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Sample records for elderly population results

  1. How healthy is community-dwelling elderly population? Results from Southern Italy

    PubMed Central

    Guerriero, Francesca; Orlando, Valentina; Tari, Daniele Ugo; Di Giorgio, Annalisa; Cittadini, Antonio; Trifirò, Gianluca; Menditto, Enrica

    2015-01-01

    PURPOSE To explore the frequency of polypharmacy, functional and cognitive capacity among the elderly in Southern Italy. METHODS Population-based retrospective cross-sectional study. Information were retrieved from electronic-geriatric-forms matched by record-linkage to outpatient pharmacy-records. The following domains were collected from geriatric forms: BMI, cognitive capacity (SPMSQ), functional status (Barthel-index), mobility, living condition. Polypharmacy status was categorized as non-polypharmacy (0–4), polypharmacy (5–9) and excessive-polypharmacy (≥10). Prevalence of all variables were stratified by age and polypharmacy group. RESULTS 88,878 old people received a geriatric assessment in the years 2013–2014. Mean age was 74.8 (±7.3) years, 56.6% females. Proportion of elderly in excessive-polypharmacy increased with age (18.9% in 65–75 age-group; 27.9% in >85). Referring to cognitive capacity, the proportion of lucid patients decreased with age (from 94.3% to 58.1%), while confused patient increased with age (from 4.7% to 30.9%). Proportion of subjects with a decline in cognitive status, functional status and mobility increased in polypharmacy and excessive polypharmacy group. CONCLUSION Polypharmacy is common in people aged 65 years and older with difficulties in activities of daily living and impaired cognition. Furthermore, its prevalence raises with increasing age. Preventive strategies such us optimization of drug regimen should be performed routinely to reduce risk of adverse-health-events. PMID:27042434

  2. [Profile of the elderly population in two poor municipalities in North and Northeast Brazil: the results of a cross-sectional population-based survey].

    PubMed

    Cesar, Juraci A; Oliveira-Filho, Joel A; Bess, Grasiele; Cegielka, Rafael; Machado, Joel; Gonçalves, Tatiane S; Neumann, Nelson A

    2008-08-01

    This study aimed to determine the profile of the elderly population (>or= 60 years) in two poor municipalities in North and Northeast Brazil in 2005. Using a cross-sectional survey with a systematic sample, previously trained interviewers applied a standard household questionnaire on demographic characteristics, socioeconomic status, household conditions, physical activity, immunization status, health problems, and expenditures on medicines. Of the total sample (n = 1,013), 528 lived in Caracol, Piauí State, and 478 in Garrafão do Norte, Pará State. 56% were 60-69 years old, 10% lived alone, 69% were illiterate, 8% had a family income less than the minimum wage, 24% of the households had a flush toilet, 60% had a radio, television, and refrigerator, 88% reported at least one chronic disease, 47% had to purchase all their medicines out-of-pocket, 84% had received influenza vaccination, and 90% were able to perform normal activities of daily living. Elderly people included in this study showed poor household conditions, inadequate access to health care, and high levels of morbidity. PMID:18709224

  3. Plasma selenium and risk of dysglycemia in an elderly French population: results from the prospective Epidemiology of Vascular Ageing Study

    PubMed Central

    2010-01-01

    Background A preventive role of selenium on the risk of diabetes has been reported and ascribed to the "insulin-like" activity of selenium and the antioxidant properties of the selenoenzymes. By contrast, data from cross-sectional studies and clinical trials have suggested an adverse effect of high selenium status and selenium supplementation on type-2 diabetes risk. Given these controversial results, we investigated prospectively the relationship between baseline plasma selenium concentration and occurrence of dysglycemia (impaired fasting glucose or type 2 diabetes) in an elderly French cohort. Methods The Epidemiology of Vascular Ageing (EVA) study (n = 1389, 59-71 years) is a 9-year longitudinal study in which, fasting plasma glucose was measured at baseline, 2, 4 and 9 years. Analyses were performed on 1162 participants with complete data. Results At baseline plasma selenium mean levels were 1.08 (0.21) μmol/l in men and 1.10 (0.20) μmol/l in women. During the 9-year follow-up, 127 cases of dysglycemia occurred. A significant interaction was found between plasma selenium and sex. Risk of dysglycemia was significantly lower in men with plasma selenium in the highest tertile (T3:1.19-1.97) compared to those in the lowest tertile (T1:0.18-1.00) [HR = 0.48 (0.25-0.92)], but no significant relationship was observed in women. After controlling for socio-demographic factors, lifestyle factors, cardiovascular diseases, body mass index, hypertension and lipid profile, plasma selenium remained marginally significantly associated with occurrence of dysglycemia in men [T3 vs. T1, HR = 0.50 (0.24-1.04)] and unrelated in women. Conclusions This prospective study suggests a sex-specific protective effect of higher selenium status at baseline on later occurrence of dysglycemia. PMID:20298544

  4. Cough in the Elderly Population: Relationships with Multiple Comorbidity

    PubMed Central

    Song, Woo-Jung; Morice, Alyn H.; Kim, Min-Hye; Lee, Seung-Eun; Jo, Eun-Jung; Lee, Sang-Min; Han, Ji-Won; Kim, Tae Hui; Kim, Sae-Hoon; Jang, Hak-Chul; Kim, Ki Woong; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2013-01-01

    Background The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. Methods A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough) were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. Results The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8%) were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. Conclusions Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly. PMID:24205100

  5. [Injury prevention in the elderly population].

    PubMed

    Richter, M; Becker, C; Seifert, J; Gebhard, F; Pieske, O; Holch, M; Lob, G

    2002-12-01

    Injuries in the elderly population have more considerable consequences (more difficult treatment, higher costs,worse outcome) than in the younger population. Therefore, the prevention is especially important. The majority of the injuries are caused by traffic accidents and falls. TRAFFIC ACCIDENTS: An analysis of the current injury situation in elderly road users (65 years and older) involved in road traffic accidents was intended to allow conclusions regarding future prophylaxis. FALLS: Falls are mostly caused by numerous factors. The most important predictors for falls are dementia,Parkinson-Syndrome and neurologic deficits after cerebrovascular insults. The most important symptoms, that indicate an increased risk for fall are gait abnormalities, balance lack and underweight. The most important anamnestic indications are more than one falls in the recent 90 days, need for assistance in daily living and prevailing medication. Another important factor is the residential setting (lighting, stairs, floor conditions,bath installations). The most affective protective interventions involve multiple factors. The incidence of falls could be reduced by 30%. The hip protector is an effective protection against proximal femur fractures. which is the most frequent fracture in the elderly population that requires treatment as an inpatient. Injury prevention in the elderly population is an interdisciplinary task as for example shown by the successful fall clinics in the anglo-american area. PMID:12486574

  6. Neighborhood Context and Cognitive Decline in Older Mexican Americans: Results From the Hispanic Established Populations for Epidemiologic Studies of the Elderly

    PubMed Central

    Peek, M. Kristen

    2009-01-01

    In previous research on cognitive decline among older adults, investigators have not considered the potential impact of contextual variables, such as neighborhood-level conditions. In the present investigation, the authors examined the association between 2 neighborhood-context variables—socioeconomic status and percentage of Mexican-American residents—and individual-level cognitive function over a 5-year follow-up period (1993–1998). Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-dwelling older Mexican Americans (n = 3,050) residing in the southwestern United States. Individual records were linked with 1990 US Census tract data, which provided information on neighborhood characteristics. Hierarchical linear growth-curve models and hierarchical logistic models were used to examine relations between individual- and neighborhood-level variables and the rate and incidence of cognitive decline. Results showed that baseline cognitive function and rates of cognitive decline varied significantly across US Census tracts. Respondents living in economically disadvantaged neighborhoods experienced significantly faster rates of cognitive decline than those in more advantaged neighborhoods. Odds of incident cognitive decline decreased as a function of neighborhood percentage of Mexican-American residents and increased with neighborhood economic disadvantage. The authors conclude that neighborhood context is associated with late-life cognitive function and that the effects are independent of individual-level risk factors. PMID:19270047

  7. Pain Management in the Elderly Population: A Review

    PubMed Central

    Kaye, Alan D.; Baluch, Amir; Scott, Jared T.

    2010-01-01

    The elderly population comprises the fastest growing segment of the world's population. As patients age, the incidence and prevalence of certain pain syndromes increase. Pain may be underreported as some elderly patients incorrectly believe that pain is a normal process of aging. A comprehensive pain assessment includes a thorough medical history and physical examination, review of systems and pertinent laboratory results, imaging studies, and diagnostic tests. Pain physicians should have a broad range of understanding of the pharmacologic and physiological changes that occur in the geriatric population. The present review on pain management in the elderly focuses on relevant information for the pain clinician. Included are appropriate pain assessment, physical examination, pathophysiologic changes in the elderly, pharmacokinetic and pharmacodynamic changes, and present pain management modalities. Elderly patients present with increased fat mass, decreased muscle mass, and decreased body water, all of which have important ramifications on drug distribution. Hepatic phase I reactions involving oxidation, hydrolysis, and reduction appear to be more altered by age than phase II conjugation such as acetylation, glucuronidation, sulfation, and glycine conjugation. There is a predictable age-related decline in cytochrome P-450 function and, combined with the polypharmacy that much of the elderly population experiences, this may lead to a toxic reaction of medications. One of the newer opiates, oxymorphone, has recently been studied as it is metabolized in a non-cytochrome P-450 pathway and therefore bypasses many of the drug-drug interactions common to the elderly. A multidisciplinary approach is recommended to investigate all possible options for optimal management, including pharmacotherapy, interventional procedures, physical rehabilitation, and psychological support. PMID:21603375

  8. Elder Abuse and Neglect in Israel: A Comparison between the General Elderly Population and Elderly New Immigrants

    ERIC Educational Resources Information Center

    Iecovich, Esther

    2005-01-01

    The present study investigated differences between the general elderly population and elderly new immigrants from former Soviet Union countries in regard to the incidence of elder abuse and neglect, victims' characteristics, and perpetrators' characteristics. In addition, the study sought to examine predictors of various types of abuse and…

  9. Population Aging and Its Impact on Elderly Welfare in Africa

    ERIC Educational Resources Information Center

    Darkwa, O. K.; Mazibuko, F. N. M.

    2002-01-01

    This article discusses the demographic transition and its impact on the welfare of the elderly in Africa. It provides a brief socio-demographic profile on elderly Africans. Also, it addresses challenges brought about by population aging and how it affects the provision of services to address the care giving needs of the elderly. Additionally, it…

  10. Educational level and chronic inflammation in the elderly--the role of obesity: results from the population-based CARLA study.

    PubMed

    Medenwald, D; Loppnow, H; Kluttig, A; Nuding, S; Greiser, K H; Thiery, J; Tiller, D; Herzog, B; Werdan, K; Haerting, J

    2015-10-01

    This study aimed to assess the mediating role of anthropometric parameters in the relation of education and inflammation in the elderly. Cross-sectional data from the population-based CARdio-vascular Disease, Living and Ageing in Halle study were used after excluding subjects with a plasma level of high-sensitive C-reactive protein (hsCRP) above 10 mg L(-1) (916 men/760 women remaining). Education was categorized in accordance with International Standard Classification of Education. As inflammation parameters, the soluble tumour necrosis factor type 1 (sTNF-R1), hsCRP and interleukin 6 (IL-6) were taken into account. Anthropometric parameters were the body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHeR). We used covariate adjusted mixed models to assess associations. Effect measures were the natural indirect effect (NIE), controlled direct effect and total effect (TE). Education was associated with sTNF-R1, hsCRP and IL-6 in men, and sTNF-R1 and hsCRP in women. Anthropometric parameters correlated with all inflammation parameters after covariate adjustment. BMI and WHeR were strong mediators of educational differences in sTNF-R1 (percentage of NIE of TE: 28% in men; 33% in women) and hsCRP (percentage of NIE of TE: 35% in men; 52% in women), while WHR was the weakest mediator. General obesity mediates roughly one-third of the association of education with chronic inflammation in the elderly. PMID:26230620

  11. Anthropometric measures and nutritional status in a healthy elderly population

    PubMed Central

    Sánchez-García, Sergio; García-Peña, Carmen; Duque-López, María Ximena; Juárez-Cedillo, Teresa; Cortés-Núñez, Alma Rosa; Reyes-Beaman, Sandra

    2007-01-01

    Background Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people. Methods The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS)". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length. Results Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p < 0.05), and the mean heights were 1.52 m for women and 1.63 m for men (p < 0.05). Age related changes in anthropometric values were identified. BMI values indicated that 62.3% of the population was overweight, and 73.6% of women and 16.5% of men had high fat tissue distribution. Conclusion Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the

  12. Mental status testing in the elderly nursing home population.

    PubMed

    Nadler, J D; Relkin, N R; Cohen, M S; Hodder, R A; Reingold, J; Plum, F

    1995-07-01

    The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old. PMID:7576043

  13. Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

    PubMed Central

    Biehl, Michelle; Takahashi, Paul Y; Cha, Stephen S; Chaudhry, Rajeev; Gajic, Ognjen; Thorsteinsdottir, Bjorg

    2016-01-01

    Rationale Identifying patients at high risk of critical illness is necessary for the development and testing of strategies to prevent critical illness. The aim of this study was to determine the relationship between high elder risk assessment (ERA) score and critical illness requiring intensive care and to see if the ERA can be used as a prediction tool to identify elderly patients at the primary care visit who are at high risk of critical illness. Methods A population-based historical cohort study was conducted in elderly patients (age >65 years) identified at the time of primary care visit in Rochester, MN, USA. Predictors including age, previous hospital days, and comorbid health conditions were identified from routine administrative data available in the electronic medical record. The main outcome was critical illness, defined as sepsis, need for mechanical ventilation, or death within 2 years of initial visit. Patients with an ERA score of 16 were considered to be at high risk. The discrimination of the ERA score was assessed using area under the receiver operating characteristic curve. Results Of the 13,457 eligible patients, 9,872 gave consent for medical record review and had full information on intensive care unit utilization. The mean age was 75.8 years (standard deviation ±7.6 years), and 58% were female, 94% were Caucasian, 62% were married, and 13% were living in nursing homes. In the overall group, 417 patients (4.2%) suffered from critical illness. In the 1,134 patients with ERA >16, 154 (14%) suffered from critical illness. An ERA score ≥16 predicted critical illness (odds ratio 6.35; 95% confidence interval 3.51–11.48). The area under the receiver operating characteristic curve was 0.75, which indicated good discrimination. Conclusion A simple model based on easily obtainable administrative data predicted critical illness in the next 2 years in elderly outpatients with up to 14% of the highest risk population suffering from critical illness

  14. Physical Activity Patterns in the Elderly Kashan Population

    PubMed Central

    Sadrollahi, Ali; Hosseinian, Masoumeh; Masoudi Alavi, Negin; Khalili, Zahra; Esalatmanesh, Sophia

    2016-01-01

    Background Physical activity is an important component of health in old age that provides personal independence, physical ability, and quality of life. Objectives The current study aimed to evaluate physical activity and associated factors among the elderly population in Kashan, Iran. Patients and Methods This is a descriptive cross-sectional study. The sample was 400 elderly people (aged more than 60 years) living in Kashan, Iran in 2014. The subjects randomly selected via multi-stage cluster sampling from healthcare centers in three regions of Kashan. The sample size differed by gender and residence type. Each participant’s demographic characteristics and level of physical activity were recorded in a questionnaire, and the data were analyzed by SPSS version 16. Descriptive statistics, chi-square tests, Pearson correlations, and ordinal regression were used in the data analysis. The significance level for all the tests was P < 0.05. Results 237 (59.2%) of the subjects were female. The average age of the study population was 67.6 ± 6.8 years. Their average physical activity energy consumption was 326.21 ± 364.84 according to the metabolic equivalent of hours per week. 20 subjects (5%) reported no physical activity. 320 (80%) and 59 (14.8%) subjects had low and moderate physical activity levels, respectively. Only 1 subject (0.2%) had extreme levels of physical activity. Men (n = 43, 26.4%) were more likely to be moderately or extremely physically active than women were (n = 17, 7.2%). There was a significant relationship between physical activity and sex (P < 0.0001), marital status (P < 0.0001), educational status (P < 0.002), current occupation (P < 0.0001), and personal independence (P < 0.00001). Of course, effective predictive variations included age (P = 0.034), gender (P = 0.001), marital status (P = 0.033), independent status (P = 0), and local environment (P =0.001). Conclusions The study revealed low physical activity in the elderly population in

  15. Adverse drug reactions in special populations - the elderly.

    PubMed

    Davies, E A; O'Mahony, M S

    2015-10-01

    The International Conference on Harmonization considers older people a 'special population', as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics and greater vulnerability to adverse drug reactions (ADRs). Medical practice is often based on single disease guidelines derived from clinical trials that have not included frail older people or those with multiple morbidities. This presents a challenge caring for older people, as drug doses in trials may not be achievable in real world patients and risks of ADRs are underestimated in clinical trial populations. The majority of ADRs in older people are Type A, potentially avoidable and associated with commonly prescribed medications. Several ADRs are particularly associated with major adverse consequences in the elderly and their reduction is therefore a clinical priority. Falls are strongly associated with benzodiazepines, neuroleptics, antidepressants and antihypertensives. There is good evidence for medication review as part of a multifactorial intervention to reduce falls risk in community dwelling elderly. Multiple medications also contribute to delirium, another multifactorial syndrome resulting in excess mortality particularly in frail older people. Clostridium difficile associated with use of broad spectrum antibiotics mainly affects frail older people and results in prolonged hospital stay with substantial morbidity and mortality. Antipsychotics increase the risk of stroke by more than three-fold in patients with dementia. Inappropriate prescribing can be reduced by adherence to prescribing guidelines, suitable monitoring and regular medication review. Given the heterogeneity within the older population, providing individualized care is pivotal to preventing ADRs. PMID:25619317

  16. Urological surgery in elderly patients: results and complications

    PubMed Central

    Brodak, Milos; Tomasek, Jan; Pacovsky, Jaroslav; Holub, Lukas; Husek, Petr

    2015-01-01

    Purpose Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients. Methods The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale. Results The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22%) complications were recorded. The most serious were as follows: one patient (<0.5%) died; and four (<2%) patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc. Conclusion Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. PMID:25673978

  17. Outcome of Colorectal Surgery in Elderly Populations

    PubMed Central

    Di Lorenzo, Nicola; Franceschilli, Luana; Perrone, Federico; Angelucci, Giulio P.; Quareisma, Silvia; Gaspari, Achille L.; Sileri, Pierpaolo

    2016-01-01

    Purpose The aim of this study is to investigate the impact of age on short-term outcomes after colorectal surgery in terms of the 30-day postoperative morbidity and mortality rates. Methods The subjects for the study were patients who had undergone colorectal surgery. Patients were divided into 2 groups according to age; groups A and B patients were ≥80 and <80 years old of age, respectively. Both groups were manually matched for body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index and procedure performed. Results A total of 200 patients, 91 men (45.5%) and 109 women (54.5%), were included in this retrospective study. These patients were equally divided into 2 groups. The mean ages were 85 years in group A (range, 80 to 104 years) and 55.3 years in group B (range, 13 to 79 years). The overall 30-day postoperative mortality rate was 1% of total 200 patients; both of these 2 patients were in group A. However, this observation had no statistical significance. No intraoperative complications were encountered in either group. The overall 30-day postoperative morbidity rate was 27% (54 of 200) for both groups. The 30-day postoperative morbidity rates in groups A and B were 28% (28 of 100) and 26% (26 of 100), respectively. However, these differences between the groups had no statistical significance importance. Conclusion Age alone should not be considered to be more of a contraindication or a worse predictor than other factors for the outcome after colorectal surgery on elderly patients. PMID:27626024

  18. [Iron metabolism: pathophysiology and biomarkers in elderly population].

    PubMed

    Gavazzi, Gaëtan

    2014-06-01

    Iron deficiency is frequent in elderly population and is responsable for numerous clinical situations. Because of the frequent association of inflammatory diseases, chronic diseases associated with iron loss, diagnosis of iron deficiency is often difficult in elderly population. For the last ten years, new biomarkers of iron physiology lead to better understand physiology and pathophysiology of iron metabolism particularly in iron deficiency. This overview aims to show modifications of iron metabolism with ageing, pathophysiological mecanisms associated with iron deficiency and give a stratification of the use of biomarkers as diagnostic tools differentiating absolute deficiency or functional deficeincy. PMID:25031216

  19. Polypharmacy and falls in the middle age and elderly population

    PubMed Central

    Ziere, G; Dieleman, J P; Hofman, A; Pols, H A P; van der Cammen, T J M; Stricker, B H CH

    2006-01-01

    Aim Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly. Methods This was a population-based cross-sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged ≥55 years. The prevalence of falls in the previous year was assessed. Medication use was determined with an interviewer-administered questionnaire with verification of use. Polypharmacy was defined as the use of four or more drugs per day. Results The prevalence of falls strongly increased with age. Falls were more common in women than in men. Fall risk increased with increasing disability, presence of joint complaints, use of a walking aid and fracture history. The risk of falling increased significantly with the number of drugs used per day (P for trend <0.0001). After adjustment for a large number of comorbid conditions and disability, polypharmacy remained a significant risk factor for falling. Stratification for polypharmacy with or without at least one drug which is known to increase fall risk (notably CNS drugs and diuretics) disclosed that only polypharmacy with at least one risk drug was associated with an increased risk of falling. Conclusions Fall risk is associated with the use of polypharmacy, but only when at least one established fall risk-increasing drug was part of the daily regimen. PMID:16433876

  20. Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa; de Leon, Carlos Mendes; Fulmer, Terry; Beck, Todd; Hebert, Liesi; Dyer, Carmel; Paveza, Gregory; Evans, Denis

    2010-01-01

    Context Both elder self-neglect and abuse have become increasingly prominent public health issues. The association of either elder self-neglect or abuse with mortality remains unclear. Objective To examine the relationship of elder self-neglect or abuse reported to social services agencies with all-cause mortality among a community-dwelling elderly population. Design, Setting, and Participants Prospective, population-based cohort study (conducted from 1993 to 2005) of residents living in a geographically defined community of 3 adjacent neighborhoods in Chicago, Illinois, who were participating in the Chicago Health and Aging Project (CHAP; a longitudinal, population-based, epidemiological study of residents aged ≥65 years). A subset of these participants had suspected elder self-neglect or abuse reported to social services agencies. Main Outcome Measures Mortality ascertained during follow-up and by use of the National Death Index. Cox proportional hazard models were used to assess independent associations of self-neglect or elder abuse reporting with the risk of all-cause mortality using time-varying covariate analyses. Results Of 9318 CHAP participants, 1544 participants were reported for elder self-neglect and 113 participants were reported for elder abuse from 1993 to 2005. All CHAP participants were followed up for a median of 6.9 years (interquartile range, 7.4 years), during which 4306 deaths occurred. In multivariable analyses, reported elder self-neglect was associated with a significantly increased risk of 1-year mortality (hazard ratio [HR], 5.82; 95% confidence interval [CI], 5.20–6.51). Mortality risk was lower but still elevated after 1 year (HR, 1.88; 95% CI, 1.67–2.14). Reported elder abuse also was associated with significantly increased risk of overall mortality (HR, 1.39; 95% CI, 1.07–1.84). Confirmed elder self-neglect or abuse also was associated with mortality. Increased mortality risks associated with either elder self-neglect or

  1. Willis-Ekbom Disease / Restless Legs Syndrome in the Elderly Population

    MedlinePlus

    ... Ekbom Disease/Restless Legs Syndrome in the Elderly Population A Guide To HelpYou Control and ManageYour WED/ ... more threatening for the elderly than the general population. Sleep loss or the use of some medications ...

  2. Built Environment and Elderly Population Health: A Comprehensive Literature Review

    PubMed Central

    Garin, Noe; Olaya, Beatriz; Miret, Marta; Ayuso-Mateos, Jose Luis; Power, Michael; Bucciarelli, Paola; Haro, Josep Maria

    2014-01-01

    Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability. Although the relationship between the built environment and health has been widely examined in working age adults, research focusing on elderly people is relatively recent. In this review, we provide a comprehensive synthesis of the evidence on the built environment and health in the elderly. PMID:25356084

  3. Biopsychosocial Characteristics, Using a New Functional Measure of Balance, of an Elderly Population with CLBP.

    PubMed

    Hulla, Ryan; Moomey, Michael; Garner, Tyler; Ray, Christopher; Gatchel, Robert J

    2016-01-01

    This study examined the biopsychosocial characteristics of chronic low back pain (CLBP) in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older). A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly) was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH)-developed Patient-Reported Outcome Measurement Information System (PROMIS) was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24); and the other without (NCLBP, n = 24). Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly. PMID:27563929

  4. Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol

    PubMed Central

    Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

    2016-01-01

    Introduction Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. Methods and analysis This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. Ethics and dissemination The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments

  5. Sexuality and Affection among Elderly German Men and Women in Long-Term Relationships: Results of a Prospective Population-Based Study

    PubMed Central

    Müller, Britta; Nienaber, Christoph A.; Reis, Olaf; Kropp, Peter; Meyer, Wolfgang

    2014-01-01

    Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German “Interdisciplinary Longitudinal Study of Adult Development” (ILSE). At three measurement points, 1993–1995, 1997–1998, and 2004–2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the ‘second language of sexuality’: for humans in their later years affection seems to be more important than for younger individuals. PMID:25369193

  6. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study.

    PubMed

    Müller, Britta; Nienaber, Christoph A; Reis, Olaf; Kropp, Peter; Meyer, Wolfgang

    2014-01-01

    Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German "Interdisciplinary Longitudinal Study of Adult Development" (ILSE). At three measurement points, 1993-1995, 1997-1998, and 2004-2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the 'second language of sexuality': for humans in their later years affection seems to be more important than for younger individuals. PMID:25369193

  7. Population pharmacokinetic modeling and simulation of huperzine A in elderly Chinese subjects

    PubMed Central

    Sheng, Lei; Qu, Yi; Yan, Jing; Liu, Gang-yi; Wang, Wei-liang; Wang, Yi-jun; Wang, Hong-yi; Zhang, Meng-qi; Lu, Chuan; Liu, Yun; Jia, Jing-yin; Hu, Chao-ying; Li, Xue-ning; Yu, Chen; Xu, Hong-rong

    2016-01-01

    Aim: Our preliminary results show that huperzine A, an acetylcholinesterase inhibitor used to treat Alzheimer's disease (AD) patients in China, exhibits different pharmacokinetic features in elderly and young healthy subjects. However, its pharmacokinetic data in elderly subjects remains unavailable to date. Thus, we developed a population pharmacokinetic (PPK) model of huperzine A in elderly Chinese people, and identified the covariate affecting its pharmacokinetics for optimal individual administration. Methods: A total of 341 serum huperzine A concentration records was obtained from 2 completed clinical trials (14 elderly healthy subjects in a phase I pharmacokinetic study; 35 elderly AD patients in a phase II study). Population pharmacokinetic analysis was performed using the non-linear mixed-effect modeling software Phoenix NLME1.1.1. The effects of age, gender, body weight, height, creatinine, endogenous creatinine clearance rate as well as drugs administered concomitantly were analyzed. Bootstrap and visual predictive checks were used simultaneously to validate the final population pharmacokinetics models. Results: The plasma concentration-time profile of huperzine A was best described by a one-compartment model with first-order absorption and elimination. Age was identified as the covariate having significant influence on huperzine A clearance. The final PPK model of huperzine A was: CL (L/h)=2.4649*(age/86)(−3.3856), Ka=0.6750 h−1, V (L)=104.216. The final PPK model was demonstrated to be suitable and effective by the bootstrap and visual predictive checks. Conclusion: A PPK model of huperzine A in elderly Chinese subjects is established, which can be used to predict PPK parameters of huperzine A in the treatment of elderly AD patients. PMID:27180987

  8. Seating and wheeled mobility in the disabled elderly population.

    PubMed

    Redford, J B

    1993-08-01

    Elderly persons constitute the largest among the populations regularly using wheelchairs. This is a review of the few studies specifically concerned with seating for the elderly; it identifies current problems, particularly in the seating for aged people who are in long-term care facilities. This review describes ways of matching currently available seating technology with the needs of disabled elderly persons. Two major barriers to greater use of newer seating technology are (1) the high cost of durable medical equipment and (2) the failure of most clinicians and institutional administrators to recognize the importance of posture and comfort to provide functional independence in wheelchair users. This review discusses seating for four groups of elderly persons: (1) the nonmobile, dependents who may be safety risks and are without energy or ability to wheel or walk by themselves; (2) mobile nonambulatory; and (3) ambulatory, but with special wheelchair needs. Research is needed in wheeled mobility in a number of areas: better matching of mobility to function, cheaper and more effective cushions, more modular seating systems, and better lifting and transfer devices. The American National Standards Institute in cooperation with Rehabilitation Engineering Society of North America has recently recommended standards for wheelchair performance that may be legislated in the next few years. PMID:8347074

  9. Comparison of Outpatient Services between Elderly People with Intellectual Disabilities and the General Elderly Population in Taiwan

    ERIC Educational Resources Information Center

    Hsu, Shang-Wei; Lin, Jin-Ding; Chiang, Po-Huang; Chang, Yu-Chia; Tung, Ho-Jui

    2012-01-01

    This study aims to analyze the ambulatory visit frequency and medical expenditures of the general elderly population versus the elderly with intellectual disabilities in Taiwan, while examining the effects of age, gender, urbanization and copayment status on ambulatory utilization. A cross-sectional study was conducted to analyze data from 103,183…

  10. Head and neck cancer in the elderly population.

    PubMed

    Siddiqui, Farzan; Gwede, Clement K

    2012-10-01

    Approximately two-thirds of head and neck cancer (HNC) patients present with locoregionally advanced stage (III and IV) disease. This requires multimodality therapy, including surgery, radiation, and/or chemotherapy. Despite recent advances in treatments for HNC, the treatment paradigms in the elderly population have not been well defined. These patients may not be considered candidates for aggressive multimodality management due to multiple comorbidities, general debility, and concerns regarding poor treatment tolerance and toxicities. The aim of this review is to highlight some of the pertinent issues in dealing with the increasing elderly HNC population, the increasing complexity and toxicities associated with combined modality treatments, and how comorbidity and age are considered during treatment selection decisions. The challenges being faced regarding potential interactions of older age and comorbidity, and their impact on prognosis and quality of life are reviewed, with a special emphasis on radiation therapy or combined modality therapy. Possible solutions to help delineate further areas of study addressing key questions in management of elderly HNC patients are discussed. PMID:22985815

  11. [Diagnosis of health needs of the elderly population of a community of Puerto Nuevo].

    PubMed

    Ramírez Cordero, B M; Figueroa Negrón, C; Pérez Vigo, M C; Anadón Vázquez, D; Oliver Vázquez, M

    2000-06-01

    The purpose of this study was to identify the health needs of the non-institutionalized population, 65 years and over, residing in a sector of the community of Puerto Nuevo. This was the first urbanization established in Puerto Rico in the early 50's. The "snowball" technique was use to identify all the residents 65 year and over of the mentioned sector. Eighty five elderly persons were interviewed to gather data of the following variables: demographics, health conditions, preventive measures, activities of daily living (ADLs, IADLs), health services utilization, psychosocial aspects and use of programs and services available for the elderly population. Statistical analysis included descriptive measures and chi-square. Results revealed a population with a higher education and economic level than the average for this age group in Puerto Rico. People over 75 years over reported more functional limitations than the 65-74 years interviewees did. In comparison with men, women were less educated and presented a higher percent of widows, persons living alone and functional limitations. In almost all the interviewees, help was available in case of need. The majority expressed satisfaction with their family and social lives. Very few utilized programs and services available for elderly persons. It is concluded that in order to improve their quality of life, this population needs to be managed in an holistic mode to address their biopsychosocial needs and to be educated in health promotion issues to prevent further functional limitations. They also need education about the available services for elderly persons. PMID:10909709

  12. [Examination results and autopsy findings in assaults on elderly people].

    PubMed

    Bode-Jänisch, Stefanie; Havermann, Robert; Germerott, Tanja; Fieguth, Armin

    2010-01-01

    As the percentage of elderly people in the population grows, violence against persons of advanced age constitutes an increasing social problem. The findings of the clinical forensic examinations (CE group) and autopsies performed on elderly violence victims (> or = 60 years) between 1999 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In all, the study material comprised 55 victims of the CE group (35 females and 20 males, median age 73.5 years) and 55 autopsies (33 females and 22 males, median age 72.7 years). In most of the autopsy cases, the suspect was a family member or partner. In contrast, the alleged perpetrator was a stranger in most cases of the CE group. Blunt force injuries were most often found in the CE group victims (63.6%). Altogether, 38.2% (CE group) and 20.0% (autopsy cases) of the violent assaults were associated with robbery. In the majority of the CE cases, the victims suffered potentially or acute life-threatening injuries. In summary, the analysis shows that elderly people frequently become victims of robbery and blunt force injury. In most homicides of old people, the perpetrator is familiar to the victim. In surviving elderly violence victims, the assault is more likely to be reported to the police if the suspect is a stranger. PMID:21254704

  13. Aortic stiffness and kidney disease in an elderly population

    PubMed Central

    Michener, Katherine H.; Mitchell, Gary F.; Noubary, Farzad; Huang, Naya; Harris, Tamara; Andresdottir, Margret B.; Palsson, Runolfur; Gudnason, Vilmundur; Levey, Andrew S.

    2015-01-01

    Background/Aims The causes of chronic kidney disease (CKD) in older people are not well understood. Aortic stiffness increases with age and results in transmission of increased pulsatility into the kidney microvasculature, potentially contributing to CKD in older populations. Methods We utilized data from the Age, Gene/Environment, Susceptibility-Reykjavik Study, a community-based prospective cohort study of cardiovascular disease (CVD) in Iceland. Associations of carotid pulse pressure (CPP) and carotid femoral pulse wave velocity (CFPWV) with estimated glomerular filtration rate based on creatinine and cystatin C (eGFR) and urine albumin-creatinine ratio (ACR) were assessed using linear regression, adjusting for demographics and CVD risk factors. Results 940 participants [mean (SD) age 75.8 (4.7) years, mean (SD) CFPWV 12.9 (4.2) m/s, mean (SD) CPP 69 (21) mm Hg, mean (SD) eGFR 68 (16) ml/min/1.73m2, and median (IQR) ACR 3 (2–6) mg/g) were studied. At CPP greater than 85 mmHg, higher CPP was associated with lower eGFR in unadjusted analyses but not after adjustment. CPP was significantly associated with higher ACR in fully adjusted models [β (95% CI)=0.14 (0.03, 0.24) ln mg/g per SD]. Higher CFPWV was associated with lower eGFR and higher ACR in unadjusted analyses but not after adjustment. Conclusion Greater aortic stiffness may be associated with modestly higher levels of albuminuria in the elderly. The association with lower eGFR may be confounded by age and CVD risk factors. PMID:26067356

  14. Dementia in a tribal landlocked elderly population at high altitude: What explains the lower prevalence?

    PubMed Central

    Raina, Sunil Kumar; Chander, Vishav; Bhardwaj, Amit

    2016-01-01

    Introduction: Studies across the populations have suggested that dementia is differentially distributed with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Earlier, we reported on the prevalence of dementia in elderly population in migrant, urban, rural, and tribal populations. The present study was conducted with a view to estimating the prevalence of dementia in Tribal Landlocked Elderly Population at high altitude and therefore to draw some conclusions on the differential distribution of dementia across populations. Methods: A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase 1 involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase 2 involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test. Results: The results revealed that six individuals out of a total of 481 studied above 60 years of age in the studied population scored between 17 and 23, thus qualifying as suffering from mild cognitive impairment. Importantly, none of the individuals above 60 years of age scored <17. Discussion: The current study is in conformity with our previous study conducted on urban, rural, and migrant areas of the state of Himachal Pradesh again emphasizing on dementia being rare in tribal populations and thereby pointing to the presence of some protective factors among tribal people. PMID:27365961

  15. Measurement properties of the Minimal Insomnia Symptom Scale (MISS) in an elderly population in Sweden

    PubMed Central

    2010-01-01

    Background Insomnia is common among elderly people and associated with poor health. The Minimal Insomnia Symptom Scale (MISS) is a three item screening instrument that has been found to be psychometrically sound and capable of identifying insomnia in the general population (20-64 years). However, its measurement properties have not been studied in an elderly population. Our aim was to test the measurement properties of the MISS among people aged 65 + in Sweden, by replicating the original study in an elderly sample. Methods Data from a cross-sectional survey of 548 elderly individuals were analysed in terms of assumptions of summation of items, floor/ceiling effects, reliability and optimal cut-off score by means of ROC-curve analysis and compared with self-reported insomnia criteria. Results Corrected item-total correlations ranged between 0.64-0.70, floor/ceiling effects were 6.6/0.6% and reliability was 0.81. ROC analysis identified the optimal cut-off score as ≥7 (sensitivity, 0.93; specificity, 0.84; positive/negative predictive values, 0.256/0.995). Using this cut-off score, the prevalence of insomnia in the study sample was 21.7% and most frequent among women and the oldest old. Conclusions Data support the measurement properties of the MISS as a possible insomnia screening instrument for elderly persons. This study make evident that the MISS is useful for identifying elderly people with insomnia-like sleep problems. Further studies are needed to assess its usefulness in identifying clinically defined insomnia. PMID:21054878

  16. Health care utilization in the elderly Mexican population: Expenditures and determinants

    PubMed Central

    2011-01-01

    Background Worldwide population aging has been considered one of the most important demographic phenomena, and is frequently referred as a determinant of health costs and expenditures. These costs are an effect either of the aging process itself (social) or because of the increase that comes with older age (individual). Objective To analyze health expenditures and its determinants in a sample of Mexican population, for three dimensions acute morbidity, ambulatory care and hospitalization focusing on different age groups, particularly the elderly. Methods A secondary analysis of the Mexican National Health and Nutrition Survey (ENSANUT), 2006 was conducted. A descriptive analysis was performed to establish a health profile by socio-demographic characteristics. Logistic regression models were estimated to determine the relation between acute morbidity, ambulatory care, hospitalization and age group; to establish the determinants of hospitalization among the population 60 years and older; and to determine hospitalization expenditures by age. Results Higher proportion of elderly reporting health problems was found. Average expenditures of hospitalization in households were $240.6 am dlls, whereas in households exclusively with elderly the expenditure was $308.9 am dlls, the highest among the considered age groups. The multivariate analysis showed higher probability of being hospitalized among the elderly, but not for risks for acute morbidity and ambulatory care. Among the elderly, older age, being male or living in a city or in a metro area implied a higher probability of hospitalization during the last year, with chronic diseases playing a key role in hospitalization. Conclusions The conditions associated with age, such as chronic diseases, have higher weight than age itself; therefore, they are responsible for the higher expenditures reported. Conclusions point towards a differentiated use and intensity of health services depending on age. The projected increase in

  17. [Elder].

    PubMed

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented. PMID:27603886

  18. Factors explaining the increase in cost for physician care in Quebec's elderly population.

    PubMed Central

    Demers, M

    1996-01-01

    OBJECTIVE: To examine what role demographic factors and increases in physician fees and utilization played in the rise in costs of physician services provided for elderly people in Quebec between 1982 and 1992, and to investigate changes in patterns of care (type and amount of services) related to utilization. DESIGN: Retrospective study of population-based data. SETTING: Province of Quebec. SUBJECTS: Elderly people (65 years of age and over) in Quebec in 1982 (n = 589,800) and in 1992 (n = 803,600). OUTCOME MEASURES: Proportion of the increase in physician care costs attributable to (a) aging (defined as a shift in the age distribution) of the elderly population, (b) the increase in the size of the elderly population, (c) the increase in physician fees and (d) the increase in utilization of physician services; proportion of care provided by general practitioners (GPs) and by specialists; proportion of minor and complete examinations provided by GPs; and rates of hospital admissions and surgery. RESULTS: Aging was responsible for 0.5% of the increase in physician care costs between 1982 and 1992, population growth for 27.0% and the increase in physician fees for 25.5%. The increased utilization accounted for 47.0% of the total cost increase. Analyses of the utilization data revealed a shift toward more costly services, more visits to specialists and higher rates of hospital admissions and surgery in 1992 than in 1982. CONCLUSIONS: Aging and population growth had minor effects on the increase in physician care costs between 1982 and 1992. Increased utilization was the most important factor. The appropriateness of this trend needs to be verified. PMID:8956832

  19. Qualitative Evaluation of Baduanjin (Traditional Chinese Qigong) on Health Promotion among an Elderly Community Population at Risk for Ischemic Stroke.

    PubMed

    Zheng, Guohua; Fang, Qianying; Chen, Bai; Yi, Hongmei; Lin, Qiu; Chen, Lidian

    2015-01-01

    Background. Baduanjin is a traditional Chinese qigong that has been practiced for a long time in China as a mind-body exercise in community elderly populations. The objective of this study was to qualitatively evaluate the perceived benefit of regular Baduanjin qigong in community elders. Methods. A total of 20 participants who had completed the 12-week Baduanjin qigong training were interviewed regarding their perceived effect on physical and psychological health and whether Baduanjin qigong was suitable for the elderly. Results. Almost all participants agreed that Baduanjin qigong could promote their multisystem or organ functions (e.g., digestive and circulatory systems), increase their immunity, make their bodies relax, and improve their mood and confidence. Most of the participants also agreed that Baduanjin qigong was appropriate for elderly individuals. Few individuals felt bored because of an hour Baduanjin training each day. Conclusions. The findings suggest that regular Baduanjin qigong may be potentially helpful to promote the overall physical and psychological health of elderly community populations and may be useful and feasible as a body-mind exercise in the health promotion in the elderly community populations. PMID:26483845

  20. Qualitative Evaluation of Baduanjin (Traditional Chinese Qigong) on Health Promotion among an Elderly Community Population at Risk for Ischemic Stroke

    PubMed Central

    Zheng, Guohua; Fang, Qianying; Chen, Bai; Yi, Hongmei; Lin, Qiu; Chen, Lidian

    2015-01-01

    Background. Baduanjin is a traditional Chinese qigong that has been practiced for a long time in China as a mind-body exercise in community elderly populations. The objective of this study was to qualitatively evaluate the perceived benefit of regular Baduanjin qigong in community elders. Methods. A total of 20 participants who had completed the 12-week Baduanjin qigong training were interviewed regarding their perceived effect on physical and psychological health and whether Baduanjin qigong was suitable for the elderly. Results. Almost all participants agreed that Baduanjin qigong could promote their multisystem or organ functions (e.g., digestive and circulatory systems), increase their immunity, make their bodies relax, and improve their mood and confidence. Most of the participants also agreed that Baduanjin qigong was appropriate for elderly individuals. Few individuals felt bored because of an hour Baduanjin training each day. Conclusions. The findings suggest that regular Baduanjin qigong may be potentially helpful to promote the overall physical and psychological health of elderly community populations and may be useful and feasible as a body-mind exercise in the health promotion in the elderly community populations. PMID:26483845

  1. Evaluation of results of surgical procedures in the elderly.

    PubMed

    Linn, B S; Linn, M W; Wallen, N

    1982-01-01

    Authorities are not in full agreement in regard to risk of surgery in the elderly. One hundred eight studies of surgery in the elderly over the past 40 years were reviewed. The purpose was not merely to tabulate results, but to identify differences existing between reports with regard to data reported that could affect results independent of the surgical management itself. Sources of variance that need to be taken into account in comparing mortality rates between studies, such as whether mortality was computed by number of patients or operations, differing lengths of follow-up for recording mortality, proportions of emergency versus elective operations, and types of surgical procedures, were documented. A nine-item confidence in results scale was used to classify studies into high and low confidence groups. Surgical specialties scored substantially higher than general surgical studies. More recent studies received higher scores than earlier studies. Although mortality rates varied widely depending on methods of their calculation, there appeared to be a trend toward increases in elective, but not emergency, mortality rates in general surgery since 1941 that should be examined more closely. One thing that cannot be answered clearly from these studies is the relative risk of surgery with age. Some control of variations between studies and standardization of reporting surgical deaths are required before risk of surgery in the elderly can be assessed more accurately. PMID:7055387

  2. An apocalyptic vision of ageing in China: Old age care for the largest elderly population in the world.

    PubMed

    Liu, Tao; Sun, Li

    2015-06-01

    According to the National Bureau of Statistics of China, by 2010 the number of people aged 60 or over had reached 178 million in China or 13% of its population. With the largest elderly population in the world in absolute numbers, China faces a challenge of providing care for the elderly both in the present and the future. Unlike old age pensions and health protection for the elderly, in Chinese society elderly care had never been considered to be a social problem but rather the individual family's responsibility. After the turn of the millennium, as the repercussions of increasingly ageing demographics, the results of the One-Child Policy and drastic changes in traditional family structures gradually became more apparent, this issue of elderly care has increasingly become one of the most pressing concerns for the ageing society. As there is little existing research on this particular topic, this article aims to shed light on elderly care in China, focusing on the care of elderly needing assistance with activities of daily living, since this group of elderly are most in need of care, their numbers having risen to 33 million in 2010. This article argues it is urgent for China to switch from informal family-based elderly care to the state's formal long-term care, illustrates that a model of social insurance (e.g. as in Germany) is advocated by many Chinese scholars and points out the ways in which it is different from both the commercialized models (e.g. as in the USA) and state organized "Beveridge" models (e.g. as in Sweden). PMID:25323978

  3. An e-Health Platform for the Elderly Population: The Butler System

    ERIC Educational Resources Information Center

    Etchemendy, E.; Banos, R. M.; Botella, C.; Castilla, D.; Alcaniz, M.; Rasal, P.; Farfallini, L.

    2011-01-01

    The Butler system is an e-health platform designed to improve the elderly population's quality of life. The Butler system has three applications diagnostic, therapeutic and playful. The objective of this work is to present the influence of the use of the platform on elderly users' mood states and the degree of acceptance. These measures were…

  4. The Elderly and Social Change in Contemporary India: Governmental Response to the Needs of Elderly Population in India.

    ERIC Educational Resources Information Center

    Mohapatra, Urmila

    The Indian people are living longer, more women are working, and the country's one billion inhabitants are becoming more industrial and urban. This research paper analyzes the impact of social changes in India upon its elderly population. The paper's specific objectives are to identify some major social changes in India as described by various…

  5. Association between functional performance and executive cognitive functions in an elderly population including patients with low ankle–brachial index

    PubMed Central

    Ferreira, Naomi Vidal; Cunha, Paulo Jannuzzi; da Costa, Danielle Irigoyen; dos Santos, Fernando; Costa, Fernando Oliveira; Consolim-Colombo, Fernanda; Irigoyen, Maria Cláudia

    2015-01-01

    Introduction Peripheral arterial disease, as measured by the ankle–brachial index (ABI), is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT). Executive cognitive function (ECF) impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI. Aim To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI. Method The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19), and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07). We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE), and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT) for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT) for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF). Results Before adjustment, the ABI group performed worse on global cognition, attention span, working memory, inhibitory control/impulsivity, semantic verbal fluency, and phonemic verbal fluency. After adjustment, the ABI group performance remained worse for working memory and semantic verbal fluency. In a simple correlation analysis including all of the subjects, the 6MWT was associated with global cognition, attention span, working memory, information processing speed, inhibitory control/impulsivity, semantic verbal fluency, and global ECF. After adjustment, all the associations remained statistically significant. Conclusion This study found an independent association between

  6. Construction and Validation of Brain MRI Templates from a Korean Normal Elderly Population

    PubMed Central

    Lee, Hyunna; Yoo, Byung Il; Han, Ji Won; Lee, Jung Jae; Oh, San Yeo Wool; Lee, Eun Young; Kim, Jae Hyoung

    2016-01-01

    Objective This study aimed to construct a Korean normal elderly brain template (KNE96) using Korean elderly individuals for use in brain MRI studies and to validate it. Methods We used high-resolution 3.0T T1 structural MR images from 96 Korean normal elderly individuals (M/F=48/48), aged 60 years or older (M=69.5±6.2 years, F=70.1±7.0 years), for constructing the KNE96 template. The KNE96 template was validated by comparing the registration-induced deformations between the KNE96 and ICBM152 templates using different MR images from 48 Korean normal elderly individuals (M/F=24/24), aged 60 years or older (M=71.5±5.9 years, F=72.8±5.1 years). We used the magnitude of displacement vectors (mag-displacement) and log of Jacobian determinants (log-Jacobian) to quantify the deformation produced during registration process to templates. Results The mag-displacement and log-Jacobian of the registration were much smaller using the KNE96 template than with the ICBM152 template in most brain regions. There was a prominent difference in the significant averaged differences (SADs) of the mag-displacement and log-Jacobian between the KNE96 and ICBM152 at the superior, medial, and middle frontal gyrus, the lingual, inferior, middle, and superior occipital gyrus, and the caudate and thalamus. Conclusion This study suggests that templates constructed from Asian populations, such as the KNE96, may be more desirable than those from Caucasian populations, like the ICBM152, in computational neuroimaging studies that measure and compare anatomical features of the frontal and occipital lobe, thalamus and caudate. PMID:26766956

  7. Gender based Dosing of Metoprolol in the Elderly using Population Pharmacokinetic Modeling and Simulations

    PubMed Central

    Eugene, Andy R.

    2016-01-01

    Introduction This article seeks to clarify if gender-based differences occur in the pharmacokinetics of metoprolol in the elderly patients. There are a series of physiologic changes that occur in the elderly ranging from decreased hepatic blood flow to increased adiposity causing higher plasma concentrations at therapeutic doses as compared to the healthy young population. Methods Population pharmacokinetic modeling were performed using MONOLIX and Monte-Carlo simulations were conducted using MATLAB. The data was based from a previously published dataset where elderly patients, having multiple comorbidities, were administered a 50mg dose of metoprolol. Results Metoprolol was modeled using a one-compartment model and resulted in the following population pharmacokinetic parameters: volume of distribution, V=38L (CV=155%), clearance rates, CL-Men=105L/hour and CL-Women=59.1L/hour (38%), time lag, Tlag=0.469 hour (CV=17%), and the absorption rate constant, Ka=0.235 hr-1 (CV=23%). Conclusion Gender stratified doses resulting in an equivalent systemic metoprolol exposure in geriatric patients have been identified. Metoprolol doses resulting a similar AUC in a healthy young male administered 50mg tablet were 15mg for geriatric women and 25mg for geriatric men. Further, Metoprolol doses of 25mg for geriatric women and 50mg for geriatric men resulted in an equivalent AUC to a healthy young males dosed with a 100mg tablet. A 15mg Metoprolol tablet may need to be compounded to account for the gender differences in Metoprolol pharmacokinetics.

  8. Prevalence and socioeconomic correlates of chronic morbidity among elderly people in Kosovo: a population-based survey

    PubMed Central

    2013-01-01

    Background Our aim was to assess the prevalence and demographic and socioeconomic correlates of chronic morbidity in the elderly population of transitional Kosovo. Methods A cross-sectional study was conducted in Kosovo in 2011 including a representative sample of 1890 individuals aged ≥65 years (949 men, mean age 73 ± 6 years; 941 women, mean age 74 ± 7 years; response rate: 83%). A structured questionnaire inquired about the presence and the number of self-reported chronic diseases among elderly people, and their access to medical care. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of demographic and socioeconomic characteristics with chronic conditions. Results In this nationwide population-based sample in Kosovo, 42% of elderly people were unable to access medical care, of whom 88% due to unaffordable costs. About 83% of the elderly people reported at least one chronic condition (63% cardiovascular diseases), and 45% had at least two chronic diseases. In multivariable-adjusted models, factors associated with the presence of chronic conditions and/or multimorbidity were female sex, older age, self-perceived poverty and the inability to access medical care. Conclusion This study provides important evidence on the magnitude and distribution of chronic conditions among the elderly population of Kosovo. Our findings suggest that, in this sample of elderly people from Kosovo, the oldest-old (especially women) and the poor endure the vast majority of chronic conditions. These findings point to the urgent need to establish a social health insurance scheme including the marginalized segments of elderly people in this transitional country. PMID:23452830

  9. [Prevalence of home care and associated factors in the Brazilian elderly population].

    PubMed

    Wachs, Louriele Soares; Nunes, Bruno Pereira; Soares, Mariangela Uhlmann; Facchini, Luiz Augusto; Thumé, Elaine

    2016-03-01

    The aim of this study was to evaluate the prevalence of home care for the Brazilian elderly population and associated factors, using a cross-sectional design with a sample of individuals 60 years or older living in the urban areas of 100 municipalities located in 23 states. A Poisson regression model was used for crude and adjusted analyses. A total of 6,624 elderly individuals were interviewed, and prevalence of home care was 11.7%. After adjustment, higher home care rates were associated with female gender, older old age, lower schooling and purchasing power, diagnosis of chronic illness, history of falls, previous hospitalization, and medical consultation in the previous three months. The results highlight more extensive use of home care by the most vulnerable elderly. This finding suggests a contribution from home care to the promotion of healthcare equity in Brazil, especially due to the expansion of the Family Health Strategy. The results can support the organization of the work process for primary care professionals and managers. PMID:27027455

  10. Cognitive Function and Sleep Related Breathing Disorders in a Healthy Elderly Population: the Synapse Study

    PubMed Central

    Sforza, Emilia; Roche, Frédéeric; Thomas-Anterion, Catherine; Kerleroux, Judith; Beauchet, Olivier; Celle, Sébastien; Maudoux, Delphine; Pichot, Vincent; Laurent, Bernard; Barthélémy, Jean Claude

    2010-01-01

    Study Objectives: Sleep related breathing disorders (SRBD) are risk factors for cognitive dysfunction in middle-aged subjects, but this association has not been observed in the elderly. We assess the impact of SRBD on cognitive performance in a large cohort of healthy elderly subjects. Design: Cross-sectional study examining the association between subjective memory test, neuropsychological battery testing and SRBD in the elderly. Setting: Community-based sample in home and research clinical settings. Participants: 827 subjects, 58.5% women, aged 68 y at study entry, participated in the study. All were free of previously diagnosed SRBD, coronary heart disease, and neurological disorders, including stroke and dementia. Clinical interview, neurological assessment, polygraphy, and extensive cognitive testing were conducted for all participants. Intervention: N/A Measurement and Results: SRBD (apnea-hypopnea index [AHI] > 15 events/h) was diagnosed in 445 (53%) subjects, 167 (37%) of them with AHI > 30. Minimal daytime sleepiness was found in the group; 9.2% of the population had an Epworth Sleepiness Scale score > 10. No significant association was found between AHI, nocturnal hypoxemia, and cognitive scores. Comparison of mild vs severe cases showed a trend toward lower cognitive scores with AHI > 30, affecting delayed recall and Stroop test. Conclusions: The impact of undiagnosed SRBD on cognitive function appeared quite limited in a generally older healthy population, and only slightly affected severe cases. The implication of undiagnosed SRBD on the cognitive impairment in elderly subjects remains hypothetical and needs to be prospectively studied. Clinical Trial Information: Autonomic Nervous System Activity, Aging and Sleep Apnea/Hypopnea (SYNAPSE); Registration #NCT 00766584 (This study is ongoing, but not recruiting participants.); URL - http://clinicaltrials.gov/ct2/show/NCT00766584?term=NCT+00766584&rank=1 Citation: Sforza E; Roche F; Thomas-Anterion C

  11. Elderly trauma.

    PubMed

    Holleran, Renee Semonin

    2015-01-01

    Across the world, the population is aging. Adults 65 years and older make up one of the fastest growing segments of the US population. Trauma is a disease process that affects all age groups. The mortality and morbidity that result from an injury can be influenced by many factors including age, physical condition, and comorbidities. The management of the elderly trauma patient can present some unique challenges. This paper addresses the differences that occur in the management of elderly patient who has been injured. This paper also includes a discussion of how to prevent injury in the elderly. PMID:26039652

  12. Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population

    PubMed Central

    Zhu, Qing Olivia; Tan, Choon Seng Gilbert; Tan, Hwee Leong; Wong, Ruining Geraldine; Joshi, Chinmaya Shrikant; Cuttilan, Ravi Amran; Sng, Gek Khim Judy; Tan, Ngiap Chuan

    2016-01-01

    INTRODUCTION The prevalence of orthostatic hypotension (OH) among the elderly population in Singapore, as defined by a decline in blood pressure upon a change in position, is not well-established. Studies associate OH with clinically significant outcomes such as falls. This study aims to determine the prevalence of OH among elderly patients attending a public primary care clinic (polyclinic) for chronic disease management, and examine the relationships between postulated risk factors and OH. METHODS Patients aged ≥ 65 years attending a typical polyclinic in Geylang were identified and targeted for recruitment at the study site. A questionnaire on symptoms and postulated risk factors was administered, followed by supine and standing blood pressure measurements. Cross-sectional analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Prevalence rate ratios with 95% confidence interval were calculated for the latter. RESULTS A total of 364 multiethnic patients participated in the study. The prevalence of OH was 11.0%. Older age, comorbidities such as cardiac failure and kidney disease, being physically inactive at work, fatigue, self-reported dizziness in the past year, and the use of loop diuretics were found to be significantly associated with OH. CONCLUSION About one in ten elderly patients at a local polyclinic was affected by OH, which was associated with multiple factors. Some of these factors are modifiable and can be addressed to reduce the incidence of OH. PMID:27549316

  13. Burden of disease due to dementia in the elderly population of Korea: present and future

    PubMed Central

    2013-01-01

    Background With the rapid aging of populations around the world, dementia has become one of the most important public health problems in Eastern Asian countries. The purpose of the present study was to provide an estimate of the burden of dementia and forecast its future burden, as generalized to the Korean population, and to provide detailed gender- and age-specific information regarding the burden of dementia in the elderly population of Korea. Methods ‘Disability-adjusted life years’ (DALYs) were used to estimate the burden of dementia. Epidemiologic data from national statistics and nationwide epidemiologic studies in the year 2008 were used to obtain representative outcomes for the Korean population. We estimated the DALYs due to dementia from the years 2010 to 2050 by applying demographic structure projections in terms of 5-year age groups in Korea. Results The burden of disease due to dementia in Korea is 528 per 100,000 population (males: 435, females: 622) and 5,117 per 100,000 in those over the age of 65 years (males: 5,228; females: 5,041); this accounts for 4.5% of the total burden of disease in the year 2008. In the year 2050, DALYs due to dementia (814,629) are expected to be 3.0 times higher than those in the year 2010 (274,849). Conclusion Dementia has the highest burden of disease in the elderly Korean population, and this burden will increase sharply with the aging of the population. More comprehensive and multi-dimensional approaches, including clinical, psychological, social, and political means will be needed for the management of the dramatically increasing burden of dementia. PMID:23552095

  14. ELDERLY HEALTH AND ITS CORRELATIONS AMONG UZBEK POPULATION

    PubMed Central

    PULATOVA, GOOLBAHOR; HARUN-OR-RASHID, MD.; YOSHIDA, YOSHITOKU; SAKAMOTO, JUNICHI

    2012-01-01

    ABSTRACT This study was conducted from November, 2007 to May, 2008 to evaluate the health status of the elderly and correlated factors affecting their health. We collected data from 682 individuals 65 years or older (214 male) from greater Tashkent City in Uzbekistan. The study revealed that 75.4% of the respondents were aged <75 years and that 16.8% of them were not educated. About three-quarters of the respondents rated themselves as ‘healthy.’ The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated through a logistic regression model to determine correlations of elderly health, and adjusted for age and sex. The elderly who had additional income were 2.6 times (95% CI=1.8–4.0) more likely to be healthy. Similarly, those <75 years old (OR=1.5, 95% CI=1.0–2.2), were able to do everyday duties (OR=6.0, 95% CI=3.8–9.3), and those who were married (OR=4.1, 95% CI=1.7–9.7) were also healthy. Conversely, males (OR=0.6, 95% CI=0.4–0.9) and the elderly who were supported by sources other than their own income from work were not healthy. We concluded that having a strong family relationship and adhering to a traditional lifestyle are important for protecting elderly health in Uzbekistan. Substantial financial support and personal care are necessary for the elderly. Creating a healthy atmosphere for them at an individual and family level could ensure a better quality life for the elderly in Uzbekistan. PMID:22515113

  15. The health of Canada's elderly population: current status and future implications

    PubMed Central

    Rosenberg, M W; Moore, E G

    1997-01-01

    The growing size of Canada's elderly population and its use of health care services has generated much discussion in policy circles and the popular press. With data from the National Population Health Survey, undertaken in 1994-95, the authors examine the health status of Canada's elderly population using 3 sets of measures: level of activity limitations, prevalence of chronic illnesses and self-assessment of overall health. They also analyse the utilization of physician and institutional services. The profile of this population the authors develop is in many respects not much different from that of the remaining adult population, until the age of 75. People aged 75 and over are much more likely than other adults to have health problems and use health care services. Also, elderly women living alone and with low income are identified as an especially vulnerable group who need access to medical and nonmedical services if they are to remain in the community. Using Statistics Canada projection data the authors discuss some aspects of the elderly population's health status in the future. Their look into the future raises issues about the preparedness of health care providers and our health care system to meet the challenges of tomorrow's elderly population. PMID:9347773

  16. Interferon (IFN) production by peripheral blood mononuclear (PBM) cells of an elderly population

    SciTech Connect

    Nelson, B.J.; Murasko, D.M.

    1986-03-05

    Previous investigations in the laboratory have reported decreased mitogen responses of PBM's from elderly individuals compared to responses of young adults to PHA and ConA. Current studies have investigated the role of IFN in this decreased T cell responsiveness of the elderly. Supernatants of PBM's from 80 elderly (mean age 85) and 50 young individuals (mean age 28) were assayed for antiviral activity, after incubation with optimum and supraoptimum concentrations of mitogen for 24-120 hrs. IFN levels were maximum for both elderly and young populations at 72 hrs coinciding with time of maximum proliferation as determined by uptake of /sup 3/H thymidine. IFN levels declined with longer incubation periods. All IFN produced was IFN-gamma as determined by sensitivity to pH 2 and by neutralizations with monoclonal antibody specific for human IFN-gamma and polyclonal antiserum specific for IFN-alpha. The elderly population's mean IFN titers for both PHA and ConA were about 39% of the mean titers of the young (p less than or equal to 0.02). Both elderly and young groups displayed significant positive correlation between the amount of IFN produced and the level of proliferation in response to the mitogens (p less than or equal to 0.036). Therefore, the above data suggests the decreased levels of IFN produced by elderly PBM's may be one of the factors responsible for the observed decreased proliferative response to mitogens.

  17. Prevalence and correlates of valvular heart diseases in the elderly population in Hubei, China.

    PubMed

    Shu, Chang; Chen, Si; Qin, Tingting; Fu, Zhen; Sun, Tucheng; Xie, Mingxing; Zhang, Li; Dong, Nianguo; Yin, Ping

    2016-01-01

    We sought to determine the prevalence and correlates of valvular heart diseases (VHD) in the elderly population. The participants' personal information, medical history, behavioral habits and clinical status were assessed by questionnaire, while the left ventricular dimensions, function and the presence and severity of VHD were evaluated by transthoracic echocardiography. This study analyzed the data of 3948 participants who were older than 60 years. Significant VHD was present in 1.93% of participants; the standardized prevalence of VHD among the elderly population in Hubei was 2.05% (95% CI: 1.61-2.49). The most frequent VHD was aortic regurgitation, followed by tricuspid regurgitation, mitral regurgitation and multiple valve diseases. Univariate analysis results indicated that compared with participants without VHD, those with VHD were older (p < 0.001), with a higher body mass index (BMI) (p < 0.001), were more likely to smoke (p = 0.04), and had higher rates of coronary artery disease (CAD) (p < 0.001) and arrhythmia (p < 0.001). The results of multinomial regression analysis of complex sampling indicated that combined mitral and aortic valve diseases were related to older age, male sex and smoking; CAD was associated with single left-sided VHD. PMID:27250873

  18. Prevalence and correlates of valvular heart diseases in the elderly population in Hubei, China

    PubMed Central

    Shu, Chang; Chen, Si; Qin, Tingting; Fu, Zhen; Sun, Tucheng; Xie, Mingxing; Zhang, Li; Dong, Nianguo; Yin, Ping

    2016-01-01

    We sought to determine the prevalence and correlates of valvular heart diseases (VHD) in the elderly population. The participants’ personal information, medical history, behavioral habits and clinical status were assessed by questionnaire, while the left ventricular dimensions, function and the presence and severity of VHD were evaluated by transthoracic echocardiography. This study analyzed the data of 3948 participants who were older than 60 years. Significant VHD was present in 1.93% of participants; the standardized prevalence of VHD among the elderly population in Hubei was 2.05% (95% CI: 1.61–2.49). The most frequent VHD was aortic regurgitation, followed by tricuspid regurgitation, mitral regurgitation and multiple valve diseases. Univariate analysis results indicated that compared with participants without VHD, those with VHD were older (p < 0.001), with a higher body mass index (BMI) (p < 0.001), were more likely to smoke (p = 0.04), and had higher rates of coronary artery disease (CAD) (p < 0.001) and arrhythmia (p < 0.001). The results of multinomial regression analysis of complex sampling indicated that combined mitral and aortic valve diseases were related to older age, male sex and smoking; CAD was associated with single left-sided VHD. PMID:27250873

  19. Factors affecting the results of the clock drawing test in elderly patients hospitalized for physical rehabilitation.

    PubMed

    Lieberman, D; Galinsky, D; Fried, V; Grinshpun, Y; Mytlis, N; Tylis, R; Lieberman, D

    1999-05-01

    The Clock Drawing Test (CDT) is a recognized and accepted instrument for the early diagnosis of dementia in the elderly. In a prospective study we evaluated the association between the results of this test and a broad range of clinical, functional and sociodemographic variables. The study was conducted on elderly patients hospitalized for rehabilitation following stroke or hip fracture (HF) in the geriatric ward of a university hospital in southern Israel. The administration of the CDT and its scoring system were adapted from Sunderland et al. and Wolfe-Klein et al. The study was conducted on all 425 elderly patients who were hospitalized during the study period and who were capable of completing the test. Stepwise multiple regression was used to evaluate the association between the results of the CDT and the other variables. The mean CDT score (+/- SD) for the entire study population was 7.8 +/- 2.5 and 145 patients (34%) had scores of 6 or below. Of the 41 variables that were tested, significant associations with the CDT were found for the following four variables only: the Folstein minimental test (beta = 0.447, p < 0.0001), the cognition value from the admission FIM (beta = 0.252, p < 0.0001), years of education (beta = 0.183, p = 0.0001), and the patient's age (beta = -0.075, p = 0.037). The total variance of the CDT explained by these four variables (Adjusted R2) was 0.554. We conclude that in the study population there was a significant proportion of patients with low CDT scores. This score, in this population, is influenced in particular by two other measures of cognitive function and by the formal level of education, together with a weaker effect of age. PMID:10389034

  20. Elder mistreatment and emotional symptoms among older adults in a largely rural population: the South Carolina elder mistreatment study.

    PubMed

    Begle, Angela M; Strachan, Martha; Cisler, Joshua M; Amstadter, Ananda B; Hernandez, Melba; Acierno, Ron

    2011-07-01

    Although two recent major studies provide some insight into the prevalence and correlates of elder mistreatment, the relationship between elder mistreatment and mental health remains unclear. This study begins to address this issue by examining the relationship between elder mistreatment (i.e., a recent history of emotional and physical abuse) and negative emotional symptoms (e.g., anxiety and depression) among 902 older adults aged 60 and above residing in South Carolina. Results demonstrate that emotional, but not physical, abuse is significantly correlated with higher levels of emotional symptoms. This relationship is sustained when controlling for established demographic and social/dependency risk factors. These data suggest that mistreated older adults also suffer from greater emotional symptoms and highlight the need for more research in this area. PMID:20829233

  1. Health Care of the Elderly in Medically Disadvantaged Populations.

    ERIC Educational Resources Information Center

    German, Pearl S.; And Others

    1978-01-01

    This study of three disadvantaged urban areas reports on the relationship between available resources and ambulatory health care. Findings indicate a high proportion of elderly receiving care for serious conditions but a sharp drop in care for less serious but potentially disabling conditions. (Author)

  2. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    PubMed Central

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

  3. Vitamin D as a marker of cognitive decline in elderly Indian population

    PubMed Central

    Vedak, Tejal Kanhaiya; Ganwir, Vaishali; Shah, Arun B.; Pinto, Charles; Lele, Vikram R.; Subramanyam, Alka; Shah, Hina; Deo, Sudha Shrikant

    2015-01-01

    Objectives: Very few studies in India have addressed the role of vitamin D in cognitive function. The present study was conducted to assess the serum levels of 25-hydroxyvitamin D (25(OH)D) and its association with markers of cognitive impairment and homocysteine levels in the elderly Indian population. Materials and Methods: The study population consisted of patients with dementia (Group A, n = 32), mild cognitive impairment (MCI; Group B, n = 24), and elderly age-matched controls (Group C, n = 30). Measurement of serum levels of 25(OH)D and total homocysteine were done. Results: Significant decreased concentration of 25(OH)D and increased concentration of homocysteine was observed. Association of serum levels of vitamin D with markers of cognitive decline as well as serum homocysteine levels was observed in patients with dementia and MCI when compared to controls. Conclusion: Correlation of vitamin D with markers of cognitive decline and homocysteine opens a new door for early diagnosis of cognitive impairment. PMID:26425010

  4. Some Prospects for the Future Elderly Population. Statistical Reports on Older Americans, Number 3.

    ERIC Educational Resources Information Center

    Fowles, Donald G.

