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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…
Numerosity estimation, the rapid assessment of the number of items in a visual scene, is historically inaccurate. We assessed whether providing feedback regarding the correct numerosity on either 0%, 50%, or 100% of the trials would affect younger and olderadults' estimation accuracy for randomized, clustered (i.e., groups of 3 or 7 dots), and stacked (i.e., column) dot formats. Participants provided estimates and confidence ratings in six blocks, each containing 48 trials (16 numerosities shown in each format). Feedback frequency was manipulated between participants during blocks 1-4; no feedback was provided during blocks 5 and 6, which contained old and new numerosities and previously estimated presentations rotated 90°. Estimation accuracy was age equivalent across blocks despite younger adults initially being more accurate than olderadults. Feedback improved both age groups' accuracy. Stacked presentations were most accurately estimated but were more likely to be over-estimated than clustered and randomized presentations. Olderadults gave lower confidence ratings than younger adults despite both age groups showing increased confidence across blocks, for more structured presentation formats, and as feedback frequency increased. These results expand our understanding of the role of presentation format and feedback in producing age equivalence or age-related differences in numerosity estimation. PMID:23600695
Price, Jodi; Clement, Lindsey M; Wright, Barbara J
An 84 year old woman with history of moderate Alzheimer's disease, depression, and an anxiety disorder presented to our emergency room at Victoria Hospital, London, Ontario in an 'unresponsive' state. The patient was akinetic with mutism, and clonic perseveration induced in the upper limbs was evident while she was examined. Heart attack, massive stroke, or intracranial bleed were ruled out, and an electroencephalogram showed no epileptiform activity. Despite a normal CT, a magnetic resonance scan was ordered and showed bilateral acute paramedian thalamogeniculate infarction arising from occlusion of the artery of Percheron. Bilateral thalamic infarcts can cause sudden onset of akinetic mutism with clonic perseveration, which may be confused with coma and seizures due to life threatening conditions such as a massive stroke. Thorough clinical assessment and early use of MRI scanning will assist physicians with a more accurate diagnosis of olderadults with this kind of presentation. PMID:20885123
Wells, Malcolm; Jacques, Rebekah; Montero Odasso, Manuel
... 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.
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
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 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
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.
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
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
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 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
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 ...
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.
... 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 ...
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 olderadultspresenting 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.
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
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
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
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
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.
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
Correlates of late presentation (LP) for HIV infection in Metropolitan France and French overseas departments (FODs) were assessed among HIV-infected patients recently diagnosed, using data from a large cross-sectional survey, representative of the French HIV-infected population, conducted in 2011. LP was defined as presentation with either clinical AIDS events within the calendar year of diagnosis or CD4 < 350/mm(3) and presentation with advanced disease (PAD) was defined as presentation with either clinical AIDS events or CD4 < 200/mm(3). Correlates of LP/PAD were assessed through logistic modelling, separately in Metropolitan France and FODs. In Metropolitan France, 47.7% of participants were late presenters and 29.3% presented with advanced disease. LP was more frequent among male and female migrants from sub-Saharan Africa (SSA; 58.5% and 56.4%) and non-African heterosexual males (61.8%) than among men who have sex with men (34.8%). In FODs, 53.2% of participants were late presenters and 36.8% presented with an advanced disease. LP was more frequent among men than women (60.6% vs. 45.3%) and among those with a lower level of education (56.6% vs. 47.5%). A consistent positive association was found in adjusted analyses between LP/PAD and increasing age at diagnosis among all subpopulations, in both settings. In Metropolitan France, among men who have sex with men, those self-declaring as bisexual were at higher risk of LP/PAD; among non-African heterosexual males and females, religiosity was associated with increased risk of LP/PAD; and among SSA migrants, those diagnosed within the year following their arrival in France were at higher risk of LP/PAD. Older age at diagnosis is a major risk factor for LP/PAD independently of any other socio-demographic characteristics. Promotion of HIV testing should be renewed to target each subgroup at risk while paying a particular attention to middle-aged or olderadults whose attitudes and beliefs towards HIV/AIDS might prevent them from seeking testing. PMID:24731147
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
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
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…
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.
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…
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)
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
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)
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.
... 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 ...
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,
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 ...
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…
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
... 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 ...
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.
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.
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
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
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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
Humans have a tendency to perceive motion even in static images that simply "imply" movement. This tendency is so strong that our memory for actions depicted in static images is distorted in the direction of implied motion--a phenomenon known as representational momentum (RM). In the present study, we created an RM display depicting a pattern of…
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.
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
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.
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
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)
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…
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…
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.
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)
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
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…
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…
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 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.
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.
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…
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
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 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
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…
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
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
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
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
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…
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.
The present research investigated the relationship between sleep and memory in younger and olderadults. Previous research has demonstrated that during the deep sleep stage (i.e., slow wave sleep), recently learned memories are reactivated and consolidated in younger adults. However, little research has examined whether memory consolidation occurs during deep sleep in olderadults. Younger adults and olderadults encoded
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…
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 firstname.lastname@example.org 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
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.
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
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
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.
Olderadults face decreasing motor capabilities due to pervasive neuromuscular degradations. As a consequence, errors in movement control increase. Thus, older individuals should maintain larger safety margins than younger adults. While this has been shown for object manipulation tasks, several reports on whole-body activities, such as posture and locomotion, demonstrate age-related reductions in safety margins. This is despite increased costs for control errors, such as a fall. We posit that this paradox could be explained by the dynamic challenge presented by the body or also an external object, and that age-related reductions in safety margins are in part due to a decreased ability to control dynamics. To test this conjecture we used a virtual ball-in-cup task that had challenging dynamics, yet afforded an explicit rendering of the physics and safety margin. The hypotheses were: (1) When manipulating an object with challenging dynamics, olderadults have smaller safety margins than younger adults. (2) Olderadults increase their safety margins with practice. Nine young and 10 healthy olderadults practiced moving the virtual ball-in-cup to a target location in exactly 2 s. The accuracy and precision of the timing error quantified skill, and the ball energy relative to an escape threshold quantified the safety margin. Compared to the young adults, olderadults had increased timing errors, greater variability, and decreased safety margins. With practice, both young and olderadults improved their ability to control the object with decreased timing errors and variability, and increased their safety margins. These results suggest that safety margins are related to the ability to control dynamics, and may explain why in tasks with simple dynamics olderadults use adequate safety margins, but in more complex tasks, safety margins may be inadequate. Further, the results indicate that task-specific training may improve safety margins in olderadults.
Objectives Research suggests that olderadults display a positivity bias at the level of information processing. However, because studies investigating attentional bias for emotional information in olderadults have produced mixed findings, research identifying inter-individual differences that may explain these inconsistent results is necessary. Therefore, we investigated whether mood, symptoms of depression, symptoms of anxiety and future time perspective are related to attentional bias in olderadults. Method Thirty-seven healthy olderadults and 25 healthy middle-aged adults completed questionnaires to assess mood, symptoms of depression, symptoms of anxiety and future time perspective. Attentional bias towards happy, sad and neutral information was measured using a modified exogenous cueing paradigm with long cue presentations, to measure maintained attention versus avoidance of emotional stimuli. Results Olderadults showed attentional avoidance for all emotional faces, whereas no attentional biases were found in the middle-aged group. Moreover, in the olderadult group, avoidance for negative information was related to anxiety. Future time perspective was unrelated to attentional bias. Discussion These findings suggest that anxiety may lead to inter-individual differences in attentional bias in olderadults, and that avoidance from negative information may be an emotion regulation strategy.
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
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
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.
Objectives When we think of technology-savvy consumers, olderadults are typically not the first persons that come to mind. The common misconception is that olderadults do not want to use or cannot use technology. But for an increasing number of olderadults, this is not true (Pew Internet and American Life Project, 2003). Olderadults do use technologies similar to their younger counterparts, but perhaps at different usage rates. Previous research has identified that there may be subgroups of olderadults, “Silver Surfers”, whose adoption patterns mimic younger adults (Pew Internet and American Life Project, 2003). Much of the previous research on age-related differences in technology usage has only investigated usage broadly -- from a “used” or “not used” standpoint. The present study investigated age-related differences in overall usage of technologies, as well as frequency of technology usage (i.e., never, occasional, or frequent). Methods The data were gathered through a questionnaire from younger adults (N=430) and olderadults (N=251) in three geographically separate and ethnically diverse areas of the United States. Results We found that younger adults use a greater breadth of technologies than olderadults. However, age-related differences in usage and the frequency of use depend on the technology domain. Conclusion This paper presents technology usage and frequency data to highlight age-related differences and similarities. The results provide insights into older and younger adults’ technology-use patterns, which in turn provide a basis for expectations about knowledge differences. Designers and trainers can benefit from understanding experience and knowledge differences.
