Peroral endoscopic myotomy for achalasia in patients aged ≥ 65 years

PubMed Central

Li, Chen-Jie; Tan, Yu-Yong; Wang, Xue-Hong; Liu, De-Liang

2015-01-01

AIM: To investigate the safety and efficacy of peroral endoscopic myotomy (POEM) for achalasia in patients aged ≥ 65 years. METHODS: From November 2011 to August 2014, 15 consecutive patients (aged ≥ 65 years) diagnosed with achalasia were prospectively recruited and all underwent POEM at our institution. Eckardt score, lower esophageal sphincter (LES) pressure, esophageal diameter, SF-36 questionnaire, and procedure-related complications were used to evaluate the outcomes. RESULTS: All 15 patients were treated successfully by POEM, with a median operation time of 55 min. Median myotomy length was 10 cm. Three patients underwent circular myotomy and 12 full-thickness myotomies. Symptoms remitted in all cases during post-POEM follow-up of 6-39 mo. Eckardt score reduced significantly (pre-operation vs post-operation: 8.0 vs 1.0, P < 0.05). Median LES pressure decreased from 27.4 to 9.6 mmHg (P < 0.05). Median diameter of the esophagus was significantly decreased (pre-operation vs post-operation: 51.0 mm vs 30.0 mm, P < 0.05). Only one patient had reflux, which was resolved with oral proton pump inhibitors. No serious complications related to POEM were found. The quality of life of the 15 patients improved significantly after POEM. CONCLUSION: POEM is a safe and effective technique for treatment of achalasia in patients aged ≥ 65 years, with improvement in symptoms and quality of life. PMID:26290645

Analysis of spirometry results in hospitalized patients aged over 65 years.

PubMed

Wróblewska, Izabela; Oleśniewicz, Piotr; Kurpas, Donata; Sołtysik, Mariusz; Błaszczuk, Jerzy

2015-01-01

The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged $65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders. In the research, 217 (100%) patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro-Wilk test, the ANOVA test, and the Scheffé's test were applied. The majority of the patients (59.4%) were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%). The study showed a statistically significant dependence between the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive ventilation defects, which was supported by the performed analyses. Highest FEV1/FVC values were observed in nonsmokers, which confirms the influence of nicotine addiction on the incidence of respiratory system diseases. The respondents' sex and the established diagnosis statistically significantly influenced the FVC index result, and the diet influenced the FEV1/FVC parameter result.

Use of levetiracetam in a population of patients aged 65 years and older: a subset analysis of the KEEPER trial.

PubMed

Ferrendelli, J A; French, J; Leppik, I; Morrell, M J; Herbeuval, A; Han, J; Magnus, L

2003-12-01

Levetiracetam (Keppra) was evaluated in a subset of patients aged >/=65 years (n=78) enrolled in a large (n=1030) open-label, phase IV trial (the KEEPER trial). A 4-week dose adjustment was followed by a 12-week evaluation period. An overall median reduction in partial seizures of 80.1% (n=65) was observed. Overall, 76.9% of patients were >/=50% responders, 56.9% were >/=75% responders, and 40.0% were 100% responders. Levetiracetam was well tolerated, with 42.3% of patients reporting one or more adverse events. A total of 15 patients (19.2%) experienced an adverse event that led to discontinuation. Somnolence (n=13,16.7%) and dizziness (n=7,9.0%) were the most commonly reported adverse events. Despite the limitations of the open-label study design, these data provide information regarding the use of levetiracetam as add-on therapy for the treatment of partial-onset seizures in patients >/=65 years of age, including those requiring concomitant medications.

Hip arthroplasty with the thrust plate prosthesis in patients of 65 years of age or older: 67 patients followed 2-7 years.

PubMed

Karatosun, Vasfi; Unver, Bayram; Gunal, Izge

2008-04-01

Thrust plate prosthesis (TPP) is a relatively new concept in total hip arthroplasty and advocated to be used in young patients. We retrospectively evaluated the results of 67 patients (71 hips) who were older than 65 years of age and underwent hip arthroplasty using the TPP. There were 50 female and 17 male patients with a mean age 71 (range 65-89) years. All patients received accelerated rehabilitation program either with full weight bearing in the second postoperative day or at 6 weeks. All patients were followed-up for at least 2 years (range 28-87 months). The average Harris hip score improved from 43 (range 8-72) to 93 (range 64-100) at the latest follow-up (p < 0.001). The overall revision rate was 8.4%. However, when the patients with definitive history of trauma were excluded the rate for loosening and technical errors decreased to 4.2%. There was no significant difference between the Harris hip score of patients with full weight bearing in the second postoperative day or 6 weeks (p = 0.57). We conclude that the TPP could be indicated for older patients without age limit and that an accelerated rehabilitation program with early weight bearing can be applied to these patients.

Analysis of spirometry results in hospitalized patients aged over 65 years

PubMed Central

Wróblewska, Izabela; Oleśniewicz, Piotr; Kurpas, Donata; Sołtysik, Mariusz; Błaszczuk, Jerzy

2015-01-01

Introduction and objective The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged $65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders. Material and methods In the research, 217 (100%) patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro–Wilk test, the ANOVA test, and the Scheffé’s test were applied. Results The majority of the patients (59.4%) were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%). The study showed a statistically significant dependence between the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive ventilation defects, which was supported by the performed analyses. Highest FEV1/FVC values were observed in nonsmokers, which confirms the influence of nicotine addiction on the incidence of respiratory system diseases. Conclusion The respondents’ sex and the established diagnosis statistically significantly influenced the FVC index result, and the diet influenced the FEV1/FVC parameter result

Low prevalence of abdominal aortic aneurysm in the Seychelles population aged 50 to 65 years.

PubMed

Yerly, Patrick; Madeleine, George; Riesen, Walter; Bovet, Pascal

2013-03-01

The prevalence of abdominal aortic aneurysm (AAA) and its risk factors are well known in Western countries but few data are available from low- and middle- income countries. We are not aware of systematically collected population- based data on AAA in the African region. We evaluated the prevalence of AAA in a population- based cardiovascular survey conducted in the Republic of Seychelles in 2004 (Indian Ocean, African region). Among the 353 participants aged 50 to 64 years and screened with ultrasound, the prevalence of AAA was 0.3% (95% CI: 0- 0.9) and the prevalence of ectatic dilatations of the abdominal aorta was 1.5% (95% CI: 0.2- 2.8). The prevalence of AAA in the general population seemed lower in Seychelles than in Western countries, despite a high prevalence in Seychelles of risk factors of AAA, such as smoking (in men), high blood pressure and hypercholesterolaemia.

Cost-Effectiveness of Herpes Zoster Vaccine for Persons Aged 50 Years.

PubMed

Le, Phuc; Rothberg, Michael B

2015-10-06

Each year, herpes zoster (HZ) affects 1 million U.S. adults, many of whom develop postherpetic neuralgia (PHN). Zoster vaccine is licensed for persons aged 50 years or older, but its cost-effectiveness for those aged 50 to 59 years is unknown. To estimate the cost-effectiveness of HZ vaccine versus no vaccination. Markov model. Medical literature. Adults aged 50 years. Lifetime. Societal. HZ vaccine. Number of HZ and PHN cases prevented and incremental cost per quality-adjusted life-year (QALY) saved. For every 1000 persons receiving the vaccine at age 50 years, 25 HZ cases and 1 PHN case could be prevented. The incremental cost-effectiveness ratio (ICER) for HZ vaccine versus no vaccine was $323 456 per QALY. In deterministic and scenario sensitivity analyses, the only variables that produced an ICER less than $100 000 per QALY were vaccine cost (at a value of $80) and the rate at which efficacy wanes. In probabilistic sensitivity analysis, the mean ICER was $500 754 per QALY (95% CI, $93 510 to $1 691 211 per QALY). At a willingness-to-pay threshold of $100 000 per QALY, the probability that vaccination would be cost-effective was 3%. Long-term effectiveness data for HZ vaccine are lacking for 50-year-old adults. Herpes zoster vaccine for persons aged 50 years does not seem to represent good value according to generally accepted standards. Our findings support the decision of the Advisory Committee on Immunization Practices not to recommend the vaccine for adults in this age group. None.

Constipation in the population over 50 years of age in Albacete province.

PubMed

López Cara, M A; Tárraga López, P J; Cerdán Oliver, M; Ocaña López, J M; Celada Rodríguez, A; Solera Albero, J; Palomino Medina, M A

2006-06-01

To Determine the incidence of constipation in Albacete province and its relation with diet and lifestyle. Cross-sectional population survey. We studied 414 participants over 50 years of age in Albacete province. 445 persons over 50 years of age were included in the study. All participants were selected by systematic random sampling; 414 participants filled in the questionnaire correctly. age, weight and height, marital status, level of education and occupation; presence of a disease, number of sleep hours a day, physical exercise, smoking, alcohol intake, drug intake (anti-inflammatories and laxatives); bowel habit, diet, meal frequency and place; food intake frequency per week, daily intake of water, coffee, tea and herbal beverages; vitamin and fiber supplements; presence of cancer in the family. 56.9% of participants were women. Mean age 67.07 years. In Albacete province, 4.4% of the population over 50 years have a bowel habit consistent with constipation. Most participants had three meals a day (breakfast, lunch, and supper), while 50% had another meal in the morning or afternoon. These meals took place, habitually, in the domicile. There was a preponderance in daily intake of the following foods: milk (83.7%), bread (95.1%), vegetables (68.8%), fruit (91.8%), and virgin olive oil (96.6%). Fish was eaten every one to two days, and pulses and meat every three to six days. 44.4% of participants drank one to two liters of water a day. Only 3.9% of participants took some supplement; 35% of participants were on a diet. It was observed that 97.7% of participants with more than three defecations a week had a high intake of virgin olive oil; 65.7% of participants did some physical exercise customarily; 70.2% of participants were non-smokers, 10.2% were smokers, and 18.4% were ex-smokers. With regard to alcohol, the percentage of drinkers was 35.1%. The main class of medications taken by participants was NSAIDs - 14.5%; 79.7% took neither NSAIDs nor laxatives. Only 2

Handwriting in healthy people aged 65 years and over.

PubMed

van Drempt, Nadege; McCluskey, Annie; Lannin, Natasha A

2011-08-01

Handwriting is an important activity that is commonly affected by neurological and orthopaedic conditions. Handwriting research has predominantly involved children. Little is known about handwriting behaviour in healthy older adults. This study aims to describe the handwriting practices of 30 unimpaired adults aged 65 years and over. In this cross-sectional observational study, data were collected from 30 older adults using a self-report questionnaire, digital pen recordings over three days and a handwriting log. Data were analysed using descriptive statistics. The mean age of participants was 75.1 years (standard deviation=6.9). Variations in handwriting were evident in letter size, slant and spacing. Participants wrote very little--a median of 18 words per occasion (interquartile range=10.5-26.9 words). Most handwriting involved self-generated text (85%), not copied or transcribed text. Participants stood while writing for 17% of handwriting occasions. The most common reasons for handwriting were note taking (23%) and puzzles (22%). Legibility may not depend exclusively on the handwriting script that a beginning writer is taught, but may be a result of other factors as the person ages. A comprehensive adult handwriting assessment and retraining programme should be relevant to older adults, including common handwriting activities, involving self-generated text and few words. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

The cost-effectiveness of influenza vaccination for people aged 50 to 64 years: an international model.

PubMed

Aballéa, Samuel; Chancellor, Jeremy; Martin, Monique; Wutzler, Peter; Carrat, Fabrice; Gasparini, Roberto; Toniolo-Neto, Joao; Drummond, Michael; Weinstein, Milton

2007-01-01

Routine influenza vaccination is currently recommended in several countries for people aged more than 60 or 65 years or with high risk of complications. A lower age threshold of 50 years has been recommended in the United States since 1999. To help policymakers consider whether such a policy should be adopted more widely, we conducted an economic evaluation of lowering the age limit for routine influenza vaccination to 50 years in Brazil, France, Germany, and Italy. The probabilistic model was designed to compare in a single season the costs and clinical outcomes associated with two alternative vaccination policies for persons aged 50 to 64 years: reimbursement only for people at high risk of complications (current policy), and reimbursement for all individuals in this age group (proposed policy). Two perspectives were considered: third-party payer (TPP) and societal. Model inputs were obtained primarily from the published literature and validated through expert opinion. The historical distribution of annual influenza-like illness (ILI) incidence was used to simulate the uncertain incidence in any given season. We estimated gains in unadjusted and quality-adjusted life expectancy, and the cost per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses were conducted. Comparing the proposed to the current policy, the estimated mean costs per QALY gained were R$4,100, EURO 13,200, EURO 31,400 and EURO 15,700 for Brazil, France, Germany, and Italy, respectively, from a TPP perspective. From the societal perspective, the age-based policy is predicted to yield net cost savings in Germany and Italy, whereas the cost per QALY decreased to R$2800 for Brazil and EURO 8000 for France. The results were particularly sensitive to the ILI incidence rate, vaccine uptake, influenza fatality rate, and the costs of administering vaccination. Assuming a cost-effectiveness threshold ratio of EURO 50,000 per QALY gained, the probabilities of the

Disease Burden Due to Herpes Zoster among Population Aged ≥50 Years Old in China: A Community Based Retrospective Survey.

PubMed

Li, Yan; An, Zhijie; Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Xu, Jianfang; Ma, Yujie; Tu, Qiufeng; Li, Qi; Wang, Huaqing

2016-01-01

To understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy. Retrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old. The cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010-2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50-years old (52.3/1000 vs 15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50-years old to 8.55/1,000 among 80-year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000 vs 18.7/1,000; annual incidence rate, 3.95/1000 vs 2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000 vs 17.2/1,000; annual incidence rate, 7.65/1000 vs 2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7-795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left. Incidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China.

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

PubMed

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (�

Greater short-term weight loss in women 20-45 versus 55-65 years of age following bariatric surgery.

PubMed

Ochner, Christopher N; Teixeira, Julio; Geary, Nori; Asarian, Lori

2013-10-01

Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals, and increase weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery. One thousand three hundred fifty-six female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 years old (presumptively premenopausal; n = 1,199) and 55-65 years old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 years post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients. Twenty- to forty-five-year-old women showed greater %EBWL 1 and 2 years post-surgery than 55-65-year-old women (p's < 0.0005). No age effect was detected in 20-25- vs. 30-35-, 30-35- vs. 40-45-, or 20-25- vs. 40-45-year-old women (p's > 0.2) This age effect was detected only after gastric banding, with 20-45-year-old women losing ∼7 kg more than 55-65-year-old women after 2 years. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men. Results indicate that 55-65-year-old women lose less weight than 20-45-year-old women in the initial 2 years after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake.

Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old - does age still matter?

PubMed

Miśkowiec, Dawid; Walczak, Andrzej; Ostrowski, Stanisław; Wrona, Ewa; Bartczak, Karol; Jaszewski, Ryszard

2014-06-01

Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age. To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG. Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1(st) group < 65 years (n = 662; 55.3%); 2(nd) group ≥ 65 years (n = 535; 44.7%). The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m(2) [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)]. Age still significantly influences postoperative complications and mortality after isolated CABG.

Prevalence of metabolic syndrome with International Diabetes Federation Criteria and ATP III Program in patients 65 years of age or older.

PubMed

De Luis, D A; Lopez Mongil, R; Gonzalez Sagrado, M; Lopez Trigo, J A; Mora, P F; Castrodeza Sanz, J

2010-05-01

The relationship between cardiovascular factors and death can vary with age, very few studies have examined metabolic syndrome in the elderly. The aim of this study is to assess the prevalence of the MS in a sample of elderly institutionalized patients (> 65 years) using ATPIII and IDF definitions. This was a cross-sectional survey covering a sample of representative of the institutionalized Spanish population aged above 65 years. The final sample study consisted of 862 patients, 556 females and 306 males. ATPIII and IDF definitions were used to classify the patients. Prevalence of MS was different according to the two definitions used. When the IDF definition was applied, total prevalence was 48.91% (CI 95%:43.47-50.25), while prevalence according to ATPIII criteria was 46.80% (CI = 43.47-50.25). a higher prevalence of MS was found in females as compared to males. Using IDF criteria, odds ratio was 1.9 (CI 95%:1.4-2.6) and 1.7 (CI 95%:1.2-2.2) according to ATPIII criteria. a steady decrease is seen in MS prevalence as the age of patients increases (the last two groups (85-94 ys and > 95 ys), both for the ATP III and the IDF definitions. A higher prevalence of MS in this elderly population as compared to general population was observed. A decrease of this prevalence above 95 years was detected.

[Acute poisoning in patients over 65 years of age].

PubMed

Miranda Arto, P; Ferrer Dufol, A; Ruiz Ruiz, F J; Menao Guillén, S; Civeira Murillo, E

2014-01-01

There are few Spanish studies on acute poisoning in the elderly despite the associated risk factors of this group of patients. Retrospective descriptive study of acute poisonings treated in the Emergency Service of the University Hospital of Zaragoza from 1995 to 2009 on patients 65 years old or older. A total of 762 patients were selected in the study (4.74% of all acute poisonings) with a mean age of 74.16 (SD ± 6) years. Ingestion was the major route of exposure (85%) and alcohol overdose (28,7%) was the most frequent type of poisoning. A trend was also observed showing a lower emetic treatment and gastric lavage and an increase in activated charcoal. Benzodiazepines (14.3%) and toxic household products (11%) with caustic properties were also the main toxics found in the study. Acute poisonings in the elderly required more hospitalizations, have a higher mortality and more autolytic attempts which result in death.

Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort.

PubMed

Maughan, B; Stafford, M; Shah, I; Kuh, D

2014-04-01

Severe youth antisocial behaviour has been associated with increased risk of premature mortality in high-risk samples for many years, and some evidence now points to similar effects in representative samples. We set out to assess the prospective association between adolescent conduct problems and premature mortality in a population-based sample of men and women followed to the age of 65 years. A total of 4158 members of the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort) were assessed for conduct problems at the ages of 13 and 15 years. Follow-up to the age of 65 years via the UK National Health Service Central Register provided data on date and cause of death. Dimensional measures of teacher-rated adolescent conduct problems were associated with increased hazards of death from cardiovascular disease by the age of 65 years in men [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.04-1.32], and of all-cause and cancer mortality by the age of 65 years in women (all-cause HR 1.16, 95% CI 1.07-1.25). Adjustment for childhood cognition and family social class did little to attenuate these risks. Adolescent conduct problems were not associated with increased risks of unnatural/substance-related deaths in men or women in this representative sample. Whereas previous studies of high-risk delinquent or offender samples have highlighted increased risks of unnatural and alcohol- or substance abuse-related deaths in early adulthood, we found marked differences in mortality risk from other causes emerging later in the life course among women as well as men.

Outcomes of childhood asthma to the age of 50 years.

PubMed

Tai, Andrew; Tran, Haily; Roberts, Mary; Clarke, Nadeene; Gibson, Anne-Marie; Vidmar, Suzanna; Wilson, John; Robertson, Colin F

2014-06-01

In 1964, The Melbourne Asthma Study was established to describe the spectrum and natural history of childhood asthma. To describe the clinical and lung function outcome of childhood asthma to the age of 50 years. Subjects were invited to complete an interviewer-administered questionnaire, skin prick testing, and measurement of lung function from the age of 7 years to the age of 50 years at 7-year intervals. Of 458 survivors (from the original 484 subjects at recruitment), 346 subjects (76%) participated, of whom, 197 completed lung function measurement. Asthma remission at the age of 50 years was 64% in those with wheezy bronchitis, 47% for those with persistent asthma, and 15% for those with severe asthma in childhood. Multivariable analysis identified severe asthma in childhood (odds ratio [OR] 11.9 [95% CI, 3.4-41.8]), female sex (OR 2.0 [95% CI, 1.1-3.6]), and childhood hay fever (OR 2.0 [95% CI, 1.0-4.0]) as risk factors for "current asthma" at age 50 years. There was no evidence of a difference in the rate of decline in FEV1 (mL/y, 95% CI) between the severe asthma group (15 mL/y [95% CI, 9-22 mL/y]) and all the other recruitment groups: control (16 mL/y [95% CI, 12-20 mL/y]), mild wheezy bronchitis (14 mL/y [95% CI, 8-19 mL/y]), wheezy bronchitis (16 mL/y [95% CI, 11-20 mL/y]), and persistent asthma (19 mL/y [95% CI, 13-24 mL/y]). The clinical and lung function outcome in adult life is strongly determined by asthma severity in childhood. The reduced lung function seen in adults is established in childhood and does not appear to decline more rapidly in adult years despite continuing symptoms. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Changes in physical functioning among men and women aged 50-79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997-1999 and 2008-2011.

PubMed

Buttery, A K; Du, Y; Busch, M A; Fuchs, J; Gaertner, B; Knopf, H; Scheidt-Nave, C

2016-12-01

This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997-1999 (GNHIES98) and 2008-2011 (DEGS1). Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50-64 and 65-79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys. Mean physical functioning increased among adults aged 50-79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65-79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65-79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men. Physical functioning improved in Germany among adults aged 50-79 years. Improvements in the population 65-79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning

Associations of work and health-related characteristics with intention to continue working after the age of 65 years.

PubMed

ten Have, Margreet; van Dorsselaer, Saskia; de Graaf, Ron

2015-02-01

This study examines the association of work and health-related characteristics with the intention to continue working after the age of 65 years. Data were from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative population survey, including 1854 employees aged 45-64 years; 29.0% reported the intention to continue working after 65 years. Lower education, more adverse psychosocial working conditions and any physical disorder were negatively associated with this intention. Mental disorders were not associated. These findings highlight the importance of favourable working conditions and good physical health in relation to employees' intention to continue working after 65 years. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Aging in Prader-Willi syndrome: twelve persons over the age of 50 years.

PubMed

Sinnema, Margje; Schrander-Stumpel, Constance T R M; Maaskant, Marian A; Boer, Harm; Curfs, Leopold M G

2012-06-01

The life expectancy of persons with Prader-Willi syndrome (PWS) has increased in recent years. Because of the paucity of reports on older persons with PWS, the natural history, the onset, and type of age-related problems are poorly understood. Twelve persons with a genetically confirmed diagnosis of PWS aged over 50 years are described (4 deletion; 8 mUPD). Data on physical, behavioral, psychiatric, and aging characteristics were collected through semi-structured interviews with the individuals with PWS and their main carers. Cardiovascular diseases, diabetes, dermatological, and orthopedic problems were common physical complaints in older people with PWS. Functioning in activities of daily living, psychological functioning, physical functions, and care dependence were substantially worse in the older age group (50+) compared to the control group (18-49 years). Seven out of eight persons with mUPD had a history of psychiatric illness. Behavioral problems were observed in the older age group. Given the combination of age-related physical morbidity, physical appearance, behavioral and psychiatric problems, and functional decline in our cohort, we hypothesize that premature aging occurs in PWS. The care for older people with PWS requires a lifespan approach that recognizes the presence, progression, and consequences of specific morbidity. Special medical surveillance of people with PWS from 40 years onwards would ensure that intervention and support is offered with respect to specific areas of decline at the earliest possible time. Copyright © 2012 Wiley Periodicals, Inc.

Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old – does age still matter?

PubMed Central

Walczak, Andrzej; Ostrowski, Stanisław; Wrona, Ewa; Bartczak, Karol; Jaszewski, Ryszard

2014-01-01

Introduction Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age. Aim of the study To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG. Material and methods Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1st group < 65 years (n = 662; 55.3%); 2nd group ≥ 65 years (n = 535; 44.7%). Results The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m2 [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)]. Conclusions Age still significantly influences postoperative complications and mortality after isolated CABG. PMID:26336419

Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis.

PubMed

Brydak, Lidia; Roiz, Julie; Faivre, Pascaline; Reygrobellet, Camille

2012-02-01

Influenza is a common respiratory disease occurring in seasonal patterns, and may lead to severe complications in frail populations such as the elderly. In Poland, influenza vaccination is recommended for people aged ≥65 years; however the vaccine coverage rate in the elderly is very low. The fact that influenza vaccine is neither reimbursed by the National Health Insurance (Narodowy Fundusz Zdrowia [NFZ]) nor financed via a National Immunization Program (NIP) could be a reason for the low coverage rate. This study assessed the cost effectiveness of the full reimbursement of an influenza vaccination programme in Poland for people aged ≥65 years. A decision-analytic model was developed to compare costs and outcomes associated with the current situation in which influenza vaccination is not reimbursed and a new situation in which it would be fully covered by the NFZ. The model was parameterized to Poland using data from the literature and from the Central Statistic Office of Poland. Within the elderly population, 50% were considered to be at high risk of influenza complications. An influenza attack rate of 3.5% was used for calculation purposes. Influenza-associated hospitalizations and death rates were estimated at 439.9 per 100 000 person-years and 79.1 per 100 000 person-years, respectively. Cost estimates were derived from a cost study conducted in Poland. Costs are presented in Polish Zloty (PLN) [2009 mean exchange rate: 1 PLN = €0.232]. Only direct medical costs were included to fit to the NFZ perspective. To reflect the seasonality of influenza, a time horizon of 1 year was chosen. Life-years and quality-adjusted life-years (QALYs) accumulated over future years were discounted at a rate of 5% as recommended by Polish guidelines. Deterministic and probabilistic sensitivity analyses were conducted. In Poland, the introduction of the public funding of influenza vaccination for people aged ≥65 years would cost PLN 79 million when an increase in

Update on herpes zoster vaccine: licensure for persons aged 50 through 59 years.

PubMed

2011-11-11

Herpes zoster vaccine (Zostavax, Merck & Co., Inc.) was licensed and recommended in 2006 for prevention of herpes zoster among adults aged 60 years and older. In March 2011, the Food and Drug Administration (FDA) approved the use of Zostavax in adults aged 50 through 59 years. In June 2011, the Advisory Committee on Immunization Practices (ACIP) declined to recommend the vaccine for adults aged 50 through 59 years and reaffirmed its current recommendation that herpes zoster vaccine be routinely recommended for adults aged 60 years and older.

Can maintaining cognitive function at 65 years old predict successful ageing 6 years later? The PROOF study.

PubMed

Castro-Lionard, Karine; Thomas-Antérion, Catherine; Crawford-Achour, Emilie; Rouch, Isabelle; Trombert-Paviot, Béatrice; Barthélémy, Jean-Claude; Laurent, Bernard; Roche, Frédéric; Gonthier, Régis

2011-03-01

preservation of cognitive abilities is required to have a good quality of life. The predictive value of cognitive functioning at 65 years old on successful ageing 6 years later is not established. nine hundred and seventy-six questionnaires were sent by mail to a sample of healthy and voluntary French pensioners. Successful ageing was defined through health status and well-being. Cognitive abilities had been assessed 6 years earlier according to an objective method (Free and Cued Selective Recall Reminding Test (FCSRT), the Benton visual retention test and the similarities subtest of the Wechsler Adult Intelligence Scale-Revised) and a subjective one (Goldberg's anxiety scale, Mac Nair's scale and a Visual Analogue Scale to evaluate memory abilities change in the last 5 years). six hundred and eighty-six questionnaires could be analysed. The mean age was 72.9 ± 1.2 years old with 59% of women and 99% lived at home. Well-being was negatively correlated with the FCSRT (r = -0.08, P = 0.0318) but positively related with the Benton (r = 0.09, P = 0.0125) and the similarities tests (r = 0.09, P = 0.0118). There is a negative correlation between anxious and cognitive complaints measured at baseline, and successful ageing indicators 6 years later. preservation of cognitive abilities at the age of retirement can predict a successful ageing 6 years later. ClinicalTrials.gov Identifier: NCT00759304.

[Health-related quality of life evaluation of elderly aged 65 years and over living at home].

PubMed

Jalenques, I; Auclair, C; Rondepierre, F; Gerbaud, L; Tourtauchaux, R

2015-06-01

To assess health-related quality of life in French adults aged 65 years and over, living at home, with a specific self-administered questionnaire, the LEIPAD, cross-culturally adapted in French. Elderly completed socio-demographic and medical questionnaires, a questionnaire about negative life events during the last 12 months and the LEIPAD. Data of 195 subjects (mean age: 72.6 years, men: 56.5%) were analyzed. The response rates to the LEIPAD scales were superior to 90%. Elderly reported on the whole a good health-related quality of life. Age had a negative effect on quality on life, which deteriorates over years. Age was correlated to the scales "Physical function", "Self-care", "Cognitive functioning" and "Sexual functioning". Elderly hospitalized in the last year had worse quality of life with a significant difference for "Physical function" scale. The number of health problems was positively correlated to "Physical function" scale. Elderly declaring at least one health problem had worse quality of life for this scale. Problems in couple, materials and financial problems had also negative effects on health-related quality of life. Our study highlights a good health-related quality of life for the majority of these adults aged 65 years and over, as well as the negative effect of age, health, couple, materials and financial problems on their quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review.

PubMed

Silva, Bruno Mota; Cartucho, António; Sarmento, Marco; Moura, Nuno

2017-04-28

The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. Medline®, PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched from January 1999 unto December 2015 for studies, regardless of language, including the words 'rotator cuff' and '65 years' or '70 years'. Inclusion criteria were studies (level I to IV) that reported clinical outcomes in patients older than 65 years, having undertaken surgical repair of a symptomatic rotator cuff tears. Arthroscopic, mini open and open techniques were included. Exclusion criteria were: studies with patients younger than 65 years, studies that did not use validated outcome evaluation scores as primary assessment tools and those with follow up under one year. This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. Data abstracted included patient demographics, tear pattern, surgical procedures, clinical and repair results. Outcome scores were converted to percentages, allowing comparison of data between studies. After deep analysis, 14 studies met the inclusion criteria: 11 level IV studies, 1 level III study and 2 level II studies. Seven studies found statistically significant outcome improvements between pre and postoperative evaluations. All studies reported good or excellent surgical outcomes. Better results would probably be achieved if all studies had rigorous and homogeneous patient selection criteria, but the fact is, that even though this was not the case, the clinical scores remained favorable, and with statistically significant outcome improvement in all studies with prospectively collected data. Based on current literature, rotator cuff repair

Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier-Edwards PERIMOUNT pericardial valve.

PubMed

Bourguignon, Thierry; Espitalier, Fabien; Pantaleon, Clémence; Vermes, Emmanuelle; El-Arid, Jean Marc; Loardi, Claudia; Karam, Elias; Candolfi, Pascal; Ivanes, Fabrice; Aupart, Michel

2018-02-12

Mitral valve replacement using a bioprosthesis remains controversial in young patients because data on long-term outcomes are missing. This study evaluated the long-term results of the PERIMOUNT pericardial mitral bioprosthesis in patients aged 65 years or younger. From 1984 to 2010, 148 Carpentier-Edwards PERIMOUNT mitral bioprostheses were implanted in 148 patients aged 65 years or younger. Baseline clinical, perioperative and follow-up data were recorded prospectively. Structural valve deterioration (SVD) was defined by strict echocardiographic assessment. The mean follow-up period was 8.6 ± 5.5 years, for a total of 1269 valve-years. Operative mortality rate was 2.0%. Fifty-one late deaths occurred (linearized rate 4.0% per valve-year). Actuarial survival rates averaged 70 ± 4%, 53 ± 6% and 31 ± 7% after 10, 15 and 20 years of follow-up, respectively. Actuarial freedom from SVD at 10, 15 and 20 years was 78 ± 5%, 47 ± 7% and 19 ± 7%, respectively. Reoperation was associated with no operative mortality. Actuarial freedom from reoperation due to SVD at 10, 15 and 20 years was 82 ± 4%, 50 ± 6% and 25 ± 8%, respectively. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 44 ± 5%. Expected valve durability was 14.2 years for this age group. In the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

[Measure of premature mortality: comparison of deaths before age 65 and expected years of life lost].

PubMed

Lapostolle, A; Lefranc, A; Gremy, I; Spira, A

2008-08-01

For many years in France, premature mortality (i.e., deaths before 65 years old) and avoidable deaths have generally been used to monitor health of the population and help to elaborate policies in this area. This paper aims to examine the utility of another indicator of premature mortality, which makes it possible to take into account the impact of deaths, the expected years of life lost (EYLL). Mortality data for France in the years 2000 to 2002 were obtained from the Centre for Epidemiology of the Medical Causes of Death. Premature mortality was defined as death before 65 years of age. For the calculation of EYLL, the mortality norm chosen was French-life expectancy for the years 2001 to 2003. In order to study the spatial distribution of the indicators above defined, standardized ratios were calculated for each administrative area, taking France as the reference population. Irrespective of the gender and indicator considered, ranking of the causes emphasized three major groups of pathological conditions, which are strongly distinguished from the others: cardiovascular diseases, malignant neoplasm and injuries. The ranking of causes varied considerably according to the indicator used. The spatial representation of standardized ratios of expected years of life lost and deaths before 65 showed a strong North-South trend. The concept of premature mortality is difficult to define and discussions persist on the age limit to use for its quantification. The choice of an indicator strongly depends on the use which one wishes to make. The simple analysis of deaths before 65 years currently used to describe premature mortality in France makes it possible to describe its frequency. The use of a summary measure as EYLL allows to quantify the impact of premature mortality by giving different weights to deaths depending on the age of occurrence. EYLL, thus, seems to be an indicator, which is particularly adapted to decision-making in public health, depending on choices and

Fifteen-year Outcomes Following Conservative Management Among Men Aged 65 Years or Older with Localized Prostate Cancer.

PubMed

Lu-Yao, Grace L; Albertsen, Peter C; Moore, Dirk F; Lin, Yong; DiPaola, Robert S; Yao, Siu-Long

2015-11-01

To understand the threat posed by localized prostate cancer and the potential impact of surgery or radiation, patients and healthcare providers require information on long-term outcomes following conservative management. To describe 15-yr survival outcomes and cancer therapy utilization among men 65 years and older managed conservatively for newly diagnosed localized prostate cancer. This is a population-based cohort study with participants living in predefined geographic areas covered by the Surveillance, Epidemiology, and End Results program. The study includes 31 137 Medicare patients aged ≥65 yr diagnosed with localized prostate cancer in 1992-2009 who initially received conservative management (no surgery, radiotherapy, cryotherapy, or androgen deprivation therapy [ADT]). All patients were followed until death or December 31, 2009 (for prostate cancer-specific mortality [PCSM]) and December 31, 2011 (for overall mortality). Competing-risk analyses were used to examine PCSM, overall mortality, and utilization of cancer therapies. The 15-yr risk of PCSM for men aged 65-74 yr diagnosed with screening-detected prostate cancer was 5.7% (95% confidence interval [CI] 3.7-8.0%) for T1c Gleason 5-7 and 22% (95% CI 16-35%) for Gleason 8-10 disease. After 15 yr of follow-up, 24% (95% CI 21-27%) of men aged 65-74 yr with screening-detected Gleason 5-7 cancer received ADT. The corresponding result for men with Gleason 8-10 cancer was 38% (95% CI 32-44%). The major study limitations are the lack of data for men aged <65 yr and detailed clinical information associated with secondary cancer therapy. The 15-yr outcomes following conservative management of newly diagnosed Gleason 5-7 prostate cancer among men aged ≥65 yr are excellent. Men with Gleason 8-10 disease managed conservatively face a significant risk of PCSM. We examined the long-term survival outcomes for a large group of patients diagnosed with localized prostate cancer who did not have surgery, radiotherapy

Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

PubMed

Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

2018-02-01

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

Bone and heart abnormalities of subclinical hyperthyroidism in women below the age of 65 years.

PubMed

Rosario, Pedro Weslley

2008-12-01

The objective of the present study was to evaluate bone and cardiac abnormalities and symptoms and signs of thyroid hormone excess in women with subclinical hyperthyroidism (SCH) aged < 65 years. Forty-eight women with SCH were evaluated. The control group consisted of 48 euthyroid volunteers. The mean symptom rating scale score was significantly higher in patients. Cardiac involvement, both morphological and affecting systolic and diastolic functions, was also observed in patients. Women with SCH showed a significant increase in serum markers of bone formation and resorption. In addition, bone mineral density (BMD) was lower in the femoral neck but not in the lumbar spine in patients before menopause, whereas a lower BMD was observed at both sites in postmenopausal patients. SCH is not completely asymptomatic in women aged < 65 years, and is associated with heart abnormalities and with increased bone turnover and reduced BMD even before menopause.

Nurses aged over 50 years and their experiences of shift work.

PubMed

Clendon, Jill; Walker, Leonie

2013-10-01

The Late Career Nurse project examined views and characteristics of nurses working in New Zealand who were born before 1960. This paper focuses on the experiences of such nurses who undertake shift work. The mean age of registered nurses in New Zealand has been rising steadily, and 40% are now aged 50 years or over. While there is substantial literature on the phenomenon and consequences of the ageing nursing workforce, little is known of the particular experiences of nurses aged over 50 years who work shifts. An anonymous online survey was emailed to eligible nurse New Zealand Nurses Organisation members aged over 50 years in February 2012. Quantitative and qualitative analyses of the 3273 responses received were undertaken. Over 45% of respondents worked shifts or flexible hours. While shift work suited many, others noted deleterious effects on family and social relationships, physical and mental health (notably sleep patterns and fatigue), and decreasing tolerance for shift work as they age. Poor scheduling practices were particularly detrimental. Worldwide, workforce ageing means strategies are required to retain older nurses in the workforce. Improved scheduling practices including increasing access to flexible and part time work hours, and development of resources on coping with shift work are recommended. © 2013 John Wiley & Sons Ltd.

The cost-effectiveness of influenza vaccination of healthy adults 50-64 years of age.

PubMed

Turner, D A; Wailoo, A J; Cooper, N J; Sutton, A J; Abrams, K R; Nicholson, K G

2006-02-13

Influenza can cause significant morbidity and mortality. Influenza vaccination is an effective and safe strategy in the prevention of influenza. Currently the National Health Service (NHS) vaccinates 'at-risk' individuals only. This definition includes everyone over 65 years of age but excludes individuals 50-64 years of age unless they have an additional risk factor, such as underlying heart disease or lung disease. In order to examine the cost-effectiveness of an extension of the vaccination policy to include this age group we constructed an economic model to estimate the costs and benefits of vaccination from both a health service and a societal perspective. Data to populate the model was obtained from the literature and the outcome measure used was the quality adjusted life year (QALY). Influenza vaccination prevented an estimated 4508 cases (95% CI: 2431-7606) per 100,000 vaccinees per influenza season for a net cost to the NHS of pound653,221 (95% CI: 354,575-1,072,257). The net cost increased to pound1,139,069 (95% CI 27,052-2,030,473) when non-NHS costs were included and the estimated cost-per-QALY were pound6174 and pound10,766 for NHS and all costs respectively. Extension of the current immunisation policy has the potential to generate a significant health benefit at a comparatively low cost.

Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men.

PubMed

Saad, Farid; Yassin, Aksam; Haider, Ahmad; Doros, Gheorghe; Gooren, Louis

2015-04-01

To investigate the potential benefits of testosterone administration to elderly men (>65 years) with late-onset hypogonadism (LOH) in comparison with younger men and to assess the safety of testosterone administration to elderly men. A total of 561 hypogonadal men from two registry studies were divided into age groups of ≤65 years (group Y, n=450; range, 32-65 years) and >65 years (group O, n=111; range, 66-84 years). Following an initial 6-week interval, all men were treated with 3-month injections of parenteral testosterone undecanoate for up to 6 years. Over the 6 years, there was a progressive decrease of body weight and waist circumference. Beneficial effects on lipids and other metabolic factors and on psychological and sexual functioning progressed over the first 24 to 42 months and were sustained. Rather than a deterioration, there was an improvement of urinary parameters. Prostate volume and prostate-specific antigen increased moderately. Hematocrit levels increased but remained within safe margins. The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins. Age itself need not be a contraindication to testosterone treatment of elderly men with LOH.

Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany.

PubMed

Teutsch, Barbara; Berger, Anja; Marosevic, Durdica; Schönberger, Katharina; Lâm, Thiên-Trí; Hubert, Kerstin; Beer, Steffi; Wienert, Peter; Ackermann, Nikolaus; Claus, Heike; Drayß, Maria; Thiel, Kathrin; van der Linden, Mark; Vogel, Ulrich; Sing, Andreas

2017-10-01

The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older. In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65-106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species. A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity. These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.

Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race.

PubMed

Sisk, Jane E; Whang, William; Butler, Jay C; Sneller, Vishnu-Priya; Whitney, Cynthia G

2003-06-17

Guidelines are increasingly recommending preventive services starting at 50 years of age, and policymakers are considering such a recommendation for pneumococcal polysaccharide vaccination. The finding that pneumococcal vaccination is cost-saving for people 65 years of age or older raises the question of the vaccination's implications for other older adults, especially black people, whose disease incidence exceeds that of nonblack people, and those with high-risk conditions. To assess the implications of vaccinating black and nonblack people 50 through 64 years of age against invasive pneumococcal disease. Cost-effectiveness analysis. Published literature for vaccination effectiveness and cost estimates; data on disease incidence and case-fatality rates from the Centers for Disease Control and Prevention. Hypothetical cohort 50 through 64 years of age with the 1995 U.S. age distribution. Lifetime. Societal. Pneumococcal polysaccharide vaccination compared with no vaccination. Incremental medical costs and health effects, in quality-adjusted life-years per vaccinee. Vaccination saved medical costs and improved health among high-risk black people (27.55 dollars savings per vaccinee) and nonblack people (5.92 dollars savings per vaccinee), excluding survivors' future costs. For low-risk black and nonblack people and the overall general population, vaccination cost 2477 dollars, 8195 dollars, and 3434 dollars, respectively, to gain 1 year of healthy life. Excluding survivors' future costs, in the general immunocompetent population, cost per quality-adjusted life-year in global worst-case results ranged from 21 513 dollars for black people to 68 871 dollars for nonblack people; in the high-risk population, cost ranged from 11 548 dollars for black people to 39 000 dollars for nonblack people. In the global best case, vaccination was cost-saving for black and nonblack people in the general immunocompetent and high-risk populations, excluding survivors' future costs. The

Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States.

PubMed

Meyers, Juliana L; Madhwani, Shweta; Rausch, Debora; Candrilli, Sean D; Krishnarajah, Girishanthy; Yan, Songkai

2017-08-03

Few peer-reviewed publications present real-world United States (US) data describing resource utilization and costs associated with herpes zoster (HZ) and postherpetic neuralgia (PHN). The primary objective of this analysis (GSK study identifier: HO-14-14270) was to assess direct costs associated with HZ and PHN in the US using a retrospective managed care insurance claims database. Patients ≥ 50 y at HZ diagnosis were selected. Patients were excluded if they were immunocompromised before diagnosis or received an HZ vaccine at any time. A subsample of patients with PHN was identified. Each patient with HZ was matched to ≤ 4 controls without HZ based on age, sex, and health plan enrollment. Incremental differences in mean HZ-related costs ("incremental costs") were assessed overall and stratified by age. Multivariable regression models controlled for the effect of demographic characteristics, prediagnosis costs, and comorbidity burden on costs using a recycled predictions approach. Overall, 142,519 patients with HZ (9,470 patients [6.6%] had PHN) and 357,907 matched controls without HZ were identified. Resource utilization was greater among patients with HZ than controls. After adjusting for demographic and clinical characteristics, annual incremental health care costs for HZ patients vs. controls were $1,210 for patients aged 50-59 years, $1,629 for those 60-64 years, $1,876 for those 65-69 years, $2,643 for those 70-79 years, and $3,804 for those 80+ years; adjusted annual incremental costs among PHN patients vs. controls were $4,670 for patients 50-59 years, $6,133 for those 60-64 years, $6,451 for those 65-69 years, $8,548 for those 70-79 years, and $11,147 for those 80+ years. HZ is associated with a significant cost burden, which increases with advancing patient age. Vaccination may reduce costs associated with HZ through case avoidance.

Polyfluoroalkyl Chemicals and Menopause among Women 20–65 Years of Age (NHANES)

PubMed Central

Hoffman, Kate; Thayer, Kristina A.; Daniels, Julie L.

2013-01-01

Background: Polyfluoroalkyl chemicals (PFCs) such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) have been associated with early menopause. However, previous cross-sectional studies have lacked adequate data to investigate possible reverse causality (i.e., higher serum concentrations due to decreased excretion after menopause). Objectives: We investigated the association between PFOS, PFOA, perfluorononanoate (PFNA), and perfluorohexane sulfonate (PFHxS) and age at natural menopause among women 20–65 years of age in NHANES (National Health and Nutrition Examination Survey). Methods: We used proportional hazard models to estimate hazard ratios (HRs) for the onset of natural menopause as a function of age and serum PFC levels, and to investigate reverse causation by estimating associations between PFC levels and the rate of hysterectomy. We also used multivariable linear regression to determine whether time since menopause predicted serum PFC levels. Results: After adjusting for age at survey, race/ethnicity, education, ever smoking, and parity, women with higher levels of PFCs had earlier menopause than did women with the lowest PFC levels. We observed a monotonic association with PFHxS: The HR was 1.42 (95% CI: 1.08, 1.87) for serum concentrations in tertile 2 versus tertile 1, and 1.70 (95% CI: 1.36, 2.12) for tertile 3 versus tertile 1. We also found evidence of reverse causation: PFCs were positively associated with rate of hysterectomy, and time since natural menopause was positively associated with serum PFCs. Conclusions: Our findings suggest a positive association between PFCs and menopause; however, at least part of the association may be due to reverse causation. Regardless of underlying cause, women appear to have higher PFC concentrations after menopause. Citation: Taylor KW, Hoffman K, Thayer KA, Daniels JL. 2014. Polyfluoroalkyl chemicals and menopause among women 20–65 years of age (NHANES). Environ Health Perspect 122:145�

Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.

PubMed

2012-06-29

Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. In July 2011, the Food and Drug Administration (FDA) approved expanding the age indication for Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) to aged 65 years and older. In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.

Comparison of Delay Times Between Symptom Onset of an Acute ST-elevation Myocardial Infarction and Hospital Arrival in Men and Women <65 Years Versus ≥65 Years of Age.: Findings From the Multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) Study.