    This publication brings together a large number of facts and statistics about the country's growing population of older adults. Data indicate that regardless of their economic situation, the elderly population will not only be growing rapidly in the future but will be changing rapidly as well. The trend toward early retirement coupled with longer…

  5. ["Quality of life" of the elderly population: a survey to evaluate elderly people's self -perceived health in 11 Italian regions (Argento Study, 2002).].

    PubMed

    Bertozzi, Nicoletta; Vitali, Patrizia; Binkin, Nancy; Perra, Alberto; D'Argenio, Paolo

    2005-01-01

    Self-perception of health influences the quality of life of the elderly. In order to identify the more vulnerable elderly and guide interventions to improve health in this population group, we evaluated self-perceived health of elderly people through a set of 4 questions called the "Healthy Days Measures", which were incorporated into the Argento Study. The latter is a study performed to evaluate the health status of the elderly population in 11 Italian regions (2002). Methods. Following cluster sampling, 2,369 elderly subjects (>64 years) were interviewed at home, by trained personnel, through a standardized questionnaire. Self-rated health (on a scale from poor to excellent) was estimated, as well as the average number of days during the previous month when physical or mental health was not good and the number of activity limitation days. Multivariate analysis was performed using Sudaan software and by considering the following outcomes: self-perceived health, physical or mental problems or activity limitations for more than 1 day. Prevalence rates by gender, age, civil status, education level, home situation, place of residence, chronic diseases, dependence on a caregiver, sedentariness and social isolation, were calculated. Results. 34.7% of interviewed subjects rated their health as good to excellent. A significantly lower proportion of women, older subjects (>75 years), those with a lower education level, those residing in southern Italy, those suffering from chronic illnesses, those dependent on a caregiver, and socially isolated or sedentary subjects rated their health favorably. The mean number of physically and mentally unhealthy days (summary index) was estimated to be 11.3 per month. Multivariate analysis showed that female gender was significantly associated with all outcomes considered; age and education level did not show any significant associations with the outcomes considered; depression was significantly associated with self-rated health and with

  6. High Levels of Heavy Metals Increase the Prevalence of Sarcopenia in the Elderly Population

    PubMed Central

    Yoo, Jun-Il; Lee, Young-Kyun; Koo, Kyung-Hoi

    2016-01-01

    Background Despite increasing concern regarding health problems as a result of environmental pollutants, no association of toxic heavy metals with sarcopenia has been demonstrated in the general population. We investigated the association of heavy metals, including lead, mercury and cadmium, with sarcopenia in the Korean population. Methods Participants included 344 males and 360 females older than 65 years based on data from the fourth and fifth Korea National Health and Nutritional Examination Surveys. Measurements of blood lead, mercury and cadmium levels were performed. To evaluate the cumulative effect of the three heavy metals, subjects were categorized into quartiles. Sarcopenia was defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS) (SMI<5.4 kg/m2 in females and <7.0 kg/m2 in males). Results Of 704 elderly persons (344 in males and 360 in females), prevalences of sarcopenia were 26.7% (92/344) in male and 7.5% (27/360) in female. Mean serum levels of lead in sarcopenia group were significantly higher than non-sarcopenia males (P=0.03). After adjustment for confounding factors, odds ratio for sarcopenia were increased with concentration category of lead (P=0.005 and P<0.001), mercury (P=0.001 and P<0.001) and cadmium (P=0.010 and P<0.001) in males and females, respectively. Conclusions This study demonstrates that high levels of blood lead, mercury and cadmium increase the prevalence of sarcopenia in both genders of elderly populations. PMID:27294082

  7. Health behaviour of an elderly population in eastern Finland in 1982.

    PubMed

    Nissinen, A; Kivelä, S L; Tuomilehto, J; Pietinen, P

    1987-01-01

    The health behaviour of men and women aged 65 to 74 years residing in eastern Finland was studied by a self-administered questionnaire as a method of data collection. About 27% of the men, but only 3% of the women smoked. About 60% of the men and 23% of the women reported that they drank alcohol at least occasionally. Men drank alcohol in greater amounts than women. Men said that they ate potatoes more often than women, but women ate other vegetables and fresh and frozen berries and fruits more frequently than men. The type of milk drank by men had a higher fat content than that drunk by women. The type of fat usually used both on bread and in cooking was similar for both men and women, and it was mostly butter. Men received more fat from milk and on bread than women. Men drank more coffee and soft drinks than women and ate sweets more frequently than women. The results suggested that the health behaviour of the elderly men was unhealthier than that of the elderly women. Older (70-74 yrs.) men and women received more fat from milk than younger (65-69 yrs.) men and women; this being the most significant difference between the two age groups. The findings showed that there is a need for health education in this elderly Finnish population. The main topics suggested are to decrease fat consumption and to change the type of fat consumed in both genders, to increase root, vegetable, berry and fruit consumption in men and to decrease smoking in men. PMID:3630315

  8. Chronic obstructive pulmonary disease and cognitive impairment in the Chinese elderly population: a large national survey

    PubMed Central

    Yin, Peng; Ma, Qingfeng; Wang, Limin; Lin, Peng; Zhang, Mei; Qi, Shige; Wang, Zhihui

    2016-01-01

    Background Previous studies suggested an association between chronic obstructive pulmonary disease (COPD) and cognitive impairment, mostly in developed countries. There is no evidence available on the association between these two common chronic disorders in the elderly people in People’s Republic of China where the population is aging rapidly. Methods The study population was randomly selected from a nationally representative Disease Surveillance Point System in People’s Republic of China. A standardized questionnaire was administered by trained interviewers during a face-to-face interview in the field survey conducted in 2010–2011. Cognitive function was assessed using the Mini-Mental State Examination. COPD was measured by self-report and the Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A multivariate logistic regression model was applied to examine the association between COPD and cognitive impairment with adjustment for potential confounding factors. Results A total of 16,629 subjects aged over 60 years were included in the study. The prevalence of cognitive impairment was 9.4% (95% confidence interval [CI] 7.7, 11.1). Chronic phlegm was associated with significantly higher prevalence of cognitive impairment in models adjusted for age, sex, marital status, geographic region, urban/rural, education, smoking status, alcohol drinking, and indoor air pollution (odds ratio [OR] 1.46, 95% CI 1.11, 1.93). Chronic respiratory symptoms and self-reported COPD were strongly related to cognitive impairment in urban areas. There were no significant effect modifications for sex, regions, educational level, smoking status, and alcohol drinking. Conclusion There was strong association between COPD and cognitive impairment in urban Chinese elderly population. PMID:26952279

  9. Relationship between Urinary Level of Phytate and Valvular Calcification in an Elderly Population: A Cross-Sectional Study

    PubMed Central

    Fernández-Palomeque, Carlos; Grau, Andres; Perelló, Joan; Sanchis, Pilar; Isern, Bernat; Prieto, Rafel M.; Costa-Bauzá, Antonia; Caldés, Onofre J.; Bonnin, Oriol; Garcia-Raja, Ana; Bethencourt, Armando; Grases, Felix

    2015-01-01

    Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate) in soft tissues. Supersaturation is the thermodynamic driving force for crystallization, so it is believed that higher blood levels of calcium and phosphate increase the risk of cardiovascular calcification. However several factors can promote or inhibit the natural process of pathological calcification. This cross-sectional study evaluated the relationship between physiological levels of urinary phytate and heart valve calcification in a population of elderly out subjects. A population of 188 elderly subjects (mean age: 68 years) was studied. Valve calcification was measured by echocardiography. Phytate determination was performed from a urine sample and data on blood chemistry, end-systolic volume, concomitant diseases, cardiovascular risk factors, medication usage and food were obtained. The study population was classified in three tertiles according to level of urinary phytate: low (<0.610 μM), intermediate (0.61–1.21 μM), and high (>1.21 μM). Subjects with higher levels of urinary phytate had less mitral annulus calcification and were less likely to have diabetes and hypercholesterolemia. In the multivariate analysis, age, serum phosphorous, leukocytes total count and urinary phytate excretion appeared as independent factors predictive of presence of mitral annulus calcification. There was an inverse correlation between urinary phytate content and mitral annulus calcification in our population of elderly out subjects. These results suggest that consumption of phytate-rich foods may help to prevent cardiovascular calcification evolution. PMID:26322979

  10. Direct costs associated with the appropriateness of hospital stay in elderly population

    PubMed Central

    Mould-Quevedo, Joaquín F; García-Peña, Carmen; Contreras-Hernández, Iris; Juárez-Cedillo, Teresa; Espinel-Bermúdez, Claudia; Morales-Cisneros, Gabriela; Sánchez-García, Sergio

    2009-01-01

    Background Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. Methods Appropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP). Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS), in Mexico City. Results The sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8) of hospital stay, of which 12.4% (n = 90) were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7). The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89). The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4), while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3), (p < 0.001). Conclusion Elderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management. PMID:19698130

  11. THE RELATIONSHIPS BETWEEN PERSONAL PM EXPOSURES FOR ELDERLY POPULATIONS AND INDOOR AND OUTDOOR CONCENTRATIONS FOR THREE RETIREMENT CENTER SCENARIOS

    EPA Science Inventory

    Personal exposures, indoor and outdoor concentrations, and questionnaire data were collected in three retirement center settings, supporting broader PM-health studies of elderly populations. The studies varied geographically and temporally, with populations studied in Baltimor...

  12. THE RELATIONSHIPS BETWEEN PERSONAL PM EXPOSURES FOR ELDERLY POPULATIONS AND INDOOR AND OUTDOOR CONCENTRATIONS FOR THREE RETIREMENT CENTER SCENARIOS

    EPA Science Inventory

    Personal exposure, indoor and outdoor concentration, "physical factor", and questionnaire data were collected in three retirement center settings, supporting broader PM-health studies of elderly populations. The studies varied geographically and temporally, with popul...

  13. Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up

    PubMed Central

    Pascual, Isaac; Muñoz-García, Antonio J; López-Otero, Diego; Avanzas, Pablo; Jimenez-Navarro, Manuel F; Cid-Alvarez, Belén; del Valle, Raquel; Alonso-Briales, Juan H; Ocaranza-Sanchez, Raimundo; Hernández, José M; Trillo-Nouche, Ramiro; Morís, César

    2015-01-01

    Objective To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients. PMID:26345138

  14. Multivitamin Use and B Vitamin Status in a Homebound Elderly Population

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Homebound elderly are at increased risk for micronutrient deficiencies, and nutritional status in this population has not been adequately described. There is evidence for beneficial effects of multivitamin use and a greater understanding of their nutritional contribution could identify behaviors tha...

  15. Falls and self-assessment of eyesight among elderly people: a population-based study in a south Brazilian municipality.

    PubMed

    Nunes, Bruno Pereira; de Oliveira Saes, Mirelle; Siqueira, Fernando Vinholes; Tomasi, Elaine; Silva, Suele Manjourany; da Silveira, Denise Silva; Soares, Mariangela Uhlmann; Facchini, Luiz Augusto; Thumé, Elaine

    2014-01-01

    This paper seeks to verify the association between falls and self-assessment of visual acuity in elderly people by means of a cross-sectional population-based study involving 1593 elderly people (aged 60 or over) from the urban zone of the municipality of Bagé-RS. Poisson regression was used for association analysis. Fall prevalence in the last year was 28.0% (95%CI: 25.8; 30.2), with 45.0% of these having suffered two or more falls in the same period. Elderly people self-assessing their eyesight as bad/very poor (10.0%) or regular (33.3%) showed a linear increase in fall occurrence when compared to individuals who considered their eyesight to be good/excellent. Self-assessment of eyesight showed itself to be an important factor associated with the occurrence of falls. This results entails the need to make progress with tracing elderly people with eyesight difficulties and its possible impact on actions to prevent the occurrence of falls. PMID:24742776

  16. Challenges to Using an Electronic Personal Health Record by a Low-Income Elderly Population

    PubMed Central

    Kim, Eung-Hun; Stolyar, Anna; Lober, William B; Herbaugh, Anne L; Shinstrom, Sally E; Zierler, Brenda K; Soh, Cheong B

    2009-01-01

    Background Electronic personal health records (PHRs) are increasingly recognized and used as a tool to address various challenges stemming from the scattered and incompatible personal health information that exists in the contemporary US health care system. Although activity around PHR development and deployment has increased in recent years, little has been reported regarding the use and utility of PHRs among low-income and/or elderly populations. Objective The aim was to assess the use and utility of PHRs in a low-income, elderly population. Methods We deployed a Web-based, institution-neutral PHR system, the Personal Health Information Management System (PHIMS), in a federally funded housing facility for low-income and elderly residents. We assessed use and user satisfaction through system logs, questionnaire surveys, and user group meetings. Results Over the 33-month study period, 70 residents participated; this number was reduced to 44 by the end of the study. Although the PHIMS was available for free and personal assistance and computers with Internet connection were provided without any cost to residents, only 13% (44/330) of the eligible residents used the system, and system usage was limited. Almost one half of the users (47%, 33/70) used the PHIMS only on a single day. Use was also highly correlated with the availability of in-person assistance; 77% of user activities occurred while the assistance was available. Residents’ ability to use the PHR system was limited by poor computer and Internet skills, technophobia, low health literacy, and limited physical/cognitive abilities. Among the 44 PHIMS users, 14 (32%) responded to the questionnaire. In this selected subgroup of survey participants, the majority (82%, 9/11) used the PHIMS three times or more and reported that it improved the quality of overall health care they received. Conclusions Our findings suggest that those who can benefit the most from a PHR system may be the least able to use it

  17. Cognitive and psychological profiles in treatment compliance: a study in an elderly population with hemophilia

    PubMed Central

    Riva, Silvia; Nobili, Alessandro; Djade, Codjo D; Mancuso, Maria Elisa; Santagostino, Elena; Pravettoni, Gabriella

    2015-01-01

    Elderly patients with hemophilia have to face new challenges linked to concomitant pathologies and concurrent use of different treatments. In order to promote optimal care in the elderly hemophilia population, this study is aimed to analyze treatment compliance in relation to the presence of comorbidities and the role of potential determinants that can affect compliance (positively or negatively), including health-related quality of life, cognitive decline, and sociodemographic parameters (eg, living situation, partnership, presence of caregivers). This will be an observational study of elderly patients with hemophilia (aged >60 years). Patients will be interviewed during their routine medical visits. The data interview will pertaining to several dimension of treatment management. This study will detect more vulnerable patients with special care needs and will highlight psychological factors that should be considered for future psychosocial interventions. PMID:26185433

  18. Medical and economic burden of influenza in the elderly population in central and eastern European countries

    PubMed Central

    Kovács, Gábor; Kovács, Gábor; Kaló, Zoltán; Kaló, Zoltán; Jahnz-Rozyk, Karina; Jahnz-Rozyk, Karina; Kyncl, Jan; Kyncl, Jan; Csohan, Agnes; Csohan, Agnes; Pistol, Adriana; Pistol, Adriana; Leleka, Mariya; Leleka, Mariya; Kipshakbaev, Rafail; Kipshakbaev, Rafail; Durand, Laure; Durand, Laure; Macabeo, Bérengère; Macabeo, Bérengère

    2014-01-01

    Influenza affects 5–15% of the population during an epidemic. In Western Europe, vaccination of at-risk groups forms the cornerstone of influenza prevention. However, vaccination coverage of the elderly (>65 y) is often low in Central and Eastern Europe (CEE); potentially because a paucity of country-specific data limits evidence-based policy making. Therefore the medical and economic burden of influenza were estimated in elderly populations in the Czech Republic, Hungary, Kazakhstan, Poland, Romania, and Ukraine. Data covering national influenza vaccination policies, surveillance and reporting, healthcare costs, populations, and epidemiology were obtained via literature review, open-access websites and databases, and interviews with experts. A simplified model of patient treatment flow incorporating cost, population, and incidence/prevalence data was used to calculate the influenza burden per country. In the elderly, influenza represented a large burden on the assessed healthcare systems, with yearly excess hospitalization rates of ~30/100 000. Burden varied between countries and was likely influenced by population size, surveillance system, healthcare provision, and vaccine coverage. The greatest burden was found in Poland, where direct costs were over EUR 5 million. Substantial differences in data availability and quality were identified, and to fully quantify the burden of influenza in CEE, influenza reporting systems should be standardized. This study most probably underestimates the real burden of influenza, however the public health problem is recognized worldwide, and will further increase with population aging. Extending influenza vaccination of the elderly may be a cost-effective way to reduce the burden of influenza in CEE. PMID:24165394

  19. Medical and economic burden of influenza in the elderly population in central and eastern European countries.

    PubMed

    Kovács, Gábor; Kaló, Zoltán; Jahnz-Rozyk, Karina; Kyncl, Jan; Csohan, Agnes; Pistol, Adriana; Leleka, Mariya; Kipshakbaev, Rafail; Durand, Laure; Macabeo, Bérengère

    2014-01-01

    Influenza affects 5-15% of the population during an epidemic. In Western Europe, vaccination of at-risk groups forms the cornerstone of influenza prevention. However, vaccination coverage of the elderly (> 65 y) is often low in Central and Eastern Europe (CEE); potentially because a paucity of country-specific data limits evidence-based policy making. Therefore the medical and economic burden of influenza were estimated in elderly populations in the Czech Republic, Hungary, Kazakhstan, Poland, Romania, and Ukraine. Data covering national influenza vaccination policies, surveillance and reporting, healthcare costs, populations, and epidemiology were obtained via literature review, open-access websites and databases, and interviews with experts. A simplified model of patient treatment flow incorporating cost, population, and incidence/prevalence data was used to calculate the influenza burden per country. In the elderly, influenza represented a large burden on the assessed healthcare systems, with yearly excess hospitalization rates of ~30/100,000. Burden varied between countries and was likely influenced by population size, surveillance system, healthcare provision, and vaccine coverage. The greatest burden was found in Poland, where direct costs were over EUR 5 million. Substantial differences in data availability and quality were identified, and to fully quantify the burden of influenza in CEE, influenza reporting systems should be standardized. This study most probably underestimates the real burden of influenza, however the public health problem is recognized worldwide, and will further increase with population aging. Extending influenza vaccination of the elderly may be a cost-effective way to reduce the burden of influenza in CEE. PMID:24165394

  20. Identifying risk for dementia across populations: A study on the prevalence of dementia in tribal elderly population of Himalayan region in Northern India

    PubMed Central

    Raina, Sunil Kumar; Raina, Sujeet; Chander, Vishav; Grover, Ashoo; Singh, Sukhjit; Bhardwaj, Ashok

    2013-01-01

    Introduction: Studies have suggested that dementia is differentially distributed across populations with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Keeping this in view, a study was planned to evaluate the prevalence of dementia in tribal elderly population. Materials and Methods: A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase one involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase two involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test. Results: The results revealed that no individual above 60 years of age in the studied population was diagnosed as a case of dementia. Thereby, pointing out at some unknown factors, which are responsible for prevention of dementia. Discussion: The differences between the prevalence rate in this study and other studies in India appear to be a function of a valid regional difference. Environmental, phenotypic and genetic factors may contribute to regional and racial variations in dementia. Societies living in isolated hilly and tribal areas seem less predisposed to dementia, particularly age related neurodegenerative and vascular dementia, which are the most common causes for dementia in elderly. This may be because some environmental risk factors are much less prevalent in these settings. PMID:24339597

  1. Elder Mistreatment and Emotional Symptoms among Older Adults in a Largely Rural Population: The South Carolina Elder Mistreatment Study

    ERIC Educational Resources Information Center

    Begle, Angela M.; Strachan, Martha; Cisler, Joshua M.; Amstadter, Ananda B.; Hernandez, Melba; Acierno, Ron

    2011-01-01

    Although two recent major studies provide some insight into the prevalence and correlates of elder mistreatment, the relationship between elder mistreatment and mental health remains unclear. This study begins to address this issue by examining the relationship between elder mistreatment (i.e., a recent history of emotional and physical abuse) and…

  2. Bone-conduction hearing aids in an elderly population: complications and quality of life assessment.

    PubMed

    Carr, Simon D; Moraleda, Javier; Baldwin, Alice; Ray, Jaydip

    2016-03-01

    To determine whether an elderly population with hearing impairment can be adequately rehabilitated with a bone-conduction hearing aid and whether the putative relationship between the elderly and an increased complication rate is justified. The study design was a retrospective case note review with a postal and telephone questionnaire, which was carried out in a tertiary centre. All patients aged 60 or over underwent implantation with a bone-conduction aid between 2009 and 2013 for conductive, SSD or mixed hearing loss. Outcome measures were complication rates and quality of life assessment using the Glasgow Benefit Inventory. The influence of patient and surgical factors on the complication rate was assessed. Fifty-one patients were implanted. Mean age was 67 years (range 60-89 years). The mean benefit, satisfaction and global GBI scores were 70 % (range 0-100 %), 70 % (0-100 %) and 82 % (83-100 %), respectively. The residual disability was 18 % (0-25 %). The adverse skin reaction rate was 16 % and the fixture loss rate was 2 %. There was a demonstrable increase in the complication rate with the dermatome (45 %; 5 patients) compared to the Sheffield 'S' (13 %; 2 patients) or linear incision techniques (29 %; 7 patients). The bone-conduction hearing aids are ideal method of hearing rehabilitation in the elderly for all forms of hearing loss. It provides significant benefit with no increased complication rate, which is imperative if social isolation is to be avoided and cognition preserved in this growing elderly population. PMID:25736468

  3. Risk factors for chronic subdural hematoma after a minor head injury in the elderly: a population-based study.

    PubMed

    Tseng, Jen-Ho; Tseng, Ming-Yuan; Liu, Ann-Jeng; Lin, Wen-Hsiung; Hu, Hsiao-Yun; Hsiao, Sheng-Huang

    2014-01-01

    Chronic subdural hematoma (CSDH) is one of the major comorbidities in elderly resulting in disability and death. Early recognition of CSDH is important for early management. However, manifestations of CSDH are nonspecific and subtle. Therefore, identification of risk factors of CSDH can offer clinical follow-up strategies for patients after episodes of head injury. The purpose of the study aimed at identifying risk factors of CSDH of Taiwanese. Analysis of data from the National Health Insurance provides important information on predictive factors influencing the early diagnosis of CSDH in elderly patients following minor head injuries. The current study is the first nationwide population-based study in Taiwan, showing that old age (≥75 years), male gender, and coexisting hydrocephalus are significantly predictive factors, irrespective to their medical comorbidities. PMID:25295251

  4. Macular Pigment Optical Density in the Elderly: Findings in a Large Biracial Midsouth Population Sample

    PubMed Central

    Iannaccone, Alessandro; Mura, Marco; Gallaher, Kevin T.; Johnson, Elizabeth J.; Todd, William Andrew; Kenyon, Emily; Harris, Tarsha L.; Harris, Tamara; Satterfield, Suzanne; Johnson, Karen C.; Kritchevsky, Stephen B.

    2008-01-01

    Purpose To report the macular pigment optical density (MPOD) findings at 0.5° of eccentricity from the fovea in elderly subjects participating in ARMA, a study of aging and age-related maculopathy (ARM) ancillary to the Health, Aging, and Body Composition (Health ABC) Study. Methods MPOD was estimated with a heterochromatic flicker photometry (HFP) method in a large biracial population sample of normal 79.1 ± 3.2-year-old adults living in the Midsouth (n = 222; 52% female; 23% black, 34% users of lutein-containing supplements). Within a modified testing protocol, subjects identified the lowest and the highest target intensity at which the flicker sensation disappeared, and the exact middle of this “no-flicker zone” was interpolated by the examiner. Results An MPOD estimate was obtained successfully in 82% of the participants. The mean MPOD in our sample was 0.34 ± 0.21 (SD). The interocular correlation was high (Pearson’s r = 0.82). Compared with lutein supplement users, mean MPOD was 21% lower in nonusers (P = 0.013). MPOD was also 41% lower in blacks than in whites (P = 0.0002), even after adjustment for lutein supplement use. There were no differences in MPOD by gender, iris color, or history of smoking. Conclusions Older adults in the Midsouth appear to have average MPOD and interocular correlation comparable to those in previous studies. Lutein supplement use and white race correlated with higher MPOD. No evidence of an age-related decline in MPOD was seen in the sample. The HFP method for the measurement of MPOD is feasible in epidemiologic investigations of the elderly, the group at highest risk of ARM. PMID:17389471

  5. Polypharmacy Reviews Among Elderly Populations Project: Assessing Needs in Patient-Provider Communication

    PubMed Central

    Balignasay, Mia-Danica; Nigg, Claudio R

    2013-01-01

    Adults sixty-five years of age and older are a growing population, and are the largest consumers of prescription and nonprescription medications in the United States with potentially increased medication interaction risks. Therefore, an investigation to determine if elderly populations at two minority serving, independent housing sites perceived any issues regarding their medication use, including any communication challenges with their providers. The data were collected using a survey in which participants had to recall information about their medication use and past provider interaction. Participants (N=21; 90.5% female; using 5.1 ± 2.6 medications) completed a needs assessment. Results indicated that patients felt comfortable talking to their doctors. However, the communication that occurs may not have included education on polypharmacy. Many participants did not believe that they could describe details about their medications, such as the purpose (47.6%), instructions (42.9%), side effects (66.7%), and the possible risk of addiction (42.9%). This assessment indicates a need for an intervention that is focused on communication about polypharmacy and medication review education. PMID:23386990

  6. Burden and Correlates of Geriatric Depression in the Uyghur Elderly Population, Observation from Xinjiang, China

    PubMed Central

    Lu, Chen; Tang, Weiming; Mahapatra, Tanmay; Wang, Yu; Wang, Xihua; Ma, Ying; Ben, Yanli; Cao, Xiaolin; Mahapatra, Sanchita; Ling, Min; Gou, Anshuan; Wang, Yanmei; Xiao, Jiangqin; Hou, Ming; Wang, Xiuli; Lin, Bo; Chen, Ruoling; Wang, Faxing; Hu, Zhi

    2014-01-01

    Background With the gradual aging of the population, geriatric depression has become a major public health issue in China owing to its overall upward trend and associated negative socio-economic impact. Dearth of information regarding the burden and correlates of geriatric depression among Uyghur minority population in Xinjiang Autonomous Region, called for a comprehensive survey involving representative sample for designing efficient targeted intervention to control this disabling disease. Methods A cross-sectional study was conducted among 1329 consenting Uyghur elderly in 2011 in six randomly selected communities/villages in Xinjiang. Information about socio-demographics, behavior, negative life-events, satisfaction regarding income/quality of life and other chronic diseases were collected while assessment of geriatric depression was done using Geriatric Mental State Schedule (GMS). Results Among these participants, majority were currently married, had attended elementary school or less, had an average annual family income of less than 3000 Yuan/person, had strong religious beliefs while 10.61% (2.77% in urban and 23.60% in rural area) had geriatric depression (5.91% among male and 14.58% among females). 61.83% were suffering from other chronic diseases, 96.16% could take care of themselves and 39.28% had experienced negative events during last two years. Religious belief (AOR = 3.92, 95% CI 1.18–13.03), satisfaction regarding quality of life (AOR = 0.53, 95% CI 0.37–0.84) and income (AOR = 0.75, 95% CI 0.35–1.60), suffering from more chronic diseases (AOR = 1.70, 95% CI 1.42–2.04), experiencing three or more negative events (AOR = 1.72, 95% CI 0.92–3.22) and lack of ability to take self-care (AOR = 2.20, 95% CI 1.09–4.48) were all associated with having geriatric depression with or without adjustment for gender, education and occupation. Conclusion High prevalence of geriatric depression among Uyghur elderly in Xinjiang

  7. Drusen and RPE atrophy automated quantification by optical coherence tomography in an elderly population

    PubMed Central

    Diniz, B; Rodger, D C; Chavali, V R; MacKay, T; Lee, S Y; Stambolian, D; Sadda, S V R

    2015-01-01

    Purpose Correlate OCT-derived measures of drusen and retinal pigment epithelium (RPE) atrophy areas (RAs) with demographic features in an elderly population. Patients and methods Subjects aged 50 years and older underwent Cirrus OCT scanning. Drusen area and volume were obtained from the macula within a central circle (CC) of 3 mm and a surrounding perifoveal ring (PR) of 3–5 mm, using the RPE analysis software (6.0). RA measurements were generated for the 6 × 6 mm2 retinal area. Gender, age, smoking status, and systolic blood pressure (SBP) were considered. Results A total of 434 eyes were included. RA was larger in women (0.63±0.16 vs 0.26±0.08 mm2, P=0.05) and with increasing age. The PR drusen area increased with increasing age (P<0.001), whereas the CC drusen area remained stable after the age of 70 years (0.25±0.06 mm2 for ages 70–79 years and 0.25±0.07 mm2 for ages >80 years). Drusen volume in the CC was smaller after the age of 80 years (0.009±0.003 mm3) compared with the 70- to 79-year-old group (0.02±0.008 mm3). Drusen measurements were similar between smokers and nonsmokers, but the PR drusen area (0.29 mm2, P=0.05) and volume (0.40 mm3, P=0.005) were correlated with years smoked. RA (0.24 mm2, P=0.10), PR drusen area (0.29 mm2, P=0.05), and volume (0.40 mm3, P=0.005) were found to be directly associated with SBP. There was a high correlation between the eyes of the same subject. Conclusion OCT-based automated algorithms can be used to analyze and describe drusen and geographic atrophy burden in such population-based studies of elderly patients. PMID:25376121

  8. Habitual intake of guaraná and metabolic morbidities: an epidemiological study of an elderly Amazonian population.

    PubMed

    Krewer, Cristina da Costa; Ribeiro, Euler Esteves; Ribeiro, Ednéa Aguiar Maia; Moresco, Rafael Noal; da Rocha, Maria Izabel de Ugalde Marques; Montagner, Greice Franciele Feyl dos Santos; Machado, Michel Mansur; Viegas, Karin; Brito, Elorídes; da Cruz, Ivana Beatrice Mânica

    2011-09-01

    The aim of the present study was to evaluate the associations of metabolic disorders and anthropometric and biochemical biomarkers of lipid, glucose and oxidative metabolism and the habitual ingestion of guaraná (Paullinia cupana, Mart. Var. sorbilis) by an elderly population residing in the Amazon Riverine region of the Maués municipality (Brazil). A case-controlled study was performed that included 637 elderly (≥60 years of age) patients classified as either those who habitually drank guaraná (GI, n = 421) or those who never drank guaraná (NG, n = 239) based upon their self-reported intake of guaraná. Indeed, the prevalence of various metabolic disorders was associated with guaraná ingestion. The prevalence of hypertension, obesity and metabolic syndrome in the GI group was lower than the prevalence found in the NG group. The NG group exhibited lower systolic and diastolic blood pressure values. The males in the GI group exhibited a lower waist circumference, on average, than the circumference found in the NG group, whereas the females in the GI group had lower cholesterol (total and LDL-c) levels than the control cohort. Additionally, a significant association was found between lower levels of advanced oxidative protein product (AOPP) and habitual guaraná consumption. The results constitute the first epidemiological study to suggest a potentially protective effect of habitual guaraná ingestion against metabolic disorders in elderly subjects. PMID:21341338

  9. Drugs with anticholinergic properties and cognitive performance in the elderly: results from the PAQUID Study

    PubMed Central

    Lechevallier-Michel, Nathalie; Molimard, Mathieu; Dartigues, Jean-François; Fabrigoule, Colette; Fourrier-Réglat, Annie

    2005-01-01

    Objectives To measure the association between the use of drugs with anticholinergic properties and cognitive performance in an elderly population, the PAQUID cohort. Methods The sample studied was composed of 1780 subjects aged 70 and older, living at home in South western France. Data on socio-demographic characteristics, medical history and drug use were collected using a standardized questionnaire. Cognitive performance was assessed using the following neuropsychological tests: the Mini-Mental State Examination (MMSE) which evaluates global cognitive functioning, the Benton Visual Retention Test (BVRT) which assesses immediate visual memory, and the Isaacs’ Set Test (IST) which assesses verbal fluency. For each test, scores were dichotomized between low performance and normal to high performance using the score at the 10th percentile of the study sample as the cut-off point, according to age, gender and educational level. The association between the use of drugs with anticholinergic properties and cognitive performance was examined using logistic regression models, adjusting for several potential confounding factors. Results About 13.7% of the subjects used at least one drug with anticholinergic properties. In multivariate analyses, the use of these drugs was significantly associated with low performance in the BVRT [odds ratio (OR) = 1.6; 95% confidence interval (CI) 1.1, 2.3] and in the IST (OR = 1.9; 95% CI 1.3, 2.8). The association found with low performance in the MMSE (OR = 1.4; 95% CI 1.0, 2.1) was barely statistically significant. Conclusion These findings suggest that the use of drugs with anticholinergic properties is associated with low cognitive performance among community-dwelling elderly people. PMID:15676035

  10. Considerations for resuscitation at high altitude in elderly and untrained populations and rescuers.

    PubMed

    Suto, Takashi; Saito, Shigeru

    2014-03-01

    With the development of transportation technologies, elderly people with chronic diseases are increasingly enjoying trekking and tours of nature resorts that include mountain highlands. Because of problems related to circulation, respiration, metabolism, and/or the musculoskeletal system in this population, the impact of high altitude on cardiopulmonary function is increased. Alpine accidents, therefore, tend to be more common in this population, and cases of cardiopulmonary arrest (CPA) at high altitudes seem to be increasing. However, relatively few studies have described cardiopulmonary resuscitation (CPR) at high altitudes. Although insufficient studies are available to standardize CPR guidelines at high altitude at this time, the aim of this review is to summarize previous studies relevant to physiologic changes after exposure to high-altitude environments and exercise, which may be a risk factor for CPA in elderly trekkers. In addition, we summarize our previous studies that described the effect of CPR procedures on cardiopulmonary function in untrained rescuers. The available data suggest that prolonged CPR at high altitudes requires strenuous work from rescuers and negatively affects their cardiopulmonary physics and subjectively measured fatigue. Alpine rescue teams should therefore be well prepared for their increased physical burden and difficult conditions. Elderly travelers should be made aware of their increased risk of CPA in alpine settings. The use of mechanical devices to assist CPR should be considered wherever possible. PMID:24388065

  11. Ten-year fatal and non-fatal myocardial infarction incidence in elderly populations in Spain: the EPICARDIAN cohort study

    PubMed Central

    Gabriel, Rafael; Alonso, Margarita; Reviriego, Blanca; Muñiz, Javier; Vega, Saturio; López, Isidro; Novella, Blanca; Suárez, Carmen; Rodríguez-Salvanés, Francisco

    2009-01-01

    Background In Spain, more than 85% of coronary heart disease deaths occur in adults older than 65 years. However, coronary heart disease incidence and mortality in the Spanish elderly have been poorly described. The aim of this study is to estimate the ten-year incidence and mortality rates of myocardial infarction in a population-based large cohort of Spanish elders. Methods A population-based cohort of 3729 people older than 64 years old, free of previous myocardial infarction, was established in 1995 in three geographical areas of Spain. Any case of fatal and non-fatal myocardial infarction was investigated until December 2004 using the "cold pursuit method", previously used and validated by the the WHO-MONICA project. Results Men showed a significantly (p < 0.001) higher cumulative incidence of myocardial infarction (7.2%; 95%CI: 5.94-8.54) than women (3.8%; 95%CI: 3.06-4.74). Although cumulative incidence increased with age (p < 0.05), gender-differences tended to narrow. Adjusted incidence rates were higher in men (957 per 100 000 person-years) than in women (546 per 100 000 person-years) (p < 0.001) and increased with age (p < 0.001). The increase was progressive in women but not in men. Adjusted mortality rates were also higher in men than in women (p < 0.001), being three times higher in the age group of ≥ 85 years old than in the age group of 65-74 years old (p < 0.001). Conclusion Incidence of fatal and non-fatal myocardial infarction is high in the Spanish elderly population. Men show higher rates than women, but gender differences diminish with age. PMID:19778417

  12. Cognitive Change in Elderly Populations: "Normal" Aging, Senile Dementia and Depression.

    ERIC Educational Resources Information Center

    Bach, Paul J.

    Cognitive change in the elderly can be due to several etiological factors which are empirically difficult to separate and clinically problematic to differentiate. Normal aging is accompanied by behavioral slowing. The slowing down of psycho-motor processes results in a lowered intelligence quotient, but cannot be taken as unequivocal evidence for…

  13. Health effects of protein intake in healthy elderly populations: a systematic literature review

    PubMed Central

    Pedersen, Agnes N.; Cederholm, Tommy

    2014-01-01

    The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy elderly persons in order to evaluate the evidence for an optimal protein intake. The literature search covered year 2000–2011. Prospective cohort, case–control, and intervention studies of a general healthy population in settings similar to the Nordic countries with protein intake from food-based sources were included. Out of a total of 301 abstracts, 152 full papers were identified as potentially relevant. After careful scrutiny, 23 papers were quality graded as A (highest, n=1), B (n=18), or C (n=4). The grade of evidence was classified as convincing, probable, suggestive, or inconclusive. The evidence is assessed as: probable for an estimated average requirement (EAR) of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance (N-balance) studies and the subsequent recommended dietary allowance (RDA) of 0.83 g good-quality protein/kg BW/day representing the minimum dietary protein needs of virtually all healthy elderly persons. Regarding the optimal level of protein related to functional outcomes like maintenance of bone mass, muscle mass, and strength, as well as for morbidity and mortality, the evidence is ranging from suggestive to inconclusive. Results from particularly prospective cohort studies suggest a safe intake of up to at least 1.2–1.5 g protein/kg BW/day or approximately 15–20 E%. Overall, many of the included prospective cohort studies were difficult to fully evaluate since results mainly were obtained by food frequency questionnaires that were flawed by underreported intakes, although some studies were ‘calibrated’ to correct for under- or over-reporting. In conclusion, the evidence is assessed as probable regarding the EAR based on N-balance studies and suggestive to inconclusive regarding an optimal protein intake higher than the estimated

  14. Prevalence and Risk Factors of Atrial Fibrillation in Chinese Elderly: Results from the Chinese Longitudinal Healthy Longevity Survey

    PubMed Central

    Chei, Choy-Lye; Raman, Prassanna; Ching, Chi Keong; Yin, Zhao-Xue; Shi, Xiao-Ming; Zeng, Yi; Matchar, David B

    2015-01-01

    Background: Prevalence of atrial fibrillation (AF) is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalence of AF differs with each population studied, and research on non-Western populations and the oldest old is scarce. Methods: We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey, a community-based study in eight longevity areas in China, to estimate AF prevalence in an elderly Chinese population (n = 1418, mean age = 85.6 years) and to identify risk factors. We determined the presence of AF in our participants using single-lead electrocardiograms. The weighted prevalence of AF was estimated in subjects stratified according to age groups (65–74, 75–84, 85–94, 95 years and above) and gender. We used logistic regressions to determine the potential risk factors of AF. Results: The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF (P < 0.05). AF was associated with weight extremes of being underweight or overweight/obese. Finally, advanced age (85–94 years), history of stroke or heart disease, low high-density lipoprotein levels, low triglyceride levels, and lack of regular physical activity were associated with AF. Conclusions: In urban elderly, AF prevalence increased with age (P < 0.05), and in rural elderly, women had higher AF prevalence (P < 0.05). Further exploration of population-specific risk factors is needed to address the AF epidemic. PMID:26365957

  15. Lifestyle Factors and Visible Skin Aging in a Population of Japanese Elders

    PubMed Central

    Asakura, Keiko; Nishiwaki, Yuji; Milojevic, Ai; Michikawa, Takehiro; Kikuchi, Yuriko; Nakano, Makiko; Iwasawa, Satoko; Hillebrand, Greg; Miyamoto, Kukizo; Ono, Masaji; Kinjo, Yoshihide; Akiba, Suminori; Takebayashi, Toru

    2009-01-01

    Background The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging. Methods The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis. Results Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women. Conclusions Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population. PMID:19700917

  16. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly

    PubMed Central

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-01-01

    Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people’s daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis. PMID:27493837

  17. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly.

    PubMed

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-08-01

    Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people's daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis. PMID:27493837

  18. Clinical and allergic sensitization characteristics of allergic rhinitis among the elderly population in Istanbul, Turkey.

    PubMed

    Ozturk, Ayse Bilge; Ozyigit, Leyla Pur; Olmez, Merve Ozata

    2015-04-01

    Prevalence of allergic rhinitis (AR) in elderly population in Turkey is not known. Studies on the prevalence and features of allergy in older adults are needed to identify safe and effective diagnostic/therapeutic methods for elderly AR patients. We aimed to identify the clinical and allergic characteristics of sensitization to aeroallergens among individuals aged ≥60 years with allergic rhinitis admitted to an allergy outpatient clinic in Istanbul. Of 109 patients, 33.9 % were atopic. Sixty-five percent of subjects were sensitized to Dermatophagoides pteronyssinus, 17 % to a grass-pollen mixture, 8 % to Aspergillus fumigatus, and 8 % to Blattella germanica. There was no difference between mono- and polysensitized patients in terms of the duration of rhinitis and symptom severity. No significant difference was observed between the two groups according to age, sex, smoking status, AR onset (<40 or ≥40 years), or duration/severity of disease. There was no significant difference between the two groups in the prevalence of asthma and conjunctivitis, (p = 0.256). Atopic dermatitis/eczema was more prevalent in those with AR (p = 0.046). Clinical characteristics of AR in the elderly could be different from those in non-allergic patients, and the prevalence of allergy may be higher than expected. PMID:25680346

  19. Components of Metabolic Syndrome and the Risk of Disability among the Elderly Population

    PubMed Central

    Liaw, Fang-Yih; Kao, Tung-Wei; Wu, Li-Wei; Wang, Chung-Ching; Yang, Hui-Fang; Peng, Tao-Chun; Sun, Yu-Shan; Chang, Yaw-Wen; Chen, Wei-Liang

    2016-01-01

    The direct relationship between metabolic syndrome (MetS) and function disability has not been established. The aim of the present study was to investigate the relationship between MetS and functional disability in the elderly. This retrospective observational study included 1,778 participants aged 60–84 years from the National Health and Nutrition Examination Survey (1999–2002). Impairments in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) were assessed. Additionally, the associations between the features of MetS and disability were evaluated. MetS was associated with a high prevalence of functional dependence in ADL, IADL, LSA, LEM, and GPA. After adjusting for potential confounders, a high number of MetS components was found to be associated with increased disability (P = 0.002). Additionally, associations were observed between MetS components, including abdominal obesity and high triglycerides levels, and functional dependence in ADL, IADL, LSA, LEM, and GPA (all, P < 0.05). A linear increase in disability might be associated with the number of MetS components in an elderly population. Additionally, MetS abnormalities, particularly abdominal obesity and high triglycerides levels, might be highly predictive of functional dependence in the elderly. PMID:26948125

  20. Mediterranean diet and leukocyte telomere length in a multi-ethnic elderly population.

    PubMed

    Gu, Yian; Honig, Lawrence S; Schupf, Nicole; Lee, Joseph H; Luchsinger, Jose A; Stern, Yaakov; Scarmeas, Nikolaos

    2015-01-01

    Leukocyte telomere length (LTL) is considered as the marker of biological aging and may be related to environmental factors. The current study aimed to examine the relation between Mediterranean-type diet and LTL. We used a cross-sectional study of 1743 multi-ethnic community residents of New York aged 65 years or older. Mediterranean-type diet (MeDi) was calculated from dietary information collected using a food frequency questionnaire. LTL was measured from leukocyte DNA using a real-time PCR method to measure T/S ratio, the ratio of telomere (T) to single-copy gene (S) sequence. Regression analysis showed that the MeDi score was not associated with LTL in the overall study population (β = 12.5; p = 0.32) after adjusting for age, sex, education, ethnicity, caloric intake, smoking, and physical and leisure activities. However, we found a significant association between MeDi and LTL among non-Hispanic whites (β = 48.3; p = 0.05), and the results held after excluding dementia subjects (β = 49.6; p = 0.05). We further found that, in the whole population, vegetable and cereal consumption above the sex-specific population median was associated with longer LTL (β = 89.1, p = 0.04) and shorter LTL (β = -93.5; p = 0.03), respectively. Among non-Hispanic whites, intake of meat or dairy below sex-specific population medians was associated with longer LTL (β = 154.7, p = 0.05; β = 240.5, p < 0.001, respectively). We found that higher adherence to a MeDi was associated with longer LTL among whites but not among African Americans and Hispanics. Additionally, a diet high in vegetables but low in cereal, meat, and dairy might be associated with longer LTL among healthy elderly. PMID:25750063

  1. Metabolically Healthy Obesity and the Risk of Cardiovascular Disease in the Elderly Population

    PubMed Central

    Koolhaas, Chantal M.; van Rossum, Elisabeth F. C.; Ikram, M. Arfan; Hofman, Albert; Kavousi, Maryam; Franco, Oscar H.

    2016-01-01

    Background Whether being metabolically healthy obese (MHO)—defined by the presence of obesity in the absence of metabolic syndrome—is associated with subsequent cardiovascular disease (CVD) remains unclear and may depend on the participants’ age. We examined the association of being MHO with CVD risk in the elderly. Methods and Findings This study included 5,314 individuals (mean age 68 years) from the prospective population-based Rotterdam Study. We categorized our population in groups according to body mass index (BMI) and presence and absence of metabolic syndrome, and estimated the hazard ratio (HR) and 95% confidence interval (95%CI) for every group by using Cox proportional hazard models. Among 1048 (19.7%) obese individuals we identified 260 (24.8%) MHO subjects. Over 14 years of follow-up there were 861 incident CVD cases. In the multivariable adjusted analysis, we did not observe an increased CVD risk in MHO individuals (HR 1.07, 95%CI 0.75–1.53), compared to normal weight individuals without metabolic syndrome. CVD risk was increased by the presence of metabolic syndrome in normal weight (HR 1.35, 95%CI 1.02–1.80), overweight (HR 1.32, 95%CI 1.09–1.60) and obese (HR 1.33, 95%CI 1.07–1.66) individuals, compared to those with normal weight without metabolic syndrome. In a mediation analysis, 71.3% of the association between BMI and CVD was explained by the presence of metabolic syndrome. Conclusions In our elderly population, we found that the presence of obesity without metabolic syndrome did not confer a higher CVD risk. However, metabolic syndrome was strongly associated with CVD risk, and was associated with an increased risk in all BMI categories. Therefore, preventive interventions targeting cardiometabolic risk factors could be considered in elderly, regardless of weight status. PMID:27100779

  2. Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study1

    PubMed Central

    Pereira, Lilian Varanda; de Vasconcelos, Patrícia Pereira; Souza, Layz Alves Ferreira; Pereira, Gilberto de Araújo; Nakatani, Adélia Yaeko Kyosen; Bachion, Maria Márcia

    2014-01-01

    OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status. METHOD: cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%. RESULTS: The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001). CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population. PMID:25296151

  3. Clinical management of arrhythmias in elderly patients: results of the European Heart Rhythm Association survey.

    PubMed

    Chen, Jian; Hocini, Mélèze; Larsen, Torben Bjerregaard; Proclemer, Alessandro; Sciaraffia, Elena; Blomström-Lundqvist, Carina

    2015-02-01

    The purpose of this survey was to assess clinical practice in management of cardiac arrhythmias in elderly patients (age ≥75 years) in the European countries. The data are based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network members. Responses were received from 50 centres in 20 countries. The results of the survey have shown that management of cardiac arrhythmias is generally in accordance with the guidelines and consensus recommendations on management of cardiac arrhythmias, although there are some areas of variation, especially on age limit and exclusion of elderly patients for anticoagulation, ablation, and device therapy. PMID:25634939

  4. Seven-year incidence of uncorrected refractive error among an elderly Chinese population in Shihpai, Taiwan: The Shihpai Eye Study.

    PubMed

    Kuang, T-M; Tsai, S-Y; Liu, C J-L; Ko, Y-C; Lee, S-M; Chou, P

    2016-04-01

    PurposeTo report the 7-year incidence of uncorrected refractive error in a metropolitan Chinese elderly population.MethodsThe Shihpai Eye Study 2006 included 460/824 (55.8%) subjects (age range 72-94 years old) of 1361 participants in the 1999 baseline survey for a follow-up eye examination. Visual acuity was assessed using a Snellen chart, uncorrected refractive error was defined as presenting visual acuity (naked eye if without spectacles and with distance spectacles if worn) in the better eye of <6/12 that improved to no impairment (≥6/12) after refractive correction.ResultsThe 7-year incidence of uncorrected refractive error was 10.5% (95% confidence interval (CI): 7.6-13.4%). 92.7% of participants with uncorrection and 77.8% with undercorrection were able to improve at least two lines of visual acuity by refractive correction. In multivariate analysis controlling for covariates, uncorrected refractive error was significantly related to myopia (relative risk (RR): 3.15; 95% CI: 1.31-7.58) and living alone (RR: 2.94; 95% CI 1.14-7.53), whereas distance spectacles worn during examination was protective (RR: 0.35; 95% CI: 0.14-0.88).ConclusionOur study indicated that the incidence of uncorrected refractive error was high (10.5%) in this elderly Chinese population. Living alone and myopia are predisposing factors, whereas wearing distance spectacles at examination is protective. PMID:26795416

  5. Normative data for a battery of free recall, cued recall and recognition tests in the elderly Italian population.

    PubMed

    Coluccia, Emanuele; Gamboz, Nadia; Brandimonte, Maria A

    2011-12-01

    The present study aimed to provide normative data on a large sample of the elderly Italian population (N = 464; range of age = 49-94; range of education = 3-25) on both the word and the picture versions of a battery of free recall, cued recall, and recognition tests of memory. Results from multiple regression analyses showed that both age and education were significant predictors of performance. Therefore, norms were calculated taking into account these demographic variables. The availability of normative data based on a large sample will allow a more reliable use of the battery for clinical assessment in Italian-speaking dementia population. PMID:21918879

  6. Does Pedometer Goal Setting Improve Physical Activity among Native Elders? Results from a Randomized Pilot Study

    ERIC Educational Resources Information Center

    Sawchuk, Craig N.; Russo, Joan E.; Charles, Steve; Goldberg, Jack; Forquera, Ralph; Roy-Byrne, Peter; Buchwald, Dedra

    2011-01-01

    We examined if step-count goal setting resulted in increases in physical activity and walking compared to only monitoring step counts with pedometers among American Indian/Alaska Native elders. Outcomes included step counts, self-reported physical activity and well-being, and performance on the 6-minute walk test. Although no significant…

  7. Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study

    PubMed Central

    Chang, Yu-Chia; Tung, Ho-Jui; Hsu, Shang-Wei; Chen, Lei-Shin; Kung, Pei-Tseng; Huang, Kuang-Hua; Chiou, Shang-Jyh; Tsai, Wen-Chen

    2016-01-01

    Background Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies. Methods By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates. Results Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67–6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81–1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62–1.69) also showed a moderate and significant association with receiving an influenza vaccination. Conclusions Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities. PMID:27336627

  8. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

    PubMed Central

    Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

    2014-01-01

    Background Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. Purpose To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. Methods This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Results Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Conclusion Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty. PMID:25336932

  9. Frailty in Elderly Persons with Essential Tremor: A Population-Based Study (NEDICES)

    PubMed Central

    Louis, Elan D.; Benito-León, Julián; Vega, Saturio; Bermejo-Pareja, Félix

    2011-01-01

    OBJECTIVES Essential tremor (ET), one of the most prevalent neurological diseases, has been associated with a variety of co-morbidities and, in some studies, a modest increase in risk of mortality. The mechanisms underlying this possible increased mortality have yet to be explored, although one possibility is increased frailty. Frailty has not been studied in ET and our objective was to address this gap in knowledge. We hypothesized that frailty would be greater in ET cases than controls. METHODS A 20-item frailty score assessed co-morbid conditions, number of medications and functional activity. The frailty score was compared in 237 non-demented elderly ET cases and 3,903 non-demented age-matched controls from a population-based study in central Spain. RESULTS The frailty score was higher in ET cases than controls (8.6 ± 5.2 vs. 6.8 ± 4.6, p<0.001). Stratifying the frailty score into quartiles and tertiles similarly revealed case-control differences (both p <0.001). The frailty score also increased with age (r = 0.25, p<0.001), was higher in women than men (p = 0.02), was correlated with subjective rating of health status (r = 0.42, p<0.001) and was inversely correlated with body weight (r = −0.06, p<0.001) and hours/day that participants performed moderate or intensive physical activities (r = −0.16, p<0.001). CONCLUSION ET cases had increased frailty compared to their counterparts without this disease. Whether this increased frailty is a contributor to the increased risk of mortality that has been observed in some studies is a question that deserves further scrutiny. PMID:21426443

  10. The prevalence of autoantibodies in an elderly sub-Saharan African population

    PubMed Central

    Njemini, R; Meyers, I; Demanet, C; Smitz, J; Sosso, M; Mets, T

    2002-01-01

    In the present prospective, census-based study we have investigated the prevalence of organ-specific and non-organ-specific autoantibodies (AAb) in 152 unselected Cameroonians aged 60 years and older living in the community. AAb were detected in 49% of the participants. Non-organ-specific AAb (47%) predominated over organ-specific AAb (7%). Anti-TPO, anti-Tm, anti-Tg and anti-PC AAb were completely absent. RF was the most frequent AAb, being found in 57 (38%) cases. The prevalences of anti-SMA and RF were significantly higher in women than in men (respectively, P = 0·023 and P = 0·016). Higher serum concentrations of gammaglobulins were accompanied by a higher prevalence of RF (P < 0·0001) and a lower prevalence of ANA (P = 0·036). The overall prevalence of AAb was higher in the filaria-infected (60%) compared to the non-infected (42%) participants (P = 0·046). There was no significant influence of the vitamin D status, number of pregnancies, physical activity or medication use on the prevalence of AAb. In this study a heterogeneous pattern for the presence of the various AAb was found. Some AAb, which are commonly encountered in other studies on elderly subjects, were completely absent in this population. This diversified pattern of AAb prevalence therefore argues in favour of exogenous influences in the occurrence of AAb in elderly populations. PMID:11882039

  11. Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China

    PubMed Central

    Wu, Lei; He, Yao; Jiang, Bin; Sun, Dongling; Wang, Jianhua; Liu, Miao; Yang, Shanshan; Wang, Yiyan

    2015-01-01

    Objective As the most important risk factors of cardiovascular disease, pre-hypertension and hypertension are important public health challenges. Few studies have focused on the trends of pre-hypertension and hypertension specifically for the aging population in China. Given the anticipated growth of the elderly population in China, there is an urgent need to document the conditions of pre-hypertension and hypertension in this aging population. Methods We conducted two cross-sectional surveys of Chinese adults aged ≥60 years in 2001 and 2010. A total of 2,272 (943 males, 1,329 females) and 2,074 (839 males, 1,235 females) participants were included in the two surveys, respectively. Results The age- and sex-standardized prevalence of hypertension significantly increased from 60.1% to 65.2% from the 2001 to the 2010 survey. Among the participants with hypertension, the awareness, treatment and control of hypertension all significantly increased from 69.8% to 74.5%, 50.3% to 63.7%, and 15.3% to 30.3%, respectively, from 2001 to 2010. A logistic regression showed that a higher education level, a higher BMI, a family history of hypertension and doctor-diagnosed cardiovascular disease were significantly associated with hypertension awareness and treatment. Conclusion Hypertension prevalence increased rapidly between the years surveyed. Although the awareness, treatment and control of hypertension improved significantly, the values of these variables remained low. More attention should be given to the elderly because the population is aging worldwide, and urgent action, optimal treatment approaches and proper public health strategies must be taken to prevent and manage hypertension. PMID:26241049

  12. Usability Study of a Wireless Monitoring System among Alzheimer's Disease Elderly Population

    PubMed Central

    Avvenuti, Marco

    2014-01-01

    Healthcare technologies are slowly entering into our daily lives, replacing old devices and techniques with newer intelligent ones. Although they are meant to help people, the reaction and willingness to use such new devices by the people can be unexpected, especially among the elderly. We conducted a usability study of a fall monitoring system in a long-term nursing home. The subjects were the elderly with advanced Alzheimer's disease. The study presented here highlights some of the challenges faced in the use of wearable devices and the lessons learned. The results gave us useful insights, leading to ergonomics and aesthetics modifications to our wearable systems that significantly improved their usability and acceptance. New evaluating metrics were designed for the performance evaluation of usability and acceptability. PMID:24963289

  13. India: population: shocking results; monetary incentives.

    PubMed

    Addressing a conference of Parliament members on population and development in New Delhi, Prime Minister Indira Gandhi was reported to have informed the gathering that results of India's latest census "shocked us." The census counted a total national population of 683 million. It was 11 million more than officially anticipated. In her speech, Mrs. Gandhi was also reported to have reiterated that her government is totally committed to "voluntary family planning" and "firmly against compulsion." J.R.D. Tata, chairman of the Family Planning Foundation of India, proposed that the government raise monetary incentives for citizens voluntarily opting for vasectomy and tubectomy. He suggested that the present Rs. 200 for vasectomy and tubectomy be upped to Rs. 5000. He made the proposal in a call to the government to increase its outlay for the family planning program. PMID:12337557

  14. A Longitudinal Study of Symptoms of Oropharyngeal Dysphagia in an Elderly Community-Dwelling Population.

    PubMed

    Nimmons, Danielle; Michou, Emilia; Jones, Maureen; Pendleton, Neil; Horan, Michael; Hamdy, Shaheen

    2016-08-01

    Dysphagia has been estimated to affect around 8-16 % of healthy elderly individuals living in the community. The present study investigated the stability of perceived dysphagia symptoms over a 3-year period and whether such symptoms predicted death outcomes. A population of 800 and 550 elderly community-dwelling individuals were sent the Sydney Swallow Questionnaire (SSQ) in 2009 and 2012, respectively, where an arbitrary score of 180 or more was chosen to indicate symptomatic dysphagia. The telephone interview cognitive screen measured cognitive performance and the Geriatric Depression Scale measured depression. Regression models were used to investigate associations with dysphagia symptom scores, cognition, depression, age, gender and a history of stroke; a paired t test was used to examine if individual mean scores had changed. A total of 528 participants were included in the analysis. In 2009, dysphagia was associated with age (P = 0.028, OR 1.07, CI 1.01, 1.13) and stroke (P = 0.046, OR 2.04, CI 1.01, 4.11) but these associations were no longer present in 2012. Those who had symptomatic dysphagia in 2009 (n = 75) showed a shift towards improvement in swallowing (P < 0.001, mean = -174.4, CI -243.6, -105.3), and for those who died from pneumonia, there was no association between the SSQ derived swallowing score and death (P = 0.509, OR 0.10, CI -0.41, -0.20). We conclude that swallowing symptoms are a temporally dynamic process, which increases our knowledge on swallowing in the elderly. PMID:27307155

  15. Breslow thickness in the Netherlands: a population-based study of 40 880 patients comparing young and elderly patients

    PubMed Central

    Kruijff, S; Bastiaannet, E; Francken, A B; Schaapveld, M; van der Aa, M; Hoekstra, H J

    2012-01-01

    Background: Melanoma incidence has increased rapidly in the last decades, and predictions show a continuing increase in the years to come. The aim of this study was to assess trends in melanoma incidence, Breslow thickness (BT), and melanoma survival among young and elderly patients in the Netherlands. Methods: Patients diagnosed with invasive melanoma between 1994 and 2008 were selected from the Netherlands Cancer Registry. Incidence (per 100 000) over time was calculated for young (<65 years) and elderly patients (⩾65 years). Distribution of BT for young and elderly males and females was assessed. Regression analysis of the log-transformed BT was used to assess changes over time. Relative survival was calculated as the ratio of observed survival to expected survival. Results: Overall, 40 880 patients were included (42.3% male and 57.7% female). Melanoma incidence increased more rapidly among the elderly (5.4% estimated annual percentage change (EAPC), P<0.0001) than among younger patients (3.9% EAPC, P<0.0001). The overall BT declined significantly over time (P<0.001). Among younger patients, BT decreased for almost all locations. Among elderly males, BT decreased for melanomas in the head and neck region (P=0.001) and trunk (P<0.001), but did not decrease significantly for the other regions. Among elderly females, BT only decreased for melanomas at the trunk (P=0.01). The relative survival of elderly patients was worse compared with that of younger patients (P<0.001). Conclusion: Melanoma incidence increases more rapidly for elderly than for younger patients and the decline in BT is less prominent among elderly patients than among young patients. Campaigns in the Netherlands should focus more on early melanoma detection in the elderly. PMID:22713665

  16. Using latent class analysis to model prescription medications in the measurement of falling among a community elderly population

    PubMed Central

    2013-01-01

    Background Falls among the elderly are a major public health concern. Therefore, the possibility of a modeling technique which could better estimate fall probability is both timely and needed. Using biomedical, pharmacological and demographic variables as predictors, latent class analysis (LCA) is demonstrated as a tool for the prediction of falls among community dwelling elderly. Methods Using a retrospective data-set a two-step LCA modeling approach was employed. First, we looked for the optimal number of latent classes for the seven medical indicators, along with the patients’ prescription medication and three covariates (age, gender, and number of medications). Second, the appropriate latent class structure, with the covariates, were modeled on the distal outcome (fall/no fall). The default estimator was maximum likelihood with robust standard errors. The Pearson chi-square, likelihood ratio chi-square, BIC, Lo-Mendell-Rubin Adjusted Likelihood Ratio test and the bootstrap likelihood ratio test were used for model comparisons. Results A review of the model fit indices with covariates shows that a six-class solution was preferred. The predictive probability for latent classes ranged from 84% to 97%. Entropy, a measure of classification accuracy, was good at 90%. Specific prescription medications were found to strongly influence group membership. Conclusions In conclusion the LCA method was effective at finding relevant subgroups within a heterogenous at-risk population for falling. This study demonstrated that LCA offers researchers a valuable tool to model medical data. PMID:23705639

  17. Musculoskeletal Disorders in the Elderly

    PubMed Central

    Gheno, Ramon; Cepparo, Juan M.; Rosca, Cristina E.; Cotten, Anne

    2012-01-01

    Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors. PMID:22919553

  18. An exposure assessment study of ambient heat exposure in an elderly population in Baltimore, Maryland.

    PubMed Central

    Basu, Rupa; Samet, Jonathan M

    2002-01-01

    Because of concern for heat-related mortality in vulnerable populations, particularly the elderly, practical epidemiologic methods are needed for the assessment of ambient heat exposure on individuals. We used a personal monitor to measure body temperature, ambient temperature, heart rate, and activity level of 42 elderly residents of Baltimore, Maryland, in the summer months of 2000. Each participant was monitored for approximately 48 hr to examine the association between ambient temperature and body temperature, using regression methods that account for highly correlated data within individuals. We also examined the associations of Baltimore temperature data with personal ambient temperature and body temperature. An average 0.15 degrees F [95% confidence interval (CI), 0.05-0.25] increase in median body temperature was found for each 1 degrees F increase in median ambient temperature. Heart rate and activity level were not found to be related to body temperature or ambient temperature, although heart rate was associated with activity level. Median heart rate increased an average of 0.17 (95% CI, 0.13-0.21) beats per minute for every unit increase in median activity level. Personal ambient temperature was slightly lower than Baltimore temperatures, whereas an association was not found between body temperature and Baltimore temperatures. The protocol established in this study for heat exposure assessment could feasibly be applied on a larger scale. PMID:12460801

  19. The Experience of Counseling Among a Singaporean Elderly Population: A Qualitative Account of What Clients Report as Beneficial.

    PubMed

    Mathews, Mathew

    2016-09-01

    Adjustments that accompany ageing pose a challenge to the mental health of the elderly. Psychologically based counseling has been documented in Western societies as an appropriate intervention for elderly persons with depressive episodes. There is however very little research documenting how Asian elderly populations experience and benefit from counseling. This study addresses this research gap through a qualitative study based on post-counseling interviews with a sample of 41 elderly persons who received counseling at a dedicated organisation catering to the elderly in Singapore. The qualitative data revealed that clients benefitted from counseling through better emotional management - they received emotional support, found emotional healing and learnt to deal with the emotions associated with grief and loss. Clients also reported that counseling assisted them in decision making processes - older persons were able to conceive of alternatives to their predicament, obtained insights to embark on change, were enabled to take the perspective of others and found validation for their decisions. While many elderly clients greatly appreciated and benefitted from this service, citing demonstrable changes, among the very old such changes were uncommon. Cultural explanations for these differential reports and possible directions for much needed future research are provided. PMID:27180171

  20. Evaluating the fall risk among elderly population by choice step reaction test.

    PubMed

    Wang, Donghai; Zhang, Jian; Sun, Yuliang; Zhu, Wenfei; Tian, Shiliu; Liu, Yu

    2016-01-01

    Falls during daily activities are often associated with injuries and physical disabilities, thereby affecting quality of life among elder adults. Balance control, which is crucial in avoiding falls, is composed of two elements: muscle strength and central nervous system (CNS) control. A number of studies have reported that reduced muscle strength raises the risk of falling. However, to date there has been only limited research focused on the relationship between fall risk and the CNS. This study aimed to investigate the relationship between CNS and risk of falling among the elderly. A total of 140 elderly people (92 females and 48 males) were divided into faller and nonfaller groups based on questionnaire responses concerning falls in their daily life. Participants undertook a choice step reaction test in which they were required to respond to random visual stimuli using foot movements as fast as possible in the left or right directions. Response time was quantified as premotor time (PMT) and motor time (MT). In addition, the participants' electro-myography data were recorded during the choice step reaction test. A maximal isokinetic torque test was also performed. PMT was greater in the fallers than in the nonfallers group. There was a significant difference between fall status and direction on PMT. PMT of the left limb in nonfallers was faster than the right, but in fallers there was no difference between left and right limbs. A similar phenomenon was also observed for MT. There were significant differences between fallers and nonfallers in maximum isokinetic torque at knee and ankle joints. The correct rate of PMT was higher than other variables, such as MT and maximal isokinetic torque, in evaluating elderly fall risk by using logistic regression analyses. The results suggest that PMT in the choice step reaction test could be a useful parameter to assess risk of fall among elder adults. In addition, decreased maximal isokinetic torque was related to greater PMT

  1. Evaluating the fall risk among elderly population by choice step reaction test

    PubMed Central

    Wang, Donghai; Zhang, Jian; Sun, Yuliang; Zhu, Wenfei; Tian, Shiliu; Liu, Yu

    2016-01-01

    Falls during daily activities are often associated with injuries and physical disabilities, thereby affecting quality of life among elder adults. Balance control, which is crucial in avoiding falls, is composed of two elements: muscle strength and central nervous system (CNS) control. A number of studies have reported that reduced muscle strength raises the risk of falling. However, to date there has been only limited research focused on the relationship between fall risk and the CNS. This study aimed to investigate the relationship between CNS and risk of falling among the elderly. A total of 140 elderly people (92 females and 48 males) were divided into faller and nonfaller groups based on questionnaire responses concerning falls in their daily life. Participants undertook a choice step reaction test in which they were required to respond to random visual stimuli using foot movements as fast as possible in the left or right directions. Response time was quantified as premotor time (PMT) and motor time (MT). In addition, the participants’ electro-myography data were recorded during the choice step reaction test. A maximal isokinetic torque test was also performed. PMT was greater in the fallers than in the nonfallers group. There was a significant difference between fall status and direction on PMT. PMT of the left limb in nonfallers was faster than the right, but in fallers there was no difference between left and right limbs. A similar phenomenon was also observed for MT. There were significant differences between fallers and nonfallers in maximum isokinetic torque at knee and ankle joints. The correct rate of PMT was higher than other variables, such as MT and maximal isokinetic torque, in evaluating elderly fall risk by using logistic regression analyses. The results suggest that PMT in the choice step reaction test could be a useful parameter to assess risk of fall among elder adults. In addition, decreased maximal isokinetic torque was related to greater

  2. Genuair® Usability Test: Results of a National Public Survey of the Elderly.

    PubMed

    Blasi, Francesco; Canonica, Giorgio Walter; Centanni, Stefano; Mereu, Carlo; Bernabei, Roberto; Paolisso, Giuseppe; Incalzi, Raffaele Antonelli; Corsico, Angelo; Di Marco, Fabiano; Milanese, Manlio; Pagano, Francesco; Santus, Pierachille; Scichilone, Nicola; Sumberesi, Massimo; Braido, Fulvio; Baiardini, Ilaria

    2016-06-01

    Proper use of inhaler devices may be problematic in elderly patients due to age-related difficulties. A survey was administered to elderly patients to investigate the usability of the Genuair® device and patients' subjective viewpoint on the device. A representative sample of the Italian population aged ≥ 65 years was completed with a pre-defined sample of 89 patients with hand arthritis/arthrosis. Of 526 respondents, 88 were not self-sufficient. Only the replies of the 438 self-sufficient respondents were analyzed. A total of 107 participants (24%) reported having respiratory diseases, and 81 of these (76%) were users of inhaler devices. After the first test, the device was considered "practical/handy" by 90% of patients and "easy to use" by 89%. After the second test, in which patients received a demonstration of the correct inhalation maneuver, the percentage of patients scoring ≥ 7 increased to 93% for the first characteristic and was confirmed for the second, with no differences between the groups in terms of age, educational level, use of devices, and presence of arthritis/arthrosis. The mean time to explain the inhaler technique and to perform a correct inhalation was 1'38"± 1'37", and 70% of the respondents required less than 2 minutes, with no differences between the groups in terms of age, education level, use of devices, and presence of arthritis/arthrosis. In conclusion, Genuair® was well accepted and easy to use in a representative sample of the Italian population aged ≥ 65 years. These characteristics make it a valid choice in the elderly, thus enabling patients to better cope with the problems and difficulties that are common to this age group. PMID:26645660

  3. The Early Result of Cementless Arthroplasty for Femur Neck Fracture in Elderly Patients with Severe Osteoporosis

    PubMed Central

    Seo, Jae-Seong; Shin, Seong-Kee; Jun, Sung-Han; Cho, Chang-Ho

    2014-01-01

    Purpose The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA). Materials and Methods From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (≥65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs. Results Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups. Conclusion The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.