Presents insights resulting from an inter-generational living/learning project involving university students and olderadults. Techniques are suggested for teaching social sciences with emphasis on the elderly. (Author/DB)
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…
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
An 8-week mindfulness-based cognitive therapy (MBCT) group for olderadults with depression and/or anxiety is described. This article is based on an exploratory study of this therapeutic approach and changes in participants' symptoms associated with participation. Pre-post data from 5 MBCT groups showed significant improvements in reported anxiety, ruminative thoughts, and sleep problems and a reduction in depressive symptoms. Case examples are presented to illustrate these symptom changes. Findings showed that this nonpharmacological intervention is acceptable to olderadults and is associated with positive changes. Suggestions are provided for both practitioners and researchers interested in using MBCT with olderadults. PMID:24329497
Foulk, Mariko A; Ingersoll-Dayton, Berit; Kavanagh, Janet; Robinson, Elizabeth; Kales, Helen C
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.
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 ...
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.
Influenza is associated with substantial morbidity and mortality in adults aged over 65 years. Although vaccination remains the most effective method of preventing influenza and its sequellae, current vaccination strategies provide less protection to olderadults than to younger persons. Influenza vaccination in community-dwelling olderadults is cost-effective, though there is room for improvement. Newer vaccine strategies considered for use in olderadults include alternate routes of administration (intradermal or intranasal), addition of adjuvant, and novel methods of antigen presentation. Measuring cell-mediated immune response to new vaccines in addition to antibody response may correlate better with vaccine efficacy in this population. Whilst pandemic influenza A/H1N1 2009 (pH1N1) has largely spared olderadults, the impact of pH1N1 vaccination has yet to be determined. PMID:20175868
Depression is a common disease among young and olderadults. Although it can be treated, non-adherence is very common among individuals of different ages. The aim of the present paper is to review and summarize research findings regarding depression among young and olderadults, with a special focus on the phenomenon of treatment non-adherence among young and olderadults with depression. The first section of the review focuses on describing the characteristics of depression in young and olderadults. The second section focuses on treatment non-adherence of young and olderadults, the prevalence of this phenomenon, and its consequences. The third section focuses on several factors (illness beliefs, treatment beliefs, self-stigma, and self-esteem) that were identified as having a significant association with treatment non-adherence of individuals with depression, with special attention focused on age differences. Results of the review of the literature reveal that research in the area of depression treatment non-adherence and its predictors among young and olderadults has received, to date, very minor and limited attention. Thus, there is a need to expand the current body of knowledge and promote future interventions geared towards the unique characteristics of depression among young and olderadults, in order to increase their treatment adherence.
Depression is a common disease among young and olderadults. Although it can be treated, non-adherence is very common among individuals of different ages. The aim of the present paper is to review and summarize research findings regarding depression among young and olderadults, with a special focus on the phenomenon of treatment non-adherence among young and olderadults with depression. The first section of the review focuses on describing the characteristics of depression in young and olderadults. The second section focuses on treatment non-adherence of young and olderadults, the prevalence of this phenomenon, and its consequences. The third section focuses on several factors (illness beliefs, treatment beliefs, self-stigma, and self-esteem) that were identified as having a significant association with treatment non-adherence of individuals with depression, with special attention focused on age differences. Results of the review of the literature reveal that research in the area of depression treatment non-adherence and its predictors among young and olderadults has received, to date, very minor and limited attention. Thus, there is a need to expand the current body of knowledge and promote future interventions geared towards the unique characteristics of depression among young and olderadults, in order to increase their treatment adherence. PMID:24307966
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
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
Despite the abundance of research reporting the neurophysiological and behavioral effects of transcranial direct current stimulation (tDCS) in healthy young adults and clinical populations, the extent of potential neuroplastic changes induced by tDCS in healthy olderadults is not well understood. The present study compared the extent and time course of anodal tDCS-induced plastic changes in primary motor cortex (M1) in young and olderadults. Furthermore, as it has been suggested that neuroplasticity and associated learning depends on the brain-derived neurotrophic factor (BDNF) gene polymorphisms, we also assessed the impact of BDNF polymorphism on these effects. Corticospinal excitability was examined using transcranial magnetic stimulation before and following (0, 10, 20, 30 min) anodal tDCS (30 min, 1 mA) or sham in young and olderadults. While the overall extent of increases in corticospinal excitability induced by anodal tDCS did not vary reliably between young and olderadults, olderadults exhibited a delayed response; the largest increase in corticospinal excitability occurred 30 min following stimulation for olderadults, but immediately post-stimulation for the young group. BDNF genotype did not result in significant differences in the observed excitability increases for either age group. The present study suggests that tDCS-induced plastic changes are delayed as a result of healthy aging, but that the overall efficacy of the plasticity mechanism remains unaffected. PMID:24936185
Fujiyama, Hakuei; Hyde, Jane; Hinder, Mark R; Kim, Seok-Jin; McCormack, Graeme H; Vickers, James C; Summers, Jeffery J
Despite the abundance of research reporting the neurophysiological and behavioral effects of transcranial direct current stimulation (tDCS) in healthy young adults and clinical populations, the extent of potential neuroplastic changes induced by tDCS in healthy olderadults is not well understood. The present study compared the extent and time course of anodal tDCS-induced plastic changes in primary motor cortex (M1) in young and olderadults. Furthermore, as it has been suggested that neuroplasticity and associated learning depends on the brain-derived neurotrophic factor (BDNF) gene polymorphisms, we also assessed the impact of BDNF polymorphism on these effects. Corticospinal excitability was examined using transcranial magnetic stimulation before and following (0, 10, 20, 30 min) anodal tDCS (30 min, 1 mA) or sham in young and olderadults. While the overall extent of increases in corticospinal excitability induced by anodal tDCS did not vary reliably between young and olderadults, olderadults exhibited a delayed response; the largest increase in corticospinal excitability occurred 30 min following stimulation for olderadults, but immediately post-stimulation for the young group. BDNF genotype did not result in significant differences in the observed excitability increases for either age group. The present study suggests that tDCS-induced plastic changes are delayed as a result of healthy aging, but that the overall efficacy of the plasticity mechanism remains unaffected.
Fujiyama, Hakuei; Hyde, Jane; Hinder, Mark R.; Kim, Seok-Jin; McCormack, Graeme H.; Vickers, James C.; Summers, Jeffery J.
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.
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
In two experiments testing age differences in the subjective experience of listening, which we call meta-audition, young and olderadults were first trained to learn pairs of semantic associates. Following training, both groups were tested on identification of words presented in noise, with the critical manipulation being whether the target item was congruent, incongruent, or neutral with respect to prior training. Results of both experiments revealed that olderadults compared to young adults were more prone to "false hearing," defined as mistaken high confidence in the accuracy of perception when a spoken word had been misperceived. These results were obtained even when performance was equated across age groups on control items by reducing the noise level for olderadults. Such false hearing is shown to reflect olderadults' heavier reliance on context. Findings suggest that olderadults' greater ability to benefit from semantic context reflects their bias to respond consistently with the context, rather than their greater skill in using context. Procedures employed are unique in measuring the subjective experience of hearing as well as its accuracy. Both theoretical and applied implications of the findings are discussed. Convergence of results with those showing higher false memory, and false seeing are interpreted as showing that olderadults are less able to constrain their processing in ways that are optimal for performance of a current task. That lessened constraint may be associated with decline in frontal-lobe functioning. PMID:22149253
Rogers, Chad S; Jacoby, Larry L; Sommers, Mitchell S
Criminal suspects with distinctive facial features, such as tattoos or bruising, may stand out in a police lineup. To prevent suspects from being unfairly identified on the basis of their distinctive feature, the police often manipulate lineup images to ensure that all of the members appear similar. Recent research shows that replicating a distinctive feature across lineup members enhances eyewitness identification performance, relative to removing that feature on the target. In line with this finding, the present study demonstrated that with young adults (n = 60; mean age = 20), replication resulted in more target identifications than did removal in target-present lineups and that replication did not impair performance, relative to removal, in target-absent lineups. Olderadults (n = 90; mean age = 74) performed significantly worse than young adults, identifying fewer targets and more foils; moreover, olderadults showed a minimal benefit from replication over removal. This pattern is consistent with the associative deficit hypothesis of aging, such that olderadults form weaker links between faces and their distinctive features. Although replication did not produce much benefit over removal for olderadults, it was not detrimental to their performance. Therefore, the results suggest that replication may not be as beneficial to olderadults as it is to young adults and demonstrate a new practical implication of age-related associative deficits in memory. PMID:23150053
Badham, Stephen P; Wade, Kimberley A; Watts, Hannah J E; Woods, Natalie G; Maylor, Elizabeth A
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
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
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
Recent studies suggest that older human immunodeficiency virus (HIV)-infected adults are at particular risk for HIV-associated neurocognitive disorders (HAND), including dementia. Deficits in attention/working memory are posited to play a central role in the development of HAND among olderadults. The aim of the present study was to examine the possible protective benefits of spontaneous strategy use during a visual working memory task in 46 older and 42 younger adults infected with HIV. Results revealed a significant interaction between age and strategy use, with olderadults who used a meta-cognitive strategy demonstrating superior working memory performance versus non-strategy users. This effect was not observed in the younger HIV-infected sample and was not better explained by possible confounding factors, such as education, comorbid medical conditions, or HIV disease severity. Within the older group, strategy use was associated with better executive functions and higher estimated verbal intelligence. Findings from this study suggest that working memory declines in older HIV-infected adults are moderated by the use of higher-level mnemonic strategies and may inform cognitive neurorehabilitation efforts to improve cognitive and everyday functioning outcomes in older persons living with HIV infection.