PubMed

Ladwig, Karl-Heinz; Fang, Xiaoyan; Wolf, Kathrin; Hoschar, Sophia; Albarqouni, Loai; Ronel, Joram; Meinertz, Thomas; Spieler, Derek; Laugwitz, Karl-Ludwig; Schunkert, Heribert

2017-12-15

Early administration of reperfusion therapy in acute ST-elevation myocardial infarctions (STEMI) is crucial to reduce mortality. Although female sex and old age are key factors contributing to an inadequate long prehospital delay time, little is known whether women ≥65 years are a particular risk population. Hence, we studied the interaction of sex and age (<65 years or ≥65 years) and the contribution of chest pain to delay time during STEMI. Bedside interview data were collected in 619 STEMI patients from the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Sex and age group stratification disclosed an excess delay risk for women ≥65 years, accounting for a 2.39 (95% confidence interval (CI) 1.39 to 4.10)-fold higher odds to delay longer than 2 hours compared with all other patient groups including younger women (p ≤0.002). Median delay time was 266 minutes in women ≥65 years and 148 minutes in younger women (p <0.001). Chest pain during STEMI had the lowest frequency both in women (81%) and men ≥65 years (83%) and the highest frequency (95%) in younger women. Experiencing non-chest pain was 2.32-fold (95% CI, 1.20 to 4.46, p <0.05) higher in women ≥65 years than in all other patients. Mediation analysis disclosed that the effect accounted for only 9% of the variance. Age specific educational strategies targeting women ≥65 years at risk are urgently needed. To tailor adequate strategies, more research is required to understand age- and sex driven barriers to timely identification of ischemic symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

50 CFR 660.65 - Groundfish harvest specifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Groundfish harvest specifications. 660.65 Section 660.65 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OFF WEST COAST STATES West Coast...

Age-specific and sex-specific prevalence of cerebral β-amyloidosis, tauopathy, and neurodegeneration in cognitively unimpaired individuals aged 50-95 years: a cross-sectional study.

PubMed

Jack, Clifford R; Wiste, Heather J; Weigand, Stephen D; Therneau, Terry M; Knopman, David S; Lowe, Val; Vemuri, Prashanthi; Mielke, Michelle M; Roberts, Rosebud O; Machulda, Mary M; Senjem, Matthew L; Gunter, Jeffrey L; Rocca, Walter A; Petersen, Ronald C

2017-06-01

-T-N- and 57 years (54-64) in A-T+N- to a median 80 years (75-84) in A+T-N+ and 79 years (73-87) in A+T+N+. The number of APOE ε4 carriers differed by ATN group (p=0·04), with carriers roughly twice as frequent in each A+ group versus the corresponding A- group. White matter hyperintensity volume (p<0·0001) and cognitive performance (p<0·0001) also differed by ATN group. Tau PET and neurodegeneration biomarkers were discordant in most individuals who would be categorised as stage 2 or 3 preclinical Alzheimer's disease (A+T+N-, A+T-N+, and A+T+N+; 86% at age 65 years and 51% at age 80 years) or with suspected non-Alzheimer's pathophysiology (A-T+N-, A-T-N+, and A-T+N+; 92% at age 65 years and 78% at age 80 years). From age 50 years, A-T-N- prevalence declined and A+T+N+ and A-T+N+ prevalence increased. In both men and women, A-T-N- was the most prevalent until age late 70s. After about age 80 years, A+T+N+ was most prevalent. By age 85 years, more than 90% of men and women had one or more biomarker abnormalities. Biomarkers of fibrillar tau deposition can be included with those of β-amyloidosis and neurodegeneration or neuronal injury to more fully characterise the heterogeneous pathological profiles in the population. Both amyloid- dependent and amyloid-independent pathological profiles can be identified in the cognitively unimpaired population. The prevalence of each ATN group changed substantially with age, with progression towards more biomarker abnormalities among individuals who remained cognitively unimpaired. National Institute on Aging (part of the US National Institutes of Health), the Alexander Family Professorship of Alzheimer's Disease Research, the Mayo Clinic, and the GHR Foundation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between the type and amount of physical activity and low back pain in Koreans aged 50 years and older.

PubMed

Kim, Won; Jin, Young Soo; Lee, Choon Sung; Hwang, Chang Ju; Lee, Sang Yoon; Chung, Sun G; Choi, Kyoung Hyo

2014-10-01

To examine the association between the type and amount of physical activity (PA) and low back pain (LBP) in people aged ≥50 years. Cross-sectional study. A nationwide survey. Data were obtained from the Fifth Korea National Health and Nutrition Examination Survey, which was conducted in 2010 and 2011. Overall, 1796 men and 2198 women aged ≥50 years were included. PA was categorized as vigorous, moderate, walking, strength exercises, or flexibility exercises. The total amount of PA was presented as quartiles of the total metabolic equivalent (MET)-minutes/week based on the PA questionnaire. Multivariate logistic regression analysis was performed to examine associations between LBP and the type and amount of PA. Odds ratio for LBP according to the type of PA and the quartiles of the total MET-minutes/week. After adjusting for age and body mass index, vigorous and moderate PA were associated with an increased risk of LBP in both men and women, whereas strength exercises were associated with a reduced risk of LBP. These associations were maintained after adjusting for all potential confounders. Subgroup analysis according to age revealed that these trends were most significantly demonstrated in women aged ≥65 years. The PA quartiles for total MET-minutes/week for men showed a U-shaped association with LBP, whereas only the fourth PA quartile for women showed an increased risk of LBP compared with the second quartile. These results suggest that both the type and amount of PA affect the development of LBP in people aged ≥50 years and thus activity modification might be helpful for prevention and management of LBP. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Repeatability of stance phase kinematics from a multi-segment foot model in people aged 50 years and older.

PubMed

Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

2013-06-01

Confidence in 3D multi-segment foot models has been limited by a lack of repeatability data, particularly in older populations that may display unique functional foot characteristics. This study aimed to determine the intra and inter-observer repeatability of stance phase kinematic data from a multi-segment foot model described by Leardini et al. [2] in people aged 50 years or older. Twenty healthy adults participated (mean age 65.4 years SD 8.4). A repeated measures study design was used with data collected from four testing sessions on two days from two observers. Intra (within-day and between-day) and inter-observer coefficient of multiple correlations revealed moderate to excellent similarity of stance phase joint range of motion (0.621-0.975). Relative to the joint range of motion (ROM), mean differences (MD) between sessions were highest for the within-day comparison for all planar ROM at the metatarsus-midfoot articulation (sagittal plane ROM 5.2° vs. 3.9°, MD 3.1°; coronal plane ROM 3.9 vs. 3.1°, MD 2.3°; transverse plane ROM 6.8° vs. 5.16°, MD 3.5°). Consequently, data from the metatarsus-midfoot articulation in the Istituto Ortopedico Rizzoli (IOR) foot model in adults aged over 50 years needs to be considered with respect to the findings of this study. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

Results of endoscopic third ventriculostomy in elderly patients ≥65 years of age.

PubMed

Niknejad, Hamid Reza; Depreitere, Bart; De Vleeschouwer, Steven; Van Calenbergh, Frank; van Loon, Johannes

2015-03-01

Endoscopic third ventriculostomy (ETV) has been accepted as the procedure of choice for the treatment of obstructive hydrocephalus in children and adults. The role and outcome of this procedure in the elderly has not been evaluated yet. Over an 11-year interval we retrospectively analyzed data of patients, 65+ years of age, who underwent ETV in our center. Success of the procedure was assessed in terms of symptom relief and/or elimination of the need for shunting. Additionally pre- and postoperative ventricular volumes were estimated using Evan's index (Ei) and fronto-occipital horn ratio (FOR). In our analysis we compared the results of the elderly patients with those of the pediatric and adult age groups treated in our center. We obtained data of 16 elderly cases (11 males, 5 females), mean age 72.8 years (66-83 years) out of the 91 patients treated with ETV in total. The success rate was 75% in this age group; mean follow-up 18.4 months (2-55 months). In 10 patients a mass lesion was the underlying cause of hydrocephalus. Mean ventricular size reduction was 18% and 13.5% (Ei and FOR) in the success group vs. 7.6% and 6.2% in the failure group. Three out of four patients who had shunting pre-EVT, became shunt independent post-operatively. The presence of flow void over the stoma was 100% correlated with success. All 7 patients with a primary or metastatic brain tumor were able to receive radiation therapy. Also in elderly, ETV is a safe and efficient procedure, with success rates similar to the younger population. Further research is required to set up a prognostic scoring system for this age group. Copyright © 2014 Elsevier B.V. All rights reserved.

Differential changes and interactions of autonomic functioning and sleep architecture before and after 50 years of age.

PubMed

Kuo, T B J; Li, Jia-Yi; Kuo, Hsu-Ko; Chern, Chang-Ming; Yang, C C H

2016-02-01

We hypothesize that the time when age-related changes in autonomic functioning and in sleep structure occur are different and that autonomic functioning modulates sleep architecture differently before and after 50 years of age. Sixty-eight healthy subjects (aged 20 to 79 years old, 49 of them women) were enrolled. Correlation analysis revealed that wake after sleep onset, the absolute and relative value of stage 1 (S1; S1%), and relative value of stage 2 (S2) were positively correlated with age; however, sleep efficiency, stage 3 (S3), S3%, and rapid-eye-movement latency (REML) were negatively correlated with age. Significant degenerations of sleep during normal aging were occurred after 50 years of age; however, significant declines of autonomic activity were showed before 50 years of age. Before 50 years of age, vagal function during sleep was negatively correlated with arousal index; however, after 50 years of age, it was positively correlated with S1 and S1%. In addition, sympathetic activity during wake stage was positively related to S2% only after 50 years of age. Our results imply that the age-related changes in autonomic functioning decline promptly as individuals leave the younger part of their adult life span and that age-related changes in sleep slowly develop as individuals enter the older part of their adult life span. Furthermore, while various aspects of sleep architecture are modulated by both the sympathetic and vagal nervous systems during adult life span, the sleep quality is mainly correlated with the sympathetic division after 50 years of age.

White Matter Lesions: Prevalence and Clinical Phenotype in Asymptomatic Individuals Aged ≥50 Years.

PubMed

David, Jean-Philippe; Ferrat, Emilie; Parisot, Juliette; Naga, Henri; Lakroun, Samia; Menasria, Feriel; Saddedine, Sofiane; Natella, Pierre-André; Paillaud, Elena; Fromentin, Isabelle; Bastuji-Garin, Sylvie

2016-01-01

To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes. Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis. Median age was 63 years; 53.9% were women, 32.6% had hypertension, and 76.6% had ≥1 cardiovascular risk factors. The prevalence of ec/cWMLs was 26.2%. Apart from age, independent risk factors were family history of cardiovascular event (OR = 5.55; 1.13-27.32) and hypertension (2.47; 1.05-5.81). Patients with ec/cWMLs had lower cognitive dual-task walking speed (1.15; 0.98-1.40), MMSE (1.41; 1.06-1.89), and FAB scores (5.21; 1.49-19.84). The Scheltens score was independently associated with the WML severity score. ec/cWMLs are common in asymptomatic community-dwelling individuals aged ≥50 years. They are associated with cardiovascular risk factors, impairments in global and executive cognitive function, and Scheltens score elevation. © 2016 S. Karger AG, Basel.

Adherence and Persistence Among Statin Users Aged 65 Years and Over: A Systematic Review and Meta-analysis.

PubMed

Ofori-Asenso, Richard; Jakhu, Avtar; Zomer, Ella; Curtis, Andrea J; Korhonen, Maarit Jaana; Nelson, Mark; Gambhir, Manoj; Tonkin, Andrew; Liew, Danny; Zoungas, Sophia

2018-05-09

Older people (aged ≥ 65 years) have distinctive challenges with medication adherence. However, adherence and persistence patterns among older statin users have not been comprehensively reviewed. As part of a broader systematic review, we searched Medline, Embase, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects, CENTRAL, and the National Health Service Economic Evaluation Database through December 2016 for English articles reporting adherence and/or persistence among older statin users. Data were analyzed via descriptive methods and meta-analysis using random-effect modeling. Data from more than 3 million older statin users in 82 studies conducted in over 40 countries were analyzed. At 1-year follow-up, 59.7% (primary prevention 47.9%; secondary prevention 62.3%) of users were adherent (medication possession ratio [MPR] or proportion of days covered [PDC] ≥ 80%). For both primary and secondary prevention subjects, 1-year adherence was worse among individuals aged more than 75 years than those aged 65-75 years. At 3 and ≥10 years, 55.3% and 28.4% of users were adherent, respectively. The proportion of users persistent at 1-year was 76.7% (primary prevention 76.0%; secondary prevention 82.6%). Additionally, 68.1% and 61.2% of users were persistent at 2 and 4 years, respectively. Among new statin users, 48.2% were nonadherent and 23.9% discontinued within the first year. The proportion of statin users who were adherent based on self-report was 85.5%. There is poor short and long term adherence and persistence among older statin users. Strategies to improve adherence and reduce discontinuation are needed if the intended cardiovascular benefits of statin treatment are to be realized.

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

26 CFR 1.37-2 - Credit for individuals age 65 or over.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Credit for individuals age 65 or over. 1.37-2... TAXES Credits Against Tax § 1.37-2 Credit for individuals age 65 or over. (a) In general. This section... age of 65 before the close of the taxable year. This section shall not apply to an individual for any...

[Relationship between dysphagia and malnutritition in patients over 65 years of age].

PubMed

Galán Sánchez-Heredero, María José; Santander Vaquero, Cecilio; Cortázar Sáez, Milagros; de la Morena López, Felipe; Susi García, Rosario; Martínez Rincón, María Del Carmen

2014-01-01

The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Cancer Specific Mortality in Men Diagnosed with Prostate Cancer before Age 50 Years: A Nationwide Population Based Study.

PubMed

Thorstenson, Andreas; Garmo, Hans; Adolfsson, Jan; Bratt, Ola

2017-01-01

We compared clinical characteristics and cancer specific mortality in men diagnosed with prostate cancer before vs after age 50 years. A total of 919 men 35 to 49 years old and 45,098 men 50 to 66 years old who were diagnosed with prostate cancer between 1998 and 2012 were identified in PCBaSe (Prostate Cancer data Base Sweden). Cancer specific mortality was compared among age groups (35 to 49, 50 to 59, 60 to 63 and 64 to 66 years) with and without adjusting for cancer characteristics, comorbidity and education in a multivariable Cox proportional hazards model. Clinical cancer characteristics indicated that most nonmetastatic cancer in men younger than 50 years was detected after prostate specific antigen testing. The proportion of nonmetastatic vs metastatic disease at diagnosis was similar in all age groups. A strong association between younger age and poor prognosis was apparent in men in whom metastatic disease was diagnosed before age 50 to 55 years. The crude and adjusted HRs of cancer specific mortality were 1.41 (95% CI 1.12-1.79) and 1.28 (95% CI 1.01-1.62) in men diagnosed before age 50 and at age 50 to 59 years, respectively. In men with nonmetastatic disease crude cancer specific mortality increased with older age but adjusted cancer specific mortality was similar in all age groups. Our findings suggest that an aggressive form of metastatic prostate cancer is particularly common in men younger than 50 to 55 years. Genetic studies and trials of intensified systemic treatment are warranted in this patient group. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Development and Initial Reliability Testing of NAK-50+: A Nutrition Attitude and Knowledge Questionnaire for Adults 50+ Years of Age.

PubMed

Ducak, Kate; Keller, Heather

2016-03-01

Few questionnaires to test nutrition knowledge and attitudes of older adults living independently in the community have been developed and tested to assess self-management tools such as Nutri-eSCREEN and other education programs. This study is a first step in the development of a questionnaire designed to evaluate the nutrition knowledge and attitudes of independent older adults (NAK-50+). The steps involved in this study were: (i) drafting initial questions based on the content of the Nutri-eSCREEN education material, (ii) using cognitive interviewing to determine if these questions were understandable and relevant (n = 9 adults ≥50 years of age), and (iii) completing test-retest reliability in a convenient community sample (n = 60 adults ≥50 years of age). Intra-class coefficients (ICC) and kappa were used to determine reliability. A 33-item questionnaire resulted from this development and analysis. ICC for the total score was 0.68 indicating good agreement and thus initial reliability. NAK-50+ is a face valid and reliable questionnaire that assesses nutrition knowledge and attitudes in independent adults aged ≥50 years. Further work to determine construct validity and to refine the questionnaire is warranted. Availability of the questionnaire for this age group will support rigorous evaluation of education and self-management interventions for this segment of the population.

Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years.

PubMed

Schmader, Kenneth E; Levin, Myron J; Gnann, John W; McNeil, Shelly A; Vesikari, Timo; Betts, Robert F; Keay, Susan; Stek, Jon E; Bundick, Nickoya D; Su, Shu-Chih; Zhao, Yanli; Li, Xiaoming; Chan, Ivan S F; Annunziato, Paula W; Parrino, Janie

2012-04-01

Herpes zoster (HZ) adversely affects individuals aged 50-59, but vaccine efficacy has not been assessed in this population. This study was designed to determine the efficacy, safety, and tolerability of zoster vaccine for preventing HZ in persons aged 50-59 years. This was a randomized, double-blind, placebo-controlled study of 22 439 subjects aged 50-59 years conducted in North America and Europe. Subjects were given 1 dose of licensed zoster vaccine (ZV) (Zostavax; Merck) and followed for occurrence of HZ for ≥1 year (mean, 1.3 years) postvaccination until accrual of ≥96 confirmed HZ cases (as determined by testing lesions swabs for varicella zoster virus DNA by polymerase chain reaction). Subjects were followed for all adverse events (AEs) from day 1 to day 42 postvaccination and for serious AEs (SAEs) through day 182 postvaccination. The ZV reduced the incidence of HZ (30 cases in vaccine group, 1.99/1000 person-years vs 99 cases in placebo group, 6.57/1000 person-years). Vaccine efficacy for preventing HZ was 69.8% (95% confidence interval, 54.1-80.6). AEs were reported by 72.8% of subjects in the ZV group and 41.5% in the placebo group, with the difference primarily due to higher rates of injection-site AEs and headache. The proportion of subjects reporting SAEs occurring within 42 days postvaccination (ZV, 0.6%; placebo, 0.5%) and 182 days postvaccination (ZV, 2.1%; placebo, 1.9%) was similar between groups. In subjects aged 50-59 years, the ZV significantly reduced the incidence of HZ and was well tolerated. NCT00534248.

Stereotactic radiosurgery for brain metastases: a case-matched study comparing treatment results for patients 80 years of age or older versus patients 65-79 years of age.

PubMed

Watanabe, Shinya; Yamamoto, Masaaki; Sato, Yasunori; Kawabe, Takuya; Higuchi, Yoshinori; Kasuya, Hidetoshi; Yamamoto, Tetsuya; Matsumura, Akira; Barfod, Bierta E

2014-11-01

Recently, an increasing number of patients with brain metastases, even patients over 80 years of age, have been treated with stereotactic radiosurgery (SRS). However, there is little information on SRS treatment results for patients with brain metastases 80 years of age and older. The authors undertook this study to reappraise whether SRS treatment results for patients 80 years of age or older differ from those of patients who are 65-79 years old. This was an institutional review board-approved, retrospective cohort study. Among 2552 consecutive brain metastasis patients who underwent SRS during the 1998-2011 period, we studied 165 who were 80 years of age or older (Group A) and 1181 who were age 65-79 years old (Group B). Because of the remarkable disproportion in patient numbers between the 2 groups and considerable differences in pre-SRS clinical factors, the authors conducted a case-matched study using the propensity score matching method. Ultimately, 330 patients (165 from each group, A and B) were selected. For time-to-event outcomes, the Kaplan-Meier method was used to estimate overall survival and competing risk analysis was used to estimate other study end points, as appropriate. Although the case-matched study showed that post-SRS median survival time (MST, months) was shorter in Group A patients (5.3 months, 95% CI 3.9-7.0 months) than in Group B patients (6.9 months, 95% CI 5.0-8.1 months), this difference was not statistically significant (HR 1.147, 95% CI 0.921-1.429, p = 0.22). Incidences of neurological death and deterioration were slightly lower in Group A than in Group B patients (6.3% vs 11.8% and 8.5% vs 13.9%), but these differences did not reach statistical significance (p = 0.11 and p = 0.16). Furthermore, competing risk analyses showed that the 2 groups did not differ significantly in cumulative incidence of local recurrence (HR 0.830, 95% CI 0.268-2.573, p = 0.75), rates of repeat SRS (HR 0.738, 95% CI 0.438-1.242, p = 0.25), or incidence

A Simple Algorithm to Predict Falls in Primary Care Patients Aged 65 to 74 Years: The International Mobility in Aging Study.

PubMed

Gomez, Fernando; Wu, Yan Yan; Auais, Mohammad; Vafaei, Afshin; Zunzunegui, Maria-Victoria

2017-09-01

Primary care practitioners need simple algorithms to identify older adults at higher risks of falling. Classification and regression tree (CaRT) analyses are useful tools for identification of clinical predictors of falls. Prospective cohort. Community-dwelling older adults at 5 diverse sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). In 2012, 2002 participants aged 65-74 years from 5 international sites were assessed in the International Mobility in Aging Study. In 2014 follow-up, 86% of the participants (n = 1718) were reassessed. These risk factors for the occurrence of falls in 2014 were selected based on relevant literature and were entered into the CaRT as measured at baseline in 2012: age, sex, body mass index, multimorbidity, cognitive deficit, depression, number of falls in the past 12 months, fear of falling (FoF) categories, and timed chair-rises, balance, and gait. The 1-year prevalence of falls in 2014 was 26.9%. CaRT procedure identified 3 subgroups based on reported number of falls in 2012 (none, 1, ≥2). The 2014 prevalence of falls in these 3 subgroups was 20%, 30%, and 50%, respectively. The "no fall" subgroup was split using FoF: 30% of the high FoF category (score >27) vs 20% of low and moderate FoF categories (scores: 16-27) experienced a fall in 2014. Those with multiple falls were split by their speed in the chair-rise test: 56% of the slow category (>16.7 seconds) and the fast category (<11.2 seconds) had falls vs 28% in the intermediate group (between 11.2 and 16.7 seconds). No additional variables entered into the decision tree. Three simple indicators: FoF, number of previous falls, and time of chair rise could identify those with more than 50% probability of falling. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Increasing incidence and importance of HIV/AIDS and gonorrhea among men aged >/= 50 years in the US in the era of erectile dysfunction therapy.

PubMed

Karlovsky, Matthew; Lebed, Brett; Mydlo, Jack H

2004-01-01

With the advent of effective pharmacotherapy for erectile dysfunction, the risk of sexually transmitted diseases is a possible consequence, especially in the older population. We wanted to review the incidence of sexually transmitted diseases in the older population in an attempt to correlate this with the advent of these new drugs. Publicly available information on the incidence of HIV, AIDS and gonorrhea was retrieved from the websites of the Centers for Disease Control (CDC), the State of Florida Department of Health, the Senior HIV Intervention Project and the National Association on HIV Over Fifty. National case incidences of HIV and AIDS in men between 1996 and 2000 were examined for trends. National and Florida state trends were compared and, in Florida, Palm Beach, Broward and Dade counties in particular were selected because of their traditionally large retiree population. In addition, the national and Florida state incidences of gonorrheal infection were examined for trends. Statistics on national sildenafil (Viagra) prescriptions were obtained via a personal communication with a regional healthcare representative from Pfizer. According to the CDC, at the end of 1998 >10% of new AIDS cases nationally were in individuals aged >50 years. In the late 1990s, new AIDS cases rose faster in middle-aged and older adults than in people aged >40 years. Many of the newly diagnosed cases of AIDS may have contracted HIV before the age of 50 years; however, many individuals are newly becoming infected above the age of 50 years. Of the reported AIDS cases in 1996 in individuals aged >/= 50 years, 48% were aged 50-54 years, 26% were aged 55-59 years, 14% were aged 60-64 years and 12% were aged >/= 65 years; 84% of these cases were male, and blacks accounted for the greatest proportion of cases (43%). In the US, 7.5 million prescriptions for sildenafil were written in 1998, 9.5 million in 1999, 12 million in 2000 and 15.5 million in 2001. The age breakdown for these

Who gets a mammogram amongst European women aged 50-69 years?

PubMed Central

2012-01-01

On the basis of the Survey of Health, Ageing, and Retirement (SHARE), we analyse the determinants of who engages in mammography screening focusing on European women aged 50-69 years. A special emphasis is put on the measurement error of subjective life expectancy and on the measurement and impact of physician quality. Our main findings are that physician quality, better education, having a partner, younger age and better health are associated with higher rates of receipt. The impact of subjective life expectancy on screening decision substantially increases after taking measurement error into account. JEL Classification C 36, I 11, I 18 PMID:22828268

The provision of mental health services in England for people over 65 years of age, 1970-78.

PubMed

Hilton, Claire

2008-09-01

The twentieth century saw an increasing number of people living into old age, and consequently a higher prevalence of age-related chronic degenerative brain disorders. By 1971 the mental hospitals were almost half full with people over 65 years of age. Thus plans to close the mental hospitals meant that the development of community mental health services for older people was a necessity. Although there was a multi-disciplinary focus on the care of older people, the lead in service development was largely taken by psychiatrists, both individually and through the Group for the Psychiatry of Old Age at the Royal College of Psychiatrists.

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Are you age 65? 408.214 Section 408.214... Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before...

50 CFR 27.65 - Tampering with vehicles and equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Tampering with vehicles and equipment. 27.65 Section 27.65 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM PROHIBITED ACTS Disturbing Violations: Against Nonwildlife Property § 27.65 Tampering with...

50 CFR 27.65 - Tampering with vehicles and equipment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Tampering with vehicles and equipment. 27.65 Section 27.65 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM PROHIBITED ACTS Disturbing Violations: Against Nonwildlife Property § 27.65 Tampering with...

Falls, risk factors and fear of falling among persons older than 65 years of age.

PubMed

Gazibara, Tatjana; Kurtagic, Ilma; Kisic-Tepavcevic, Darija; Nurkovic, Selmina; Kovacevic, Nikolina; Gazibara, Teodora; Pekmezovic, Tatjana

2017-07-01

Falling represents a major public health problem among older persons because it leads to premature mortality, loss of independence, and placement in assisted-living facilities. The purpose of this study was to assess the main features and risks for falls among persons older than 65 years of age as well as to quantify their fear of falling. A total of 354 persons older than 65 years of age were recruited at a community health centre. Characteristics of the most recent fall were obtained through detailed interviews with study participants. The Falls Efficacy Scale was used to quantify fear of falling. Frequency of falling was 15.8%. Falls occurred most often while walking (49%). One-half of fallers (49.1%) sustained an injury. Head haematomas and soft tissues contusions were the most common consequences of falls. The average Falls Efficacy Scale score was significantly higher in fallers ( P = 0.001). Multiple logistic regression analysis showed that having a fear of falling (odds ratio = 4.14, 95% confidence interval: 1.22-14.08, P = 0.02) and being a woman (odds ratio = 2.10, 95% confidence interval: 0.97-4.53, P = 0.05) were independent risk factors for falling among older persons. The frequency of falls among older people was similar to those in other populations. These results could be used to help select older persons who should be enrolled in fall prevention programmes. © 2017 Japanese Psychogeriatric Society.

Marine radiocarbon reservoir age simulations for the past 50,000 years

NASA Astrophysics Data System (ADS)

Butzin, M.; Köhler, P.; Lohmann, G.

2017-08-01

Radiocarbon (14C) dating calibration for the last glacial period largely relies on cross-dated marine 14C records. However, marine reservoirs are isotopically depleted with respect to the atmosphere and therefore have to be corrected by the Marine Radiocarbon Ages of surface waters (MRAs), whose temporal variabilities are largely unknown. Here we present simulations of the spatial and temporal variability in MRAs using a three-dimensional ocean circulation model covering the past 50,000 years. Our simulations are compared to reconstructions of past surface ocean Δ14C. Running the model with different climatic boundary conditions, we find that low-latitude to midlatitude MRAs have varied between 400 and 1200 14C years, with values of about 780 14C years at the Last Glacial Maximum. Reservoir ages exceeding 2000 14C years are simulated in the polar oceans. Our simulation results can be used as first-order approximation of the MRA variability in future radiocarbon calibration efforts.

[Controversial attitude to mammography screening in asymptomatic women between 40 and 50 years of age].

PubMed

Frischbier, H J

1994-01-01

The results of screening studies conducted in the United States and in Europe in females between the ages of 40 and 50 are analysed. It is shown, that the results of this study on mortality reduction are less favourable, the poorer the technique of mammography (foregoing of general two-view mammography) and the longer the time interval between two mammography screenings. Arguments are presented, that are brought forward when declining to perform general mammography screening in this age group. The author's own results, obtained in the Hamburg mammography screening study, which included from 1971 to 1986 also premenopausal women, show, that the survival rates of patients below 50 years of age with mammographically detected carcinomas of the breast do not differ from those in patients older than 50 years, according to a relevant age group classification. The advances in the technique of mammography in recent years are analysed on the basis of the author's own patient material. It is evident, that the positive predictive value has been doubled, especially in the age group between 40 and 50. An analysis of the distribution of diagnosed noninvasive carcinomas compared with the invasive carcinomas reveals, that particularly this age group has the highest percentage of identification of prognostically favourable carcinoma stages. Further analyses show, why the randomised European mammography studies could not yield a significant mortality rate improvement. A prerequisite for the inclusion of mammography screening in the legally prescribed early detection of carcinoma examinations, however, are the quality controls, whose realisation, in our health system, will have to be confirmed by the German mammography study.

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years.

PubMed

Otsuka, R; Nishita, Y; Tange, C; Tomida, M; Kato, Y; Imai, T; Ando, F; Shimokata, H

2018-01-01

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit

A comparison of measured height and demi-span equivalent height in the assessment of body mass index among people aged 65 years and over in England.

PubMed

Hirani, Vasant; Mindell, Jennifer

2008-05-01

to examine differences between measured height and demi-span equivalent height (DEH) among people aged >or=65 and investigate the impact on body mass index (BMI) of using DEH. nationally representative cross-sectional sample of adults living in England. 3,346 non-institutionalised adults aged >or=65, taking part in the Health Survey for England (HSE) 2001. height, weight and demi-span measurements were taken according to standardised HSE protocols. DEH was calculated using Bassey's equation. the height measurement was lower than the DEH from age group 70-74 years onwards in men and in each age group in women. No significant differences in mean DEH and measured height were found for men (-0.46) or women (-2.64). BMI derived from measured height did not differ significantly from BMI derived from DEH. The prevalence of underweight was lower when using measured height than when using DEH in women aged >or=65, particularly in those aged 80 years and over. The prevalence of overweight and obesity was higher using measured height than DEH in women aged >or=65. we confirmed in a large nationally representative sample that demi-span measurement may be a useful estimate of stature in people (particularly women) aged >or=65 for BMI calculations.

Health information literacy in everyday life: a study of Finns aged 65-79 years.

PubMed

Eriksson-Backa, Kristina; Ek, Stefan; Niemelä, Raimo; Huotari, Maija-Leena

2012-06-01

This article examines the health information literacy of elderly Finns. The results are based on a survey conducted in January 2011. The questionnaire was distributed to 1000 persons that were randomly drawn from the Finnish Population Register. The respondents were aged 65-79 years (mean age 70 years) and lived in the Turku region in Finland. A total of 281 questionnaires (28%) were returned. χ(2) analyses were used to find possible relationships between demographic factors, as well as interest, seeking activity, current self-rated health and different dimensions of health information literacy, including needs, seeking and use of health-related information. Significant relationships were found between education level, interest in health information, seeking activity, self-rated current health and dimensions of health information literacy. Some categories of elderly people are more vulnerable regarding obtaining and use of health information: those with lower levels of education, those with poor health, and those who are not interested in and active at seeking information. For people who are found in any of these categories, it is important that available health-related information is understandable and can be accessed without too much effort-something that information providers should take into account.

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Are you age 65? 408.214 Section 408.214 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day...

20 CFR 408.214 - Are you age 65?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Are you age 65? 408.214 Section 408.214 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB Qualification and Entitlement Age § 408.214 Are you age 65? You become age 65 on the first moment of the day...

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

PubMed Central

Karyekar, Chetan S; Ravichandran, Shoba; Allen, Elsie; Fleming, Douglas; Frederich, Robert

2013-01-01

Purpose To assess safety and efficacy of saxagliptin in older patients with type 2 diabetes mellitus (T2DM). Patients and methods This was a post hoc analysis of pooled data from older patients (≥65 years of age) from five 24-week phase III trials: three studies of saxagliptin versus placebo as an add-on therapy to metformin, glyburide, or a thiazolidinedione; and two studies of saxagliptin versus placebo as monotherapy in drug-naïve patients. Separate analyses were conducted on one study of initial combination therapy with saxagliptin plus metformin versus metformin monotherapy in drug-naïve patients. The safety analysis population for the five-study pool included 428 patients ≥ 65 years of age with baseline glycated hemoglobin (HbA1c) 7.0% to 10.5% who received saxagliptin 2.5 or 5 mg or placebo, and for the study of initial combination therapy included 69 patients ≥ 65 years of age with baseline HbA1c 8.0% to 12.0% who received saxagliptin 5 mg in combination with metformin or metformin monotherapy. The primary efficacy endpoint was change from baseline HbA1c. Results In the five-study pool, the differences in the adjusted mean change from baseline HbA1c among older patients receiving saxagliptin versus placebo were −0.60% (95% confidence interval [CI], −0.99% to −0.21%) for saxagliptin 2.5 mg and −0.55% (−0.97% to −0.14%) for saxagliptin 5 mg; in the initial combination study, the difference was −1.22% (−2.27% to −0.17%) among older patients receiving saxagliptin 5 mg plus metformin versus metformin monotherapy. The results were generally similar in older and younger patients. Saxagliptin was well tolerated; the incidence and types of adverse events were similar for saxagliptin and comparators. Hypoglycemia was reported in 3.0% to 9.4% of patients receiving saxagliptin (0%–8.0% for comparators) and was confirmed (finger stick glucose ≤ 50 mg/dL, with associated symptoms) in 0% to 0.7% (0%–0.7% for comparators); hypoglycemic

Colorectal Cancer Screening Initiation After Age 50 Years in an Organized Program.

PubMed

Fedewa, Stacey A; Corley, Douglas A; Jensen, Christopher D; Zhao, Wei; Goodman, Michael; Jemal, Ahmedin; Ward, Kevin C; Levin, Theodore R; Doubeni, Chyke A

2017-09-01

Recent studies report racial disparities among individuals in organized colorectal cancer (CRC) programs; however, there is a paucity of information on CRC screening utilization by race/ethnicity among newly age-eligible adults in such programs. This was a retrospective cohort study among Kaiser Permanente Northern California enrollees who turned age 50 years between 2007 and 2012 (N=138,799) and were served by a systemwide outreach and facilitated in-reach screening program based primarily on mailed fecal immunochemical tests to screening-eligible people. Kaplan-Meier and Cox model analyses were used to estimate differences in receipt of CRC screening in 2015-2016. Cumulative probabilities of CRC screening within 1 and 2 years of subjects' 50th birthday were 51% and 73%, respectively. Relative to non-Hispanic whites, the likelihood of completing any CRC screening was similar in blacks (hazard ratio, 0.98; 95% CI=0.96, 1.00); 5% lower in Hispanics (hazard ratio, 0.95; 95% CI=0.93, 0.96); and 13% higher in Asians (hazard ratio, 1.13; 95% CI=1.11, 1.15) in adjusted analyses. Fecal immunochemical testing was the most common screening modality, representing 86% of all screening initiations. Blacks and Hispanics had lower receipt of fecal immunochemical testing in adjusted analyses. CRC screening uptake was high among newly screening-eligible adults in an organized CRC screening program, but Hispanics were less likely to initiate screening near age 50 years than non-Hispanic whites, suggesting that cultural and other individual-level barriers not addressed within the program likely contribute. Future studies examining the influences of culturally appropriate and targeted efforts for screening initiation are needed. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of metabolic syndrome and associated factors in women aged 35 to 65 years who were enrolled in a family health program in Brazil.

PubMed

Schmitt, Ana Carolina Basso; Cardoso, Maria Regina Alves; Lopes, Heno; Pereira, Wendry Maria Paixão; Pereira, Elaine Cristina; de Rezende, Debora Aparecida Paccola; Guarizi, Rubia Guibo; Dellu, Mayra Cecilia; Oliveira, Jéssica de Moura; Flauzino, Erika; Blümel, Juan E; Aldrighi, José Mendes

2013-04-01

The aims of this study were to estimate the prevalence of metabolic syndrome among women aged 35 to 65 years and to identify associated factors. This was a cross-sectional study. We randomly selected 581 women (aged 35-65 y) from among those enrolled in a family health program in the city of Pindamonhangaba, Brazil. Metabolic syndrome was identified in accordance with the definition of the National Cholesterol Education Program Adult Treatment Panel III. Health conditions and lifestyle habits were evaluated by a survey, and anthropometric measurements were obtained. The prevalence of metabolic syndrome was estimated, and Poisson regression was used to evaluate the associations between metabolic syndrome `and the factors investigated. The prevalence of metabolic syndrome was 42.2% (95% CI, 38.1-46.2). The most common metabolic syndrome component was abdominal obesity (60.6%), followed by low levels of high-density lipoprotein cholesterol (51.3%), high levels of triglycerides (41.4%), high blood pressure (31.7%), and diabetes (13.9%). The following factors were associated with metabolic syndrome: the 45- to 54-year age group (prevalence ratio, 1.54; 95% CI, 1.08-2.01), the 55- to 65-year age group (prevalence ratio, 3.51; 95% CI, 1.49-3.10), hyperuricemia (prevalence ratio, 2.95; 95% CI, 1.15-1.86), and sleep apnea risk (prevalence ratio, 2.41; 95% CI, 1.16-1.82). We found an inverse association between metabolic syndrome and having had more than 5 years of schooling (prevalence ratio, 0.65; 95% CI, 0.65-1.04). The prevalence of metabolic syndrome is high, and the associated clinical factors are hyperuricemia and risk of sleep apnea.

Comparison of immunization rates of adults ages 65 years and older managed within two nurse practitioner-owned clinics with national immunization rates.

PubMed

Wright, Wendy L; Morrell, Elise; Lee, Jennie; Cuellar, Norma Graciela; White, Patricia

2017-07-01

Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics. The vaccine records of each subject were reviewed for documentation of having received five vaccines (tetanus, diphtheria, and pertussis; influenza; pneumococcal polysaccharide vaccine 23; pneumococcal conjugate vaccine 13; and herpes zoster vaccine). One hundred and fifty females (70.8%) and 62 males (29.2%) met inclusion criteria. NP-managed patients had higher immunization rates than the national averages across all five major vaccines. The herpes zoster vaccination rates exceeded the recommendations from Healthy People 2020 whereas pneumococcal and influenza rates were below. The stocking of vaccines within the NP-managed clinics, direct billing to Medicare for Part D vaccines, and previsit care planning likely contributed to the high vaccination rates. These high immunization rates in patients managed by NPs provide support for the important role that NPs play in the care of older adults. ©2017 American Association of Nurse Practitioners.

Beverage consumption patterns of Canadian adults aged 19 to 65 years.

PubMed

Nikpartow, Nooshin; Danyliw, Adrienne D; Whiting, Susan J; Lim, Hyun J; Vatanparast, Hassanali

2012-12-01

To investigate the beverage intake patterns of Canadian adults and explore characteristics of participants in different beverage clusters. Analyses of nationally representative data with cross-sectional complex stratified design. Canadian Community Health Survey, Cycle 2.2 (2004). A total of 14 277 participants aged 19-65 years, in whom dietary intake was assessed using a single 24 h recall, were included in the study. After determining total intake and the contribution of beverages to total energy intake among age/sex groups, cluster analysis (K-means method) was used to classify males and females into distinct clusters based on the dominant pattern of beverage intakes. To test differences across clusters, χ2 tests and 95 % confidence intervals of the mean intakes were used. Six beverage clusters in women and seven beverage clusters in men were identified. 'Sugar-sweetened' beverage clusters - regular soft drinks and fruit drinks - as well as a 'beer' cluster, appeared for both men and women. No 'milk' cluster appeared among women. The mean consumption of the dominant beverage in each cluster was higher among men than women. The 'soft drink' cluster in men had the lowest proportion of the higher levels of education, and in women the highest proportion of inactivity, compared with other beverage clusters. Patterns of beverage intake in Canadian women indicate high consumption of sugar-sweetened beverages particularly fruit drinks, low intake of milk and high intake of beer. These patterns in women have implications for poor bone health, risk of obesity and other morbidities.

Influenza vaccination recommended for all adults aged between 50 and 64 years: conceptual basis and methodological limitations.

PubMed

Manzoli, L; De Vito, C; Flacco, M E; Marzuillo, C; Boccia, A; Villari, P

2012-01-01

In the first half of this year the experts of the Italian Society of Hygiene (SItI), along with those of other National Scientific Societies, agreed with the recommendations made by the USA CDC in 2009, and developed a proposal for a vaccination schedule (Vaccine Schedule for Life), in which influenza vaccination is recommended for all adults aged between 50 and 64 years. In the National Plan for Vaccinal Prevention 2012-2014, which was published just before the issue of the SItI Calendar but concluded earlier (end of 2011), influenza vaccination is recommended "only" for all persons > or = 65 years or included in one of the many at-risk categories. The issue is controversial and has generated considerable debate at national and international level. This short note discusses the logical processes and the scientific evidence in support or against the decision to extend the influenza vaccination. The Authors conclude that the epidemiological approach used by SItI experts is appropriate. In any case, further studies on the topic are strongly needed, and their results should be taken into account in the drafting of future vaccination schedules.

Total energy expenditure in adults aged 65 years and over measured using doubly-labelled water: international data availability and opportunities for data sharing.

PubMed

Porter, Judi; Nguo, Kay; Gibson, Simone; Huggins, Catherine E; Collins, Jorja; Kellow, Nicole J; Truby, Helen

2018-03-26

Increasing population lifespan necessitates a greater understanding of nutritional needs in older adults (65 year and over). A synthesis of total energy expenditure in the older population has not been undertaken and is needed to inform nutritional requirements. We aimed to establish the extent of the international evidence for total energy expenditure (TEE) using doubly-labelled water (DLW) in older adults (65 years and over), report challenges in obtaining primary data, and make recommendations for future data sharing. Four databases were searched to identify eligible studies; original research of any study design where participant level TEE was measured using DLW in participants aged ≥65 years. Once studies were identified for inclusion, authors were contacted where data were not publicly available. Screening was undertaken of 1223 records; the review of 317 full text papers excluded 170 records. Corresponding or first authors of 147 eligible studies were contacted electronically. Participant level data were publicly available or provided by authors for 45 publications (890 participants aged ≥65 years, with 248 aged ≥80 years). Sixty-seven percent of the DLW data in this population were unavailable due to authors unable to be contacted or declining to participate, or data being irretrievable. The lack of data access limits the value of the original research and its contribution to nutrition science. Openly accessible DLW data available through publications or a new international data repository would facilitate greater integration of current research with previous findings and ensure evidence is available to support the needs of the ageing population. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016047549 .

The effectiveness of pneumococcal polysaccharide vaccine 23 (PPV23) in the general population of 50 years of age and older: A systematic review and meta-analysis.

PubMed

Kraicer-Melamed, Hannah; O'Donnell, Shauna; Quach, Caroline

2016-03-18

Two pneumococcal vaccines currently exist and have been recommended for the prevention of pneumococcal infection in adults 65 years of age and older: the 23-valent polysaccharide (PPV23) and the conjugate 13-valent (PCV13) vaccine. To evaluate and summarize the results from all studies reporting on the vaccine effectiveness of PPV23 in preventing invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP) in individuals over the age of 50. Systematic database searches were completed in PubMed, Medline, Embase, CINAHL, Web of Science, and Cochrane. Google Scholar and hand searches of seminal articles and past systematic reviews were employed. Studies were included if they independently evaluated the effect of PPV23 on IPD and/or CAP in adults (50+). Data extraction and quality assessment were both completed independently by two researchers. Quality was assessed using the National Advisory Committee on Immunization methodology for quality assessment. All conflicts were resolved by consensus. The vaccine effectiveness for PPV23 in preventing IPD was 50% (95% CI: 21%-69%) for cohort studies and 54% (95% CI: 32%-69%) for case-control studies. The VE estimates for CAP were 4% (95% CI: -26%-26%) for trials, 17% (95% CI: -26%-45%) for cohort studies, and 7% (95% CI: -10%-21%) for case-control studies. The vaccine effectiveness of PPV23 in preventing IPD and all-cause CAP was consistent with past systematic reviews and similar to the estimates that were reported in the CAPiTA trial evaluating the vaccine effectiveness of PCV13. Consistent benefits were also reported across ecological studies and reports of surveillance data for the general population 50 years and older. The results suggests that the current practice of vaccinating the adults 65 years of age and older with PPV23 would have similar benefits to PCV13 in preventing potential cases of all-serotype IPD and all-cause CAP. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Nutritional status of the population over 65 years of age in the city of Badajoz].

PubMed

Suárez-Gómez, A; Sánchez-Vega, J; Suárez-González, F; Peral-Pacheco, D; Dorado-Martin, J J; Suárez-Gómez, M

2017-03-01

Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China.

PubMed

Huang, Ling; Jiang, Huihong; Zhu, Maoling; Wang, Baocai; Tong, Minsi; Li, Huaguang; Lin, Mou-Bin; Li, Li

2017-05-31

BACKGROUND Chronic constipation (CC) is a major public health problem worldwide, especially in elderly women. This study aimed to investigate the prevalence and risk factors of CC among women aged 50 years and older in Shanghai, China. MATERIAL AND METHODS A cross-sectional survey was conducted on 1950 women aged 50 years and older, randomly sampled in Yangpu District of Shanghai from April to October 2015. Information on demographic characteristics, lifestyle habits, medical history, and defecation situation was collected through in-person interviews. CC was defined according to Rome III criteria. The data were analyzed by chi-square test and multiple logistic regression analysis. RESULTS The response rate to the survey was 80.4%. Of the 1568 participants, 77 were diagnosed with CC, with a prevalence of 4.9%. Moreover, the prevalence increased with advancing age. Multiple logistic analyses showed that body mass index (BMI) ≥25.0 kg/m², non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise were significant risk factors for CC in the population of women aged 50 years and older. CONCLUSIONS CC was a common health problem among women aged 50 years and older in Shanghai, and the prevalence was positively associated with BMI ≥25.0 kg/m², non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise. Further studies are needed to identify the risk factors and potential interventions for CC.