  4. Chronic pain among community-dwelling elderly: a population-based clinical study

    PubMed Central

    Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena

    2016-01-01

    Objective To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home. Design/setting A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration ≥ 3 months) pain with an average intensity of ≥ 4/10 and/or ≥ moderate interference in daily life. Main outcome measures Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain. Results According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009–2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain. Conclusions Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic

  5. Is Dementia Differentially Distributed? A Study on the Prevalence of Dementia in Migrant, Urban, Rural, and Tribal Elderly Population of Himalayan Region in Northern India

    PubMed Central

    Raina, Sunil Kumar; Raina, Sujeet; Chander, Vishav; Grover, Ashoo; Singh, Sukhjit; Bhardwaj, Ashok

    2014-01-01

    Background: Throughout the world, a large number of surveys have been carried out to find the prevalence of dementia with variable results. Aims: This study was to generate data on the prevalence of dementia and to generate a hypothesis on the differential distribution across populations. Materials and Methods: Four settings identified for the purpose of this study included a migrant, urban, rural, and tribal. The study was conducted in two phases: 1) A screening phase and 2) a clinical phase, on 2,000 individuals above 60 years of age. To complete the required sample of 2,000 elderly individuals, 500 individuals were approached from each site. Nobody refused to participate. Results: A total of 32/2,000 (1.6%) elderly individuals were classified as demented. No case of dementia was reported from tribal population. A look at sex differential reveals that majority (21/32; 66%) of individuals identified as demented were females. As age advanced scores on cognitive screen decreased with elders above 80 years of age showing lowest scores. Out of 32, 18 (56%) of patients classified as demented were more than 80 years of age. Conclusion: The findings of this study are in agreement with previous studies which point towards differential distribution of dementia across populations. PMID:24843850

  6. Determinants of Living Situation in a Population of Community-Dwelling and Assisted-Living Dwelling Elders

    PubMed Central

    Avery, Erika; Kleppinger, Alison; Feinn, Richard; Kenny, Anne M

    2010-01-01

    Objective To determine what variables separate community-dwelling elders from assisted-living dwelling elders. Design Cross-sectional Setting Community and assisted living facilities in Connecticut Participants 114 individuals (77 community-dwelling, 37 assisted living) Assessments Nutritional survey, 6 minute walk, Mini-Mental Status Exam (MMSE), Center of Epidemiologic Studies (CES)-Depression Scale, 25-OH vitamin D Results At baseline, assisted-living dwelling elders appeared to have lower serum 25-OH vitamin D levels, lower MMSE scores, higher CES-depression scale scores, and walked shorter distances in the six minute walk. Serum 25-OH vitamin D levels and six minute walk were significantly different between the two groups using logistic regression analysis. As serum 25-OH vitamin D levels increased, the probability of an elder living in an ALF decreased, and as distance walked during the six minute walk increased, the probability of an elder living in an ALF decreased. Conclusions Elders living in assisted living facilities had significantly lower 25-OH vitamin D levels and walked shorter distances during the six minute walk. These variables can be used to predict the probability of an elder living in an assisted living facility. The lack of effect of nutrition suggests that the role of vitamin D in this setting is in physical function. PMID:20142070

  7. Pharmacokinetics in the elderly.

    PubMed Central

    Mayersohn, M

    1994-01-01

    Animals undergo substantial changes in many physiologic and biochemical functions as a natural consequence of aging. In the absence of disease or other pathologic conditions, these changes occur in a gradual manner with time (generally expressed as a fractional or percentage change in that function per year or decade). Furthermore, for any given function and at any given chronologic age, there is large variation in that function among individuals. Given the increase in life expectancy, the substantial increase in the number of elderly (and aged elderly) in the population, and the escalating costs of health care, there is great interest in learning more about the risks associated with aging as a result of toxic exposure. Are the elderly at greater risk than younger adults to the toxic effects of drugs and environmental exposure? Is the elderly population an inherently more sensitive one? PMID:7737036

  8. Impact of roflumilast on exacerbations of COPD, health care utilization, and costs in a predominantly elderly Medicare Advantage population

    PubMed Central

    Moll, Keran; Sun, Shawn X; Ellis, Jeffrey J; Howe, Andrew; Amin, Alpesh

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) exacerbations are associated with declining lung function and health-related quality of life, and increased hospitalization and mortality. Clinical trials often poorly represent the elderly and thus have only partial applicability to their clinical care. Objective To compare exacerbations, COPD-related health care utilization (HCU), and costs in a predominantly elderly Medicare COPD population initiated on roflumilast versus those not initiated on roflumilast. Methods Deidentified administrative claims data from a large, national payer were utilized. Medicare patients aged 40–89 years with at least one COPD diagnosis from May 1, 2010 to December 31, 2012 were included. Members with at least one roflumilast pharmacy claim (index) were assigned to the roflumilast group and those without were assigned to the non-roflumilast group. Proxy index dates for the non-roflumilast group were randomly assigned for similar distribution of all patients’ time at risk. Subjects with at least one pre-index COPD exacerbation had to be continuously enrolled for ≥365 days pre-index and post-index. Unadjusted and adjusted difference-in-difference (DID) analyses contrasted pre-index with post-index changes in exacerbations, HCU, and costs of roflumilast treatment compared with non-roflumilast treatment. Results A total of 500 roflumilast and 60,145 non-roflumilast patients were included (mean age 69.7 and 72.3 years, respectively; P<0.0001). Unadjusted DID favored roflumilast for all exacerbations, with greater pre-index to post-index reductions in mean per 30-day COPD-related hospitalizations (−0.0182 versus −0.0013, P=0.009), outpatient visits (−0.2500 versus −0.0606, P<0.0001), and COPD-related inpatient costs (−US$141 versus −US$11, P=0.0346) and outpatient costs (−US$31 versus −US$4, P<0.0001). Multivariate analyses identified significantly improved pre-index to post-index COPD-related total costs (P=0

  9. Balancing struggles with desired results in everyday activities: strategies for elderly persons with physical disabilities.

    PubMed

    Bontje, Peter; Asaba, Eric; Josephsson, Staffan

    2016-03-01

    The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons' actions. The aim of the present study was to identify meanings of persons' actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons' actions. The analysis identified an overall plot termed 'balancing struggles with desired results'. This plot illustrated that participants' and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by 'acting on a plan to achieve one's goals', the other by 'taking a step in a preferred direction by capitalising on emerging opportunities'. The third strategy focused on avoiding undesirable experiences by 'modifying problematic situations'. In conclusion, these findings call for care and rehabilitation providers' sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons' skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons' quality of daily living through everyday activities. PMID:26189963

  10. Is surgery in the elderly for oesophageal cancer justifiable? Results from a single centre.

    PubMed

    Mirza, A; Pritchard, S; Welch, I

    2013-01-01

    Aims. Advanced age is an identified risk factor for patients undergoing oncological surgical resection. The surgery for oesophageal cancer is associated with significant morbidity and mortality. Our aim was to study the operative management of elderly patients (≥70 years) at a single institute. Methods. The data was collected from 206 patients who have undergone operative resection of oesophageal cancer. The demographic, operative, histological, and postoperative follow-up of all patients were analysed. Results. A total of 46 patients of ≥70 years who had surgical resection for oesophageal cancer were identified. Patients ≥70 years had poor overall survival (P = 0.00). Also elderly patients with nodal involvement had poor survival (P = 0.04). Age at the time of surgery had no impact on the incidence of postoperative complication and inpatient mortality. Both the univariate and multivariate analyses showed age, nodal stage, and positive resection margins as independent prognostic factors for patients undergoing surgery for oesophageal cancer. Conclusions. Advanced age is associated with poor outcome following oesophageal resection. However, the optimisation of both preoperative and postoperative care can significantly improve outcomes. The decision of operative management should be individualised. Age should be considered as one of the factors in surgical resection of oesophageal cancer in the elderly patients. PMID:24205444

  11. PRE-HOSPITAL EMERGENCY MEDICAL SERVICES FOR ELDERLY POPULATION IN TBILISI.

    PubMed

    Dalakishvili, S; Bakuradze, N; Gugunishvili, M; Jojua, R; Eremashvili, M

    2016-04-01

    The importance of the issue is determined by the current demographic situation in Georgia and the world in general. The trend of growing the number of older people and the increase of the life span is obvious. At the same time in the number of countries, particularly in the developed western countries and Japan, the decrease of birth rate is noticed. Similar processes are taking place in Georgia; this logically increases the number of sick and weakened people, which means that taking care of them becomes more acute problem. Therefore, the purpose of this paper was the study of the situation of the pre-hospital emergency medical services in the Georgian capital Tbilisi during the period of 2012-2014. For this reason, the data provided by the Tbilisi Emergency Medical Service were used. Besides, we have also looked for the statistics of the different countries, including the US, Japan and South-East Asian countries. Attention was paid to the recommendations proposed because of the Monitoring of the European Union Mission in Georgia, which focuses on the social and economic protection of elderly. The tables and diagrams, describing the current conditions are provided. Since 2012, there has been launched the state health care program for the elderly in Georgia, but based on research conducted, it does not cover home care services while, the majority of the elderly are chronically sick people and suffer from the number of diseases. Results of the study can be used for improving quality of the Emergency Medical Service model in Georgia and finding the possible ways for its reforms. PMID:27249441

  12. Prevalence of Obstructive Sleep Apnea Syndrome and CPAP Adherence in the Elderly Chinese Population

    PubMed Central

    To, Kin-Wang; Chan, Ken K. P.; Ngai, Jenny; Tung, Alvin; Ko, Fanny W. S.

    2015-01-01

    Background This study assessed the prevalence of obstructive sleep apnea syndrome (OSAS) and CPAP adherence in the elderly Chinese in Hong Kong. Methods We conducted a sleep questionnaire survey among the elders aged ≥60 years in the community centres followed by level 3 home sleep study (Embletta). Subjects with an apnea hypopnea index (AHI) ≥ 15/hr alone and those with AHI ≥ 5/hr plus either cardiovascular risk factors or Epworth Sleepiness Score (ESS) ≥ 10 were offered CPAP treatment. Results Altogether 819 subjects were interviewed with mean (SD) age of 73.9 (7.5) years, BMI 24.2 (3.6) kg/m2, neck circumference 34.9 (3.4) cm and ESS 6.6 (5.2). Daytime sleepiness was reported by 72.4%, snoring loudly 5.1% and witnessed apnea 4%. Among 234 subjects who underwent home sleep study, 156 (66.7%), 102 (43.6%), 70 (29.9%) and 45 (19.2%) had AHI ≥ 5, ≥ 10, ≥ 15 and ≥ 20/hr respectively, with the prevalence increasing with age and BMI. In the sample, 149 subjects (63.7%) were classified as having OSAS, as defined by an AHI ≥ 5/hr with associated symptoms, involving 81 men (74.3%) and 68 women (54.4%). Neck circumference and snoring frequency were the only positive independent factors associated with the AHI and the diagnosis of OSAS. Among 141 subjects who were offered CPAP treatment, 30 accepted CPAP prescription with improvement of ESS and cognitive function over 12 months with CPAP usage of 4.2 (2.2) h/night. Conclusion This study showed a high prevalence of OSAS among the community elders in Hong Kong. Home CPAP acceptance was low but there was significant improvement of subjective sleepiness and cognitive function among those on CPAP treatment. PMID:25774657

  13. Perceived sleep quality is associated with depression in a Korean elderly population.

    PubMed

    Chang, Ki Jung; Son, Sang Joon; Lee, Yunhwan; Back, Joung Hwan; Lee, Kang Soo; Lee, Soo Jin; Chung, Young Ki; Lim, Ki Young; Noh, Jai Sung; Kim, Hyun Chung; Koh, Sang Hyun; Roh, Hyun Woong; Park, Mi Ae; Kim, Jin Ju; Hong, Chang Hyung

    2014-01-01

    Our study aimed to examine the relationship between perceived sleep quality and depression using Pittsburgh Sleep Quality Index (PSQI) and Cole's model to materialize the concept of perceived sleep quality in the non-cognitively impaired elderly. Older adults aged 60+ were recruited from the baseline study of Suwon Project (SP) between 2009 and 2011 (n=2040). Perceived sleep quality was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K), and depression was accessed using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K). We excluded the cognitively impaired elderly using the Korean version-Mini Mental Status Examination (K-MMSE) score less than or equal to 17. In multivariable adjusted logistic regression related to PSQI-K components, poor perceived sleep quality, including poor subjective sleep quality (Odds ratio (OR)=1.27, 95% confidence interval (CI)=1.01-1.61), longer sleep latency (OR=1.32, 95% CI=1.13-1.55) and the frequent use of sleeping medication (OR=1.30, 95% CI=1.10-1.53) were significantly associated with depression after adjusting for age, sex, education, living status, current smoking and current alcohol drinking, the number of comorbidity and Beck Anxiety Inventory (BAI). PSQI-K global score also had greater odds of reporting depression (OR=1.12, 95% CI=1.07-1.16). These results suggested that poor perceived sleep quality was associated with a greater level of depression in the elderly. PMID:24852666

  14. Association of post stroke depression with social factors, insomnia, and neurological status in Chinese elderly population.

    PubMed

    Wang, Lingru; Tao, Yong; Chen, Yang; Wang, Hua; Zhou, Huadong; Fu, Xiaoyan

    2016-08-01

    The purpose of this study was to investigate the association of post stroke depression (PSD) with social factors, insomnia, and neurological status among elderly Chinese patients with ischemic stroke. Six hundred and eight patients over 60 years of age, who had suffered from a first episode of ischemic stroke within 7 days, were enrolled into the study. They were divided into PSD and non-PSD groups according to the Self-rating Depression Scale (SDS) scores. The association of PSD with social factors, insomnia, and neurological status was analyzed using multivariable logistic regression analysis. Compared with the patients who did not develop PSD, those with PSD reported adverse life events more frequently, and more subjects with PSD lived alone, had left carotid artery infarction and cortical infarction (P < 0.05), history of insomnia, and high National Institute of Health Stroke Scale (NIHSS) scores and low Barthel Index (BI) scores (P < 0.01). The multivariable logistic regression analysis showed that the occurrence of PSD was associated with a history of insomnia (HR = 1.59, 95 % CI 1.12-2.36, P < 0.01), NIHSS scores (HR = 2.45, 95 % CI 1.42-3.91, P < 0.01) and BI scores (HR = 2.56, 95 % CI 1.39-4.25, P < 0.01). Insomnia and the degree of neurological deficit were associated with PSD in an elderly population of Chinese people. PMID:27120072

  15. Population structure and uropathogenic virulence-associated genes of faecal Escherichia coli from healthy young and elderly adults.

    PubMed

    Vollmerhausen, Tara L; Ramos, Nubia L; Gündogdu, Aycan; Robinson, Wayne; Brauner, Annelie; Katouli, Mohammad

    2011-05-01

    We investigated the population structures of faecal Escherichia coli in 30 healthy young adults (13 males and 17 females) aged between 20 and 45 years and 29 elderly adults (14 females and 15 males) aged between 65 and 77 years. In all, 1566 strains were typed with the PhPlate system and grouped into biochemical phenotypes (BPTs). Strains with shared BPTs were further typed using randomly amplified polymorphic DNA analysis. Forty-four per cent of the strains were shared between two or more age and gender groups. Elders had a significantly higher (P<0.001) number of BPTs (mean±standard error 3.3±0.27) than younger groups (1.82±0.27). Phylogenetic affiliation and virulence-associated genes (VAGs) of the strains showed that more than 80 % of the strains belonging to dominant types belonged to phylogroups B2 and D. Amongst dominant BPTs, phylogenetic group A was significantly associated with females (P<0.0001), and elders were more likely to carry group D (P<0.0124). Elderly males had a higher prevalence of VAGs than young males (P<0.0001) and young females (P<0.0005). We conclude that there is a lower prevalence of E. coli with uropathogenic properties in healthy young adults than in elders. PMID:21292854

  16. Age and education adjusted normative data and discriminative validity for Rey's Auditory Verbal Learning Test in the elderly Greek population.

    PubMed

    Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis

    2016-01-01

    Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings. PMID:26588427

  17. Smoking patterns and predictors of smoking cessation in elderly populations in Lebanon

    PubMed Central

    Chaaya, M.; Mehio-Sibai, A.; El-Chemaly, S.

    2006-01-01

    SUMMARY OBJECTIVE To investigate smoking patterns in an elderly, low-income population and to identify predictors of smoking cessation, in addition to analyzing the importance of smoking in relation to other risk factors for hospitalization. DESIGN The data were part of an urban health study conducted among 740 individuals aged ≥60 years in three suburban communities of low socio-economic status in Beirut, one of them a refugee camp. A detailed interview schedule was administered that included comprehensive social and health information. RESULTS The overall prevalence of current smokers was 28.1%. Almost half of the group were ever smokers, of whom 44% had quit smoking when they experienced negative health effects. Having at least one chronic illness and having a functional disability significantly increased the odds of smoking cessation. In addition, being a former smoker increased the likelihood of hospital admission. CONCLUSIONS This study is of particular importance, as it has implications for similar low-income and refugee communities in the region and elsewhere. There is a need for more concerted efforts by public health officials to target elderly individuals as a group for smoking cessation interventions, particularly now that mortality and health benefits have been well documented. RÉSUMÉ OBJECTIF Investiguer les types de tabagisme dans une population âgée à faibles revenus et identifier les facteurs prédictifs de l’arrêt du tabagisme, tout en analysant l’importance du tabagisme par rapport aux autres facteurs de risque d’hospitalisation. SCHÉMA Les données constituent une fraction de l’étude de santé urbaine menée chez 740 personnes âgées de ≥60 ans à Beyrouth dans trois collectivités suburbaines à faible statut socio-économique dont une des trois se situe dans un camp de réfugiés. Un schéma détaillé d’interview a été utilisé comportant des informations complètes sur le plan social et celui de la santé. R

  18. Parathyroid Surgery in the Elderly

    PubMed Central

    Morris, Lilah F.; Zelada, Juliette; Wu, Bian; Hahn, Theodore J.

    2010-01-01

    Introduction. The prevalence of primary hyperparathyroidism (PHPT) is expected to increase in developed nations as the aged population grows. This review discusses issues related to PHPT in the elderly population with a focus on differences in disease presentation, medical and surgical management, and outcomes. Methods. Literature review of English-language studies of PHPT or parathyroidectomy (PTx) in the elderly was performed. Surgical literature reviewed included original clinical studies published after 1990. Priority was given to studies with >30 patients where institutional practice and outcomes have not changed significantly over time. Results. Elderly patients primarily present with nonclassic symptoms of PHPT that can sometimes be missed in favor of other diagnoses. They have equivalent surgical outcomes, including morbidity, mortality, and cure rates, compared with younger patients, although their length of hospital stay is significantly longer. Several recent studies demonstrate the safety and efficacy of outpatient, minimally invasive parathyroidectomy in an elderly population. Patients are referred for PTx less frequently with each advancing decade, although surgical referral patterns have increased over time in centers that offer minimally invasive parathyroidectomy. Elderly patients experience increased fracture-free survival after PTx. The majority of elderly patients report symptomatic relief postoperatively. Conclusion. PTx can offer elderly patients with PHPT improved quality of life. PTx is safe and effective in elderly patients, and advanced age alone should not deter surgical referral. PMID:21159725

  19. Heart valve disease in elderly Chinese population: effect of advanced age and comorbidities on treatment decision-making and outcomes

    PubMed Central

    Hu, Kui; Li, Jun; Wan, Yun; Hong, Tao; Lu, Shu-Yang; Guo, Chang-Fa; Wang, Chun-Sheng

    2016-01-01

    Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively despite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment decision-making and therapeutic outcomes. Methods Patients (n = 234, mean age: 78.5 ± 3.7 years) with symptomatic severe heart valve disease hospitalized in our center were included. One hundred and fifty-one patients (65%) were treated surgically (surgical group) and 83 (35%) were treated conservatively (conservative group). Factors that affected therapeutic decision-making and treatment outcomes were investigated and long-term survival was explored. Results Isolated aortic valve disease, female sex, chronic renal insufficiency, aged ≥ 80 years, pneumonia, and emergent status were independent factors associated with therapeutic decision-making. In-hospital mortality for the surgical group was 5.3% (8/151). Three patients (3.6%) in the conservative group died during initial hospitalization. Low cardiac output syndrome and chronic renal insufficiency were identified as predictors of in-hospital mortality in the surgical group. Conservative treatment was identified as the single risk factor for late death in the entire study population. The surgical group had better 5-year (77.2% vs. 45.4%, P < 0.0001) and 10-year (34.5% vs. 8.9%, P < 0.0001) survival rates than the conservative group, even when adjusted by propensity score-matched analysis. Conclusions Advanced age and geriatric comorbidities profoundly affect treatment decision-making for severe heart valve disease. Valve surgery in the elderly was not only safe but was also associated with good long-term survival while conservative treatment was unfavorable for patients with symptomatic severe valve disease.

  20. Population pharmacokinetics of nefopam in elderly, with or without renal impairment, and its link to treatment response

    PubMed Central

    Djerada, Zoubir; Fournet-Fayard, Aurélie; Gozalo, Claire; Lelarge, Chantal; Lamiable, Denis; Millart, Hervé; Malinovsky, Jean-Marc

    2014-01-01

    Aims Nefopam is a nonmorphinic central analgesic, for which no recommendation exists concerning adaptation of regimen in aged patients with or without renal impairment. The objective was to describe the pharmacology of nefopam in aged patients to obtain guidelines for practical use. Methods Elderly patients (n = 48), 65–99 years old, with severe or moderate renal impairment or with normal renal function, were recruited. Nefopam (20 mg) was administered as a 30 min infusion postoperatively. Simultaneously, a 1 min intravenous infusion of iohexol was performed, in order to calculate the glomerular filtration rate. Blood samples were drawn to determine nefopam, desmethyl-nefopam and iohexol plasma concentrations. Nefopam and desmethyl-nefopam concentrations were analysed using a nonlinear mixed-effects modelling approach with Monolix version 4.1.3. The association between pharmacokinetic parameters and treatment response was assessed using logistic regression. Results A two-compartment open model was selected to describe the pharmacokinetics of nefopam. The typical population estimates (between-subject variability) for clearance, volume of distribution, intercompartmental clearance and peripheral volume were, respectively, 17.3 l h−1 (53.2%), 114 l (121%), 80.7 l h−1 (79%) and 208 l (63.6%). Morphine requirement was related to exposure of nefopam. Tachycardia and postoperative nausea and vomiting were best associated with maximal concentration and the rate of increase in nefopam plasma concentration. Conclusions We identified the nefopam pharmacokinetic predictors for morphine requirement and side-effects, such as tachycardia and postoperative nausea and vomiting. In order to maintain morphine sparing and decrease side-effects following a single dose of nefopam (20 mg), simulations suggest an infusion time of >45 min in elderly patients with or without renal impairment. PMID:24252055

  1. Subsequent mortality after hyperglycemic crisis episode in the non-elderly: a national population-based cohort study.

    PubMed

    Kao, Yuan; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2016-01-01

    Hyperglycemic crisis episodes (HCEs)-diabetic ketoacidosis and the hyperosmolar hyperglycemic state-are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2). Both groups were compared, and follow-up prognoses were done until 2011. One thousand eighty-five (14.1%) patients with HCE and 725 (4.71%) patients without HCE died (P < 0.0001) during follow-up. Incidence rate ratios (IRR) of mortality were 3.24 times higher in patients with HCE than in patients without HCE (P < 0.0001). Individual analysis of diabetic ketoacidosis and hyperosmolar hyperglycemic state also showed the similar result with combination of both. After stratification by age, mortality was significant higher in the middle age (40-64 years) [IRR 3.29; 95% confidence interval (CI) 2.98-3.64] and young adult (18-39 years) (IRR 3.91; 95% CI 3.28-4.66), but not in the pediatric subgroup (<18 years) (IRR 1.28; 95% CI 0.21-7.64). The mortality risk was highest in the first month (IRR 54.43; 95% CI 27.98-105.89), and still high after 8 years (IRR 2.05; 95% CI 1.55-2.71). After adjusting for age, gender, and selected comorbidities, the mortality hazard ratio for patients with HCE was still four times higher than for patients without HCE. Moreover, older age, male gender, stroke, cancer, chronic obstructive pulmonary disease, congestive heart failure, and liver disease were independent mortality predictors. HCE significantly increases the subsequent mortality risk in the non-elderly with diabetes. Strategies for prevention and control of comorbidities are needed as soon as possible. PMID:26115971

  2. Fear of falling and quality of life of apparently-healthy elderly individuals from a Nigerian population.

    PubMed

    Akosile, Christopher O; Anukam, Gabriel O; Johnson, Olubusola E; Fabunmi, Ayodeji A; Okoye, Emmanuel C; Iheukwumere, Ngozi; Akinwola, Mojisola O

    2014-06-01

    Ageing is associated with increased morbidity, increased fear of falling (FOF) and reduced activity. These may consequently impair the quality of life (QOL) of the elderly. Studies from Africa investigating FOF and its relationship with QOL among elderly individuals are rare. This study investigated the prevalence of FOF and QOL of apparently-healthy elderly residents of two Local Government Areas (LGAs) from Anambra State, Nigeria and also determined the relationship between the two variables. Two hundred and sixty-one (131 males and 130 females) volunteering elderly individuals, from three randomly-selected communities from each of the LGAs, participated in this cross-sectional survey. The Modified Fall Efficacy Scale (MFES) and the Short-Form Health Survey 36-item (SF-36) questionnaire were used to evaluate FOF and QOL respectively. Data were analysed using frequency, percentage, mean and standard deviation, Chi-square, Independent t-test, Pearson correlation and multivariate regression analysis statistics. Alpha level was set at 0.05. FOF was markedly prevalent in the population at 23.4 % and the QOL score of 55.27 ± 17.28 was just modest. QOL was particularly low in the role limitations due to the physical and emotional problems domains but high in the mental health, social function and bodily pain domains. Significant relationship was found between FOF and all the QOL domains. FOF was present in nearly one of every four elderly individuals in the sample and was related to their QOL. FOF should be routinely investigated in community-dwelling elderly and strategies devised to combat it. PMID:24710949

  3. Cost-effectiveness of a hypertension management programme in an elderly population: a Markov model

    PubMed Central

    2011-01-01

    Background Mounting evidence shows that multi-intervention programmes for hypertension treatment are more effective than an isolated pharmacological strategy. Full economic evaluations of hypertension management programmes are scarce and contain methodological limitations. The aim of the study was to evaluate if a hypertension management programme for elderly patients is cost-effective compared to usual care from the perspective of a third-party payer. Methods We built a cost-effectiveness model using published evidence of effectiveness of a comprehensive hypertension programme vs. usual care for patients 65 years or older at a community hospital in Buenos Aires, Argentina. We explored incremental cost-effectiveness between groups. The model used a life-time framework adopting a third-party payer's perspective. Incremental cost-effectiveness ratio (ICER) was calculated in International Dollars per life-year gained. We performed a probabilistic sensitivity analysis (PSA) to explore variable uncertainty. Results The ICER for the base-case of the "Hypertension Programme" versus the "Usual care" approach was 1,124 International Dollars per life-year gained. PSA did not significantly influence results. The programme had a probability of 43% of being dominant (more effective and less costly) and, overall, 95% chance of being cost-effective. Discussion Results showed that "Hypertension Programme" had high probabilities of being cost-effective under a wide range of scenarios. This is the first sound cost-effectiveness study to assess a comprehensive hypertension programme versus usual care. This study measures hard outcomes and explores robustness through a probabilistic sensitivity analysis. Conclusions The comprehensive hypertension programme had high probabilities of being cost-effective versus usual care. This study supports the idea that similar programmes could be the preferred strategy in countries and within health care systems where hypertension treatment for

  4. 10 years results of an uncemented metaphyseal fit modular stem in elderly patients

    PubMed Central

    De la Torre, Basilio J; Chaparro, Manuel; Romanillos, Juan O; Zarzoso, Sara; Mosquera, Margarita; Rodriguez, Gil

    2011-01-01

    Background: There are concerns with regard to the femoral fixation in cementless total hip arthroplasty in elderly patients. We report a retrospective analysis of clinical and radiological results of uncemented metaphyseal fit modular stem in elderly patients irrespective of anatomic characterstics of proximal femur. Materials and Methods: This study reviews the outcomes of 60 primary hip replacements using a metaphyseal fit modular stem (third-generation Omniflex stem) conducted in 54 patients, of age 75 years or older. After a mean follow-up of 10,4 years, complete clinical and radiographic records were available for 52 hips of 48 patients. The patients were evaluated by Harris Hip Score (HHS). Results: There was a significantly improved pain score and Harris Hip Score (41,6 to 83,2). Six stems (11.53%) were revised: four because of periprosthetic fracture; one stem was well fixed, but presented a large osteolytic lesion in the metaphyseal area and the last stem was revised because of aseptic loosening. Stem survival taking aseptic loosening as the end-point was 98%. Bone atrophy in the proximal femur caused by stress shielding was observed in 39 stems (75%), but there was no case of subtrochanteric stress shielding. Moreover, atrophy appeared within two years postoperatively, with no extension thereafter. Conclusions: We achieved good clinical and radiographic results by uncemented metaphyseal fit femoral stem regardless of patient's age and femoral canal type. PMID:21772630

  5. Hypnotics and mortality in an elderly general population: a 12-year prospective study

    PubMed Central

    2013-01-01

    Background Hypnotics are widely used by the elderly, and their impact on mortality remains controversial. The inconsistent findings could be due to methodological limitations, notably the lack of control for underlying sleep symptoms or illness associated with hypnotic use, for example, insomnia symptoms and excessive daytime sleepiness, depression and anxiety. Our objective was to examine the association between the use of hypnotics and mortality risk in a large cohort of community-dwelling elderly, taking into account a wide range of potential competing risks including sociodemographic characteristics, lifestyle, and chronic disorders as well as underlying psychiatric disorders and sleep complaints. Methods Analyses were carried out on 6,696 participants aged 65 years or older randomly recruited from three French cities and free of dementia at baseline. Adjusted Cox proportional hazards models with delayed entry, and age of the participants as the time scale, were used to determine the association between hypnotic use and 12-year survival. Results At baseline, 21.7% of the participants regularly used at least one hypnotic. During follow-up, 1,307 persons died, 480 from cancer and 344 from cardiovascular disease. Analyses adjusted for study center, age and gender showed a significantly greater risk of all-cause and cardiovascular-related mortality with hypnotics, particularly benzodiazepines, and this increased with the number of hypnotics used. None of these associations were significant in models adjusting for sociodemographic and lifestyle characteristics, chronic disorders including cardiovascular pathologies, sleep and psychiatric disorders. Results remained unchanged when duration of past hypnotic intake or persistent versus intermittent use during follow-up were taken into account. Conclusions When controlling for a large range of potential confounders, the risk of mortality was not significantly associated with hypnotic use regardless of the type and

  6. Residential segregation and spatial distribution of a non-labor force population: the needy elderly and disabled.

    PubMed

    Massey, D S

    1980-01-01

    "Processes of urban change [in the United States] were hypothesized to have created a segregated residential distribution typified by a concentration of disadvantaged and chronically unemployed individuals in decaying inner cities and the employed middle class in suburbs. This hypothesis was tested in one heavily urbanized area for a non-labor force population of needy elderly and disabled persons." Data were obtained from the Fourth Count Summary Tapes of the 1970 census PMID:12263197

  7. Bone Mineral Density and Cognitive Decline in Elderly Women: Results from the InCHIANTI Study.

    PubMed

    Laudisio, Alice; Fontana, Davide Onofrio; Rivera, Chiara; Ruggiero, Carmelinda; Bandinelli, Stefania; Gemma, Antonella; Ferrucci, Luigi; Antonelli Incalzi, Raffaele

    2016-05-01

    Osteoporosis and cognitive impairment, which are highly prevalent conditions in elderly populations, share several risk factors. This study aims at evaluating the association of bone mineral density (BMD) with prevalent and incident cognitive impairment after a 3-year follow-up. We studied 655 community-dwelling women aged 65+ participating in the InCHIANTI study, who had been followed for 3 years. Total, trabecular, and cortical BMD were estimated by peripheral quantitative computed tomography using standard transverse scans at 4 and 38 % of the tibial length. Cognitive performance was evaluated using the Mini-Mental State Examination and the Trail Making Tests (TMT) A and B; a MMSE score <24 was adopted to define cognitive impairment. The TMT A-B score was calculated as the difference between TMT-A and TMT-B times (ΔTMT). The association of cognitive performance after 3 years with baseline indices of BMD was assessed by logistic and linear regression analyses. Cortical, but not trabecular, BMD was independently associated with incident cognitive impairment (OR 0.93, 95 % CI 0.88-0.98; P = 0.012), worsening cognitive performance (OR 0.96, 95 % CI 0.92-0.98; P = 0.039), and worsening performance in ΔTMT (OR 0.96, 95 % CI 0.92-0.99; P = 0.047). Increasing cortical BMD tertiles was associated with decreasing probability of incident cognitive impairment (P for linear trend =0.001), worsening cognitive performance (P = 0.013), and a worsening performance below the median value (P for linear trend <0.0001). In older women, low BMD might represent an independent and early marker of subsequent cognitive impairment. Physicians should assess and monitor cognitive performance in the routine management of elderly women with osteoporosis. PMID:26713334

  8. Application of Short Screening Tools for Post-Traumatic Stress Disorder in the Korean Elderly Population

    PubMed Central

    Jang, Yu Jin; Chung, Hae Gyung; Choi, Jin Hee; Kim, Tae Yong; So, Hyung Seok

    2016-01-01

    Objective Post-traumatic stress disorder (PTSD) is often missed or incorrectly diagnosed in primary care settings. Although brief screening instruments may be useful in detecting PTSD, an adequate validation study has not been conducted with older adults. This study aimed to evaluate the reliability and validity of the Korean version of the primary care PTSD screen (PC-PTSD) and single-item PTSD screener (SIPS) in elderly veterans. Methods The PC-PTSD and SIPS assessments were translated into Korean, with a back-translation to the original language to verify accuracy. Vietnamese war veterans [separated into a PTSD group (n=41) and a non-PTSD group (n=99)] participated in several psychometric assessments, including the Korean versions of the PC-PTSD (PC-PTSD-K), SIPS (SIPS-K), a structured clinical interview from the Diagnostic and Statistical Manual of Mental Disorders-IV(SCID), and PTSD checklist(PCL). Results The PC-PTSD-K showed high internal consistency (Cronbach α=0.76), and the test-retest reliability of the PC-PTSD-K and SIPS-K were also high (r=0.97 and r=0.91, respectively). A total score of 3 from the PC-PTSD-K yielded the highest diagnostic efficiency, with sensitivity and specificity values of 0.90 and 0.86, respectively. The 'bothered a lot' response level from the SIPS-K showed the highest diagnostic efficiency, with sensitivity and specificity values of 0.85 and 0.89, respectively. Conclusion Our findings suggest that both PC-PTSD-K and SIPS-K have good psychometric properties with high validity and reliability for detecting PTSD symptoms in elderly Korean veterans. However, further research will be necessary to increase our understanding of PTSD characteristics in diverse groups with different types of trauma. PMID:27482241

  9. Evaluation of properties of the Vestibular Disorders Activities of Daily Living Scale (Brazilian version) in an elderly population

    PubMed Central

    Ricci, Natalia A.; Aratani, Mayra C.; Caovilla, Heloisa H.; Cohen, Helen S.; Ganança, Fernando F.

    2014-01-01

    Background The Vestibular Disorders Activities of Daily Living Scale (VADL) is considered an important subjective assessment to evaluate patients suffering from dizziness and imbalance. Although frequently used, its metric characteristics still require further investigation. Objective This paper aims to analyze the psychometric properties of the Brazilian version of the VADL in an elderly population. Method The sample comprises patients (≥65 years old) with chronic dizziness resulting from vestibular disorders. For discriminant analysis, patients were compared to healthy subjects. All subjects answered the VADL-Brazil by interview. To examine the VADL validity, patients filled out the Dizziness Handicap Inventory (DHI) and the ABC scale and were tested on the Dynamic Gait Index (DGI). To evaluate the VADL responsiveness, 20 patients were submitted to rehabilitation. Results Patients (n=140) had a VADL total score of 4.1±1.6 points. Healthy subjects scored significantly less than patients in all the subscales and in the VADL total score. The VADL-Brazil was weakly correlated with the DHI and moderately to the ABC scale and the DGI. Instead of the original 3 subscales, factor analysis resulted in 6 factors. The VADL was capable of detecting changes after rehabilitation, which means that the instrument has responsiveness. Conclusions This study provided more data about the psychometric properties and usefulness of the VADL-Brazil. The use of such a reliable and valid instrument increases the knowledge about disability in patients with vestibular disorders. PMID:24676704

  10. Home Non-Invasive Ventilation Fails to Improve Quality of Life in the Elderly: Results from a Multicenter Cohort Study

    PubMed Central

    Tissot, Adrien; Jaffre, Sandrine; Gagnadoux, Frédéric; Levaillant, Marc; Corne, Frédéric; Chollet, Sylvaine; Blanc, François-Xavier; Goupil, François; Priou, Pascaline; Trzepizur, Wojciech; Magnan, Antoine

    2015-01-01

    Background Home non-invasive ventilation (NIV) is a widely used treatment for chronic hypoventilation but little is known on its impact in the elderly. In a multicenter prospective cohort study, we studied tolerance and efficacy of domiciliary NIV in patients aged 75 or more compared to younger ones. Methods and Results 264 patients with at least a six-month follow-up were analyzed. Among them, 82 were elderly. In the elderly and the younger, we found an improvement of arterial blood gas, the Epworth sleepiness scale and the Pittsburgh sleep quality index at 6 months. Mean daily use of NIV at 6 months was 7 hours and the rate of non-adherent patients was similar in both group. Health-related quality of life (HRQL) assessed by SF-36 questionnaires did not change significantly after NIV initiation in the elderly whereas HRQL improved in the less than 75. On univariate analysis, we found that diabetes was a predictive factor for non-adherence in the elderly (Odds ratio: 3.95% confidence interval: 1.06–8.52). Conclusion NIV was efficient in the elderly while evaluation at 6 months showed a good adherence but failed to improve HRQL. PMID:26489014

  11. Changes in and Patterns of Smoking Exposure in an Elderly Urban Population in Beijing: 2001–2010

    PubMed Central

    Yang, Shanshan; He, Yao; Liu, Miao; Wang, Yiyan; Wu, Lei; Wang, Jianhua; Zhang, Di; Zeng, Jing; Jiang, Bin; Li, Xiaoying

    2015-01-01

    Objective The study aims to explore the patterns and changes of active and passive smoking in the elderly population. Methods Two cross-sectional surveys with representative samples of urban populations, aged between 60 and 95 years old, were conducted in 2001 and 2010 in Beijing. A current smoker was defined as a person who smoked a tobacco product at the time of the survey, and a passive smoker was defined as a person who had been exposed to smoke exhaled by a smoker for more than 15 minutes per day more than once per week. Results A total of 2,277 participants in 2001 and 2,102 participants in 2010 completed the survey. The current smoking prevalence changed slightly in males (24.7 vs. 21.2%, P = 0.081), while the prevalence in females decreased significantly from 8.8% (95% CI: 7.3–10.3%) in 2001 to 4.1% (95% CI: 3.0–5.2%) in 2010 (P<0.001). The prevalence of passive smoking was 30.5% (95% CI: 28.6–32.4%) in 2001 and 30.0% (95% CI: 28.1–32.0%) in 2010. The main source of secondhand smoke switched from a spouse in 2001 to offspring in 2010. This trend was observed in both sexes. Passive smoking in males from a smoking spouse decreased from 5.7% to 2.4% (P<0.001), while that from smoking offspring increased from 7.3 to 14.5% (P<0.001). Passive smoking in females from a spouse decreased from 30.6 to 17.6%, while that from offspring increased from 5.3 to 15.4% (P<0.001). Conclusion Offspring became the main source of secondhand smoke for the elderly. Our findings demonstrated the importance of implementing smoking prevention programs, to educate older adults who live with a smoking spouse and/or offspring. PMID:25785722

  12. Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction

    PubMed Central

    Seljeflot, Ingebjørg; Schmidt, Erik B.; Myhre, Peder; Tveit, Arnljot; Arnesen, Harald

    2016-01-01

    Background. Epidemiological and randomized clinical trials indicate that marine polyunsaturated n-3 fatty acids (n-3 PUFAs) may have cardioprotective effects. Aim. Evaluate the associations between serum fatty acid profile, traditional risk factors, the presence of cardiovascular diseases (CVD), and peak Troponin T (TnT) levels in elderly patients with an acute myocardial infarction (AMI). Materials and Methods. Patients (n = 299) consecutively included in the ongoing Omega-3 fatty acids in elderly patients with myocardial infarction (OMEMI) trial were investigated. Peak TnT was registered during the hospital stay. Serum fatty acid analysis was performed 2–8 weeks later. Results. No significant correlations between peak TnT levels and any of the n-3 PUFAs were observed. However, patients with a history of atrial fibrillation had significantly lower docosahexaenoic acid levels than patients without. Significantly lower peak TnT levels were observed in patients with a history of hyperlipidemia, angina, MI, atrial fibrillation, intermittent claudication, and previous revascularization (all p < 0.02). Conclusions. In an elderly population with AMI, no association between individual serum fatty acids and estimated myocardial infarct size could be demonstrated. However, a history of hyperlipidemia and the presence of CVD were associated with lower peak TnT levels, possibly because of treatment with cardioprotective medications. PMID:26989512

  13. Serum antibody response to respiratory syncytial virus F and N proteins in two populations at high risk of infection: children and elderly.

    PubMed

    Sastre, P; Cusi, M G; Manoha, C; Schildgen, O; Ruiz, T; Vela, C; Rueda, P

    2010-09-01

    Human respiratory syncytial virus (hRSV) is the main viral cause of severe respiratory infections in children and a common cause of morbidity in the elderly. The nucleocapsid (N) and fusion (F) proteins of hRSV were expressed in insect cells and used as antigens in two independent enzyme-linked immunosorbent assays (ELISAs) to measure the serum antibody response in two populations at high risk of hRSV infection, children and the elderly. Fifty-seven serum specimens from children aged from 1 to 10 years old and 91 sera from adults over 60 years old were tested. The ELISA results were compared with those obtained by an immunofluorescence assay (IFA) based on hRSV-infected cells, which was considered as the reference technique. Sensitivity and specificity were 94% and 85% for the N-ELISA and 86% and 81% for the F-ELISA, respectively. When the immune responses of the two groups of individuals were compared, it appeared that almost 100% of the elderly had antibodies against the N or F protein whereas only 50% of the sera from children had antibodies against either of the two viral proteins. In conclusion, the F and N ELISAs can be used successfully for detecting a specific antibody response to hRSV. PMID:20488207

  14. Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction.

    PubMed

    Laake, Kristian; Seljeflot, Ingebjørg; Schmidt, Erik B; Myhre, Peder; Tveit, Arnljot; Arnesen, Harald; Solheim, Svein

    2016-01-01

    Background. Epidemiological and randomized clinical trials indicate that marine polyunsaturated n-3 fatty acids (n-3 PUFAs) may have cardioprotective effects. Aim. Evaluate the associations between serum fatty acid profile, traditional risk factors, the presence of cardiovascular diseases (CVD), and peak Troponin T (TnT) levels in elderly patients with an acute myocardial infarction (AMI). Materials and Methods. Patients (n = 299) consecutively included in the ongoing Omega-3 fatty acids in elderly patients with myocardial infarction (OMEMI) trial were investigated. Peak TnT was registered during the hospital stay. Serum fatty acid analysis was performed 2-8 weeks later. Results. No significant correlations between peak TnT levels and any of the n-3 PUFAs were observed. However, patients with a history of atrial fibrillation had significantly lower docosahexaenoic acid levels than patients without. Significantly lower peak TnT levels were observed in patients with a history of hyperlipidemia, angina, MI, atrial fibrillation, intermittent claudication, and previous revascularization (all p < 0.02). Conclusions. In an elderly population with AMI, no association between individual serum fatty acids and estimated myocardial infarct size could be demonstrated. However, a history of hyperlipidemia and the presence of CVD were associated with lower peak TnT levels, possibly because of treatment with cardioprotective medications. PMID:26989512

  15. Possibilities and acceptance of mobile information technologies for the elderly - first results of an empirical study.

    PubMed

    Szarvas, Ildikó; Nitsch, Manuela; Lambacher, Oliver; Howe, Jürgen; Reichwaldt, Nina; von Bargen, Tobias; Haux, Reinhold

    2013-01-01

    This paper summarizes the results of a questionnaire-study conducted for the project "Safe and mobile through accompanying assistance systems" (SIMBA) founded by the German Federal Ministry of Education and Research. The study analyzes the mobility requirements and obstacles of the 55 yearold and older seniors in three age-groups (N=210) to develop suitable health-enabling technologies. It focuses on the mobility of the elderly on foot, by public transport, by bicycle and by taxi. The usage and the acceptance of existing mobile devices are determined, to select a suitable terminal for assistance systems. The results show, that although public transport is a very important way of travelling for seniors, its role decreases with higher age. Above the age of 65 years only a small fraction of seniors uses new communication technologies. This implies that smartphones as mobility aids are only suitable for the youngest group of seniors and for future, perhaps more technology-friendly generations. PMID:23920722

  16. Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)

    PubMed Central

    Benito-León, Julián; Louis, Elan D.; Rivera-Navarro, Jesús; Medrano, María José; Vega, Saturio; Bermejo-Pareja, Félix

    2010-01-01

    Objective: the study aimed to assess the association between morale and mortality. Design: we used data from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Subjects: 2,516 older persons (mean age 75.7 years) participated in the study. Methods: Cox models were used to estimate risk of mortality. Morale was assessed using the Philadelphia Geriatric Center Morale Scale. Results: 489 (21.8%) participants died over a median follow-up of 5.9 years (range 0.1–7.7 years), including 253 (21.8%) deaths among 1,163 participants with low morale scores, 168 (19.3%) among 870 participants with moderate scores and 68 (14.1%) among participants with high scores. In an unadjusted Cox model, relative risk (RR) of mortality in participants with low morale scores = 1.69 (P < 0.001) and RR in participants with moderate scores = 1.47 (P < 0.01) were compared to the reference group (participants with high scores). In a Cox model that adjusted for a variety of demographic factors and co-morbidities, RR of mortality in participants with low morale scores = 1.35 (P <0.05) and moderate scores = 1.16 (not significant) were compared to the reference group. Conclusion: low morale may be an independent predictor of mortality in the elderly. By assessing morale, practitioners might be better positioned to identify patients with poorer prognoses. PMID:20299322

  17. Development and analysis of acceptance of a nutrition education package among a rural elderly population: an action research study

    PubMed Central

    2012-01-01

    Background It is well known that older adults are often vulnerable to malnutrition. This action research was conducted to develop a nutrition education package for promoting healthy ageing and reducing risk of chronic diseases among older adults in a rural area of Malaysia. Methods This study was designed and conducted in three stages, including needs assessment, development of the package and analysis of acceptance among 33 older adults aged 60 years and over in rural communities, and 14 health staff members at rural health clinics. Subjects completed a questionnaire including sociodemographic factors and acceptance evaluation of the nutrition education package with respect to content, graphics and design. Data were analysed descriptively using numbers and percentages. Results A nutrition education package comprising a booklet, flipchart and placemats was developed. A total of 42.4% of the older adults expressed that the sentences in the flipchart needed to be simplified and medical terms explained. Terminology (60%), illustrations (20%) and nutrition recommendations (20%) were the aspects that prevented elderly subjects from fully understanding the booklet. Information on the placemats was easily understood by subjects. Conclusions A well accepted nutrition education package for promoting healthy ageing and reducing risk of chronic diseases was developed that incorporated modifications based on feedback from older adult subjects and health clinic staff in a rural area. It is a tool that can effectively be used for health education in this population. PMID:22676577

  18. Primary prevention for risk factors of ischemic stroke with Baduanjin exercise intervention in the community elder population: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Stroke is a major cause of death and disability in the world, and the prevalence of stroke tends to increase with age. Despite advances in acute care and secondary preventive strategies, primary prevention should play the most significant role in the reduction of the burden of stroke. As an important component of traditional Chinese Qigong, Baduanjin exercise is a simple, safe exercise, especially suitable for older adults. However, current evidence is insufficient to inform the use of Baduanjin exercise in the prevention of stroke. The aim of this trail is to systematically evaluate the prevention effect of Baduanjin exercise on ischemic stroke in the community elder population with high risk factors. Methods A total of 170 eligible participants from the community elder population will be randomly allocated into the Baduanjin exercise group and usual physical activity control group in a 1:1 ratio. Besides usual physical activity, participants in the Baduanjin exercise group will accept a 12-week Baduanjin exercise training with a frequency of five days a week and 40 minutes a day. Primary and secondary outcomes will be measured at baseline, 13 weeks (at end of intervention) and 25 weeks (after additional 12-week follow-up period). Discussion This study will be the randomized trial to evaluate the effectiveness of Baduanjin exercise for primary prevention of stroke in community elder population with high risk factors of stroke. The results of this trial will help to establish the optimal approach for primary prevention of stroke. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-13003588. Registration date: 24 July, 2013. PMID:24712684

  19. The Association Between Physical Activity, Mental Status, and Social and Family Support with Five Major Non-Communicable Chronic Diseases Among Elderly People: A Cross-Sectional Study of a Rural Population in Southern China

    PubMed Central

    Huang, Xiang; Yang, Huajie; Wang, Harry H.X.; Qiu, Yongjun; Lai, Xiujuan; Zhou, Zhiheng; Li, Fangjian; Zhang, Liwei; Wang, Jiaji; Lei, Jimin

    2015-01-01

    Background: Non-communicable chronic diseases (NCDs) have become the top threat in China. This study aimed to estimate the prevalence of major NCDs among the elderly population in rural areas in southern China and explore its associated social determinants. Methods: A multistage cluster random sampling methodology was adopted to select a total of 9245 rural elderly people from 3860 rural households in Guangdong Province. Interviews and physical examinations were performed to collect patient information. Descriptive and logistic regression analyses were conducted to explore factors associated with the presence of major NCDs. Results: Over one-third (38.5%) of the study population suffered from five major NCDs. The grade of activities of daily living (ADL), mental status, and social relationship of elderly people without NCDs were better than those with NCDs. The major factors associated with the presence of NCDs among the elderly people included age (70–79 years group and 80–89 years group), education level (senior high/technical secondary school and junior college and above), mental status (concentration, enrichment and happy life and memory), relationship with neighbours, activities of daily living (ADL) (being able to climb three floors and bend over), physical activity, marital status (bereft), and living conditions (with offspring and family members). Conclusions: The study identified several social determinants associated with the presence of major NCDs. A higher level of family support and physical exercise might contribute to improved physical condition, mental status, and ADL among the elderly people in rural areas in southern China. PMID:26506364

  20. Primary Cementless Hip Arthroplasty in Unstable Intertrochanteric Femur Fracture in Elderlys: Short-term Results

    PubMed Central

    Cho, Hyung Lae; Cho, Hong

    2014-01-01

    Purpose This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys. Materials and Methods Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score. Retrospective evaluation was performed by operative time, transfusion amount, time to operation days, hospital stay and time to full weight bearing. Clinically, ambulatory ability was checked by Parker and Palmer (P&P) score and function of hip was appraised by Harris hip score (HSS). Radiologically, bone healing of fractured trochanteric fragment and presence of subsidence, stress shielding or osteolysis were checked. Results Fracture type was 11 cases of A2.2, 18 cases of A2.3 and 6 cases of A3.3. Femoral stems used were 8 cases of rectangular tapered wedge type and 27 cases of fluted modular distal fixation type. P&P score improved from mean preinjury score of 7.1 to mean postoperative last follow-up score of 6.5. Median HHS at last follow-up was 75. Mean time to full weight bearing was 47 days (24-79 days). Postoperative complications were one case of linear periprosthetic femoral fracture and one case of postoperative dislocation. Conclusion Cementless hip replacement arthroplasty could be a good option for unstable intertrochanteric femoral fracture in elderlys.

  1. An Evaluation of Nearly-Extinct Cohort Methods for Estimating the Very Elderly Populations of Australia and New Zealand

    PubMed Central

    Terblanche, Wilma; Wilson, Tom

    2015-01-01

    The rapid growth of very elderly populations requires accurate population estimates up to the highest ages. However, it is recognised that estimates derived from census counts are often unreliable. Methods that make use of death data have not previously been evaluated for Australia and New Zealand. The aim was to evaluate a number of nearly-extinct cohort methods for producing very elderly population estimates by age and sex for Australia and New Zealand. The accuracy of official estimates was also assessed. Variants of three nearly-extinct cohort methods, the Survivor Ratio method, the Das Gupta method and a new method explicitly allowing for falling mortality over time, were evaluated by retrospective application over the period 1976-1996. Estimates by sex and single years of age were compared against numbers derived from the extinct cohort method. Errors were measured by the Weighted Mean Absolute Percentage Error. It is confirmed that for Australian females the Survivor Ratio method constrained to official estimates for ages 90+ performed well. However, for Australian males and both sexes in New Zealand, more accurate estimates were obtained by constraining the Survivor Ratio method to official estimates for ages 85+. Official estimates in Australia proved reasonably accurate for ages 90+ but at 100+ they varied significantly in accuracy from year to year. Estimates produced by Statistics New Zealand in aggregate for ages 90+ proved very accurate. We recommend the use of the Survivor Ratio method constrained to official estimates for ages 85+ to create very elderly population estimates for Australia and New Zealand. PMID:25849096

  2. The Validity of the WHO-5 as an Early Screening for Apathy in an Elderly Population

    PubMed Central

    Lucas-Carrasco, Ramona; Allerup, Peter; Bech, Per

    2012-01-01

    Aim. The objective of our study has been to evaluate the WHO-5 as a new early screening instrument for apathy in a group of elderly persons. Methods. The WHO-5 was compared to the Geriatric Depression Scale (GDS-15). The GDS contains five items measuring well-being and ten items measuring depression. The internal validity of the WHO-5 (total score being a sufficient statistic) was evaluated with both parametric and nonparametric item response theory models. The external validity of the WHO-5 and the GDS was evaluated by ROC using depression as index of validity. Results. The item response theory analyses confirmed that the total score of the WHO-5 is a sufficient statistic. The ROC analysis shows an adequate sensitivity (61%) and specificity (84%). The GDS15 and its two subscales obtained low sensitivity (25–42%), but high specificity (90–98%). Conclusion. The WHO-5 was found both internally and externally valid when considering decreased positive well-being to be an early indication of apathy reflecting that the wind has begun to be taken out of the “motivation sail.” PMID:22991511

  3. Primitive society, health & elderly.

    PubMed

    Dhar, H L

    2000-03-01

    Mankind have been ravaged by diseases since primitive age and remedial measures were emprirical learnt either by accident, experience or superstition. But most elderly population were killed and hardly died of diseases. Fate of women were no better. Care for elderly came with civilization. They were little better in the East compared to the West. Although elderly population were better treated in India, China tops the list for elderly care. Even today the oldest man in the family is most respected. Civilized nations even today discriminate elderly population compared to children and adult, but apply the yardstick in a different manner, direct killing alone is not allowed. PMID:11227620

  4. Influenza Vaccination Reduces Hospitalization for Heart Failure in Elderly Patients with Chronic Kidney Disease: A Population-Based Cohort Study

    PubMed Central

    Fang, Yu-Ann; Chen, Chang-I; Liu, Ju-Chi; Sung, Li-Chin

    2016-01-01

    Background Elderly patients with chronic kidney disease (CKD) are at a higher risk of hospitalization for cardiovascular diseases (CVD). Previous studies have reported the beneficial effects of the influenza vaccine in patients with CVD. However, the effects of influenza vaccination on the reduction of hospitalizations for heart failure (HF) in elderly patients with CKD remain unclear. Methods This cohort study comprised elderly patients (≥ 55 years of age) with a recorded diagnosis of CKD (n = 4406) between January 1, 1999 and December 31, 2008. Each patient was followed-up until the end of 2008. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the first HF hospitalization were analyzed. In addition, the patients were categorized into four groups based on their vaccination status (unvaccinated and total number of vaccinations: 1, 2-3, and ≥ 4). Results We found that elderly patients with CKD receiving influenza vaccination exhibited a lower risk of HF hospitalization (adjusted HR, 0.31; 95% CI, 0.26-0.39, p < 0.001). The protective effects of influenza vaccination remained consistent regardless of the age group (55-64, 65-74, ≥ 75), sex, and influenza seasonality. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for HF hospitalization were 0.60 (0.47-0.77), 0.30 (0.23-0.41), and 0.10 (0.06-0.16) for patients who received 1, 2-3, and ≥ 4 vaccinations during the follow-up period, respectively. Conclusions The results revealed that elderly patients with CKD receiving annual influenza vaccination are at a lower risk of HF hospitalization.

  5. Dental prosthetic status and prosthetic needs of institutionalised elderly population in oldage homes of jabalpur city, madhya pradesh, India.

    PubMed

    Deogade, Suryakant C; Vinay, S; Naidu, Sonal

    2013-12-01

    Oral disorders are cumulative throughout life and hence unfavourable outcomes are likely to be greatest among the elderly. A descriptive cross-sectional study was conducted among institutionalized geriatric population in old-age homes of Jabalpur city, Madhya Pradesh, to assess their prosthetic status and prosthetic needs. A cross-sectional survey was conducted in all the four old-age homes of Jabalpur city, Madhya Pradesh state, India. All residents aged 60 years and above formed the study population. The recording of prosthetic status and prosthetic needs was carried out according to the World Health Organisation (WHO) Oral Health Assessment Form (1997). A total of 224 individuals were included in the study of which 123 were females and 101 were males. Seventy five percent of the females and 55 % of the males had no prostheses in their upper arch and 61 % of the females and 76 % of the males had no prostheses in their lower arch. More number of males presented with 'Bridges' in their upper arch when compared to females (P value = 0.006). Highest prosthetic need in males was multi-unit prosthesis (42 % in upper arch and 41 % in lower arch) whereas, females' required full prosthesis (39 % in both the upper arch and lower arches). Ageing presents some formidable challenges, particularly with the institutionalised. This study clearly demonstrates a high insufficiency of prosthetic care among the institutionalized elderly population. Any preparation towards the provision of oral health care should not be limited to treatment alone but, more importantly focus on empowering this elderly community with information and education programmes. PMID:24431796

  6. Colorectal Cancer Screening in the Elderly Population: Disparities by Dual Medicare–Medicaid Enrollment Status

    PubMed Central

    Koroukian, Siran M; Xu, Fang; Dor, Avi; Cooper, Gregory S

    2006-01-01

    Objectives To assess the disparities in colorectal cancer (CRC) screening between elderly dual Medicare–Medicaid enrollees (or duals), the most vulnerable subgroup of the Medicare population, and nonduals. Data Sources/Study Setting The 1999 Medicare Denominator File, the Medicare Outpatient Standard Analytic Files, and Physician Supplier Part B files. In addition, the 1998 Area Resource File was used as a source for county-level attributes. Data Collection/Extraction Methods CRC screening procedures for 1999—fecal occult blood test (FOBT), flexible sigmoidoscopy (FLEX), colonoscopy with FOBT and/or FLEX (COL-WFF), and colonoscopy only (COL-ONLY)—were extracted from claim records, using diagnostic and procedure codes. Duals (n =2.5 million) and nonduals (n =20.2 million) receiving their care through the fee-for-service system were identified from the Denominator file. Hierarchical logistic regression analysis was conducted to adjust for individual- and county-level characteristics. Principal Findings Compared with nonduals, duals were disproportionately represented by female, older-old, and minority individuals (respectively 74.4 versus 58.5 percent; 19.3 versus 10.8 percent; 35.7 versus 8.0 percent), and CRC screening was significantly lower in duals than in nonduals (5.1 versus 12.2 percent for FOBT adjusted odds ratio [AOR]: 0.48, 95 percent confidence interval [CI]: 0.45–0.51); 0.7 versus 1.9 percent for FLEX, (AOR: 0.55, 95 percent CI: 0.49–0.61); 0.4 versus 0.8 percent for COL-WFF (AOR: 0.60, 95 percent CI: 0.54–0.67); and 1.8 versus 2.5 percent for COL-ONLY (AOR: 0.85, 95 percent CI: 0.80–0.89); p<.001 for all comparisons. Conclusions Duals are significantly less likely than nonduals to undergo CRC screening, even after adjusting for individual- and county-level covariates. Future studies should evaluate the contribution of comorbidity and low socioeconomic status to these disparities. PMID:17116113

  7. Urban and rural variations in the characteristics associated with elder mistreatment in a community-dwelling Chinese population.

    PubMed

    Dong, Xinqi; Simon, Melissa Andrea

    2013-01-01

    This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM. PMID:23473295

  8. Methodological Issues in Studying Elderly Populations: Looking at Survivors of the Holocaust.

    ERIC Educational Resources Information Center

    Kahana, Boaz; And Others

    To investigate the coping skills and adaptational outcomes among elderly survivors of the holocaust and a comparison group of aged individuals who did not endure extreme stress requires overcoming several methodological challenges. First, stress must be defined to include the personal meaning or evaluation of the sources of stress and its…

  9. Allergy in urban elderly population living in Campania region (Southern Italy). A multicenter study.

    PubMed

    Liccardi, G; Baldi, G; Berra, A; Ciccarelli, A; Cutajar, M; D'Amato, M; D'Angelo, R; Gargano, D; Giannattasio, D; Leone, G; Lo Schiavo, M; Madonna, F; Montera, C; Monti, R; Parente, R; Pedicini, A; Pio, A; Russo, M; Salzillo, A; Stanziola, A; Vatrella, A; Manzi, F; Bilò, M B

    2016-07-01

    Given the increasing life expectancy observed in Western countries, there is a marked interest to know more about how aging could influence respiratory health. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic elders living in Campania region area (Southern Italy). Fourteen Allergy units or Centres examined a total of 462 patients. In this context 215 (46.53%) had positive skin prick tests (SPTs) to at least one allergen and were diagnosed with respiratory allergy. Parietaria represents the most common sensitizing agent in elders living in Campania region, followed by dust mites, grass pollen and Olea europaea. A relatively high percentage of atopic subjects suffered from respiratory symptoms at a fairly advanced age, namely 8.3% at 60-64 years, 10.2% at 65-70 and 5.7% at > 70 years. In conclusion, the prevalence and clinical significance of airway allergic sensitization in the elderly living in Campania region is more significant than expected in latter stages of life. Physicians should not neglect the role of atopy as a risk factor for the onset of allergic respiratory symptoms even in elderly patients. PMID:27425174

  10. Prevalence of sarcopenia among community‐dwelling elderly of a medium‐sized South American city: results of the COMO VAI? study

    PubMed Central

    Bielemann, Renata M.; Gonzalez, Maria Cristina; Menezes, Ana Maria B.

