older adults is related to their social relationships, investigating the social networks of older adults and their relationship to health status is important for establishing public health policies. The aims of this study were to identify social network types among older adults in South Korea and to examine the relationship of these social network types with self-rated health and depression. Data from the Korean Social Life, Health, and Aging Project were analyzed. Model-based clustering using finite normal mixture modeling was conducted to identify the social network types based on ten criterion variables of social relationships and activities: marital status, number of children, number of close relatives, number of friends, frequency of attendance at religious services, attendance at organized group meetings, in-degree centrality, out-degree centrality, closeness centrality, and betweenness centrality. Multivariate regression analysis was conducted to examine associations between the identified social network types and self-rated health and depression. The model-based clustering analysis revealed that social networks clustered into five types: diverse, family, congregant, congregant-restricted, and restricted. Diverse or family social network types were significantly associated with more favorable subjective mental health, whereas the restricted network type was significantly associated with poorer ratings of mental and physical health. In addition, our analysis identified unique social network types related to religious activities. In summary, we developed a comprehensive social network typology for older Korean adults. Copyright © 2016

Social network types and functional dependency in older adults in Mexico

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Espinosa-Alarcón Patricia

2010-02-01

Full Text Available Abstract Background Social networks play a key role in caring for older adults. A better understanding of the characteristics of different social networks types (TSNs in a given community provides useful information for designing policies to care for this age group. Therefore this study has three objectives: 1 To derive the TSNs among older adults affiliated with the Mexican Institute of Social Security; 2 To describe the main characteristics of the older adults in each TSN, including the instrumental and economic support they receive and their satisfaction with the network; 3 To determine the association between functional dependency and the type of social network. Methods Secondary data analysis of the 2006 Survey of Autonomy and Dependency (N = 3,348. The TSNs were identified using the structural approach and cluster analysis. The association between functional dependency and the TSNs was evaluated with Poisson regression with robust variance analysis in which socio-demographic characteristics, lifestyle and medical history covariates were included. Results We identified five TSNs: diverse with community participation (12.1%, diverse without community participation (44.3%; widowed (32.0%; nonfriends-restricted (7.6%; nonfamily-restricted (4.0%. Older adults belonging to widowed and restricted networks showed a higher proportion of dependency, negative self-rated health and depression. Older adults with functional dependency more likely belonged to a widowed network (adjusted prevalence ratio 1.5; 95%CI: 1.1-2.1. Conclusion The derived TSNs were similar to those described in developed countries. However, we identified the existence of a diverse network without community participation and a widowed network that have not been previously described. These TSNs and restricted networks represent a potential unmet need of social security affiliates.

Orchestrating care: nursing practice with hospitalised older adults.

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Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

2015-12-01

The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

Affect or cognition: which is more influencing older adult consumers' loyalty?

Science.gov (United States)

Kaur, Deepraj; Mustika, Martina Dwi; Sjabadhyni, Bertina

2018-04-01

In studies on consumer behavior science, it is argued that brand affect, consumer satisfaction, and disconfirmation influence brand loyalty. This study aims to investigate whether the interaction of brand affect and cognition predicts brand loyalty in older adult consumers if consumer satisfaction is considered. A group of 344 older adult consumers participated and a mediated moderation analysis of the data was used to test our hypotheses. The results showed that consumer satisfaction increased the relationship between brand affect and brand loyalty in older adult consumers. However, disconfirmation did not influence that relationship. It can be concluded that the loyalty of older adult consumers toward a brand was more likely to be influenced by their affection than their cognition. Therefore, marketers should design products that better satisfy this population group and create loyalty to the product through enhancing affect connections.

Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis.

Science.gov (United States)

Siriwardhana, Dhammika D; Hardoon, Sarah; Rait, Greta; Weerasinghe, Manuj C; Walters, Kate R

2018-03-01

To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. Low-income and middle-income countries. Community-dwelling older adults aged ≥60 years. We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I 2 =99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I 2 =97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. CRD42016036083. © 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.

Older Motorcyclists in Ireland

LENUS (Irish Health Repository)

Fitzpatrick, D

2017-06-01

Older motorcyclists are under-recognised as vulnerable road users. Using Irish data from the Central Statistics Office, the Road Safety Authority and the Healthcare Pricing Office, we explored the trend of ageing riders and factors in older motorcyclist collisions and injuries. In 2005, 17 motorcyclists ≥55 were injured compared to 31 in 2012. Motorcyclists aged between 30 and 49 years and ≥50 have longer lengths of stay compared to riders <30. The percentage of motorcycles with an engine capacity of ≥750cc increased from 39.6% in 2007 to 46.7% in 2015. Older motorcyclists are less likely to be fatally injured in single vehicle collisions. Older motorcyclists are generally safer than younger riders but the proportion of older motorcyclist injury is rising. Irish road safety strategies and trauma services need to incorporate these findings into planning and development of preventive and treatment approaches

Impact of Social Integration and Living Arrangements on Korean Older Adults' Depression: A Moderation Model.

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Lee, Youjung; Jang, Kyeonghee; Lockhart, Naorah C

2018-04-01

Depression among older adults is a challenging public health concern in Korea. Using panel data from the Korea Institute for Health and Social Affairs on Korean older adults and their family caregivers, this study explores significant predictors of depression among Korean older adults as well as the moderating effect of living arrangements on the association between social integration and depression. A multivariate logistic regression analysis showed that preexisting depression was the most significant predictor of Korean older adults' current depression, followed by health status and family support. In addition, social integration significantly decreased Korean older adults' depression. Importantly, a significant moderation effect of living arrangements between Korean older adults' social integration and depression was observed. This study implies the development of individually tailored and culturally responsive programs to engage marginalized Korean older adults living alone, helping foster their well-being and optimal aging.

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

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

2013-05-06

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

Transforming Practice with Older People through an Ethic of Care.