Detection of mild cognitive impairment in people older than 65 years of age and its relationship to cardiovascular risk factors (DECRIVAM)

PubMed Central

2011-01-01

Background Studies centered on the detection of cognitive impairment and its relationship to cardiovascular risk factors in elderly people have gained special relevance in recent years. Knowledge of the cardiovascular risk factors that may be associated to cognitive impairment could be very useful for introducing treatments in early stages - thereby possibly contributing to improve patient quality of life. The present study explores cognitive performance in people over 65 years of age in Salamanca (Spain), with special emphasis on the identification of early symptoms of cognitive impairment, with the purpose of detecting mild cognitive impairment and of studying the relationships between this clinical situation and cardiovascular risk factors. Methods/Design A longitudinal study is contemplated. The reference population will consist of 420 people over 65 years of age enrolled through randomized sampling stratified by healthcare area, and who previously participated in another study. Measurement: a) Sociodemographic variables; b) Cardiovascular risk factors; c) Comorbidity; d) Functional level for daily life activities; and e) Study of higher cognitive functions based on a neuropsychological battery especially adapted to the evaluation of elderly people. Discussion We hope that this study will afford objective information on the representative prevalence of cognitive impairment in the population over 65 years of age in Salamanca. We also hope to obtain data on the relationship between cognitive impairment and cardiovascular risk factors in this specific population group. Based on the results obtained, we also will be able to establish the usefulness of some of the screening tests applied during the study, such as the Mini-Mental State Examination and the 7 Minute Screen test. Trial registration ClinicalTrials.gov: NCT01327196 PMID:21708036

General practice and the provision of information and services for physically disabled people aged 16 to 65 years.

PubMed Central

Chesson, R A; Sutherland, A M

1992-01-01

The study reported here was part of a larger survey investigating the nature and extent of disability in the Grampian region. Interviews with 212 people aged between 16 and 65 years who had a wide range of physical disabilities elicited perceptions of current and past service provision. Respondents expressed a strong need for information on disability services and reported difficulty in knowing whom to approach for this. General practitioners were the most commonly reported source of such information and low usage of the Department of Social Security, social work departments and voluntary organizations was identified. No significant relationship was found between degree of disability and frequency of consultation with a general practitioner. However, the more severe the disability the more likely it was that the general practitioner initiated contact rather than the patient. Although in general those interviewed were satisfied with medical information given regarding their diagnosis, they were more critical of information provided in relation to coping with the disorder, including that concerning benefits and services. The study confirmed the pivotal role of the general practitioner in the care of physically disabled people in the community aged between 16 and 65 years. The need to re-evaluate the role of the general practitioner in the provision of information and services is discussed. PMID:1472395

AIDS in adults 50 years of age and over: characteristics, trends and spatial distribution of the risk.

PubMed

Nogueira, Jordana de Almeida; Silva, Antônia Oliveira; Sá, Laísa Ribeiro de; Almeida, Sandra Aparecida de; Monroe, Aline Aparecida; Villa, Tereza Cristina Scatena

2014-01-01

to analyze the sociodemographic characteristics, epidemic trend and spatial distribution of the risk of AIDS in adults 50 years of age and over. population-based, ecological study, that used secondary data from the Notifiable Disease Information System (Sinan/AIDS) of Paraíba state from the period January 2000 to December 2010. during the study period, 307 cases of AIDS were reported among people 50 years of age or over. There was a predominance of males (205/66, 8%), mixed race, and low education levels. The municipalities with populations above 100 thousand inhabitants reported 58.5% of the cases. There was a progressive increase in cases among women; an increasing trend in the incidence (positive linear correlation); and an advance in the geographical spread of the disease, with expansion to the coastal region and to the interior of the state, reaching municipalities with populations below 30 thousand inhabitants. In some locations the risk of disease was 100 times greater than the relative risk for the state. aging, with the feminization and interiorization of the epidemic in adults 50 years of age and over, confirms the need for the induction of affirmative policies targeted toward this age group.

Safety and immunogenicity of high-dose trivalent inactivated influenza vaccine in adults 50-64 years of age.

PubMed

DiazGranados, Carlos A; Saway, William; Gouaux, James; Baron, Mira; Baker, Jeffrey; Denis, Martine; Jordanov, Emilia; Landolfi, Victoria; Yau, Eddy

2015-12-16

Individuals 50-64 years of age have reduced immune responses to influenza vaccines. The current study examined whether a high-dose inactivated trivalent influenza vaccine (IIV3-HD) might improve immune responses over a standard-dose inactivated influenza vaccine (IIV3-SD) in this age group. This was a multicenter, observer-blinded, randomized, active-controlled phase II trial. Adults 50-64 years of age were randomized 1:1 to receive IIV3-HD or IIV3-SD. Hemagglutination inhibition titers were measured before and 28 days after vaccination. Reactogenicity was recorded for 7 days after vaccination and adverse events for 28 days. 148 participants received IIV3-HD and 152 received IIV3-SD. For all vaccine strains, day 28 geometric mean hemagglutination inhibition titers were significantly higher in the IIV3-HD group than in the IIV3-SD group (geometric mean titer ratio [95% confidence interval (CI)]=1.43 [1.04-1.97] for A/H1N1, 1.65 [1.21-2.25] for A/H3N2, and 1.60 [1.23-2.08] for B). Seroconversion rates were significantly higher in the IIV3-HD group than in the IIV3-SD group for strains A/H3N2 and B but not A/H1N1 (difference [95% CI]=13.5% [4.76-22.0] for A/H3N2, 23.1% [11.7-33.6] for B, and -0.2% [-9.66 to 9.18] for A/H1N1). The post-vaccination seroprotection rate was significantly higher in the IIV3-HD group than in the IIV3-SD group for strain B but not for strains A/H1N1 or A/H3N2 (difference=9.1% [2.95-15.7] for B, 2.0% [-0.907 to 5.68] for A/H1N1, and 0.6% [-3.14 to 4.43] for A/H3N2). Reactogenicity was higher in the IIV3-HD group than in the IIV3-SD group, but reactions were mostly of low intensity, transient, and self-limited. Rates of unsolicited adverse events were similar between groups. No serious AEs, AEs leading to early withdrawal, or deaths were reported. The study suggests that in adults 50-64 years of age, IIV3-HD may improve immunogenicity compared to IIV3-SD while maintaining an acceptable safety profile. Copyright © 2015 The Authors. Published

Continuing screening mammography in women aged 70 to 79 years: impact on life expectancy and cost-effectiveness.

PubMed

Kerlikowske, K; Salzmann, P; Phillips, K A; Cauley, J A; Cummings, S R

1999-12-08

Mammography is recommended and is cost-effective for women aged 50 to 69 years, but the value of continuing screening mammography after age 69 years is not known. In particular, older women with low bone mineral density (BMD) have a lower risk of breast cancer and may benefit less from continued screening. To compare life expectancy and cost-effectiveness of screening mammography in elderly women based on 3 screening strategies. Decision analysis and cost-effectiveness analysis using a Markov model. General population of women aged 65 years or older. The analysis compared 3 strategies: (1) Undergoing biennial mammography from age 65 to 69 years; (2) undergoing biennial mammography from age 65 to 69 years, measurement of distal radial BMD at age 65 years, discontinuing screening at age 69 years in women in the lowest BMD quartile for age, and continuing biennial mammography to age 79 years in those in the top 3 quartiles of distal radius BMD; and (3) undergoing biennial mammography from age 65 to 79 years. Deaths due to breast cancer averted, life expectancy, and incremental cost-effectiveness ratios. Compared with discontinuing mammography screening at age 69 years, measuring BMD at age 65 years in 10000 women and continuing mammography to age 79 years only in women with BMD in the top 3 quartiles would prevent 9.4 deaths and add, on average, 2.1 days to life expectancy at an incremental cost of $66773 per year of life saved. Continuing mammography to age 79 years in all 10000 elderly women would prevent 1.4 additional breast cancer deaths and add only 7.2 hours to life expectancy at an incremental cost of $117689 per year of life saved compared with only continuing mammography to age 79 years in women with BMD in the top 3 quartiles. This analysis suggests that continuing mammography screening after age 69 years results in a small gain in life expectancy and is moderately cost-effective in those with high BMD and more costly in those with low BMD. Women

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

PubMed Central

Huang, Ling; Jiang, Huihong; Zhu, Maoling; Wang, Baocai; Tong, Minsi; Li, Huaguang; Lin, Mou-bin; Li, Li

2017-01-01

Background Chronic constipation (CC) is a major public health problem worldwide, especially in elderly women. This study aimed to investigate the prevalence and risk factors of CC among women aged 50 years and older in Shanghai, China. Material/Method A cross-sectional survey was conducted on 1950 women aged 50 years and older, randomly sampled in Yangpu District of Shanghai from April to October 2015. Information on demographic characteristics, lifestyle habits, medical history, and defecation situation was collected through in-person interviews. CC was defined according to Rome III criteria. The data were analyzed by chi-square test and multiple logistic regression analysis. Results The response rate to the survey was 80.4%. Of the 1568 participants, 77 were diagnosed with CC, with a prevalence of 4.9%. Moreover, the prevalence increased with advancing age. Multiple logistic analyses showed that body mass index (BMI) ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise were significant risk factors for CC in the population of women aged 50 years and older. Conclusions CC was a common health problem among women aged 50 years and older in Shanghai, and the prevalence was positively associated with BMI ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise. Further studies are needed to identify the risk factors and potential interventions for CC. PMID:28562581

Coeval Ar-40/Ar-39 ages of 65.0 million years ago from Chicxulub crater melt rock and Cretaceous-Tertiary boundary tektites

NASA Technical Reports Server (NTRS)

Swisher, Carl C., III; Grajales-Nishimura, Jose M.; Montanari, Alessandro; Margolis, Stanley V.; Claeys, Philippe; Alvarez, Walter; Renne, Paul; Cedillo-Pardo, Esteban; Maurrasse, Florentin J.-M. R.; Curtis, Garniss H.

1992-01-01

Ar-40/Ar-39 dating of drill-core samples of a glassy melt rock recovered from beneath a massive impact breccia contained with the 180-kilometer subsurface Chicxulub crater yields well-behaved incremental heating spectra with a mean plateau age of 64.98 +/- 0.05 million years ago (Ma). The glassy melt rock of andesitic composition was obtained from core 9 (1390 to 1393 meters) in the Chicxulub 1 well. The age of the melt rock is virtually indistinguishable from Ar-40/Ar-39 ages obtained on tektite glass from Beloc, Haiti, and Arroyo el Mimbral, northeastern Mexico, of 65.01 +/- 0.08 Ma (mean plateau age for Beloc) and 65.07 +/- 0.10 Ma (mean total fusion age for both sites). The Ar-40/Ar-39 ages, in conjunction with geochemical and petrological similarities, strengthen the suggestion that the Chicxulub structure is the source for the Haitian and Mexican tektites and is a viable candidate for the Cretaceous-Tertiary boundary impact site.

Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

PubMed

Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

2014-01-01

In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

Periodontal status and selected parameters of oral condition of Poles aged 65 to 74 years.

PubMed

Konopka, Tomasz; Dembowska, Elżbieta; Pietruska, Małgorzata; Dymalski, Paweł; Górska, Renata

2015-01-01

The goal of this study was the evaluation of the periodontal health by means of CPI score in inhabitants of big and small cities in the age range from 65 to 74 and making comparison with previous Polish and European studies from XXI century. Also an average number of natural teeth, the edentulous persons percentage, the percentage of people with oral function maintenance and prevalence of oral mucosal diseases were evaluated. There were also attempts to evaluate essential behaviours related to the oral health and the percentage of people that are treated with use of non-reimbursed or reimbursed services. Studies were conducted in 5 big cities: Warszawa, Szczecin, Wrocław, Białystok and Toruń, as well as in 4 towns, such as Oława, Police, Łobez and Ełk. From sampling 7400 people aged from 65 to 74 years for the study reported only 807 people. In the mouth evaluated CPI score, number of natural teeth and prevalence of pathological lesions on cavity mucosa. Answers for questions on selected attitudes and health-seeking behaviours related to the oral health and the range of dental treatment were also analysed. Distribution of values of CPI codes in the whole group was as follows: CPI0-1.2%, CPI1-9.4%, CPI2-16.6%, CPI3-21.8%, CPI4-19.7% and the number of people excluded from examinations (1 tooth in the sextant or edentulous 31.3%). The state of the periodontium was worse in big cities and in men. An average number of teeth was 13.7 and was higher in big cities and in men. The percentage of edentulous persons was 28.9% and was higher in towns and in woman. The percentage of people with oral function maintenance was 25.15% and was higher in big cities and in men. The most three common pathologies of the oral cavity were leukoplakia and leukokeratosis that were found in 10.5% of examined people, candidiasis 5.82% and lichen planus 2.2%. The state of the periodontium of Poles at the age from 65 to 74 has not been improved in XXI century, but also does not

10 CFR 50.65 - Requirements for monitoring the effectiveness of maintenance at nuclear power plants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... maintenance at nuclear power plants. 50.65 Section 50.65 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC... Construction Permits § 50.65 Requirements for monitoring the effectiveness of maintenance at nuclear power..., including normal shutdown operations. (a)(1) Each holder of an operating license for a nuclear power plant...

10 CFR 50.65 - Requirements for monitoring the effectiveness of maintenance at nuclear power plants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... maintenance at nuclear power plants. 50.65 Section 50.65 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC... Construction Permits § 50.65 Requirements for monitoring the effectiveness of maintenance at nuclear power..., including normal shutdown operations. (a)(1) Each holder of an operating license for a nuclear power plant...

10 CFR 50.65 - Requirements for monitoring the effectiveness of maintenance at nuclear power plants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... maintenance at nuclear power plants. 50.65 Section 50.65 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC... Construction Permits § 50.65 Requirements for monitoring the effectiveness of maintenance at nuclear power..., including normal shutdown operations. (a)(1) Each holder of an operating license for a nuclear power plant...

10 CFR 50.65 - Requirements for monitoring the effectiveness of maintenance at nuclear power plants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... maintenance at nuclear power plants. 50.65 Section 50.65 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC... Construction Permits § 50.65 Requirements for monitoring the effectiveness of maintenance at nuclear power..., including normal shutdown operations. (a)(1) Each holder of an operating license for a nuclear power plant...

Effectiveness of cervical screening after age 60 years according to screening history: Nationwide cohort study in Sweden.

PubMed

Wang, Jiangrong; Andrae, Bengt; Sundström, Karin; Ploner, Alexander; Ström, Peter; Elfström, K Miriam; Dillner, Joakim; Sparén, Pär

2017-10-01

The relatively high incidence of cervical cancer in women at older ages is a continuing concern in countries with long-established cervical screening. Controversy remains on when and how to cease screening. Existing population-based studies on the effectiveness of cervical screening at older ages have not considered women's screening history. We performed a nationwide cohort study to investigate the incidence of cervical cancer after age 60 years and its association with cervical screening at age 61-65, stratified by screening history at age 51-60. Using the Total Population Register, we identified 569,132 women born between 1 January 1919 and 31 December 1945, resident in Sweden since age 51. Women's cytological screening records, cervical cancer occurrence, and FIGO stage (for those diagnosed with cancer) were retrieved from national registers and medical charts. We calculated the cumulative incidence of cervical cancer from age 61 to age 80 using a survival function considering competing risk, and estimated the hazard ratio (HR) of cervical cancer in relation to screening status at age 61-65 from Cox models, adjusted for birth cohort and level of education, conditioning on women's screening history in their 50s. In women unscreened in their 50s, the cumulative incidence up to age 80 was 5.0 per 1,000 women, and screening at age 61-65 was associated with a lower risk for cervical cancer (HR = 0.42, 95% CI 0.24-0.72), corresponding to a decrease of 3.3 cancer cases per 1,000 women. A higher cumulative incidence and similarly statistically significant risk decrease was seen for women with abnormal smears in their 50s. In women adequately or inadequately screened with only normal results between age 51 and age 60, the cumulative incidence of cervical cancer from age 61 to 80 was 1.6 and 2.5 per 1,000 women, respectively, and further screening at age 61-65 was not associated with statistically significant decreases of cervical cancer risk up to age 80, but with fewer

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

PubMed

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-09-01

Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden.

PubMed

Carlsson, Axel C; Li, Xinjun; Holzmann, Martin J; Ärnlöv, Johan; Wändell, Per; Gasevic, Danijela; Sundquist, Jan; Sundquist, Kristina

2017-10-01

Objective We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years. Methods All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated. Results A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23). Conclusions In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.

Estimated incidence of pertussis in people aged <50 years in the United States

PubMed Central

Chen, Chi-Chang; Balderston McGuiness, Catherine; Krishnarajah, Girishanthy; Blanchette, Christopher M.; Wang, Yuanyuan; Sun, Kainan; Buck, Philip O.

2016-01-01

ABSTRACT The introduction of pertussis vaccination in the United States (US) in the 1940s has greatly reduced its burden. However, the incidence of pertussis is difficult to quantify, as many cases are not laboratory-confirmed or reported, particularly in adults. This study estimated pertussis incidence in a commercially insured US population aged <50 years. Data were extracted from IMS' PharMetrics Plus claims database for patients with a diagnosis of pertussis or cough illness using International Classification of Diseases (ICD-9) codes, a commercial outpatient laboratory database for patients with a pertussis laboratory test, and the Centers for Disease Control influenza surveillance database. US national pertussis incidence was projected using 3 methods: (1) diagnosed pertussis, defined as a claim for pertussis (ICD-9 033.0, 033.9, 484.3) during 2008–2013; (2) based on proxy pertussis predictive logistic regression models; (3) using the fraction of cough illness (ICD-9 033.0, 033.9, 484.3, 786.2, 466.0, 466.1, 487.1) attributed to laboratory-confirmed pertussis, estimated by time series linear regression models. Method 1 gave a projected annual incidence of diagnosed pertussis of 9/100,000, which was highest in those aged <1 year. Method 2 gave an average annual projected incidence of 21/100,000. Method 3 gave an overall regression-estimated weighted annual incidence of pertussis of 649/100,000, approximately 58–93 times higher than method 1 depending on the year. These estimations, which are consistent with considerable underreporting of pertussis in people aged <50 years and provide further evidence that the majority of cases go undetected, especially with increasing age, may aid in the development of public health programs to reduce pertussis burden. PMID:27246119

Impact of Gait Speed and Instrumental Activities of Daily Living on All-Cause Mortality in Adults ≥65 Years of Age with Heart Failure

PubMed Central

Lo, Alexander X.; Donnelly, John P.; McGwin, Gerald; Bittner, Vera; Ahmed, Ali; Brown, Cynthia J.

2015-01-01

Mobility and function are important predictors of survival. However, their combined impact on mortality in adults ≥65 years of age with heart failure (HF) is not well understood. This study examined the role of gait speed and instrumental activities of daily living (IADL) in all-cause mortality in a cohort of 1,119 community-dwelling Cardiovascular Health Study participants ≥65 years of age with incident HF. Data on HF and mortality were collected through annual examinations or contact during the 10-year follow-up period. Slower gait speed (<0.8m/s vs. ≥0.8m/s) and IADL impairment (≥1 vs. 0 areas of dependence) were determined from baseline and follow-up assessments. A total of 740 (66%) of the 1119 participants died during the follow-up period. Multivariate Cox proportional hazards models showed that impairments in either gait speed (hazard ratio 1.37, 95% CI 1.10-1.70; p=0.004) or IADL (HR 1.56, 95% CI 1.29-1.89; p<0.001), measured within 1 year before the diagnosis of incident HF, were independently associated with mortality, adjusting for socio-demographic and clinical characteristics. The combined presence of slower gait speed and IADL impairment was associated with a greater risk of mortality and suggested an additive relationship between gait speed and IADL. In conclusion, gait speed and IADL are important risk factors for mortality in adults ≥65 years of age with HF, but the combined impairments of both gait speed and IADL can have an especially important impact on mortality. PMID:25655868

[Forensic medical peculiarities of mechanical strangulation asphyxia in the hanged subjects aged above 50 years].

PubMed

Chertovskikh, A A; Tuchik, E S; Astashkina, O G

2014-01-01

This paper presents the qualitative and quantitative characteristics of the morphological manifestations of mechanical strangulation asphyxia in the hanged subjects aged 50 years and the elder ones. In addition, the new diagnostic approaches to the expert confirmation of this condition are proposed.

Aged over 50 years and practising: separation and changes in nursing practice among New Zealand's older Registered Nurses.

PubMed

North, Nicola; Leung, William; Lee, Rochelle

2014-12-01

To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. A cohort of all nurses aged ≥50 years on the register and practising in 2006 (n = 12,606) was tracked until 2011. After 5 years, a quarter (n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. © 2014 John Wiley & Sons Ltd.

AIDS in adults 50 years of age and over: characteristics, trends and spatial distribution of the risk1

PubMed Central

Nogueira, Jordana de Almeida; Silva, Antônia Oliveira; de Sá, Laísa Ribeiro; de Almeida, Sandra Aparecida; Monroe, Aline Aparecida; Villa, Tereza Cristina Scatena

2014-01-01

Objective to analyze the sociodemographic characteristics, epidemic trend and spatial distribution of the risk of AIDS in adults 50 years of age and over. Method population-based, ecological study, that used secondary data from the Notifiable Disease Information System (Sinan/AIDS) of Paraíba state from the period January 2000 to December 2010. Results during the study period, 307 cases of AIDS were reported among people 50 years of age or over. There was a predominance of males (205/66, 8%), mixed race, and low education levels. The municipalities with populations above 100 thousand inhabitants reported 58.5% of the cases. There was a progressive increase in cases among women; an increasing trend in the incidence (positive linear correlation); and an advance in the geographical spread of the disease, with expansion to the coastal region and to the interior of the state, reaching municipalities with populations below 30 thousand inhabitants. In some locations the risk of disease was 100 times greater than the relative risk for the state. Conclusion aging, with the feminization and interiorization of the epidemic in adults 50 years of age and over, confirms the need for the induction of affirmative policies targeted toward this age group. PMID:25029044

HIV transmission and high rates of late diagnoses among adults aged 50 years and over.

PubMed

Smith, Ruth D; Delpech, Valerie C; Brown, Alison E; Rice, Brian D

2010-08-24

Describe the epidemiology and impact of late diagnosis among older adults living with HIV and estimate age at infection. Comparative national analyses between individuals diagnosed when aged 50 years and over with individuals diagnosed prior to 50 years. Age at infection was estimated using CD4 cell count at diagnosis. A total of 8255 older adults accessed HIV care in England, Wales and Northern Ireland in 2007, a 3.5-fold increase compared to 2000; with one in 10 individuals newly diagnosed in 2007. When compared with younger adults at diagnosis, older adults were significantly more likely to be men (74 vs. 58%; P < 0.001), infected through sex between men (40 vs. 34%; P < 0.001) and of white ethnicity (60 vs. 38%; P < 0.001). Older heterosexual adults were more likely to be infected within the UK (16 vs. 12%; P < 0.001), with evidence of travel abroad among white heterosexual men. Almost half (48%) of older adults were late presenters vs. a third (33%) of younger adults. Older late presenters were 14 times more likely to die within a year of diagnosis compared with older adults who were not diagnosed late (14 vs. 1%; P < 0.001) and had 2.4 times the risk of dying than younger late presenters. We estimate that nearly half (48%) of older adults diagnosed between 2000 and 2007 acquired their infection at age 50 and over. Our study provides evidence of HIV transmission, high rates of late presentation and an increased risk of short-term mortality among older adults. These findings highlight the need for increased targeted prevention efforts and strategies to increase HIV testing among older adults at risk of HIV.

Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.

PubMed

Henshaw, Helen; Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-08-24

The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the "PC confidence index." The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group's PC and Internet use was 81.0% and 60.9%, respectively; the older group's PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly

Computer Skills and Internet Use in Adults Aged 50-74 Years: Influence of Hearing Difficulties

PubMed Central

Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A

2012-01-01

Background The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. Objective To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. Methods Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the “PC confidence index.” The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). Results The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group’s PC and Internet use was 81.0% and 60.9%, respectively; the older group’s PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing

Age-related decrements in bone mineral density in women over 65

NASA Technical Reports Server (NTRS)

Steiger, P.; Cummings, S. R.; Black, D. M.; Spencer, N. E.; Genant, H. K.

1992-01-01

Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cm2 was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in all regions except the spine, where the difference between the two age groups was 6%. Ward's triangle and the calcaneus exhibited the largest decrements, with 26 and 21%, respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from -0.82% at the femoral neck and trochanter to -1.30% at Ward's triangle. Correlations between the different regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and calcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.

Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial.

PubMed

González Blanco, Virginia; Pérula de Torres, Luis Ángel; Martín Rioboó, Enrique; Martínez Adell, Miguel Ángel; Parras Rejano, Juan Manuel; González Lama, Jesús; Ruiz Moruno, Javier; Martín Alvarez, Remedios; Fernández García, José Ángel; Ruiz de Castroviejo, Joaquin; Roldán Villalobos, Ana; Ruiz Moral, Roger

2017-01-06

The goal of this study was to assess the effectiveness of opportunistic screening through pulse palpation in the early detection of atrial fibrillation in subjects aged≥65 years versus detection through an active search for patients with symptoms and/or complications and sequelae associated. This was a cluster randomized controlled trial performed in 48 primary care centers of the Spanish National Healthcare System. A total of 368 physicians and nurses were randomized. The researchers in the experimental group (EG) performed opportunistic screening for auricular fibrillation, whereas the researchers in the control group (CG) actively searched for symptomatic patients. An ECG was performed on patients found to have an irregular heartbeat to confirm the diagnosis of auricular fibrillation. A total of 5,465 patients with a mean age of 75.61 years were recruited for the EG, and 1,525 patients with a mean age of 74.07 years were recruited for the CG. Of these, 58.6% were female, without significant differences between groups. Pulse was irregular in 4.3 and 15.0% of the patients in the EG and the CG, respectively (P<.001). A total of 164 new cases of atrial fibrillation were detected (2.3%), 1.1% in the EG and 6.7% in the CG (adjusted OR: 0.29; 95% CI 0.18-0.45). Case finding for atrial fibrillation in patients aged≥65 years with symptoms or signs suggestive of atrial fibrillation is a more effective strategy than opportunistic screening through pulse palpation in asymptomatic patients. The trial is registered in ClinicalTrials.gov (NCT01291953; February 8, 2011). Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

A systematic review and meta-analysis of exercise-based falls prevention strategies in adults aged 50+ years with visual impairment.

PubMed

Dillon, Lisa; Clemson, Lindy; Ramulu, Pradeep; Sherrington, Catherine; Keay, Lisa

2018-05-06

To determine the impact of exercise or physical training on falls or physical function in people aged 50+ years with visual impairment, compared with control (no intervention or usual care). An updated systematic review of randomised controlled trials, investigating the effect of exercise or physical activity on falls prevention or physical function in adults aged 50+ with visual impairment. Searches of CINAHL, the Cochrane Register of Controlled Trials (CENTRAL), Embase, and Medline were undertaken. Three trials were identified for the period February 2013 to July 2017 and added to the four in the original review. New trials evaluated yoga, the Otago Exercise Programme in combination with a home safety programme and the Alexander Technique. Meta-analysis of data from two trials (n = 163) indicated a non-statistically significant positive impact of exercise on the Chair Stand Test (WMD -1.85 s, 95% CI -4.65 to 0.96, p = 0.20, I 2 22%). In this update, two new trials measured falls so meta-analysis was possible for three trials (n = 539) and revealed no impact on falls (RR 1.05, 95% CI 0.73 to 1.50, p = 0.81, I 2 30%). Although exercise or physical training can improve physical function in older adults with visual impairment, and diverse strategies are being evaluated, there are no proven falls prevention strategies. In the few studies available, falls are not consistently reported and more work is required to investigate falls prevention in older adults with visual impairment. © 2018 The Authors Ophthalmic & Physiological Optics © 2018 The College of Optometrists.

Greater Short-Term Weight Loss in Women 20-45 versus 55-65 Years of Age Following Bariatric Surgery

PubMed Central

Ochner, Christopher N.; Teixeira, Julio; Geary, Nori; Asarian, Lori

2013-01-01

Background Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals and increased weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery. Methods 1,356 female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 y old (presumptively premenopausal; n = 1199) and 55-65 y old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t-tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 y post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients. Results 20-45 y-old women showed greater %EBWL 1 and 2 y post-surgery than 55-65 y-old women (p’s < 0.0005). No age effect was detected in 20-25 vs. 30-35, 30-35 vs. 40-45, or 20-25 vs. 40-45 y-old women (p’s > 0.2) This age effect was detected only after gastric banding, with 20-45 y-old women losing ~7 kg more than 55-65 y-old women after 2 y. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men. Conclusions Results indicate that 55-65 y-old women lose less weight than 20-45 y-old women in the initial 2 y after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake. PMID:23700235

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

PubMed

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

2017-03-01

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

Association of Physical Performance and Pain With Fear of Falling Among Community—Dwelling Japanese Women Aged 65 Years and Older

PubMed Central

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-01-01

Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906

Impact of post-remission therapy in patients aged 65-70 years with de novo acute myeloid leukemia: a comparison of two concomitant randomized ALFA trials with overlapping age inclusion criteria.

PubMed

Itzykson, Raphael; Gardin, Claude; Pautas, Cécile; Thomas, Xavier; Turlure, Pascal; Raffoux, Emmanuel; Terré, Christine; Fenaux, Pierre; Castaigne, Sylvie; Dombret, Hervé; Boissel, Nicolas

2011-06-01

There is no standard post-remission therapy in older patients with acute myeloid leukemia. From 1999 to 2006, the Acute Leukemia French Association group ran two concurrent randomized trials with overlapping inclusion criteria for patients aged 65 to 70 with acute myeloid leukemia, with different post-remission strategies: two intensive courses in the 9801 trial, one intensive course or six outpatient courses in the 9803 trial. We analyzed the outcome of these patients per protocol and per post-remission therapy. Two hundred and eleven patients aged 65 to 70 years with de novo acute myeloid leukemia were enrolled in trial 9801 (n=76) or 9803 (n=135). The patients in the two trials had comparable white blood cell counts (P=0.3), cytogenetics (P=0.49), and complete remission rates (70% and 57%, respectively; P=0.17). Overall survival was identical in both trials (32% and 34% at 2 years, respectively; P=0.71). Overall survival after complete remission was identical in the 103 of 130 patients who received the planned post-remission courses (n=44 with two intensive courses, n=28 with one intensive course, n=31 with six outpatient courses; 41%, 55%, and 58% at 2 years, respectively; P=0.34). Even in patients with favorable or normal karyotype (n=97), overall survival from complete remission was not improved by more intensive post-remission therapy. In patients aged 65 to 70 years with de novo acute myeloid leukemia in complete remission after standard intensive induction chemotherapy, there is no apparent benefit from intensive post-remission therapy. (ClinicalTrials.gov Identifiers: NCT00931138 and NCT00363025).

Blood pressure at age 60-65 versus age 70-75 and vascular dementia: a population based observational study.

PubMed

Peng, Mingkai; Chen, Guanmin; Tang, Karen L; Quan, Hude; Smith, Eric E; Faris, Peter; Hachinski, Vladimir; Campbell, Norm R C

2017-10-27

Vascular dementia (VaD) is the second most common form of dementia. However, there were mixed evidences about the association between blood pressure (BP) and risk of VaD in midlife and late life and limited evidence on the association between pulse pressure and VaD. This is a population-based observational study. 265,897 individuals with at least one BP measurement between the ages of 60 to 65 years and 211,116 individuals with at least one BP measurement between the ages of 70 to 75 years were extracted from The Health Improvement Network in United Kingdom. Blood pressures were categorized into four groups: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Cases of VaD were identified from the recorded clinical diagnoses. Multivariable survival analysis was used to adjust other confounders and competing risk of death. All the analysis were stratified based on antihypertensive drug use status. Multiple imputation was used to fill in missing values. After accounting for the competing risk of death and adjustment for potential confounders, there was an association between higher BP levels in the age 60-65 cohort with the risk of developing VaD (hazard ratio [HR] 1.53 (95% confidence interval: 1.04, 2.25) for prehypertension, 1.90 (1.30, 2.78) for stage 1 hypertension, and 2.19 (1.48, 3.26) for stage 2 hypertension) in the untreated group. There was no statistically significant association between BP levels and VaD in the treated group in the age 60-65 cohort and age 70-75 cohort. Analysis on Pulse Pressure (PP) stratified by blood pressure level showed that PP was not independently associated with VaD. High BP between the ages of 60 to 65 years is a significant risk for VaD in late midlife. Greater efforts should be placed on early diagnosis of hypertension and tight control of BP for hypertensive patients for the prevention of VaD.

[Xp11.2 translocation renal carcinoma in adults over 50 years of age: about four cases].

PubMed

Arnoux, V; Long, J-A; Fiard, G; Pasquier, D; Bensaadi, L; Terrier, N; Rambeaud, J-J; Descotes, J-L

2012-11-01

To describe demographic, therapeutic and follow-up data of four cases of renal cell carcinoma with Xp11.2 translocation in adults older than 50 years of age. Between January 2008 and December 2011, 170 patients underwent surgery for renal cell carcinoma in our center. Systematic histopathologic analysis of specimen removed was performed. Complementary immunohistochemical analysis was performed only in cases with uncertain diagnosis or in patients younger than 40 years of age. Among these 170 patients with a median age of 59years old (21-89), immunohistochemistry helped find a TFE3 translocation in four cases (2.4%). There were three women and one man of 53, 71, 75 and 86years old respectively. One patient was metastatic at diagnosis. Radical nephrectomy was first performed in all cases. TNM staging was T3aN2R0, T3bN0R0, T2N2R0 and T3aN2R2, with a Furhman grade of 4. Two patients progressed with metastasis 5 and 7months after surgery, and two with lymphatic invasion 2 and 9months after nephrectomy. One patient died during follow-up. Xp11.2 translocation renal cell carcinoma was uncommon after 50years of age in our series, but probably under estimated. It seemed to be associated with a poor prognosis. Larger studies must be performed to optimize its specific treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

[MESGI50 study: description of a cohort on Maturity and Satisfactory Ageing].

PubMed

Corominas Barnadas, Josep María; López-Pousa, Secundino; Vilalta-Franch, Joan; Calvó-Perxas, Laia; Juvinyà Canal, Dolors; Garre-Olmo, Josep

To describe the demographic, health and socio-economic characteristics of the participants in the Study on Maturity and Satisfactory Ageing in Girona (MESGI50 study). Population-based Study linked to the Survey of Health, Ageing, and Retirement in Europe (SHARE). The reference population was the inhabitants of the province of Girona (Spain) aged 50 and over. A probabilistic two-stage stratified cluster sampling according to the number of inhabitants and the degree of ageing of the population was used. Twenty-eight municipalities were randomly selected according to their type (demographically aged or young), and then stratified by the population size. The response rate was 65% with a mean of 1.7 eligible individuals per household and a final sample of 2,065 households and 3,331 participants. The design effect was 1.27. 52.9% were women and the mean age was 66.9 years (SD=11.5). The self-rated health status, hand grip strength, restriction in daily life activities and depressive symptomatology increased with age and more markedly in women. There were differences in alcohol consumption and eating patterns depending on the area of residence. The demographic, health and socio-economic characteristics during the ageing process differ depending on age group, gender, and area of residence. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Chronic periodontitis among diabetics and nondiabetics aged 35-65 years, in a rural block in Vellore, Tamil Nadu: A cross-sectional study.

PubMed

Nand, Khushboo Yamima; Oommen, Anu Mary; Chacko, Rabin Kurudamannil; Abraham, Vinod Joseph

2017-01-01

Chronic periodontitis is a common cause of poor oral health globally. Those at higher risk of this preventable and easily treatable condition need to be identified so that efforts can be taken to decrease disease burden and subsequent consequences. The aims of the study were (1) To compare the prevalence of chronic periodontitis among individuals with and without type 2 diabetes, aged 35-65 years from a rural block in Vellore, Tamil Nadu and (2) to assess risk factors for chronic periodontitis among individuals with diabetes. A cross-sectional study was done in nine villages of Kaniyambadi block, Vellore, between October 2015 and July 2016 among participants aged 35-65 years of a previous cross-sectional survey which had identified individuals with and without type 2 diabetes. Chronic periodontitis was assessed using the Community Periodontal Index and Treatment Needs index. Oral hygiene was assessed clinically using the Simplified Oral Hygiene Index. Diabetes was defined as on medication for type 2 diabetes or detected to have fasting blood glucose ≥126 mg/dl (in a previous survey). Chi-square test and odds ratios (adjusted using logistic regression) were used to study risk factors for periodontitis among those with diabetes. Prevalence of chronic periodontitis was 45.9% (95% confidence interval [CI]: 40.88%-50.9%) among 98 individuals with diabetes and 35.6% (95% CI: 30.91-40.29%) among 104 individuals without diabetes. Poor oral hygiene (odds ratio: 8.33, 95% CI: 3.33-25.00), low socioeconomic status (odds ratio: 3.19, 95% CI: 1.00-10.12), and smoking (odds ratio: 3.51, 95% CI: 1.17-10.51) were associated with periodontitis among diabetics. Individuals with type 2 diabetes have a higher prevalence of periodontitis. As poor oral hygiene is a strong risk factor for periodontitis, there is a need for targeted education regarding dental hygiene to reduce this preventable condition.

Age at Menarche: 50-Year Socioeconomic Trends Among US-Born Black and White Women

PubMed Central

Kiang, Mathew V.; Kosheleva, Anna; Waterman, Pamela D.; Chen, Jarvis T.; Beckfield, Jason

2015-01-01

Objectives. We investigated 50-year US trends in age at menarche by socioeconomic position (SEP) and race/ethnicity because data are scant and contradictory. Methods. We analyzed data by income and education for US-born non-Hispanic Black and White women aged 25 to 74 years in the National Health Examination Survey (NHES) I (1959–1962), National Health Examination and Nutrition Surveys (NHANES) I–III (1971–1994), and NHANES 1999–2008. Results. In NHES I, average age at menarche among White women in the 20th (lowest) versus 80th (highest) income percentiles was 0.26 years higher (95% confidence interval [CI] = −0.09, 0.61), but by NHANES 2005–2008 it had reversed and was −0.33 years lower (95% CI = −0.54, −0.11); no socioeconomic gradients occurred among Black women. The proportion with onset at younger than 11 years increased only among women with low SEP, among Blacks and Whites (P for trend < .05), and high rates of change occurred solely among Black women (all SEP strata) and low-income White women who underwent menarche before 1960. Conclusions. Trends in US age at menarche vary by SEP and race/ethnicity in ways that pose challenges to several leading clinical, public health, and social explanations for early age at menarche and that underscore why analyses must jointly include data on race/ethnicity and socioeconomic position. Future research is needed to explain these trends. PMID:25033121

Comprehension of a Colon Cancer Pamphlet among American Adults at Least 50 Years of Age

ERIC Educational Resources Information Center

Liu, Chiung-ju

2010-01-01

Objective: The purpose of this study was to identify determinants of comprehension of an educational pamphlet on colon cancer, by adults at least 50 years of age living in the United States. Design: Data were analysed from the "2003 National Assessment of Adult Literacy" survey. The survey was designed to assess functional English…

Gender differences in association between psychological distress and detailed living arrangements among Japanese older adults, aged 65-74 years.

PubMed

Kikuchi, Hiroyuki; Takamiya, Tomoko; Odagiri, Yuko; Ohya, Yumiko; Nakaya, Tomoki; Shimomitsu, Teruichi; Inoue, Shigeru

2014-05-01

Past studies have shown that living alone is detrimental to older adults' mental health. However, there has been little focus on how older adults' psychological distress differed by more detailed living arrangement, as well as by gender. The present study investigates various living arrangements in association with psychological distress among older men and women. Data from community-dwelling Japanese older adults were collected through a mail survey (n = 1,807, aged 65-74 years, 51.5 % men). Psychological distress level was measured using Kessler's six-item psychological distress scale. Living arrangements were categorized into four groups; "living with spouse only", "living with spouse and other family", "living with other family without spouse" or "living alone". Multiple logistic regression analyses were used to examine the associations of living arrangements with psychological distress level. Older adults living alone were observed to have higher psychological distress. In addition, gender-stratified analyses showed that higher distress levels were observed among older men living with family, but without a spouse (OR: 2.85, 95 % CI: 1.51-5.39). In contrast, higher distress was observed among older women living with spouse and other family (OR: 1.53, 95 % CI: 1.03-2.28). Psychological distress in older Japanese adults was associated with living arrangements, but such associations differed by gender. The association of living with a spouse on older men's mental health was striking, while living with any family was found to be rather important for older women, aged 65-74 years.

The gender- and age-specific 10-year and lifetime absolute fracture risk in Tromsø, Norway.

PubMed

Ahmed, Luai A; Schirmer, Henrik; Bjørnerem, Ashild; Emaus, Nina; Jørgensen, Lone; Størmer, Jan; Joakimsen, Ragnar M

2009-01-01

Aim of this study is to estimate the gender- and age-specific 10-year and lifetime absolute risks of non-vertebral and osteoporotic (included hip, distal forearm and proximal humerus) fractures in a large cohort of men and women. This is a population-based 10 years follow-up study of 26,891 subjects aged 25 years and older in Tromsø, Norway. All non-vertebral fractures were registered from 1995 throughout 2004 by computerized search in radiographic archives. Absolute risks were estimated by life-table method taking into account the competing risk of death. The absolute fracture risk at each year of age was estimated for the next 10 years (10-year risk) or up to the age of 90 years (lifetime risk). The estimated 10-year absolute risk of all non-vertebral fracture was higher in men than women before but not after the age of 45 years. The 10-year absolute risk for non-vertebral and osteoporotic fractures was over 10%, respectively, in men over 65 and 70 years and in women over 45 and 50 years of age. The 10-year absolute risks of hip fractures at the age of 65 and 80 years were 4.2 and 18.6% in men, and 9.0 and 24.0% in women, respectively. The risk estimates for distal forearm and proximal humerus fractures were under 5% in men and 13% in women. The estimated lifetime risks for all fracture locations were higher in women than men at all ages. At the age of 50 years, the risks were 38.1 and 24.8% in men and 67.4 and 55.0% in women for all non-vertebral and osteoporotic fractures, respectively. The estimated gender- and age-specific 10-year and lifetime absolute fracture risk were higher in Tromsø than in other populations. The high lifetime fracture risk reflects the increased burden of fractures in this cohort.

Adverse events after tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine administered to adults 65 years of age and older reported to the Vaccine Adverse Event Reporting System (VAERS), 2005-2010.

PubMed

Moro, Pedro L; Yue, Xin; Lewis, Paige; Haber, Penina; Broder, Karen

2011-11-21

Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was not licensed for use in adults aged ≥65 years due to lack of sufficient efficacy and safety data. To characterize reports to the Vaccine Adverse Event Reporting System (VAERS) among adults aged ≥65 years who received Tdap vaccine 'off-label' to assess for potential vaccine safety concerns. We searched VAERS for US reports of adverse events (AEs) in subjects aged ≥65 years who received Tdap vaccine from 9/1/2005 to 9/08/2010. Medical records were requested for all reports coded as serious (death, hospitalization, prolonged hospitalization, permanent disability, life-threatening-illness). Proportional reporting ratio (PRR) was used to assess for higher proportionate reporting for AEs after Tdap compared with Td reports in subjects aged ≥65 years. VAERS received 243 reports following Tdap administered to persons aged ≥65 years. Eleven (4.5%) reports were serious, including two deaths. Most common AEs were local reactions in 100 (41.2%) reports. Seventy-eight (32.1%) reports contained coding terms that denoted inappropriate administration of vaccine. 'Cough' was the only term associated with disproportionately higher reporting after Tdap compared with Td. Six of seven Tdap reports containing the term 'Cough' were non-serious. Clinical review of serious reports identified no unusual patterns of AEs. Our VAERS review of the 'off-label' use of Tdap vaccine in adults ≥65 years did not find any safety concerns that warrant further study. These data will provide useful baseline information to assist CDC and FDA with monitoring efforts as permissive recommendations for Tdap in older persons are adopted. Published by Elsevier Ltd.

The High-risk Groups According to the Trends and Characteristics of Fatal Occupational Injuries in Korean Workers Aged 50 Years and Above.

PubMed

Yi, Kwan Hyung

2018-06-01

Due to an increasing number of workers aged 50 years and above, the number of those employed is also on the rise, and those workers aged 50 and over has exceeded 50% of the total fatal occupational injuries. Therefore, it is necessary to implement the selection and concentration by identifying the characteristics of high-risk groups necessary for an effective prevention against and reduction of fatal occupational injuries. This study analyzed the characteristics of high-risk groups and the occupational injury fatality rate per 10,000 workers among the workers aged 50 and over through a multi-dimensional analysis by sex, employment status of workers, industry and occupation by targeting 4,079 persons who died in fatal occupational injuries from January 2007 to December 12. The share of the workers aged 50 years and above is increasing every year in the total fatal occupational injuries occurrence, and the high-risk groups include 'male workers' by sex, 'daily workers' by worker's status, 'craft and related-trades workers' by occupation, and 'mining' by industry. The most frequent causal objects of fatal occupational injuries of the workers aged 50 years and above are found out to be 'installment and dismantlement of temporary equipment and material on work platforms including scaffold' in the construction industry and 'mobile crane, conveyor belt and fork lifts' in the manufacturing industry.

The effectiveness of shingles vaccine among Albertans aged 50 years or older: A retrospective cohort study.