    2015-01-01

    Abstract Background There is insufficient data concerning sarcopenia prevalence in South America. The aim of this study was to estimate sarcopenia prevalence and its clinical subgroups in a Southern Brazilian city. Methods A cross‐sectional population‐based study was performed among community‐dwelling elderly aged 60 years or over. Subjects were evaluated according to the European Working Group on Sarcopenia in Older People established criteria. Muscle mass was estimated by calf circumference (CC). Cut‐off CC points were defined by a subsample's dual X‐ray absorptiometry estimation of the appendicular skeletal muscle mass index (ASMI), which was subsequently compared with the values of a young adult population from the same city. Muscle strength was measured by manual dynamometry. Muscle performance was assessed through the 4 m gait speed test. Results The three diagnostic tests were performed in 1291 subjects. CC of ≤34 cm (males) and ≤33 cm (females) were defined as indicatives of low ASMI. The overall sarcopenia prevalence was 13.9% (CI95% 12.0; 15.8%). Its frequency was significantly higher among elderly with low schooling, without a partner, with low socioeconomic status, smokers, inactive, and with low body mass index. A higher prevalence of pre‐sarcopenia was found in the youngest elderly; a higher prevalence of the clinical stages of the syndrome was found in older age groups. Conclusions Approximately one in ten elderly aged 60–69 years was in the preclinical stage of the disease. This is the age group in which public policies should focus to establish early diagnosis and prevent clinical progression of the syndrome. PMID:27493867

  11. INDOOR AIR QUALITY AND THERMAL COMFORT—RESULTS OF A PILOT STUDY IN ELDERLY CARE CENTERS IN PORTUGAL

    PubMed Central

    Mendes, Ana; Pereira, Cristiana; Mendes, Diana; Aguiar, Lívia; Neves, Paula; Silva, Susana; Batterman, Stuart; Teixeira, João Paulo

    2014-01-01

    The age of the European population is rising and percentage of adults aged 65 years and older is projected to increase from 16% in 2000 to 20% in 2020. It has been estimated that older subjects spend approximately 19 to 20 h/d indoors. Older individuals may be particularly at risk for detrimental effects from pollutants, even at low concentrations, due to reduced immunological defenses and multiple underlying chronic diseases. Six Porto, Portugal, urban area elderly care centers (ECC), housing a total of 425 older persons, were studied to assess indoor air quality (IAQ) and thermal comfort (TC) in two seasons. This study presents the IAQ and TC results in 36 rooms and constitutes part of a wider and ongoing study. The study areas were all naturally ventilated, and indoor concentrations in winter were within Portuguese reference values. However, 42% of the participants were dissatisfied with indoor thermal conditions, rating it “slightly cool.” In summer, the index rate of dissatisfied individuals was lower (8%). Significant differences were found between seasons in predicted percent of dissatisfied people (PPD) and predicted mean vote (PMV) indices. Fungal concentrations frequently exceeded reference levels (>500 colony-forming units [CFU]/m3). In addition, other pollutants occasionally exceeded reference levels. To our knowledge, this is the first study in Portugal to assess effects of indoor air contaminants on the health status and quality of life in older subjects living in ECC. Although IAQ and TC parameters were mostly within reference values, the results suggest a need to improve the balance between IAQ and TC in ECC, a critical environment housing a susceptible population. PMID:23514075

  12. The Nonmetro Elderly: Economic and Demographic Status.

    ERIC Educational Resources Information Center

    Glasgow, Nina

    A disproportionate share of the U.S. elderly population lives in nonmetro areas and has substantially more poverty than the metro elderly population. The nonmetro elderly's poverty rate was 21% in 1980 versus 13% for metro elderly, while median incomes were $4,111 versus $5,003. Lower personal incomes of the nonmetro elderly, regression analysis…

  13. Feasibility and efficacy of chemoradiotherapy for elderly patients with locoregionally advanced nasopharyngeal carcinoma: results from a matched cohort analysis

    PubMed Central

    2013-01-01

    Background To clarify the feasibility and efficacy of chemoradiotherapy (CRT) in elderly (age≥65 years) patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Methods From January 2000 to December 2006, 101 newly diagnosed elderly non-metastatic NPC patients (age≥65 years) who received cisplatin 3-weekly or weekly concurrent CRT with/without sequential chemotherapy were recruited. Each patient from the CRT group was matched to another patient treated with radiotherapy (RT) alone based on age, gender, pathological type, performance status, overall stage, stage method, Adult Comorbidity Evaluation-27 (ACE-27) score and RT technique, from the same institute and time period. We also recruited 101 young patients (age<65 years) as the referent group, which had been matched to the CRT group based on patient characteristics and treatment parameters. Treatment tolerability and toxicity were clarified, and treatment outcomes were calculated and compared among groups. Results CRT was feasible in elderly NPC patients, while a concurrent regimen of weekly cisplatin was more tolerable. Grade≥3 acute toxicity in CRT group was similar with referent group, although it was significantly higher than the RT alone group (65.3% vs. 43.6%, P=0.002). Furthermore, patients with ACE-27 score≥2 in the CRT group had significantly higher severe acute toxicity and dose reduction. Survival was poorer in elderly patients than the referent group. Compared to RT alone, CRT significantly improved the 5-year overall survival (OS: 54.6% vs. 39.3%, P=0.009), cancer-specific survival (CSS: 56.6% vs. 42.7%, P=0.022), disease-free survival (DFS: 51.6% vs. 30.2%, P=0.028) and locoregional relapse-free survival (LRRFS: 78.4% vs. 52.2%, P=0.003), but not distant metastasis-free survival (DMFS: 69.6% vs. 63.6%, P=0.669). However, CRT did not significantly improve 5-year OS (43.6% vs. 27.3%, P=0.893) or CSS (43.6% vs. 34.1%, P=0.971) in elderly NPC patients with ACE-27 score≥2

  14. Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study – 2005)

    PubMed Central

    Khandekar, Rajiv; Al Riyami, Asiya; Attiya, Mahmood; Morsi, Magdi

    2010-01-01

    Aim: We conducted a survey in 2005 to estimate the prevalence and determinants of visual and hearing impairment in a population aged 60 years and above, from the Nizwa Wilayat of Oman. We also correlated them with major bone fracture. Study Design: Cross-sectional survey. Materials and Methods: Vision was tested on Snellen's 'E' chart. Persons with vision less than 20/200 were reexamined by an ophthalmologist to find cause of impairment. Hearing was tested by a screening audiometer. Self-reported information on fracture of major bones was confirmed by review of case records. The prevalence, 95% confidence intervals (CI), and number of visually impaired individuals were calculated. Statistical Analysis: Univariate method and parametric tests were used for analysis. Results: We examined 1,639 (80.3%) Omani persons aged 60 years and above. The prevalence of blindness (vision less than 20/200 in the better eye) was 37.4% (95% CI 35.7–39.1). Blindness was significantly higher in females (Odd's Ratio = 2.1) but was similar in urban and rural Nizwa (OR = 0.73). The prevalence of vision impairment (20/60 to 10/200) was 36.0% (95% CI 34.3–37.7). Cataract was the principal cause in 50% of the blind. The prevalence of glaucoma, corneal opacity, and chronic trachoma was 3.1%, 66.8%, and 53.2%, respectively. Among participants, 36.1% had diabetes. Hearing impairment was noted in 33.5% and profound hearing loss was noted in 3.6% of participants. In the past year, 1.4% of participants had a major bone fracture. Conclusion: Visual and hearing impairment and blinding eye diseases were common among senior Omani citizens. PMID:20534922

  15. Clinicopathological characteristics of infiltrating lobular breast carcinoma in elderly women: Preliminary results

    PubMed Central

    RUIBAL, ALVARO; AGUIAR, PABLO; DEL CAMEN DEL RÍO, MARIA; MENÉNDEZ, PRIMITIVA; ARIAS, JOSÉ IGNACIO; HERRANZ, MICHEL

    2015-01-01

    This study was conducted to investigate the clinicopathological parameters in elderly women (aged >70 years) with infiltrating lobular carcinoma (ILC) of the breast and compare the results with those obtained from younger patients (aged 55–70 years). The study sample included a total of 46 women with ILCs, 10 aged >70 and 36 aged 55–70 years. The parameters analysed were tumor size, histological grade (HG), axillary lymph node involvement, distant metastasis and immunohistochemical expression of estrogen, progesterone and androgen receptors, Ki67, p53 and B cell lymphoma 2. Compared to women aged 55–70 years, ILCs in women aged >70 years were commonly of larger size (P=0.068) and were more frequently HG3 (P=0.024). There were no statistically significant differences in the other parameters analysed. Furthermore, we were unable to determine differences in cancer recurrence and mortality in the two patient subgroups during our follow-up. In conclusion, our preliminary results, based on the limited number of cases included in this study, indicate that i) ILCs in women aged >70 years tended to be larger compared to those in women aged 55–70 years and were more frequently of grade 3; and ii) there were no significant differences in terms of recurrence and mortality between the two patient subgroups during our follow-up. PMID:26807244

  16. Elderly self-management: a qualitative study

    PubMed Central

    Ravanipour, Maryam; Salehi, Shayesteh; Taleghani, Fariba; Abedi, Heidar Ali

    2010-01-01

    BACKGROUND: The population of elderly in Iran and in the world is increasing. It is predicted that the population of elderly reaches to 10 millions in Iran by the year 2019. Elders more than other age groups are at risk of chronic diseases and health problems; and elderly affects their self-management and makes them feel disabled. Since the knowledge of self-management for Iranian elderly is not well developed, this paper aimed to determine the concept of self-management for Iranian elders. METHODS: This was a qualitative study with grounded theory approach on Iranian elderly self-management. Data were collected through deep interviews with 26 participants in a period of one year and were analyzed using a Strauss Corbin analysis method. RESULTS: Self-management in the context of power means using different managing methods in dealing with daily life needs, especially in interactions with others in a way that accelerates affairs with efficiency and satisfaction. The main categories emerged from this qualitative study included: managing plans, managing life goals and policies, persuading the desired goals, managing self-care, directing others, coordinating and consulting with others. CONCLUSIONS: The findings of this study provided a deep understanding of elderly perceptions of self-management in their lives. These findings can be a baseline for future researches on developing effective health interventions such as developing a nursing model for increasing the elderly self-management abilities in Iran. Such a model can provide a strong basis for nursing care. PMID:21589781

  17. Comparative analysis of survival between elderly and non-elderly severe sepsis and septic shock resuscitated patients

    PubMed Central

    Palomba, Henrique; Corrêa, Thiago Domingos; Silva, Eliézer; Pardini, Andreia; de Assuncao, Murillo Santucci Cesar

    2015-01-01

    Objective To compare outcomes between elderly (≥65 years old) and non-elderly (<65 years old) resuscitated severe sepsis and septic shock patients and determine predictors of death among elderly patients. Methods Retrospective cohort study including 848 severe sepsis and septic shock patients admitted to the intensive care unit between January 2006 and March 2012. Results Elderly patients accounted for 62.6% (531/848) and non-elderly patients for 37.4% (317/848). Elderly patients had a higher APACHE II score [22 (18-28) versus 19 (15-24); p<0.001], compared to non-elderly patients, although the number of organ dysfunctions did not differ between the groups. No significant differences were found in 28-day and in-hospital mortality rates between elderly and non-elderly patients. The length of hospital stay was higher in elderly compared to non-elderly patients admitted with severe sepsis and septic shock [18 (10-41) versus 14 (8-29) days, respectively; p=0.0001]. Predictors of death among elderly patients included age, site of diagnosis, APACHE II score, need for mechanical ventilation and vasopressors. Conclusion In this study population early resuscitation of elderly patients was not associated with increased in-hospital mortality. Prospective studies addressing the long-term impact on functional status and quality of life are necessary. PMID:26313436

  18. Gender Difference on the Association between Dietary Patterns and Obesity in Chinese Middle-Aged and Elderly Populations

    PubMed Central

    Yuan, Ya-Qun; Li, Fan; Meng, Pai; You, Jie; Wu, Min; Li, Shu-Guang; Chen, Bo

    2016-01-01

    Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012–2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132–1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673–0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094–1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China. PMID:27455322

  19. Gender Difference on the Association between Dietary Patterns and Obesity in Chinese Middle-Aged and Elderly Populations.

    PubMed

    Yuan, Ya-Qun; Li, Fan; Meng, Pai; You, Jie; Wu, Min; Li, Shu-Guang; Chen, Bo

    2016-01-01

    Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012-2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132-1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673-0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094-1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China. PMID:27455322

  20. Increase of elderly poor in developing nations--the implications of dependency theory and modernization theory for the aging of world population.

    PubMed

    Osako, M

    1982-12-01

    Despite the growing number of elderly residents in developing countries, little is known about the impact of economic development policies on the elderly in these countries. In an effort to identify public policies which may have a beneficial impact on the elderly, the impact of development policies and of foreign aid on the elderly in Taiwan was examined. Information on the elderly in developing countries and in Taiwan was derived from reports of various international organizations and from social science literature. Between 1980-2000, the proportion of elderly persons in developing countries will increase from 6.1%-7.1%, and the absolute number of elderly will increase from 200 million to 350 million. In 2000, the proportion of elderly persons in the developed countries will be 18.2%, but the absolute number of elderly will be only 244 million. There is little information on the income of the elderly in developing countries , but the elderly are probably over represented among the poor in developing countries just as they are in most developed countries. A disproportionate number of the elderly live in the rural areas of developing countries. Structural changes which occur in developing countries under conditions of economic development may have a negative impact on the elderly. Little is known about the impact of foreign aid on the general population of poor people in developing countries and even less in known about the impact of foreign aid on the elderly. Neo-classical economic theorists argue that foreign aid has a trickle down effect and that the poor ultimately benefit from foreign aid and investment. Dependency theorists argue that foreign aid and investment slows economic growth, perpetuates a dual economy for the elite and the poor, and increases income differences between the poor and the elite. It is difficult to assess the validity of these theories in the abstract. The impact of foreign aid and other policies must be assessed in reference to

  1. Short to Mid-Term Term Surgical Outcome Study with Posterior Only Approach on Tuberculous Spondylodiscitis in an Elderly Population

    PubMed Central

    Kothari, Manish; Tikoo, Agnivesh; Nene, Abhay

    2016-01-01

    Study Design Retrospective study. Purpose To study short to mid-term outcome of surgically managed elderly patients of tuberculous spondylodiscitis with posterior only approach in terms of decision making and challenges in treatment, choice of implants and outcomes. Overview of Literature Tuberculous spondylodiscitis in the elderly is increasing due to longer survival rates. It presents with varied clinical manifestations needing surgical management. Management in tuberculous spondylodiscitis has been scarcely reported in the elderly, with a paucity of data on the choice of implants and approach. Methods Sixteen patients (five males, 11 females) older than 70-years-of-age culture and/or histopathology proven tuberculous spondylodiscitis were included in the study. All patients were operated using a single posterior approach. Pedicle screw with rods (PS/rods) or spinal loop with sublaminar wires (SL/SLW) were used for fixation. Clinical and surgical details were recorded. Sagittal correction achieved postoperatively and loss of correction at follow-up were noted. Results The mean age was 73.6 years (range, 70 to 80 years). The mean follow up was 44.5 months (range, 24 to 84 months). The mean immediate postoperative correction of sagittal deformity was 11.3 degrees; this correction was lost by a mean of 3.1 degrees at last follow-up. All 10 patients with deficit showed neurological recovery and all but one of the seven non-walkers were capable of independent ambulation at follow-up. Patients with SL/SLW and PS/rods had similar radiological outcome at final follow up. Conclusions Operative management gives satisfactory results in elderly patients with tuberculous spondylodiscitis. The posterior approach provides adequate exposure for decompression and rigid fixation, providing satisfactory clinical and radiological outcomes. SSL/SLW and pedicle screw rod construct both give similar radiological results if used appropriately in patients. PMID:27114766

  2. Estimation of prevalence of Helicobacter pylori infection in an asymptomatic elderly population comparing [14C] urea breath test and serology.

    PubMed Central

    Newell, D G; Hawtin, P R; Stacey, A R; MacDougall, M H; Ruddle, A C

    1991-01-01

    A non-invasive serological assay devised in this laboratory had a sensitivity and specificity of 100% as determined by culture and confirmed by histology in a group of 47 patients who had undergone endoscopy. The correlation between serology and the non-invasive [14C] breath test was very good. Only one of 24 culture positive patients was, while all 23 culture negative patients were, breath test negative. In a group of 46 healthy elderly persons, however, significant anomalies between serology and breath test were observed. Only 83% of the breath test negative persons were seronegative, while only 68% of the breath test positive persons were seropositive. These results can be explained in terms of age related atrophic gastritis and immune incompetence, causing reduced colonisation and decreased antibody production, respectively. These investigations suggest that non-invasive tests for H pylori infection may not be reliable in the elderly. PMID:2045496

  3. Potentially inappropriate medications (PIMs) and anticholinergic levels in the elderly: a population based study in a French region.

    PubMed

    Beuscart, Jean-Baptiste; Dupont, Corinne; Defebvre, Marie-Margueritte; Puisieux, Francois

    2014-01-01

    Prescriptions of PIMs and anticholinergic drugs lead to adverse events and hospitalizations in the elderly. The objective of this study was to determine the prevalence of PIMs and prescriptions with a high anticholinergic effect in a French region. All prescriptions dispensed at community pharmacies in patients aged 75 and older between January 1 and March 31, 2012 were extracted from French Health Insurance information System - Nord-Pas-de-Calais Region for patients affiliated to the Social Security. Prescription of PIMs was defined according to the Laroche list. The anticholinergic score for each prescription was calculated using the Anticholinergic Drug Scale (ADS). 65.6% (n=207,979) of people aged over 75 years, living in the Nord-Pas-de-Calais Region were included, of which 4.5% (n=9284) living in nursing homes. Patients received an average of 8.3 drugs over the 3-month study period. In 32.6% (n=67,863) of patients, at least one PMI was prescribed. According to the ADS, 10.0% (n=20,978) of patients in the general population and 24.0% (n=2231) of patients living in nursing homes was exposed to a prescription with a high or very high anticholinergic score (ADS≥3). Hydroxyzine prescribed in 51.4% (n=10,792) of them ranked first among drugs most often reported. In conclusion, PMIs and anticholinergic drugs were commonly prescribed in elderly living in the Nord-Pas-de-Calais Region. Improving the quality of prescriptions in the elderly appears necessary. PMID:25192614

  4. Reasons for elderly patients GP visits: results of a cross-sectional study

    PubMed Central

    Frese, Thomas; Mahlmeister, Jarmila; Deutsch, Tobias; Sandholzer, Hagen

    2016-01-01

    Objective The aim of this study is to describe the frequency of reasons for elderly patients visits to a general practice (GP) setting. Subjects and methods Cross-sectional data from 8,877 randomly selected patients were assessed during a 1-year period by 209 GPs in the German federal state of Saxony. The reasons for visits, performed procedures, and results of visits were documented. In this study, the data of patients aged 65 years and older are analyzed and the procedural and nonprocedural reasons for visits are described. Results In all, 2,866 patients aged 65 years and older were included. The majority of patients (1,807) were female. A total of 4,426 reasons for visits were found, distributed on 363 International Classification of Primary Care-2 codes. In the mean, there were 1.5 reasons for a GP visit from each patient. The top five nonprocedural reasons for visiting the GP were: cough (1.8%), back complaints (1.6%), shoulder complaints (1.3%), knee complaints (1.1%), and dyspnea (1.0% of all reasons for visit). The top five procedural reasons for visiting the GP included follow-up investigations of cardiovascular or endocrine disorders and immunizations. The top 30 nonprocedural reasons for visits covered 21.9% of all reasons for visiting. The top 30 procedural reasons covered 54.3% of all reasons for visits. Conclusion The current work indicates that people aged 65 years and older consult the GP more frequently for procedural than for nonprocedural reasons. The top 30 procedural and nonprocedural reasons for visits cover ~75% of all reasons for visits in these patients. PMID:26893549

  5. Prevalence of Hearing Loss in Black and White Elders: Results of the Cardiovascular Health Study

    ERIC Educational Resources Information Center

    Pratt, Sheila R.; Kuller, Lewis; Talbott, Evelyn O.; McHugh-Pemu, Kathleen; Buhari, Alhaji M.; Xu, Xiaohui

    2009-01-01

    Purpose: The goal of this study was to determine the impact of age, gender, and race on the prevalence and severity of hearing loss in elder adults, aged 72-96 years, after accounting for income, education, smoking, and clinical and subclinical cardiovascular disease. Methods: Air-conduction thresholds for standard and extended high-frequency…

  6. Familial Aggregation of Hyperopia in an Elderly Population of Siblings in Salisbury, Maryland

    PubMed Central

    Wojciechowski, Robert; Congdon, Nathan; Bowie, Heidi; Munoz, Beatriz; Gilbert, Donna; West, Sheila

    2011-01-01

    Purpose To determine whether hyperopia aggregates in families in an older mixed-race population. Design Cross-sectional familial aggregation study using sibships. Methods We recruited 759 subjects (mean age, 73.4 years) in 241 families through the population-based Salisbury Eye Evaluation study. Subjects underwent noncycloplegic refraction if best-corrected visual acuity (BCVA) was ≤20/40, had lensometry to measure their currently worn spectacles if BCVA was >20/40 with spectacles, or were considered to be plano (refraction of zero) if the BCVA was >20/40 without spectacles. Preoperative refraction from medical records was used for bilaterally pseudophakic subjects. Results Utilizing hyperopia cutoffs from 1.00 to 2.50 diopters, age-, race-, and gender-adjusted odds ratios for hyperopia with an affected sibling ranged from 2.72 (95% confidence interval [CI], 1.84–4.01) to 4.87 (95% CI, 2.54–9.30). The odds of hyperopia increased with age until 75 years, after which they remained relatively constant. Black men were significantly less likely to be hyperopic than white men, white women, or black women. Conclusions Hyperopia appears to be under strong genetic control in this older population. PMID:15629824

  7. Normative data for a computer-assisted version of the auditory three-consonant Brown-Peterson paradigm in the elderly French-Quebec population.

    PubMed

    Callahan, Brandy L; Belleville, Sylvie; Ferland, Guylaine; Potvin, Olivier; Tremblay, Marie-Pier; Hudon, Carol; Macoir, Joël

    2014-01-01

    The Brown-Peterson task is used to assess verbal short-term memory as well as divided attention. In its auditory three-consonant version, trigrams are presented to participants who must recall the items in correct order after variable delays, during which an interference task is performed. The present study aimed to establish normative data for this test in the elderly French-Quebec population based on cross-sectional data from a retrospective, multi-center convenience sample. A total of 595 elderly native French-speakers from the province of Quebec performed the Memoria version of the auditory three-consonant Brown-Peterson test. For both series and item-by-item scoring methods, age, education, and, in most cases, recall after a 0-second interval were found to be significantly associated with recall performance after 10-second, 20-second, and 30-second interference intervals. Based on regression model results, equations to calculate Z scores are presented for the 10-second, 20-second and 30-second intervals and for each scoring method to allow estimation of expected performance based on participants' individual characteristics. As an important ceiling effect was observed at the 0-second interval, norms for this interference interval are presented in percentiles. PMID:24498960

  8. Cognitive performance as a predictor of functional decline among the non-disabled elderly dwelling in a Japanese community: a 4-year population-based prospective cohort study.

    PubMed

    Iwasa, Hajime; Gondo, Yasuyuki; Yoshida, Yuko; Kwon, Jinhee; Inagaki, Hiroki; Kawaai, Chieko; Masui, Yukie; Kim, Hunkyung; Yoshida, Hideyo; Suzuki, Takao

    2008-01-01

    This study longitudinally examined the relationships between the specific domains of cognitive performance and functional decline among the community elderly. The study population was 119 men and 194 women aged 70-84 at baseline, who were examined at both baseline and in a 4-year follow-up survey. Katz's Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) were used for measuring the functional capacities of basic activities of daily living (BADL) and higher-level competence, respectively. For the purpose of analyses, declines in each subscale of functional capacity during the follow-up period were used as outcome variables; and specific domains of cognitive performances, including information processing speed, executive function, orientation, and episodic memory at baseline, were used as independent variables. Multiple logistic regression analyses, adjusted for the potential confounders, showed that information processing speed and orientation were associated independently and inversely with BADL decline, and that information processing speed and executive function were related independently and inversely to higher-level competence decline. These results suggested that information processing speed and orientation are reliable predictors for decline in BADL, and information processing speed and executive function are also reliable predictors for decline in higher-level competence among the community elderly. PMID:17854924

  9. The effects of health changes on projections of health service needs for the elderly population of the United States.

    PubMed

    Singer, B H; Manton, K G

    1998-12-22

    The 1982-1994 National Long-Term Care Surveys indicate an accelerating decline in disability among the U.S. elderly population, suggesting that a 1.5% annual decline in chronic disability for elderly persons is achievable. Furthermore, many risk factors for chronic diseases show improvements, many linked to education, from 1910 to the present. Projections indicate the proportion of persons aged 85-89 with less than 8 years of education will decline from 65% in 1980 to 15% in 2015. Health and socioeconomic status trends are not directly represented in Medicare Trust Fund and Social Security Administration beneficiary projections. Thus, they may have different economic implications from projections directly accounting for health trends. A 1.5% annual disability decline keeps the support ratio (ratio of economically active persons aged 20-64 to the number of chronically disabled persons aged 65+) above its 1994 value, 22:1, when the Hospital Insurance Trust Fund was in fiscal balance, to 2070. With no changes in disability, projections indicate a support ratio in 2070 of 8:1-63% below a cash flow balance. PMID:9861019

  10. The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics

    PubMed Central

    2013-01-01

    Background Lebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of community dwelling elderly people, aged 65 years and above, living in a rural settings in Lebanon, in line of socioeconomic factors, health and living conditions. The present paper will describe the gender specific characteristics of the study population. Methods AMEL is a cross-sectional population based study conducted between April 2011 and April 2012 including 1200 elderly individuals living in the 24 rural Caza (districts) of Lebanon. People aged greater than or equal to 65 y were randomly selected through multistage cluster sampling. Subjects were interviewed at their homes by trained interviewers. The questionnaire included the following measures: socio-demographic factors, nutritional status (Mini Nutritional Assessment, MNA), health related characteristics, functional ability, cognitive status, mood and social network. Results The sample included 591 men (49.3%) and 609 women (50.8%). Mean age was 75.32 years and similar between genders. Malnutrition (MNA < 17) and risk of malnutrition (MNA between 17 and 23.5) were present in 8.0% (95%CI 4.9%-11.1%) and 29.1% (95%CI 24.0%-34.2%) respectively of the participants, and more frequent in women (9.1% and 35.3% respectively). Regarding socio-demographic status, among women the level of illiteracy and poor income was significantly higher than in men. Moreover, chronic diseases, poor self perceived health, frailty, functional disability, depressive symptoms and cognitive impairment were particularly high and significantly more frequent in women than in

  11. Association of depression and psychotropic medication on cardiac-related outcomes in a nationwide community-dwelling elderly population in Taiwan

    PubMed Central

    Hsu, Wen-Yu; Tsai, Hui-Ju; Yu, Shu-Han; Hsu, Chih-Cheng; Tsai, Yu-Ting; Tzeng, Han-Yun; Lin, I-Ching; Liu, Kiang; Lee, Marion M.; Chiu, Nan-Ying; Hsiung, Chao A.

    2016-01-01

    Abstract The objective of this study was to examine the association of depression, psychotropic medications, and mental illness with cardiovascular disease in a nationwide community-dwelling elderly population in Taiwan. A total of 5664 participants who enrolled in the Healthy Aging Longitudinal Study in Taiwan (HALST) were included in the study. Multiple logistic regression was applied to investigate the association of depression, psychotropic medication use, and mental illness, separately, with cardiovascular disease. The results suggested that cardiovascular disease was significantly associated with various definitions of depression, including: the Center for Epidemiologic Studies-Depression scale (CES-D) ≥ 16, self-reported, and physician-diagnosed for depression (adjusted odds ratio [AOR] = 1.51; 95% confidence interval (CI): 1.14–2.00 for CES-D; AOR = 3.29; 95% CI: 1.99–5.42 for self-reported; and AOR = 2.45; 95% CI: 1.51–3.97 for physician-diagnosed). Additionally, significant associations of cardiovascular disease with the use of antipsychotics (AOR = 2.04; 95% CI: 1.25–3.34), benzodiazepines (BZDs) (AOR = 1.84; 95% CI: 1.52–2.21), and Z-drugs (AOR = 1.41; 95% CI: 1.03–1.93), respectively, were also observed, but not the use of antidepressants. In addition, a significant association of cardiovascular disease with mental illness was found in this study (AOR = 2.33; 95% CI: 1.68–3.24). In line with previous reports, these findings provided supportive evidence that depression and/or mental illness were significantly associated with cardiovascular disease in a community-dwelling elderly population in Taiwan. Moreover, significant associations of cardiovascular disease with the use of antipsychotics, BZDs, and Z-drugs, individually, were found. Further investigation would be of importance to clarify the causal relationship of depression and/or psychotropic medications with cardiovascular disease, especially among

  12. Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal

    PubMed Central

    Burkart, Katrin; Meier, Fred; Schneider, Alexandra; Breitner, Susanne; Canário, Paulo; Alcoforado, Maria João; Scherer, Dieter; Endlicher, Wilfried

    2015-01-01

    Background: Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status. Objectives: We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008. Methods: We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (≤ 4 km vs. > 4 km), while adjusting for potential confounders. Results: The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas ≤ 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%). Conclusions: Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water. Citation: Burkart K, Meier F, Schneider A, Breitner S, Canário P, Alcoforado MJ, Scherer D, Endlicher W. 2016. Modification of

  13. Association of depression and psychotropic medication on cardiac-related outcomes in a nationwide community-dwelling elderly population in Taiwan.

    PubMed

    Hsu, Wen-Yu; Tsai, Hui-Ju; Yu, Shu-Han; Hsu, Chih-Cheng; Tsai, Yu-Ting; Tzeng, Han-Yun; Lin, I-Ching; Liu, Kiang; Lee, Marion M; Chiu, Nan-Ying; Hsiung, Chao A

    2016-08-01

    The objective of this study was to examine the association of depression, psychotropic medications, and mental illness with cardiovascular disease in a nationwide community-dwelling elderly population in Taiwan. A total of 5664 participants who enrolled in the Healthy Aging Longitudinal Study in Taiwan (HALST) were included in the study. Multiple logistic regression was applied to investigate the association of depression, psychotropic medication use, and mental illness, separately, with cardiovascular disease. The results suggested that cardiovascular disease was significantly associated with various definitions of depression, including: the Center for Epidemiologic Studies-Depression scale (CES-D) ≥ 16, self-reported, and physician-diagnosed for depression (adjusted odds ratio [AOR] = 1.51; 95% confidence interval (CI): 1.14-2.00 for CES-D; AOR = 3.29; 95% CI: 1.99-5.42 for self-reported; and AOR = 2.45; 95% CI: 1.51-3.97 for physician-diagnosed). Additionally, significant associations of cardiovascular disease with the use of antipsychotics (AOR = 2.04; 95% CI: 1.25-3.34), benzodiazepines (BZDs) (AOR = 1.84; 95% CI: 1.52-2.21), and Z-drugs (AOR = 1.41; 95% CI: 1.03-1.93), respectively, were also observed, but not the use of antidepressants. In addition, a significant association of cardiovascular disease with mental illness was found in this study (AOR = 2.33; 95% CI: 1.68-3.24). In line with previous reports, these findings provided supportive evidence that depression and/or mental illness were significantly associated with cardiovascular disease in a community-dwelling elderly population in Taiwan. Moreover, significant associations of cardiovascular disease with the use of antipsychotics, BZDs, and Z-drugs, individually, were found. Further investigation would be of importance to clarify the causal relationship of depression and/or psychotropic medications with cardiovascular disease, especially among elderly populations

  14. Towards the importance of minimum toe clearance in level ground walking in a healthy elderly population.

    PubMed

    Hamacher, Dennis; Hamacher, Daniel; Schega, Lutz

    2014-09-01

    Tripping is presumed to be the principal cause for falls during walking. At minimum toe clearance, the potential for trip-related falls is considered to be highest. Thus, controlling minimum toe clearance is essential for walking without tripping. In theory, the central nervous system should therefore give priority to accurate control of the variability in minimum toe clearance, as compared to other gait parameters, since people tend to only modify variability in any given task if it interferes with the task performance. The aim of this study was to determine whether elderly individuals show less increase in variability of minimum toe clearance during a dual-task condition (where an increase of gait variability is provoked), while allowing a larger range of variability in the other gait parameters. Forty elderly participants walked back and forth on a 25 m long track for five minutes. They then walked a second time performing an additional cognitive task. The variability in stride time, stride length and minimum toe clearance as well as dual-task costs of each gait parameter were calculated for each walk. The variability in minimum toe clearance did not change during dual task-walking, whereas the variability of stride length and stride time increased, showing dual-task costs of about 66% and 84%, respectively. To avoid additional detrimental load on the central nervous system, the modification of task-irrelevant variability may be tolerated during dual-task conditions, whereas minimum toe clearance is controlled with high priority. PMID:25128155

  15. Use of telemedicine to manage severe ischaemic strokes in a rural area with an elderly population.

    PubMed

    Richard, Sébastien; Lavandier, K; Zioueche, Y; Pelletier, S; Vezain, A; Ducrocq, X

    2014-05-01

    The rural district of the Meuse (East France) has a high number of elderly patients for whom prognosis of ischaemic strokes is poor with high-haemorrhagic transformation risk of intravenous tissue plasminogen activator (rt-PA). This disadvantage is made worse by the distances a patient has to travel to the nearest stroke unit. We set out to assess the effectiveness of a telestroke system implemented in this area. Between October 2010 and February 2012, data from each "tele-expertised" patient were collected. 53 patients were examined. Diagnosis of ischaemic stroke was confirmed in 43 cases (81 %), and intravenous rt-PA treatment performed in 21 cases (40 %). In the treated patient group, median age was 73 years, with 29 % of octogenarians. Baseline National Institutes of Health Stroke Scale (NIHSS) was 16, with 29 % ≥ 20. The median onset to needle time was 169 min, and the median door to needle time was 69 min. Intracranial haemorrhage occurred in 3 cases (14 %), and was symptomatic in two (10 %). At 3 months, median NIHSS was 6, 6 patients (29 %) presented a favourable outcome (modified Rankin scale ≤ 1) and 3 (14 %) had died. In rural areas, for elderly patients with severe ischaemic strokes, telemedicine appears to be a way of improving accessibility and benefits of rt-PA treatment. PMID:24277200

  16. Descriptive study of suicide attempts in the Brazilian elderly population, 2000 - 2014.

    PubMed

    Pinto, Liana Wernersbach; Assis, Simone Gonçalves de

    2015-06-01

    The study describes hospital admission rates for suicide attempts among the Brazilian elderly and discusses the weaknesses of data from information systems. Data were extracted from the Hospital Information System (HIS) and from the Violence and Injury Surveillance System (VIVA). The analyzes included: (1) temporal evolution of rates by age group (1-9; 10-19; 20-39; 40-59 and 60 or over) from 2000 to 2014 by region; (2) triennial hospital admission rates by sex for age groups 60-69, 70-79 and 80 or over by region and state; (3) hospital admission rates for the elderly from the two information systems. Temporal evolution showed higher rates in the north and lower ones in the northeast. The analysis by age group and sex showed higher rates for older men of the three investigated age groups. The comparison of rates obtained from the two information systems showed a gradual increase in rates from VIVA. After 2012, rates obtained from VIVA were higher in the Southeast, South and Midwest regions. The study highlights the need for further improvement of information on hospital morbidity and data from compulsory notification of violence. PMID:26060946

  17. Edentulism associates with worse cognitive performance in community-dwelling elders in rural Ecuador: results of the Atahualpa project.

    PubMed

    Del Brutto, Oscar H; Gardener, Hannah; Del Brutto, Victor J; Maestre, Gladys E; Zambrano, Mauricio; Montenegro, Jipson E; Wright, Clinton B

    2014-12-01

    Studies in industrialized nations suggest that severe edentulism correlates with cognitive impairment, but there is little information on this association in underserved populations. We conducted a community-based study to assess whether edentulism associates with cognitive impairment in elders living in rural Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door census and evaluated using the Montreal Cognitive Assessment (MoCA). Persons were classified into two groups according to whether they have severe edentulism (<10 remaining teeth) or not. In addition, a questionnaire allowed self-rating of oral health. A total of 274 persons (mean age 69.6 ± 7.7 years; 59% women) were included. Persons with <10 remaining teeth (n = 116) have significantly lower MoCA scores than those with ≥10 teeth (n =158), after adjusting for demographics, cardiovascular risk factors, depression and dementia (β = -1.06, p = 0.03). Self-rated poor oral health was more prevalent among persons with <10 teeth (p < 0.0001), but did not correlate with MoCA scores (good vs. poor, β = -0.89, p = 0.89). Severe edentulism is associated with poor cognitive performance in elders living in rural Ecuador. Public health campaigns directed to improve oral health may facilitate early recognition of persons with cognitive impairment in underserved populations. PMID:24627152

  18. Influenza Vaccination Uptake and Associated Factors among Elderly Population in Hong Kong: The Application of the Health Belief Model

    ERIC Educational Resources Information Center

    Mo, P. K. H.; Lau, J. T. F.

    2015-01-01

    The impact of influenza on elderly can be severe and fatal. Influenza vaccination (IV) has been shown to be effective in reducing influenza-related complications, but the IV uptake among elderly in Hong Kong remains low. This study investigated the prevalence and factors associated with IV among Chinese elderly in Hong Kong using the Health Belief…

  19. Alzheimer's disease and the elderly in Israel: are we paying enough attention to the topic in the Arab population?

    PubMed

    Werner, Perla; Friedland, Robert P; Inzelberg, Rivka

    2015-08-01

    With the continuing rise in the elderly population, Alzheimer’s disease (AD) and dementia represent an increasing public health concern worldwide. In recent years, research has focused on the relationship between AD and ethnicity. Israel, a multiethnic society, provides a natural laboratory for research on ethnicity and health. The largest ethnic group is that of Israeli Jews, followed by Arab citizens, mostly Arab Muslims, with smaller numbers of Arab Christians in addition to Druze, Circassians, and others. The aim of this review is to clarify ethnic differences in prevalence and risk factors for Alzheimer’s disease. We review available literature on ethnic differences in epidemiologic and risk factors for Alzheimer’s disease, including genetic differences as well as disparities in health access and quality of health services. We will conclude with research and policy implications. PMID:25794510

  20. Practice of geriatric psychiatry and mental health services for the elderly: results of an international survey.

    PubMed

    Reifler, B V; Cohen, W

    1998-12-01

    The authors conducted a survey of members of the International Psychogeriatric Association (IPA) to determine the state of development of both the profession of geriatric psychiatry and services for mentally ill elderly. Ratings for both issues were based on a scale of 1 to 4, with 1 being little to no development and 4 being the highest. A rating of 2 was set as the desired minimum, and 12 countries met this goal in both categories, with 6 more countries reaching this goal in service development only. We conclude that although the field of geriatric psychiatry and services for mentally ill elderly are still underdeveloped in much of the world, in many countries they are developed sufficiently enough that the IPA is in an excellent position to provide both information and technical assistance to nations wishing to advance. PMID:9924830

  1. Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12

    PubMed Central

    2010-01-01

    Background Due to demographic change, the advanced elderly represent the fastest growing population group in Europe. Health problems tend to be frequent and increasing with age within this cohort. Aims of the study To describe and compare health status of the elderly population in six European countries and to analyze the impact of socio-demographic variables on health. Methods In the European Study of the Epidemiology of Mental Disorders (ESEMeD), representative non-institutionalized population samples completed the EQ-5D and Short Form-12 (SF-12) questionnaires as part of personal computer-based home interviews in 2001-2003. This study is based on a subsample of 1659 respondents aged ≥ 75 years from Belgium (n = 194), France (n = 168), Germany (n = 244), Italy (n = 317), the Netherlands (n = 164) and Spain (n = 572). Descriptive statistics, bivariate- (chi-square tests) and multivariate methods (linear regressions) were used to examine differences in population health. Results 68.8% of respondents reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (55.2%), followed by mobility (50.0%), usual activities (36.6%), self-care (18.1%) and anxiety/depression (11.6%). The proportion of respondents reporting any problems increased significantly with age in bivariate analyses (age 75-79: 65.4%; age 80-84: 69.2%; age ≥ 85: 81.1%) and differed between countries, ranging from 58.7% in the Netherlands to 72.3% in Italy. The mean EQ VAS score was 61.9, decreasing with age (age 75-79: 64.1; age 80-84: 59.8; age ≥ 85: 56.7) and ranging from 60.0 in Italy to 72.9 in the Netherlands. SF-12 derived Physical Component Summary (PCS) and Mental Component Summary (MCS) scores varied little by age and country. Age and low educational level were associated with lower EQ VAS and PCS scores. After controlling for socio-demographic variables and reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and Belgium, and

  2. Urinary phthalate metabolites and depression in an elderly population: National Health and Nutrition Examination Survey 2005-2012.

    PubMed

    Kim, Kyoung-Nam; Choi, Yoon-Hyeong; Lim, Youn-Hee; Hong, Yun-Chul

    2016-02-01

    Previous animal studies have demonstrated that phthalate exposure is associated with depression-like behaviors. However, no human study has explored this relationship. We explored the association between urinary phthalate metabolite concentrations and depression in a nationally representative sample of the U.S. elderly population. We analyzed 2030 participants aged 60 years or older with available data on phthalates and depression from the 2005 to 2012 National Health and Nutrition Examination Survey (NHANES). We selected 10 urinary phthalate metabolites with a weighted detection rate >60%. Depression was defined as a 9-item Patient Health Questionnaire score ≥10. The models were adjusted for age, sex, race/ethnicity, education level, income-to-poverty ratio, health insurance coverage, marital status, smoking status, alcohol consumption, moderate physical activity, body mass index, comorbidity status, NHANEs cycle, and urinary creatinine levels. One-unit increases in log-transformed mono-(3-carboxypropyl) phthalate (MCPP) (odds ratio [OR]=1.24, 95% confidence interval [CI]=1.02-1.52) and mono(carboxynonyl) phthalate (MCNP) (OR=1.42, 95% CI=1.15-1.75) were positively associated with depression. When we stratified the urinary phthalate metabolites into quartiles, the highest quartiles (Q4) of MCNP (OR=2.57, 95% CI=1.25-5.27) and mono-n-butyl phthalate (MBP) (OR=2.40, 95% CI=1.10-5.22) were associated with depression compared with the lowest quartiles (Q1). Concentrations of urinary phthalate metabolites MCPP, MCNP, and MBP were positively associated with the risk of depression in a representative sample of the U.S. elderly population. However, the present cross-sectional study is hypothesis generating and the associations need to be investigated through further longitudinal studies. PMID:26624239

  3. Itch Management in the Elderly.

    PubMed

    Leslie, Tabi Anika

    2016-01-01

    Itch is a common symptom in the elderly population over 65 years old, and is often a chronic condition lasting more than 6 weeks. As in all age groups, but especially in the elderly, there can be a significant effect on the general health status and quality of life, with impaired daily activities and lack of sleep, which can also lead in some cases to depression or anxiety. The cause of chronic itch in the elderly is often multifactorial due to physiological changes in the aging skin, including impaired skin barrier function, and also due to decline in immunological (immunosenescence), neurological, and psychological changes associated with age. Common causes of chronic pruritus in the aging skin include xerosis (dry skin), dermatological disorders (eczema, psoriasis, lichen planus), and systemic (renal, hepatic, endocrine), neurodegenerative, and psychological diseases. Comorbidities in the elderly population lead to polypharmacy, increasing the potential risk of drug side effects, which can result in causing or exacerbating itch in the elderly patient. It is essential to obtain a detailed history, including drugs, as well as a thorough clinical examination with appropriate subsequent investigations. Management of the elderly patient with chronic pruritus should include treatment with topical therapies such as emollients as well as other agents for symptomatic relief. Systemic therapies should be directed at any underlying cutaneous or systemic diseases. Often the cause of itch in the elderly cannot be found and some systemic treatments can be used for symptomatic control of the itch, including antihistamines, gabapentin, and selective antidepressants. A holistic approach needs to be taken on an individual basis to relieve chronic pruritus, as the management of itch in the elderly can be a challenge. PMID:27578088

  4. Association of Renal Biochemical Parameters with Left Ventricular Diastolic Dysfunction in a Community-Based Elderly Population in China: A Cross-Sectional Study

    PubMed Central

    Zhou, Jun; Zhang, Hanying; Tang, Bixiao; Fu, Michael; Herlitz, Hans; Cui, Jie; Zhu, Hongmin; Sun, Aijun; Hu, Kai; Ge, Junbo

    2014-01-01

    Background Relationship of left ventricular diastolic dysfunction (LVDD) with parameters that could provide more information than hemodynamic renal indexes has not been clarified. We aimed to explore the association of comprehensive renal parameters with LVDD in a community-based elderly population. Methods 1,166 community residents (aged ≥ 65 years, 694 females) participating in the Shanghai Heart Health Study with complete data of renal parameters were investigated. Echocardiography was used to evaluate diastolic function with conventional and tissue Doppler imaging techniques. Serum urea, creatinine, urea-to-creatinine ratio, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were analyzed on their associations with LVDD. Results The prevalence of LVDD increased in proportion to increasing serum urea, urea-to-creatinine ratio and UACR. These three renal parameters were found negatively correlated to peak early (E) to late (A) diastolic velocities ratio (E/A), and positively to left atrial volume index; UACR also positively correlated with E to peak early (E’) diastolic mitral annular velocity ratio (E/E’). Serum urea, urea-to-creatinine ratio and UACR correlated with LVDD in logistic univariate regression analysis, and urea-to-creatinine ratio remained independently correlated to LVDD [Odds ratio (OR) 2.82, 95% confidence interval (CI) 1.34–5.95] after adjustment. Serum urea (OR 1.18, 95%CI 1.03–1.34), creatinine (OR 6.53, 95%CI 1.70­–25.02), eGFR (OR 0.22, 95%CI 0.07–0.65) and UACR (OR 2.15, 95%CI 1.42–3.24) were revealed independent correlates of advanced (moderate and severe) LVDD. Conclusions Biochemical parameters of renal function were closely linked with LVDD. This finding described new cardio-renal relationship in the elderly population. PMID:24533126

  5. Genetic Association Study with Metabolic Syndrome and Metabolic-Related Traits in a Cross-Sectional Sample and a 10-Year Longitudinal Sample of Chinese Elderly Population

    PubMed Central

    Yang, Jinghui; Liu, Jianwei; Liu, Jing; Li, Wenyuan; Li, Xiaoying; He, Yao; Ye, Ling

    2014-01-01

    Background The metabolic syndrome (MetS) has been known as partly heritable, while the number of genetic studies on MetS and metabolic-related traits among Chinese elderly was limited. Methods A cross-sectional analysis was performed among 2 014 aged participants from September 2009 to June 2010 in Beijing, China. An additional longitudinal study was carried out among the same study population from 2001 to 2010. Biochemical profile and anthropometric parameters of all the participants were measured. The associations of 23 SNPs located within 17 candidate genes (MTHFR, PPARγ, LPL, INSIG, TCF7L2, FTO, KCNJ11, JAZF1, CDKN2A/B, ADIPOQ, WFS1, CDKAL1, IGF2BP2, KCNQ1, MTNR1B, IRS1, ACE) with overweight and obesity, diabetes, metabolic phenotypes, and MetS were examined in both studies. Results In this Chinese elderly population, prevalence of overweight, central obesity, diabetes, dyslipidemia, hypertension, and MetS were 48.3%, 71.0%, 32.4%, 75.7%, 68.3% and 54.5%, respectively. In the cross-sectional analyses, no SNP was found to be associated with MetS. Genotype TT of SNP rs4402960 within the gene IGF2BP2 was associated with overweight (odds ratio (OR)  = 0.479, 95% confidence interval (CI): 0.316-0.724, p = 0.001) and genotype CA of SNP rs1801131 within the gene MTHFR was associated with hypertension (OR = 1.560, 95% CI: 1.194–2.240, p = 0.001). However, these associations were not observed in the longitudinal analyses. Conclusions The associations of SNP rs4402960 with overweight as well as the association of SNP rs1801131 with hypertension were found to be statistically significant. No SNP was identified to be associated with MetS in our study with statistical significance. PMID:24959828

  6. Assessment of morbidity pattern, quality of life and awareness of government facilities among elderly population in South India

    PubMed Central

    Joseph, Nitin; Nelliyanil, Maria; Nayak, Sriraksha R.; Agarwal, Vyom; Kumar, Arjun; Yadav, Harsh; Ramuka, Gourav; Mohapatra, Kshirabdhi Tanaya

    2015-01-01

    Background: This study was done to assess the determinants of morbidity pattern, quality of life (QoL) and awareness of elderly about various government schemes and social security legislations. Materials and Methods: Data was collected by house to house survey among participants aged 60 years and above using a structured interview schedule. The QoL was assessed using Kannada version of WHOQOL-BREF instrument following language validation. Results: Mean age of 206 participants was 69.6±6.7 years. Half of them were males and majority were graduates 54 (26.2%). Morbidity was present among 194 (94.2%) participants (95% CI 89.5–98.9%), most common being hypertension 96 (46.6%). Morbid conditions were seen more among less educated (P = 0.007). Only 68 (33%) were under medical insurance coverage, 17 (8.3%) were under old age government pension and 74 (35.9%) were under retirement pension scheme. Social relationships, psychological health and environmental domain scores were associated with socio-economic status. Social relationship domain score was significantly better among well educated participants and those without morbidities. Level of ambulation was significantly associated with QoL scores in all domains (P < 0.001). Majority of the participants 132 (64.1%) had moderate level of awareness about government facilities for senior citizens. Awareness level was significantly better among males (P < 0.001), well educated (P < 0.001), better socio-economic status respondents (P < 0.001) and those currently working (P = 0.026). Conclusion: Health status of elderly needs improvement which would also improve their QoL. Awareness about various government schemes needs to be enhanced to improve its utilization. The results of this study are expected to help policy makers in planning comprehensive services for elderly residing in this area. PMID:26288782

  7. A community study of the effect of particulate matter on blood measures of inflammation and thrombosis in an elderly population

    PubMed Central

    Sullivan, Jeffrey H; Hubbard, Rebecca; Liu, Sally L-J; Shepherd, Kristen; Trenga, Carol A; Koenig, Jane Q; Chandler, Wayne L; Kaufman, Joel D

    2007-01-01

    Background The mechanism behind the triggering effect of fine particulate matter (PM) air pollution on cardiovascular events remains elusive. We postulated that elevated levels of PM would be associated with increased blood levels of inflammatory and thrombotic markers in elderly individuals. We also hypothesized that elevated PM would increase levels of cytokines in individuals with heart disease. Methods We measured these blood markers in 47 elderly individuals with (23) and without (16 COPD and 8 healthy) cardiovascular disease (CVD) on 2 or 3 mornings over a 5 or 10-day period between February 2000 and March 2002. Blood measures were paired with residence level outdoor PM measured by nephelometry. Analyses determined the within-individual effect of 24-hour averaged outdoor PM on blood measures. Results Analyses found no statistically significant effect of a same day 10 ug/m3 increase in fine PM on log transformed levels of CRP 1.21 fold-rise [95% CI: 0.86, 1.70], fibrinogen 1.02 fold-rise [95% CI: 0.98, 1.06], or D-dimer 1.02 fold-rise [95% CI: 0.88, 1.17] in individuals with CVD. One-day lagged analyses in the CVD subgroup found similar null results. These same models found no change in these blood markers at the same-day or 1-day lag in the group without CVD. In 21 individuals with CVD, a 10 μg/m3 increase in same-day PM was associated with a 1.3 fold-rise [95% CI: 1.1, 1.7] in the level of monocyte chemoattractant protein-1. Conclusion We did not find consistent effects of low ambient levels of PM on blood measures of inflammation or thrombosis in elderly individuals. PMID:17270049

  8. Neutrophil adhesion in the elderly: inhibitory effects of plasma from elderly patients.

    PubMed

    Damtew, B; Spagnuolo, P J; Goldsmith, G G; Marino, J A

    1990-02-01

    Neutrophil (PMN) adherence is a critical component of host defense against infection. We questioned whether abnormalities of PMN adherence may be responsible, in part, for the increased susceptibility to infection in the elderly. We examined the adherence of 51Cr-labeled PMN from 18 elderly (65-95 years) and 18 younger subjects (18-40 years) to gelatin-coated plastic (gel) and bovine aortic endothelial monolayers (BAEC). There was no difference in unstimulated or baseline adherence of elderly or control PMN to either gel or BAEC substrates. N-Formyl-methionyleucylphenylalanine (FMLP), phorbol myristate acetate (PMA), and calcium ionophore A23187 (CI) significantly increased adherence of elderly PMN to gel and BAEC by 204 and 140% for FMLP, 271 and 263% for PMA, and 211 and 150% for CI, respectively. No differences were observed in the increment in stimulated adherence between young and elderly PMN. In contrast, in 5 of 18 subjects, incubation of elderly or young PMN with 10% elderly plasma resulted in greater than 25% inhibition in baseline adherence to BAEC compared to their sex-matched controls. The effect of elderly plasma was specific for BAEC and not seen with the gel substrate and was also demonstrated using human venous endothelium. When the adherence assay was repeated with varying ratios of elderly and young plasma, PMN adherence to BAEC correlated inversely with the proportion of elderly plasma in the assay. With greater than 70% elderly plasma, adherence was depressed below that observed in the absence of plasma. These data suggest the presence of a factor(s) in elderly plasma which may diminish adherence to endothelium. This factor(s) may be important in the increased risk of infection in a segment of the elderly population. PMID:2295155

  9. Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons - A Population Based Study

    PubMed Central

    Parsaik, Ajay K; Singh, Balwinder; Roberts, Rosebud O; Pankratz, Shane; Edwards, Kelly K.; Geda, Yonas E; Gharib, H; Boeve, Bradley F; Knopman, David S; Petersen, Ronald C

    2014-01-01

    IMPORTANCE Association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) is not established. OBJECTIVE To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population based cohort. DESIGN A cross-sectional, population-based study. SETTING Olmsted County, Minnesota. PARTICIPANTS Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia. A total of 2,050 participants were evaluated and underwent in-person interview, neurological evaluation and neuropsychological testing to assess performance in memory, attention/executive function, visuospatial, and language domains. Subjects were diagnosed by consensus as cognitively normal, MCI or dementia according to published criteria. Clinical and subclinical hypothyroidism was ascertained from a medical records-linkage system. MAIN OUTCOME MEASURES Association of clinical and subclinical hypothyroidism with MCI. Results Among 1904 eligible participants, the frequency of MCI was 16% in 1450 subjects with normal thyroid function, 17% in 313 subjects with clinical hypothyroidism, and 18% in 141 subjects with subclinical hypothyroidism. After adjusting for covariates (age, gender, education, education years, sex, ApoE ε 4, depression, diabetes, hypertension, stroke, BMI and coronary artery disease) we found no significant association between clinical or subclinial hypothyroidism and MCI [OR 0.99 (95% CI 0.66–1.48) and OR 0.88 (95% CI 0.38–2.03) respectively]. No effect of gender interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidisn among males was 1.02 (95%CI, 0.57–1.82) and 1.29 (95%CI 0.68–2.44), among females was 1.04 (95% 0.66–1.66) and 0.86 (95% CI 0.37–2.02) respectively. Conclusion In this population based cohort of eldery, neither clinical nor subclinical hypothyrpodism was associated with MCI. Our findings

  10. Vitamin D Deficiency in Healthy Male Population: Results of the Iranian Multi- Center Osteoporosis Study

    PubMed Central

    Rahnavard, Z; Eybpoosh, S; Homami, M Rezaei; Meybodi, HR Aghaei; Azemati, B; Heshmat, R; Larijani, B

    2010-01-01

    Background: The prevalence of vitamin D deficiency and its causative factors has been estimated more frequently in elder population, women, and patients with osteoporosis in different countries, but this issue is less defined in male population within different age groups especially in Asian countries. Therefore, we studied the role of effective factors in vitamin D deficiency and its prevalence in Iranian healthy men. Methods: This study was a multi center and carried out in five metropolitans in Iran. Serum 25 Hydroxy vitamin D and other biochemical variables were determined in 2396 healthy men in late winter of 2001. Results: 68.8% of participants suffered from vitamin D deficiency. Vitamin D levels were the highest in Bushehr (n= 111, 40.3%) (P< 0.05) and between Shiraz and Tabriz, Shiraz had the better values (P< 0.05). Tehran had the highest prevalence of vitamin D deficiency (n= 380, n= 85.7%). Geographical zone independently predicted vitamin D status (P< 0.05). There was not any association among age (r= 0.035, P> 0.05), physical activity (r= 0.023, P> 0.05), and exposure of face & hands to sunlight (r= 0.022, P> 0.05) with vitamin D levels. Conclusion: Prevalence of vitamin D deficiency in Iranian male population is high, considering Iranian cultural and geographical zones, food fortification and life style modification is recommended. PMID:23113022

  11. Association of polymorphisms of the transporter associated with antigen processing (TAP2) gene with pulmonary tuberculosis in an elderly Japanese population.

    PubMed

    Thu, Kaung Si; Sato, Noriko; Ikeda, Shinobu; Naka-Mieno, Makiko; Arai, Tomio; Mori, Seijiro; Sawabe, Motoji; Muramatsu, Masaaki; Tanaka, Masashi

    2016-08-01

    The transporter associated with antigen processing 2 (TAP2) gene is involved in the immunological response to tuberculosis (TB) infection. Variations in the TAP2 gene have been associated with TB infection in small population studies in India, Columbia, and Korea. We investigated the association of TAP2 polymorphisms with TB susceptibility in an elderly Japanese population. We analyzed samples from consecutive autopsy cases (n = 1850) registered in the Japanese Geriatric SNP Research database. TB was diagnosed pathologically by TB granuloma on autopsy samples. There were 289 cases and 1529 controls. Twenty-four single nucleotide variations (SNVs), including four missense variations in the TAP2 region, were genotyped using the Illumina Infinium Human Exome BeadChip array. Of the 24 SNVs in the TAP2 gene, rs4148871, rs4148876 (R651C), and rs2857103 showed statistically significant associations with TB susceptibility, and rs4148871 and rs2857103 also showed significant genotypic associations in a dominant allele model adjusted for age, sex, and smoking. Haplotype analysis showed that TAP2 allele *0103 conferred an increased TB risk (OR = 1.48, p = 0.0008), while the TAP2 *0201 allele was protective against TB (OR = 0.73, p = 0.0007). Our results suggest that TAP2 polymorphisms influence TB susceptibility in a Japanese population. PMID:27325005

  12. Prevalence, awareness, treatment, and control of hypertension in the older population: results from the multiple national studies on ageing.

    PubMed

    Yang, Fan; Qian, Dongfu; Hu, Dan

    2016-02-01

    The international comparisons that provided useful epidemiologic information of hypertension in the elderly people is still sparse; we aim to provide the latest international estimates on the burden of hypertension. These sampling methods of the selection of surveys mainly used multistage population registry; this cross-national study of 63,014 adults aged ≥50 years was from in four high-income countries, four upper-middle-income countries (UMICs), and three low-middle-income countries (LMICs). Overall, the age-standardized prevalence of hypertension among the adult population aged ≥50 years was 53.2% (51.9% of men and 54.3% of women). The high-income countries and UMICs had more or less twice the prevalence of hypertension compare with LMICs. The rates of awareness, treatment, and control of hypertension were 55.6%, 44.1%, and 17.1%, respectively, and awareness and control of hypertension were lowest in UMICs and treatment of hypertension was lowest in LMICs. Among this multiple national study population, hypertension was very common among elderly population. Even more worrisome is that the rates of awareness, treatment, and control of hypertension were relatively low in UMICs and IMICs. These results indicate that improving the ability to control and prevention of hypertension in resource-limited settings is needed. PMID:26778770

  13. Assessing the Health of Individuals and Populations in Surveys of the Elderly: Some Concepts and Approaches.

    ERIC Educational Resources Information Center

    Wallace, Robert B.

    1994-01-01

    Health survey research assesses health of individuals in population. Measures include prevalence/incidence of diseases, signs/symptoms, functional states, and health services utilization. Although assessing individual biologic robustness can be problematic, testable approaches do exist. Characteristics of health of populations/communities, not…

  14. Conservation among Elderly Women.

    ERIC Educational Resources Information Center

    Hughston, George A.; Protinsky, Howard O.

    1979-01-01

    The majority of 63 elderly women were able to pass tests in the conservation of mass (98 percent), volume (100 percent), and surface area (65 percent). These results conflict with previous research about Piagetian abilities of elderly people. (RL)

  15. The BELFRAIL (BFC80+) study: a population-based prospective cohort study of the very elderly in Belgium

    PubMed Central

    2010-01-01

    Background In coming decades the proportion of very elderly people living in the Western world will dramatically increase. This forthcoming "grey epidemic" will lead to an explosion of chronic diseases. In order to anticipate booming health care expenditures and to assure that social security is funded in the future, research focusing on the relationship between chronic diseases, frailty and disability is needed. The general aim of the BELFRAIL cohort study (BFC80+) is to study the dynamic interaction between health, frailty and disability in a multi-system approach focusing on cardiac dysfunction and chronic heart failure, lung function, sarcopenia, renal insufficiency and immunosenescence. Methods/Design The BFC80+ is a prospective, observational, population-based cohort study of subjects aged 80 years and older in three well-circumscribed areas of Belgium. In total, 29 general practitioner (GP) centres were asked to include patients aged 80 and older. Only three exclusion criteria were used: severe dementia, in palliative care and medical emergency. Two sampling methods for the recruitment of patients were used. Between November 2, 2008 and September 15, 2009, 567 subjects were included in the BFC80+ study. Every study participant was invited to undergo four study visits. The GP recorded background variables and medical history and performed a detailed anamnesis and clinical examination. The clinical research assistant performed an extensive examination including performance testing, questionnaires and technical examinations. Echocardiography was performed at home by a cardiologist. A blood sample was collected in the morning. Follow-up reporting of hard outcome measures including mortality, hospitalization and morbidity was organized. A second data collection is planned after 18 months. Discussion The BFC80+ was designed to acquire a better understanding of the epidemiology and pathophysiology of chronic diseases in the very elderly and to study the dynamic

  16. Recombinant human erythropoietin in very elderly patients with myelodysplastic syndromes: results from a retrospective study.

    PubMed

    Tatarelli, Caterina; Piccioni, Anna Lina; Maurillo, Luca; Naso, Virginia; Battistini, Roberta; D'Andrea, Mariella; Criscuolo, Marianna; Nobile, Carolina; Villivà, Nicoletta; Mancini, Stefano; Neri, Benedetta; Breccia, Massimo; Fenu, Susanna; Buccisano, Francesco; Voso, Maria Teresa; Latagliata, Roberto; Aloe Spiriti, Maria Antonietta

    2014-08-01

    Myelodysplastic syndromes (MDS) are common in elderly patients. Recombinant human erythro-poietin (rHuEPO) has been widely used to treat anemia in lower risk MDS patients, but few data are known about rHuEPO treatment in the very elderly patient group. In order to investigate the role of rHuEPO treatment in terms of response, overall survival (OS), and toxicity in a very elderly MDS patient group, 93 MDS patients treated with rHuEPO when aged ≥80 years were selected among MDS cases enrolled in a retrospective multicenter study by the cooperative group Gruppo Romano Mielodisplasie (GROM) from Jan 2002 to Dec 2010. At baseline, median age was 82.7 (range 80-99.1) with a median hemoglobin (Hb) level of 9 g/dl (range 6-10.8). The initial dose of rHuEPO was standard (epoetin alpha 40,000 IU/week or epoetin beta 30,000 IU/week) in 59 (63.4 %) patients or high in 34 (36.6 %) (epoetin alpha 80,000 IU/week) patients. We observed an erythroid response (ER) in 59 (63.4 %) patients. No thrombotic event was reported. Independent predictive factors for ER were low transfusion requirement before treatment (p = 0.004), ferritin <200 ng/ml (p = 0.017), Hb >8 g/dl (p = 0.034), and a high-dose rHuEPO treatment (p = 0.032). Median OS from rHuEPO start was 49.3 months (95 % CI 27.5-68.4) in responders versus 30.6 months (95 % CI 7.3-53.8) in resistant patients (p = 0.185). In conclusion, rHuEPO treatment is safe and effective also in the very elderly MDS patients. However, further larger studies are warranted to evaluate if EPO treatment could be worthwhile in terms of quality of life and cost-efficacy in very old patients. PMID:24647684

  17. Randomised controlled trial of the effect of long-term selenium supplementation on plasma cholesterol in an elderly Danish population.

    PubMed

    Cold, Frederik; Winther, Kristian H; Pastor-Barriuso, Roberto; Rayman, Margaret P; Guallar, Eliseo; Nybo, Mads; Griffin, Bruce A; Stranges, Saverio; Cold, Søren

    2015-12-14

    Although cross-sectional studies have shown a positive association between Se and cholesterol concentrations, a recent randomised controlled trial in 501 elderly UK individuals of relatively low-Se status found that Se supplementation for 6 months lowered total plasma cholesterol. The Danish PRECISE (PREvention of Cancer by Intervention with Selenium) pilot study (ClinicalTrials.gov ID: NCT01819649) was a 5-year randomised, double-blinded, placebo-controlled trial with four groups (allocation ratio 1:1:1:1). Men and women aged 60-74 years (n 491) were randomised to 100 (n 124), 200 (n 122) or 300 (n 119) μg Se-enriched yeast or matching placebo-yeast tablets (n 126) daily for 5 years. A total of 468 participants continued the study for 6 months and 361 participants, equally distributed across treatment groups, continued for 5 years. Plasma samples were analysed for total and HDL-cholesterol and for total Se concentrations at baseline, 6 months and 5 years. The effect of different doses of Se supplementation on plasma lipid and Se concentrations was estimated by using linear mixed models. Plasma Se concentration increased significantly and dose-dependently in the intervention groups after 6 months and 5 years. Total cholesterol decreased significantly both in the intervention groups and in the placebo group after 6 months and 5 years, with small and nonsignificant differences in changes in plasma concentration of total cholesterol, HDL-cholesterol, non-HDL-cholesterol and total:HDL-cholesterol ratio between intervention and placebo groups. The effect of long-term supplementation with Se on plasma cholesterol concentrations or its sub-fractions did not differ significantly from placebo in this elderly population. PMID:26420334

  18. Dietary intake and food contributors of polyphenols in adults and elderly adults of Sao Paulo: a population-based study.

    PubMed

    Miranda, A M; Steluti, J; Fisberg, R M; Marchioni, D M

    2016-03-28

    A comprehensive estimation of polyphenol intake is needed to gain a better understanding of the association between polyphenol-rich food intake and the potential effects of this intake on chronic diseases. The aim of this study was to estimate the intake of polyphenols and the major dietary contributors in the population of Sao Paulo. Data were obtained from the Health Survey-São Paulo (ISA-Capital 2008) and were reported for 1103 adults and elderly adults. Food intake was estimated by one 24-h dietary recall (24HR). Polyphenol intake was calculated by matching food consumption data from the 24HR with the polyphenol content in foods listed in the Phenol-Explorer database. The mean total intake of polyphenols was 377·5 (se 15·3) mg/d. The main polyphenol classes were phenolic acids (284·8 (se 15·9) mg/d) and flavonoids (54·6 (se 3·5) mg/d). Intakes were higher in the elderly adults than in other adults (P<0·001) and higher in individuals with lower educational level (P=0·01) and current smokers (P=0·02). The main dietary contributors for total polyphenols were coffee (70·5 %), citrus fruits (4·6 %) and tropical fruits (3·4 %). Coffee was the major source of polyphenols, providing 266·2 (se 16·5) mg/d, and contributed 92·3 % of the phenolic acids and 93·1 % of the alkylmethoxyphenols. These findings will be useful for assessing the potential role on health of polyphenols and specific polyphenol-rich foods, such as coffee, and enable a comparison with people from other countries. PMID:26810764

  19. Longitudinal course of mild parkinsonian signs in elderly people: A population-based study in Japan.

    PubMed

    Wada-Isoe, Kenji; Tanaka, Kenichiro; Uemura, Yusuke; Nakashita, Satoko; Tajiri, Yuki; Tagashira, Shugo; Yamamoto, Mikie; Yamawaki, Mika; Kishi, Masafumi; Nakashima, Kenji

    2016-03-15

    We aimed to clarify the longitudinal course of mild parkinsonian signs (MPS) and their association with dementia and functional disability by conducting a comprehensive epidemiological study, including brain MRI, and assessments of cognition, depression, and sleep, in people aged ≥65years living in Ama-cho. We diagnosed MPS and parkinsonism (PS) using a modified Unified Parkinson's Disease Rating Scale. The phase I study was conducted between 2008 and 2010 (n=729) and the phase II between 2011 and 2013 (n=436). By phase II, 8.5% of the phase I participants without PS had developed PS. In addition to older age, a lower Mini-Mental State Examination (MMSE) score, and lower body mass index, the MPS rigidity subtype was a significant independent predictor of PS onset. By phase II, 10.1% of the participants without dementia or PS at phase I had developed dementia. Older age, lower MMSE score, and the axial dysfunction and tremor MPS subtypes were significant independent predictors of dementia development. By phase II, 38.8% of participants with MPS at phase I showed no motor symptoms. Younger age and adequate sleep were significant predictors for this reversion. Periventricular and deep white matter hyperintensity Fazekas scores increased with the evolution of parkinsonian signs. MPS is therefore critically, although sometimes reversibly, associated with PS and dementia development in elderly people. PMID:26944110

  20. Traditional versus modern values and interpersonal factors predicting stress response syndromes in a Swiss elderly population.

    PubMed

    Müller, Mario; Forstmeier, Simon; Wagner, Birgit; Maercker, Andreas

    2011-12-01

    Stress response syndromes like adjustment disorders or complicated grief are assumed to be shaped by social-cultural factors in addition to biological and psychological factors. In previous research, value orientations and interpersonal factors were found to jointly predict those syndromes (Maercker, A., Mohiyeddini, C., Müller, M., Xie, W., Hui Yang, Z., Wang, J., & Müller, J. ( 2009 ). Traditional versus modern values, self-perceived interpersonal factors, and posttraumatic stress in Chinese and German crime victims. Psychology and Psychotherapy, 82(Pt 2), 219-232.). In addition to the previous finding, the current study using Swiss elderly (65-97 years) aimed to replicate patterns of predictors leading to stress responses in people with recent bereavement or severe life events. Traditional (conformity, tradition and benevolence) and modern values (stimulation, hedonism and achievement) and two self-perceived interpersonal mediator processes (disclosure intentions and social acknowledgement as a victim) were assessed. The current study confirms the previous model in parts, that is, the indirect path from social acknowledgment to stress response syndrome is mediated by disclosure intentions. Traditional values and not modern values explained substantial variance for disclosure intentions and are therefore indirectly linked to worse mental health outcomes whereas the direct association appears somewhat controversial in light of previous findings. PMID:21678201

  1. Quantitative approaches for assessment of white matter hyperintensities in elderly populations

    PubMed Central

    Brickman, Adam M.; Sneed, Joel R.; Provenzano, Frank A.; Garcon, Ernst; Johnert, Lauren; Muraskin, Jordan; Yeung, Lok-Kin; Zimmerman, Molly E.; Roose, Steven P.

