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Sample records for elderly population results

  1. Results of Cataract Surgery in the Very Elderly Population

    PubMed Central

    Mehmet, Borazan; Abuzer, Gunduz

    2010-01-01

    Purpose The aim of this study was to retrospectively evaluate the effect of cataract surgery on visual acuity (VA) and daily living activities in participants aged over 80 years. Methods For eighty-three eyes from eighty three eligible patients aged 80 or above who had undergone cataract surgery between 2000 and 2005, preoperative and postoperative best-corrected visual acuity (BCVA), satisfaction score for daily living activities, surgical complications, and retinal pathologies affecting vision were recorded from the patient's file. Results The mean age of the patients was 86.80±5.24 years (range, 80-98). VA improved in the operated eye for patients aged 80 to 89 and for those over 90 years. Postoperative VA of 0.5 or better was more frequently observed in those aged 80 to 89 than in those aged over 90 years (90.6% and 73.4%, respectively). Mean postoperative scores for the daily living activities scale were significantly better in both groups as compared to preoperative levels, and were better in the 80 to 89-year age group than for those older than 90. Intraoperative posterior capsule perforation occurred in two participants, cystoid macular edema in one, iridodialysis in one and postoperative refractory stromal edema occurred in one case. Conclusions Our results showed that better VA levels for daily living activities can be obtained after cataract surgery in elderly patients aged over 80 years, thereby suggesting that cataract removal is effective removal in this population.

  2. Results of cataract surgery in the very elderly population

    PubMed Central

    Michalska-Małecka, Katarzyna; Nowak, Mariusz; Gościniewicz, Piotr; Karpe, Jacek; Słowińska-Łożyńska, Ludmiła; Łypaczewska, Agnieszka; Romaniuk, Dorota

    2013-01-01

    Aim The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as “very elderly.” Methods The study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery. Results Best corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ≥0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma. Conclusion Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe. PMID:23966774

  3. Morbidity, mortality and quality of life in the ageing haemodialysis population: results from the ELDERLY study

    PubMed Central

    Dschietzig, Wilfried; Leimenstoll, Gerd; Rob, Peter M.; Kuhlmann, Martin K.; Pommer, Wolfgang; Fraass, Uwe; Ritz, Eberhard; Schwenger, Vedat

    2016-01-01

    Background The physical–functional and social–emotional health as well as survival of the elderly (≥75 years of age) haemodialysis patient is commonly thought to be poor. In a prospective, multicentre, non-interventional, observational study, the morbidity, mortality and quality of life (QoL) in this patient group were examined and compared with a younger cohort. Methods In 92 German dialysis centres, 2507 prevalent patients 19–98 years of age on haemodialysis for a median of 19.2 months were included in a drug monitoring study of darbepoetin alfa. To examine outcome and QoL parameters, 24 months of follow-up data in the age cohorts <75 and ≥75 years were analysed. Treatment parameters, adverse and intercurrent events, hospitalizations, morbidity and mortality were assessed. QoL was evaluated by means of the 47-item Functional Assessment of Chronic Illness Therapy–Anaemia score (FACT-An, version 4). Results The 2-year mortality rate was 34.7% for the older cohort and 15.8% for the younger cohort. The mortality rate for the haemodialysed elderly patients was 6.2% higher in absolute value compared with the age-matched background population. A powerful predictor of survival was the baseline FACT-An score and a close correlation with the 20-item anaemia subscale (AnS) was demonstrated. While the social QoL in the elderly patients was more stable than in the younger cohort (leading to equivalent values at the end of the study period), a pronounced deterioration of physical and functional status was observed. The median number of all-cause hospital days per patient-year was 12.3 for the elderly cohort and 8.9 for the younger patient population. The overall 24-month hospitalization rate was only marginally higher in the elderly cohort (34.0 versus 33.3%). Conclusions In this observational study, the mortality rate of elderly haemodialysis patients was not exceedingly high compared with the age-matched background population. Furthermore, the hospitalization

  4. Tinnitus in elderly population

    PubMed Central

    Negrila-Mezei, A.; Enache, R.; Sarafoleanu, C.

    2011-01-01

    Introduction: Tinnitus is a common health problem that affects between 10 - 30% of the population, approximately 3 - 4% presenting to the doctor at least once in their life. There are many causes that lead to tinnitus in elderly population, including otology, metabolic, neurologic or cardiovascular conditions. The aim of this study was to determine the association of tinnitus with these chronic comorbidities among elderly community and its impact upon their quality of life. Materials and Methods: We performed a clinical retrospective study on 471 ENT patients hospitalized for various diseases, up to 60 years old, for a period of 24 months. All subjects were assessed for subjective tinnitus, neuro-vascular comorbidities and QoL by use of the brief version of the World Health Organization QoL instrument. Results: Tinnitus was reported in 114 patients, giving a prevalence of 24,2%. Variables like gender, residence, economic status, alcohol or smoking were not significantly associated with tinnitus. On the other hand, otic and sinonasal pathology, dizziness, hypertension, arteriosclerosis or diabetes were significantly correlated. All patients with tinnitus presented a more negative perception of their overall health and a poorer QoL, compared to those without. Conclusions: Tinnitus is a common pathology among elderly community. Its association with chronic treatable health comorbidities reduces QoL and highlights the need of cooping strategies among this group population. Abbreviations: RR = Relative Risk; 95%CL=95%Confidence Level; OR = Ods Ratio; QoL= quality of life PMID:22514575

  5. Visuospatial characteristics of an elderly Chinese population: results from the WAIS-R block design test

    PubMed Central

    Yin, Shufei; Zhu, Xinyi; Huang, Xin; Li, Juan

    2015-01-01

    Visuospatial deficits have long been recognized as a potential predictor of dementia, with visuospatial ability decline having been found to accelerate in later stages of dementia. We, therefore, believe that the visuospatial performance of patients with mild cognitive impairment (MCI) and dementia (Dem) might change with varying visuospatial task difficulties. This study administered the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT) to determine whether visuospatial ability can help discriminate between MCI patients from Dem patients and normal controls (NC). Results showed that the BDT could contribute to the discrimination between MCI and Dem. Specifically, simple BDT task scores could best distinguish MCI from Dem patients, while difficult BDT task scores could contribute to discriminating between MCI and NC. Given the potential clinical value of the BDT in the diagnosis of Dem and MCI, normative data stratified by age and education for the Chinese elderly population are presented for use in research and clinical settings. PMID:25762931

  6. Visuospatial characteristics of an elderly Chinese population: results from the WAIS-R block design test.

    PubMed

    Yin, Shufei; Zhu, Xinyi; Huang, Xin; Li, Juan

    2015-01-01

    Visuospatial deficits have long been recognized as a potential predictor of dementia, with visuospatial ability decline having been found to accelerate in later stages of dementia. We, therefore, believe that the visuospatial performance of patients with mild cognitive impairment (MCI) and dementia (Dem) might change with varying visuospatial task difficulties. This study administered the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT) to determine whether visuospatial ability can help discriminate between MCI patients from Dem patients and normal controls (NC). Results showed that the BDT could contribute to the discrimination between MCI and Dem. Specifically, simple BDT task scores could best distinguish MCI from Dem patients, while difficult BDT task scores could contribute to discriminating between MCI and NC. Given the potential clinical value of the BDT in the diagnosis of Dem and MCI, normative data stratified by age and education for the Chinese elderly population are presented for use in research and clinical settings.

  7. Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

    PubMed Central

    Avolio, M.; Montagnoli, S.; Marino, M.; Basso, D.; Furia, G.; Ricciardi, W.; de Belvis, A. G.

    2013-01-01

    Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors) on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT) survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA) was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS).” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people's life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network's nodes, are likely to play an important role in this relationship. PMID:23878536

  8. Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample.

    PubMed

    Lee, Li-Chin; Tsai, Alan C

    2012-06-01

    Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional status-predictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the 'Survey of Health and Living Status of the Elderly in Taiwan', a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects (≥65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes.

  9. Health status correlates of malnutrition in the polish elderly population - Results of the Polsenior Study.

    PubMed

    Krzyminska-Siemaszko, R; Chudek, J; Suwalska, A; Lewandowicz, M; Mossakowska, M; Kroll-Balcerzak, R; Wizner, B; Tobis, S; Mehr, K; Wieczorowska-Tobis, K

    2016-11-01

    The aim of the study was to analyze health-related factors associated with poor nutritional status (PNS) of a representative group of Polish older people, based on data from the PolSenior project (the first nation-wide study of Polish senior citizens). Nutritional status was assessed in 3751 community-dwelling older people (1770 females, mean age: 77.4±8.0 years) using the Mini Nutritional Assessment - Short Form. Elements of comprehensive geriatric assessment (cognitive and mood screening), selected medical data were analyzed in relation to the nutritional status. These were: the number of medications, the number of chronic diseases, selected diseases potentially related to malnutrition (anaemia, stroke, peptic ulcer, Parkinson's disease, cancer - past or present), total edentulism, use of dentures, and chronic pain. PNS was observed in 44.2% of participants. Female sex [OR 1.72, 95% Cl (1.45-2.04)], advanced age [OR 2.16 (1.80-2.58)], symptoms of depression [OR 11.52 (9.24-14.38)], cognitive impairment [OR 1.52 (1.20-1.93], multimorbidity [OR 1.27 (1.04-1.57)], anaemia [OR 1.80 (1.41-2.29)] and total edentulism [OR 1.26 (1.06-1.49)] were independently correlated with PNS. PNS in Polish elderly population is strongly related to the occurrence of symptoms of depression. People in advanced age with symptoms of depression, cognitive impairment, multimorbidity, anaemia and total edentulism should be screened and monitored for early symptoms of malnutrition.

  10. Population impact of depression on functional disability in elderly: results from "São Paulo Ageing & Health Study" (SPAH).

    PubMed

    da Silva, Simone Almeida; Scazufca, Marcia; Menezes, Paulo R

    2013-03-01

    With the fast population aging, functional disability among the elderly is becoming a major public health issue. Depression is highly prevalent in this phase of life and may be associated with a significant proportion of the disability among elderly populations. We investigated the association of depressive symptoms and ICD-10 depression with functional disability in older adults and estimated the corresponding population attributable fractions (PAF). A cross-sectional one-phase population-based study was carried out with 2,072 individuals aged 65 years or over living in a low-income area of São Paulo, Brazil. Depressive symptoms and ICD-10 depression were assessed with the Geriatric Mental State and the Neuropsychiatric Inventory. We assessed functional disability with the WHO Disability Assessment Schedule Instrument. Prevalence Ratios and PAF were calculated using Poisson regression. The prevalence of depressive symptoms and ICD-10 depression was 21.4 and 4.8 %, respectively. Depression and depressive symptoms were strongly associated with high functional disability, even after adjustment for demographic factors, socioeconomic conditions, physical morbidities, and dementia. The PAFs for depressive symptoms and ICD-10 depression were 12.0 % for each of the psychiatric morbidity. Depressive symptoms contributed as much as ICD-10 depression to the population burden of functional disability in the elderly. Effective management of clinically significant depressive symptoms, delivered mainly at the primary care level, may reduce the total population disability.

  11. Significance and costs of complex biopsychosocial health care needs in elderly people: results of a population-based study.

    PubMed

    Wild, Beate; Heider, Dirk; Maatouk, Imad; Slaets, Joris; König, Hans-Helmut; Niehoff, Dorothea; Saum, Kai-Uwe; Brenner, Hermann; Söllner, Wolfgang; Herzog, Wolfgang

    2014-09-01

    To improve health care for the elderly, a consideration of biopsychosocial health care needs may be of particular importance-especially because of the prevalence of multiple conditions, mental disorders, and social challenges facing elderly people. The aim of the study was to investigate significance and costs of biopsychosocial health care needs in elderly people. Data were derived from the 8-year follow-up of the ESTHER study-a German epidemiological study in the elderly population. A total of 3124 participants aged 57 to 84 years were visited at home by trained medical doctors. Biopsychosocial health care needs were assessed using the INTERMED for the Elderly (IM-E) interview. Health-related quality of life (HRQOL) was measured by the 12-Item Short-Form Health Survey, and psychosomatic burden was measured by the Patient Health Questionnaire. The IM-E correlated with decreased mental (mental component score: r = -0.38, p < .0001) and physical HRQOL (physical component score: r = -0.45, p < .0001), increased depression severity (r = 0.53, p < .0001), and costs (R = 0.41, p < .0001). The proportion of the participants who had an IM-E score of at least 21 was 8.2%; according to previous studies, they were classified as complex patients (having complex biopsychosocial health care needs). Complex patients showed a highly reduced HRQOL compared with participants without complex health care needs (mental component score: 37.0 [10.8] versus 48.7 [8.8]; physical component score: 33.0 [9.1] versus 41.6 [9.5]). Mean health care costs per 3 months of complex patients were strongly increased (1651.1 &OV0556; [3192.2] versus 764.5 &OV0556; [1868.4]). Complex biopsychosocial health care needs are strongly associated with adverse health outcomes in elderly people. It should be evaluated if interdisciplinary treatment plans would improve the health outcomes for complex patients.

  12. Potential benefits of slow titration of paroxetine treatment in an elderly population: eight-week results from a naturalistic setting.

    PubMed

    Gibiino, Sara; Mori, Elisa; De Ronchi, Diana; Serretti, Alessandro

    2013-08-01

    Late-life depression, often in association with anxiety, affects approximately 15% of individuals older than 65 years. Selective serotonin reuptake inhibitors are the first-line treatment but could be responsible of an early exacerbation of anxiety, possibly reduced by a very gradual titration of drugs. The main aim of this study is to compare gradual and rapid (standard) titration of paroxetine in an elderly population. In a naturalistic setting, 50 elderly (≥60 years old) outpatients with unipolar mood disorder or anxiety disorder were naturalistically assigned to abrupt initiation of 10 mg of paroxetine or to a gradual increase with 2.5 mg on alternate days up to 10 mg in 7 days. Then dosage could be maintained at 10 mg or increased according to clinical response. Primary outcome was efficacy as assessed by the Hamilton Depression Rating Scale (HAM-D) 21, HAM-D symptom subscales (core, psychic anxiety, somatic anxiety cluster), and Hamilton Anxiety Rating Scale changes. Secondary outcome was evaluation of overall dropouts at eighth week and evaluation of most common adverse effects through the global judgment of the Dosage Record and Treatment Emergent Symptom Scale. All data were recorded weekly for the first 8 weeks of treatment (with 1 more evaluation after 3 days from the baseline). Samples were comparable at baseline, with patients in gradual titration showing a higher level of psychic anxiety. During the first 3 days of treatment, a significant worsening in psychic anxiety was observed in patients treated abruptly with 10 mg of paroxetine (difference in HAM-D psychic anxiety subscale from baseline: 110.61% vs 89.38% with rapid and slow titration, respectively; t test P = 0.03). Overall, a significantly greater improvement in depressive and anxious symptoms favored gradual titration (HAM-D core cluster and HAM-D psychic anxiety cluster, respectively, P = 0.014 and P < 0.001, also when controlling for confounders). At the eighth week, significant higher

  13. Social and economic correlates of malnutrition in Polish elderly population: the results of PolSenior study.

    PubMed

    Krzymińska-Siemaszko, R; Mossakowska, M; Skalska, A; Klich-Rączka, A; Tobis, S; Szybalska, A; Cylkowska-Nowak, M; Olszanecka-Glinianowicz, M; Chudek, J; Wieczorowska-Tobis, K

    2015-04-01

    The aim of this study was to evaluate the prevalence of malnutrition in Polish elderly population and analyse its social and economic correlates based on the data from the PolSenior project, the first large-scale study of a representative group of Polish seniors. A cross-sectional population-based study. All territorial provinces in Poland. 4482 community-dwelling respondents aged 65 years or above (women: n=2142, age=79.0±8.4 years; men: n=2340, age= 78.3±8.6 years). The nutritional status of participants was assessed through the Mini Nutritional Assessment Short Form (the revised MNA-SF). Out of social and economic correlates we evaluated age, sex, level of education, marital status, place of residence, living conditions and economic status. Economic status of the respondents was determined on the basis of questions on how well they could manage their own budgets. Those who could afford only the cheapest food or clothes were considered the group of self-reported poverty. Frequency of malnutrition in the PolSenior population accounted for 7.5% (in 5.0% men and 9.0% women; p<0.001). The risk of malnutrition was present in 38.9% (33.3% men and 42.4% women; p<0.001). In our study female sex, older age, unmarried status, living in a rural area and self-reported poverty were independent correlates of malnutrition. Our data showed high prevalence of malnutrition and the risk of its development among the community-dwelling elderly people in Poland. Screening with MNA-SF should focus in particular on unmarried, poorly educated individuals, in late old age, living in rural areas and self-reporting a poor financial state, especially women.

  14. [Hypertension in the elderly population].

    PubMed

    Sierra, Cristina; López-Soto, Alfonso; Coca, Antonio

    2008-10-01

    The prevalence of essential hypertension in the Spanish population aged more than 60 years old is greater than 65%, mainly due to the high prevalence of elevated systolic pressure. Essential hypertension is known to be the most important risk factor for the development of cardiovascular disease, which continues to be the leading cause of death among adults in the developed world. Several randomized, placebo-controlled clinical trials have demonstrated the beneficial effects of antihypertensive treatment in hypertensive elderly people. However, the management of high blood pressure in the elderly population can be difficult due to a series of factors in this group such as altered pharmacokinetics, comorbidity, and polypharmacy. In addition, although there is recent evidence of the benefit of antihypertensive treatment in the oldest old (> 85 years), comprehensive geriatric assessment and individualized treatment should be applied in daily clinical practice.

  15. Disability in Singapore's Elderly Population.

    PubMed

    Mahesh, Mithila; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Picco, Louisa; Jeyagurunathan, Anita; Shafie, Saleha Binte; Pang, Shirlene; Sagayadevan, Vathsala; Seow, Esmond; Chong, Siow Ann; Subramaniam, Mythily

    2016-07-01

    Disability increases an individual's dependence and negatively impacts their physical, mental, and social functioning. The current study aims to establish the prevalence and risk factors of disability in Singapore's population. Data was extracted from the Well-being of the Singapore Elderly (WiSE) study. This cross-sectional study recruited participants aged 60 years and above (n = 2421) who were representative of Singapore's multiethnic population. We used the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 to assess the severity of disability in our sample while establishing its associations and correlations with cognitive levels, sociodemographic variables, and chronic illness. Cognitive deficits, old age, female gender, Malay and Indian ethnicity, lack of education, retired or homemaker status, presence of chronic illness (specifically stroke, heart problems, depression, and dementia) were found to be significantly associated with disability in Singapore's elderly population. As hypothesised, participants with deficits in cognition were more likely to indicate higher WHODAS scores. The findings highlighted specific factors associated with disability in this multiethnic population. The identification of these factors would lead the way to the development of appropriate interventions.