PubMed

McDonald, Bruce M; Dover, Douglas C; Simmonds, Kimberley A; Bell, Christopher A; Svenson, Lawrence W; Russell, Margaret L

2017-12-15

We assessed the effectiveness of shingles vaccine in preventing incident shingles among Alberta residents aged 50 years or older over the period 2009 - 2015, using administrative health data. The cohort comprised of Albertans from the Alberta Health Care Insurance Plan Registry (AHCIP) as of June 30, 2009 and aged 50 years or older. Those who received shingles vaccine were identified from the provincial pharmaceutical information network. The occurrence of incident shingles was identified through both inpatient and outpatients/community care data. Incident shingles was defined as the earliest dated record of ICD 9-CM 053 or ICD-10-CA B02. Starting on November 1, 2009, individuals with no history of shingles or shingles vaccination were followed until Nov 1, 2015 (6 years), or until shingles incidence, death, or AHCIP cancellation (including leaving Alberta). Vaccine effectiveness (VE) was estimated as the inverse of the relative risk of developing incident shingles in each year following vaccination compared to time at risk without vaccination, while adjusting for age, sex, income quintile, and immune compromising conditions (identified from physician claims, inpatient, and cancer registry data). There were 1,094,236 individuals in the cohort, with 85,439 (7.80%) vaccinated individuals. The shingles incidence rate was 9.03 [95% CI: 8.95, 9.11] cases per 1,000 person years (49,243 cases). Adjusted VE in the first year following immunization was 50.02% [95% CI: 44.71%, 54.83%] against incident shingles, decreasing to no effect by the fifth year (VE = 14.00% [95% CI: -20.99%, 38.88%]). Our findings are consistent with observations from other population based studies and provide population level data for policy-makers to review when making decisions related to public funding of shingles vaccine. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impact of post-remission therapy in patients aged 65–70 years with de novo acute myeloid leukemia: a comparison of two concomitant randomized ALFA trials with overlapping age inclusion criteria

PubMed Central

Itzykson, Raphael; Gardin, Claude; Pautas, Cécile; Thomas, Xavier; Turlure, Pascal; Raffoux, Emmanuel; Terré, Christine; Fenaux, Pierre; Castaigne, Sylvie; Dombret, Hervé; Boissel, Nicolas

2011-01-01

Background There is no standard post-remission therapy in older patients with acute myeloid leukemia. Design and Methods From 1999 to 2006, the Acute Leukemia French Association group ran two concurrent randomized trials with overlapping inclusion criteria for patients aged 65 to 70 with acute myeloid leukemia, with different post-remission strategies: two intensive courses in the 9801 trial, one intensive course or six outpatient courses in the 9803 trial. We analyzed the outcome of these patients per protocol and per post-remission therapy. Results Two hundred and eleven patients aged 65 to 70 years with de novo acute myeloid leukemia were enrolled in trial 9801 (n=76) or 9803 (n=135). The patients in the two trials had comparable white blood cell counts (P=0.3), cytogenetics (P=0.49), and complete remission rates (70% and 57%, respectively; P=0.17). Overall survival was identical in both trials (32% and 34% at 2 years, respectively; P=0.71). Overall survival after complete remission was identical in the 103 of 130 patients who received the planned post-remission courses (n=44 with two intensive courses, n=28 with one intensive course, n=31 with six outpatient courses; 41%, 55%, and 58% at 2 years, respectively; P=0.34). Even in patients with favorable or normal karyotype (n=97), overall survival from complete remission was not improved by more intensive post-remission therapy. Conclusions In patients aged 65 to 70 years with de novo acute myeloid leukemia in complete remission after standard intensive induction chemotherapy, there is no apparent benefit from intensive post-remission therapy. (ClinicalTrials.gov Identifiers: NCT00931138 and NCT00363025) PMID:21459791

Motives of Dutch persons aged 50 years and older to accept vaccination: a qualitative study.

PubMed

Eilers, Renske; Krabbe, Paul F M; de Melker, Hester E

2015-05-16

Elderly in several European countries are currently being vaccinated against influenza and pneumococcal disease, and various reasons have been put forward to expand these programs. To successfully immunize the older adult population, however, it is crucial for the target group to accept such interventions. This study aims to elucidate the motives of Dutch persons aged ≥ 50 years for accepting vaccination. Thirteen focus groups were composed with persons aged 50 years and older. A semi-structured topic list with open-ended questions was used to guide the focus groups. The transcripts were analyzed according the principles of thematic survey. By an inductive process, the main themes and related subthemes were extracted from the responses. Eight themes were found to play an important role in accepting vaccination: healthy aging; usefulness of vaccination in older age; risk of getting an infectious disease; vaccine characteristics; severity of the disease and its implications; the experiences of previous vaccinations; the influence of healthcare workers and other people; and the need for information. This qualitative study reveals that acceptance of vaccination is not based on a single argument. The most important one appears to be the risk of getting an infectious disease. In that light, vaccination campaigns may emphasize the susceptibility of older adults. It is also advisable to consider the usefulness of vaccination in older age as an overall argument. A tailored approach to offering vaccination may be considered. Further research would be needed to determine the relative importance of the factors identified in this study.

[Old and offline? : Findings on the use of the Internet by people aged 65 years and older in Switzerland].

PubMed

Seifert, Alexander; Schelling, Hans Rudolf

2016-10-01

The supply of information and communication is becoming continuously more focused on the Internet. While the age groups up to 64 years have shown a vast increase in the use of the Internet since 1997, intensive use of the Internet by age groups above 64 years lags behind and this is not only the case in Switzerland. Against this background and an interest in finding out more about Internet (non)use of older people, two representative surveys were conducted in Switzerland, one in 2009 and another one in 2014. The data used were acquired throughout Switzerland via a standardized telephone survey. The random sample (2014) consisted of 1037 people aged between 65 and 100 years old. Although the digital divide between the age groups has lessened over the past years, only 55.7 % of the elderly people interviewed were using the Internet in the autumn of 2014. Internet usage differs greatly between age groups. Resources such as education, income and health positively impact actual use of the Internet. Additionally, recommendations from a person's social environment, as well as an affinity for technology and a personal benefit assessment have a positive impact on Internet usage. In particular, security concerns and difficulties of use were mentioned as predominant reasons for the non-use of the Internet. Some of the people questioned felt excluded from society because they did not use the Internet. Internet usage among elderly people depends on individual and social resources, as well as on general attitude towards technology and personal benefit expectations. The exclusion of today's elderly "offliners" should be avoided, even if the digital divide will decrease in the future.

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

PubMed

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

2013-05-01

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

Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years.

PubMed

Jain, Ram B

2017-03-01

Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

Age differences in health care spending, fiscal year 1976.

PubMed

Gibson, R M; Mueller, M S; Fisher, C R

1977-08-01

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years

PubMed Central

Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

2015-01-01

Background: Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Methods: Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010–2011). Height and weight were measured at wave 4 (2008–2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Results: Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53–2.40) in those who were overweight, 8.86 (4.65–16.88) in those with class I obesity, 35.06 (18.30–67.16) in class II obese and 56.43 (27.72–114.87) in class III obese. Conclusions: Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public

Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years.

PubMed

Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

2015-05-01

Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010-2011). Height and weight were measured at wave 4 (2008-2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53-2.40) in those who were overweight, 8.86 (4.65-16.88) in those with class I obesity, 35.06 (18.30-67.16) in class II obese and 56.43 (27.72-114.87) in class III obese. Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public policy and highlight the need for effective interventions

Urinary incontinence, depression, and economic outcomes in a cohort of women between the ages of 54 and 65 years.

PubMed

Hung, Kristin J; Awtrey, Christopher S; Tsai, Alexander C

2014-04-01

To estimate the association between urinary incontinence (UI) and probable depression, work disability, and workforce exit. The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about UI were added to the survey instrument, and at which time study participants were 54-65 years of age. Women were followed-up with biennial interviews until 2010-2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline sociodemographic and health status variables previously found to confound the association between UI and the outcomes of interest. At baseline, 727 participants (survey-weighted prevalence, 16.6%; 95% confidence interval [CI] 15.4-18.0) reported any UI, of which 212 (survey-weighted prevalence, 29.2%; 95% CI 25.4-33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6%; 95% CI 19.8-23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio, 1.43; 95% CI 1.27-1.62) and work disability (adjusted hazard ratio, 1.21; 95% CI 1.01-1.45), but not workforce exit (adjusted hazard ratio, 1.06; 95% CI 0.93-1.21). In a population-based cohort of women between ages 54 and 65 years, UI was associated with increased risks for probable depression and work disability. Improved diagnosis and management of UI may yield significant economic and psychosocial benefits.

Mild cognitive impairment due to alzheimer disease is less likely under the age of 65.

PubMed

Shin, Soojeong; Kim, Jong Hun; Cho, Jeong Hee; Kim, Gyu Sik; Choi, Sun-Ah; Lee, Jun Hong

2015-01-01

Patients with amnestic mild cognitive impairment (aMCI) are considered to have a high risk for Alzheimer dementia (AD). Even high positive predictive values, however, cannot be guaranteed even by tests with high sensitivity and specificity when disease prevalence is low. If we regard the clinical criteria for aMCI as a test for predicting aMCI due to AD, the positive predictive value of the criteria will be low by definition in young patients with aMCI (age below 65 years) because of the low prevalence of AD in this age group. To test this hypothesis, we compared CSF biomarkers for AD between young (age below 65 years) and old (age 65 years or older) age groups of normal cognition, aMCI, and AD of the Alzheimer's Disease Neuroimaging Initiative database. Using these biomarkers, we observed that the prevalence of aMCI due to AD differed significantly between the young and the old. For example, only 28.2% young aMCI, but 63.2% old aMCI, had abnormal CSF amyloid measures consistent with AD pathology. As posited, the presence of aMCI due to AD was lower in young aMCI than in old aMCI. Given that the likelihood of aMCI due to AD is reduced in younger subjects, more attention to and evaluation of alternative diagnoses need to be considered in this group.

Age-specific population frequencies of amyloidosis and neurodegeneration among cognitively normal people age 50-89 years: a cross-sectional study

PubMed Central

Jack, Clifford R.; Wiste, Heather J.; Weigand, Stephen D.; Rocca, Walter A.; Knopman, David S.; Mielke, Michelle M.; Lowe, Val J.; Senjem, Matthew L.; Gunter, Jeffrey L.; Preboske, Gregory M.; Pankratz, Vernon S.; Vemuri, Prashanthi; Petersen, Ronald C.

2015-01-01

Summary Background As treatment of pre-clinical Alzheimer's disease (AD) becomes a focus of therapeutic intervention, observational research studies should recognize the overlap between imaging abnormalities associated with typical aging vs those associated with AD. Our objective was to characterize how typical aging and pre-clinical AD blend together with advancing age in terms of neurodegeneration and b-amyloidosis. Methods We measured age-specific frequencies of amyloidosis and neurodegeneration in 985 cognitively normal subjects age 50 to 89 from a population-based study of cognitive aging. Potential participants were randomly selected from the Olmsted County, Minnesota population by age- and sex-stratification and invited to participate in cognitive evaluations and undergo multimodality imaging. To be eligible for inclusion, subjects must have been judged clinically to have no cognitive impairment and have undergone amyloid PET, FDG PET and MRI. Imaging studies were obtained from March 2006 to December 2013. Amyloid positive/negative status (A+/A−) was determined by amyloid PET using Pittsburgh Compound B. Neurodegeneration positive/negative status (N+/N−) was determined by an AD-signature FDG PET measure and/or hippocampal volume on MRI. We labeled subjects positive or negative for neurodegeneration (FDG PET or MRI) or amyloidosis by using cutpoints defined such that 90% of 75 clinically diagnosed AD dementia subjects were categorized as abnormal. APOE genotype was assessed using DNA extracted from blood. Every individual was assigned to one of four groups: A−N−, A+N−, A−N+, or A+N+. Age specific frequencies of the 4 A/N groups were determined cross-sectionally using multinomial regression models. Associations with APOE ε4 and sex effects were evaluated by including these covariates in the multinomial models. Findings The population frequency of A−N− was 100% (n=985) at age 50 and declined thereafter. The frequency of A+N− increased to a

Incidence and costs of herpes zoster and postherpetic neuralgia in German adults aged ≥50 years: A prospective study.

PubMed

Schmidt-Ott, Ruprecht; Schutter, Ulf; Simon, Jörg; Nautrup, Barbara Poulsen; von Krempelhuber, Alfred; Gopala, Kusuma; Anastassopoulou, Anastassia; Guignard, Adrienne; Curran, Desmond; Matthews, Sean; Espié, Emmanuelle

2018-05-01

Herpes zoster (HZ) mainly affects elderly people and immunocompromised individuals. HZ is usually characterized by a unilateral painful skin rash. Its most common complication, postherpetic neuralgia (PHN), may cause chronic debilitating pain. This study aimed to estimate the HZ incidence in individuals aged ≥50 years in Germany, the proportion of PHN and the economic burden. From 2010 to 2014, HZ patients were recruited when consulting physicians in physician networks covering about 157,000 persons aged ≥50 years. PHN was defined as "worst pain" rated ≥3 on the zoster brief pain inventory persisting or appearing over 90 days after rash onset. Costs were calculated based on medical resource utilization and lost working time. HZ incidence was estimated as 6.7/1000 person-years, increasing with age to 9.4/1000 in ≥80 year-olds. Among 513 HZ patients enrolled, the proportion of PHN was 11.9%, rising with age to 14.3% in HZ patients ≥80 years. Estimated total cost per HZ patient was €156 from the healthcare system perspective and €311 from the societal perspective. The study confirmed previous findings that HZ causes a substantial clinical and economic burden in older German adults. It also confirmed the age-related increasing risk of HZ and PHN. Copyright © 2018 GlaxoSmithKline Biologicals SA. Published by Elsevier Ltd.. All rights reserved.

United States national prevalence of electrocardiographic abnormalities in black and white middle-age (45- to 64-Year) and older (≥65-Year) adults (from the Reasons for Geographic and Racial Differences in Stroke Study).

PubMed

Prineas, Ronald J; Le, Anh; Soliman, Elsayed Z; Zhang, Zhu-Ming; Howard, Virginia J; Ostchega, Yechiam; Howard, George

2012-04-15

A United States national sample of 20,962 participants (57% women, 44% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study provided general population estimates for electrocardiographic (ECG) abnormalities among black and white men and women. The participants were recruited from 2003 to 2007 by random selection from a commercially available nationwide list, with oversampling of blacks and those from the stroke belt, with a cooperation rate of 49%. The measurement of risk factors and 12-lead electrocardiograms (centrally coded using Minnesota code criteria) showed 28% had ≥1 major ECG abnormality. The prevalence of abnormalities was greater (≥35%) for those ≥65 years old, with no differences between blacks and whites. However, among men <65 years, blacks had more major abnormalities than whites, most notably for atrial fibrillation, major Q waves, and left ventricular hypertrophy. Men generally had more ECG abnormalities than women. The most common ECG abnormalities were T-wave abnormalities. The average heart rate-corrected QT interval was longer in women than in men, similar in whites and blacks, and increased with age. However, the average heart rate was greater in women than in men and in blacks than in whites and decreased with age. The prevalence of ECG abnormalities was related to the presence of hypertension, diabetes, blood pressure, and age. In conclusion, black men and women in the United States have a significantly greater prevalence of ECG abnormalities than white men and women at age 45 to 64 years; however, these proportions, although larger, tended to equalize or reverse after age 65. Copyright © 2012 Elsevier Inc. All rights reserved.

Predictors of overweight and obesity among adults aged 50 years and above: Serbian national health survey.

PubMed

Grujić, Vera; Dragnić, Nataša; Mijatović-Jovanović, Vesna; Ukropina, Snežana; Harhaji, Sanja; Radić, Ivana; Kvrgić, Svetlana

2017-01-01

Obesity is a complex and multifactorial condition related to morbidity, mortality, poor quality of life and many other problems. The aim of the study was to determine the prevalence of overweight and obesity and factors associated with them (demographic, socioeconomic factors and lifestyle) in adults aged 50 years and above in Serbia. This cross-sectional study, representative for the population in Serbia, was carried out in one-year period, including 6,932 people aged 50 and over. Individuals were interviewed and anthropometrically examined. The association between overweight and obesity with demographic, socioeconomic and behavioral factors was analyzed using multivariate logistic regression. Age, level of education and smoking were significantly associated with overweight and obesity, regardless of gender. Marital status was significantly associated with obesity, regardless of gender and with overweight only in women. Breakfast consumption habit was significantly associated with obesity only in men. There was no significant association of overweight and obesity with the type of settlement, alcohol consumption and physical activity, regardless of gender. The results of our study indicate the need for more intensive implementation of measures affecting the factors which contribute to overweight and obesity. Emphasis should be put on the population-based policies and programs that support environmental changes.

Cross-sectional and longitudinal factors influencing physical activity of 65 to 75-year-olds: a pan European cohort study based on the survey of health, ageing and retirement in Europe (SHARE).

PubMed

Lübs, Lena; Peplies, Jenny; Drell, Carina; Bammann, Karin

2018-04-16

The promotion of physical activity (PA) plays a major role for healthy ageing even in older age. There is a lack of cross-sectional and longitudinal studies explicitly dealing with barriers and drivers to PA in older adults. Therefore the aims of this study are a) to determine the prevalence of insufficient physical activity (IPA) in 65 to 75-year-olds in Europe and to identify factors associated with IPA in cross-section and b) to identify longitudinal risk factors for IPA in prior active persons. This study is using data of the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a cross-national panel database including individual data of the non-institutionalised population aged 50+ from 27 European countries. For the present paper, we included a cohort that participated in all first four waves of SHARE (2004-2011) aged 65-to-75-years at wave four (male n = 1761, female n = 2085) from 10 European countries. To identify cross-sectional and longitudinal associations, we calculated prevalence odds ratios and hazard ratios with 95% confidence intervals. The prevalence of IPA in 65-75-year-olds varied widely between countries, ranging from 55.4% to 83.3% in women and from 46.6% to 73.7% in men. IPA was associated with several intrapersonal factors and strength of association was similar for men and women for almost all investigated factors. Statistically significant associated with IPA were socioeconomic factors as low educational level (own and parental) and financial difficulties (male: POR: 1.60: 95%-CI: 1.26-2.03; female: POR: 1.58; 95%-CI: 1.26-1.97) and health-related factors as e.g. number of chronic diseases (male: POR: 1.34: 95%-CI: 1.23-1.45; female: POR: 1.31; 95%-CI: 1.21-1.42). Interpersonal only the size of social network was associated with IPA (male and female: POR: 0.88, 95%-CI: 0.81-0.95). Longitudinally in a fully adjusted model, only grip strength (HR: 0.99; CI-95%: 0.98-0.99) and BMI (HR: 1.02; CI-95%: 1.00-1.04) were

Effect of early and current Helicobacter pylori infection on the risk of anaemia in 6.5-year-old Ethiopian children.

PubMed

Taye, Bineyam; Enquselassie, Fikre; Tsegaye, Aster; Amberbir, Alemayehu; Medhin, Girmay; Fogarty, Andrew; Robinson, Karen; Davey, Gail

2015-07-14

Epidemiological and clinical studies in high income countries have suggested that Helicobacter pylori (H. pylori) may cause anaemia, but evidence is lacking from low income countries.We examined associations between H. pylori infection in early childhood and anaemia at the age of 6.5 years in an Ethiopian birth cohort. In 2011/12, 856 children (85.1 % of the 1006 original singletons in a population-based birth cohort) were followed up at age six and half. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Haemoglobin level and red cell indices were examined using an automated haematological analyzer (Cell Dyn 1800, Abbott, USA), and stool samples analyzed for H. pylori antigen. The independent effects of H. pylori infection (measured at age 3.5 and 6.5 years) on anaemia, haemoglobin level, and red cell indices (measured at age 6.5 years) were determined using multiple logistic and linear regression. The prevalence of anemia was 34.8 % (257/739), and the mean (SD) haemoglobin concentration was 11.8 (1.1) gm/dl. Current H. pylori infection at age 6.5 years was positively, though not significantly related to prevalence of anaemia (adjusted OR, 95 % CI, 1.15; 0.69, 1.93, p = 0.59). Any H. pylori infection up to age 6.5 years was significantly associated with an increased risk of anaemia at age 6.5 (adjusted OR, 95 % CI, 1.68; 1.22, 2.32, p = 0.01). A significant reduction in haemoglobin concentration and red cell indices was also observed among children who had any H. pylori infection up to age 6.5 (Hb adjusted β = -0.19, 95 % CI, -0.35 to -0.03, p = 0.01; MCV adjusted β = -2.22, 95 % CI, -3.43 to -1.01, p = 0.01; MCH adjusted β = -0.63, 95 % CI, -1.15 to - 0.12, p = 0.01; and MCHC adjusted β = -0.67, 95 % CI, -1.21 to -0.14, p = 0.01), respectively. This study provides further evidence from a low income country that any H. pylori infection up to age 6.5 is associated with higher prevalence

Physical performance and daily walking duration: associations in 1271 women and men aged 65-90 years.

PubMed

Rapp, Kilian; Klenk, Jochen; Benzinger, Petra; Franke, Sebastian; Denkinger, Michael D; Peter, Richard

2012-10-01

Several tests of physical performance like gait speed or standing balance are part of the geriatric assessment. Measures of physical activity like daily walking duration are more difficult to assess but may be of higher relevance for daily requirements. It is therefore of interest to what extent physical performance measures are associated with physical activity. In a cohort study, baseline screening was performed in 1271 community-living people aged 65-90 years from Ulm, Germany. Average daily walking duration was assessed in all participants by accelerometers over a one-week period. Habitual gait speed, 5-Chair-Rise test, standing balance and handgrip strength served as measures of physical performance. The association between measures of physical performance and physical activity was calculated by linear regression analysis. The mean daily walking duration was 104.8 minutes in men and 103.0 minutes in women. A positive relationship between gait speed and walking duration was observed in men and women with low gait speed (≤0.8 m/s) but not in participants above this threshold. Standing balance and hand grip strength were positively and 5-Chair-Rise test inversely related with average daily walking duration. A relationship between hand grip strength and walking duration was only observed in women aged 75 years and more. Physical performance measures and objectively measured walking duration are related with each other but only a small percentage of the variance of daily walking duration was explained by physical performance measures. Therefore, factors other than physical performance seem to influence daily walking duration to a great extent.

Vaccination of adults 65 years of age and older with tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Boostrix(®)): results of two randomized trials.

PubMed

Weston, Wayde M; Friedland, Leonard R; Wu, Xiangfeng; Howe, Barbara

2012-02-21

Pertussis can cause significant morbidity in elderly patients, who can also transmit this disease to infants and young children. There is little data available on the use of acellular pertussis vaccines in recipients ≥65 years of age. Two studies examined the safety and immunogenicity of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine (Boostrix(®)) in healthy ≥65 year olds. In Study A subjects received single doses of Tdap and seasonal influenza vaccine either co-administered or given one month apart. In Study B subjects received either Tdap or tetanus-diphtheria (Td) vaccine. Antibodies were measured before and one month after vaccination. Reactogenicity and safety were actively assessed using diary cards. A total of 1104 subjects 65 years of age and older received a Tdap vaccination in the two studies. In study A, no differences in immune responses to Tdap or influenza vaccine were observed between co-administered or sequentially administered vaccines. In study B, Tdap was non-inferior to Td with respect to diphtheria and tetanus seroprotection, and anti-pertussis GMCs were non-inferior to those observed in infants following a 3-dose diphtheria, tetanus and acellular pertussis (DTaP) primary vaccination series, in whom efficacy against pertussis was demonstrated. Reports of adverse events were similar between Tdap and Td groups. Tdap was found to be immunogenic in subjects ≥65 years, with a safety profile comparable to US-licensed Td vaccine. Tdap and influenza vaccine may be co-administered without compromise of either the reactogenicity or immunogenicity profiles of the two vaccines. Copyright © 2012 Elsevier Ltd. All rights reserved.

Frequency and outcomes of painful physical symptoms in a naturalistic population with major depressive disorder: an analysis of pooled observational studies focusing on subjects aged 65 years and over.

PubMed

Brnabic, A; Raskin, J; Alev, L; Serap Monkul, E; Lowry, A

2012-12-01

To estimate the frequency of painful physical symptoms (PPS) in elderly subjects (≥ 65 years) with major depressive disorder (MDD) in real-world clinical conditions and to establish whether PPS are associated with poor depression outcomes, including more severe depression and worse health-related quality of life (HRQoL). Observational studies of MDD that included assessment of PPS and elderly subjects were screened. Measures of PPS were based on the Somatic Symptom Inventory (SSI) or Visual Analogue Scale (VAS). Data from a variety of depressive symptom severity and HRQoL scales were used. Analysis cohorts were based on age [aged ≥ 65 years (elderly) or < 65 years (younger)] and/or PPS status (presence or absence); five subsets were used to examine specific outcomes in matched elderly subjects. Data from seven studies (representing 26 countries) were collated. Of the 11,477 subjects, 14% were aged ≥ 65 years and 71% were classified as having PPS (PPS+). PPS were more frequent in elderly subjects (74% vs. 70% of younger subjects) and were positively associated with being female and Hispanic, and negatively associated with being East Asian in the elderly. The presence of PPS was associated with more severe clinical symptomatology and comparatively poorer HRQoL in elderly subjects. PPS, although frequent in younger MDD patients, were slightly more frequent in elderly MDD patients and associated with comparatively poorer clinical and functional outcomes. As elderly patients report somatic symptoms more readily than emotional symptoms, physicians should consider depression in addition to physical causes when PPS are present. © 2012 Blackwell Publishing Ltd.

Cardiovascular and other causes of death as a function of lifestyle habits in a quasi extinct middle-aged male population. A 50-year follow-up study.

PubMed

Menotti, Alessandro; Puddu, Paolo Emilio; Maiani, Giuseppe; Catasta, Giovina

2016-05-01

To relate major causes of death with lifestyle habits in an almost extinct male middle-aged population. A 40-59 aged male population of 1712 subjects was examined and followed-up for 50 years. Baseline smoking habits, working physical activity and dietary habits were related to 50 years mortality subdivided into 12 simple and 3 composite causes of death by Cox proportional hazard models. Duration of survival was related to the same characteristics by a multiple linear regression model. Death rate in 50 years was of 97.5%. Out of 12 simple groups of causes of death, 6 were related to smoking habits, 3 to physical activity and 4 to dietary habits. Among composite groups of causes of death, hazard ratios (and their 95% confidence limits) of never smokers versus smokers were 0.68 (0.57-0.81) for major cardiovascular diseases; 0.65 (0.52-0.81) for all cancers; and 0.72 (0.64-0.81) for all-cause deaths. Hazard ratios of vigorous physical activity at work versus sedentary physical activity were 0.63 (0.49-0.80) for major cardiovascular diseases; 1.01 (0.72-1.41) for all cancers; and 0.76 (0.64-0.90) for all-cause deaths. Hazard ratios of Mediterranean Diet versus non-Mediterranean Diet were 0.68 (0.54-0.86) for major cardiovascular diseases; 0.54 (0.40-0.73) for all cancers; and 0.67 (0.57-0.78) for all-cause deaths. Expectancy of life was 12 years longer for men with the 3 best behaviors than for those with the 3 worst behaviors. Some lifestyle habits are strongly related to lifetime mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Economic burden of informal care attributable to stroke among those aged 65 years or older in China.

PubMed

Joo, Heesoo; Liang, Di

2017-02-01

Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.

Work after age 65: A prospective study of Australian men and women.

PubMed

Majeed, Tazeen; Forder, Peta M; Tavener, Meredith; Vo, Kha; Byles, Julie

2017-06-01

This study describes hours in paid work for Australian men and women aged over 65, focusing on associations between work and education. Data were analysed separately for men and women, from baseline and first follow-up surveys of the 45 and Up Study. Generalised estimating equation models were used to identify associations between work, education and other factors over time. The odds of doing paid work increased with higher education level and decreased with time, age, poorer physical function and having health conditions (high blood pressure, diabetes, stroke and breast cancer). Un-partnered women were more likely to work in later life than partnered women. This study quantifies the importance of education and health factors in determining continued participation of Australian men and women in paid work in later life. These factors need to be considered for policies aiming to increase workforce participation beyond 65 years of age. © 2017 AJA Inc.

Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55-65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.

PubMed

Ribera, Josep-Maria; García, Olga; Gil, Cristina; Mercadal, Santiago; García-Cadenas, Irene; Montesinos, Pau; Barba, Pere; Vives, Susana; González-Campos, José; Tormo, Mar; Esteve, Jordi; López, Aurelio; Moreno, María José; Ribera, Jordi; Alonso, Natalia; Bermúdez, Arancha; Amigo, María Luz; Genescà, Eulàlia; García, Daniel; Vall-Llovera, Ferran; Bergua, Juan Miguel; Guàrdia, Ramon; Monteserín, María Carmen; Bernal, Teresa; Calbacho, María; Martínez, María Pilar; Feliu, Evarist

2018-05-01

The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients. The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07). Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians: 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, p = 0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], p = .003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], p = 0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI]: 2 [1.3, 3], p = .002). Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years. Copyright © 2018 Elsevier Ltd. All rights reserved.

The use of Zostavax in Spain: the economic case for vaccination of individuals aged 50 years and older.

PubMed

Lopez-Belmonte, Juan Luis; Cisterna, Ramón; Gil de Miguel, Angel; Guilmet, Caroline; Bianic, Florence; Uhart, Mathieu

2016-06-01

Background Population aging brings up a number of health issues, one of which is an increased incidence of herpes zoster (HZ) and its complication, post-herpetic neuralgia (PHN). Zostavax vaccine has recently become available to prevent HZ and PHN. This study evaluates the cost-effectiveness of vaccination against HZ in Spain considering a vaccination of the population aged 50 years and older and comparing this to the current situation where no vaccination is being administered. Methods An existing, validated, and published economic model was adapted to Spain using relevant local input parameters and costs from 2013. Results Vaccinating 30% of the Spanish population aged 50 years and older resulted in €16,577/QALY gained, €2025/HZ case avoided, and €5594/PHN case avoided under the third-party payer perspective. From a societal perspective, the ICERs increased by 6%, due to the higher price of the vaccine. The number needed to vaccinate to prevent one case was 20 for HZ, and 63 for PHN3. Sensitivity analyses showed that the model was most sensitive to the HZ and PHN epidemiological data, the health state utilities values, and vaccine price used. Conclusion Considering an acceptable range of cost-effectiveness of €30,000-€50,000 per QALY gained, vaccination of the 50+ population in Spain against HZ with a new vaccine, Zostavax, is cost-effective and makes good use of the valuable healthcare budget.

Age differences in health care spending, fiscal year 1977.

PubMed

Gibson, R M; Fisher, C R

1979-01-01

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

A study on cognitive status of 50 years and above aged non-demented women in a rural area of West Bengal.

PubMed

Saha, Sanjay Kumar; Sanyal, Debasish; Bhattacharyya, Agnihotri; Bhattacharyya, Ranjan; Barman, Neepamanjari; Mukherjee, Anindya

2010-11-01

The prevalence of ageing population is increasing not only in developed countries but also in developing world like India. Epidemiological reports about cognitive impairment or dementia in elderly people from developing countries are scarce. To study the cognitive status of women more than 50 years of age and to study the relationship of sociodemographic factors with cognitive status of the study subjects a descriptive epidemiological, community based cross-sectional survey was done involving 179 old women of 50 years and above in the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata. The data were analysed using Epi-info 6.04, software packages. The mean age of the sample was 64.0 +/- 7.6 years. In the total sample, 53 subjects (29.6%) were in 50-59 years, 83 (43.4%) in 60-69 years, 34 (19%) in 70-79 years and 9 (5%) in women who were more than 80 years old. The cognitive defect was found to be 42.4% in elderly women .The variables like age > 70 years, widowhood, low per capita income, economic dependence, non-support from children, not staying with own children and having no satisfaction with life, were found to be significantly associated with cognitive defect. On (stepwise) multiple regression analysis these factors together contributed to 37% of cognitive impairment among these women. Prevalence of cognitive defect of more than 40% in the elderly women of this study emphasises the need for more attention and more social security measures for this neglected group.

46 CFR 167.65-50 - Posting placards of lifesaving signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Posting placards of lifesaving signals. 167.65-50... signals. On all vessels to which this subpart applies there must be readily available to the deck officer of the watch a placard containing instructions for the use of the life saving signals set forth in...

46 CFR 167.65-50 - Posting placards of lifesaving signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Posting placards of lifesaving signals. 167.65-50... signals. On all vessels to which this subpart applies there must be readily available to the deck officer of the watch a placard containing instructions for the use of the life saving signals set forth in...

Cancer and Alcohol Consumption in People Aged 50 Years or More in Europe.

PubMed

Bosque-Prous, Marina; Mendieta-Paredes, Jenny; Bartroli, Montse; Brugal, M Teresa; Espelt, Albert

2018-05-01

To estimate the prevalence of hazardous drinking in individuals aged 50 and older who had or had had cancer in 17 European countries and Israel and to analyze the factors associated with their consumption. Cross-sectional study based on data from 2011 to 2013 SHARE surveys. A total of 69,509 individuals aged 50 or more from 17 European countries and Israel participated in the study. Prevalence of hazardous drinking in people with cancer was estimated (adapting the SHARE questionnaire to the AUDIT-C). To ascertain whether type of cancer or time since diagnosis were associated with hazardous drinking, Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR). Overall, 5.4% of participants reported having been diagnosed with cancer. Prevalence of hazardous drinking in people with cancer was 18% in women and 23% in men. After adjusting for various socioeconomic and health variables, no significant differences were observed between hazardous drinking and type of cancer [PR = 0.99 (95% confidence interval (95% CI) = 0.83-1.17) in people with alcohol-related cancers compared to non-alcohol related cancers] and time since diagnosis [PR = 1.01 (95% CI = 0.82-1.25) in people with a cancer diagnosed >5 years ago compared to those diagnosed ≤5 years ago]. Significant differences were found between hazardous drinking and smoking status and self-perceived health. In total, 20% of people diagnosed with cancer were hazardous drinkers, despite the known relationship between alcohol use and a worse prognosis of the disease and an increased likelihood of recurrence. Overall, 20% of people diagnosed with cancer were hazardous drinkers. There were no significant differences in the prevalence of hazardous drinking depending on the type of cancer (alcohol-related versus non-alcohol related cancers). Highest prevalence of hazardous drinking in people with cancer is found in smokers and people with good self-perceived health.

Risk factors and outcome of increased red blood cell transfusion in cardiac surgical patients aged 65 years and older.

PubMed

Isil, Canan Tulay; Yazici, Pinar; Bakir, Ihsan

2015-02-01

The use of blood products is not uncommon during cardiac surgery in elderly patients. We conducted this study to investigate the risk factors and adverse outcomes of increased red blood cell (RBC) transfusion in the patients aged ≥ 65 years undergoing cardiac surgery. During 1 year period, 288 patients (197 male/91 female) aged ≥ 65 years who underwent coronary and/or valvular surgery were retrospectively reviewed. Patients were stratified into groups on the basis of the number of transfusions received (< 4 and ≥ 4 U) which was classified as increased transfusion. Univariate analysis and multivariate logistic regression were used to identify risk factors for increased transfusion. The mean unit of RBC transfusion was 4.5 ± 3.1 and 55.9% (n = 161) of patients received ≥ 4 U RBC. The overall postoperative complication rate was 36% and significantly higher in those with ≥ 4 U) RBC transfusion (p < 0.01). Risk factors including age, EuroSCORE, and low body surface were significantly higher in patient with ≥ 4 U RBC transfusion. Besides, preoperative anemia, postoperative drainage volume, and fresh frozen plasma (FFP) transfusion during hospital stay were found to be significantly associated with increased transfusion requirements. No difference was observed in mortality (p = 0.13). These results suggest that improvement in blood transfusion policy in elderly patients undergoing cardiac surgery requires elimination of preoperative anemia, careful attention to surgical hemostasis, and FFP use. Georg Thieme Verlag KG Stuttgart · New York.

Lung transplantation for patients older than 65 years: is it a feasible option?

PubMed

Machuca, T N; Camargo, S M; Schio, S M; Lobato, V; Sanchez, L B; Perin, F; Felicetti, J C; Camargo, J J

2011-01-01

Advanced age has been a relative contraindication to lung transplantation. However, the exact age limit for this procedure has not yet been established. The aim of this work is to present our experience with this particular group. This retrospective review included medical charts of patients who underwent lung transplantation at our institution from January 2004 to February 2009: namely, 112 cadaveric lung transplants with 12 patients (10.7%) >65 years old. There were 9 male patients and the overall mean age was 68 years (range 66-72). The indications were pulmonary fibrosis in 8 and emphysema in 4 cases. Four patients had mild coronary artery disease and 4 systemic hypertension. All of the procedures were unilateral and only 2 required extracorporeal circulation. Only 5 patients received blood product transfusions intraoperatively; the mean ischemic time was 222 minutes. Four patients developed primary graft dysfunction, the mean requirement for mechanical ventilation was 30 hours, and the mean intensive care unit stay, 11 days. Postoperative complications were respiratory infections (n = 8), catheter-related infection (n = 1), atrial fibrillation (n = 2). The mean hospital stay was 28 days and the 1-year survival was 75%. Lung transplantation is a feasible option for well-selected patients with end-stage pulmonary disease who are >65 years old. Our study reinforces the modern trend for unilateral procedures in this situation. Copyright © 2011 Elsevier Inc. All rights reserved.

Phenolic compositions of 50 and 30 year sequences of Australian red wines: the impact of wine age.

PubMed

McRae, Jacqui M; Dambergs, Robert G; Kassara, Stella; Parker, Mango; Jeffery, David W; Herderich, Markus J; Smith, Paul A

2012-10-10

The phenolic composition of red wine impacts upon the color and mouthfeel and thus quality of the wine. Both of these characteristics differ depending on the age of a wine, with the purple of young wines changing to brick red and the puckering or aggressive astringency softening in older wines. This study investigated the color parameters, tannin concentrations and tannin composition of a 50 year series of Cabernet Sauvignon wines from a commercial label as well as 30 year series of Cabernet Sauvignon and Shiraz wines from a separate commercial label to assess the impact of wine age on phenolic composition and concentration. The wine color density in wines of 40 to 50 years old was around 5 AU compared with 16 AU of wine less than 12 months old, which correlated well with the concentration of non-bleachable pigments and pigmented polymers. Conversely, the anthocyanin concentrations in 10 year old wines were substantially lower than that of recently bottled wines (around 100 mg/L compared with 627 mg/L, respectively), adding further evidence that non-bleachable pigments including pigmented polymers play a much larger role in long-term wine color than anthocyanins. No age-related trend was observed for tannin concentration, indicating that the widely noted softer astringency of older red wines cannot necessarily be directly related to lower concentrations of soluble wine tannin and is potentially a consequence of changes in tannin structure. Wine tannins from older wines were generally larger than tannins from younger wines and showed structural changes consistent with oxidation.

Genetic Counselling, BRCA1/2 Status and Clinico-pathologic Characteristics of Patients with Ovarian Cancer before 50 Years of Age

PubMed Central

Cvelbar, Mirjam; Hocevar, Marko; Novakovic, Srdjan; Stegel, Vida; Perhavec, Andraz

2017-01-01

Abstract Background In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC) has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m) within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years. Patients and methods All clinical data have to be interpreted in the light of many changes happened in the field of EOC just in the last few years: new hystology stage classification (FIGO), new hystology types and differentiation grades classification, new therapeutic possibilities (PARP inhibitors available, also in Slovenia) and new guidelines for genetic counselling of EOC patients (National Comprehensive Cancer Network, NCCN), together with next-generation sequencing possibilities. Results Compliance rate at the invitation was 43.1%. In the group of 27 invited or previously tested patients with EOC diagnosed before the age of 45 years, five gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within the group was 18.5%. There were 4 gBRCA1 and 1 gBRCA2 mutations detected. In the extended group of 42 tested patients with EOC diagnosed before the age of 50 years, 14 gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within this extended, partially selected group was 33.3%. There were 11 gBRCA1 and 3 gBRCA2 mutations detected. Conclusions The rate of gBRCA1/2 mutation in tested unselected EOC patients under the age of 50 years was higher than 10%, namely 18.5%. Considering also a direct therapeuthic benefit of PARP inhibitors for BRCA positive patients, there is a double reason to offer genetic testing to

Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years.

PubMed

Jain, Ram B

2016-07-01

Using data from National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among adults aged 20-64 years (adults) and seniors aged ≥65 years (seniors). In addition, the contribution of other factors like gender, race/ethnicity, smoking, and exposure to secondhand smoke at home in explaining variability in BLL was also evaluated by fitting regression models with log10 transformed values of BLL as dependent variables. BLL decreased over 2003-2012 (p < 0.01). Irrespective of gender, race/ethnicity, and smoking status, seniors were found to have higher BLL than adults. Based on the magnitude of differences between the 5th and 95th percentiles, variability in the levels of blood lead was found to be substantially higher among seniors than among adults. Males had statistically significantly higher adjusted BLL than females (2.32 vs. 1.76 μg/dL for seniors, p < 0.01 and 1.66 vs. 1.13 μg/dL for adults, p < 0.01). Non-Hispanic whites had statistically significantly lower adjusted BLL than non-Hispanic blacks (1.99 vs. 2.42 μg/dL for seniors, p < 0.01 and 1.22 vs. 1.42 μg/dL for adults, p < 0.01). When compared with non-smokers, smokers had statistically significantly higher BLL (2.19 vs. 1.86 μg/dL for seniors, p < 0.01 and 1.54 vs. 1.22 μg/dL for adults, p < 0.01). Non-obese had statistically significantly higher BLL than obese individuals (2.11 vs. 1.93 μg/dL for seniors, p < 0.01 and 1.48 vs. 1.27 μg/dL for adults, p < 0.01). Exposure to secondhand smoke at home (SHS) was associated with statistically significantly higher BLL than when there was no exposure to SHS (β = 0.0683, p = 0.03 for seniors; β = 0.034, p = 0.034, p < 0.01 for adults).

Immune Responses to a Recombinant Glycoprotein E Herpes Zoster Vaccine in Adults Aged 50 Years or Older

PubMed Central

Cunningham, Anthony L; Heineman, Thomas C; Lal, Himal; Godeaux, Olivier; Chlibek, Roman; Hwang, Shinn-Jang; McElhaney, Janet E; Vesikari, Timo; Andrews, Charles; Choi, Won Suk; Esen, Meral; Ikematsu, Hideyuki; Choma, Martina Kovac; Pauksens, Karlis; Ravault, Stéphanie; Salaun, Bruno; Schwarz, Tino F; Smetana, Jan; Abeele, Carline Vanden; Van den Steen, Peter; Vastiau, Ilse; Weckx, Lily Yin; Levin, Myron J

2018-01-01

Abstract Background The herpes zoster subunit vaccine (HZ/su), consisting of varicella-zoster virus glycoprotein E (gE) and AS01B Adjuvant System, was highly efficacious in preventing herpes zoster in the ZOE-50 and ZOE-70 trials. We present immunogenicity results from those trials. Methods Participants (ZOE-50: ≥50; ZOE-70: ≥70 years of age) received 2 doses of HZ/su or placebo, 2 months apart. Serum anti-gE antibodies and CD4 T cells expressing ≥2 of 4 activation markers assessed (CD42+) after stimulation with gE-peptides were measured in subcohorts for humoral (n = 3293) and cell-mediated (n = 466) immunogenicity. Results After vaccination, 97.8% of HZ/su and 2.0% of placebo recipients showed a humoral response. Geometric mean anti-gE antibody concentrations increased 39.1-fold and 8.3-fold over baseline in HZ/su recipients at 1 and 36 months post-dose 2, respectively. A gE-specific CD42+ T-cell response was shown in 93.3% of HZ/su and 0% of placebo recipients. Median CD42+ T-cell frequencies increased 24.6-fold (1 month) and 7.9-fold (36 months) over baseline in HZ/su recipients and remained ≥5.6-fold above baseline in all age groups at 36 months. The proportion of CD4 T cells expressing all 4 activation markers increased over time in all age groups. Conclusions Most HZ/su recipients developed robust immune responses persisting for 3 years following vaccination. Clinical Trials Registration NCT01165177; NCT01165229. PMID:29529222

[Pharmaco-economic aspects of vaccination against invasive pneumococcal infections in persons over 65 years of age; review of the literature on cost effectiveness analysis].

PubMed

Postma, M J; Heijnen, M L A; Beutels, Ph; Jager, J C

2002-05-04

To assess the cost-effectiveness of vaccination to prevent invasive pneumococcal disease in the elderly. Review of the literature. Articles in Dutch or English reporting studies into the cost-effectiveness of vaccination for the prevention of invasive pneumococcal infection in persons over 65 years of age were retrieved from Medline (1980-2000; search terms: 'pneumococcal' and 'vaccine' in combination with 'costs' or 'economics') and on the basis of the reference lists in the articles found. The following aspects of the selected studies were assessed: the net costs per year of life gained, the incidence of invasive pneumococcal disease in the elderly, the mortality due to invasive pneumococcal infections, the effectiveness of the vaccine in the prevention of invasive pneumococcal infections, and the costs of the vaccine and its administration. Attention was also given to specific age categories and to the effects of varying certain crucial assumptions. We retrieved a total of five studies: one each for the USA, Canada, the Netherlands and Spain and a multinational study for five European countries. The cost-effectiveness of vaccination of the elderly against invasive pneumococcal infections varied from cost savings to [symbol: see text] 33,000,-per life-year gained. The Dutch study estimated the cost-effectiveness at [symbol: see text] 10,100,-per life-year gained (price level 1995). Almost all the studies selected based their estimate of the effectiveness of vaccination on the same case-control study from the USA. The potential effects on cost-effectiveness of more extensive influenza vaccination and of the inclusion of re-vaccination against pneumococci were not included in the analyses. The cost-effectiveness of vaccination against invasive pneumococcal infections in persons over 65 years of age (in the Netherlands as well as in several other countries) was below the previously accepted threshold of [symbol: see text] 20,000,-.

The material convoy after age 50.