Woods, Steven Paul; Weber, Erica; Cameron, Marizela V.; Dawson, Matthew S.; Delano-Wood, Lisa; Bondi, Mark W.; Grant, Igor
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.
Among young adults and clinical populations, perceived inability to control internal and external events is associated with anxiety. At present, it is unclear what role perceived anxiety control plays in anxiety among olderadults. The Anxiety Control Questionnaire (ACQ) was developed to assess one's perceived ability to cope with anxiety-related…
Gerolimatos, Lindsay A.; Gould, Christine E.; Edelstein, Barry A.
Recent findings have revealed age-related changes in neural recruitment during the processing of emotional information. The present study examined whether these age-related changes would be more pronounced for words, thought to be processed in a controlled manner versus relatively automatically processed pictures. Compared to young adults, olderadults showed less amygdala activation, and more medial prefrontal cortex (PFC) activation, for
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
Background Depressive symptoms, apathy, and fatigue are common symptoms among medically ill olderadults and patients with advanced disease, and are associated with morbidity and mortality. Methylphenidate has been used to treat these symptoms because of its rapid effect. Objective To review the literature regarding the efficacy and safety of methylphenidate to treat depressive symptoms, apathy, and fatigue in medically ill olderadults and in palliative care. Methods English-language articles presenting systematic reviews, clinical trials, or case series describing use of methylphenidate to treat depressive symptoms, fatigue, or apathy in medically ill olderadults or in palliative care were identified. The keywords “methylphenidate” and either “depressive”, “depression”, “fatigue”, or “apathy” were used to search the Cochrane Database, MEDLINE, PsycINFO, and International Pharmaceutical Abstracts. Included articles addressed depressive symptoms, apathy, or fatigue in 1) olderadults (generally age 65 years or older), particularly those with comorbid medical illness; 2) adult patients receiving palliative care; and 3) adults with other chronic illnesses. We excluded articles regarding 1) treatment of depression in healthy young adults; 2) treatment of bipolar disorder or attention-deficit hyperactivity disorder; and 3) treatment of narcolepsy, chronic fatigue syndrome and related disorders. Results 19 controlled trials of methylphenidate in medically ill olderadults or in palliative care were identified. Unfortunately, their conflicting results, small size, and poor methodologic quality limit our ability to draw inferences regarding the efficacy of methylphenidate, although the evidence of its safety is stronger. The available evidence suggests possible effectiveness of methylphenidate for depressive symptoms, fatigue, apathy, and cognitive slowing in various medically ill populations. Conclusions In the absence of definitive evidence of effectiveness, trials of low-dose methylphenidate in medically ill adults suffering from depression, apathy, or fatigue with monitoring for response and adverse effects are appropriate.
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
PURPOSE In recognition of the impact of chronic diseases on mental health and the lack of research on Asian American subgroups, the present study examined subjective perceptions of health as a potential mediator in the association between diabetes and depressive symptoms in Korean American olderadults. METHODS Multivariate analysis with data from 672 Korean American olderadults in Florida explored the mediation model of health perceptions. RESULTS The presence of diabetes was associated with negative perceptions of health and elevated symptoms of depression. The proposed mediation model was also supported: negative perceptions of health served as an intervening step between diabetes and depressive symptoms. CONCLUSIONS The intervening role of health perceptions yields implications for developing health promotion interventions targeting older individuals with diabetes. Results suggest that even in the presence of chronic health conditions, mental well-being of olderadults can be maintained by having optimistic beliefs and positive attitudes towards their own health.
Jang, Yuri; Park, Nan Sook; Cho, Soyeon; Roh, Soonhee; Chiriboga, David A.
The ability to read and appropriately respond to emotions in others is central for successful social interaction. Young and olderadults are better at identifying positive than negative facial expressions and also expressions of young than older faces. Little, however, is known about the neural processes associated with reading different emotions, particularly in faces of different ages, in samples of young and olderadults. During fMRI, young and older participants identified expressions in happy, neutral, and angry young and older faces. The results suggest a functional dissociation of ventromedial prefrontal cortex (vmPFC) and dorsomedial prefrontal cortex (dmPFC) in reading facial emotions that is largely comparable in young and olderadults: Both age groups showed greater vmPFC activity to happy compared to angry or neutral faces, which was positively correlated with expression identification for happy compared to angry faces. In contrast, both age groups showed greater activity in dmPFC to neutral or angry than happy faces which was negatively correlated with expression identification for neutral compared to happy faces. A similar region of dmPFC showed greater activity for older than young faces, but no brain-behavior correlations. Greater vmPFC activity in the present study may reflect greater affective processing involved in reading happy compared to neutral or angry faces. Greater dmPFC activity may reflect more cognitive control involved in decoding and/or regulating negative emotions associated with neutral or angry than happy, and older than young, faces.
Objective To describe the performance of healthy olderadults on common clinical vestibular tests. Patients Fifty community-dwelling olderadults aged 70 and older, with mean age of 77.2 ± 6.1 years and range of 70 to 95 years. Intervention(s) Clinical vestibular tests, including spontaneous and head-shaking nystagmus, head impulse test (HIT), bucket test of subjective visual vertical, modified Romberg test (MRT), and Dizziness Handicap Inventory (DHI). Main Outcome Measure(s) Prevalence of abnormal vestibular tests and DHI score. Results We observed a 36% and 44% prevalence of abnormal right and left horizontal HIT, respectively. The bucket test was abnormal in 18% of participants; head-shaking nystagmus was present in 2%, and no participant had spontaneous nystagmus. Approximately 68% of participants had abnormal MRT. Abnormal horizontal HIT and MRT were significantly more prevalent among individuals age 80 years and older compared with those age 70 to 79 years (p < 0.05). Mean DHI score was 5.6 ± 11.2, consistent with no self-reported dizziness handicap. Conclusion This study documents the expected performance of normative olderadults on vestibular tests commonly administered in the neurotology clinic. We observed a high prevalence of abnormalities on clinical vestibular testing in healthy olderadults, although self-perceived dizziness handicap was low. Further studies using newly available clinical testing methods (e.g., video HIT) may identify finer gradations of vestibular function in older individuals and the levels of vestibular loss associated with functional impairment.
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
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.
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…
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
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…
Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among olderadults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among olderadults residing in South Carolina. 902 olderadults aged 60 and above participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors.
Cisler, Josh M.; Amstadter, Ananda B.; Begle, Angela M.; Hernandez, Melba; Acierno, Ron
Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among olderadults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among olderadults residing in South Carolina. Olderadults aged 60 and above (N = 902) participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors. PMID:20690195
Cisler, Josh M; Amstadter, Ananda B; Begle, Angela M; Hernandez, Melba; Acierno, Ron
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
Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and olderadults. The purpose of this study was to investigate the differences in foot kinematics between young and olderadults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 olderadults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between olderadults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The olderadults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = <0.001), a smaller sagittal plane range of motion (ROM) of the midfoot (11.9° vs. 14.8°, d = 1.3, p = <0.001) and smaller coronal plane ROM of the metatarsus (3.2° vs. 4.3°, d = 1.1, p = 0.006) compared to the young adults. Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, olderadults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments. PMID:24183676
Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic
To investigate which neural correlates are associated with successful working memory performance, fMRI was recorded in healthy younger and olderadults during performance on an n-back task with varying task demands. To identify functional networks supporting working memory processes, we used independent component analysis (ICA) decomposition of the fMRI data. Compared to younger adults, olderadults showed a larger neural (BOLD) response in the more complex (2-back) than in the baseline (0-back) task condition, in the ventral lateral prefrontal cortex (VLPFC) and in the right fronto-parietal network (FPN). Our results indicated that a higher BOLD response in the VLPFC was associated with increased performance accuracy in olderadults, in both the baseline and the more complex task condition. This ‘BOLD-performance’ relationship suggests that the neural correlates linked with successful performance in the olderadults are not uniquely related to specific working memory processes present in the complex but not in the baseline task condition. Furthermore, the selective presence of this relationship in older but not in younger adults suggests that increased neural activity in the VLPFC serves a compensatory role in the aging brain which benefits task performance in the elderly.
Saliasi, Emi; Geerligs, Linda; Lorist, Monicque M.; Maurits, Natasha M.
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
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
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
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)
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…
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
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.