    2011-01-01

    White matter hyperintensities (WMH) are areas of increased signal on T2-weighted magnetic resonance imaging (MRI), including fluid attenuated inverse recovery sequences. Total and regional WMH burden (i.e., volume or severity) has been associated with myriad cognitive, neurological, and psychiatric conditions among older adults. In the current report, we illustrate two approaches to quantify periventricular, deep, and total WMH and examine their reliability and criterion validity among 28 elderly patients enrolled in a depression treatment trial. The first approach, an operator-driven quantitative approach, involves visual inspection of individual MRI scans and manual labeling using a three-step series of procedures. The second approach, a fully automated quantitative approach, uses a processing stream that involves image segmentation, voxel intensity thresholding, and seed growing to label WMH and calculate their volume automatically. There was good agreement in WMH quantification between the two approaches (Cronbach’s alpha values from 0.835 to 0.968). Further, severity of WMH was significantly associated with worse depression and increased age, and these associations did not differ significantly between the two quantification approaches. We provide evidence for good reliability and criterion validity for two approaches for WMH volume determination. The operator-driven approach may be better suited for smaller studies with highly trained raters, whereas the fully automated quantitative approach may be more appropriate for larger, high-throughput studies. PMID:21680159

  2. Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans

    PubMed Central

    Rosero-Bixby, Luis; Coto-Yglesias, Fernando; Dow, William H

    2015-01-01

    We studied the relationships between blood pressure (BP), pulse pressure (PP), and cardiovascular (CV) death in older adults using data from 2346 participants enrolled in the Costa Rican CRELES study, mean age 76 years (SD 10.2), 31% qualified as wide PP. All covariates included and analyzed were collected prospectively as part of a 4 year home-based follow-up; mortality was tracked for an additional three years, identifying 266 CV deaths. Longitudinal data revealed little change over time in systolic BP, a decline in diastolic BP, and widening of PP. Wide PP was associated with higher risk of CV death but only among individuals receiving antihypertensive drug therapy. Individuals with both wide PP and receiving therapy had 2.6 hazard rate (HR) of CV death relative to people with normal PP plus not taking treatment, even adjusting for systolic BP. Increasing PP between visits was significantly associated to higher CV death independently of treatment status. Systolic and diastolic BP were not significantly associated to CV death when the effect of PP was controlled for. Conclusion: elderly hypertensive patients with wide or increasing PP, especially if receiving treatment, are the highest CV risk group, thus must be carefully assessed, monitored, and treated with caution. PMID:26674758

  3. Cognitive Deficits in Healthy Elderly Population With "Normal" Scores on the Mini-Mental State Examination.

    PubMed

    Votruba, Kristen L; Persad, Carol; Giordani, Bruno

    2016-05-01

    This study investigated whether healthy older adults with Mini-Mental State Examination (MMSE) scores above 23 exhibit cognitive impairment on neuropsychological tests. Participants completed the MMSE and a neuropsychological battery including tests of 10 domains. Results were compared to published normative data. On neuropsychological testing, participants performed well on measures of naming and recall but showed mild to moderate impairment in working memory and processing speed and marked impairment in inhibition, sustained attention, and executive functioning. Almost everyone (91%) scored at least 1 standard deviation (SD) below the mean in at least 1 domain. The median number of domains in which individuals scored below 1 SD was 3.0 of 10.0, whereas over 21% scored below 1 SD in 5 domains or more. With the strictest of definitions for impairment, 20% of this population scored below 2.0 SDs below the norm in at least 2 domains, a necessary condition for a diagnosis of dementia. The finding that cognitive impairment, particularly in attention and executive functioning, is found in healthy older persons who perform well on the MMSE has clinical and research implications in terms of emphasizing normal variability in performance and early identification of possible impairment. PMID:26850856

  4. THE NUTRITION, AGING, AND MEMORY IN ELDERS (NAME) STUDY: DESIGN AND METHODS FOR A STUDY OF MICRONUTRIENTS AND COGNITIVE FUNCTION IN A HOMEBOUND ELDERLY POPULATION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background Micronutrient status can affect cognitive function in the elderly; however, there is much to learn about the precise effects. Understanding mediating factors by which micronutrient status affects cognitive function would contribute to elders’ quality of life and their ability to remain in...

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

    PubMed

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

    2015-09-01

    Acculturation is a difficult process for minority older adults for a variety of reasons, including access and exposure to mainstream culture, competing ethnic identities, and linguistic ability and preference. There is a paucity of research regarding overall level of acculturation for Chinese older adults in the United States. This study aimed to provide an overall estimate of level of acculturation of Chinese older adults in the United States and to examine correlations between sociodemographic characteristics, self-reported health measures, and level of acculturation. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed 3,159 Chinese older adults aged 60 and older. The PINE Study Acculturation Scale was used to assess level of acculturation in three dimensions: language preference, media use, and ethnic social relations. Mean acculturation level for all items was 15.3 ± 5.1, indicating low levels of acculturation. Older age, more offspring, lower income, fewer years living in the United States, lower overall health status, and lower quality of life were associated with lower levels of acculturation. Level of acculturation was low in Chinese older adults, and certain subsets of the population were more likely to have a lower level of acculturation. Future research should investigate causality and effects of level of acculturation. PMID:26313023

  6. Physical activity among elderly people in a city population: the influence of neighbourhood level violence and self perceived safety

    PubMed Central

    Piro, Fredrik Niclas; Nœss, Øyvind; Claussen, Bjørgulf

    2006-01-01

    Study objective To study the associations between neighbourhood level violence/fear of violence and physical activity among elderly people, accounting for somatic health. Design Self reported data from the Oslo health study, a cross sectional study conducted in 2000, were linked with sociodemographic and social security data from Statistics Norway. A multilevel regression analysis was conducted by MlwiN using contextual level variables provided by the Oslo City Council. Setting Oslo, Norway. Participants 3499 inhabitants aged 74/5 (53.2% of all invitees). Main results 20.5% of the elderly were physically active less than one hour a week. Somatic health was clearly associated with physical activity among both men and women. Neighbourhood level violence was associated with physical activity only for men, while fear of violence was only associated with physical activity for women. Differences in somatic health did not explain differences in physical activity between neighbourhoods. These differences were explained by socioeconomic variables, and neighbourhood level violence/fear of violence. Conclusions In a sample of presumably healthy 75/76 year olds in Oslo, the associations between neighbourhood level violence and physical activity (among men), and fear of violence and physical activity (among women), are of the same sizes as those between somatic health and physical activity. These two dimensions of violence have, in contrast with somatic health, an explanatory function in exploring differences in physical activity between neighbourhoods in Oslo. PMID:16790836

  7. The duration of stage transition during pharyngeal swallowing among young-elderly, and mid-elderly individuals

    PubMed Central

    Byeon, Haewon; Koh, Hyeung Woo

    2016-01-01

    [Purpose] Understanding the normal movements of the pharyngeal stage is important in the assessment of dysphagia. This study classified an elderly population into young-elderly and mid-elderly individuals and investigated the difference in stage transition duration between the two groups to provide basic material for assessment of dysphagia in old age. [Subjects and Methods] The subjects of the study were 12 middle-aged individuals (40–49 years), young-elderly individuals (65–74 years), and 9 mid-elderly individuals (75–84 years). Stage transition duration was defined as the time from the moment food boluses passed the ramus of the mandible until the start of upward movement of the hyoid. All image data were measured using a videofluoroscopic study. Difference in measured values for stage transition duration between the groups were confirmed with one-way analysis of variance. [Results] Although analysis of variance was significantly longer in the young-elderly and mid-elderly individuals than in the middle-aged individuals, there was no significant difference in stage transition duration between the young-elderly and mid-elderly individuals. [Conclusion] In this study, there was no significant difference between the young-elderly and mid-elderly individuals in the movement speed of muscles related to pharyngeal swallowing. PMID:27313360

  8. The duration of stage transition during pharyngeal swallowing among young-elderly, and mid-elderly individuals.

    PubMed

    Byeon, Haewon; Koh, Hyeung Woo

    2016-05-01

    [Purpose] Understanding the normal movements of the pharyngeal stage is important in the assessment of dysphagia. This study classified an elderly population into young-elderly and mid-elderly individuals and investigated the difference in stage transition duration between the two groups to provide basic material for assessment of dysphagia in old age. [Subjects and Methods] The subjects of the study were 12 middle-aged individuals (40-49 years), young-elderly individuals (65-74 years), and 9 mid-elderly individuals (75-84 years). Stage transition duration was defined as the time from the moment food boluses passed the ramus of the mandible until the start of upward movement of the hyoid. All image data were measured using a videofluoroscopic study. Difference in measured values for stage transition duration between the groups were confirmed with one-way analysis of variance. [Results] Although analysis of variance was significantly longer in the young-elderly and mid-elderly individuals than in the middle-aged individuals, there was no significant difference in stage transition duration between the young-elderly and mid-elderly individuals. [Conclusion] In this study, there was no significant difference between the young-elderly and mid-elderly individuals in the movement speed of muscles related to pharyngeal swallowing. PMID:27313360

  9. Prediction of Elderly Anthropometric Dimension Based On Age, Gender, Origin, and Body Mass Index

    NASA Astrophysics Data System (ADS)

    Indah, P.; Sari, A. D.; Suryoputro, M. R.; Purnomo, H.

    2016-01-01

    Introduction: Studies have indicated that elderly anthropometric dimensions will different for each person. To determine whether there are differences in the anthropometric data of Javanese elderly, this study will analyze whether the variables of age, gender, origin, and body mass index (BMI) have been associated with elderly anthropometric dimensions. Age will be divided into elderly and old categories, gender will divide into male and female, origins were divided into Yogyakarta and Central Java, and for BMI only use the normal category. Method: Anthropometric studies were carried out on 45 elderly subjects in Sleman,Yogyakarta. Results and Discussion: The results showed that some elderly anthropometric dimensions were influenced by age, origin, and body mass index but gender doesn't significantly affect the elderly anthropometric dimensions that exist in the area of Sleman. The analysis has provided important aid when designing products that intended to the Javanese elderly Population.

  10. Elderly Mental Health: Needs*

    PubMed Central

    Parkar, Shubhangi R.

    2015-01-01

    This paper highlights the mental health needs of the elderly. It tackles the issues of their institutionalisation and community care. Rapid urbanisation in Indian society throws up special problems in elderly care. There is great evidence of a raise in morbidity, mortality, hospitalisation and loss of functional status related to common mental disorders in the elderly patients. Overlap of depression and anxiety is very common with up to almost half of the elderly patients reporting significant depressive and anxiety symptoms. Also, depression is the most common psychiatric disorder in late life. Growth in the elderly population means a direct increase in age related diseases such as dementia and poor mental health outcomes such as depression, anxiety, suicide and serious constraints on the quality of life among elderly individuals. The need to identify new and unmet problem areas and develop efficient therapeutic outcomes for this special population is stressed. PMID:25838727

  11. Comprehensive Comparison between Empty Nest and Non-Empty Nest Elderly: A Cross-Sectional Study among Rural Populations in Northeast China.

    PubMed

    Chang, Ye; Guo, Xiaofan; Guo, Liang; Li, Zhao; Yang, Hongmei; Yu, Shasha; Sun, Guozhe; Sun, Yingxian

    2016-01-01

    This study aimed to comprehensively compare the general characteristics, lifestyles, serum parameters, ultrasonic cardiogram (UCG) parameters, depression, quality of life, and various comorbidities between empty nest and non-empty nest elderly among rural populations in northeast China. This analysis was based on our previous study which was conducted from January 2012 to August 2013, using a multistage, stratified, random cluster sampling scheme. The final analyzed sample consisted of 3208 participants aged no less than 60 years, which was further classified into three groups: non-empty nest group, empty nest group (living as a couple), and empty nest group (living alone). More than half of the participants were empty nest elderly (60.5%). There were no significant statistical differences for serum parameters, UCG parameters, lifestyles, dietary pattern, and scores of Patient Health Questionnaire-9 (PHQ-9) and World Health Organization Quality of Life questionnaire, abbreviated version (WHOQOL-BREF) among the three groups. Empty nest elderly showed no more risk for comorbidities such as general obesity, abdominal obesity, hyperuricemia, hyperhomocysteinemia, diabetes, dyslipidemia, left atrial enlargement (LAE), and stroke. Our study indicated that empty nest elderly showed no more risk for depression, low quality of life and comorbidities such as general obesity, abdominal obesity, hyperuricemia, hyperhomocysteinemia, diabetes, dyslipidemia, LAE, and stroke among rural populations in northeast China. PMID:27618905

  12. Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study

    PubMed Central

    Tiwari, S. C.; Tripathi, Rakesh Kumar; Kumar, Aditya; Kar, A. M.; Singh, Ragini; Kohli, V. K.; Agarwal, G. G.

    2014-01-01

    Background: Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health. Aim: The present study aims to investigate the distribution of physical, neuropsychiatric, and cognitive disorders of a community sample of elderlies with certain socioeconomic data. Materials and Methods: A door-to-door household survey was conducted to identify houses with elderlies (≥55 years) in two urban localities of Lucknow. Mini mental state examination (MMSE), Survey Psychiatric Assessment Schedule (SPAS)/Mood Disorder Questionnaire (MDQ) and physical and neurological examination were used for screening all consenting elderlies. MMSE positive participants were assessed on Cambridge Mental Disorders of the Elderly Examination-Revised for diagnosis of cognitive disorders; SPAS/MDQ positives were assessed on Schedule for Clinical Assessment in Neuropsychiatry based clinical interview for diagnosis of neuropsychiatric disorders other than cognitive disorders (using ICD-10 criteria). Routine and indicated laboratory/radiological investigations on all and on MMSE/SPAS (organic section) positive/physically ill participants respectively were done to confirm organic and/or physical illness. Only percentages were calculated to find the distribution of morbidity. Results: The sample had proportionate age structure as that of the surveyed population and had balanced gender representation in each age deciles. Prevalence of neuropsychiatric disorders (with/without comorbidities) was 11.8% in the elderlies (60 years and above) highest being in the 60-69 years age group. Being women and of lower socioeconomic status was more commonly associated with a neuropsychiatric diagnosis. 7.6% of the elderlies had cognitive impairment. Overall findings suggest a prevalence rate of 17.34% of total psychiatric morbidity among elderlies. A significant number had comorbid physical illness diagnoses

  13. Constipation in the Elderly

    PubMed Central

    Stitt, Van J.

    1983-01-01

    Constipation is a common problem that affects not only the young, but the elderly as well. Treatment in the elderly, however, may cause more problems than the constipation itself. A review of the prevalence of constipation in the elderly and its etiology and suggestions for treatment are presented. Some of the complications that may result from constipation or its treatment are described. PMID:6631998

  14. Breast-Conserving Treatment in the Elderly: Long-Term Results of Adjuvant Hypofractionated and Normofractionated Radiotherapy

    SciTech Connect

    Kirova, Youlia M. Campana, Francois; Savignoni, Alexia; Laki, Fatima; Muresan, Marius; Dendale, Remi; Bollet, Marc A.; Salmon, Remy J.; Fourquet, Alain

    2009-09-01

    Purpose: To evaluate the long-term cause-specific survival (CSS), locoregional recurrence-free survival (LRFS), and metastases-free survival (MFS) in elderly breast cancer patients receiving adjuvant normofractionated (NF) or hypofractionated (HF) radiotherapy (RT). Methods and Materials: Between 1995 and 1999, 367 women aged {>=}70 years with nonmetastatic Stage T1 or T2 tumors were treated by breast-conserving surgery and adjuvant RT at the Institut Curie. They underwent wide tumor excision with or without lymph node dissection followed by RT. They received either a NF-RT schedule, which delivered a total dose of 50 Gy (25 fractions, 5 fractions weekly) to the whole breast, followed by a boost to the tumor bed when indicated, or a HF-RT schedule, which delivered a total dose of 32.5 Gy (five fractions of 6.5 Gy, once weekly) with no subsequent boost. The HF-RT schedule was indicated for the more elderly patients. Results: A total of 317 patients were in the NF-RT group, with 50 in the HF-RT group. The median follow-up was 93 months (range, 9-140). The 5- and 7-year CSS, LRFS, and MFS rates were similar in both groups. The 5-year NF-RT and HF-RT rate was 96% and 95% for CSS, 95% and 94% for LRFS, and 94% and 95% for MFS, respectively. The 7-year NF-RT and HF-RT rate was 93% and 87% for CSS, 93% and 91% for LRFS, and 92% and 93% for MFS, respectively. Conclusion: According to the findings from this retrospective study, the HF-RT schedule is an acceptable alternative to NF-RT for elderly patients. However, large-scale prospective randomized trials are needed to confirm these results.

  15. The Utility of Ambulatory Electrocardiographic Monitoring for Detecting Silent Arrhythmias and Clarifying Symptom Mechanism in an Urban Elderly Population with Heart Failure and Hypertension: Clinical Implications.

    PubMed

    Hickey, Kathleen T; Reiffel, James; Sciacca, Robert R; Whang, William; Biviano, Angelo; Baumeister, Maurita; Castillo, Carmen; Talathothi, Jyothi; Garan, Hasan

    2010-01-01

    BACKGROUND: Atrial and ventriclar tachyarrhythmias, as well as bradyarrhythmias, in the elderly with heart failure (HF) and/or hypertension (HTN) have been well documented. However, the frequency of these arrhythmias, whether silent or symptomatic, and their association with subsequent cardiac events has not been well defined in patients 65 years or older with HF and other cardiovascular risk factors. OBJECTIVE: To assess the value of 2 weeks of remote, transtelephonic cardiac monitoring for detecting arrhythmias in an elderly, urban population living with HF. METHODS: Fifty-four patients with a history of systolic HF and/or HTN were consented and enrolled. All wore an auto triggered cardiac loop monitor for 2 weeks that captures EKG data and both silent and symptomatic arrhythmias were recorded. RESULTS: Mean age was 73 ± 6 years with 59% of subjects were females, 74% Hispanic, 22% black, and 4% white/other. All patients had HF and 94% had HTN. From the cardiac monitoring, 72% demonstrated ectopic atrial and ventricular activity, and 1 paroxysmal episode of atrial fibrillation was documented. In addition, 3 subjects had significant non-sustained ventricular tachycardia, and 4 individuals had severe bradycardia recorded on cardiac monitoring. These 7 individuals underwent placement of an implantable cardioverter defibrillator (ICD) or pacemaker based on the documented arrhythmias which may have otherwise gone undetected. CONCLUSION: A substantial proportion of patients exhibited cardiac arrhythmias. Future morbidity was prevented because of the detection of arrhythmias on monitoring that led to specific therapies such as pacemaker or ICD implantation which otherwise may not have been implemented. PMID:20798788

  16. The Utility of Ambulatory Electrocardiographic Monitoring for Detecting Silent Arrhythmias and Clarifying Symptom Mechanism in an Urban Elderly Population with Heart Failure and Hypertension: Clinical Implications

    PubMed Central

    Hickey, Kathleen T.; Reiffel, James; Sciacca, Robert R.; Whang, William; Biviano, Angelo; Baumeister, Maurita; Castillo, Carmen; Talathothi, Jyothi; Garan, Hasan

    2010-01-01

    Background Atrial and ventriclar tachyarrhythmias, as well as bradyarrhythmias, in the elderly with heart failure (HF) and/or hypertension (HTN) have been well documented. However, the frequency of these arrhythmias, whether silent or symptomatic, and their association with subsequent cardiac events has not been well defined in patients 65 years or older with HF and other cardiovascular risk factors. Objective To assess the value of 2 weeks of remote, transtelephonic cardiac monitoring for detecting arrhythmias in an elderly, urban population living with HF. Methods Fifty-four patients with a history of systolic HF and/or HTN were consented and enrolled. All wore an auto triggered cardiac loop monitor for 2 weeks that captures EKG data and both silent and symptomatic arrhythmias were recorded. Results Mean age was 73 ± 6 years with 59% of subjects were females, 74% Hispanic, 22% black, and 4% white/other. All patients had HF and 94% had HTN. From the cardiac monitoring, 72% demonstrated ectopic atrial and ventricular activity, and 1 paroxysmal episode of atrial fibrillation was documented. In addition, 3 subjects had significant non-sustained ventricular tachycardia, and 4 individuals had severe bradycardia recorded on cardiac monitoring. These 7 individuals underwent placement of an implantable cardioverter defibrillator (ICD) or pacemaker based on the documented arrhythmias which may have otherwise gone undetected. Conclusion A substantial proportion of patients exhibited cardiac arrhythmias. Future morbidity was prevented because of the detection of arrhythmias on monitoring that led to specific therapies such as pacemaker or ICD implantation which otherwise may not have been implemented. PMID:20798788

  17. Structured Group Interaction: An Intervention Strategy for the Continued Development of Elderly Populations

    ERIC Educational Resources Information Center

    Lago, Daniel; Hoffman, Stephanie

    1978-01-01

    Structured group interaction, through an emphasis on pre-group structuring, didactic presentations, experiential learning, and evaluation, provides a flexible approach to achieving a variety of goals while compensating for many problem characteristics of an aged institutionalized population. Limitations and hazards involved in the approach are…

  18. Non-ICU hospital care of diabetes mellitus in the elderly population.

    PubMed

    Gilden, Janice L; Gupta, Aditi

    2015-05-01

    The concept of lower is better when considering the goal for glycemic control in patients with diabetes mellitus has recently been challenged due to recent studies, such as ACCORD, ADVANCE, and VADT, which have observed increased morbidity and mortality from intensive control, especially in older adults, and in those with long duration of diabetes disease and chronic complications. Although evidence in younger patients suggest that blood glucose levels should not be above 180 mg/dl (10.0 mmol/l), there are many unanswered questions and controversies regarding the benefits and risks, methods to achieve and maintain these levels while avoiding hypoglycemia (<70 mg% (3.9 mmol/l)) in the older population. Since the population is aging with a greater life expectancy, it is crucial that these questions be answered. Although several studies of inpatient non-ICU diabetes management have been published, few include older patients. This review will examine available recommendations and explore those controversies regarding non-ICU hospital management in this vulnerable patient population. Additional conditions that impact upon achieving glycemic control will also be discussed. Finally, the older individual has many special needs which may be more important to consider than in young or middle-aged individuals, when transitioning care from in-hospital to home in a patient-centered approach, as recommended by the American Diabetes Association (ADA) and European Society for the Study of Diabetes (EASD). PMID:25772641

  19. Sex differences in the serum level of endogenous ligands for estrogen receptor β in the elderly population

    PubMed Central

    Kobayashi, Miyuki; Sugiyama, Nobuhiro; Sasayama, Daimei; Sasamoto, Hidehiko; Miyashiro, Yoshimichi; Arima, Kunimasa; Washizuka, Shinsuke

    2016-01-01

    Animal studies suggest that estrogen receptor β (ERβ)-agonists, but not ERα-agonists, are antidepressants. Several endogenous ligands for ERβ have been proposed, including 5α-androstane-3β, 17β-diol (3βAdiol), Androstenediol (Δ5-diol), and 7α-hydroxydehydroepiandrosterone (7α-OH-DHEA). The aim of this study was to determine the serum and salivary levels of natural ERβ ligands in men and women with and without past depressive episodes in the elderly population. DHEA (a precursor of 3βAdiol, Δ5-diol, and 7α-OH-DHEA), 17β-estradiol (E2), and cortisol (F) were also measured. Samples were collected from 51 subjects and liquid chromatography tandem mass spectrometry was used for measurement. Comparisons were made between groups based on sex and depression history. E2, 3βAdiol, and Δ5-diol levels were significantly lower in women than in men regardless of depression history. There were no significant differences between men and women in DHEA or 7α-OH-DHEA levels. DHEA was significantly lower in women with depression than in women without depression. Reduced DHEA levels may be related to depression vulnerability in women. Further studies are needed to determine the mechanism underlying sex differences in the prevalence of depression and increased risk of depression during menopause. Not only E2 but also two other estrogenic steroids (3βAdiol and Δ5-diol) should be involved in these studies. PMID:27165125

  20. Sex differences in the serum level of endogenous ligands for estrogen receptor β in the elderly population.

    PubMed

    Kobayashi, Miyuki; Sugiyama, Nobuhiro; Sasayama, Daimei; Sasamoto, Hidehiko; Miyashiro, Yoshimichi; Arima, Kunimasa; Washizuka, Shinsuke

    2016-01-01

    Animal studies suggest that estrogen receptor β (ERβ)-agonists, but not ERα-agonists, are antidepressants. Several endogenous ligands for ERβ have been proposed, including 5α-androstane-3β, 17β-diol (3βAdiol), Androstenediol (Δ5-diol), and 7α-hydroxydehydroepiandrosterone (7α-OH-DHEA). The aim of this study was to determine the serum and salivary levels of natural ERβ ligands in men and women with and without past depressive episodes in the elderly population. DHEA (a precursor of 3βAdiol, Δ5-diol, and 7α-OH-DHEA), 17β-estradiol (E2), and cortisol (F) were also measured. Samples were collected from 51 subjects and liquid chromatography tandem mass spectrometry was used for measurement. Comparisons were made between groups based on sex and depression history. E2, 3βAdiol, and Δ5-diol levels were significantly lower in women than in men regardless of depression history. There were no significant differences between men and women in DHEA or 7α-OH-DHEA levels. DHEA was significantly lower in women with depression than in women without depression. Reduced DHEA levels may be related to depression vulnerability in women. Further studies are needed to determine the mechanism underlying sex differences in the prevalence of depression and increased risk of depression during menopause. Not only E2 but also two other estrogenic steroids (3βAdiol and Δ5-diol) should be involved in these studies. PMID:27165125

  1. Medical treatments of elderly, French patients with type 2 diabetes: results at inclusion in the GERODIAB Cohort.

    PubMed

    Doucet, Jean A; Bauduceau, Bernard; Le Floch, Jean-Pierre; Verny, Christiane

    2016-02-01

    Prevalence of diabetes in the elderly increases, and half of the French diabetics are over the age of 75 years. The GERODIAB study is the first French multicentre, prospective, observational study designed to analyse over 5 years the influence of glycaemic control on morbidity-mortality in type 2 diabetics patients 70 years old and over. This study analysed the diabetic and geriatric factors associated with the treatment modalities, particularly insulin, at inclusion in the cohort. The cohort of 987 type 2 diabetics was divided into three groups according to the method of treatment. Slightly fewer than one-third of these patients (26.4%) were treated with insulin alone, 31% received insulin and oral antidiabetic drugs, and 42.7% oral antidiabetic drugs alone. The patients that received insulin alone were significantly older, had poorer glycaemic control (HbA1c = 7.9 ± 1.4, 7.8 ± 1.0 and 7.1 ± 1.2%, respectively; P < 0.001) and had greater alterations of glomerular filtration rate (GFR). HbA1c was below 6.5% in 15% of patients and 37.3% of patients had a GFR below 60 mL/min. The patients treated with insulin alone had significantly more hypoglycaemic episodes (respectively 53.3, 36.3 and 19.5%, P < 0.001), retinopathy, cardiovascular involvement and more specific geriatric complications, such as cognitive disorders (respectively 34.1, 31.4 and 23.6%, P = 0.006). In this specific population of elderly type 2 diabetic patients, diabetic and geriatric conditions significantly differed between the types of drug treatments. Considering low values of HbA1c and GFR, some patients seemed overtreated and other patients received inappropriate drugs. PMID:26478566

  2. Elderly Demographic Profiles of U.S. States: Impacts of "New Elderly Births," Migration, and Immigration.

    ERIC Educational Resources Information Center

    Frey, William H.

    1995-01-01

    Examines how 1990 state elderly populations have been affected by "new elderly births" (a state's population, ages 55-59 in 1985, which survived to ages 60-64 in 1990) as well as by migration components. During the 1985-90 period, elderly births exerted a greater impact than migration on elderly gains and demographic composition for all states.…

  3. A review of demographic and infrastructural factors and potential solutions to the physician and nursing shortage predicted to impact the growing US elderly population.

    PubMed

    Cohen, Steven A

    2009-01-01

    This review highlights several of the key demographic, infrastructural, and cultural factors associated with the predicted labor force shortage in the healthcare field. Population dynamics play a significant role in exacerbating the healthcare labor force shortage. These factors work to simultaneously increase the size and proportion of the population needing the most care, namely, the elderly, and also to reduce the availability of physicians and nurses to provide adequate care for the growing elderly population. Physicians and nurses have expressed consistent dissatisfaction with healthcare infrastructure and have cited decreased job satisfaction, further exacerbating the shortage. Potential solutions to the shortage, aside from dramatic changes to the healthcare system, include increased medical and nursing training in geriatrics and gerontology to increase interest, competency, and knowledge of health issues specifically pertaining to the elderly. Other solutions include monetary incentives for geriatric training for nurses and physicians. Any specific measures to remedy this growing problem should be implemented in a timely manner to reduce this critical shortage of healthcare workers that will only continue to grow in the coming decades. PMID:19525780

  4. Results of distal revascularization in elderly patients for critical ischemia of the lower limbs.

    PubMed

    Illuminati, G; Calio, F G; Bertagni, A; Piermattei, A; Vietri, F; Martinelli, V

    1999-04-01

    Thirty eight patients over 75 years of age were operated upon of 40 distal arterial revascularizations for critical ischaemia of the lower limbs. Arterial reconstruction was proposed to ambulatory, self sufficient patients, with a patent artery of the leg or the foot in continuity with pedal arch, at arteriography. The revascularized artery was the peroneal in 14 cases, the anterior tibial in 11, the posterior tibial in 9, the dorsalis pedis in 5, and the external plantar artery in 1 case. Postoperative mortality was 2.6%. No postoperative arterial occlusion occurred and no postoperative amputation needed to be performed. The mean follow-up of 37 patients surviving operation was 21 months (ext. 2-52 months). At 36 months interval, patients' survival was 43%, primary patency rate was 57%, and limb salvage rate was 76%, at life-table analysis. Distal revascularization enables a good number of elderly patients in critical ischaemia of the lower limb, to enjoy an active, independent life, with a viable limb. PMID:10352735

  5. An increased risk of reversible dementia may occur after zolpidem derivative use in the elderly population: a population-based case-control study.

    PubMed

    Shih, Hsin-I; Lin, Che-Chen; Tu, Yi-Fang; Chang, Chia-Ming; Hsu, Hsiang-Chin; Chi, Chih-Hsien; Kao, Chia-Hung

    2015-05-01

    We evaluate the effects of zolpidem use to develop dementia or Alzheimer disease from the Taiwan National Health Insurance Research Database (NHIRD).A retrospective population-based nested case-control study. Newly diagnosed dementia patients 65 years and older and controls were sampled. A total of 8406 dementia and 16,812 control subjects were enrolled from Taiwan NHIRD during 2006 to 2010. The relationships between zolpidem use and dementia were measured using odds and adjusted odds ratios. The relationship between the average cumulative doses for zolpidem and dementia was also analyzed.Zolpidem alone or with other underlying diseases, such as hypertension, diabetes, and stroke, was significantly associated with dementia after controlling for potential confounders, such as age, sex, coronary artery disease, diabetes, anti-hypertension drugs, stroke, anticholesterol statin drugs, depression, anxiety, benzodiazepine, anti-psychotic, and anti-depressant agents' use (Adjusted OR = 1.33, 95% CI 1.24-1.41). Zolpidem use also has significant dose-response effects for most of the types of dementia. In patient with Alzheimer diseases, the effects of zolpidem among patients with Alzheimer's disease remained obscure. The adjusted OR for patients whose cumulative exposure doses were between 170 and 819 mg/year (adjusted OR: 1.65, 95% CI 1.08-2.51, P = 0.0199) was significant; however, the effects for lower and higher cumulative dose were not significant.Zolpidem used might be associated with increased risk for dementia in elderly population. Increased accumulative dose might have higher risk to develop dementia, especially in patients with underlying diseases such as hypertension, diabetes, and stroke. PMID:25929937

  6. Are healthcare expenditures increasing faster for the elderly than the rest of the population?

    PubMed

    Melberg, Hans Olav

    2014-10-01

    The debate about whether health expenditures will increase more or less for the old is conceptually confused because the participants focus on different factors, use different assumptions and, finally, do not connect the predictions to more general theories of demand for health services. Some focus on increases in life expectancy and how this will change the distribution of end-of-life costs. Others focus on how changes in income and technology will affect the relationship between age and health spending. Higher income, and a larger share of the population, will make it more profitable to invest in treatments aimed at old people, which will lead to steepening in some age groups, but a flattening in other age groups. PMID:24831863

  7. Influence of Serotonin Transporter Gene Polymorphisms and Adverse Life Events on Depressive Symptoms in the Elderly: A Population-Based Study

    PubMed Central

    Davin, Annalisa; Monti, Maria Cristina; Polito, Letizia; Vaccaro, Roberta; Abbondanza, Simona; Gnesi, Marco; Villani, Simona; Guaita, Antonio

    2015-01-01

    Background Depression is common in the elderly. The role of genetic and environmental factors in modulating depressive symptoms is not clear. Methods We evaluated the influence of serotonin transporter gene polymorphisms and recent adverse life events on depressive symptoms in an elderly Italian population. We used data from “InveCe.Ab”, a population-based study of 1321 subjects aged 70–74 years. We used the 15-item Geriatric Depression Scale (GDS) to assess depressive symptoms–a GDS score ≥5 points (GDS≥5) indicated the presence of clinically relevant symptoms–and performed 5-HTTLPR and rs25531 genotyping to obtain the triallelic polymorphism of the serotonin transporter. We used the Geriatric Adverse Life Events Scale to measure adverse life events, and logistic regression models to evaluate the role of genotype and recent adverse life events in depressive symptoms, controlling for potential confounders and independent predictors. Results Two hundred subjects (15.76%) had a GDS≥5. The 5-HTTLPR triallelic polymorphism was significantly associated with GDS≥5. Only S′S′ carriers showed an increased risk of depressive symptoms (ORadj = 1.81, p = .022); one extra adverse life event increased this risk by 14% (p = .061) independently of genotype. Other factors significantly related to GDS≥5 were: female gender (ORadj = 2.49, p < .001), age (ORadj = 1.19, p = .007), a history of depression (ORadj = 4.73, p < .001), and comorbidity (ORadj = 1.23, p = .001). One extra adverse life event increased the risk of depressive symptoms by 57% (p = .005) only in the L′L′ carriers, while antidepressant intake was directly related to GDS≥5 in the L′S′ carriers (ORadj = 2.46, p = .036) and borderline significant in the S′S′ carriers (ORadj = 2.41, p = .081). Discussion The S′S′ genotype and recent exposure to adverse life events were independently associated with depressive symptoms. The S′S′ genotype, compared with the environment

  8. Correlates of Protection against Influenza in the Elderly: Results from an Influenza Vaccine Efficacy Trial

    PubMed Central

    Dunning, Andrew J.; Voloshen, Timothy; Hu, Branda; Landolfi, Victoria A.; Talbot, H. Keipp

    2016-01-01

    Although a number of studies have investigated and quantified immune correlates of protection against influenza in adults and children, data on immune protection in the elderly are sparse. A recent vaccine efficacy trial comparing standard-dose with high-dose inactivated influenza vaccine in persons 65 years of age and older provided the opportunity to examine the relationship between values of three immunologic assays and protection against community-acquired A/H3N2 influenza illness. The high-dose vaccine induced significantly higher antibody titers than the standard-dose vaccine for all assays. For the hemagglutination inhibition assay, a titer of 40 was found to correspond with 50% protection when the assay virus was antigenically well matched to the circulating virus—the same titer as is generally recognized for 50% protection in younger adults. A dramatically higher titer was required for 50% protection when the assay virus was a poor match to the circulating virus. With the well-matched virus, some protection was seen at the lowest titers; with the poorly matched virus, high levels of protection were not achieved even at the highest titers. Strong associations were also seen between virus neutralization test titers and protection, but reliable estimates for 50% protection were not obtained. An association was seen between titers of an enzyme-linked lectin assay for antineuraminidase N2 antibodies and protection; in particular, the proportion of treatment effect explained by assay titer in models that included both this assay and one of the other assays was consistently higher than in models that included either assay alone. (This study has been registered at ClinicalTrials.gov under registration no. NCT01427309.) PMID:26762363

  9. [Duxil and cognitive deficiency in the elderly. Results of a 6-month controlled multicenter study].

    PubMed

    Poitrenaud, J; Piette, F; Malbezin, M; Sebban, C; Guez, D

    1990-01-01

    Two hundred and four patients, 70-85 years old, were included in a double-blind (Duxil/placebo), controlled, multicentric study. The inclusion criteria were a subjective complaint of a cognitive deficiency and a cognitive deficit objectively determined using the Folstein mini-mental state test and the Sandoz geriatric clinical evaluation score. The patients, treated for 6 months, were examined at the onset of the study (T0), then 3 (T3) and 6 months (T6) later. The assessment criteria included: a visual self-evaluation test measuring cognitive function and the following psychometric tests: trail making A (TMA), memorization of a shopping list, verbal fluidity, letter identification, repetition of a story, immediate recall of numbers and immediate visual memory. Anxiety and depression evaluations were also used to assess the effects of Duxil on the affective state. Statistical analysis of the observations made on the entire population did not reveal a significant difference between the treated group and the control placebo group, in terms of assessment criteria, between T0 and T6. However, this lack of a difference could be explained, in part, by the very wide variation in the initial psychometric performance scores of the subjects. In an attempt to control this possible bias, another statistical analysis was made for each psychometric test, after the patients had been divided into 3 classes based on their initial performance scores. The results of this second analysis showed that Duxil was able to improve memory performances in TMA and number retention better than the placebo. However, this effect was limited to the group of patients whose initial scores were in the intermediate class for TMA. These findings suggest that Duxil improves the concentrating ability of patients with light to moderate deficits in this function. PMID:2082783

  10. Prevalence of thyroid dysfunction in elderly subjects from the general population in an iodine deficiency area.

    PubMed

    Hintze, G; Burghardt, U; Baumert, J; Windeler, J; Köbberling, J

    1991-12-01

    The prevalence of thyroid disorders was investigated in 466 (403 female, 63 male) subjects over the age of 60 years (79.2 +/- 7.5 years; mean +/- SD) from the general population in an area of iodine deficiency. In addition to thyroid hormone assays, thyroid antibodies and urinary iodine excretion were determined. In cases with thyroid dysfunction, ultrasound investigations were performed. Twenty-two of the 466 subjects (4.7%) showed hyper- or hypothyroidism; 7 subjects were hyperthyroid (1.5%), 5 had primary hypothyroidism (1.1%), and 10 showed "subclinical" hypothyroidism (2.2%). The latter constellation is defined as an elevation of thyrotropin (TSH) with normal values for thyroxine and triiodothyronine. Most subjects with hyperthyroidism had a goiter by palpation (6/7); thyroid volume by ultrasound (median) was 26.2 mL with an inhomogeneous echo pattern in 6 of the 7 subjects. In 4 cases, a rise in urinary iodine excretion was documented; none had TSH-receptor antibodies. Most subjects with overt or subclinical hypothyroidism had a homogeneous or low-echogenic pattern by ultrasound; thyroid volume (median) was 12.9 mL and 12.7 mL, respectively. By palpation, 8 of the 15 subjects had no goiter. In general, these persons had no rise in urinary iodine excretion (11/13), but most showed an elevation of antibodies against the microsomal antigen and/or thyroglobulin (11/15).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1841604

  11. Depression - elderly

    MedlinePlus

    ... highest risk. Families should pay close attention to elderly relatives who are depressed and who live alone. ... health care provider. Alternative Names Depression in the elderly Images Depression among the elderly References Abbasi O, ...

  12. Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

    PubMed

    Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

    2015-12-15

    Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (<12 ng/ml) were associated with 2.2-fold increase in odds of VaD after adjustment with covariates. Hypertension was independently associated with 11.3-fold increased odds of VaD. In hypertensives with vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, p<0.01, respectively) in vitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. PMID:26671097

  13. Social Participation and the Prevention of Decline in Effectance among Community-Dwelling Elderly: A Population-Based Cohort Study

    PubMed Central

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2015-01-01

    Background We examined the association between a decline in effectance and social participation (SP) from the perspective of the number and the type of SP in a prospective cohort study. Methods Included in this analysis were community-dwelling elderly aged ≥65 without dependency on the basic activities of daily living and reporting a perfect baseline effectance score (n = 4,588; mean age 72.8±5.7). SP was categorized into 5 types: neighborhood associations, hobby groups, local event groups, senior citizen clubs, and volunteer groups. Effectance was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using logistic regression analysis, odds ratio (OR) and a 95% confidence interval (CI) for a decline in effectance were calculated. Age, family, BMI, pensions, medical history, medications, alcohol, smoking, cognitive function, depression, social support, ADL, and IADL were used as covariates. Results During the 3-year follow-up, 17.8% of eligible participants reported a decline in effectance. After adjustment for covariates, participation in various groups was associated with the preservation of effectance for both genders. Regarding the type of SP, among females, participation in neighborhood associations (OR: 0.62, 95%CI: 0.48–0.81), hobby groups (0.58, 0.43–0.77), local event groups (0.63, 0.47–0.86), and volunteer groups (0.53, 0.35–0.82) was inversely associated with a decline in effectance. Among males, the beneficial effect was more likely limited to hobby groups (0.59, 0.43–0.81) and volunteer groups (0.57, 0.39–0.83). Conclusions Our results suggest that participation in a variety of social groups is effective for maintenance of older people’s effectance, while the beneficial effect of each type of SP on effectance is stronger for females than for males. Recommending community-dwelling elderly to participate in social groups appropriate for their gender may be effective for successful aging. PMID:26406326

  14. Adaptively resizing populations: Algorithm, analysis, and first results

    NASA Technical Reports Server (NTRS)

    Smith, Robert E.; Smuda, Ellen

    1993-01-01

    Deciding on an appropriate population size for a given Genetic Algorithm (GA) application can often be critical to the algorithm's success. Too small, and the GA can fall victim to sampling error, affecting the efficacy of its search. Too large, and the GA wastes computational resources. Although advice exists for sizing GA populations, much of this advice involves theoretical aspects that are not accessible to the novice user. An algorithm for adaptively resizing GA populations is suggested. This algorithm is based on recent theoretical developments that relate population size to schema fitness variance. The suggested algorithm is developed theoretically, and simulated with expected value equations. The algorithm is then tested on a problem where population sizing can mislead the GA. The work presented suggests that the population sizing algorithm may be a viable way to eliminate the population sizing decision from the application of GA's.

  15. Appendicular Skeletal Muscle Mass and Insulin Resistance in an Elderly Korean Population: The Korean Social Life, Health and Aging Project-Health Examination Cohort

    PubMed Central

    Lee, Seung Won; Youm, Yoosik; Lee, Won Joon; Choi, Wungrak; Chu, Sang Hui; Park, Yeong-Ran

    2015-01-01

    Background Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population. Methods This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models. Results The HOMA-IR was positively associated with ASM (β=0.43, P<0.0001) and ASM/height2 (β=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (β=-0.43, P<0.001) and ASM/height2 (β=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders. Conclusion Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered. PMID:25729711

  16. [Social representations of elders' quality of life].

    PubMed

    Silva, Luípa Michele; Silva, Antonia Oliveira; Tura, Luiz Fernando Rangel; Moreira, Maria Adelaide Silva Paredes; Rodrigues, Rosalina Aparecida Partezani; Marques, Maria do Céu

    2012-03-01

    This study aimed to identify elders' social representations of quality of life. This is an exploratory study with a sample of 240 elders, of both sexes. For data collection we used a Free Association Test with Words, using the inductive stimulus 'quality of life" and sociodemographic variables. The interviews were analyzed with the software Alceste. Of the 240 studied eslders, 167 were women, with the dominant age from 60 to 69 years, income between two and three minimum wages, most of the married and with catholicism as the predominant religion. The results from Alceste pointed towards seven hierarchical classes: accessibility, work, activity, support affection, care and interactions. Social representations of quality of life by elders can support professionals in understanding the adhesion to preventive practices for the elderly and in strengthening policies directed to this population. PMID:22737803

  17. Gender differences between WOMAC index scores, health-related quality of life and physical performance in an elderly Taiwanese population with knee osteoarthritis

    PubMed Central

    Fang, Wen-Hui; Huang, Guo-Shu; Chang, Hsien-Feng; Chen, Ching-Yang; Kang, Chi-Yu; Wang, Chih-Chien; Lin, Chin; Yang, Jia-Hwa; Su, Wen; Kao, SenYeong; Su, Sui-Lung

    2015-01-01

    Objective To investigate the importance of the WOMAC index score, health-related quality of life and physical performance in each domain affected by knee osteoarthritis (OA) and to identify gender differences in the importance of these domains and physical performances. Material and methods We performed a population-based study for radiographic knee OA among participants aged more than 65 years. Demographic data were collected and anthropometric measurement, radiographic assessment, the WOMAC index score, the short-form 12 (SF-12), the Timed and Up to Go Test (TUGT) and the Five Times Sit to Stand Test (FTSST) were performed. Result There were 901 individuals (409 males and 492 females) aged 74.04±6.92 (male: 76.35±7.33; female: 72.12±5.92) years included in this study. The WOMAC scores of participants with OA were higher than those without OA in males and females (male: 11.97±15.79 vs 8.23±12.84, p<0.001; female: 10.61±14.97 vs 7.59±3.31, p=0.032). The physical component summary (PCS) score was only significant in females with knee OA (62.14±24.66 vs 66.59±23.85, p=0.043), while the mental component summary (MCS) score was only significant in males with knee OA (78.02±18.59 vs 81.98±15.46, p=0.02). The TUGT and FTSST were not significant in individuals with and without OA in males and females. Moreover, the multivariate results for the WOMAC score were significant for females (3.928 (95% CI 1.287 to 6.569), p=0.004). Conclusions The PCS domains of SF-12 and MCS domains of SF-12 are crucial in Taiwanese females and elderly males, respectively, with knee OA. Different evaluation and treatment strategies based on gender differences should be considered in elderly Taiwanese patients with knee OA to improve their quality of life. PMID:26373405

  18. Pragmatic Action Research With 2 Vulnerable Populations Mexican American Elders and Formerly Incarcerated Women

    PubMed Central

    Crist, Janice D.; Parsons, Mickey L.; Warner-Robbins, Carmen; Mullins, María Victoria; Espinosa, Yvette M.

    2014-01-01

    Eliminating health disparities involving minority groups is a major national priority. Action research, a response to this national priority, may be derived from different theoretical models. The purposes of action research are to involve key community stakeholders in developing knowledge and taking pragmatic action to solve problems. In this article, the authors examine how the model was put into action for 2 distinct programs of research, comparing and contrasting final results, one report primarily focusing on recruitment and retention of participants and the other focusing on a community faith-based action research with formerly incarcerated women. PMID:19752634

  19. Microvascular decompression for elderly patients with trigeminal neuralgia.

    PubMed

    Phan, Kevin; Rao, Prashanth J; Dexter, Mark

    2016-07-01

    Microvascular decompression (MVD) has been demonstrated to be an excellent surgical treatment approach in younger patients with trigeminal neuralgia (TN). However, it is not clear whether there are additional morbidity and mortality risks for MVD in the elderly population. We performed a systematic literature review using six electronic databases for studies that compared outcomes for MVD for TN in elderly (cut-off ⩾60, 65, 70years) versus younger populations. Outcomes examined included success rate, deaths, strokes, thromboembolism, meningitis, cranial nerve deficits and cerebrospinal fluid leaks. There were 1524 patients in the elderly cohort and 3488 patients in the younger cohort. There was no significant difference in success rates in elderly versus younger patients (87.5% versus 84.8%; P=0.47). However, recurrence rates were lower in the elderly (11.9% versus 15.6%; P=0.03). The number of deaths in the elderly cohort was higher (0.9% versus 0.1%; P=0.003). Rates of stroke (2.5% versus 1%) and thromboembolism (1.1% versus 0%) were also higher for elderly TN patients. No differences were found for rates of meningitis, cranial nerve deficits or cerebrospinal fluid leak. MVD remains an effective and reasonable strategy in the elderly population. There is evidence to suggest that rates of complications such as death, stroke, and thromboembolism may be significantly higher in the elderly population. The presented results may be useful in the decision-making process for MVD in elderly patients with TN. PMID:26944213

  20. Gender Differences in the Prevalence of Electrocardiogram Abnormalities in the Elderly: A Population Survey in India

    PubMed Central

    Sachin Khane, Rupali; Surdi, Anil D.

    2012-01-01

    Background: The health transition in India reflects the growing burden of cardiovascular diseases. It is well-known that there are significant and meaningful differences in the measured electrocardiogram (ECG) parameters between females and males. Specific to ECG diagnosis and ischemia, reports have indicated a higher number of false positive results in female patients than in male patients. This study was aimed at examining gender difference in the prevalence of ECG abnormality in older people who were free of coronary heart disease (CHD) and its associated risk factors. Methods: This study was conducted in Solapur city using 400 apparently healthy asymptomatic subjects with an age range of 45 to 74 years. A resting 12-lead ECG was recorded in supine position in accordance with classical recommendations. The various ECG abnormalities were defined according to Minnesota code. The findings were analyzed using Chi Square test at P<0.05. Results: Out of 400 ECGs recorded, 152 showed abnormalities. The prevalence of ECG abnormalities was significantly (P<0.001) more in males than in females. Major prevalence of ECG abnormalities in males observed were LAD, LVH, sinus bradycardia, LBBB and Q/QS patterns. There was no significant gender difference in the prevalence of other ECG abnormalities. Conclusion: This study has outlined the overall prevalence of ECG abnormalities in males as well as in females in Solapur city. We found highly significant (P<0.001) increase in the prevalence of ECG abnormalities in males as compare to females. PMID:23115437

  1. Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka

    PubMed Central

    Watt, Melissa H.; Perera, Bilesha; Østbye, Truls; Ranabahu, Shyama; Rajapakse, Harshini; Maselko, Joanna

    2014-01-01

    The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder-caregiver relationships in Southern Sri Lanka. Data included 4 focus group discussions and 5 in-depth interviews with elderly, and 10 in-depth interviews with adult children of the elderly. Discussion guide topics included caregiving arrangements, and roles/responsibilities of elders and caregivers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the caregiver dynamic. Both elders and caregivers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modeling of parental caregiving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Caregiving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and caregivers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future. PMID:25152553

  2. Treatment of Elderly Patients With Non-Small-Cell Lung Cancer: Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology.

    PubMed

    Gridelli, Cesare; Balducci, Lodovico; Ciardiello, Fortunato; Di Maio, Massimo; Felip, Enriqueta; Langer, Corey; Lilenbaum, Rogerio C; Perrone, Francesco; Senan, Suresh; de Marinis, Filippo

    2015-09-01

    Most patients with non-small-cell lung cancer (NSCLC) are elderly, and age has important implications for their management and treatment. In May 2014, the Italian Association of Thoracic Oncology organized an International Experts Panel Meeting with the intent to review the available evidence regarding the treatment of elderly patients with NSCLC and to discuss the implications for clinical practice and future research in this field; this article summarizes the panelists' conclusions. All patients aged more than 70 years should receive an assessment of physiologic age, including mortality and toxicity prediction. Age itself does not contraindicate adjuvant chemotherapy after resection. Elderly patients with locally advanced NSCLC should be considered for combined chemo-radiotherapy. In the advanced setting, the combination of carboplatin/paclitaxel results in prolonged survival compared with single-agent gemcitabine or vinorelbine, albeit with increased toxicity. In fit selected patients, other carboplatin-based or cisplatin-based regimens are feasible, but randomized trials specifically showing survival prolongation in elderly patients are lacking. The survival benefit for bevacizumab added to chemotherapy seems limited to patients aged less than 75 years. In unfit elderly patients, single agents are recommended. Regardless of age, patients with advanced nonsquamous NSCLC, and those who have never smoked independently of their histologic subtype, should be tested for epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement. In patients with NSCLC harboring EGFR mutation or ALK rearrangement, targeted drugs are feasible and well tolerated. PMID:25862554

  3. Differential profile of ultrasound findings associated with malignancy in mixed and solid thyroid nodules in an elderly female population.

    PubMed

    Vera, María Inés; Meroño, Tomás; Urrutia, María Agustina; Parisi, Carina; Morosan, Yanina; Rosmarin, Melanie; Schnitman, Marta; Brites, Fernando; Grisendi, Silvio; Serrano, María Sol; Luciani, Wilfredo; Serrano, Leonardo; Zuk, Carlos; De Barrio, Guillermo; Cejas, Claudia; Faingold, María Cristina; Brenta, Gabriela

    2014-01-01

    Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (≥50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age = 69 ± 8 years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, P: 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all P < 0.05). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25-6.10), P: 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules. PMID:25050189

  4. Differential Profile of Ultrasound Findings Associated with Malignancy in Mixed and Solid Thyroid Nodules in an Elderly Female Population

    PubMed Central

    Vera, María Inés; Urrutia, María Agustina; Parisi, Carina; Morosan, Yanina; Rosmarin, Melanie; Schnitman, Marta; Brites, Fernando; Grisendi, Silvio; Serrano, María Sol; Luciani, Wilfredo; Serrano, Leonardo; Zuk, Carlos; De Barrio, Guillermo; Cejas, Claudia; Faingold, María Cristina

    2014-01-01

    Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (≥50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age = 69 ± 8 years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, P: 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all P < 0.05). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25–6.10), P: 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules. PMID:25050189

  5. Potentially inappropriate prescribing in an Irish elderly population in primary care

    PubMed Central

    Ryan, Cristín; O'Mahony, Denis; Kennedy, Julia; Weedle, Peter; Byrne, Stephen

    2009-01-01

    AIMS Screening tools have been formulated to identify potentially inappropriate prescribing (IP) in older people. Beers' criteria are the most widely used but have disadvantages when used in Europe. New IP screening tools called Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) have been developed to identify potential IP and potential prescribing omissions (PPOs). The aim was to measure the prevalence rates of potential IP and PPOs in primary care using Beers' criteria, STOPP and START. METHODS Case records of 1329 patients ≥65 years old from three general practices in one region of southern Ireland were studied. The mean age ± SD of the patients was 74.9 ± 6.4 years, 60.9% were female. Patients' current diagnoses and prescription medicines were reviewed and the Beers' criteria, STOPP and START tools applied. RESULTS The total number of medicines prescribed was 6684; median number of medicines per patient was five (range 1–19). Overall, Beers' criteria identified 286 potentially inappropriate prescriptions in 18.3% (243) of patients, whilst the corresponding IP rate identified by STOPP was 21.4% (284), in respect of 346 potentially inappropriate prescriptions. A total of 333 PPOs were identified in 22.7% (302) of patients using the START tool. CONCLUSION Potentially inappropriate drug prescribing and errors of drug omission are highly prevalent among older people living in the community. Prevention strategies should involve primary care doctors and community pharmacists. PMID:20002089

  6. Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey.

    PubMed

    Kissal, Aygul; Beşer, Ayşe

    2011-01-01

    The objective of this study is to investigate the prevalence of abuse and neglect of the elderly aged 65 years and older, living with their relative in a primary health care center area and affecting factors. A descriptive study included 331 people aged 65 years. The most frequent type of abuse was psychological abuse and the least frequent was sexual abuse. Female gender, low education levels, living with spouses and children, and perception of familial relationships as average or below average significantly increased abuse. The nurses providing primary health care should be able to identify and observe the elderly at risk of abuse and conduct programs preventing abuse. PMID:21347984

  7. [Obesity in elderly].

    PubMed

    Lechleitner, Monika

    2016-03-01

    The prevalence of obesity is increasing also in the elderly population. The European Euronut-Seneca study described an obesity prevalence of 12-41% in elderly women and of 8-24% in elderly men. Obesity in the elderly is related to the cardiometabolic risk, but also to degenerative joint diseases and impaired physical functions. Some discrepancies are caused by the description of a so-called obesity paradox with a more favourable prognosis for certain diseases in the presence of overweight compared to normal or reduced body weight. The so-called sarcopenic obesity is associated with the worst prognosis.Preventive and therapeutic regimens should consider the increased risk of malnutrition in elderly. The combinations of individually tailored nutritional recommendations and physical exercise is of advantage for the prognosis of comorbidities and the quality of life. PMID:26820990

  8. [Preventive effect of an immunomodulator, OM-85 BV, on acute exacerbations of chronic bronchitis in elderly patients. Preliminary results at six months in 291 patients].

    PubMed

    Orcel, B; Delclaux, B; Baud, M; Derenne, J P

    1993-01-01

    Three hundred fifty six patients aged 65 years or more (mean age 81.8 years) who were suffering from chronic bronchitis were included in a double-blind trial against placebo to assess the preventative effect of OM-85 BV against acute exacerbations of chronic bronchitis. OM-85 BV is an immunostimulant composed of lyophilised factions of 8 bacteria which are most frequently encountered during the course of respiratory tract infections. 291 patients completed the study. In the group treated by OM-85 BV, a significant increase in the number of patients with no episode of acute bronchitis was noted (96 versus 71, p = 0.006). There was a 38.8% reduction in the absolute numbers of episodes of acute bronchitis and a 33% reduction in the number of prescriptions for antibiotics, however there was no difference in the number of pneumonias and bronchopneumonias. These results show the protective effect of OM-85 BV against bronchial superinfections in a large population of elderly patients suffering from chronic bronchitis. PMID:8451491

  9. The Critical Need to Promote Research of Aging and Aging-related Diseases to Improve Health and Longevity of the Elderly Population

    PubMed Central

    Jin, Kunlin; Simpkins, James W.; Ji, Xunming; Leis, Miriam; Stambler, Ilia

    2015-01-01

    Due to the aging of the global population and the derivative increase in aging-related non-communicable diseases and their economic burden, there is an urgent need to promote research on aging and aging-related diseases as a way to improve healthy and productive longevity for the elderly population. To accomplish this goal, we advocate the following policies: 1) Increasing funding for research and development specifically directed to ameliorate degenerative aging processes and to extend healthy and productive lifespan for the population; 2) Providing a set of incentives for commercial, academic, public and governmental organizations to foster engagement in such research and development; and 3) Establishing and expanding coordination and consultation structures, programs and institutions involved in aging-related research, development and education in academia, industry, public policy agencies and at governmental and supra-governmental levels. PMID:25657847

  10. Evaluation of the Retinal Vasculature in Hypertension and Chronic Kidney Disease in an Elderly Population of Irish Nuns

    PubMed Central

    McGowan, Amy; Silvestri, Giuliana; Moore, Evelyn; Silvestri, Vittorio; Patterson, Christopher C.; Maxwell, Alexander P.; McKay, Gareth J.

    2015-01-01

    Background Chronic kidney disease (CKD) and hypertension are global public health problems associated with considerable morbidity, premature mortality and attendant healthcare costs. Previous studies have highlighted that non-invasive examination of the retinal microcirculation can detect microvascular pathology that is associated with systemic disorders of the circulatory system such as hypertension. We examined the associations between retinal vessel caliber (RVC) and fractal dimension (DF), with both hypertension and CKD in elderly Irish nuns. Methods Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study (INES) were assessed from digital photographs with a standardized protocol using computer-assisted software. Multivariate regression analyses were used to assess associations with hypertension and CKD, with adjustment for age, body mass index (BMI), refraction, fellow eye RVC, smoking, alcohol consumption, ischemic heart disease (IHD), cerebrovascular accident (CVA), diabetes and medication use. Results In total, 1122 (91%) participants (mean age: 76.3 [range: 56–100] years) had gradable retinal images of sufficient quality for blood vessel assessment. Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm). No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found. Conclusions Individuals with hypertension have significantly narrower retinal arterioles which may afford an earlier opportunity for tailored prevention and treatment options to optimize the structure and function of the microvasculature, providing additional clinical utility. No significant associations between retinal vascular parameters and CKD were detected. PMID:26327531

  11. Elderly patients and inflammatory bowel disease.

    PubMed

    Nimmons, Danielle; Limdi, Jimmy K

    2016-02-01

    The incidence and prevalence of inflammatory bowel disease (IBD) is increasing globally. Coupled with an ageing population, the number of older patients with IBD is set to increase. The clinical features and therapeutic options in young and elderly patients are comparable but there are some significant differences. The wide differential diagnosis of IBD in elderly patients may result in a delay in diagnosis. The relative dearth of data specific to elderly IBD patients often resulting from their exclusion from pivotal clinical trials and the lack of consensus guidelines have made clinical decisions somewhat challenging. In addition, age specific concerns such as co-morbidity; loco-motor and cognitive function, poly-pharmacy and its consequences need to be taken into account. In applying modern treatment paradigms to the elderly, the clinician must consider the potential for more pronounced adverse effects in this vulnerable group and set appropriate boundaries maximising benefit and minimising harm. Meanwhile, clinicians need to make personalised decisions but as evidence based as possible in the holistic, considered and optimal management of IBD in elderly patients. In this review we will cover the clinical features and therapeutic options of IBD in the elderly; as well as addressing common questions and challenges posed by its management. PMID:26855812

  12. Elderly patients and inflammatory bowel disease

    PubMed Central

    Nimmons, Danielle; Limdi, Jimmy K

    2016-01-01

    The incidence and prevalence of inflammatory bowel disease (IBD) is increasing globally. Coupled with an ageing population, the number of older patients with IBD is set to increase. The clinical features and therapeutic options in young and elderly patients are comparable but there are some significant differences. The wide differential diagnosis of IBD in elderly patients may result in a delay in diagnosis. The relative dearth of data specific to elderly IBD patients often resulting from their exclusion from pivotal clinical trials and the lack of consensus guidelines have made clinical decisions somewhat challenging. In addition, age specific concerns such as co-morbidity; loco-motor and cognitive function, poly-pharmacy and its consequences need to be taken into account. In applying modern treatment paradigms to the elderly, the clinician must consider the potential for more pronounced adverse effects in this vulnerable group and set appropriate boundaries maximising benefit and minimising harm. Meanwhile, clinicians need to make personalised decisions but as evidence based as possible in the holistic, considered and optimal management of IBD in elderly patients. In this review we will cover the clinical features and therapeutic options of IBD in the elderly; as well as addressing common questions and challenges posed by its management. PMID:26855812

  13. The (interconnected) reasons elder Americans file consumer bankruptcy.

    PubMed

    Thorne, Deborah

    2010-04-01

    Since the early 1990s, the age distribution of the bankruptcy population has shifted. Specifically, the age distribution curve has flattened, due in large part to an increase in the number of elder Americans (65 and older) who are filing bankruptcy. To date, the reasons for elder bankruptcies have not been studied. Quantitative and qualitative data from 381 elder bankruptcy respondents who participated in the 2007 Consumer Bankruptcy Project suggest that overwhelming interest and fees on credit cards, illnesses and injuries, income problems, aggressive debt collectors, and housing problems are the leading reasons that elder debtors file bankruptcy. Further, the vast majority of elder bankruptcies result not from a single cause, but rather from multiple interconnected causes. PMID:20390721

  14. Result of Internal Fixation for Stable Femoral Neck Fractures in Elderly Patients

    PubMed Central

    Min, Byung-Woo; Bae, Ki-Cheor; Lee, Si-Wuk; Lee, Seok-Jung; Choi, Jung-Hoon

    2016-01-01

    Purpose This study was conducted to evaluate the results of internal fixation for stable femoral neck fractures occurring in patients over 65 years old. Materials and Methods Between 2008 and 2014, we evaluated 25 patients over 65 years old with Garden type 1 and 2 femoral neck fractures that were treated with internal fixation after a minimum follow up of 1 year. There were 5 males and 20 females and the average age was 72.3 years (range, 65-84 years) at the time of surgery. Fracture site union, horizontal shortening and complications were evaluated as radiographic parameters and change of walking ability (as measured using Koval walking ability score) was investigated as a clinical parameter. Results Union of fracture site was achieved in 24 out of the 25 cases (96.0%). The average length of horizontal shortening was 6.5 mm (range, 0.2-19.7 mm). At final follow up, 3 cases experienced complications: nonunion (n=1), avascular necrosis (n=1), and subtrochanteric fracture after minor trauma (n=1). Walking ability decreased an average of 1 step at the final follow up. Conclusion Internal fixation for stable femoral neck fractures occurring in patients over 65 years showed satisfactory union rates. However, care should be taken with this technique given the possibility of decreased walking ability resulting from horizontal shortening.

  15. Associations Between Ankle-Brachial Index and Cognitive Function: Results from the Lifestyle Interventions and Independence for Elders Trial

    PubMed Central

    Espeland, Mark A.; Newman, Anne B.; Sink, Kaycee; Gill, Thomas M.; King, Abby C.; Miller, Michael E.; Guralnik, Jack; Katula, Jeff; Church, Timothy; Manini, Todd; Reid, Kieran F.; McDermott, Mary M.

    2015-01-01

    OBJECTIVE To evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function DESIGN Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial) SETTING Eight US academic centers PARTICIPANTS 1,601 adults (ages 70–89 years, sedentary, non-demented, and with functional limitations MEASUREMENTS Baseline ABI and interviewer- and computer-administered cognitive function assessments were obtained from which compared a physical activity intervention with a health education control. Cognitive function was re-assessed 24 months later (interviewer-administered) and 18 or 30 months later (computer-administered) and central adjudication was used to classify individuals as having mild cognitive impairment, probable dementia, or neither. RESULTS Lower ABI had a modest independent association poorer cognitive functioning at baseline (partial r=0.09; p<0.001). While, lower baseline ABI was not associated with overall changes in cognitive function test scores, it was associated with higher odds for two-year progression to a composite of either mild cognitive impairment or probable dementia (OR=2.60 per unit lower ABI; 95% confidence interval [1.06,6.37]). Across two years, changes in ABI were not associated with changes in cognitive function. CONCLUSION In an older cohort of non-demented sedentary individuals with functional limitations, lower baseline ABI was independently correlated with cognitive function and associated with greater 2-year risk for progression to mild cognitive impairment or probable dementia. PMID:25869993

  16. Mistreatment and self-reported emotional symptoms: results from the National Elder Mistreatment Study.

    PubMed

    Cisler, Josh M; Begle, Angela M; Amstadter, Ananda B; Acierno, Ron

    2012-07-01

    Many community-residing older adults in the United States report past year mistreatment; however, little is known about mental health correlates of abuse. This study investigated whether a recent history of emotional, physical, or sexual abuse is associated with self-reported emotional symptoms (e.g., anxiety, depression) among a representative sample of older adults. Results demonstrated that each abuse type increased likelihood of reporting emotional symptoms; when other known correlates were controlled, only emotional abuse remained a significant predictor. Additional study of mistreatment-related correlates of depression and anxiety is needed, with a focus on the often overlooked category of emotional mistreatment. PMID:22737973

  17. Sex Differences in the Association between Serum Levels of Testosterone and Frailty in an Elderly Population: The Toledo Study for Healthy Aging

    PubMed Central

    Carcaillon, Laure; Blanco, Carmen; Alonso-Bouzón, Cristina; Alfaro-Acha, Ana; Garcia-García, Francisco-José; Rodriguez-Mañas, Leocadio

    2012-01-01

    Background Age-associated decline in testosterone levels represent one of the potential mechanisms involved in the development of frailty. Although this association has been widely reported in older men, very few data are available in women. We studied the association between testosterone and frailty in women and assessed sex differences in this relationship. Methods We used cross-sectional data from the Toledo Study for Healthy Aging, a population-based cohort study of Spanish elderly. Frailty was defined according to Fried's approach. Multivariate odds-ratios (OR) and 95% confidence intervals (CI) associated with total (TT) and free testosterone (FT) levels were estimated using polytomous logistic regression. Results In women, there was a U-shaped relationship between FT levels and frailty (p for FT2 = 0.03). In addition, very low levels of FT were observed in women with ≥4 frailty criteria (age-adjusted geometric means = 0.13 versus 0.37 in subjects with <4 components, p = 0.010). The association of FT with frailty appeared confined to obese women (p-value for interaction = 0.05).In men, the risk of frailty levels linearly decreased with testosterone (adjusted OR for frailty = 2.9 (95%CI, 1.6–5.1) and 1.6 (95%CI, 1.0–2.5), for 1 SD decrease in TT and FT, respectively). TT and FT showed association with most of frailty criteria. No interaction was found with BMI. Conclusion There is a relationship between circulating levels of FT and frailty in older women. This relation seems to be modulated by BMI. The relevance and the nature of the association of FT levels and frailty are sex-specific, suggesting that different biological mechanisms may be involved. PMID:22403651

  18. Survival Benefits and Trends in Use of Adjuvant Therapy Among Elderly Stage II and III Rectal Cancer Patients in the General Population

    PubMed Central

    Dobie, Sharon A.; Warren, Joan L.; Matthews, Barbara; Schwartz, David; Baldwin, Laura-Mae; Billingsley, Kevin

    2011-01-01

    BACKGROUND This study examined elderly stage II and III rectal cancer patients’ adjuvant chemoradiation therapy adherence, trends in adherence over time, and the relation of levels of adherence to mortality. METHODS The authors studied 2886 stage II and III rectal cancer patients who had surgical resection and who appeared in 1992–1999 linked SEER-Medicare claims data. The authors compared measures of adjuvant radiation and chemotherapy receipt and completion between stage II and III patients. Adjusted risk of cancer-related 5-year mortality was calculated by multivariate logistic regression for different levels of chemoradiation adherence among stage II and III patients. RESULTS Of the 2886 patients, 45.4% received both adjuvant radiation and chemotherapy. Stage III patients were more likely to receive chemoradiation than stage II patients. The receipt of chemoradiation by stage II patients increased significantly from 1992 to 1999. Stage III patients were more likely to complete radiation therapy (96.6%), chemotherapy (68.2%), and both modalities (67.5%) than stage II patients (91.5%, 49.8%, 47.6%, respectively). Only a complete course of both radiation and chemotherapy for both stage II (relative risk [RR] 0.74; 95% CI, 0.54, 0.97) and III (RR 0.80; 95% CI, 0.65, 0.96) decreased the adjusted 5-year cancer mortality risk compared with counterparts with no adjuvant therapy. CONCLUSIONS Even though stage II rectal cancer patients were less likely than stage III patients to receive and complete adjuvant chemoradiation, both patient groups in the general population had lower cancer-related mortality if they completed chemoradiation. These patients deserve support and encouragement to complete treatment. PMID:18189291

  19. Natural History of Dependency in the Elderly: A 24-Year Population-Based Study Using a Longitudinal Item Response Theory Model.