  16. Associations between former exposure to manganese and olfaction in an elderly population: Results from the Heinz Nixdorf Recall Study.

    PubMed

    Casjens, Swaantje; Pesch, Beate; Robens, Sibylle; Kendzia, Benjamin; Behrens, Thomas; Weiss, Tobias; Ulrich, Nadin; Arendt, Marina; Eisele, Lewin; Pundt, Noreen; Marr, Anja; van Thriel, Christoph; Van Gelder, Rainer; Aschner, Michael; Moebus, Susanne; Dragano, Nico; Jöckel, Karl-Heinz; Brüning, Thomas

    2017-01-01

    Occupational exposure to manganese (Mn) has been associated with impairments in olfaction and motor functions, but it has yet to be determined if such effects persist upon cessation of exposure. The objective of this study was to evaluate the influence of former occupational Mn exposure on olfaction within the framework of a prospective cohort study among an elderly German population. Information on job tasks with recognized Mn exposure and data on odor identification assessed with Sniffin' sticks was collected during the second follow-up of the Heinz Nixdorf Recall Study. The study population consisted of 1385 men aged 55-86 years, 354 of whom ever worked in jobs with potential Mn exposure (median 58.3μg/m(3) years, interquartile range 19.0-185μg/m(3) years). Multiple exposure measures, including job tasks, cumulative Mn exposure, and Mn determined in blood samples (MnB) archived at baseline, were used to estimate effects of Mn on olfaction. Having ever worked as welder was associated with better olfaction compared to other blue-collar workers without Mn exposure. Blue-collar workers identified less odors in comparison to white-collar workers. Concentrations of previous Mn exposure >185μg/m(3) years or MnB ≥15μg/L were not associated with impaired olfaction. In addition to a strong age effect, participants with lower occupational qualification identified less odors. We found no relevant association of former Mn exposure at relatively low levels with impaired olfaction. Possible neurotoxic Mn effects may not be persistent after cessation.

  17. Asymptomatic bacteriuria - prevalence in the elderly population.

    PubMed

    Ariathianto, Yohanes

    2011-10-01

    To identify the prevalence of asymptomatic bacteriuria in the elderly population and to examine associated risk factors, complications and natural history, and whether treatment improves prognosis. A literature search of MEDLINE, PubMed and the Cochrane Library was undertaken of studies published from 1980 to 2009. A total of 70 articles were identified. Emphasis was given to randomised controlled trials, review articles and more recent publications. Asymptomatic bacteriuria is common in the elderly, especially among institutionalised or hospitalised patients. Risk factors include cognitive impairment, diabetes mellitus, structural urinary tract abnormalities and indwelling catheters. Antimicrobial therapy does not result in improved survival or genitourinary morbidity and may potentially cause avoidable side effects and the emergence of resistant organisms. Bacteriuria is common in functionally impaired elderly patients. In the absence of symptoms or signs of infection, routine dipstick screening and subsequent antimicrobial therapy is not recommended.

  18. The assessment of cognitive impairment suspected of dementia in Polish elderly people: results of the population-based PolSenior Study.

    PubMed

    Klich-Rączka, Alicja; Piotrowicz, Karolina; Mossakowska, Małgorzata; Skalska, Anna; Wizner, Barbara; Broczek, Katarzyna; Wieczorowska-Tobis, Katarzyna; Grodzicki, Tomasz

    2014-09-01

    The growing incidence of dementia in ageing societies is a major concern of health care organizations. Because of its detrimental influence on the mental and functional statuses of elderly people, it leads to increased economic burdens caused by the social and financial needs of patients with dementia and their caregivers. There has been no data concerning the prevalence of dementia in the elderly in the general Polish community so far. The main aim of the study was to assess the prevalence of cognitive impairment suspected of dementia among the Polish elderly and the relationships between cognitive performance and age, gender, place of residence and educational status. The presented data was the result of nationwide, multicentre PolSenior Study conducted from 2007 to 2011 in the Polish elderly population. Cognitive functions were evaluated using Mini-Mental State Examination (MMSE) performed by pre-trained nurses. The result of MMSE lower than 24 points was classified as cognitive impairment suspected of dementia and divided according to its severity into three stages: mild, moderate and severe dementia. The results were analysed in two ways: raw MMSE and MMSE scores after Mungas adjustment (MMSEadj), that is, corrected for age and educational level, and these were compared. To verify the suspicion of dementia an assessment was complemented by an interview of carers for the occurrence and course of memory disorders, treatment of dementia and by functional status assessment. In order to assess the prevalence of suspicion of dementia in the general Polish population, statistical analyses based on weighting were done. The suspicion of dementia on the basis of raw MMSE was made in 20.4% of respondents aged 65years and more, and after Mungas adjustment in 12.1% of older subjects. The prevalence of cognitive impairment grew with increasing age, as well as depending on the educational status of elderly respondents in both types of analyses; raw MMSE and MMSEadj. There

  19. Urinary tract infections in the elderly population.

    PubMed

    Matthews, S James; Lancaster, Jason W

    2011-10-01

    Urinary tract infections (UTIs) are a common problem in the elderly population. The spectrum of disease varies from a relatively benign cystitis to potentially life-threatening pyelonephritis. This review covers the management of asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter-associated bacteriuria/symptomatic UTIs, and antibiotic prophylaxis for recurrent infections in elderly men and women. Literature was obtained from English-language searches of MEDLINE (1966-April 2011), Cochrane Library, BIOSIS (1993-April 2011), and EMBASE (1970-April 2011). Further publications were identified from citations of resulting articles. Search terms included, but were not limited to, urinary tract infections, asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter associated urinary tract infections, recurrent urinary tract infections, and elderly. The prevalence of UTIs in elderly women depends on the location in which these women are living. For elderly women living in the community, UTIs compromise the second most common infection, whereas in residents of long-term care facilities (LTCFs) and hospitalized subjects, it is the number one cause of infection. The spectrum of patient presentation varies from classic signs and symptoms in the independent elderly population to atypical presentations, including increased lethargy, delirium, blunted fever response, and anorexia. Although there are few guidelines specifically directed toward the management of UTIs in the elderly population, therapy generally mirrors the recommendations for the younger adult age groups. When choosing a treatment regimen, special attention must be given to the severity of illness, living conditions, existing comorbidities, presence of external devices, local antibiotic resistance patterns, and the ability of the patient to comply with therapy. Improved guidelines

  20. Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study.

    PubMed

    Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Barillaro, Christian; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

    2013-04-01

    There is increasing evidence that anorexia of aging can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between anorexia and sarcopenia in elderly persons aged 80 years or older. Data are from the baseline evaluation of 354 subjects enrolled in the ilSIRENTE study. The ilSIRENTE study is a prospective cohort study performed in the mountain community living in the Sirente geographic area (L'Aquila, Abruzzo) in Central Italy. We defined anorexia as the presence of loss of appetite and/or lower food intake. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. The relationship between anorexia and sarcopenia was estimated by deriving odds ratios from the multiple logistic regression models considering sarcopenia as the dependent variable. Nearly 21 % of the study sample showed symptoms of anorexia. Using the EWGSOP-suggested algorithm, 103 subjects (29.1 %) with sarcopenia were identified. Thirty-four (46.6 %) participants were affected by sarcopenia among subjects with anorexia compared to 69 subjects [24.6 %] without anorexia (p < 0.001). After adjusting for potential confounders including age, gender, functional and cognitive impairment, physical activity, urinary incontinence, comorbidity, congestive heart failure, COPD, depression, anti-cholinergic drugs, and TNF-α plasmatic levels, participants with anorexia had a higher risk of sarcopenia compared with non-anorexic subjects (HR 1.88, 95 % CI 1.01-3.51). Anorexia is common among community-dwelling older subjects in Italy. Our results suggest that among old-old subjects, anorexia is independently associated with sarcopenia.

  1. Patterns of prescription drug utilization in elder Mexican Americans: results from the Hispanic EPESE Study. Established Population for the Epidemiologic Study of the Elderly.

    PubMed

    Espino, D V; Palmer, R F; Mouton, C P; Miles, T P; Bayne, N S; Markides, K S

    2000-01-01

    The objective of this study was to determine the patterns of prescription medication usage among community-dwelling Mexican-American elders. This was a cross-sectional survey of a regional probability sample of 2,895 community-dwelling Mexican Americans, aged 65 and over. Of the sample, 58.1% used at least one prescribed medication within the two weeks prior to their participation in the study. Women were significantly more likely than men to use analgesics, non-steroidal anti-inflammatory agents, prescription nutritional supplements, and other central nervous system and endocrine medications. Subjects aged 75 and over were more likely to use cardiovascular medications, nutritional supplements, ophthalmic preparations and antihistamines, while those in the age groups 65-69 and 70-74 were more likely to use hypoglycemic and endocrine medications. Interestingly, there was a significantly decreased usage of hypoglycemic medications in the older age group (aged 75 and over) as compared with the younger age groups (65-69 and 69-74). This may indicate that Mexican American elders are dying at younger ages from complications related to diabetes mellitus and are not alive to use hypoglycemic medications at ages 75 and over. Also, men used more hypoglycemic medication than women (77% vs 70%). There was no relationship between use of medication and severity of diabetic illness.

  2. Renal Replacement Therapy in the Elderly Population

    PubMed Central

    Berger, Joseph R.

    2012-01-01

    Summary ESRD has become an important problem for elderly patients. The segment of the ESRD population age 65 years or older has grown considerably, and this growth is expected to accelerate in coming years. Nephrologists caring for the elderly with advanced kidney disease will encounter patients with comorbid conditions common in younger patients, as well as physical, psychological, and social challenges that occur with increased frequency in the aging population. These challenging factors must be addressed to help inform decisions regarding the option to initiate dialysis, the choice of dialysis modality, whether to pursue kidney transplantation, and end-of-life care. This article will highlight some common problems encountered by elderly patients with ESRD and review data on the clinical outcomes of elderly patients treated with different modalities of dialysis, outcomes of kidney transplantation in the elderly, and nondialytic management of CKD stage 5. PMID:22516288

  3. Inequalities in out-of-pocket payments for health care services among elderly Germans – results of a population-based cross-sectional study

    PubMed Central

    2014-01-01

    Introduction In order to limit rising publicly-financed health expenditure, out-of-pocket payments for health care services (OOPP) have been raised in many industrialized countries. However, higher health-related OOPP may burden social subgroups unequally. In Germany, inequalities in OOPP have rarely been analyzed. The aim of this study was to examine OOPP of the German elderly population in the different sectors of the health care system. Socio-economic and morbidity-related determinants of inequalities in OOPP were analyzed. Methods This cross-sectional analysis used data of N = 3,124 subjects aged 57 to 84 years from a population-based prospective cohort study (ESTHER study) collected in the Saarland, Germany, from 2008 to 2010. Subjects passed a geriatric assessment, including a questionnaire for health care utilization and OOPP covering a period of three months in the following sectors: inpatient care, outpatient physician and non-physician services, medical supplies, pharmaceuticals, dental prostheses and nursing care. Determinants of OOPP were analyzed by a two-part model. The financial burden of OOPP for certain social subgroups (measured by the OOPP-income-ratio) was investigated by a generalized linear model for the binomial family. Results Mean OOPP during three months amounted to €119, with 34% for medical supplies, 22% for dental prostheses, 21% for pharmaceuticals, 17% for outpatient physician and non-physician services, 5% for inpatient care and 1% for nursing care. The two-part model showed a significant positive association between income (square root equivalence scale) and total OOPP. Increasing morbidity was associated with significantly higher total OOPP, and in particular with higher OOPP for pharmaceuticals. Total OOPP amounted to about 3% of disposable income. The generalized linear model for the binomial family showed a significantly lower financial burden for the wealthiest quintile as compared to the poorest one. Conclusions This is

  4. Relationship between circulating visfatin/NAMPT, nutritional status and insulin resistance in an elderly population - results from the PolSenior substudy.

    PubMed

    Olszanecka-Glinianowicz, Magdalena; Owczarek, Aleksander; Bożentowicz-Wikarek, Maria; Brzozowska, Aniceta; Mossakowska, Małgorzata; Zdrojewski, Tomasz; Grodzicki, Tomasz; Więcek, Andrzej; Chudek, Jerzy

    2014-11-01

    Circulating visfatin/nicotinamide phosphoribosyltransferase (visfatin/NAMPT) levels according to some studies are related to nutritional status and insulin resistance. These associations have not been studied in large elderly populations. Therefore, the aim of our study was to assess the relationships between circulating visfatin/NAMPT levels, nutritional status, and insulin resistance in a large population of the elderly. Concentrations of glucose, albumin, creatinine, CRP, interleukin-6, insulin, and visfatin/NAMPT (by ELISA) were assessed, and HOMA-IR calculated in 3050 elderly participants of the PolSenior study. The highest plasma visfatin/NAMPT levels were observed in obese, as well as in non-diabetic insulin resistant subjects; however there were only significant differences found in women. The regression models showed that plasma visfatin/NAMPT levels decline with age and increased with waist circumference, BMI, and hs-CRP. Waist circumference was better correlated than BMI for visfatin/NAMPT levels in statistical models not adjusted by sex, and just the opposite in models which were. We demonstrated a 0.023ng/mL increase of Visfatin/NAMPT levels for 1mg/L increase of hs-CRP, and a 0.007ng/mL decline for each year of age. Our study revealed that in elderly subjects, circulating visfatin/NAMPT levels are related to age, nutritional status, especially visceral obesity, and inflammation. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE

    PubMed Central

    Guillén, Montserrat; Crimmins, Eileen M.

    2013-01-01

    Differences in health care utilization of immigrants 50 years of age and older relative to the native-born populations in eleven European countries are investigated. Negative binomial and zero-inflated Poisson regression are used to examine differences between immigrants and native-borns in number of doctor visits, visits to general practitioners, and hospital stays using the 2004 Survey of Health, Ageing, and Retirement in Europe database. In the pooled European sample and in some individual countries, older immigrants use from 13 to 20% more health services than native-borns after demographic characteristics are controlled. After controlling for the need for health care, differences between immigrants and native-borns in the use of physicians, but not hospitals, are reduced by about half. These are not changed much with the incorporation of indicators of socioeconomic status and extra insurance coverage. Higher country-level relative expenditures on health, paying physicians a fee-for-service, and physician density are associated with higher usage of physician services among immigrants. PMID:21660564

  6. Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE.

    PubMed

    Solé-Auró, Aïda; Guillén, Montserrat; Crimmins, Eileen M

    2012-12-01

    Differences in health care utilization of immigrants 50 years of age and older relative to the native-born populations in eleven European countries are investigated. Negative binomial and zero-inflated Poisson regression are used to examine differences between immigrants and native-borns in number of doctor visits, visits to general practitioners, and hospital stays using the 2004 Survey of Health, Ageing, and Retirement in Europe database. In the pooled European sample and in some individual countries, older immigrants use from 13 to 20% more health services than native-borns after demographic characteristics are controlled. After controlling for the need for health care, differences between immigrants and native-borns in the use of physicians, but not hospitals, are reduced by about half. These are not changed much with the incorporation of indicators of socioeconomic status and extra insurance coverage. Higher country-level relative expenditures on health, paying physicians a fee-for-service, and physician density are associated with higher usage of physician services among immigrants.

  7. Anemia and activities of daily living in the Korean urban elderly population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA).

    PubMed

    Bang, Soo-Mee; Lee, Jeong-Ok; Kim, Yu Jung; Lee, Keun-Wook; Lim, Soo; Kim, Jee Hyun; Park, Young Joo; Chin, Ho Jun; Kim, Ki Woong; Jang, Hak-Chul; Lee, Jong Seok

    2013-01-01

    This study was planned to investigate the prevalence and risk factors of anemia and its impact on health-related quality of life and activities of daily living (ADL) in elderly Koreans. Of the 1,118 randomly sampled elderly Koreans aged 65 years or older living in Seongnam, Korea, on Aug. 1, 2005, we estimated the prevalence of anemia from 695 responders. We investigated the risk factors of anemia using a merged sample of this random sample and 270 volunteers enrolled from Seongnam residents aged 85 years or older. We diagnosed anemia according to the World Health Organization criteria. The estimated age- and gender-standardized prevalence of anemia was 8.33 % for the overall random sample (95 % confidence intervals (CI) 6.28-10.39), 10.58 % in men (95 % CI 7.09-14.07), and 6.85 % in women (95 % CI 4.37-9.34). The identified risk factors were age ≥80 years, male, iron deficiency, history of stroke, renal dysfunction, and metabolic syndrome. Anemia was associated with impairment in physical functioning (p = 0.031) and instrumental ADL (p < 0.001). This is the first report about anemia's prevalence in community-dwelling Korean elders, adjusted and standardized according to the city's and nation's population. Timely diagnosis of anemia and correction of its treatable cause may improve QOL and ADL in elderly individuals.