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
Recruiting olderadults and their family caregivers into research studies presents challenges. Although the literature notes some general recruitment challenges, no studies specifically address the unique challenges of recruiting olderadults who have Alzheimer's Disease (AD) and their family caregivers in studies about delirium or suggest using a framework to identify barriers to recruiting this population. In conducting a pilot study about preparing family caregivers to detect delirium symptoms in olderadults with (AD) the researchers used the Public Health Model for identifying barriers to recruitment. The goals of this methodological article are to: (1) briefly describe the methodology of the pilot study to illustrate how the Public Health Model was applied in the context of the present study and (2) discuss the benefits of the Public Health Model for identifying the barriers to recruitment in a study that prepared family caregivers to detect delirium symptoms in olderadults with AD. The Public Health Model helped us to identify four specific barriers to recruitment (lack of knowledge about delirium, desire to maintain normalcy, protective caregiving behaviors, and olderadult's fears) and ways to overcome them. The Public Health Model might also help other researchers address similar issues. PMID:24387779
Bull, Margaret J; Boaz, Lesley; Sjostedt, Jennifer M
Presented are the basic design, methods, and baseline data analyses for the Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR Project) an experimental study to investigate the relative effectiveness of a 12-month, stage of readiness to change-based multiple-behavior intervention (exercise and nutrition) compared to single-behavior interventions in a community-dwelling population of 1,277 olderadults. Relationships between stage of
Phillip G. Clark; Joseph S. Rossi; Mary L. Greaney; Deborah A. Riebe; Geoffrey W. Greene; Sandra D. Saunders; Faith D. Lees; Claudio R. Nigg
A common complaint of olderadults is difficulty understanding speech, especially in challenging listening environments. In addition to well known declines in the peripheral auditory system that reduce audibility, age-related changes in central auditory and attention-related systems are hypothesized to have additive negative effects on speech recognition. We examined the extent to which functional and structural differences in speech- and attention-related cortex predicted differences in word recognition between 18 younger adults (19-39 years) and 18 olderadults (61-79 years). Subjects performed a word recognition task in an MRI scanner where the intelligibility of words was parametrically varied. Olderadults exhibited significantly poorer word recognition in a challenging listening condition compared with younger adults. An anteromedial Heschl's gyrus/superior temporal gyrus (HG/STG) region, engaged by the word recognition task, exhibited age group differences in gray matter volume and predicted word recognition in younger and olderadults. Age group differences in anterior cingulate (ACC) activation were also observed. The association between HG gray matter volume, word recognition, and ACC activation was present after controlling for hearing loss. In younger and olderadults, causal path modeling analyses demonstrated that individual variation in left HG/STG morphology affected word recognition performance, which was reflected by error monitoring activity in the dorsal ACC. These results have clinical implications for rehabilitation and suggest that some of the perceptual difficulties experienced by olderadults are due to structural changes in HG/STG. More broadly, the results suggest the possibility that aging may exaggerate developmental limitations on the ability to recognize speech. PMID:19439585
Harris, Kelly C; Dubno, Judy R; Keren, Noam I; Ahlstrom, Jayne B; Eckert, Mark A
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…
Background:Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations.Objective:To test this association in a representative sample of an older-adult population.Methods:Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aìnés [ESA]), a longitudinal survey conducted in Quebec among 2,811 olderadults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders.Results:The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation (? ?=? 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed.Conclusion:Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in olderadults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in olderadults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic. PMID:25008442
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
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
Background: Alcohol misuse, especially binge drinking in young people, and alcoholic liver disease are major public health concerns. However, alcohol misuse in older people is underestimated and often goes undetected.Objective: To document alcohol consumption and clinical presentation of alcohol misuse in hospital inpatients aged ?60 years.Methods: 208 inpatients aged ?60 years, referred to the alcohol liaison nurse between 1998 and
Milan M Mehta; Kieran J Moriarty; David Proctor; Mary Bird; Wendy Darling
Sleep problems, prevalent among olderadults, are associated with poor outcomes and high healthcare costs. In 2008, rest and sleep became its own area of occupation in the AOTA Occupational Therapy Practice Framework. This scoping review examined a broad context of sleep research in order to highlight efficacious interventions for olderadults that fall within the occupational therapy scope of practice and present an agenda for research and practice. Four sleep intervention areas clearly aligned with the Practice Framework, including cognitive behavioral therapy for insomnia, physical activity, and multi-component interventions. Occupational therapy is primed to address sleep problems by targeting the context and environment, performance patterns, and limited engagement in evening activities that may contribute to poor sleep. Occupational therapy researchers and clinicians need to work collaboratively to establish the evidence-base for occupation-centered sleep interventions in order to improve the health and quality of life of the olderadult.
Leland, Natalie E.; Marcione, Nicole; Niemiec, Stacey L. Schepens; Don Fogelberg, Kaivalya Kelkar
The recruitment of community-dwelling olderadults, particularly those with cognitive impairment and those residing in rural areas, has been consistently challenging for researchers, especially in the dental field. This study reports on recruitment experiences from an ongoing study investigating the association between oral health and cognitive status in later life. Multiple recruitment strategies, including educational presentations and traveling to participants’ homes, were used to enroll rural elderly participants with various levels of cognitive function. In general, multi-pronged, proactive recruitment strategies were more effective than traditional, passive methods in reaching participants with varying degrees of cognitive impairment. The outcome of this study suggests that successful recruitment of such populations involves gaining the support of staff at relevant community organizations, informing community members (including olderadults and their family members) of the project and the importance of oral health, and making data collection sites accessible for olderadults.
Wu, Bei; Goedereis, Eric A.; Crout, Richard J.; Plassman, Brenda L.; DiNapoli, Elizabeth A; McNeil, Daniel W.; Wiener, Michael; Boone, Martin L.; Wiener, R. Constance; Kao, Elizabeth; Bai, Lina
Cognitive flexibility is one aspect of executive functioning that encompasses the ability to produce diverse ideas, consider response alternatives, and modify behaviors to manage changing circumstances. These processes are likely to be important for implementing cognitive restructuring. The present study investigated the impact of cognitive flexibility on olderadults' ability to learn cognitive restructuring. Neuropsychological measures of cognitive flexibility were administered to 40 normal community-dwelling olderadult volunteers and their ability to implement cognitive restructuring was coded and analyzed. Results indicated that the majority of participants showed good cognitive restructuring skill acquisition with brief training. The multiple regression analysis suggested that those with poorer cognitive flexibility on neuropsychological testing demonstrated poorer quality cognitive restructuring. In particular, perseverative thinking styles appear to negatively impact the ability to learn cognitive restructuring. Further research is needed to clarify whether olderadults with poor cognitive flexibility can improve their cognitive restructuring skills with repetition over treatment or whether alternative skills should be considered. PMID:23253357
The aim of the present study was to investigate neuropsychological performance in an untried trauma sample of olderadults displaced during childhood at the end of World War II (WWII) with and without posttraumatic stress disorder (PTSD) as well as transgenerational effects of trauma and PTSD on their offspring. Displaced olderadults with (n=20) and without PTSD (n=24) and nondisplaced healthy individuals (n=11) as well as one of their respective offspring were assessed with a large battery of cognitive tests (primarily targeting memory functioning). No evidence for deficits in neuropsychological performance was found in the aging group of displaced people with PTSD. Moreover, no group difference emerged in the offspring groups. Findings may be interpreted as first evidence for a rather resilient PTSD group of olderadults that is available for assessment 60 years after displacement. PMID:23896354
Jelinek, Lena; Wittekind, Charlotte E; Moritz, Steffen; Kellner, Michael; Muhtz, Christoph
Objectives: Substantial evidence indicates that depressed participants perform more poorly than nondepressed participants on a number of memory tasks. Cognitive deficits associated with depression (i.e., poor allocation of attention, poor encoding strategies), may help explain why depressed olderadults are particularly prone to evidence poorer memory performance. Method: The present study compared the impact of two self-administered treatment protocols, cognitive bibliotherapy for depression plus memory training (CBT + MT) and cognitive bibliotherapy alone (CBT), to a wait-list control condition on measures of memory functioning and depression in a group of olderadults experiencing depressive symptoms and memory complaints. Results: Results provide partial support for CBT as a treatment for depressive symptoms; however, memory training augmentation did not produce improvements. Conclusion: Suggestions for improving retention of olderadults in self-administered treatments are discussed. PMID:24073847
Scogin, Forrest; Fairchild, J Kaci; Yon, Adriana; Welsh, Douglas L; Presnell, Andrew
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
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
Olderadults tend to retrieve autobiographical information that is overly general (i.e., not restricted to a single event, termed the overgenerality effect) relative to young adults' specific memories. A vast majority of studies that have reported overgenerality effects explicitly instruct participants to retrieve specific memories, thereby requiring participants to maintain task goals, inhibit inappropriate responses, and control their memory search. Since these processes are impaired in healthy ageing, it is important to determine whether such task instructions influence the magnitude of the overgenerality effect in olderadults. In the current study participants retrieved autobiographical memories during presentation of musical clips. Task instructions were manipulated to separate age-related differences in the specificity of underlying memory representations from age-related differences in following task instructions. Whereas young adults modulated memory specificity based on task demands, olderadults did not. These findings suggest that reported rates of overgenerality in olderadults' memories might include age-related differences in memory representation, as well as differences in task compliance. Such findings provide a better understanding of the underlying cognitive mechanisms involved in age-related changes in autobiographical memory and may also be valuable for future research examining effects of overgeneral memory on general well-being. PMID:23915176
Ford, Jaclyn Hennessey; Rubin, David C; Giovanello, Kelly S
Arthritis is highly prevalent and is the leading cause of disability among olderadults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of olderadults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions.
