Note: This page contains sample records for the topic older adults harboring from Science.gov.
While these samples are representative of the content of Science.gov,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of Science.gov
to obtain the most current and comprehensive results. Last update: August 15, 2014.
Amyloid deposition is present in 20–50% of nondemented olderadults yet the functional consequences remain unclear. The current study found that amyloid accumulation is correlated with functional disruption of the default network as measured by intrinsic activity correlations. Clinically normal participants (n=38, aged 60–88) were characterized using [11C]-Pittsburgh Compound B (PiB) PET imaging to estimate fibrillar amyloid burden and, separately, underwent functional MRI (fMRI). The integrity of the default network was estimated by correlating rest-state fMRI time courses extracted from a priori regions including the posterior cingulate, lateral parietal, and medial prefrontal cortices. Clinically normal participants with high amyloid burden displayed significantly reduced functional correlations within the default network relative to participants with low amyloid burden. These reductions were also observed when amyloid burden was treated as a continuous, rather than a dichotomous, measure and when controlling for age and structural atrophy. Whole-brain analyses initiated by seeding the posterior cingulate cortex, a region of high amyloid burden in Alzheimer1s disease (AD), revealed significant disruption in the default network including functional disconnection of the hippocampal formation.
Hedden, Trey; Van Dijk, Koene R. A.; Becker, J. Alex; Mehta, Angel; Sperling, Reisa A.; Johnson, Keith A.; Buckner, Randy L.
... treatment. If left untreated, depression can lead to suicide. Depression is a common problem among olderadults, ... not wanting to eat at all Thoughts of suicide, suicide attempts Aches or pains, headaches, cramps, or ...
... What Is A Standard Drink? Moderate & Binge Drinking Alcohol's Effects on the Body Alcohol Use Disorders Genetics of ... tolerance for alcohol. Olderadults generally experience the effects of alcohol more quickly than when they were younger. This ...
In an effort to improve the quality of life for area senior citizens, De Anza College has established an olderadult education program which combines adaptive physical education with holistic health care principles to instruct students in relaxation, nutrition, and physical activity. Classes are held in convalescent hospitals, retirement homes,…
... OlderAdults Text Size: S M L | About Diabetes Resources for OlderAdults Diabetes occurs in people of ... issues that affect this population. Help me find resources for: Managing My Diabetes Preventing Type 2 Diabetes ...
... blood). What Are Some Treatment Problems Among OlderAdults? Treatment of asthma in olderadults can be complicated by the ... pressure. Talk With Your Doctor As with any asthma patient, treatment for olderadults should be a joint decision between patient and ...
Among olderadult admissions to substance abuse treatment, about half (48 percent) were admitted for abuse of alcohol only. Olderadult alcohol-only admissions were less likely than other olderadult admissions to be self/individual referrals (37 vs. 45 p...
Rhinitis symptoms of rhinorrhea, congestion, sneezing, nasal/ocular pruritis, and postnasal drainage can significantly affect the quality of life for olderadults. As the US population ages, it will be increasingly important for healthcare providers to effectively diagnose and manage rhinitis. Rhinitis is categorized broadly into allergic rhinitis and non-allergic rhinitis. Environmental changes and avoidance measures are a primary means of intervention. In addition, there are several topical therapies (nasal sprays) that can be effective for symptom control.
WHY: Studies on pain in olderadults (persons 65 years of age and older) have demonstrated that 25%-50% of community dwelling older people have persistent pain. Additionally, 45-80% of nursing home residents report pain that is often left untreated. Pain is strongly associated with depression and can result in decreased socialization, impaired ambulation and increased healthcare utilization and costs. Older
Invasive fungal infections have become an increasing problem in olderadults. Infections with opportunistic fungi have increased because older patients are more likely to be considered for transplantation, receive aggressive regimens of chemotherapy for cancer, and take immunosuppressive drugs for nonmalignant diseases. In addition, healthy olderadults are now more likely to travel extensively and to indulge in outdoor activities, which put them at risk for exposure to endemic mycoses. Although many of the clinical manifestations of fungal infections in older and younger adults are similar, there are aspects of histoplasmosis, aspergillosis, and cryptococcosis that are unique to older patients. Treatment of olderadults with amphotericin B is difficult because of the intrinsic nephrotoxicity of the drug. Although they are less toxic, azoles must be used carefully for treatment of olderadults, who are more likely to experience serious drug-drug interactions than are younger persons. PMID:11462194
Weight loss has devastating consequences in olderadults. A body mass index (the weight in kilograms divided by height in meters squared, BMI) of less than 22 Kg\\/m 2 has been associated with a higher one-year mortality rate and with poorer functional status among older communitydwelling persons . The risk for higher mortality in men older than 65 years begins
Over the next few decades the olderadult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to olderadults. The current paper discusses the…
Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.
This report is one in a series of four that discuss the increased fire risks for four groups of the general population: olderadults; the mobility impaired; the deaf or hard of hearing; and the blind or visually impaired. Olderadults those over 65 years ...
Purpose of review Sarcopenia, or the decline of skeletal muscle tissue with age, is one of the most important causes of functional decline and loss of independence in olderadults. The purpose of this article is to review the current definitions of sarcopenia, its potential causes and clinical consequences, and the potential for intervention. Recent findings Although no consensus diagnosis has been reached, sarcopenia is increasingly defined by both loss of muscle mass and loss of muscle function or strength. Its cause is widely regarded as multifactorial, with neurological decline, hormonal changes, inflammatory pathway activation, declines in activity, chronic illness, fatty infiltration, and poor nutrition, all shown to be contributing factors. Recent molecular findings related to apoptosis, mitochondrial decline, and the angiotensin system in skeletal muscle have highlighted biological mechanisms that may be contributory. Interventions in general continue to target nutrition and exercise. Summary Efforts to develop a consensus definition are ongoing and will greatly facilitate the development and testing of novel interventions for sarcopenia. Although pharmaceutical agents targeting multiple biological pathways are being developed, adequate nutrition and targeted exercise remain the gold standard for therapy.
... of fractures if needed annual flu shots. Protein-Calorie Malnutrition Many olderadults living at home eat ... so serious that a condition known as protein-calorie malnutrition (PCM) develops. Sometimes, PCM occurs after a ...
Even though computers play a massive role in everyday life of modern societies, olderadults, and especially older women, are less likely to use a computer, and they perform fewer activities on it than younger adults. To get a better understanding of the factors affecting olderadults' intention towards and usage of computers, the Unified Theory of Acceptance and Usage of Technology (UTAUT) was applied as part of a more extensive study with 52 users and non-users of computers, ranging in age from 50 to 90 years. The model covers various aspects of computer usage in old age via four key constructs, namely performance expectancy, effort expectancy, social influences, and facilitating conditions, as well as the variables gender, age, experience, and voluntariness it. Interestingly, next to performance expectancy, facilitating conditions showed the strongest correlation with use as well as with intention. Effort expectancy showed no significant correlation with the intention of olderadults to use a computer. PMID:22317258
... the Centers for Disease Control and Prevention (CDC). Challenges for OlderAdults Click for more information There ... a smoker to quit. One of the biggest challenges that most smokers face for the first couple ...
Adults aged 65 and older represent an increasingly important segment of the US population. Cancer is an important cause of death in this group. Screening for cancer can significantly reduce cancer incidence and mortality. In this review I address screening for breast, cervical, prostate, lung, colorectal, and ovarian cancer in older Americans. Decisions about screening for cancer must consider the effects of screening, diagnostic evaluations, and treatments on the quality of life of each person.
Polypharmacy is a major concern in the care of olderadults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of olderadults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in olderadults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard olderadult patients. PMID:24899563
Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in olderadults. Although the…
Societal myths argue against active expression of sexuality in olderadults, but these prejudices are unfounded. Using a deconstructionist framework, this article addresses issues surrounding sexuality in olderadults. Implications for clinical practice are given.
This paper uses the social cognitive theory model to review the literature on olderadult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by olderadults, followed by casino games. Olderadults take trips to casinos to socialize, find excitement, and win…
Abstract: Resistance training is widely,advocated,for olderadults to alleviate the muscle,and strength loss that occurs with aging. While primary and secondary prevention of disability are often mentioned as benefits of strength training, the evidence for this is limited and inconclusive. Researchers have started to examine,another form of resistance train- ing that may,prove to be more,beneficial than strength training in terms
A U.S. Fire Administration Fire Safety Checklist for OlderAdults FA-221/July 2012 Olderadults (age 65 and older) are more than twice as likely to die in fires than the Nation’s population as a whole. Individuals ...
... of the American Medical Association JAMA PATIENT PAGE Fitness for OlderAdults K eeping active and remaining ... can help you live on your own longer. Fitness and physical activity are safe for most older ...
This paper uses the social cognitive theory model to review the literature on olderadult gambling, and related personal and\\u000a environment characteristics. Results show that lottery is the kind of gambling most frequently played by olderadults, followed\\u000a by casino games. Olderadults take trips to casinos to socialize, find excitement, and win money. Although prevalence estimate\\u000a studies suggest that
Herpes zoster (HZ) is a common condition among olderadults, manifested by pain and the classic presentation of a unilateral rash that follows a dermatomal distribution and does not cross the midline of the body. It is caused by reactivation of the virus that caused chickenpox during an earlier infection. In many cases, acute HZ is followed by a severe and disabling complication known as postherpetic neuralgia (PHN), characterized by pain that persists for months or even years after the HZ rash heals. Using an individual example, this article provides information on the clinical manifestations, evidence-based treatment recommendations for, and prevention of HZ and PHN through use of the zoster vaccine Zostavax, licensed in the United States in 2006. PMID:20302254
Purpose: Health educators used health contracts with sedentary olderadults for the purpose of increasing exercise or physical activity. Design and Methods: Two health educators helped 25 sedentary olderadults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully…
This study investigated variables contributing to olderadults' information technology acceptance through a survey, which was used to find factors explaining and predicting olderadults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…
Examined knowledge, attitudes, and opinions of 60 olderadults about cardiopulmonary resuscitation (CPR). Most had little or no accurate knowledge of CPR. Knowledge deficits and misconceptions of olderadults should be addressed so that they may become informed and active participants in CPR decision-making process. (BF)
WHY: Use of physical restraints in olderadults is associated with poor outcomes: functional decline, decreased peripheral circulation, cardiovascular stress, incontinence, muscle atrophy, pressure ulcers, infections, agitation, social isolation, psychiatric morbidity, serious injuries, and death. Olderadults with dementia have the highest risk of all patients for being restrained when hospitalized. Impaired memory, judgment, and comprehension contribute to the difficulty
This chapter examines the potential for personal growth, development, and learning of olderadult women who will have many productive years in the workforce. What implications are there for adult education communities who will interact with these older women? How do they adapt to the educational environment, and what social support will enable…
Results of a study to examine the recycling practices and needs of olderadults (n=217) indicated that olderadults do recycle traditional materials, but need accommodations for physical limitations. They report textile recycling as time consuming and difficult and used donations to religious organizations as their principal means of textile…
Provides normative data on the Bender Gestalt Test (BGT) with a sample of 334 normal olderadults. Showed that these olderadults do not perform on the BGT in a manner that can be called brain damaged. Use of the cut-off score developed with younger persons appears appropriate. (Author)
Objective To review key aspects of family caregiving as it applies to olderadults with cancer, discuss the implications of caregiving on the physical and emotional health of caregivers, and discuss future research needs to optimize the care of olderadults with cancer and their caregivers. Data Sources Literature Review Conclusions The number of olderadults with cancer is on the rise and these olderadults have significant caregiving needs. There is a physical, emotional, and financial toll associated with caregiving. Implications for Nursing Practice As the US population ages, it will be even more important that we identify vulnerable olderadults, understand their caregiving needs, and mobilize healthcare and community resources to support and assist their caregivers.
Understanding Task Force Recommendations Screening for Cognitive Impairment in OlderAdults The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Cognitive Impairment in ...
Identifying feasible and effective interventions aimed at mitigating the effects of cognitive decline in olderadults is currently a high priority for researchers, clinicians, and policy makers. Evidence suggests that exercise and cognitive training benefit cognitive health in olderadults; however, a preferred modality has to be endorsed yet by the scientific community. The purpose of this review is to discuss and critically examine the current state of knowledge concerning the effects of aerobic, resistance, cognitive, and novel dual-task exercise training interventions for the preservation or improvement of cognitive health in olderadults. A review of the literature suggests that the potential exists for multiple exercise modalities to improve cognitive functioning in olderadults. Nonetheless current limitations within the field need to be addressed prior to providing definitive recommendations concerning which exercise modality is most effective at improving or maintaining cognitive health in aging. PMID:23851414
Gregory, Michael A; Gill, Dawn P; Petrella, Robert J
British students 60 years and older in 1985-86 were studied in order to learn about their age, sex, marital status, employment background, the subjects they study, their reasons for studying, how they study, and what they think about their studies. Considered by the researchers to be the largest survey of older students, the study involved 2,254…
The Centers for Disease Control (CDC) states that within the next few decades, adults aged 65 and older will represent 20% of the US population. As a result, health professionals will see an increase in the number of older patients they treat and as such, must be knowledgeable about the aging process and age-associated issues in order to provide appropriate
A number of factors and trends contribute to an increase in olderadults in the workforce including demographics, financial concerns, changing concepts of retirement, longer and healthier life spans, and demand for the knowledge and skills possessed by the current generation of older workers. Careers are now considered to be more fluid, nonlinear…
This year the Crisis Counseling Assistance and Training Program marks its twenty-fifth anniversary. One of the lessons learned over the years is the resiliency of disaster victims, especially olderadults. Older persons have much to offer in times of cris...
Olderadults are less likely to be using computers and less knowledgeable about Internet security than are younger users. The two groups do not differ on trust of Internet information. The younger group shows no age or gender differences. Within the older group, computer users are more trusting of Internet information, and along with those with…
Grimes, Galen A.; Hough, Michelle G.; Mazur, Elizabeth; Signorella, Margaret L.
The diversity of older learners demands diverse educational opportunities provided by such community-based organizations as community centers, senior centers, area agencies on aging, public libraries, and churches. (SK)
Chronic insomnia and cognitive impairment are both common complaints among olderadults. This study explores the association between chronic insomnia and changes in cognitive functioning among olderadults. The study population comprised two groups: 64 olderadults without insomnia and 35 olderadult insomniacs. The cognitive capacity of each participant was tested at the participant's home using the computerized “MindFit”
This study examined how Flesch Reading Ease and text cohesion affect olderadults' comprehension of common health texts. All olderadults benefited when high Flesh Reading Ease was combined with high cohesion. Olderadults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, olderadults…
Results from the Kolb Learning Style Inventory for 172 olderadults showed them evenly distributed across Accommodator (ages 55-65), Diverger (66-74), and Assimilator (75+) styles, with few Convergers. With age, it appears that adults tend to become more observational and reflective. (SK)
... vitamins and minerals. These substances give your body energy. They help your body grow, repair tissues and regulate processes such as breathing and the beating of your heart. In the United States, it is estimated that 3.7 million older ...
Although physical activity is a recognized component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age (Manini & Pahor, 2009; Schutzer & Graves, 2004). In this article we examine the key factors that facilitate physical activity in highly active community-dwelling olderadults. Using a strengths based approach, we examined the factors that facilitated physical activity in our sample of highly active olderadults. Twenty-seven olderadults participated in face-to face interviews. We extracted a sub-sample of 10 highly active olderadults to be included in the analyses. Based on a framework analysis of our transcripts we identified three factors that facilitate physical activity in our sample, these include: 1) resourcefulness: engagement in self-help strategies such as self-efficacy, self-control and adaptability; 2) social connections: the presence of relationships (friend, neighborhood, institutions) and social activities that support or facilitate high levels of physical activity; and 3) the role of the built and natural environments: features of places and spaces that support and facilitate high levels of physical activity. Findings provide insight into, and factors that facilitate olderadults' physical activity. We discuss implications for programs (e.g., accessible community centers, with appropriate programming throughout the lifecourse) and policies geared towards the promotion of physical activity (e.g., the development of spaces that facilitate both physical and social activities). PMID:24300060
... adults need? Most adults need 7 or 8 hours of sleep each night to feel fully alert during the ... watch TV in bed. Use your bedroom for sleep and other rooms for other activities. Avoid caffeine about 8 hours before bedtime. Avoid nicotine and alcohol in the ...
This article discusses the efficacy, use and adverse effects of antihypertensive drug therapy in olderadults. Numerous double-blind, randomized, placebo-controlled studies have demonstrated that antihypertensive drug therapy reduces cardiovascular events in olderadults. All antihypertensive drugs may predispose older patients to the development of symptomatic orthostatic hypotension and postprandial hypotension, and syncope or falls. Adverse effects of diuretics, beta-adrenergic receptor antagonists, ACE inhibitors, angiotensin receptor antagonists, calcium channel antagonists, alpha-adrenergic receptor antagonists, centrally acting drugs and direct vasodilators are discussed. The adverse effects depend on the antihypertensive drugs used, the doses used, the co-morbidities present in older patients taking these drugs and drug-drug interactions. PMID:19236118
This chapter focuses on the special issues that need to be considered when making decisions to screen older persons for cancer.\\u000a Specifically, while there is substantial evidence that screening for colorectal, breast, and cervical cancer reduces cancer\\u000a mortality among persons in their 50s and 60s [1–6], few screening trials included persons over age 70. Therefore, clinicians\\u000a must assess whether to
Objectives. Previous research has suggested that olderadults’ ability to detect a word as correctly or incorrectly spelled is intact, relative to younger adults. The purpose of the present experiment was to investigate the stability of misspelling detection processes across older adulthood when misspellings are presented in the context of reading. Methods. Participants included 180 olderadults represented equally from three decades: young–old adults in their 60s, middle-old adults in their 70s, and old–old adults in their 80s. They read sentences about health-related topics one word at a time and pressed a key to detect misspellings. A repeated measures analysis of variance was conducted on misspelling detection accuracy as well as response times for correctly detected misspellings. Results. There was a consistent age-related decline in misspelling detection, where middle-old and old–old adults were less accurate and slower than young–old adults in detecting misspellings. Discussion. Requiring misspelling detection during reading increases the working memory demands that are necessary for successful comprehension. In resource-demanding contexts, the top–down verification process of confirming a word’s orthographic features becomes more difficult with increasing age.
... sure the drug dosages are correct. Stroke and Amyloid Angiopathy : In adults aged 60 and higher, the ... is hypertension. However, a condition known as cerebral amyloid angiopathy may occur even without hypertension and becomes ...
Purpose The aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of olderadults’ wellness. A theoretical framework is presented that informs the design of a technology enhanced screening platform for wellness. We highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies (including a telehealth component to capture vital signs and customized questionnaires, a gait analysis component and cognitive assessment software) to assess the multiple aspects of wellness of olderadults. Methods A demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for olderadults. Subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance, physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks. Data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness. Results Preliminary findings indicate that olderadults are willing to participate in technology-enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers. Conclusion Informatics can advance health care for olderadults and support a holistic assessment of olderadults’ wellness. The described framework can support decision making, link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events.
The most profound consequences of immune senescence with respect to public health are the increased susceptibility to influenza and loss of efficacy of the current split-virus influenza vaccines in olderadults, which are otherwise very effective in younger populations. Influenza infection is associated with high rates of complicated illness including pneumonia, heart attacks and strokes in the 65+ population. Changes in both innate and adaptive immune function not only converge in the reduced response to vaccination and protection against influenza, but present significant challenges to new vaccine development. In olderadults, the goal of vaccination is more realistically targeted to providing clinical protection against disease rather sterilizing immunity. Correlates of clinical protection may not be measured using standard techniques such as antibody titres to predict vaccine efficacy. Further, antibody responses to vaccination as a correlate of protection may fail to detect important changes in cellular immunity and enhanced vaccine-mediated protection against influenza illness in older people. This article will discuss the impact of influenza in olderadults, immunologic targets for improved efficacy of the vaccines, and alternative correlates of clinical protection against influenza that are needed for more effective translation of novel vaccination strategies to improved protection against influenza in olderadults.
The most profound consequences of immune senescence with respect to public health are the increased susceptibility to influenza and loss of efficacy of the current split-virus influenza vaccines in olderadults, which are otherwise very effective in younger populations. Influenza infection is associated with high rates of complicated illness including pneumonia, heart attacks and strokes in the 65+ population. Changes in both innate and adaptive immune function not only converge in the reduced response to vaccination and protection against influenza, but present significant challenges to new vaccine development. In olderadults, the goal of vaccination is more realistically targeted to providing clinical protection against disease rather sterilizing immunity. Correlates of clinical protection may not be measured using standard techniques such as antibody titres to predict vaccine efficacy. Further, antibody responses to vaccination as a correlate of protection may fail to detect important changes in cellular immunity and enhanced vaccine-mediated protection against influenza illness in older people. This article will discuss the impact of influenza in olderadults, immunologic targets for improved efficacy of the vaccines, and alternative correlates of clinical protection against influenza that are needed for more effective translation of novel vaccination strategies to improved protection against influenza in olderadults. PMID:21055484
Falls, a common cause of injury among olderadults, have become increasingly prevalent. As the world’s population ages, the increase in—and the prevalence of—falls among older people makes this a serious and compelling societal and healthcare issue. Physical weakness is a critical predictor in falling. While considerable research has examined this relationship, comprehensive reviews of neuropsychological predictors of falls have been lacking. In this paper, we examine and discuss current studies of the neuropsychological predictors of falls in olderadults, as related to sporting and non-sporting contexts. By integrating the existing evidence, we propose that brain aging is an important precursor of the increased risk of falls in olderadults. Brain aging disrupts the neural integrity of motor outputs and reduces neuropsychological abilities. Olderadults may shift from unconscious movement control to more conscious or attentive motor control. Increased understanding of the causes of falls will afford opportunities to reduce their incidence, reduce consequent injuries, improve overall well-being and quality of life, and possibly to prolong life.
... Risk in Adolescents, Adults, and OlderAdults in Primary Care The U.S. Preventive Services Task Force (Task Force) ... Risk in Adolescents, Adults, and OlderAdults in Primary Care. This final recommendation statement applies to teens, adults, ...
Olderadults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, olderadults are an underserved population in that most olderadults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…
Objective Investigate the importance of viewing belief systems about health maintenance holistically. Methods Qualitative (N=74) and quantitative data (N=95) were obtained from multi-ethnic rural-dwelling olderadults with diabetes to characterize their Common Sense Models (CSMs) of diabetes. Results There is a discrete number of CSMs held by olderadults, each characterized by unique clusters of diabetes-related knowledge and beliefs. Individuals whose CSM was shaped by biomedical knowledge were better able to achieve glycemic control. Conclusions Viewing individuals’ health beliefs incrementally or in a piece-meal strategy may be less effective for health behavior change than focusing on beliefs holistically.
Grzywacz, Joseph G.; Arcury, Thomas A.; Ip, Edward H.; Chapman, Christine; Kirk, Julienne K.; Bell, Ronny A.; Quandt, Sara A.
Clostridium difficile infection, the most frequent cause of nosocomial diarrhea, disproportionately affects olderadults. The two most important risk factors for developing C. difficile infection are antimicrobial exposure and age >65 years old. Risk factors specific to olderadults are frequent interactions with healthcare systems and age-related changes in physiology, including immune senescence and changes to the gut microbiome. Metronidazole and oral vancomcyin are the mainstays of conventional treatment for C. difficile infection. Alternative therapies include fidaxomicin, a narrow-spectrum macrocyclic antibiotic, and fectal bacteriotherapy, which offers an excellent therapeutic outcome. Strategies to prevent C. difficile infections include enhanced infection control measures and reducing inappropriate antimicrobial use through stewardship.
Cortisol has a well-documented circadian pattern. However, recent studies have demonstrated that individual variation in diurnal cortisol patterns occurs in young adult populations. Since olderadults experience altered sleep–wake cycles and changes in circadian rhythmicity, we may see even greater variations in diurnal cortisol patterns in olderadults. This study examined salivary cortisol patterns in 48 community dwelling olderadults.
Previous research has demonstrated that olderadults prefer less autonomy and seek less information when making decisions on their own relative to younger adults (for a review, see Mather, 2006). Would olderadults also prefer fewer options from which to choose? We tested this hypothesis in the context of different decision domains. Participants completed a choice preferences survey in which they indicated their desired number of choices across six domains of healthcare and everyday decisions. Our hypothesis was confirmed across all decision domains. We discuss implications from these results for theories of aging and healthcare policy.
Reed, Andrew E.; Mikels, Joseph A.; Simon, Kosali I.
Community-dwelling olderadults (N=364) described their own sex roles using the Bem Sex Role Inventory and were tested with additional measures of mental and physical health and current life situation. Most elderly persons described androgynous roles. Perceived sex roles related to several dimensions of life situation and well-being. (Author)
This qualitative study explores the international migration patterns and the family lives of olderadults. Informants (N = 54) reported that they came to the United States to help out their grown children with housekeeping, child care, and domestic economizing. They described how they strategically navigated U.S. immigration laws choosing to…
Discussion of olderadults in the workforce focuses on methods for training them how to use computers. Topics discussed include changes in processing information into memory, learning skills, learning processes, the learning environment, content planning, self-pacing materials, group and cooperative learning, and the instructor's role. (five…
This article is a summary of the findings of a research project that included ten older rural adults from a county in south Georgia. The research focused on self-directed learning. The researcher conducted two interviews with each participant over a two day period. The findings focused around four research questions: what is the nature of…
Several studies have shown a heightened inflammatory state in frail olderadults, marked by high serum levels of interleukin-6 and C-reactive protein and an increased number of circulating leukocytes. Activation of monocytes and macrophages, marked by increased levels of neopterin, may contribute to chronic inflammation in the frail olderadult. However, the reduced mononuclear cell response to lipopolysaccharide in vitro suggests the existence of defective activation pathways within the innate immune system possibly due to desensitization. Conversely, the expansion of CD8+ T cells, and specifically those expressing the CCR5 chemokine receptor, above and beyond the levels observed in senescence, points to the involvement of adaptive immune pathways. In line with these observations, frail olderadults exhibit a reduced antibody response to pneumococcal and influenza vaccines. Collectively, these observations support the existence of a dysregulated immune system in frail olderadults and highlight the need for strategies to improve its function. Abbreviations AIDS, acquired immunodeficiency syndrome; CCL, CC-chemokine receptor ligand; CCR, CC-chemokine receptor; CHS, Cardiovascular Health Study; CMV, cytomegalovirus; GTP, guanosine trisphosphate; HAART, highly active anti-retroviral therapy; HIV, human immunodeficiency virus; IDO, indoleamine-pyrrole 2,3-dioxygenase; IL, interleukin; IFN, interferon; MACS, Multicenter AIDS Cohort Study; NH2PPP, dihydro-neopterin trisphosphate; Tc, T cytotoxic; TCR, T-cell receptor; TEMRA, T effector memory cells re-expressing CD45RA; Th, T helper; TNF, tumor necrosis factor; WHAS, Women’s Health and Aging Study
In this study we will analyze the attitude of olderadults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the…
The objectives of this continuing education article are to analyze the aging process and its effect on the nutritional status of frail olderadults; determine how sarcopenia, anorexia, malnutrition, and Alzheimer disease increase the risk for pressure ulcer development and impact the healing process; and to apply evidence-based nutrition guidelines and implement practical solutions for wound healing. PMID:23426414
Posthauer, Mary Ellen; Collins, Nancy; Dorner, Becky; Sloan, Colleen
A quantitative descriptive secondary data analysis design was used to describe older black adult communication of osteoarthritis pain and the communication strategies used to convey the pain information. Pain content from 74 older black adults with persistent osteoarthritis pain was analyzed using criteria from the American Pain Society arthritis pain management guidelines that included type of pain (nociceptive/neuropathic), quality of pain, source, location, intensity, duration/time course, pain affect, effect on personal lifestyle, functional status, current pain treatments, use of recommended glucosamine sulfate, effectiveness of prescribed treatments, prescription analgesic side effects, weight management to ideal body weight, exercise regimen or physical therapy and/or occupational therapy, and indications for surgery. Communication strategies were analyzed with criteria derived from Communication Accommodation Theory that included being clear, using medical syntax, using ethnic specific syntax, being explicit, and staying on topic when discussing pain. The majority of communicated pain content included pain location, intensity, and timing. Regarding communication strategies, most of the older black adults used specific descriptions of pain and remained on topic. Fewer used explicit descriptions of pain that produced a vivid mental image, and few used medical terminology. Use of medical syntax and more explicit descriptions might improve communication about pain between health care practitioners and patients. Practitioners might assist older black adults with persistent osteoarthritis pain to communicate important clinical pain information by helping them to use relevant medical terminology and more explicit pain descriptions when discussing pain management. PMID:23141080
This article discusses hearing impairment and the frequency with which it occurs in olderadults. Anatomy and physiology of the ear are examined. Categories of hearing loss, causes, assessment and management are explored, including hearing aids, auditory implants and approaches to communication with hearing-impaired patients. PMID:22206155
Use of patient-controlled analgesia (PCA) was compared with nurse-administered intermittent intramuscular (NM) Injections of morphine in olderadults during their postoperative recovery. Data analyses indicated that the PCA and IM groups did not dyfer in pain intensity, pain distress, and satisfaction. The PCA group had significantly less sleep disturbance from pain than the IM group. Neither group was considered to
Slip and fall accidents are among the leading generators of injuries in the workplace, especially among olderadults. The aging dynamics of the work force have motivated the long-term goal of this proposed study, that is to reduce slip-precipitated falls ...
This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that olderadults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income olderadults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of olderadults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs. PMID:24804354
Importance Although there is a growing recognition that olderadults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on olderadults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening. Objective To obtain a deeper understanding of olderadults’ perspectives on screening cessation and their experiences communicating with clinicians about this topic. Design Semistructured interview study. Setting Senior health center affiliated with an urban hospital. Participants We interviewed 33 olderadults presenting to a senior health center. Their median age was 76 years (range, 63–91 years). Of the 33 participants, 27 were women; 15 were African American, 16 were white, 1 was Asian, and 1 was American Indian. Main Outcome Measures We transcribed audio recordings of interviews and analyzed them using methods of grounded theory to identify themes and illustrative quotes. Results Undergoing screening tests was perceived by participants as morally obligatory. Although many saw continued screening as a habit or custom not involving any decision, cessation of screening would require a major decision. Many asserted that they had never discussed screening cessation with their physicians or considered stopping on their own; some reported being upset when their physician recommended stopping. Although some would accept a physician’s strong recommendation to stop, others thought that such a physician’s recommendation would threaten trust or lead them to get another opinion. Participants were skeptical about the role of statistics and the recommendations of government panels in screening decisions but were more favorable toward stopping because of the balance of risks and benefits, complications, or test burdens. Conclusions and Relevance For many olderadults, stopping screening is a major decision, but continuing screening is not. A physician’s recommendation to stop may threaten patient trust. Effective strategies to reduce nonbeneficial screening may include discussion of the balance of risks and benefits, complications, or burdens.
Torke, Alexia M.; Schwartz, Peter H.; Holtz, Laura R.; Montz, Kianna; Sachs, Greg A.
Background We identified 4-year (2 years before and 2 years after the index [baseline] interview) ED use patterns in olderadults and the factors associated with them. Methods A secondary analysis of baseline interview data from the nationally representative Survey on Assets and Health Dynamics Among the Oldest Old linked to Medicare claims data. Participants were 4310 self-respondents 70 years old or older. Current Procedural Terminology (CPT) codes 99281 and 99282 identified low-intensity use, and CPT codes 99283–99285 identified high-intensity use. Exploratory factor analysis and multivariable multinomial logistic regression were used. Results The majority (56.6%) of participants had no ED visits during the 4-year period. Just 5.7% had only low-intensity ED use patterns, whereas 28.9% used the ED only for high-intensity visits, and 8.7% had a mixture of low-intensity and high-intensity use. Participants with lower immediate word recall scores and those who did not live in major metropolitan areas were more likely to be low-intensity-only ED users. Older individuals, those who did not live in rural counties, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to be high-intensity-only ED users. Participants who were older, did not live in major cities, had lower education levels, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to have mixed ED use patterns. Conclusions Nearly half of these olderadults used the ED at least once over a 4-year period, with a mean annual ED use percentage of 18.4. Few, however, used the ED only for visits that may have been avoidable. This finding suggests that triaging Medicare patients would not decrease ED overcrowding, although continued surveillance is necessary to detect potential changes in ED use patterns among olderadults.