  8. Personality, Cortisol, and Cognition in Non-demented Elderly Subjects: Results from a Population-Based Study.

    PubMed

    Ouanes, Sami; Castelao, Enrique; von Gunten, Armin; Vidal, Pedro M; Preisig, Martin; Popp, Julius

    2017-01-01

    Certain personality traits, in particular higher neuroticism, have been associated, on one hand, with elevated cortisol levels, and on the other hand, with poorer cognitive performance. At the same time, several studies highlighted the association between high cortisol and poor cognitive functioning. Here, we hypothesized that increased cortisol may be associated with poorer cognition and with certain personality traits (mainly high neuroticism), and that personality might explain the association between cortisol and cognition. A cross-sectional analysis was conducted using data from Colaus/PsyColaus, a population-based study involving residents of Lausanne, Switzerland. Salivary cortisol samples (upon waking, 30 min after waking, at 11 am and at 8 pm) along with cognitive and personality measures were obtained from 643 non-demented participants aged at least 65. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI). We examined the links between the cortisol Area under the Curve (AUC), the Clinical Dementia Rating Sum of Boxes (CDRSOB) and the NEO-FFI scores. No association was found between personality traits and the CDRSOB or the MMSE score, controlling for age, sex, depression, education and BMI. However, the executive functioning domain z-score was negatively associated with agreeableness (p = 0.005; slope = -0.107 [-0.181; -0.033]) and openness (p = 0.029; slope = -0.081 [-0.154; -0.008]) after controlling for age, sex, depression, education and BMI. The CDRSOB score was positively associated with the cortisol AUC after controlling for age, sex, BMI, education and depression, (p = 0.003; slope = 0.686 [0.240; 1.333]). This association remained significant after controlling for personality traits and for the interaction between personality traits and the cortisol AUC (p = 0.006; slope = 0.792 [0.233; 1.352]. High agreeableness and openness might be associated with poorer executive performance in later life. Increased cortisol may be

  9. Personality, Cortisol, and Cognition in Non-demented Elderly Subjects: Results from a Population-Based Study

    PubMed Central

    Ouanes, Sami; Castelao, Enrique; von Gunten, Armin; Vidal, Pedro M.; Preisig, Martin; Popp, Julius

    2017-01-01

    Certain personality traits, in particular higher neuroticism, have been associated, on one hand, with elevated cortisol levels, and on the other hand, with poorer cognitive performance. At the same time, several studies highlighted the association between high cortisol and poor cognitive functioning. Here, we hypothesized that increased cortisol may be associated with poorer cognition and with certain personality traits (mainly high neuroticism), and that personality might explain the association between cortisol and cognition. A cross-sectional analysis was conducted using data from Colaus/PsyColaus, a population-based study involving residents of Lausanne, Switzerland. Salivary cortisol samples (upon waking, 30 min after waking, at 11 am and at 8 pm) along with cognitive and personality measures were obtained from 643 non-demented participants aged at least 65. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI). We examined the links between the cortisol Area under the Curve (AUC), the Clinical Dementia Rating Sum of Boxes (CDRSOB) and the NEO-FFI scores. No association was found between personality traits and the CDRSOB or the MMSE score, controlling for age, sex, depression, education and BMI. However, the executive functioning domain z-score was negatively associated with agreeableness (p = 0.005; slope = -0.107 [-0.181; -0.033]) and openness (p = 0.029; slope = -0.081 [-0.154; -0.008]) after controlling for age, sex, depression, education and BMI. The CDRSOB score was positively associated with the cortisol AUC after controlling for age, sex, BMI, education and depression, (p = 0.003; slope = 0.686 [0.240; 1.333]). This association remained significant after controlling for personality traits and for the interaction between personality traits and the cortisol AUC (p = 0.006; slope = 0.792 [0.233; 1.352]. High agreeableness and openness might be associated with poorer executive performance in later life. Increased cortisol may be

  10. Unique Aspects of the Elderly Surgical Population

    PubMed Central

    Yang, Relin; Wolfson, Matthew; Lewis, Michael C.

    2011-01-01

    Increasing life expectancies paired with age-related comorbidities have resulted in the continued growth of the elderly surgical population. In this group, age-associated changes and decreased physiological reserve impede the body’s ability to maintain homeostasis during times of physiological stress, with a subsequent decrease in physiological reserve. This can lead to age-related physiological and cognitive dysfunction resulting in perioperative complications. Changes in the cardiovascular, pulmonary, nervous, hepatorenal, endocrine, skin, and soft tissue systems are discussed as they are connected to the perioperative experience. Alterations affect both the pharmacodynamics and pharmacokinetics of administered drugs. Elderly patients with coexisting diseases are at a greater risk for polypharmacy that can further complicate anesthetic management. Consequently, the importance of conducting a focused preoperative evaluation and identifying potential risk factors is strongly emphasized. Efforts to maintain intraoperative normothermia have been shown to be of great importance. Procedures to maintain stable body temperature throughout the perioperative period are presented. The choice of anesthetic technique, in regard to a regional versus general anesthetic approach, is debated widely in the literature. The type of anesthesia to be administered should be assessed on a case-by-case basis, with special consideration given to the health status of the patient, the type of operation being conducted, and the expertise of the anesthesiologist. Specifically addressed in this article are age-related cognitive issues such as postoperative cognitive dysfunction and postoperative delirium. Strategies are suggested for avoiding these pitfalls. PMID:23569671

  11. Prevalence of major depressive disorder and minor depressive disorder in an elderly Korean population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA).

    PubMed

    Park, Joon Hyuk; Lee, Jung Jae; Lee, Seok Bum; Huh, Yoonseok; Choi, Eun Ae; Youn, Jong Choul; Jhoo, Jin Hyeong; Kim, Jin Sun; Woo, Jong Inn; Kim, Ki Woong

    2010-09-01

    We investigated the prevalence, risk factors and impact of major depressive disorder (MDD) and minor depressive disorder (MnDD) in a randomly selected community-dwelling Korean elderly population. This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA). A study population of 1118 Korean elders was randomly sampled from residents of Seongnam, Korea aged 65 years or older. Standardized face-to-face interviews and neurological and physical examinations were conducted on 714 respondents using the Korean version of Mini International Neuropsychiatric Interview. MDD was diagnosed according to the DSM-IV criteria, and MnDD according to research criteria proposed in Appendix B of the DSM-IV criteria. Age-, gender- and education-standardized prevalence rates in Korean elders aged 65 years or older were estimated as 5.37% (95% CI=3.72-7.03) for MDD, 5.52% (95% CI=3.84-7.19) for MnDD, and 10.89% (95% CI=8.60-13.17) for overall late-life depression (LLD). A prior MDD episode (OR=3.07, 95% CI=1.38-6.82 in MDD, OR=3.44, 95% CI=1.49-7.94 in MnDD), female gender (OR=3.55, 95% CI=1.53-8.24 in MDD, OR=2.68, 95% CI=1.19-6.04 in MnDD) and history of stroke or TIA (OR=3.45, 95% CI=1.62-7.35 in MDD, OR=2.95, 95% CI=1.34-6.52 in MnDD) were associated with the risks of both MDD and MnDD. Lack of formal education (OR=2.75, 95% CI=1.30-5.85) and low income (OR=2.83, 95% CI=1.02-7.88) were associated with the risk of MDD only. Quality of life (QOL) of the MDD and MnDD patients was worse than that of non-depressed elders (P<0.001, ANOVA). MnDD was as prevalent as MDD in Korean elders and impacted QOL as MDD did. MnDD patients may increase in the future with accelerated population aging and westernization of lifestyle in Korea. 2010 Elsevier B.V. All rights reserved.

  12. Body mass index, waist-hip ratio and risk of chronic medical condition in the elderly population: results from the Well-being of the Singapore Elderly (WiSE) Study.

    PubMed

    Fauziana, Restria; Jeyagurunathan, Anitha; Abdin, Edimansyah; Vaingankar, Janhavi; Sagayadevan, Vathsala; Shafie, Saleha; Sambasivam, Rajeswari; Chong, Siow Ann; Subramaniam, Mythily

    2016-06-18

    The aim of the current study was to establish the prevalence and relationship of Body Mass Index (BMI) and Waist-Hip Ratio (WHR) with chronic health conditions and their associated socio-demographic correlates in the elderly population of Singapore. The data was extracted from the Well-being of the Singapore Elderly (WiSE) study, a comprehensive single phase, cross-sectional, population-based, epidemiological study conducted in 2013 among Singaporean residents (n = 2565) aged 60 years and above with a mean age of 72.7 years (range 60 to 105, SD = 9.53). The respondents were assessed with anthropometric measurements including height, weight, BMI, waist circumference, hip circumference and WHR. Participants provided information on their socio-demographic details and chronic health conditions. Prevalence of those who were obese, overweight, normal and underweight based on BMI was 8.7 %, 33.4 %, 52.5 % and 5.5 % respectively. Malays were more likely to be overweight compared to Chinese and Indians, while Malays and Indians were more likely to be obese compared to Chinese. Participants who were never married were less likely to be overweight compared to married. Participants aged 85 years and above were more likely to be underweight compared to those aged 60-75 years. Prevalence of high WHR (above 0.90 for men and 0.80 for women) was 79.8 % and this was more pervasive amongst Indians. Participants who were homemakers were more likely to have high WHR while those with tertiary education tended to have low WHR. Being overweight was associated with hypertension and heart problems, while obesity was associated with hypertension and diabetes, and a high WHR was associated with hypertension and diabetes. There were no significant differences in the other chronic conditions in this elderly population. This study demonstrates the importance of anthropometric measurements in the elderly and its association with certain chronic physical conditions, indicating

  13. Probability and amounts of yogurt intake are differently affected by sociodemographic, economic, and lifestyle factors in adults and the elderly-results from a population-based study.

    PubMed

    Possa, Gabriela; de Castro, Michelle Alessandra; Marchioni, Dirce Maria Lobo; Fisberg, Regina Mara; Fisberg, Mauro

    2015-08-01

    The aim of this population-based cross-sectional health survey (N = 532) was to investigate the factors associated with the probability and amounts of yogurt intake in Brazilian adults and the elderly. A structured questionnaire was used to obtain data on demographics, socioeconomic information, presence of morbidities and lifestyle and anthropometric characteristics. Food intake was evaluated using two nonconsecutive 24-hour dietary recalls and a Food Frequency Questionnaire. Approximately 60% of the subjects were classified as yogurt consumers. In the logistic regression model, yogurt intake was associated with smoking (odds ratio [OR], 1.98), female sex (OR, 2.12), and age 20 to 39 years (OR, 3.11). Per capita family income and being a nonsmoker were factors positively associated with the amount of yogurt consumption (coefficients, 0.61 and 3.73, respectively), whereas the level of education of the head of household was inversely associated (coefficient, 0.61). In this study, probability and amounts of yogurt intake are differently affected by demographic, socioeconomic, and lifestyle factors in adults and the elderly.

  14. Restless Legs Syndrome in a Nigerian Elderly Population

    PubMed Central

    Fawale, Michael B.; Ismaila, Isiaka Alani; Mustapha, Adekunle F.; Komolafe, Morenikeji A.; Adedeji, Tewogbade A.

    2016-01-01

    Study Objectives: The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. Methods: The study population comprised of 633 consecutive elderly individuals aged 65–105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Results: Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283–8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750–12.577; p = 0.002) was found. Conclusions: Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. Citation: Fawale MB, Ismaila IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless legs syndrome in a Nigerian elderly population. J Clin Sleep Med 2016;12(7):965–972. PMID:27070251

  15. Tetanus immunisation in the elderly population.

    PubMed Central

    Reid, P M; Brown, D; Coni, N; Sama, A; Waters, M

    1996-01-01

    OBJECTIVE--To emphasise that tetanus still occurs in the United Kingdom, particularly in elderly people-as illustrated by two case reports-and to examine the state of tetanus immunity in elderly people. METHODS--111 elderly people (over 65 years) were studied: 43 males, mean age 77.7 years, range 67-94; 68 females, mean age 81.3 years, range 67-95. They were either attending the accident service or were hospital inpatients. An attempt was made to obtain an immunisation history and antitetanus antibody titres were measured. RESULTS--Immunisation history was uncertain and unreliable. Measurement of antibody titres showed that they were inadequate to ensure protection in 50% of those studied. Low levels were particularly prevalent in the over 80 age group and in females. Questioning about military service confirmed that this had predominantly involved males. CONCLUSIONS--Elderly people are at risk of contracting tetanus and should be targeted for community immunisation. Extra precautions in the form of passive immunisation with human anti-tetanus immunoglobulin should be used in this age group in addition to the usual wound management measures when the elderly sustain tetanus prone injuries. PMID:8733655

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

    PubMed

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

    2015-10-01

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

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

    ERIC Educational Resources Information Center

    Iecovich, Esther

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Iecovich, Esther

    2005-01-01

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

  19. Time use and costs of institutionalised elderly persons with or without dementia: results from the Nordanstig cohort in the Kungsholmen Project--a population based study in Sweden.

    PubMed

    Nordberg, Gunilla; Wimo, Anders; Jönsson, Linus; Kåreholt, Ingemar; Sjölund, Britt-Marie; Lagergren, Mårten; von Strauss, Eva

    2007-07-01

    The aging of the population has become a worldwide phenomenon. This leads to increased demand for services and with limited resources it is important to find a way to estimate how resources can be match to those with greatest need. To analyse time use and costs in institutional care in relation to different levels of cognitive and functional capacity for elderly persons. The population consisted of all institutionalised inhabitants, 75 + years, living in a rural community (n = 176). They were clinically examined by physicians and interviewed by nurses. Staff and informal care-giving time was examined with the RUD (Resource Utilization in Dementia) instrument. Tobit regression analyses showed that having dementia increased the amount of ADL care time with 0.9 h when compared to those not having dementia, whereas each loss of an ADL function (0-6) added 0.6 h of ADL care time. Analysing the total care time use, the presence of dementia added more than 9 h, while each loss of one ADL function added 2.9 h. There were some informal care contributions, however with no correlation to severity in dependency. The estimated cost for institutional care increased with more than 85% for people being dependent in 5-6 ADL activities compared to persons with no functional dependency, and with 30% for persons with dementia compared to the non-demented. There is a variation in time use in institutional settings due to differences in ADL dependency but also whether dementia is present or not. This variation has implications for costs of institutional care.

  20. Application-Based Hearing Screening in the Elderly Population.

    PubMed

    Livshitz, Leonid; Ghanayim, Reem; Kraus, Carmi; Farah, Raymond; Even-Tov, Ella; Avraham, Yaniv; Sharabi-Nov, Adi; Gilbey, Peter

    2017-01-01

    The effects of age-related hearing loss are severe. Early detection is essential for maximum benefit. However, most hearing-impaired adults delay obtaining treatment. Diagnostic hearing testing at an appropriate facility is impractical, and new methods for screening audiometry aim to provide easy access for patients and reliable outcomes. The purpose of this study was to examine the accuracy of application-based hearing screening in an elderly population. The uHear application was downloaded to an iPad. Application-based hearing screening was performed in a non-soundproofed quiet room, and subsequently all participants underwent full diagnostic audiometry in a soundproof booth. Sixty patients were recruited and completed both tests. Significant differences were observed between the hearing results obtained with the application and the standard audiogram at all frequencies and in both ears. Following subtraction of a constant factor of 25 dB from the application-based results in order to compensate for ambient noise, no significant differences in pure tone average were found between the 2 methods. The uHear application is inaccurate in assessing hearing thresholds for screening in the elderly. However, when site-specifically corrected, the uHear application may be used as a screening tool for hearing loss in an elderly population. © The Author(s) 2016.

  1. Elder abuse in Chinese populations: a global review.

    PubMed

    Dong, XinQi

    2015-01-01

    This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.

  2. Elderly Black Farm Women: A Population at Risk.

    ERIC Educational Resources Information Center

    Carlton-LaNey, Iris

    1992-01-01

    Elderly black farm women are neglected segment of elderly population. Their self-reliance, mutual support, and rurality have helped keep them isolated and underserved. Ten such women recalled their productive lifestyles in oral-history interviews and described problems faced because of their advancing age, poor health, caregiving responsibilities,…

  3. Measurement of Aging Anxiety in an Elderly Australian Population.

    ERIC Educational Resources Information Center

    Watkins, Rochelle E.; Coates, Rosemary; Ferroni, Paola

    1998-01-01

    The Anxiety About Aging Scale (AAS) was modified to produce an instrument designed to assess aging anxiety in an elderly population; specifically, the future orientation of the AAS was modified for use with older adults. Validity testing was done on elderly individuals living in an independent community (N=123). (Author/EMK)

  4. Care for Canada's frail elderly population: Fragmentation or integration?

    PubMed Central

    Bergman, H; Béland, F; Lebel, P; Contandriopoulos, A P; Tousignant, P; Brunelle, Y; Kaufman, T; Leibovich, E; Rodriguez, R; Clarfield, M

    1997-01-01

    Budget constraints, technological advances and a growing elderly population have resulted in major reforms in health care systems across Canada. This has led to fewer and smaller acute care hospitals and increasing pressure on the primary care and continuing care networks. The present system of care for the frail elderly, who are particularly vulnerable, is characterized by fragmentation of services, negative incentives and the absence of accountability. This is turn leads to the inappropriate and costly use of health and social services, particularly in acute care hospitals and long-term care institutions. Canada needs to develop a publicly managed community-based system of primary care to provide integrated care for the frail elderly. The authors describe such a model, which would have clinical and financial responsibility for the full range of health and social services required by this population. This model would represent a major challenge and change for the existing system. Demonstration projects are needed to evaluate its cost-effectiveness and address issues raised by its introduction. PMID:9347783

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

    PubMed Central

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

    2007-01-01

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

  6. [Results of dental implantation in elderly patients].

    PubMed

    Botabaev, B K

    2010-01-01

    In absence of contraindications, with competent planning and complex oral mouth treatment and adequate use of surgical and orthopedic protocols, the dental implantation could be successfully implemented for esthetical and functional rehabilitation of elderly patients with different forms of adentia. Dental implantation can significantly increase the quality of life of elderly patients.

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

    PubMed

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

    2007-01-03

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

  8. Transradial approach for coronary procedures in the elderly population

    PubMed Central

    Aamir, Shamsi; Mohammed, Shah; Sudhir, Rathore

    2016-01-01

    Transradial cardiac catheterisation has been reported to be more beneficial compared to other approaches with easier and safer post-procedural haemostasis, better patient comfort, earlier ambulation and possibility of performing procedure and discharge on the same day. There is only limited data examining transradial access in the elderly population. In this review we looked at the available literature to give an insight into how the transradial approach compared to the transfemoral and other approaches in the elderly population. Elderly population is at higher risk of vascular access site bleeding and the transradial approach has shown equal efficacy to transfemoral approach. However, transradial approach significantly reduces vascular complications, hospital stay, mobilization times and adverse cardiac events. Therefore, transradial approach should be considered as the preferred vascular access site in the elderly population. PMID:27899945

  9. Cough in the elderly population: relationships with multiple comorbidity.

    PubMed

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

    2013-01-01

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

  10. Population aging and its impact on elderly welfare in Africa.

    PubMed

    Darkwa, K; Mazibuko, F N M; Candidate, P H D

    2002-01-01

    This article discusses the demographic transition and its impact on the welfare of the elderly in Africa. It provides a brief socio-demographic profile on elderly Africans. Also, it addresses challenges brought about by population aging and how it affects the provision of services to address the care giving needs of the elderly. Additionally, it examines the major features and limitations of current social insurance and retirement programs in Africa. Finally, it proposes measures to better meet the challenges brought about by population aging.