Musculoskeletal pain is common, frequently under-reported, and inadequately treated in the olderadult. The objective of this article is to review the management of musculoskeletal pain syndromes in olderadults emphasising the potential role of opioid agents in carefully selected patients. Systematic analysis of the relevant literature was done. Even in cognitively impaired patients, assessment of musculoskeletal pain is mandatory. An algorithm for musculoskeletal pain is presented emphasising a stepwise pharmacological approach in combination with an array of non-pharmacological therapies. Comorbid conditions may limit therapeutic choices, particularly in the elderly. Repeated assessment of pain levels as well as functional status is critical for optimal pain management.
Objectives To present data on the dental and periodontal status of a convenience sample of 101 ambulant China-born olderadults who now\\u000a live in Melbourne. These olderadults participated in a study to assess the prevalence of specific oral diseases.\\u000a \\u000a \\u000a \\u000a \\u000a Methods Participants were interviewed in Cantonese using a structured questionnaire and received an oral examination to assess dental\\u000a and periodontal status using
Rodrigo Mariño; Mike Morgan; Asuman Kiyak; Eli Schwarz; Syed Naqvi
The present study examines source memory for actions (e.g. placing items in a suitcase). For both young and olderadult participants, source memory for actions performed by the self was better than memory for actions performed by either a known (close) or unknown other. In addition, neither young nor olderadults were more likely to confuse self with close others than unknown others. Results suggest an advantage in source memory for actions performed by the self compared to others, possibly associated with sensorimotor cues that are relatively preserved in aging.
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 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 management of osteoarthritis requires a careful combination of pharmacologic and nonpharmacologic therapies to effect improvements in pain and function. When choosing pharmacologic therapy, the potential toxicities must be considered relative to potential benefits. This review highlights commonly used medications and presents the evidence for their effectiveness as well as their toxicities. Acetaminophen and nonsteroidal antiinflammatory drugs are the mainstay of pharmacologic therapy, but there are numerous adjunctive or alternative medications that may provide some benefit to patients with osteoarthritis. PMID:20699168
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
Rapid increases in the proportion of olderadults in the population present major challenges to policy-makers worldwide. Using a nationally representative sample from the PAPFAM survey in Lebanon, this study examined the living arrangements of olderadults (aged > or = 65 years), and their correlates, with a focus on co-residence with married children. Of 1774 olderadults 17.1% co-resided with their married children: 28.1% of the 559 unmarried (widowed/divorced/single) and 11.3% of the 1071 married olderadults. Among both the married and unmarried, the likelihood of co-residence was significantly lower in regions outside the capital and decreased with increasing socioeconomic status. Among the unmarried elderly, co-residence with a married child was also significantly associated with increasing age and availability of sons, as well as presence of a vascular disorder and speech problems. While solitary living has traditionally been the focus for policy-makers, older people living with a married child may also be a vulnerable group. PMID:24684101
Abstract Older people with intellectual disability (ID) are characterized by low physical activity (PA) levels. PA is important for reducing health risks and maintaining adequate fitness levels for performing activities of daily living. The aim of this study was to explore preferences of olderadults with ID for specific physical activities, and to gain insight into facilitators and barriers to engaging into PA. Fourteen in-depth interviews and four focus groups were undertaken, with a total of 40 olderadults with mild and moderate ID included in the analysis. NVivo software was used for analysing the transcribed verbatim interviews. In total, 30 codes for facilitators and barriers were identified. Themes concerning facilitators to PA were enjoyment, support from others, social contact and friendship, reward, familiarity, and routine of activities. Themes concerning barriers to PA were health and physiological factors, lack of self-confidence, lack of skills, lack of support, transportation problems, costs, and lack of appropriate PA options and materials. The results of the present study suggest that olderadults with ID may benefit from specific PA programs, adapted to their individual needs and limitations. Results can be used for developing feasible health promotion programs for olderadults with ID. PMID:24937743
van Schijndel-Speet, Marieke; Evenhuis, Heleen M; van Wijck, Ruud; van Empelen, Pepijn; Echteld, Michael A
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
Wireless patient monitoring systems are emerging as a low cost, reliable and accurate way of healthcare delivery. In this paper we present a wireless remote vital sign monitoring system with audio/video data transmission. Vital signs include; blood pressure (systolic and diastolic), heart rate, pulse, oxygen saturation, body temperature, lungs air volume and blood glucose level. In addition, a two-way audio/video communication link connects patients to their healthcare providers. The proposed system employs a computer-based software application that effectively incorporates current data with electronic medical record in order to enhance patient care. We evaluated this system with 10 individuals for assessing its acceptability by the users and its compatibility with other medical devices. A clinical trial with more than 30 participants aged over 65 years is also in progress at a local hospital. PMID:24110217
This report presents a manual segmentation protocol for the hippocampus that yields a reliable and comprehensive measure of volume, a goal that has proven difficult with prior methods. Key features of this method include alignment of the images in the long axis of the hippocampus and the use of a three-dimensional image visualization function to disambiguate anterior and posterior hippocampal boundaries. We describe procedures for hippocampal volumetry and shape analysis, provide inter- and intra-rater reliability data, and examine correlates of hippocampal volume in a sample of healthy olderadults. Participants were 40 healthy olderadults with no significant cognitive complaints, no evidence of mild cognitive impairment or dementia, and no other neurological or psychiatric disorder. Using a 1.5 T GE Signa scanner, three-dimensional spoiled gradient recalled acquisition in a steady state (SPGR) sequences were acquired for each participant. Images were resampled into 1 mm isotropic voxels, and realigned along the interhemispheric fissure in the axial and coronal planes, and the long axis of the hippocampus in the sagittal plane. Using the BRAINS program (Andreasen et al., 1993), the boundaries of the hippocampus were visualized in the three orthogonal views, and boundary demarcations were transferred to the coronal plane for tracing. Hippocampal volumes were calculated after adjusting for intracranial volume (ICV). Intra- and inter-rater reliabilities, measured using the intraclass correlation coefficient, exceeded .94 for both the left and right hippocampus. Total ICV-adjusted volumes were 3.48 (±0.43) cc for the left hippocampus and 3.68 (±0.42) for the right. There were no significant hippocampal volume differences between males and females (p > .05). In addition to providing a comprehensive volumetric measurement of the hippocampus, the refinements included in our tracing protocol permit analysis of changes in hippocampal shape. Shape analyses may yield novel information about structural brain changes in aging and dementia that are not reflected in volumetric measurements alone. These and other novel directions in research on hippocampal function and dysfunction will be facilitated by the use of reliable, comprehensive, and consistent segmentation and measurement methods.