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Ward, Lizzie; Barnes, Marian

2016-06-01

This article explores the relevance of deliberative practices framed by feminist care ethics to social work practice with older people. It draws on two connected projects which brought together older people: practitioners and academics. The first was a participatory research project in which the significance of care to well-being in old age emerged. The second was a knowledge exchange project which generated learning resources for social care practice based on the research findings of the first project. Here we analyse selected transcripts of recordings from meetings of both projects to consider the ways that discussions about lived experiences and everyday lives demonstrate care through this dialogue. Using this analysis, we propose that care ethics can be useful in transforming relationships between older people and those working with them through the creation of hybrid spaces in which 'care-full deliberation' can happen. We argue that such reflective spaces can enable transformative dialogue about care and its importance to older people and offer a counterbalance to the procedurally driven environments in which much social work practice takes place and can support practice more attuned to the circumstances and concerns of older people.

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

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

2014-01-01

This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were more likely than their Chinese and Indian counterparts to experience loneliness. Loneliness was found to be associated with age, marital status, education level, sources of income, health status, and physical limitations. Among older people, feelings of loneliness were inversely related with coresidence with adult children and participation in religious activities. Sociodemographic changes have eroded the traditional family support system for the elderly, while social security remains inadequate. This study shows the important role of family in alleviating loneliness among older people. Hence the need to promote and facilitate coresidence, as well as participation in religious activities, and a healthy lifestyle as a priority strategy is in line with the objectives of the National Policy for the Older People. PMID:25383374

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

Directory of Open Access Journals (Sweden)

Jane Kimm Lii Teh

2014-01-01

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

Family support and loneliness among older persons in multiethnic Malaysia.

Science.gov (United States)

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

2014-01-01

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

Analysis of influencing factors for short-term outcome in patients with hepatitis B virus-related acute-on-chronic liver failure

Directory of Open Access Journals (Sweden)

ZHANG Xin

2015-05-01

Full Text Available ObjectiveTo investigate the effects of antiviral drugs, lamivudine (LAM and entecavir (ETV, on the short-term outcome in patients with hepatitis B virus (HBV-related acute-on-chronic liver failure (ACLF. MethodsThe demographic and clinical data of 445 patients with HBV-related ACLF (LAM∶ETV, 333∶112 who were hospitalized in the First Clinical Medical College of Fujian Medical University from January 2004 to December 2010 were collected, including age, sex, complications, clinical biochemical parameters, coagulation parameters, the use of antiviral drug, artificial liver treatment, and the survival at 24 weeks. The independent risk factors for the outcome at 24 weeks were determined by univariate and multivariate logistic regression analyses. ResultsThe univariate analysis indicated that the LAM group had significantly higher globulin, total bilirubin (TBil, alanine aminotransferase, international normalized ratio (INR, serum creatinine, and model for end-stage liver disease (MELD score than the ETV group (P＜0.05, but had significantly lower cholinesterase and prothrombin time activity (PTA than the ETV group (P＜0.05. The death group had significantly older age, higher incidence rates of liver cirrhosis, hepatic encephalopathy, spontaneous bacterial peritonitis, pulmonary infection, mycotic infection, electrolyte disturbance, hepatorenal syndrome, and upper gastrointestinal hemorrhage, and higher TBil, INR, white blood count, and MELD score than the survival group (P＜0.05, but had significantly lower albumin, gamma-glutamyl transpeptidase, cholesterol, cholinesterase, serum sodium, PTA, alpha-fetoprotein, hemoglobin, platelet, and positive rate of HBeAg than the survival group (P＜0.05. And there was no significant difference in the use of antiviral drugs (LAM∶ETV between the death group and the survival group (P=0.21. The multivariate logistic regression analysis showed that older age, hepatic encephalopathy, hepatorenal syndrome

Exploratory Factor Analysis of the Anxiety Control Questionnaire among Older Adults

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Gerolimatos, Lindsay A.; Gould, Christine E.; Edelstein, Barry A.

2012-01-01

Among young adults and clinical populations, perceived inability to control internal and external events is associated with anxiety. At present, it is unclear what role perceived anxiety control plays in anxiety among older adults. The Anxiety Control Questionnaire (ACQ) was developed to assess one's perceived ability to cope with anxiety-related…

Discrimination and psychiatric disorders among older African Americans.

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Mouzon, Dawne M; Taylor, Robert Joseph; Keith, Verna M; Nicklett, Emily J; Chatters, Linda M

2017-02-01

This study examined the impact of everyday discrimination (both racial and non-racial) on the mental health of older African Americans. This analysis is based on the older African American subsample of the National Survey of American Life (NSAL) (n = 773). We examined the associations between everyday discrimination and both general distress and psychiatric disorders as measured by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Six dependent variables were examined: lifetime mood disorders, lifetime anxiety disorders, any lifetime disorder, number of lifetime disorders, depressive symptoms as measured by the 12-item Center for Epidemiological Scale of Depression (CES-D), and serious psychological distress as measured by the Kessler 6 (K6). Overall, racial and non-racial everyday discrimination were consistently associated with worse mental health for older African Americans. Older African Americans who experienced higher levels of overall everyday discrimination had higher odds of any psychiatric disorder, any lifetime mood disorder, any lifetime anxiety disorder, and more lifetime DSM-IV disorders, in addition to elevated levels of depressive symptoms and serious psychological distress. These findings were similar for both racial discrimination and non-racial discrimination. This study documents the harmful association of not only racial discrimination, but also non-racial (and overall) discrimination with the mental health of older African Americans. Specifically, discrimination is negatively associated with mood and anxiety disorders as well as depressive symptoms and psychological distress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Healthcare-Associated Meningitis or Ventriculitis in Older Adults.

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Srihawan, Chanunya; Habib, Onaizah; Salazar, Lucrecia; Hasbun, Rodrigo

2017-12-01

Healthcare-associated meningitis or ventriculitis (HCAMV) is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk of adverse outcomes in community-acquired meningitis but studies of HCAMV are lacking. Therefore, we perform the study to define the differences in clinical outcomes between older and younger adults with HCAMV. Retrospective study. A large tertiary care hospital in Houston, Texas, from July 2003 to November 2014. Adults with a diagnosis of HCAMV (N = 160) aged ≥65 (n = 35), aged 18-64 (n = 125). Demographic characteristics, clinical presentation, laboratory results, treatments, and outcomes (Glasgow Outcome Scale). Older adults had more comorbidities and CSF abnormalities [pleocytosis, high cerebrospinal fluid (CSF) protein, low CSF glucose) and were more likely to have altered mental status than younger adults (P older (97%) and younger (86%) adults (P = .13). On logistic regression analysis, abnormal neurological examination (adjusted odds ratio (aOR) = 7.13, 95% confidence interval (CI) = 2.15-23.63, P = .001) and mechanical ventilation (aOR = 11.03, 95% CI = 1.35-90.51, P = .02) were associated with adverse clinical outcomes. Older adults with HCAMV have more comorbidities and CSF abnormalities and are more likely to have altered mental status than younger adults but have similar high rates of adverse clinical outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Factors associated with cane use among community dwelling older adults.