  11. Physical Activity Patterns in the Elderly Kashan Population

    PubMed Central

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

    2016-01-01

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

  12. [Anthropometric characterization of an institutionalized elderly population from Caracas, Venezuela].

    PubMed

    Hérrera, Hector; Rebato, Esther; Rocandio, Ana María; Hernández, Rosa; Rodríguez, Nahir; Barbosa, Johanna; Hernández-Valera, Yolanda

    2005-06-01

    Most of the anthropometric standards are derived from adult populations but not from older subjects, so their use to evaluate the nutritional status in the elderly may not be the most appropriate. In this sense, the anthropometric characteristics and their relationship to sex and age in a cross-sectional sample of 809 Venezuelan subjects (370 males and 439 females), aged 60 to 102 years old, randomly selected from a elderly institution-alised population were studied. The results indicate that anthropometric variables show different degrees and signs of sexual dimorphism. Males presented higher stature, weight, waist and calf circumferences and higher bone diameters, while females have higher hip and thigh perimeters, and bigger trunk and extremities skinfolds. Independently of the changes observed in these variables with age, the difference spread between the sexes tends to stay and even to increase with age in the height and weight, in hip perimeter and in thigh and calf skinfolds; while, on the contrary, they attenuate in waist perimeter and in triceps, subescapular and suprailiac skinfolds. Males and females appear to be more similar for these variables in the advanced ages. In general, these results could be used as reference elements for similar researches in Venezuela, due to the low number of studies developed in the country in older populations

  13. Tetanus immunisation in the elderly population.

    PubMed

    Reid, P M; Brown, D; Coni, N; Sama, A; Waters, M

    1996-05-01

    To emphasise that tetanus still occurs in the United Kingdom, particularly in elderly people-as illustrated by two case reports-and to examine the state of tetanus immunity in elderly people. 111 elderly people (over 65 years) were studied: 43 males, mean age 77.7 years, range 67-94; 68 females, mean age 81.3 years, range 67-95. They were either attending the accident service or were hospital inpatients. An attempt was made to obtain an immunisation history and antitetanus antibody titres were measured. Immunisation history was uncertain and unreliable. Measurement of antibody titres showed that they were inadequate to ensure protection in 50% of those studied. Low levels were particularly prevalent in the over 80 age group and in females. Questioning about military service confirmed that this had predominantly involved males. Elderly people are at risk of contracting tetanus and should be targeted for community immunisation. Extra precautions in the form of passive immunisation with human anti-tetanus immunoglobulin should be used in this age group in addition to the usual wound management measures when the elderly sustain tetanus prone injuries.

  14. Depression and elder abuse and neglect among a community-dwelling Chinese elderly population.

    PubMed

    Dong, XinQi; Simon, Melissa A; Odwazny, Richard; Gorbien, Martin

    2008-01-01

    Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51-5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53-5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35-5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10-4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49-7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.

  15. Falling in the elderly: Do statistical models matter for performance criteria of fall prediction? Results from two large population-based studies.

    PubMed

    Kabeshova, Anastasiia; Launay, Cyrille P; Gromov, Vasilii A; Fantino, Bruno; Levinoff, Elise J; Allali, Gilles; Beauchet, Olivier

    2016-01-01

    To compare performance criteria (i.e., sensitivity, specificity, positive predictive value, negative predictive value, area under receiver operating characteristic curve and accuracy) of linear and non-linear statistical models for fall risk in older community-dwellers. Participants were recruited in two large population-based studies, "Prévention des Chutes, Réseau 4" (PCR4, n=1760, cross-sectional design, retrospective collection of falls) and "Prévention des Chutes Personnes Agées" (PCPA, n=1765, cohort design, prospective collection of falls). Six linear statistical models (i.e., logistic regression, discriminant analysis, Bayes network algorithm, decision tree, random forest, boosted trees), three non-linear statistical models corresponding to artificial neural networks (multilayer perceptron, genetic algorithm and neuroevolution of augmenting topologies [NEAT]) and the adaptive neuro fuzzy interference system (ANFIS) were used. Falls ≥1 characterizing fallers and falls ≥2 characterizing recurrent fallers were used as outcomes. Data of studies were analyzed separately and together. NEAT and ANFIS had better performance criteria compared to other models. The highest performance criteria were reported with NEAT when using PCR4 database and falls ≥1, and with both NEAT and ANFIS when pooling data together and using falls ≥2. However, sensitivity and specificity were unbalanced. Sensitivity was higher than specificity when identifying fallers, whereas the converse was found when predicting recurrent fallers. Our results showed that NEAT and ANFIS were non-linear statistical models with the best performance criteria for the prediction of falls but their sensitivity and specificity were unbalanced, underscoring that models should be used respectively for the screening of fallers and the diagnosis of recurrent fallers. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Adverse drug reactions in special populations – the elderly

    PubMed Central

    Davies, E A; O’Mahony, M S

    2015-01-01

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

  17. Elderly black farm women: a population at risk.

    PubMed

    Carlton-LaNey, I

    1992-11-01

    Elderly black farm women are a neglected segment of the elderly population. Their self-reliance, mutual support, and rurality have helped keep them isolated and underserved. This article describes the productive life-styles that 10 such women in southeastern North Carolina recalled in oral-history interviews and the problems these women face because of their advancing age, poor health, caregiving responsibilities, and isolation and the deterioration of traditional resources.

  18. Low-Income and Elderly Populations.

    ERIC Educational Resources Information Center

    Brun, Judy K.; Clancy, Katherine L.

    1980-01-01

    Recommendations are given in this task force report which focus on nutrition education programs for the low income and elderly. Issues include: accessibility to food, national policy, nutritionally vulnerable individuals, program development, health care, preparation of nutrition educators, and evaluation of existing nutrition programs. (SA)

  19. Low-Income and Elderly Populations.

    ERIC Educational Resources Information Center

    Brun, Judy K.; Clancy, Katherine L.

    1980-01-01

    Recommendations are given in this task force report which focus on nutrition education programs for the low income and elderly. Issues include: accessibility to food, national policy, nutritionally vulnerable individuals, program development, health care, preparation of nutrition educators, and evaluation of existing nutrition programs. (SA)

  20. Flexible-dose fesoterodine in elderly adults with overactive bladder: results of the randomized, double-blind, placebo-controlled study of fesoterodine in an aging population trial.

    PubMed

    Wagg, Adrian; Khullar, Vik; Marschall-Kehrel, Daniela; Michel, Martin C; Oelke, Matthias; Darekar, Amanda; Bitoun, Caty E; Weinstein, David; Osterloh, Ian

    2013-02-01

    To assess the efficacy and safety of flexible-dose fesoterodine in elderly adults with overactive bladder (OAB). Twelve-week, randomized, double-blind, placebo-controlled trial. Sixty-one outpatient clinics in Europe, Israel, and Turkey. Seven hundred ninety-four individuals aged 65 and older (47% male) with OAB symptoms for 3 months or longer, mean of eight or more micturitions and three or more urgency episodes per 24 hours, at least some moderate problems on Patient Perception of Bladder Condition (PPBC), and Mini-Mental State Examination (MMSE) score of 20 or greater. Participants were randomized to fesoterodine or placebo for 12 weeks, with stratification according to age (>75 vs ≤ 75) and dosing time (morning vs evening). Participants receiving fesoterodine started on 4 mg and could increase to 8 mg at week 4 or 8 and de-escalate to 4 mg at week 8 (sham escalation for placebo). Changes from baseline in bladder-diary variables (primary endpoint, urgency episodes) and patient-reported outcomes including OAB Questionnaire, Treatment Benefit Scale (TBS), PPBC, Urgency Perception Scale (UPS), and OAB Satisfaction Questionnaire (OAB-S); all observed or reported adverse events. By week 8, 64% of fesoterodine-treated and 71% of placebo-treated participants opted for dose escalation. At week 12, the fesoterodine group had statistically significantly greater improvement than the placebo group in urgency episodes, micturitions, nocturnal micturitions, incontinence pad use, and OAB Questionnaire scores but not urgency urinary incontinence episodes. Responder rates on TBS, PPBC, UPS, and OAB-S were statistically significantly higher with fesoterodine. Improvements in most diary variables and participant-reported outcomes were greater with fesoterodine than placebo in participants in both age groups and when administered in the morning and evening. Rates of dry mouth and constipation were 34% and 9% with fesoterodine and 5% and 3% with placebo, respectively. Rates of

  1. Two populations in need. The Metropolitan Elder Care Alliance.

    PubMed

    Bridgeman, M; Karoll, N; Schuerman, C K

    1993-04-01

    The elderly population in the Chicago area benefits from an unusual home care aide program--one in which the aides also benefit: aides are drawn from the population receiving public assistance and given training that offers them a career ladder and opportunity they might otherwise not have had, all while helping others.

  2. Elder abuse and neglect in an urban chinese population.

    PubMed

    Dong, Xinqi; Simon, Melissa A; Gorbien, Martin

    2007-01-01

    This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.

  3. Nutrition and cognitive deficit in the elderly: a population study.

    PubMed

    Corrêa Leite, M L; Nicolosi, A; Cristina, S; Hauser, W A; Nappi, G

    2001-12-01

    To investigate the association between a healthy diet indicator and the prevalence of cognitive impairment in the elderly. Cross-sectional study. Population based. A total of 1651 subjects (560 men and 1091 women) including everybody aged 70 y or more, and a random sample of people (about 40%) aged 65-69 y resident in four rural towns in the province of Pavia, Italy in 1992-1993. The healthy diet indicator based on the WHO guidelines for the prevention of chronic diseases was calculated as reported by Huijbregts et al (1998; Eur. J. Clin. Nutr. 52, 826-831). Food intake was estimated by means of a 180-item food-frequency questionnaire and nutrient intake was calculated using the food composition database compiled for epidemiologic studies in Italy. The cognitive function was categorized into four levels-normal cognition, mild, moderate and severe cognitive deficit-according to the neuropsychological test score. The relationship between the dietary and the ordinal cognitive function variables was studied using the proportional-odds model. After adjustment for age, sex, education, total energy intake, cigarette smoking, alcohol consumption and physical activity, a better healthy diet score was associated with a lower prevalence of cognitive deficit. The cumulative odds ratio was 0.85 (95% CI 0.77-0.93). Our results suggest an association between a globally satisfactory diet and better cognitive performance in the elderly. However, the specific aspects of a 'healthy diet' for the elderly should be clarified. National Research Council (Italy), 'Invecchiamento' Project no. 95.01048.PF40.

  4. Potentially inappropriate prescribing in a population of frail elderly people.

    PubMed

    Récoché, Isabelle; Lebaudy, Cécile; Cool, Charlène; Sourdet, Sandrine; Piau, Antoine; Lapeyre-Mestre, Maryse; Vellas, Bruno; Cestac, Philippe

    2017-02-01

    Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention. Potentially inappropriate prescribing was defined by combining explicit criteria: Laroche list, screening tool of older people's prescriptions, and screening tool to alert to right treatment with an implicit method (drug utilization review for each medication). Prescriptions' optimizations were then suggested to the geriatricians of the day hospital and classified according to criteria defined by the French Society of Clinical Pharmacy. Main outcome measure Prevalence of potentially inappropriate prescribing. Results Among the 229 patients included, 71.2% had potentially inappropriate prescribing. 76 patients (33.2%) had at least one drug without any valid indication. 51 (22.3%) had at least one drug with an unfavorable benefit-to-risk ratio according to their clinical and biological data, 42 (18.3%) according to the Laroche list and 38 (16.6%) had at least one drug with questionable efficacy. Conclusion Our work shows that the incidence of PIP is high in the frail elderly and that, in most cases, it could be avoided with an adequate and regular reassessment of the prescriptions. In future, prescription optimization will be integrated into the personalized medical care plan to further prevent drug-related disability.

  5. Results of nutritional screening in institutionalized elderly in Hungary.

    PubMed

    Lelovics, Zsuzsanna; Bozó, Réka Kegyes; Lampek, Kinga; Figler, Mária

    2009-01-01

    Dietetics contributes to life-long, sustainable health and optimal life quality of people. The knowledge of the nutritional state can be informative and normative in order to optimize personal care. The aims of this study were to summarize the relevant legislative considerations of nourishing the elderly in different long-term residential social institutions and to screen the nutritional state of those living there. No investigation of this type has ever been carried out in Hungary or in central eastern Europe before. We used the malnutrition universal screening tool (MUST) screening program for the evaluation of nutritional status. Our survey was done in 20 Hungarian nursing homes in 2006. The sample (n=1381) was representative of regional distribution and number of residents. In our study population 38.2% of the patients were endangered in point of malnutrition. The results of our survey call attention to the elevated number of elderly people at risk of malnutrition in nursing homes. As malnutrition has serious consequences regarding also quality of life, nutritional screening of nursing home residents is not only a basic economical interest, but is also in full harmony with the idea "not only to feed, but to nourish" and it is a basic moral duty.

  6. Association of Personality Traits with Elder Self-Neglect in a Community Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2010-01-01

    Objective Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Methods Population-based study conducted from 1993–2005 of community-dwelling older adults (N=9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N=1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity and information processing. Logistic and linear regressions were used to assess these associations. Results In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Conclusion Neuroticism, extraversion, rigidity and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders. PMID:21788924

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  10. The dementia and disability project in Thai elderly: rational, design, methodology and early results

    PubMed Central

    2013-01-01

    Background A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects

  11. MEDICAL COSTS OF OSTEOPOROSIS IN THE ELDERLY MEDICARE POPULATION

    PubMed Central

    Blume, Steven W; Curtis, JR

    2013-01-01

    Introduction National cost estimates of osteoporosis and fractures in the U.S. have been based on diverse sets of provider data or selected commercial insurance claims. We sought to characterize prevalence and costs for osteoporosis using a random population-based sample of older adults. Methods A cross-sectional estimate of medical cost was made with 2002 data from the Medicare Current Beneficiary Survey (MCBS). MCBS combines health interviews with claims information from all payers to profile a random sample of 12,700 Medicare recipients. Three cohorts aged 65 or over were defined: 1) patients experiencing a fracture-related claim in 2002; 2) patients with a diagnosis, medication, or self-report for osteoporosis or past hip fracture; and 3) non-case controls. The total cost of patient claims was compared to that of controls using multivariate regression. Results Of 30.2 million elderly Medicare recipients in 2002, 1.6 million (5%) were treated for a fracture that year and an additional 7.2 million (24%) have osteoporosis without a fracture. The estimated mean impact of fractures on annual medical cost was $8600 (95%CI: $6400 to $10,800), implying a U.S. cost of $14 billion ($10 to $17 billion). Half of the non-fracture osteoporosis patients received drug treatment, averaging $500 per treated patient, or $2 billion nationwide. Conclusions The annual cost of osteoporosis and fractures in the U.S. elderly was estimated at $16 billion, using a national 2002 population-based sample. This amount corroborates previous estimates based on substantially different methodologies. Projected to 2008, the national cost of osteoporosis and fractures was $22 billion. PMID:21165602

  12. The Epidemiology of Meibomian Gland Dysfunction in an Elderly Population

    PubMed Central

    Alghamdi, Yousef A; Mercado, Carolina; McClellan, Allison L; Batawi, Hatim; Karp, Carol L; Galor, Anat

    2016-01-01

    Purpose To study the epidemiology of meibomian gland dysfunction (MGD) in an elderly, predominantly male population. Methods Prospective study of 233 subjects seen in the Miami Veterans Affairs eye clinic. Patients underwent a complete ocular surface examination, including dry eye questionnaires and tear assessments (osmolarity, tear break up time (TBUT), corneal staining, Schirmer’s). The main outcome measures were correlations between meibomian gland (MG) parameters and demographics, dry eye symptoms, and tear parameters. The studied MG parameters were eyelid vascularity and meibum quality; a score of ≥2 in either parameter was considered abnormal. Results Mean age of the 233 subjects was 63 (SD=11); 91% were male and 59% had at least one abnormal MG parameter (abnormal quality 55%; vascularity 17%). Demographically, patients with abnormal MG parameters were significantly older than their counterparts without these findings. Whites were more likely to have abnormal eyelid vascularity compared to blacks (n=36 (31%) versus n=1 (1%), p < 0.0005) but no differences were noted between races with respect to meibum quality. Abnormal meibum quality, but not abnormal vascularity, was significantly associated with more severe dry eye symptoms. Similarly, abnormal meibum quality, but not eyelid vascularity, significantly associated with worse dry eye signs, including decreased TBUT, and increased corneal staining (p<0.05 for all). Conclusion MGD is a frequent finding in an elderly, predominantly male population with racial differences noted in the frequency of abnormal eyelid vascularity but not in MG quality. Abnormal meibum quality was significantly associated with more severe dry eye symptoms and signs. PMID:27027919

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

    PubMed Central

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

    2014-01-01

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

  14. Surgery for invasive gynecologic cancer in the elderly female population.

    PubMed

    Lawton, F G; Hacker, N F

    1990-08-01

    Radical, curative surgery may not be considered in elderly patients with gynecologic cancer, yet the morbidity for this population from radiotherapy and cytotoxics may be high. This study compared the feasibility and outcome of such surgery in 226 consecutive patients, 72 women over 70 years old and 154 younger patients, in our institution over a 26-month period. Older patients presented with more advanced-stage cancers and, as a group, had significantly poorer presurgical performance status and more intercurrent medical problems. Nevertheless, the planned radical surgical procedure could be carried out in 90% of elderly patients, with a postoperative mortality of 1.5%. Minor postoperative complication rates were similar for the two groups and, except for vulvectomy patients, the mean inpatient stay was the same for both groups. Chronological age alone is a poor determinant of surgical risk, and elderly patients withstand radical surgery almost as well as their younger counterparts.

  15. Restless Legs Syndrome in a Nigerian Elderly Population.

    PubMed

    Fawale, Michael B; Ismail, Ishaq Alani; Mustapha, Adekunle F; Komolafe, Morenikeji A; Adedeji, Tewogbade A

    2016-07-15

    The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. The study population comprised of 633 consecutive elderly individuals aged 65-105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283-8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750-12.577; p = 0.002) was found. Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. © 2016 American Academy of Sleep Medicine.