    PubMed

    Edjolo, Arlette; Proust-Lima, Cécile; Delva, Fleur; Dartigues, Jean-François; Pérès, Karine

    2016-02-15

    We aimed to describe the hierarchical structure of Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) and trajectories of dependency before death in an elderly population using item response theory methodology. Data were obtained from a population-based French cohort study, the Personnes Agées QUID (PAQUID) Study, of persons aged ≥65 years at baseline in 1988 who were recruited from 75 randomly selected areas in Gironde and Dordogne. We evaluated IADL and ADL data collected at home every 2-3 years over a 24-year period (1988-2012) for 3,238 deceased participants (43.9% men). We used a longitudinal item response theory model to investigate the item sequence of 11 IADL and ADL combined into a single scale and functional trajectories adjusted for education, sex, and age at death. The findings confirmed the earliest losses in IADL (shopping, transporting, finances) at the partial limitation level, and then an overlapping of concomitant IADL and ADL, with bathing and dressing being the earliest ADL losses, and finally total losses for toileting, continence, eating, and transferring. Functional trajectories were sex-specific, with a benefit of high education that persisted until death in men but was only transient in women. An in-depth understanding of this sequence provides an early warning of functional decline for better adaptation of medical and social care in the elderly. PMID:26825927

  20. [Use of medication by the elderly in urban and rural areas in southern Brazil: a population-based study].

    PubMed

    Dal Pizzol, Tatiane da Silva; Pons, Emilia da Silva; Hugo, Fernando Neves; Bozzetti, Mary Clarisse; Sousa, Maria da Luz Rosário de; Hilgert, Juliana Balbinot

    2012-01-01

    The study aimed to measure use of medication and polypharmacy among the elderly in Carlos Barbosa, Rio Grande do Sul State, Brazil, and to compare socio-demographic, economic, and health characteristics in relation to area of residence (urban versus rural) in a random sample of 811 persons 60 year of age or older. Interviews were used to collect data on socio-demographic characteristics, chronic illnesses, and self-reported use of medications. The association between area of residence and medication or polypharmacy was adjusted for confounders using Poisson regression with robust variance. Prevalence rates for use of medication and polypharmacy were higher among older persons living in the urban area. Living in the urban area was positively and independently associated with use of medication (PR = 1.10; 95%CI: 1.02-1.20) and polypharmacy (PR = 1.83; 95%CI: 1.27-2.65) in this group of elderly in southern Brazil. PMID:22267070

  1. Sodium recommendations for special populations and the resulting implications.

    PubMed

    Cotugna, Nancy; Wolpert, Sara

    2011-10-01

    Based on the most recent Dietary Guidelines for Americans, sodium recommendations are set at 2,300 mg for the general population and 1,500 mg for special populations. However, sodium intake among adults has been shown to be much higher than this; on average 3,436 mg. The Centers for Disease Control and Prevention notes that special populations (those with hypertension, African Americans, and those 40 years of age and older) make up 70% of adults in the United States. Excess sodium in the diet has been shown to contribute to problems such as blood pressure abnormalities, kidney function problems, and congestive heart failure, which account for a large sum of health care costs in the United States. The purpose of this review and accompanying three case studies was to explore if adherence to the sodium recommendations for special populations is feasible. Current literature shows that while a food industry-wide sodium reduction would help reduce overall sodium intake, adherence to low-sodium diets is difficult for the majority of individuals. Three case studies were completed which looked at subjects with a sodium recommendation of 1,500 mg. None of the participants met the recommendation, were aware of their daily sodium intake or knew how much they should be consuming. The snapshot provided by these case studies suggests further research is warranted. Because of the current state of sodium in the American diet, a combination of personal interventions coupled with widespread industry sodium reduction would be the most beneficial way to reduce dietary sodium for most individuals. PMID:21327502

  2. Inappropriate prescribing of antithrombotic therapy in Ethiopian elderly population using updated 2015 STOPP/START criteria: a cross-sectional study

    PubMed Central

    Getachew, Henok; Bhagavathula, Akshaya Srikanth; Abebe, Tamrat Befekadu; Belachew, Sewunet Admasu

    2016-01-01

    Background Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients. Methods A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital. A total of 156 hospitalized elderly patients fulfilling the inclusion/exclusion criteria were included in the study. The Screening Tool for Older Person’s Prescription/Screening Tool to Alert doctors to Right Treatment criteria version 2 were applied to patients’ data to identify the total number of inappropriate prescribing (IPs) including potentially inappropriate medications and potential prescribing omissions. Results A total of 70 IPs were identified in 156 patients who met the inclusion criteria. Of these, 36 (51.4%) were identified as potentially inappropriate medications by the Screening Tool for Older Person’s Prescription criteria. The prevalence of IP per patient indicated that 58 of the 156 (37.2%) patients were exposed to at least one IP. Of these, 32 (55.2%) had at least one potentially inappropriate medication and 33 (56.9%) had at least one potential prescribing omission. Patients hospitalized due to venous thromboembolism (adjusted odds ratio [AOR] =29.87, 95% confidence interval [CI], 1.26–708.6), stroke (AOR =7.74, 95% CI, 1.27–47.29), or acute coronary syndrome (AOR =13.48, 95% CI, 1.4–129.1) were less likely to be exposed to an IP. An increase in Charlson comorbidity index score was associated with increased IP exposure (AOR =0.60, 95% CI, 0.39–0.945). IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR =6.23, 95% CI, 1.90–20.37) than those receiving any other groups of antithrombotics. Conclusion IPs are less common in elderly patients primarily admitted due to venous thromboembolism, stroke, and acute

  3. Incidence of cartilaginous and ligamentous lesions of the radio-carpal and distal radio-ulnar joint in an elderly population.

    PubMed

    Fortems, Y; De Smet, L; Dauwe, D; Stoffelen, D; Deneffe, G; Fabry, G

    1994-10-01

    51 wrists of 30 embalmed cadavers have been used to perform an anatomical and radiological study relating cartilaginous and ligamentous lesions of the wrist with sex, age, ulnar variance (UV) and the state of the triangular fibrocartilage complex (TFCC) in an elderly population (mean 76.6 years). Two-thirds of all wrists (66%) showed cartilaginous lesions, mainly on the lunate (22, or 44%). The TFCC was perforated in 23 wrists (46%), and most were central degenerative perforations. Correlations were found between ulnar variance and TFCC thickness (P < 0.05) and ulnar variance and TFCC perforations (P < 0.05). A significant relation was observed between age and proximal row intercarpal ligamentous ruptures (P < 0.05) and between age and ulnar variance (P < 0.05). No statistical correlation was seen between ulnar variance and cartilaginous lesions on the lunate (P < 0.05) in this slightly ulnar negative population (mean-0.37 mm). PMID:7822912

  4. Stellar populations of stellar halos: Results from the Illustris simulation

    NASA Astrophysics Data System (ADS)

    Cook, B. A.; Conroy, C.; Pillepich, A.; Hernquist, L.

    2016-08-01

    The influence of both major and minor mergers is expected to significantly affect gradients of stellar ages and metallicities in the outskirts of galaxies. Measurements of observed gradients are beginning to reach large radii in galaxies, but a theoretical framework for connecting the findings to a picture of galactic build-up is still in its infancy. We analyze stellar populations of a statistically representative sample of quiescent galaxies over a wide mass range from the Illustris simulation. We measure metallicity and age profiles in the stellar halos of quiescent Illustris galaxies ranging in stellar mass from 1010 to 1012 M ⊙, accounting for observational projection and luminosity-weighting effects. We find wide variance in stellar population gradients between galaxies of similar mass, with typical gradients agreeing with observed galaxies. We show that, at fixed mass, the fraction of stars born in-situ within galaxies is correlated with the metallicity gradient in the halo, confirming that stellar halos contain unique information about the build-up and merger histories of galaxies.

  5. WISE/NEOWISE OBSERVATIONS OF THE HILDA POPULATION: PRELIMINARY RESULTS

    SciTech Connect

    Grav, T.; Mainzer, A. K.; Bauer, J.; Masiero, J.; Eisenhardt, P. R.; Blauvelt, E.; DeBaun, E.; Elsbury, D.; Gautier, T.; Gomillion, S.; Hand, E.; Wilkins, A.; Spahr, T.; McMillan, R. S.; Walker, R.; Cutri, R.; Wright, E.

    2012-01-10

    We present the preliminary analysis of 1023 known asteroids in the Hilda region of the solar system observed by the NEOWISE component of the Wide-field Infrared Survey Explorer (WISE). The sizes of the Hildas observed range from {approx}3 to 200 km. We find no size-albedo dependency as reported by other projects. The albedos of our sample are low, with a weighted mean value of p{sub V} = 0.055 {+-} 0.018, for all sizes sampled by the NEOWISE survey. We observed a significant fraction of the objects in the two known collisional families in the Hilda population. It is found that the Hilda collisional family is brighter, with a weighted mean albedo of p{sub V} = 0.061 {+-} 0.011, than the general population and dominated by D-type asteroids, while the Schubart collisional family is darker, with a weighted mean albedo of p{sub V} = 0.039 {+-} 0.013. Using the reflected sunlight in the two shortest WISE bandpasses, we are able to derive a method for taxonomic classification of {approx}10% of the Hildas detected in the NEOWISE survey. For the Hildas with diameter larger than 30 km, there are 67{sup +7}{sub -15}% D-type asteroids and 26{sup +17}{sub -5%} C-/P-type asteroids (with the majority of these being P-types).

  6. Vitamin D Levels Are Inversely Associated with Liver Fat Content and Risk of Non-Alcoholic Fatty Liver Disease in a Chinese Middle-Aged and Elderly Population: The Shanghai Changfeng Study

    PubMed Central

    Aleteng, Qiqige; Li, Xiaoming; Ma, Hui; Pan, Baishen; Gao, Jian; Gao, Xin

    2016-01-01

    Background/Objectives Vitamin D exerts metabolic activities. We investigated whether the 25-hydroxy vitamin D [25(OH)D] is associated with liver fat content (LFC) and non-alcoholic fatty liver disease (NAFLD) in a middle-aged, elderly Chinese population. Subject/Methods A total of 2,960 participants (954 men and 2,006 women) aged over 45 years old were enrolled. Each participant underwent a standard interview, anthropometric measurements and laboratory examinations. Vitamin D deficiency and insufficiency was diagnosed when serum 25(OH) D level was < 50 and 50–75nmol/L. An ultrasound quantitative method was used to assess the LFC. Results Among the 2,960 participants, 1,982 (67.0%) subjects had vitamin D deficiency, 769 (26.0%) had vitamin D insufficiency, and 209 (7%) had normal vitamin D. Male subjects with vitamin D deficiency and insufficiency had significantly higher LFC than those with normal 25(OH)D (P = 0.034), while the LFC values showed no significant difference among the female subjects with vitamin D sufficiency, insufficiency and deficiency (P = 0.396). Univariate correlation analysis showed that 25(OH)D had a significantly negative association with LFC in men (r = -0.085, P = 0.009), but not in women. After adjusting for age, cigarette smoking, examination season, serum calcium, PTH and all possible confounders that displayed significant associations with LFC in univariate correlation analysis, serum 25(OH)D remained associated with LFC in middle-aged and elderly Chinese men. Conclusion Serum 25(OH)D level was inversely associated with LFC in middle-aged and elderly Chinese men. PMID:27284686

  7. Cardiovascular disease, risk factors and heart rate variability in the elderly general population: Design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) Study

    PubMed Central

    Greiser, Karin H; Kluttig, Alexander; Schumann, Barbara; Kors, Jan A; Swenne, Cees A; Kuss, Oliver; Werdan, Karl; Haerting, Johannes

    2005-01-01

    Background The increasing burden of cardiovascular diseases (CVD) in the ageing population of industrialized nations requires an intensive search for means of reducing this epidemic. In order to improve prevention, detection, therapy and prognosis of cardiovascular diseases on the population level in Eastern Germany, it is necessary to examine reasons for the East-West gradient of CVD morbidity and mortality, potential causal mechanisms and prognostic factors in the elderly. Psychosocial and nutritional factors have previously been discussed as possible causes for the unexplained part of the East-West gradient. A reduced heart rate variability appears to be associated with cardiovascular disease as well as with psychosocial and other cardiovascular risk factors and decreases with age. Nevertheless, there is a lack of population-based data to examine the role of heart rate variability and its interaction with psychosocial and nutritional factors regarding the effect on cardiovascular disease in the ageing population. There also is a paucity of epidemiological data describing the health situation in Eastern Germany. Therefore, we conduct a population-based study to examine the distribution of CVD, heart rate variability and CVD risk factors and their associations in an elderly East German population. This paper describes the design and objectives of the CARLA Study. Methods/design For this study, a random sample of 45–80 year-old inhabitants of the city of Halle (Saale) in Eastern Germany was drawn from the population registry. By the end of the baseline examination (2002–2005), 1750 study participants will have been examined. A multi-step recruitment strategy aims at achieving a 70 % response rate. Detailed information is collected on own and family medical history, socioeconomic, psychosocial, behavioural and biomedical factors. Medical examinations include anthropometric measures, blood pressure of arm and ankle, a 10-second and a 20-minute electrocardiogram

  8. Analysis of Muscle Force-Velocity Parameter Changes in Elderly Women Resulting from Physical Activity--In Continuous Examinations

    ERIC Educational Resources Information Center

    Skrzek, Anna; Stefanska, Malgorzata

    2012-01-01

    The aim of the paper was to evaluate changes in muscle force-velocity parameters (F-v) in elderly women subjected to physical exercise. The examinations encompassed 20 women, aged 62-71, who were students at the University of the Third Age in Wroclaw. The evaluation of flexors and extensors of the knee joint, as well as flexors and extensors of…

  9. Influenza vaccination among the elderly in Italy.

    PubMed Central

    Pregliasco, F.; Sodano, L.; Mensi, C.; Selvaggi, M. T.; Adamo, B.; D'Argenio, P.; Giussani, F.; Simonetti, A.; Carosella, M. R.; Simeone, R.; Dentizi, C.; Montanaro, C.; Ponzio, G.

    1999-01-01

    This article surveys the attitudes and perceptions of a random sample of the elderly population in three regions of Italy on the use and efficacy of influenza vaccine. The data were collected by direct interviews using a standard questionnaire. The results show that vaccination coverage against influenza is inadequate (26-48.6%). The major reasons for nonvaccination were lack of faith in the vaccine and disbelief that influenza is a dangerous illness. These data emphasize the need for a systematic education programme targeted at the elderly and the provision of influenza vaccination, with the increased cooperation of general practitioners. PMID:10083710

  10. Ergothioneine levels in an elderly population decrease with age and incidence of cognitive decline; a risk factor for neurodegeneration?

    PubMed

    Cheah, Irwin K; Feng, Lei; Tang, Richard M Y; Lim, Keith H C; Halliwell, Barry

    2016-09-01

    Ergothioneine (ET), a naturally occurring thione, can accumulate in the human body at high concentrations from diet. Following absorption via a specific transporter, OCTN1, ET may accumulate preferentially in tissues predisposed to higher levels of oxidative stress and inflammation. Given its potential cytoprotective effects, we examined how ET levels change with age. We found that whole blood ET levels in elderly individuals decline significantly beyond 60 years of age. Additionally, a subset of these subjects with mild cognitive impairment had significantly lower plasma ET levels compared with age-matched subjects. This decline suggests that deficiency in ET may be a risk factor, predisposing individuals to neurodegenerative diseases. PMID:27444382

  11. Anticoagulation in the Elderly

    PubMed Central

    Robert-Ebadi, Helia; Righini, Marc

    2010-01-01

    Management of anticoagulation in elderly patients represents a particularly challenging issue. Indeed, this patient population is at high thromboembolic risk, but also at high hemorrhagic risk. Assessment of the benefit-risk balance of anticoagulation is the key point when decisions are made about introducing and/or continuing such treatments in the individual elderly patient. In order to maximise the safety of anticoagulation in the elderly, some specific considerations need to be taken into account, including renal insufficiency, modified pharmacodynamics of anticoagulants, especially vitamin K antagonists, and the presence of multiple comorbidities and concomitant medications. New anticoagulants could greatly simplify and possibly increase the safety of anticoagulation in the elderly in the near future.

  12. [Coronary angioplasty in elderly patients].

    PubMed

    Liistro, Francesco; Colombo, Antonio

    2002-01-01

    Developed nations are experiencing an unprecedented growth in the number of elderly citizens. Thanks to the modernization of both society and medical care, over the past century, life expectancy in most countries has nearly doubled. The elderly (80 years or over) represent the fastest-growing segment of our population. Owing to their age, the elderly are more afflicted with chronic diseases, including coronary artery disease. Recently, clinicians became more aggressive in the use of invasive cardiovascular diagnostic tests in these patients. With regard to younger patients, we have a wealth of data from large, randomized trials that defined which subsets of patients benefit from revascularization therapies. However, because the very elderly were severely underrepresented in these randomized studies, we have almost no information concerning the choice of treatment in these patients. Initial results of percutaneous revascularization procedures in elderly patients come from retrospective analysis performed during the pre-stent era. In these studies a procedural mortality risk 5-fold higher in patients > 80 years compared with those < 60 is reported. With the advent of coronary stenting, a significant increase in the rate of procedural success and a reduction in the incidence of procedural mortality, acute myocardial infarction and emergency coronary artery bypass grafting were observed also in the elderly. These initial positive results prompted physicians to treat patients with impaired clinical conditions and with unfavorable angiographic characteristics, resulting in a long-term freedom from major adverse cardiac events comparable to those observed in younger patients (78% in patients < 70 years vs 75% in patients > 80 years). The comparison between the percutaneous approach and the surgical approach to coronary artery disease in the elderly has its major limitation in the lack of data from randomized trials. The available information suggests similar results with

  13. Circulatory Diseases in the U.S. Elderly in the Linked National Long-Term Care Survey-Medicare Database: Population-Based Analysis of Incidence, Comorbidity, and Disability

    PubMed Central

    Akushevich, Igor; Kravchenko, Julia; Ukraintseva, Svetlana; Arbeev, Konstantin; Yashin, Anatoli I.

    2014-01-01

    Incidence rates of acute coronary heart disease (ACHD; including myocardial infarction and angina pectoris), stroke, and heart failure (HF) were studied for their age, disability, and comorbidity patterns in the U.S. elderly population using the National Long Term Care Survey (NLTCS) data linked to Medicare records for 1991–2005. Incidence rates increased with age with a decrease in the oldest old (stroke and HF) or were stable at all ages (ACHD). For all diseases, incidence rates were lower among institutionalized individuals and higher in individuals with higher comorbidity indices. The results could be used for understanding currently debated effects of biomedical research, screening, and therapeutic innovations on changes in disease incidence with advancing age as well as for projecting future Medicare costs. PMID:26609189

  14. Frailty among rural elderly adults

    PubMed Central

    2014-01-01

    Background This study aimed to estimate the prevalence and associated factors related to frailty, by Fried criteria, in the elderly population in a rural area in the Andes Mountains, and to analyze the relationship of these with comorbidity and disability. Methods A cross-sectional study was undertaken involving 1878 participants 60 years of age and older. The frailty syndrome was diagnosed based on the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). Variables were grouped as theoretical domains and, along with other potential confounders, were placed into five categories: (a) demographic and socioeconomic status, (b) health status, (c) self-reported functional status, (d) physical performance-based measures, and (e) psychosocial factors. Chi-square, ANOVA, and multinomial logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest. Results The prevalence of frailty was 12.2%. Factors associated with frailty were age, gender, health status variables that included self-perceived health and number of chronic conditions, functional covariate variables that included disability in activities in daily living (ADL), disabilities in instrumental ADL, chair stand time, and psychosocial variables that included depressive symptoms and cognitive impairment. Higher comorbidity and disability was found in frail elderly people. Only a subset of frail elderly people (10%) reported no disease or disability. Conclusions A relevant number of elderly persons living in rural areas in the Andes Mountains are frail. The prevalence of frailty is similar to that reported in other populations in the Latin American region. Our results support the use of modified Cardiovascular Health Study criteria to measure frailty in communities other than urban settings. Frailty in this study was strongly associated with comorbidities, and frailty and comorbidity predicted disability. PMID:24405584

  15. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    NASA Astrophysics Data System (ADS)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P < 0.001). Moreover, the highest incidence was observed in months with HI > 90 °F for >3 h per day for at least 10 days ( P < 0.001). A direct correlation was found between the average monthly temperature and the monthly number of patients undergoing temporary cardiac pacing (r = 0.54, P < 0.001). Compared with other patients, those observed during the hottest months were significantly older and more frequently affected by chronic disabling neurological diseases (all P < 0.05). In addition, they more frequently showed biochemical indices of dehydration, renal function impairment and hyperkalemia (all P < 0.05). This study showed an increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  16. Education and WHO Recommendations for Fruit and Vegetable Intake Are Associated with Better Cognitive Function in a Disadvantaged Brazilian Elderly Population: A Population-Based Cross-Sectional Study

    PubMed Central

    Pastor-Valero, Maria; Furlan-Viebig, Renata; Menezes, Paulo Rossi; da Silva, Simon Almeida; Vallada, Homero; Scazufca, Marcia

    2014-01-01

    Brazil has one of the fastest aging populations in the world and the incidence of cognitive impairment in the elderly is expected to increase exponentially. We examined the association between cognitive impairment and fruit and vegetable intake and associated factors in a low-income elderly population. A cross-sectional population-based study was carried out with 1849 individuals aged 65 or over living in São Paulo, Brazil. Cognitive function was assessed using the Community Screening Instrument for Dementia (CSI-D). Fruit and vegetable intake was assessed with a Food Frequency Questionnaire (FFQ) and categorized into quartiles of intake and into total daily fruit and vegetable intake using the cut-off points for the WHO recommendations (<400grams/day or ≥400 grams/day). The association between cognitive impairment and each quartile of intake, and WHO recommendation levels, was evaluated in two separate multivariate logistic models. The WHO recommendations for daily intakes ≥400 grams/day were significantly associated with 47% decreased prevalence of cognitive impairment. An effect modification was found in both models between cognitive impairment and “years of education and physical activity” and “years of education and blood levels of HDL” So that, having 1 or more years of education and being physically active or having 1 or more years of education and levels higher than 50 mg/dl of HDL-cholesterol strongly decreased the prevalence of cognitive impairment. In this socially deprived population with very low levels of education and physical activity and fruit and vegetable intake, those who attained WHO recommendations, had 1 year or more of education and were physically active had a significantly lower prevalence of cognitive impairment. A more comprehensive understanding of the social determinants of mental health is needed to develop effective public policies in developing countries. PMID:24736378

  17. [CMV infection in elderly].

    PubMed

    Pytka, Dorota; Czarkowska-Paczek, Bozena

    2016-01-01

    Cytomegalovirus (CMV) infects approximately 40-90% of the world population. The infection is usually asymptomatic in immunocompetent persons. However, it may have negative impact on physiological status or accompanying diseases especially in the elderly. In particular, increasing number of data suggests that persistent infection with CMV is associated with accelerated aging of the immune system accompanying by the decrease in the number of naïve T cells, the increase in in the number of late-differentiated T cells, and reduced TCD4/ TCD8 ratio. This constellation reduces immunity against a variety of diseases, including infectious diseases, cancer, autoimmune diseases, and alters the response to vaccinations. CMV infection could also influence the pathophysiology of age-related diseases, including cardiovascular diseases, however, the mechanism of such influence is still not clear. It is not clear as well, whether CMV infection influences the all-cause and cardiovascular diseases-related mortality. In conclusion, CMV infection could intensify immunosenescence and contribute to age-related diseases, but inconsistent results of many experiments do not allow currently to define clear guidelines for the treatment of CMV infection in elderly. PMID:27526428

  18. An adapted mindfulness-based stress reduction program for elders in a continuing care retirement community: quantitative and qualitative results from a pilot randomized controlled trial.

    PubMed

    Moss, Aleezé S; Reibel, Diane K; Greeson, Jeffrey M; Thapar, Anjali; Bubb, Rebecca; Salmon, Jacqueline; Newberg, Andrew B

    2015-06-01

    The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week Mindfulness-Based Stress Reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized waitlist control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n = 20) or a waitlist control group (n = 19), mean age was 82 years. Both groups completed pre-post measures of health-related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed qualitative interviews. MBSR participants showed significantly greater improvement in acceptance and psychological flexibility and in role limitations due to physical health. In the qualitative interviews, MBSR participants reported increased awareness, less judgment, and greater self-compassion. Study results demonstrate the feasibility and potential effectiveness of an adapted MBSR program in promoting mind-body health for elders. PMID:25492049

  19. Bladder Cancer in the Elderly

    PubMed Central

    Shariat, Shahrokh F.; Milowsky, Matthew; Droller, Michael J.

    2014-01-01

    Introduction Age is now widely accepted as the greatest single risk factor for developing bladder cancer, and bladder cancer is considered as primarily a disease of the elderly. Because of the close link between age and incidence of bladder cancer, it can be expected that this disease will become an enormous challenge with the growth of an aging population in the years ahead. Methods Using MEDLINE, a search of the literature between January 1966 and July 2007 was performed to describe normative physiologic changes associated with aging, elucidate genetic and epigenetic alterations that associate aging with bladder cancer and its phenotypes; and to characterize how aging influences efficacies, risks, side effects and potential complications of the treatments needed for the various stages of bladder cancer.. Results We discuss influence of aging on host physiology, genetic and epigenetic changes, environmental influences, and host factors in the development and treatment of bladder cancer. Treatments with intravesical Bacille Calmette Guerin, radical cystectomy, and perioperative chemotherapy are less well tolerated and have poorer response in elderly patients compared to their younger counterparts. Elderly patients face both clinical and broader institutional barriers to appropriate treatment and may receive less aggressive treatment and sub-therapeutic dosing. However, when appropriately selected, elderly patients tolerate and respond well to cancer treatments. Conclusions The decision to undergo treatment for cancer is a tradeoff between loss of function and/or independence and extension of life which is complicated by a host of concomitant issues such as co-morbid medical conditions, functional declines and “frailty”, family dynamics, and social and psychological issues. Chronological age should not preclude definitive surgical therapy. It is imperative that healthcare practitioners and researchers from disparate disciplines collectively focus efforts towards

  20. Melanoma incidence increase in the elderly of Catalonia with stabilization of incidence in the younger population: effect of prevention or consequence of immigration?

    PubMed Central

    Puig, Susana; Marcoval, Joaquim; Paradelo, Cristina; Azon, Antoni; Bartralot, Ramon; Bel, Susana; Bigata, Xavier; Boada, Aram; Campoy, Antoni; Carrera, Cristina; Curco, Neus; Dalmau, Joan; Ferrandiz, Carlos; Ferreres, Josep R.; Formigon, Manel; Gallardo, Fernando; Gonzalez, Alberto; Just, Miquel; Llistosella, Enric; Marti, Rosa M.; Nogues, M. Elena; Pedragosa, Ramon; Pujol, Josep A.; Roldán-Marín, Rodrigo; Sabat, Mireia; Salleras, Montserrat; Smandia, Juan A.; Zaballos, Pedro; Plana, Estel; Malvehy, Josep

    2016-01-01

    All cases of MM diagnosed in 23 Hospitals in Catalonia, from 2000 to 2007 were recorded and its incidence calculated and adjusted for the European standard population through the direct method. The age standardized rate varied from 6.74 in 2000 to 8.64 in 2007 for all melanomas and from 4.79 to 5.80 for invasive MMs, the Breslow thickness being stable during the period. The increase in invasive melanoma incidence in the elderly was remarkable, the crude rate increasing from 11.04 (2000) to 15.49 (2007) in the 60–64 yr population, while remaining more stable from 3.97 in 2000 to 4.55 in 2007 for the age range of 30–34 ys or with a tendency to decrease from 5.1 in 2000 to 2.5 in 2007 for age range of 25–29 yr, age ranges much more affected by immigration. Despite the large immigrant population (nearly one million immigrants that arrived in Catalonia during the study period from countries with a low melanoma incidence), melanoma incidence in our region has risen considerably and this trend will likely persist in the near future. PMID:25367888

  1. Congestive heart failure in the elderly.

    PubMed

    Rengo, F; Acanfora, D; Trojano, L; Furgi, G; Picone, C; Iannuzzi, G L; Vitale, D F; Rengo, C; Ferrara, N

    1996-01-01

    Several aspects of congestive heart failure are discussed in the light of international literature and of recent findings of our group. The annual incidence of heart failure in elderly subjects, aged >or=75y, is 13 to 50/1000, while it is 1.6/1000 in people aged 45-54 y. The prevalence of heart failure is about 3% in subjects aged 45-64% in subjects aged more than 65 y and 10% in subjects aged more than 75 y. These data are confirmed by our population based study in elderly subjects. The etiology of congestive heart failure is similar in elderly and middle-aged patients. However, several anatomo-functional, hormonal and autonomic nervous system changes, typical of congestive heart failure, occur during physiologic ageing processes also. These findings may explain the dramatic evolution of congestive heart failure in elderly patients. Moreover, some features of the elderly - e.g. comorbidity, atypical clinical presentations, loss of autonomy, increased iatrogen risk should be considered. No specific drugs exist for the pharmacologic treatment of heart failure in the elderly, so that the geriatric specificity in the treatment of heart failure can be recognized in the art of drug choice and dosage, to obtain the best results with the least side effects. The multiple etiology of congestive heart failure, the comorbidity, the loss of autonomy and the deterioration of cognitive functions suggest the need for multidimensional approach and continuative intervention in elderly patients with heart disease, and in particular with congestive heart failure. Further studies on disease- and age-related changes are necessary to develop new and more potent strategies to secure 'successful ageing'. PMID:15374141

  2. Season of birth and population schizotypy: Results from a large sample of the adult general population.

    PubMed

    Konrath, Lisa; Beckius, Danièle; Tran, Ulrich S

    2016-08-30

    Although the last years have seen an increasing interest in schizotypy and its pathogenesis, there exist only a handful of studies examining the possible interaction between season of birth (SOB) and schizotypic personality structure. Available research used differing screening instruments, rendering comparisons between studies difficult, and sample sizes in adult populations may have been too small to detect a mild effect. The current study examined the association between SOB and psychometric schizotypy in the so far single-largest sample from the adult general population (N=8114), balanced for men and women, and utilizing a valid and reliable instrument for the assessment of schizotypy. Using the 12 most informative items of the Schizotypal Personality Questionnaire Brief, we obtained evidence of a small, but significant, effect of late winter and early spring births (February/March) on psychometric schizotypy. The effect was not constrained to women, but affected men and women alike. The observed association between SOB and schizotypy appears compatible with seasonal variations of temperature and influenza prevalence, and with recent evidence on seasonal variability in the activity of the human immune system. Our findings lend support to the continuum hypothesis of schizotypy and schizophrenia, for which SOB effects have been previously established. PMID:27310922

  3. Multiple risk factors and ischaemic stroke in the elderly Asian population with and without atrial fibrillation. An analysis of 425,600 Chinese individuals without prior stroke.

    PubMed

    Guo, Yutao; Wang, Hao; Tian, Yingchun; Wang, Yutang; Lip, Gregory Y H

    2016-01-01

    -VASc =1 had a 1.9 fold increase in stroke risk, and those with CHA2DS2-VASc ≥ 2 had more than four-fold increased risk for stroke, compared with those with CHA2DS2-VASc=0. In conclusion, an increasing cluster of multiple cardiovascular risk factors (besides AF) contributes to a greater risk for ischaemic stroke, especially in the elderly population. If elderly and with multiple risk factors, non-AF patients may have a risk of incident ischaemic stroke that is comparable or even higher than patients with AF, suggesting that the incremental stroke risk attributable to AF is marginal in such 'high risk' patients. PMID:26322338

  4. [Stories by the elderly].

    PubMed

    Cintra, Fernanda A; Delboux Diogo, Maria José; Filomena Ceolim, Maria

    2005-10-01

    This Brazilian article bears interest for its qualitative methodology which allows us to get a feeling for the elderly of this country being able to relate the results of their lives and knowledge to our own. The lack of an educational health program for the elderly led the authors to create the Health Care Group for the Elderly (GRASI in Portuguese) in which we developed an educational program based on the social-historical perspective of L. S. Vygotsky. This current study analyzes the dynamic speeches recorded by a group of elderly in the GRASI educational program. A group of seven elderly people, from both sexes, having an age equal to or greater than 60, participated in an analysis of the content from meetings among themselves. To analyze the data obtained, in the underlying text as well as their recorded speech, the feelings and meanings of their conversations and stories were identified and separated into thematic units. The results obtained reveal that the opportunity to express their experiences regarding the transformation the elderly have lived during their lives, and to find new ways to treat health problems or how to carry out self health care, is an important resource for elderly nursing care which can lead to the development of health education programs. PMID:16304835

  5. Social support and mobility limitation as modifiable predictors of improvement in depressive symptoms in the elderly: results of a national longitudinal study.

    PubMed

    Lee, Chun-Te; Yeh, Chih-Jung; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Vincent Chin-Hung; Hsieh, Ming-Hong; Yen, Chi-Hua; Lai, Te-Jen

    2012-01-01

    Few national longitudinal studies have investigated the predictors of a better depression outcome in geriatric depression. This study examined the predictors of improvement in case-level depressive symptoms in the elderly. In this prospective cohort and population-based study in Taiwan, 206 non-demented and case-level depressed subjects aged 65 and older were interviewed at baseline in 2003 and follow-up in 2007. The independent variables included demographics, chronic medical diseases, and health-related behaviors assessed at baseline. The dependent variable was depressive symptoms, assessed using the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CESD-10) assessed at follow-up. Multivariate analyses were used to identify the predictors of improvement in depression. The independent predictors of improvement in depression over a 4-year follow-up period are more social support and fewer mobility limitations at baseline. With regards to practical health-related behaviors, the 2 items of social support most associated with improvement in depression were willingness of significant others to talk with you and satisfaction with dependence upon significant others; the 2 items of mobility limitations most associated with non-improvement of depression were difficulty in carrying things and squatting. These findings suggested that health-related behaviors were important to the depression outcome in the elderly; moreover, interventions to improve depression should include practical health-related behaviors aimed at these modifiable risk factors. PMID:22459317

  6. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS).

    PubMed

    2008-12-01

    The benefits of lowering a systolic blood pressure below 140 mmHg in elderly hypertension remain controversial. This study is a prospective, randomized, open-label study with blinded assessment of endpoints to compare the 2-year effect of strict treatment to maintain systolic blood pressure below 140 mmHg with that of mild treatment to maintain systolic blood pressure below 160 but at or above 140 mmHg in elderly hypertensive patients. Patients with essential hypertension (65-85 years old, with a pretreatment systolic blood pressure of above 160 mmHg) were randomly assigned to receive strict treatment (n=2,212) or mild treatment (n=2,206). The baseline drug was efonidipine hydrochloride, a long-acting calcium antagonist. The primary endpoint was the combined incidence of cardiovascular disease and renal failure, and the secondary endpoints were total deaths and any safety problems. Although final blood pressures (systolic/diastolic) were significantly lower in the strict-treatment group compared with the mild-treatment group (135.9/74.8 vs. 145.6/78.1 mmHg; p<0.001), the incidence of the primary endpoint was similar in the two groups (86 patients in each group; p=0.99). Total deaths were 54 in the strict-treatment group vs. 42 in the mild-treatment group (p=0.22), and treatment was withdrawn because of adverse events in 36 patients in each group (p=0.99). An interaction between age and treatment for the primary endpoints (p=0.03) was seen. Complex clinical features associated with aging seem to have obscured the difference in effect between the two treatments. Further studies are needed to assess the optimal treatment strategy for hypertension in the elderly. PMID:19139601

  7. Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden.

    PubMed Central

    Nicholson, K. G.; Kent, J.; Hammersley, V.; Cancio, E.

    1997-01-01

    OBJECTIVE: To evaluate the disease burden of upper respiratory infections in elderly people living at home. DESIGN: Prospective surveillance of elderly people. INTERVENTION: None. SETTING: Leicestershire, England SUBJECTS: 533 subjects 60 to 90 years of age. MAIN OUTCOME MEASURES: Pathogens, symptoms, restriction of activity, duration of illness, medical consultations, interval between onset of illness and medical consultation, antibiotic use, admission to hospital, and death. RESULTS: 231 pathogens were identified for 211 (43%) of 497 episodes for which diagnostic specimens were available: 121 (52%) were rhinoviruses, 59 (26%) were coronaviruses, 22 (9.5%) were influenza A or B, 17 (7%) were respiratory syncytial virus, 7 (3%) were parainfluenza viruses, and 3 (1%) were Chlamydia species; an adenovirus and Mycoplasma pneumoniae caused one infection each. Infections occurred at a rate of 1.2 episodes per person per annum (95% confidence interval 1.0 to 1.7; range 0-10) and were clinically indistinguishable. Lower respiratory tract symptoms complicated 65% of upper respiratory infections and increased the medical consultation rate 2.4-fold (chi 2 test P < 0.001). The median interval between onset of illness and medical consultation was 3 days for influenza and 5 days for other infections. Rhinoviruses caused the greatest disease burden overall followed by episodes of unknown aetiology, coronaviruses, influenza A and B, and respiratory syncytial virus. CONCLUSIONS: Respiratory viruses cause substantial morbidity in elderly people. Although respiratory syncytial virus and influenza cause considerable individual morbidity, the burden of disease from rhinovirus infections and infections of unknown aetiology seems greater overall. The interval between onset of illness and consultation together with diagnostic difficulties raises concern regarding the role of antiviral drugs in treating influenza. PMID:9366736

  8. Food variety and dietary diversity as indicators of the dietary adequacy and health status of an elderly population in Sharpeville, South Africa.

    PubMed

    Oldewage-Theron, Wilna H; Kruger, Rozanne

    2008-01-01

    This cross-sectional, analytical study was a comprehensive health assessment focusing on dietary quality of 170 randomly selected elderly respondents in Sharpeville, South Africa. The methods included a sociodemographic, health food frequency questionnaire, 24h-recall questionnaires, and anthropometric and biochemical measurements. The low mean +/- standard deviation (SD) dietary diversity score (3.41 +/- 1.34) and food variety score (4.77 +/- 2.2) compared with poverty parameters confirmed household food insecurity in this community. Although three (n = 99, 58.6%) or two (n = 49, 28.9%) daily meals were mostly consumed, these were mainly carbohydrate-based and nutrient-deficient. The cereal group (2.01 +/- 0.81) had the highest mean food variety score +/- SD, followed by dairy (0.62 +/- 0.53) and flesh foods (0.40 +/- 0.53). When a mean adequacy ratio of 70% was used as a cut-off point for nutrient adequacy, it was found that the food variety score must be eight or higher and the dietary variety score must be at least six. These indicators thus have a high ability to identify those respondents with an inadequate diet but lower ability to identify those respondents with a nutritionally adequate diet. The data further showed a trend that with a higher food variety and dietary diversity, a better mean adequacy ratio is reached for this low-income group of elderly subjects. In conclusion, the results showed that food variety and dietary diversity scores give a fairly good assessment of the adequacy of the diet, and scoring dietary diversity is a significant, yet simple tool to identify elderly persons at risk of food and nutrition insecurity. PMID:18928193

  9. Use of the Montreal Cognitive Assessment test to investigate the prevalence of mild cognitive impairment in the elderly elective surgical population.

    PubMed

    Na, Smith; Yy, Yeow

    2016-09-01

    Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test. Secondarily, we wished to determine the proportion of patients with mild cognitive impairment who presented with this information available, the effect of increasing age on the prevalence of mild cognitive impairment and whether the timing and location of testing influenced results. We used the Montreal Cognitive Assessment test to screen preoperative patients aged 65 years and over. Our results suggested a potential prevalence of mild cognitive impairment of 56%, with prevalence increasing with age. No patients in the sample had a recorded diagnosis of mild cognitive impairment. Testing in either the preadmission clinic or on admission on the day of surgery yielded similar results. We found the Montreal Cognitive Assessment test to be a simple screening tool that was easily administered during the pre-admission visit. PMID:27608340

  10. Elderly health and literature therapy: a theoretical review.

    PubMed

    Eum, Yeongcheol; Yim, Jongeun; Choi, Wonjae

    2014-01-01

    Recently, the problems of old age have been discussed in terms of two aspects: preventive and therapeutic approach. The previous studies on the preventive aspect have been mostly concerned with the educational preparation for successful approach to elderly, directing focus toward the transitional period of the old age. Most research into the therapeutic aspect on the elderly diseases has focused on organic mental disorders such as dementia and functional mental diseases such as depression. This study aims to suggest the preventive and new therapeutic possibility in old people through combining the elderly health with literature. First, the research results regarding the social background for the elderly problems indicate that geriatric diseases increase in proportion to the increase of the population. Secondly, for the literature therapy, it is initially required to seek a comprehensive understanding about the health of the elderly through the phased consideration for the elderly problems. Thirdly, for the treatment of geriatric diseases by using literature, it is necessary to develop more active and integrative literature therapy than passive bibliotherapy. Literature therapy is the use of literature in the treatment of people with emotional or mental illness. Fourthly, theoretical approach should be considered for the health of the elderly and the literature therapy. From a literary approach, the literature therapy can help the study on geriatric diseases such as dementia and depression. Thus, the program for the health of geriatric issues and literature therapy should be developed as the next step in the future. PMID:24522118

  11. Hypofractionated Radiotherapy and Stereotactic Boost with Concurrent and Adjuvant Temozolamide for Glioblastoma in Good Performance Status Elderly Patients – Early Results of a Phase II Trial

    PubMed Central

    Floyd, Scott R.; Kasper, Ekkehard M.; Uhlmann, Erik J.; Fonkem, Ekokobe; Wong, Eric T.; Mahadevan, Anand

    2012-01-01

    Glioblastoma Multiforme (GBM) is an aggressive primary brain neoplasm with dismal prognosis. Based on successful phase III trials, 60 Gy involved-field radiotherapy in 30 fractions over 6 weeks [Standard radiation therapy (RT)] with concurrent and adjuvant temozolomide is currently the standard of care. In this disease, age and Karnofsky Performance Status (KPS) are the most important prognostic factors. For elderly patients, clinical trials comparing standard RT with radiotherapy abbreviated to 40 Gy in 15 fractions over 3 weeks demonstrated similar outcomes, indicating shortened radiotherapy may be an appropriate option for elderly patients. However, these trials did not include temozolomide chemotherapy, and included patients with poor KPS, possibly obscuring benefits of more aggressive treatment for some elderly patients. We conducted a prospective Phase II trial to examine the efficacy of a hypofractionated radiation course followed by a stereotactic boost with concurrent and adjuvant temozolomide chemotherapy in elderly patients with good performance status. In this study, patients 65 years and older with a KPS > 70 and histologically confirmed GBM received 40 Gy in 15 fractions with 3D conformal technique followed by a 1–3 fraction stereotactic boost to the enhancing tumor. All patients also received concurrent and adjuvant temozolomide. Patients were evaluated 1 month post-treatment and every 2 months thereafter. Between 2007 and 2010, 20 patients (9 males and 11 females) were enrolled in this study. The median age was 75.4 years (range 65–87 years). At a median follow-up of 11 months (range 7–32 months), 12 patients progressed and 5 are alive. The median progression free survival was 11 months and the median overall survival was 13 months. There was no additional toxicity. These results indicate that elderly patients with good KPS can achieve outcomes comparable to the current standard of care using an abbreviated

  12. Pain in the Elderly.

    PubMed

    Jones, Mark R; Ehrhardt, Ken P; Ripoll, Juan G; Sharma, Bharat; Padnos, Ira W; Kaye, Rachel J; Kaye, Alan D

    2016-04-01

    Pain management in the elderly has increasingly become problematic in the USA as the aged population grows. The proportion of the population over 65 continues to climb and may eclipse 20 % in the next decade. In order to effectively diagnosis and treat these patients, a proper history and physical exam remain essential; pain assessment scales such as the Verbal Descriptor Scales (VDS), the Numerical Rating Scales (NRS), and the Visual Analogue Scales (VAS) often but not always prove beneficial. The conditions most frequently afflicting this population include osteoarthritis, diabetic neuropathy, post-herpetic neuralgia, and lower back pain which include spondylosis and radiculopathies. While the normal aging process does not necessarily guarantee symptoms of chronic pain, elderly individuals are far more likely to develop these painful conditions than their younger counterparts. There are many effective treatment modalities available as potential therapeutic interventions for elderly patients, including but not limited to analgesics such as NSAIDs and opioids, as well as multiple interventional pain techniques. This review will discuss chronic pain in the elderly population, including epidemiology, diagnostic tools, the multitude of co-morbidities, and common treatment modalities currently available to physicians. PMID:26896947

  13. Low DHEAS levels are associated with depressive symptoms in elderly Chinese men: results from a large study.

    PubMed

    Wong, Samuel Y S; Leung, Jason C; Kwok, Timothy; Ohlsson, Claes; Vandenput, Liesbeth; Leung, Ping C; Woo, Jean

    2011-11-01

    This study investigated the association between depressive symptoms in elderly Chinese men and the total testosterone, dehydroepiandrosterone (DHEA), DHEA sulphate (DHEAS), oestradiol and sex hormone-binding globulin (SHBG) levels, and the free androgen index. Cross-sectional data from 1147 community-dwelling elderly men, aged 65 and older, were used. Depressive symptoms were measured using the Chinese Geriatric Depression Scale (GDS). Total testosterone, free testosterone, DHEA, DHEAS, total oestradiol, the free androgen index and SHBG levels were assessed. DHEA was significantly associated with GDS score, and there was a trend towards DHEAS association, but this was not significant (β=-0.110, P=0.015; β=-0.074, P=0.055). However, no association was seen between depressive symptoms and total testosterone levels, free testosterone levels, oestradiol levels or SHBG levels. In terms of the presence of clinically relevant depressive symptoms, there were no statistically significant differences between patients in the lowest quartile of sex steroid hormone levels and those in other quartiles of sex steroid hormone levels. Similarly to Western studies, our study shows that DHEA and DHEAS levels are associated with depressive symptoms. PMID:21874029

  14. Management of Anemia of Inflammation in the Elderly

    PubMed Central

    Macciò, Antonio; Madeddu, Clelia

    2012-01-01

    Anemia of any degree is recognized as a significant independent contributor to morbidity, mortality, and frailty in elderly patients. Among the broad types of anemia in the elderly a peculiar role seems to be played by the anemia associated with chronic inflammation, which remains the most complex form of anemia to treat. The origin of this nonspecific inflammation in the elderly has not yet been clarified. It seems more plausible that the oxidative stress that accompanies ageing is the real cause of chronic inflammation of the elderly and that the same oxidative stress is actually a major cause of this anemia. The erythropoietic agents have the potential to play a therapeutic role in this patient population. Despite some promising results, rHuEPO does not have a specific indication for the treatment of anemia in the elderly. Moreover, concerns about their side effects have spurred the search for alternatives. Considering the etiopathogenetic mechanisms of anemia of inflammation in the elderly population, an integrated nutritional/dietetic approach with nutraceuticals that can manipulate oxidative stress and related inflammation may prevent the onset of this anemia and its negative impact on patients' performance and quality of life. PMID:23091709

  15. Elderly Abuse and Alcohol Consumption.

    PubMed

    Rusac, Silvia

    2015-12-01

    Excessive alcohol consumption and the exposure of the elderly to family violence are in close connection. They represent both a general and social problem from a legal, medical and social aspect. The objectives of this study were to 1) test the frequency of alcohol consumption in older persons with respect to certain social and demographic characteristics; and 2) test the correlation between alcohol consumption and family violence towards the elderly. The sample used in this study was constructed as probabilistic with a random selection of participants in order to ensure representativeness for the City of Zagreb population over 65 years. The study included 1000 persons older than 65, among which 38% were male (N = 380) and 62% female (N = 620). The results showed a significantly more frequent consumption of alcohol among older men aged between 65 and 74, elderly people with life partners (unmarried), and financially independent older persons. A correlation between alcohol consumption frequency and exposure to violence was also established, as well as that older persons who consume alcohol are more likely to commit acts of violence. Further research is needed on the risk and protective factors for specific forms of family violence so as to detect the causes of violence within families as well as mechanisms that al- leviate coping with violence. PMID:26987154

  16. Effect of Gaboxadol on Sleep in Adult and Elderly Patients with Primary Insomnia: Results From Two Randomized, Placebo-Controlled, 30-Night Polysomnography Studies

    PubMed Central

    Lankford, D. Alan; Corser, Bruce C.; Zheng, Yan-Ping; Li, Zhengrong; Snavely, Duane B.; Lines, Christopher R.; Deacon, Steve

    2008-01-01

    Study Objectives: To evaluate the efficacy and tolerability of gaboxadol in the treatment of adult and elderly patients with primary insomnia. Design: Randomized, double-blind, placebo-controlled, multicenter, 30-night, polysomnography studies. Setting: Sleep laboratory. Patients: Primary insomnia, 18–64 y (adult study), or ≥65 y (elderly study). Interventions: Adult study: gaboxadol 15 mg (GBX15; N = 148), 10 mg (GBX10; N = 154), or placebo (N = 156); elderly study: GBX10 (N = 157), gaboxadol 5 mg (GBX5; N = 153), or placebo (N=176). Measurements and Results: Primary endpoints were wake after sleep onset (WASO) and latency to persistent sleep (LPS). Slow wave sleep (SWS) was a secondary endpoint. Analyses were based on the change from baseline for the average of nights 1/2, and nights 29/30, and compared gaboxadol versus placebo. Exploratory endpoints included patient's subjective assessment of total sleep time (sTST), WASO (sWASO), time to sleep onset (sTSO), and number of awakenings (sNAW); these analyses were based on weekly means. 1) Adult study. GBX15 significantly (P ≤ 0.05) improved WASO through nights 29/30 but had no significant effects on LPS. No significant differences were seen for GBX10 versus placebo on WASO or LPS. GBX15 and GBX10 enhanced SWS. GBX15 significantly improved sTST, sWASO, sTSO, and sNAW at weeks 1 and 4. 2) Elderly study. GBX10 significantly improved WASO through nights 29/30; a significant improvement was also seen for GBX5 at nights 1/2 but this was not maintained through nights 29/30. GBX10 significantly improved LPS at nights 1/2 but the improvement was not maintained through nights 29/30; no significant differences were seen for GBX5 versus placebo on LPS. GBX10 and GBX5 enhanced SWS. GBX10 significantly improved sTST at week 1, and sTST, sWASO, and sNAW at week 4. Gaboxadol was generally well tolerated in both studies. Conclusions: The maximum studied doses of gaboxadol (GBX15 in adult patients and GBX10 in elderly patients

  17. Detection of non-CLL-like monoclonal B cell lymphocytosis increases dramatically in the very elderly, while detection of CLL-like populations varies by race: findings in a multiethnic population-based cohort of elderly women.

    PubMed

    Edlefsen, Kerstin L; Cherian, Sindhu; De Roos, Anneclaire J; Getaneh, Asqual; Lessin, Lawrence; Li, Wenjun; Wood, Brent L; Reiner, Alexander P

    2016-10-01

    Monoclonal B cell lymphocytosis (MBL) is both a marker of immune senescence and a potential precursor of B cell malignancy. Most MBL populations have a chronic lymphocytic leukemia-like (CLL-like) immunophenotype, but those that are CD5-negative (non-CLL-like) are also recognized and may represent a distinct diagnostic entity. To date, MBL studies have taken place in relatively homogenous populations, although risk of CLL varies across racial groups and geographic regions. We report flow cytometry data from 597 ethnically diverse 64-94-year-old women from across the USA who are participants in the Women's Health Initiative (WHI) Long-Life Study (LLS). Overall, MBL was detected in 26 % of the participants and included 20.9 % with a CLL-like immunophenotype, 5 % with a non-CLL-like immunophenotype, and 1.3 % with both. White and Hispanic women were more than twice as likely to have a CLL-like MBL population detected than African American women, corrected for age (P = 0.003). By contrast, detection of non-CLL-like MBL did not vary significantly by race, but did increase markedly with advancing age, being present in 12.7 % of those aged 85 and older. We provide new evidence that rates of detection of CLL-like MBL are lower in African Americans, and further suggest that non-CLL-like clonal expansions should be regarded as distinct from CLL-like MBL. PMID:27468854

  18. Design, methodology and baseline characteristics of Tai Chi and its protective effect against ischaemic stroke risk in an elderly community population with risk factors for ischaemic stroke: a randomised controlled trial

    PubMed Central

    Zheng, Guohua; Zheng, Xin; Li, Junzhe; Duan, Tingjin; Qi, Dalu; Ling, Kun; He, Jian; Chen, Lidian

    2015-01-01

    Introduction Controlling risk factors with regular exercise is effective and cost-effective for the primary prevention of ischaemic stroke. As a traditional Chinese form of exercise, Tai Chi might be beneficial in decreasing ischaemic stroke, but the evidence remains insufficient. We hypothesise that elderly community adults with risk factors for ischaemic stroke will decrease their ischaemic stroke risk by improving cerebral haemodynamic parameters, cardiopulmonary function, motor function, plasma risk indices, physical parameters or psychological outcomes after receiving 12 weeks of regular Tai Chi training compared with those who maintained their original physical activities. Therefore, we designed a randomised controlled trial that will systematically evaluate the protective effects of Tai Chi exercise on ischaemic stroke risk in an elderly community population with risk factors for ischaemic stroke. Methods and analysis A total of 170 eligible participants were randomly allocated into either the Tai Chi training group or the usual physical activity group. This paper reports on the design, intervention development and baseline characteristics of the participants. There were no significant differences between comparison groups in demographic characteristics or the baseline data of primary or secondary outcomes. Participants in the Tai Chi training group will receive 12 weeks of Tai Chi training with a frequency of 5 days/week and 60 min/day, while those in the usual physical activities group will maintain their original activities. Primary and secondary outcomes will be measured at the 12-week and 24-week follow-ups. Ethics and dissemination Ethical approval has been obtained from the Medical Ethics Committee of The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine (number 2013-020-02). The findings of this study will be communicated to healthcare professionals, participants and the public through peer

  19. Restoration of root surface caries in vulnerable elderly patients: a review of the literature.

    PubMed

    Amer, R S; Kolker, J L

    2013-01-01

    The authors conducted a review to evaluate the current literature addressing root surface caries treatment in the vulnerable elderly, to identify any gaps in the literature that will need to be addressed in the future. The authors conducted a literature search of the electronic databases using MEDLINE, PubMed, to identify original clinical research articles regarding treatment of root caries lesions, with emphasis on research focused on the vulnerable elderly. Five articles were clinical studies of root caries restorations. Only one was conducted on a vulnerable elderly population. The results of the literature review show that there is a need for further studies addressing the restorative needs of the vulnerable elderly. With the aging of the American population, more research is needed to provide adequate care to this population. At this time, glass ionomers are a good treatment option. PMID:23600986

  20. Meals for the Elderly

    NASA Technical Reports Server (NTRS)

    1977-01-01

    NASA is drawing upon its food-preparation expertise to assist in solving a problem affecting a large segment of the American population. In preparation for manned space flight programs, NASA became experienced in providing astronauts simple, easily-prepared, nutritious meals. That experience now is being transferred to the public sector in a cooperative project managed by Johnson Space Center. Called Meal System for the Elderly, the project seeks to fill a gap by supplying nutritionally balanced meal packages to those who are unable to participate in existing meal programs. Many such programs are conducted by federal, state and private organizations, including congregate hot meal services and home-delivered "meals on wheels." But more than 3.5 million elderly Americans are unable to take advantage of these benefits. In some cases, they live in rural areas away from available services; in others, they are handicapped, temporarily ill, or homebound for other reasons. Meal System for the Elderly, a cooperative program in which the food-preparation expertise NASA acquired in manned space projects is being utilized to improve the nutritional status of elderly people. The program seeks to fill a gap by supplying nutritionally-balanced food packages to the elderly who are unable to participate b existing meal service programs.

  1. Elder abuse.

    PubMed

    Costa, A J

    1993-06-01

    Elder abuse is a tragedy both for the individual and for society because it occupies a pivotal position in the family life cycle of violence. Great variety exists among victims, abusers, and situations; thus, no single model is adequate to explain cause and direct treatment. Primary care physicians must be alert to the possibility of elder abuse in their patients and aware of resources within their community for managing cases once identified. Federal laws and regulations must take a proactive, long-term approach to the solution of this problem and must respect the autonomy of competent elderly patients. PMID:8356158

  2. Surgical management of the elderly elbow.

    PubMed

    Gibbs, V N; Middleton, R; Rees, J L

    2016-09-01

    The elbow has a major role in helping with the positioning of the hand in space. Any pathology of the joint can result in pain, loss of function and difficulties with activities of daily living. With an increasingly elderly population the degenerative conditions affecting the elbow are becoming more prevalent. Besides traumatic injury, the more commonly encountered problems are osteoarthritis, inflammatory arthritis, nerve compression and stiffness. An awareness of these conditions is important for those who provide care to this patient group. Whilst many of these conditions can be managed conservatively in primary care, some patients are referred to secondary care and elect for surgical treatments. This review considers the surgical treatments for the common elbow pathologies in the elderly population, including the potential complications associated with such treatments. PMID:27451319

  3. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis

    PubMed Central

    Wang, Chuanling; Tian, Fuming; Zhou, Yingjun; He, Wenbo; Cai, Zhiyou

    2016-01-01

    Background and purpose Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. Methods In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. Results The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. Conclusion A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of

  4. [Are the "elderly" living at the expense of the "young"? Remarks on the burden distribution between "generations" in an aging population from the economic perspective].

    PubMed

    Schmähl, W

    2002-08-01

    Public and scientific discussion on the effects of an aging population is often biased: aging is primarily seen as an economic burden. Increasing contribution rates in pension schemes, health and long-term care insurance are highlighted. This paper tries to provide a more balanced view. The distinction between a cross-sectional and a longitudinal view already gives different information on distributional effects. Labeling older people as "economically inactive" is a much too narrow perspective focused on the activity on the labor market only. Other types of work are neglected such as caring for children or frail elderly as well as economic activities from wealth, consumption as well as paying taxes to finance public expenditure. The approach of "generational accounting" is also narrow, focusing on public expenditure, social insurance contributions and only some types of taxes, but not dealing with private, especially intrafamily transfers. In economic terms, a comprehensive approach is needed regarding the effect of institutions and measures on the economic situation of cohorts. The role of investment in human capital is mentioned as a decisive factor for productivity in a country. Further education and retraining of older workers is one important element. An integrative approach dealing with the different fields of activities is needed when analyzing the intergenerational as well as the intragenerational distribution. This requires an elaborated and differentiated reporting of distributional effects. This important precondition, however, does not exist in Germany. PMID:12426877

  5. Projection of Young-Old and Old-Old with Functional Disability: Does Accounting for the Changing Educational Composition of the Elderly Population Make a Difference?

    PubMed Central

    Ansah, John P.; Malhotra, Rahul; Lew, Nicola; Chiu, Chi-Tsun; Chan, Angelique; Bayer, Steffen; Matchar, David B.

    2015-01-01

    This study compares projections, up to year 2040, of young-old (aged 60-79) and old-old (aged 80+) with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education)-specific transition probabilities (between active, functional disability and death states) estimated from two waves (2009 and 2011) of a nationally representative survey of community-dwelling Singaporeans aged ≥60 years (N=4,990). Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy. PMID:25974069

  6. The associations of gender, depression and elder mistreatment in a community-dwelling Chinese population: the modifying effect of social support.

    PubMed

    Dong, XinQi; Beck, Todd; Simon, Melissa A

    2010-01-01

    The aims of this study are to: (1) examine the gender differences in the association of depression and elder mistreatment (EM) in a community-dwelling Chinese population; and (2) examine the potential differential modifying effect of greater social support on these associations. We conducted a cross-sectional study of 141 women and 270 men aged 60 years or greater who presented to an urban medical center. EM was assessed using the modified Vulnerability to Abuse Screening Scale (VASS) and depression was assessed using the Geriatric Depression Scale (GDS) and overall social support was measured using the Social Support Index (SSI). After adjusting for potential confounders, depression was associated with 447% increased risk for EM among men (odds ratio, OR = 4.47; 95% confidence intervals (CI) = 1.52-13.13) and 854% increased risk for EM among women (OR = 8.54; 95% CI = 2.85-25.57). After examining the effect of greater social support on depression (social support x depression), depression was no longer associated with increased risk for EM in men (parameter estimate = PE = 0.62 + or - 0.82 (+ or - S.E.M.) = 0.82, p = 0.454). However, among women, depression remained as a significant risk factor for EM (PE = 1.49 + or - 0.68, p = 0.029). Depression is significant risk factor for EM for both men and women. However, effect of greater overall social support may have higher protective effect in men than in women. PMID:19398133

  7. Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review.

    PubMed

    Corrêa, Márcia Mara; Thumé, Elaine; De Oliveira, Elizabete Regina Araújo; Tomasi, Elaine

    2016-01-01

    A systematic review was carried out aiming to collect evidence on the use of the waist-to-height ratio (WHtR) on the elderly population, focusing on validity measures to identify the best anthropometric indicator in assessing obesity associated with non-communicable diseases. The review consisted in a search of papers published on the databases Pubmed, Web of Science, and Lilacs, with no restriction regarding period of publication, using the following combinations: abdominal fat or overweight or obesity and waist-to-height ratio or waist height or waist ht or WHtR or waist to stature ratio or wst stature or WSR or stature and girth. Sixteen papers were selected, most of which with high methodological quality. The receiver-operating characteristic (ROC) curves was the validity measure explored in 13 papers, followed by sensitivity and specificity measures. In all studies, the body mass index (BMI) and waist circumference (WC) received special attention for analysis along with WHtR. Five manuscripts showed evidence of WHtR being the best anthropometric index when used alone, four showed that both WHtR and WC had the best discriminatory power in predicting cardiovascular risk factors compared to the other indices, and two ranked WHtR at the same performance level as waist-to-hip ratio (WHR) and BMI. An association was shown of the obesity assessed by WHtR in predicting risk factors for cardiovascular diseases, metabolic syndrome, and diabetes compared to other anthropometric parameters. PMID:27061665

  8. Prevalence and Risk Factors of Abuse among Community Dwelling Elderly of Guwahati City, Assam

    PubMed Central

    Saikia, Anku Moni; Mahanta, Neelakshi; Mahanta, Ajaya; Deka, Ashok Jyoti; Kakati, Arupjyoti

    2015-01-01

    Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above) were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST). Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population. PMID:26435603

  9. Elder Abuse

    MedlinePlus

    ... Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs ... may be a sudden change in the person's financial situation. Elder abuse will not stop on its ...

  10. Elder Abuse

    MedlinePlus

    ... facilities or nursing homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, ...

  11. [Liver diseases in the elderly].

    PubMed

    Bruguera, Miguel

    2014-11-01

    Liver diseases in the elderly have aroused less interest than diseases of other organs, since the liver plays a limited role in aging. There are no specific liver diseases of old age, but age-related anatomical and functional modifications of the liver cause changes in the frequency and clinical behavior of some liver diseases compared with those in younger patients. This review discusses the most important features of liver function in the healthy elderly population, as well as the features of the most prevalent liver diseases in this age group, especially the diagnostic approach to the most common liver problems in the elderly: asymptomatic elevation of serum transaminases and jaundice. PMID:24951302

  12. Renal Cancer in the Elderly.

    PubMed

    González León, Tania; Morera Pérez, Maricela

    2016-01-01

    The increase of the aging population corresponds with the rise of renal cancer in elderly patients. The distinction between functional and chronological age, quality of life, and survival estimate are important issues, among others, that should be considered in the management of renal cancer in elderly patients. We made this review with the purpose of synthesizing the most updated criteria regarding indications and outcomes of the different therapeutic options in the management of elderly patients with renal cancer, beginning from the physiologic considerations that characterize them, their capacity to tolerate different therapeutic possibilities, and the prognosis of the patients' risks and comorbidity assessment. PMID:26715222

  13. Predictors of Extraordinary Survival in the Iowa Established Populations for Epidemiologic Study of the Elderly: Cohort follow-up to ‘Extinction’

    PubMed Central

    Dutta, Ambarish; Henley, William; Lang, Iain; Llewellyn, David; Guralnik, Jack; Wallace, Robert B; Melzer, David

    2011-01-01

    OBJECTIVES To identify predictors of extraordinary survival (ES). DESIGN Longitudinal study of a cohort of elderly people followed up until almost all have died SETTING Two counties in Iowa, USA, a part of the Epidemiological Study of the Elderly. PARTICIPANTS 2890 community-dwelling citizens, 65–85 years at baseline, surviving at least three years. MEASUREMENTS Data relating to age, sex, birth order, parental longevity, marital status, education, family income, social support, self-reported health, chronic diseases, blood pressure, body mass index, physical ability, exercises, life attitude and mental health were obtained. Extraordinary survivors were defined as those belonging to approximately top 10% longest survivors for their sex group. RESULTS 253 ES were far more likely to have never smoked. In basic models (age/sex/smoking adjusted) for earlier-life factors, parent’s longevity, being earlier in the birth order (in women only) and BMI at age 50 were associated with ES. In similar models for predictors at age 65–85 years (later-life or baseline), ES was associated with excellent self-reported health, fewest chronic diseases, better physical mobility, memory and positive attitude towards life, but not with depression, anxiety or sleep. In multi-variable models, attitude towards life was not an independent predictor. On a cumulative score of independent predictors, women in the top third of longevity attributes were 9.26 (CI 4.38–19.57, p<0.0001) times as likely to reach ES compared to bottom third. CONCLUSION Extraordinary survivors had fewer ‘classical’ risk factors and were in better health than their contemporaneous controls. Earlier-life, possibly genetic factors appear less predictive in men. PMID:21649635

  14. [The medical autonomy of elderly in Taiwan].

    PubMed

    Chen, Kai-Li; Chen, Ching-Huey

    2014-10-01

    The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan. PMID:25271030

  15. Edentulousness, Denture Wear and Denture Needs of the Elderly in Rural South India

    PubMed Central

    Ariga, P; Bridgitte, A; Rangarajan, V; Philip, J M

    2012-01-01

    Background: The objectives of this study were to evaluate the prevalence of edentulousness, patient’s perception on dietary changes resulting from tooth loss and to identify the disparity between actual and patient perceived need to replace missing teeth in an elderly rural population in south India. Methods: A cross sectional study using the systematic cluster sampling method was used to select the study sample of 150 elderly men and women. Data were collected using questionnaires and oral examination. The data were statistically analyzed using chi square test and pearson correlation. Results: 15.6% of the rural elderly were completely edentulous and 54.7% were partially edentulous. Observed differences in distribution between the sampled elderly age groups were found to be statistically significant. Although 70.3% of the evaluated elderly actually required prosthodontic treatment, only 14.4% perceived the need to replace missing teeth. A small percentage of the elderly (18%) perceived a severe change in their diets due to tooth loss. Thirty three percent of them perceived a moderate change and 28% felt that there were no dietary changes because of tooth loss. Conclusions: It is essential to identify feasible strategies to provide primary dental health education and treatment to all rural elderly in the future. We suggest community dental health services as a general health need of the elderly rather than a special health need of the community. PMID:23113208

  16. Association between muscular strength and inflammatory markers among elderly persons with cardiac disease: results from the KORA-Age study.