PubMed

Ekerdt, David J; Baker, Lindsey A

2014-05-01

Possessions constitute a dynamic "material convoy" that accumulates across adulthood to furnish role enactments and the development of the self. Following a familiar life course arc, older people should hypothetically release the possessions that equipped the daily lives that they no longer have. We use new survey data on possession divestment from the 2010 Health and Retirement Study to assess activity on behalf of the material convoy after age 50. After age 50, people are progressively less likely to divest themselves of belongings. After age 70, about 30% of persons say that they have done nothing in the past year to clean out, give away, or donate things, and over 80% have sold nothing. We tested whether divestments diminish with age because they do not seem necessary or because of health limitations, but the age pattern is robust, suggesting retention of the material convoy in later life. Further research on this age pattern might consider housing, the construction of the self, and social networks as explanations for retention. Inertia toward the material convoy maintains the availability and comfort of things, but it may also lead to a predicament wherein the collection becomes a worry for self and others.

Influence of aging and chronic heart failure on temporal dispersion of myocardial repolarization.

PubMed

Piccirillo, Gianfranco; Moscucci, Federica; Pascucci, Matteo; Pappadà, Maria Antonella; D'Alessandro, Gaetana; Rossi, Pietro; Quaglione, Raffaele; Di Barba, Daniele; Barillà, Francesco; Magrì, Damiano

2013-01-01

QT and T(peak)-T(end) (Te) intervals are associated with sudden cardiac death in patients with chronic heart failure (CHF). We studied age-dependent influence on short-term temporal dispersion of these two variables in patients with postischemic CHF. We grouped 75 CHF and 53 healthy control subjects into three age subsets: ≤ 50 years, >50 years and ≤ 65 years, and >65 years. We then calculated the following indices: QT and Te variability index (QTVI and TeVI), the ratio between the short-term variability (STV) of QT or Te, and the STV of resting rate (RR) (QT/RR STV and Te/RR STV). In all different age subgroups, patients with CHF showed a higher level of QTVI than age-matched control subjects (≤ 50 years: P < 0.0001; >50 years and ≤ 65 years: P < 0.05; >65 years: P < 0.05). Patients with CHF < 50 years old also had all repolarization variability indices higher than normal age-matched controls (TeVI, P < 0.05; QT/RR STV, P < 0.05; Te/RR STV, P < 0.05), whereas we did not find any difference between the two older classes of subjects. Both QTVI (r²: 0.178, P < 0.05) and TeVI (r²: 0.433, P < 0.001) were positively related to age in normal subjects, even if the first correlation was weaker than the second one. Our data showed that QTVI could be used in all ages to evaluate repolarization temporal liability, whereas the other indices are deeply influenced by age. Probably, the age-dependent increase in QTVI was more influenced by a reduction of RR variability reported in older normal subjects.

Thyrotropin levels within the lower normal range are associated with an increased risk of hip fractures in euthyroid women, but not men, over the age of 65 years.

PubMed

Leader, Avi; Ayzenfeld, Racheli Heffez; Lishner, Michael; Cohen, Efrat; Segev, David; Hermoni, Doron

2014-08-01

The contemporary literature on the relationship between serum TSH levels and osteoporotic fractures in euthyroid individuals is limited by conflicting results and analyses conducted on a small number of fractures. Our objective was to examine the association between the normal range of variation of TSH and the incidence of hip fractures in male and female euthyroid patients aged 65 years or older. We performed a population-based historical prospective cohort study within the Clalit Health Services population. Clalit Health Services members aged ≥65 years with at least 1 TSH measurement during the year 2004. We excluded patients with preexisting hip fracture, thyroid disease, malignancy, or chronic kidney disease. The primary outcome was hip fracture, and the secondary outcome was any other osteoporotic fracture. Adjusted odds ratios comparing episodes of each outcome across 3 TSH groups (low, 0.35-1.6 mIU/L; intermediate, 1.7-2.9 mIU/L; high, 3-4.2 mIU/L) were generated using logistic regression models. The 14 325 included participants suffered from 514 hip fractures (mean follow-up, 102 ± 3 months). Women, but not men, in the lowest TSH group had a higher incidence of hip fractures (odds ratio = 1.28, 95% confidence interval = 1.03-1.59, P = .029) when compared with the intermediate group, after multivariate adjustment for age, comorbidities, and use of drugs affecting bone metabolism. There was no difference in hip fracture incidence between intermediate- and high-TSH groups. No association was found between TSH levels and other osteoporotic fractures. TSH levels within the lower normal range are associated with an increased risk of hip fractures in euthyroid women, but not men, aged 65 years and more.

[Proportion of breast cancer in women aged 50 to 69 years from Girona, Spain, according to detection method].

PubMed

Puig-Vives, Montse; Osca-Gelis, Gemma; Camprubí-Font, Carla; Vilardell, M Loreto; Izquierdo, Angel; Marcos-Gragera, Rafael

2014-10-07

The aim of this study was to determine the tumor stage, the proportion of cases and the age specific rate of breast cancer (BC) cases according to detection method. Cases of women aged 50 to 69 years diagnosed with BC in the Girona province during 1999-2006 were extracted from the population-based Girona Cancer Registry (n=1,254). BC was classified by detection method: screen-detected cancer, interval cancer and others. Proportion of cases and age-specific incidence were calculated according to detection method. During the period 2002-2006, the proportion of screen-detected cancers, interval cancers and other cancers were 42.2%, 5.8% and 52.2%, respectively. After implementation of the early detection of breast cancer program (PDPCM), the incidence of screen-detected cases raised; thereafter, interval cancers also increased and the rate of other cancers decreased. In the Girona province during the fully implemented PDPCM period (2002-2006), interval cancers represented a low proportion (5.8%) of women diagnosed with BC at 50 to 69 years old. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Pneumococcal Vaccination Among Medicare Beneficiaries Occurring After the Advisory Committee on Immunization Practices Recommendation for Routine Use Of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults Aged ≥65 Years.

PubMed

Black, Carla L; Williams, Walter W; Warnock, Rob; Pilishvili, Tamara; Kim, David; Kelman, Jeffrey A

2017-07-14

On September 19, 2014, CDC published the Advisory Committee on Immunization Practices (ACIP) recommendation for the routine use of 13-valent pneumococcal conjugate vaccine (PCV13) among adults aged ≥65 years, to be used in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) (1). This replaced the previous recommendation that adults aged ≥65 years should be vaccinated with a single dose of PPSV23. As a proxy for estimating PCV13 and PPSV23 vaccination coverage among adults aged ≥65 years before and after implementation of these revised recommendations, CDC analyzed claims for vaccination submitted for reimbursement to the Centers for Medicare & Medicaid Services (CMS). Claims from any time during a beneficiary's enrollment in Medicare Parts A (hospital insurance) and B (medical insurance) since reaching age 65 years were assessed among beneficiaries continuously enrolled in Medicare Parts A and B during annual periods from September 19, 2009, through September 18, 2016. By September 18, 2016, 43.2% of Medicare beneficiaries aged ≥65 years had claims for at least 1 dose of PPSV23 (regardless of PCV13 status), 31.5% had claims for at least 1 dose of PCV13 (regardless of PPSV23 status), and 18.3% had claims for at least 1 dose each of PCV13 and PPSV23. Claims for either type of pneumococcal vaccine were highest among beneficiaries who were older, white, or with chronic and immunocompromising medical conditions than among healthy adults. Implementation of the National Vaccine Advisory Committee's standards for adult immunization practice to assess vaccination status at every patient encounter, recommend needed vaccines, and administer vaccination or refer to a vaccinating provider might help increase pneumococcal vaccination coverage and reduce the risk for pneumonia and invasive pneumococcal disease among older adults (2).

Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25–65 Years

PubMed Central

Winer, Rachel L.; Hughes, James P.; Feng, Qinghua; Stern, Joshua E.; Xi, Long Fu; Koutsky, Laura A.

2016-01-01

Background. The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25–65 years). Methods. Triannually, 420 female online daters aged 25–65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan–Meier and Cox proportional hazards methods. Results. The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%–30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38–5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners. Conclusions. Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections. PMID:27009602

The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya.

PubMed

Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Bastawrous, Madeleine; Rono, Hillary; Weiss, Helen A; Macleod, David; Foster, Allen; Peto, Tunde; Blows, Peter; Burton, Matthew; Kuper, Hannah

2017-03-23

The epidemic rise of diabetes carries major negative public health and economic consequences particularly for low and middle-income countries. The highest predicted percentage growth in diabetes is in the sub-Saharan Africa (SSA) region where to date there has been no data on the incidence of diabetic retinopathy from population-based cohort studies and minimal data on incident diabetes. The primary aims of this study were to estimate the cumulative six-year incidence of Diabetes Mellitus (DM) and DR (Diabetic Retinopathy), respectively, among people aged ≥50 years in Kenya. Random cluster sampling with probability proportionate to size were used to select a representative cross-sectional sample of adults aged ≥50 years in 2007-8 in Nakuru District, Kenya. A six-year follow-up was undertaken in 2013-14. On both occasions a comprehensive ophthalmic examination was performed including LogMAR visual acuity, digital retinal photography and independent grading of images. Data were collected on general health and risk factors. The primary outcomes were the incidence of diabetes mellitus and the incidence of diabetic retinopathy, which were calculated by dividing the number of events identified at 6-year follow-up by the number of people at risk at the beginning of follow-up. Age-adjusted risk ratios of the outcomes (DM and DR respectively) were estimated for each covariate using a Poisson regression model with robust error variance to allow for the clustered design and including inverse-probability weighting. At baseline, 4414 participants aged ≥50 years underwent complete examination. Of the 4104 non-diabetic participants, 2059 were followed-up at six-years (50 · 2%). The cumulative incidence of DM was estimated at 61 · 0 per 1000 (95% CI: 50 · 3-73 · 7) in people aged ≥50 years. The cumulative incidence of DR in the sample population was estimated at 15 · 8 per 1000 (95% CI: 9 · 5-26 · 3) among those without DM at baseline

Patient-Reported Outcomes, Quality of Life, and Satisfaction Rates in Young Patients Aged 50 Years or Younger After Total Knee Arthroplasty.

PubMed

Goh, Graham Seow-Hng; Liow, Ming Han Lincoln; Bin Abd Razak, Hamid Rahmatullah; Tay, Darren Keng-Jin; Lo, Ngai-Nung; Yeo, Seng-Jin

2017-02-01

Recent studies have shown a discrepancy between traditional functional outcomes and patient satisfaction, with some reporting less than 85% satisfaction in older patients undergoing total knee arthroplasty (TKA). As native knee biomechanics are not completely replicated, the resulting functional limitations may cause dissatisfaction in higher-demand individuals. Few studies have recorded patient-reported outcomes, health-related quality of life scores, and patient satisfaction in a young population undergoing TKA. One hundred thirty-six primary TKAs were performed in 114 patients aged 50 years or younger (mean age, 47.0 years; range, 30-50 years) at a single institution. The main diagnoses were osteoarthritis (85%) and rheumatoid arthritis (10%). The range of motion, Knee Society Score, Oxford Knee Score, and Physical and Mental Component Scores of Short Form-36 increased significantly (P < .001). At 2 years, 85.3% of patients had good/excellent knee scores, 71.3% had good/excellent function scores, 94.9% met the minimal clinically important difference for the Oxford Knee Score, and 84.6% met the minimal clinically important difference for the Physical Component Score. We found that 88.8% of patients were satisfied with their surgeries, whereas 86.8% had their expectations fulfilled. Survivorship using revision as an end point was 97.8% at a mean of 7 years (range, 3-16 years). Patients aged 50 years or younger undergoing TKA can experience significant improvements in their quality of life, have their expectations met, and be satisfied with their surgeries, at rates similar to those of non-age-restricted populations. Surgeons should inform them of these benefits and the potential risk of revision surgery in the future, albeit increasingly shown to be low. Copyright © 2016 Elsevier Inc. All rights reserved.

[Study of polymedicated patients over 65 years-old in an urban primary care centre].

PubMed

Garrido-Garrido, E M; García-Garrido, I; García-López-Durán, J C; García-Jiménez, F; Ortega-López, I; Bueno-Cavanillas, A

2011-01-01

To identify and characterise the polymedicated population over 65 years-old; and to determine the prevalence of drugs and the diseases in this population subgroup. Cross-sectional study. A primary care centre Zaidín-Centro in Granada. Andalusian Public Health Service. A total of 305 patients over 65 years-old taking polypharmacy (defined as use of five or more drugs, during a period equal to or greater than six months by any route) selected by stratified sampling by sex, age and number of drugs consumed. The analysed variables were sex, age, number of diseases, number of drugs and medical doctor. The prevalence of polypharmacy in patients over 65 years-old was 33.77%. These patients were using an average number of drugs of 8.7±2.5 and had an average number of diseases of 5.56±1.89. The prevalence of polypharmacy was greater among women, but differences decreased in people more than 85 years old. The antihypertensive pharmacological group was the most commonly used, in accordance with the most frequent disease, arterial hypertension. We found a strong relationship between the number of drugs and the number of diseases (p=0.05). Chronic use of drugs in the elderly is of considerable magnitude, affecting one out of every three. Polypharmacy in the elderly is a common and serious problem that needs to be reviewed and evaluated continuously. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Prevalence of vitamin D inadequacy in European women aged over 80 years.

PubMed

Bruyère, Olivier; Slomian, Justine; Beaudart, Charlotte; Buckinx, Fanny; Cavalier, Etienne; Gillain, Sophie; Petermans, Jean; Reginster, Jean-Yves

2014-01-01

Inadequate vitamin D status is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate vitamin D status in European women aged over 80 years. Assessments of serum 25-hydroxyvitamin D levels (25(OH)D) were performed on 8532 European women with osteoporosis or osteopenia of which 1984 were aged over 80 years. European countries included in the study were: France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed: <75 nmol/L (30 ng/ml) and <50 nmol/L (20 ng/ml). Mean (SD) age of the patients was 83.4 (2.9) years, body mass index was 25.0 (4.0) kg/m(2) and level of 25(OH)D was 53.3 (26.7) nmol/L (21.4 [10.7] ng/ml). There was a highly significant difference of 25(OH)D level across European countries (p<0.0001). In these women aged over 80 years, the prevalence of 25(OH)D inadequacy was 80.9% and 44.5% when considering cut-offs of 75 and 50 nmol/L, respectively. In the 397 (20.0%) patients taking supplemental vitamin D with or without supplemental calcium, the mean serum 25(OH)D level was significantly higher than in the other patients (65.2 (29.2) nmol/L vs. 50.3 (25.2) nmol/L; P<0.001). This study indicates a high prevalence of vitamin D (25(OH)D) inadequacy in old European women. The prevalence could be even higher in some particular countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The efficacy and safety of febuxostat for urate lowering in gout patients ≥65 years of age

PubMed Central

2012-01-01

Background The incidence of gout rises with increasing age. Management of elderly (≥65 years) gout patients can be challenging due to high rates of comorbidities, such as renal impairment and cardiovascular disease, and concomitant medication use. However, there is little data specifically addressing the efficacy and safety of available urate-lowering therapies (ULT) in the elderly. The objective of this post hoc analysis was to examine the efficacy and safety of ULT with febuxostat or allopurinol in a subset of elderly subjects enrolled in the CONFIRMS trial. Methods Hyperuricemic (serum urate [sUA] levels ≥ 8.0 mg/dL) gout subjects were enrolled in the 6-month, double-blind, randomized, comparative CONFIRMS trial and randomized, 1:1:1, to receive febuxostat, 40 mg or 80 mg, or allopurinol (200 mg or 300 mg based on renal function) once daily. Flare prophylaxis was provided throughout the study duration. Study endpoints were the percent of elderly subjects with sUA <6.0 mg/dL at the final visit, overall and by renal function status, percent change in sUA from baseline to final visit, flare rates, and rates of adverse events (AEs). Results Of 2,269 subjects enrolled, 374 were elderly. Febuxostat 80 mg was significantly more efficacious (82.0%) than febuxostat 40 mg (61.7%; p < 0.001) or allopurinol (47.3%; p < 0.001) for achieving the primary efficacy endpoint. Febuxostat 40 mg was also superior to allopurinol in this population (p = 0.029). In subjects with mild-to-moderate renal impairment, significantly greater ULT efficacy was observed with febuxostat 40 mg (61.6%; p = 0.028) and febuxostat 80 mg (82.5%; p < 0.001) compared to allopurinol 200/300 mg (46.9%). Compared to allopurinol 200/300 mg, the mean percent change in sUA from baseline was significantly greater for both febuxostat 80 mg (p < 0.001) and febuxostat 40 mg (p = 0.011) groups. Flare rates declined steadily in all treatment groups. Rates of AEs were low and comparable across treatments

Influence of aging and chronic heart failure on temporal dispersion of myocardial repolarization

PubMed Central

Piccirillo, Gianfranco; Moscucci, Federica; Pascucci, Matteo; Pappadà, Maria Antonella; D’Alessandro, Gaetana; Rossi, Pietro; Quaglione, Raffaele; Di Barba, Daniele; Barillà, Francesco; Magrì, Damiano

2013-01-01

Background and purpose: QT and Tpeak-Tend (Te) intervals are associated with sudden cardiac death in patients with chronic heart failure (CHF). We studied age-dependent influence on short-term temporal dispersion of these two variables in patients with postischemic CHF. Method: We grouped 75 CHF and 53 healthy control subjects into three age subsets: ≤50 years, >50 years and ≤65 years, and >65 years. We then calculated the following indices: QT and Te variability index (QTVI and TeVI), the ratio between the short-term variability (STV) of QT or Te, and the STV of resting rate (RR) (QT/RR STV and Te/RR STV). Results: In all different age subgroups, patients with CHF showed a higher level of QTVI than age-matched control subjects (≤50 years: P < 0.0001; >50 years and ≤65 years: P < 0.05; >65 years: P < 0.05). Patients with CHF < 50 years old also had all repolarization variability indices higher than normal age-matched controls (TeVI, P < 0.05; QT/RR STV, P < 0.05; Te/RR STV, P < 0.05), whereas we did not find any difference between the two older classes of subjects. Both QTVI (r2: 0.178, P < 0.05) and TeVI (r2: 0.433, P < 0.001) were positively related to age in normal subjects, even if the first correlation was weaker than the second one. Conclusion: Our data showed that QTVI could be used in all ages to evaluate repolarization temporal liability, whereas the other indices are deeply influenced by age. Probably, the age-dependent increase in QTVI was more influenced by a reduction of RR variability reported in older normal subjects. PMID:23662051

Vitamin D status in healthy Moroccan men and women aged 50 years and older: a cross-sectional study.

PubMed

El Maataoui, Aissam; Biaz, Asmae; El Machtani, Samira; Bouhsain, Sanae; Dami, Abdellah; El Maghraoui, Abdellah; Ouzzif, Zohra

2016-12-01

This study aimed to compare the vitamin D status in healthy Moroccan men and women aged 50 years and older. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. We found in this study a high prevalence of hypovitaminosis D with no difference between men and women. The main purpose of this study was to describe and compare the vitamin D status, parathormone, calcium, and phosphate of healthy Moroccan men and women aged 50 years and older. We conducted two cross-sectional studies, in postmenopausal women from October 2008 to November 2009 and in men over 50 years old, from December 2009 to August 2010. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. For the definition of hypovitaminosis D, the preferred level for 25-hydroxyvitamin D (25(OH)D) insufficiency, which is now recommended by many experts, is 30 ng/mL (75 nmol/L), and the levels below 10 ng/ml (25 nmol/L) indicate deficiency. The prevalence of vitamin D deficiency in men and women was 4.4 and 8.6 %, respectively, and the prevalence of vitamin D(25(OH) D) insufficiency in men and women were 85.2 and 77.4 %, respectively. In men and women, no correlations were found between intact parathormone (PTHi) and 25(OH) D (r = 0.056). Despite a sunny environment, we found in this study a high prevalence of hypovitaminosis D (insufficiency + deficiency) in Moroccan men over 50 years old and postmenopausal women.

Intelligence in youth and health at age 50

PubMed Central

Wraw, Christina; Deary, Ian J.; Gale, Catharine R.; Der, Geoff

2015-01-01

Background The link between intelligence in youth and all-cause mortality in later-life is well established. To better understand this relationship, the current study examines the links between pre-morbid intelligence and a number of specific health outcomes at age 50 using the NLSY-1979 cohort. Methods Participants were the 5793 participants in the NLSY-79 who responded to questions about health outcomes at age 50. Sixteen health outcomes were examined: two were summary measures (physical health and functional limitation), 9 were diagnosed illness conditions, 4 were self-reported conditions, and one was a measure of general health status. Linear and logistic regressions were used, as appropriate, to examine the relationship between intelligence in youth and the health outcomes. Age, sex and both childhood and adult SES, and its sub-components – income, education, & occupational prestige – are all adjusted for separately. Results & conclusion Higher pre-morbid intelligence is linked with better physical health at age 50, and a lower risk for a number of chronic health conditions. For example, a 1 SD higher score in IQ was significantly associated with increased odds of having good, very good, or excellent health, with an odds ratio of 1.70 (C.I. 1.55–1.86). Thirteen of the illness outcomes were significantly and negatively associated with IQ in youth; the odds ratios ranged from 0.85 for diabetes/high blood sugar to 0.65 for stroke, per one standard deviation higher score in IQ. Adjustment for childhood SES led to little attenuation but adult SES partially mediated the relationship for a number of conditions. Mediation by adult SES was not consistently explained by any one of its components—income, education, and occupation status. The current findings contribute to our understanding of lower intelligence as a risk factor for poor health and how this may contribute to health inequalities. PMID:26766880

Projecting diabetes prevalence among Mexicans aged 50 years and older: the Future Elderly Model-Mexico (FEM-Mexico)

PubMed Central

Tysinger, Bryan; Goldman, Dana P; Wong, Rebeca

2017-01-01

Objective Diabetes has been growing as a major health problem and a significant burden on the population and on health systems of developing countries like Mexico that are also ageing fast. The goal of the study was to estimate the future prevalence of diabetes among Mexico’s older adults to assess the current and future health and economic burden of diabetes. Design A simulation study using longitudinal data from three waves (2001, 2003 and 2012) of the Mexican Health and Aging Study and adapting the Future Elderly Model to simulate four scenarios of hypothetical interventions that would reduce diabetes incidence and to project the future diabetes prevalence rates among populations 50 years and older. Participants Data from 14 662 participants with information on self-reported diabetes, demographic characteristics, health and mortality. Outcome measures We obtained, for each scenario of diabetes incidence reduction, the following summary measures for the population aged 50 and older from 2012 to 2050: prevalence of diabetes, total population with diabetes, number of medical visits. Results In 2012, there were approximately 20.7 million persons aged 50 and older in Mexico; 19.3% had been diagnosed with diabetes and the 2001–2003 diabetes incidence was 4.3%. The no-intervention scenario shows that the prevalence of diabetes is projected to increase from 19.3% in 2012 to 34.0% in 2050. Under the 30% incidence reduction scenario, the prevalence of diabetes will be 28.6% in 2050. Comparing the no-intervention scenario with the 30% and 60% diabetes incidence reduction scenarios, we estimate a total of 816 320 and 1.6 million annual averted cases of diabetes, respectively, for the year 2020. Discussion Our study underscores the importance of diabetes as a disease by itself and also the potential healthcare demands and social burden of this disease and the need for policy interventions to reduce diabetes prevalence. PMID:29074514

Projecting diabetes prevalence among Mexicans aged 50 years and older: the Future Elderly Model-Mexico (FEM-Mexico).

PubMed

Gonzalez-Gonzalez, Cesar; Tysinger, Bryan; Goldman, Dana P; Wong, Rebeca

2017-10-25

Diabetes has been growing as a major health problem and a significant burden on the population and on health systems of developing countries like Mexico that are also ageing fast. The goal of the study was to estimate the future prevalence of diabetes among Mexico's older adults to assess the current and future health and economic burden of diabetes. A simulation study using longitudinal data from three waves (2001, 2003 and 2012) of the Mexican Health and Aging Study and adapting the Future Elderly Model to simulate four scenarios of hypothetical interventions that would reduce diabetes incidence and to project the future diabetes prevalence rates among populations 50 years and older. Data from 14 662 participants with information on self-reported diabetes, demographic characteristics, health and mortality. We obtained, for each scenario of diabetes incidence reduction, the following summary measures for the population aged 50 and older from 2012 to 2050: prevalence of diabetes, total population with diabetes, number of medical visits. In 2012, there were approximately 20.7 million persons aged 50 and older in Mexico; 19.3% had been diagnosed with diabetes and the 2001-2003 diabetes incidence was 4.3%. The no-intervention scenario shows that the prevalence of diabetes is projected to increase from 19.3% in 2012 to 34.0% in 2050. Under the 30% incidence reduction scenario, the prevalence of diabetes will be 28.6% in 2050. Comparing the no-intervention scenario with the 30% and 60% diabetes incidence reduction scenarios, we estimate a total of 816 320 and 1.6 million annual averted cases of diabetes, respectively, for the year 2020. Our study underscores the importance of diabetes as a disease by itself and also the potential healthcare demands and social burden of this disease and the need for policy interventions to reduce diabetes prevalence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

[Recurrences of bipolar disorders - comparative study of bipolar disorders, recurring depressions and single depressions in a cohort of patients aged over 65 years].

PubMed

Galland, F; Vaille-Perret, E; Gerbaud, L; Jalenques, I

2007-09-01

Bipolar mood disorders, after starting at adulthood, may remain active throughout life, but bipolar disorders may only be revealed in later life. Indeed, Yet few data on bipolar disorders in the elderly have been reported in the litterature. The influence of normal aging on the outcome of the disease as well as the specific prognosis of bipolar disorders in the elderly has occasionally been studied. Eventually Finally, and contrasting with adults, few studies comparing the various subtypes of mood disorders were have been performed in the elderly. We therefore developed a study in patients aged 65 or above, in order to evaluate the course (recurrences) of bipolar disorders, compared to recurring depressions and single depressions, and to determine the influence of recurrences on the outcome of bipolar disorders. Patients aged over 65 years were inpatients admitted to the department of psychiatry in 2000 for one of the three previously mentioned diagnoses according to DSM IV. Retrospective data were collected from medical reports. Prospectively, data were collected from the general practitioner of each patient (relying on telephone calls), before statistical analysis was performed. Our study demonstrates a more severe outcome for bipolar disorders compared to recurring depressions and single depressions. Patients with bipolar disorders have a higher prevalence of psychiatric recurrences. Furthermore, the greater the number of previous relapses (or the longer the duration and intensity of the disease), the higher the risk of future new future recurrences both in bipolar disorders and recurring depressions. An age of onset of bipolar disorders before 60 years and more than 5 in-hospital admissions increase the risk of recurrences. We originally compare the outcome of bipolar disorders in the elderly, to recurring depressions and single depressions. We confirm the fatal outcome of recurrences in bipolar disorders in old age. Bipolar disorders in the elderly should be

[Recommendations for prevention of community-acquired pneumonia with bacteremia as the leading form of invasive pneumococcal infections in the population of people over 50 years of age and risk groups above 19 years of age].

PubMed

Albrecht, Piotr; Antczak, Adam; Hryniewicz, Waleria; Skoczyńska, Anna; Radzikowski, Andrzej; Kedziora-Kornatowska, Kornelia; Bernatowska, Ewa; Stompór, Tomasz; Grodzicki, Tomasz; Gyrczuk, Ewa; Imiela, Jacek; Jedrzejczak, Wiesław; Windak, Adam

2014-02-01

Invasive pneumococcal disease (IPD) is a main cause of mortality associated with pneumococcal infections. Although, IPD is regarding mainly small children and persons in the age > 65 years, the investigations showed that because of IPD exactly sick persons are burdened with the greatest mortality in the older age, rather than of children. The most frequent form of IPD is community acquired pneumonia (CAP) with the bacteremia. The presence of even a single additional risk factor is increasing the probability of the unfavorable descent of pneumococcal infection. The risk factors for IPD and/or pneumonia with bacteremia apart from the age are among others asthma (> 2 x), chronic obstructive pulmonary disease (COPD), sarcoidosis (4 x), idiopathic pulmonary fibrosis (5 x), bronchiectases (2 x), allergic alveolitis (1.9 x) and pneumoconiosis (2 x), type 1 diabetes (4.4 x), type 2 diabetes (1.2 x), autoimmune diseases (e.g. rheumatoid arthritis (4.2 to 14.9 x), kidney failure with the necessity to dialysis (12 x), immunosuppression, cardiovascular disease, alcoholism and cancers. Examinations show that the best method of IPD and CAP preventing are pneumococcal vaccinations. On the market for ages 23-valent polysaccharide vaccine (PPV23) is available covering close the 90% of IPD triggering stereotypes. Her role in preventing CAP is uncertain and the immunological answer after vaccination at older persons and after revaccination is weak. Widely discussed disadvantageous effects of growing old of the immunological system show on the benefit from applying the immunization inducing the immunological memory, i.e. of conjugated vaccines which are activating the T-dependent reply and are ensuring the readiness for the effective secondary response. Examinations so far conducted with conjugated 7-valent and 13-valent (PCV13) vaccines at persons in the age > 50 years are confirming these expectations. Also sick persons can take benefits from PCV13 applying back from so-called IPD

Celebrating 50 Years!

ERIC Educational Resources Information Center

Kristjansdottir, Anna

2011-01-01

The author congratulates members of the Association of Teachers of Mathematics (ATM) on celebrating the 50th anniversary of their annual conference. These conferences have kept the spirit alive from the early years, especially the engagement in investigative, collaborative, and reasoning activities. In the 50th year as an association, the author…

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow

PubMed Central

Tkacheva, Olga N; Runikhina, Nadezda K; Ostapenko, Valentina S; Sharashkina, Natalia V; Mkhitaryan, Elen A; Onuchina, Julia S; Lysenkov, Sergei N; Yakhno, Nikolai N

2018-01-01

Background Geriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow. Methods A cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA). Results The mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17–23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25) in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more). Conclusion The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population. PMID:29467572

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow.

PubMed

Tkacheva, Olga N; Runikhina, Nadezda K; Ostapenko, Valentina S; Sharashkina, Natalia V; Mkhitaryan, Elen A; Onuchina, Julia S; Lysenkov, Sergei N; Yakhno, Nikolai N; Press, Yan

2018-01-01

Geriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow. A cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA). The mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17-23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25) in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more). The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population.

Income of People Aged 65 and Older: Overview From 1968 Survey of the Aged.

ERIC Educational Resources Information Center

Bixby, Lenore E.

1970-01-01

In a 1968 survey of the income of the aged, 8,248 persons were interviewed out of a population of 19.3 million persons aged 65 or over, excluding approximately 95,000 federal annuitants, 30,000 aliens, and a small number of persons not enrolled. The Current Medicare Survey was utilized to obtain certain selected characteristics of aged persons.…

[Kidney traumatism in general surgery (65 cases)].

PubMed

Brunet, C; Sielezneff, I; Voinchet, V; Rosset, E; Grégoire, R; Thirion, X; Ugarte, S; Farisse, J

1995-01-01

From September 1989 to September 1994, 65 patients, 15 females and 50 males, with a mean age of 32 +/- 14 years were admitted in the emergency unit for renal trauma. In 38.5% of cases multiple trauma was present. Lesional mechanism was most frequently contusions (49.2%) and deceleration injuries (43.1%). Gross hematuria or microscopic hematuria were presents in 72.3% of cases. The sensibility of systematic abdominal echography was 100% in case of perirenal hematoma and 65% in case of parenchymatous lesions. Only 23 patients were operated (35.3%) because of low blood pressure. None secondary operation was necessary in abstention group. Global mortality was 7.7%. Postoperative morbidity was 20% and specific morbidity in abstention group was 10.7%.

Projections of the number of Australians with disability aged 65 and over eligible for the National Disability Insurance Scheme: 2017-2026.

PubMed

Biddle, Nicholas; Crawford, Heather

2017-12-01

To develop projections of the size of the Australian population aged 65 years and over eligible for disability support through the National Disability Insurance Scheme (NDIS) for the decade following its introduction, to support planning and costing of the scheme. We estimate disability and mortality transition probabilities and develop projections of the NDIS-eligible, ageing population from 2017 to 2026. An estimated 8000 men and 10 200 women aged 65 years and over will be eligible for support through the NDIS in 2017 (the scheme's first full year), increasing to 48 800 men and 56 900 women in 2026. Growth in the NDIS-eligible, ageing population has implications for relative budget allocations between the NDIS and the aged-care system, and projections of the size of this population are useful for calculating the overall cost of the NDIS. © 2017 AJA Inc.

Measuring Years of Inactivity, Years in Retirement, Time to Retirement, and Age at Retirement Within the Markov Model

PubMed Central

SKOOG, GARY R.; CIECKA, JAMES E.

2010-01-01

Retirement-related concepts are treated as random variables within Markov process models that capture multiple labor force entries and exits. The expected number of years spent outside of the labor force, expected years in retirement, and expected age at retirement are computed—all of which are of immense policy interest but have been heretofore reported with less precisely measured proxies. Expected age at retirement varies directly with a person’s age; but even younger people can expect to retire at ages substantially older than those commonly associated with retirement, such as age 60, 62, or 65. Between 1970 and 2003, men allocated most of their increase in life expectancy to increased time in retirement, but women allocated most of their increased life expectancy to labor force activity. Although people can exit and reenter the labor force at older ages, most 65-year-old men who are active in the labor force will not reenter after they eventually exit. At age 65, the probability that those who are inactive will reenter the labor force at some future time is .38 for men and .27 for women. Life expectancy at exact ages is decomposed into the sum of the expected time spent active and inactive in the labor force, and also as the sum of the expected time to labor force separation and time in retirement. PMID:20879680

Effectiveness of inactivated influenza vaccines in preventing influenza-associated deaths and hospitalizations among Ontario residents aged ≥ 65 years: estimates with generalized linear models accounting for healthy vaccinee effects.

PubMed

Ridenhour, Benjamin J; Campitelli, Michael A; Kwong, Jeffrey C; Rosella, Laura C; Armstrong, Ben G; Mangtani, Punam; Calzavara, Andrew J; Shay, David K

2013-01-01

Estimates of the effectiveness of influenza vaccines in older adults may be biased because of difficulties identifying and adjusting for confounders of the vaccine-outcome association. We estimated vaccine effectiveness for prevention of serious influenza complications among older persons by using methods to account for underlying differences in risk for these complications. We conducted a retrospective cohort study among Ontario residents aged ≥ 65 years from September 1993 through September 2008. We linked weekly vaccination, hospitalization, and death records for 1.4 million community-dwelling persons aged ≥ 65 years. Vaccine effectiveness was estimated by comparing ratios of outcome rates during weeks of high versus low influenza activity (defined by viral surveillance data) among vaccinated and unvaccinated subjects by using log-linear regression models that accounted for temperature and time trends with natural spline functions. Effectiveness was estimated for three influenza-associated outcomes: all-cause deaths, deaths occurring within 30 days of pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations. During weeks when 5% of respiratory specimens tested positive for influenza A, vaccine effectiveness among persons aged ≥ 65 years was 22% (95% confidence interval [CI], -6%-42%) for all influenza-associated deaths, 25% (95% CI, 13%-37%) for deaths occurring within 30 days after an influenza-associated pneumonia/influenza hospitalization, and 19% (95% CI, 4%-31%) for influenza-associated pneumonia/influenza hospitalizations. Because small proportions of deaths, deaths after pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations were associated with influenza virus circulation, we estimated that vaccination prevented 1.6%, 4.8%, and 4.1% of these outcomes, respectively. By using confounding-reducing techniques with 15 years of provincial-level data including vaccination and health outcomes, we estimated that

Long Term Effects on Cognitive Function of Postmenopausal Hormone Therapy Prescribed to Women Aged 50–55 Years

PubMed Central

Espeland, Mark A.; Shumaker, Sally A.; Leng, Iris; Manson, JoAnn E.; Brown, Candice M.; LeBlanc, Erin S.; Vaughan, Leslie; Robinson, Jennifer; Rapp, Stephen R.; Goveas, Joseph S.; Lane, Dorothy; Wactawski-Wende, Jean; Stefanick, Marcia L.; Li, Wenjun; Resnick, Susan M.

2013-01-01

Background Postmenopausal hormone therapy with conjugated equine estrogens (CEE) may adversely affect older women’s cognitive function. It is not known whether this extends to younger women. Methods 1,326 postmenopausal women, who had begun treatment in two randomized placebo-controlled clinical trials of hormone therapy when aged 50–55 years, were assessed with an annual telephone-administered cognitive battery that included measures of global (primary outcome) and domain-specific cognitive functions (verbal memory, attention, executive function, verbal fluency, and working memory). The clinical trials in which they participated had compared 0.625 mg CEE with or without 2.5 mg medroxyprogesterone acetate (MPA) over an average of 7.0 years. Cognitive testing was conducted an average of 7.2 years following the end of the trials, when women had mean age 67.2 years, and repeated one year later. Results Global cognitive function scores from women who had been assigned to CEE-based therapies were similar to those from women assigned to placebo: mean [95% confidence interval] intervention effect of 0.02 [−0.08,0.12]standard deviation units (p=0.66). Similarly, no overall differences were found for any individual cognitive domain (all p>0.15). Pre-specified subgroup analyses found some evidence that CEE-based therapies may have adversely affected verbal fluency among women who had prior hysterectomy or prior use of hormone therapy: mean treatment effects of −0.17 [−0.33, −0.02] and −0.25 [−0.42, −0.08], respectively, however this may be a chance finding. We are not able to address whether initiating hormone therapy during the menopause and maintaining therapy until any symptoms are passed affects cognitive function, either in the short or longer term. Conclusions CEE-based therapies produced no overall sustained benefit or risk to cognitive function when administered to postmenopausal women aged 50–55 years. PMID:23797469

42 CFR 440.181 - Home and community-based services for individuals age 65 or older.

Code of Federal Regulations, 2010 CFR

2010-10-01

... age 65 or older. 440.181 Section 440.181 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Definitions § 440.181 Home and community-based services for individuals age 65 or older. (a) Description of services— Home and community-based services for individuals age 65 or older means services, not otherwise...

Aging in the Americas: Disability-free Life Expectancy Among Adults Aged 65 and Older in the United States, Costa Rica, Mexico, and Puerto Rico.

PubMed

Payne, Collin F

2018-01-11

To estimate and compare disability-free life expectancy (DFLE) and current age patterns of disability onset and recovery from disability between the United States and countries in Latin America and the Caribbean. Disability is measured using the activities of daily living scale. Data come from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States. Age patterns of transitions in and out of disability are modeled with a discrete-time logistic hazard model, and a microsimulation approach is used to estimate DFLE. Overall life expectancy for women aged 65 is 20.11 years in Costa Rica, 19.2 years in Mexico, 20.4 years in Puerto Rico, and 20.5 years in the United States. For men, these figures are 19.0 years in Costa Rica, 18.4 years in Mexico, 18.1 years in Puerto Rico, and 18.1 years in the United States. Proportion of remaining life spent free of disability for women at age 65 is comparable between Mexico, Puerto Rico, and the United States, with Costa Rica trailing slightly. Male estimates of DFLE are similar across the four populations. Though the older adult population of Latin America and the Caribbean lived many years exposed to poor epidemiological and public health conditions, their functional health in later life is comparable with the older adult population of the United States. © The Author(s) 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.

[Experiences and results in hypertension screening in women between 20 and 65 years of age in Karl-Marx-City].

PubMed

Voigt, G; Börker, G; Edelmann, S; Hartung, A; Hartung, G; Heyne, S; Töpfer, V

1980-11-15

From 1975 to 1979 in the district of the City of Karl-Marx-Stadt 91,130 females at the age between 20 and 65 years were summoned to a gynaecologico-cardiological mass examination which was supported by computer. 56,460 females underwent the examination. According to the WHO-criteria two measurements of blood pressure were carried out, when increased blood pressure was present a third one and a fourth one by an examination group. A diagnostic standard programme was used. In the second measurement of blood pressure we established 19.8% of patients with hypertension and 28.6% patients with borderline values. 52.8% of the hypertensions were known. Of 10,685 females with known or established hypertension 10.1% underwent an optimum therapy. On the basis of these results a programme for the fight against hypertension was developed for the county Karl-Marx-Stadt.

Components of metabolic syndrome in relation to plasma levels of retinol binding protein 4 (RBP4) in a cohort of people aged 65 years and older.

PubMed

Majerczyk, M; Kocełak, P; Choręza, P; Arabzada, H; Owczarek, A J; Bożentowicz-Wikarek, M; Brzozowska, A; Szybalska, A; Puzianowska-Kuźnicka, M; Grodzicki, T; Więcek, A; Olszanecka-Glinianowicz, M; Chudek, J

2018-03-09

Elevated plasma concentration of retinol binding protein 4 (RBP4) has recently emerged as a potential risk factor as a component of developing metabolic syndrome (MS). Therefore, this study aimed to analyse the relationship between components of MS and concentrations of plasma RBP4 in a population of subjects 65 years and older. The study sample consisted of 3038 (1591 male) participants of the PolSenior study, aged 65 years and older. Serum lipid profile, concentrations of RBP4, glucose, insulin, C-reactive protein, IL-6, and activity of aminotransferases were measured. Nutritional status (BMI/waist circumference) and treatment with statins and fibrates were evaluated. Glomerular filtration rate (eGFR), de Ritis ratio, and fatty liver index (FLI), as well as HOMA-IR were calculated. Our study revealed a strong relationship between components of MS and RBP4 in both sexes: plasma RBP4 levels were increased in men by at least 3×, and in women by at least 4×. Hypertriglyceridemia was most strongly associated with elevated plasma RBP4 levels. Multivariate, sex-adjusted regression analysis demonstrated that chronic kidney disease [OR 1.86 (95% CI 1.78-1.94)], hypertriglyceridemia [OR 1.52 (1.24-1.87)], hypertension [OR 1.15 (1.12-1.19)], low serum HDL cholesterol [OR 0.94 (0.92-0.97)], and age > 80 years [OR 0.86 (0.81-0.90)] were each independently associated with RBP4 concentration (all p < 0.001). In Caucasians 65 years and older, RBP4 serum levels are associated with a number of components of MS, independent of sex and kidney function. Hypertriglyceridemia as a component of MS is most significantly related to RBP4 concentration.

Description of OPRA: A Danish database designed for the analyses of risk factors associated with 30-day hospital readmission of people aged 65+ years.

PubMed

Pedersen, Mona K; Nielsen, Gunnar L; Uhrenfeldt, Lisbeth; Rasmussen, Ole S; Lundbye-Christensen, Søren

2017-08-01

To describe the construction of the Older Person at Risk Assessment (OPRA) database, the ability to link this database with existing data sources obtained from Danish nationwide population-based registries and to discuss its research potential for the analyses of risk factors associated with 30-day hospital readmission. We reviewed Danish nationwide registries to obtain information on demographic and social determinants as well as information on health and health care use in a population of hospitalised older people. The sample included all people aged 65+ years discharged from Danish public hospitals in the period from 1 January 2007 to 30 September 2010. We used personal identifiers to link and integrate the data from all events of interest with the outcome measures in the OPRA database. The database contained records of the patients, admissions and variables of interest. The cohort included 1,267,752 admissions for 479,854 unique people. The rate of 30-day all-cause acute readmission was 18.9% ( n=239,077) and the overall 30-day mortality was 5.0% ( n=63,116). The OPRA database provides the possibility of linking data on health and life events in a population of people moving into retirement and ageing. Construction of the database makes it possible to outline individual life and health trajectories over time, transcending organisational boundaries within health care systems. The OPRA database is multi-component and multi-disciplinary in orientation and has been prepared to be used in a wide range of subgroup analyses, including different outcome measures and statistical methods.

Effectiveness and Duration of Protection Provided by the Live-attenuated Herpes Zoster Vaccine in the Medicare Population Ages 65 Years and Older.

PubMed

Izurieta, Hector S; Wernecke, Michael; Kelman, Jeffrey; Wong, Sarah; Forshee, Richard; Pratt, Douglas; Lu, Yun; Sun, Qin; Jankosky, Christopher; Krause, Philip; Worrall, Chris; MaCurdy, Tom; Harpaz, Rafael

2017-03-15

Tens of millions of seniors are at risk of herpes zoster (HZ) and its complications. Live attenuated herpes zoster vaccine (HZV) reduces that risk, although questions regarding effectiveness and durability of protection in routine clinical practice remain. We used Medicare data to investigate HZV effectiveness (VE) and its durability. This retrospective cohort study included beneficiaries ages ≥65 years during January 2007 through July 2014. Multiple adjustments to account for potential bias were made. HZV-vaccinated beneficiaries were matched to unvaccinated beneficiaries (primary analysis) and to HZV-unvaccinated beneficiaries who had received pneumococcal vaccination (secondary analysis). HZ outcomes in community and hospital settings were analyzed, including ophthalmic zoster (OZ) and postherpetic neuralgia (PHN). Among eligible beneficiaries (average age 77 years), the primary analysis found VE for community HZ of 33% (95% CI: 32%-35%) and 19% (95% CI: 17%-22%), for the first 3, and subsequent 4+ years postvaccination, respectively. In the secondary analysis, VE was, respectively, 37% (95% CI: 36%-39%) and 22% (95% CI: 20%-25%). In the primary analysis, VE for PHN was 57% (95% CI: 52%-61%) and 45% (95% CI: 36%-53%) in the first 3 and subsequent 4+ years, respectively; VE for hospitalized HZ was, respectively, 74% (95% CI: 67%-79%) and 55% (95% CI: 39%-67%). Differences in VE by age group were not significant. In both the primary and secondary analyses, HZV provided protection against HZ across all ages, but effectiveness declined over time. VE was higher and better preserved over time for PHN and HZ-associated hospitalizations than for community HZ. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Prevalence of osteoporosis in men aged 65-75 in a primary care setting. A practice audit after application of the Canadian 2010 guidelines for osteoporosis screening.