  16. Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population

    PubMed Central

    Ma, Lina; Li, Yun; Wang, Jieyu; Zhu, Hong; Yang, Wei; Cao, Ruojin; Qian, Yuying; Feng, Ming

    2015-01-01

    Objective To explore the association between quality of life and social support in elderly osteoporosis patients in a Chinese population. Methods A total of 214 elderly patients who underwent bone mineral density screening were divided into two groups: elderly patients with primary osteoporosis (case group, n = 112) and normal elderly patients (control group, n = 102). Quality of life and social support were compared between the two groups. Results Quality of life and social support were significantly different between the case and control groups. The physical function, role-physical, bodily pain, general health, vitality, social-functioning, role-emotional and mental health scores in case group were significantly lower than those in the control group (P < 0.01). The objective support, subjective support, utilization of support, and total scores in case group were significantly lower than those in the control group (P < 0.01). Quality of life and social support were positively correlated in the case group (r = 0.672, P < 0.01). Conclusion Quality of life and social support in elderly patients with osteoporosis in China were poorer than in elderly patients without osteoporosis and were positively correlated. Our findings indicate that increased efforts to improve the social support and quality of life in elderly osteoporosis patients are urgently needed in China. Further longitudinal studies should be conducted to provide more clinical evidence to determine causative factors for the observed association between risk factors and outcomes. PMID:26061550

  17. [Comparative analysis of the migration increase dynamics of the elderly population living in the Samara region].

    PubMed

    Gridasov, G N; Zakharova, N O; Balueva, E S

    2011-01-01

    On the large amount of factual material we studied the dynamics of net migration of elderly in urban and rural areas of Samara region for the period from 2002 to 2009. We made a comparative analysis of changes in the structure and settlement characteristics of different groups of migrants (the elderly, children and able-bodied). We came to the conclusion, that the net migration of elderly in Samara region has considerably grown, mainly due to the influx of female population. The vector of net migration of people over working age moved into the countryside and this growth is ensured by older women to a large extent. The research results of one of the main demographic processes, migration, should be considered in the formation of local and regional policies for the elderly.

  18. A review of management strategies of malignant gliomas in the elderly population

    PubMed Central

    Kumthekar, Priya U; Macrie, Bryan D; Singh, Simran K; Kaur, Gurvinder; Chandler, James P; Sejpal, Samir V

    2014-01-01

    Glioblastoma Multiforme (GBM) is the most frequent primary malignant brain tumor in adults. It is an aggressive primary brain neoplasm, associated with a poor prognosis and median survival of less than 1 year. Approximately 50% of patients diagnosed with malignant gliomas in the United States are over the age of 65. Advancing age and poor performance status are two variables that have found to negatively affect prognosis. When compared to younger patients, not only is the treatment of elderly patients associated with decreased efficacy but also greater toxicity. As a result, elderly patients often receive less aggressive treatment and are excluded from clinical trials. There are many challenges in the treatment of elderly patients with GBM including increased surgical morbidity and mortality as well as increased toxicity to radiation and chemotherapy. As such, the optimal therapy remains unclear and controversial for the elderly malignant glioma population. PMID:25232486

  19. Elder Orphans Hiding in Plain Sight: A Growing Vulnerable Population

    PubMed Central

    Fujiwara, Janice; Liberman, Tara A.; Paris, Barbara

    2016-01-01

    Adults are increasingly aging alone with multiple chronic diseases and are geographically distant from family or friends. It is challenging for clinicians to identify these individuals, often struggling with managing the growing difficulties and the complexities involved in delivering care to this population. Clinicians often may not recognize or know how to address the needs that these patients have in managing their own health. While many such patients function well at baseline, the slightest insult can initiate a cascade of avoidable negative events. We have resurrected the term elder orphan to describe individuals living alone with little to no support system. Using public data sets, including the US Census and University of Michigan's Health and Retirement Study, we estimated the prevalence of adults 65 years and older to be around 22%. Thus, in this paper, we strive to describe and quantify this growing vulnerable population and offer practical approaches to identify and develop care plans that are consistent with each person's goals of care. The complex medical and psychosocial issues for elder orphans significantly impact the individual person, communities, and health-care expenditures. We hope to encourage professionals across disciplines to work cooperatively to screen elders and implement policies to prevent elder orphans from hiding in plain sight. PMID:27843450

  20. [Benzodiazepine use in elderly population in Latin America].

    PubMed

    Gómez, Saúl; León, Tomás; Macuer, Maximiliano; Alves, Mariana; Ruiz, Sergio

    2017-03-01

    Growing information has emphasized the risk of benzodiazepines (BZD), particularly among the elderly. However, the information available in Latin America is scarce. to review the available information on the use of BZD in older adults in Latin America to achieve an overview of the information currently available, and a thorough understanding of this phenomenon in our region. A systematic review with MeSH terms “elderly”, “latinamerican” and “benzodiazepines” was performed in PubMed and with each Latin American country. A search in databases SciELO and LILACS was also performed. In all, 126 items of finally selected 21 that met the inclusion criteria. Studies show that consumption of benzodiazepines in the elderly population in Latin America is high, with a preponderance of long half-life benzodiazepines in women, and frequent self-medication. The revised articles establish the importance of further study of the phenomenon of the use of benzodiazepines in our elderly population. Strikingly, scientific information is scarce, with most studies coming from only one country (Brazil). Moreover, most of them are transversal and descriptive, with few studies that explore long-term side effects, or specific hypotheses. Further studies should address these important issues.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. The evaluation of disability and its related factors among the elderly population in Kashan, Iran

    PubMed Central

    Adib-Hajbaghery, Mohsen; Aghahoseini, Shima

    2007-01-01

    Background Recent literature indicates that developing countries in Asia are aging faster than other countries in the world and disability has become one of the greater public health concern in these countries. Pausity of published data on the elderly disability in Iran signifies the importance of this study designed to evaluate the disability and its related factors among the elderly population in Kashan, Iran during 2006–2007. Methods/Design A cross-sectional study is conducting on a multy-stage random sample of elderly people in Kashan ages 65 years and older. Volunteer participants were included by age 65 and older and excluded if they had the medical diagnosis of Alzhimer disease. The WHO DAS II was used as the generic disability measure in this survey. The original version of WHO DAS II was translated into Farsi according to the standardized guidelines for cross-cultural adaptation of health-related measures. Upon completion of data collection the descriptive statistics will compute all the variables. Chi-square, t-test analysis and ANOVA will be used to examine significant differences between the subgroups. Discussion This is the first research protocol to study disability among the Iranian elderly population. Presently, 80% of eligible subjects have been selected. The results of this study will help to develop more effective protocols to assist Iranian elderly population with disabilities. PMID:17888171

  4. Prospective Study of the Elder Self-Neglect and Emergency Department Use in a Community Population

    PubMed Central

    Dong, XinQi; Simon, Melissa A.; Evans, Denis

    2011-01-01

    Purpose This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. Methods A prospective population-based study is conducted in a geographically-defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6,864 participants in the Chicago Health and Aging Project, 1,165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3) and for those with reported elder self-neglect was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, cognitive and physical function, elders who self-neglect had significantly higher rates of emergency department utilization (RR, 1.42, 95% CI, 1.29–1.58). Greater self-neglect severity (Mild: PE=0.27, SE=0.04, p<0.001; Moderate: PE=0.41, SE=0.03, p<0.001; Severe: PE=0.55, SE=0.09, p<0.001) was associated with increased rates of emergency department utilization, after considering the same confounders. Conclusion Elder self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. PMID:21411263

  5. Personalized surgical management of colorectal cancer in elderly population

    PubMed Central

    Ugolini, Giampaolo; Ghignone, Federico; Zattoni, Davide; Veronese, Giacomo; Montroni, Isacco

    2014-01-01

    Colorectal cancer (CRC) in the elderly is extremely common but only a few clinicians are familiar with the complexity of issues which present in the geriatric population. In this phase of the life cycle, treatment is frequently suboptimal. Despite the fact that, nowadays, older people tend to be healthier than in previous generations, surgical undertreatment is frequently encountered. On the other hand, surgical overtreatment in the vulnerable or frail patient can lead to unacceptable postoperative outcomes with high mortality or persistent disability. Unfortunately, due to the geriatric patient being traditionally excluded from randomized controlled trials for a variety of factors (heterogeneity, frailty, etc.), there is a dearth of evidence-based clinical guidelines for the management of these patients. The objective of this review was to summarize the most relevant clinical studies available in order to assist clinicians in the management of CRC in the elderly. More than in any other patient group, both surgical and non-surgical management strategies should be carefully individualized in the elderly population affected by CRC. Although cure and sphincter preservation are the primary goals, many other variables need to be taken into account, such as maintenance of cognitive status, independence, life expectancy and quality of life. PMID:24833841

  6. Posterior vaginal sling experience in elderly patients yields poor results.

    PubMed

    Mattox, T Fleming; Moore, Susan; Stanford, Edward J; Mills, Benjie B

    2006-05-01

    The objective of the study was to evaluate our experience with the posterior vaginal sling in an elderly population. Elderly patients with significant vaginal prolapse underwent a posterior vaginal sling using the IVS Tunneller device (Tyco Healthcare, United States Surgical, Norwalk, CT). Primary failure was defined as a postoperative pelvic organ prolapse quantitative point C (the apex of the vagina) within 2 cm of the preoperative value. Secondary failure was defined as any portion of the anterior or posterior vaginal walls protruding to or beyond the hymeneal ring (pelvic organ prolapse quantitative points Aa or Ap equal to or greater than 0). Twenty-one patients underwent the procedure; 19 were seen for follow up. The average age was 70 years (range 60-78). Twelve patients had primary or secondary failures (12 of 19, 63%). There were 5 primary failures (5 of 19, 26%) and 7 secondary failures (7 of 19, 37%). The mean time to failure was 7 weeks (range 1-18). In our elderly population, the posterior vaginal sling has a high failure rate, occurring early in the postoperative period.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2000-06-01

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

  10. [Burden of disease in the elderly population in Spain].

    PubMed

    Gènova-Maleras, Ricard; Álvarez-Martín, Elena; Catalá-López, Ferrán; Fernández de Larrea-Baz, Nerea; Morant-Ginestar, Consuelo

    2011-12-01

    We analyzed the burden of disease in the elderly population in Spain in 2008. A population-based cross-sectional study was performed to calculate the disability-adjusted life years (DALYs) of the Spanish population aged ≥ 60 years old. DALYs are the sum of the number of years of life lost (YLLs) and the number of years lived with disability (YLDs). Data sources included the national mortality register for YLLs, and inference of Euro-A subregion (including Spain) estimates for YLDs. In the elderly population, DALYs lost due to all diseases were estimated at 2.1 million. The main causes of DALYs were malignancies (21.3%), neuropsychiatric disorders (21.1%) and cardiovascular diseases (20.4%). The main specific subcategories were dementias, ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, hearing loss and osteoarthritis. Burden of disease analysis allows distinct health problems to be reassessed in relation to classical mortality analysis. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Prevalence and Correlates of Dental Caries in an Elderly Population in Northeast China

    PubMed Central

    Liu, Lu; Zhang, Ying; Wu, Wei; Cheng, Min; Li, Yan; Cheng, Ruibo

    2013-01-01

    Objectives The present study aimed to investigate the prevalence and correlates of dental caries in elderly population in northeast China. Methods A community-based, cross-sectional study among 2376 elderly subjects (age: 65–74 years) from nine urban areas and nine rural areas in three provinces of northeast China was conducted using multistage stratified random sampling per the World Health Organization oral health survey methodology. Decayed-missing-filled teeth (DMFT) and decayed-filled teeth (DFT) indices were used to evaluate the prevalence of dental caries. Face-to-face questionnaire survey on oral health was performed in a randomly selected subset (n = 1197). T test and chi square test were employed to compare groups for continuous and categorical variables, respectively. Multivariate logistic regression was used to estimate odds ratios (ORs) and corresponding confidence intervals (CIs). Results 67.5% of elderly subjects reported dental caries (average DFT = 2.68±3.40), and the prevalence was higher in urban areas (P<0.01). Missing teeth accounted for 80.72% of DMFT, and filled teeth due to caries accounted for 2.08% with a rate higher in urban areas (P<0.01). Logistic regression analysis indicated significant association among elderly population in urban areas (OR 1.713; 95% CI 1.337–2.195), smoking (OR 1.779; 95% CI 1.384–2.288), and individuals without dental insurance (OR 2.050; 95% CI 1.120–3.754) with dental caries. Conclusions The prevalence of dental caries in the elderly population in northeast China is high. The elderly from urban areas who smoke and who do not have a dental insurance are at a higher risk to develop dental caries. PMID:24260129

  12. Explaining Disability Trends in the U.S. Elderly and Near-Elderly Population

    PubMed Central

    Chen, Yiqun; Sloan, Frank A

    2015-01-01

    Objective To examine disability trends among U.S. near-elderly and elderly persons and explain observed trends. Data Source 1996–2010 waves of the Health and Retirement Study. Study Design We first examined trends in Activities of Daily Living and Instrumental Activities of Daily Living limitations, and large muscle, mobility, gross motor, and fine motor indexes. Then we used decomposition analysis to estimate contributions of changes in sociodemographic composition, self-reported chronic disease prevalence and health behaviors, and changes in disabling effects of these factors to disability changes between 1996 and 2010. Principal Findings Disability generally increased or was unchanged. Increased trends were more apparent for near-elderly than elderly persons. Sociodemographic shifts tended to reduce disability, but their favorable effects were largely offset by increased self-reported chronic disease prevalence. Changes in smoking and heavy drinking prevalence had relatively minor effects on disability trends. Increased obesity rates generated sizable effects on lower-body functioning changes. Disabling effects of self-reported chronic diseases often declined, and educational attainment became a stronger influence in preventing disability. Conclusions Such unfavorable trends as increased chronic disease prevalence and higher obesity rates offset or outweighed the favorable effects with the result that disability remained unchanged or increased. PMID:25655273

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

    PubMed

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

    2016-05-25

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

  14. Sleep correlates of depression and anxiety in an elderly Asian population.

    PubMed

    Yu, Junhong; Rawtaer, Iris; Fam, Johnson; Jiang, Min-Jun; Feng, Lei; Kua, Ee Heok; Mahendran, Rathi

    2016-05-01

    Research looking at the association between sleep and psychiatric symptoms in elderly Asian populations is lacking. The present study examines the sleep correlates of depression and anxiety in a sample of cognitively healthy older adults. The Geriatric Depression Scale, Geriatric Anxiety Inventory, and the Pittsburgh Sleep Quality Index were administered to a community sample of elderly participants (n = 107; 81 women; Mage = 71.3 years, SD = 5.7) RESULTS: Geriatric Depression Scale and Geriatric Anxiety Inventory scores are both significantly correlated with sleep disturbance. Geriatric Depression Scale scores are uniquely associated with daytime dysfunction, and Geriatric Anxiety Inventory scores are uniquely associated with perceived sleep quality, sleep latency, and global Pittsburgh Sleep Quality Index scores. Depression and anxiety in a cohort of elderly Asian subjects are associated with a number of sleep-related issues; both are related to a somewhat different profile of sleep problems. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  15. Preventive Care Use among the Belgian Elderly Population: Does Socio-Economic Status Matter?

    PubMed Central

    Hoeck, Sarah; van der Heyden, Johan; Geerts, Joanna; van Hal, Guido

    2013-01-01

    Objective: To analyze the association between influenza and pneumococcus vaccination and blood cholesterol and blood sugar measurement by Belgian elderly respondents (≥65 years) and socio-demographic characteristics, risk factors, health status and socio-economic status (SES). Methods: A cross-sectional study based on 4,544 non-institutionalized elderly participants of the Belgian Health Interview Surveys 2004 and 2008. Multivariate logistic regression models were constructed to examine the independent effect of socio-demographic characteristics, risk factors, health status and SES on the four preventive services. Results: After adjustment for age, sex, region, survey year, living situation, risk factors (body mass index, smoking status, physical activity) and health status (self-assessed health and longstanding illness) lower educated elderly were significantly less likely to report a blood cholesterol and blood sugar measurement. For instance, elderly participants with no degree or only primary education were less likely to have had a cholesterol and blood sugar measurement compared with those with higher education. Pneumococcus vaccination was not related to educational level, but lower income groups were more likely to have had a pneumococcus immunization. Influenza vaccination was not significantly related to SES. Conclusion: The results highlight the need to promote cholesterol and blood sugar measurement for lower SE groups, and pneumococcus immunization for the entire elderly population. Influenza immunization seems to be equally spread among different SE groups. PMID:24368427

  16. Predicting medication use in an elderly hypertensive sample: Revisiting the Established Populations for Epidemiologic Studies of the Elderly study

    PubMed Central

    Howard, Daniel L.; Kaufman, Jay S.; Holmes, DaJuanicia

    2009-01-01

    Though some research has begun to examine specific factors related to race that should be targeted in the design of interventions to improve medication adherence, there remains an underreporting of factors that contribute to the use of hypertensive medications by race. Methods This study examined medication use reported by a sample of elderly, controlled and uncontrolled hypertensive patients from the North Carolina Established Populations for the Epidemiologic Studies of the Elderly (NC EPESE) study. Results In the adjusted final multivariable models of medication use over time, in both Caucasian and African-American women, those with higher BMI were more likely to report taking their medication over time; satisfaction with their medical care was predictive among Caucasian women and receiving treatment from a minority physician was predictive among African-American women. Conclusion Focusing on individual-level characteristics and the different issues that may underlie specific ethnic groups, particularly health care provider characteristics, may help to develop more precisely targeted interventions to improve a full range of healthcare services that are often needed by elderly hypertensive patients. PMID:19110906

  17. One-leg standing test for elderly populations.

    PubMed

    Michikawa, Takehiro; Nishiwaki, Yuji; Takebayashi, Toru; Toyama, Yoshiaki

    2009-09-01

    The one-leg standing (OLS) test is one of the balance tests used to diagnose musculoskeletal ambulation disability symptom complex (MARS), a condition newly defined by three professional Japanese medical societies in 2006 to help identify the symptoms of motor organ deterioration and establish preventive strategies. Although many studies have used the OLS test, none has shown conclusively that the test can be used as a practical marker of frailty among elderly people, especially in community settings. Based on the type of epidemiological study -- i.e., descriptive epidemiology and analytical epidemiology (observational and intervention studies) -- we reviewed evidence on three fundamental issues related to the OLS test: (1) testing procedures and reference values; (2) the associations between the OLS time and negative events; (3) improvement of the OLS time by intervention. These issues are key to any discussion of whether the OLS test can be used as a practical marker for predicting frailty in community-dwelling elderly populations. Articles were collected from MEDLINE databases using the search terms "one- leg standing" and the other names included in the same category. Because various procedures are used to carry out the OLS test, the measured values for the OLS time varied widely from study to study. Some observational studies showed that the OLS time is related to negative events such as falls, declines in activity of daily living, and other morbidity. OLS times could be improved by several interventions. This review suggests that the OLS test can be a tool for predicting frailty in community-dwelling elderly populations. However, our review should be interpreted with caution because we did not confirm the evidence level of each of the studies we selected. Further research on this topic is needed.