    PubMed

    Volaklis, K A; Halle, M; Koenig, W; Oberhoffer, R; Grill, E; Peters, A; Strasser, B; Heier, M; Emeny, R; Schulz, H; Ladwig, K H; Meisinger, C; Thorand, B

    2015-11-01

    Little is known about the association between muscle strength and inflammation in diseased individuals and particularly in cardiac patients. Thus, our purpose was to examine the association of muscular strength with the inflammatory status in older adults with and without cardiac disease. The cross-sectional analysis was based on 1079 adults aged 65-94 years, who participated in the KORA-Age study. Participants underwent an interview and extensive physical examinations including anthropometric measurements, registration of diseases and drug intake, determination of health-related behaviors, collection of blood samples for measurements of interleukin-6 and hs-CRP and muscle strength measurement using hand-grip dynamometry. Cardiac patients (n = 323) had higher levels of IL-6 and poorer muscle strength compared with older adults without cardiac disease. Among persons with cardiac diseases, muscle strength in the lower tertile compared to the upper tertile was significantly associated with increased odds of having elevated IL-6 levels (OR 3.53, 95 % CI 1.18-10.50, p = 0.024) after controlling for age, gender, body fat, alcohol intake, smoking status, diseases, medications and physical activity, whereas the association between muscle strength and hs-CRP remained borderline significant (OR 2.80, 95 % CI 0.85-9.24, p = 0.092). The same trends, with slightly lower odds ratios, were also observed in older adults without cardiac disease. Lower levels of muscular strength are associated with higher concentrations of IL-6 and hs-CRP in elderly individuals with and without cardiac disease suggesting a significant contribution of the muscular system in reducing low-grade inflammation that accompanies cardiac disease and aging. PMID:25967155

  17. Serum lipoprotein (a) concentrations are inversely associated with T2D, prediabetes, and insulin resistance in a middle-aged and elderly Chinese population[S

    PubMed Central

    Ding, Lin; Song, An; Dai, Meng; Xu, Min; Sun, Wanwan; Xu, Baihui; Sun, Jichao; Wang, Tiange; Xu, Yu; Lu, Jieli; Wang, Weiqing; Bi, Yufang; Ning, Guang

    2015-01-01

    Lipoprotein (a) [Lp(a)], an LDL-like particle, has been proposed as a causal risk factor for CVD among general populations. Meanwhile, both serum Lp(a) and diabetes increase the risk of CVD. However, the relationship between serum Lp(a) and T2D is poorly characterized, especially in the Asian population. Therefore, we conducted a cross-sectional study in 10,122 participants aged 40 years or older in Jiading District, Shanghai, China. Our study found that the prevalence of T2D was decreased from 20.9% to 15.0% from the lowest quartile to the highest quartile of serum Lp(a) concentrations (P for trend <0.0001). Logistic regression analyses showed that the odds ratios and 95% confidence intervals of prevalent T2D for quartiles 2–4 versus quartile 1 were 0.86 (0.73–1.01), 0.88 (0.75–1.04), and 0.76 (0.64–0.90) (P for trend = 0.0002), after adjustment for traditional confounding factors. Moreover, the risks for prevalent prediabetes, insulin resistance, and hyperinsulinemia were also decreased from the lowest to the top quartile. This inverse association between serum Lp(a) and T2D was not appreciably changed after we adjusted hypoglycemic medications or excluded the subjects with hypoglycemic and/or lipid-lowering agents and/or a history of self-reported CVD. PMID:25649924

  18. Engaging Elderly People in Telemedicine Through Gamification

    PubMed Central

    Tabak, Monique; Dekker - van Weering, Marit; Vollenbroek-Hutten, Miriam

    2015-01-01

    Background Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. Objective This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. Methods We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Results Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great

  19. Functional status of the elderly in Singapore--the trend over a decade.

    PubMed

    Lee, K S; Tan, T C

    1997-11-01

    The study looks at the level and types of functional disabilities of a random sample of elderly individuals in the community through direct interviews using a questionnaire in 1992 and compares the results to that obtained from a similar study done in 1982. Two hundred and eighty-three elderly aged 60 years and above were studied. In the activities of daily living (ADL) functions category, most elderly individuals were independent in dressing (96.1%), bathing (95.4%), preparing meals (92.6%) and using the toilet (89.4%). There was increasing disabilities in the instrumental activities of daily living (IADL) functions, in ascending order of difficulty--light chores (81.3% independent), shopping (67.8% independent) and heavy chores (60.1% independent). Eight (2.8%) of the elderly were confined to bed most of the time. Comparing the results with the 1982 cohort, the 1992 cohort was more dependent, with significant increase in difficulty with dressing, using the toilet, bathing, and higher functional activities. There was also significant increase in the number of elderly confined to bed most of the time, from 1% to 2.8%. The only activity that showed a reverse trend was food preparation. The trend of dependence among the elderly is growing and deserves further specific studies to examine the possible reasons for the increasing disabilities in the elderly population, especially as the population is ageing rapidly. PMID:9522968

  20. Hypertension in the elderly

    PubMed Central

    Lionakis, Nikolaos; Mendrinos, Dimitrios; Sanidas, Elias; Favatas, Georgios; Georgopoulou, Maria

    2012-01-01

    The elderly are the most rapidly growing population group in the world. Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age. The risk of coronary artery disease, stroke, congestive heart disease, chronic kidney insufficiency and dementia is also increased in this subgroup of hypertensives. Hypertension in the elderly patients represents a management dilemma to cardiovascular specialists and other practioners. During the last years and before the findings of the Systolic Hypertension in Europe Trial were published, the general medical opinion considered not to decrease blood pressure values similarly to other younger patients, in order to avoid possible ischemic events and poor oxygenation of the organs (brain, heart, kidney). The aim of this review article is to highlight the importance of treating hypertension in aged population in order to improve their quality of life and lower the incidence of the cardiovascular complications. PMID:22655162

  1. Association Between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project

    PubMed Central

    Dong, XinQi; Simon, Melissa

    2014-01-01

    Background Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. Methods Chicago Health and Aging Project (CHAP) cohort is a population-based study (N=4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. Results In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes (22.4% vs. 10.7% [WHO], 50.7% vs. 40.0% [AHA], and 47.7% vs. 33.5% [IDF]). After adjusting for potential confounding factors, elder abuse was associated with increased risk for metabolic syndromes according to WHO (OR, 3.95 (2.86-5.47), AHA (OR, 2.03 (1.56-2.64) and IDF (OR, 2.55 (1.97-3.29) criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics, but not by health related or psychosocial factors. Conclusion Elder abuse is associated with increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease. PMID:25471532

  2. The Comparison of the Minimum Data Set for Elderly Health in Selected Countries

    PubMed Central

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2015-01-01

    Introduction: Ongoing increase in the elderly population in many developed countries has drawn attention to health of this age group. Recording adequate and relevant data for the elderly is considered as the basis for future planning for this segment of society. So this study was conducted to compare minimum data about elderly health in selected countries. Methods: This review study was conducted through Internet and library studies. Key words were extracted from search engines and data bases including Google, Yahoo, Google Scholar, PubMed, ProQuest and Iranian National Medical Digital Library. Inclusion criteria included English language with no time limits. All articles, research projects, theses, guidelines and progress reports were retrieved from the United States, Sweden, Japan and Iran and reviewed. Also, websites of organizations responsible for elderly health in selected countries were visited and their documents were reviewed. Results from this search were provided narratively and finally were presented within comparison tables. Findings: The findings of this study showed that elderly data in the selected countries are collected around four axis including minimum demographic data, medical histories, health assessment and financial data of elderly health. Discussion and Conclusion: Given the importance of the minimum data set of elderly health for future planning, the use of experiences of leading countries in elderly health seems necessary; however, localization of it according to the country’s needs is inevitable. PMID:26862252

  3. A critical appraisal of lubiprostone in the treatment of chronic constipation in the elderly.

    PubMed

    Gras-Miralles, Beatriz; Cremonini, Filippo

    2013-01-01

    Chronic constipation is a common disorder in the general population, with higher prevalence in the elderly, and is associated with worse quality of life and with greater health care utilization. Lubiprostone is an intestinal type-2 chloride channel activator that increases intestinal fluid secretion, small intestinal transit, and stool passage. Lubiprostone is currently approved by the US Food and Drug Administration for the treatment of chronic idiopathic constipation and of irritable bowel syndrome with predominant constipation. This review outlines current approaches and limitations in the treatment of chronic constipation in the elderly and discusses the results, limitations, and applicability of randomized, controlled trials of lubiprostone that have been conducted in the general and elderly population, with additional focus on the use of lubiprostone in constipation in Parkinson's disease and in opioid-induced constipation, two clinical entities that can be comorbid in elderly patients. PMID:23439964

  4. Remote Safety Monitoring for Elderly Persons Based on Omni-Vision Analysis

    PubMed Central

    Xiang, Yun; Tang, Yi-ping; Ma, Bao-qing; Yan, Hang-chen; Jiang, Jun; Tian, Xu-yuan

    2015-01-01

    Remote monitoring service for elderly persons is important as the aged populations in most developed countries continue growing. To monitor the safety and health of the elderly population, we propose a novel omni-directional vision sensor based system, which can detect and track object motion, recognize human posture, and analyze human behavior automatically. In this work, we have made the following contributions: (1) we develop a remote safety monitoring system which can provide real-time and automatic health care for the elderly persons and (2) we design a novel motion history or energy images based algorithm for motion object tracking. Our system can accurately and efficiently collect, analyze, and transfer elderly activity information and provide health care in real-time. Experimental results show that our technique can improve the data analysis efficiency by 58.5% for object tracking. Moreover, for the human posture recognition application, the success rate can reach 98.6% on average. PMID:25978761

  5. Association of serum fatty acid and estimated desaturase activity with hypertension in middle-aged and elderly Chinese population

    PubMed Central

    Yang, Bo; Ding, Fang; Wang, Feng-Lei; Yan, Jing; Ye, Xiong-Wei; Yu, Wei; Li, Duo

    2016-01-01

    We aimed to investigate the cross-sectional associations of serum fatty acid (FA) and related Δ-desaturase with hypertension among 2,447 community-dwellers aged 35–79 years living in Zhejiang Province, China. Individual FA was determined in serum, Δ5-desaturase (D5D) and Δ6-desaturase (D6D) activities were indirectly estimated by FA product/precursor ratios. Participants in the highest quartile of D5D component scores (20:4n–6, 20:5n–3, 22:6n–3 and D5D) have significantly lower odds of hypertension compared with individuals in the lowest (multivariate-adjusted odds ratio (OR) = 0.68, 95% CI: 0.46–0.98). When further stratified by gender, high D5D component scores were significantly associated with lower odds of hypertension in women (OR = 0.53, 95% CI: 0.35–0.80), but not in men (OR = 0.78, 95% CI: 0.52-1.18). Multivariate-adjusted prevalent OR for an interquartile increment of individual FA and estimated desaturase was 1.27 (95% CI: 1.08–1.50) for 16:0, 1.15 (95% CI: 1.01–1.30) for 16:1n–7, 0.89 (95% CI: 0.80–0.99) for 22:6n–3, 1.32 (95% CI: 1.01–1.72) for D6D (18:3n–6/18:2n–6), and 0.74 (95% CI: 0.56, 0.98) for D5D (20:4n–6/20:3n–6). Present findings suggested that high serum 22:6n–3 and D5D as well as low 16:0, 16:1n–7 and D6D were associated with a low prevalence of hypertension in this Chinese population. PMID:27006169

  6. Socio-Demographic Variables and Successful Aging of the Angolan Elderly.

    PubMed

    Galiana, Laura; Gutiérrez, Melchor; Sancho, Patricia; Francisco, Elizabeth-Hama; Tomás, José M

    2016-01-01

    The proportion of elderly people is growing faster than any other age group. Amongst them, the group of oldest old is indeed the segment of the elderly population with the fastest growth rate. The increase in the proportion of elderly in the Angolan population makes research on this area badly needed. Within the theoretical framework of successful aging, the study aims to test for sociodemographic group differences in perceived health, life satisfaction, and social relations in Angolan elderly. The dependent variables are three of the components of what has been called successful aging. Data came from a cross-sectional survey of elderly people living in Luanda. 1003 Angolan elderly were surveyed on sociodemographic information, perceived health, life satisfaction, and social support. MANOVAs were calculated to test for mean differences in the dependent variables. Results permit to conclude that the factors associated with the largest differences on the Angolan elderly's quality of life and social relations were age (becoming oldest old) and institutionalization. The interactions of several factors with age pointed out that the oldest old were clearly a group in which the decreased quality of life due to becoming oldest old could not be compensated by other factors, as it was the case in the group of young old. PMID:27088039

  7. Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression.

    PubMed

    de Araújo, Aurigena Antunes; Rebouças Barbosa, Rosa Angélica Silveira; de Menezes, Marília Stefani Souza; de Medeiros, Ingrid Iana Fernandes; de Araújo, Raimundo Fernandes; de Medeiros, Caroline Addison Carvalho Xavier

    2016-06-01

    The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders. PMID:26195233

  8. Socio-Demographic Variables and Successful Aging of the Angolan Elderly

    PubMed Central

    Galiana, Laura; Gutiérrez, Melchor; Sancho, Patricia; Francisco, Elizabeth-Hama; Tomás, José M.

    2016-01-01

    The proportion of elderly people is growing faster than any other age group. Amongst them, the group of oldest old is indeed the segment of the elderly population with the fastest growth rate. The increase in the proportion of elderly in the Angolan population makes research on this area badly needed. Within the theoretical framework of successful aging, the study aims to test for sociodemographic group differences in perceived health, life satisfaction, and social relations in Angolan elderly. The dependent variables are three of the components of what has been called successful aging. Data came from a cross-sectional survey of elderly people living in Luanda. 1003 Angolan elderly were surveyed on sociodemographic information, perceived health, life satisfaction, and social support. MANOVAs were calculated to test for mean differences in the dependent variables. Results permit to conclude that the factors associated with the largest differences on the Angolan elderly's quality of life and social relations were age (becoming oldest old) and institutionalization. The interactions of several factors with age pointed out that the oldest old were clearly a group in which the decreased quality of life due to becoming oldest old could not be compensated by other factors, as it was the case in the group of young old. PMID:27088039

  9. Disaggregating measurement uncertainty from population variability and Bayesian treatment of uncensored results

    SciTech Connect

    Strom, Daniel J.; Joyce, Kevin E.; Maclellan, Jay A.; Watson, David J.; Lynch, Timothy P.; Antonio, Cheryl L.; Birchall, Alan; Anderson, Kevin K.; Zharov, Peter

    2012-04-17

    In making low-level radioactivity measurements of populations, it is commonly observed that a substantial portion of net results are negative. Furthermore, the observed variance of the measurement results arises from a combination of measurement uncertainty and population variability. This paper presents a method for disaggregating measurement uncertainty from population variability to produce a probability density function (PDF) of possibly true results. To do this, simple, justifiable, and reasonable assumptions are made about the relationship of the measurements to the measurands (the 'true values'). The measurements are assumed to be unbiased, that is, that their average value is the average of the measurands. Using traditional estimates of each measurement's uncertainty to disaggregate population variability from measurement uncertainty, a PDF of measurands for the population is produced. Then, using Bayes's theorem, the same assumptions, and all the data from the population of individuals, a prior PDF is computed for each individual's measurand. These PDFs are non-negative, and their average is equal to the average of the measurement results for the population. The uncertainty in these Bayesian posterior PDFs is all Berkson with no remaining classical component. The methods are applied to baseline bioassay data from the Hanford site. The data include 90Sr urinalysis measurements on 128 people, 137Cs in vivo measurements on 5,337 people, and 239Pu urinalysis measurements on 3,270 people. The method produces excellent results for the 90Sr and 137Cs measurements, since there are nonzero concentrations of these global fallout radionuclides in people who have not been occupationally exposed. The method does not work for the 239Pu measurements in non-occupationally exposed people because the population average is essentially zero.

  10. Nutrition in the elderly.

    PubMed

    Morley, J E; Mooradian, A D; Silver, A J; Heber, D; Alfin-Slater, R B

    1988-12-01

    Nutritional modulation is one approach to successful aging. In animals, dietary restriction increases life span. Alterations in the macronutrient and micronutrient constituent of the diet can modulate gene expression. Anorexia is common in elderly persons. The results of studies in animals suggest that aging is associated with a decrease in the opioid feeding drive and an increase in the satiating effect of cholecystokinin. Unrecognized depression is a common, treatable cause of anorexia and weight loss in elderly persons. Protein synthesis decreases in elderly persons; nevertheless, nitrogen balance can be maintained in patients with fairly low intakes of protein. Carbohydrate intolerance is common and may be modulated by nutritional intervention and physical activity. The role of cholesterol in the development of heart disease in very old persons is controversial. Homebound and institutionalized elderly persons often do not expose their skin to sunlight; because the skin of older persons has a decreased ability to form vitamin D, the vitamin D status in these persons is precarious and they are at risk for osteopenia. Vitamins are often abused by elderly persons. Drug administration alters the vitamin requirements of persons. Borderline zinc state has been associated with deteriorating immune function, especially in persons who have diabetes mellitus or who abuse alcohol. Zinc administration appears to protect against the deteriorating vision associated with age-related macular degeneration. Selenium deficiency seems to be associated with an increased prevalence of cancer. PMID:3056165

  11. Populations at Increased Risk for HIV Infection in Kenya: Results From a National Population-Based Household Survey, 2012

    PubMed Central

    Githuka, George; Hladik, Wolfgang; Mwalili, Samuel; Cherutich, Peter; Muthui, Mercy; Gitonga, Joshua; Maina, William K.; Kim, Andrea A.

    2016-01-01

    Background Populations with higher risks for HIV exposure contribute to the HIV epidemic in Kenya. We present data from the second Kenya AIDS Indicator Survey to estimate the size and HIV prevalence of populations with high-risk characteristics. Methods The Kenya AIDS Indicator Survey 2012 was a national survey of Kenyans aged 18 months to 64 years which linked demographic and behavioral information with HIV results. Data were weighted to account for sampling probability. This analysis was restricted to adults aged 18 years and older. Results Of 5088 men and 6745 women, 0.1% [95% confidence interval (CI): 0.03 to 0.14] were persons who inject drugs (PWID). Among men, 0.6% (CI: 0.3 to 0.8) had ever had sex with other men, and 3.1% (CI: 2.4 to 3.7) were males who had ever engaged in transactional sex work (MTSW). Among women, 1.9% (CI: 1.3 to 2.5) had ever had anal sex, and 4.1% (CI: 3.5 to 4.8) were women who had ever engaged in transactional sex work (FTSW). Among men, 17.6% (CI: 15.7 to 19.6) had been male clients of transactional sex workers (TSW). HIV prevalence was 0% among men who have sex with men, 6.3% (CI: 0 to 18.1) among persons who injected drugs, 7.1% (CI: 4.8 to 9.4) among male clients of TSW, 7.6% (CI: 1.8 to 13.4) among MTSW, 12.1% (CI: 7.1 to 17.1) among FTSW, and 12.1% (CI: 5.0 to 19.2) among females who ever had engaged in anal sex. Conclusions Population-based data on high-risk populations can be used to set realistic targets for HIV prevention, care, and treatment for these groups. These data should inform priorities for high-risk populations in the upcoming Kenyan strategic plan on HIV/AIDS. PMID:24732821

  12. Mid-term results of 17-mm St. Jude Medical Regent prosthetic valves in elder patients with small aortic annuli: comparison with 19-mm bioprosthetic valves.

    PubMed

    Teshima, Hideki; Ikebuchi, Masahiko; Sano, Toshikazu; Tai, Ryuta; Horio, Naohiro; Irie, Hiroyuki

    2014-09-01

    This study was designed to compare the mid-term outcomes after aortic valve replacement (AVR) between 17-mm mechanical heart valves (MV) and 19-mm bioprosthetic valves (BV) in elderly patients with small aortic annuli. Between 2000 and 2011, 127 consecutive patients (mean age 79 years; 87 % female) underwent AVR for aortic valve stenosis with a small aortic annulus. 19-mm BV (n = 67) was implanted. When the 19-mm BV did not fit the annulus, 17-mm St. Jude Medical Regent prosthetic mechanical valve (n = 60) was used instead of an aortic root-enlargement procedure. The follow-up rate was 94.0 % in the BV group, and 98.5 % in the MV group. No significant differences in survival rate and valve-related complications were found between the 2 groups. In-hospital mortality rates were 1.5 % (n = 1) in the BV group and 5.0 % (n = 3) in the MV group. Late mortality rates were 3.9 % per patient-years (p-y; n = 8) in the BV group, and 6.0 % per p-y (n = 10) in the MV group. Five-year Kaplan-Meier survival rates were 62 % in the BV group, and 72 % in the MV group (log-rank P = 0.280). Freedom from major adverse valve-related stroke and cerebral bleeding events was 92.5 and 98.5 % in the BV group, and 94.7 and 100 % in the MV group. AVR using 17-mm MV in elder patients with small aortic annuli provided equivalent mid-term clinical results to that with 19-mm BV. PMID:24878870

  13. Elder Abuse and Help-Seeking Behavior in Elderly Chinese.

    PubMed

    Yan, Elsie

    2015-09-01

    Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. PMID:25331371

  14. Hepatitis C Infection in the Elderly.

    PubMed

    Saab, Sammy; Rheem, Justin; Sundaram, Vinay

    2015-11-01

    Hepatitis C virus (HCV) infection in the elderly population is a global medical burden and healthcare utilization concern. The majority of patients with hepatitis C in the USA are "baby boomers," who were born between 1945 and 1965. Consistently worldwide, HCV infection in elderly population is overrepresented and poses public health concerns. These individuals have been infected now for over two decades and are presenting with advanced liver disease. Traditionally, the use of pegylated interferon-based therapy has been limited in the elderly because of its adverse effects. The sustained virologic responses have also tended to be lower in the elderly than in younger adults. The emergence of non-interferon-based therapy with direct acting antiviral agents has expanded the pool of patients eligible for treatment. These agents have been found to be effective, tolerable, and safe in the elderly population. PMID:26008618

  15. Prevalence of Alcohol Abuse among the Elderly.

    ERIC Educational Resources Information Center

    Woodward, Paul S.

    The current prevailing professional opinion is that the prevalence rates of alcohol abuse among the elderly are low compared to the general population. The prevalence of alcohol abuse among the elderly was examined through a review of the empirical research. This review revealed a number of serious methodological problems. The most important of…

  16. Effect of Tai Chi Exercise Combined with Mental Imagery Theory in Improving Balance in a Diabetic and Elderly Population

    PubMed Central

    Alsubiheen, Abdulrahman; Petrofsky, Jerrold; Daher, Noha; Lohman, Everett; Balbas, Edward

    2015-01-01

    Background One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Material/Methods Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), functional reach test (FRT) and hemoglobin A1C. These measures were taken twice, pre and post-study, for both groups. Results Both groups experienced significant improvements in ABC, OLS, FRT (P<0.01) after completing 8 weeks of TC exercise with no significant improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant change between groups. There was no significant change in HbA1C for the diabetic group. Conclusions All results showed an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Since the DM group had more problems with balance impairment at baseline than the control, the diabetic group showed the most benefit from the TC exercise. PMID:26454826

  17. Current challenges in antihypertensive treatment in the elderly.

    PubMed

    Imprialos, Konstantinos P; Boutari, Chrysoula; Stavropoulos, Konstantinos; Doumas, Michael; Athyros, Vasilios G; Karagiannis, Asterios I

    2016-08-25

    Arterial hypertension affects more than 25% of the global population, and its prevalence is increasing with age. Arterial stiffening occurs with aging and results in a pattern of increased systolic and decreased diastolic blood pressure (BP). In the elderly population, elevated BP has been related with increased cardiovascular risk. Trials on this population have shown great benefits for morbidity and mortality from reducing systolic BP (SBP) levels to less than 150 mmHg. Most guidelines for the management of elderly hypertensive patients agree on BP reduction to less than 150/90 mmHg. However, there is still uncertainty whether further BP reduction could provide beneficial results. The recently published SPRINT trial demonstrated that reducing SBP to between 120 and 125 mmHg in patients over the age of 75 years is related with increased survival and is expected to affect future recommendations. On the contrary, the limited data that are available for octogenarians and frail nursing home patients create concerns for more aggressive BP strategies in these subgroups, and thus they should be treated more conservatively. Among the various antihypertensive classes of drugs, diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers were proved beneficial in the elderly and are favored as first choices for the management of elderly hypertensive individuals. Given the common coexistence of other comorbidities and polypharmacy, physicians should be careful when initiating or uptitrating treatments to avoid potential adverse events or interaction with other drugs or diseases. PMID:27578222

  18. Arrests for Major Crimes: Trends and Patterns for Elderly Offenders.

    ERIC Educational Resources Information Center

    Sapp, Allen D.

    1989-01-01

    Examined data from the Uniform Crime Reports of the Federal Bureau of Investigation for 1972 through 1981. Findings indicated that the percentage of all arrests that were arrests of the elderly was declining while the elderly population itself was rapidly increasing; and the percentage of elderly arrests for index (major) crimes was increasing…

  19. Families and Elder Care in the Twenty-First Century

    ERIC Educational Resources Information Center

    Bookman, Ann; Kimbrel, Delia

    2011-01-01

    Although most Americans know that the U.S. population is aging, they are far less informed about the reality of providing elders with personal care, health care, and social support. Families--particularly women--have always been critical in providing elder care, but the entry of so many women into the paid labor force has made elder care…

  20. Nutritional assessment of institutionalized elderly

    PubMed Central

    Volpini, Milena Maffei; Frangella, Vera Silvia

    2013-01-01

    ABSTRACT Objective: To define the nutritional profile of institutionalized elderly individuals. Methods: Comparative correlation and quantitative field study conducted in a Long-Stay Institution in Sao Paulo (SP), Brazil, between December 2010 and January 2012. To define nutritional diagnosis, data were collected from patient files, such as body mass index, circumferences, triceps skinfold, muscle area of the arm, thickness of the adductor pollicis, handgrip strength, and biochemical test results. The anthropometric variables were presented as mean, standard deviation, and percentages, and were grouped by gender and stratified by age. The level of statistical significance was p<0.05. Results: One hundred and two elderly individuals were selected, and 84 were females. Excess weight was the most common anthropometric diagnosis in men (n=11; 61%), with the detection of protein depletion in those aged 70 years, and possible cases of sarcopenic obesity. All women were in good health conditions (n=84; 100%). However, in 27% (n=23) of them, protein depletion was evident. Conclusion: More anthropometric studies are necessary which would allow a definition of local reference standards, stratified by gender and age group. The difference between populations and factors, such as inclusion and exclusion criteria, and methodological characteristics, limit the use of international standards, interfering in the reliability of the nutritional diagnosis. PMID:23579741

  1. Implantable intrathecal pumps for the treatment of noncancer chronic pain in elderly population: drug dose and clinical efficacy.

    PubMed

    Raffaeli, William; Righetti, Donatella; Caminiti, Alessandro; Ingardia, Alessandro; Balestri, Marco; Pambianco, Lucia; Fanelli, Guido; Facondini, Francesca; Pantazopoulos, Pantazis

    2008-01-01

    Objective.   This study aims to assess long-term follow-up of efficacy and quality of life for 34 geriatric patients (10 men, 24 women, mean age 72.3 ± 11.6 years) with intrathecal (IT) drug delivery systems (IDDS), implanted between 1994 and 2002, for the treatment of severe noncancer chronic pain. Methods.   Patients equal to or older than 64 years, who had no pain relief after administration of a placebo injection (subcutaneous saline), and who responded positively to an IT trial (morphine and bupivacaine at low doses) with pain relief greater 70% without intolerable adverse effects were included into our study. Clinical assessment forms and questionnaires assessing pain intensity, adverse events, complications, concommitent use of analgesics, and doses of IT drugs administered were filled out by our patients prior to and after IT drug delivery implantation. Results.   Pain intensity was substantially reduced (60%) at three-month follow-up after commencing IT therapy and was consistently reduced at 48-month follow-up. The mean visual analog scale (VAS) value decreased from 8.09 (± 1.25) before implantation to 1.68 (± 0.63) after implantation at 48-month follow-up. This benefit, at 48 months, was achieved using mean low doses of IT morphine and bupivacaine, 1.03 ± 0.61 mg and 1.15 ± 0.58 mg, respectively. Only two out of 34 patients (5.9%) had complications related to the implantation procedure, itself. Side-effects of therapy were reported by 50% of the patients, the most frequent being constipation (34.4%), drowsiness (21.9%), nausea (21.9%), and urinary retention (18.8%). No side-effects of therapy resulted in removal of the IDDS. Conclusion.   The use of IT drug delivery through IDDS for the treatment of non-cancer- and cancer-related pain in geriatric patients is successful. PMID:22150989

  2. Geographical patterns of turnover and nestedness-resultant components of allelic diversity among populations.

    PubMed

    Diniz-Filho, Jose Alexandre Felizola; Collevatti, Rosane Garcia; Soares, Thannya Nascimento; Telles, Mariana Pires de Campos

    2012-06-01

    The analysis of geographical patterns in population divergence has always been a powerful way to infer microevolutionary processes involved in population differentiation, and several approaches have been used to investigate such patterns. Most frequently, multivariate spatial patterns of population differentiation are analyzed by computing pairwise genetic distances or F(ST) (or related statistics, such as ϕ(ST) from AMOVA), which are then correlated with geographical distances or landscape features. However, when calculating distances, especially based on presence-absence of alleles in local populations, there would be a confounding effect of allelic richness differences in the population differentiation. Moreover, the relative magnitude of these components and their spatial patterns can help identifying microevolutionary processes driving population differentiation. Here we show how recent methodological advances in ecological community analyses that allows partitioning dissimilarity into turnover (turnover) and richness differences, or nestedness-resultant dissimilarity, can be applied to allelic variation data, using an endemic Cerrado tree (Dipteryx alata) as a case study. Individuals from 15 local populations were genotyped for eight microsatellite loci, and pairwise dissimilarities were computed based on presence-absence of alleles. The turnover of alleles among populations represented 69 % of variation in dissimilarity, but only the richness difference component shows a clear spatial structure, appearing as a westward decrease of allelic richness. We show that decoupling richness difference and turnover components of allelic variation reveals more clearly how similarity among populations reflects geographical patterns in allelic diversity that can be interpreted in respect to historical range expansion in the species. PMID:22886007

  3. The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012.

    PubMed

    Taheri Tanjani, Parisa; Moradinazar, Mehdi; Esmail Mottlagh, Mohammad; Najafi, Farid

    2015-01-01

    DM type II is one of the most common chronic diseases. The objective of this study is to investigate the prevalence of DM and its association with other age-related diseases in Iran, 2012. In this cross-sectional study, people aged 60 years and over were selected using multistage sampling method. Mini-Nutritional Assessment (MNA), Activity of Daily Living (ADL), and Geriatric Depression Scale (GDS-15 items) questionnaires were used. History of common disorders was taken through self-report, medical records and the results of clinical examinations. A total of 1350 old people were studied. DM type II was found in 297 (22.0%) subjects and 371 (27.5%) of subjects were not aware of their DM status. Hypertension (55.6%), high serum cholesterol (51.8%), malnutrition (40.1%), Alzheimer's disease (16.9%), weight loss within past year (16.1%), weight gain within past year (11.7%), frailty (64.6%), insomnia (50.1%), and vision problems (62.6%) were significantly more common in diabetics. Those who were not aware of their status of DM either were between diabetics and non-diabetics or more similar to non-diabetics. Considering high prevalence of age-related diseases among Iranian elderly people, in particular women and those with DM type II, preventive measures are recommended so as to decrease and control DM type II and its consequent complications. PMID:25623857

  4. Elder Abuse.

    PubMed

    Lachs, Mark S; Pillemer, Karl A

    2015-11-12

    Because older victims of abuse tend to be isolated, their interactions with physicians are important opportunities to recognize abuse and intervene. This review explores the manifestations of elder abuse and the role of multidisciplinary teams in its assessment and management. PMID:26559573

  5. Isolated Elderly.

    ERIC Educational Resources Information Center

    Fischer, Lucy Rose; And Others

    The Minnesota Senior Study, the first statewide survey of the elderly in nearly 20 years, was based on a telephone survey with a statewide sample of 1,500 non-institutionalized Minnesotans age 60 and older. Substantial numbers of Minnesotans age 60-plus were found to have low social contacts. Five percent, or about 33,000 older Minnesotans, fell…

  6. Elderly Suicide

    MedlinePlus

    ... for completing suicide among the elderly. Men use firearms more often than women. • Alcohol or substance abuse plays a diminishing role in later life suicides compared to younger suicides. Source: Centers for Disease Control and Prevention. National Vital Statistics System. Mortality Data. ...

  7. Differential influence of physical activity on lumbar spine and femoral neck bone mineral density in the elderly population.

    PubMed

    Vuillemin, A; Guillemin, F; Jouanny, P; Denis, G; Jeandel, C

    2001-06-01

    This study investigates the relationship between lifetime physical activity and bone mineral density (BMD) at various sites in 129 healthy men and women aged 72.1 +/- 6.5 years. BMD was measured by dual energy x-ray absorptiometry, and physical activity was assessed by using the QUANTAP system (Quantification de l'Activité Physique), a standardized and structured computer-assisted interview tool designed to assess lifetime physical activity. Linear regression models controlling for age, gender, height, body mass, lean mass, and smoking habits were performed. Higher levels of sporting activity during youth were associated with greater lumbar spine BMD ( p < .001). Similarly, femoral neck BMD was greatest in subjects who reported regularly taking part in sports over the previous 20 years ( p <. 05) and during their whole lifetime ( p < 0.05). Sporting activity at the time of bone mass development increases subsequent lumbar spine BMD, and more recent sporting activity contributes to the preservation of femoral neck BMD. These results suggest that physical activity has a differential influence on BMD at different sites and at different ages, possibly related to the processes of bone construction and bone aging taking place at the time. PMID:11382786

  8. [Chronic heart failure in the elderly patient].

    PubMed

    Chivite, David; Franco, Jhonatan; Formiga, Francesc

    2015-01-01

    The prevalence and incidence of heart failure (HF) is increasing, especially in the elderly population, and is becoming a major geriatric problem. Elderly patients with HF usually show etiopathogenic, epidemiological, and even clinical characteristics significantly different from those present in younger patients. Their treatment, however, derives from clinical trials performed with only a few elderly subjects. Moreover, beyond the cardiovascular disease itself, it is essential to evaluate the patient as a whole, given the interrelationship between HF and the characteristic geriatric syndromes of the elderly patient. This review examines the peculiarities in the most prevalent "real world" HF patient. PMID:25962334

  9. Breast cancer in the elderly.

    PubMed

    Crivellari, Diana; Aapro, Matti; Leonard, Robert; von Minckwitz, Gunter; Brain, Etienne; Goldhirsch, Aron; Veronesi, Andrea; Muss, Hyman

    2007-05-10

    Screening and adjuvant postoperative therapies have increased survival among women with breast cancer. These tools are seldom applied in elderly patients, although the usually reported incidence of breast cancer is close to 50% in women 65 years or older, reaching 47% after 70 years in the updated Surveillance, Epidemiology, and End Results (SEER) database. Elderly breast cancer patients, even if in good medical health, were frequently excluded from adjuvant clinical trials. Women age 70 years who are fit actually have a median life expectancy of 15.5 years, ie, half of them will live much longer and will remain exposed for enough time to the potentially preventable risks of a relapse and specific death. In the last few years, a new concern about this issue has developed. Treatment now faces two major end points, as in younger women: to improve disease-free survival in the early stages, and to palliate symptoms in advanced disease. However, in both settings, the absolute benefit of treatment is critical because protecting quality of life and all its related aspects (especially functional status and independence), is crucial in older persons who have more limited life expectancy. Furthermore, the new hormonal compounds (aromatase inhibitors) and chemotherapeutic drugs (capecitabine, liposomal doxorubicin), are potentially less toxic than and equally as effective as older more established therapies. These new treatments bring new challenges including higher cost, and defining their benefit in elderly breast cancer must include an analysis of the cost/benefit ratio. These issues emphasize the urgent need to develop and support clinical trials for this older population of breast cancer patients both in the adjuvant and metastatic settings, a move that will take us from a prejudiced, age-based medicine to an evidence-based medicine. PMID:17488987

  10. Prevalence of metabolic syndrome in elderly Japanese-Brazilians

    PubMed Central

    Xavier, Natasha Priscilla; Chaim, Rita Cristina; Gimeno, Suely Godoy Agostinh; Ferreira, Sandra Roberta Gouvea; Hirai, Amelia Toyomi; Rosa, Camila Moreno; Padovani, Carlos Roberto; Okoshi, Marina Politi; Okoshi, Katashi

    2012-01-01

    Summary Background Prevalence of individuals with a high cardiovascular risk is elevated in elderly populations. Although metabolic syndrome (MS) increases cardiovascular risk, information is scarce on the prevalence of MS in the elderly. In this study we assessed MS prevalence in a population of elderly Japanese-Brazilians using different MS definitions according to waist circumference cutoff values. Material/Methods We studied 339 elderly subjects, 44.8% males, aged between 60 to 88 years (70.1±6.8). MS was defined according to criteria proposed by the Joint Interim Statement in 2009. As waist circumference cutoff point values remain controversial for Asian and Japanese populations, we employed 3 different cutoffs that are commonly used in Japanese epidemiological studies: 1) ≥90 cm for men and ≥80 cm for women; 2) ≥85 cm for men and ≥90 cm for women; 3) ≥85 cm for men and ≥80 cm for women. Results MS prevalence ranged from 59.9% to 65.8% according to the different definitions. We observed 90% concordance and no statistical difference (p>0.05) in MS prevalence between the 3 definitions. MS diagnosis according to all 3 cutoff values was found in 55.8% of our population, while in only 34.2% was MS discarded by all cutoffs. The prevalence of altered MS components was as follows: arterial blood pressure 82%, fasting glycemia 65.8%, triglyceride 43.4%, and HDL-C levels 36.9%. Conclusions Elderly Japanese-Brazilians present high metabolic syndrome prevalence independent of waist circumference cutoff values. Concordance between the 3 definitions is high, suggesting that all 3 cutoff values yield similar metabolic syndrome prevalence values in this population. PMID:22293888

  11. [The perception of the young and long-lived elderly 'Gauchos' (from the State of Rio Grande do Sul, Brazil) about the public spaces they live in Resumo].

    PubMed

    Navarro, Joel Hirtz do Nascimento; Andrade, Francini Porcher; Paiva, Tiago Sousa; da Silva, Diovana Ourique; Gessinger, Cristiane Fernanda; Bós, Ângelo José Gonçalves

    2015-02-01

    By 2050, the number of Brazilians living in urban areas will be over 200 million and 29% of the population will be elderly. The long-lived elderly are 80 or more years old and the young elderly are between 60 and 79 years of age. The scope of this article was to verify the difference in perception between the young elderly and the long-lived elderly from Rio Grande do Sul (RS) about the urban environment they live in. This is a population-based, observational, descriptive, retrospective study with a quantitative analysis paradigm. Data was analyzed from Elderly Profile research in RS conducted by the Geriatric and Gerontological Institute of PUCRS in partnership with the RS School of Public Health. The sample consisted of 6913 questionnaires answered by the elderly from 59 cities. Data analysis was performed for each age group and independent variables were processed using the Chi-square test, with p under 0.05. Results showed that the perception of difficulties such as a lack of park benches and safety strips, short traffic light times for pedestrians, high steps and bad-smelling public toilets was greater among the young elderly. The long-lived elderly noticed these facts less, though they admitted that they frequent community environments less often. PMID:25715140

  12. Magnesium status and association with diabetes in the Taiwanese elderly.

    PubMed

    Wang, Jui-Line; Shaw, Ning-Sing; Yeh, Hsiang-Yu; Kao, Mei-Ding

    2005-01-01

    The average dietary intake of magnesium is below recommended dietary allowances in many affluent Western countries. Prolonged low magnesium intake tends to result in hypomagnesaemia which might increase the risk of chronic diseases in elderly people. A national population-based cross-sectional nutrition survey, the Elderly Nutrition and Health Survey in Taiwan (1999-2000), was used to investigate the magnesium status and association with diabetes in the Taiwanese elderly. Dietary magnesium intake was based on 24-hour dietary recalls. Blood biochemical parameters including plasma magnesium and blood glucose were also measured. Average magnesium intake was 250 mg in men and 216 mg in women, which is equivalent to 68-70% of relevant Taiwanese Dietary Reference Intakes. The mean plasma magnesium concentration was 0.903 mmol/L in men and 0.906 mmol/L in women. The prevalence of a plasma magnesium level of <0.7 mmol/L was 0.7-0.9% in the elderly, and that of <0.8 mmol/L was 8.0-9.1%. Elderly vegans had a significantly lower magnesium intake than ovo-lacto vegetarians and non-vegetarians. Diabetic men and women had significantly higher blood glucose levels than non-diabetics. The risk of diabetes was elevated 3.25 times at plasma magnesium levels<0.863 mmol/L. There was an inverse association between plasma magnesium concentration and the prevalence of diabetes. However, no association was found between diabetes and low dietary magnesium. Taiwanese elderly persons had suboptimal levels of dietary magnesium intake, which although may be sufficient to avoid overt magnesium deficiency, may not be sufficient to reduce the risk of diabetes in the elderly. Further prospective study is required to help explain the differential results between dietary and plasma magnesium levels. PMID:16169838

  13. [Immunization schedule in the elderly].

    PubMed

    Gavazzi, Gaëtan; Berrut, Gilles; Jeandel, Claude

    2015-09-01

    Elderly people are more likely to develop severe infections diseases. Given the significant increase in the number of the elderly population, reducing the risk of infection by vaccination is a major preventive approach. The immunization schedule for 2014 in France yields, for the first time, vaccination recommendations for patients over 65 years. Tetanus-Diphtheria-Poliomyelitis vaccination is recommended to be given at the age of 65 years and then every 10 years, together with the pertussis vaccine to protect infants less than 6 months. Recommendation for vaccinations against seasonal influenza in autumn is maintained by the High Council for Public Health, which estimates that the population benefit persists despite the lower individual effectiveness in the elderly. The pneumococcal vaccine is recommended only in high-risk populations, and only once after the age 65. Zoster vaccine is recommended between 65 and 74, and the first year of its availability, can be proposed to elderly patients between 75 and 79 years. Vaccination in the elderly must be enhanced, and information about its advantages should be disseminated. PMID:26967928

  14. Global Forum: Fractures in the Elderly.

    PubMed

    Court-Brown, Charles M; McQueen, Margaret M

    2016-05-01

    Fractures in the elderly are increasing in incidence and becoming a major health issue in many countries. With an increasing number of the elderly living to an older age, the problems associated with fractures will continue to increase. We describe the epidemiology of fractures in the elderly and identify six fracture patterns in the population of patients who are sixty-five years of age or older. We also analyzed multiple fractures and open fractures in the elderly and we show that both increase in incidence with older age. The incidence of open fractures in elderly women is equivalent to that in young men. Many factors, including patient socioeconomic deprivation, increase the incidence of fractures in the elderly. More than 90% of fractures follow low-energy falls and the mortality is considerable. Mortality increases with older age and medical comorbidities, but there is also evidence that it relates to premature discharge from the hospital. PMID:27147693

  15. Near-fatal asthma in the elderly.

    PubMed

    Arjona, Nydia

    2015-01-01

    Asthma affects the elderly as often as other age groups; however, it more often becomes fatal in the elderly. Unfortunately, asthma is often unmanaged or underdiagnosed in the older population. It is important for health care providers to recognize risk factors in the elderly and properly treat them before asthma becomes fatal. This article describes near-fatal asthma and identifies risk factors specifically for the elderly. Symptoms of asthma are reviewed as well as assessments and diagnostic tests to identify asthma severity and complications. Proper management needs to be urgently initiated to prevent worsening respiratory distress; this includes fast-acting drug treatments appropriate for elderly patients. Decompensated acute respiratory failure, secondary to severe asthma, requires the skills of an experienced anesthesiologist because these patients may rapidly deteriorate during induction and intubation. Ventilator management must include strategies to prevent worsening hyperinflation of the lungs. Elderly asthma patients have a higher mortality risk related to ventilator complications and other comorbidities. PMID:25470264

  16. Multiple program participation and exits from food stamps among elders.

    PubMed

    Issar, Sukriti

    2010-01-01

    This article uses population-level administrative data from Rhode Island's Food Stamp Program to examine exits from the Food Stamp Program by elders. Multivariate event history models estimate the relations of multiple program participation and the timing of eligibility reviews to the probability of exiting food stamps. Results suggest that elders who are age 65 or older and who receive both Supplemental Security Income and food stamps have a higher probability of exiting the Food Stamp Program than do elders who receive only food stamps. The timing of eligibility reviews is also found to be positively associated with the probability of exit from food stamps. This article is argued to extend conceptual models of the determinants of food stamp exits. PMID:20873021

  17. Thyroid diseases in elderly.

    PubMed

    Faggiano, A; Del Prete, M; Marciello, F; Marotta, V; Ramundo, V; Colao, A

    2011-09-01

    Thyroid diseases are the commonest endocrine disorders in the general population. In most of the cases, they are consistent with benign conditions which may be asymptomatic or affect people at a variable extent. Since they often represent chronic conditions their prevalence increases by age and reaches in elderly the highest rates. Thyroid nodules are a common clinical finding. Most subjects with thyroid nodules have few or no symptoms. Thyroid nodules are more commonly non-functioning. However, in elderly, toxic multinodular goiter is the most frequent cause of spontaneous hyperthyroidism and often, it emerges insidiously from nontoxic multinodular goiter. Although autoimmune thyroiditis is the most common cause of hypothyroidism in elderly subjects, other causes, such as drugs, neck radiotherapy, thyroidectomy or radioiodine therapy, are frequently observed among these subjects. A small subset of medications including dopamine agonists, glucocorticoids and somatostatin analogs affect thyroid function through suppression of TSH. Other medications that may affect TSH levels are metformin, antiepileptic medications, lithium carbonate and iodine-containing medications. Other drugs can alter T4 absorption, T4 and T3 transport in serum and metabolism of T4 and T3, such as proton-pump inhibitors and antacids, estrogens, mitotane and fluorouracil, phenobarbital and rifampin. Amiodarone administration is associated with thyrotoxicosis or hypothyroidism. Thyroid cancer has similar characteristics in elderly as in general population, however the rate of aggressive forms such as the anaplastic histotype, is higher in older than younger subjects. Diagnosis of thyroid diseases includes a comprehensive medical history and physical examination and appropriate laboratory tests. A correct diagnosis of thyroid diseases in the elderly is crucial for proper treatment, which consists in the removal of medications that may alter thyroid function, in the use of levo-thyroxine in case of

  18. Interference Control In Elderly Bilinguals: Appearances Can Be Misleading.

    PubMed

    Ansaldo, Ana Inés; Ghazi-Saidi, Ladan; Adrover-Roig, Daniel

    2015-01-01

    Bilingualism has been associated with successful aging. In particular, research on the cognitive advantages of bilingualism suggests that it can enhance control over interference and help delay the onset of dementia signs. However, the evidence on the so-called cognitive advantage is not unanimous; furthermore, little is known about the neural basis of this supposed cognitive advantage in bilingual as opposed to monolingual elderly populations. In this study, elderly bilingual and monolingual participants performed a visuospatial interference control task during functional magnetic resonance imaging (fMRI) scanning. Response times and accuracy rates were calculated for congruent and incongruent conditions of the Simon task, and the neurofunctional correlates of performance on the Simon task were examined. The results showed equivalent performance on the Simon task across groups but different underlying neural substrates in the two groups. With incongruent trials, monolinguals activated the right middle frontal gyrus, whereas bilinguals relied upon the left inferior parietal lobule. These results show that elderly bilinguals and monolinguals have equivalent interference control abilities, but relay on different neural substrates. Thus, while monolinguals show a classical PASA (posterior-anterior shift in aging) effect, recruiting frontal areas, bilinguals activate visuospatial processing alone and thus do not show this posterior-anterior shift. Moreover, a modulation of frontal activity with task-dynamic control of interference, observed in the elderly bilingual group alone, suggests that elderly bilinguals deal with interference control without recruiting a circuit that is particularly vulnerable to aging. PMID:25641572

  19. Intractable incontinence in the elderly.

    PubMed

    Ouslander, J G

    2000-05-01

    The number of people living into extreme old age is rising exponentially in the USA, Europe and other developed countries. Urinary incontinence is prevalent in this population. While many very old (age > 75 years) incontinent individuals are relatively healthy and respond well to various treatments, a substantial proportion has impaired cognitive function and impaired mobility. These impairments make urinary incontinence much more difficult to assess, manage and cure than in younger populations. Irrespective of age and disability, a basic assessment of incontinence should be carried out to identify potentially reversible causes and indications for further evaluation. The outcome of such an assessment may not be cure or improvement of incontinence, but better quality of life and the prevention of morbid and expensive medical conditions that may result from poorly managed incontinence. Incontinence in this population should generally not be considered 'intractable' until a trial of noninvasive therapy (i.e. behavioural and/or pharmacological) has been undertaken. Some very frail elderly respond well to a toileting programme such as prompted voiding, and a small but significant proportion benefit from the careful addition of a bladder relaxant drug to the toileting programme. Others, depending on their ability and willingness to toilet and their preferences for further treatment, may be candidates for surgical intervention. Pads and garments should not be used so that they foster dependency, or as a primary treatment until other specific interventions have been tried. Indwelling catheters should be used only for specific and well-documented indications, because of the risks of urinary tract infection and sepsis associated with their long-term use. The dictionary defines 'intractable' as 'not easily relieved or cured'. In the elderly, cure for incontinence, and most other chronic conditions, is the exception rather than rule. Relief (or amelioration), improvement in

  20. The Solid Rocket Motor Slag Population: Results of a Radar-based Regressive Statistical Evaluation

    NASA Technical Reports Server (NTRS)

    Horstman, Matthew F.; Xu, Yu-Lin

    2008-01-01

    Solid rocket motor (SRM) slag has been identified as a significant source of man-made orbital debris. The propensity of SRMs to generate particles of 100 m and larger has caused concern regarding their contribution to the debris environment. Radar observation, rather than in-situ gathered evidence, is currently the only measurable source for the NASA/ODPO model of the on-orbit slag population. This simulated model includes the time evolution of the resultant orbital populations using a historical database of SRM launches, propellant masses, and estimated locations and times of tail-off. However, due to the small amount of observational evidence, there can be no direct comparison to check the validity of this model. Rather than using the assumed population developed from purely historical and physical assumptions, a regressional approach was used which utilized the populations observed by the Haystack radar from 1996 to present. The estimated trajectories from the historical model of slag sources, and the corresponding plausible detections by the Haystack radar, were identified. Comparisons with observational data from the ensuing years were made, and the SRM model was altered with respect to size and mass production of slag particles to reflect the historical data obtained. The result is a model SRM population that fits within the bounds of the observed environment.

  1. Expenses related to hospital admissions for the elderly in Brazil: perspectives of a decade

    PubMed Central

    da Silveira, Rodrigo Eurípedes; Santos, Álvaro da Silva; de Sousa, Mariana Campos; Monteiro, Taciana Silva Alves

    2013-01-01

    ABSTRACT Objective: To describe the profile of morbidities and expenses related to hospitalization of the elderly compared to the adult population (20 to 59 years). Methods: A descriptive, cross-sectional investigation of hospitalizations of the elderly (60 years or older) in Brazil during the period from 2002 to 2011, with data from DATASUS and based on ICD-10. Results: Although the highest number of hospitalizations were in the adult age range, the expenses were greater with the elderly, and in this case especially with mental and behavioral disorders, musculoskeletal and connective tissue diseases, followed by circulatory diseases and external causes. Conclusion: The results suggest the adoption of more comprehensive policies and increased investment in health promotion, disease prevention, and appropriate and suitable treatment for the most prevalent diseases in the elderly, particularly in primary care. PMID:24488394

  2. Elder abuse: factors related to perceptions of severity and likelihood of reporting.

    PubMed

    Fitzpatrick, Maureen J; Hamill, Sharon Boland

    2011-01-01

    This study examined factors that affect assessments of abuse as depicted in scenarios in which a caregiving daughter abuses her elderly mother through over-medication. College students (N = 239) read scenarios that varied in terms of the past quality of the caregiver/elder relationship and whether or not the elder adult was depicted as suffering from dementia. The role of the participants' own family caregiving experiences also was explored. Results from a factorial ANOVA showed that individuals who perceived the relationship as difficult and whose parents had served as caregivers rated the behavior in the scenario as more abusive and were more willing to notify authorities than participants in other conditions. Results are discussed with a focus on educating families and those working with elderly populations. PMID:21253927

  3. Aging Research in Higher Education: Research in Reading Processes of the Elderly (Problems and Promise).

    ERIC Educational Resources Information Center

    Walmsley, Sean A.; Allington, Richard

    1980-01-01

    Considers three issues related to the conduct of research into reading problems of the elderly: (1) the lack of federal funding of literacy research concerning the elderly, (2) differences between conducting research with school-aged populations and with the elderly, and (3) problems encountered in testing elderly individuals. (GT)

  4. Antecedents of Elderly Home Residency in Cognitive Healthy Elders: A Qualitative Study

    PubMed Central

    Sigaroudi, Abdolhosein Emami; Nayeri, Nahid Dehghan; Peyrovi, Hamid

    2013-01-01

    Admission to elderly homes brings with itself fear of losing home and many other mental consequences to both the elder and family members. The aim of this study was to explore the experiences of elders about factors influencing living in the elderly home. Using a qualitative design, 14 elder people living in elderly homes were chosen through purposive sampling based on defined criteria. Semi-structured interviews were held with the participants and field noting was taken during the interviews. Collected data was analyzed using thematic analysis, which resulted in the development of three main themes: “basic Predictors”, “self-care crisis”, and “role crisis”, which were consisted of a couple of subthemes. We conclude that nurses to better care in community and elderly homes, need to know that living in elderly homes has universal predictors; Of course their weight and position are different on different contexts. PMID:23445709

  5. Cardiac Effects of Anticancer Therapy in the Elderly

    PubMed Central

    Accordino, Melissa K.; Neugut, Alfred I.; Hershman, Dawn L.

    2014-01-01

    Cancer incidence increases with age, and as life expectancy increases, the number of elderly patients with cancer is increasing. Cancer treatments, including chemotherapy and radiotherapy, have significant short- and long-term effects on cardiovascular function. These cardiotoxic effects can be acute, such as changes in electrocardiogram (ECG), arrhythmias, ischemia, and pericarditis and/or myocarditis-like syndromes, or they can be chronic, such as ventricular dysfunction. Anticancer therapies can also have indirect effects, such as alterations in blood pressure, or can cause metabolic abnormalities that subsequently increase risk for cardiac events. In this review, we explore both observational and clinical trial evidence of cardiac risk in the elderly. In both observational and clinical trial data, risk of cardiotoxicity with anthracycline-based chemotherapy increases with age. However, it is less clear whether the association between age and cardiotoxicity exists for newer treatments. The association may not be well demonstrated as a result of under-representation of elderly patients in clinical trials and avoidance of these therapies in this population. In addition, we discuss strategies for surveillance and prevention of cardiotoxicity in the elderly. In the elderly, it is important to be aware of the potential for cardiotoxicity during long-term follow-up and to consider both prevention and surveillance of these late effects. PMID:25071122

  6. Risk factors and manifestations of digoxin toxicity in the elderly.

    PubMed

    Wofford, J L; Ettinger, W H

    1991-03-01

    The incidence of digoxin toxicity increases with age, largely because the two most common conditions that benefit from use of digoxin, congestive heart failure and atrial fibrillation, are markedly more prevalent in old age. Whether the elderly are more sensitive to the effects of digoxin because of age per se is unclear. However, several other factors render the elderly more susceptible to digoxin toxicity. These include an age-related decline in renal function and a decrease in volume of digoxin distribution. There is also an increase in the number of comorbid conditions, including cardiovascular and chronic obstructive pulmonary disease, which heighten susceptibility to digoxin toxicity. Moreover, treatment of these diseases with such interactive medications as quinidine and calcium channel blockers may increase the serum level of digoxin. Similarly, such electrolyte imbalances as hypokalemia and hypomagnesemia occur more frequently in the elderly as a result of diuretic therapy. However, recent data suggest that manifestations of digoxin toxicity among younger and older patients do not differ. Similar incidences of cardiac toxicity, gastrointestinal toxicity, and altered mental status are found in both patient populations. Treatment of digitalis toxicity in the elderly is the same as for younger patients. Response rates to Digibind are not diminished in the elderly. PMID:1997015

  7. Population sinks resulting from degraded habitats of an obligate life-history pathway.

    PubMed

    Hickford, Michael J H; Schiel, David R

    2011-05-01

    Many species traverse multiple habitats across ecosystems to complete their life histories. Degradation of critical, life stage-specific habitats can therefore lead to population bottlenecks and demographic deficits in sub-populations. The riparian zone of waterways is one of the most impacted areas of the coastal zone because of urbanisation, deforestation, farming and livestock grazing. We hypothesised that sink populations can result from alterations of habitats critical to the early life stages of diadromous fish that use this zone, and tested this with field-based sampling and experiments. We found that for Galaxias maculatus, one of the most widely distributed fishes of the southern hemisphere, obligate riparian spawning habitat was very limited and highly vulnerable to disturbance across 14 rivers in New Zealand. Eggs were laid only during spring tides, in the highest tidally influenced vegetation of waterways. Egg survival increased to >90% when laid in three riparian plant species and where stem densities were great enough to prevent desiccation, compared to no survival where vegetation was comprised of other species or was less dense. Experimental exclusion of livestock, one of the major sources of riparian degradation in rural waterways, resulted in quick regeneration, a tenfold increase in egg laying by fish and a threefold increase in survival, compared to adjacent controls. Overall, there was an inverse relationship between river size and egg production. Some of the largest rivers had little or no spawning habitat and very little egg production, effectively becoming sink populations despite supporting large adult populations, whereas some of the smallest pristine streams produced millions of eggs. We demonstrate that even a wide-ranging species with many robust adult populations can be compromised if a stage-specific habitat required to complete a life history is degraded by localised or more diffuse impacts. PMID:21076966

  8. Designing Clinical Trials of Intervention for Mobility Disability: Results from the Lifestyle Interventions and Independence for Elders (LIFE) Pilot Trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Clinical trials to assess interventions for mobility disability are critically needed, however data for efficiently designing such trials are lacking. Our results are described from the LIFE pilot clinical trial, in which 424 volunteers aged 70-89 years were randomly assigned to one of two intervent...

  9. A framework for a context-aware elderly entertainment support system.

    PubMed

    Hossain, M Anwar; Alamri, Atif; Almogren, Ahmad S; Hossain, S K Alamgir; Parra, Jorge

    2014-01-01

    Elderly people constitute a major portion of world's population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL) with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers) to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living. PMID:24936946

  10. A Framework for a Context-Aware Elderly Entertainment Support System

    PubMed Central

    Hossain, M. Anwar; Alamri, Atif; Almogren, Ahmad S.; Hossain, SK Alamgir; Parra, Jorge

    2014-01-01

    Elderly people constitute a major portion of world's population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL) with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers) to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living. PMID:24936946

  11. Elderly and Nonelderly Use of a Dedicated Ambulance Corps' Emergency Medical Services in Taiwan.

    PubMed

    Huang, Chien-Chia; Chen, Wei-Lung; Hsu, Chien-Chin; Lin, Hung-Jung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng; Chen, Pi-Ching

    2016-01-01

    Backgrounds and Aim. Taiwan's population is gradually aging; however, there are no comparative data on emergency medical services (EMS) use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years) and nonelderly (<65 years). Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management. Results. There were 1,001 EMS calls: 226 nontransport and 775 transport calls. The elderly accounted for significantly (P < 0.05) fewer (28 (9.2%)) nontransport calls than did the nonelderly (136 (21.4%)). In the transport calls, 276 (35.6%) were the elderly. The elderly had a higher proportion of histories for cardiovascular disease, cerebrovascular disease, hypertension, diabetes, end-stage renal disease, cancer, Parkinson's disease, and Alzheimer's disease. In addition, the elderly had significantly longer total transport time, more nontrauma reasons, and poorer consciousness levels and lower oxygen saturation and needed more respiratory management and more frequent resuscitation during transport than did the nonelderly. Conclusion. The elderly have more specific needs than do the nonelderly. Adapting EMS training, operations, and government policies to aging societies is mandatory and should begin now. PMID:27478825

  12. Elderly and Nonelderly Use of a Dedicated Ambulance Corps' Emergency Medical Services in Taiwan

    PubMed Central

    Huang, Chien-Chia; Chen, Wei-Lung; Hsu, Chien-Chin; Lin, Hung-Jung; Su, Shih-Bin; Guo, How-Ran

    2016-01-01

    Backgrounds and Aim. Taiwan's population is gradually aging; however, there are no comparative data on emergency medical services (EMS) use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years) and nonelderly (<65 years). Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management. Results. There were 1,001 EMS calls: 226 nontransport and 775 transport calls. The elderly accounted for significantly (P < 0.05) fewer (28 (9.2%)) nontransport calls than did the nonelderly (136 (21.4%)). In the transport calls, 276 (35.6%) were the elderly. The elderly had a higher proportion of histories for cardiovascular disease, cerebrovascular disease, hypertension, diabetes, end-stage renal disease, cancer, Parkinson's disease, and Alzheimer's disease. In addition, the elderly had significantly longer total transport time, more nontrauma reasons, and poorer consciousness levels and lower oxygen saturation and needed more respiratory management and more frequent resuscitation during transport than did the nonelderly. Conclusion. The elderly have more specific needs than do the nonelderly. Adapting EMS training, operations, and government policies to aging societies is mandatory and should begin now. PMID:27478825

  13. [Healthy life expectancy to Brazilian elders, 2003].

    PubMed

    Camargos, Mirela Castro Santos; Rodrigues, Roberto do Nascimento; Machado, Carla Jorge

    2009-01-01

    The increase of the percentage of elderly population in Brazil and the increase in longevity incite a demand for information on the quantity of years spent in good health. The aim of the present study is to measure the life expectancy for the elderly of 60 years and above, by sex and age, in the year of 2003. The Sullivan method was used, which combined the life-table with the current experience of mortality and the self-perceived health. The mortality information was obtained from the life tables published by the IBGE (Brazilian Institute of Geography and Statistics), 2003. The self-perceived health was used and it was dichotomized in good and bad. This information came from the National Research of Household Sample (PNAD), 2003. The results indicate that women live longer, but spend a higher number of years perceiving their health as bad, as compared to men. The results also highlights to the need of considering the differences between sexes in relation to the demand for health care. It is also important to consider the need to have policies designed to allow the increase in the number of years that the elderly can live in good health conditions. PMID:19851603

  14. Evaluation of observation-fused regional air quality model results for population air pollution exposure estimation.

    PubMed

    Chen, Gang; Li, Jingyi; Ying, Qi; Sherman, Seth; Perkins, Neil; Rajeshwari, Sundaram; Mendola, Pauline

    2014-07-01

    In this study, Community Multiscale Air Quality (CMAQ) model was applied to predict ambient gaseous and particulate concentrations during 2001 to 2010 in 15 hospital referral regions (HRRs) using a 36-km horizontal resolution domain. An inverse distance weighting based method was applied to produce exposure estimates based on observation-fused regional pollutant concentration fields using the differences between observations and predictions at grid cells where air quality monitors were located. Although the raw CMAQ model is capable of producing satisfying results for O3 and PM2.5 based on EPA guidelines, using the observation data fusing technique to correct CMAQ predictions leads to significant improvement of model performance for all gaseous and particulate pollutants. Regional average concentrations were calculated using five different methods: 1) inverse distance weighting of observation data alone, 2) raw CMAQ results, 3) observation-fused CMAQ results, 4) population-averaged raw CMAQ results and 5) population-averaged fused CMAQ results. It shows that while O3 (as well as NOx) monitoring networks in the HRRs are dense enough to provide consistent regional average exposure estimation based on monitoring data alone, PM2.5 observation sites (as well as monitors for CO, SO2, PM10 and PM2.5 components) are usually sparse and the difference between the average concentrations estimated by the inverse distance interpolated observations, raw CMAQ and fused CMAQ results can be significantly different. Population-weighted average should be used to account for spatial variation in pollutant concentration and population density. Using raw CMAQ results or observations alone might lead to significant biases in health outcome analyses. PMID:24747248

  15. Evaluation of Observation-Fused Regional Air Quality Model Results for Population Air Pollution Exposure Estimation

    PubMed Central

    Chen, Gang; Li, Jingyi; Ying, Qi; Sherman, Seth; Perkins, Neil; Rajeshwari, Sundaram; Mendola, Pauline

    2014-01-01

    In this study, Community Multiscale Air Quality (CMAQ) model was applied to predict ambient gaseous and particulate concentrations during 2001 to 2010 in 15 hospital referral regions (HRRs) using a 36-km horizontal resolution domain. An inverse distance weighting based method was applied to produce exposure estimates based on observation-fused regional pollutant concentration fields using the differences between observations and predictions at grid cells where air quality monitors were located. Although the raw CMAQ model is capable of producing satisfying results for O3 and PM2.5 based on EPA guidelines, using the observation data fusing technique to correct CMAQ predictions leads to significant improvement of model performance for all gaseous and particulate pollutants. Regional average concentrations were calculated using five different methods: 1) inverse distance weighting of observation data alone, 2) raw CMAQ results, 3) observation-fused CMAQ results, 4) population-averaged raw CMAQ results and 5) population-averaged fused CMAQ results. It shows that while O3 (as well as NOx) monitoring networks in the HRR regions are dense enough to provide consistent regional average exposure estimation based on monitoring data alone, PM2.5 observation sites (as well as monitors for CO, SO2, PM10 and PM2.5 components) are usually sparse and the difference between the average concentrations estimated by the inverse distance interpolated observations, raw CMAQ and fused CMAQ results can be significantly different. Population-weighted average should be used to account spatial variation in pollutant concentration and population density. Using raw CMAQ results or observations alone might lead to significant biases in health outcome analyses. PMID:24747248

  16. Serotonin transporter polymorphism modifies the association between depressive symptoms and sleep onset latency complaint in elderly people: results from the 'InveCe.Ab' study.

    PubMed

    Polito, Letizia; Davin, Annalisa; Vaccaro, Roberta; Abbondanza, Simona; Govoni, Stefano; Racchi, Marco; Guaita, Antonio

    2015-04-01

    Previous studies have documented the involvement of the central nervous system serotonin in promoting wakefulness. There are few and conflicting results over whether there is an actual association between bearing the short allele of serotonin transporter promoter polymorphism (5-HTTLPR) and worse sleep quality. This study examined whether sleep onset latency complaint is associated with the 5-HTTLPR triallelic polymorphism in the SLC6A4 gene promoter and whether this polymorphism influences the relationship between sleep onset latency complaint and depressive symptoms in elderly people. A total of 1321 community-dwelling individuals aged 70-74 years were interviewed for sleep onset latency complaint and for sleep medication consumption. Participants' genomic DNA was typed for 5-HTTLPR and rs25531 polymorphisms. Depressive symptoms were evaluated with the Geriatric Depression Scale Short form and general medical comorbidity was assessed by the Cumulative Illness Rating Scale. The presence of a past history of depression was recorded. The S' allele of the 5-HTTLPR triallelic polymorphism was associated with sleep onset latency complaint. This association was maintained after adjusting for depressive symptoms, sex, age, history of depression and medical comorbidity. After stratification for 5-HTTLPR/rs25531, only in S'S' individuals high depressive symptoms were actually associated with sleep onset latency complaint. These data indicate that the low-expressing 5-HTTLPR triallelic polymorphism is an independent risk factor for sleep onset latency disturbance. Furthermore, the 5-HTTLPR genotype influences the association between depressive symptoms and sleep onset latency complaint. PMID:25297871

  17. Male Osteoporosis in the Elderly

    PubMed Central

    D'Amelio, Patrizia; Isaia, Giovanni Carlo

    2015-01-01

    Osteoporosis is now recognized as an important public health problem in elderly men as fragility fractures are complicated by increased morbidity, mortality, and social costs. This review comprises an overview of recent findings in pathophysiology, diagnosis, and treatment of male osteoporosis, with particular regard to the old population. PMID:26457082

  18. Hypertension in the elderly.

    PubMed

    Coope, J

    1987-08-01

    Hypertension is a common finding in patients aged over 60 years, but the following questions need answering. How dangerous is it? Will lowering the blood pressure reduce the attendant risks? What is the 'cost' of such treatment in terms of side effects, drug-induced disease and health service finance? Two recently completed trials throw light on these problems: EWPHE (European Working Party on Hypertension in the Elderly), a European study based on hospital-clinic attenders, using a diuretic backed up with methyldopa; and HEP (randomized trial of treatment of Hypertension in Elderly Patients in Primary Care), based on general-practice screening in England and Wales using atenolol and bendrofluazide. The results of these trials were compared and the findings were broadly similar in the two studies. Some of the differences may be due to the different selection of patients. It is concluded that elderly patients with sustained blood pressures greater or equal to 170/90 mmHg would benefit from treatment by substantial reduction of stroke. Diuretics or beta-blockers, alone or together, are acceptable treatments in elderly subjects. PMID:3312529

  19. [Dyslipidemia in the elderly].

    PubMed

    Lasses y Ojeda, Luis Alberto; Gutiérrez, Jorge Luis Torres; Salazar, Eduardo

    2004-01-01

    Age is an independent and unmodifiable risk factor for coronary atherosclerosis. In Mexico, coronary heart disease is responsible for 50 % of the deaths for those older than 65 years of age. Aging produces major differences in the presentation, diagnosis, prognosis, and response to therapy in coronary heart disease. The goal of treatment is the prolongation of survival and the improvement of the quality of life. However, in the elderly, the aim of therapy should focus on attaining a meaningful quality of life thus allowing them to be functionally independent. Clinical trials demonstrate conclusively that lowering serum cholesterol levels will reduce the incidence of coronary heart disease irrespective of age. Dietary advise and life-style modifications are the first-line approach in the elderly. When these measures are insufficient to achieve target lipid reductions, statins are the drug of choice. Fibrates may be indicated if triglycerides are high and C-HDL is low. Given the grater coronary risk of older population, the absolute benefit will be greater in the elderly. PMID:15709510

  20. A fall prediction methodology for elderly based on a depth camera.

    PubMed

    Alazrai, Rami; Mowafi, Yaser; Hamad, Eyad

    2015-01-01

    With the aging of society population, efficient tracking of elderly activities of daily living (ADLs) has gained interest. Advancements of assisting computing and sensor technologies have made it possible to support elderly people to perform real-time acquisition and monitoring for emergency and medical care. In an earlier study, we proposed an anatomical-plane-based human activity representation for elderly fall detection, namely, motion-pose geometric descriptor (MPGD). In this paper, we present a prediction framework that utilizes the MPGD to construct an accumulated histograms-based representation of an ongoing human activity. The accumulated histograms of MPGDs are then used to train a set of support-vector-machine classifiers with a probabilistic output to predict fall in an ongoing human activity. Evaluation results of the proposed framework, using real case scenarios, demonstrate the efficacy of the framework in providing a feasible approach towards accurately predicting elderly falls. PMID:26737412

  1. Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients.