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Aminzadeh, F; Edwards, N

2000-01-01

Guided by the Theory of Planned Behavior (TPB), this study examined factors associated with cane use among community dwelling older adults. Data were collected in a cross-sectional survey of a convenience sample of 106 community residing older adults in Ottawa, Canada. Using a stepwise discriminant analysis, subjective norms, attitudes, and age surfaced as the key variables associated with cane use in this sample. The discriminant function accounted for 67% of the variance in cane use and correctly classified 91% of cases (Wilks's lambda = 0.33, lambda2 = 110.12, df = 3, p cane use behaviors of older persons and have important implications for the design of theory-based fall prevention interventions to enhance the acceptance and effective use of mobility aids.

Comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults: a network meta-analysis.

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Thorlund, Kristian; Druyts, Eric; Wu, Ping; Balijepalli, Chakrapani; Keohane, Denis; Mills, Edward

2015-05-01

To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. Systematic review and network meta-analysis. Individuals aged 60 and older. Data on partial response (defined as at least 50% reduction in depression score from baseline) and safety (dizziness, vertigo, syncope, falls, loss of consciousness) were extracted. A Bayesian network meta-analysis was performed on the efficacy and safety outcomes, and relative risks (RRs) with 95% credible intervals (CrIs) were produced. Fifteen randomized controlled trials were eligible for inclusion in the analysis. Citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, fluoxetine, and sertraline were represented. Reporting on partial response and dizziness was sufficient to conduct a network meta-analysis. Reporting on other outcomes was sparse. For partial response, sertraline (RR=1.28), paroxetine (RR=1.48), and duloxetine (RR=1.62) were significantly better than placebo. The remaining interventions yielded RRs lower than 1.20. For dizziness, duloxetine (RR=3.18) and venlafaxine (RR=2.94) were statistically significantly worse than placebo. Compared with placebo, sertraline had the lowest RR for dizziness (1.14) and fluoxetine the second lowest (1.31). Citalopram, escitalopram, and paroxetine all had RRs between 1.4 and 1.7. There was clear evidence of the effectiveness of sertraline, paroxetine, and duloxetine. There also appears to be a hierarchy of safety associated with the different antidepressants, although there appears to be a dearth of reporting of safety outcomes. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

OpenAIRE

Orces, Carlos H.

2013-01-01

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and tho...

Longitudinal Physical Activity Patterns Among Older Adults: A Latent Transition Analysis.

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Mooney, Stephen J; Joshi, Spruha; Cerdá, Magdalena; Kennedy, Gary J; Beard, John R; Rundle, Andrew G

2018-05-14

Most epidemiologic studies of physical activity measure either total energy expenditure or engagement in a single activity type, such as walking. These approaches may gloss over important nuances in activity patterns. We performed a latent transition analysis to identify patterns of activity types as well as neighborhood and individual determinants of changes in those activity patterns over two years in a cohort of 2,023 older adult residents of New York City, NY, surveyed between 2011 and 2013. We identified seven latent classes: 1) Mostly Inactive, 2) Walking, 3) Exercise, 4) Household Activities and Walking, 5) Household Activities and Exercise, 6) Gardening and Household Activities, and 7) Gardening, Household Activities, and Exercise. The majority of subjects retained the same activity patterns between waves (54% unchanged between waves 1 and 2, 66% unchanged between waves 2 and 3).Most latent class transitions were between classes distinguished only by one form of activity, and only neighborhood unemployment was consistently associated with changing between activity latent classes. Future latent transition analyses of physical activity would benefit from larger cohorts and longer follow-up periods to assess predictors of and long-term impacts of changes in activity patterns.

Experience of emotion in frail older people towards the end of life: A secondary data analysis.

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Findlay, Caitlin; Lloyd, Anna; Finucane, Anne M

2017-12-02

People are living longer, but with increased age comes greater frailty and multi-morbidity. This secondary data analysis examines transcripts from interviews with 11 frail older people and 6 informal carers to explore emotion in relation to frailty and deteriorating health. Anger and frustration were frequently experienced with declining functional ability; sadness occurred with social isolation, loss of autonomy and independence; anxiety was evident when transition to a care home was discussed; and contentment was described when connecting with others. Reluctant acceptance emerged as a coping strategy. Insights gained from analysing emotion may inform communications training courses for community nurses, though further research is required.

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

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Huang, Helen J.

2013-01-01

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

The Decreasing Prevalence of Nonrefractive Visual Impairment in Older Europeans: A Meta-analysis of Published and Unpublished Data.

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Delcourt, Cécile; Le Goff, Mélanie; von Hanno, Therese; Mirshahi, Alireza; Khawaja, Anthony P; Verhoeven, Virginie J M; Hogg, Ruth E; Anastosopoulos, Eleftherios; Cachulo, Maria Luz; Höhn, René; Wolfram, Christian; Bron, Alain; Miotto, Stefania; Carrière, Isabelle; Colijn, Johanna M; Buitendijk, Gabriëlle H S; Evans, Jennifer; Nitsch, Dorothea; Founti, Panayiota; Yip, Jennifer L Y; Pfeiffer, Norbert; Creuzot-Garcher, Catherine; Silva, Rufino; Piermarocchi, Stefano; Topouzis, Fotis; Bertelsen, Geir; Foster, Paul J; Fletcher, Astrid; Klaver, Caroline C W; Korobelnik, Jean-François