McHugh, Tara L.; Saykin, Andrew J.; Wishart, Heather A.; Flashman, Laura A.; Cleavinger, Howard B.; Rabin, Laura A.; Mamourian, Alexander C.; Shen, Li
The unprecedented growth in the nation's olderadult population has called attention to the increasing need for geriatric social workers. However, research suggests that social work students hold ageist attitudes that prevent many from pursuing careers in gerontology. The present study sought to identify student perceptions of gerontology content…
Volunteering is viewed as an empowerment process whereby olderadults actively participate in the community and improve their well-being and health. Yet little is known about racial differences in volunteering, and even less in terms of perceived benefits from volunteering as a means of empowerment. The present study addresses this research gap by…
Purpose: We present final outcomes from the multiple-component Fit and Strong! intervention for olderadults with lower extremity osteoarthritis. Design and Methods: A randomized controlled trial compared the effects of this exercise and behavior-change program followed by home-based reinforcement (n = 115) with a wait list control (n = 100) at 2,…
Hughes, Susan L.; Seymour, Rachel B.; Campbell, Richard T.; Huber, Gail; Pollak, Naomi; Sharma, Leena; Desai, Pankaja
Community wellbeing is a function of many factors working in concert to promote an optimal quality of life for all members of a community. It is argued here that the promotion of lifelong learning among olderadults can significantly contribute to community wellbeing. The aging society is a worldwide phenomenon presenting both opportunities and…
Mistreatment of olderadults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…
Presents an overview of self-regulation models: theory of planned behavior, protection motivation theory, health belief model, action control theory, transtheoretical model of behavior change, health action process, and precaution adoption process. Applies models to health behavior change in olderadults with cardiovascular disease or diabetes.…
The present study tested cognitive-behavioral therapy (CBT) for insomnia in olderadults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW,…
Presents the experience of, and case studies resulting from, working with olderadults whose changing physical health has directly affected their emotional health. Claims that adjustments to a new body concept can be aided by a team-oriented approach, which includes medical doctors, physical therapists, occupational therapists, dieticians, and…
Explores whether indirect measures of memory are associated with age. Results, based on 30 younger and 30 olderadults, suggest that direct measures, such as number of words recalled, were related to age, whereas indirect measures (consistency of order of presentation of words recalled) were not associated with age. (RJM)
The purpose of this sourcebook is to provide information about health promotion program planning, activities, and resources to people planning wellness programs for olderadults. The materials are divided into two parts: background information and resources. The Wallingford Wellness Project is presented as an example of a comprehensive health…
Multisensory reweighting (MSR) is an adaptive process that prioritizes the visual, vestibular, and somatosensory inputs to provide the most reliable information for postural stability when environmental conditions change. This process is thought to degrade with increasing age and to be particularly deficient in fall-prone versus healthy olderadults. In the present study, the authors investigate the dynamics of sensory reweighting,
Notes that age-related changes in physiology and pharmacokinetics (how drugs are used in the body) lead to increased drug sensitivity and potentially harmful drug effects. Addresses heightened sensitivity to drug effects seen in olderadults. Presents three examples of physiologic decline and discusses some broad considerations for geriatric…
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
Since most working memory (WM) tasks used in dual-task (DT) postural paradigms include both storage and processing of information, it is difficult to determine the extent to which each of these contributes to interference with balance control. In the current study, a change-detection task (changes in colored squares between two presentation events) that estimates visual working memory capacity (VWMC) was paired with tasks of increasing postural demand (stance, perturbation) in young adults (YAs) and olderadults (OAs) and performance compared between the two postural conditions and across the two populations. The change-detection task was selected as it requires storage of information without updating or manipulation; 34 YAs, 34 OAs, and five frail OAs were recruited. A significant reduction in VWMC occurred with increasing postural demand during the perturbation condition for both YAs (p < 0.01) and OAs (p < 0.001). VWMC was also significantly lower for OAs than YAs in the control condition (1.8 ± 0.7 vs. 2.8 ± 0.6) (p < 0.001). OAs showed a significant increase in the number of trials in which steps or rise to toes occurred during recovery between single-task (ST) and DT (p < 0.05; p < 0.05). OAs also showed a significant increase in normalized tibialis anterior amplitude (p < 0.001) following perturbations. YAs showed an increase in normalized area under the center of pressure trajectory and in AP forces (nAcopx1: p < 0.001; nFap1: p < 0.05) during the DT condition. PMID:24639065
The present study focuses on auditory discrimination abilities in olderadults aged 65–89 years. We applied the “Leipzig inventory for patient psychoacoustic” (LIPP), a psychoacoustic test battery specifically designed to identify deficits in central auditory processing. These tests quantify the just noticeable differences (JND) for the three basic acoustic parameters (i.e., frequency, intensity, and signal duration). Three different test modes [monaural, dichotic signal/noise (s/n) and interaural] were used, stimulus level was 35?dB sensation level. The tests are designed as three-alternative forced-choice procedure with a maximum-likelihood procedure estimating p?=?0.5 correct response value. These procedures have proven to be highly efficient and provide a reliable outcome. The measurements yielded significant age-dependent deteriorations in the ability to discriminate single acoustic features pointing to progressive impairments in central auditory processing. The degree of deterioration was correlated to the different acoustic features and to the test modes. Most prominent, interaural frequency and signal duration discrimination at low test frequencies was elevated which indicates a deterioration of time- and phase-dependent processing at brain stem and cortical levels. LIPP proves to be an effective tool to identify basic pathophysiological mechanisms and the source of a specific impairment in auditory processing of the elderly.
Adaptation to a visuomotor rotation is known to be impaired at olderadult age. The authors examined whether the impairment is present already at preretirement age and whether it depends on the difficulty of the adaptation task. Moreover, the authors tested predictions of the hypothesis that the age-related impairment pertains primarily to strategic corrections and the explicit knowledge on which they are based but not to the acquisition of an (implicit) internal model of the novel visuomotor transformation. The authors found an age-related impairment of adaptation and explicit knowledge already at preretirement age but no age-related change of aftereffects. With an incremental simplification of the adaptation task, age-related changes were able to be eliminated. Individual differences of the quality of explicit knowledge were associated with differences of adaptation, but not of aftereffects. When age groups were matched by explicit knowledge, age-related impairments of adaptation largely disappeared. However, a reliable difference remained in one of the experiments, suggesting that other processes of adjustment to a visuomotor rotation might be affected by aging as well. PMID:18361666
Information on residential pesticide usage and behaviors that may influence pesticide exposure was collected in three population-based studies of olderadults residing in the three Central California counties of Fresno, Kern, and Tulare. We present data from participants in the Study of Use of Products and Exposure Related Behaviors (SUPERB) study (N = 153) and from community controls ascertained in two Parkinson’s disease studies, the Parkinson’s Environment and Gene (PEG) study (N = 359) and The Center for Gene-Environment Studies in Parkinson’s Disease (CGEP; N = 297). All participants were interviewed by telephone to obtain information on recent and lifetime indoor and outdoor residential pesticide use. Interviews ascertained type of product used, frequency of use, and behaviors that may influence exposure to pesticides during and after application. Well over half of all participants reported ever using indoor and outdoor pesticides; yet frequency of pesticide use was relatively low, and appeared to increase slightly with age. Few participants engaged in behaviors to protect themselves or family members and limit exposure to pesticides during and after treatment, such as ventilating and cleaning treated areas, or using protective equipment during application. Our findings on frequency of use over lifetime and exposure related behaviors will inform future efforts to develop population pesticide exposure models and risk assessment.
We present an evaluation of a self-administered, biofeedback-aided, alertness training programme called the Alertness: Training for Focused Living (ATFL) Programme, which was developed as part of the Technology Research for Independent Living (TRIL) collaboration. We conducted two studies in order to evaluate the programme. A randomized controlled trial was, first of all, conducted with 40 olderadults aged between 60 and 83. A series of five single case studies was then conducted to examine the suitability of the programme for use with people with more severe memory difficulties. In the randomized controlled trial, participants were assigned to the ATFL Programme or to a placebo programme. Aspects of participants' memory, attention and executive functioning were assessed via telephone prior to and following completion of the training programmes and at 1, 3, and 6-month follow-up sessions. Significant improvements in sustained attention and verbal fluency were noted in the ATFL group. The series of single case studies illustrated the importance of tailoring a programme to the needs and abilities of the clients in question. The potential benefits of the ATFL programme in terms of periodically boosting alertness and aiding executive functioning are discussed.
Milewski-Lopez, Agnieszka; Greco, Eleonora; van den Berg, Flip; McAvinue, Laura P.; McGuire, Sarah; Robertson, Ian H.
We present an evaluation of a self-administered, biofeedback-aided, alertness training programme called the Alertness: Training for Focused Living (ATFL) Programme, which was developed as part of the Technology Research for Independent Living (TRIL) collaboration. We conducted two studies in order to evaluate the programme. A randomized controlled trial was, first of all, conducted with 40 olderadults aged between 60 and 83. A series of five single case studies was then conducted to examine the suitability of the programme for use with people with more severe memory difficulties. In the randomized controlled trial, participants were assigned to the ATFL Programme or to a placebo programme. Aspects of participants' memory, attention and executive functioning were assessed via telephone prior to and following completion of the training programmes and at 1, 3, and 6-month follow-up sessions. Significant improvements in sustained attention and verbal fluency were noted in the ATFL group. The series of single case studies illustrated the importance of tailoring a programme to the needs and abilities of the clients in question. The potential benefits of the ATFL programme in terms of periodically boosting alertness and aiding executive functioning are discussed. PMID:24782764
Milewski-Lopez, Agnieszka; Greco, Eleonora; van den Berg, Flip; McAvinue, Laura P; McGuire, Sarah; Robertson, Ian H
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
The chronic venous disease (CVD) results from a situation of venous hypertension which occurs when there is a dysfunction of the calf pump musculature. Such alteration contributes to the worsening of the disease and may generate physical and functional limitations among olderadults, carriers of CVD. In the present study, we aimed to compare the performance of the plantar flexor, the range of motion (ROM) of the ankle, gait speed and functional capacity among olderadults with and without CVD. This is a cross-sectional study, with a convenience sample of 30 olderadults with CVD and 30 without the disease. Gait speed was assessed by the GAITrite system, version 3.9; the dorsiflexion (DF) and plantar flexion (PF) ROMs, by goniometry, and the function of the plantar flexors by the isokinetic dynamometry. Functional capacity was evaluated by Katz and Lawton scales and by the assessment of the activities of social nature. The CVD group presented lesser ROM of DF and PF, peak torque and power of plantar flexors, gait speed and social restriction when compared to the control group (p<0.05). We concluded that olderadults with CVD present important limitations of ROM and strength, mobility and social restriction confirming findings of previous studies. Such results might guide professionals in their approaches both for determining the relevance of parameters to be assessed and of their therapeutic approaches. PMID:22682424
de Moura, Regina Márcia Faria; Gomes, Henrique de Alencar; da Silva, Silvia Lanziotti Azevedo; Britto, Raquel Rodrigues; Dias, Rosângela Correa
Objective The purpose of the present study was to examine the relationship between the use of senior center and health-related quality of life in Korean olderadults. Methods A questionnaire survey was conducted to two types of olderadults who lived in Busan, Korea: 154 olderadults who used a senior center and 137 olderadults who did not use a senior center. The Korean version of short-form 36-item health survey was administered to assess the health-related quality of life. Demographic variables were obtained from a questionnaire. These were gender, age, family status, marital status, education, monthly income, present illness, body mass index and physical activity. Results The 8-domain scales of physical function and role-physical were significantly higher in the users of the senior center compared with the non-users (F=4.87, p=0.027 and F=7.02, p=0.009, respectively). The 8-domain scales of vitality was also significantly higher in the users of the senior center compared with the non-users (F=7.48, p=0.007). Conclusions The present study showed that the users of the senior center have higher physical function, role-physical and vitality compared with the non-users. These findings suggest that although the results are unable to specify causal relationships using the senior center may lead to some improvement in health-related quality of life.