Wolinsky, Fredric D.; Liu, Li; Miller, Thomas R.; An, Hyonggin; Geweke, John F.; Kaskie, Brian; Wright, Kara B.; Chrischilles, Elizabeth A.; Pavlik, Claire E.; Cook, Elizabeth A.; Ohsfeldt, Robert L.; Richardson, Kelly K.; Rosenthal, Gary E.; Wallace, Robert B.
... Resource What special issues apply to olderadults? Visual Impairment What you can do & starter tips Resources Hearing ... Cultural Competence Health Literacy OlderAdults Plain Language Visual Impairment Web sites Content last updated: October 30, 2007
... Stroke Related Documents PDF Living With Multiple Health Problems: What OlderAdults Should Know Download Join our e-newsletter! Resources Living With Multiple Health Problems: What OlderAdults Should Know Tools and Tips ...
In this article, I discuss Paul W. Pruyser's view presented in his article "An Essay on Creativity" (Pruyser in Bull Menninger Clin 43:294-353, 1979) that creative persons manifest early childhood qualities of playfulness, curiosity, and pleasure seeking and that adaptation is itself a form of creativity. I then discuss his article "Creativity in Aging Persons" (Pruyser in Bull Menninger Clin 51:425-435, 1987) in which he presents his view that aging itself is a potentially creative process, that creativity among olderadults is not limited to the talented few, and that older adulthood has several specific features that are conducive to creativity. Significant among these features are object loss (especially involving human relationships) and functional loss (due to the vicissitudes of aging). Noting his particular emphasis on object loss and its role in late-life creativity, I focus on functional loss, and I emphasize the importance of adaptation in sustaining the creativity of olderadults who experience such loss. I illustrate this adaptation by considering well-known painters who in late life suffered visual problems common to olderadults. I suggest that in adapting to their visual problems these artists drew on the early childhood qualities (playfulness, curiosity and pleasure seeking) that all creative persons possess and that they are therefore illustrative for other olderadults who are experiencing functional losses. I conclude with Erik H. Erikson's (Toys and reasons: stages in the ritualization of experience, W. W. Norton, New York, 1977) and Paul W. Pruyser's (Pastor Psychol 35:120-131, 1986) reflections on the relationship between seeing and hoping. PMID:22706923
Interventions to improve the cognitive health of olderadults are of critical importance. In the current study, we conducted a double-blind, placebo-controlled clinical trial using a pill-based nutraceutical (NT-020) that contained a proprietary formulation of blueberry, carnosine, green tea, vitamin D3, and Biovin to evaluate the impact on changes in multiple domains of cognitive functioning. One hundred and five cognitively intact adults aged 65-85 years of age (M=73.6 years) were randomized to receive NT-020 (n=52) or a placebo (n=53). Participants were tested with a battery of cognitive performance tests that were classified into six broad domains--episodic memory, processing speed, verbal ability, working memory, executive functioning, and complex speed at baseline and 2 months later. The results indicated that persons taking NT-020 improved significantly on two measures of processing speed across the 2-month test period in contrast to persons on the placebo whose performance did not change. None of the other cognitive ability measures were related to intervention group. The results also indicated that the NT-020 was well tolerated by olderadults, and the presence of adverse events or symptoms did not differ between the NT-020 and placebo groups. Overall, the results of the current study were promising and suggest the potential for interventions like these to improve the cognitive health of olderadults. PMID:24134194
Small, Brent J; Rawson, Kerri S; Martin, Christina; Eisel, Sarah L; Sanberg, Cyndy D; McEvoy, Cathy L; Sanberg, Paul R; Shytle, R Douglas; Tan, Jun; Bickford, Paula C
Context: Identifying ways to meet the health care needs of olderadults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps olderadults adjust to the hardships associated with aging. Rural community-dwelling olderadults often face unique challenges such…
By searching the keywords of "olderadult" and "computer" in ERIC, Academic Search Premier, and PsycINFO, this study reviewed 70 studies published after 1990 that address olderadults' computer learning and usage. This study revealed 5 prominent themes among reviewed literature: (a) motivations and barriers of olderadults' usage of computers, (b)…
Information about the specific literacy levels, needs, motivations, and resources of olderadults is virtually nonexistent. As the percentage of olderadults in the U.S. population continues to increase, federal/state policymakers must take the following actions: increase the attention/funding given to literacy programs targeting olderadults;…
\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Medication effects and specific dietary factors, such as acid and foods lowering esophageal sphincter pressure, require special\\u000a attention in olderadults with esophageal and gastric disorders.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a The high prevalence of atrophic gastritis in olderadults increases the risk for vitamin B12 malabsorption and deficiency.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Evaluation of both diarrhea and constipation requires a thorough history (paying attention to
Although automobiles remain the transportation of choice for olderadults, late life cognitive impairment and dementia often impair the ability to drive safely. There is, however, no commonly utilized method of assessing dementia severity in relation to driving, no consensus on the assessment of older drivers with cognitive impairment, and no gold standard for determining driving fitness. Yet, clinicians are called upon by patients, their families, other health professionals, and often the Department of Motor Vehicles (DMV) to assess their patients' fitness-to-drive and to make recommendations about driving privileges. Using the case of Mr W, we describe the challenges of driving with cognitive impairment for both the patient and caregiver, summarize the literature on dementia and driving, discuss evidenced-based assessment of fitness-to-drive, and address important ethical and legal issues. We describe the role of physician assessment, referral to neuropsychology, functional screens, dementia severity tools, driving evaluation clinics, and DMV referrals that may assist with evaluation. Finally, we discuss mobility counseling (eg, exploration of transportation alternatives) since health professionals need to address this important issue for olderadults who lose the ability to drive. The application of a comprehensive, interdisciplinary approach to the older driver with cognitive impairment will have the best opportunity to enhance our patients' social connectedness and quality of life, while meeting their psychological and medical needs and maintaining personal and public safety.
Objectives: to examine perceived age discrimination in a large representative sample of olderadults in England. Methods: this cross-sectional study of over 7,500 individuals used data from the fifth wave of the English Longitudinal Study of Ageing (ELSA), a longitudinal cohort study of men and women aged 52 years and older in England. Wave 5 asked respondents about the frequency of five everyday discriminatory situations. Participants who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. Multivariable logistic regression analysis was used to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. Results: approximately a third (33.3%) of all respondents experienced age discrimination, rising to 36.8% in those aged 65 and over. Perceived age discrimination was associated with older age, higher education, lower levels of household wealth and being retired or not in employment. The correlates of age discrimination across the five discriminatory situations were similar. Conclusion: understanding age discrimination is vital if we are to develop appropriate policies and to target future interventions effectively. These findings highlight the scale of the challenge of age discrimination for olderadults in England and illustrate that those groups are particularly vulnerable to this form of discrimination.
Rippon, Isla; Kneale, Dylan; de Oliveira, Cesar; Demakakos, Panayotes; Steptoe, Andrew
Abstract It is not yet clear whether intestinal mucosal permeability changes with advancing age in humans. This question is of high importance for drug and nutrition approaches for olderadults. Our main objective was to answer the question if small intestinal barrier integrity deteriorates with healthy aging. We conducted a cross-sectional study including the pooled data of 215 nonsmoking healthy adults (93 female/122 male), 84 of whom were aged between 60 and 82 years. After a 12-h fast, all participants ingested 10 g of lactulose and 5 g of mannitol. Urine was collected for 5 h afterwards and analyzed for test sugars. The permeability index (PI = lactulose/mannitol) was used to assess small intestinal permeability. Low-grade inflammation defined by high-sensitivity C-reactive protein ?1 mL/L and kidney function (estimated glomerular filtration rate) were determined in the older age group. The PI was similar in older compared to younger adults (P = 0.887). However, the urinary recovery of lactulose and mannitol was lower in the olderadults and this change was neither associated with urinary volume nor glomerular filtration rate. The PI was not significantly correlated with low-grade inflammation or presence of noninsulin-dependent type 2 diabetes. However, it significantly deteriorated in the copresence of both conditions compared to low-grade inflammation alone (P = 0.043) or type 2 diabetes alone (P = 0.015). Small intestinal mucosal barrier does not deteriorate with age per se. But low-grade inflammation coupled with minor disease challenges, such as type 2 diabetes, can compromise the small intestinal barrier. PMID:24771689
Antipsychotic medications are widely used to manage psychotic and behavioral disorders in olderadults, including primary\\u000a psychotic disorders such as schizophrenia, and psychosis and behavioral disturbances associated with dementia. These two broad\\u000a diagnostic indications are associated with contrasting recommended treatment durations, with the former requiring indefinite\\u000a treatment across the life span. Antipsychotic drug dosing for schizophrenia is based primarily on
Chloe Leon; Philip Gerretsen; Hiroyuki Uchida; Takefumi Suzuki; Tarek Rajji; David C. Mamo
Abstract It is not yet clear whether intestinal mucosal permeability changes with advancing age in humans. This question is of high importance for drug and nutrition approaches for olderadults. Our main objective was to answer the question if small intestinal barrier integrity deteriorates with healthy aging. We conducted a cross?sectional study including the pooled data of 215 nonsmoking healthy adults (93 female/122 male), 84 of whom were aged between 60 and 82 years. After a 12?h fast, all participants ingested 10 g of lactulose and 5 g of mannitol. Urine was collected for 5 h afterwards and analyzed for test sugars. The permeability index (PI = lactulose/mannitol) was used to assess small intestinal permeability. Low?grade inflammation defined by high?sensitivity C?reactive protein ?1 mL/L and kidney function (estimated glomerular filtration rate) were determined in the older age group. The PI was similar in older compared to younger adults (P =0.887). However, the urinary recovery of lactulose and mannitol was lower in the olderadults and this change was neither associated with urinary volume nor glomerular filtration rate. The PI was not significantly correlated with low?grade inflammation or presence of noninsulin?dependent type 2 diabetes. However, it significantly deteriorated in the copresence of both conditions compared to low?grade inflammation alone (P =0.043) or type 2 diabetes alone (P =0.015). Small intestinal mucosal barrier does not deteriorate with age per se. But low?grade inflammation coupled with minor disease challenges, such as type 2 diabetes, can compromise the small intestinal barrier.
There is evidence from high quality studies to strongly support the positive association between increased levels of physical activity, exercise participation and improved health in olderadults. Worldwide, around 3.2 million deaths per year are being attributed to inactivity. In industrialised countries where people are living longer lives, the levels of chronic health conditions are increasing and the levels of physical activity are declining. Key factors in improving health are exercising at a moderate-to-vigorous level for at least 5?days per week and including both aerobic and strengthening exercises. Few olderadults achieve the level of physical activity or exercise that accompanies health improvements. A challenge for health professionals is to increase physical activity and exercise participation in olderadults. Some success in this has been reported when physicians have given specific, detailed and localised information to their patients, but more high quality research is needed to continue to address this issue of non-participation in physical activity and exercise of a high enough level to ensure health benefits.
This study examined how Flesch Reading Ease and text cohesion affect olderadults' comprehension of common health texts. All olderadults benefited when high Flesh Reading Ease was combined with high cohesion. Olderadults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, olderadults with low verbal ability or older than 77 years of age had difficulty understanding texts high in text cohesion but low in Flesch Reading Ease. These results imply that writers must increase Flesch Reading Ease without disrupting text cohesion to ensure comprehension of health-related texts.
The aim of this study was to develop and validate an assessment tool for research consent competence in older participants. A four-item instrument was developed to assess the capacity of the olderadults to consent to research. Data were obtained from 203 nursing home residents from two facilities and 201 community-dwelling olderadults in a metropolitan city in South Korea.
A limited amount of literature has discussed olderadults in formal education, especially their motivations to learn in higher education. This study aims to understand olderadults' learning in the context of higher education. Specifically, this study argues that higher education can function as a stimulating learning environment that helps older…
Purpose: This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits olderadults. Design and Methods: This is a 2-wave study of 253 olderadult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling…
The aim of this study was to develop and validate an assessment tool for research consent competence in older participants. A four-item instrument was developed to assess the capacity of the olderadults to consent to research. Data were obtained from 203 nursing home residents from two facilities and 201 community-dwelling olderadults in a…
Numerous studies support the use of rehabilitative interventions in the olderadult. Given the many fiscal challenges in health care today, it is of utmost importance that funding for rehabilitation result in fruitful outcomes. Specific rehabilitative interventions have been found to be very effective in the elderly and can be demonstrated through numerous studies. Outcomes for conditions including stroke, traumatic brain injury, spinal cord injury, amputation, hip fracture, and joint replacement are discussed. There is great need for ongoing research to determine optimal rehabilitative interventions in the elderly. PMID:16627077
Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized OlderAdults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216. PMID:18156858
This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of olderadults. The finding revealed that the higher age or the lower education attainment of olderadults, the lower their learning motivation. The…
Eldercare employees (73 women, 15 men) at rural and urban facilities in Australia responded to two open-ended questions related to perceptions of olderadults. On average, employees assisted 62 adults per week, working at the facility for 19 years. Participants identified the following characteristics of an "independent olderadult:" someone who…
Tailor, Megha; Zaturenskaya, Mariya; Iwamasa, Gayle Y.; Ferrari, Joseph R.
The prevention of elder abuse is important as current estimates show the world's population of adults over age 65 will triple with an associated rise in the number of olderadults who are diagnosed with dementia. Many olderadults with dementia are hospitalized for psychiatric treatment, thus presenting an opportunity for elder abuse screening. Which instrument is most suitable for
The purpose of this study was to investigate the extent to which Korean seniors report employing different motivational and social cognitive strategies related to physical activity, and to evaluate which motivational and social cognitive strategies were related to physical activity, and which motivational and social cognitive strategies differentiate between high active and low-active Korean seniors. Community-dwelling olderadults (N = 187) participated in the study and completed questionnaires assessing self-reported physical activity and a range of motivational and social cognitive variables. The results showed that physical activity was predicted by quality goal-setting practices, self-efficacy, social support from family and physical activity self-regulation subscales of social support and exercise planning and scheduling. Between the groups of highly physically active and low-active participants, we observed differences in satisfaction with life, self-efficacy, quality goal-setting practices, and self-regulatory strategies related to self-monitoring, goal-setting, social support and time management. In conclusion, these findings indicate that physical activity promotion efforts among Korean olderadults should focus on enhancing self-efficacy, social support, and self-regulation skills. PMID:24678504
Objectives: The objectives of this study were to examine whether a leisure education program could facilitate leisure competence among olderadults and whether it could also reduce their stress.Methods: A pre-test-post-test randomized experimental design was conducted. Subjects were randomly assigned to either an experimental group (n = 30) or a control group (n = 30). A leisure education program was used to serve as the intervention. A day before this experiment was carried out, pre-test data were collected using leisure competence and stress scales. Thirty minutes after this experiment ended, post-test data were collected using the same scales. These data were analyzed using an analysis of covariance.Results: The results indicated that the average post-test scores of leisure competence in the experimental group were significantly higher than those in the control group and that the average post-test scores of stress in the experimental group were significantly lower than those in the control group.Conclusion: Healthcare practitioners should adopt the provision of leisure education as a priority to facilitate leisure competence and reduce stress among olderadults. PMID:24479853
ABSTRACT Merely observing another person performing an action can make young people later misremember having performed this action themselves (the observation-inflation effect). We examined this type of memory error in healthy olderadults. Overall, both young and olderadult groups showed robust observation inflation. Although the number of people committing observation-inflation errors did not differ between age groups, those olderadults who were prone to this illusion showed a greater observation-inflation effect compared to the corresponding young. At the same time, observation also had beneficial effects on subsequent action memory, especially in olderadults. Surprisingly, executive functioning was not correlated with the degree to which olderadults made observation-inflation errors, but it was related to the degree to which olderadults benefited from observation. We consider accounts of observation inflation based on source monitoring, familiarity misattribution, and motor simulation. PMID:24128163
Context Survival estimates help individualize goals of care for geriatric patients, but life tables fail to account for the great variability in survival. Physical performance measures, such as gait speed, might help account for variability, allowing clinicians to make more individualized estimates. Objective To evaluate the relationship between gait speed and survival. Design, Setting, and Participants Pooled analysis of 9 cohort studies (collected between 1986 and 2000), using individual data from 34 485 community-dwelling olderadults aged 65 years or older with baseline gait speed data, followed up for 6 to 21 years. Participants were a mean (SD) age of 73.5 (5.9) years; 59.6%, women; and 79.8%, white; and had a mean (SD) gait speed of 0.92 (0.27) m/s. Main Outcome Measures Survival rates and life expectancy. Results There were 17 528 deaths; the overall 5-year survival rate was 84.8% (confidence interval [CI], 79.6%–88.8%)and 10-year survival rate was 59.7% (95%CI, 46.5%–70.6%). Gait speed was associated with survival in all studies (pooled hazard ratio per 0.1 m/s, 0.88; 95% CI, 0.87–0.90; P<. 001). Survival increased across the full range of gait speeds, with significant increments per 0.1 m/s. At age 75, predicted 10-year survival across the range of gait speeds ranged from 19% to 87% in men and from 35% to 91% in women. Predicted survival based on age, sex, and gait speed was as accurate as predicted based on age, sex, use of mobility aids, and self-reported function or as age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalization. Conclusion In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in olderadults.
Background Olderadults are susceptible to reduced saliva production related to certain medications, radiation and chronic conditions. Many of these people have many physical and oral health problems and limited access to dental care. The use of effective screening tools for xerostomia and hyposalivation would be helpful in identifying those at risk. The authors conducted a study to investigate the association between three measures of oral dryness: hyposalivation (low unstimulated salivary flow), self-reported xerostomia and clinically assessed dry mouth. Methods The authors included a convenience sample of 252 nondemented and dentate West Virginia participants 70 years and older who were part of a larger study on oral health and cognition among olderadults. Participants completed a self-reported xerostomia index, provided an unstimulated salivary sample and underwent an oral assessment for the study. Results Twenty-eight (11.1 percent) had hyposalivation, eight of whom reported having xerostomia (sensitivity = 28.6 percent). Of the 43 participants who reported having xerostomia, only eight had hyposalivation (positive predictive value = 18.6 percent). Hyposalivation and self-reported xerostomia were not significantly related. Clinically assessed dry mouth correlated modestly, but significantly, with hyposalivation and self-reported xerostomia. Conclusions Obtaining routine unstimulated salivary flow rates in addition to self-reported information and oral evaluations may increase early detection of oral dryness, which would assist in implementing early interventions to improve patients’ quality of life. Clinical Implications Visually inspecting oral tissues for dryness and asking a patient if his or her mouth is dry are insufficient measures for clinicians to use to determine if the patient has hyposalivation. The authors recommend that clinicians determine the patients’ unstimulated salivary flow rate.
Wiener, R. Constance; Wu, Bei; Crout, Richard; Wiener, Michael; Plassman, Brenda; Kao, Elizabeth; McNeil, Daniel
Until recently, the area of psychological sexual dysfunction in the olderadult has been relatively ignored. A functional\\u000a analysis of sexual dysfunctions among olderadults continues to be lacking. Numerous general and age-specific psychosocial\\u000a factors are implicated in development and maintenance of sexual dysfunction among olderadults. These factors are discussed\\u000a in the context of our model of sexual dysfunction.
Osteoarthritis (OA) is the most common form of arthritis and the leading cause of disability among olderadults in the United States. Treatment options such as acetaminophen and nonsteroidal anti-inflammatory drugs are the most widely used agents to manage mild-to-moderate pain. Treatment with tramadol or opioids is usually reserved for severe pain associated with OA. These agents do not come without risk, especially for olderadults. Patient-specific parameters and comorbid conditions must be considered when evaluating treatment options for olderadults. This article reviews pharmacological and nonpharmacological approaches to the management of OA in olderadults. PMID:21441760
There are a rising number of olderadults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by olderadults, used by an estimated 5% of olderadults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the olderadult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for olderadults. PMID:22348431
Dougherty, Paul E; Hawk, Cheryl; Weiner, Debra K; Gleberzon, Brian; Andrew, Kari; Killinger, Lisa
This report, ?Data Sources Available for Modeling Environmental Exposures in OlderAdults,? focuses on information sources and data available for modeling environmental exposures in the older U.S. population, defined here to be people 60 years and older, with an emphasis on those...
Within a communication predicament of aging and disability framework, this study examined the impact of two types of contextual variation on perceptions of olderadult assertiveness within problematic service encounters. Young (N = 66) and older (N = 66) participants evaluated conversational scenarios in which a visually-impaired older woman…
Previous research demonstrates that patients typically have difficulty remembering information presented during healthcare consultations. This study examined how olderadults learn and remember verbally presented medical information. Healthy olderadults were tested for recall in experimental and field settings. Participants viewed a five-minute…
Abstract Olderadults with schizophrenia need physical activity interventions to improve their physical health. The purpose of this report is to describe the preliminary acceptability of a videogame-based physical activity program using the Kinect™ for Xbox 360 game system (Microsoft, Redmond, WA) in olderadults with schizophrenia.
Hubbard, Erin M.; Vinogradov, Sophia; Dowling, Glenna A.
Improving the quality of life is an important goal in the treatment of psychiatric disorders. The current study described subjective quality of life, or life satisfaction, in a sample of olderadults with generalized anxiety disorder (GAD). Patients with GAD were compared to other anxious and nonpsychiatric samples on measures of life satisfaction. Olderadults with GAD reported lower quality
S. L. Bourland; M. A. Stanley; A. G. Snyder; D. M. Novy; J. G. Beck; P. M. Averill; A. C. Swann
As more nonprofit organizations rely on olderadult volunteers to provide services, it is important to retain volunteers for an extended period of time to ensure service quality and the beneficial outcomes of volunteering. Nonprofit organizations are positioned to facilitate olderadult volunteers' role performance. Based on an institutional…
The book is a textbook for preparing students for positions in professions through which the needs of olderadults are met. It is a manual for in-service training of agency staff, aides, and technicians and serves as a guide for leadership training workshops for board, council, and committee members, and other volunteers working with olderadults.…
In this comprehensively updated second edition, written by Alicia Ann Clair and Jenny Memmott the extraordinary benefits of music therapy for olderadults are detailed. "Therapeutic Uses of Music with OlderAdults" not only examines these benefits but also clarifies the reasons that music is beneficial. This important book shows both informal and…
FLANAGAN, S., G. J. SALEM, M.-Y. WANG, S. E. SANKER, and G. A. GREENDALE. Squatting Exercises in OlderAdults: Kinematic and Kinetic Comparisons. Med. Sci. Sports Exerc., Vol. 35, No. 4, pp. 635- 643, 2003. Purpose: Squatting activities may be used, within exercise programs, to preserve physical function in olderadults. This study characterized the lower-extremity peak joint angles, peak
SEAN FLANAGAN; GEORGE J. SALEM; MAN-YING WANG; SERENA E. SANKER; GAIL A. GREENDALE
Approximately 50% of olderadults complain of difficulty sleeping. Poor sleep results in increased risk of significant morbidity and mortality. The decrements seen in the sleep of the olderadult are often due to a decrease in the ability to get needed sleep. However, the decreased ability is less a function of age and more a function of other factors
With a declining pool of youth to draw from, community colleges need to be concerned about what can be done to serve the needs of a burgeoning olderadult population. Recent research on the educational needs of olderadults reveals that they are interested in: (1) information on such personal business and financial topics as social security…
Olderadults make up the fastest growing age group in North America. This has demanded increased attention in supporting the health and well-being of this population and, in particular, the role of health information in promoting the health and well-being of olderadults. Increased availability and accessibility of information as well as a greater…
Background: Age-related sensory and cognitive impairments have been related to functional performance in olderadults. With regard to cognitive abilities, processing speed in particular may be strongly related to olderadults’ abilities to perform everyday tasks. Identifying and comparing cognitive correlates of functional performance is particularly important in order to design interventions to promote independence and prevent functional disability. Objective:
Kimberly M. Wood; Jerri D. Edwards; Olivio J. Clay; Virginia G. Wadley; Daniel L. Roenker; Karlene K. Ball
The current study investigated the nature of subjective cognitive complaints of olderadults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether olderadults experience problems with these cognitive functions (problems with cognition); (2) the…
Olderadults generally have multiple medical problems as well as subclinical changes in several physiologic systems. This special article presents a framework (based on the World Health Organization International Classification of Functioning, Disability, and Health) for organizing comorbid processes and diseases to facilitate research and assist clinicians caring for olderadults. The nosology begins with physiologic systems (e.g., cardiovascular, endocrine)
Arun Karlamangla; Mary Tinetti; Jack Guralnik; Stephanie Studenski; Terrie Wetle; David Reuben
To effectively address medication adherence and improve cardiovascular health among olderadults, a deeper understanding is needed of the barriers that this age group faces and of approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n = 25) in a diverse population of olderadults with…
Holt, Elizabeth W.; Rung, Ariane L.; Leon, Kyla A.; Firestein, Catherine; Krousel-Wood, Marie
The National Council on Problem Gambling 730 11th St, NW, Ste 601 Washington, DC 20001 Phone 202.547.9204 Fax 202.547.9206 email@example.com OlderAdults at Increased Risk of Gambling Addiction For Immediate Release OlderAdults at Increased ...
The olderadult (55+) population is becoming a significant presence in the personal computer market. Seniors have the discretionary income, experience, interest, and free time to make use of computers in interesting ways. A literature review found that olderadults make use of computers in significant numbers: 30 percent of computer owners are…
Background: various modalities of exercise have been demonstrated to improve physical function and quality of life in olderadults. Current guidelines stress the importance of multi-modal exercise for this cohort, including strengthening exercises, cardiovascular, flexibility and balance training. There is a lack of evidence, however, that simultaneously prescribed doses and intensities of strength, aerobic, and balance training in olderadults
MICHAEL K. BAKER; E VAN ATLANTIS; M ARIA A. FIATARONE SINGH
This study assesses the functional fitness of a convenient sample of olderadults (greater than 70 years), to examine correlations between functional fitness and several other health-related variables and to compare with criterion performance data as established by Rikli and Jones (2001). One hundred and seven community-dwelling olderadults with…
In North America, 40-50 per cent of olderadults are actively involved as formal volunteers in providing diverse health and human services. We review empirical studies concerning olderadults' motivations for volunteering, as well as the health and morale benefits they derive from this expression of altruism. Knowledge of the exact nature and…
Emerging research suggests that olderadults who experience age-related declines in regulatory abilities may have more difficulty inhibiting their expression of negative bias to stigmatized individuals as compared with young adults. However, it remains largely unexplored why this might be. For instance, olderadults may hold stigmatized individuals more accountable for their conditions as compared with young adults, which could subsequently increase their expression of negative bias. The current study investigated this question by testing 90 olderadults and 44 young adults. Researchers found that olderadults with relatively impaired executive function placed a greater emphasis on controllability when evaluating stigmatized individuals and rated the stigmatized conditions overall as being more changeable. PMID:23042645
The present study examined age differences in the discrimination between anxiety and depressive symptoms in a community sample of 374 adults, ages 18–93. Olderadults were less accurate and more likely than younger adults to label symptoms as neither anxiety nor depression. Both older and younger adults were more accurate in their classification of depressive than anxiety symptoms. These findings suggest that additional efforts are needed to educate the general public, particularly olderadults, about anxiety and its symptoms.
Wetherell, Julie Loebach; Petkus, Andrew J.; McChesney, Kathleen; Stein, Murray B.; Judd, Patricia H.; Rockwell, Enid; Sewell, Daniel D.; Patterson, Thomas L.
Whereas olderadults typically show declines in various cognitive processes, they also typically demonstrate greater interest in social relationships. Part of this increased focus on interpersonal relations may extend to morality, which by its very nature is concerned with social contracts, obligations, and the give-and-take among people. The authors tested whether in comparison to younger adults, olderadults show increased activation and memory for morally charged information relative to nonmoral information. Three experiments examined older and younger adult comprehension and memory of moral content in stories. Participants read stories and were tested for surface form, textbase, and situation model recognition memory. In contrast to past studies that have not focused on moral content, in this study olderadults had textbase memory for moral information equal to that of young adults, suggesting an enhanced attention to morally charged details. To examine online moral inference making, Experiment 2 used lexical decision probes. There was greater facilitation of moral inferences for olderadults relative to younger adults, suggesting greater focus of processing on moral content. Experiment 3 explored methodological issues to resolve some discrepancies between the experiments, and replicated the basic findings. In general, olderadults had enhanced memory for morally charged story events and, relative to younger adults, were more likely to draw moral inferences during comprehension. PMID:21800972
Narvaez, Darcia; Radvansky, Gabriel A; Lynchard, Nicholas A; Copeland, David E
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at https://villanova.gosignmeup.com/dev_students.asp?action=browse&main=Nursing+Journals&misc=564. To obtain contact hours you must: 1. Read the article, "Orthostatic Hypotension in OlderAdults with Dementia" found on pages 22-29, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until May 31, 2016. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the significance of orthostatic hypotension in olderadults with dementia. 2. Identify factors that contribute to orthostatic hypotension. 3. Review nursing interventions to minimize a drop in blood pressure with position change. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Orthostatic hypotension (OH) in olderadults with dementia is associated with increased confusion, dizziness, syncope, and falls. These problems may result in a negative, downward spiral accompanied by high morbidity and mortality. The literature supports that nonpharmacological interventions are effective in the reduction of symptoms and prevention of orthostasis. The purpose of this quality improvement project was to increase staff knowledge and skill in the assessment, documentation, and care of residents with OH in dementia care units within a continuing care retirement community. An in-service program using a protocol based on clinical practice guidelines was presented to RNs, licensed practical nurses, therapists, and unlicensed caregivers. Assessments, documentation of assessments, and interventions for residents with OH increased following the in-service program. As staff continue to apply their knowledge in care routines, it is expected that this evidence-based practice will reduce symptoms of OH and increase safety and quality of life within this specific population. [Journal of Gerontological Nursing, 40(6), 22-29.]. PMID:24779368
Olderadults look at the ground more while they are walking than younger adults do. In the present study, the effect of blocking that exproprioceptive visual information on the walking pattern of olderadults was investigated. The first 0.75 m of the floor in front of healthy young adults (n = 10, mean age = 26.0 years) and 2 groups
Patricia G. Anderson; Bart Nienhuis; Theo Mulder; Wouter Hulstijn
Olderadults sometimes show a "positivity effect" in memory, remembering proportionally more positive information than younger adults. Using a modified Memory Characteristics Questionnaire, this study examined whether emotional valence impacts the phenomenological qualities of young and olderadults' memories. Ageing did not impact the effect of valence on the qualities of high-arousal memories. However, ageing sometimes impacted subjective memory for details of low-arousal memories: In Experiment 2, olderadults reported remembering more thoughts, feelings, and temporal order details about positive low-arousal stimuli, while young adults' ratings for those dimensions were higher for negative low-arousal stimuli. These findings suggest that valence most readily affects the qualities of young and olderadults' emotional memories when those memories are low in arousal. PMID:19468956
The thermic effect of food accounts for ??10% of daily energy expenditure. A reduction in the thermic effect of food, which has been variably observed in the olderadults, could predispose to fat gain. We tested whether the thermic effect of food is reduced in olderadults compared with young adults by analyzing our database of standardized studies conducted at the Mayo Clinic between 1999 and 2009. Data were available from 136 olderadult volunteers aged 60-88 (56 females) and 141 young adults aged 18-35 years (67 females). Basal energy expenditure was measured by indirect calorimetry to assess basal metabolic rate. Body fat, fat free mass, and visceral fat were measured using a combination of dual energy X-ray absorptiometry and an abdominal CT scan. The thermic effect of food and postprandial insulinemia were measured in 123 olderadults (52 females) and 86 young adults (38 females) of these volunteers. Basal metabolic rate adjusted for fat-free mass was less in olderadults (p=0.01) and the thermic effect of food was ??1% (p=0.02) less in the olderadults. After controlling for meal size and fat-free mass, body fat and fat distribution did not predict the thermic effect of food. Both basal metabolic rate and the thermic effect of food are less in olderadults than young adults, even when they have similar amounts of lean tissue and consume a similar size meal. These factors contribute to lower daily energy expenditure in the olderadults. PMID:24155251
Laughter, the physical response to perceived humor, has demonstrated positive effects on physical and psychological well-being. Studies that focus on effects of humor on health and well-being of olderadults are scarce. No studies were found that examine what olderadults find humorous. The purpose of this descriptive study was to explore the humor stimulus in a population of olderadults. One hundred thirty (130) hospital auxiliary personnel aged 50 and older were asked the question What makes you laugh? Content analysis of responses revealed nine themes in two major categories, which were (a) people or animals and (b) situations or events. Children represented the largest category of people (30%), and telling jokes represented the largest category of situations or events (51%). Humor can be used by nurses as an effective therapeutic tool when caring for olderadults if appropriate sources of humor are identified and applied. PMID:16880415
Many olderadults are working beyond what was considered a "normal" retirement age in past generations. If work-related injury occurs, olderadults may have increased vulnerabilities due to age and comorbid conditions not shared by their younger working peers. This article presents an individual example in which these vulnerabilities are explored, and unique processes within the work environment are noted. Awareness of the risks to older workers will aid clinicians in any setting to maximize prevention and management of co-morbidities that improve health status, function, and employment performance for older workers. PMID:22897127
Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural olderadults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural olderadults received dental care. Slightly more than one-quarter (27.1%) of dentate rural olderadults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural olderadults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of olderadults to pay for dental care must be addressed by public health policy to improve the health and quality of life of olderadults in rural communities.
Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.
In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in olderadults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in olderadults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for olderadults with diabetes. PMID:23130317
Kim, Kyung Soo; Kim, Soo Kyung; Sung, Kyung Mi; Cho, Yong Wook; Park, Seok Won
There is increasing evidence of the importance of regular mental and physical exercise to maximize overall health and functioning in olderadults. However, many individuals find that reduced strength or disabilities prevent them from participating in the kinds of exercise they enjoyed when they were younger. Music can provide the important benefits of both mental and physical stimulation to even frail olderadults. Whether using Conductorcise for aerobic exercise, enjoying the communal experience of singing in a choir, or quietly reflecting on a music recording, music can serve as a healing art for olderadults. PMID:18416271
This article reports the findings from a recent study of olderadults in the rural southwestern United States and discusses practice and research implications. The aim of the study was to analyze health disparities and strengths in the contexts of rurality, aging, a depressed economy, and limited health resources. Identified themes needing action included sustained access to prescriptions, transportation solutions for olderadults in isolated communities, inadequate access to care, poor infrastructure and coordination of services, scarce assisted living and in-home care for frail olderadults, and barriers related to culture, language, and economics.
The purpose of this study was to investigate the perceived barriers to physical activity by olderadults. 199 volunteers responded to the Perceived Barriers Questionnaire (PBQ). The subjects resided in apartment residences for independent, healthy, olderadults. Olderadults perceived as many as 17 barriers to physical activity. The number of barriers per subject was significantly related to age and illness or handicap. The remaining factors, gender, income, activity and educational levels, were not related to the number of barriers. There was a significant difference among four specific types of barriers (i.e. Psychological, Administrative, Physical/Health, Knowledge) with barriers of the knowledge dimension being most often identified. PMID:1790502
Although older homeless adults have high rates of geriatric syndromes, risk factors for these syndromes are not known. We used multivariable regression models to estimate the association of subject characteristics with the total number of geriatric syndromes in 250 homeless adults aged 50 years and older. Geriatric syndromes included falls, cognitive impairment, frailty, major depression, sensory impairment, and urinary incontinence. A higher total number of geriatric syndromes was associated with having less than a high school education, medical comorbidities (diabetes and arthritis), alcohol and drug use problems, and difficulty performing one or more activities of daily living. Clinicians who care for older homeless patients with these characteristics should consider screening them for geriatric syndromes. Moreover, this study identifies potentially modifiable risk factors associated with the total number of geriatric syndromes in older homeless adults. This knowledge may provide targets for clinical interventions to improve the health of older homeless patients. PMID:23728022
Brown, Rebecca T; Kiely, Dan K; Bharel, Monica; Mitchell, Susan L
Although older homeless adults have high rates of geriatric syndromes, risk factors for these syndromes are not known. We used multivariable regression to estimate the association of subject characteristics with the total number of geriatric syndromes in 250 homeless adults aged 50 years and older. Geriatric syndromes included falls, cognitive impairment, frailty, major depression, sensory impairment, and urinary incontinence. A higher total number of geriatric syndromes was associated with having less than a high school education, medical comorbidities (diabetes and arthritis), alcohol and drug use problems, and difficulty performing one or more ADLs. Clinicians who care for older homeless patients with these characteristics should consider screening them for geriatric syndromes. Moreover, this study identifies potentially modifiable risk factors associated with the total number of geriatric syndromes in older homeless adults. This knowledge may provide targets for clinical interventions to improve the health of older homeless patients.
Brown, Rebecca T.; Kiely, Dan K.; Bharel, Monica; Mitchell, Susan L.
Gambling participation rates among olderadults (65+ years) have been increasing in recent years. Very few studies have compared\\u000a older and younger gamblers on gambling motivation and problem gambling. This study compared 41 male and 63 female older gamblers\\u000a (66–87 years; median 73) to 20 male and 85 female younger gamblers (17–34 years; median 20) in New Zealand on gambling involvement,\\u000a gambling
Purpose: Listening in noisy situations is a challenging experience for many olderadults. The authors hypothesized that olderadults exert more listening effort compared with young adults. Listening effort involves the attention and cognitive resources required to understand speech. The purpose was (a) to quantify the amount of listening effort…
Adults aged 65 years or older have been routinely and systematically excluded from research. With the number of olderadults at a record high and growing faster than any other age group, there must be an increased priority on meeting the enrollment challenges so intervention studies are relevant to this population. The challenge centers around the complexity and heterogeneity of olderadults, leaving a gap between olderadults who participate in studies and those who exist in the real world. Barriers to enrollment stem from both the researcher and participant side. Eight barriers from the research perspective and six from the participant perspective are identified and discussed. Solutions to these barriers can be approached from a three-tier framework. The lowest tier is direct solutions to problems, the middle involves support from funders and journals, and the top tier considers a comprehensive view of sampling and design decisions.
Viral respiratory disease in olderadults has been increasingly recognized as a significant cause of hospitalizations and death. Unfortunately, the recognition and diagnosis of infection due to many viral respiratory pathogens in olderadults can be elusive due to atypical clinical presentations and the insensitivity of current laboratory diagnostic tests in this population. For influenza diagnosis, rapid antigen tests followed by viral culture if negative, can be useful in olderadults as long as clinicians are mindful of test limitations. Although specific, rapid antigen tests are insensitive in this population. Erroneous negative results may lead to delays in timely administration of antiviral treatment and institution of appropriate isolation precautions. The increasing availability of new rapid and sensitive molecular diagnostics such as polymerase chain reaction testing, should provide more accurate and timely diagnoses of viral respiratory infections in olderadults in the near future.
This article illustrates how old bicycle inner tubes, wire coat hangers, stockings, panty hose, and milk dispenser bladders can be used as part of an exercise program for olderadults. Specific exercises and activities are suggested. (MT)
A 48-item questionnaire was administered to 100 olderadults to determine their expectations regarding hearing aid use. The sample consisted of volunteers from a variety of senior citizen organizations and ranged in age from 55 to 92 years. Only individuals who reported no prior hearing aid usage were included in the sample. Expectations for the following factors were considered: cosmetics, acoustics, communication benefits, comfort, ease of use, cost and upkeep, and attitudes toward hearing aid use. In general, the olderadults in this sample appeared to have very positive expectations regarding the use of hearing aids. Eighty-seven percent apparently have medium to high expectations for hearing aid use. Since the olderadult's satisfaction with amplification may be influenced by original expectations and attitudes, the information provided in this study may be useful in improving the pre-fitting counseling of older hearing-impaired adults. PMID:1768880
... gov . Physical Activity Physical Activity Share Compartir Making Physical Activity a Part of an OlderAdult's Life When it comes to getting the physical activity you need each week, it's important to pick ...
... activities may change considerably based on your personal health. There is insufficient evidence to support some screening tests in olderadults. However, some vaccines, screening, and actions are recommended ...
... you or anyone around you; if there is evidence of substance abuse or mental health problems in the caregiver; or if the caregiver is financially dependent on the olderadult and expresses continual concern about money, this is ...
Olderadults have the highest risk of death by suicide in the United States. Improving our understanding of the factors that lead to increased risk of suicide in olderadults will greatly inform our ability to prevent suicide in this high-risk group. Two studies were conducted to test the effect of perceived burdensomeness, a component of the interpersonal-psychological theory of suicide (Joiner, 2005), on suicide ideation in olderadults. Further, gender was examined as a moderator of this association to determine if perceived burdensomeness exerted a greater influence on suicide ideation in males. The results of these studies suggest that perceived burdensomeness accounts for significant variance in suicide ideation, even after predictors such as depressive symptoms, hopelessness, and functional impairment are controlled. Gender did not moderate the association. The implications of these findings for treatment of olderadults with suicide ideation and elevated suicide risk are discussed.
Cukrowicz, Kelly C.; Cheavens, Jennifer S.; Van Orden, Kimberly A.; Ragain, R. Michael; Cook, Ronald L.
Provides an overview of the epidemiology of falls among olderadults, describes current prevention strategies, and highlights key areas that need to be addressed, including risk assessments, exercise, and environmental changes. (Contains 50 references.) (JOW)
Medicines and You: A Guide for OlderAdults (PDF version - 334KB) • Aging and Health: You and Your ... What You Need to Know About Your Prescription Medicines The following questions will help you get the ...
... family can help: Establish the older person’s feelings of security, stability, and safety Reunite the older person with family ... providers’ names and contact information Credit card and bank account ... investment records List of insurance policies with name of company, type of ...
While previous studies have mostly examined holistic face processing in childhood and young adulthood, the present study investigated developmental changes of holistic face processing under a lifespan perspective, including older adulthood. Children 5–7 and 9–10 years of age, as well as young and olderadults were instructed to assign faces into two categories. The categories were constructed to allow either
Behavioral interventions based on operant principles are commonly attempted to manage agitation in olderadults with dementia. The extent to which operant conditioning can occur in persons with particular dementias, however, is unclear. The present study involved use of a button-pressing task to evaluate the sensitivity of the responding of older…
In the United States today, more than 40 cents of every health care dollar is spent on people who are 65 or older. Olderadults suffer from a multitude of conditions and are especially susceptible to the effects of poor care, yet we know relatively little...
Individuals aged 60 years and older are at an increased risk for listeriosis and other foodborne illnesses. They can reduce their risk by following recommended food safety practices. A total of 8 focus groups were conducted to characterize olderadults' food safety knowledge and practices, their impressions of educational materials on listeriosis…
Cates, Sheryl C.; Kosa, Katherine M.; Moore, Christina M.; Jaykus, Lee-Ann; Ten Eyck, Toby A.; Cowen, Peter
The rapid growth in the number of older Americans has many implications for public health, including the need to better understand the risks posed by environmental exposures to olderadults. An important element for evaluating risk is the understanding of the doses of environment...
Purpose: The purpose of this study is to examine the relationships among lifetime exposure to traumatic events, emotional support, and life satisfaction in three cohorts of olderadults. Design and Methods: Face-to-face interviews were conducted with a nationwide sample of 1,518 older people in 2003. Approximately 500 elders were interviewed in…
WHY: Hearing impairment is common in olderadults; its prevalence increases progressively with age. Studies estimate that at least 30% of individuals aged 65 to 74 years and 40% to 66% of those aged 75 years and older have some degree of hearing loss. Hearing loss related to normal aging is the most common cause, but other risk factors include:
Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 olderadults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…
Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.
Introduction The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for olderadults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of olderadults. The objective of the study is to identify baseline EM resident attitudes toward olderadults using a validated attitude scale and multidimensional analysis. Methods Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results 173 EM residents participated showing an overall positive attitude toward olderadults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels. Conclusion EM residents demonstrate an overall positive attitude towards the care of olderadults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.
The end-stage renal disease population is aging. Nearly half of all new patients are older than 65 years and one third are older than 70 years. Assessing the possibility of transplantation for older patients with end-stage renal disease often involves contemplating more complex issues, including cognitive impairment, decreased functional status, and frailty, which makes selecting appropriate candidates more difficult. Older transplant recipients have decreased patient and transplant survival compared with younger recipients. For example, 75% of deceased donor transplant recipients aged 30-49 years are alive after 5 years compared to only 61% for those older than 65 years. Despite poorer outcomes compared with younger recipients, older transplant recipients have a significant improvement in survival compared with similar patients who remain on the wait list, with decreases in mortality of 41%-61% depending on the study. Use of living donors, even older living donors, provides significantly better outcomes for elderly recipients compared with the use of deceased donors. However, in the absence of a living donor, survival is improved significantly by accepting an expanded criteria donor organ rather than waiting for a standard criteria deceased donor. Older transplant recipients experience more infectious complications and less acute rejection, but the risk of transplant loss from rejection is increased compared with younger patients. These immunologic issues, along with the fact that older patients often are excluded from transplant trials, have made selecting an ideal immunosuppressive regimen challenging. Prospective comparative trials of different agents in the elderly population are warranted to better define the risk-benefit profile. This review discusses transplantation outcomes, including patient and transplant survival, different donor types, quality of life, and immunosuppression for older dialysis patients. PMID:23261121
More than 2 million olderadults identify as lesbian, gay, bisexual, or transgender (LGBT). The purpose of this article is to present an overview of the physical and mental health needs of LGBT olderadults to sensitize nurses to the specific needs of this group. Nurses are in a prominent position to create health care environments that will meet the needs of this invisible, and often misunderstood, group of people. PMID:24066784
Jablonski, Rita A; Vance, David E; Beattie, Elizabeth
This study examines the perceptions and treatment of older Native American adults in colonial New England (1620–1783). Social\\u000a scientists have found that varying degrees of persistence and change have historically characterized Indian attitudes toward\\u000a olderadults in communities located in the central and western United States. In regards to northeastern North America, historians\\u000a have learned that, during the colonial period,
Context Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival ad- vantages. Objective To determine whether free-living activity energy expenditure is associ- ated with all-cause mortality among olderadults. Design, Setting, and Participants Free-living activity energy expenditure was assessed in 302 high-functioning, community-dwelling olderadults (aged 70-82 years).
Todd M. Manini; James E. Everhart; Kushang V. Patel; Dale A. Schoeller; Lisa H. Colbert; Marjolein Visser; Frances Tylavsky; Douglas C. Bauer; Bret H. Goodpaster; Tamara B. Harris
Although the empirical base is still limited when providing clear directions for pain assessment and management in olderadults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in olderadults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed.
Aging is associated with loss of muscle volume (MV) and force leading to difficulties with activities of daily living. However, the relationship between upper limb MV and joint strength has not been characterized for olderadults. Quantifying this relationship may help our understanding of the functional upper limb declines olderadults experience. Our objective was to assess the relationship between upper limb MV and maximal isometric joint moment-generating capacity (IJM) in a single cohort of healthy olderadults (age?65 years) for 6 major functional groups (32 muscles). MV was determined from MRI for 18 participants (75.1±4.3 years). IJM at the shoulder (abduction/adduction), elbow (flexion/extension), and wrist (flexion/extension) was measured. MV and IJM measurements were compared to previous reports for young adults (28.6±4.5 years). On average olderadults had 16.5% less total upper limb MV compared to young adults. Additionally, olderadult wrist extensors composed a significantly increased percentage of upper limb MV. Olderadult IJM was reduced across all joints, with significant differences for shoulder abductors (p<0.0001), adductors (p=0.01), and wrist flexors (p<0.0001). Young adults were strongest at the shoulder, which was not the case for olderadults. In olderadults, 40.6% of the variation in IJM was accounted for by MV changes (p?0.027), compared to 81.0% in young adults. We conclude that for olderadults, MV and IJM are, on average, reduced but the significant linear relationship between MV and IJM is maintained. These results suggest that olderadult MV and IJM cannot be simply scaled from young adults.
Vidt, Meghan E.; Daly, Melissa; Miller, Michael E.; Davis, Cralen C.; Marsh, Anthony P.; Saul, Katherine R.
ABSTRACT OBJECTIVE To determine the effects of adding stages of change–based counseling to an exercise prescription for older, sedentary adults in family practice. DESIGN The Step Test Exercise Prescription Stages of change counseling study was a 12-month cluster randomized trial. SETTING Forty family practices in 4 regions of Canada. PARTICIPANTS Healthy, community-dwelling men (48%) and women (52%) with a mean (SD) age of 64.9 (7.1) years (range 55 to 85 years). There were a total of 193 participants in the intervention group and 167 in the control group. INTERVENTION Intervention physicians were trained to deliver a tailored exercise prescription and a transtheoretical behaviour change counseling program. Control physicians were trained to deliver the exercise prescription alone. MAIN OUTCOME MEASURES Predicted cardiorespiratory fitness, measured by predicted maximal oxygen consumption (pVO2max), and energy expenditure, measured by 7-day physical activity recall. RESULTS Mean increase in pVO2max was significant for both the intervention (3.02 [95% confidence interval 2.40 to 3.65] mL/kg/min) and control (2.21 [95% confidence interval 1.27 to 3.15] mL/kg/min) groups at 12 months (P < .001); however, there was no difference between groups. Women in the intervention group improved their fitness significantly more than women in the control group did (3.20 vs 1.23 mL/kg/min). The intervention group had a 4–mm Hg reduction in systolic blood pressure, while the control group’s mean reduction was 0.4 mm Hg (P < .001). The mean (SD) energy expended significantly increased and was higher in the intervention group than in the control group (69.06 [169.87] kcal/d vs ?6.96 [157.06] kcal/d, P < .006). Practice setting characteristics did not significantly affect the primary outcomes. CONCLUSION The Step Test Exercise Prescription Stages of change exercise and behavioural intervention improved fitness and activity and lowered systolic blood pressure across a range of Canadian practices, but this was not significantly different from the control group, which received only the exercise prescription. Women in the intervention group showed higher levels of fitness than women in the control group did; men in both groups showed similar improvement.
Petrella, Robert J.; Lattanzio, Chastity N.; Shapiro, Sheree; Overend, Tom
Little is known about how older persons determine if someone deserves their trust or not based on their facial appearance, a process referred to as “facial trustworthiness.”In the past few years, Todorov and colleagues have argued that, in young adults, trustworthiness judgments are an extension of emotional judgments, and therefore, that trust judgments are made based on a continuum between anger and happiness (Todorov, 2008; Engell et al., 2010). Evidence from the literature on emotion processing suggest that olderadults tend to be less efficient than younger adults in the recognition of negative facial expressions (Calder et al., 2003; Firestone et al., 2007; Ruffman et al., 2008; Chaby and Narme, 2009). Based on Todorov';s theory and the fact that olderadults seem to be less efficient than younger adults in identifying emotional expressions, one could expect that older individuals would have different representations of trustworthy faces and that they would use different cues than younger adults in order to make such judgments. We verified this hypothesis using a variation of Mangini and Biederman's (2004) reverse correlation method in order to test and compare classification images resulting from trustworthiness (in the context of money investment), from happiness, and from anger judgments in two groups of participants: young adults and older healthy adults. Our results show that for elderly participants, both happy and angry representations are correlated with trustworthiness judgments. However, in young adults, trustworthiness judgments are mainly correlated with happiness representations. These results suggest that young and olderadults differ in their way of judging trustworthiness.
Falls consistently rank among the most serious problems facing older persons and cause a tremendous amount of morbidity, mortality,\\u000a and disability (Brown, 1999; Nevitt, 1997; Robbins et al., 1989; Rubenstein, Josephson, & Robbins, 1994; Tinetti, Williams,\\u000a & Mayewski, 1986). At least a third of community-dwelling people aged 65 years and older fall each year (Centers for Disease\\u000a Control and Prevention
Laurence Z. Rubenstein; Judy A. Stevens; Vicky Scott
Background Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear. Aims/Method The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy olderadult comparison group (n = 25). We hypothesized that olderadults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] (Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]). Results Olderadults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, olderadults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group. Conclusions Compared with demographically-matched controls, olderadults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for olderadults with HD.
A fundamental objective of the National Strategy for Suicide Prevention is the prevention of suicide in olderadults, especially elderly males, because these individuals are at higher risk for suicide than any other age group. Furthermore, they are the fastest growing segment of the population. The suicide rates for older Caucasian men are particularly high. Because nurses play an important role in the identification of persons at risk for suicide, it is important that they be cognizant of the complex risk factors involved in late life suicide. Toward that end, we review the prevalence of suicidal behaviors in olderadults and discuss risk factors that contribute to completed suicide in these individuals. Lastly, we discuss the role of nurses in the identification of olderadults at risk for suicidal behavior so that life-saving treatment measures can be implemented.
Garand, Linda; Mitchell, Ann M.; Dietrick, Ann; Hijjawi, Sophia P.; Pan, Di
Olderadults represent a rapidly growing segment of the population in developed countries. Advancing age is the most powerful risk factor for the development of cardiovascular disease (CVD), and CVD-related mortality increases markedly in older individuals. Procedures for patients with CVD, including percutaneous coronary intervention, aortic valve replacement and implantable cardioverter defibrillators were all initially validated in younger individuals but are increasingly being applied in olderadults who for the most part have been significantly understudied in clinical trials. While advanced age alone is not a contraindication to these procedures, with the advent of less invasive methods to manage CVD including percutaneous techniques to treat both coronary artery disease and valvular heart disease, future research will need to weigh the potential harms of intervention in a population of olderadults with multiple medical comorbidities and complex physiologic phenotypes against outcomes that include preventing functional decline and improving quality of life.
Background Many olderadults drink alcohol and use medications that may be harmful when consumed together. Objective This article reviews the literature on alcohol and medication interactions with a focus on olderadults. Methods Relevant articles were identified through a search of MEDLINE (1966-August 2006) for articles on alcohol medication interactions, diseases worsened by alcohol use, alcohol metabolism, absorption and distribution. Additional articles were identified by a manual search of the reference lists of the identified articles and review articles. Results Many olderadults drink alcohol and take medications that may interact negatively with alcohol. Some of these interactions are due to age-related changes in the absorption, distribution and metabolism of alcohol and medications. Others are due to disulfiram-like reactions observed with some medications, exacerbation of therapeutic effects and adverse effects of medications when combined with alcohol, and alcohol’s interference with the effectiveness of some medications. Conclusions Olderadults who drink alcohol and who take medications are at risk for a variety of harms depending on the amount of alcohol and the type of medications consumed. It is important for clinicians to know how much alcohol their older patients are drinking to be able to effectively assess their risks and to counsel them about safe use of alcohol and medications. Similarly, it is important for olderadults to understand the potential risks of their combined alcohol and medication use to avoid the myriad of harms possible with unsafe use of these substances.
Moore, Alison A.; Whiteman, Elizabeth J.; Ward, Katherine T.
Using data from a national survey of adults in Taiwan, this study presents findings regarding olderadults' reading practices with respect to newspapers, magazines, books, and Internet information. The study also identifies four reading profiles defined by the frequency and diversification of the material read: the nonreaders, the less diversified…
The study examines whether social support interacts with health literacy in affecting the health status of olderadults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…
Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel
This study examined similarities between the Expressed Emotion (EE) construct developed in the psychiatric literature and interpersonally relevant constructs derived from gerontology caregiver research. Expressed emotion and other indices derived from the Camberwell Family Interview (CFI) were assessed in 46 adult children and spouses providing care to an olderadult hospitalized for major depressive disorder. The relationship of CFI indices
Purpose: The purpose of the study was to examine the relationships among measures of comprehension and production for stories depicted in wordless pictures books and measures of memory and attention for 2 age groups. Method: Sixty cognitively healthy adults participated. They consisted of two groups--young adults (20-29 years of age) and older…
The motivations and benefits of educational travel among individuals aged 55 years old and over were examined in this study. A total of 136 olderadults enrolled in Elderhostel programs participated in this study and reported their perceived benefits and motivations for engaging in educational travel experiences. Correlation analyses were used to explore relationships between the adults' perceived benefits and
Forty young adults, 40 healthy olderadults, and 39 probable AD patients were asked to estimate small (e.g., 25) and large (e.g., 60) collections of dots in a choice condition and in two no-choice conditions. Participants could choose between benchmark and anchoring strategies on each collection of dots in the choice condition and were required to…
Gandini, Delphine; Lemaire, Patrick; Michel, Bernard Francois
Effective health care is a core determinant of successful aging, and medications are one of the most important therapeutic tools of health care providers. Most olderadults use at least one prescription drug. Costs for these drugs are a substantial out-of-pocket expense for Medicare beneficiaries, and low-income olderadults must weigh these costs against those of other basic needs. Although medications bring welcome relief to millions of elderly persons with age-related conditions, adverse drug events are an important cause of illness and death in these patients. Thus, the appropriate, cost-effective use of medication is central to successful aging. Despite increasing attention to geriatric pharmacotherapy, there is an enormous need for additional research to improve the use of medications among olderadults. The necessary research agenda encompasses much more than just the discovery of new drugs; better use of the current pharmacopeia has great potential to improve the lives of olderadults. We review four domains of pharmaceutical research: drug discovery and delivery, drug efficacy and safety, pharmacoepidemiology and drug policy, and improved access to and use of drugs. These domains encompass both the pre- and postmarketing phases of drug research. Premarketing research currently has greater magnitude and a better infrastructure than postmarketing research, yet issues arising in the two phases of research are equally important to the health and safety of olderadults. A national, federally supported pharmaceutical database could greatly enhance the infrastructure of postmarketing research. However, many major improvements in medication use among olderadults will also depend on closing the gap between knowledge and practice and increasing the ability of olderadults to manage their medications. PMID:12965970
This study compared young and olderadults' ability to recognize bodily and auditory expressions of emotion and to match bodily and facial expressions to vocal expressions. Using emotion discrimination and matching techniques, participants assessed emotion in voices (Experiment 1), point-light displays (Experiment 2), and still photos of bodies with faces digitally erased (Experiment 3). Olderadults' were worse at least some of the time in recognition of anger, sadness, fear, and happiness in bodily expressions and of anger in vocal expressions. Compared with young adults, olderadults also found it more difficult to match auditory expressions to facial expressions (5 of 6 emotions) and bodily expressions (3 of 6 emotions). PMID:19739917
The study tested the effect of Web page design accommodations for olderadults. Two websites, designed by the researchers, were viewed and evaluated by three groups of adults: Younger (ages 30 to 64), Older (ages 65 to 84), and Oldest (ages 85 and older). The two sites, one with accommodations and one without, had identical health content. Thirty adults in each of three age groups rated both web pages. A 2 X 3, mixed ANOVA, age by page style was calculated. Both main effects and the interaction were significant. In all groups, ratings for the website without accommodations were lower than for the site with accommodations. The ratings of the site without accommodations were lowest among adults in the Oldest group. PMID:17378186
With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n =…
Brock, Kaye; Clemson, Lindy; Cant, Rosemary; Ke, Liang; Cumming, Robert G.; Kendig, Hal; Mathews, Mark
Olderadults continue to be underrepresented in clinical research despite their burgeoning population in the United States and worldwide. Physicians often propose treatment plans for olderadults based on data from studies involving primarily younger, more-functional, healthier participants. Major barriers to recruitment of olderadults in aging research relate to their substantial health problems, social and cultural barriers, and potentially impaired capacity to provide informed consent. Institutionalized olderadults offer another layer of complexity that requires cooperation from the institutions to participate in research activities. This paper provides study recruitment and retention techniques and strategies to address concerns and overcome barriers to olderadult participation in clinical research. Key approaches include early in-depth planning; minimizing exclusion criteria; securing cooperation from all interested parties; using advisory boards, timely screening, identification, and approach of eligible patients; carefully reviewing the benefit:risk ratio to be sure it is appropriate; and employing strategies to ensure successful retention across the continuum of care. Targeting specific strategies to the condition, site, and population of interest and anticipating potential problems and promptly employing predeveloped contingency plans are keys to effective recruitment and retention.
Mody, Lona; Miller, Douglas K.; McGloin, Joanne M.; Div, M; Freeman, Marcie; Marcantonio, Edward R.; Magaziner, Jay; Studenski, Stephanie
Purpose The purpose of the study was to examine the relationships among measures of comprehension and production for stories depicted in wordless pictures books and measures of memory and attention for 2 age groups. Method Sixty cognitively healthy adults participated. They consisted of two groups—young adults (20–29 years of age) and olderadults (70–89 years of age). Participants completed cognitive measures and several discourse tasks; these included telling stories depicted in wordless picture books and answering multiple-choice comprehension questions pertaining to the story. Results The 2 groups did not differ significantly for proportion of story propositions conveyed; however, the younger group performed significantly better on the comprehension measure as compared with the older group. Only the older group demonstrated a statistically significant relationship between the story measures. Performance on the production and comprehension measures significantly correlated with performance on the cognitive measures for the older group but not for the younger group. Conclusions The relationship between adults’ comprehension of stimuli used to elicit narrative production samples and their narrative productions differed across the life span, suggesting that discourse processing performance changes in healthy aging. Finally, the study’s findings suggest that memory and attention contribute to olderadults’ story processing performance.
Goals for immunization in olderadults may differ from those in young adults and children, in whom complete prevention of disease is the objective. Often, reduced hospitalization and death but also averting exacerbation of underlying chronic illness, functional decline, and frailty are important goals in the older age group. Because of the effect of age on dendritic cell function, T cell-mediated immune suppression, reduced proliferative capacity of T cells, and other immune responses, the efficacy of vaccines often wanes with advanced age. This article summarizes the discussion and proceedings of a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the American Geriatrics Society, the National Institute on Aging, and the National Institute of Allergy and Infectious Diseases. Leading researchers and clinicians in the fields of immunology, epidemiology, infectious diseases, geriatrics, and gerontology reviewed the current status of vaccines in olderadults, identified knowledge gaps, and suggest priority areas for future research. The goal of the workshop was to identify what is known about immunizations (efficacy, effect, and current schedule) in olderadults and to recommend priorities for future research. Investigation in the areas identified has the potential to enhance understanding of the immune process in aging individuals, inform vaccine development, and lead to more-effective strategies to reduce the risk of vaccine-preventable illness in olderadults. PMID:20398161
High, Kevin P; D'Aquila, Richard T; Fuldner, Rebecca A; Gerding, Dale N; Halter, Jeffrey B; Haynes, Laura; Hazzard, William R; Jackson, Lisa A; Janoff, Edward; Levin, Myron J; Nayfield, Susan G; Nichol, Kristin L; Prabhudas, Mercy; Talbot, Helen K; Clayton, Charles P; Henderson, Randi; Scott, Catherine M; Tarver, Erika D; Woolard, Nancy F; Schmader, Kenneth E
Background The increasing number of people living with HIV aged 50 years and older has been recognised around the world yet non-pharmacologic HIV behavioural and cognitive interventions specifically targeted to olderadults are limited. Evidence is needed to guide the response to this affected group. Methods We conducted a systematic review of the available published literature in MEDLINE, Embase and the Education Resources Information Center. A search strategy was defined with high sensitivity but low specificity to identify behavioural interventions with outcomes in the areas of treatment adherence, HIV testing uptake, increased HIV knowledge and uptake of prevention measures. Data from relevant articles were extracted into excel. Results Twelve articles were identified all of which originated from the Americas. Eight of the interventions were conducted among olderadults living with HIV and four for HIV-negative olderadults. Five studies included control groups. Of the included studies, four focused on general knowledge of HIV, three emphasised mental health and coping, two focused on reduced sexual risk behaviour, two on physical status and one on referral for care. Only four of the studies were randomised controlled trials and seven – including all of the studies among HIV-negative olderadults – did not include controls at all. A few of the studies conducted statistical testing on small samples of 16 or 11 olderadults making inference based on the results difficult. The most relevant study demonstrated that using telephone-based interventions can reduce risky sexual behaviour among olderadults with control reporting 3.24 times (95% CI 1.79-5.85) as many occasions of unprotected sex at follow-up as participants. Overall however, few of the articles are sufficiently rigorous to suggest broad replication or to be considered representative and applicable in other settings. Conclusions More evidence is needed on what interventions work among olderadults to support prevention, adherence and testing. More methodological rigourised needed in the studies targeting olderadults. Specifically, including control groups in all studies is needed as well as sufficient sample size to allow for statistical testing. Addition of specific bio-marker or validated behavioural or cognitive outcomes would also strengthen the studies.