2018-03-13

To estimate the prevalence of nonrefractive visual impairment and blindness in European persons 55 years of age and older. Few visual impairment and blindness prevalence estimates are available for the European population. In addition, many of the data collected in European population-based studies currently are unpublished and have not been included in previous estimates. Fourteen European population-based studies participating in the European Eye Epidemiology Consortium (n = 70 723) were included. Each study provided nonrefractive visual impairment and blindness prevalence estimates stratified by age (10-year strata) and gender. Nonrefractive visual impairment and blindness were defined as best-corrected visual acuity worse than 20/60 and 20/400 in the better eye, respectively. Using random effects meta-analysis, prevalence rates were estimated according to age, gender, geographical area, and period (1991-2006 and 2007-2012). Because no data were available for Central and Eastern Europe, population projections for numbers of affected people were estimated using Eurostat population estimates for European high-income countries in 2000 and 2010. The age-standardized prevalence of nonrefractive visual impairment in people 55 years of age or older decreased from 2.22% (95% confidence interval [CI], 1.34-3.10) from 1991 through 2006 to 0.92% (95% CI, 0.42-1.42) from 2007 through 2012. It strongly increased with age in both periods (up to 15.69% and 4.39% in participants 85 years of age or older from 1991 through 2006 and from 2007 through 2012, respectively). Age-standardized prevalence of visual impairment tended to be higher in women than men from 1991 through 2006 (2.67% vs. 1.88%), but not from 2007 through 2012 (0.87% vs. 0.88%). No differences were observed between northern, western, and southern regions of Europe. The projected numbers of affected older inhabitants in European high-income countries decreased from 2.5 million affected individuals in 2000 to 1

Feasibility study of an attention training application for older adults.

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Hill, Nikki L; Mogle, Jacqueline; Colancecco, Elise; Dick, Robert; Hannan, John; Lin, Feng Vankee

2015-09-01

Technology-based attention training has demonstrated promise in its potential to improve cognitive functioning in older people. Developing mobile applications, with older users specifically in mind, may support future dissemination of these interventions and integration into daily life. The purpose of this pilot study was to test the feasibility of an Attention Training Application (ATA) for community-dwelling older adults using mobile technology. A descriptive, mixed-methods design was used to capture older adults' feedback on the usability and acceptability of the ATA. A convenience sample of older adults (n = 9) from two independent living facilities participated in a 2-hour training and practice session with the ATA. Participants were given personally tailored instructions for using the mobile device and the ATA specifically. Following a practice session, participants provided ratings on multiple components of the ATA and completed an audio-recorded, semi-structured interview to provide detailed descriptions of their experience and perceptions. An iterative process of content analysis was used to characterise the open-ended responses. Participants rated the ATA favourably overall on several 0-10 scales including likeability [8.5 (1.6)], interest [8.8 (2.3)] and satisfaction [8.2 (1.9)]. The qualitative analyses revealed several issues relevant to the feasibility of the ATA among older people including the importance of the technological background of the user, limiting negative feedback, challenges with the touch screen interface, personal preferences for challenge, extending the practice period and the difficulty of the dual-task condition. The use of the ATA is feasible in the older adult population. Future development should specifically consider personal characteristics as well as preferences to maximise usability and acceptability among older people. Older adults enjoyed the ATA. This opens doors to user-friendly technological interventions that may be

The Precarity of Older Adults Living Alone With Cognitive Impairment.

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Portacolone, Elena; Rubinstein, Robert L; Covinsky, Kenneth E; Halpern, Jodi; Johnson, Julene K

2018-01-24

To examine the lived experience of older adults living alone with cognitive impairment to better understand their needs and concerns. Based on our previous work suggesting that older adults living alone often experience a sense of precarity, we were interested in exploring this construct in older adults living alone with a diagnosis of cognitive impairment. The notion of precarity points to the uncertainty deriving from coping with cumulative pressures while trying to preserve a sense of independence. This is a qualitative study of 12 adults aged 65 and older living alone with cognitive impairment. Six participants had a diagnosis of Alzheimer's disease; 6 had a diagnosis of mild cognitive impairment. Participants' lived experiences were elicited through 40 ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Qualitative analysis of transcripts revealed three themes. Theme 1 described the distress stemming from the uncertainty of having cognitive impairment that has an unpredictable course. Theme 2 drew attention to the tendency of participants to feel responsible for managing their cognitive impairment. Theme 3 described the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment. These 3 themes all pointed to facets of precarity. Findings also suggest the dearth of programs to support older adults living alone with cognitive impairment and the need to develop novel programs and interventions. © The Author(s) 2018. 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.

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Clinical Features and Outcomes Differ between Skeletal and Extraskeletal Osteosarcoma

Directory of Open Access Journals (Sweden)

Sheila Thampi

2014-01-01

Full Text Available Background. Extraskeletal osteosarcoma (ESOS is a rare subtype of osteosarcoma. We investigated patient characteristics, overall survival, and prognostic factors in ESOS. Methods. We identified cases of high-grade osteosarcoma with known tissue of origin in the Surveillance, Epidemiology, and End Results database from 1973 to 2009. Demographics were compared using univariate tests. Overall survival was compared with log-rank tests and multivariate analysis using Cox proportional hazards methods. Results. 256/4,173 (6% patients with high-grade osteosarcoma had ESOS. Patients with ESOS were older, were more likely to have an axial tumor and regional lymph node involvement, and were female. Multivariate analysis showed ESOS to be favorable after controlling for stage, age, tumor site, gender, and year of diagnosis [hazard ratio 0.75 (95% CI 0.62 to 0.90; p=0.002]. There was an interaction between age and tissue of origin such that older patients with ESOS had superior outcomes compared to older patients with skeletal osteosarcoma. Adverse prognostic factors in ESOS included metastatic disease, larger tumor size, older age, and axial tumor site. Conclusion. Patients with ESOS have distinct clinical features but similar prognostic factors compared to skeletal osteosarcoma. Older patients with ESOS have superior outcomes compared to older patients with skeletal osteosarcoma.

Physical activity and depression in older adults with and without cognitive impairment.