Kim, Hyun-Shik; Harada, Kazuhiro; Miyashita, Masashi; Lee, Eun-A; Park, Jin-Kee
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
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
Introduction. Fatigue is often present in olderadults with no identified underlying cause. The accruing burden of oxidative stress and inflammation might be underlying factors of fatigue. We therefore hypothesized that leukocyte telomere length (LTL) is relatively short in olderadults who experience fatigue. Materials and Methods. We assessed 439 older nondisabled Danish twins. LTL was measured using Southern blots of terminal restriction fragments. Fatigue was measured by the Mob-T Scale based on questions on whether the respondents felt fatigued after performing six mobility items. Results. LTL was significantly associated with fatigue (P = 0.023), showing an increase of 0.038?kb/fatigue score unit. Aging-related diseases and mental health did not explain the association, while lifestyle factors slightly attenuated the estimates. Conclusion. Our results support an association between LTL and fatigue. Further studies are required to confirm this finding and the link of LTL with oxidative stress/inflammation over the life course.
The minimum number of days of pedometer monitoring needed to estimate valid average weekly step counts and reactivity was investigated for olderadults with intellectual disability. Participants (N ?=? 268) with borderline to severe intellectual disability ages 50 years and older were instructed to wear a pedometer for 14 days. The outcome measure was steps per day. Reactivity was investigated with repeated measures analysis of variance, and monitoring frame was assessed by comparing combinations of days with average weekly step counts (with intraclass correlation coefficients [ICCs] and regression analyses). No reactivity was present. Any combination of 4 days resulted in ICCs of 0.96 or higher and 90% of explained variance. The study concludes that any 4 days of wearing a pedometer is sufficient to validly measure physical activity in olderadults with intellectual disability. PMID:22861135
Hilgenkamp, Thessa; Van Wijck, Ruud; Evenhuis, Heleen
As the population of many industrialized countries ages, the number of older drivers on the roads increases. Statistics show that older drivers are at increased risk for involvement in fatal accidents. One explanation for this is the cognitive and motor declines associated with the aging process. As we age, performance on attention, memory and motor control tasks, three important components of driving, declines. In the present study we examined the relationship between performance on component cognitive tasks and the influence of training on these tasks on the simulated driving performance of olderadults. More specifically, we assessed performance on and trained olderadults on single and dual tasks of attention, working memory and manual control. Regression analyses demonstrated that performance on the single and dual cognitive tasks and improvements in these computer-based tasks with training were predictive of improvements in driving simulator performance across the course of the study. These data suggest that relatively simple single and dual computer-based tasks and modest amounts of training on these tasks can improve driving performance in olderadults, thereby extending functional independence. PMID:19268912
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
Summary A significant percentage of children with hemangiomas may have PHACES syndrome which refers to the association of posterior fossa malformations, facial hemangiomas, arterial cerebrovascular abnormalities, cardiovascular anomalies, eye abnormalities and ventral defects like sternal clefting or supraumbilical raphe. A variety of factors have led to under diagnosis of PHACES syndrome in the past including lack of awareness and limited imaging modalities. Also, patients with PHACES syndrome with arterial cerebrovascular abnormalities can present with acute ischemic stroke. However, these patients usually present before one year of age. We describe a 29-year-old woman with no history of cerebrovascular disease who initially presented with symptoms of a stroke and was subsequently diagnosed to have PHACES syndrome exhibiting an array of multiple unusual imaging findings. We also discuss the current literature and recommendations about PHACES syndrome.
Competency in health numeracy is essential in understanding risk about disease susceptibility and the consequences of disease treatment. Both health literacy and skill in using the Internet to obtain health information are lower among older compared with younger adults. Presentation format of health information has been shown to influence comprehension. The objective of this study was to determine the influence of information formatting (text and graphic) on olderadults' comprehension of Internet-based numeric cancer risk information. This cross-sectional study involved a convenience sample of adults, aged 50 years and older from diverse ethnic and educational backgrounds. Cancer risk information, obtained from a Canadian Cancer Society web page, was presented as text, graphics or as a combination of text and graphics formats. Comprehension of the information was assessed by six questions focused on basic numeracy skill and ability to perform simple calculations and operations. A three-item general context numeracy and an eight-item health context numeracy instrument were used to describe health numeracy skills of participants. The six-item Newest Vital Sign (NVS) test was used to assess prose and numeric health literacy. There was no statistically significant effect of presentation format on participants' comprehension of the cancer information. Participants' comprehension of basic health numeracy information was positively correlated with education (p < or = 0.05) and income (p < or = 0.01) whereas comprehension of information that assessed calculation and operations numeracy skill was positively correlated only with income (p < or = 0.05). Health literacy skill and income explained a significant proportion of the variance in overall comprehension of Internet-based cancer risk information (R(2) = 0.414, p < or = 0.01) in this sample of olderadults. Format of numeric risk information was not a significant factor in the comprehension of cancer risk information in this group of ethnically diverse, olderadults. However, comprehension of the information was related to health literacy skill and income. PMID:19919298
Donelle, Lorie; Hoffman-Goetz, Laurie; Gatobu, Sospeter; Arocha, Jose F
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.
Objective. The objective of the present study was to investigate the impact of incident falls on the balance, gait, and Activities of Daily Living functioning in community-dwelling olderadults. Methods. This was a population-based, 1-year prospective cohort study in olderadults. We performed baseline assessment of potential predictors, the 1-year occurrence of falls, and then 1-year reassessment of the following
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 diagnosis of influenza is often missed in olderadults and illness presentation may be modified by prior vaccination. We evaluated the symptoms and immunologic markers predicting laboratory-confirmed influenza (LCI) among vaccinated olderadults. In subjects with influenza-like illness (ILI), fever distinguished subjects with laboratory-confirmed influenza (LCI) from those with other ILI (39% vs. 12.5%, p=0.009). In LCI subjects who did not seroconvert to influenza infection, pre-infection levels of the cytolytic mediator, granzyme B, correlated with fever (r=1.00; p=0.01) and the IFN-?:IL-10 ratio (r=0.99; p=0.03), and increased following influenza infection in LCI vs. ILI subjects (p=0.03). The cell-mediated immune response to influenza distinguishes A/H3N2 LCI from other ILI in olderadults, and suggests a link between cell-mediated immunity and influenza illness severity in vaccinated olderadults.
Shahid, Zainab; Kleppinger, Alison; Gentleman, Beth; Falsey, Ann R.; McElhaney, Janet E.
The diagnosis of influenza is often missed in olderadults and illness presentation may be modified by prior vaccination. We evaluated the symptoms and immunologic markers predicting laboratory-confirmed influenza (LCI) among vaccinated olderadults. In subjects with influenza-like illness (ILI), fever distinguished subjects with laboratory-confirmed influenza (LCI) from those with other ILI (39% vs. 12.5%, p=0.009). In LCI subjects who did not seroconvert to influenza infection, pre-infection levels of the cytolytic mediator, granzyme B, correlated with fever (r=1.000; p=0.01) and the IFN-gamma:IL-10 ratio (r=0.999; p=0.03), and increased following influenza infection in LCI vs. ILI subjects (p=0.03). The cell-mediated immune response to influenza distinguishes A/H3N2 LCI from other ILI in olderadults, and suggests a link between cell-mediated immunity and influenza illness severity in vaccinated olderadults. PMID:20646987
Shahid, Zainab; Kleppinger, Alison; Gentleman, Beth; Falsey, Ann R; McElhaney, Janet E
Background There are several negative stereotypes about olderadults that have negatively influenced people’s attitude about aging. The present study compared emotional well-being between olderadults and adolescents. Methods Data for this study came from 1,403 community-dwelling elderly persons and 1,190 secondary school students and were obtained from two national cross-sectional surveys. Emotional well-being was measured using the World Health Organization-Five Well-Being Index. Data analysis was conducted using a multivariate analysis of covariance with SPSS software version 20 (IBM Corporation, Armonk, NY, USA). Results Elderly people significantly scored higher levels of emotional well-being (mean, 62.3; standard deviation, 22.55) than younger people (mean, 57.9; standard deviation, 18.46; t, 5.32; P?0.001). The findings from the multivariate analysis of covariance revealed a significant difference between olderadults and younger people in emotional well-being [F(3, 2587)=120.21; P?0.001; ?2=0.122] after controlling for sex. Conclusion Contrary to negative stereotypes about aging, our findings show a higher level of emotional well-being among olderadults compared with younger people.