Pain is a prevalent symptom affecting as many as 50% of community-dwelling olderadults. Pain affects quality of life, functional status, cognition, mood, sleep, and well-being. A multimodal approach to pain management consists of both non-pharmacologic and pharmacologic interventions. Prescribing analgesics is safe and effective in older persons if done judiciously by starting low and titrating slowly while monitoring closely for potential side effects. PMID:20704069
Purpose: The purpose of this study is to examine the relationships among lifetime exposure to traumatic events, emotional support, and life satisfaction in three cohorts of olderadults. Design and Methods: Face-to-face interviews were conducted with a nation- wide sample of 1,518 older people in 2003. Approximately 500 elders were interviewed in each of the following age cohorts: Young-old (age
This study investigated the influence of attention on the sensory integration component of postural control in young and olderadults. Eighteen young and 18 older healthy subjects performed information-processing tasks during different postural challenge conditions. Postural conditions included seated, standing on a firm surface, standing on a sway-referenced floor, and standing on a sway-referenced floor while viewing a sway-referenced scene.
Mark S Redfern; J. Richard Jennings; Christopher Martin; Joseph M Furman
Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 olderadults, aged 65 and older, who lived in the community, took at least one prescrip- tion medication, and were then self-medicating. Non- medical study staff
Denise Orwig; Nicole Brandt; Ann L. Gruber-Baldini
Psychogenic non-epileptic seizures (PNES) are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, as a functional neurological symptom disorder. This disorder is often misdiagnosed as epilepsy, with the consequence that olderadults may have been treated for years for epilepsy before they learn their seizures are non-epileptic. Video electroencephalography monitoring, which is the standardized approach for ruling out epilepsy, is often performed in a specialized epilepsy monitoring unit where the patient lies in bed 24 hours per day waiting for a seizure to be recorded. The immobility, loss of independence, and anxiety that occurs during the monitoring process can be difficult for olderadults. It is important for all nurses to be aware of PNES and to be sensitive to the unique needs of olderadults who are experiencing these seizures. [Journal of Psychosocial Nursing and Mental Health Services, 52(5), 17-20.]. PMID:24815758
Nurse educators must foster development of clinical judgment in students to help them provide the best care for the increasing population of olderadult patients. This article reports qualitative findings from a mixed-methods study that focused on clinical judgment in the simulated perioperative care of an olderadult. The sample was composed of treatment and control groups of prelicensure students (N = 275) at five sites. The treatment group watched a video of an expert nurse role model caring for a patient similar to the simulation patient, whereas the control group did not watch the video. Four weeks after simulation, participants cared for real-life, olderadult perioperative patients. After the simulated and real-life care experiences, participants completed questionnaires related to clinical judgment dimensions. These two data sets revealed rich findings about the students' simulation learning, affirming the value of expert role models. Transferability of simulation learning to practice was also explored. PMID:24716674
Lasater, Kathie; Johnson, Elizabeth A; Ravert, Patricia; Rink, Doris
Objectives Depressive symptoms and physical inactivity are health risks among minority olderadults. This study examined whether social support moderated the relationship of depressive symptoms to walking behavior among 217 community-dwelling, Hispanic olderadults. Method Cross-sectional analyses were used to test whether different forms of social support interacted with depressive symptoms to affect both likelihood and amount of walking. Results Analyses showed a significant interaction between depressive symptoms and instrumental support related to the likelihood of walking and a marginally significant interaction between depressive symptoms and instrumental social support related to the amount of walking. Depressive symptoms were associated with a lower likelihood and lower amount of walking among participants receiving high levels of instrumental social support (e.g., help with chores) but not low instrumental support. Emotional and informational support did not moderate the depression to walking relationship. Conclusion Receiving too much instrumental support was related to sedentary behavior among depressed olderadults.
Perrino, Tatiana; Brown, Scott C.; Huang, Shi; Brown, C. Hendricks; Gomez, Gianna Perez; Pantin, Hilda; Szapocznik, Jose
Cardiovascular disease is the major cause of death as well as a leading cause of disability and impaired quality of life in olderadults with diabetes. Therefore, preventing cardiovascular events in this population is an important goal of care. Available evidence supports the use of lipid-lowering agents and treatment of hypertension as effective measures to reduce cardiovascular risk in olderadults with diabetes. Glucose control, smoking cessation, weight control, regular physical activity, and a prudent diet are also recommended, although data supporting the efficacy of these interventions are limited. While reducing cardiovascular morbidity and mortality remains a primary objective of preventive cardiology in olderadults with diabetes, the impact of these interventions on functional well-being, cognition, and other geriatric syndromes requires further study. PMID:19944264
Cigolle, Christine T; Blaum, Caroline S; Halter, Jeffrey B
Abstract The HIV/AIDS surveillance data indicates that the proportion of people living with HIV/AIDS (PLWHAs) who were 50 years old or older increased to 42.7% in 2011 from 16.5% in 2007 in Nanning, the capital city of Guangxi Province. A greater number of newly diagnosed HIV cases compared to clinical AIDS cases were identified from olderadults. The dominant HIV transmission mode among older PLWHAs was heterosexual although approximately 30% of all PLWHAs acquired HIV through heterosexual contacts.
Lin, Xinqin; Xu, Yongfang; Chen, Shiyi; Shi, Jian; Morisky, Donald
The sensory and gastrointestinal changes that occur with ageing affect olderadults' food and liquid intake. Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in olderadults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in olderadults is critical, particularly for adults in residential care. This pilot study investigated the contribution of bioelectrical impedance analysis to measure hydration in 19 older women in residential care: 13 who viewed themselves as healthy and six with dysphagia. Mann-Whitney U analyses documented no significant between-group differences for Total Body Water (TBW), Fat Free Mass (FFM), Fat Mass (FM), and percentage Body Fat (%BF). However, when compared to previously published data for age-matched women, the TBW and FFM values of the two participant groups were notably less, and FM and %BF values were notably greater than expected. If results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status. PMID:24521507
Goldberg, Lynette R; Heiss, Cynthia J; Parsons, Susan D; Foley, Amanda S; Mefferd, Antje S; Hollinger, Deborah; Parham, Douglas F; Patterson, Jeremy
Our aging population is growing in size and diversity. To integrate different views on aging and make explicit the role of\\u000a culture as a contextual factor, we modified Knight’s (Psychotherapy with olderadults, 2004) Contextual, Cohort-based, Maturity,\\u000a Specific Challenge (CCMSC) model of psychotherapy with olderadults into the Contextual Adult Lifespan Theory for Adapting\\u000a Psychotherapy (CALTAP). This article describes various
The authors examined the neural correlates of emotion processing and how they relate to individual differences in optimism among olderadults. Brain response during processing of fearful faces was measured by functional magnetic resonance imaging in 16 olderadults and was correlated with level of optimism. Greater optimism was associated with reduced activation in the fusiform gyrus and frontal regions, which may reflect decreased salience of negative emotional information or better emotion regulation among optimistic individuals. Relationships persisted after taking into account cortical thickness, amygdala volume, and resting perfusion. Findings have potential implications for the promotion of successful aging. PMID:24275797
Bangen, Katherine J; Bergheim, Marianne; Kaup, Allison R; Mirzakhanian, Heline; Wierenga, Christina E; Jeste, Dilip V; Eyler, Lisa T
Baccalaureate nursing programs must find innovative methods to transform educational culture to value and reward excellence in caring for olderadults. Mennonite College of Nursing at Illinois State University used a multidimensional approach to engage college constituents and change the way baccalaureate students are prepared to care for olderadults. The college engaged faculty, students, and the community in exchange activities that focused on generating excitement for geriatric nursing within the college and the community. Engaging college constituents enabled large numbers of individuals to work toward creating an educational culture that values and rewards excellence in geriatric nursing. PMID:16021806
The beneficial effects of self-referential processing on memory have been demonstrated in numerous experiments with younger adults but have rarely been studied in older individuals. In the present study we tested young people, younger-olderadults, and older-olderadults in a self-reference paradigm, and compared self-referential processing to general semantic processing. Findings indicated that olderadults over the age of 75
A growing number of reports state that regular exercise enhances brain function in olderadults. Recently a functional near-infrared spectroscopy (fNIRS) study revealed that an acute bout of moderate exercise enhanced activation of the left dorsolateral prefrontal cortex (L-DLPFC) associated with Stroop interference in young adults. Whether this acute effect is also applicable to olderadults was examined. Sixteen olderadults performed a color-word matching Stroop task before and after 10 minutes of exercise on a cycle ergometer at a moderate intensity. Cortical hemodynamics of the prefrontal area was monitored with a fNIRS during the Stroop task. We analyzed Stroop interference (incongruent-neutral) as Stroop performance. Though activation for Stroop interference was found in the bilateral prefrontal area before the acute bout of exercise, activation of the right frontopolar area (R-FPA) was enhanced after exercise. In the majority of participants, this coincided with improved performance reflected in Stroop interference results. Thus, an acute bout of moderate exercise improved Stroop performance in olderadults, and this was associated with contralateral compensatory activation. PMID:22300952
OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson's regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals. PMID:24897042
With the spread of gambling in its many forms across the American landscape the question arises as to how senior citizens have been effected. This study examines data on gambling behavior and related attitudes gathered from a random sample of community residents in jurisdictions that had recently allowed casinos to open. Comparisons are made between senior and younger adults regarding
Twenty adults received training in prospective memory; 23 who received training in reducing worries about forgetfulness and 22 controls formed a comparison group. Results of a telephone task and a prospective categorization task revealed significant but small effects for the prospective memory group. After 3 months, the comparison group's…
Eighty-four olderadults who had retired from the workforce and were enrolled in Vancouver adult education programs completed a short form of the Education Participation Scale (E.P.S.), from which items known to be job-related had been deleted. The new version of the E.P.S. was factor analyzed to examine the extent to which previously identified factors would re-emerge. The E.P.S. clustered
Although existing literature addresses adults' motivation to learn, and some specifically focuses on olderadults, it is now recognized that olderadults are more heterogeneous and complex than other age groups. Therefore, this study seeks to provide an alternative theoretical framework to investigate motivation to learn for olderadult learners…
In the present study, we examined the link between goal and problem-solving strategy preferences in 130 young and olderadults using hypothetical family problem vignettes. At baseline, young adults preferred autonomy goals, whereas olderadults preferred generative goals. Imagining an expanded future time perspective led olderadults to show…
Two studies were conducted to reexamine the psychometric properties of two major scales measuring attitudes toward olderadults. The Kogan Attitudes Toward Old People Scale (Kogan OP Scale; Kogan, 1961b) was administered to a sample of 512 college students in Study One. The refined version (Polizzi & Millikin, 2002) of the Aging Semantic Differential (ASD; Rosencranz & McNeivin, 1969) using an attitudinal target, olderadults, was evaluated in Study Two with a sample of 785 college students. Overall, the refined ASD using a nongender and age-specific attitudinal target, olderadults, was found to be more psychometrically promising than the Kogan OP Scale. Much refinement is needed for the Kogan OP Scale because of a major flaw associated with OP+ and OP subscales. The refined ASD using olderadults as the attitudinal target is a potentially practical tool in gerontological and geriatric fields with future clarification of its factor structure. Strengths and shortcomings of these scales are discussed based on psychometric features. Implications for future studies are discussed. PMID:19042232
The motivations and benefits of educational travel among individuals aged 55 years old and over were examined in this study. A total of 136 olderadults enrolled in Elderhostel programs participated in this study and reported their perceived benefits and motivations for engaging in educational travel experiences. Correlation analyses were used to…
We investigated associations between suicide ideation and a set of potential risk and resiliency factors in a heterogeneous sample of 107 olderadults (mean age = 81.5 years, SD = 7.7 years; range, 67 to 98 years; 76% female) recruited in community, residential, and healthcare settings. Participants completed the Geriatric Suicide Ideation Scale (GSIS; Heisel & Flett, 2006) and measures
Olderadults (n = 113) participated in focus groups discussing their use of and attitudes about technology in the context of their home, work, and healthcare. Participants reported using a wide variety of technology items, particularly in their homes. Positive attitudes (i.e., likes) outnumbered negative attitudes (i.e., dislikes), suggesting that olderadults perceive the benefits of technology use to outweigh the costs of such use. Positive attitudes were most frequently related to how the technology supported activities, enhanced convenience, and contained useful features. Negative attitudes were most frequently associated with technology creating inconveniences, unhelpful features, as well as security and reliability concerns. Given that olderadults reported more positive than negative attitudes about the technologies they use, these results contradict stereotypes that olderadults are afraid or unwilling to use technology. These findings also highlight the importance of perceived benefits of use and ease of use for models of technology acceptance. Emphasizing the benefits of technology in education and training programs may increase future technology adoption.
Mitzner, Tracy L.; Boron, Julie B.; Fausset, Cara Bailey; Adams, Anne E.; Charness, Neil; Czaja, Sara J.; Dijkstra, Katinka; Fisk, Arthur D.; Rogers, Wendy A.; Sharit, Joseph
It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the "Journal of Applied Behavior Analysis" ("JABA") on behavioral gerontology (Iwata, 1986), there continues to be a paucity of…
The pathophysiology of negative affect states in olderadults is complex, and a host of central nervous system and peripheral systemic mechanisms may play primary or contributing roles. We conducted an unbiased analysis of 146 plasma analytes in a multiplex biochemical biomarker study in relation to number of depressive symptoms endorsed by 566 participants in the Alzheimer's Disease Neuroimaging Initiative
S E Arnold; S X Xie; Y-Y Leung; L-S Wang; M A Kling; X Han; E J Kim; D A Wolk; D A Bennett; A Chen-Plotkin; M Grossman; W Hu; V M-Y Lee; R Scott Mackin; J Q Trojanowski; R S Wilson; L M Shaw
The present paper, drawing from the perspective of social cognition, examines and evaluates an intervention based on social-cognitive perspective-taking on the reduction of stereotyping and prejudice in olderadults. Data were collected in a sample of Spanish participants with a mean age of 63.2 years. The intervention, aimed at reducing prejudice…
Castillo, Jose-Luis Alvarez; Camara, Carmen Palmero; Eguizabal, Alfredo Jimenez
Olderadults with generalized anxiety disorder (GAD; N = 75; M age = 67.1 years) were randomly assigned to cognitive-behavioral therapy (CBT), a discussion group (DG) organized around worry-provoking topics, or a waiting period. Participants in both active conditions improved relative to the waiting list. Although CBT participants improved on more measures than DG participants, the authors found only 1
Julie Loebach Wetherell; Margaret Gatz; Michelle G. Craske
Presents a study of the contrasting social attitudes toward olderadults in three different social structures: the Caucasus region of the Soviet Union, a traditional society; Japan, transitional but retaining some traditional values; and the United States, with its obsolescence technology and youth-oriented culture. (MF)
This experiment investigated the readability of medication labels using various combinations of fonts, sizes, and weights of print. Older and younger adult reading speeds and error rates for different print types were compared for both bottle and flat labels. Findings of the study indicated significant differences in reading speed, error rates, and subjective evaluations for print characteristics investigated. Furthermore, the
Background Olderadults who cease driving have poorer health than those who continue to drive. However, it is unclear whether the transition to driving cessation itself results in health declines or whether driving cessation subsequently exacerbates health declines over time. Methods The current study addresses these questions using multilevel modeling among 690 olderadults from the Advanced Cognitive Training for Independent and Vital Elderly study. Driving status and health, as indicated by the SF-36 questionnaire, self-rated health, physical performance (Turn 360° Test), and depressive symptoms were assessed at baseline and at 1-, 2-, 3-, and 5-year follow-up visits. Results The transition to driving cessation was accompanied by significant declines in physical and social functioning, physical performance, and physical role (ps < .05). Health declines after driving cessation were steeper for general health. Conclusions The transition to driving cessation is associated with health declines for olderadults as measured by several indicators. Additionally, general health declines more sharply following driving cessation. These findings highlight the importance of interventions to sustain driving mobility among olderadults.
Lunsman, Melissa; Perkins, Martinique; Rebok, George W.; Roth, David L.
The contribution of personality traits and social support to mental health is well established, but to our knowledge there have been no longitudinal investigations of the relation between personality and social support in depressed olderadults. In the current study, we examined a repeated measures multi-level mixed model of change in perceived social support to determine whether personality traits and
Kelly C. Cukrowicz; Alexis T. Franzese; Steven R. Thorp; Jennifer S. Cheavens; Thomas R. Lynch
The impact of the global aging of the population on social, economic, political, and health care institutions is unequaled. Parallel to this, evolving developments in technology promise opportunities for sales and product development to support positive aging. Olderadults are excited to utilize technologies that they perceive as practical.…
Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural olderadults, little research has examined how they perceive and define…
Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly
Background: Alternating motion rate (AMR) and sequential motion rate (SMR) are tests of articulatory diadochokinesis that are widely used in the evaluation of motor speech. However, there are no quality normative data available for adults aged 65 years and older. Aims: There were two aims: (1) to obtain a representative, normative dataset of…
Advanced aging is associated with slower and less flexible performance on demanding cognitive tasks. Here we used rapid event-related functional magnetic resonance imaging to explore differences between young (n 5 65) and olderadults (n 5 75) during memory retrieval. Methods were optimized to afford exploration of both amplitude and timing differences in neural activity. Although many correlates of retrieval
Katerina Velanova; Cindy Lustig; Larry L. Jacoby; Randy L. Buckner
This document provides a step-by-step description of the planning and implementation of a two day consumer concerns conference for olderadults held at Palomar Community College (California). The bulk of the document is made up of practical discussions of such planning phases as facility selection and decoration, conference publicity, snack and…
The purpose of this study was to investigate whether hyphens that disambiguate phrasing in ambiguous sentences influence reading rate and reading comprehension for younger and olderadults. Moreover, as working memory (WM) has been implicated in age-related changes in sentence comprehension for both auditory and written materials, we asked if it…
Physical inactivity has been established to be an independent risk factor for a range of chronic diseases and con- ditions that threaten the health of the nation. However, only a minority of the population is currently meeting the recommended levels of regular physical activity, which have been linked with important health and quality- of-life benefits. Olderadults are at particular
The SeniorCise booklet and program (based on the Transtheoretical Model of behavior change) were evaluated by 61 olderadults; 91% said it helped them think about exercise and 72% engaged in exercise. Positive aspects were presentation, instructions, motivation, and ease of understanding. Few illustrations and lack of a Spanish edition were…
Poor health has been implicated as a suppressor of the life satisfaction of olderadults. To clarify the contribution of arthritis to this process, functional disability, negative affect, pain, current severity of the disease, self-esteem, perception of general health, and internal health locus of control, were placed within a causal model as…
There were two objectives to this study: (a) to establish flow and (2) to establish whether computer game interaction or content was important to the olderadult, using the Nintendo Wii and the Sony PlayStation 2 consoles. An earlier study had identified the sports genre as a preference, and three games (golf, tennis, and boxing) were selected…
This study examined Master's in Social Work students' (N = 304) interest in working with olderadults following the use of case studies to infuse aging content into the foundation social work curriculum. Faculty members were provided with extensive materials to support their use of the cases with aging content in class. Compared to an earlier study, students were significantly more interested
Irene A. Gutheil; Janna C. Heyman; Roslyn H. Chernesky
WHY: Normal aging brings about inevitable and irreversible changes. These normal aging changes are partially responsible for the increased risk of developing health-related problems within the elderly population. Prevalent problems experienced by olderadults include: sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls and skin breakdown. Familiarity with these commonly-occurring disorders helps the nurse prevent unnecessary
This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among olderadults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral…
Cummings, Sherry M.; Cooper, R. Lyle; Cassie, Kim McClure
Describes the creation of SeniorSage, an eight week facilitated online learning community for olderadult volunteers in a Florida learning center. Discusses how members were prepared to participate in the community, explains the instructional design theory that guided the development of SeniorSage, and recommends future research. (Author/LRW)
This study examined the abilities of adult listeners to discriminate and identify temporal order of sounds presented in tonal sequence. Listeners had either normal hearing or mild to moderate sensorineural hearing losses. In general, older listeners performed more poorly than younger listeners on the discrimination and identification tasks. Order…
Generativity is a concept first introduced by Erik Erikson as a part of his psychosocial theory which outlines eight stages of development in the human life. Generativity versus stagnation is the main developmental concern of middle adulthood; however, generativity is also recognized as an important theme in the lives of olderadults. Building on…
Young and nondemented olderadults completed a visual object continuous recognition memory task in which some stimuli (lures) were similar but not identical to previously presented objects. The lures were hypothesized to result in increased interference and increased pattern separation demand. To examine variability in object pattern separation…
Holden, Heather M.; Toner, Chelsea; Pirogovsky, Eva; Kirwan, C. Brock; Gilbert, Paul E.
This study was conducted to explore some of the differences between older and younger participants on measures of emotional support, depression, loneliness and life satisfaction. A total of 160 adults (72 males and 87 females), ranging in age from 18 to 83, who attended one of 18 different AA. meetings in Massachusetts were examined. The respondents were divided into three
This study aims to examine which resources olderadults utilize for their health information needs, how trustworthy and reliable they find these resources, and the difficulties they face in obtaining health-related information. A 41-item survey designed to understand the information-seeking characteristics of olderadults was developed and distributed to retirement communities. Some items were taken from the Health Information National Trends Survey. Of 1520 surveys, 403 were returned completed (26.6%). Respondents’ mean age was 77.65 years. Average scores indicated respondents trusted particular sources of health information in the following order (highest to lowest): health care providers, pharmacists, friends and relatives, retirement community staff, newspapers, the Internet, television, and the radio. In conclusion, olderadults have a greater amount of trust in a person with whom they are able to actively discuss their health as opposed to a nonliving source, which they have to access or manipulate, such as the Internet. Efforts must be made to help olderadults better navigate and utilize the Internet and recognize dependable online sources so that they may increase their trust in its use, thereby increasing satisfaction with their own ability to seek and use sources of health information.
CHAUDHURI, SHOMIR; LE, THAI; WHITE, CATHY; THOMPSON, HILAIRE; DEMIRIS, GEORGE
Examines three common disorders, dementia, depression, and delirium, which can be particularly difficult to diagnose in olderadults. Presents three aspects that are helpful in making a decision: age-related differences, medical issues that need to be ruled out, and assessment methods particularly useful in the diagnostic process. (JPS)
With the growing size of the population of aging Black individuals, it is important to understand successful aging in this group. This study, therefore, piloted the Successful Aging Inventory (SAI) with a convenience sample of Black olderadults. Participants completed a demographic form, the SAI, Purpose in Life Test, Life Satisfaction…
Troutman, Meredith; Nies, Mary A.; Bentley, Monica
Physical function is a common complication of hospitalized olderadults, resulting in increased morbidity, mortality, institutionalization, and cost. Nursing staff play a central role in the hospital experience for olderadults, including the promotion of physical function. Although quality geriatric care requires an organizational approach, there are no empirically based guidelines to promote the physical function of hospitalized olderadults. A first step to develop an organizational intervention is to identify nursing staff perceptions of physical function, defined as basic activities of daily living (eating, dressing, toileting, transferring, bathing, and continence), in hospitalized olderadults, including their beliefs about prevalence, risk factors, onset, effective interventions, and institutional barriers and facilitators to promoting physical function. Using purposive sampling, six focus groups yielding 55 participants were conducted at one of two sites, a suburban community hospital in New Jersey and an urban teaching hospital in New York, using a semistructured interview. Each site provided three focus groups composed of nursing staff cohorts as follows: two groups of registered nurses (staff nurses, managers, advanced practice nurses, and educators) and one group of patient care associates. There were important similarities identified in the themes of each group. Participants identified a system-level approach to preventing functional decline, including multimodal interventions and system-level enablers. PMID:20974088
To determine structural brain correlates of naming abilities in olderadults, we tested 24 individuals aged 56-79 on two confrontation-naming tests (the Boston Naming Test (BNT) and the Action Naming Test (ANT)), then collected from these individuals structural Magnetic-Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) data. Overall,…
Obler, Loraine K.; Rykhlevskaia, Elena; Schnyer, David; Clark-Cotton, Manuella R.; Spiro, Avron, III; Hyun, JungMoon; Kim, Dae-Shik; Goral, Mira; Albert, Martin L.
Individual differences in working memory capacity (WMC) are associated with speech recognition in adverse conditions, reflecting the need to maintain and process speech fragments until lexical access can be achieved. When working memory resources are engaged in unlocking the lexicon, there is less Cognitive Spare Capacity (CSC) available for higher level processing of speech. CSC is essential for interpreting the linguistic content of speech input and preparing an appropriate response, that is, engaging in conversation. Previously, we showed, using a Cognitive Spare Capacity Test (CSCT) that in young adults with normal hearing, CSC was not generally related to WMC and that when CSC decreased in noise it could be restored by visual cues. In the present study, we investigated CSC in 24 olderadults with age-related hearing loss, by administering the CSCT and a battery of cognitive tests. We found generally reduced CSC in olderadults with hearing loss compared to the younger group in our previous study, probably because they had poorer cognitive skills and deployed them differently. Importantly, CSC was not reduced in the older group when listening conditions were optimal. Visual cues improved CSC more for this group than for the younger group in our previous study. CSC of olderadults with hearing loss was not generally related to WMC but it was consistently related to episodic long term memory, suggesting that the efficiency of this processing bottleneck is important for executive processing of speech in this group.
Mishra, Sushmit; Stenfelt, Stefan; Lunner, Thomas; Ronnberg, Jerker; Rudner, Mary
This study seeks to gain a holistic understanding of how older Korean-American adults' socio-demographic factors affect their attitudes toward the computer. The research was guided by four main questions: (1) What do participants describe as the consequences of their using the computer? (2) What attitudes toward the computer do participants…
This qualitative research investigates the meaning of "keitai" (mobile phones) for older Japanese adults between the ages of 59 and 79. Participants' emails from keitai, handwritten daily logs, and audio and video recordings from meetings and interviews were collected during my stay of nearly seven months in one of the largest cities in Japan.…
Asserting that both humanistic and manpower considerations dictate that we address the aging process, this article describes the characteristics of olderadults and illustrates the way in which they may be allowed to remain productive. Maslow's "Need Hierarchy" and Thorndike's "Theory of Developmental Tasks" are applied to the aging process. (JC)
The primary purpose of this study was to investigate the phenomenon of creativity in a population of olderadults. This study utilized a phenomenologic research design to explore the lived experience of creativity in four women ranging in age from 63 to 75 who were noted by their peers to be creative. Subjects were asked to respond to the following
Martha H. Bramlett; Sarah H. Gueldner; Gerald Bennett
Objectives To identify neuropsychological factors associated with driving errors in olderadults. Design Cross-sectional observational study. Setting Neuropsychological assessment laboratory and an instrumented vehicle on a 35-mile route on urban and rural roads. Participants One hundred eleven olderadult drivers (ages 65-89 years; mean age 72.3 years) and 80 middle-aged drivers (age 40 to 64 years; mean age 57.2 years). Measurements Explanatory variables included age, neuropsychological measures (cognitive, visual, and motor), and a composite cognitive score (COGSTAT). The outcome variable was the safety error count, as classified by video review using a standardized taxonomy. Results Older drivers committed an average of 35.8 safety errors/drive (SD=12.8), compared to an average of 28.8 (SD=9.8) for middle-age drivers (P<0.001). Among older drivers, there was an increase of 2.6 errors per drive observed for each five-year age increase (P=0.026). After adjustment for age, education, and gender, COGSTAT was a significant predictor of safety errors in older drivers (P=0.005), with approximately a 10% increase in safety errors observed for a 10% decrease in cognitive function. Individual significant predictors of increased safety errors in older drivers included poorer scores on Complex Figure Test-Copy, Complex Figure Test-Recall, Block Design, Near Visual Acuity, and the Grooved Pegboard task. Conclusion Driving errors in olderadults tend to increase, even in the absence of neurological diagnoses. Some of this increase can be explained by age-related decline in cognitive abilities, vision, and motor skills. Changes in visuospatial and visuomotor abilities appear to be particularly associated with unsafe driving in old age.
Dawson, Jeffrey D; Uc, Ergun Y.; Anderson, Steven W.; Johnson, Amy M.; Rizzo, Matthew
Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. The most common etiologies are malignancy, nonmalignant gastrointestinal disease, and psychiatric conditions. Overall, nonmalignant diseases are more common causes of unintentional weight loss in this population than malignancy. Medication use and polypharmacy can interfere with taste or cause nausea and should not be overlooked. Social factors may contribute to unintentional weight loss. A readily identifiable cause is not found in 16% to 28% of cases. Recommended tests include a complete blood count, basic metabolic panel, liver function tests, thyroid function tests, C-reactive protein levels, erythrocyte sedimentation rate, glucose measurement, lactate dehydrogenase measurement, and urinalysis. Chest radiography and fecal occult blood testing should be performed. Abdominal ultrasonography may also be considered. When baseline evaluation is unremarkable, a three- to six-month observation period is justified. Treatment focuses on the underlying cause. Nutritional supplements and flavor enhancers, and dietary modification that takes into account patient preferences and chewing or swallowing disabilities may be considered. Appetite stimulants may increase weight but have serious adverse effects and no evidence of decreased mortality. PMID:24784334
The authors examined same- and cross-gender friendship norms in a sample of 135 adults (average age 73 years). Participants evaluated a friend’s behavior, quantitatively and qualitatively, in vignettes in which the friend’s gender was experimentally manipulated. Gender often significantly, though modestly, influenced normative evaluations. Women frequently had higher expectations of friends than men and placed a greater emphasis on intimacy. Women were more disapproving of violations of friendship rules, such as betraying a confidence, paying a surprise visit, and failing to stand up for a friend in public. However, both men and women were less approving of a man than a woman who greets another friend with a kiss or who requests to stay overnight. Respondents’ open-ended comments reflected positive attitudes regarding cross-gender friendships. Most findings demonstrated that men and women across a wide age range held similar cultural norms for close ties, norms of trust, commitment, and respect.
Background Asymmetries in dynamic balance stability have been previously observed. The goal of this study was to determine whether leg preference influenced the stepping response to a waist-pull perturbation in olderadult fallers and non-fallers. Methods 39 healthy, community-dwelling, olderadult (>65 years) volunteers participated. Participants were grouped into non-faller and faller cohorts based on fall history in the 12 months prior to the study. Participants received 60 lateral waist-pull perturbations of varying magnitude towards their preferred and non-preferred sides during quiet standing. Outcome measures included balance tolerance limit, number of recovery steps taken and type of recovery step taken for perturbations to each side. Findings No significant differences in balance tolerance limit (P ? 0.102) or number of recovery steps taken (?2partial ? 0.027; P ? 0.442) were observed between perturbations towards the preferred and non-preferred legs. However, non-faller participants more frequently responded with a medial step when pulled towards their non-preferred side and cross-over steps when pulled towards their preferred side (P = 0.015). Interpretation Leg preference may influence the protective stepping response to standing balance perturbations in olderadults at risk for falls, particularly with the type of recovery responses used. Such asymmetries in balance stability recovery may represent a contributing factor for falls among older individuals and should be considered for rehabilitation interventions aimed at improving balance stability and reducing fall risk.
Young, Patricia M.; Whitall, Jill; Bair, Woei-Nan; Rogers, Mark W.