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Yuenyongchaiwat, Kornanong; Pongpanit, Khajonsak; Hanmanop, Somrudee

2018-01-01

Low physical activity and depression may be related to cognitive impairment in the elderly. To determine depression and physical activity (PA) among older adults with and without cognitive impairment. 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

Comparative study of the efficiency of computed univariate and multivariate methods for the estimation of the binary mixture of clotrimazole and dexamethasone using two different spectral regions

Science.gov (United States)

Fayez, Yasmin Mohammed; Tawakkol, Shereen Mostafa; Fahmy, Nesma Mahmoud; Lotfy, Hayam Mahmoud; Shehata, Mostafa Abdel-Aty

2018-04-01

Three methods of analysis are conducted that need computational procedures by the Matlab® software. The first is the univariate mean centering method which eliminates the interfering signal of the one component at a selected wave length leaving the amplitude measured to represent the component of interest only. The other two multivariate methods named PLS and PCR depend on a large number of variables that lead to extraction of the maximum amount of information required to determine the component of interest in the presence of the other. Good accurate and precise results are obtained from the three methods for determining clotrimazole in the linearity range 1-12 μg/mL and 75-550 μg/mL with dexamethasone acetate 2-20 μg/mL in synthetic mixtures and pharmaceutical formulation using two different spectral regions 205-240 nm and 233-278 nm. The results obtained are compared statistically to each other and to the official methods.

Older and Wiser: Older Adults’ Episodic Word Memory Benefits from Sentence Study Contexts

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Matzen, Laura E.; Benjamin, Aaron S.

2013-01-01

A hallmark of adaptive cognition is the ability to modulate learning in response to the demands posed by different types of tests and different types of materials. Here we evaluate how older adults process words and sentences differently by examining patterns of memory errors. In two experiments, we explored younger and older adults’ sensitivity to lures on a recognition test following study of words in these two types of contexts. Among the studied words were compound words such as “blackmail” and “jailbird” that were related to conjunction lures (e.g. “blackbird”) and semantic lures (e.g. “criminal”). Participants engaged in a recognition test that included old items, conjunction lures, semantic lures, and unrelated new items. In both experiments, younger and older adults had the same general pattern of memory errors: more incorrect endorsements of semantic than conjunction lures following sentence study and more incorrect endorsements of conjunction than semantic lures following list study. The similar pattern reveals that older and younger adults responded to the constraints of the two different study contexts in similar ways. However, while younger and older adults showed similar levels of memory performance for the list study context, the sentence study context elicited superior memory performance in the older participants. It appears as though memory tasks that take advantage of greater expertise in older adults--in this case, greater experience with sentence processing--can reveal superior memory performance in the elderly. PMID:23834493

Is Sex with Older Male Partners Associated with Higher Sexual Risk Behavior Among Young Black MSM?

Science.gov (United States)

Chamberlain, Nicholas; Mena, Leandro A; Geter, Angelica; Crosby, Richard A

2017-08-01

Participants at a sexual health clinic completed a survey with questions regarding sexual risk behavior and partner characteristics. Of 585 participants eligible for analysis, 124 reported generally having older male partners. These participants were significantly more likely to be HIV-infected (p < 0.001), have four or more sex partners as a "bottom" (p = 0.04), have concurrent partners (p = 0.01), and have partners suspected of having an sexually transmitted infection (p = 0.05) than participants without older partners. With analysis restricted to HIV- individuals, risk behaviors did not differ significantly between the groups. HIV- individuals with older partners may be at increased risk of HIV infection due to increased HIV prevalence among older sexual partners and not due to increased risk behaviors with these partners.

Pathways into chronic multidimensional poverty amongst older people: a longitudinal study.

Science.gov (United States)

Callander, Emily J; Schofield, Deborah J

2016-03-07

The use of multidimensional poverty measures is becoming more common for measuring the living standards of older people. However, the pathways into poverty are relatively unknown, nor is it known how this affects the length of time people are in poverty for. Using Waves 1 to 12 of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey, longitudinal analysis was undertaken to identify the order that key forms of disadvantage develop - poor health, low income and insufficient education attainment - amongst Australians aged 65 years and over in multidimensional poverty, and the relationship this has with chronic poverty. Path analysis and linear regression models were used. For all older people with at least a Year 10 level of education attainment earlier mental health was significantly related to later household income (p = 0.001) and wealth (p = 0.017). For all older people with at less than a Year 10 level of education attainment earlier household income was significantly related to later mental health (p = 0.021). When limited to those in multidimensional poverty who were in income poverty and also had poor health, older people generally fell into income poverty first and then developed poor health. The order in which income poverty and poor health were developed had a significant influence on the length of time older people with less than a Year 10 level of education attainment were in multidimensional poverty for. Those who developed poor health first then fell into income poverty spend significantly less time in multidimensional poverty (-4.90, p poverty then developed poor health. Knowing the order that different forms of disadvantage develop, and the influence this has on poverty entrenchment, is of use to policy makers wishing to provide interventions to prevent older people being in long-term multidimensional poverty.

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

Science.gov (United States)

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

2015-01-01

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

Cognitive Social Capital and Formal Volunteering Among Older Adults in Urban China: Does Gender Matter?

Science.gov (United States)

Lu, Nan; Peng, Changmin; Jiang, Nan; Lou, Vivian W Q

2018-03-01

This study examined the moderating effect of gender on the relationship between cognitive social capital and formal volunteering among older adults in urban China. Cognitive social capital refers to individuals' perceptions of their social relationships in local communities. We used quota sampling to recruit 456 older adults aged 60 years and older from 16 communities of Gusu district, Suzhou city, in late 2015. Multiple group analysis was used to examine the proposed model. Gender had a moderating effect on the relationship between cognitive social capital and volunteering. The associations between cognitive social capital and volunteering were higher among older men than older women. The findings highlight the important role of cognitive social capital in influencing formal volunteering among older adults in urban Chinese contexts. The findings are particularly important for enhancing volunteering among older adults across different social and economic backgrounds. Policy and intervention implications are discussed.