PubMed

Ferrari, Robert

2015-03-01

Current Canadian osteoporosis guidelines recommend routine bone density screening of men at age 65. The purpose of this study is to determine the prevalence of osteoporosis in men aged 65-75 in after application of screening guidelines. All males aged 65-75 years who attended a large primary care clinic were advised of the 2010 Canadian osteoporosis guidelines and advised to obtain a bone density scan at or after their 65th birthday. Those who did not have a bone density scan since their 65th birthday were advised to obtain a scan, unless there was obvious reason not to do so (i.e. known osteoporosis). A record of the results for each patient were kept and tallied to determine the prevalence of osteoporosis. Osteoporosis was defined as a T-score of ≤ -2.5 in either the hip or lumbar spine. Of 574 male subjects in this clinic, between the ages of 65-75, 557 had a bone density scan, either already having done so at the time of being informed of the guidelines or obtaining a scan in the subsequent year after being informed of the guidelines. The prevalence of osteoporosis was 1.6% (9/557, 95% confidence interval 0.8-3.1%) in this sample. The average age of subjects with osteoporosis was 70.5 ± 1.4 years (range 68-75). None of the subjects under 68 years of age were found to have osteoporosis. The prevalence of osteoporosis in unselected male cohorts aged 65 may be too low to justify the routine bone density screening recommended in the 2010 Canadian osteoporosis guidelines.

Quality of Life in Rural and Urban Adults 65 Years and Older: Findings from the National Health and Nutrition Examination Survey

ERIC Educational Resources Information Center

Baernholdt, Marianne; Yan, Guofen; Hinton, Ivora; Rose, Karen; Mattos, Meghan

2012-01-01

Purpose: The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community-dwelling adults 65 years and older according to…

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

PubMed

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

2017-08-01

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

High prevalence of frequent attendance in the over 65s.

PubMed

McMahon, C Geraldine; Power Foley, Megan; Robinson, David; O'Donnell, Kate; Poulton, Miriam; Kenny, Rose A; Bennett, Kathleen

2018-02-01

Characteristics of older frequent users of Emergency Departments (EDs) are poorly understood. Our aim was to examine the characteristics of the ED frequent attenders (FAs) by age (under 65 and over 65 years). We examined the prevalence of FA attending the ED of an Urban Teaching Hospital in a cross-sectional study between 2009 and 2011. FA was defined as an individual who presented to the ED four or more times over a 12-month period. Randomly selected groups of FA and non-FA from two age groups (under 65 and over 65 years) were then examined to compare the characteristics between older FAs and non-FAs and older FAs and younger FAs. Logistic regression was used to calculate the odds ratio and 95% confidence intervals for 12-month mortality in FA compared with non-FA aged at least 65 years. Overall, 137 150 ED attendances were recorded between 2009 and 2011. A total of 21.6% were aged at least 65 years, 4.4% of whom were FAs, accounting for 18.4% of attendances by patients older than 65 years. There was a bimodal age distribution of FA (mean±SD; under 65 years 40±12.7; and over 65 years 76.9±7.4). Older FAs were five times more likely to present outside normal working hours and 5.5 times more likely to require admission. Cardiovascular emergencies were the most common complaint, in contrast with the younger FA group, where injury and psychosocial conditions dominated. The odds ratio for death at 12 months was 2.07 (95% confidence interval 0.93-4.63; P=0.07), adjusting for age and sex. One-in-five ED patients older than 65 years of age are FAs. Older FAs largely present with complex medical conditions. Enhanced access to expert gerontology assessment should be considered as part of effective intervention strategies for older ED users.

Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study.

PubMed

Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Patino-Alonso, María C; García-García, Ricardo; Escribano-Hernández, Alfonso; García-Ortiz, Luis; Perea-Bartolomé, Ma Victoria; Gómez-Marcos, Manuel A

2011-11-17

Few data are available on the prevalence of cognitive impairment (CI) in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors. A descriptive, cross-sectional, home questionnaire-based study; Populational, urban setting. The reference population comprised over-65s living in the city of Salamanca (Spain) in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%), with a mean age of 76.35 years (SD: 7.33). Women accounted for 64.5% of the total. A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND), and dementia. The prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia). The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p < 0.001) and decreased with increasing educational level (p < 0.001). Significant risk factors were found with the multivariate analyses: age (OR = 1.08, 95%CI: 1.03-1.12), anxiety-depression (OR = 3.47, 95%CI: 1.61-7.51) and diabetes (OR = 2.07, 95%CI: 1.02-4.18). In turn, years of education was found to be a protective factor (OR = 0.79, 95%CI: 0.70-0.90). Although CI was more frequent among women and in people living without a partner, these characteristics were not significantly associated with CI risk. The observed raw prevalence of CI was 19% (14.9% after adjusting for age

A Maximal Graded Exercise Test to Accurately Predict VO2max in 18-65-Year-Old Adults

ERIC Educational Resources Information Center

George, James D.; Bradshaw, Danielle I.; Hyde, Annette; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

2007-01-01

The purpose of this study was to develop an age-generalized regression model to predict maximal oxygen uptake (VO sub 2 max) based on a maximal treadmill graded exercise test (GXT; George, 1996). Participants (N = 100), ages 18-65 years, reached a maximal level of exertion (mean plus or minus standard deviation [SD]; maximal heart rate [HR sub…

Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over.

PubMed

Bates, Christopher J; Mansoor, Mohammed A; Pentieva, Kristina D; Hamer, Mark; Mishra, Gita D

2010-09-01

Predictive power, for total and vascular mortality, of selected indices measured at baseline in the British National Diet and Nutrition Survey (community-living subset) of People Aged 65 Years and Over was tested. Mortality status and its primary and underlying causes were recorded for 1100 (mean age 76.7 (sd 7.5) years, 50.2% females) respondents from the baseline survey in 1994-5 until September 2008. Follow-up data analyses focussed especially on known predictors of vascular disease risk, together with intakes and status indices of selected nutrients known to affect, or to be affected by, these predictors. Total mortality was significantly predicted by hazard ratios of baseline plasma concentrations (per sd) of total homocysteine (tHcy) (95% CI) 1.19 (1.11, 1.27), pyridoxal phosphate 0.90 (0.81, 1.00), pyridoxic acid 1.10 (1.03, 1.19), alpha1-antichymotrypsin 1.21 (1.13, 1.29), fibrinogen 1.14 (1.05, 1.23), creatinine 1.20 (1.10, 1.31) and glycosylated Hb 1.23 (1.14, 1.32), and by dietary intakes of energy 0.87 (0.80, 0.96) and protein 0.86 (0.77, 0.97). Prediction patterns and significance were similar for primary-cause vascular mortality. The traditional risk predictors plasma total and HDL cholesterol were not significant mortality predictors in this age group, nor were the known tHcy-regulating nutrients, folate and vitamin B12 (intakes and status indices). Model adjustment for known risk predictors resulted in the loss of significance for some of the afore-mentioned indices; however, tHcy 1.34 (1.04, 1.73) remained a significant predictor for vascular mortality. Thus, total and primary vascular mortality is predicted by energy and protein intakes, and by biochemical indices including tHcy, independent of serum folate or vitamin B12.

Comprehensive care program for elderly patients over 65 years with hip fracture.

PubMed

Fernández-Moyano, A; Fernández-Ojeda, R; Ruiz-Romero, V; García-Benítez, B; Palmero-Palmero, C; Aparicio-Santos, R

2014-01-01

To report the health outcomes of a multidisciplinary care program for patients over 65 years with hip fracture. We have developed a care coordination model for the comprehensive care of hip fracture patients. It establishes what, who, when, how and where orthopedists, internists, family physicians, emergency, intensive care, physiotherapists, anesthetists, nurses and workers social intervene. All elderly patients over 65 years admitted with the diagnosis of hip fracture (years 2006 to 2010) were retrospectively evaluated. One thousand episodes of hip fracture, corresponding to 956 patients, were included. Mean age was 82 years and mean stay 6.7 days. This was reduced by 1.14 days during the 5 years of the program. A total of 85.1% were operated on before 72 yours, and 91.2% during the program. Incidence of surgical site infection was 1.5%. In-hospital mortality was 4.5%, (24.2% at 12 months). Readmissions at one years was 14.9%. Independence for basic activity of daily living was achieved by 40% of the patients. This multidisciplinary care program for hip fracture patients is associated with positive health outcomes, with a high percentage of patients treated early (more than 90%), reduced mean stay (less than 7 days), incidence of surgical site infections, readmissions and inpatient mortality and at one year, as well as adequate functional recovery. Copyright © 2012 Elsevier España, S.L. All rights reserved.

[Sexual intercourse debut and associated factors in Mexican students aged 14-19 years in public schools].

PubMed

Rivera-Rivera, Leonor; Leyva-López, Ahidée; García-Guerra, Armando; de Castro, Filipa; González-Hernández, Dolores; de Los Santos, Lilia Margarita

2016-01-01

To estimate the mean age of sexual intercourse debut (SID) and associated family and individual factors in 14-19-year-olds of both sexes in the 32 states of Mexico in 2007. A cross-sectional study was conducted of a representative sample of 9,893 students aged between 14 and 19 years old. The data were collected through a self-administered, anonymous and voluntary questionnaire. Logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (95%CI) by category: no SID, SID at 10-15 years and SID at 16-19 years. The national mean age of SID was 16 years, being 15 years for boys (95%CI: 15.88-16.11) and 16 years for girls (95%CI: 15.26-15.42). Factors associated with SID in boys were disadvantaged socioeconomic level (OR=0.66; 95%CI: 0.46-0.94), living with parents (OR=0.65; 95%CI: 0.56-0.75), less offensive communication between parents and boys/girls (OR=0.66; 95%CI: 0.57-0.77), and high social self-esteem (OR=1.68; 95%CI: 1.35-1.77). Factors associated with SID in girls were traditional gender beliefs (OR=0.49; 95%CI: 0.32-0.74), high depressive symptoms (OR=1.88; 95%CI: 1.19-2.99), and high family self-esteem (OR= 0.50; 95%CI: 0.38-0.65). In Mexico, SID occurred early in boys. In addition, the findings of this study show that in Mexico, the age of SID and associated factors differ in boys and girls. The age of SID is strongly influenced by gender and cultural beliefs. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Severity and outcomes according to stroke etiology in patients under 50 years of age with ischemic stroke.

PubMed

Prefasi, Daniel; Martínez-Sánchez, Patricia; Fuentes, Blanca; Díez-Tejedor, Exuperio

2016-08-01

To analyze the association of stroke etiological subtypes with severity and outcomes at 3 and 12 months in patients ≤50 years. Observational study of patients admitted to a stroke unit (2007-2013). demographic data, vascular risk factors, comorbidities, severity on admission (NIHSS), and good functional outcome (mRS ≤ 1) at 3 and 12 months. We used multivariate analyses to evaluate the influence of stroke etiology on severity and outcomes. We included 214 patients, 58.3 % men, mean age 41.4 years. General linear models showed all etiologies were more severe than lacunar strokes (P < 0.05). Atherothrombotic strokes showed greater severity than those of undetermined and uncommon etiology, whereas cardioembolic strokes were more severe than cryptogenic. Taking into account specific etiologies, atherothrombotic strokes (B = 5.860; 95 % CI 2.979-8.751), cervical artery dissection (CAD) [B = 7.485; 95 % confidence interval (CI) 4.734-10.237], and atrial fibrillation (AF) strokes (B = 5.773; 95 % CI 2.704-8.132) were more severe than other etiologies. Logistic regression models showed that strokes of uncommon etiology, especially those not related to CAD, had a lower probability of good outcome at 3 months [odds ratio (OR) = 0.197; CI 95 % 0.044-0.873], whereas atherothrombotic strokes were associated with this probability at 12 months (OR = 0.187; 95 % CI 0.037-0.951; P = 0.007). In patients ≤50 years of age, strokes of atherothrombotic, cardioembolic (particularly those due to AF), and uncommon etiology had a greater severity than the rest. Furthermore, strokes of uncommon etiology, especially those different from CAD, decreased the probability of a good outcome at 3 months, as did atherothrombotic strokes at 1 year.

Prevalence of menstrual cycles and outcome of 50 pregnancies after high-dose chemotherapy and auto-SCT in non-Hodgkin and Hodgkin lymphoma patients younger than 40 years.

PubMed

Akhtar, S; Youssef, I; Soudy, H; Elhassan, T A M; Rauf, S M; Maghfoor, I

2015-12-01

Data are limited regarding the prevalence of menstrual cycles and pregnancies after high-dose chemotherapy (HDC) and auto-stem cell transplantation (SCT). Female patients who underwent HDC auto-SCT for non-Hodgkin and Hodgkin lymphoma (1997-2012) were reviewed. The selection criteria were as follows: (1) alive without disease 12 and 24 months after auto-SCT for menstrual cycles and pregnancy, respectively, (2) age <40 years at auto-SCT, and (3) no primary infertility. One-hundred and seventy-six females underwent single auto-SCT. Eighty-nine were eligible for menstrual cycles and pregnancy analysis. Median age at auto-SCT was 25 years (14-40 years), at pregnancy 27 years (20-37 years), median follow-up 65 months (range 24-190). Regular menstrual-cycles resumed in 56/89 patients (63%). Increasing age (P=0.02) and number of prior chemotherapy cycles (P=0.02) are associated with higher risk of amenorrhea. Forty patients tried to get pregnant, 26 (65%) became pregnant 50 times: 43 (86%) live birth, 7 (14%) miscarriage and 2/50 had birth defects. Twenty-four patients practiced breastfeeding (median duration 4 months (1-24 months)). Enough breast milk production was reported 62.5% vs 100% in those patients who did or did not receive above the diaphragm radiation therapy, respectively, (P=0.066). Our data highlights significantly higher than perceived incidence of menstrual cycle resumption, successful pregnancies and breastfeeding after HDC auto-SCT.

Usefulness of peak exercise oxygen consumption and the heart failure survival score to predict survival in patients >65 years of age with heart failure.

PubMed

Parikh, Mona N; Lund, Lars H; Goda, Ayumi; Mancini, Donna

2009-04-01

Peak exercise oxygen consumption (Vo(2)) and the Heart Failure (HF) Survival Score (HFSS) were developed in middle-aged patient cohorts referred for heart transplantation with HF. The prognostic value of Vo(2) in patients >65 years has not been well studied. Accordingly, the prognostic value of peak Vo(2) was evaluated in these patients with HF. A retrospective analysis of 396 patients with HF >65 years with cardiopulmonary exercise testing was performed. Peak Vo(2) and components of the HFSS (presence of coronary artery disease, left ventricular ejection fraction, heart rate, mean arterial blood pressure, presence of intraventricular conduction defects, and serum sodium) were collected. Follow-up averaged 1,038 +/- 983 days. Outcome events were defined as death, implantation of a left ventricular assist device, or urgent transplantation. Patients were divided into risk strata for peak Vo(2) and HFSS based on previous cut-off points. Survival curves were derived using Kaplan-Meier analysis and compared using log-rank analysis. Survival differed markedly by Vo(2) stratum (p <0.0001), with significantly better survival rates for the low- (>14 ml/kg/min) versus medium- (10 to 14 ml/kg/min), low- versus high- (<10 ml/kg/min), and medium- versus high-risk strata (all p <0.05). Survival also differed markedly by HFSS stratum (p <0.0001), with significantly better survival rates for the low- (> or =8.10) versus medium- (7.20 to 8.09), low- versus high- (< or =7.19), and medium- versus high-risk strata (all p <0.0001). In conclusion, peak Vo(2) and the HFSS were both excellent parameters to predict survival in patients >65 years with HF.

Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial

PubMed Central

Fitzmaurice, David A; Jowett, Sue; Mant, Jonathon; Murray, Ellen T; Holder, Roger; Raftery, J P; Bryan, S; Davies, Michael; Lip, Gregory Y H; Allan, T F

2007-01-01

Objectives To assess whether screening improves the detection of atrial fibrillation (cluster randomisation) and to compare systematic and opportunistic screening. Design Multicentred cluster randomised controlled trial, with subsidiary trial embedded within the intervention arm. Setting 50 primary care centres in England, with further individual randomisation of patients in the intervention practices. Participants 14 802 patients aged 65 or over in 25 intervention and 25 control practices. Interventions Patients in intervention practices were randomly allocated to systematic screening (invitation for electrocardiography) or opportunistic screening (pulse taking and invitation for electrocardiography if the pulse was irregular). Screening took place over 12 months in each practice from October 2001 to February 2003. No active screening took place in control practices. Main outcome measure Newly identified atrial fibrillation. Results The detection rate of new cases of atrial fibrillation was 1.63% a year in the intervention practices and 1.04% in control practices (difference 0.59%, 95% confidence interval 0.20% to 0.98%). Systematic and opportunistic screening detected similar numbers of new cases (1.62% v 1.64%, difference 0.02%, −0.5% to 0.5%). Conclusion Active screening for atrial fibrillation detects additional cases over current practice. The preferred method of screening in patients aged 65 or over in primary care is opportunistic pulse taking with follow-up electrocardiography. Trial registration Current Controlled Trials ISRCTN19633732. PMID:17673732

Determination of dissociation constant of the NFκB p50/p65 heterodimer using fluorescence cross-correlation spectroscopy in the living cell

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tiwari, Manisha; Mikuni, Shintaro; Muto, Hideki

Highlights: •We used two-laser-beam FCCS to determine the dissociation constant (K{sub d}) of IPT domain of p50/p65 heterodimer in living cell. •Interaction of p50 and p65 was analyzed in the cytoplasm and nucleus of single living cell. •Binding affinity of p50/p65 heterodimer is higher in cytoplasm than that of nucleus. -- Abstract: Two-laser-beam fluorescence cross-correlation spectroscopy (FCCS) is promising technique that provides quantitative information about the interactions of biomolecules. The p50/p65 heterodimer is the most abundant and well understood of the NFκB dimers in most cells. However, the quantitative value of affinity, namely the K{sub d}, for the heterodimer inmore » living cells is not known yet. To quantify the heterodimerization of the IPT domain of p50/p65 in the living cell, we used two-laser-beam FCCS. The K{sub d} values of mCherry{sub 2}- and EGFP-fused p50 and p65 were determined to be 0.46 μM in the cytoplasm and 1.06 μM in the nucleus of the living cell. These results suggest the different binding affinities of the p50/p65 heterodimer in the cytoplasm and nucleus of the living cell and different complex formation in each region.« less

Burden of disease associated with lower levels of income among US adults aged 65 and older.

PubMed

Lubetkin, Erica I; Jia, Haomiao

2017-01-16

Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality. We ascertained respondents' health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents' age and answers to the 4 core Healthy Days questions was used to obtain values of a preference-based measure of HRQOL, the EuroQol five dimensions questionnaire (EQ-5D) index, which enables quality-adjusted life years (QALYs) to be calculated. We included only respondents aged 65 years and older at the baseline, yielding a total sample size of 4952. We estimated mean QALYs according to different categories of income based on the percentage of Federal Poverty Level (FPL). After adjusting for age, gender and education, the remaining QALYs decreased with each successive decrement of category of income, ranging from 18.4 QALY (≥500% FPL) to 8.6 QALY (<100% FPL). Compared with participants with a mean income of ≥250% FPL, participants with an income <250% FPL had significant losses in QALY for most of the sociodemographic groups examined. In contrast, persons with a lower educational attainment did not show a corresponding loss in QALY according to income category. This study confirmed the association between lower income category and greater burden of disease, as measured by QALYs lost, among the US population aged 65 years and older. Our findings provide additional evidence of the role played by other key determinants of health and how factors not traditionally addressed by the healthcare system impact the life cycle of individuals and communities

An Accurate VO[subscript 2]max Nonexercise Regression Model for 18-65-Year-Old Adults

ERIC Educational Resources Information Center

Bradshaw, Danielle I.; George, James D.; Hyde, Annette; LaMonte, Michael J.; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

2005-01-01

The purpose of this study was to develop a regression equation to predict maximal oxygen uptake (VO[subscript 2]max) based on nonexercise (N-EX) data. All participants (N = 100), ages 18-65 years, successfully completed a maximal graded exercise test (GXT) to assess VO[subscript 2]max (M = 39.96 mL[middle dot]kg[superscript -1][middle…

Trends in tooth loss in relation to socio-economic status among Swedish women, aged 38 and 50 years: repeated cross-sectional surveys 1968-2004.

PubMed

Wennström, Anette; Ahlqwist, Margareta; Stenman, Ulrika; Björkelund, Cecilia; Hakeberg, Magnus

2013-11-06

Oral diseases are a health problem worldwide. Differences in oral health status may vary with geographical locations, but also within the same country and between groups with different social backgrounds. The specific aims were to describe secular trends in oral health status regarding number of remaining teeth and also to describe differences in socio-economic status, among 38- and 50-year-old women, over a 36-year period. Cross-sectional health surveys were performed at four occasions; 1968/69 (n = 746), 1980/81 (n = 532), 1992/93 (n = 165) and 2004/05 (n = 500), including randomly selected women aged 38 and 50 years. The number of teeth was determined using panoramic radiographs and self-reported measures of marital status, social class, educational level, and income were recorded. The mean number of teeth among women has increased significantly. The educational level has increased while fewer women are married/cohabiting over time. There has been a shift in the social group the women belong to, where proportionally more women were categorized in a higher social group in 2004/05 than in 1968/69. Moreover, there is a significant relationship between fewer teeth and a lower social group, and among the 50-year-old women, this was irrespective of examination year. However, multivariate analyses showed that the risk to be edentulous or not, or to have fewer remaining teeth was significantly higher for women of lower social group, or living alone, in all studies over the 36 year-period. This was independent of age group, even though the risk diminished over the study period. Cohort comparisons of women aged 38 and 50 years during 36 years showed that dental status improved, with (i) a decreasing prevalence of edentulism and, (ii) an increasing number of remaining teeth in dentate individuals over time. Differences due to social group and education were still present, with more remaining teeth in the women in the higher social group. A time trend analysis indicated

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study.

PubMed

van de Luijtgaarden, Moniek W M; Caskey, Fergus J; Wanner, Christoph; Chesnaye, Nicholas C; Postorino, Maurizio; Janmaat, Cynthia J; Rao, Anirudh; Torino, Claudia; Klinger, Marian; Drechsler, Christiane; Heimburger, Olof; Szymczak, Maciej; Evans, Marie; Dekker, Friedo W; Jager, Kitty J

2018-06-13

The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care. The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age  years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1.73 m2 for the first time during the last 6 months. The Dialysis Symptom Index was used to assess the prevalence and severity of 33 uraemic symptoms. Data on the clinical state at baseline were collected from medical records. Prevalence was standardized using the age distribution of women as the reference. The results in women (n = 512) and men (n = 967) did not differ with age (77.0 versus 75.7 years) or eGFR (19.0 versus 18.5). The median number of symptoms was 14 [interquartile range (IQR) 9-19] in women, and 11 (IQR 7-16) in men. Women most frequently reported fatigue {39% [95% confidence interval (CI) 34-45]} and bone/joint pain [37% (95% CI 32-42)] as severe symptoms, whereas more men reported difficulty in becoming sexually aroused [32% (95% CI 28-35)] and a decreased interest in sex [31% (95% CI 28-35)]. Anaemia [73% (95% CI 69-77) versus 85% (95% CI 82-87)] was less common in women than in men, as were smoking history and cardiovascular comorbidity. However, a diagnosis of liver disease other than cirrhosis, psychiatric disease and mild malnutrition were more common among women. Women in secondary care with an incident eGFR ≤20 mL/min/1.73 m2 reported a higher symptom burden, while their clinical state was considered similar or even more favourable as compared with men.

Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care

PubMed Central

2013-01-01

Background Frailty in the elderly increases their vulnerability and leads to a greater risk of adverse events. According to various studies, the prevalence of the frailty syndrome in persons age 65 and over ranges between 3% and 37%, depending on age and sex. Walking speed in itself is considered a simple indicator of health status and of survival in older persons. Detecting frailty in primary care consultations can help improve care of the elderly, and walking speed may be an indicator that could facilitate the early diagnosis of frailty in primary care. The objective of this work was to estimate frailty-syndrome prevalence and walking speed in an urban population aged 65 years and over, and to analyze the relationship between the two indicators from the perspective of early diagnosis of frailty in the primary care setting. Methods Population cohort of persons age 65 and over from two urban neighborhoods in northern Madrid (Spain). Cross-sectional analysis. Bivariate and multivariate analysis with binary logistic regression to study the variables associated with frailty. Different cut-off points between 0.4 and 1.4 m/s were used to study walking speed in this population. The relationship between frailty and walking speed was analyzed using likelihood ratios. Results The study sample comprised 1,327 individuals age 65 and older with mean age 75.41 ± 7.41 years; 53.4% were women. Estimated frailty in the study population was 10.5% [95% CI: 8.9-12.3]. Frailty increased with age (OR = 1.14; 95% CI: 1.10-1.19) and was associated with poor self-rated health (OR = 2.52; 95% CI: 1.43-4.44), number of drugs prescribed (OR = 1.17; 95% CI: 1.08-1.26) and disability (OR = 6.58; 95% CI: 3.92-11.05). Walking speed less than 0.8 m/s was found in 42.6% of cases and in 56.4% of persons age 75 and over. Walking speed greater than 0.9 m/s ruled out frailty in the study sample. Persons age 75 and older with walking speed <0.8 m/s are at particularly high

Aging road user studies of intersection safety.

DOT National Transportation Integrated Search

2014-10-01

Task 1.1 assessed younger (21-35 years), middle-aged (50-64 years), and older (65+) drivers ability to : quickly perceive the presence of marked/unmarked crosswalks and pedestrians within them in computer-based : laboratory tasks that recorded res...

Is there an association between food patterns and life satisfaction among Norway's inhabitants ages 65 years and older?

PubMed

André, Beate; Canhão, Helena; Espnes, Geir A; Ferreira Rodrigues, Ana Maria; Gregorio, Maria João; Nguyen, Camilla; Sousa, Rute; Grønning, Kjersti

2017-03-01

The lack of information regarding older adults' health and lifestyles makes it difficult to design suitable interventions for people at risk of developing unhealth lifestyles. Therefore, there is a need to increase knowledge about older adults' food patterns and quality of life. Our aim was to determine associations among food patterns, anxiety, depression, and life satisfaction in Norwegian inhabitants ages 65+. The Nord-Trøndelag Health Study (The HUNT Study) is a large, population-based cohort study that includes data for 125 000 Norwegian participants. The cohort used for this study is wave three of the study, consisting of 11 619 participants age 65 and over. Cluster analysis was used to categorize the participants based on similarities in food consumption; two clusters were identified based on similarities regarding food consumption among participants. Significant differences between the clusters were found, as participants in the healthy food-patterns cluster had higher life satisfaction and lower anxiety and depression than those in the unhealthy food-patterns cluster. The associations among food patterns, anxiety, depression, and life satisfaction among older adults show the need for increased focus on interactions among food patterns, food consumption, and life satisfaction among the elderly in order to explore how society can influence these patterns. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability].

PubMed

Gennaro, Nicola; Maggi, Stefania; Pellizzari, Michele; Carlucci, Francesco; Pilotto, Alberto; Saugo, Mario

2014-01-01

Early implementation of home care and 30 day readmissions in >65 years Veneto region patients discharged for heart failure and with disability. The effectiveness of Home care (HC) on preventing rehospitalizations in patients discharged for heart failure (HF) are uncertain. The aim of the study was to measure the impact of HC on early rehospitalizations of patients discharged for HF and with disabilities. Cohort retrospective study on >65 years patients, discharged at home and with a Barthel index <50. Variables considered were: previous hospitalizations for ischaemic cardiopathy ad/or chronic obstructive pulmonary disease, number of hospital admissions in the previous year, length of index hospitalization; outcomes considered were: hospital readmissions and days of hospitalizations 30 days from hospital discharge in patients with or without a home care visit within two days from hospital discharge. Of the 5.094 patients (60%>85 years), 14.8% received a HC visit within 2 days from discharge (43.7% from a nurse); 18.3% of patients (933) were readmitted within one month. In multivariate analyses an HC access within 2 days did not reduce the risk for readmission (although with better results in younger males but not in older women). An early HC visit reduced the days of hospital stay in males of all ages (65-74 years IRR 0.53 CI 95% 0.37-0.75; 75-84 years IRR 0.71 CI95% 0.60-0.83; 85+ years IRR 0.79 CI 95% 0.67-0.93) while in >75 years females there was a significant increase. An early HC visit (within two days from discharge) may have positive effects on males, but not in older women, possibly for the coexistence of socio-economic factors.

Prevalence of Eligibility Criteria for the Systolic Blood Pressure Intervention Trial in US Adults Among Excluded Groups: Age <50 Years, Diabetes Mellitus, or a History of Stroke.

PubMed

Bress, Adam P; Tanner, Rikki M; Hess, Rachel; Gidding, Samuel S; Colantonio, Lisandro D; Shimbo, Daichi; Muntner, Paul

2016-07-12

Adults <50 years old, with diabetes mellitus, or a history of stroke were not enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Estimating the size and characteristics of these excluded groups who meet the other SPRINT eligibility criteria may provide information on the potential impact of providers extending the SPRINT findings to these populations. We analyzed the National Health and Nutrition Examination Survey 2003-2012 (n=25 076) to estimate the percentage and characteristics of US adults ≥20 years in 3 populations (age <50 years, diabetes mellitus, or history of stroke) excluded from SPRINT who otherwise meet the trial eligibility criteria: age ≥50 years, systolic blood pressure (SBP) 130-180 mm Hg, high cardiovascular disease risk, and not having trial exclusion criteria. Overall, 1.0% (95% CI 0.8-1.3) of US adults age <50 years, 25.4% (95% CI 23.4-27.6) with diabetes mellitus, and 19.0% (95% CI 16.0-22.4) with history of stroke met the other SPRINT eligibility criteria. Among US adults with SBP ≥130 mm Hg, other SPRINT eligibility criteria were met by 7.5% (95% CI 6.1-9.2) of those age <50 years, 32.9% (95% CI 30.5-35.4) with diabetes mellitus, and 23.0% (95% CI 19.4-27.0) with history of stroke. Among US adults meeting the other SPRINT eligibility criteria, antihypertensive medication was being taken by 31.0% (95% CI 23.9-41.3) of those <50 years, 63.0% (95% CI 58.2-67.6) with diabetes mellitus, and 68.9% (95% CI 59.4-77.1) with a history of stroke. A substantial percentage of US adults with diabetes mellitus or history of stroke and a small percentage <50 years old meet the other SPRINT eligibility criteria. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

[Evaluation of a supervised physical exercise program in sedentary patients over 65 years with type 2 diabetes mellitus].

PubMed

Parra-Sánchez, Javier; Moreno-Jiménez, María; Nicola, Carla M; Nocua-Rodríguez, Ileana I; Amegló-Parejo, María R; Del Carmen-Peña, Marlen; Cordero-Prieto, Carlos; Gajardo-Barrena, María J

2015-11-01

To analyze whether an exercise program can modify glycated hemoglobin (HbA1c), blood pressure (BP), body mass index (BMI), lipids, cardiovascular risk profile (CVR), self-perceived health status (SHS), and pharmaceutical expenditure (PE). A randomized, single blind, controlled trial. program of supervised aerobic physical exercise. Analysis by intention to treat. Primary Care: 2 rural health areas. Health Area of Navalmoral. Cáceres. Extremadura. Spain. 100 type 2 diabetic patients, aged 65 to 80 years, sedentary. Distribution: 50% control group (CG) and 50% intervention group (IG). Abandoned 12%. monitored aerobic exercise: 40minutes, 2 days/week, 3 months. HbA1c, BP, BMI, lipid, CVR, SHS, PE. Complications during exercise. There were post-intervention differences between groups in HbA1c, BP, BMI, cholesterol and SHS. In the IG, there was a significant decrease in; HbA1c: 0.2±0.4% (95% CI: 0.1 to 0.3), systolic BP: 11.8±8.5mmHg (95% CI: 5.1 to 11.9), BMI: 0.5±1 (95% CI: 0.2 to 0.8), total cholesterol: 14±28.2mg/dl (95% CI: 5.9 to 22.2), LDL: 18.3±28.2mg/dl 95% CI: 10.2 to 26.3), CVR: 6.7±7.7% (95% CI: 4.5 to 8.9), PE: 3.9±10.2 € (95% CI: 0.9 to 6.8), and an increase in SHS; 4.7±5.7 (95% CI: 3 to 6.3). In diabetics over 65 years, a program of monitored aerobic exercise, of easy implementation, improves HbA1c, BP, cholesterol, CVR, PE, and SHS. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Renal Tumors in Children Younger Than 12 Months of Age: A 65-Year Single Institution Review.

PubMed

Lamb, Margaret G; Aldrink, Jennifer H; O'Brien, Sarah H; Yin, Han; Arnold, Michael A; Ranalli, Mark A

2017-03-01

Wilms tumor (WT) is the most prevalent pediatric renal tumor and most commonly occurs between ages 1 and 5 years. Data are lacking on children younger than 12 months with renal tumors. The cancer registry at the authors' institution was queried to identify patients 12 months and younger with renal masses. Demographics, clinical presentation, histopathology, stage, and survival outcomes were reviewed. The most common presenting symptoms included an asymptomatic abdominal mass (73%) and hematuria (9%). Histopathology revealed WT in 73% of patients, mesoblastic nephroma in 20%. Of those infants younger than 1 month of age, mesoblastic nephroma was the most common histopathology (68%). The 5-year overall survival (OS) was 93%, and 5-year event-free survival (EFS) was 93% for the entire group. For patients with WT, 5-year OS was 88% and 5-year EFS was 83%. Outcomes for congenital mesoblastic nephroma were excellent with 5-year OS and EFS of 100%. Reasons for good prognosis may be multifactorial and may include frequent well child checks in the first year of life and favorable histology. Patients in this age group are more likely to be classified as very low risk and may be treated with surgical resection alone.

The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older.

PubMed

Morillas, Pedro; Pallarés, Vicente; Fácila, Lorenzo; Llisterri, Jose Luis; Sebastián, María Eugenia; Gómez, Manuel; Castilla, Elena; Camarasa, Raquel; Sandin, Miriam; García-Honrubia, Antonio

2015-06-01

The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population. The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

[Aging negative stereotypes and their relationship with sociodemographic variables over 65 elderly].

PubMed

Sánchez Palacios, Concepción; Trianes Torres, M Victoria; Blanca Mena, M José

2009-01-01

The aim of the present study was to determine whether there are any associations between the degree of belief in negative stereotypes of aging in 65- to 96-year-old and the following sociodemographic variables: gender, age, marital status and educational level. The sample consisted of 757 non-institutionalized people divided into four age groups. Gender was homogeneously distributed in all groups. During an interview, the participants responded to a questionnaire that was organized in two parts. The first part collected data on age, educational level, gender and marital status. The second part consisted of a scale of negative stereotype of aging (Cuestionario de Estereotipos Negativos hacia la Vejez [CENVE]), with three factors: health, social-motivational and character-personality. Significant differences were found in relation to age but not in relation to gender. In relation to the health factor, participants aged more than 80 showed weaker stereotypes than the remaining age groups. In relation to the social-motivational factor, the older the participants, the stronger the negative stereotypes in relation to a decrease in interests in life. Persons with lower educational level scored higher on the health and character-personality factors of the CENVE. The results are discussed in relation to their potential applications in psychosocial interventions.

Improved Outcome of Enteric Peritonitis in Peritoneal Dialysis Patients Aged 50 Years and Older with Temporary Discontinuation of Peritoneal Dialysis and Intravenous Meropenem.

PubMed

Abrahams, Alferso C; Rüger, Wim; Ter Wee, Pieter M; van Ittersum, Frans J; Boer, Walther H

2017-01-01

♦ BACKGROUND: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol). ♦ METHODS: In this observational study, we compared the outcome of 203 peritonitis episodes in 71 patients treated with the Mero-PerRest protocol, with 217 episodes in 104 patients treated with a more traditional intraperitoneal gentamicin-rifampicin-based regimen. ♦ RESULTS: In EM peritonitis episodes, the Mero-PerRest protocol resulted in a higher primary cure rate (90.0% vs 65.3%, adjusted odds ratio [OR] 4.54 [95% confidence interval (CI) 1.46 - 14.15]) and better technique survival (90.0% vs 69.4%, adjusted OR 3.41 [95% CI 1.07 - 10.87]). This effect was most distinct in patients with polymicrobial EM peritonitis (cure rate 87.5% vs 34.8%, p = 0.0003). Interestingly, primary cure rate (95.6% vs 84.7%, adjusted OR 3.92 [95% CI 1.37 - 11.19]) and technique survival (95.6% vs 85.6%, adjusted OR 3.60 [95% CI 1.25 - 10.32]) were also excellent in non-EM peritonitis episodes. Patient survival did not differ significantly. ♦ CONCLUSION: The poor outcome of peritonitis caused by EM in PD patients aged 50 years and older could be improved by applying a treatment protocol involving temporary discontinuation of PD without catheter removal and intravenous and intracatheter meropenem. Copyright © 2017 International Society for Peritoneal Dialysis.

50 CFR 679.65 - Bering Sea Chinook Salmon Bycatch Management Program Economic Data Report (Chinook salmon EDR...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Bering Sea Chinook Salmon Bycatch Management Program Economic Data Report (Chinook salmon EDR program). 679.65 Section 679.65 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE...

Chronic health conditions in Medicare beneficiaries 65 years old, and older with HIV infection.

PubMed

Friedman, Eleanor E; Duffus, Wayne A

2016-10-23

To examine sociodemographic factors and chronic health conditions of people living with HIV (PLWHIV/HIV+) at least 65 years old and compare their chronic disease prevalence with beneficiaries without HIV. National fee-for-service Medicare claims data (parts A and B) from 2006 to 2009 were used to create a retrospective cohort of beneficiaries at least 65 years old. Beneficiaries with an inpatient or skilled nursing facility claim, or outpatient claims with HIV diagnosis codes were considered HIV+. HIV+ beneficiaries were compared with uninfected beneficiaries on demographic factors and on the prevalence of hypertension, hyperlipidemia, ischemic heart disease, rheumatoid arthritis/osteoarthritis, and diabetes. Odds ratios (OR), 95% confidence intervals (CIs), and P values were calculated. Adjustment variables included age, sex, race/ethnicity, end stage renal disease (ESRD), and dual Medicare-Medicaid enrollment. Chronic conditions were examined individually and as an index from zero to all five conditions. Of 29 060 418 eligible beneficiaries, 24 735 (0.09%) were HIV+. HIV+ beneficiaries were more likely to be Hispanic, African-American, male, and younger (P > 0.0001) and were 1.5-2.1 times as likely to have a chronic disease [diabetes (adjusted OR) 1.51, 95% CI (1.47, 1.55): rheumatoid arthritis/osteoarthritis 2.14, 95% CI (2.08, 2.19)], and 2.4-7 times as likely to have 1-5 comorbid chronic conditions [1 condition (adjusted OR) 2.38, 95% CI (2.21, 2.57): 5 conditions 7.07, 95% CI (6.61, 7.56)]. Our results show that PLWHIV at least 65 years old are at higher risk of comorbidities than other fee-for-service Medicare beneficiaries. This finding has implications for the cost and health management of PLWHIV 65 years and older.

Lifelong occupational exposures and hearing loss among elderly Latino Americans aged 65–75 years

PubMed Central

Hong, OiSaeng; Chin, Dal Lae; Kerr, Madeleine J.

2015-01-01

Objective The purpose of this study is to determine the relationship between occupational exposures and hearing among elderly Latino Americans. Design A descriptive, correlational design used for this secondary analysis with the data from the Sacramento Area Latino Study of Aging (SALSA). Study sample A total of 547 older adults were included. Results A majority of participants (58%) reported occupational exposures to loud noise and/or ototoxic chemicals. About 65% and over 90% showed hearing loss at low and high frequencies, respectively. Participants with occupational exposure to loud noise and/or ototoxic chemicals were, significantly, two times more likely to have hearing loss at high frequencies compared to those without exposure (OR = 2.29; 95% CI: 1.17 – 4.51, p = .016), after controlling for other risk factors of hearing loss such as age, gender, household income, current smoking, and diabetes. However, lifelong occupational exposure was not significantly associated with hearing loss at low frequencies (OR = 1.43; 95% CI: 0.94 – 2.18, p = .094). Conclusion Lifelong occupational exposure to loud noise and/or ototoxic chemicals was significantly associated with hearing loss among elderly Latino Americans. Healthy work life through protection from harmful auditory effects of occupational exposures to noise and chemicals will have a positive impact on better hearing in later life. PMID:25549170

Perceived stress and change in cognitive function among adults 65 years and older.

PubMed

Aggarwal, Neelum T; Wilson, Robert S; Beck, Todd L; Rajan, Kumar B; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

2014-01-01

Exposure to acute and chronic stress can affect learning and memory, but most evidence comes from animal studies or clinical observations. Almost no population-based studies have investigated the relation of stress to cognition or changes in cognition over time. We examined whether higher levels of perceived stress were associated with accelerated decline in cognitive function in older blacks and whites from a community-based population sample. Participants included 6207 black and white adults (65.7% black, 63.3% women) from the Chicago Health and Aging Project. Two to five in-home assessments were completed over an average of 6.8 years of follow-up and included sociodemographics, health behaviors, psychosocial measures, cognitive function tests, and health history. Perceived stress was measured by a six-item scale, and a composite measure of four tests of cognition was used to determine cognitive function at each assessment. Mixed-effects regression models showed that increasing levels of perceived stress were related to lower initial cognitive scores (B = -0.0379, standard error = 0.0025, p < .001) and a faster rate of cognitive decline (stress × time interaction: B = -0.0015, standard error = 0.0004, p < .001). Results were similar after adjusting for demographic variables, smoking, systolic blood pressure, body mass index, chronic medical conditions, and psychosocial factors and did not vary by race, sex, age, or education. Increasing levels of stress are independently associated with accelerated declines in cognitive function in black and white adults 65 years and older.

The Associations between Falls, Fall Injuries and Labor Market Outcomes among U.S. Workers 65 Years and Older.

PubMed

Scott, Kenneth; Fisher, Gwenith G; Barón, Anna E; Tompa, Emile; Stallones, Lorann; DiGuiseppi, Carolyn

2018-06-13

To examine whether falls are associated with the subsequent ability to work among workers 65 years and older. This longitudinal cohort study followed older workers enrolled in the Health and Retirement Study. Outcomes included time to health-related work limitation and to labor force exit. After adjustment multiple falls with or without a medically-treated injury were associated with time to limitation (HR = 1.77, 95% CI: 1.30-2.40; HR = 1.48, 95% CI: 1.26-1.73, respectively). Adjustment mitigated a crude relationship between falls and time to exit. Significant interactions suggest the relationship between falls and labor force exit depends on age, race and job demands. Falls, both non-injurious and injurious, are associated with subsequent health-related work limitation among workers 65 and older. Fall prevention activities would benefit workers who want or need to keep working past age 65.

Myocardial infarction in men and women under 65 years of age: no evidence of gender bias.

PubMed

Bannerman, A; Hamilton, K; Isles, C; Barrington, H; Donaldson, B; Lockhart, L; McMeeken, K; Mark, J; Norrie, J

2001-06-01

We examined short and long term outcomes of MI in a consecutive series of 169 men and 50 women who were followed for an average of 3.5 years. Similar percentages of men and women were admitted to medical intensive care, received in-patient cardiac rehabilitation, quit smoking at one year, were still smoking, were taking a lipid lowering drug or had returned to work at one year, underwent coronary angiography at 3.5 years or had died by 3.5 years. The lack of gender difference in outcome may reflect an absence of gender bias in the management of men and women with MI in southwest Scotland.

Influenza immunisation rate for 2005 and factors associated with receiving this vaccine in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital.

PubMed

Curry, Elizabeth; Kerr, Nathan; Yang, Joseph; Briggs, Simon

2006-10-13

To assess the influenza immunisation rate for 2005 in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital, New Zealand; to identify factors associated with receiving this vaccine; and to assess whether particular patient groups have a low influenza immunisation rate. Consecutive patients aged 65 years and over admitted to two medical wards were surveyed. Demographic data, how recently patients had last seen their general practitioner (GP), whether patients had received an influenza vaccine reminder from their GP, and whether patients had received the influenza vaccine in 2005 were recorded. Logistic regression analysis was performed to investigate which variables were associated with receiving the influenza vaccine. 148 of 200 (74%) patients who answered the questionnaire received the influenza vaccine. The variables found to be associated with receiving the influenza vaccine were whether patients had seen their GP in the last 6 months and whether patients had received an influenza vaccine reminder from their GP. Three-quarters of patients in this study received the influenza vaccine. We have not been able to identify patient groups that have a low influenza immunisation rate. Reminding patients of the benefits of the influenza vaccine or offering this at the time of discharge from hospital as autumn approaches each year may increase the influenza immunisation rate of those recently hospitalised.

Lifelong physical activity in maintaining bone strength in older men and women of the Age, Gene/Environment Susceptibility-Reykjavik Study.

PubMed

Rianon, N J; Lang, T F; Sigurdsson, G; Eiriksdottir, G; Sigurdsson, S; Garcia, M; Pajala, S; Koster, A; Yu, B; Selwyn, B J; Taylor, W C; Kapadia, A S; Gudnason, V; Launer, L J; Harris, T B

2012-09-01

We examined if lifelong physical activity is important for maintaining bone strength in the elderly. Associations of quantitative computerized tomography-acquired bone measures (vertebral and femoral) and self-reported physical activity in mid-life (mean age, 50 years), in old age (≥65 years), and throughout life (recalled during old age) were investigated in 2,110 men and 2,682 women in the AGES-Reykjavik Study. Results conclude lifelong physical activity with continuation into old age (≥65 years) best maintains better bone health later in life. Skeletal loading is thought to modulate the loss of bone in later life, and physical activity is a chief means of affecting bone strength by skeletal loading. Despite much discussion regarding lifelong versus early adulthood physical activity for preventing bone loss later in life, inconsistency still exists regarding how to maintain bone mass later in life (≥65 years). We examined if lifelong physical activity is important for maintaining bone strength in the elderly. The associations of quantitative computerized tomography-acquired vertebral and femoral bone measures and self-reported physical activity in mid-life (mean age, 50 years), in old age (≥65 years), and throughout life (recalled during old age) were investigated in 2,110 men and 2,682 women in the AGES-Reykjavik Study. Our findings conclude that lifelong physical activity with continuation into old age (≥65 years) best maintains better bone health in the elderly.

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years

PubMed Central

Wolosker, Nelson; Krutman, Mariana; Teivelis, Marcelo Passos; de Paula, Rafael Pessanha; Kauffman, Paulo; de Campos, Jose Ribas Milanez; Puech-Leão, Pedro

2014-01-01

ABSTRACT Objective: Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods: Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results: In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion: Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis. PMID:24728245

The influence of different classification standards of age groups on prognosis in high-grade hemispheric glioma patients.