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

    PubMed Central

    2010-01-01

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

  19. Lymphocyte Subsets in a Population of Nonfrail Elderly Individuals.

    PubMed

    Valdiglesias, Vanessa; Sánchez-Flores, María; Maseda, Ana; Marcos-Pérez, Diego; Millán-Calenti, José C; Pásaro, Eduardo; Lorenzo-López, Laura; Laffon, Blanca

    2015-01-01

    Age-related frailty is characterized by increased vulnerability to stress due to decline in homeostatic reserve, which results in increased risk of adverse health outcomes including disability, hospitalization, and death. The relationship between frailty and immunological system alterations is well established. Thus, analysis of immunological changes, such as alterations in lymphocyte subsets, during senescence may provide useful markers for frailty and associated pathologies. Since reference ranges currently used for lymphocyte subsets do not specifically differentiate the elderly group, the aim of this study was to (1) establish reference ranges in nonfrail elderly individuals and (2) assess the evolution of these parameters with age. Further, the influence of other physiological and lifestyle factors was also evaluated. The study was performed on 144 elderly individuals (aged 65-95) from Galicia (in northwestern Spain). Percentages of lymphocyte subpopulations (CD3(+) T lymphocytes, CD4(+) T-helper lymphocytes, CD8(+) T-cytotoxic lymphocytes, CD19(+) B lymphocytes, and CD56(+)16(+) natural killer cells) were analyzed in peripheral blood by flow cytometry, and reference ranges were calculated. The individual status as nonfrail or prefrail did not markedly affect the immunological parameters, but an apparent influence of age was obtained for %CD3(+), %CD4(+), and %CD19(+) cells, all of which fell with increasing age. Women showed higher levels of %CD19(+) lymphocytes. No significant influence of smoking habits, physical activity, or drinking alcohol or caffeine beverages was observed. The results obtained may serve as a basis to establish comparisons between frail and nonfrail elderly individuals, in order to determine the usefulness of lymphocyte subsets as immunological biomarkers of frailty.

  20. Description of spatio-temporal gait parameters in elderly people and their association with history of falls: results of the population-based cross-sectional KORA-Age study.

    PubMed

    Thaler-Kall, Kathrin; Peters, Annette; Thorand, Barbara; Grill, Eva; Autenrieth, Christine S; Horsch, Alexander; Meisinger, Christa

    2015-03-25

    In this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years. In addition, we investigated the associations between certain gait parameters and a history of falls in study participants. In descriptive analyses spatio-temporal gait parameters were assessed according to history of falls, frailty, multimorbidity, gender, multiple medication use, disability status, and age group. Logistic regression models were calculated to examine the association between gait velocity and stride length with a history of falls (at least one fall in the last 12 month). Data on gait were collected on an electronic walkway on which participants walked at their usual pace. We found significant differences within gait parameters when stratifying by frailty, multimorbidity, disability and multiple medication use as well as age (cut point 75 years) and sex, with p < 0.05 for all gait parameters (velocity, cadence, time, stride duration, stride length, step width). After stratification by history of falls, only stride length showed a significant difference (p < 0.05) between the groups of fallers and non-fallers. Logistic regression models showed that a decreased stride length was independently associated with falls in men aged older than 74 years (OR 1.34 (CI: 1.05-1.70 per 10 cm decrease)), while this was neither the case for women of similar age nor for men or women aged 65 to 74 years. A decreased walking speed was not associated with falls. Age, frailty, multimorbidity, disability, history of falls, sex, and multiple medication use show an association with different gait parameters measured during gait assessment on an electronic walkway in elderly people. Furthermore, stride length is a good indicator to differentiate fallers from non-fallers in older men from the general population.

  1. Effectiveness of telecare in elderly populations-a comparison of three settings.

    PubMed

    Onor, Maria L; Trevisiol, Marianna; Urciuoli, Ornella; Misan, Shai; Bertossi, Francesca; Tirone, Gabriella; Aguglia, Eugenio; Pascolo-Fabrici, Elisabetta

    2008-03-01

    The primary aim of this study was to assess the level of satisfaction with 3 types of formal care systems of the elderly: (1) a day care center, (2) a nursing home, and (3) telecare service in a group of oldest frail elderly, and to describe the characteristics of the population using the services. The study involved a population of 162 oldest elderly using 3 different types of formal care services. Study participants were asked to complete a questionnaire, investigating socio-demographic characteristics and degree of overall satisfaction with the service, as well as eliciting possible suggestions for improvement. In our study, nearly all subjects using the telecare service were satisfied or very satisfied (98.5%), as compared to 75.3% of those residing in a nursing home, and 76.5% of those attending the day care center. This result confirms the findings of previous studies on elderly subjects satisfaction with telecare services. Telecare, therefore, seems to be the service achieving the greatest levels of satisfaction, a service that can also be used by low-income subjects, by whom it is also perceived as a source of social support.

  2. Postprandial hypotension in the elderly: Findings in a Mexican population.

    PubMed

    Asensio, Enrique; Alvarez, José Benito; Lara, Susano; Alvarez de la Cadena, Jorge E; Juárez, Daniela

    2015-01-01

    Postprandial hypotension is a known cause of syncope in the elderly. Its prevalence is unknown in our country. A prospective cross-sectional study was performed to determine PPH's Prevalence in elderly adults of both an urban and a rural Community in the State of Queretaro. Blood pressure measurements included a basal pre-prandial record, minute 0 recording at the moment they finished the meal and every 10 min until a 90 min record was complete. We included a medical history, a mental state test for cognitive evaluation (Minimental) and Minnesota Quality of life score and a food macronutrient composition analysis. We included 256 subjects, 78.1 ± 8.8 years old, 195 (76.2%) female. Two-hundred and five subjects (80.1%) had Postprandial hypotension after one or both analyzed meals, with non-significant differences in the studied items. Sixty-six (26.2%) patients had "significant postprandial hypotension". Patients living in a special care facility had more postprandial hypotension than people at the family home (87-3% vs 69.8% respectively, p<0.0001). Post-prandial hypotension is a common finding in this elderly population. We did not find distinctive conditions or markers that allow identification of subjects at risk for postprandial hypotension and its complications. This should prompt for routine screenings in specialized facilities to prevent complications. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  3. [Gerontological profile of an elderly population in Tabasco, México].

    PubMed

    Guerrero-Pérez, Ramiro; Quevedo-Tejero, Elsy Del Carmen; García-Rochín, Ramón; Zavala-González, Marco A

    2012-01-01

    Defining the gerontological profile of an elderly population in Tabasco, Mexico. This was an observational, retrospective, cross-sectional, descriptive study. The study population consisted of 35,745 elderly adults who were enrolled in the Mexican Older Adults' Institute (Instituto Nacional de las Personas Adultas Mayores-INAPAM) in Tabasco. Sampling was not used. The selection criteria invol ved elderly adults who were enrolled in INAPAM from January/2004-December/2006. Socio-demographic, sanitary and personal preferences were the variables considered. INAPAM's Mexican Survey of Senior Citizens' database for the study period was used for providing the necessary information; descriptive statistics were used for analysis. Some elderly adults were unable to work (11.9 %); those working did so in the countryside (10.5 %). Almost all of them had some sort of income (99.8 %): family support (46 %) or employment (22.3 %). A fifth of the population were illiterate (21 %). Most of them li ved with someone else (88.9 %) with a spouse (57.3 %) or children (45.9 %). Most li ved in their own houses (87.1 %), had basic services (94.3 %) and a stove, television and refrigerator (74.5 %). The frequently occurring diseases were osteo-degenerative (50.4 %), ophthalmic (39.2 %) dental (16.3 %), high blood pressure-related, Diabetes mellitus and tumours. Most had social security (63.3 %) but mostly used Mexican Ministry of Health services (28.7 %). They fostered the following values: health (81.2 %), family (72.4 %) and love (45.9 %); sharing family time was the most frequent free-time activity (72 %) followed by religious activities (56.4 %). The aforementioned features formed the gerontological profile for elderly adults in Tabasco; and the results of this series partially differed from that reported by other Mexican institutions.

  4. Forefoot Surgery in Elderly Compared With Younger Patient Populations: Complications and Type of Procedure.

    PubMed

    Vermersch, Thibault; Fessy, Michel Henri; Besse, Jean-Luc

    2015-01-01

    In forefoot surgery, the presenting complaints and expected benefits differ between elderly and younger patients. The present study mapped forefoot procedures recommended to elderly patients compared with those recommended to the general population and assessed the complications according to age group and comorbidity. Consecutive patients were included in a single-center, continuous, retrospective case-control study. Three age groups were defined: <65 years, 65 to 74 years, and ≥ 75 years. All patients, regardless of age, underwent the same procedure; elderly-specific techniques such as the Keller procedure were not used. A total of 321 patients were included, with a mean age of 60.6 (range 16 to 86) years. A similar procedure was used in all 3 groups, but at differing frequencies, with arthrodesis and minor procedures increasing with increasing patient age. In all 3 groups, in the population as a whole, the incidence of delayed healing, deep infection, and nonunion was 9%, 1%, and 2%, respectively. These complications were independent of age group. In the <65-year-old group, just as in the study population as a whole, arthrodesis associated with resection arthroplasty resulted in greater rates of delayed healing and deep infection. The complications rates were equivalent among the 3 age groups. Major surgical procedures should be avoided in elderly patients, if possible. However, no particular procedure is contraindicated in the elderly, although the method of fixation must be robust owing to the frequency of osteoporosis. A first step would be to achieve consensus on the age threshold for "elderliness."

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

    PubMed Central

    2011-01-01

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

  6. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders.

    PubMed

    Gros, Auriane; Bensamoun, David; Manera, Valeria; Fabre, Roxane; Zacconi-Cauvin, Anne-Marie; Thummler, Susanne; Benoit, Michel; Robert, Philippe; David, Renaud

    2016-01-01

    Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia.

  7. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders

    PubMed Central

    Gros, Auriane; Bensamoun, David; Manera, Valeria; Fabre, Roxane; Zacconi-Cauvin, Anne-Marie; Thummler, Susanne; Benoit, Michel; Robert, Philippe; David, Renaud

    2016-01-01

    Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia. PMID:27877126

  8. Management of stage III colon cancer in the elderly: Practice patterns and outcomes in the general population.

    PubMed

    Merchant, Shaila J; Nanji, Sulaiman; Brennan, Kelly; Karim, Safiya; Patel, Sunil V; Biagi, James J; Booth, Christopher M

    2017-08-01

    Clinical trials have established surgical resection and adjuvant chemotherapy (ACT) as the standard management for stage III colon cancer; however, the extent to which these results apply to elderly patients in routine practice is unclear. This article describes the management and outcomes of elderly patients with stage III colon cancer. All cases of surgically resected colon cancer from 2002 to 2008 were identified with the population-based Ontario Cancer Registry. Pathology reports were obtained for a random sample (25% of all cases); those with stage III disease constituted the study population. The utilization of ACT, cancer-specific survival (CSS), and overall survival (OS) in elderly patients (≥70 years) and nonelderly patients (<70 years) were compared. The study population included 2920 patients, and 1521 (52%) were elderly. The 30- and 90-day mortality rates increased with advanced age: <70 years, 2% and 5%; 70 to 74 years, 3% and 7%; 75 to 79 years, 5% and 8%, and ≥80 years, 9% and 16% (P < .001). ACT was delivered to 48% of elderly patients and to 81% of younger patients (P < .001). Factors independently associated with ACT utilization among the elderly were a younger age (P < .001), male sex (P = .041), and no comorbidities (P = .001). Among elderly patients, ACT was associated with improved CSS (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.88) and OS (HR, 0.71; 95% CI, 0.60-0.83); however, the magnitude of the benefit was smaller for elderly patients than younger patients (HR for CSS, 0.53; 95% CI, 0.42-0.67; HR for OS 0.56; 95% CI, 0.45-0.69). Half of elderly patients with stage III colon cancer do not receive ACT. Although the effect size is smaller than that in younger patients, ACT is associated with improved long-term survival. Cancer 2017;123:2840-49. © 2017 American Cancer Society. © 2017 American Cancer Society.

  9. The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results

    PubMed Central

    Heidari, Zahra; Feizi, Awat

    2017-01-01

    Background: This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES). Materials and Methods: In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. Results: The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). Conclusion: The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population. PMID:28919912

  10. Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans

    PubMed Central

    2012-01-01

    Background Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP), glycated hemoglobin (HbA1c), and dehydroepiandrosterone sulfate (DHEAS). Strikingly, high blood pressure (BP) and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow), are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in other settings: despite the

  11. Elder Self-Neglect in a Community-Dwelling U.S. Chinese Population: Findings from the Population Study of Chinese Elderly in Chicago (PINE) Study

    PubMed Central

    Dong, XinQi

    2014-01-01

    Objectives To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling U.S. Chinese aging population. Design Population-based cohort study. Setting Community-dwelling population of Chinese older adults. Participants 3,159 Chinese older adults in the greater Chicago area interviewed from 2011-2013. Measurements Participant’s personal and home environment was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented across self-reported quality-of-life. Results Prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate/severe self-neglect among Chinese older adults. In terms of specific phenotypes, unsanitary conditions (17.0%) was the most prevalent, followed by need of home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and its phenotypes was higher among older adults with fair or poor quality-of-life as compared to that of older adults with good or very good quality-of-life. Lower quality-of-life was significantly associated with and increased risk for self-neglect of all severities (mild self-neglect: OR 1.93, 95% CI 1.26-2.96, p<0.001; moderate/severe self-neglect: OR 3.58, 95% CI 1.79-7.13, p<0.001) and specific personal and environmental hazards. Conclusion Elder self-neglect is prevalent, especially among those with lower levels of quality-of-life. Future research is needed to examine risk/protective factors associated with elder self-neglect. PMID:25439674

  12. What is the prevalence of musculoskeletal problems in the elderly population in developed countries? A systematic critical literature review

    PubMed Central

    2012-01-01

    Background The proportion of older people will be tripled by the year 2050. In addition, the incidence of chronic musculoskeletal (MSK) conditions will also increase among the elderly people. Thus, in order to prepare for future health care demands, the magnitude and impact of MSK conditions from this growing population is needed. The objective of this literature review is to determine the current prevalence of MSK disorders in the elderly population. Methods A systematic literature search was conducted in Pubmed on articles in English, published between January 2000 and July 2011. Studies from developed countries with prevalence estimates on elderly people (60+) on the following MSK conditions were included: Non-specific extremity pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and back pain. The included articles were extracted for information and assessed for risk of bias. Results A total of 85 articles were included with 173 different prevalence estimates. Musculoskeletal disorders are common in the elderly population, but due to heterogeneity of the studies, no general estimate on the prevalence of MSK can be determined. Women report more often MSK pain than men. Overall, prevalence estimates either remain fairly constant or increase slightly with increasing age, but with a tendency to decrease in the oldest (80+) people. Conclusions Musculoskeletal disorders remain prevalent in the elderly population. Given the increasing proportion of elderly population in the world population and the burden of MSK diseases among the elderly people, efforts must be made to maintain their functional capacity for as long as possible through optimal primary and secondary health care. PMID:23006836

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Factors contributing to participation in food assistance programs in the elderly population

    PubMed Central

    Hong, Seo Ah

    2014-01-01

    BACKGROUND/OBJECTIVES The study objectives were to examine the participation rate in food assistance programs and explore the factors that contribute to such participation among the Korean elderly population. SUBJECTS/METHODS The study sample comprised 3,932 respondents aged 65 years or older who were selected from a secondary data set, the fourth Korean Welfare Panel Study (KoWePS). The factors, related to participation in programs were examined based on the predisposing, enabling and need factors of the help-seeking behavior model. Multiple logistic regression analysis was used to select the best contributors among the factors related to program participation. RESULTS The predisposing rate in food assistance programs was 8.5% (7.1% for men and 10.4% for women). When all variables were included in the model, living without spouse, no formal education, low income, having social security benefits and food insecurity in elderly men, and age, low income, having social security benefits and feeling poor in elderly women were significantly related to a higher tendency to program participation. CONCLUSIONS The predisposing and need factors, such as living without spouse, low education level, food insecurity and feeling poor were important for program participation, as well as enabling factors, such as household income and social security benefits. A comprehensive approach considering these factors to identify the target population for food assistance programs is needed to increase the effectiveness and target population penetration of these programs. PMID:25110563

  16. Analysis of the elderly patient population in a tertiary-care university hospital.

    PubMed

    Juárez, A; Garde, J; Caballero, C; Iranzo, V; Gavilá, J; Safont, M; Blasco, A; Camps, C

    2009-05-01

    A progressively ageing population and the high association between advanced age and cancer has resulted in an increased interest in the field of geriatric oncology with the objective being a more effective diagnosis and treatment of these patients. We performed an epidemiological analysis on an intent-to-treat of elderly population within our healthcare unit. This is a retrospective study of all patients attended in our Medical Oncology Department during the year 2002. A total 667 patients were assessed, 42% older than 70 years of age. The most frequent tumour sites were lung, colorectal and breast. The most frequent histology was adenocarcinoma. The diagnosis in advanced stages was significantly higher in older age group (76% vs. 59%). The use of symptom-control follow-up and palliative-care, compared with radio- and chemo-therapy, was higher in older age group. However, we observed no statistically significant differences with respect to inclusion in clinical trials. In conclusion, the elderly represents an important percentage of patients receiving cancer care. The distributions by sites and histology types are similar in both groups of age. Although the election of palliative treatment is more frequent in elderly population, the most frequently used treatments in both groups, were radiotherapy and chemotherapy. We didn't observe any significant differences about the inclusion in clinical trials.