Older active users of ICTs make sense of their engagement

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Magdalena Kania-Lundholm

2017-05-01

Full Text Available Research on older people’s ICT usage tends to focus on either the ways in which they go about learning to use these technologies or the impact that ICTs have on their lives. This research seems, in other words, to take for granted that older people are ‘digital immigrants’ as the digital divide debate proposed. Research that specifically looks at the ways in which older ICT users make sense of their engagement with these technologies is still limited. This article explores therefore – through focus group interviews – how a group of older people who are active ICT users make sense of their ‘digital nativeness’. The analysis shows that the interviewees are well aware that their ICT proficiency differentiated them from their peers, which is why they make sense of their ICT usage by making reference to the issues that make them ‘exceptional’ older people. These include the fact that they have used computers for many years and therefore made ICT usage an everyday habit early on; the fact that most older people do not have the skills that they themselves have, which is why they feel the need to share them with others; and the fact that their lifelong experience means they can use these technologies in judicious ways. By bringing attention to how older active ICT users make sense of their engagement, this article contributes to the notion of the digital spectrum and the debate on the inequalities that ICT proficiency brings about. 

Risk factors for hip fracture among institutionalised older people.

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Chen, Jian Sheng; Sambrook, Philip N; Simpson, Judy M; Cameron, Ian D; Cumming, Robert G; Seibel, Markus J; Lord, Stephen R; March, Lyn M

2009-07-01

risk factors for hip fracture in community-dwelling individuals have been extensively studied, but there have been fewer studies of institutionalised older people. a total of 1,894 older people (1,433 females, 461 males; mean age 86 years, SD 7.1 years) were recruited from 52 nursing homes and 30 intermediate-care nursing care facilities in Australia during March 1999 and February 2003. We assessed clinical risk factors for hip fracture and skeletal fragility by calcaneus broadband ultrasound attenuation (BUA) at baseline and then followed up for fracture for 4 years. Hip fractures were validated by x-ray reports. Survival analysis with age as a time-dependent covariate was used to analyse the data. during a mean follow-up period of 2.65 years (SD 1.38), 201 hip fractures in 191 residents were recorded, giving an overall hip fracture incidence rate of 4.0% per person year (males 3.6% and females 4.1%). Residents living in intermediate-care hostels had a higher crude hip fracture rate (4.6% vs. 3.0%) than those living in high-care nursing homes. In multivariate analysis, an increased risk of hip fracture was significantly associated with older age, cognitive impairment, a history of fracture since age 50, lower body weight, longer lower leg length and poorer balance in intermediate-care hostel residents, but not with lower BUA. institutionalised older people, who are at a higher risk of hip fracture than community-dwelling individuals, have differences in some risk factors for hip fracture that should be considered in targeting intervention programs.

Why do some older adults start drinking excessively late in life?

DEFF Research Database (Denmark)

Emiliussen, Jakob; Andersen, Kjeld; Nielsen, Anette Søgaard

2017-01-01

Introduction:This is a pioneering qualitative phenomenological hermeneutical study investigating a so far under-investigated group of older adults with verylate onset alcohol use disorder. The number of older adults is increasing, and the number of older adults with alcohol problems is increasing...... accordingly. We investi- gated older adults with very late-onset alcohol use disorder to identify what causes some people to develop problems with alcohol after the age of 60. Method: We interviewed 12 Danish individuals (seven men) whose alcohol use disorder started after the age of 60. For our analysis, we...... was one of the main factors in very late-onset alcohol use disorder among our participants. We found that the participants experienced a marked loss of identity when they had no activities to fill up their time after retirement. Social activities involving alcohol were also closely related to very late...

Affect or cognition: which is more influencing older adult consumers' loyalty?

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Deepraj Kaur

2018-04-01

Full Text Available In studies on consumer behavior science, it is argued that brand affect, consumer satisfaction, and disconfirmation influence brand loyalty. This study aims to investigate whether the interaction of brand affect and cognition predicts brand loyalty in older adult consumers if consumer satisfaction is considered. A group of 344 older adult consumers participated and a mediated moderation analysis of the data was used to test our hypotheses. The results showed that consumer satisfaction increased the relationship between brand affect and brand loyalty in older adult consumers. However, disconfirmation did not influence that relationship. It can be concluded that the loyalty of older adult consumers toward a brand was more likely to be influenced by their affection than their cognition. Therefore, marketers should design products that better satisfy this population group and create loyalty to the product through enhancing affect connections. Keywords: Business, Psychology

Exploring the Relationship Between Online Social Network Site Usage and the Impact on Quality of Life for Older and Younger Users: An Interaction Analysis.

Science.gov (United States)

Quinn, Darren; Chen, Liming; Mulvenna, Maurice D; Bond, Raymond

2016-09-29

Analyzing content generated by users of social network sites has been shown to be beneficial across a number of disciplines. Such analysis has revealed the precise behavior of users that details their distinct patterns of engagement. An issue is evident whereby without direct engagement with end users, the reasoning for anomalies can only be the subject of conjecture. Furthermore, the impact of engaging in social network sites on quality of life is an area which has received little attention. Of particular interest is the impact of online social networking on older users, which is a demographic that is specifically vulnerable to social isolation. A review of the literature reveals a lack of knowledge concerning the impact of these technologies on such users and even less is known regarding how this impact varies across different demographics. The objective of our study was to analyze user interactions and to survey the attitudes of social network users directly, capturing data in four key areas: (1) functional usage, (2) behavioral patterns, (3) technology, and (4) quality of life. An online survey was constructed, comprising 32 questions. Each question directly related to a research question. Respondents were recruited through a variety of methods including email campaigns, Facebook advertisements, and promotion from related organizations. In total, data was collected from 919 users containing 446 younger and 473 older users. In comparison to younger users, a greater proportion of older users (289/473, 61.1% older vs 218/446, 48.9% younger) (PFacebook had either a positive or huge impact on their quality of life. Furthermore, a greater percentage of older users strongly agreed that Facebook strengthened their relationship with other people (64/473, 13.5% older vs 40/446, 9.0%younger) (P=.02). In comparison to younger users, a greater proportion of older users had more positive emotions-classified as slightly better or very good-during their engagement with

Multivariate refined composite multiscale entropy analysis

International Nuclear Information System (INIS)

Humeau-Heurtier, Anne

2016-01-01

Multiscale entropy (MSE) has become a prevailing method to quantify signals complexity. MSE relies on sample entropy. However, MSE may yield imprecise complexity estimation at large scales, because sample entropy does not give precise estimation of entropy when short signals are processed. A refined composite multiscale entropy (RCMSE) has therefore recently been proposed. Nevertheless, RCMSE is for univariate signals only. The simultaneous analysis of multi-channel (multivariate) data often over-performs studies based on univariate signals. We therefore introduce an extension of RCMSE to multivariate data. Applications of multivariate RCMSE to simulated processes reveal its better performances over the standard multivariate MSE. - Highlights: • Multiscale entropy quantifies data complexity but may be inaccurate at large scale. • A refined composite multiscale entropy (RCMSE) has therefore recently been proposed. • Nevertheless, RCMSE is adapted to univariate time series only. • We herein introduce an extension of RCMSE to multivariate data. • It shows better performances than the standard multivariate multiscale entropy.