PubMed

Chen, Jian-Wu; Zhou, Chang-Fu; Lin, Zhi-Xiong

2015-09-15

Although age is thought to correlate with the prognosis of glioma patients, the most appropriate age-group classification standard to evaluate prognosis had not been fully studied. This study aimed to investigate the influence of age-group classification standards on the prognosis of patients with high-grade hemispheric glioma (HGG). This retrospective study of 125 HGG patients used three different classification standards of age-groups (≤ 50 and >50 years old, ≤ 60 and >60 years old, ≤ 45 and 45-65 and ≥ 65 years old) to evaluate the impact of age on prognosis. The primary end-point was overall survival (OS). The Kaplan-Meier method was applied for univariate analysis and Cox proportional hazards model for multivariate analysis. Univariate analysis showed a significant correlation between OS and all three classification standards of age-groups as well as between OS and pathological grade, gender, location of glioma, and regular chemotherapy and radiotherapy treatment. Multivariate analysis showed that the only independent predictors of OS were classification standard of age-groups ≤ 50 and > 50 years old, pathological grade and regular chemotherapy. In summary, the most appropriate classification standard of age-groups as an independent prognostic factor was ≤ 50 and > 50 years old. Pathological grade and chemotherapy were also independent predictors of OS in post-operative HGG patients. Copyright © 2015. Published by Elsevier B.V.

Cost-effectiveness of digital mammography screening before the age of 50 in The Netherlands.

PubMed

Sankatsing, Valérie D V; Heijnsdijk, Eveline A M; van Luijt, Paula A; van Ravesteyn, Nicolien T; Fracheboud, Jacques; de Koning, Harry J

2015-10-15

In the Netherlands, routine mammography screening starts at age 50. This starting age may have to be reconsidered because of the increasing breast cancer incidence among women aged 40 to 49 and the recent implementation of digital mammography. We assessed the cost-effectiveness of digital mammography screening that starts between age 40 and 49, using a microsimulation model. Women were screened before age 50, in addition to the current programme (biennial 50-74). Screening strategies varied in starting age (between 40 and 50) and frequency (annual or biennial). The numbers of breast cancers diagnosed, life-years gained (LYG) and breast cancer deaths averted were predicted and incremental cost-effectiveness ratios (ICERs) were calculated to compare screening scenarios. Biennial screening from age 50 to 74 (current strategy) was estimated to gain 157 life years per 1,000 women with lifelong follow-up, compared to a situation without screening, and cost €3,376/LYG (3.5% discounted). Additional screening increased the number of LYG, compared to no screening, ranging from 168 to 242. The costs to generate one additional LYG (i.e., ICER), comparing a screening strategy to the less intensive alternative, were estimated at €5,329 (biennial 48-74 vs. current strategy), €7,628 (biennial 45-74 vs. biennial 48-74), €10,826 (biennial 40-74 vs. biennial 45-74) and €18,759 (annual 40-49 + biennial 50-74 vs. biennial 40-74). Other strategies (49 + biennial 50-74 and annual 45-49 + biennial 50-74) resulted in less favourable ICERs. These findings show that extending the Dutch screening programme by screening between age 40 and 49 is cost-effective, particularly for biennial strategies. © 2015 UICC.

Reference values for body composition and associations with blood pressure in Kenyan adults aged ≥50 years old.

PubMed

Bastawrous, Madeleine C; Piernas, Carmen; Bastawrous, Andrew; Oke, Jason; Lasserson, Daniel; Mathenge, Wanjiku; Burton, Matthew J; Jebb, Susan A; Kuper, Hannah

2018-05-15

To develop age- and sex-specific centile reference curves for fat-free mass (FFM) and fat mass (FM) adjusted for height in an adult Kenyan population and to investigate the association between FM, FFM and blood pressure (BP). Measures of body composition from bioimpedance analyses and BP were collected in 1995 participants aged ≥50 years in Nakuru County, Kenya. Reference curves were produced using the LMS method. Multivariable linear regression models were used to test the cross-sectional association between body composition indexes and BP. The age- and sex-specific reference curves for body composition (FMI and FFMI) confirmed that FFMI is lower in both men and women with increasing age. FMI declines with age in women while among men the decline starts after 70 years. FFM was higher in men (47.4 ± 7.2 kg) than in women (38.8 ± 5.5 kg), while FM was lower in men (17.3 ± 8.1 kg) than in women (24.4 ± 10.2 kg). FMI, FFMI and BMI were all positively associated with systolic and diastolic BP, and after adjusting for body weight, FFMI remained positively associated with systolic BP and the FMI remained positively associated with diastolic BP. There was no evidence to suggest that FMI and FFMI were superior to measurement of BMI alone. These body composition reference curves provide normative data on body composition for older adults in Kenya. Further research should consider the prospective associations with health, including frailty-related outcomes.

Contextualizing Psychosocial Determinants of Alcohol Use by Age Cohorts of Adults Living With HIV, Ages 50 and Older.

PubMed

Mannes, Zachary L; Burrell, Larry E; Dunne, Eugene M; Hearn, Lauren E; Whitehead, Nicole Ennis

We examined the influence of age on associations between affective states, social support, and alcohol use by age cohorts. We recruited 96 older Black adults living with HIV from the southeastern United States in 2013 and 2014. Participants completed questionnaires assessing demographics, psychological function, and substance use. Hierarchical regression analyses assessed the relationship between psychosocial factors and alcohol use in a 50- to 59-year-old group, and a 60-years-and-older age group. After controlling for covariates, trait anger, state anger, and life stress were positively associated with alcohol consumption in the younger group, while social support was negatively associated with alcohol consumption in the older group. Interventions should target negative affective states in 50- to 59-year-old adults with HIV, and preserve social support for adults with HIV as they age, as such interventions will likely have an impact on these individuals' alcohol consumption and longstanding quality of life. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

The Effect of Overweight/Obesity on Cardiovascular Responses to Acute Psychological Stress in Men Aged 50-70 Years

PubMed Central

Torres, Susan J.; Turner, Anne I.; Jayasinghe, Sisitha U.; Reynolds, John; Nowson, Caryl A.

2014-01-01

Background To determine the effect of adiposity in males aged 50-70 years on cardiovascular responses to acute psychological stress. Methods Lean (BMI 20-25 kg/m2) (n = 21) and overweight/obese (BMI 27-35 kg/m2) (n = 21) men aged 50-70 years were subjected to psychological stress. Systolic blood pressure, diastolic blood pressure, heart rate, total peripheral resistance, and cardiac output were measured by a Finometer during resting (60 min), stress (30 min), and recovery (90 min). Results The lean group had a significantly higher SBP stress reactivity when compared to the overweight/obese group (51.5 ± 3.7% vs. 41.0 ± 2.9% (mean ± SEM); p < 0.05). A significant effect of time was observed for systolic blood pressure, diastolic blood pressure, heart rate, total peripheral resistance, and cardiac output (p < 0.0001 for all). There were significant time × body type interactions for systolic blood pressure, diastolic blood pressure, heart rate, total peripheral resistance, and cardiac output (p < 0.05 for all). Total peripheral resistance during recovery was higher in the lean compared to the overweight/obese group (p < 0.05). In the lean group, systolic and diastolic blood pressure variability remained elevated after stress (p < 0.05) but returned to resting levels in the overweight/obese group (p > 0.05). Conclusion Moderate adiposity in men was associated with reduced systolic blood pressure % reactivity, total peripheral resistance, and blood pressure variability after psychological stress. Overweight/obese men appear to be at no greater risk of unfavorable cardiovascular responses to stress. PMID:25428119

Profile of NF-κBp(65/NFκBp50) among prostate specific antigen sera levels in prostatic pathologies.

PubMed

Bouraoui, Y; Ben Jemaa, A; Rodriguez, G; Ben Rais, N; Fraile, B; Paniagua, R; Sellemi, S; Royuela, M; Oueslati, R

2012-10-01

The aim of this work was to characterise the immunoexpression of NF-κB (p50/p65) in human prostatic pathologies and to study its profiles of activation among sera prostate specific antigen antigen (PSA) according the three groups: 0-4ng/mL, 4-20ng/mL and >20ng/mL. Twenty-four men with benign prostate hyperplasia (BPH); 19 men with prostate cancer (PC) and five men with normal prostates (NP). Immunohistochemical and western blot analysis was performed. Serum levels of PSA were assayed by immulite autoanalyser. In BPH and PC samples, immunoexpressions were observed for NF-κBp65 and NF-κBp50; while in NP samples, only were detected NF-κBp50. PC samples showed immunoreactions to NF-κBp65 and NF-κBp50 more intense (respectively 24.18±0.67 and 28.23±2.01) than that observed in BPH samples (respectively18.46±2.04 and 18.66±1.59) with special localisation in the nucleus. Different profiles of NF-κBp65 immunoexpressions were observed and BPH patients with sera PSA levels between 0-4ng/mL presented a significant weak percentage compared to BPH patients with sera PSA levels between 4-20ng/mL and >20ng/mL. No immunoreactions to NF-κBp65 were observed in PC patients with sera PSA levels between 4-20ng/mL. The sensibility of both NF-κB and PSA to inflammation allowed confirming the relationship between these two molecules and its involvement in prostatic diseases progression (inflammatory and neoplasic). Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Successful amblyopia therapy initiated after age 7 years: compliance cures.

PubMed

Mintz-Hittner, H A; Fernandez, K M

2000-11-01

To report successful therapy for anisometropic and strabismic amblyopia initiated after age 7 years. A consecutive series of 36 compliant children older than 7 years (range, 7.0 to 10.3 years; mean, 8.2 years) at initiation of amblyopia therapy for anisometropic (19 patients; mean age, 8.3 years), strabismic (9 patients; mean age, 8.0 years), or anisometropic and strabismic (8 patients; mean age, 8.0 years) amblyopia was studied. Initial (worst) visual acuities were between 20/50 and 20/400 (log geometric mean, -0.83 [antilog, 20/134] for all patients; -0.88 [antilog, 20/151] for anisometropic patients; -0.70 [antilog, 20/100] for strabismic patients; and -0.88 [antilog, 20/151] for anisometropic and strabismic patients). Initial (worst) binocularity was absent or reduced in all cases. Therapy consisted of (1) full-time standard occlusion (21 patients; mean age, 8.0 years), (2) total penalization (7 patients; mean age, 7.8 years), or (3) full-time occlusive contact lenses (8 patients; mean age, 8.8 years). Final (best) visual acuities were between 20/20 and 20/30 for all 36 patients. Final (best) binocularity was maintained or improved for 22 (61%) of 36 patients, including 16 anisometropic patients (84%), 2 strabismic patients (22%), and 4 anisometropic and strabismic patients (50%). Given compliance, therapy for anisometropic and strabismic amblyopia can be successful even if initiated after age 7 years. Arch Ophthalmol. 2000;118:1535-1541

Relationship Between the Remaining Years of Healthy Life Expectancy in Older Age and National Income Level, Educational Attainment, and Improved Water Quality.

PubMed

Kim, Jong In; Kim, Gukbin

2016-10-01

The remaining years of healthy life expectancy (RYH) at age 65 years can be calculated as RYH (65) = healthy life expectancy-aged 65 years. This study confirms the associations between socioeconomic indicators and the RYH (65) in 148 countries. The RYH data were obtained from the World Health Organization. Significant positive correlations between RYH (65) in men and women and the socioeconomic indicators national income, education level, and improved drinking water were found. Finally, the predictors of RYH (65) in men and women were used to build a model of the RYH using higher socioeconomic indicators (R(2 )= 0.744, p < .001). Overall country-level educational attainment, national income level, and improved water quality influenced the RYH at 65 years. Therefore, policymaking to improve these country-level socioeconomic factors is expected to have latent effects on RYH in older age. © The Author(s) 2016.

An Intervention Study on Screening for Breast Cancer Among Single African-American Women Aged 65 and Older

DTIC Science & Technology

1999-09-01

Since the single constitute 75% of African-American women aged 65 and older , and the incidence and mortality of cancer are especially high in elderly ...Breast Cancer Among Single African-American Women Aged 65 and Older PRINCIPAL INVESTIGATOR: Kangmin Zhu, M.D., Ph.D. CONTRACTING ORGANIZATION: Meharry...to improve the breast screening behavior among single African-American women ages 65 and older . During the period, we (1) finished post-intervention

The incidence and survival of acute de novo leukaemias in Estonia and in a well-defined region of western Sweden during 1982-1996: a survey of patients aged > or =65 years.

PubMed

Luik, E; Palk, K; Everaus, H; Varik, M; Aareleid, T; Wennström, L; Juntikka, E-L; Safai-Kutti, S; Stockelberg, D; Holmberg, E; Kutti, J

2004-07-01

To compare the incidence and survival of acute de novo leukaemias with particular reference to political/socio-economic and environmental factors in two neighbouring countries over the three 5-year periods (1982-1996). The present report covers only patients diagnosed when aged > or =65 years. A well-defined area of Sweden, the so-called Western Swedish Health Care Region and Estonia. Population-wise, the western Swedish Region and Estonia are very similar; area-wise they are also well comparable. The number of acute de novo leukaemias was quite dissimilar in the two countries (Estonia, n = 137, Sweden, n = 354). The age standardized incidence rates regarding the total number of acute de novo leukaemias was 5.31 per 100,000 inhabitants/year for Estonia and 7.99 for Sweden, this difference being statistically significant. However, the difference was merely attributable to incidence rates as regards acute myeloblastic leukaemias (AML); on the contrary, differences as regards acute lymphoblastic leukaemias (ALL) and non-classifiable, undifferentiated or biphenotypic acute leukaemias (uAL) were negligible. The relative survival for the total material of patients was significantly higher for Swedish when compared with Estonian patients (P < 0.001). Thus, the relative survival for the total material of patients aged > or =65 years in Estonia at 1 year was 8.5% and at 3 years 3.5% respectively. The corresponding figures for the Swedish patients were considerably higher, 22.7 and 7.7% respectively. This difference, however, applied only for patients with AML (P < 0.001), whereas the results for patients with ALL and uAL were equally dismal. The results clearly reflect how political and socio-economic factors may influence the survival of acute leukemia patients in two neighbouring countries.

Sick leave among people in paid work after age 65: A Swedish population-based study covering 1995, 2000, 2005 and 2010.

PubMed

Farrants, K; Marklund, S; Kjeldgård, L; Head, J; Alexanderson, K

2018-05-01

Extending working life into older age groups is discussed in many countries. However, there is no knowledge about how this affects rates of sick leave. The aim of this work was to investigate rates of sick leave among people in paid work after retirement age and if such rates have changed over time. Swedish nationwide register data on people aged >65 years and living in Sweden in 1995, 2000, 2005 and 2010 were analysed. All people with a sufficiently high work income to be eligible for public sick leave benefits were included. The proportions in paid work and compensated rates of sick leave for people aged 66-70 and ≥71 were analysed by sex, educational level, country of birth, living area, and employment type and sector. The percentage of people in paid work at ages 66-70 years increased from <10% in 1995 to 24% in 2010 and among those aged ≥71 years from 2.7% in 1995 to 3.5% in 2010. The rates of sick leave among working people aged 66-70 years were 3.3% in 1995 and 2.4% in 2010 and for people aged ≥71 years the rates of sick leave were 2.2% in 1995 and 0.2% in 2010. Women had higher rates of sick leave than men in 2005 and 2010, but lower in 1995 and 2000. In 2010, the rates of sick leave were similar between employees and the self-employed, and higher among employees in the public sector than among employees in the private sector. Rates of sick leave among workers aged >65 years were lower in 2010 than in 1995, despite much higher rates of labour market participation in 2010.

A cross-sectional analysis of age and sex patterns in grip strength, tooth loss, near vision and hearing levels in Chinese aged 50-74 years.

PubMed

Wu, Yili; Pang, Zengchang; Zhang, Dongfeng; Jiang, Wenjie; Wang, Shaojie; Li, Shuxia; Kruse, Torben A; Christensen, Kaare; Tan, Qihua

2012-01-01

By focusing on four health variables, handgrip strength, near visual acuity, tooth loss and hearing level, this study examined the different patterns of age-related changes in these variables in Chinese aged from 50 to 74 years, as well as explored the relationship among the variables in a cross-sectional sample of 2006 individuals. The data exhibited high quality with a low missing rate of under 5% in any age groups for each variable. Effects of age and sex on the changes in the four health variables were assessed using multiple regression models with age and sex interactions included. Upon the highly significant effects of age on all four measurements, we observed substantially higher grip strength for men who, however, exhibited a faster age-related decline than for women. No sex difference or age-sex interaction was found in the number of teeth lost. Near visual acuity displayed a faster age-related decline in women than in men but neither the overall sex difference nor age-sex interaction reached statistical significance. For hearing function, while no sex difference was found at middle frequency, women had better sensitivity at high frequency and men were more sensitive at low frequency. Multivariate analysis did not support an age-related common mechanism underlying the four health variables. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Gender and age-dependent differences in body composition changes in response to cardiac rehabilitation exercise training in patients after coronary artery bypass grafting.

PubMed

Socha, Małgorzata; Wronecki, Krzysztof; Sobiech, Krzysztof A

2017-09-21

Cardiac rehabilitation (CR) is the standard procedure in persons after coronary artery bypass grafting (CABG). Its basic aim is to combat coronary heart disease (CHD) risk factors through physical activity and normalization of body mass. Many authors highlight the differences in response to training in CR as dependent on gender, age and occurrence of accompanying disease. The aim of this study is to assess the effectiveness of a three-week early CR in reference to changing body composition parameters in patients over 50 years of age. The study involved a random group of 65 patients (44 men and 21 women) between the ages of 50-76 (average: 62.6 ± 7.2) years with CHD following CABG. Anthropometric and body composition (bioelectrical impedance method) measurements were taken at the commencement of CR and after the training programme. After CR, body mass and body mass index were reduced in men < 65 and ≥ 65 years, and in women <65 years. A reduction % body fat and increase % fat free mass and % total body water was observed only in patients <65. years. Furthermore, in men < 65 years, an increase in % body cell mass was observed. In women ≥ 65 years, no statistically significant changes were observed in body fat indices and body composition features between initial and final study. Patients ≥ 65 years of age following surgery over a period of hospital cardiac rehabilitation do not experience the same significant improvement in body composition parameters associated with risk of CHD as middle-aged adults. Older women post-cardiac surgery are characterized by a higher disability index in relation to tolerance to physical stress in comparison with men of the same age and persons < 65 years of age.

Comparison of intramuscular and subcutaneous administration of a herpes zoster live-attenuated vaccine in adults aged ≥50 years: a randomised non-inferiority clinical trial.

PubMed

Diez-Domingo, Javier; Weinke, Thomas; Garcia de Lomas, Juan; Meyer, Claudius U; Bertrand, Isabelle; Eymin, Cécile; Thomas, Stéphane; Sadorge, Christine

2015-02-04

Zostavax(®) is a live, attenuated varicella zoster virus (VZV) vaccine developed specifically for the prevention of HZ and PHN in individuals aged ≥50 years. During the clinical development of Zostavax, which was mainly in the US, the vaccine was administrated by the subcutaneous (SC) route. In Europe, many healthcare professionals prefer administering vaccines by the intramuscular (IM) route. This was an open-label, randomised trial conducted in 354 subjects aged ≥50 years. The primary objectives were to demonstrate that IM administration is both non-inferior to SC administration in terms of 4-week post-vaccination geometric mean titres (GMTs), and elicits an acceptable geometric mean fold-rise (GMFR) of antibody titres measured by glycoprotein enzyme-linked immunosorbent assay. Pre-specified non-inferiority was set as the lower bound of the 95% confidence interval (CI) of the GMT ratio (IM/SC) being >0.67. An acceptable GMFR for the IM route was pre-specified as the lower bound of its 95% CI being >1.4. Description of the VZV immune response using the interferon-gamma enzyme-linked immunospot (IFN-γ ELISPOT) assay and of the safety were secondary objectives. Participants were randomised to IM or SC administration (1:1). The baseline demographics were comparable between groups; mean age: 62.6 years (range: 50.0-90.5). The primary immunogenicity objectives were met (per protocol analysis): GMT ratio (IM/SC): 1.05 (95% CI: 0.93-1.18); GMFR: 2.7 (2.4-3.0). VZV immune response using IFN-γ ELISPOT were comparable between groups. Frequencies of systemic adverse events were comparable between groups. Injection-site reactions were less frequent with IM than SC route: erythema (15.9% versus 52.5%), pain (25.6% versus 39.5%) and swelling (13.6% versus 37.3%), respectively. In adults aged ≥50 years, IM administration of Zostavax elicited similar immune responses to SC administration and was well tolerated, with fewer injection-site reactions than with SC

Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol.

PubMed

Pérula-de-Torres, Luis Á; Martínez-Adell, Miguel Á; González-Blanco, Virginia; Baena-Díez, José M; Martín-Rioboó, Enrique; Parras-Rejano, Juan M; González-Lama, Jesús; Martín-Alvarez, Remedios; Ruiz-Moral, Roger; Fernández-García, José Á; Pérez-Díaz, Modesto; Ruiz-de-Castroviejo, Joaquin; Pérula-de-Torres, Carlos; Valero-Martín, Antonio; Roldán-Villalobos, Ana; Criado-Larumbe, Margarita; Burdoy-Joaquín, Emili; Coma-Solé, Montserrat; Cervera-León, Mercè; Cuixart-Costa, Lluís

2012-10-30

Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. The study is registered as NCT01291953 (ClinicalTrials.gob).

Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol

PubMed Central

2012-01-01

Background Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. Methods/design An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). Discussion If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. Trial registration The study is registered as NCT01291953 (ClinicalTrials.gob) PMID:23130754

Cervical spine fractures in patients 65 years or older: a 3-year experience at a level I trauma center.

PubMed

Damadi, Amir A; Saxe, Andrew W; Fath, John J; Apelgren, Keith N

2008-03-01

Cervical spine fractures in the elderly carry a mortality as high as 26%. We reviewed our experience to define the level of injury, prevalence of neurologic deficits, treatments employed, and the correlation between patients' pre- and posthospital residences. Also, we correlated the prevalence of advanced directives with length of stay. We queried the data collected prospectively at an American College of Surgeons verified Level I hospital (National TRACS, American College of Surgeons) regarding patients aged 65 years or older presenting with cervical spine fractures (International Classification of Diseases-9 code 805.X) in calendar years 2000 through 2003. We identified 58 patients (ages 65-94). Mortality was 24%. Twelve patients had quadriplegia or paraplegia and seven of these patients died. Respiratory failure was the primary cause of death. Application of rigid collars and a halo brace were the most commonly employed therapies. Mortality rates for halo stabilization and rigid collar and halo stabilization were similar (23% vs. 29%). Despite having a higher mean Injury Severity Score, the 16 patients with advanced directives had an intensive care unit length of stay similar to that of patients without advanced directives but a statistically significant shorter overall length of stay (13 vs. 6.9 days). Eighteen of 45 patients living at home at the time of injury returned home. Cervical spine injury in the elderly does not inevitably relegate patients to a setting of more acute nursing care. The health and social factors that allowed many to return to living at home warrant investigation, as support of these factors may assist others with this injury.

Obstetric and neonatal outcome in women aged 50 years and up: A collaborative, Nordic population-based study.

PubMed

Khatibi, Ali; Nybo Andersen, Anne-Marie; Gissler, Mika; Morken, Nils-Halvdan; Jacobsson, Bo

2018-05-01

Childbearing at extremely advanced maternal age is a globally increasing trend, but only a few studies have described the outcomes of these pregnancies. The aim of this study was to describe the occurrence of childbearing at age 50 and up in the Nordic countries, as well as to examine the frequency of adverse obstetric and neonatal outcomes. A descriptive population-based study was designed. Data from 1991 to 2013 were collected from the Medical Birth Registries in Denmark, Finland, Norway and Sweden. We investigated the occurrence of antepartum, delivery and neonatal outcomes. A total of 170 deliveries, in 141 singleton and 29 multiple pregnancies, were identified in mothers aged 50 and up. The highest frequency during this period was 6 per 100,000 deliveries. The prevalence for selected adverse outcomes in singleton pregnancies were: intrauterine fetal death (IUFD) 6%, preeclampsia 4%, preterm delivery 14%, gestational diabetes 8% and cesarean delivery 50%. In multiple pregnancies, the respective prevalence were: IUFD 2%, preeclampsia 22%, preterm delivery 57%, gestational diabetes 10% and cesarean delivery 79%. Pregnancy after assisted reproductive technologies was frequent (29% of singleton and 50% of multiple pregnancies). This study found high frequency of obstetric and neonatal complications at extremely advanced maternal age. Despite a high prevalence of stillbirth in singleton pregnancies in the studied Nordic countries, other complications were less frequent than those previously reported in different populations. Adequate preconception consultation concerning maternal and neonatal hazards is highly recommended in this group of women. Copyright © 2018. Published by Elsevier B.V.

42 CFR 406.11 - Individual age 65 or over who is not eligible as a social security or railroad retirement...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Individual age 65 or over who is not eligible as a... Without Monthly Premiums § 406.11 Individual age 65 or over who is not eligible as a social security or... certain individuals who were age 65 or would soon attain age 65 but would not be able to qualify for...

Co-existence of severe coarctation of the aorta and aortic valve stenosis in a 65-year-old woman: a case report.

PubMed

Onohara, Daisuke; Sato, Aiko; Tasaki, Yuichi; Yamada, Takafumi

2014-01-01

Coarctation of the aorta is usually diagnosed and corrected early in life. Survival to more than 60 years of age of a patient with unrepaired coarctation of the aorta is extremely unusual, and the optimal management strategies for such patients are controversial. We describe the case of a woman who was first diagnosed as having coarctation of the aorta and aortic valve stenosis at the age of 65 years and underwent successful aortic valve replacement.

Has Adult Sleep Duration Declined Over the Last 50+ Years?

PubMed Central

Youngstedt, Shawn D.; Goff, Eric E.; Reynolds, Alex M.; Kripke, Daniel F.; Irwin, Michael R.; Bootzin, Richard R.; Khan, Nidha; Jean-Louis, Girardin

2015-01-01

Summary The common assumption that population sleep duration has declined in the past few decades has not been supported by recent reviews, which have been limited to self-reported data. The aim of this review was to assess whether there has been a reduction in objectively recorded sleep duration over the last 50+ years. The literature was searched for studies published from 1960–2013, which assessed objective sleep duration (TST) in healthy normal-sleeping adults. The search found 168 studies that met inclusion criteria, with 257 data points representing 6,052 individuals ages 18–88 years. Data were assessed by comparing the regression lines of age vs. TST in studies conducted between 1960–1989 vs. 1990–2013. Weighted regression analyses assessed the association of year of study with age-adjusted TST across all data points. Regression analyses also assessed the association of year of study with TST separately for 10-year age categories (e.g., ages 18–27 years), and separately for polysomnographic and actigraphic data, and for studies involving a fixed sleep schedule and participants’ customary sleep schedules. Analyses revealed no significant association of sleep duration with study year. The results are consistent with recent reviews of subjective data, which have challenged the notion of a modern epidemic of insufficient sleep. PMID:26478985

Shingles (herpes zoster) vaccine (zostavax(®)): a review of its use in the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years.

PubMed

Keating, Gillian M

2013-07-01

The live, attenuated shingles (herpes zoster) vaccine Zostavax(®) is approved in the EU for use in the prevention of herpes zoster and postherpetic neuralgia in adults aged ≥50 years. In adults aged ≥60 years, zoster vaccine reduced the burden of illness associated with herpes zoster, with reductions in the incidence of postherpetic neuralgia and herpes zoster, according to the results of the Shingles Prevention Study. Results of subsequent Short- and Long-Term Persistence Substudies indicate that the efficacy of zoster vaccine is maintained in the longer term, albeit with a gradual decline over time. In the Zostavax Efficacy and Safety Trial, zoster vaccine reduced the incidence of herpes zoster in adults aged 50-59 years. Findings of these studies are supported by the results of large, retrospective, cohort studies. Zoster vaccine was generally well tolerated, with injection-site adverse events being the most commonly reported adverse events. In conclusion, zoster vaccine provides an important opportunity to reduce the burden of illness associated with herpes zoster by reducing the incidence of herpes zoster and postherpetic neuralgia.

Education Level Is a Strong Prognosticator in the Subgroup Aged More Than 50 Years Regardless of the Molecular Subtype of Breast Cancer: A Study Based on the Nationwide Korean Breast Cancer Registry Database.

PubMed

Hwang, Ki-Tae; Noh, Woochul; Cho, Se-Heon; Yu, Jonghan; Park, Min Ho; Jeong, Joon; Lee, Hyouk Jin; Kim, Jongjin; Oh, Sohee; Kim, Young A

2017-10-01

This study investigated the role of the education level (EL) as a prognostic factor for breast cancer and analyzed the relationship between the EL and various confounding factors. The data for 64,129 primary breast cancer patients from the Korean Breast Cancer Registry were analyzed. The EL was classified into two groups according to the education period; the high EL group (≥ 12 years) and low EL group (< 12 years). Survival analyses were performed with respect to the overall survival between the two groups. A high EL conferred a superior prognosis compared to a low EL in the subgroup aged > 50 years (hazard ratio, 0.626; 95% confidence interval [CI], 0.577 to 0.678) but not in the subgroup aged ≤ 50 years (hazard ratio, 0.941; 95% CI, 0.865 to 1.024). The EL was a significant independent factor in the subgroup aged > 50 years according to multivariate analyses. The high EL group showed more favorable clinicopathologic features and a higher proportion of patients in this group received lumpectomy, radiation therapy, and endocrine therapy. In the high EL group, a higher proportion of patients received chemotherapy in the subgroups with unfavorable clinicopathologic features. The EL was a significant prognosticator across all molecular subtypes of breast cancer. The EL is a strong independent prognostic factor for breast cancer in the subgroup aged > 50 years regardless of the molecular subtype, but not in the subgroup aged ≤ 50 years. Favorable clinicopathologic features and active treatments can explain the main causality of the superior prognosis in the high EL group.

Screening Women Aged 50-59 for CRC Using Fecal Occult Blood Test Produces Outcomes Similar to Men Undergoing Screening Colonoscopy.

PubMed

Mooers, Harrison M; Holub, Jennifer L; Lieberman, David A

2018-06-13

Average-risk women aged 50-59 years have a lower incidence and mortality of colorectal cancer relative to age-matched men, calling into question the benefit of screening colonoscopy in this age group. We aimed to determine whether FOBT is an effective initial screening test in 50-59-year-old women. We conducted a cross-sectional study using a computerized endoscopic report generator. We identified 320,906 individuals who had average-risk screening colonoscopy and 32,369 who had colonoscopy for positive FOBT. The primary outcome was the positive predictive value (PPV) of FOBT for large polyp(s) greater than 9 mm, as a surrogate for advanced neoplasia. Among patients aged 50-59 years undergoing screening colonoscopy, men were more likely than women to have large polyps (6.3 vs 4.2%, p < 0.0001). Black women undergoing screening colonoscopy had higher rates of large polyps compared to non-Black women. The PPV in FOBT-positive men aged 50-54 (11.5%) and 55-59 (14.4%) was higher than in women aged 50-54 (6.1%) and 55-59 (5.4%). Despite this lower PPV, women aged 50-54 with a positive FOBT had a similar rate of large polyps as 50-54-year-old men undergoing screening colonoscopy (6.1 vs 6.3%, p = 0.626). CRC screening with FOBT identifies 50-59-year-old men and women with a higher risk of large polyps. Since younger women have a lower risk of large polyps than men, screening with FOBT in 50-59-year-old non-Black women could be an effective screening strategy, with outcomes similar to the use of screening colonoscopy in 50-59-year-old men.

Cardiac Stress Test Trends Among US Patients Younger Than 65 Years, 2005-2012.

PubMed

Kini, Vinay; McCarthy, Fenton H; Dayoub, Elias; Bradley, Steven M; Masoudi, Frederick A; Ho, P Michael; Groeneveld, Peter W

2016-12-01

After a period of rapid growth, use of cardiac stress testing has recently decreased among Medicare beneficiaries and in a large integrated health system. However, it is not known whether declines in cardiac stress testing are universal or are confined to certain populations. To determine trends in rates of cardiac stress testing among a large and diverse cohort of commercially insured patients. A serial cross-sectional study with time trends was conducted using administrative claims from all members aged 25 to 64 years belonging to a large, national managed care company from January 1, 2005, to December 31, 2012. Linear trends in rates were determined using negative binomial regression models with procedure count as the dependent variable, calendar quarter as the key independent variable, and the size of the population as a logged offset term. Data analysis was performed from January 1, 2005, to December 31, 2012. Age- and sex-adjusted rates of cardiac stress tests per calendar quarter (reported as number of tests per 100 000 person-years). A total of 2 085 591 cardiac stress tests were performed among 32 921 838 persons (mean [SD] age, 43.2 [10.9] years; 16 625 528 women [50.5%] and 16 296 310 [49.5%] men; 7 604 945 nonwhite [23.1%]). There was a 3.0% increase in rates of cardiac stress testing from 2005 (3486 tests; 95% CI, 3458-3514) to 2012 (3589 tests; 95% CI, 3559-3619; P = .01 for linear trend). Use of nuclear single-photon emission computed tomography decreased by 14.9% from 2005 (1907 tests; 95% CI, 1888-1926) to 2012 (1623 tests; 95% CI, 1603-1643; P = .03). Use of stress echocardiography increased by 27.8% from 2005 (709 tests; 95% CI, 697-721) to 2012 (906 tests; 95% CI, 894 to 920; P < .001). Use of exercise electrocardiography increased by 12.5% from 2005 (861 tests; 95% CI, 847-873) to 2012 (969 tests; 95% CI, 953-985; P < .001). Use of other stress testing modalities increased 65.5% from 2006 (55 tests; 95% CI

Greying of the human hair: a worldwide survey, revisiting the '50' rule of thumb.

PubMed

Panhard, S; Lozano, I; Loussouarn, G

2012-10-01

While numerous papers have reported on the biological mechanisms of human hair pigmentation and greying, epidemiological descriptions of both natural hair colour and the greying process, worldwide, remain scarce. To assess hair colour and greying in a large world sample of human subjects, and to revisit the validity of the 50/50/50 rule of thumb, which states that 'at age 50 years, 50% of the population has at least 50% grey hair'. The natural hair colour of 4192 healthy male and female volunteers was assessed using a sensorial expert evaluation through the comparison of each volunteer's hair with standard swatches. Hair colour was studied according to age, gender and ethnic or geographical origin. Overall we observed that between 45 and 65 years of age, 74% of people were affected by grey hair with a mean intensity of 27%. Men harboured significantly more grey hair than women. Both age at onset and rate of greying with age appeared to be clearly linked to ethnic/geographical origin. Subjects of Asian and African descent showed less grey hair than those of caucasian origin, at comparable ages, confirming previously reported data. Calculating the percentage of people showing at least 50% grey hair coverage at age 50 years leads to a global range of 6-23%, according to ethnic/geographical origin and natural hair colour: well below that expressed by the '50' rule of thumb. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

Patterns of dental services and factors that influence dental services among 64-65-year-old regular users of dental care in Denmark.

PubMed

Christensen, Lisa B; Rosing, Kasper; Lempert, Susanne M; Hede, Børge

2016-03-01

To describe the pattern of dental services provided to 64-65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence 'Data on elderly's dental service are scarce, although increased use is seen and more teeth are present in this age group.' was removed.] A cross-sectional study of all aged 64-65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Almost all received restorations, while periodontal treatment was received by <50% during 5 years. Heavy use of dental services was dominated by periodontal services. Periodontal services were most prevalent in the capital and the most affluent areas. Relatively more extractions were related to low income and persons in least affluent areas. Total number of services was highest among women, persons with ≥20 teeth, persons living in the capital, and where the ratio user per dentist was low. For future planning of dental care for elderly, dental status, geographical and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Structure-Function Analysis of Nonarteritic Anterior Ischemic Optic Neuropathy and Age-Related Differences in Outcome.

PubMed

Sun, Ming-Hui; Liao, Yaping Joyce

2017-09-01

The optic nerve head is vulnerable to ischemia leading to anterior ischemic optic neuropathy (AION), the most common acute optic neuropathy in those older than 50 years of age. We performed a cross-sectional study of 55 nonarteritic anterior ischemic optic neuropathy (NAION) eyes in 34 patients to assess clinical outcome and perform structure-function correlations. The peak age of NAION onset was between 50 and 55 years. Sixty-seven percent of patients presented with their first event between the ages of 40 and 60 years, and 32% presented at ≤50 years. Those with NAION onset at age ≤50 years did not have significantly better visual outcome per logMAR visual acuity, automated perimetric mean deviation (PMD) or optical coherence tomography (OCT) measurements. Kaplan-Meier survival curve and multivariate Cox proportional regression analysis showed that age >50 years at NAION onset was associated with greater risk of second eye involvement, with hazard ratio of 20. Older age at onset was significantly correlated with greater thinning of the ganglion cell complex (GCC) (P = 0.022) but not with logMAR visual acuity, PMD, or thinning of retinal nerve fiber layer (RNFL). Using area under receiver operating characteristic curve analyses, we found that thinning of RNFL and GCC was best able to predict visual outcome, and that mean RNFL thickness >65 μm or macular GCC thickness >55 μm significantly correlated with good visual field outcome. We showed that NAION onset at age >50 years had a greater risk of second eye involvement. Patients with OCT mean RNFL thickness >65 μm and mean macular ganglion cell complex thickness >55 μm had better visual outcomes.

Examination of Veterans Affairs disability compensation as a disincentive for employment in a population-based sample of Veterans under age 65.

PubMed

Tsai, Jack; Rosenheck, Robert A

2013-12-01

Concerns that disability benefits may create disincentives for employment may be especially relevant for young American military veterans, particularly veterans of the recent wars in Iraq and Afghanistan who are facing a current economic recession and turning in large numbers to the Department of Veterans Affairs (VA) for disability compensation. This study describes the rate of employment and VA disability compensation among a nationally representative sample of veterans under the age of 65 and examines the association between levels of VA disability compensation and employment, adjusting for sociodemographics and health status. Data on a total of 4,787 veterans from the 2010 National Survey of Veterans were analyzed using multinomial logistic regressions to compare employed veterans with two groups that were not employed. Two-thirds of veterans under the age of 65 were employed, although only 36 % of veterans with a VA service-connected disability rating of 50 % or higher were employed. Veterans who received no VA disability compensation or who were service-connected 50 % or more were more likely to be unemployed and not looking for employment than veterans who were not service-connected or were service-connected less than 50 %, suggesting high but not all levels of VA disability compensation create disincentives for employment. Results were similar when analyses were limited to veterans who served in Iraq and Afghanistan. Education and vocational rehabilitation interventions, as well as economic work incentives, may be needed to maximize employment among veterans with disabilities.

Age and sex of surgeons and mortality of older surgical patients: observational study

PubMed Central

Jena, Anupam B; Orav, E John; Blumenthal, Daniel M; Tsai, Thomas C; Mehtsun, Winta T; Jha, Ashish K

2018-01-01

Abstract Objective To investigate whether patients’ mortality differs according to the age and sex of surgeons. Design Observational study. Setting US acute care hospitals. Participants 100% of Medicare fee-for-service beneficiaries aged 65-99 years who underwent one of 20 major non-elective surgeries between 2011 and 2014. Main outcome measure Operative mortality rate of patients, defined as death during hospital admission or within 30 days of the operative procedure, after adjustment for patients’ and surgeons’ characteristics and indicator variables for hospitals. Results 892 187 patients who were treated by 45 826 surgeons were included. Patients’ mortality was lower for older surgeons than for younger surgeons: the adjusted operative mortality rates were 6.6% (95% confidence interval 6.5% to 6.7%), 6.5% (6.4% to 6.6%), 6.4% (6.3% to 6.5%), and 6.3% (6.2% to 6.5%) for surgeons aged under 40 years, 40-49 years, 50-59 years, and 60 years or over, respectively (P for trend=0.001). There was no evidence that adjusted operative mortality differed between patients treated by female versus male surgeons (adjusted mortality 6.3% for female surgeons versus 6.5% for male surgeons; adjusted odds ratio 0.97, 95% confidence interval 0.93 to 1.01). After stratification by sex of surgeon, patients’ mortality declined with age of surgeon for both male and female surgeons (except for female surgeons aged 60 or older); female surgeons in their 50s had the lowest operative mortality. Conclusion Using national data on Medicare beneficiaries in the US, this study found that patients treated by older surgeons had lower mortality than patients treated by younger surgeons. There was no evidence that operative mortality differed between male and female surgeons. PMID:29695473

Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

PubMed Central

Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

2016-01-01

Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521

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

PubMed Central

Kulkarni, Sucheta R; Aghashe, Supriya R; Khandekar, Rajiv B; Deshpande, Madan D

2013-01-01

Background: We present the magnitude and determinants of age-related macular degeneration (ARMD) among the 50 year and older population that visited our hospital. Materials and Methods: This was a cohort of eye patients with ARMD, seen from 2006 to 2009. Optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. The ARMD was confirmed by fluoresceine angiography and optical coherent tomography. The age, sex, history of smoking, sun exposure, family history of ARMD, diet, body mass index (BMI), hypertension, and diabetes were associated with ARMD. Result: Of the 19,140 persons of ≥ 50 years of age-attending eye clinic in our hospital, 302 persons had ARMD in at least one eye. The proportion of overall ARMD was 1.38% (95% CI 1.21--1.55). The proportion of age-related maculopathy (ARM) and late ARMD was 1.14% (95% CI 0.99--1.29) and 0.24% (95% CI 0.21–0.24) respectively. ARM was unilateral and bilateral in 64 (29.2%) and 155 (70.8%) persons respectively. Dry ARMD was found in 47.8%. On regression analysis, old age (OR = 1.05), male (OR = 0.54), and history of smoking (OR = 2.32) were significant risk factors of ARMD. A total of 4.2% of persons with ARMD were blind (vision <3/60). Only 43% of persons with ARMD had J6 grade of the best-corrected near vision. Conclusion: ARMD does not seem to be of public health magnitude in the study area. Early stages of ARMD were common among patients. ge, being male, and history of smoking were significant risk factors for ARMD. PMID:23571245

Health-related quality of life among people aged ≥65 years with self-reported visual impairment: findings from the 2006-2010 behavioral risk factor surveillance system.

PubMed

Crews, John E; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M; Saaddine, Jinan B

2014-10-01

To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. We used cross-sectional data from the 2006-2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey's complex design. People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1-1.3), life dissatisfaction (OR 1.6, 95% CI 1.3-2.0), and disability (OR 1.5, 95% CI 1.3-1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6-2.0), life dissatisfaction (OR 2.3, 95% CI 1.8-2.9), and disability (OR 2.0, 95% CI 1.8-2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7-2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5-2.1), and activity limitations days (OR 1.9, 95% CI 1.6-2.2). Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years.

Babies born with gastroschisis and followed up to the age of six years faced long-term morbidity and impairments.

PubMed

Giúdici, Lidia; Bokser, Vivian Susana; Maricic, Maximiliano Alejo; Golombek, Sergio G; Ferrario, Claudia Cecilia

2016-06-01

The aims of this Argentinian study were to describe and analyse the outcomes of a continuous interdisciplinary follow-up programme of patients with gastroschisis. This was a prospective, longitudinal study of babies with gastroschisis admitted from 1 November 2003 to 31 October 2014, and this paper presents results at one, three and six years of age. Matched-pairs analyses were carried out when they were one and six. We enrolled 62 babies and assessed 52 at one year of age, 34 at three years and 17 at six years. This showed that 63% had mental health problems and 5% had recurrent wheezing. Normal outcomes at one, three and six years were growth (80%, 85% and 80%), neurology-psychomotor development index (64%, 50% and 82%), audiology (100%, 76% and 76%), vision (98%, 94% and 89%) and language (55%, 62% and 65%). The rehospitalisation rates were 30%, 0.3% and zero, and the surgical re-intervention rates were 9%, 0.3% and 12%. Matched-pairs analysis showed no significant differences between outcomes at the ages of one and six. Babies born with gastroschisis were at risk for long-term morbidity and impairments, according to follow-up assessments at the ages of one, three and six years. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Biology of larval sea lampreys (Petromyzon marinus) of the 1960 year class, isolated in the Big Garlic River, Michigan, 1960-65

USGS Publications Warehouse

Manion, Patrick J.; McLain, Alberton L.

1971-01-01

The capture of four recently metamorphosed sea lampreys (two males and two females), 152-172 mm long, in the fall of 1965, established the minimum age at transformation for larvae in the Big Garlic River at 5 years. Age and length (with the exception of a possible minimum length) were determined not to be critical factors in metamorphosis. The presence of larvae 65-176 mm long (mean, 107 mm) in the river in 1965 indicated that metamorphosis of lampreys in a single year class takes place over a period of years.

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

PubMed

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

2014-03-01

This study aims to evaluate the prevalence of sexual activity, factors associated with being sexually active, and sexual self-perception in women 50 years or older living in a Brazilian city. This population-based study applied a questionnaire to a random sample of 622 Brazilian women 50 years or older, representative of a population of 131,800 women, to obtain data on sexual activity and women's perception of their sexual life as part of a broader study that dealt with women's health. Associations between sexual activity, women's perception of their sexual life, and demographic, behavioral, and medical characteristics were determined. Overall, 36.7% of the participants reported being sexually active. Of these, 53.5% classified their sexual life as very good or good. Multiple regression analysis showed that the main factors associated with the absence of sexual activity were not having a partner (prevalence ratio [PR], 0.16; 95% CI, 0.12-0.23; P < 0.001), aging (PR, 0.95; 95% CI, 0.94-0.96; P < 0.001), and current or past smoking of five or more cigarettes per day (PR, 0.79; 95% CI, 0.63-0.98; P = 0.034), whereas being sexually active was associated with the practice of physical activity (PR, 1.20; 95% CI, 1.02-1.41; P = 0.032). A woman's classification of her sexual life as very poor, poor, or fair was associated with current or past use of natural remedies to treat menopausal symptoms (PR, 1.38; 95% CI, 1.06-1.81; P = 0.020). The main factors associated with the absence of sexual activity are not having a sexual partner, aging, and smoking, whereas weekly physical activity is associated with being sexually active. A poorer classification of a woman's sexual life is associated with her having used natural remedies to treat menopausal symptoms.