    PubMed

    Buccisano, F; Maurillo, L; Piciocchi, A; Del Principe, M I; Sarlo, C; Cefalo, M; Ditto, C; Di Veroli, A; De Santis, G; Irno Consalvo, M; Fraboni, D; Panetta, P; Palomba, P; Attrotto, C; Del Poeta, G; Sconocchia, G; Lo-Coco, F; Amadori, S; Venditti, A

    2015-08-01

    In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart. PMID:25869029

  2. A Model of Active Ageing through Elder Learning: The Elder Academy Network in Hong Kong

    ERIC Educational Resources Information Center

    Tam, Maureen

    2013-01-01

    This article presents the Elder Academy (EA) Network as the policy and practice in promoting active ageing through elder learning in Hong Kong. First, the article examines how the change in demographics and the prevalent trend of an ageing population have propelled the government in Hong Kong to tackle issues and challenges brought about by an…

  3. Clinical Effectiveness of Coronary Stents in the Elderly: Results from 262,700 Medicare Patients in ACC-NCDR®

    PubMed Central

    Douglas, Pamela S.; Brennan, J. Matthew; Anstrom, Kevin J.; Sedrakyan, Art; Eisenstein, Eric L.; Haque, Ghazala; Dai, David; Kong, David F.; Hammill, Bradley; Curtis, Lesley; Matchar, David; Brindis, Ralph; Peterson, Eric D.

    2010-01-01

    Objective To compare outcomes in older individuals receiving drug-eluting (DES) and bare metal stents (BMS). Background Comparative effectiveness of DES relative to BMS remains unclear. Methods Outcomes were evaluated in 262,700 patients from 650 National Cardiovascular Data Registry sites during 2004-2006 using procedural registry data linked to Medicare claims for follow-up. Outcomes including death, myocardial infarction (MI), revascularization, major bleeding, stroke, death or MI, death or MI or revascularization, and death or MI or stroke, were compared using estimated cumulative incidence rates with inverse probability weighted estimators and Cox proportional hazards ratios. Results DES were implanted in 217,675 patients and BMS in 45,025. At 30-months, DES patients had lower unadjusted rates of death (12.9% vs. 17.9%), MI (7.3 vs. 10.0/100 pts) and revascularization (23.0 vs. 24.5/100 pts) with no difference in stroke or bleeding. After adjustment, DES patients had lower rates of death (13.5% vs. 16.5%, HR=0.75, (95% CI: 0.72 ,0.79), p<0.001) and MI (7.5 vs. 8.9/100 pts, HR=0.77, (95% CI: 0.72,0.81), p<0.001), with minimal difference in revascularization (23.5 vs. 23.4/100 pts; HR=0.91, (95% CI: 0.87,0.96), stroke (3.1 vs. 2.7/100 pts, HR=0.97, (95% CI: 0.88,1.07) or bleeding (3.4 vs. 3.6/100 pts, HR=0.91, (95% CI: 0.84,1.00). The DES survival benefit was observed in all subgroups analyzed and persisted throughout 30-months’ follow-up. Conclusion In this largest ever real-world study, patients receiving DES had significantly better clinical outcomes than their BMS counterparts, without an associated increase in bleeding or stroke, throughout 30 months’ follow-up and across all prespecified subgroups. PMID:19406337

  4. Population.

    ERIC Educational Resources Information Center

    King, Pat; Landahl, John

    This pamphlet has been prepared in response to a new problem, a rapidly increasing population, and a new need, population education. It is designed to help teachers provide their students with some basic population concepts with stress placed on the elements of decision making. In the first section of the pamphlet, some of the basic concepts of…

  5. Dysphagia in the Elderly

    PubMed Central

    Aslam, Muhammad

    2013-01-01

    Elderly patients are inherently predisposed to dysphagia predominately because of comorbid health conditions. With the aging of the population in the United States, along with the increased prevalence of obesity and gastroesophageal reflux disease, healthcare providers will increasingly encounter older patients with either oropharyngeal or esophageal disease and complaints of dysphagia. Useful tests to evaluate dysphagia include the videofluoroscopic swallowing study and the fiberoptic endoscopic evaluation of swallowing. Swallow rehabilitation is useful to help patients compensate for swallowing difficulty and ultimately help strengthen the neuromusculature involved in swallowing. PMID:24772045

  6. Elder mistreatment and physical health among older adults: the South Carolina Elder Mistreatment Study.

    PubMed

    Cisler, Josh M; Amstadter, Ananda B; Begle, Angela M; Hernandez, Melba; Acierno, Ron

    2010-08-01

    Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among older adults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among older adults residing in South Carolina. Older adults aged 60 and above (N = 902) participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors. PMID:20690195

  7. An examination of the effects of the antioxidant Pycnogenol on cognitive performance, serum lipid profile, endocrinological and oxidative stress biomarkers in an elderly population.

    PubMed

    Ryan, J; Croft, K; Mori, T; Wesnes, K; Spong, J; Downey, L; Kure, C; Lloyd, J; Stough, C

    2008-07-01

    The study examines the effects of the antioxidant flavonoid Pycnogenol on a range of cognitive and biochemical measures in healthy elderly individuals. The study used a double-blind, placebo-controlled, matched-pair design, with 101 elderly participants (60-85 years) consuming a daily dose of 150 mg of Pycnogenol for a three-month treatment period. Participants were assessed at baseline, then at 1, 2, and 3 months of the treatment. The control (placebo) and Pycnogenol groups were matched by age, sex, body mass index, micronutrient intake, and intelligence. The cognitive tasks comprised measures of attention, working memory, episodic memory, and psychomotor performance. The biological measures comprised levels of clinical hepatic enzymes, serum lipid profile, human growth hormone, and lipid peroxidation products. Statistically significant interactions were found for memory-based cognitive variables and lipid peroxidation products, with the Pycnogenol group displaying improved working memory and decreased concentrations of F2-isoprostanes relative to the control group. PMID:18701642

  8. Attenuation of virulence in an apicomplexan hemoparasite results in reduced genome diversity at the population level

    PubMed Central

    2011-01-01

    Background Virulence acquisition and loss is a dynamic adaptation of pathogens to thrive in changing milieus. We investigated the mechanisms of virulence loss at the whole genome level using Babesia bovis as a model apicomplexan in which genetically related attenuated parasites can be reliably derived from virulent parental strains in the natural host. We expected virulence loss to be accompanied by consistent changes at the gene level, and that such changes would be shared among attenuated parasites of diverse geographic and genetic background. Results Surprisingly, while single nucleotide polymorphisms in 14 genes distinguished all attenuated parasites from their virulent parental strains, all non-synonymous changes resulted in no deleterious amino acid modification that could consistently be associated with attenuation (or virulence) in this hemoparasite. Interestingly, however, attenuation significantly reduced the overall population's genome diversity with 81% of base pairs shared among attenuated strains, compared to only 60% of base pairs common among virulent parental parasites. There were significantly fewer genes that were unique to their geographical origins among the attenuated parasites, resulting in a simplified population structure among the attenuated strains. Conclusions This simplified structure includes reduced diversity of the variant erythrocyte surface 1 (ves) multigene family repertoire among attenuated parasites when compared to virulent parental strains, possibly suggesting that overall variance in large protein families such as Variant Erythrocyte Surface Antigens has a critical role in expression of the virulence phenotype. In addition, the results suggest that virulence (or attenuation) mechanisms may not be shared among all populations of parasites at the gene level, but instead may reflect expansion or contraction of the population structure in response to shifting milieus. PMID:21838895

  9. Psychomotor Retardation in Elderly Untreated Depressed Patients

    PubMed Central

    Beheydt, Lieve Lia; Schrijvers, Didier; Docx, Lise; Bouckaert, Filip; Hulstijn, Wouter; Sabbe, Bernard

    2015-01-01

    Background: Psychomotor retardation (PR) is one of the core features in depression according to DSM V (1), but also aging in itself causes cognitive and psychomotor slowing. This is the first study investigating PR in relation to cognitive functioning and to the concomitant effect of depression and aging in a geriatric population ruling out contending effects of psychotropic medication. Methods: A group of 28 non-demented depressed elderly is compared to a matched control group of 20 healthy elderly. All participants underwent a test battery containing clinical depression measures, cognitive measures of processing speed, executive function and memory, clinical ratings of PR, and objective computerized fine motor skill-tests. Statistical analysis consisted of a General Linear Method multivariate analysis of variance to compare the clinical, cognitive, and psychomotor outcomes of the two groups. Results: Patients performed worse on all clinical, cognitive, and PR measures. Both groups showed an effect of cognitive load on fine motor function but the influence was significantly larger for patients than for healthy elderly except for the initiation time. Limitations: Due to the restrictive inclusion criteria, only a relatively limited sample size could be obtained. Conclusion: With a medication free sample, an additive effect of depression and aging on cognition and PR in geriatric patients was found. As this effect was independent of demand of effort (by varying the cognitive load), it was apparently not a motivational slowing effect of depression. PMID:25674065

  10. Neurologic Emergencies in the Elderly.

    PubMed

    Nentwich, Lauren M; Grimmnitz, Benjamin

    2016-08-01

    Neurologic diseases are a major cause of death and disability in elderly patients. Due to the physiologic changes and increased comorbidities that occur as people age, neurologic diseases are more common in geriatric patients and a major cause of death and disability in this population. This article discusses the elderly patient presenting to the emergency department with acute ischemic stroke, transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, chronic subdural hematoma, traumatic brain injury, seizures, and central nervous system infections. This article reviews the subtle presentations, difficult workups, and complicated treatment decisions as they pertain to our older patients." PMID:27475016

  11. Association between Dietary Patterns and Cardiovascular Risk Factors among Middle-Aged and Elderly Adults in Taiwan: A Population-Based Study from 2003 to 2012

    PubMed Central

    Muga, Miriam Adoyo; Owili, Patrick Opiyo; Hsu, Chien-Yeh; Rau, Hsiao-Hsien; Chao, Jane C-J

    2016-01-01

    Background Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults. Methods Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, “vegi-fruits” and “meat-processed”, were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression. Results The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p < 0.001, model 3), but not with triacylglycerol. In addition, high intake of vegi-fruit dietary pattern (Q5) was negatively associated with CVD risk factors (p < 0.001), but not with high-density lipoprotein, while high consumption of meat-processed dietary pattern (Q5) was positively associated with CVD risk factors (p < 0.001), but negatively related with triacylglycerol in Q3 level and no association with C-reactive protein. Conclusion A negative association was observed between Taiwanese or vegi-fruit dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk

  12. Community-acquired pneumonia in the elderly: Spanish multicentre study.

    PubMed

    Zalacain, R; Torres, A; Celis, R; Blanquer, J; Aspa, J; Esteban, L; Menéndez, R; Blanquer, R; Borderías, L

    2003-02-01

    Community-acquired pneumonia (CAP) in the elderly has increased as a consequence of an overall increase of the elderly population. A controversy about the aetiology and outcome of CAP in this population still exists and more epidemiological studies are needed. A prospective, 12-month, multicentre study was carried out to assess the clinical characteristics, aetiology, evolution and prognostic factors of elderly patients (> or = 65 yrs) admitted to hospital for CAP. The study included 503 patients (age 76 +/- 7 yrs). The clinical picture lasted < or = 5 days in 318 (63%) and the main clinical features were cough (n = 407, 81%) and fever (n = 380, 76%). Aetiological diagnosis was achieved in 199 (40%) cases, with a definite diagnosis obtained in 164 (33%). Of the 223 microorganisms isolated the main agents found were Streptococcus pneumoniae in 98 (49%) and Haemophilus influenzae in 27 (14%). A total of 53 patients died (11%) and the multivariate analysis showed the following factors of bad prognosis: previous bed confinement, alteration in mental status, absence of chills, plasma creatinine > or = 1.4 mg x dL(-1), oxygen tension in arterial blood/inspiratorv oxygen fraction ratio < 200 at the time of admission, and shock and renal failure during the evolution. The results of this study may aid in the management of empiric antibiotic treatment in elderly patients with community-acquired pneumonia and the patients who have a greater probability of bad evolution may be identified based on the risk factors. PMID:12608444

  13. Health of Elderly Mexican American Adults and Family Caregiver Distress

    PubMed Central

    Rote, Sunshine; Angel, Jacqueline L.; Markides, Kyriakos

    2016-01-01

    Using newly available data on family caregivers from a large epidemiological study of elderly Mexican-origin adults (Hispanic Established Population for the Epidemiologic Study of the Elderly [HEPESE], 2010/2011), we identify which types of impairment (functional, psychological, and cognitive) in the elderly individual are associated with family caregiver depressive symptoms. Results from ordinary least squares regressions using 626 caregiver–care recipient dyads demonstrate that more severe mobility limitations (Performance-Oriented Mobility Assessment), social disability (instrumental activities of daily living), neuropsychiatric disturbances related to cognitive decline (Neuropsychiatric Inventory), and depressive symptoms in the elderly subject are positively associated with caregiver psychological distress. Perceived social stress partially accounts for these associations. We also identify certain segments of this caregiver population that are especially vulnerable to burden when caring for a family member with high levels of impairment, namely female and low-income caregivers. These vulnerabilities should be the focus of intervention efforts to reduce stress and improve the emotional and psychological well-being of Mexican-origin caregivers. PMID:25651573

  14. Elder neglect.

    PubMed

    del Carmen, Tessa; LoFaso, Veronica M

    2014-11-01

    Because neglect is the most common form of elder abuse, identifying patients who are vulnerable to neglect allows clinicians to intervene early and potentially prevent situations that can escalate and lead to harm or even death. Health care workers have a unique opportunity to uncover these unfortunate situations and in many cases may be the only other contact isolated vulnerable patients have with the outside world. Responding appropriately and quickly when neglect is suspected and using a team approach can improve the health and well-being of older victims of neglect. PMID:25439641

  15. Varying performance in mammographic interpretation across two countries: Do results indicate reader or population variances?

    NASA Astrophysics Data System (ADS)

    Soh, BaoLin P.; Lee, Warwick B.; Wong, Jill; Sim, Llewellyn; Hillis, Stephen L.; Tapia, Kriscia A.; Brennan, Patrick C.

    2016-03-01

    Aim: To compare the performance of Australian and Singapore breast readers interpreting a single test-set that consisted of mammographic examinations collected from the Australian population. Background: In the teleradiology era, breast readers are interpreting mammographic examinations from different populations. The question arises whether two groups of readers with similar training backgrounds, demonstrate the same level of performance when presented with a population familiar only to one of the groups. Methods: Fifty-three Australian and 15 Singaporean breast radiologists participated in this study. All radiologists were trained in mammogram interpretation and had a median of 9 and 15 years of experience in reading mammograms respectively. Each reader interpreted the same BREAST test-set consisting of sixty de-identified mammographic examinations arising from an Australian population. Performance parameters including JAFROC, ROC, case sensitivity as well as specificity were compared between Australian and Singaporean readers using a Mann Whitney U test. Results: A significant difference (P=0.036) was demonstrated between the JAFROC scores of the Australian and Singaporean breast radiologists. No other significant differences were observed. Conclusion: JAFROC scores for Australian radiologists were higher than those obtained by the Singaporean counterparts. Whilst it is tempting to suggest this is down to reader expertise, this may be a simplistic explanation considering the very similar training and audit backgrounds of the two populations of radiologists. The influence of reading images that are different from those that radiologists normally encounter cannot be ruled out and requires further investigation, particularly in the light of increasing international outsourcing of radiologic reporting.

  16. Gender differences in the health status of elderly living alone compared to those who are not alone: Evidence of the AHAP study, North of Iran.

    PubMed Central

    Mouodi, Simin; Bijani, Ali; Hosseini, Seyed Reza; Hajian-Tilaki, Karimollah

    2016-01-01

    Background: One of the factors that have impact on the health status of elderly people is living alone. This study was conducted to examine the living condition of elderly population in Babol and probable differences which this condition induced on the health disorders of elderly people. Methods: This cross-sectional study was performed on 1544 elderly people aged 60 and over in Amirkola, Babol. Demographic characteristics, the incidence of falls, chronic diseases, polypharmacy, headache with uncertain cause, chronic pains and back pain were collected by the study questionnaire; social support, physical activity, depression and cognitive disorders were assessed with standard questionnaires. Results: 6.8% of elderly people were living alone. Lack of social support, cognitive disorders, depression, multiple chronic diseases, occurrence of falls and headache with uncertain cause were significantly higher among those elderly who live alone (p<0.05). Regardless of age and educational level, headache and depressive symptoms in male individuals living alone, and falls occurrence in female individuals were significantly more than those who did not live alone (p<0.05). Also, in female elderly subjects, the effect of the marital status factor on health-related disorders was more than the effect of living alone factor. Conclusion: Many disorders and disabilities are higher in the elderly people who live alone; also there is a difference in the health status of elderly people who live alone, according to their gender.

  17. Evidence That the Heterogeneity of a T4 Population Is the Result of Heritable Traits

    PubMed Central

    Storms, Zachary J.; Sauvageau, Dominic

    2014-01-01

    Many bacteriophage populations display heterogeneity in their adsorption characteristics; a portion of the phage population remains free in solution throughout adsorption experiments (residual fraction). This residual fraction generally constitutes a minority of phages that exhibit significantly slower adsorption kinetics than the main phage stock (main fraction). While this phenomenon is likely the result of evolutionary driving forces, the present study demonstrates that the residual fraction is not always the result of phenotypic variations within a single genotype, as is generally thought. Experiments with phage T4 showed that two subgroups with distinct adsorption traits that were passed on to their progeny could be isolated from the original phage stock. Sequencing of genes involved in adsorption revealed two point mutations in gene 37 of residual fraction isolates, which resulted in modifications to the long tail-fiber, the organelle of attachment and host cell recognition. Adsorption studies consistently showed that T4 phage stocks amplified from residual fraction isolates had significantly lower adsorption efficiencies than those amplified from main fractions. The conducted experiments provide convincing evidence that the observed heterogeneity in T4 adsorption behavior is the result of conserved mutations to the phage genome and is not exclusively the result of phenotypic variations within the population. While it is believed high mutation rates exist to hasten phage adaptation, this study shows that this bet hedging strategy can also, in the short term, inadvertently handicap the phage's adsorption capabilities to a given host under normal infection conditions, resulting in the residual fraction observed in adsorption experiments. PMID:25551763

  18. Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

    PubMed Central

    Walcher, Thomas; Haenle, Mark Martin; Kron, Martina; Hay, Birgit; Mason, Richard Andrew; von Schmiesing, Alexa Friederike Alice; Imhof, Armin; Koenig, Wolfgang; Kern, Peter; Boehm, Bernhard Otto; Kratzer, Wolfgang

    2005-01-01

    AIM: To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS: A total of 2 147 persons (1 111 females, age 42.8 ± 12.7 years; 1 036 males, age 42.3 ± 13.1 years) participating in an investigation on the prevalence of Echinococcus multilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index (BMI). A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS: Gallbladder stones were detected in 171 study participants (8.0%, n = 2 147). Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy (yes/no) and number of pregnancies did not exert any influence. CONCLUSION: Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations. PMID:16425387

  19. Synergistic effect of interaction between perceived health and social activity on depressive symptoms in the middle-aged and elderly: a population-based longitudinal study

    PubMed Central

    Chun, Sung-Youn; Han, Kyu-Tae; Lee, Seo Yoon; Kim, Chan Ok; Park, Eun-Cheol

    2015-01-01

    Objective To examine the synergistic effect of interaction between perceived health and social activity on depressive symptoms. Methods We investigated whether the interaction between perceived health and social activity has a synergistic effect on depressive symptoms in the middle-aged and elderly using data from 6590 respondents aged 45 and older in the Korean Longitudinal Study on Aging (KLoSA), 2006–2012. A generalised linear mixed-effects model was used to investigate the association in a longitudinal data form. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 10 Scale (CES-D10). Perceived health and level of social activity were categorical variables with three values. Participation in six social activities was assessed. Results Interactions between perceived health status and social activity were statistically significant for almost all social activity/perceived health combinations. Addition of the interaction term significantly decreased CES-D10 scores, confirming the synergistic effect of the interaction between perceived health status and social activity (‘normal×moderate’, β=−0.1826; ‘poor×moderate’, β=−0.5739; ‘poor×active’, β=−0.8935). In addition, we performed stratified analyses by region: urban or rural. In urban respondents, the additional effect of the interaction term decreased CES-D10 scores and all social activity/perceived health combinations were statistically significant (‘normal×moderate’, β=−0.2578; ‘normal×active’, β=−0.3945; ‘poor×moderate’, β=−0.5739; ‘poor×active’, β=−0.8935). In rural respondents, only one social activity/perceived health combination was statistically significant, and the additional effect of the interaction term showed no consistent trend on CES-D10 scores. Conclusions The interaction between perceived health and social activity has a synergistic effect on depressive symptoms; the additional effect of the interaction

  20. Chlorambucil plus Rituximab as Front-Line Therapy in Elderly/Unfit Patients Affected by B-Cell Chronic Lymphocytic Leukemia: Results of a Single-Centre Experience

    PubMed Central

    Laurenti, Luca; Vannata, Barbara; Innocenti, Idanna; Autore, Francesco; Santini, Francesco; Piccirillo, Nicola; Za, Tommaso; Bellesi, Silvia; Marietti, Sara; Sica, Simona; Efremov, Dimitar G.; Leone, Giuseppe

    2013-01-01

    The current standard first line therapy for fit patients with B-CLL/SLL is based on combination of fludarabine-cyclophosphamide and rituximab. However, elderly patients or patients with comorbidities poorly tolerate purine analogue-based chemotherapy and they are often treated with Chlorambucil (Chl) only. However, complete response (CR) and overall response (OR) rates with Chl are relatively low. We now investigated whether the addition of Rituximab to Chl will improve the efficacy without impairing the tolerability in elderly and unfit patients. We included in our study 27 elderly or unfit patients that had not received prior therapy. All patients were treated with Chl (1mg/Kg per 28-day cycle for 8 cycles) plus Rituximab (375 mg/m2 for the first course and 500 mg/m2 for subsequent cycles until the 6th cycle). We obtained an OR rate of 74%. The most frequent adverse effect was grade 3–4 neutropenia, which occurred in 18.5% of the patients. Infections or grade 3–4 extra-hematological side effects were not recorded. None of the patients required reduction of dose, delay of therapy or hospitalization. Overall, these data suggest that Chl-R is an effective and well tolerated regimen in elderly/unfit patients with CLL. PMID:23667729

  1. Change in Indices of Distress among Latino and Anglo Female Caregivers of Elderly Relatives with Dementia: Site-Specific Results from the REACH National Collaborative Study

    ERIC Educational Resources Information Center

    Gallagher-Thompson, Dolores; Coon, David W.; Solano, Nancy; Ambler, Christian; Rabinowitz, Yaron; Thompson, Larry W.

    2003-01-01

    Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with…

  2. Divergence Effect at Alaska's Treelines a Result of Sub-Population Behavior?

    NASA Astrophysics Data System (ADS)

    Wilmking, M.; Singh, J.

    2007-12-01

    The "divergence effect" (off-set between tree-ring based temperature reconstruction and measured temperatures) in northern forest poses a serious question to tree-ring based climate reconstructions, since it seems to violate the uniformitarian principle of dendroclimatology. Several possible reasons emerge, among them false assumptions about 1) climate data (e.g. which climate parameter can be modeled most effectively), 2) tree-ring data (e.g. shift in climate sensitivity of tree growth) or 3) a truly new and unprecedented phenomenon (e.g. rapid climate warming exceeding the adaptive capacity of trees). Here we test, if undetected emergent sub-population behavior at Alaska's treelines might result in a divergence effect. We reanalyzed seven data sets spanning the entire northern treeline in the Brooks Range, Alaska, which showed populations of trees responding positively, non-significant and negatively to recent warming. There is no effect of standardization (i.e. conventional versus RCS) technique on the grouping and we thus used RCS for the following analysis. Without grouping into sub- populations, a clear divergence between tree-ring based temperature reconstruction and actual climate data emerged. However, if only those trees were used for the climate reconstruction, which showed a consistent positive response to the target temperatures (June/July), tree growth modeled climate data extremely well following the rise in temperature during the last decades (actual climate data 0.53°/decade versus tree-ring based reconstruction 0.44°/decade over 1970-2000 period). This result hints at the possibility that some of the reported divergence might be eliminated (at least at Alaska's treelines) through careful test of sub-population behavior.

  3. Chronic heart failure in the elderly: a current medical problem.

    PubMed

    Nessler, Jadwiga; Skrzypek, Agnieszka

    2008-10-01

    As a result of population ageing and improved medical care that contribute to better life expectancy, heart failure occurs more and more commonly in the elderly. In the USA approximately 80% of patients discharged from hospital with newly diagnosed heart failure are over 65 years of age, whereas 50% are over 75. The average 5-year mortality rate is about 50% in subjects with systolic dysfunction and similar in those with preserved left ventricular systolic function. Disorders of the cardiovascular system occurring in the elderly (e.g. increased left ventricular mass, myocardial rigidity, atrial fibrillation, decreased maximum oxygen uptake in cardiopulmonary exercise tests) result from the physiological ageing; they may also be caused by a concomitant cardiac failure syndrome. In the elderly, heart failure is often accompanied by concomitant conditions that often make diagnosis and treatment of chronic heart disease difficult. Non-specific clinical symptoms in the elderly as well as those associated with age (e.g. easy fatigability, exertional dyspnea) make a correct diagnosis difficult. The recognized biochemical marker of heart failure--brain natriuretic peptide, N-terminal pro-brain natriuretic peptide--has a limited diagnostic value in the elderly. Echocardiography plays a key role in the diagnosis. Owing to altered metabolism, impairment of hepatic processes to various degrees and decreased renal excretion of drugs, treatment requires attention, individual choice of drugs and doses, as well as periodic modification of both the doses and the intervals between them. Correct treatment improves quality of life and prolongs it. The aim of the present work is to present the differences in the pathophysiology, diagnostic evaluation and management of chronic heart failure in the elderly, in light of the current views and standards. PMID:19112819

  4. The impact of surgical outcome after pancreaticoduodenectomy in elderly patients

    PubMed Central

    2011-01-01

    Background The elderly population has increased in many countries. Indications for cancer treatment in elderly patients have expanded, because surgical techniques and medical management have improved remarkably. Pancreaticoduodenectomy (PD) requires high-quality techniques and perioperative management methods. If it is possible for elderly patients to withstand an aggressive surgery, age should not be considered a contraindication for PD. Appropriate preoperative evaluation of elderly patients will lead to their safer management. The purpose of the present study was to evaluate the safety of PD in patients older than 75 years and to show the influence of advanced age on the morbidity and mortality associated with this operation. Patients and methods Subjects were 98 patients who underwent PD during the time period from April 2005 to April 2011. During this study, 31 patients were 75 years of age or older (group A), and the other 67 patients were less than 75 years old (group B). Preoperative demographic and clinical data, surgical procedure, pathologic diagnosis, postoperative course and complication details were collected prospectively and they were analyzed in two group. Results There was no statistical difference between patient groups in terms of gender, comorbidity, preoperative drainage, diagnosis, or laboratory data. Preoperative albumin values were lower in group A (P = 0.04). The mean surgical time in group A was 408.1 ± 73.47 min. Blood loss and blood transfusion were not significantly different between both groups. There was no statistical differences in mortality rate (P = 0.14), morbidity rate (P = 0.43), and mean length of hospital stay (P = 0.22) between both groups. Long-term survival was also no statistically significant difference between the two groups using the log-rank test (P = 0.10). Conclusion It cannot be ignored that the elderly population is getting larger. We must investigate the management of elderly patients after PD and prepare

  5. Reduced intensity VEPEMB regimen compared with standard ABVD in elderly Hodgkin lymphoma patients: results from a randomized trial on behalf of the Fondazione Italiana Linfomi (FIL).

    PubMed

    Zallio, Francesco; Tamiazzo, Stefania; Monagheddu, Chiara; Merli, Francesco; Ilariucci, Fiorella; Stelitano, Caterina; Liberati, Anna Marina; Mannina, Donato; Vitolo, Umberto; Angelucci, Emanuele; Rota Scalabrini, Delia; Vallisa, Daniele; Bellei, Monica; Bari, Alessia; Ciccone, Giovannino; Salvi, Flavia; Levis, Alessandro

    2016-03-01

    Survival rates for elderly Hodgkin Lymphoma (HL) have not improved substantially in recent years, mainly because of a lack of prospective randomized studies, due to difficulties in enrolling patients. Between 2002 and 2006, 54 untreated HL patients, aged between 65 and 80 years and considered 'non-frail' according to a comprehensive geriatric evaluation, were enrolled into a phase III randomized trial to compare a reduced-intensity regimen (vinblastine, cyclophosphamide, procarbazine, prednisone, etoposide, mitoxantrone, bleomycin; VEPEMB) with standard ABVD (adriamycin, bleomycin, vinblastine, dacarbazine). Primary endpoint was progression-free survival (PFS). Seventeen patients were in early stage (I-IIA), while 37 were advanced stage. Median age was 72 years and median follow-up was 76 months. Five-year PFS rates were 48% vs. 70% [adjusted Hazard ratio (HR) = 2·19, 95% confidence interval (CI) = 0·94-5·10, P = 0·068] and 5-year overall survival (OS) rates were 63% vs. 77% (adjusted HR = 1·67, 95% CI = 0·69-4·03, P = 0·254) for VEPEMB compared to ABVD. Overall treatment-related mortality was 4%. World Health Organization grade 4 cardiac and lung toxicity occurred in four patients treated with ABVD versus no cases in the VEPEMB arm. Standard ABVD regimen resulted in better PFS and OS than the VEPEMB, although the differences were not statistically significant. The low toxicity of both treatments was probably attributable to stringent selection of patients based on a Comprehensive Geriatric Assessment that excluded frail patients. PMID:26763986

  6. WHEN AND WHY OPERATE ELDERLY OBESE

    PubMed Central

    NASSIF, Paulo Afonso Nunes; MALAFAIA, Osvaldo; RIBAS-FILHO, Jurandir Marcondes; CZECZKO, Nicolau Gregori; GARCIA, Rodrigo Ferreira; ARIEDE, Bruno Luiz

    2015-01-01

    Introduction : Concurrently with the pandemic obesity is observed global aging phenomenon, with a significant increase of obesity in the elderly population. Aim : To review the indications for bariatric surgery for the elderly, mainly focusing on the morbidity and mortality of procedures. Method : Review of the literature in PubMed/Medline and Scielo focusing on the relationship of risk factors with different techniques of bariatric surgery in the elderly. The following descriptors were crossed in the form of AND/OR: Obesity; Bariatric surgery; Complications; Elderly. Conclusion : In people older than 60 years bariatric procedures represent acceptable and effective treatment option. The elderly should be treated in specialized centers with experience in major surgical procedures and low morbimortality. Going in this way, they experience the benefits of bariatric surgery with acceptable morbidity and mortality. However, age alone should not be considered as an absolute impediment for surgical indication. PMID:26537282

  7. The Solid Rocket Motor Slag Population: Results of a Radar-Based Regressive Statistical Evaluation

    NASA Technical Reports Server (NTRS)

    Horstman, Matthew F.; Xu, Yu-Lin

    2008-01-01

    estimated locations and times of tailoff to produce and propagate the SRM debris clouds. Comparisons with radar data from the ensuing years were made, and the SRM model was altered with respect to size and mass production of slag particles to reflect the populations estimated from the data. The result is a model SRM population that fits within the bounds of the observed environment and estimates of the production and contribution of SRM debris to the environment.

  8. Education and Learning for the Elderly: Why, How, What

    ERIC Educational Resources Information Center

    Boulton-Lewis, Gillian M.

    2010-01-01

    This paper is concerned with the general issues of ageing, learning, and education for the elderly. It also examines the more specific issues of why, how and what elders want to learn. The world's population is ageing rapidly. For example, it is estimated that by 2020 20% of the population in the USA will be 65 years old and over. It is predicted…

  9. Glioblastoma care in the elderly.

    PubMed

    Jordan, Justin T; Gerstner, Elizabeth R; Batchelor, Tracy T; Cahill, Daniel P; Plotkin, Scott R

    2016-01-15

    Glioblastoma is common among elderly patients, a group in which comorbidities and a poor prognosis raise important considerations when designing neuro-oncologic care. Although the standard of care for nonelderly patients with glioblastoma includes maximal safe surgical resection followed by radiotherapy with concurrent and adjuvant temozolomide, the safety and efficacy of these modalities in elderly patients are less certain given the population's underrepresentation in many clinical trials. The authors reviewed the clinical trial literature for reports on the treatment of elderly patients with glioblastoma to provide evidence-based guidance for practitioners. In elderly patients with glioblastoma, there is a survival advantage for those who undergo maximal safe resection, which likely includes an incremental benefit with increasing completeness of resection. Radiotherapy extends survival in selected patients, and hypofractionation appears to be more tolerable than standard fractionation. In addition, temozolomide chemotherapy is safe and extends the survival of patients with tumors that harbor O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation. The combination of standard radiation with concurrent and adjuvant temozolomide has not been studied in this population. Although many questions remain unanswered regarding the treatment of glioblastoma in elderly patients, the available evidence provides a framework on which providers may base individual treatment decisions. The importance of tumor biomarkers is increasingly apparent in elderly patients, for whom the therapeutic efficacy of any treatment must be weighed against its potential toxicity. MGMT promoter methylation status has specifically demonstrated utility in predicting the efficacy of temozolomide and should be considered in treatment decisions when possible. Cancer 2016;122:189-197. © 2015 American Cancer Society. PMID:26618888

  10. Caregiver Abuse of Chicago Chinese Older Adults in a Community-Dwelling Population

    PubMed Central

    Dong, Xin Qi; Li, Ge

    2016-01-01

    Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse.

  11. Surveying the effects of an exercise program on the sleep quality of elderly males

    PubMed Central

    Karimi, Saba; Soroush, Ali; Towhidi, Farhad; Makhsosi, Behnam Reza; Karimi, Maryam; Jamehshorani, Saeid; Akhgar, Afshin; Fakhri, Mahmoud; Abdi, Alireza

    2016-01-01

    Background Old age is a stage of life featured with many physiological and mental changes. The Iranian population is aging, and one of the problems that the elderly are faced with is sleep disorders. The present study is an attempt to examine the effectiveness of an exercise program on the sleep quality of the elderly. Methods A semi-experimental study was carried out on the elderly males referred to the Shahid Yari Elderly Center, Kermanshah, Iran. The sample group comprised of 46 participants: 23 in the experimental group and 23 in the control group. The study was carried out for a period of 2 months and follow-up was conducted every week. To improve the quality of sleep of the participants, a four-stage exercise program was implemented and the collected data were analyzed by SPSS version 20. Results The results of a Mann–Whitney test showed that the quality of sleep of the majority in the experimental group improved compared with that of the control group (P<0.05). In addition, a Wilcoxon test showed improvement of the Petersburg’s sleep quality index based on subelements and the results of a total score of sleep in the experimental group after the intervention. Conclusion The study showed effectiveness of scheduled exercising on the quality of sleep of the elderly. It is recommended, therefore, to add an exercise program to the daily program of the elderly. PMID:27555754

  12. Late onset variants in Fabry disease: Results in high risk population screenings in Argentina

    PubMed Central

    Serebrinsky, G.; Calvo, M.; Fernandez, S.; Saito, S.; Ohno, K.; Wallace, E.; Warnock, D.; Sakuraba, H.; Politei, J.

    2015-01-01

    Background Screening for Fabry disease (FD) in high risk populations yields a significant number of individuals with novel, ultra rare genetic variants in the GLA gene, largely without classic manifestations of FD. These variants often have significant residual α-galactosidase A activity. The establishment of the pathogenic character of previously unknown or rare variants is challenging but necessary to guide therapeutic decisions. Objectives To present 2 cases of non-classical presentations of FD with renal involvement as well as to discuss the importance of high risk population screenings for FD. Results Our patients with non-classical variants were diagnosed through FD screenings in dialysis units. However, organ damage was not limited to kidneys, since LVH, vertebrobasilar dolichoectasia and cornea verticillata were also present. Lyso-Gb3 concentrations in plasma were in the pathologic range, compatible with late onset FD. Structural studies and in silico analysis of p.(Cys174Gly) and p.(Arg363His), employing different tools, suggest that enzyme destabilization and possibly aggregation could play a role in organ damage. Conclusions Screening programs for FD in high risk populations are important as FD is a treatable multisystemic disease which is frequently overlooked in patients who present without classical manifestations. PMID:26937405

  13. Conflicting views on elder care responsibility in Japan.

    PubMed

    Lee, Kristen Schultz

    2016-05-01

    I examine the attitudinal ambivalence created by conflicting social expectations regarding parent-child devotion, filial obligation and family membership, and gender norms in a national population of Japanese adults. I ask: in a context of rapidly changing family and elder care norms, how do different beliefs and attitudes overlap and conflict and how are they related to elder care preferences? I analyze data from the 2006 Japanese General Social Survey and use Latent Class Analysis to identify latent groups in the population defined by their beliefs and examine the relationship between class membership and elder care preferences. I found variation in the population with respect to the measured beliefs as well as a relationship between patterns of beliefs and choice of elder caregiver. I found conflicting expectations regarding elder care responsibility in one latent class and this class also expressed elder care preferences that conflict with at least some of their strongly held beliefs. PMID:26973036

  14. Elderly patients’ participation in clinical trials

    PubMed Central

    Shenoy, Premnath; Harugeri, Anand

    2015-01-01

    The elderly population is a large and the fastest-growing portion of the population worldwide. The elderly make up the lion's share of patients for certain health conditions including cancer, cardiovascular disease, arthritis, and Parkinson's disease, among others in most parts of the world. Furthermore, elderly make up the majority of patients for many medications treating chronic conditions. Typically, clinical trials conducted in adult population include patients between the ages of 18 and 64 years. However, drugs should be studied in all age groups and trial participants should be representative of the patient population receiving the therapy in daily medical practice. Elderly patients are poorly represented in clinical trials. Hence, there is inadequate evidence and knowledge about responses of geriatric patients to medications. Regulatory authorities in developed countries urge to avoid arbitrary upper age limits and advise researchers and industry not to exclude elderly people from clinical trials without a valid reason. Since last few years Indian regulatory authority has been stipulating upper age limit for studies conducted in India. The Central Drugs Standard Control Organization (CDSCO) will be doing a great contribution to the researchers if it changes its view on stipulating upper age restrictions in clinical studies. This article describes the need for including elderly patients in the clinical trials in order to garner data from geriatric patients who form major medication users in most of the chronic diseases. PMID:26623388

  15. Simple Stellar Population Modeling of Quasar Host Galaxies with Diffusion K-Means Test Results

    NASA Astrophysics Data System (ADS)

    Mosby, Gregory; Moravec, E. A.; Tremonti, C. A.; Wolf, M. J.

    2013-01-01

    In the last decade, the correlation of the masses of supermassive black holes (SMBHs) and their host galaxy stellar spheroid velocity dispersions (the M-sigma relation) was greeted as clear evidence for the co-evolution of host galaxies and their SMBHs. However, studies in the last five years have posited that this relation could arise from central-limit properties of hierarchical formation alone. To address the question of whether and how often the SMBHs evolve with their host galaxies, it is necessary to look at galaxies whose SMBHs are actively growing—quasars—and determine the host galaxy properties. The central nuclei of quasar host galaxies complicate this type of study because their high luminosity tends to wash out their host galaxies. But, by using 3-D spectroscopy with the integral field unit (IFU) Sparsepak on the WIYN telescope, we have shown that the quasar light can be mostly isolated to one fiber in order to obtain the spectra of the quasar and the host galaxy concurrently. We can then model simultaneously the scattered quasar light and the stellar populations in the host galaxy fiber using a new simple stellar population (SSP) modeling method called diffusion k-means (DFK). The objectives of the research presented in this poster are to model synthetic quasar host galaxies using a DFK basis and a more traditional basis, compare the accuracy of both modeling methods, and test the affects of various prescriptions for masking the quasar lines in the host galaxy fiber. We present results from our SSP modeling and Markov Chain Monte Carlo (MCMC) results for DFK and traditional modeling schemes using synthetic data. By determining and then using the more robust stellar population modeling method, we can more confidently study quasar host galaxies to answer remaining questions in galaxy evolution. This work was partially supported by a National Science Foundation Graduate Fellowship (NSF Grant DGE-0718123) and through the NSF's REU program (NSF Award

  16. Determinants of healthy lifestyle and its related factors among elderly people

    PubMed Central

    Zanjani, Samaneh; Tol, Azar; Mohebbi, Bahram; Sadeghi, Roya; Jalyani, Keramat Nouri; Moradi, Azita

    2015-01-01

    Background: Medical and health advances have led to relative increases in human longevity and elderly population. Common diseases in elders can be prevented using healthy lifestyle. Identifying current status of the elderly is necessary to design educational intervention programs to improve their health and quality of life. Therefore, this study aimed at assessing the lifestyle of the elderly in Islamshar (suburban of Tehran). Materials and Methods: A descriptive – analytical study conducted among 480 elderly people over 60 years old referred to Islamshahr Health Center of Tehran University of Medical Sciences for a period of 12 months in 2012–2013. Data were collected through at two-part questionnaire including sociodemographic and health-related characteristics and healthy lifestyle instrument. Healthy lifestyle of the elderly was assessed using a 46 items self-report standard instrument with five subscales reflecting domains including exercise, nutrition, prevention, stress management, and social relationship. Finally, the data obtained were analyzed using the SPSS 18 software using an independent t-test, analysis of variance and ordinal logistic regression test at a significant level of P < 0.05. Results: Mean score of total healthy lifestyle was 148.56 ± 11.5. Men and women scored 151.95 ± 11.15 and 145 ± 10.32, respectively (P < 0.001). 76.2% of participants had moderately healthy lifestyle, and 23.8% had desirable healthy lifestyle. Marital status and gender were important factors in elderly healthy lifestyle. Discussion: The status of a healthy lifestyle among the elderly in Islamshar was relatively moderate. However, more studies are needed for further information to confirm study results. Study results were posed the necessity of tailoring specific interventional programs to achieve desirable healthy lifestyle.

  17. Supportive telephone outreach as an interventional strategy for elderly patients in a period of crisis.

    PubMed

    Berkman, P; Heinik, J; Rosenthal, M; Burke, M

    1999-01-01

    During the Gulf War in 1991 a telephone-based support system was established for elderly patients living at home in Israel. The study population involved 93 elderly patients (mean age 74), who had recently been discharged from hospital and were chosen for supervision by the Home-Care Unit of the Tel Aviv Sourasky Medical Center, Israel. Two different teams were involved with the telephone support calls: secretarial staff (nonprofessional team) and social workers (professional team). The research examined the characteristics of the study population and also included a comparison between the two groups of patients receiving the psycho-social support. The latter indicated that better results of outcome indices were achieved by the professional team. Further, this study demonstrated the feasibility of telephone-support outreach as an interventional strategy for psycho-social support for elderly patients at a time of crisis. PMID:10425672

  18. Endometrial carcinoma in elderly women.

    PubMed

    Hoffman, K; Nekhlyudov, L; Deligdisch, L

    1995-08-01

    Endometrial carcinoma remains the most common invasive gynecologic malignancy. Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serous papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. The increased virulence of EC in the elderly may be related to the tumor's independence from hormonal factors, to the poorly understood but well-known diminished immunologic defense against cancer in general in elderly patients, and/or to the belated diagnosis of the disease in this population. PMID:7622105

  19. Management of pancreatic cancer in the elderly.

    PubMed

    Higuera, Oliver; Ghanem, Ismael; Nasimi, Rula; Prieto, Isabel; Koren, Laura; Feliu, Jaime

    2016-01-14

    Currently, pancreatic adenocarcinoma mainly occurs after 60 years of age, and its prognosis remains poor despite modest improvements in recent decades. The aging of the population will result in a rise in the incidence of pancreatic adenocarcinoma within the next years. Thus, the management of pancreatic cancer in the elderly population is gaining increasing relevance. Older cancer patients represent a heterogeneous group with different biological, functional and psychosocial characteristics that can modify the usual management of this disease, including pharmacokinetic and pharmacodynamic changes, polypharmacy, performance status, comorbidities and organ dysfunction. However, the biological age, not the chronological age, of the patient should be the limiting factor in determining the most appropriate treatment for these patients. Unfortunately, despite the increased incidence of this pathology in older patients, there is an underrepresentation of these patients in clinical trials, and the management of older patients is thus determined by extrapolation from the results of studies performed in younger patients. In this review, the special characteristics of the elderly, the multidisciplinary management of localized and advanced ductal adenocarcinoma of the pancreas and the most recent advances in the management of this condition will be discussed, focusing on surgery, chemotherapy, radiation and palliative care. PMID:26811623

  20. Management of pancreatic cancer in the elderly

    PubMed Central

    Higuera, Oliver; Ghanem, Ismael; Nasimi, Rula; Prieto, Isabel; Koren, Laura; Feliu, Jaime

    2016-01-01

    Currently, pancreatic adenocarcinoma mainly occurs after 60 years of age, and its prognosis remains poor despite modest improvements in recent decades. The aging of the population will result in a rise in the incidence of pancreatic adenocarcinoma within the next years. Thus, the management of pancreatic cancer in the elderly population is gaining increasing relevance. Older cancer patients represent a heterogeneous group with different biological, functional and psychosocial characteristics that can modify the usual management of this disease, including pharmacokinetic and pharmacodynamic changes, polypharmacy, performance status, comorbidities and organ dysfunction. However, the biological age, not the chronological age, of the patient should be the limiting factor in determining the most appropriate treatment for these patients. Unfortunately, despite the increased incidence of this pathology in older patients, there is an underrepresentation of these patients in clinical trials, and the management of older patients is thus determined by extrapolation from the results of studies performed in younger patients. In this review, the special characteristics of the elderly, the multidisciplinary management of localized and advanced ductal adenocarcinoma of the pancreas and the most recent advances in the management of this condition will be discussed, focusing on surgery, chemotherapy, radiation and palliative care. PMID:26811623

  1. Cocaine Use in the Infertile Male Population: A Marker for Conditions Resulting in Subfertility

    PubMed Central

    Samplaski, Mary K.; Bachir, Bassel G.; Lo, Kirk C.; Grober, Ethan D.; Lau, Susan; Jarvi, Keith A.

    2015-01-01

    Introduction We sought to evaluate the incidence and effect of cocaine use in the infertile male population. Materials and Methods Men presenting for fertility evaluation reporting cocaine usage were identified via prospectively collected database. Data were analyzed for usage patterns, reproductive history, associated drug use and medical conditions, hormonal and semen parameters. Results Thirty-eight out of 4,400 (0.9%) men reported cocaine use. Most used cocaine every 3 months or less. Compared with non-cocaine using men, cocaine users reported more recreational drug use (89 vs. 9.2%), marijuana use (78.9 vs. 11.4%), chlamydia (10.5 vs. 3%), herpes (7.9 vs. 2.5%), and tobacco use (55.3 vs. 19.5%). After excluding men with causes for azoospermia, the mean semen parameters for cocaine users were: volume 2.47 ± 1.02 ml; concentration 53.55 ± 84.04 × 106/ml; motility 15.72 ± 12.26%; total motile sperm count 76.67 ± 180.30 × 106. Conclusions Few (< 1%) men in our infertile population reported the use of cocaine, and the frequency of use was low. Given the low use rates and limitations of reporting bias, it is difficult to determine the direct effect of cocaine use on male fertility. However, while infrequent cocaine use seems to have limited impact on semen parameters, men reporting cocaine use represent a different cohort of men than the overall infertile population, with higher rates of concurrent substance abuse, tobacco use and infections, all of which may negatively impact their fertility. Reported cocaine users should be screened for concurrent drug use and infections. PMID:26195962

  2. Heart failure and cardiorenal syndrome in the elderly.

    PubMed

    Santoro, Antonio

    2012-01-01

    In the view of the aging of the general population and particularly the aging of the dialysis population, it is of considerable interest to examine the combined effects of age and uremia on cardiovascular status. The effects of uremia per se interact with the effects of aging in cardiovascular end-organ damage and in the genesis of heart failure (HF) and cardiorenal syndrome (CRS). Structural abnormalities with fibrosis and calcification of the heart and central arteries, along with autonomic nervous system dysfunction, underlie reduced cardiac performance leading to cardiac decompensation and HF. HF in the elderly is characterized by the heart's inability to maintain an adequate cardiac output and may be the result of systolic dysfunction or reduced compliance and diastolic dysfunction. In the elderly, HF symptoms are generally light, upon admission to the hospital, while HF is sometimes in an advanced stage. The pathophysiology of CRS involves interrelated hemodynamic and neurohormonal mechanisms that in the elderly are often increased/emphasized because there is no compensatory response. The therapy of HF and CRS in the elderly with chronic kidney disease is almost entirely empirical since there are no large trials of drugs to reduce mortality and morbidity in this setting. This may lead nephrologists and cardiologists managing these patients toward a sort of "therapeutic nihilism." But this is not the attitude we should adopt in the elderly. Instead we should make a rather careful assessment of each patient and use a personalized treatment that takes into consideration the characteristics of the individual patient and his or her cardiac and renal history as well as social context. PMID:23032915

  3. Preventive Health Care for the Elderly

    PubMed Central

    Stults, Barry M.

    1984-01-01

    Demographic, economic and humanitarian considerations dictate that effective preventive health care be provided to the elderly. A disease-specific approach to geriatric preventive health care will not suffice; measures to enhance or maintain physical, mental and social function must also be emphasized. Unfortunately, the effectiveness of many preventive care procedures has not been adequately investigated in the elderly. Research is urgently needed to determine the efficacy of and appropriate target population for various geriatric preventive health care measures. PMID:6395498

  4. Smoking and mental illness: results from population surveys in Australia and the United States

    PubMed Central

    Lawrence, David; Mitrou, Francis; Zubrick, Stephen R

    2009-01-01

    Background Smoking has been associated with a range of mental disorders including schizophrenia, anxiety disorders and depression. People with mental illness have high rates of morbidity and mortality from smoking related illnesses such as cardiovascular disease, respiratory diseases and cancer. As many people who meet diagnostic criteria for mental disorders do not seek treatment for these conditions, we sought to investigate the relationship between mental illness and smoking in recent population-wide surveys. Methods Survey data from the US National Comorbidity Survey-Replication conducted in 2001–2003, the 2007 Australian Survey of Mental Health and Wellbeing, and the 2007 US National Health Interview Survey were used to investigate the relationship between current smoking, ICD-10 mental disorders and non-specific psychological distress. Population weighted estimates of smoking rates by disorder, and mental disorder rates by smoking status were calculated. Results In both the US and Australia, adults who met ICD-10 criteria for mental disorders in the 12 months prior to the survey smoked at almost twice the rate of adults without mental disorders. While approximately 20% of the adult population had 12-month mental disorders, among adult smokers approximately one-third had a 12-month mental disorder – 31.7% in the US (95% CI: 29.5%–33.8%) and 32.4% in Australia (95% CI: 29.5%–35.3%). Female smokers had higher rates of mental disorders than male smokers, and younger smokers had considerably higher rates than older smokers. The majority of mentally ill smokers were not in contact with mental health services, but their rate of smoking was not different from that of mentally ill smokers who had accessed services for their mental health problem. Smokers with high levels of psychological distress smoked a higher average number of cigarettes per day. Conclusion Mental illness is associated with both higher rates of smoking and higher levels of smoking among

  5. Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?

    PubMed Central

    Choi, Dae Han; Kim, Hyun Gun; Lee, Tae Hee; Lee, Woong Cheul; Kang, Byung Soo; Cho, Jun-Hyung; Jung, Yunho; Kim, Wan Jung; Ko, Bong Min; Cho, Joo Young; Lee, Joon Seong; Lee, Moon Sung

    2014-01-01

    Background/Aims Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients. Methods We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs). Results In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548). Conclusions DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate. PMID:25374498

  6. Fatty acids intake in the Mexican population. Results of the National Nutrition Survey 2006

    PubMed Central

    2011-01-01

    Background There is growing evidence that quality, rather that quantity of fat is the determinant of cardiovascular risk. The objective of the study is to describe quantitatively the intake and adequacy of fatty acid classes among the Mexican population aged 5-90 years from a probabilistic survey. Methods Dietary intake of individual and classes of fatty acids was computed from the dataset of the 2006 Mexican National Health and Nutrition Survey (ENSANUT2006), collected by a food frequency questionnaire. Adequacy was calculated in reference to authoritative recommendations. Results The mean intake of total fatty acids (TFA ≈ 25%E) fell within WHO recommendations; the intakes of saturated fatty acids (SFA) among all age-groups (45-60%) and of trans fatty acids (TrFA) in 30% of school-age children and adolescents and 20% of adults exceeded international recommendations. The mean intake of polyunsaturated fatty acids (PUFA) and particularly of n6 and n3 PUFAS, was inadequately insufficient in 50% of the sample. Conclusions The main public health concerns are the high intake of SFA and the suboptimal intake of PUFA in Mexican population. The TrFA intake represents a low public health risk. PMID:21651771

  7. Lipid Correlates of Attentional Impulsivity in First Episode Mania: Results from an Indian Population

    PubMed Central

    Kavoor, Anjana Rao; Ram, Daya; Mitra, Sayantanava

    2014-01-01

    Background: Attentional/cognitive impulsivity has been demonstrated as being associated with an increased risk for suicide and other self-harming behaviors, along with a more severe course in patients with bipolar disorder. That an alteration of the various serum lipid fractions might be associated with increased impulsivity has been proposed in the past, but evidences are ambiguous and mainly based on western population data. Objective: The present study was aimed to analyze the attentional impulsivity and various serum lipid fractions in bipolar patients, from an Indian perspective. Materials and Methods: At presentation, 60 drug free/naïve first episode Mania patients were rated on the Barratt impulsiveness scale-version 11 and Young Mania Rating Scale; body mass index (BMI) was calculated and blood samples were analyzed for total cholesterol (TC), high density lipoproteins, low density lipoproteins and very low density lipoproteins (VLDL), triglycerides (TG) and apolipoproteins A1 and B. Results: The analysis revealed statistically significant negative correlation and inverse linear relationship between TC, TG, VLDL and BMI with attentional impulsivity. Conclusion: The present study adds to the growing literature on a complex relationship between lipid fractions and attentional impulsivity. The findings present interesting insights into the possible substrates of human behavior at biochemical levels. The implications are many, including a need to introspect regarding the promotion of weight loss and cholesterol reduction programs in constitutionally vulnerable population. PMID:25336769

  8. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea

    PubMed Central

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin

    2015-01-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects. PMID:26539012

  9. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea.

    PubMed

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin; Chang, Sung Man

    2015-11-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects. PMID:26539012

  10. Ambulatory monitoring derived blood pressure variability and cardiovascular risk factors in elderly hypertensive patients.

    PubMed

    Magdás, Annamária; Szilágyi, László; Belényi, Boglárka; Incze, Alexandru

    2014-01-01

    Hypertension in the elderly is characterized by isolated systolic hypertension and high variability, but its clinical significance is not yet fully understood. The goal of this paper was to assess circadian blood pressure variability (BPV) in elderly hypertensives, and to determine its relationship to cardiovascular risk factors. To achieve this goal, a number of 75 inefficiently treated hypertensive patients were studied, 45 elderly, aged over 60 years, 30 middle-aged, younger than 60 years. After 24-hour ambulatory blood pressure monitoring (ABPM), blood pressure (BP) values, pulse pressure (PP), morning surge were compared between the groups. BPV was calculated using average real variability (ARV). The relationships between BPV, pulse pressure, left ventricular mass index (LVMI), and cardiovascular risk factors were assessed in both groups. As a result, it was found that left ventricular mass (p=0.01), PP, morning surge, 24-hour systolic ARV were significantly higher in the elderly group (p<0.05). In both groups, higher 24-hour BPV was associated with an increase in LVMI. In the elderly population 24-hour BPV was positively correlated to increased PP, total cholesterol and triglyceride levels (p<0.05). Moreover, it was concluded that ABPM-derived BP variability index could be an early predictive marker of end-organ damage in hypertension. Its reduction might be an important objective of hypertension management in elderly. PMID:25226958

  11. [The reality of the oral/dental health of the elderly in the Brazilian Southeast].

    PubMed

    Simões, Ana Carolina de Assis; Carvalho, Denise Maciel

    2011-06-01

    The scope of this work was to describe the alterations revealed in oral/dental structures resulting from ageing and to verify, through the national scientific production, with emphasis on the Southeastern region, the prevaling oral/dental problems in the elderly. A review of the literature on the theme of ageing in the context of dentistry was conducted. The results pointed to the fact that the elderly population is the fastest growing population segment. The prevailing oral/dental problems in this age bracket are radicular caries and periodontal illness, which contribute to the vast majority of dental extractions. In the Southeastern region of Brazil, the use of prostheses is low when compared with the high rate of tooth loss and the percentage of partially toothed elderly people; the value of the CPOD index is high and the elderly have a positive perception on their teeth, despite the fact that oral/dental problems have a negative impact on their lives. It is concluded that the inclusion of a dental surgeon in the healthcare team of the institutions and the systematization of oral/dental hygiene are pressing needs, in addition to the need for ongoing work of guidance for the the oral/dental healthcare of the elderly. Broadening of the study in this area is also fundamental to ensure dental care and treatment of these individuals. PMID:21709994

  12. Prevalence of age-related macular degeneration among the elderly

    PubMed Central

    Rasoulinejad, Seyed Ahmad; Zarghami, Amin; Hosseini, Seyed Reza; Rajaee, Neda; Rasoulinejad, Seyed Elahe; Mikaniki, Ebrahim

    2015-01-01

    Background: Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in elderly population in the developing countries. Previous epidemiological studies revealed various potential modifiable risk factors for this disease. The purpose of this study was to evaluate the prevalence of AMD among elderly living in Babol, North of Iran. Methods: The study population of this cross-sectional study came from the Amirkola Health and Ageing Project (AHAP), the first comprehensive cohort study of the health of people aged 60 years and over in Amirkola, North of Iran. The prevalence of AMD was estimated and its risk was determined using logistic regression analysis (LRA) with regard to variables such as smoking, hyperlipidemia, hypertension and diabetes. Results: Five hundred and five participants with mean age of 71.55±5.9 (ranged 60-89) years entered the study. The prevalence of AMD was 17.6%. There was a significant association between AMD and smoking (P<0.001) but no association was seen with AMD and age, level of education, history of hyperlipidemia, hypertension and diabetes. Multiple LRAs revealed that smoking increased AMD by odds ratio of 5.03 (95% confidence interval 2.47-10.23 p<0.001) as compared to nonsmokers Conclusion: According to our findings, the prevalence of AMD was relatively high and smoking increased the risk of AMD in the elderly population. PMID:26644880

  13. Bladder cancer in the elderly patient: challenges and solutions

    PubMed Central

    Guancial, Elizabeth A; Roussel, Breton; Bergsma, Derek P; Bylund, Kevin C; Sahasrabudhe, Deepak; Messing, Edward; Mohile, Supriya G; Fung, Chunkit

    2015-01-01

    Bladder cancer (BC) is an age-associated malignancy with increased prevalence in the elderly population. Elderly patients are a vulnerable population at increased risk for treatment-related toxicity secondary to medical comorbidities and geriatric syndromes. As a result, this population has been historically undertreated and suffers worse disease-specific outcomes than younger patients with BC. Recognition of this disparity has led to efforts to individualize treatment decisions based on functional status rather than chronologic age in an effort to optimize the use of curative therapies for the fit elderly and modify treatments to reduce the risk of toxicity and disease-related morbidity in vulnerable or frail patients. The comprehensive geriatric assessment is a decision framework that helps to balance underlying health considerations and risks of therapy with aggressiveness of the cancer. Development of systemic therapies with increased efficacy against BC and reduced toxicity are eagerly awaited, as are techniques and interventions to reduce the morbidity from surgery and radiation for patients with BC. PMID:26089655

  14. Oral health care needs in the dependant elderly in India.

    PubMed

    Panchbhai, Arati S

    2012-01-01

    There is a sudden blast of the "65 plus" population in the last decade, and India is no exception to that. A continuing progress in the medical field has raised the longevity of life. This changing face of population offers the oral professionals to observe unique challenges to treat the rapidly growing segment of the elderly and the dependant overage population- the Homebound residents and the Nursing homebound residents. The old age of the residents is compounded with chronic medical problems they are suffering from and the medications they are taking. This cohort is characteristically different from other elderly due to their dependency to carry even the routine activities such as tooth cleaning which results in increased risk towards the oral ailments. As very few surveys are done regarding the oral health status among this section, the prevalence of oral and dental problems in them is under a cloud. "Dental care at home or at destinations of residents" is yet a novel concept in India, hence not only there is a need to reach to the residents but also to treat them in the holistic manner. The purpose of this paper is to review the existing oral health conditions in the elderly in India. PMID:22837606

  15. Prevalence of Oral and Maxillofacial Trauma in Elders Admitted to a Reference Hospital in Northeastern Brazil

    PubMed Central

    Carvalho Filho, Marcus Antonio Melo; Saintrain, Maria Vieira de Lima; Dos Anjos, Rita Edna da Silveira; Pinheiro, Solange Sousa; Cardoso, Luciana de Carvalho Pádua; Moizan, Jean André Hervé; de Aguiar, Andréa Silvia Walter

    2015-01-01

    Objective To know the prevalence and etiology of oral and maxillofacial trauma in elders. Methods Analytical quantitative cross-sectional study conducted at a public trauma hospital located in Fortaleza-Ceará, Brazil. The study population comprised patients with trauma who were hospitalized from April to August 2014. Of these patients, patients with oral and maxillofacial trauma were chosen to be included in the research. A questionnaire was administered in order to obtain information on socio-demographics, systemic comorbidities, use of medication, deleterious habits (smoking and alcohol consumption), etiology of oral and maxillofacial trauma and type of pre-hospital care. Results Of the 280 elderly hospitalized with trauma, 47 had oral and maxillofacial trauma, with a prevalence of 16.8%. In this group, the age ranged from 60 to 88 years, with a mean age of 72.4 years (SD± 8.38). The elderly were mostly women (55.3%), self-declared pardos (53.2%), who presented with cardiovascular disorders (48.9%), and who received formal pre-hospital care (70.2%). Elderly who were in the 60–69 years age group, spent 6–9 years at school and drank alcohol were 2.64, 3.75, and 1.97, respectively, more likely to suffer oral and maxillofacial trauma. The main causes of trauma were physical aggression, traffic accidents, falls and domestic accidents. All of the physical aggressions resulted in oral and maxillofacial traumas, and the elderly who suffered traffic accidents were four times more likely to have oral and maxillofacial trauma. Conclusion The prevalence of 16.8% and the lack of research on oral and maxillofacial traumas in the elderly is worrisome and should be included in the oral health indicators for the elderly population to support the importance of oral health. PMID:26288229

  16. Collapse of the echinoid Paracentrotus lividus populations in the Eastern Mediterranean—result of climate change?

    PubMed Central

    Yeruham, Erez; Rilov, Gil; Shpigel, Muki; Abelson, Avigdor

    2015-01-01

    The European purple sea urchin (Paracentrotus lividus) is considered to be a key herbivore throughout its distribution range—North-East Atlantic and Mediterranean Sea. It was also abundant in its eastern distributional edge, on rocky habitats of the coastline of Israel, but its populations have recently collapsed, and today it is an extremely rare species in the region. Field and laboratory experiments, that were carried out in order to examine the impact of the recent sea surface temperature rise in the Eastern Mediterranean, showed massive urchin mortality when temperatures crossed 30.5 °C before reaching peak summer values. These results suggest that elevated seawater temperatures in recent years may be a main cause for the disappearance of P. lividus from the southeast Mediterranean Sea, which may indicate distributional range contraction in this region. PMID:26315893

  17. Incidence of ectopic pregnancy. First results of a population-based register in France.

    PubMed

    Coste, J; Job-Spira, N; Aublet-Cuvelier, B; Germain, E; Glowaczower, E; Fernandez, H; Pouly, J L

    1994-04-01

    A population-based register of ectopic pregnancy was established in 1992 for two French departments, with the primary aim of monitoring the trend in ectopic pregnancy over a prolonged period. In this paper, data collected during the first year of registration (1992) are analysed. The rate of ectopic pregnancy was 20.2 per 1000 live births, 15.8 per 1000 reported pregnancies and 9.5 per 10,000 women aged 15-44 years. The ectopic pregnancy rate per 1000 live births increased steeply after the age of 30 years and especially after the age of 35 years, whereas rates per 10,000 women of reproductive age steadily increased until the age of 35 years and decreased thereafter. The rates of ectopic pregnancy were lower in spring and summer than autumn and winter. These results are discussed and comparisons with similar studies conducted in the USA and Scandinavia are attempted. PMID:8046033

  18. Does mild COPD affect prognosis in the elderly?

    PubMed Central

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) affects independence and survival in the general population, but it is unknown to which extent this conclusion applies to elderly people with mild disease. The aim of this study was to verify whether mild COPD, defined according to different classification systems (ATS/ERS, BTS, GOLD) impacts independence and survival in elderly (aged 65 to 74 years) or very elderly (aged 75 years or older) patients. Methods We used data coming from the Respiratory Health in the Elderly (Salute Respiratoria nell'Anziano, SaRA) study and compared the differences between the classification systems with regards to personal capabilities and 5-years survival, focusing on the mild stage of COPD. Results We analyzed data from 1,159 patients (49% women) with a mean age of 73.2 years (SD: 6.1). One third of participants were 75 years or older. Mild COPD, whichever was its definition, was not associated with worse personal capabilities or increased mortality after adjustment for potential confounders in both age groups. Conclusions Mild COPD may not affect survival or personal independence of patients over 65 years of age if the reference group consists of patients with a comparable burden of non respiratory diseases. Comorbidity and age itself likely are main determinants of both outcomes. PMID:20529281

  19. Prevalence and risk factors of depression among community dwelling elderly.

    PubMed

    Yaka, Erdem; Keskinoglu, Pembe; Ucku, Reyhan; Yener, Görsev Gülmen; Tunca, Zeliha

    2014-01-01

    Depression in the elderly is associated with increased morbidity and mortality. The purpose of this study was to determine the prevalence and risk factors of depression among community-dwelling older population in an urban setting in Turkey. This cross-sectional study was conducted among 482 elderly individuals 65 years and over in an urban area. Cluster sampling method was used for sample size. Depression in the elderly had been diagnosed by a clinical interview and Geriatric Depression Scale. Data were collected by door-to-door survey. Chi square test was used for statistical analysis. P value, which was calculated by the results of chi square test and coefficient of phi (φ), below 0.05 was included in the analysis of logistic regression. Depression was significantly associated with female gender, being single or divorced, lower educational status, low income, unemployment, and lack of health insurance. However, logistic regression analysis revealed higher depression rates in the elderly with chronic obstructive pulmonary disease, psychiatric disease, cerebrovascular disease, low income and being dependent. Depression is common among community-dwelling older people in an urban area of Izmir, Turkey. Older adults living in community should be cautiously screened to prevent or manage depression. PMID:24767692

  20. Influence of Statins on Influenza Vaccine Response in Elderly Individuals.

    PubMed

    Black, Steven; Nicolay, Uwe; Del Giudice, Giuseppe; Rappuoli, Rino

    2016-04-15

    Influenza vaccination strategies have targeted elderly individuals because they are at high risk of disease complications and mortality. Statins are a class of drugs used to treat hypercholesterolemia and are frequently used in the elderly population to reduce the risk of cardiovascular disease. However, statins are also known to have immunomodulatory effects that could impact influenza vaccine response. In a post hoc analysis, we performed a cross-sectional observational study nested within a comparative immunogenicity clinical trial of adjuvanted versus unadjuvanted influenza vaccine in elderly persons to evaluate the influence of statin therapy on the immune response to vaccination. Overall, data on >5000 trial participants were available for analysis. Comparison of hemagglutination-inhibiting geometric mean titers to influenza A(H1N1), A(H3N2), and B strains revealed that titers were 38% (95% confidence interval [CI], 27%-50%), 67% (95% CI, 54%-80%), and 38% (95% CI, 28%-29%) lower, respectively, in subjects receiving chronic statin therapy, compared with those not receiving chronic statin therapy. This apparent immunosuppressive effect of statins on the vaccine immune response was most dramatic in individuals receiving synthetic statins. These effects were seen in both the adjuvanted and unadjuvanted vaccine groups in the clinical trial. These results, if confirmed, could have implications both for future clinical trials design, as well as for vaccine use recommendations for elderly individuals. PMID:26516142