The ability to perform instrumental activities of daily living (IADLs) is necessary for independent living. Research suggests that community-dwelling olderadults are at risk for experiencing subtle decrements in the performance of IADLs. Neuropsychological tests have been used to account for differences in IADL status. Studies of the relationship between cognitive ability and functional status have produced variable results, however, and cognitive ability appears to be only a moderate predictor. Several studies of normal aging have revealed cognitive and functional benefits of higher cognitive reserve (CR) in healthy, nondemented olderadults. The purposes of the present study were to: (a) examine the relationship between global cognitive ability and IADL performance among 53 community-dwelling olderadults, and (b) determine whether formal education, as a proxy of CR, significantly moderates this relationship. Consistent with previous findings, global cognitive ability accounted for a considerable portion of variance in IADL performance [?R(2) = .54; ?F(2, 53) = 67.96; p < .001]. Additionally, CR modestly but significantly attenuated this relationship [?R(2) = .044; ?F(4, 53) = 5.98; p = .018; total R(2) = .65]. This finding suggests that community-dwelling olderadults with lower levels of formal education may be at greater risk for functional decrements associated with age-related cognitive decline. PMID:24611794
Duda, Bryant; Puente, Antonio N; Miller, Lloyd Stephen
Background Undernutrition in homebound olderadults is a significant problem. The purpose of this study was to investigate the effect of the presence of others, both within the household and during meals, on caloric intake in homebound olderadults. Methods In-depth interviews and three 24-hour dietary recalls were obtained from 50 olderadults who were receiving home health services. Descriptive statistics were used to characterize participants, and hierarchical linear modeling was performed to evaluate predictors of caloric intake per meal. Results Participants’ mean age was 77. Females composed 65% and African Americans composed 42% of the sample. Analyses are based on 553 meal observations. The majority (84%) of participants consumed all meals for each of the 3 days of data collection; however, they consumed an average of only 1305 calories per day. Hierarchical linear modeling analysis indicated that persons who had others present during meals consumed an average of 114.0 calories more per meal than those who ate alone (p = .009) and that women consumed 76.7 fewer calories per meal than did men (p = .045). The presence of others within the household had no effect on caloric intake. Conclusion This research suggests that a simple and inexpensive way to increase caloric intake in homebound olderadults is to make arrangements for family members or caregivers to eat with them.
Locher, Julie L.; Robinson, Caroline O.; Roth, David L.; Ritchie, Christine S.; Burgio, Kathryn L.
Objectives: Olderadults who have experienced traumatic events earlier in life may be especially vulnerable to additional challenges associated with aging. In a cross-sectional study of older females, the present study examines whether a history of rape is associated with current psychological and health problems. Method: This study used existing data from the female respondents (N = 1228) in the National Social Life, Health, and Aging Project (NSHAP), a national probability sample of adults between the ages of 57 and 85 interviewed in their homes. It was determined whether or not the participant experienced forced sexual contact since the age of 18. Measures of psychological health (e.g., scales of depression, anxiety, and loneliness), the presence or absence of a number of serious health problems, and a one-item measure of self-esteem were obtained. Results: Adult rape occurred in 7% of the sample. On average, 36 years had elapsed since the rape had occurred. Using structural equation modeling (SEM), rape was associated with lower self-esteem, psychological, and physical health functioning. Self-esteem partially mediated the association between rape and psychological functioning, but not health functioning. These associations were significant even after controlling for participant characteristics and risky health behaviors. Conclusions: Mechanisms linking prior rape to psychological and health problems in older age are discussed, as well as treatment recommendations for symptomatic olderadults. PMID:24521090
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
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.
Background As the population ages, olderadults are seeking meaningful, and impactful, post-retirement roles. As a society, improving the health of people throughout longer lives is a major public health goal. This paper presents the design and rationale for an effectiveness trial of Experience Corps™, an intervention created to address both these needs. This trial evaluates (1) whether senior volunteer roles within Experience Corps™ beneficially impact children's academic achievement and classroom behavior in public elementary schools and (2) impact on the health of volunteers. Methods Dual evaluations of (1) an intention-to-treat trial randomizing eligible adults 60 and older to volunteer service in Experience Corps™, or to a control arm of usual volunteering opportunities, and (2) a comparison of eligible public elementary schools receiving Experience Corps™ to matched, eligible control schools in a 1:1 control:intervention school ratio. Outcomes For olderadults, the primary outcome is decreased disability in mobility and Instrumental Activities of Daily Living (IADL). Secondary outcomes are decreased frailty, falls, and memory loss; slowed loss of strength, balance, walking speed, cortical plasticity, and executive function; objective performance of IADLs; and increased social and psychological engagement. For children, primary outcomes are improved reading achievement and classroom behavior in Kindergarten through the 3rd grade; secondary outcomes are improvements in school climate, teacher morale and retention, and teacher perceptions of olderadults. Summary This trial incorporates principles and practices of community-based participatory research and evaluates the dual benefit of a single intervention, versus usual opportunities, for two generations: olderadults and children.
Fried, Linda P.; Carlson, Michelle C.; McGill, Sylvia; Seeman, Teresa; Xue, Qian-Li; Frick, Kevin; Tan, Erwin; Tanner, Elizabeth K.; Barron, Jeremy; Frangakis, Constantine; Piferi, Rachel; Martinez, Iveris; Gruenewald, Tara; Martin, Barbara K.; Berry-Vaughn, Laprisha; Stewart, John; Dickersin, Kay; Willging, Paul R.; Rebok, George W.
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
The relationship between strategy use and cognitive training gains on reasoning ability is examined in a sample of 393 older participants in the Seattle Longitudinal Training Study. Pre- and posttest gains on the use of strategies specific to reasoning ability were compared for the elderly trained on reasoning versus spatial orientation ability. The present study involves an objective behavioral method
Jane S. Saczynski; Sherry L. Willis; K. Warner Schaie
Daily living skills are important to ageing adults with intellectual disabilities (ID). The purpose of this study was to investigate the level of these skills in olderadults with ID and to investigate the influence of gender, age, level of ID and mobility on these skills. Daily living skills were measured with the Barthel Index (for Activities of Daily Living, ADL) and the Lawton IADL scale (for Instrumental Activities of Daily Living, IADL) in 989 adults with ID aged 50 years and over living in community-based and institutional settings. Descriptives were presented by categories of gender, age, level of ID and mobility. Regression analysis was used to investigate the influence of these variables on total and item scores of ADL and IADL questionnaires. ADL and IADL scores in olderadults with ID are comparable to those of vulnerable patient groups. Total ADL score was mainly determined by mobility, while total IADL score was mainly determined by level of ID. Of all 18 separate items of these questionnaires, 11 were determined more by mobility than level of ID. The Barthel Index and Lawton IADL scale are recommended for future use in research and clinical practice in this group. This study stresses the need to support mobility olderadults with ID as much as possible, in order to optimize independency in this group. PMID:21550771
Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M
Generating predictions during action observation is essential for efficient navigation through our social environment. With age, the sensitivity in action prediction declines. In younger adults, the action observation network (AON), consisting of premotor, parietal and occipitotemporal cortices, has been implicated in transforming executed and observed actions into a common code. Much less is known about age-related changes in the neural representation of observed actions. Using fMRI, the present study measured brain activity in younger and olderadults during the prediction of temporarily occluded actions (figure skating elements and simple movement exercises). All participants were highly familiar with the movement exercises whereas only some participants were experienced figure skaters. With respect to the AON, the results confirm that this network was preferentially engaged for the more familiar movement exercises. Compared to younger adults, olderadults recruited visual regions to perform the task and, additionally, the hippocampus and caudate when the observed actions were familiar to them. Thus, instead of effectively exploiting the sensorimotor matching properties of the AON, olderadults seemed to rely predominantly on the visual dynamics of the observed actions to perform the task. Our data further suggest that the caudate played an important role during the prediction of the less familiar figure skating elements in better-performing groups. Together, these findings show that action prediction engages a distributed network in the brain, which is modulated by the content of the observed actions and the age and experience of the observer.
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
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.
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
How does encoding context affect memory? Participants studied visually presented words viewed concurrently with a rich (intact face) or weak (scrambled face) image as context and subsequently made “Remember”, “Know”, or “New” judgements to words presented alone. In Experiment 1a, younger, but not older, adults showed higher recollection accuracy to words from rich- than from weak-context encoding trials. The age-related