50 Years of Fermilab

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lincoln, Don

America’s leading particle physics laboratory is turning 50 years old this year. Fermilab’s Dr. Don Lincoln remembers the laboratory’s first half century and looks forward to the fascinating research topics that Fermilab’s scientific staff are looking at as they leap forward into the future.

Education Level Is a Strong Prognosticator in the Subgroup Aged More Than 50 Years Regardless of the Molecular Subtype of Breast Cancer: A Study Based on the Nationwide Korean Breast Cancer Registry Database

PubMed Central

Hwang, Ki-Tae; Noh, Woochul; Cho, Se-Heon; Yu, Jonghan; Park, Min Ho; Jeong, Joon; Lee, Hyouk Jin; Kim, Jongjin; Oh, Sohee; Kim, Young A

2017-01-01

Purpose This study investigated the role of the education level (EL) as a prognostic factor for breast cancer and analyzed the relationship between the EL and various confounding factors. Materials and Methods The data for 64,129 primary breast cancer patients from the Korean Breast Cancer Registry were analyzed. The EL was classified into two groups according to the education period; the high EL group (≥ 12 years) and low EL group (< 12 years). Survival analyses were performed with respect to the overall survival between the two groups. Results A high EL conferred a superior prognosis compared to a low EL in the subgroup aged > 50 years (hazard ratio, 0.626; 95% confidence interval [CI], 0.577 to 0.678) but not in the subgroup aged ≤ 50 years (hazard ratio, 0.941; 95% CI, 0.865 to 1.024). The EL was a significant independent factor in the subgroup aged > 50 years according to multivariate analyses. The high EL group showed more favorable clinicopathologic features and a higher proportion of patients in this group received lumpectomy, radiation therapy, and endocrine therapy. In the high EL group, a higher proportion of patients received chemotherapy in the subgroups with unfavorable clinicopathologic features. The EL was a significant prognosticator across all molecular subtypes of breast cancer. Conclusion The EL is a strong independent prognostic factor for breast cancer in the subgroup aged > 50 years regardless of the molecular subtype, but not in the subgroup aged ≤ 50 years. Favorable clinicopathologic features and active treatments can explain the main causality of the superior prognosis in the high EL group. PMID:28161933

Cost-effectiveness of polysaccharide pneumococcal vaccination in people aged 65 and above in Poland

PubMed Central

Grzesiowski, Pawel; Aguiar-Ibáñez, Raquel; Kobryń, Aleksandra; Durand, Laure; Puig, Pierre-Emmanuel

2012-01-01

Introduction: Invasive pneumococcal disease is associated with substantial morbidity, mortality and cost implications, which could be reduced by vaccination. Aim: To assess the cost-effectiveness of a 23-valent pneumococcal vaccine in the elderly (65 and older) in Poland. Methods: A Markov model with a 1-year cycle length was developed, allowing up to 10 cohorts to enter the model over the lifetime horizon (35 years). In the base case, costs and benefits were assessed using the public health care payer (NFZ) perspective. The analysis included routine vaccination of all elderly and high-risk (HR) elderly versus no vaccination. The analysis assumed that the government would reimburse 50% of the vaccine price. Costs and benefits were discounted 5%, with costs expressed in 2009 Polish Zloty (PLN). Extensive sensitivity analyses were carried out. Results: PPV23 vaccination targeting all elderly and HR elderly in Poland would avoid 8,935 pneumococcal infections, 2,542 hospitalisations, 671 deaths and 5,886 infections, 1,673 hospitalisations and 441 deaths respectively. The incremental cost per QALY gained would be PLN 3,382 in all elderly and PLN2,148 in HR elderly. Conclusion: Vaccinating adults 65 and older regardless of risk status with a 23-valent pneumococcal vaccine, is cost-effective, resulting in clinical and economic benefits including a non-negligible reduction of ambulatory doctor visits, hospitalizations and, deaths in Poland. PMID:23095867

[Prevalence of osteoporosis and osteopenia among women over fifty years of age, from the city of Durango, Mexico, diagnosed by forearm-DEXA].

PubMed

González-Arellano, J Andrés; Milla-Villeda, Reynaldo H; Hernández-Vera, Gloria E; Cisneros-Pérez, Vicente; Lazalde, Brissia; Reyes, Miguel R

2007-01-01

To estimate the prevalence of osteopenia and osteporosis using distal forearm dual-energy X-ray absorptiometry among a random sample of women of 50 years or older living in the city of Durango, Mexico. 258 women participated in a cross-sectional study fielded at the Osteoporosis Clinic of Durango. Bone mineral density was determined by dual-energy X-ray absorptiometry. Scanning was performed on the distal third of the dominant forearm. Diagnosis of osteopenia and osteoporosis was based on the WHO criteria. Osteoporosis was diagnosed in 13.65% (95%CI: 9.6-18.5) and osteopenia in 30.12% (95% CI: 24.5-36.2) of participants. Mean age, weight, height and body mass index were 65 years, 60.5 kg, 147.8 cm and 28.3 kg/m2 respectively. Osteoporosis and osteopenia were a common diagnosis given the mean age of our sample. These results can be extrapolated to the general population thereby suggesting the need for preventive measures to decrease disease prevalence, especially considering the increase in life expectancy.

The effect of sensorimotor training on the postural stability of visually impaired women over 50 years of age.

PubMed

Maćkowiak, Zuzanna; Osiński, Wieslaw; Salamon, Artur

2015-01-01

Previous studies indicated that blind and visually impaired people are a group with greater risk of falls. Postmenopausal changes significantly decrease physical efficiency and impair the body's mechanisms for maintaining postural stability. In addition, the frequency of falls among women is much higher than in men. The aim of this study was to analyze the effect of sensorimotor exercise on changes in postural stability of visually impaired women over 50 years of age. Visually impaired women from group E showed a lower level of postural stability measured with EO compared to the healthy women. After completing the exercise, a more pronounced improvement in the level of postural stability was observed in group E.

Association of Autistic Traits With Depression From Childhood to Age 18 Years.

PubMed

Rai, Dheeraj; Culpin, Iryna; Heuvelman, Hein; Magnusson, Cecilia M K; Carpenter, Peter; Jones, Hannah J; Emond, Alan M; Zammit, Stanley; Golding, Jean; Pearson, Rebecca M

2018-06-13

Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear. To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying. Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017. Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years. The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6

Iron, zinc and iodide status in Mexican children under 12 years and women 12-49 years of age. A probabilistic national survey.

PubMed

Villalpando, Salvador; García-Guerra, Armando; Ramírez-Silva, Claudia Ivonne; Mejía-Rodríguez, Fabiola; Matute, Guadalupe; Shamah-Levy, Teresa; Rivera, Juan A

2003-01-01

To describe the epidemiology of iron, zinc and iodide deficiencies in a probabilistic sample of Mexican women and children and explore its association with some dietary and socio-demographic variables. We carried out in 1999 an epidemiological description of iron (percent transferrin saturation, PTS, < 16%), serum zinc (< 65 ug/dl) and iodide (< 50 ug/l urine) deficiencies in a probabilistic sample of 1,363 Mexican children under 12 years and of 731 women of child-bearing age. Serum iron, Total Iron Binding Capacity (TIBC) and zinc were measured by atomic absorption spectrometry, and urinary iodide by a colorimetric method. Logistic regression models explored determinants for such micromineral deficiencies. Iron deficiency was higher (67%) in infants < 2 years of age. Prevalence declined (34-39%) at school age. The prevalence for iron deficiency in women was 40%. Zinc deficiency was higher in infants < 2 years of age (34%) than in school-age children (19-24%). Prevalence in women was 30%, with no rural/urban difference. In women the likelihood of iron deficiency decreased as SEL improved (p = 0.04) and increased with the intake of cereals (p = 0.01). The likelihood of low serum zinc levels was greater in women and children of low socioeconomic level (SEL) (p < 0.02 and p = 0.001) iodide deficiency was negligible in both children and women. The data shows high prevalence of iron deficiency-specially in infants 12 to 24 months of age. It is suggested that in older children and women 12 to 49 years of age that iron bioavailability is low. The prevalence of zinc deficiency was also very high. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Insurance disruption due to spousal Medicare transitions: implications for access to care and health care utilization for women approaching age 65.

PubMed

Schumacher, Jessica R; Smith, Maureen A; Liou, Jinn-Ing; Pandhi, Nancy

2009-06-01

To assess whether a husband's Medicare transition leads to insurance disruptions for his wife that impact her perceived access to care, health care utilization, or health status. Respondents were married women under age 65 from the 2003-2005 round of the Wisconsin Longitudinal Study (N=655). Instrumental variable (IV) linear and IV-probit analyses provided unbiased estimates of the effect of an insurance disruption on study outcomes. The instrument was the husband's age: (1) women with husbands who transitioned to Medicare within the previous year (age 65-66); (2) women with husbands who did not transition (60<age<65). Respondents were surveyed via telephone and mail. After adjustment, women who experienced an insurance disruption due to their husband's Medicare transition had a greater probability of experiencing a change in usual clinic/provider (71 percent), delaying filling or taking fewer medications than prescribed because of cost (75 percent), going to the emergency room (52 percent), and had lower average mental health scores than women who did not experience an insurance disruption. Despite consistent insurance coverage, the insurance disruption that accompanies a spouse's Medicare transition has adverse access and health care utilization consequences for women.

Comparison of functional gains after arthroscopic rotator cuff repair in patients over 70 years of age versus patients under 50 years of age: a prospective multicenter study.

PubMed

Moraiti, Constantina; Valle, Pablo; Maqdes, Ali; Boughebri, Omar; Dib, Chourky; Giakas, Giannis; Kany, Jean; Elkholti, Kamil; Garret, Jérôme; Katz, Denis; Leclère, Franck Marie; Valenti, Philippe

2015-02-01

To assess rotator cuff rupture characteristics and evaluate healing and the functional outcome after arthroscopic repair in patients older than 70 years versus patients younger than 50 years. We conducted a multicenter, prospective, comparative study of 40 patients younger than 50 years (group A) and 40 patients older than 70 years (group B) treated with arthroscopic rotator cuff repair. Patients older than 70 years were operated on only if symptoms persisted after 6 months of conservative treatment, whereas patients younger than 50 years were operated on regardless of any persistent symptoms. Imaging consisted of preoperative magnetic resonance imaging and postoperative ultrasound. Preoperative and postoperative function was evaluated with Constant and modified Constant scores. Patient satisfaction was also assessed. The evaluations were performed at least 1 year postoperatively. No patient was lost to follow-up. The incidence of both supraspinatus and infraspinatus tears was greater in group B. Greater retraction in the frontal plane and greater fatty infiltration were observed in group B. The Constant score was significantly improved in both groups (51 ± 12.32 preoperatively v 77.18 ± 11.02 postoperatively in group A and 48.8 ± 10.97 preoperatively v 74.6 ± 12.02 postoperatively in group B, P < .05). The improvement was similar in both groups. The modified Constant score was also significantly improved in both groups (57.48 ± 18.23 preoperatively v 81.35 ± 19.75 postoperatively in group A and 63.09 ± 14.96 preoperatively v 95.62 ± 17.61 postoperatively in group B, P < .05). The improvement was greater for group B (P < .05). Partial rerupture of the rotator cuff occurred in 2 cases in group A and 5 cases in group B. Complete rerupture was observed in 2 patients in group B. In group A, 29 patients (72.5%) were very satisfied, 8 (20%) were satisfied, and 3 (7.5%) were less satisfied. In group B, 33 patients (82.5%) were very satisfied, 6 (15%) were

Recipient age and time spent hospitalized in the year before and after kidney transplantation1

PubMed Central

Grams, Morgan E.; McAdams DeMarco, Mara A.; Kucirka, Lauren M.; Segev, Dorry L.

2012-01-01

BACKGROUND Kidney transplantation (KT) is a life-prolonging therapy in certain older end-stage renal disease (ESRD) patients, but concerns regarding peri-transplant morbidity remain. We estimate the relative increase in time spent hospitalized in the year post-KT for older versus younger ESRD patients. METHODS This was a retrospective analysis of 27,247 Medicare-primary KT recipients from 2000–2005 using United States Renal Data System and Organ Procurement and Transplantation Network data. Time spent hospitalized was enumerated in the year pre- and post-KT from Medicare Part A claims. Excess inpatient days were the difference in an individual’s post-KT and pre-KT hospital and skilled nursing facility days, standardized by time spent alive in the year post-KT. RESULTS Median excess inpatient days were similar by age group (9 in recipients ≥65 years vs. 7 in recipients < 65 years); however, the distribution was skewed, such that many more older adults had large increases in inpatient time (8.6% totaled > 120 excess inpatient days vs. 4.2% in younger recipients). Among older recipients, risk factors for poor outcomes included recipient age, donor age, longer dialysis vintage, diabetic nephropathy, and congestive heart failure. Reasons for post-transplant hospitalization were similar by age with the exception of rehabilitation, which was common only in the 65+ age group. Mean inpatient costs were equivalent pre-transplant by age but significantly higher post-transplant among older KT recipients. CONCLUSIONS Post-transplant morbidity may not be so different in the majority of older individuals selected for KT; however, a minority fares much worse. PMID:22932116

Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age

PubMed Central

Barnevik Olsson, Martina; Holm, Anette; Westerlund, Joakim; Lundholm Hedvall, Åsa; Gillberg, Christopher; Fernell, Elisabeth

2017-01-01

Background Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as “high-functioning”, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70–84) is limited. Methods From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5–6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support. PMID:29042781

Construct validity of the BESTest, mini-BESTest and briefBESTest in adults aged 50 years and older.

PubMed

O'Hoski, Sachi; Sibley, Kathryn M; Brooks, Dina; Beauchamp, Marla K

2015-09-01

The Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community. Determine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk. This was a secondary analysis of data from 79 adults (mean age 68.7±10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST). The BESTest measures showed moderate associations with the ABC scale and TUG (r=0.62-0.67 and -0.60 to -0.68 respectively), fair associations (r=0.33-0.40) with the PASE and moderate to high associations (r=0.67-0.77) with the SLS. Fallers showed a trend (p=0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions. These findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old. Copyright © 2015 Elsevier B.V. All rights reserved.

Comorbidity and socio-demographic factors associated with renal lithiasis in persons aged 40 to 65: A cross-sectional study.

PubMed

Arias Vega, Raquel; Pérula de Torres, Luis Angel; Jiménez García, Celia; Carrasco Valiente, Julia; Requena Tapia, Maria José; Cano Castiñeira, Roque; Silva Ayçaguer, Luis Carlos

2017-11-09

Renal lithiasis is one of the most important urological diseases. It seems to be related to different socio-demographic and climatic factors, lifestyle and pre-existing comorbidity. The aim of this study was to examine the relationship between socio-demographic variables, certain risk factors and chronic diseases and the renal lithiasis. A cross-sectional population-based study was carried out, selecting the Spanish population aged from 40 to 65 years, combining 2 random samples (PreLiRenA and PreLiRenE studies). Data were collected by personal telephone surveys, gathering information on socio-demographic variables and perceived morbidity. Data on annual average temperatures in each Spanish region were also collected. A bivariate and multivariate analysis was performed. A total of 4,894 subjects were surveyed; 51.3% were women; 25% were aged 40-45 years, 36% had primary school education and 31.4% were of low social class. The overall prevalence of renal lithiasis was 15.0% (95% confidence interval [95% CI] 14.5-15.5). By means of multivariate analysis, the variables that showed a strong statistical relationship with the presence of renal lithiasis were: older age (61-65 years; OR=1.39; 95% CI 1.06-1.80), high social class (OR=1.98; 95% CI 1.29-2.62), family history of renal lithiasis (OR=2.22; 95% CI 1.88-2.65), high blood pressure (OR=1.68; 95% CI 1.39-2.02) and overweight/obesity (OR=1.31; 95% CI 1.12-1.54). A correlation was observed between renal lithiasis and average annual temperatures in the Spanish regions (r=0.59; P=.013). A relationship was observed between renal lithiasis and older age, belonging to higher social classes, the existence of a family history of urolithiasis, and hypertension and overweight or obesity. The prevalence of renal lithiasis is greater in warmer climate zones. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Correlates of sexuality in men and women aged 52-90 years attending a university medical health service in Colombia.

PubMed

Arias-Castillo, Liliana; Ceballos-Osorio, Janeth; Ochoa, Jhon Jair; Reyes-Ortiz, Carlos A

2009-11-01

Limited information is available regarding sexuality among Colombian adults aged 50 years and older. To assess demographic or health characteristics associated with sexuality measures among middle- and older-aged men and women. Cross-sectional face-to-face interviews were conducted with retired persons from a university ambulatory medical care setting. Data on sexuality were obtained along with data on their demographic, emotional intimacy, practice of religion, medical conditions, and functional health measures. There were 136 participants. Appropriateness of sex, sexual desire, importance of sex, masturbation, and sexual intercourse. Fifty-seven percent of the participants were over 65 years of age, 52% were female, and 66% reported being married; 67% indicated sex is appropriate, 58% reported having sexual desire, 45% considered sex very important in their lives, 54% reported one or more instances of sexual intercourse, and 16% reported masturbating within the last year. In multivariate analyses, importance of sex and sexual intercourse decreased by age. Women had decreased odds ratios (0.20 to 0.33) for sexuality measures compared with men with the exception of appropriateness of sex. Married persons had increased odds ratios (3.06 to 9.45) for importance of sex, appropriateness of sex, and sexual intercourse compared with those of the same age who reported being unmarried. Other factors associated with some particular sexuality measures were emotional intimacy, religious practice, medical conditions, and functional health measures. There were significant mediation effects for appropriateness of sex on the relationship between sexual desire and sexual intercourse, and for importance of sex on the relationship between appropriateness of sex and sexual intercourse. Men and married persons had higher rates of most sexuality measures compared with women or their unmarried counterparts. These differences were greater at older ages (> or =65) for all sexuality

Celebrating 50 Years of Testing

NASA Image and Video Library

2016-04-19

What better way to mark 50 years of rocket engine testing than with a rocket engine test? Stennis Space Center employees enjoyed a chance to view an RS-68 engine test at the B-1 Test Stand on April 19, almost 50 years to the day that the first test was conducted at the south Mississippi site in 1966. The test viewing was part of a weeklong celebration of the 50th year of rocket engine testing at Stennis. The first test at the site occurred April 23, 1966, with a 15-second firing of a Saturn V second stage prototype (S-II-C) on the A-2 Test Stand. The center subsequently tested Apollo rocket stages that carried humans to the moon and every main engine used to power 135 space shuttle missions. It currently tests engines for NASA’s new Space Launch System vehicle.

Arterial hypertension after age 65: from epidemiology and pathophysiology to therapy Do we know where we stand?

PubMed

Gąsowski, Jerzy; Piotrowicz, Karolina; Messerli, Franz H

2018-01-01

Arterial hypertension is a prevalent disease with great harming potential. After the age of 55 years the remaining lifetime risk of hypertension amounts to 90%. Despite the constant advances some important issues such as the cut-off blood pressure for the initiation of antihypertensive therapy or the therapeutic goal are debated. In this review, we present - based on the available literature - the current concepts concerning the pathophysiology, epi-demiology and antihypertensive therapy in patients aged 65 years or older. The pathophysiology of hypertension in older patients in principle rests on stiffening of large conduit arteries, which leads to greater systolic and lower diastolic blood pressure. This in most older patients results in isolated systolic hypertension. Additionally most of these patients have low-renin hypertension. Data from large-scale clinical trials indicate that therapy of such individuals with thiazide-like diuretics and long-acting dihydropiridine calcium channel blockers as first-line medications reduces risk of complications. Based on results of recently published trials, meta-analyses, and prospective observations, the optimal on-treatment blood pressure values for most older hypertensive patients should be set within the 130-139 mmHg range. At present, lower values of standard office blood pressure in this group of patients have not been shown to be associ-ated with additional benefits, and may be associated with a greater risk of adverse events. In conclusion, we recommend that for most patients aged 65 years or more, standard office systolic blood pressure should be cautiously reduced to within 140 and 130 mmHg, preferably with a thiazide-like diuretic, long acting dihydropiridine calcium channel blocker or their combination.

Risk Factors for Falls and Fall-Related Injuries in Adults 85 Years of Age and Older

PubMed Central

Grundstrom, Anna C.; Guse, Clare E.; Layde, Peter M.

2011-01-01

Background Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. Methods We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Results Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65–84 years of age. Conclusions Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. PMID:21862143

Risk factors for falls and fall-related injuries in adults 85 years of age and older.

PubMed

Grundstrom, Anna C; Guse, Clare E; Layde, Peter M

2012-01-01

Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65-84 years of age. Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Fourfold increased detection of Lynch syndrome by raising age limit for tumour genetic testing from 50 to 70 years is cost-effective.

PubMed

Sie, A S; Mensenkamp, A R; Adang, E M M; Ligtenberg, M J L; Hoogerbrugge, N

2014-10-01

Recognising colorectal cancer (CRC) patients with Lynch syndrome (LS) can increase life expectancy of these patients and their close relatives. To improve identification of this under-diagnosed disease, experts suggested raising the age limit for CRC tumour genetic testing from 50 to 70 years. The present study evaluates the efficacy and cost-effectiveness of this strategy. Probabilistic efficacy and cost-effectiveness analyses were carried out comparing tumour genetic testing of CRC diagnosed at age 70 or below (experimental strategy) versus CRC diagnosed at age 50 or below (current practice). The proportions of LS patients identified and cost-effectiveness including cascade screening of relatives, were calculated by decision analytic models based on real-life data. Using the experimental strategy, four times more LS patients can be identified among CRC patients when compared with current practice. Both the costs to detect one LS patient (€9437/carrier versus €4837/carrier), and the number needed to test for detecting one LS patient (42 versus 19) doubled. When family cascade screening was included, the experimental strategy was found to be highly cost-effective according to Dutch standards, resulting in an overall ratio of €2703 per extra life-year gained in additionally tested patients. Testing all CRC tumours diagnosed at or below age 70 for LS is cost-effective. Implementation is important as relatives from the large number of LS patients that are missed by current practice, can benefit from life-saving surveillance. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Crop-tree release thinning in 65-year-old commercial cherry-maple stands (5-year results)

Treesearch

H. Clay Smith; Gary W. Miller; Neil I. Lamson

1994-01-01

Crop-tree release was applied to a 65-year-old cherry-maple stand in north central West Virginia. Criteria were developed for selecting crop trees for high quality sawtimber and veneer products. Five-year stand growth, mortality, and ingrowth using basal areas, volume, relative density, and number of trees were discussed for the treatments.

Older patients with chronic myeloid leukemia (≥65 years) profit more from higher imatinib doses than younger patients: a subanalysis of the randomized CML-Study IV.

PubMed

Proetel, Ulrike; Pletsch, Nadine; Lauseker, Michael; Müller, Martin C; Hanfstein, Benjamin; Krause, Stefan W; Kalmanti, Lida; Schreiber, Annette; Heim, Dominik; Baerlocher, Gabriela M; Hofmann, Wolf-Karsten; Lange, Elisabeth; Einsele, Hermann; Wernli, Martin; Kremers, Stephan; Schlag, Rudolf; Müller, Lothar; Hänel, Mathias; Link, Hartmut; Hertenstein, Bernd; Pfirrman, Markus; Hochhaus, Andreas; Hasford, Joerg; Hehlmann, Rüdiger; Saußele, Susanne

2014-07-01

The impact of imatinib dose on response rates and survival in older patients with chronic myeloid leukemia in chronic phase has not been studied well. We analyzed data from the German CML-Study IV, a randomized five-arm treatment optimization study in newly diagnosed BCR-ABL-positive chronic myeloid leukemia in chronic phase. Patients randomized to imatinib 400 mg/day (IM400) or imatinib 800 mg/day (IM800) and stratified according to age (≥65 years vs. <65 years) were compared regarding dose, response, adverse events, rates of progression, and survival. The full 800 mg dose was given after a 6-week run-in period with imatinib 400 mg/day. The dose could then be reduced according to tolerability. A total of 828 patients were randomized to IM400 or IM800. Seven hundred eighty-four patients were evaluable (IM400, 382; IM800, 402). One hundred ten patients (29 %) on IM400 and 83 (21 %) on IM800 were ≥65 years. The median dose per day was lower for patients ≥65 years on IM800, with the highest median dose in the first year (466 mg/day for patients ≥65 years vs. 630 mg/day for patients <65 years). Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients. Grades 3 and 4 adverse events were similar in both age groups. Five-year relative survival for older patients was comparable to that of younger patients. We suggest that the optimal dose for older patients is higher than 400 mg/day. ClinicalTrials.gov identifier: NCT00055874

Health-Related Quality of Life Among People Aged ≥65 Years with Self-reported Visual Impairment: Findings from the 2006–2010 Behavioral Risk Factor Surveillance System

PubMed Central

Crews, John E.; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M.; Saaddine, Jinan B.

2016-01-01

Purpose To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. Methods We used cross-sectional data from the 2006–2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey’s complex design. Results People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1–1.3), life dissatisfaction (OR 1.6, 95% CI 1.3–2.0), and disability (OR 1.5, 95% CI 1.3–1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6–2.0), life dissatisfaction (OR 2.3, 95% CI 1.8–2.9), and disability (OR 2.0, 95% CI 1.8–2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7–2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5–2.1), and activity limitations days (OR 1.9, 95% CI 1.6–2.2). Conclusion Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years. PMID:24955821

Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China

PubMed Central

Liu, Ya; Hu, Rong; Ouyang, Ling-yun; Liu, Jian-xiong; Li, Xiu-jun; Yi, Yan-jing; Wang, Tzung-Dau; Zhao, Shui-ping

2017-01-01

This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (P<0.001). DM prevalence increased with age age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40–49, 50–59, 60–69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMI<18.5, 18.5–24.9, 25.0–29.9, and ≥30, respectively. Prevalence of unrecognized DM were 20.8% in hypertensive patients aged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis. PMID:28192474

Superior long-term outcome with idarubicin compared with high-dose daunorubicin in patients with acute myeloid leukemia age 50 years and older.

PubMed

Gardin, Claude; Chevret, Sylvie; Pautas, Cécile; Turlure, Pascal; Raffoux, Emmanuel; Thomas, Xavier; Quesnel, Bruno; de Revel, Thierry; de Botton, Stéphane; Gachard, Nathalie; Renneville, Aline; Boissel, Nicolas; Preudhomme, Claude; Terré, Christine; Fenaux, Pierre; Bordessoule, Dominique; Celli-Lebras, Karine; Castaigne, Sylvie; Dombret, Hervé

2013-01-20

Although standard chemotherapy remains associated with a poor outcome in older patients with acute myeloid leukemia (AML), it is unclear which patients can survive long enough to be considered as cured. This study aimed to identify factors influencing the long-term outcome in these patients. The study included 727 older patients with AML (median age, 67 years) treated in two idarubicin (IDA) versus daunorubicin (DNR) Acute Leukemia French Association trials. Prognostic analysis was based on standard univariate and multivariate models and also included a cure fraction model to focus on long-term outcome. Age, WBC count, secondary AML, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and adverse-risk and favorable-risk AML subsets (European LeukemiaNet classification) all influenced complete remission (CR) rate and overall survival (OS). IDA random assignment was associated with higher CR rate, but not with longer OS (P = .13). The overall cure rate was 13.3%. Older age and ECOG-PS more than 1 negatively influenced cure rate, which was higher in patients with favorable-risk AML (39.1% v 8.0% in adverse-risk AML; P < .001) and those treated with IDA (16.6% v 9.8% with DNR; P = .018). The long-term impact of IDA was still observed in patients younger than age 65 years, although all of the younger patients in the DNR control arm received high DNR doses (cure rate, 27.4% for IDA v 15.9% for DNR; P = .049). In multivariate analysis, IDA random assignment remained associated with a higher cure rate (P = .04), together with younger age and favorable-risk AML, despite not influencing OS (P = .11). In older patients with AML, younger age, favorable-risk AML, and IDA treatment predict a better long-term outcome.

Studying the burden of community-acquired pneumonia in adults aged ⩾50 years in primary health care: an observational study in rural Crete, Greece

PubMed Central

Bertsias, Antonios; Tsiligianni, Ioanna G; Duijker, George; Siafakas, Nikolaos; Lionis, Christos

2014-01-01

Background: Community-acquired pneumonia (CAP) is a potentially life-threatening condition that often requires hospitalisation particularly in the elderly population or in patients with comorbidities. Aims: The aims of this study were to estimate the CAP frequency and severity in a well-defined primary healthcare setting in rural Crete, to record patient characteristics, their immunisation status and to estimate hospitalisation frequency and determinants. Methods: An observational study was designed and implemented in a rural setting within the prefecture of Heraklion in the island of Crete, Greece. Eligible patients were those aged 50 years or above, presenting with CAP based on signs and symptoms and positive X-ray findings. Results: A total of 124 CAP cases were recorded, 40 of which (32.3%) were hospitalised. Τhe age-standardised CAP incidence was estimated to be 236.7 cases per 100,000 persons aged ⩾50 years. Forty-three patients (35.2%) were vaccinated against pneumococcus. The most frequent chronic illnesses were heart disease (64.5%), chronic obstructive pulmonary disease (32.5%), and type 2 diabetes (21%). Hospitalisation determinants included advanced age (⩾74 years, Odds ratio (OR) 7.13; P value=0.001; 95% confidence interval (CI), 2.23–22.79), obesity (OR 3.36, P=0.037; 95% CI, 1.08–10.52), ⩾40 pack-years of smoking (OR 3.82, P value=0.040; 95% CI, 1.07–18.42), presence of multimorbidity (OR 5.77, P value=0.003; 95% CI, 1.81–18.42) and pneumococcal vaccination (OR 0.29, P value=0.041; 95% CI, 0.09–0.95). Conclusions: This study highlighted patient characteristics and aspects of CAP epidemiology in the context of a rural primary care setting in southern Europe where limited data have been published until now. PMID:24965889

Lifecourse adversity and physical performance across countries among men and women aged 65-74.

PubMed

Sousa, Ana Carolina Patrício de Albuquerque; Guerra, Ricardo Oliveira; Thanh Tu, Mai; Phillips, Susan P; Guralnik, Jack M; Zunzunegui, Maria-Victoria

2014-01-01

This study examines the associations between lifecourse adversity and physical performance in old age in different societies of North and South America and Europe. We used data from the baseline survey of the International Study of Mobility in Aging, conducted in: Kingston (Canada), Saint-Hyacinthe (Canada), Natal (Brazil), Manizales (Colombia) and Tirana (Albania). The study population was composed of community dwelling people between 65 and 74 years of age, recruiting 200 men and 200 women at each site. Physical Performance was assessed with the Short Physical Performance Battery (SPPB). Economic and social adversity was estimated from childhood adverse events, low education, semi-skilled occupations during adulthood and living alone and insufficient income in old age. A total of 1995 people were assessed. Low physical performance was associated with childhood social and economic adversity, semi-skilled occupations, living alone and insufficient income. Physical performance was lower in participants living in Colombia, Brazil and Albania than in Canada counterparts, despite adjustment for lifecourse adversity, age and sex. We show evidence of the early origins of social and economic inequalities in physical performance during old age in distinct populations and for the independent and cumulative disadvantage of low socioeconomic status during adulthood and poverty and living alone in later life.

Are religiosity and prayer use related with multiple behavioural risk factors for chronic diseases in European adults aged 50+ years?

PubMed

Linardakis, M; Papadaki, A; Smpokos, E; Sarri, K; Vozikaki, M; Philalithis, A

2015-05-01

Behavioural risk factors for chronic diseases involve factors relating to lifestyle habits. This study examined the relationship of religious and spiritual beliefs with the adoption and presence of multiple behavioural risk factors (MBRFs) in European adults. Cross-sectional study. Data were used from 16,557 individuals, aged 50+ years, participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). MBRFs clustering was defined by high body weight, smoking, physical inactivity and risky alcohol consumption, and regression estimations with religiosity and prayer use were assessed based on sampling weights. In total, 79.4% of participants had received religious education, 33.4% had used prayer '≥1 time/day' and 53.3% had clustering of 2+ MBRFs. Lower prevalence of smoking was found in males (20.6% vs. 29.4%, P < 0.05), as well as in females (13.1% vs. 22.6%, P < 0.05), who prayed '≥1 time/day', compared to those who never prayed. Categorical regression analysis revealed that the presence of MBRFs was associated negatively with religious education (standardized beta = -0.048, P < 0.001) and positively with low frequency of prayer use (standardized beta = 0.056, P < 0.001). Having received religious education and prayer use were related to the presence of fewer MBRFs in European adults aged 50+ years. These lifestyle factors should be assessed as potential determinants of MBRFs adoption when examining chronic disease development in multicultural populations. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[The long term (15 years) evolution after valvular replacement with mechanical prosthesis or bioprosthesis between the age of 60 and 70 years].

PubMed

Hanania, G; Michel, P L; Montély, J M; Warembourg, H; Nardi, O; Leguerrier, A; Agnino, A; Despins, P; Legault, B; Petit, H; Bouraindeloup, M

2004-01-01

the aim of this study was to document the choice between prosthesis and bioprosthesis in cases of valvular replacement during the seventh decade of life. a retrospective and cooperative study linking eleven cardiac surgical teams and five medical cardiology teams combined 497 subjects born between 1915 and 1925 (average age 64.4 years) who underwent aortic (313 cases) or mitral (184 cases) valvular replacement with mechanical prosthesis (259 cases) or bioprosthesis (238 cases). Information was collected at each centre during the year 2000 on the long term evolution (going back 15 years), in particular on the mortality, non-fatal complications linked to the valve, cardiac complications and extra-cardiac events. These results were subjected to statistical analysis. the operative mortality of this group was 4.8%. The 15 year survival was 46% for the aortic mechanical prostheses, 32% for the aortic bioprostheses (p=0.04). 34% for the mitral bioprostheses and 33% for the mitral mechanical prostheses. Events linked to the valve were more frequent for the mitral valvulopathies than for the aortic valves (49% vs 26%, p<0.001). The absence of events linked to the valve at 15 years was 69% for the aortic mechanical prostheses and 68% for the aortic bioprostheses. This was the case in only 57% of mitral mechanical prostheses and 36% of the mitral bioprostheses (p=0.11). Thromboembolic accidents were three times more frequent in the mitrals than in the aortics (11.5 vs 3.8%, p=0.002). Haemorrhage was four times more frequent for the mechanical prostheses than for the bioprostheses (7.7 vs 2%, p=0.01). The risk of degeneration for the aortic bioprostheses was 20% at 15 years, three times less so after 65 years of age (p=0.03). At 48% it was much higher in the mitral valves at 15 years with no significant difference before and after 65 years of age (p=0.3). the current life expectancy of subjects in their seventh decade is important. The greatly elevated risk of bioprosthesis

Cost-effectiveness of high-dose versus standard-dose inactivated influenza vaccine in adults aged 65 years and older: an economic evaluation of data from a randomised controlled trial.

PubMed

Chit, Ayman; Becker, Debbie L; DiazGranados, Carlos A; Maschio, Michael; Yau, Eddy; Drummond, Michael

2015-12-01

Adults aged 65 years and older account for most seasonal influenza-related hospital admissions and deaths. Findings from the randomised controlled FIM12 study showed that high-dose inactivated influenza vaccine is more effective than standard-dose vaccine for prevention of laboratory-confirmed influenza in this age group. We aimed to assess the economic impact of high-dose versus standard-dose influenza vaccine in participants in the FIM12 study population. The FIM12 study was a head-to-head randomised controlled trial in which 31,989 participants aged 65 years and older were randomly assigned (1:1) to receive either high-dose or standard-dose trivalent inactivated influenza vaccine over two influenza seasons (2011-12 and 2012-13). Data for health-care resource consumption obtained in the FIM12 study were summarised across vaccine groups. Unit costs obtained from standard US cost sources were applied to each resource item, including to the vaccines (high dose US$31·82, standard dose $12·04). Clinical illness data were mapped to existing quality-of-life data. The time horizon was one influenza season; however, quality-adjusted life-years (QALYs) lost due to death during the study were calculated over a lifetime. We calculated incremental cost-effectiveness ratios (ICERs) for high-dose versus standard-dose vaccine and used QALYs as an outcome in the cost-utility analysis. We undertook a probabilistic sensitivity analysis using bootstrapping to explore the effect of statistical uncertainty on the study results. Mean per-participant medical costs were lower in the high-dose vaccine group ($1376·72 [SD 6857·59]) than in the standard-dose group ($1492·64 [7447·14]; difference -$115·92 [95% CI -264·18 to 35·48]). Mean societal costs were likewise lower in the high-dose versus the standard-dose group ($1506·48 [SD 7305·19] vs $1634·50 [7952·99]; difference -$128·02 [95% CI -286·89 to 33·30]). Hospital admissions contributed 95% of the total health

Must patients over 65 be haemodialysed?

PubMed

Rotellar, E; Lubelza, R A; Rotellar, C; Martinez-Camps, E; Alea, M V; Valls, R

1985-01-01

This manuscript consists of a study of the results of 26 end stage renal failure (ESRF) patients, who commenced regular haemodialysis treatment (RHDT) from the age of 65 onwards (65-85) and who have been undergoing this treatment for periods ranging from 7 years to 3 months. These results are to be compared with those obtained from another group of 26 patients whose age ranged between 40 and 55 and who were treated with the same policy. The following parameters are compared: mortality, morbidity, life-style, cardiovascular situation, hypotension in haemodialysis, vascular access, anaemia, osteoarticular and peripheral nervous disorders, hypertension. We have not found any significant differences between both groups, besides a higher morbidity for patients over 65. Therefore, we recommend the inclusion of the older patients into RHDT programmes.

Incidence of Cushing's syndrome and Cushing's disease in commercially-insured patients <65 years old in the United States.

PubMed

Broder, Michael S; Neary, Maureen P; Chang, Eunice; Cherepanov, Dasha; Ludlam, William H

2015-06-01

To estimate the incidence of Cushing's syndrome (CS) and Cushing's disease (CD) in the US. MarketScan Commercial database 2007-2010 (age <65 years) was used. CS patients were defined with ≥2 claims of CS diagnosis, while CD patients were defined with CS plus a benign pituitary adenoma diagnosis or hypophysectomy in the same calendar year. Annual incidence was calculated by dividing the number of CS or CD cases by the total number of members with the same enrollment requirement during the calendar years. CS incidence rates per million person-years were 48.6 in 2009 and 39.5 in 2010. The lowest rates of CS were in ≤17-year-olds and highest rates were in 35 to 44-year-olds. CD incidence rates were 7.6 in 2009 and 6.2 in 2010. The lowest rates of CD were in ≤17-year-olds and highest rates were in 18 to 24-year-olds. The rates varied by sex (2.3-2.7 in males, 9.8-12.1 in females). In females, lowest rates ranged 2.5-4.0 in ≤17-year-olds and highest 16.7-27.2 in 18-24 year olds. In males, there were too few cases to report estimates by age. In the first large US-based study, the annual incidence of CS in individuals <65 years old was nearly 49 cases per million, substantially higher than previous estimates, which were based primarily on European data. Using similar methods, we estimated the incidence of CD at nearly 8 cases per million US population. These estimates, if confirmed in other epidemiologic databases, represent a new data reference in these rare conditions.

Maternal choline supplementation improves spatial mapping and increases basal forebrain cholinergic neuron number and size in aged Ts65Dn mice

PubMed Central

Ash, Jessica A.; Velazquez, Ramon; Kelley, Christy M.; Powers, Brian E.; Ginsberg, Stephen D.; Mufson, Elliott J.; Strupp, Barbara J.

2014-01-01

Down syndrome (DS) is marked by intellectual disability (ID) and early-onset of Alzheimer’s disease (AD) neuropathology, including basal forebrain cholinergic neuron (BFCN) degeneration. The present study tested the hypothesis that maternal choline supplementation (MCS) lessens hippocampal dysfunction and protects against BFCN degeneration in the Ts65Dn mouse model of DS and AD. During pregnancy and lactation, dams were assigned to either a choline sufficient (1.1 g/kg choline chloride) or choline supplemented (5.0 g/kg choline chloride) diet. Between 13 and 17 months of age, offspring were tested in the radial arm water maze (RAWM) to examine spatial learning and memory followed by unbiased quantitative morphometry of BFCNs. Spatial mapping was significantly impaired in unsupplemented Ts65Dn mice relative to normal disomic (2N) littermates. Additionally, a significantly lower number and density of medial septum (MS) hippocampal projection BFCNs was also found in unsupplemented Ts65Dn mice. Notably, MCS significantly improved spatial mapping and increased number, density, and size of MS BFCNs in Ts65Dn offspring. Moreover, the density and number of MS BFCNs correlated significantly with spatial memory proficiency, providing powerful support for a functional relationship between these behavioral and morphometric effects of MCS for the trisomic offspring. Thus, increasing maternal choline intake during pregnancy may represent a safe and effective treatment approach for expectant mothers carrying a DS fetus, as well as a possible means of BFCN neuroprotection during aging for the population at large. PMID:24932939

The Universal Declaration of Human Rights: 50 Years Old but Still Coming of Age.

ERIC Educational Resources Information Center

Flowers, Nancy

1998-01-01

Highlights the events of the past 50 years concerning the Universal Declaration of Human Rights that is the first document in human history to codify rights that apply to every person regardless of citizenship in a particular country. Explains why the United States does not comprehend the value of the declaration. (CMK)

Older kidney transplantation candidates' expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and older.

PubMed

Lønning, Kjersti; Midtvedt, Karsten; Heldal, Kristian; Andersen, Marit Helen

2018-06-22

The aim was to study the expectations of improvement in life and health following kidney transplantation (KTx) in a population of wait-listed patients ≥65 years with end-stage kidney disease. Qualitative research with individual in-depth interviews. Patients on dialysis enlisted for a KTx from a deceased donor were included from an ongoing study of older patients' perspectives on KTx. Qualitative face-to-face interviews were conducted in a safe and familiar setting, and were analysed thematically using the theoretical framework of lifespan. Fifteen patients (median age 70 years, range 65-82) from all parts of Norway were interviewed. Informants were included consecutively until no new information was gained. Two main themes were evident: receiving a kidney is getting life back and grasp the chance. In addition, the themes 'hard to loose capacity and strength', 'reduced freedom' and 'life on hold' described the actual situation and thereby illuminated the informants' expectations. The informants tried to balance positive expectations and realism towards KTx, and they were hoping to become free from dialysis and to live a normal life. This study shows that older KTx candidates comprise a heterogeneous group of patients who take individual approaches that allow them to maintain autonomy and control while waiting for a transplant. This study provides new knowledge about the older KTx candidates relevant for clinicians, patients and researchers. © 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.

Shared and Unique Genetic and Environmental Influences on Aging-Related Changes in Multiple Cognitive Abilities

PubMed Central

Tucker-Drob, Elliot M.; Reynolds, Chandra A.; Finkel, Deborah; Pedersen, Nancy L.

2013-01-01

Aging-related declines occur in many different domains of cognitive function during later adulthood. However, whether a global dimension underlies individual differences in changes in different domains of cognition, and whether global genetic influences on cognitive changes exist, is less clear. We addressed these issues by applying multivariate growth curve models to longitudinal data from 857 individuals from the Swedish Adoption/Twin Study of Aging, who had been measured on 11 cognitive variables representative of verbal, spatial, memory, and processing speed abilities up to 5 times over up to 16 years between ages 50 and 96 years. Between ages 50 and 65 years scores on different tests changed relatively independently of one another, and there was little evidence for strong underlying dimensions of change. In contrast, over the period between 65 and 96 years of age, there were strong interrelations among rates of change both within and across domains. During this age period, variability in rates of change were, on average, 52% domain-general, 8% domain-specific, and 39% test specific. Quantitative genetic decomposition indicated that 29% of individual differences in a global domain-general dimension of cognitive changes from 65 to 96 years were attributable to genetic influences, but some domain-specific genetic influences were also evident, even after accounting for domain-general contributions. These findings are consistent with a balanced global and domain-specific account of the genetics of cognitive aging. PMID:23586942

Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study.

PubMed

Geessink, Noralie H; Schoon, Yvonne; Olde Rikkert, Marcel Gm; van Goor, Harry

2017-01-01

Treatment decision-making in older patients with colorectal (CRC) or pancreatic cancer (PC) needs improvement. We introduced the EASYcare in Geriatric Onco-surgery (EASY-GO) intervention to optimize the shared decision-making (SDM) process among these patients. The EASY-GO intervention comprised a working method with geriatric assessment and SDM training for surgeons. A non-equivalent control group design was used. Newly diagnosed CRC/PC patients aged ≥65 years were included. Primary patient-reported experiences were the quality of SDM (SDM-Q-9, range 0-100), involvement in decision-making (Visual Analog Scale for Involvement in the decision-making process [range 0-10]), satisfaction about decision-making (Visual Analog Scale for Satisfaction concerning the decision-making process [range 0-10]), and decisional regret (Decisional Regret Scale [DRS], range 0-100). Only for DRS, lower scores are better. A total of 71.4% of the involved consultants and 42.9% of the involved residents participated in the EASY-GO training. Only 4 trained surgeons consulted patients both before (n=19) and after (n=19) training and were consequently included in the analyses. All patient-reported experience measures showed a consistent but non-significant change in the direction of improved decision-making after training. According to surgeons, decisions were significantly more often made together with the patient after training (before, 38.9% vs after, 73.7%, p =0.04). Sub-analyses per diagnosis showed that patient experiences among older PC patients consistent and clinically relevant changed in the direction of improved decision-making after training (SDM-Q-9 +13.4 [95% CI -7.9; 34.6], VAS-I +0.27 [95% CI -1.1; 1.6], VAS-S +0.88 [95% CI -0.5; 2.2], DRS -10.3 [95% CI -27.8; 7.1]). This pilot study strengthens the practical potential of the intervention's concept among older surgical cancer patients.

Insurance Disruption due to Spousal Medicare Transitions: Implications for Access to Care and Health Care Utilization for Women Approaching Age 65