  17. Health-related behavior and quality of life among the elderly: a population-based study.

    PubMed

    Lima, Margareth Guimarães; Barros, Marilisa Berti de Azevedo; César, Chester Luiz Galvão; Goldbaum, Moisés; Carandina, Luana; Alves, Maria Cecília Goi Porto

    2011-06-01

    To assess the association between health-related behaviors and quality of life among the elderly. A population-based cross-sectional study was carried out including 1,958 elderly living in four areas in the state of São Paulo, southeastern Brazil, 2001/2002. Quality of life was assessed using the Medical Outcomes Study SF-36-Item Short Form Health Survey instrument. This instrument's eight subscales and two components were the dependent variables. Independent variables were physical activity, weekly frequency of alcohol consumption and smoking. Multiple linear regression models were used to control for the effect of gender, age, schooling, work, area of residence and number of chronic conditions. Physical activity was positively associated with the eight SF-36 subscales. The stronger associations were found for role-physical (β=11.9), physical functioning (β=11.3) and physical component. Elderly individuals who consumed alcohol at least once a week showed a better quality of life than those did not consume alcohol. Compared to non-smokers, smokers had a poorer quality of life for the mental component (β=-2.4). The study results showed that physical activity, moderate alcohol consumption and no smoking are positively associated with a better quality of life in the elderly.

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

    PubMed

    Liu, Tao; Sun, Li

    2015-06-01

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

  19. Association between handgrip strength and cognitive impairment in elderly Koreans: a population-based cross-sectional study

    PubMed Central

    Jang, Jae Yong; Kim, Junghoon

    2015-01-01

    [Purpose] The purpose of this study was to investigate the association between handgrip strength and mild cognitive impairment in elderly adults. [Subjects] Study participants included 2,982 adults (1,366 males and 1,616 females), aged 65 years or older. [Methods] This population-based cross-sectional study used the baseline database from the Korean Longitudinal Study of Ageing. [Results] The odds ratio for mild cognitive impairment showed a significant linear decrease in relation to the quartile of handgrip strength, independent of potential covariates, in both men and women. Moreover, after excluding incident cases of mild cognitive impairment, the results showed that greater handgrip strength was associated with higher cognitive function scores in the elderly. [Conclusion] The findings presented here suggest that handgrip strength is associated with a risk of mild cognitive impairment in the Korean elderly. Moreover, greater handgrip strength is associated with higher cognitive function in cognitively normal elderly individuals. PMID:26834379

  20. Dietary habits and cardiovascular disease risk in middle-aged and elderly populations: a review of evidence.

    PubMed

    Tourlouki, Eleni; Matalas, Antonia-Leda; Panagiotakos, Demosthenes B

    2009-01-01

    The proportion of elderly is increasing worldwide. This trend is paralleled by an increase in chronic diseases, such as cardiovascular disease. A limited number of studies have investigated the effect of diet on cardiometabolic risk factors (such as hypertension, hypercholesterolemia, diabetes, obesity) in older populations, despite the fact that diet plays a significant role in elderly health. In this review, a summary of studies that have evaluated the effect of dietary habits on cardiovascular disease risk in elderly populations is presented. A search was made in available databases (PubMed and Scopus) looking for results from observational studies and clinical trials that assessed dietary habits on cardiovascular disease risk in elderly populations (>65 years old). Studies during the last decade were retrieved and summarized. All eight of the reviewed observational studies and all three reviewed clinical trials performed in elderly populations reported an inverse association between healthy dietary patterns with cardiovascular disease risk and its predisposing markers. Dietary intervention strategies should be implemented in older adults, in order to prevent cardiovascular disease morbidity and mortality, and improve quality of life.

  1. Factors associated with pneumococcal vaccination among an urban elderly population in China

    PubMed Central

    Liu, Shijun; Xu, Erping; Liu, Yan; Xu, Yuyang; Wang, Jun; Du, Jian; Zhang, Xiaoping; Che, Xinren; Gu, Wenwen

    2014-01-01

    Objectives: To investigate the coverage of the 23-valent pneumococcal polysaccharide vaccine (23-PPV) in the Chinese urban elderly population and to understand the attitudes, knowledge and beliefs of this population toward the 23-PPV vaccination. Methods: A cross-sectional approach was employed to survey the willingness of this population to receive the 23-PPV vaccination. Two thousand 9 hundred 2 six subjects over the age of 60 y were enrolled via a multi-stage random sampling method from the urban community population in Hangzhou, China. The relationships between the variables and the willingness to receive the 23-PPV vaccination were computed as odds ratios (ORs) by multivariate analysis. Results Of the participants, 21.77% were willing to undergo 23-PPV vaccination, and 61.65% of the subjects agreed that pneumonia is a serious disease among elderly people. The rate of reasonable perceptions about vaccination, including the perception about vaccine efficacy and safety, among the subjects was below 50%. Only 1.23% of subjects had been vaccinated with 23-PPV, and a similarly low rate was observed for the seasonal influenza vaccine (4.17%). The factors that were independently related to the willingness to receive the 23-PPV vaccine included consensus with the hazards of pneumonia (OR = 1.67, 95% CI: 1.28 – 2.17), the safety of vaccination (OR = 2.00, 95% CI: 1.54 – 2.59), advice about the 23-PPV vaccination from family members (OR = 2.37, 95% CI: 1.39 – 4.40), influenza vaccination history (OR = 2.57, 95% CI: 1.66 – 3.98) and pneumococcal vaccination history (OR = 7.48, 95% CI: 2.4–22.92). Conclusion: The administration of the 23-PPV vaccine among the urban elderly population is not optimistic in China. Emphasis on persuasion from families and the improvement of knowledge about vaccination might encourage elderly people to get the 23-PPV vaccination. Suggestions from physicians did not affect the participants’ willingness to get the 23-PPV vaccination

  2. [Analysis of cancer incidence and mortality in elderly population in China, 2013].

    PubMed

    Chen, W Q; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; He, J

    2017-01-23

    Objective: To estimate the cancer incidence and mortality in elderly Chinese population in 2013 based on the data from local cancer registries submitted to National Central Cancer Registry (NCCR). Methods: Data from 255 cancer registries submitted to NCCR with qualified data after checked and evaluated, were selected for this estimation. Cancer incidence and mortality were stratified by areas, sex, age groups and cancer site, combined with population data of the year 2013 to estimate cancer epidemiology in older people in China. Chinese population census in 2000 and Segi's population were used for the estimation of age-standardized incidence/mortality rates. Results: All the 255 cancer registries (88 in urban and 167 in rural areas) were selected for this estimation, covered 37 407 728 elderly subjects, accounting for 17.73% of the entire national elderly population. It was estimated about 2 171.0 thousand new cancer cases in older people in China, accounting for 58.96% of all cancer incidence, with the crude incidence rate of 1 029.16/100 000 (1 297.96 per 100 000 in male, 777.18 per 100 000 in female), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 1 019.25 per 100 000. It was estimated about 1 600.5 thousand deaths in older people in China, accounting for 67.70% of all cancer deaths, with the crude mortality of 758.72/100 000 (988.37 per 100 000 in males, 543.44 per 100 000 in females), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 730.78 per 100 000. Lung cancer, stomach cancer, colorectal cancer, liver cancer and esophageal cancer were the most common cancers, accounting for about 67.70% of all cancer cases in China. Those cancers are also the most common cancers in China, accounting for about 73.45% of all cancer deaths. Conclusions: The cancer burden of elderly population in China is very serious. The major cancer incidence and mortality in urban and rural areas are similar

  3. Injuries and outcomes associated with traumatic falls in the elderly population on oral anticoagulant therapy.

    PubMed

    Boltz, Melissa M; Podany, Abigail B; Hollenbeak, Christopher S; Armen, Scott B

    2015-09-01

    Fall risk for older adults is a multi-factorial public health problem as 90% of geriatric injuries are caused by traumatic falls. The CDC estimated 33% of adults >65 years incurred a fall in 2011, with 30% resulting in moderate injury. While much has been written about overall risk to trauma patients on oral anticoagulant (OAC) therapy, less has been reported on outcomes in the elderly trauma population. We used data from the National Trauma Data Bank (NTDB) to identify the types of injury and complications incurred, length of stay, and mortality associated with OACs in elderly patients sustaining a fall. Using standard NTDB practices, data were collected on elderly patients (≥65 years) on OACs with diagnosis of fall as the primary mechanism of injury from 2007 to 2010. Univariate analysis was used to determine patient variables influencing risk of fall on OACs. Odds ratios were calculated for types of injury sustained and post-trauma complications. Logistic regression was used to determine mortality associated with type of injury incurred. Of 118,467 elderly patients sampled, OAC use was observed in 444. Predisposing risk factors for fall on OACs were >1 comorbidity (p<0.0001). Patients on OACs were 188% and 370% more likely to develop 2 and >3 complications (p<0.0001); the most significant being ARDS and ARF (p<0.0001). The mortality rate on OACs was 16%. Injuries to the GI tract, liver, spleen, and kidney (p<0.0002) were more likely to occur. However, if patients suffered a mortality, the most significant injuries were skull fractures and intracranial haemorrhage (p<0.0001). Risks of anticoagulation in elderly trauma patients are complex. While OAC use is a predictor of 30-day mortality after fall, the injuries sustained are markedly different between the elderly who die and those who do not. As a result there is a greater need for healthcare providers to identify preventable and non-preventable risks factors indicative of falls in the anti-coagulated elderly

  4. Association between advanced oxidation protein products and 5-year mortality risk among amazon riparian elderly population.

    PubMed

    Silva, T O; Jung, I E C; Moresco, R N; Barbisan, F; Ribeiro, E E; Ribeiro, E A M; Motta, K; Britto, E; Tasch, E; Bochi, G; Duarte, M M F; Oliveira, A R; Marcon, M; Belló, C; dos Santos Montagner, G F; da Cruz, I B M

    2015-02-01

    Proteins are important targets of several modifications caused by oxidative stress, leading to structural changes and consequently partial or total loss of their functions. The oxidized proteins include advanced oxidation protein products (AOPP) derived from oxidation-modified albumin, as well as fibrinogen and lipoproteins. An increase in AOPP levels indicates an oxidative stress state and the presence of coexisting inflammation. Several investigations have also suggested an association between high AOPP levels and aging-related diseases. However, the link between elevated AOPP levels and elderly mortality risk has not yet been investigated. Here, we report on a 5-year longitudinal study that investigated the potential association between AOPP levels and mortality using a population-based representative sample of riparian elders living in Brazilian Amazon region (Maués-AM). Age, sex, socioeconomic and cultural conditions, chronic morbidities, polypharmacy, and previous morbidities were also tested as potential confounders. The AOPP levels were measured in 540 (84.78%) individuals, all of whom were followed over a 5-year period in order to establish the mortality rate. Within this study period, 74 (13.7%) elders died and 466 (86.3%) survived. The AOPP levels were higher among the elders who died within the 5-year period (46.27 ± 40.6 mmol/L) compared with those who survived (36.79 ± 20.84 mmol/L) (p = 0.002). The analysis confirmed the link between high AOPP levels and mortality risk, independent of other intervenient factors. These results suggest that elevated AOPP levels could be used to predict mortality risk in elderly patients.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. The effect of visual biofeedback on balance in elderly population: a systematic review

    PubMed Central

    Alhasan, Hammad; Hood, Victoria; Mainwaring, Frederick

    2017-01-01

    Background Balance is commonly affected by multiple factors, especially among the elderly population. Visual biofeedback (VBF) is an intervention tool that can be used in balance rehabilitation. Aim This study aimed to systematically review randomized controlled trials that examine whether VBF training is effective in improving balance in an elderly population. Data sources Three databases were searched: CIAHL, EMBASE, and MEDLINE. The searches were limited to the period from 2010 to 2016. Eligibility criteria Healthy adults, aged ≥65 years, with no specific disorders were included. Interventions were any VBF intervention with the aim of improving balance and were compared to no intervention, traditional exercises, placebo, or standard care. The outcome measures were balance as measured by any validated outcome measure. Studies appraisal method The Physiotherapy Evidence Database quality assessment tool and The Cochrane Collaboration tool for assessing risk of bias were used by two independent authors (HA and FM) in order to appraise the included studies. Results The database search resulted in 879 articles, of which five papers were included. VBF was compared to no intervention, a placebo, and traditional exercise. The total number of participants in all the five included studies was 181, with a mean age of 74.3 years (standard deviation 6.7). Two studies were rated as high-quality studies, and three were rated as fair quality. Conclusion Engaging elderly people living in the community in VBF training was found to be effective and could improve their balance ability. However, the variation between studies in methodology, intervention protocol, and outcomes utilized made it difficult to inform a definitive statement regarding the potential application of VBF for balance training with the elderly. Furthermore, high-quality randomized control trials are required. The systematic review level of evidence is moderate, and the strength of recommendation is that VBF is

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

    ERIC Educational Resources Information Center

    Mohapatra, Urmila

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

  10. Zinc Absorption from Representative Diet in a Chinese Elderly Population Using Stable Isotope Technique.

    PubMed

    Li, Ya Jie; Li, Min; Liu, Xiao Bing; Ren, Tong Xiang; Li, Wei Dong; Yang, Chun; Wu, Meng; Yang, Lin Li; Ma, Yu Xia; Wang, Jun; Piao, Jian Hua; Yang, Li Chen; Yang, Xiao Guang

    2017-06-01

    To determine the dietary zinc absorption in a Chinese elderly population and provide the basic data for the setting of zinc (Zn) recommended nutrient intakes (RNI) for Chinese elderly people. A total of 24 elderly people were recruited for this study and were administered oral doses of 3 mg 67Zn and 1.2 mg dysprosium on the fourth day. The primary macronutrients, energy, and phytic acid in the representative diet were examined based on the Chinese National Standard Methods. Fecal samples were collected during the experimental period and analyzed for zinc content, 67Zn isotope ratio, and dysprosium content. The mean (± SD) zinc intake from the representative Chinese diet was 10.6 ± 1.5 mg/d. The phytic acid-to-zinc molar ratio in the diet was 6.4. The absorption rate of 67Zn was 27.9% ± 9.2%. The RNI of zinc, which were calculated by the absorption rate in elderly men and women, were 10.4 and 9.2 mg/d, respectively. This study got the dietary Zn absorption in a Chinese elderly population. We found that Zn absorption was higher in elderly men than in elderly women. The current RNI in elderly female is lower than our finding, which indicates that more attention is needed regarding elderly females' zinc status and health. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  11. Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

    PubMed Central

    Lucaroni, Francesca; Gilardi, Francesco; Caredda, Emanuele; Pesaresi, Alessia; Coscia, Massimo; Orlando, Stefano; Brandi, Antonella; Giovagnoli, Germano; Di Lecce, Vito N.; Visconti, Giuseppe; Palombi, Leonardo

    2016-01-01

    Introduction The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with “elderly frequent users”. Material and Methods A retrospective study was performed during the calendar year 2014 (1st January 2014 – 31st December 2014) analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models. Results A total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4–1.7) and hospitalization (OR 3.8: CI 3.7–4). Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9–3.2). Discussion Older patients presented clinical and social characteristics related to the definition of “elderly frail frequent users”. The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established. Conclusion Enhancement of continuity of care, establishment of a tracking system

  12. Social connections and happiness among the elder population of Taiwan.

    PubMed

    Hsu, H-C; Chang, W-C

    2015-01-01

    The purpose of this study was to examine the association between social connections and happiness among members of the elder population of Taiwan. Longitudinal panel data collected in three waves from 1999 to 2007 that are selected from national samples of Taiwanese older people were used for the analysis (n = 4731 persons). Happiness was defined as a dichotomous variable. Social connection variables included living arrangements, contacts with children/grandchildren/parents/relatives/friends, telephone contacts, providing instrumental and informational support, receiving instrumental and emotional support, and social participation. We controlled for the variables demographics, physical and mental health, economic satisfaction, and lifestyle. A generalized linear model (GLM) was applied in the analysis. Happiness remained stable over time. Receiving more emotional support and participating in social events were related to happiness at the beginning, while the effect of social participation was offset over time. Living arrangements, telephone contacts, providing social support, and receiving instrumental support were not significant. The quality of social relationships experienced is possibly more important than the quantity of social interaction for older people, and having social relationships outside the informal social network may increase happiness.

  13. [Development of products for the elderly population: vitamin enriched pudding].

    PubMed

    Vera, M S; de Penna, E W; Bunger, A; Soto, D; Cariaga, L; Fuenzalida, R; Cornejo, E; Lopez, L

    1995-03-01

    An instant dessert powder, pudding type was developed to be consumed at lunch or dinner time. The dessert was designed to be prepared in skim milk and meets the nutritional needs of elderly people. The dessert contains modified starch, carragenine, vegetal fat, sacharose. Each serving has been enriched with 30% of the daily vitamin requirement advised for adults over 51 years old. The optimized process was carried out according to the Karlsruhe test. Each serving consists of 22g powder prepared in proportion of 18% in skim milk. The optimized dessert powder was controlled by means of physical, chemical and microbiological analyses. The sensory quality was determined in the ready to eat product and the acceptability level was measured in a group of people selected according to the characteristics of the target population. The dessert powder contains 1.1% protein, 5.2% fats, 89.76% carbohidrates, and provides 409 Kcal/100g. Both the sensory and microbiological quality were good and the level of acceptance reached 98%.

  14. Inter-individual variability in discourse informativeness in elderly populations.

    PubMed

    Pistono, Aurélie; Pariente, Jérémie; Bézy, Catherine; Pastor, Josette; Tran, Thi Mai; Renard, Antoine; Fossard, Marion; Nespoulous, Jean-Luc; Jucla, Mélanie

    2017-01-01

    An increasing number of studies focus on discourse production in patients with neurodegenerative diseases and underline its clinical usefulness. However, if this is to be used as a clinical tool, one needs to consider how normal discourse varies within cognitively unimpaired elderly populations. In the current study, the aim has been to investigate discourse macrolinguistic variability. For this, 123 participants aged between 55 and 84 were recruited. A cluster analysis of their discourse macrolinguistic features was conducted. Then, cluster characterisation based on socio-demographic and linguistic performance was tested (fluency, naming, syntax and spelling). This method aims to identify various profiles of speaker and informativeness and then see if inter-individual variability may be related to socio-demographic and/or linguistic aspects. Four clusters of informativeness were found but no socio-demographic features appeared significant. The fourth cluster, defined as 'off topic', had lower performance during linguistic tasks than others and thus the boundary between normality and pathology should be questioned.