Older Siblings' Contributions to Young Child's Cognitive Skills.

Science.gov (United States)

Dai, Xianhua; Heckman, James J

2013-09-01

This work finds that older siblings as well as early parenting influence young children's cognitive skills directly or indirectly, for example, Mathematics, and English. Our findings challenge a pervasive view in the economical literatures that early parenting play a dominant role in explaining child development. In economics, early environmental conditions are important to demonstrate the evolution of adolescent and adult cognitive skills (Knudsen, Heckman, Cameron, and Shonkoff, 2006; Cunha and Heckman, 2007), and it establishes causal impacts of early parental inputs and other environmental factors on cognitive and non-cognitive skills (Heckman, Stixrud, and Urzua, 2006; Borghans, Duckworth, Heckman, and Weel, 2006; Cunha, Heckman, and Schennach, 2010). Early parenting as well as older siblings should explain a diverse array of academic and social outcomes, for example, Mathematics, English, maritage and pregnancy. In fact, older siblings' characteristics are as important, if not more important, than parenting for child development. Our analysis addresses the problems of measurement error, imperfect proxies, and reverse causality that plague conventional approach in psychology. We find that older brother contributes much more than older sister to child's mathematical achievement, while older sister contributes much more to child's english achievement. Our evidence is consistent with psychology literature, for example, Hetherington (1988), Jenkins (1992), Zukow-Goldring (1995), Marshall, Garcia-Coll, Marx, McCartney, Keffe, and Rub (1997), Maynard (2002), and Brody Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings' direct contributions to child development, Bronfenbrenner (1997), East (1998), Whiteman and Buchanan (2002), and Brody, Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings's indirect contributions, and Reiss, Neiderhiser, Hetherington, and Plomin (2000), Feinberg and Hetherington (2001), Kowal, Kramer, Krull

Older and Younger Adults’ Accuracy in Discerning Health and Competence in Older and Younger Faces

Science.gov (United States)

Zebrowitz, Leslie A.; Franklin, Robert G.; Boshyan, Jasmine; Luevano, Victor; Agrigoroaei, Stefan; Milosavljevic, Bosiljka; Lachman, Margie E.

2015-01-01

We examined older and younger adults’ accuracy judging the health and competence of faces. Accuracy differed significantly from chance and varied with face age but not rater age. Health ratings were more accurate for older than younger faces, with the reverse for competence ratings. Accuracy was greater for low attractive younger faces, but not for low attractive older faces. Greater accuracy judging older faces’ health was paralleled by greater validity of attractiveness and looking older as predictors of their health. Greater accuracy judging younger faces’ competence was paralleled by greater validity of attractiveness and a positive expression as predictors of their competence. Although the ability to recognize variations in health and cognitive ability is preserved in older adulthood, the effects of face age on accuracy and the different effects of attractiveness across face age may alter social interactions across the life span. PMID:25244467

Dietary patterns and survival in older Dutch women.

NARCIS (Netherlands)

Waijers, Patricia M C M; Ocké, Marga C; Rossum, Caroline T M van; Peeters, Petra H M; Bamia, Christina; Chloptsios, Yiannis; Schouw, Yvonne T van der; Slimani, Nadia; Bueno-de-Mesquita, H Bas

2006-01-01

BACKGROUND: The need to gain insight into prevailing eating patterns and their health effects is evident. OBJECTIVE: This study aimed to identify dietary patterns and their relation to total mortality in older Dutch women. DESIGN: A principal component analysis of 22 food groups was used to identify

What Accounts for the Relationship Between Internet Use and Suicidal Ideation of Korean Older Adults? A Mediation Analysis.

Science.gov (United States)

Jun, Hey Jung; Kim, Myoung-Yong

2017-09-01

This study sought to examine the relationship between Internet use and suicidal ideation in Korean older adults and the mediating roles of social relationships and depressive symptoms. A nationally representative sample of older adults aged 50 or older (N = 6,306), from four waves of the Korean Welfare Panel Study, was used in the analyses. All analyses were conducted using generalized estimation equations, and the mediation effects of social relationship satisfaction and depression in the relationship between Internet use and suicidal ideation were calculated using the product-of-coefficients approach. Internet use was linked with lower levels of suicidal ideation directly and indirectly via the protective effects of Internet use on lowering depression, which was partially mediated by the positive influence Internet use has on older adults' social relationship satisfaction. The results support previous theories about the relationship between social relationships, depression, and suicidal behavior and prior results about how the Internet might confer mental and social health benefits to older adults. This suggests that the Internet is an important social and health activity that contributes to lowering suicidal ideation in older adults. © 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.

Employers’ Attitudes Toward Older Workers and Obstacles and Opportunities for the Older Unemployed to Reenter Working Life

Directory of Open Access Journals (Sweden)

Roland Kadefors

2012-08-01

Full Text Available The present study aimed at identifying the attitude-related barriers that older unemployed, jobseeking workers (50+ face when they endeavor to reenter the labor market and to investigate employers’ attitudes and perceptions of older workers. Two studies were conducted. In study 1, interviews were undertaken with 26 unemployed persons and 24 representatives of other stakeholders, including social partners and officials representing the Social Insurance Agency (FK and the Public Employment Service (AF. In study 2, the attitudes among private sector employers were studied by carrying out a questionnaire survey (N = 147. The interview results showed that many unemployed job seekers had experienced negative age-related attitudes among employers. This observation was supported by other stakeholders. Perceived attitudes to older workers and lack of updated competence were considered crucial. The questionnaire study showed a mixed picture concerning employer attitudes. There was a statistical difference between older (>50 years and younger employers; older employers believed that older women wanted competence development to a greater extent. There was also a significant difference between female and male employers’ opinions; female employers, in particular the older ones, assessed that older women wished competence development to a greater extent. These differences were not found with respect to views on older men. About half (52% of the employers had the opinion that there was no difference between older and younger employees with respect to the ability to cope with changes or learning new things. However, younger female employers (but not older female employers considered that older employees had greater difficulties with changes or learning new things. It is concluded that negative attitudes to older workers with respect to competence development tend to be most common among younger employers.