Objectives Poor sleep diminishes mental and physical health. The objective of this study was to examine associations between sleep disturbance and interleukin-6 (IL-6) responses to acute mental stress in olderadults. Design Observational study of community-dwelling, healthy olderadults. Setting Participants completed the study in a clinical research laboratory of a mid-sized university. Participants Generally healthy, community-dwelling men and women 50 years of age and older. Measurements IL-6 and negative affect at rest and following a series of challenging cognitive tests; sleep quality; depressive symptoms; perceived stress; loneliness. Results Participants categorized as poor sleepers based on Pittsburgh Sleep Quality Index scores had significantly larger IL-6 responses to the cognitive stressors compared to good sleepers. The association between poor sleep and heightened IL-6 response to acute stress was not explained by other psychosocial factors previously linked to immune dysregulation, including depressive symptoms, perceived stress, and loneliness. Conclusions Findings add to the growing evidence for poor sleep as an independent risk factor for poor mental and physical health. Olderadults may be particularly vulnerable to effects of sleep disturbance due to significant age-related changes in both sleep and inflammatory regulation.
Heffner, Kathi L.; Ng, H. Mei; Suhr, Julie A.; France, Christopher R.; Marshall, Gailen D.; Pigeon, Wilfred R.; Moynihan, Jan A.
Our rapidly aging population is expected to place heavy demands on all segments of society, particularly the health care resources needed to attend to health concerns associated with aging. Is this a looming crisis, as some predict, or a challenge to use resources more wisely and to help olderadults and their caregivers share in the responsibility for health promotion and chronic disease self-management activities? Community-based organizations serving olderadults are uniquely positioned to augment health care providers' health promotion counseling activities and to bridge the gap between the research and practice of health promotion in olderadults. They already play a crucial role by providing appropriate health promotion education, screening and referral, service planning, and reinforcement to facilitate self-care activities and behavior changes that promote healthy aging. By increasing teamwork across the network of services for the aging, the health sector, public and private organizations, and academe, there is a great opportunity to enhance the health and well-being of all older Americans. PMID:14621420
Beattie, Bonita Lynn; Whitelaw, Nancy; Mettler, Molly; Turner, David
This paper overviews existing research on how one teaches the older person. It is aimed at the many persons who work with olderadults, regardless of whether they are trained to teach olderadults. Suggestions are outlined for the design and implementation of effective education for older persons. Several areas that are examined are (1) the…
Objective: To determine if negative social interactions are prospectively associated with hypertension among olderadults. Method: This is a secondary analysis of data from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling olderadults (age > 50 years). Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions across 4 domains (partner, children, other family, friends). Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Analyses excluded those who were hypertensive at baseline and controlled for demographics, personality, positive social interactions, and baseline health. Results: Twenty-nine percent of participants developed hypertension over the 4-year follow-up. Each 1-unit increase in the total average negative social interaction score was associated with a 38% increased odds of developing hypertension. Sex moderated the association between total average negative social interactions and hypertension, with effects observed among women but not men. The association of total average negative interactions and hypertension in women was attributable primarily to interactions with friends, but also to negative interactions with family and partners. Age also moderated the association between total average negative social interactions and hypertension, with effects observed among those ages 51-64 years, but not those ages 65 or older. Conclusion: In this sample of olderadults, negative social interactions were associated with increased hypertension risk in women and the youngest olderadults. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24884909
Lumbar spinal stenosis (LSS) is becoming more frequent as the population ages and is now the most common spinal diagnosis for individuals older than 65. Because LSS is a common source of pain and disability among olderadults, understanding the pathophysiology, clinical presentation, and clinical management of this condition is important. An individual example is used to highlight classic signs and symptoms. Nursing strategies for LSS-associated pain and symptom management to improve physical function and quality of life are discussed. PMID:21634312
Low health literacy is common among Medicare recipients and affects their understanding of complex medication regimens. Interventions are needed to improve medication use among olderadults, while addressing low health literacy. Community-dwelling olderadults in this study were enrolled in an inner-city adult day center. They completed a baseline measure of health literacy, medication self-efficacy, and medication adherence. They were provided with a personalized, illustrated daily medication schedule (PictureRx™). Six weeks later, their medication self-efficacy and adherence were assessed. Among the 20 participants in this pilot project, 70% had high likelihood of limited health literacy and took an average of 13.2 prescription medications. Both self-efficacy and medication adherence increased significantly after provision of the PictureRx cards (p<0.001 and p<0.05, respectively). Al participants rated the PictureRx cards as very helpful in terms of helping them remember the medication’s purpose and dosing. Illustrated daily medication schedules improve medication self-efficacy and adherence among at-risk, community-dwelling olderadults.
Younger adults' "remember" judgments are accompanied by better memory for the source of an item than "know" judgments. Furthermore, remember judgments are not merely associated with better memory for individual source features but also with bound memory for multiple source features. However, olderadults, independent of their subjective memory experience, are generally less likely to "bind" source features to an item and to each other in memory (i.e., the associative deficit). In two experiments, we tested whether memory for perceptual source features, independently or bound, is also the basis for olderadults' remember responses or if their associative deficit leads them to base their responses on other types of information. The results suggest that retrieval of perceptual source features, individually or bound, forms the basis for younger but not for olderadults' remember judgments even when the overall level of memory for perceptual sources is closely equated (Experiment 1) and when attention is explicitly directed to the source information at encoding (Experiment 2). PMID:21843008
Boywitt, C Dennis; Kuhlmann, Beatrice G; Meiser, Thorsten
Cognitive research on the plasticity of fluid intelligence has demonstrated that olderadults benefit markedly from guided practice in cognitive skills and problem-solving strategies. We examined to what degree olderadults are capable by themselves of achieving similar practice gains, focusing on the fluid ability of figural relations. A sample of 72 healthy olderadults was assigned randomly to three
This paper draws a socio-demographic, physical, psychosocial, and behavioural profile of housebound olderadults with arthritis and compares olderadults with rheumatoid arthritis to those with osteoarthritis. Data from 125 housebound olderadults with osteoarthritis (65%) or rheumatoid arthritis (35%) were compared to published samples and to…
Nour, Kareen; Laforest, Sophie; Gignac, Monique; Gauvin, Lise
The present study examined attitudes and knowledge of 96 first year MSW social work students toward olderadults using the Aging Semantic Differential (ASD) and the Facts on Aging Quiz II. Results suggest that the sample had limited previous contact with olderadults and little knowledge about aging prior to admission. Students reported negative attitudes toward olderadults on productivity,
Purpose: Olderadults watch more television than younger people do. Television's role in mental health has been described in the general population, but less is known about how olderadults think of television in the context of depression. Design and Methods: Using a semistructured interview created to help clinicians understand how olderadults…
In order to determine the actual and perceived needs of undereducated olderadults, a study was conducted: (1) to determine and compare the perceived educational needs of olderadults using a sample of older individuals, adult basic education (ABE) teachers, and nutrition site directors; and (2) to compare the primary identified educational needs…
Herbert Simon's work on bounded rationality has had little impact on researchers studying olderadults' decision making. This omission is surprising, as human constraints on computation and memory are exacerbated in olderadults. The study of olderadults' decision-making processes could benefit from employing a bounded rationality perspective,…
In previous research, olderadults responded to mortality salience (MS) with increased tolerance, whereas younger persons responded with increased punitiveness. One possible explanation for this is that many olderadults adapt to challenges of later life, such as the prospect of mortality, by becoming more flexible. Recent studies suggest that positively oriented adaptation is more likely for olderadults with
Molly Maxfield; Tom Pyszczynski; Jeff Greenberg; Renee Pepin; Hasker P. Davis
Suicide rates are higher among olderadults than any other age group and suicidal ideation is one of the best predictors of completed suicide in olderadults. Despite this, few studies have evaluated predictors of suicidal ideation and other correlates of death by suicide (e.g. hopelessness) among olderadults. Even fewer studies on this topic have been conducted among samples
K. C. Cukrowicz; A. G. Ekblad; J. S. Cheavens; M. Z. Rosenthal; T. R. Lynch
Objectives: Despite evidence of disproportionate underutilization of mental health services by olderadults and by individuals with anxiety disorders, little is known specifically about service use by olderadults with anxiety. This study examines the prevalence of mental health service use among olderadults with anxiety disorders and clinically significant anxiety symptoms, as well as factors associated with service use.Method:
Tiffany Scott; Corey S. Mackenzie; Judith G. Chipperfield; Jitender Sareen
While aerobic exercise has been linked to improved performance on cognitive tasks of executive functioning among olderadults, not all olderadults can avail themselves of such exercise due to physical limitations. In this study, community-dwelling olderadults were evaluated on tasks of executive functioning before and after a month-long strengthening, nonaerobic exercise program. A total of 16 participants who
Cay Anderson-Hanley; Joseph P. Nimon; Sarah C. Westen
Based on Nicholas' framework for assessing information needs, this research aims to construct a profile of both Israeli olderadults and their information needs regarding laws and social services. Data were collected by questionnaires answered by 200 olderadults, born in Europe, Asia and Africa, who attended social clubs for olderadults. The…
The prevalence of human immunodeficiency virus (HIV) infection among people older than 50 years is increasing. Older HIV-infected patients are particularly at risk for polypharmacy because they often have multiple comorbidities that require pharmacotherapy. Overall, there is not much known with respect to both the impact of aging on medication use in HIV-infected individuals, and the potential for interactions with highly active antiretroviral therapy (HAART) and coadministered medications and its clinical consequences. In this review, we aim to provide an overview of polypharmacy with a focus on its impact on the HIV-infected olderadult population and to also provide some clinical considerations in this high-risk population.
This study explored dressing and grooming habits and preferences of olderadults. Fifty-eight community-dwelling older persons (mean age = 80 years) in suburban Maryland responded to the Self-maintenance Habits and Preferences in Elderly (SHAPE) questionnaire. There was a large variability in preferences, and all items were very important for at least some of the participants. Women attributed higher levels of importance to dressing and grooming than did men. Importance ratings increased with level of education and were higher for unmarried persons, but were not related to age or need for assistance with instrumental activities of daily living (IADLs). On an individual basis, this information can be used to suggest items for interventions or to structure a personal care environment. Alternately, it can be used in the aggregate as a guideline for designing programs of care to reflect the preferences of a majority of older persons. PMID:17310661
OBJECTIVE: To investigate how training olderadults to find medical information using the Internet affects their locus of control. METHODS: Quantitative methods were utilized. Specifically, the Multidimensional Health Locus of Control survey was distributed at the onset of each seminar and again at the conclusion. RESULTS: Paired t-tests revealed that the subjects did not change their locus of control regarding their health beliefs over the period of the seminar. However, there was statistical significance with regard to eight specific questions. CONCLUSION: Subjects scored high on their level of internal locus of control coming into the study. The majority of subjects had already learned to use the computer, owned a home computer, and had access to the Internet, but had not used the Internet to search for healthcare information. The challenge continues to be reaching those olderadults who have not encountered the computer and the Internet.
Campbell, Robert J.; Harris, Kimberly D.; Wabby, James
The purpose of this study was to quantify the cardiovascular responses and enjoyment of one trial of electronic exercise gaming (EG) (Nintendo(®) Wii(™) Tennis) in healthy, olderadults (mean age = 81 [SD = 4 years]). Findings indicate that 15 minutes of EG moderately increased heart rate (p < 0.001), blood pressure (p < 0.001), and perceived exertion (p < 0.0001) compared to resting levels. This corresponded to achieving 64% of age-predicted maximum heart rate. No differences were observed for the cardiovascular responses to EG between genders, but participants taking beta-blocker drugs showed an attenuated response (p < 0.05). All participants completed EG tennis without excessive fatigue, with 86% of participants enjoying the experience. There were only a few cases of EG-related arrhythmias (n = 2) and post-exercise muscle soreness (n = 3). These results suggest that Nintendo Wii Tennis EG technology represents an enjoyable, moderate intensity physical activity for healthy, olderadults. PMID:23855328
Fachko, Michael J; Xiao, Canhau; Bowles, Kathryn H; Robinson, Keith M; Libonati, Joseph R
For nurses interested in keeping up to date with developments in geriatric treatment, this set of resources created by expert practitioners will be quite a find. The entire site was developed as part of the Nurse Competence in Aging initiative created by the American Nurses Association. Here, visitors can read over twenty-five two-page assessment tools that include such helpful titles as Ã¢ÂÂAssessing Nutrition in OlderAdultsÃ¢ÂÂ, Ã¢ÂÂPredicting Pressure Ulcer RiskÃ¢ÂÂ, and Ã¢ÂÂImmunizations for the OlderAdultÃ¢ÂÂ. Written in clear and direct language, these resources will also be of assistance for nursing educators and those who are responsible for professional development workshops. It is also worth mentioning that these short tools are designed as screening tools, and are not for diagnosis.
The purpose of this study is to explore the attitudes older Chinese adults have about engaging in counseling-based services as measured by a fear of intimacy with helping professionals scale. Data were collected from 150 olderadults living in Chongqing, China. Information from this study will be helpful in developing effective strategies for the provision of social work services in China. In contrast with previous research, attitudes about intimacy with helping professionals varied and were normally distributed. Significant predictors of fear of intimacy were level of trust, mental health stigma, family support and friend support. Surprisingly, family and friend support had opposite associations with fear of intimacy. Family support was related to higher fear and friend support to lower fear. The cultural implications of these findings for researchers and social workers working with elderly Chinese clients are discussed. PMID:21161356
Witt, Heather; Poulin, John; Ingersoll, Travis; Deng, Rong
Objectives The current study investigated olderadults’ level of engagement with a video game training program. Engagement was measured using the concept of Flow (Csikszentmihalyi, 1975). Methods Forty-five olderadults were randomized to receive practice with an action game (Medal of Honor), a puzzle-like game (Tetris), or a gold-standard Useful Field of View (UFOV) training program. Results Both Medal of Honor and Tetris participants reported significantly higher Flow ratings at the conclusion, relative to the onset of training. Discussion Participants are more engaged in games that can be adjusted to their skill levels and that provide incremental levels of difficulty. This finding was consistent with the Flow theory (Csikszentmihalyi, 1975)
Belchior, Patricia; Marsiske, Michael; Sisco, Shannon; Yam, Anna; Mann, William
This qualitative study describes environmental supports and barriers to physical activity in an olderadult sample drawn from low- and high-walkable neighborhoods. Thirty-seven individuals age 55 and over were recruited and answered open-ended survey questions, with a subsample invited back to partake in a semistructured interview. Content analysis identified categories and themes linking perceptions of neighborhood-environment characteristics to activity. Emerging categories and themes did not differ across neighborhood walkability, so results are presented for both groups combined. Infrastructure was the most common category identified to encourage activity, specifically, well-maintained sidewalks, bike paths or lanes, and traffic control. Other categories of land use, landscape, and aesthetics were reported. Poorly maintained or missing sidewalks, crosswalks, bike paths or lanes, and traffic safety were categories that discouraged activity. In conclusion, the information obtained is helpful in solidifying which environmental characteristics are important to measure as they relate to activity behavior in an olderadult population.
Strath, Scott; Isaacs, Raymond; Greenwald, Michael J.
This article describes lessons learned from implementing sodium-reduction strategies in programs that provide meals to olderadults in 2 New York counties, with one county replicating the approaches of the other. The implemented sodium-reduction strategies were product substitutions, recipe modifications, and cooking from scratch. Both counties were able to achieve modest sodium reductions in prepared meals. Lessons learned to implement sodium reduction strategies include the following: (1) identifying partners with shared experience and common goals; (2) engaging experts; (3) understanding the complexity of the meals system for olderadults; (4) conducting sodium nutrient analysis; (5) making gradual and voluntary reductions to sodium content; and (6) working toward sustainable sodium reduction. PMID:24322812
Approximately one third of hospitalized olderadults develop a new disability by discharge, which places them at risk for readmission, institutionalization, and death. Various risk factors, both modifiable and nonmodifiable, coalesce in the acute care setting. As frontline health care providers, nurses are crucial to the process of altering modifiable risk factors by assessing patients’ risk for functional decline during hospitalization using a standardized instrument and treating risk with evidence-based interventions. Barriers to meeting this goal must be overcome, such as a lack of evidence to recommend use of one functional assessment tool over another, as well as the paucity of evidence-based interventions. Other obstacles such as the tacit acceptance of functional decline by health care providers and a lack of resources for mobilizing olderadults contribute to the ongoing problem. Nurses are encouraged to develop new innovations to prevent the widespread and frequently untreated problem of hospital-acquired disability. PMID:23189993
... health conditions and treatment on older adolescents and young adults Recently released data shows that older adolescents and young adults with emotional and behavioral health conditions are much ...
The Elderly Nutrition Program (ENP) is being challenged to improve the quality of meal programs. The purpose of this study was to explore how food preferences varied depending on gender and ethnic groups. A total of 2,024 participants in the ENP aged 60 years or older were interviewed. A majority of the participants were female (74.7%), served by congregate meal programs (71.7%), with the mean ± SD age of 76.9 ± 9.2 years. A general impression of the meals and preferences for 13 food groups (fresh fruit, chicken, soup, salad, vegetables, potatoes, meat, sandwiches, pasta, canned fruit, legumes, deli meats, and ethnic foods) were assessed. After adjusting other variables, older males were significantly more likely to prefer deli meats, meat, legumes, canned fruit, and ethnic foods compared to females. In addition, compared with African Americans, Caucasians demonstrated higher percentages of preference for 9 of 13 food groups including pasta, meat, and fresh fruit. To improve the quality of the ENP, and to increase dietary compliance of the olderadults to the programs, the nutritional services require a strategic meal plan that solicits and incorporates olderadults' food preferences. PMID:24597997
The present experiment examined temporal discounting across 3 different age bands: adolescents, adults, and olderadults (mean ages 14, 46, and 73 years, respectively). A computerized task was employed in which participants were asked to choose between larger rewards available at a specified time in the future--either 100 British Pounds or 1,000…
Thirty-seven olderadults (14 male, 23 female) who experienced the 1997 Red River Flood were tested at three times following the flood (1997,1998, 2000) on measures of self-rated health, numbers of medications taken, depression (GDS-SF), and vocabulary ability (WAIS-R). Several 2 (gender) X 3 (time of measurement) ANOVAs revealed few main or interactions effects, providing some support for the inoculation
This study examined potential predictors of treatment outcome in late-life insomnia. Fifty-four olderadults with chronic insomnia were treated with cognitive–behavior therapy (CBT), pharmacotherapy (PCT), or combined CBT plus PCT. Pretreatment characteristics such as demographic, clinical, psychometric, and sleep variables were examined as correlates or potential predictors of treatment response. Treatment response was defined by posttreatment sleep efficiency as measured
Background Characterization of the behavioral correlates of neuromorphometry and neurochemistry in olderadults has important implications for an improved understanding of the aging process. The objective of this study was to test the hypothesis that a measure of hippocampal neuronal metabolism was associated with verbal memory in nondemented olderadults after controlling for hippocampal volume. Methods 4-T MRI, proton magnetic resonance spectroscopy (1H MRS), and neuropsychological assessment were conducted in 48 olderadults (23 women; mean age 81 years). Average hippocampal N-acetyl aspartate/creatine ratios (NAA/Cr) and hippocampal volumes were obtained. Neuropsychological evaluation included tests of verbal memory (Buschke and Grober Free and Cued Selective Reminding Test–Immediate Recall [FCSRT-IR], Wechsler Memory Scale–Revised Logical Memory subtest) and attention and executive function (Trail Making Test Parts A and B). Results Linear regression analysis indicated that after adjusting for age, hippocampal NAA/Cr was a significant predictor of FCSRT-IR performance (? = 0.38, p = 0.01, R 2 = 0.21). Hippocampal volume was also a significant predictor of FCSRT-IR performance after adjusting for age and midsagittal area (? = 0.47, p = 0.01, R 2 = 0.24). In a combined model, hippocampal NAA/Cr (? = 0.33, p = 0.03) and volume (? = 0.35, p = 0.03) were independent predictors of FCSRT-IR performance, accounting for 30% of the variance in memory. Conclusions These findings indicate that nondemented olderadults with smaller hippocampal volumes and lower levels of hippocampal N-acetyl aspartate/creatine ratio metabolites perform more poorly on a test of verbal memory. The integrity of both the structure and metabolism of the hippocampus may underlie verbal memory function in nondemented elderly.
In this chapter, we review the psychological needs and service provisions for olderadults with an intellectual disability\\u000a (ID). The reader will be directed toward research that identifies an increasing longevity, concomitant increases in aging-related\\u000a morbidities, and psychosocial factors. Specific aging-related conditions will be discussed, along with their impact on functional\\u000a status and mental health, including a discussion of the
James P. Acquilano; Philip W. Davidson; Matthew P. Janicki
\\u000a This chapter is designed to review the basics of public health, to highlight its relevance to health-care professionals, and\\u000a to outline opportunities for the use of health policy in improving and protecting the health of olderadults with arthritis.\\u000a Many public health interventions intersect with the medical system at the level of the individual patient and complement clinical\\u000a care efforts.
Kristina A. Theis; Debra R. Lubar; Teresa J. Brady
OBJECTIVE: To examine the association between treatment with antipsychotics (both conventional and atypical) and all-cause mortality.\\u000aDESIGN: Population-based, retrospective cohort study.\\u000aSETTING: Ontario, Canada.\\u000aPATIENTS: Olderadults with dementia who were followed between 1 April 1997 and 31 March 2003.\\u000aMEASUREMENTS: The risk for death was determined at 30, 60, 120, and 180 days after the initial dispensing of antipsychotic
Sudeep S. Gill; Susan E. Bronskill; Sharon-Lise T. Normand; Geoffrey M. Anderson; Kathy Sykora; Kelvin Lam; Chaim M. Bell; Philip E. Lee; Hadas D. Fischer; Nathan Herrmann; Jerry H. Gurwitz; Paula A. Rochon
\\u000a Rheumatic diseases and their resultant musculoskeletal and cardiopulmonary impairments are primary conditions limiting activity\\u000a and function in olderadults. Certain rheumatologic conditions such as polymyalgia rheumatica, degenerative spinal stenosis,\\u000a and osteoporosis occur later in life. Other conditions such as rheumatoid arthritis, osteoarthritis (OA), and ankylosing spondylitis\\u000a manifest at younger ages but their clinical manifestations may exacerbate with advancing age and
In summary, there are clearly significant immunological declines associated with depression, depressed mood, and stress. Unfortunately,\\u000a these distress-related effects are magnified in elderly populations because the aging process itself contributes to downward\\u000a change in immune function. The interaction of distress and aging leaves olderadults open to physical health complications.\\u000a Alterations of immune function have been linked to poorer vaccine
Katherine L. Applegate; Janice K. Kiecolt-Glaser; Ronald Glaser
Inflammation increases with age and is associated with many chronic diseases that are prevalent among olderadults. Persistent pathogens such as latent herpesviruses and chronic bacterial infections can act as a source of inflammation. Herpesviruses, including Epstein-Barr virus (EBV) and cytomegalovirus (CMV), establish latent infections following primary infection and reactivate when the cellular immune system is compromised. EBV and CMV replication can induce proinflammatory cytokine production and thus could influence systemic inflammation. The present study addressed relationships among EBV and CMV antibody titers, and levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in a sample of 222 community dwelling olderadults (meanage= 64.1 ± 14.1 years). Participants were divided into two groups based on whether they were EBV seropositive and CMV seronegative (EBV+CMV?), or EBV and CMV seropositive (EBV+CMV+). Among individuals who were EBV+CMV?, EBV antibody titers were not associated with either CRP or IL-6 levels. However, among those who were EBV+CMV+, higher EBV antibody titers were related to elevated levels of CRP and IL-6 in those individuals with higher CMV antibody titers; there was no relationship between EBV antibody titers and CRP or IL-6 levels in those participants with lower CMV antibody titers. These data suggest that the combination of latent EBV and CMV reactivation (indexed by antibody titers) may boost CRP and IL-6 production. Thus, reactivation of multiple herpesviruses may drive inflammation and could contribute to poorer health among olderadults.
Bennett, Jeanette M.; Glaser, Ronald; Malarkey, William B.; Beversdorf, David Q.; Peng, Juan; Kiecolt-Glaser, Janice K.
Objective While neuropathy is common in the elderly, nerve conduction (NC) reproducibility in olderadults is not well-established. We sought to evaluate intraobserver reproducibility of peroneal motor NC measures in a diverse sample of olderadults. Methods We measured peroneal motor NC amplitude and velocity in a subset of participants (mean age=82.9 ± 2.7, n=62, 50% female, 51.6% black, 35.5% DM) in the Health, Aging, and Body Composition Study. Using coefficients of variation (CVs), intraclass correlation coefficients (ICCs), and Bland Altman Plots, we compared two sets of measurements taken by the same examiner hours apart on the same day. Results Low CVs (2.15–4.24%) and moderate to high ICCs (0.75–0.99) were observed. No systematic variation was found across measures. Despite small numbers in some subgroups, we found no differences in reproducibility by diabetes, race, or study site. Conclusion NC measures have moderate to high intraobsever reproducibility in olderadults and are not affected by diabetes, race, or gender. Significance These data provide evidence to support use of these measures in aging research.
Ward, Rachel E.; Boudreau, Robert M.; Vinik, Aaron I.; Zivkovic, Sasa A.; Njajou, Omer T.; Satterfield, Suzanne; Harris, Tamara B.; Newman, Anne B.; Strotmeyer, Elsa S.
Falls are devastating events and are the largest contributor towards injury-related hospitalization of olderadults. Orthostatic hypotension (OH) represents an intrinsic risk factor for falls in olderadults. OH refers to a significant decrease in blood pressure upon assuming an upright posture. Declines in blood pressure can reduce cerebral perfusion; this can impair consciousness, lead to dizziness, and increase the likelihood of a fall. Although theoretical mechanisms linking OH and falls exist, the magnitude of the association remains poorly characterized, possibly because of methodological differences between previous studies. The use of non-invasive beat-to-beat blood pressure monitoring has altered the way in which OH is now defined, and represents a substantial improvement for detecting OH that was previously unavailable in many studies. Additionally, there is a lack of consistency and standardization of orthostatic assessments and analysis techniques for interpreting blood pressure data. This review explores the previous literature examining the relationship between OH and falls. We highlight the impact of broadening the timing, degree, and overall duration of blood pressure measurements on the detection of OH. We discuss the types of orthostatic stress assessments currently used to evaluate OH and the various techniques capable of measuring these often transient blood pressure changes. Overall, we identify future solutions that may better clarify the relationship between OH and falling risk in order to gain a more precise understanding of potential mechanisms for falls in olderadults. PMID:24253897
Objective to examine the structure of symptoms of affective disorder among olderadults with a chronic health problem (osteoarthritis), and to explore cross-sectional and longitudinal associations of obtained affective symptom clusters with key health outcomes (pain, functional disability, perceived health). Methods One-year longitudinal study of olderadults with diagnosed osteoarthritis of the knee. Symptoms of DSM depression and anxiety were assessed in a research diagnostic interview using a DSM-IV symptom checklist; self-reports captured demographic characteristics, objective health, pain, disability, and perceived health. Confirmatory factor analysis tested comparability of affective symptom structure in this sample to findings of previous research; ordinary least squares regression examined cross-sectional and longitudinal associations of affective symptoms with health outcomes, controlling for demographics and objective health. Results The current sample displayed an affective symptom structure comparable to that observed in previous research, with symptoms clustering into Depressed Mood, Somatic Symptoms and Psychic Anxiety factors. Depressed Mood was cross-sectionally associated with pain and disability and marginally with perceived health; Somatic Symptoms predicted current pain and perceived health. Only Depressed Mood predicted one-year change in disability and perceived health (but not pain). Conclusions This research confirms the role of somatic symptoms of distress in fueling disability and perceived ill health among chronically ill olderadults. However, it is depressed mood that drives changes in perceived health and functional ability.
Parmelee, Patricia A.; Harralson, Tina L.; McPherron, Jesse A.; Schumacher, H. Ralph
Perceived autonomy refers to perceived personal self-governance, or rather that a person feels free from external constraint to determine his or her own actions and behaviors. This study examined perceived autonomy among community-dwelling olderadults residing in New York City and West Japan. A cross-sectional design was adopted using self-reports from 340 olderadults (n = 220 Japanese, n = 120 Americans) recruited from senior centers. Perceived autonomy was quantified with the Hertz Perceived Enactment of Autonomy Scale (HPEAS), which includes three subscales: voluntariness, individuality, and self-direction. Compared to American respondents, more Japanese respondents were male (67.7% vs. 40.8%), more likely to live with others (78% vs. 25.7%), reported lower perceived autonomy (86.9 vs. 109.5), and scored lower on all three subscales of the HPEAS. Despite significant differences in perceived autonomy, a sociocultural factor such as social support was identified as an important factor for olderadults in both groups. [Journal of Gerontological Nursing, 40(5), 36-44.]. PMID:24529389
The purpose of this study was to determine a profile for predicting attrition among olderadults involved in a 12-month exercise program. The parent study was a single-blinded randomized controlled trial. The study took place between 2006 and 2009 within a university setting. Olderadults (N?=?179) completed baseline assessments of functional performance and psychosocial measures. Participants who were randomized, elected to receive treatment, and did not complete the exercise program were considered "dropouts" (n?=?35). Those who completed the program (n?=?144) were classified as "completers." A latent profile analysis revealed two distinct patterns of memory complaints, self-efficacy to overcome barriers to exercise, balance performance, and stair performance. Dropouts were nearly twice as likely to be members of the profile that exhibited a higher degree of memory complaints, lower self-efficacy for overcoming exercise barriers, poorer single leg balance, and longer times to walk down stairs. The results provide an initial validation of a profile for discriminating between "dropouts" and "completers," one that may have considerable utility for screening olderadults prior to study entry. PMID:23412942
Mullen, Sean P; Wójcicki, Thomas R; Mailey, Emily L; Szabo, Amanda N; Gothe, Neha P; Olson, Erin A; Fanning, Jason; Kramer, Arthur; McAuley, Edward
Age provides opportunity not only for a person to grow spiritually, but also for people to enlarge their understandings of the world about them, including God, and connect them to previous learnings and life-experiences. In older age, learning is not merely an affirmation of what has been, but a re-creation of the self in relation to everything that surrounds the
ABSTRACT BACKGROUND Ageing and depression are associated with disability and have significant consequences for health systems in many other developing countries. Depression prevalence figures among the elderly are scarce in developing countries. OBJECTIVE To estimate the prevalence of depressive symptoms and their cross-sectional association with selected covariates in a community sample of Mexico City olderadults affiliated to the main healthcare provider. DESIGN Cross-sectional, multistage community survey. PARTICIPANTS A total of 7,449 persons aged 60 years and older. MEASUREMENTS Depression was assessed using the 30-item Geriatric Depression Scale (GDS); cognitive impairment, using the Mini-Mental State Examination; and health-related quality of life with the SF-36 questionnaire. MAIN RESULTS The prevalence of significant depressive symptoms was estimated to be 21.7%, and 25.3% in those aged 80 and older. After correcting for GDS sensitivity and specificity, major depression prevalence was estimated at 13.2%. Comparisons that follow are adjusted for age, sex, education and stressful life events. The prevalence of cognitive impairment was estimated to be 18.9% in depressed elderly and 13.7% in non-depressed. SF-36 overall scores were 48.0 in depressed participants and 68.2 in non-depressed (adjusted mean difference?=??20.2, 95% CI?=??21.3, ?19.1). Compared to non-depressed elderly, the odds of healthcare utilization were higher among those depressed, both for any health problem (aOR 1.4, 95% CI?=?1.1, 1.7) and for emotional problems (aOR 2.7, 95% CI?=?2.2, 3.2). CONCLUSIONS According to GDS estimates, one of every eight Mexican olderadults had major depressive symptoms. Detection and management of older patients with depression should be a high priority in developing countries.
Wagner, Fernando A.; Sanchez-Garcia, Sergio; Juarez-Cedillo, Teresa; Espinel-Bermudez, Claudia; Garcia-Gonzalez, Jose Juan; Gallegos-Carrillo, Katia; Franco-Marina, Francisco; Gallo, Joseph J.