Effects of univariate and multivariate regression on the accuracy of hydrogen quantification with laser-induced breakdown spectroscopy

Science.gov (United States)

Ytsma, Cai R.; Dyar, M. Darby

2018-01-01

Hydrogen (H) is a critical element to measure on the surface of Mars because its presence in mineral structures is indicative of past hydrous conditions. The Curiosity rover uses the laser-induced breakdown spectrometer (LIBS) on the ChemCam instrument to analyze rocks for their H emission signal at 656.6 nm, from which H can be quantified. Previous LIBS calibrations for H used small data sets measured on standards and/or manufactured mixtures of hydrous minerals and rocks and applied univariate regression to spectra normalized in a variety of ways. However, matrix effects common to LIBS make these calibrations of limited usefulness when applied to the broad range of compositions on the Martian surface. In this study, 198 naturally-occurring hydrous geological samples covering a broad range of bulk compositions with directly-measured H content are used to create more robust prediction models for measuring H in LIBS data acquired under Mars conditions. Both univariate and multivariate prediction models, including partial least square (PLS) and the least absolute shrinkage and selection operator (Lasso), are compared using several different methods for normalization of H peak intensities. Data from the ChemLIBS Mars-analog spectrometer at Mount Holyoke College are compared against spectra from the same samples acquired using a ChemCam-like instrument at Los Alamos National Laboratory and the ChemCam instrument on Mars. Results show that all current normalization and data preprocessing variations for quantifying H result in models with statistically indistinguishable prediction errors (accuracies) ca. ± 1.5 weight percent (wt%) H2O, limiting the applications of LIBS in these implementations for geological studies. This error is too large to allow distinctions among the most common hydrous phases (basalts, amphiboles, micas) to be made, though some clays (e.g., chlorites with ≈ 12 wt% H2O, smectites with 15-20 wt% H2O) and hydrated phases (e.g., gypsum with ≈ 20

Making working memory work: A meta-analysis of executive control and working memory training in younger and older adults

OpenAIRE

Karbach, Julia; Verhaeghen, Paul

2014-01-01

This meta-analysis examined the effects of process-based cognitive training (49 studies) in the domains of executive function and working memory in older adults (>60 years). The interventions resulted in significant effects on the trained task (pre-to-posttest net gain: MSD = 0.5 compared to active control, MSD = 0.8 compared to passive control; net posttest effect: MSD = 1.2 compared to active control, MSD = 1.1 compared to passive control), significant near transfer (pre-post: MSD = 0.3, 0....

Exploring older driver crash trend: New Jersey case study

Directory of Open Access Journals (Sweden)

Vanvi Trieu

2014-04-01

Full Text Available Older drivers age 65 and above are known to experience greater risk on the roadway as well as increasing the risk to other roadway users. Within the next 20 years, their population is expected to increase from 41 million in 2011 to 70 million in 2030. To address this foreseeable change, the nation's recent Moving Ahead for Progress in the 21st Century (MAP-21 act requires state and local governments to examine older drivers and pedestrian risks and implement countermeasures as appropriate. This research was conducted to assist agencies in strategising for future plans, programmes and initiatives to better address the problem presented. This was accomplished by performing a detailed engineering analysis on crash data of older drivers over a 10-year period (2003–2012 from the state of New Jersey to identify crash trends and characteristics. A major finding from this research was the increase in fatal crashes of older drivers as a function of age. Top-ranking collision types with other vehicles and non-vehicles were identified. Crashes as a function of seasonal change, climate and lighting conditions were also examined.

Ground reaction forces and kinematics in distance running in older-aged men.

Science.gov (United States)

Bus, Sicco A

2003-07-01

The biomechanics of distance running has not been studied before in older-aged runners but may be different than in younger-aged runners because of musculoskeletal degeneration at older age. This study aimed at determining whether the stance phase kinematics and ground reaction forces in running are different between younger- and older-aged men. Lower-extremity kinematics using three-dimensional motion analysis and ground reaction forces (GRF) using a force plate were assessed in 16 older-aged (55-65 yr) and 13 younger-aged (20-35 yr) well-trained male distance runners running at a self-selected (SRS) and a controlled (CRS) speed of 3.3 m.s-1. The older subjects ran at significantly lower self-selected speeds than the younger subjects (mean 3.34 vs 3.77 m.s-1). In both speed conditions, the older runners exhibited significantly more knee flexion at heel strike and significantly less knee flexion and extension range of motion. No age group differences were present in subtalar joint motion. Impact peak force (1.91 vs 1.70 BW) and maximal initial loading rate (107.5 vs 85.5 BW.s-1) were significantly higher in the older runners at the CRS. Maximal peak vertical and anteroposterior forces and impulses were significantly lower in the older runners at the SRS. The biomechanics of running is different between older- and younger-aged runners on several relevant parameters. The larger impact peak force and initial loading rate indicate a loss of shock-absorbing capacity in the older runners. This may increase their susceptibility to lower-extremity overuse injuries. Moreover, it emphasizes the focus on optimizing cushioning properties in the design and prescription of running shoes and suggests that older-aged runners should be cautious with running under conditions of high impact.

Falls among older adults in the South of Brazil: prevalence and determinants.

Science.gov (United States)

Vieira, Luna S; Gomes, Ana Paula; Bierhals, Isabel O; Farías-Antúnez, Simone; Ribeiro, Camila G; Miranda, Vanessa I A; Lutz, Bárbara H; Barbosa-Silva, Thiago G; Lima, Natália P; Bertoldi, Andréa D; Tomasi, Elaine

2018-01-01

OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.