Background and aims Many economic factors are associated with diet, yet the evidence is generally cross-sectional. Older people are considered especially vulnerable to poor diets from negative changes to varied economic factors. This review extends current knowledge on known correlates to decipher actual economic determinants of diet in olderadults. Methods Eight bibliometric databases were searched between May and December 2012, supplemented by hand-searches, with no restrictions on publication date or country. Longitudinal studies, or reviews, were eligible when examining diet as a function of change in an economic factor in non-institutionalised adults ?60?years. Data were extracted using a standardised evidence table and quality assessed before narrative synthesis. Results We found nine original studies for inclusion, of which eight examined change from work to retirement and one evaluated a food price intervention. Designs were generally pre-post without controls and varying in follow-up. Studies reported mixed impact on food spending and/or food intake. Retirement was shown to both reduce and have no impact on food spending and to have either positive and negative, or positive and no impact on food intake. Subgroup differences were observed, especially between men and women. Conclusions Despite ample research on economic correlates of olderadults' diets, little is still known about actual economic determinants of diet in this population. Studies of retirement suggest divergent effects in some but not all older people. Robust high-quality longitudinal studies to decipher economic drivers of diet must be prioritised in research and policy as firm conclusions remain elusive.
Conklin, Annalijn I; Maguire, Eva R; Monsivais, Pablo
Whereas some olderadults show significant cognitive deficits, others perform as well as young adults. We investigated the neural basis of these different aging patterns using positron emission tomography (PET). In PET and functional MRI (fMRI) studies, prefrontal cortex (PFC) activity tends to be less asymmetric in older than in younger adults (Hemispheric Asymmetry Reduction in Old Adults or HAROLD).
Roberto Cabeza; Nicole D. Anderson; Jill K. Locantore; Anthony R. McIntosh
Background Currently, age-related changes in foot mechanics are poorly understood. A greater understanding of the natural changes in foot motion is needed to improve our understanding of pathological foot conditions. Methods The purpose of this study was to compare multisegment foot kinematic data during gait in younger and older individuals. Eleven (N = 11) adult male participants between the ages of 18 - 30 years (younger group; mean ± SD: 24.6 ± 3.0 years) and eleven (N = 11) adults aged 55 years or older (older group; mean ± SD: 65.0 ± 4.2 years) were recruited for the study. The foot was modeled as a four-segment rigid body model. Three-dimensional kinematic and kinetic gait parameters were recorded using an 8-camera Vicon MCam motion capture system and two Kistler force plates. A MANOVA was used to test for significant differences in mean temporal-spatial data, mean ranges of motion, and mean peak joint angle data between age groups. Results No significant differences (P > 0.05) were found between the two age groups for any of the gait parameters. The results of the present study suggest that individuals aged 65.0 ± 4.2 years have foot mechanics that are comparable to younger walkers. Conclusions As such, any deviations in motion at this age may be indicative of an underlying disease or disorder.
Legault-Moore, Dominique; Chester, Victoria L.; de Vries, Gwyneth
Animal research and human neuroimaging studies indicate that stress increases dopamine levels in brain regions involved in reward processing and stress also appears to increase the attractiveness of addictive drugs. The current study tested the hypothesis that stress increases reward salience, leading to more effective learning about positive than negative outcomes in a probabilistic selection task. Changes to dopamine pathways with age raise the question of whether stress effects on incentive-based learning differ by age. Thus, the present study also examined whether effects of stress on reinforcement learning differed for younger (age 18–34) and older participants (age 65–85). Cold pressor stress was administered to half of the participants in each age group and salivary cortisol levels were used to confirm biophysiological response to cold stress. Following the manipulation, participants completed a probabilistic learning task involving positive and negative feedback. In both younger and olderadults, stress enhanced learning about cues that predicted positive outcomes. In addition, during the initial learning phase, stress diminished sensitivity to recent feedback across age groups. These results indicate that stress affects reinforcement learning in both younger and olderadults and suggests that stress exerts different effects on specific components of reinforcement learning depending on their neural underpinnings.
Lighthall, Nichole R.; Gorlick, Marissa A.; Schoeke, Andrej; Frank, Michael J.; Mather, Mara
Animal research and human neuroimaging studies indicate that stress increases dopamine levels in brain regions involved in reward processing, and stress also appears to increase the attractiveness of addictive drugs. The current study tested the hypothesis that stress increases reward salience, leading to more effective learning about positive than negative outcomes in a probabilistic selection task. Changes to dopamine pathways with age raise the question of whether stress effects on incentive-based learning differ by age. Thus, the present study also examined whether effects of stress on reinforcement learning differed for younger (age 18-34) and older participants (age 65-85). Cold pressor stress was administered to half of the participants in each age group, and salivary cortisol levels were used to confirm biophysiological response to cold stress. After the manipulation, participants completed a probabilistic learning task involving positive and negative feedback. In both younger and olderadults, stress enhanced learning about cues that predicted positive outcomes. In addition, during the initial learning phase, stress diminished sensitivity to recent feedback across age groups. These results indicate that stress affects reinforcement learning in both younger and olderadults and suggests that stress exerts different effects on specific components of reinforcement learning depending on their neural underpinnings. PMID:22946523
Lighthall, Nichole R; Gorlick, Marissa A; Schoeke, Andrej; Frank, Michael J; Mather, Mara
Objective: Although the link between enhanced social relationships and better health has generally been well established, few studies have examined the role of leisure activity in this link. This study examined how leisure influences the link between social relationships and health in older age. Method: Using data from the 2006 and 2010 waves of the nationally representative U.S. Health and Retirement Study and structural equation modeling analyses, we examined data on 2,965 older participants to determine if leisure activities mediated the link between social relationships and health in 2010, controlling for race, education level, and health in 2006. Results: The results demonstrated that leisure activities mediate the link between social relationships and health in these age groups. Perceptions of positive social relationships were associated with greater involvement in leisure activities, and greater involvement in leisure activities was associated with better health in older age. Conclusion: The contribution of leisure to health in these age groups is receiving increasing attention, and the results of this study add to the literature on this topic, by identifying the mediating effect of leisure activity on the link between social relationships and health. Future studies aimed at increasing leisure activity may contribute to improved health outcomes in olderadults. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24884905
Clinical outcomes of older and younger adults with extended-spectrum ?-lactamase-producing Escherichia coli isolation were compared. Two hundred thirty-two olderadults (aged ?65 years), and 145 younger adults with infection were identified between February 2010 and July 2011. After controlling for the propensity score and receipt of effective therapy, olderadults were not at increased risk for adverse outcomes. PMID:24773798
Farooq, Sameen; Hayakawa, Kayoko; Marchaim, Dror; Pogue, Jason M; Kaye, Keith S
The authors evaluated the reliability and validity of a tool for measuring olderadults' decision-making competence (DMC). A sample of 205 younger adults (25–45 years), 208 young-olderadults (65–74 years), and 198 old-olderadults (75–97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Comparison of the
Drug-induced liver injury (DILI) is an important cause of hospitalisation and of medication deregistration. In old age, susceptibility to DILI is affected by changes in physiology and increased interindividual variability, compounded by an increased prevalence of disease and the frailty syndrome. While dose-related or predictable DILI reactions are often detected in preclinical trials, the occurrence of rare hypersensitivity or idiosyncratic reactions cannot be reliably predicted from preclinical studies or even by clinical trials. The limited participation of olderadults in clinical trials means that the susceptibility of this population to DILI is largely unknown. Vigilance during clinical trials and postmarketing surveillance must be universally practised. A systematic approach should be taken to determine not only which medicines are hepatotoxic and should be removed from the market, but also the hepatotoxicity risks from marketed drugs to consumers with different characteristics, many of whom are older people.
Introduction: Olderadults constitute 20% of the ED population. Of older patients discharged from the emergency department, 40% receive at least one new medication to add to their already complex medication regimen. The purpose of this study was to determine the effect of increasing medication complexity on knowledge of newly prescribed medications for olderadults discharged from the emergency department.
Purpose: This U.K. study explored how olderadults with depression (treated and untreated) and the general older population conceptualize depression. A multicultural approach was used that incorporated the perspectives of Black Caribbean, South Asian, and White British olderadults. The study sought to explore and compare beliefs about the nature…
Olderadults are the largest group of wheelchair users yet there are no peer-reviewed studies on the national profile of older wheelchair users in Canada. We investigated the characteristics of wheelchair users in a national sample of community-dwelling olderadults from the Canadian Study of Health and Aging (CSHA-2). Questions on the use of…
Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of olderadults. While these technologies offer significant benefits to older people and their families, they are also transforming olderadults into lead adopters of a
J. F. Coughlin; L. A. D'Ambrosio; B. Reimer; M. R. Pratt
Abstract Objective To describe factors associated with multimorbidity in community-dwelling olderadults; to determine if a simple measure of multimorbidity predicts death over 5 years; and to assess if any effect of multimorbidity on mortality is independent of key covariates. Design Analysis of an existing population-based cohort study. Cox proportional hazards models were constructed for time to death. Setting Manitoba. Participants A total of 1751 community-dwelling adults aged 65 and older were interviewed and followed for 5 years. Main outcome measures Age, sex, marital status, living arrangement, education, Mini-Mental State Examination (MMSE) score, Center for Epidemiologic Studies Depression Scale score, and the Older Americans Resource and Services Multidimensional Functional Assessment Questionnaire score were recorded for each participant. Multimorbidity was defined based on a simple list of common health complaints and diseases, followed by an open-ended question about other problems. These were summed and the scores ranged from 0 to 16. Death and time of death were determined during the 5-year interval by death certificate, administrative data, or proxy report. Results Multimorbidity was more prevalent in women; older age groups; and those with lower educational levels, lower MMSE scores, more depressive symptoms, and higher levels of disability. Multimorbidity was a predictor of mortality in unadjusted models (hazard ratio 1.09, 95% CI 1.05 to 1.12). In models adjusting for age, sex, education, marital status, living arrangement, and Center for Epidemiologic Studies Depression Scale and MMSE scores, this effect persisted (hazard ratio 1.04, 95% CI 1.00 to 1.08). However, after adjusting for functional status, the effect of multimorbidity was no longer significant. Conclusion Multimorbidity predicts 5-year mortality but the effect might be mediated by disability.
St John, Philip D.; Tyas, Suzanne L.; Menec, Verena; Tate, Robert
Understanding age-related decline in gait stability and the role of alterations in brain structure is crucial. Here, we studied the relationship between white matter microstructural organization using Diffusion Tensor Imaging (DTI) and advanced gait stability measures in 15 healthy young adults (range 18–30 years) and 25 healthy olderadults (range 62–82 years). Among the different gait stability measures, only stride time and the maximum Lyapunov exponent (which quantifies how well participants are able to attenuate small perturbations) were found to decline with age. White matter microstructural organization (FA) was lower throughout the brain in olderadults. We found a strong correlation between FA in the left anterior thalamic radiation and left corticospinal tract on the one hand, and step width and safety margin (indicative of how close participants are to falling over) on the other. These findings suggest that white matter FA in tracts connecting subcortical and prefrontal areas is associated with the implementation of an effective stabilization strategy during gait.
Bruijn, Sjoerd M.; Van Impe, Annouchka; Duysens, Jacques; Swinnen, Stephan P.
PURPOSE To give an overview of the third in a series of research forums emerged from the second International Conference on Adult Hearing Screening (AHS 2012), which was held in Cernobbio (Lake Como, Italy) in June 2012. The first two research forums, published in the previous and current issues of this journal, included several key contributions from the AHS meeting in 2 major topic areas, "Hearing Screening in Adults and OlderAdults" (Vol. 22, June 2013) and "Aging and Hearing: Mechanisms and Effects" (this issue). In the 7 articles showcased in this Research Forum on "Intervention and Rehabilitation Strategies for Adults and OlderAdults," the authors provide a multifaceted view on recent advancements in intervention strategies for adults with hearing loss, with ample emphasis on auditory training; discuss the research challenges that need to be tackled in this field; and explore new ways to take into account the individual needs and obtain a deeper understanding of the peculiar attributes of hearing in olderadults. PMID:23975123
Background Acquired brain injury (ABI), which includes traumatic (TBI) and non-traumatic brain injury (nTBI), is a leading cause of death and disability worldwide. The objective of this study was to examine the trends, characteristics, cause of brain injury, and discharge destination of hospitalized olderadults aged 65 years and older with an ABI diagnosis in a population with universal access to hospital care. The profile of characteristics of patients with TBI and nTBI causes of injury was also compared. Methods A population based retrospective cohort study design with healthcare administrative databases was used. Data on acute care admissions were obtained from the Discharge Abstract Database and patients were identified using the International Classification of Diseases – Version 10 codes for Ontario, Canada from April 1, 2003 to March 31, 2010. Olderadults were examined in three age groups – 65 to 74, 75 to 84, and 85+ years. Results From 2003/04 to 2009/10, there were 14,518 episodes of acute care associated with a TBI code and 51, 233 episodes with a nTBI code. Overall, the rate of hospitalized TBI and nTBI episodes increased with older age groups. From 2007/08 to 2009/10, the percentage of patients that stayed in acute care for 12 days or more and the percentage of patients with delayed discharge from acute care increased with age. The most common cause of TBI was falls while the most common type of nTBI was brain tumours. The percentage of patients discharged to long term care and complex continuing care increased with age and the percentage discharged home decreased with age. In-hospital mortality also increased with age. Olderadults with TBI and nTBI differed significantly in demographic and clinical characteristics and discharge destination from acute care. Conclusions This study showed an increased rate of acute care admissions for both TBI and nTBI with age. It also provided additional support for falls prevention strategies to prevent injury leading to cognitive disability with costly human and economic consequences. Implications for increased numbers of people with ABI are discussed.
The objective of this study was to measure the anticholinergic activity (AA) of medications commonly used by olderadults. A radioreceptor assay was used to investigate the AA of 107 medications. Six clinically relevant concentrations were assessed for each medication. Rodent forebrain and striatum homogenate was used with tritiated quinuclidinyl benzilate. Drug-free serum was added to medication and atropine standard-curve samples. For medications that showed detectable AA, average steady-state peak plasma and serum concentrations (C(max)) in olderadults were used to estimate relationships between in vitro dose and AA. All results are reported in pmol/mL of atropine equivalents. At typical doses administered to olderadults, amitriptyline, atropine, clozapine, dicyclomine, doxepin, L-hyoscyamine, thioridazine, and tolterodine demonstrated AA exceeding 15 pmol/mL. Chlorpromazine, diphenhydramine, nortriptyline, olanzapine, oxybutynin, and paroxetine had AA values of 5 to 15 pmol/mL. Citalopram, escitalopram, fluoxetine, lithium, mirtazapine, quetiapine, ranitidine, and temazepam had values less than 5 pmol/mL. Amoxicillin, celecoxib, cephalexin, diazepam, digoxin, diphenoxylate, donepezil, duloxetine, fentanyl, furosemide, hydrocodone, lansoprazole, levofloxacin, metformin, phenytoin, propoxyphene, and topiramate demonstrated AA only at the highest concentrations tested (patients with above-average C(max) values, who receive higher doses, or are frail may show AA). The remainder of the medications investigated did not demonstrate any AA at the concentrations examined. Psychotropic medications were particularly likely to demonstrate AA. Each of the drug classifications investigated (e.g., antipsychotic, cardiovascular) had at least one medication that demonstrated AA at therapeutic doses. Clinicians can use this information when choosing between equally efficacious medications, as well as in assessing overall anticholinergic burden. PMID:18510583
Chew, Marci L; Mulsant, Benoit H; Pollock, Bruce G; Lehman, Mark E; Greenspan, Andrew; Mahmoud, Ramy A; Kirshner, Margaret A; Sorisio, Denise A; Bies, Robert R; Gharabawi, Georges
Depression in olderadults has been detected, diagnosed and treated more frequently in recent years. However, substantial gaps in effective treatment remain. Adherence to depression treatment can be viewed as the 'next frontier' in the treatment of late-life depression. Using the Theory of Reasoned Action, a model of health behaviours, this paper conceptualizes and reviews the current evidence for key patient-level factors associated with depression treatment adherence among olderadults. We categorize these factors according to how their impact on adherence might be affected by specialized treatment approaches or interventions as: (i) modifiable; (ii) potentially modifiable; and (iii) non-modifiable. Based on current evidence, modifiable factors associated with depression treatment adherence include patient attitudes, beliefs and social norms. Patient attitudes include perceptions of the effectiveness of depression treatment, preferences for the type of depression treatment and concepts regarding the aetiology of depression (e.g. resistance to viewing depression as a medical illness). There is also evidence from the literature that spiritual and religious beliefs may be important determinants of adherence to depression care. Social norms such as the impact of caregiver agreement with treatment recommendations and stigma may also affect adherence to depression treatment. Other factors may be less modifiable per se, but they may have an impact on adherence that is potentially modifiable by specialized interventions. Based upon a review of the current literature, potentially modifiable factors associated with adherence to depression treatment include co-morbid anxiety, substance use, cognitive status, polypharmacy and medical co-morbidity, social support and the cost of treatment. Finally, non-modifiable factors include patient gender and race. Importantly, non-modifiable factors may interact with modifiable factors to affect health behavioural intent (e.g. race and spiritual beliefs). Thus, adherence to depression treatment in olderadults is associated with multiple factors. Strategies to improve patient adherence need to be multidimensional, including consideration of age-related cognitive and co-morbidity factors, environmental and social factors, functional status and belief systems. Evidence-based interventions involving greater patient, caregiver, provider and public health education should be developed to decrease stigma, negative attitudes and other modifiable barriers to detection, diagnosis, treatment and adherence to depression treatment. These interventions should also be tailored to the individual as well as to the treatment setting. While important progress has been made in increasing detection of depression in olderadults, greater focus now needs to be placed on treatment engagement and continuation of improvements in quality of life, reducing suffering and achieving better outcomes. PMID:18582145
The call for interdisciplinary research, education, and practice is heightened by the recognition of the potential it holds in generating creative solutions to complex problems in health care and to improving quality and effectiveness of care. With the aging of the population and the complex issues in caring for olderadults, interdisciplinary collaboration is particularly salient to the field of geriatrics. However, despite interest in this approach for several decades, adoption has been slow and dissemination is not widespread. This article provides examples of recent initiatives and presents driving and restraining forces involved in adoption of interdisciplinary approaches. PMID:21757083
Young, Heather M; Siegel, Elena O; McCormick, Wayne C; Fulmer, Terry; Harootyan, Linda K; Dorr, David A
Pain can have negative effects leading to prolonged hospital stays. Determining the presence of uncontrolled and untreated pain in patients with cognitive impairments such as delirium, dementia, and delirium superimposed on dementia (DSD) is challenging. One tool commonly suggested for use in assessment of pain in olderadults with cognitive impairment is the Pain Assessment In Advanced Dementia (PAINAD) scale. Proper use of the PAINAD scale as part of a comprehensive pain management plan can help reduce the likelihood of a patient experiencing unrecognized and untreated pain. Using an individual example, this article illustrates best practices in pain assessment and management for a woman experiencing DSD during an acute hospitalization. PMID:24800815
Paulson, Christina May; Monroe, Todd; Mion, Lorraine C
As the population of olderadults increases, there is a corresponding increase in the number of individuals with communication disorders resulting from brain damage. The purpose of this article was to describe the effects of aphasia and dementia on language and communication, and to suggest support systems for improving communication and maximizing residual language abilities. For both these disorders, we address the psychosocial environment, the roles of professionals and caregivers, individual versus group therapy, and support groups. Finally, we report on 2 specific support groups, one for aphasia and one for Alzheimer's dementia, with which the authors have been involved for many years. PMID:15495748
This literature review quantitatively summarized 49 published and unpublished research studies concerning the relationship between death anxiety and age, ego integrity, gender, institutionalization, physical and psychological problems, and religiosity in olderadults. Results indicated that lower ego integrity, more physical problems, and more psychological problems are predictive of higher levels of death anxiety in elderly people. A suggestive but equivocal relationship was found for the predictor institutionalization. Furthermore, the review statistically demonstrated the importance of using sound methods for measuring death anxiety and sampling from the elderly population. PMID:10558505
Memory training was compared in adults aged 60-80. Groups 1 and 2 studied a self-instructional memory training manual; Group 2 also attended supplementary group discussions of typical problems of later life, related coping methods, and the techniques in the self-instructional manuals. Group 3 was a wait-list control group. Memory performance on 2 word lists significantly improved in the supplemental discussion group but not in the group that only studied the self-instructional manual. Enhanced performances were maintained at a 1-month follow-up. Bibliotherapy alone may be inferior to treatment involving a group component, although the mechanisms of such enhancement remain unexplored with respect to memory training. Neither treated group improved their digit span or recall of names and a brief prose passage; teaching olderadults the strategies of chunking and use of imagery may not be beneficial. PMID:2378683
This study examined similarities between the Expressed Emotion (EE) construct developed in the psychiatric literature and interpersonally relevant constructs derived from gerontology caregiver research. Expressed emotion and other indices derived from the Camberwell Family Interview (CFI) were assessed in 46 adult children and spouses providing care to an olderadult hospitalized for major depressive disorder. The relationship of CFI indices with the family member's past and current relationship with the depressed relative, illness attributions, and emotional functioning was examined. Of the family members, 60.9% were classified as high EE. Measures of past and current relationship and illness attributions were significantly associated with most of the CFI indices. In multivariate analyses, past relationship and illness attributions predicted high EE status. Only past relationship predicted the CFI index of warmth. There is conceptual and empirical overlap between the EE construct and interpersonally relevant gerontology variables. Expressed emotion holds promise for a more complex understanding of caregiving and better caregiver interventions. PMID:15370051
Context While fatigue is a common and distressing symptom, a well-specified definition of fatigue is lacking. One of the least well-defined aspects of fatigue is its quality, which might reflect the underlying pathophysiology. Objectives To identify qualities of fatigue and assess whether they are associated with distinct chronic conditions. Methods We identified five fatigue qualities in the literature, two mental and three physical, and selected representative items from those available in our data from a prospective cohort of 495 community-dwelling primary care patients aged 65 years or older. We then examined the prevalence of each quality, the correlations among qualities, and the association of fatigue qualities with health and functional status, including chronic conditions. Results Fatigue was very common among older primary care patients, with 70% reporting any fatigue and 43% reporting feeling tired most of the time, and was associated with worse health and functional status. Physical fatigue qualities were more common than mental qualities. Correlations among fatigue qualities were 0.09–0.27 and did not support the mental versus physical classification. Different fatigue qualities were not well explained by olderadults’ underlying chronic conditions. Rather the cumulative number of fatigue qualities was associated with worse health and function. Conclusion These first steps in exploring fatigue qualities suggest that different fatigue qualities could represent disparate manifestations of a common underlying etiology, while not ruling out distinct underlying pathophysiologies.
Previous findings on olderadults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by olderadults for which CSSs might be appropriate. In telephone interviews, 1,152 adults…
Denton, M.; Ploeg, J.; Tindale, J.; Hutchison, B.; Brazil, K.; Akhtar-Danesh, N.; Quinlan, M.; Lillie, J.; Plenderleith, J. Millen; Boos, L.
The paper assesses whether the needs of people with schizophrenia over 65 years differ from those of younger adults with the diagnosis. It reviews studies comparing older and younger adults and olderadults with schizophrenia and non-clinical or clinical controls on measures of psychosocial functioning. It also considers how psychological interventions can be best designed to cater for the specific needs
Adults aged 60 or older are more likely than younger adults to experience severe complications or even death as a result of foodborne infections. This study investigated which specific groups of healthcare providers or other caregivers are most receptive to providing food safety information to olderadults. Telephone-based focus groups were…
Background. Physical disability is increasingly recognized as an adverse health consequence of type 2 diabetes in olderadults. We studied the effect of diabetes on disability in middle-aged and olderadults to: 1) characterize the association of diabetes with physical disability in middle-aged adults, and 2) determine the extent to which the effect of diabetes is explained by related covariates
Linda A. Wray; Mary Beth Ofstedal; Kenneth M. Langa; Caroline S. Blaum
Judgments about stimulus characteristics are affected by enhanced processing fluency that results from an earlier presentation of the stimulus. By monitoring for an episodic source of processing fluency, younger adults can more easily avoid this influence than can olderadults. In Experiment 1, olderadults discounted the effects of fluency when task demands encouraged the use of analytic judgments based
Integrative medicine (IM) is a subset of interprofessional health care that seeks to join the knowledge and practices of various allopathic and complementary and alternative medicine disciplines in an attempt to offer cost-effective and clinically significant healthcare options for persons with acute or chronic illnesses. Although touted as a means for improving health outcomes and patient satisfaction while possibly lowering costs, further scientific evidence regarding the utility of IM approaches to health services delivery is needed. Collaborative Care for OlderAdults (COCOA) is a chiropractic demonstration project that brings together an interdisciplinary team of researchers and clinicians from the Palmer Center for Chiropractic Research, Genesis Quad Cities Family Practice Residency, The University of Iowa, and Thomas Jefferson University to study the impact of a model of interprofessional education on geriatric health care. The Health Resources and Services Administration funded COCOA in 2009 to further develop and assess a patient-centered care model for the treatment of low back pain in olderadults that uses a team-based approach between medical doctors and doctors of chiropractic. PMID:21174032
Objectives The present study examined the impact of cumulative trauma exposure on current posttraumatic stress disorder (PTSD) symptom severity in a nonclinical sample of adults in their 60s. The predictive utility of cumulative trauma exposure was compared to other known predictors of PTSD, including trauma severity, personality traits, social support, and event centrality. Method Community-dwelling adults (n = 2,515) from the crest of the Baby Boom generation completed the Traumatic Life Events Questionnaire, the PTSD Checklist, the NEO Personality Inventory, the Centrality of Event Scale, and rated their current social support. Results Cumulative trauma exposure predicted greater PTSD symptom severity in hierarchical regression analyses consistent with a dose-response model. Neuroticism and event centrality also emerged as robust predictors of PTSD symptom severity. In contrast, the severity of individuals’ single most distressing life event, as measured by self-report ratings of the A1 PTSD diagnostic criterion, did not add explanatory variance to the model. Analyses concerning event categories revealed that cumulative exposure to childhood violence and adulthood physical assaults were most strongly associated with PTSD symptom severity in older adulthood. Moreover, cumulative self-oriented events accounted for a larger percentage of variance in symptom severity compared to events directed at others. Conclusion Our findings suggest that the cumulative impact of exposure to traumatic events throughout the life course contributes significantly to post-traumatic stress in older adulthood above and beyond other known predictors of PTSD.
Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.
This study examined the effects of the reactions of younger adukts toward olderadults on the psychological attributese and behavior of elderly. Participants were 34 older male adults aged 60-82 years. They completed a questionnaire on generativity before and after the experimental condition, and were also observed taking flyers on different topics after the experiment. They were assigned to the younger condition or the same generation condition. In both conditions, the participants were asked to talk to recipients about experiences from their youth and the wisdom they have gained. The recipients responded to the participants in either a positive or a neutral way. The results showed that generativity was promoted most when the younger recipients responded in a positive manner, whereas the neutral reactions of younger recipients led to the inhibition of generativity. Younger persons' positive reactions promoted the participants' helping behaviors, as indicated by the flyers they took. The present study shows increases in the generativity of the elderly following positive reactions from younger recipients not only on questionnaires but also in an experimental setting. PMID:24669505
A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy olderadults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported olderadults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative. PMID:22792378
Kueider, Alexandra M; Parisi, Jeanine M; Gross, Alden L; Rebok, George W
Aims To identify clinical factors associated with disability in depressed olderadults with bipolar disorder (BPD) receiving lamotrigine. Methods Secondary analysis of a multi-site, 12-week, open-label, uncontrolled study of addon lamotrigine in 57 adults 60 years and older with BD I or II depression. Measures included the Montgomery Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Cumulative Illness Rating Scale for Geriatrics (CIRS-G), Dementia Rating Scale (DRS), and WHO-Disability Assessment Scale II (WHO-DAS II). Results Medical comorbidiy in this group of elders was substantial, with roughly 60% of subjects having disorders of the vascular, musculoskeletal/integument, and endodrine/metabolic/breast systems. We found significant relationships among mood (MADRS), medical comorbidity (CIRS-G), cognition (DRS), and disability (WHO-DAS II). More severe BPD depression, more medical comorbidity and more impaired cognition were all associated with lower functioning in BPD elders. Conclusions Our findings fit the paradigm shift that has been occurring in BPD, supporting the notion that BPD is not solely an illness of mood but that it affects multiple domains impacting overall functioning.
A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy olderadults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer’s disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported olderadults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.
Kueider, Alexandra M.; Parisi, Jeanine M.; Gross, Alden L.; Rebok, George W.
This paper presents an adaptation of the Family Management Style Framework (FMSF) -a well-established framework of family response to chronic condition care of children-- to families caring for olderadults with dementia. Using the FMSF to better understand how families manage dementia care can provide clinicians with insights on how to work effectively with families. Using data from interviews with eight female caregivers of olderadults with dementia this secondary analysis adapts the FMSF, and identifies new dimensions that apply specifically to families caring for olderadults with dementia. The discussion draws comparisons between the family management of a child with chronic condition to management of an olderadult with dementia. The paper concludes with a discussion of how understanding how families manage care of an olderadult with dementia informs assessment for management styles and the tailoring of interventions specific to family, caregiver, and olderadult needs.
Background Falls have enormous impact in olderadults. Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting. The objectives were to measure the frequency of falls and associated factors among older people living institutions. Methods Data were obtained from a survey on a probabilistic sample of residents aged ?65 years, drawn in 1998-99 from institutions of Madrid (Spain). Residents, their caregivers, and facility physicians were interviewed. Fall rates were computed based on the number of physician-reported falls in the preceding 30 days. Adjusted rate ratios were computed using negative binomial regression models, including age, sex, cognitive status, functional dependence, number of diseases, and polypharmacy. Results The final sample comprised 733 residents. The fall rate was 2.4 falls per person-year (95% confidence interval [CI], 2.04-2.82). The strongest risk factor was number of diseases, with an adjusted rate ratio (RR) of 1.32 (95% CI, 1.17-1.50) for each additional diagnosis. Other variables associated with falls were: urinary incontinence (RR?=?2.56 [95% CI, 1.32-4.94]); antidepressant use (RR?=?2.32 [95% CI, 1.22-4.40]); arrhythmias (RR?=?2.00 [95% CI, 1.05-3.81]); and polypharmacy (RR?=?1.07 [95% CI, 0.95-1.21], for each additional medication). The attributable fraction for number of diseases (with reference to those with???1 condition) was 84% (95% CI, 45-95%). Conclusions Number of diseases was the main risk factor for falls in this population of institutionalized olderadults. Other variables associated with falls, probably more amenable to preventive action, were urinary incontinence, antidepressants, arrhythmias, and polypharmacy. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3916151157277337
Background and objective Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. Methods We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. Results The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. Conclusions Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among olderadults.
Objective To determine the role of obesity, adult behavioural risk factors, and markers of specific childhood exposures in the association between adult socioeconomic position and hypertension in a cohort of people aged 60 years and older. Design Cross sectional study. Setting Spain. Participants 4009 subjects representative of the Spanish non?institutionalised population aged 60 years and older. Main outcome measure Prevalence of hypertension according to education and social class, and proportion of excess difference in hypertension prevalence in lower socioeconomic groups explained by different risk factors for hypertension. Results The highest prevalence of hypertension was seen in subjects with less education and in those belonging to a low social class. In men, the hypertension risk factors analysed did not explain the difference in prevalence by education, but they explained almost half of the difference by social class. In women, these risk factors explained the differences in hypertension prevalence by education and a substantial part of the differences by social class. Central and general obesity, and physical inactivity were the risk factors that were the most important in this association in women. Conclusions In women, socioeconomic position has no direct effect on hypertension in the case of education and only a small effect in the case of social class. In contrast, most of the effect of education and half of the effect of social class on hypertension in men is direct or, at least, is not explained by the risk factors analysed. The mechanisms that can explain the association between socioeconomic position and hypertension in older men remain to be established.
Regidor, Enrique; Gutierrez-Fisac, Juan L; Banegas, Jose R; Dominguez, Vicente; Rodriguez-Artalejo, Fernando
The goal of this multiple-case study was to explore the benefits for olderadult volunteers who are mentoring at-risk youth in one-on-one pairings, either in schools or family environments. We wanted to learn more about the specific outcomes of working in these programs for the olderadult volunteers since, in our community, olderadults are an important source of new
OBJECTIVE To evaluate associations between health-related quality of life (HRQL) and geriatric syndromes, diabetes complications, and hypoglycemia in olderadults with diabetes. RESEARCH DESIGN AND METHODS A race-stratified random sample of 6,317 adults with type 2 or type 1 diabetes, aged 60 to 75 years, enrolled in Kaiser Permanente Northern California, who completed a survey that included a HRQL instrument based on the Short Form 8-item health survey. Administrative records were used to ascertain diagnoses of geriatric syndromes, diabetes complications, and hypoglycemia. Associations were estimated between HRQL and exposures in exposure-specific and combined exposure models (any syndrome, any complication, or hypoglycemia). Conservatively, differences of ?3 points were considered the minimally important difference in HRQL scores. RESULTS HRQL was lower with nearly all exposures of interest. The lowest physical HRQL was associated with amputation. In combined exposure models, geriatric syndromes (?5.3 [95% CI ?5.8 to ?4.8], P < 0.001) and diabetes complications (?3.5 [?4.0 to ?2.9], P < 0.001) were associated with lower physical HRQL. The lowest mental HRQL was associated with depression, underweight (BMI <18 kg/m2), amputation, and hypoglycemia. In combined exposure models, only hypoglycemia was associated with lower mental HRQL (?4.0 [?7.0 to ?1.1], P = 0.008). CONCLUSIONS Geriatric syndromes and hypoglycemia are associated with lower HRQL to a comparable degree as diabetes complications. Addressing geriatric syndromes and avoiding hypoglycemia should be given as high a priority as preventing diabetes complications in olderadults with diabetes.
Laiteerapong, Neda; Karter, Andrew J.; Liu, Jennifer Y.; Moffet, Howard H.; Sudore, Rebecca; Schillinger, Dean; John, Priya M.; Huang, Elbert S.
Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 olderadults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population. PMID:24936734
The purposes of the study presented were to compare the health-promoting behaviors of olderadults with those of young and middle-aged adults, to examine the relationship of age and other sociodemographic characteristics to life style throughout adulthood, and to identify differing life-style patterns among olderadults. Six dimensions of life style were measured by the Health-Promoting Lifestyle Profile in 452 adults aged 18 to 88. Olderadults had higher scores in overall health-promoting life style and in the dimensions of health responsibility, nutrition, and stress management than both young and middle-aged adults. Sociodemographic variables accounted for only 13.4% of the variance in life style and for 5.2% to 18.6% in its six dimensions. Five major health-promoting life-style patterns were identified among olderadults, depicting a heterogeneous group with varying needs for health promotion programming. PMID:3140723
Walker, S N; Volkan, K; Sechrist, K R; Pender, N J
Decreased food and beverage consumption among olderadults can lead to inadequate intakes of energy and numerous micronutrients. Although olderadults are prone to having inadequate diets, little research attention has been directed at their dietary behaviors, such as snacking. The purpose of this study was to examine the association between snacking frequency and olderadults' daily intakes of vitamins, carotenoids, and minerals. Cross-sectional data for 2,056 olderadults (65 years and older) from the 2003-2006 National Health and Nutrition Examination Survey were used for this study. Dietary data were collected through two 24-hour dietary recall interviews. Participants' snacking occasions and daily nutrient intakes were averaged during the two 24-hour recalls. Using linear regression models to adjust for multiple covariates, mean vitamin, carotenoid, and mineral intakes by snacking category were estimated. As snacking frequency increased, daily intakes of vitamins A, C, and E and beta carotene increased. Olderadults' daily intakes of magnesium, copper, and potassium also increased as snacking frequency increased. As olderadults' snacking frequency increased, their daily intake of selenium decreased, and their snacking frequency was not associated with their daily intakes of the B-complex vitamins, vitamin K, lycopene, phosphorus, iron, and zinc. Providing healthy snacks on a regular basis has practical implications for institutions, centers, or organizations that serve olderadults; however, nutritional benefits obtained from snack food and beverages warrant their inclusion in olderadults' diet. PMID:20430139
Zizza, Claire A; Arsiwalla, Dilbur D; Ellison, Kathy Jo
The current study incorporated a life span perspective into existing theories of intrusive thoughts to examine age-related differences in the difficulty controlling intrusive thoughts, the distress following intrusive thought recurrences, and the meanings assigned to these recurrences. Younger (N = 51) and older (N = 49) community adults were randomly assigned to suppress (i.e., keep out of mind) or monitor an intrusive thought. Participants rated their positive and negative affect throughout engagement with the intrusive thought, and they also rated the meanings they gave to recurrences of their everyday intrusive thoughts. The results demonstrated that olderadults tended to perceive greater difficulty with controlling the intrusive thought than younger adults despite the fact that they did not differ in the actual recurrence of the intrusive thought. With regard to distress, olderadults experienced steadier levels of positive affect than younger adults throughout engagement with the intrusive thought. However, olderadults also reported greater residual negative affect after engaging with the intrusive thought than younger adults. Finally, older and younger adults appeared to assign meanings to recurrences of intrusive thoughts in line with age-relevant concerns. Specifically, olderadults were prone to interpret the recurrence of intrusive thoughts as a sign of cognitive decline, but they were less likely than younger adults to see intrusive thoughts as a sign of moral failure. Together, these results highlight a range of potential risk and protective factors in olderadults for experiencing emotion dysregulation after intrusive thoughts. PMID:21707184
Background Maintaining muscle mass while aging is important to prevent falls and fractures. Metabolic acidosis promotes muscle wasting, and the net acid load from diets that are rich in net acid–producing protein and cereal grains relative to their content of net alkali–producing fruit and vegetables may therefore contribute to a reduction in lean tissue mass in olderadults. Objective We aimed to determine whether there was an association of 24-h urinary potassium and an index of fruit and vegetable content of the diet with the percentage lean body mass (%LBM) or change in %LBM in older subjects. Design Subjects were 384 men and women ?65 y old who participated in a 3-y trial comparing calcium and vitamin D with placebo. Potassium was measured in 24-h urine collections at baseline. The %LBM, defined as total body nonfat, nonbone tissue weight ÷ weight × 100, was measured by using dual-energy X-ray absorptiometry at baseline and at 3 y. Physical activity, height, and weight were assessed at baseline and at 3 y. Results At baseline, the mean urinary potassium excretion was 67.0 ± 21.1 mmol/d. Urinary potassium (mmol/d) was significantly positively associated with %LBM at baseline (? = 0.033, P = 0.006; adjusted for sex, weight, and nitrogen excretion) but not with 3-y change in %LBM. Over the 3-y study, %LBM increased by 2.6 ± 3.6%. Conclusion Higher intake of foods rich in potassium, such as fruit and vegetables, may favor the preservation of muscle mass in older men and women.
Dawson-Hughes, Bess; Harris, Susan S; Ceglia, Lisa
Two experiments examined whether younger and olderadults' self-regulated study (item selection and study time) conformed to the region of proximal learning (RPL) model when studying normatively easy, medium, and difficult vocabulary pairs. Experiment 2 manipulated the value of recalling different pairs and provided learning goals for words recalled and points earned. Younger and olderadults in both experiments selected items for study in an easy-to-difficult order, indicating the RPL model applies to olderadults' self-regulated study. Individuals allocated more time to difficult items, but prioritized easier items when given less time or point values favoring difficult items. Olderadults studied more items for longer but realized lower recall than did younger adults. Olderadults' lower memory self-efficacy and perceived control correlated with their greater item restudy and avoidance of difficult items with high point values. Results are discussed in terms of RPL and agenda-based regulation models. PMID:19866382
In two experiments recognition of actions of a robbery presented in a video was examined in older and younger adults. In both experiments olderadults had more false alarms and showed less accurate recognition than younger adults. In addition, when participants were asked in Experiment 1 to indicate Remember/Know/Guess judgments for actions they considered true, olderadults accepted more false actions with Remember judgments. And when participants were asked in Experiment 2 to attribute the source (i.e., perpetrator), the olderadults were less able to attribute actions that occurred during the robbery to their correct sources. Furthermore, we found a robust positive correlation between source attribution ability and recognition accuracy. Thus, source-memory deficits may contribute to olderadults' false memories in real-life eyewitness situations. PMID:21534031
Self-neglect in olderadults is an increasingly prevalent, poorly understood problem, crossing both the medical and social arenas, with public health implications. Although lacking a standardized definition, self-neglect is characterized by profound inattention to health and hygiene. In light of the aging demographic, physicians of all specialties will increasingly encounter self-neglectors. We outline here practical strategies for the clinician, and suggestions for the researcher. Clinical evaluation should include attention to medical history, cognition, function, social networks, psychiatric screen and environment. The individual’s capacity is often questioned, and interventions are case-based. More research is needed in basic epidemiology and risk factors of the problem, so that targeted interventions may be designed and tested. The debate of whether self-neglect is a medical versus societal problem remains unresolved, yet as health sequelae are part of the syndrome, physicians should be part of the solution.
This article presents a qualitative study following a 6-month Taiji (T'ai Chi)/Qigong (Ch'i Kung) intervention for olderadults. The researchers conducted in-depth interviews of eight selected participants who elected to continue practicing Taiji after the intervention ended, in order to explore their subjective experiences of Taiji's effects and their motivations for continuing to practice. We created a Layers Model to capture the significance and meaning of the multidimensionality of their reported experiences. Participants not only reported simple benefits along five dimensions of experience (physical, mental, emotional, social and spiritual) but also described complex multidimensional experiences. Overall findings indicate that participants derived a very wide variety of perceived benefits, the most meaningful being a felt sense of body-mind-spirit integration. Our results support the important role of qualitative studies in researching the effects of Taiji and Qigong.
This article describes the processes and outcomes of three-dimensional concept mapping to conceptualize financial exploitation of olderadults. Statements were generated from a literature review and by local and national panels consisting of 16 experts in the field of financial exploitation. These statements were sorted and rated using Concept Systems software, which grouped the statements into clusters and depicted them as a map. Statements were grouped into six clusters, and ranked by the experts as follows in descending severity: (a) theft and scams, (b) financial victimization, (c) financial entitlement, (d) coercion, (e) signs of possible financial exploitation, and (f) money management difficulties. The hierarchical model can be used to identify elder financial exploitation and differentiate it from related but distinct areas of victimization. The severity hierarchy may be used to develop measures that will enable more precise screening for triage of clients into appropriate interventions. PMID:21978290
Conrad, Kendon J; Iris, Madelyn; Ridings, John W; Fairman, Kimberly P; Rosen, Abby; Wilber, Kathleen H
Originally developed in 1960 as an emergency intervention for individuals who unexpectedly went into cardiac arrest, cardiopulmonary resuscitation (CPR) is now in widespread use. With broader use of CPR over the past several decades, some limitations and unintended consequences of the procedure have been identified. In addition, accumulated data have demonstrated low probabilities of survival and uneven success rates of CPR for certain subgroups. Despite advances in the understanding of CPR outcomes, the general public and many health professionals significantly overestimate the benefits and underestimate any negative consequences. As a result, CPR decision making is often based on incomplete or inaccurate information. This article discusses the "rest of the story" about CPR, namely the existing evidence about CPR survival and potential complications of CPR. The article also highlights how nurses can help promote informed decision making about CPR to olderadults and their families. PMID:21117527
Examining the interpersonal effects of suffering in the context of family caregiving is an important step to a broader understanding of how exposure to suffering affects humans. In this review article, we first describe existing evidence that being exposed to the suffering of a care recipient (conceptualized as psychological distress, physical symptoms, and existential/spiritual distress) directly influences caregivers’ emotional experiences. Drawing from past theory and research, we propose that caregivers experience similar, complementary, and/or defensive emotions in response to care recipient suffering through mechanisms such as cognitive empathy, mimicry, and conditioned learning, placing caregivers at risk for psychological and physical morbidity. We then describe how gender, relationship closeness, caregiving efficacy, and individual differences in emotion regulation moderate these processes. Finally, we provide directions for future research to deepen our understanding of interpersonal phenomena among olderadults, and we discuss implications for clinical interventions to alleviate the suffering of both caregivers and care recipients.
Are age differences in source memory inevitable? The two experiments reported here examined the hypothesis that the type of source information being tested mediates the magnitude of age differences in source memory. In these studies, participants listened to statements made by two different speakers. We compared younger and olderadults' source memory in a traditional perceptual source task (memory for voice) and in two affective, conceptually based source tasks (truth of the statements, character of a person in a photo). In both studies, the perceptual and conceptual source information were conveyed in the same manner, as one speaker was associated with one type of information (e.g., female voice speaks truth). Age differences were robust for decisions regarding who said each statement but were negligible for truth or character decisions. These findings are provocative because they suggest that the type of information can influence age-related patterns of performance for source-conveyed information.
Examining the interpersonal effects of suffering in the context of family caregiving is an important step to a broader understanding of how exposure to suffering affects humans. In this review article, the authors first describe existing evidence that being exposed to the suffering of a care recipient (conceptualized as psychological distress, physical symptoms, and existential/spiritual distress) directly influences caregivers' emotional experiences. Drawing from past theory and research, the authors propose that caregivers experience similar, complementary, and/or defensive emotions in response to care recipient suffering through mechanisms such as cognitive empathy, mimicry, and conditioned learning, placing caregivers at risk for psychological and physical morbidity. The authors then describe how gender, relationship closeness, caregiving efficacy, and individual differences in emotion regulation moderate these processes. Finally, the authors provide directions for future research to deepen understanding of interpersonal phenomena among olderadults, and they discuss implications for clinical interventions to alleviate the suffering of both caregivers and care recipients. PMID:19739924
Sickle cell disease (SCD) is a chronic disease with acute, painful exacerbations that often results in a shortened life expectancy. We explored the life stories of middle-age and olderadults with SCD to ascertain how they explain their longevity and how they see the place of SCD in their lives. Data were gathered using semi-structured interviews with 12 individuals living with SCD--seven women and five men. Respondents offered four main reasons for their longevity: self-care, supportive family/friends, a higher power, and medical care. Respondents reported life satisfactions of family, employment/education, and religious activities. The life stories reflect challenges of often living with a disease prior to diagnosis and without modern advances and the unpredictable nature of the disease. Their stories provide healthcare providers with insight into the supports SCD patients need to improve their health outcomes as they move through the life course. PMID:21901994
Jenerette, Coretta M; Leak, Ashley N; Sandelowski, Margarete
Synopsis Complimentary and alternative medicines (CAM) are frequently used for the treatment of sleep disorders, but in many cases, patients do not discuss these therapies directly with their health care provider. There is a growing body of well-designed clinical trials using CAM that have shown the following: 1) Melatonin is an effective agent for the treatment of circadian phase disorders that affect sleep, however, the role of melatonin in the treatment of primary or secondary insomnia is less well established. 2) Valerian has shown a benefit in some, but not all clinical trials. 3) Several other modalities, such as Tai Chi, acupuncture, acupressure, yoga and meditation have improved sleep parameters in a limited number of early trials. Future work examining CAM has the potential to significantly add to our treatment options for sleep disorders in olderadults.
Olderadults with major depressive disorder (MDD) may also have preclinical Alzheimer’s disease (AD). Differential diagnosis is quite challenging due to the over-lapping symptoms of MDD and AD. In the current study, we predicted that impaired long-term memory (an area most affected in early AD), but not executive function (an area affected in MDD and AD), would distinguish older depressed patients who developed AD from those who did not. Patients (N = 120) assessed as having MDD but not dementia at baseline were administered tests of cognitive function and followed longitudinally for subsequent diagnosis of AD. Using structural equation modeling we found a latent construct of long-term memory to be associated with AD to a greater extent than executive functioning. Additional analyses to enhance clinical utility of findings indicated that individual tests of episodic memory were most predictive of AD status. Tests of long-term memory can be utilized by the clinician when assessing for preclinical AD among depressed elderly.
Rushing, Nicole C.; Sachs-Ericsson, Natalie; Steffens, David C.
Oral symptoms and their effects on well-being provide an indication of the social impact of oral disease and can be used to document the burden of illness within populations. This report presents findings about the social impact of oral disease among a random sample of 1217 non-institutionalized persons aged 60 years and over living in Adelaide and Mt Gambier. They completed a questionnaire containing 49 questions about the effect of oral conditions on dysfunction, discomfort and disability. Over 5 per cent of dentate persons and over 10 per cent of edentulous persons reported impacts such as difficulty in chewing, discomfort during eating and avoidance of foods 'fairly often' or 'very often' during the previous 12 months. Impacts on social roles and interpersonal relationships were reported by up to 5 per cent of persons. Edentulous persons reported social impact more frequently, particularly in areas related to chewing and eating. Older age was associated with significantly greater amounts of impact among dentate persons, while edentulous males reported significantly more impact than edentulous females. There were larger variations among dentate persons according to their dental utilization patterns, with the highest levels of impact reported by individuals who usually attended for dental problems and who had attended the previous year. The high frequency of social impact reported in this study no doubt reflects extensive levels of disease experience, including high rates of missing teeth and edentulism, among olderadults. PMID:7832683
Vascular disease has been proposed as a contributing factor for presbyacusis (age-related hearing loss). While this hypothesis is supported by pathological evidence of vascular decline in post-mortem human and animal studies, evidence in human subjects has been mixed with associations typically reported between a measure of vascular health and low frequency hearing in older women. Given the difficulty of characterizing the in vivo health of the cochlear artery in humans, an estimate of cerebral small vessel disease was used to test the prediction that age-related change in low frequency hearing and not high frequency hearing is related to a global decline in vascular health. We examined the extent to which these associations were specific to women and influenced by a history of high blood pressure in 72 olderadults (mean age 67.12 years, SD = 8.79). Probability estimates of periventricular white matter hyperintensities (WMH) from T1- and fluid attenuated T2-weighted magnetic resonance images were significantly associated with a low frequency hearing metric across the sample, which were independent of age, but driven by women and people with a history of high blood pressure. These results support the premise that vascular declines are one mechanism underlying age-related changes in low frequency hearing. PMID:23512682
Eckert, Mark A; Kuchinsky, Stefanie E; Vaden, Kenneth I; Cute, Stephanie L; Spampinato, Maria V; Dubno, Judy R
Although healthy aging is accompanied by a general decline in memory functioning, environmental support at retrieval can improve olderadults’ (+65 years) episodic remembering. Despite those over the age of 65years representing a growing proportion of the population, few environmental retrieval support methods have been empirically evaluated for use with older witnesses and victims of crime. Here, the efficacy of a novel retrieval technique, the Sketch Mental Reinstatement of Context, is compared with a standard Mental Reinstatement of Context and a no support control (Control). Fifty-one participants witnessed an unexpected live event, and 48 hours later were interviewed using one of three aforementioned techniques. In line with predictions emanating from cognitive theories of aging and the environmental support hypothesis, participants in the Sketch Mental Reinstatement of Context condition recalled significantly more correct information and fewer inaccurate items. The Sketch Mental Reinstatement of Context technique appears to scaffold memory retrieval in an age-appropriate manner during a post-event interview, possibly by encouraging more effortful retrieval and reducing dual-task load. As such, this procedure offers an effective alternative to current approaches, adding to the toolbox of techniques available to forensic and other interviewers.
Although healthy aging is accompanied by a general decline in memory functioning, environmental support at retrieval can improve olderadults' (+65 years) episodic remembering. Despite those over the age of 65 years representing a growing proportion of the population, few environmental retrieval support methods have been empirically evaluated for use with older witnesses and victims of crime. Here, the efficacy of a novel retrieval technique, the Sketch Mental Reinstatement of Context, is compared with a standard Mental Reinstatement of Context and a no support control (Control). Fifty-one participants witnessed an unexpected live event, and 48 hours later were interviewed using one of three aforementioned techniques. In line with predictions emanating from cognitive theories of aging and the environmental support hypothesis, participants in the Sketch Mental Reinstatement of Context condition recalled significantly more correct information and fewer inaccurate items. The Sketch Mental Reinstatement of Context technique appears to scaffold memory retrieval in an age-appropriate manner during a post-event interview, possibly by encouraging more effortful retrieval and reducing dual-task load. As such, this procedure offers an effective alternative to current approaches, adding to the toolbox of techniques available to forensic and other interviewers. PMID:23922863
OBJECTIVES To investigate patient-level determinants of in-hospital death, adjusting for patient and regional characteristics. DESIGN Using multivariable regression, the relationship between in-hospital death and participants’ social, functional, and health characteristics was investigated, controlling for regional Hospital Care Intensity Index (HCI) from the Dartmouth Atlas of Health Care. SETTING The Health and Retirement Study, a longitudinal nationally representative cohort of olderadults. PARTICIPANTS People aged 67 and older who died between 2,000 and 2,006 (N = 3,539) were sampled. MEASUREMENTS In-hospital death. RESULTS Thirty-nine percent (n = 1,380) of participants died in the hospital (range 34% in Midwest to 45% in Northeast). Nursing home residence, functional dependence, and cancer or dementia diagnosis, among other characteristics, were associated with lower adjusted odds of in-hospital death. Being black or Hispanic, living alone, and having more medical comorbidities were associated with greater adjusted odds, as was higher HCI. Sex, education, net worth, and completion of an advance directive did not correlate with in-hospital death. CONCLUSION Black race, Hispanic ethnicity, and other functional and social characteristics are correlates of in hospital death, even after controlling for the role of HCI. Further work must be done to determine whether preferences, provider characteristics and practice patterns, or differential access to medical and community services drive this difference.
Kelley, Amy S.; Ettner, Susan L.; Wenger, Neil S.; Sarkisian, Catherine A.
Objective Limited data are available on how olderadults access public mental health systems. This study examines how uninsured or publicly insured olderadults with severe mental illness in San Diego County initially accessed the public mental health system, as well as their subsequent use of public mental health services, as compared to younger adults. Methods Data from San Diego County, 2002–2006, was used to examine how olderadults initially accessed the public mental health system, and their utilization over the subsequent 90 days. Multivariate regression models were used to control for demographic and clinical characteristics. Results Olderadults (age 60+) were more likely to access the public mental health system through the Psychiatric Emergency Response Team (PERT), a combined law-enforcement and psychiatric service that responds to psychiatric related 911 calls. Olderadults were also less likely to receive follow-up care. This lower rate of follow-up was due to both the initial site of service – and an associated lower rate of follow-up among PERT clients – as well as a lower rate of follow-up among olderadult clients initiating services in other sectors. Conclusions This paper suggests two areas for intervention that would improve access to care for olderadults: improving linkages and referrals between PERT and outpatient providers; and additional efforts to retain olderadults at outpatient programs.
The authors evaluated the reliability and validity of a tool for measuring olderadults’ decision-making competence (DMC). Two-hundred-five younger adults (25-45 years), 208 young-olderadults (65-74 years), and 198 old-olderadults (75-97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Unlike previous research, the authors were able to compare old-older with young-olderadults’ performance. As hypothesized, old-olderadults performed more poorly than young-olderadults; both groups of olderadults performed more poorly than younger adults. Hierarchical regression analyses showed that a large amount of variance in decision performance across age groups (including mean trends) could be accounted for by social variables, health measures, basic cognitive skills, attitudinal measures, and numeracy. Structural equation modeling revealed significant pathways from three exogenous latent factors (crystallized intelligence, other cognitive abilities, and age) to the endogenous DMC latent factor. Further research is needed to validate the meaning of performance on these tasks for real-life decision making.
Perceived age plays an important role in the context of age identity and social interactions. To examine how accurate individuals are in estimating how old they look and how old others are, younger, middle-aged, and olderadults rated photographs of older target persons (for whom we had information about objective and subjective age) in terms of…
Abstract Background: Acute hospital readmission of olderadults receiving hospice care is not aligned with hospice goals. Objective: To identify factors associated with 30-day readmission among olderadults newly discharged to hospice. Design/Subjects: Medical record review of 59 patients, 19 readmitted within 30 days and 40 randomly selected controls not readmitted, from 206 patients newly discharged to home hospice care between February 1, 2005 and January 31, 2010. Measures/Analysis: Information was collected about hospital course, end-of-life planning, and posthospitalization follow-up. We calculated bivariate associations and developed a Cox Proportional Hazards model examining the relation between index admission characteristics and readmission. Results: Patients' mean age was 79.7±8.4; 74.6% were female; 52.5% were black. Among those readmitted, 25% had received a palliative care consultation, compared to 47.1% of those not readmitted (p=0.06). Patients without a participating decision-maker involved in their hospice decision had 3.5 times the risk of readmission within 30 days, compared to those with (hazard ratio [HR] 3.53, confidence interval [CI] 0.97, 12.82). Patients who had one or more telephone contacts with their primary care physician (PCP) during week 1 after discharge had 2.4 times the readmission risk within 30 days, compared to patients with no such contacts during this period (HR 2.35, CI 0.9, 6.1). Conclusions: Readmission within 30 days of initial discharge to hospice is associated with several measures of care and care planning. Further study of these measures may identify opportunities for interventions to improve the hospital-to-hospice transition and to decrease hospital readmissions. PMID:24708490
Objectives To examine the association between serum parathyroid hormone (PTH) levels and incident falls in older diabetic adults. Design Longitudinal analysis of incident falls over 1 year in a sub-study of diabetic participants in the Health, Aging and Body Composition study. Setting Pittsburgh, PA, and Memphis, TN. Participants Well-functioning, community-dwelling black and white adults aged 70-79 with diabetes (n = 472). Measurements Measured baseline serum PTH. Self-report of falls over the subsequent 12 months. Baseline physical performance and self-reported demographic, behavioral, and health status measures including kidney function, chronic conditions and medication use. Results 30.3% of participants reported falling over one year of follow-up. The mean ± SD baseline serum PTH was 53.5 ± 30.0 pg/mL in non-fallers and 62.6 ± 46.2 pg/mL in fallers (p = 0.01). For every 1 SD (36 pg/mL) increment in baseline serum PTH, there was approximately a 30% increased likelihood of reporting a fall in the subsequent year after adjusting for age, gender, race, field center, alcohol consumption, BMI, physical activity, and winter/spring season (adjusted odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.06-1.59). Further adjustment for kidney function, chronic conditions, medication and supplement use, and physical performance attenuated the association slightly (OR (95% CI): 1.26 (1.01-1.58)). A trend remained after additional adjustment for reported falls in the previous year. Conclusion Higher serum PTH was associated with incident falls among older, well-functioning diabetic men and women. Further investigation aimed at understanding the underlying mechanism for the association between serum PTH and falls is needed.
Houston, Denise K.; Schwartz, Ann V.; Cauley, Jane A.; Tylavsky, Frances A.; Simonsick, Eleanor M.; Harris, Tamara B.; de Rekeneire, Nathalie; Schwartz, Gary G.; Kritchevsky, Stephen B.
Objectives The purpose of this paper is to identify: motivations and perceived barriers associated with food choices made by homebound olderadults; whether motivations and perceived barriers vary according to social demographic characteristics; and whether motivations and perceived barriers are associated with dietary quality. Design This was an observational study using standard interview methods where participants were administered a questionnaire and completed three 24-hour dietary recalls. Setting Participants were interviewed in their homes. Participants 185 homebound olderadults were included. Measurement Motivations were assessed using a modification of The Food Choice Questionnaire and perceived barriers were assessed using the Vailas Food Enjoyment Questionnaire. Participants answered questions regarding social demographic characteristics. Dietary quality measures of adequate intakes of calories, protein, vitamin D, and vitamin B12 were obtained from the three 24-hour dietary recalls. Results Mean age was 78.9; 80% were female; and 36% were African American. Key motivations in food choice included sensory appeal, convenience, and price. Key barriers included health, being on a special diet, and being unable to shop. These varied little by social demographics, except for age. Dietary quality varied according to different motivations and barriers. Conclusion Food choices are based upon a complex interaction between the social and environmental context, the individual, and the food. Efforts to change eating behaviors, especially community-based interventions involving self-management approaches, must carefully take into account individuals’ self-perceived motivations and barriers to food selection. Incorporating foods that are tasty, easy to prepare, inexpensive, and that involve caregivers are critical for successful interventions.
LOCHER, J.L.; RITCHIE, C.S.; ROTH, D.L.; SEN, B.; DOUGLAS, K. VICKERS; VAILAS, L.I.
Although previous studies have demonstrated that the hippocampus plays a role in pain processing, the role of hippocampal subfields is uncertain. The goal of this study was to examine the relationship between hippocampal subfield volumes and chronic pain in nondemented olderadults. The study sample included 86 community-residing adults age 70 or older who were free of dementia and recruited from the Einstein Aging Study. Chronic pain was defined as pain over the last 3 months, that was moderate or severe (minimum rating of 4 out of 10) most, or all of the time. Hippocampal subfield volumes were estimated using FreeSurfer software. We modeled the association between chronic pain and hippocampal and subfield volume using linear regression. The sample had a mean age of 80 and was 58% female. Chronic pain, present in 55% of the sample, was associated with smaller right and total hippocampal volumes, particularly in women, after adjusting for age, education, and intracranial volume (eTICV). In addition, in women, volume was significantly reduced in participants with chronic pain in right CA2-3 (?=-0.35, p=0.010), right CA4-DG (?=-0.35, p=0.011), left presubiculum (?=-0.29, p=0.030), and left fimbria (?=-0.30, p=0.023). In men, chronic pain was not associated with the volume of any of the hippocampal subfield volumes. Chronic pain in women is associated with a reduction in the volume of right hippocampus and also selected hippocampal subfields. Future studies should clarify the mechanisms underlying the association between regional hippocampal volumes and chronic pain, particularly in women. PMID:24878607
Ezzati, Ali; Zimmerman, Molly E; Katz, Mindy J; Sundermann, Erin E; Smith, Jeremy L; Lipton, Michael L; Lipton, Richard B
OBJECTIVE To evaluate whether assessment of barriers to self-care and strategies to cope with these barriers in olderadults with diabetes is superior to usual care with attention control. The American Diabetes Association guidelines recommend the assessment of age-specific barriers. However, the effect of such strategy on outcomes is unknown. RESEARCH DESIGN AND METHODS We randomized 100 subjects aged ?69 years with poorly controlled diabetes (A1C >8%) in two groups. A geriatric diabetes team assessed barriers and developed strategies to help patients cope with barriers for an intervention group. The control group received equal amounts of attention time. The active intervention was performed for the first 6 months, followed by a “no-contact” period. Outcome measures included A1C, Tinetti test, 6-min walk test (6MWT), self-care frequency, and diabetes-related distress. RESULTS We assessed 100 patients (age 75 ± 5 years, duration 21 ± 13 years, 68% type 2 diabetes, 89% on insulin) over 12 months. After the active period, A1C decreased by ?0.45% in the intervention group vs. ?0.31% in the control group. At 12 months, A1C decreased further in the intervention group by ?0.21% vs. 0% in control group (linear mixed-model, P < 0.03). The intervention group showed additional benefits in scores on measures of self-care (Self-Care Inventory-R), gait and balance (Tinetti), and endurance (6MWT) compared with the control group. Diabetes-related distress improved in both groups. CONCLUSIONS Only attention between clinic visits lowers diabetes-related distress in olderadults. However, communication with an educator cognizant of patients’ barriers improves glycemic control and self-care frequency, maintains functionality, and lowers distress in this population.
Objectives To define the prevalence and correlates of depression among olderadults receiving assessments by nonmedical community-based care managers at the point of entry to care and thus prior to provision of aging services. Our long-term goal is to inform development of collaborative care models for late life depression that incorporate Aging Services Providers. Methods Aging Services Provider Network (ASPN) clients receiving in-home assessments were administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition module for affective disorders and measures of depression symptom severity, alcohol use, physical health, functional status, social support, stressful life events, and religiosity. Engagement in mental healthcare was documented. Results Subjects (N = 378) were primarily white (84%) and women (69%) with household incomes under $1,750/month (62%). Half lived alone (48%). Their mean age was 77 years. Thirty-one percent had clinically significant depressive symptoms and 27% met criteria for a current major depressive episode, of which 61% were being treated with medication and 25% by a mental health provider. Nearly half (47%) had experienced one or more episodes of major depression during their lives. Disability, number of medical conditions, number and severity of recent stressful life events, low social support, and low religiosity were independently associated with current major depression. Conclusion Depressive illness was common among this sample of ASPN clients. Because ASPN care managers have expertise in managing many of the problems correlated with depression, they may play a significant role in identifying, preventing, and collaborating in the treatment of depressive illnesses among community-dwelling olderadults.
Richardson, Thomas M.; Friedman, Bruce; Podgorski, Carol; Knox, Kerry; Fisher, Susan; He, Hua; Conwell, Yeates
Hypertension is one of the most preventable chronic conditions. Improving hypertension awareness is a critical first step to reducing morbidity and mortality from hypertension in the elderly, yet the factors associated with hypertension awareness in China are poorly understood. The objective of this paper is to examine the extent to which older Chinese adults are aware of their hypertension, and factors associated with this awareness. We included 2404 adults aged 60?years or older clinically identified as hypertensive from panel data surveyed in 1997, 2000, 2004, and 2006 as part of the China Health and Nutrition Survey. Comparing this data with respondents’ self-reported diagnosis of hypertension enabled us to characterize hypertension awareness. Covariates included socio-demographic, health status, functional disability, and behavioral factors. Generalized estimating equations were used to identify factors for hypertension awareness. We found 22.9% in 1997 and 42.7% in 2006 of study participants were aware of their hypertensive status. Lower awareness was found among those who lived in rural areas [odds ratio (OR)?=?0.64, 95% Confidence Interval (CI), 0.47–0.88]. Higher awareness was noted for persons who were aware of their hypertensive status in a previous survey wave (OR?=?7.43, 95% CI, 5.45–10.13), had high income (OR?=?1.55, 95% CI, 1.05–2.28), had stage two hypertension (OR?=?2.28, 95% CI, 1.69–3.06), had acute condition (OR?=?2.54, 95% CI, 1.89–3.42), and had greater activities of daily living limitations (OR?=?1.24, 95% CI, 1.08–1.43). Studying dynamics of hypertension awareness can help inform both clinical and public health approaches to improve healthcare.
Ahn, SangNam; Smith, Matthew Lee; Cho, Jinmyoung; Bailey, James E.; Ory, Marcia G.
Background Previous studies suggest that the ?4 and ?2 alleles of apolipoprotein E (APOE) may be associated with decreased and increased risks of CKD, respectively, but there are limited data in olderadults. We evaluated the associations of apolipoprotein E alleles with kidney function among olderadults in the cardiovascular health study (CHS). Methods Caucasian participants had APOE allelic analysis and serum creatinine and cystatin C measured at baseline (n = 3,844 for cross sectional analysis) and in follow up (n = 3,226 for longitudinal analysis). APOE variation was evaluated as an additive model with number of ?2, ?3 and ?4 alleles. GFR was estimated using the CKD epidemiology equation (eGFRcreat) and the cystatin C demographic equation (eGFRcys). The primary outcome was CKD defined by eGFR < 60 ml/min/1.73 m2. The secondary outcome was rapid progression defined by annual loss of eGFR > 3 ml/min/1.73 m2. Results Mean eGFRcreat was 72 ml/min/1.73 m2 (25% CKD). Compared with the ?3 allele, the APOE ?4 allele was associated with reduced risk of CKD by eGFRcreat: unadjusted odds ratio (OR) and 95% confidence interval (CI) 0.79 (0.67 – 0.93) per allele, fully adjusted OR (95% CI) 0.80 (0.68 – 0.96) per allele. Results were consistent using eGFRcys. There was no association of the ?2 allele with CKD or between the apolipoprotein E gene with rapid progression. Conclusions The apolipoprotein ?4 allele was associated with lower odds of CKD in elderly Caucasian individuals. Future research should confirm these findings in other races and explore mechanisms to explain these results.
Seshasai, Rebecca Kurnik; Katz, Ronit; de Boer, Ian H.; Siscovick, David; Shlipak, Michael G.; Rifkin, Dena E.; Sarnak, Mark J.
Background The impact of abnormal spirometric findings on risk for incident heart failure among olderadults without clinically apparent lung disease is not well elucidated. Methods We evaluated the association of baseline lung function with incident heart failure, defined as first hospitalization for heart failure, in 2125 participants of the community-based Health, Aging, and Body Composition Study (age, 73.6±2.9 years; 50.5% men; 62.3% white; 37.7% black) without prevalent lung disease or heart failure. Abnormal lung function was defined either as forced vital capacity (FVC) or forced expiratory volume in 1st second (FEV1) to FVC ratio below lower limit of normal. Percent predicted FVC and FEV1 were also assessed as continuous variables. Results During follow-up (median, 9.4years), heart failure developed in 68 of 350 (19.4%) participants with abnormal baseline lung function, as compared to 172 of 1775 (9.7%) participants with normal lung function (hazard ratio [HR], 2.31; 95% confidence interval [CI], 1.74-3.07; P<.001). This increased risk persisted after adjusting for previously identified heart failure risk factors in the Health ABC Study, body mass index, incident coronary heart disease, and inflammatory markers (HR, 1.83; 95% CI, 1.33-2.50; P<.001). Percent predicted (%) FVC and FEV1 had a linear association with heart failure risk (HR, 1.21; 95%CI, 1.11-1.32 and 1.18; 95%CI, 1.10-1.26, per 10% lower %FVC and %FEV1, respectively; both P<.001 in fully adjusted models). Findings were consistent in sex and race subgroups, and for heart failure with preserved or reduced ejection fraction. Conclusions Abnormal spirometric findings in olderadults without clinical lung disease are associated with increased heart failure risk.
Georgiopoulou, Vasiliki V.; Kalogeropoulos, Andreas P.; Psaty, Bruce M.; Rodondi, Nicolas; Bauer, Douglas C.; Butler, Abida B.; Koster, Annemarie; Smith, Andrew L.; Harris, Tamara B.; Newman, Anne B.; Kritchevsky, Stephen B.; Butler, Javed
Bone fractures affecting elderly people are a true public health burden, because they represent one of the most important causes of long-standing pain, functional impairment, disability, and death among this population. Compromised bone strength (osteoporosis) and falling, alone, or more frequently in combination, are the two independent and immediate risk factors of elderly people's fractures through which all the other, more distant risk factors, such as aging, inactivity, poor nutrition, smoking, use of alcohol, diseases, medications, functional impairments, and disabilities, operate. Of these two, falling, not osteoporosis, is the strongest single risk factor for a fracture. The most usual occurrence resulting in a fracture of an olderadult is a 'simple' fall from standing height or less. Although in general terms this type of trauma is mild or moderate only (compared with, for example, motor vehicle collisions), to the specific injury site these traumas are high-impact injuries often creating forces clearly exceeding the breaking strength of the bone. Therefore, fractures affecting elderly people should be called 'fall-induced high-impact injuries' instead of the commonly used, partly misleading terms of osteoporotic fractures or minimal-trauma fractures. Prevention of elderly people's fractures consists of prevention of osteoporosis and of falling, and prevention of fractures using injury-site protection. Concerning osteoporosis, maximizing peak bone mass and preventing bone loss by regular exercise, calcium, and vitamin D, and, treatment of established osteoporosis with bone-specific drugs, have a strong scientific basis. In fall prevention, regular strength and balance training, reducing psychotropic medication, and diet supplementation with vitamin D and calcium have been shown to be effective. The multifaceted risk factor-assessing and modifying interventions have also been successful in preventing falls among the olderadults by simultaneously affecting many of the risk factors of falling. Finally, concerning injury-site protection, padded strong-shield hip protectors whose effectiveness is scientifically proven seem to be a promising option in preventing hip fractures. PMID:16019730
Kannus, Pekka; Uusi-Rasi, Kirsti; Palvanen, Mika; Parkkari, Jari
Examined preferences for physical design characteristics of group living facilities of 229 congregate apartment residents, 205 older community residents, and 44 experts. Found that older groups of subjects had similar physical design preferences, whereas experts preferred more physical features than did olderadults. (Author/NB)
Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined olderadults' perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men (N = 55), ages 65 to 74 in South Carolina. Constant comparison methods…
Price, Anna E.; Corwin, Sara J.; Friedman, Daniela B.; Laditka, Sarah B.; Colabianchi, Natalie; Montgomery, Kara M.
Olderadults (age 50?+?) are less likely to be tested for HIV and are diagnosed at a later disease stage than younger individuals. To examine the barriers and facilitating factors to testing in this age group, interview data from 35 older men and women who tested HIV positive at age 50 or older were analysed. Participants described a variety of
Helen-Maria Lekas; Eric W. Schrimshaw; Karolynn Siegel
Identified two subdimensions of an index designed to measure children's perceptions of olderadults in responses from 120 Afro-Caribbean children living in a rural Costa Rican community. Findings showed older females were perceived as more authoritative and older males as more affective. Used ethnographic techniques with survey results to…
This study explores the relationship between the life satisfaction of olderadults and the social support from grandchildren in Hong Kong. Two hundred and fifteen older people (from the ages of 64 to 101, mean age 79.3), whose youngest grandchild was aged 12 or older, were recruited from elderly service agencies to participate in the study.…
Purpose: The objective of this study is to develop an instrument to evaluate satisfaction with care for olderadults in capitated environments. Although satisfaction with care is now widely accepted as an important outcome measure, there are relatively few satisfaction measures developed or validated on older persons. Because many older persons…
Studies of face recognition in olderadults (60 years of age and older) report increases in false alarms over younger adults (usually 18-30 years of age), but no age differences in hits. To examine this phenomenon, we compared older and younger adults in categorical perception of faces. We hypothesized that face representations in olderadults would be broadly tuned, resulting in overlapping representations, manifested by a shallower slope in identity categorization than in younger adults, and age-related reductions in the advantage for between-categories, as compared with within-category, face discrimination. We morphed faces to change linearly from one identity to another. We used familiar or unfamiliar faces in separate conditions to examine the role of familiarity. Categorical perception was assessed in an identity-classification task and a discrimination task. Olderadults showed a shallower slope and poorer discrimination compared with younger adults, and both groups exhibited better performance with familiar than unfamiliar faces. Enhanced discriminability for between-categories as compared with within-category faces was seen for both familiar and unfamiliar faces in younger adults, but only for familiar faces in olderadults. The more broadly tuned representations of unfamiliar faces in olderadults may lead to misidentification and greater false alarms for unfamiliar faces, but not for familiar faces. PMID:24490946
BACKGROUND: This study represents the first attempt to perform a profiling analysis of the intergenerational differences in the microRNAs (miRNAs) of primary cutaneous melanocytic neoplasms in young adult and older age groups. The data emphasize the importance of these master regulators in the transcriptional machinery of melanocytic neoplasms and suggest that differential levels of expressions of these miRs may contribute
Drazen M Jukic; Uma N. M. Rao; Lori Kelly; Jihad S Skaf; Laura M Drogowski; John M Kirkwood; Monica C Panelli
Prior research has examined whether parenthood is associated with higher levels of well-being among olderadults, but definitions of parental status have varied. The authors examine links between parental status and depressive symptoms among olderadults, comparing biological and social definitions of parenthood. The study finds few differences…
Bures, Regina M.; Koropeckyj-Cox, Tanya; Loree, Michael
This article reports on a study that investigated the role of cognitive resources in the everyday functioning of 121 olderadults who were visually impaired and 150 sighted olderadults, with a mean age of 82 years. Cognitive performance and everyday functioning were most strongly related in the group who were visually impaired. The authors…
This study sought to identify the psychiatric, physical, and social services needs experienced by olderadults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five olderadults with SMI were recruited from a community mental health center to participate in the…
Despite the number of publications concerning legal and ethical issues faced by psychologists, and despite the increased interest in addressing specific concerns related to aging, little is known about the actual beliefs and practices of psychologists when they work with olderadults. Given the changing demographics in the United States, many mental health professionals will have contact with olderadult
Olderadults in the US are the fastest-growing demographic, and also the largest-growing group of internet users. The aim of this research was to evaluate websites designed for olderadults in terms of (1) how well they adhere to "senior-friendly" guidelines and (2) overall ease of use and satisfaction. In Experiment I, 40 websites designed for…
Perceptions of, adaptations to, and use of the dwelling environment were examined in relation to time lapse following relocation of idependent olderadults. Objectives of the study were based on the assumption that length of time, after relocation to an apartment expressly designed for the olderadult, would have no effect on space use or attitudes concerning the new dwelling.
To investigate whether processing fluency or cognitive control processes underlie aging-related positivity effects in memory, we compared retrieval of words on a fluency task, and of events on an autobiographical task, in younger and olderadults. No positivity effect in word output was found on the fluency task, though olderadults output more neutral words. For our autobiographical task, participants
This study in Spain explored three aspects of olderadult volunteering (motivations, satisfaction, and perceptions of benefits and drawbacks) and examines to what extent these aspects are influenced by the type of organization and other factors (sociodemographic variables and level of volunteering). The sample consisted of 88 olderadults…
Effective strategies that bring health promotion messages to olderadults in a developing country are needed. To evaluate the impact of various education media upon changes in knowledge and health behavior, a double-blind, randomized controlled trial was conducted involving 1,268 olderadults in a southwest Bangkok suburb. Group teaching…
Objectives: To investigate the evacuation needs and beliefs of olderadults in 2 counties in Georgia; to identify health risk factors; and to provide public health and emergency management officials with planning information. Design: A descriptive survey using The OlderAdult Disaster Evacuation Assessment. Sample: 139 lower socioeconomic participants at congregate meal sites. Results: Hurricane Katrina significantly influenced decisions to
Marlene M. Rosenkoetter; Eleanor Krassen Covan; Brenda K. Cobb; Sheila Bunting; Martin Weinrich
Purpose: We estimate the independent contribution of crime victimization to nursing home placement in a cohort of olderadults who were community dwelling at baseline. Design and Methods: The data come from an observational cohort study of 2,321 community-residing olderadults who were members of the New Haven Established Populations for…
Lachs, Mark; Bachman, Ronet; Williams, Christianna S.; Kossack, Alice; Bove, Carolyn; O'Leary, John R.
This study examined the relative contribution of physical conditions, functional health, and financial adequacy to mental health status of the Chinese olderadults in Hong Kong. A total of 554 olderadults aged 70 and over (mean age = 77.0, SD =5.4) participated in the present study. The data were collected through individual interviews with the use of a standardized
This study aimed to describe the benefits of memory training for olderadults with low education. Twenty-nine healthy olderadults with zero to two years of formal education participated. Sixteen participants received training based on categorization (categorization group = CATG) and 13 received training based on mental images (imagery…
da Silva, Henrique Salmazo; Yassuda, Monica Sanches
This article reports on a project to sensitize graduate social work students taking courses in substance abuse to the needs of olderadults. Graduate social work students at a major urban school of social work in the Northeast were recruited and trained to interview olderadults with a history of substance abuse problems regarding their life…
Bial, Martha C.; Gutheil, Irene A.; Hanson, Meredith; White-Ryan, Linda
Comparatively little research has been conducted regarding the smart technology needs of the olderadult population despite the proliferation of smart technology prototypes. The purpose of this study was to explore the perceived smart technology needs of olderadults with mobility impairments while using an ethnographic research approach to…
The purpose of this study was to address factors related to caregiver burnout as a result of caring for an olderadult with a chronic disease. Characteristics of care recipients and caregivers as well as social support were included to identify the relationships with caregiver burnout. The analysis was based on a sample of 334 olderadults and…
Purpose: Age-related loss and atrophy of fast-twitch mus- cle fibers was associated with decline in explosive force pro- duction (EFP). Strength training with explosive and rapid muscle contractions has shown promise for increasing EFP in olderadults. Current exercise recommendations for untrained olderadults from the American College of Sports Medicine and Surgeon General do not include such activities. Using
James W. Bellew; J. W. Yates; David R. Gater; Jody Clasey; Physiology Lab
Complaints of xerostomia and salivary hypofunction are common in olderadults. However, recent studies reported that dehydration-induced salivary hypofunction caused fewer xerostomic complaints in older compared with young adults. This may predispose olderadults to developing oral problems that will subsequently not receive attention from health care providers. Since many medications are known to inhibit salivation, this study attempted to determine if an anticholinergic drug (glycopyrrolate) had a differential effect on xerostomic complaints in young vs. olderadults. Eighteen young (age 20-38 yrs) and 18 older (age 60-77 yrs) healthy adults were given a 4.0 micrograms/kg dose of i.v. glycopyrrolate. For 6 hrs after drug administration, stimulated parotid salivary flow was collected, and an eight-item Visual Analogue Scale (VAS) subjective xerostomia test was given. At several time points post-i.v. glycopyrrolate, salivary flow rates were consistently lower in older compared with young adults. For some measures of xerostomic complaint (time to first complaint; time to maximum complaint; mean maximum complaint), there were no age-related differences for all VAS items. However, a trend for increased xerostomic complaints in olderadults was demonstrated (time to recovery; total duration of complaint; number xerostomic at 6 hrs). These findings suggest that, given equal doses of an anti-sialogogue, salivary hypofunction is greater in healthy olderadults, while increased complaints of xerostomia are not as consistent. PMID:11803641
The goal of this study was to determine how HIV and AIDS risk was framed in newspaper coverage of olderadults. A content analysis was performed on articles published from 1989 to 2005 in urban newspapers. The findings were then compared with relevant information on the actual risks facing olderadults. The results indicate a discrepancy in coverage between articles,
This article provides an overview of current challenges in the diagnosis and treatment of depressed olderadults in primary care and considers suggestions for clinicians, researchers, and policy makers to improve care for this population. Despite the enormous toll of depression on individuals and society and the availability of effective treatments, depressed olderadults remain largely untreated or undertreated. They
This pilot study investigated the willingness of two generational cohorts (current baby boomers and olderadults) to accept home monitoring technology. Thirty individuals (15 baby boomers and 15 olderadults) of both genders and living in the community participated in structured, mixed methods interviews. The participants' opinions and views on various technologies (e.g., personal emergency response systems, fall detection systems)
Alex Mihailidis; Amy Cockburn; Catherine Longley; Jennifer Boger
A study was conducted to assess the educational needs of olderadults residing in McCook Community College's service area. A questionnaire focusing on respondents' interest in courses on financial management skills, employment needs, health and health care, social interaction, and self-esteem was administered to 150 olderadults. The sample…
This article examines the contribution of olderadults as co-researchers to the evaluation of a gerontological social work course. The evaluation was conducted at an Israeli college as part of a collaborative project with a United Kingdom university. Here, we follow the olderadults who are service users through their transition to the role of…
Physical inactivity is a health issue with serious consequences for olderadults. Investigating physical activity promotion within a multi-theoretical approach may increase the predictive strength of physical activity determinants and facilitate the development and implementation of effective interventions for olderadults. This article examines…
Grodesky, Janene M.; Kosma, Maria; Solmon, Melinda A.
BACKGROUND: For olderadults, hospitalization frequently results in deterioration of mobility and function. Nevertheless, there are little data about how olderadults exercise in the hospital and definitive studies are not yet available to determine what type of physical activity will prevent hospital related decline. Strengthening exercise may prevent deconditioning and Pilates exercise, which focuses on proper body mechanics and
Laurie H Mallery; Elizabeth A MacDonald; Cheryl L Hubley-Kozey; Marie E Earl; Kenneth Rockwood; Chris MacKnight
The purpose of this study was to examine whether executive dysfunction differentially impacts list-learning and story recall tasks in a sample of olderadults referred for suspected cognitive impairment. Olderadults (N = 61) with mild cognitive impairment (MCI) or probable mild dementia, and those who did not meet criteria for diagnosis of dementia, were assessed using measures of executive function and
Brian L. Brooks; Linda E. Weaver; Charles T. Scialfa
Alcohol misuse increases risk of suicidal behavior in olderadults. The Depressive Symptom Inventory-Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for olderadults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061)…
Ribeiro, Jessica D.; Braithwaite, Scott R.; Pfaff, Jon J.; Joiner, Thomas E.
The authors examined the ability of olderadults to modify their search strategies to detect changes in dynamic displays. Olderadults who made few eye movements during search (i.e., covert searchers) were faster and more accurate compared with individuals who made many eye movements (i.e., overt searchers). When overt searchers were instructed to adopt a covert search strategy, target detection
Cognitive decline is common in olderadults, even in the absence of significant medical or neurological conditions. Recent work implicates serum levels of brain-derived neurotrophic factor in age-related cognitive decline, though no study has directly examined this possibility. A total of 35 olderadults without neurological history underwent fasting blood draw and completed a brief neuropsychological test battery during a
John Gunstad; Andreana Benitez; Joseph Smith; Ellen Glickman; Mary B. Spitznagel; Thomas Alexander; Judi Juvancic-Heltzel; Leigh Murray
Constipation is a major complaint of olderadults. Approximately 30% of olderadults use laxatives at least once weekly, and laxatives account for 1% of physician prescriptions in addition to approximately 700 over-the-counter preparations. This study evaluated the efficacy of a fiber and fluid nursing intervention on the maintenance of bowel movements and elimination aid withdrawal in residents of a
Lorraine Rodrigues-Fisher; Cheryl Bourguignon; Barbara Vonthron Good
Objectives: To develop strategies to recruit and retain inactive olderadults into a physical activity pro- gram. Methods: Names of 7378 olderadults were obtained from 60 neigh- borhoods. Then, 6401 potential subjects were matched to tele- phone numbers and phoned. Sub- jects meeting the screening crite- ria were invited to join the program (n = 4209). Walk leaders and
Jonine Jancey; Peter Howat; Andy Lee; Ann Clarke; Trevor Shilton; John Fisher; Helena Iredell
The circadian sleep-wake rhythm changes with aging, resulting in a more fragmented sleep-wake pattern. In individuals with intellectual disabilities (ID), brain structures regulating the sleep-wake rhythm might be affected. The aims of this study were to compare the sleep-wake rhythm of olderadults with ID to that of olderadults in the general…
Maaskant, Marijke; van de Wouw, Ellen; van Wijck, Ruud; Evenhuis, Heleen M.; Echteld, Michael A.
Both obesity and aging increase intrahepatic fat (IHF) content, which leads to nonalcoholic fatty liver disease (NAFLD) and metabolic abnormalities such as insulin resistance. We evaluated the effects of diet and diet in conjunction with exercise on IHF content and associated metabolic abnormalities in obese olderadults. Eighteen obese (BMI ?30 kg\\/m2) older (?65 years old) adults completed a 6-month
Krupa Shah; Abby Stufflebaum; Tiffany N. Hilton; David R. Sinacore; Samuel Klein; Dennis T. Villareal
Purpose: To establish the range of talker variability for vowel intelligibility in clear versus conversational speech for olderadults with hearing loss and to determine whether talkers who produced a clear speech benefit for young listeners with normal hearing also did so for olderadults with hearing loss. Method: Clear and conversational vowels…
Interest in civic engagement focused on the natural environment has grown dramatically, as has the population of olderadults. Our article explores the potential for increased environmental volunteerism among olderadults to enrich the lives of volunteers while benefitting the community and environmental quality. Curiously, this convergence has…
Bushway, Lori J.; Dickinson, Janis L.; Stedman, Richard C.; Wagenet, Linda P.; Weinstein, David A.
Background: Physical inactivity is a primary contributor to decreasing functional physical fitness and increasing chronic disease in olderadults. Purpose: This study assessed the health-related benefits of ExerStart for Lay Leaders, a 20-week, community based, peer-led, low-impact exercise program for olderadults. ExerStart focuses on aerobic…
As people age, they naturally experience sensory, perceptual, and cognitive changes. Many of these changes necessitate adaptations in designing programs for olderadults. Choral singing is an activity that has many potential benefits for olderadults, yet the rehearsal environment, presentation style, and content of material presented may need to…
Olderadults (?65 years of age) are particularly vulnerable to influenza illness. This is due to a waning immune system that reduces their ability to respond to infection, which leads to more severe cases of disease. The majority (?90%) of influenza-related deaths occur in olderadults and, in addition, catastrophic disability resulting from influenza-related hospitalization represents a significant burden in
Arnold S. Monto; Filippo Ansaldi; Richard Aspinall; Janet E. McElhaney; Luis F. Montaño; Kristin L. Nichol; Joan Puig-Barberà; Joe Schmitt; Iain Stephenson
Physical self-concept plays a central role in olderadults' physical health, mental health and psychological well-being; however, little attention has been paid to the underlying dimensions of physical self-concept in the elderly. The purpose of this study was to develop and validate a new measurement for olderadults. First, a qualitative…
Background: Olderadults with Intellectual Disabilities (ID) have an excess disease burden that standard health assessments are designed to detect. Olderadults with ID have a broader concept of health with dimensions of well being in addition to absence of disease in line with the World Health Organization's health definition. We sought to…
An intergenerational initiative was developed and implemented to enhance gerontology in the first course of the practice sequence. Seventeen students met with olderadults (ages 82-98) in the classroom and at an assisted living facility. The evaluation of this olderadult infusion project was conducted through two questionnaires and by the review…
BACKGROUND: Many olderadults with dementia require constant assistance from a caregiver when completing activities of daily living (ADL). This study examines the efficacy of a computerized device intended to assist people with dementia through ADL, while reducing caregiver burden. The device, called COACH, uses artificial intelligence to autonomously guide an olderadult with dementia through the ADL using audio
Alex Mihailidis; Jennifer N Boger; Tammy Craig; Jesse Hoey
Investigated older (N=98) and younger (N=116) persons' responsibility attributions for the cause and solution to a memory problem. Results indicate that both the age of the help-seeker and the problem type affected attributions. An olderadult was perceived as less responsible than a younger adult for a memory problem. (RJM)
This paper reports current progress on a project that aims to find the factors that play an important role in motivating olderadults to maintain a physical exercise routine, a habit recommended by doctors but difficult to sustain. Our initial data gathering includes an interview with an expert in aging and physical therapy, and a focus group with olderadults
An increasing number of olderadults are using computers for communication, entertainment, and information. This descriptive study examined the perceived benefits and barriers encountered by 58 olderadults. Benefits of computer use listed by these elders included a sense of connectedness, satisfaction, utility, and positive learning experiences. Barriers included frustration, physical and mental limitations, mistrust, and time issues. Professionals who
Purpose of the Study: To identify needs encountered by olderadult patients after hospital discharge and assess the impact of a telephone transitional care intervention on stress, health care utilization, readmissions, and mortality. Design and Methods: Olderadult inpatients who met criteria for risk of post-discharge complications were…
Altfeld, Susan J.; Shier, Gayle E.; Rooney, Madeleine; Johnson, Tricia J.; Golden, Robyn L.; Karavolos, Kelly; Avery, Elizabeth; Nandi, Vijay; Perry, Anthony J.
The purpose of this qualitative study was to explore the experiences of olderadult dislocated workers who participated in community college non-credit workforce training programs. The research questions guiding the study were: (a) what are the experiences of olderadult dislocated workers who attend community college non-credit workforce…
Although maladaptive and compulsive behaviors are increasingly well-described in young persons with Prader-Willi syndrome, it is unclear how these problems manifest in olderadults with this syndrome. In Part I, I compared maladaptive and compulsive behaviors in 45 olderadults with Prader-Willi syndrome (ages 30 to 50 years) to 195 children,…
The purpose of this study was to evaluate an experiential learning project with BSW students to see if their perceptions of olderadults have changed. The project consisted of an oral history project and presentation that matched BSW students with olderadults from diverse ethnic backgrounds to gather their immigration narratives. The study used a…
Human services educators must address the issue of students' bias toward olderadults to encourage interest and meet the growing need for professionals in the field. The use of literature can challenge students' preconceptions of olderadults while innovative teaching methods can guide their development of more tolerant views and introduce them to…
Tice, Carolyn J.; Harnek Hall, Diane M.; Miller, Shari E.
Using the stress and coping model, this article explores how olderadults prepared for and coped with the aftermath of Hurricane Katrina. Interviews with a sample of 122 displaced adults, 60 years of age or older, provided insights regarding the daily hassles they faced that included securing basic resources, facing communication difficulties, and finding transportation. Positive thinking, modified thinking, staying
Tammy L. Henderson; Karen A. Roberto; Yoshinori Kamo
This demonstration presents a storytelling application specif- ically designed for olderadults to share stories and thoughts. Studies claim that olderadults commonly have diculties in engaging with on- line social networks (1), but increased social inclusion and sense of well- being has been observed in those who engage (2). While following a user-centered design approach, we have developed an
Tiago Boldt Sousa; Pedro Tenreiro; Paula Alexandra Silva; Eduarda Mendes Rodrigues
Although podiatrists treat a large number of olderadults, few studies have examined podiatry students' attitudes to treating them. Using data from a nationally representative random sample of podiatry students (n = 528), a theoretical model was tested that examined the impact on the level of expected satisfaction from treating olderadults in terms of: students' perceptions of the effectiveness
Despite the growing proportion of olderadults in the population, ageism is prevalent and can facilitate discriminatory behavior, even in healthcare settings. This study used multiple regression to investigate the relationship between knowledge of aging, aging anxiety, and degree of olderadult contact with ageism in undergraduates training for…
This study was performed to identify the patterns and mechanisms of the development of personal strength of bereaved olderadults over a 4-year period after spousal death. The findings showed that while bereaved olderadults, on average, experienced a moderate level of personal strength at 6 months post-spousal death with a slight increase over a…
Kim, Su Hyun; Kjervik, Diane; Belyea, Michael; Choi, Eun Sook
The hypothesis that source monitoring in olderadults is specifically related to frontal lobe function was tested. In a fame-judgment task, olderadults' ability to monitor the source of name familiarity was independent of their short-term recognition ability. Source errors were not related to performance on the Wisconsin Card Sorting Test, a psychometric index of frontal function, or to the
This paper presents a comprehensive literature review to investigate whether and why olderadults accept handheld computers, and how to design elderly-friendly handheld computers. Findings about acceptance, input devices, menu and functions, and output devices are summarized. First, olderadults were under social pressure to use mobile phones, but they had low acceptance of advanced functions. Also, they had a
Background: The importance of maintaining strength in olderadults is well documented and various training modalities have been recommended; however, the effectiveness of various interventions with high translation to public health practice has not been completely characterized. Additionally, the interrelations among mode, strength, and lower extremity physical function (LEPF) changes in olderadults warrant further investigation. Purpose: The primary aims
Mark M. Misic; Rudy J. Valentine; Karl S. Rosengren; Jeffrey A. Woods; Ellen M. Evans
Gardening is a moderate intensity physical activity for olderadults. Thus, health benefits are possible, however, body positions while gardening, such as stooping, kneeling, and squatting, may be uncomfortable. The purpose of this study was to characterize both the type of gardening tasks done by olderadults and their body positions while performing the tasks so that safe and effective
Risk factors for serious suicidal behavior among olderadults were examined in a case control study of adults aged 55 and older who died by suicide or made suicide attempts and who were compared with randomly selected comparison subjects. Multivariate analyses suggested that mood disorders were the most significant risk factor for suicidal…
Compared the effect of vocalization on the daily motor performance of 13 young and 13 olderadults. Results suggest that vocalization improves motor performance. The study design has clinical potential that may be used for facilitating task-related motor performance of olderadults. (Contains 45 references.) (JOW)
Maitra, K. K.; Curry, D.; Gamble, C.; Martin, M.; Phelps, J.; Santisteban, M. E.; Slattery, E.; Thomas, J.; Telage, K. M.
Administrators of olderadult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of olderadult-centered facilities. As identified by administrators, the predominant barriers to the…
A music therapy strategy for depressed olderadults involves eight music-listening programs facilitated by a music therapist for use in the home environment. Body relaxation, imagery, stimulation, and sleep enhancement are included in these programs that use music to cue relaxation and positive thinking. Four case studies describing successful application of this approach to olderadults with depression and\\/or anxiety
The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project II is an intervention study to promote the maintenance of both exercise and healthful eating in olderadults. It is the second phase of an earlier study, SENIOR Project I, that originally recruited 1277 community-dwelling olderadults to participate in behavior-specific interventions designed to increase exercise and\\/or fruit
Phillip G. Clark; Bryan J. Blissmer; Geoffrey W. Greene; Faith D. Lees; Deborah A. Riebe; Karen E. Stamm