  15. The effect of visual biofeedback on balance in elderly population: a systematic review.

    PubMed

    Alhasan, Hammad; Hood, Victoria; Mainwaring, Frederick

    2017-01-01

    Balance is commonly affected by multiple factors, especially among the elderly population. Visual biofeedback (VBF) is an intervention tool that can be used in balance rehabilitation. This study aimed to systematically review randomized controlled trials that examine whether VBF training is effective in improving balance in an elderly population. Three databases were searched: CIAHL, EMBASE, and MEDLINE. The searches were limited to the period from 2010 to 2016. Healthy adults, aged ≥65 years, with no specific disorders were included. Interventions were any VBF intervention with the aim of improving balance and were compared to no intervention, traditional exercises, placebo, or standard care. The outcome measures were balance as measured by any validated outcome measure. The Physiotherapy Evidence Database quality assessment tool and The Cochrane Collaboration tool for assessing risk of bias were used by two independent authors (HA and FM) in order to appraise the included studies. The database search resulted in 879 articles, of which five papers were included. VBF was compared to no intervention, a placebo, and traditional exercise. The total number of participants in all the five included studies was 181, with a mean age of 74.3 years (standard deviation 6.7). Two studies were rated as high-quality studies, and three were rated as fair quality. Engaging elderly people living in the community in VBF training was found to be effective and could improve their balance ability. However, the variation between studies in methodology, intervention protocol, and outcomes utilized made it difficult to inform a definitive statement regarding the potential application of VBF for balance training with the elderly. Furthermore, high-quality randomized control trials are required. The systematic review level of evidence is moderate, and the strength of recommendation is that VBF is likely to be beneficial.

  16. Fall risk in an active elderly population – can it be assessed?

    PubMed Central

    Laessoe, Uffe; Hoeck, Hans C; Simonsen, Ole; Sinkjaer, Thomas; Voigt, Michael

    2007-01-01

    Background Falls amongst elderly people are often associated with fractures. Training of balance and physical performance can reduce fall risk; however, it remains a challenge to identify individuals at increased risk of falling to whom this training should be offered. It is believed that fall risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. Results Ninety-four elderly males and females between 70 and 80 years of age were included in a one year follow-up study. A fall incidence of 15% was reported. The test battery scores were not different between the fallers and non-fallers. Test scores were, however, related to self-reported health. In spite of inclusion of dynamic tests, the test battery had low fall prediction rates, with a sensitivity and specificity of 50% and 43% respectively. Conclusion Individuals with poor balance were identified but falls were not predicted by this test battery. Physiological balance characteristics can apparently not be used in isolation as adequate indicators of fall risk in this population of community dwelling elderly. Falling is a complex phenomenon of multifactorial origin. The crucial factor in relation to fall risk is the redundancy of balance capacity against the balance demands of the individuals levels of fall-risky lifestyle and behavior. This calls for an approach to fall risk assessment in which the physiological performance is evaluated in relation to the activity profile of the individual. PMID:17257414

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

    PubMed Central

    2013-01-01

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

  18. Accuracy and robustness of Kinect pose estimation in the context of coaching of elderly population.

    PubMed

    Obdrzálek, Stepán; Kurillo, Gregorij; Ofli, Ferda; Bajcsy, Ruzena; Seto, Edmund; Jimison, Holly; Pavel, Michael

    2012-01-01

    The Microsoft Kinect camera is becoming increasingly popular in many areas aside from entertainment, including human activity monitoring and rehabilitation. Many people, however, fail to consider the reliability and accuracy of the Kinect human pose estimation when they depend on it as a measuring system. In this paper we compare the Kinect pose estimation (skeletonization) with more established techniques for pose estimation from motion capture data, examining the accuracy of joint localization and robustness of pose estimation with respect to the orientation and occlusions. We have evaluated six physical exercises aimed at coaching of elderly population. Experimental results present pose estimation accuracy rates and corresponding error bounds for the Kinect system.

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

    PubMed Central

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

    2016-01-01

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

  20. Social Security Measures for Elderly Population in Delhi, India: Awareness, Utilization and Barriers

    PubMed Central

    Kohli, Charu; Banerjee, Bratati; Ingle, Gopal Krishna

    2017-01-01

    Introduction World population of elderly is increasing at a fast pace. The number of elderly in India has increased by 54.77% in the last 15 years. A number of social security measures have been taken by Indian government. Aim To assess awareness, utilization and barriers faced while utilizing social security schemes by elderly in a secondary care hospital situated in a rural area in Delhi, India. Materials and Methods A cross-sectional study was conducted among 360 individuals aged 60 years and above in a secondary care hospital situated in a rural area in Delhi. A pre-tested, semi-structured schedule prepared in local language was used. Data was analysed using SPSS software (version 17.0). Chi-square test was used to observe any statistical association between categorical variables. The results were considered statistically significant if p-value was less than 0.05. Results A majority of study subjects were females (54.2%), Hindu (89.7%), married (60.3%) and were not engaged in any occupation (82.8%). Awareness about Indira Gandhi National Old Age Pension Scheme (IGNOAPS) was present among 286 (79.4%) and Annapurna scheme in 193 (53.6%) subjects. Among 223 subjects who were below poverty line, 179 (80.3%) were aware of IGNOAPS; while, 112 (50.2%) were utilizing the scheme. There was no association of awareness with education status, occupation, religion, family type, marital status and caste (p>0.05). Corruption and tedious administrative formalities were major barriers reported. Conclusion Awareness generation, provision of information on how to approach the concerned authority for utilizing the scheme and ease of administrative procedures should be an integral part of any social security scheme or measure. In the present study, about 79.4% of elderly were aware and 45% of the eligible subjects were utilizing pension scheme. Major barriers reported in utilization of schemes were corruption and tedious administrative procedures. PMID:28658811

  1. Amino acid requirements in children and the elderly population.

    PubMed

    Pillai, Raja R; Kurpad, Anura V

    2012-08-01

    The factorial approach is used to measure the dietary indispensable amino acid (IAA) requirements in children, although recent measurements based on the indicator amino acid oxidation (IAAO) method have begun to generate more direct evidence. Difficulties with the factorial method are that it depends on accurate estimates of the maintenance protein requirement, as well as of protein deposition during growth. Also, a value for the efficiency of utilizing dietary protein for deposition has to be selected, based on published Nitrogen (N) balance studies. In the recent 2007 WHO/FAO/UNU report, the amino acid requirement pattern for infants was taken to be similar to the amino acid composition of breast milk. For pre-school and older children, the factorial method gave values for the scoring pattern of protein that were fairly close to the earlier 1985 WHO/FAO/UNU report for children, since growth progressively became a smaller component of the factorial calculation as age progressed. However, given that there are several assumptions in the derivation of factorial estimates, direct experimental measurements of the amino acid requirement are desirable. The IAAO method, as it is non-invasive, as made it possible to measure the IAA requirements in children. Over the last decade, some of the IAA requirements have been determined by using the IAAO method in healthy school age children; however, the data on IAA requirements in developing country populations are still being conducted. In the elderly, there are not enough data to make a separate recommendation for IAA requirements from that of adults.

  2. Quality of life, perceptions of change, and psychological well-being of the elderly population in small rural towns in the Midwest.

    PubMed

    Cantarero, Rodrigo; Potter, James

    2014-01-01

    This study examines the quality of life of the elderly residents of two rural Nebraska towns, both having experienced a large increase in population. The study examines how the residents' perception of changes in the community affect their view of quality of life, and identifies determinants of psychological well-being for these elderly residents. The results are compared to the non-elderly residents of these two communities for purposes of contrast. A face-to-face survey of the residents addressed physical, social/cultural, economic, and service issues. Both correlation and regression were used to analyze the data. The quality of life of the elderly residents in our study, in terms of satisfaction with the various components of general well-being--home and neighborhood, accessibility and adequacy of services (including transportation), health and safety--were very positive or satisfactory; this applies equally to the non-elderly population, with the exception of access to public transportation.

  3. Sexual disorders among elderly: An epidemiological study in south Indian rural population

    PubMed Central

    Sathyanarayana Rao, T. S.; Ismail, Shajahan; Darshan, M. S.; Tandon, Abhinav

    2015-01-01

    Background: Realizing a dearth of data on this topic, especially in the Indian context, an epidemiological study was conducted in a south Indian rural population to identify the sexual activity patterns and sexual problems among the population above 60 years of age. Objectives: (1) Assessment of sexual activity patterns among individuals above 60 years. (2) Assessment of the prevalence of sexual disorders among individuals above 60 years. Materials and Methods: The study sample consisted of 259 participants, which included both males and females above 60 years of age. Subjects who were sexually active and fulfilled the study criteria were administered Arizona Sexual Experience Scale as a screening tool, for the presence of sexual problems. Those who were found to have sexual problems were interviewed further using appropriate questionnaires. Results: Only 27.4% of the individuals above 60 years were sexually active, and it progressively dropped as age advanced and none were sexually active after 75 years of age. Among the sexually active males, erectile dysfunction (ED) was prevalent in 43.5%, premature ejaculation in 10.9%, hypoactive sexual desire disorder (HSSD) in 0.77% and anorgasmia in 0.38% of the subjects. Among females, arousal disorder was prevalent in 28%, HSSD in 16%, anorgasmia in 20% and dyspareunia in 8% of the subjects. Conclusion: The study gives us an insight into the sexual problems of the elderly and brings home the point that sexual problems are very much common among both men and women in the older population. Among elderly males, ED is the most common sexual disorder whereas in elderly females, arousal disorder is the most prevalent female sexual dysfunction, implicating biology plays an important role in men, whereas psychology plays an important role in women sexual functioning. PMID:26600575

  4. Incidence and risk factors for cognitive impairment in rural elderly populations in Costa Rica.

    PubMed

    Nadel, Jeffrey L; Ulate, Diana

    2014-09-01

    Risk factors for the onset of cognitive impairment in Costa Rica are not well understood, despite a substantial elderly population stemming from a higher than average life expectancy for the western hemisphere. To investigate the risk factors that predict the onset of cognitive impairment in the rural elderly of Costa Rica, a modified version of the Mini Mental State Exam-designed for illiterate populations-was administered to 90 elderly inhabitants of San Carlos, Alajuela, Costa Rica between April and May of 2011. Subsequently, each participant took a structured interview assessing viability of risk factors and behaviors potentially contributing to a diagnosis of cognitive impairment. Results showed strong dependencies between age (p = 0.0001), education level (p = 0.0095), the ability to read (p = 0.0001) and write (p = 0.0153), frequency of reading (p = 0.0011), use of puzzles and mind games (p < 0.0001), vocation (p = 0.0225), area of residence (p < 0.0001), comorbid mental dis- eases (p = 0.0005), history of stroke or brain trauma (p = 0.0104), urinary or renal problems (p = 0.0443), consistent cooking practices (p = 0.0262) and number of living companions (p = 0.0299) in susceptibility for developing cognitive impairment. The study concluded that high intellectual use, or lack thereof, during the lifetime of a person was a predictor for cognitive status later in life. In addition, comorbid mental disorders, including neu- rological trauma due to stroke, impeded normal cognitive function. Future research should examine incidence and risk factors of cognitive impairment in urban, more educated populations.

  5. [Counseling and preventive action in elderly population in hospitals and residences in Spain].

    PubMed

    Maestre-Miquel, Clara; Figueroa, Carmen; Santos, Juana; Astasio, Paloma; Gil, Pedro

    2016-10-01

    To establish the profile of elderly patients, and to assess current preventive actions in hospitals, geriatric residences, and different health-care centres in Spain. Cross-sectional descriptive study, based on a questionnaire to be answered by doctors who treat the elderly population in Spain (2013). Health-care centres from different regions of Spain. A total of 420 practitioners from hospitals, residences and other community centres, with data from 840 geriatric clinics. Main outcome variables are: dependence, reason for assistance, comorbidity, professional consultation, and life style recommendations. Association factor, type of institution where patients have been attended. Analysis of prevalence and association using Chi-squared test. Two-thirds (66.7%) of the study population were shown to be dependent, with a higher percentage among women than men: 68.9% vs. 62.4% (P=.055). It was also found that among the population aged 85 or more, 88.6% of the women and 85.2% of the men suffered comorbidity. In spite of these results, only 6.6% of the patients suffering comorbidity received additional advice concerning healthy-lifestyle. A large majority (79.6%) of the patients treated in hospitals received advice concerning healthy lifestyle, while 59.62% of those treated in nursing homes received it (P<.001). It was observed that there is a lack of preventive action related to health promotion among the elderly, with differences between hospitals and geriatric residences. This suggests that it is time to put forward new specialised programs addressed to health professionals, in order to reinforce health promotion attitudes and preventive interventions in gerontology clinical practice. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  6. Surgical outcome in an elderly population with intracranial meningioma.

    PubMed Central

    Umansky, F; Ashkenazi, E; Gertel, M; Shalit, M N

    1992-01-01

    Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial meningioma who had craniotomy between the years 1978-88 were reviewed. There were 20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%) cases and each tumour was histologically verified. The location of the tumours were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1. The most frequent associated diseases were: hypertension (35%), chronic ischaemic heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean = 59). It was less than 40 in ten patients. The length of anaesthesia during the surgical procedure varied from 4 to 12 hours and was not related to the outcome. There were two perioperative deaths (mortality = 5.4%). There were major complications in 8 patients and minor complications in 7 patients. In a mean follow up period of 29 months (shortest 6 and longest 96 months) the results were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59) and the mean postoperative KS value (KS = 80) was statistically significant (P less than 0.001). The results support a more aggressive therapeutic approach to the elderly patient with an intracranial meningioma. PMID:1619416

  7. Risk Factors for Dementia in a Senegalese Elderly Population Aged 65 Years and Over

    PubMed Central

    Toure, K.; Coume, M.; Ndiaye, M.; Zunzunegui, M. V.; Bacher, Y.; Diop, A. G.; Ndiaye, M. M.

    2012-01-01

    Background With the aging of the population, dementia is increasing worldwide. The objective of this study was to identify risk factors for dementia in an elderly population utilizing a primary health care service in Dakar, Senegal. Methods Through a cross-sectional study conducted from March 2004 to December 31, 2005, 507 elderly patients aged ≥65 years who came to the Social and Medical Center of IPRES, Dakar, Senegal, were first screened with the screening interview questionnaire ‘Aging in Senegal’. Those who were cognitively impaired underwent a clinical examination to detect dementia. Univariate, bivariate, and multivariate logistic regression analyses were done. Results The whole population had a mean age of 72.4 years (±5.2) and was mostly male, married, and non-educated. Hypertension, arthritis, and gastrointestinal diseases were the main health conditions reported in the past medical history. Smoking was important while alcohol consumption was rare. Social network was high. Forty-five patients (8.87%) had dementia. In the multivariate model, only advanced age, education, epilepsy, and family history of dementia were independently associated with dementia. Conclusion The risk factors identified are also found in developed countries confirming their role in dementia. It is important to take dementia into consideration in Senegal and to sensitize the community for prevention. PMID:22590476

  8. Social Security Measures for Elderly Population in Delhi, India: Awareness, Utilization and Barriers.

    PubMed

    Kohli, Charu; Gupta, Kalika; Banerjee, Bratati; Ingle, Gopal Krishna

    2017-05-01

    World population of elderly is increasing at a fast pace. The number of elderly in India has increased by 54.77% in the last 15 years. A number of social security measures have been taken by Indian government. To assess awareness, utilization and barriers faced while utilizing social security schemes by elderly in a secondary care hospital situated in a rural area in Delhi, India. A cross-sectional study was conducted among 360 individuals aged 60 years and above in a secondary care hospital situated in a rural area in Delhi. A pre-tested, semi-structured schedule prepared in local language was used. Data was analysed using SPSS software (version 17.0). Chi-square test was used to observe any statistical association between categorical variables. The results were considered statistically significant if p-value was less than 0.05. A majority of study subjects were females (54.2%), Hindu (89.7%), married (60.3%) and were not engaged in any occupation (82.8%). Awareness about Indira Gandhi National Old Age Pension Scheme (IGNOAPS) was present among 286 (79.4%) and Annapurna scheme in 193 (53.6%) subjects. Among 223 subjects who were below poverty line, 179 (80.3%) were aware of IGNOAPS; while, 112 (50.2%) were utilizing the scheme. There was no association of awareness with education status, occupation, religion, family type, marital status and caste (p>0.05). Corruption and tedious administrative formalities were major barriers reported. Awareness generation, provision of information on how to approach the concerned authority for utilizing the scheme and ease of administrative procedures should be an integral part of any social security scheme or measure. In the present study, about 79.4% of elderly were aware and 45% of the eligible subjects were utilizing pension scheme. Major barriers reported in utilization of schemes were corruption and tedious administrative procedures.

  9. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

    PubMed Central

    2010-01-01

    Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake. Results Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. Conclusions The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population. PMID:20513246

  10. [Influenza vaccination in the elderly population in Mexico: economic considerations].

    PubMed

    Gutiérrez, Juan Pablo; Bertozzi, Stefano M

    2005-01-01

    To estimate costs and health outcomes that could be attained by an influenza vaccination program in adults 65 years of age and older in Mexico. Between June and October 2004, a model was constructed to estimate the number of life years lost due to influenza and the fraction that could be prevented by vaccination among adults 65 years of age and older. The model also allowed the estimation of the net cost of a vaccination program, including both the cost of delivering the vaccine and savings from prevented infections and their treatment costs. Using two scenarios of vaccine effectiveness, between 7 454 and 11 169 life years could saved by the vaccine if given to all adults 65 years and older in Mexico, with a net cost per life year saved between 13 301 and 21 037 Mexican pesos (about dollar 1 210 and dollar 1 910 US dollars). Influenza vaccination among the elderly in Mexico would result in savings per life year saved well below the Mexican gross domestic product (GDP) per capita, suggesting, even without examining alternative uses for these resources, that this is a cost effective intervention in Mexico and probably also in other middle-income developing countries.

  11. Increase of Elderly Population in the Rainstorm Hazard Areas of China

    PubMed Central

    Liang, Pujun; Xu, Wei; Ma, Yunjia; Zhao, Xiujuan; Qin, Lianjie

    2017-01-01

    In light of global warming, increased extreme precipitation events have enlarged the population exposed to floods to some extent. Extreme precipitation risk assessments are of great significance in China and allow for the response to climate change and mitigation of risks to the population. China is one of the countries most influenced by climate change and has unique national population conditions. The influence of extreme precipitation depends on the degree of exposure and vulnerability of the population. Accurate assessments of the population exposed to rising rainstorm trends are crucial to mapping extreme precipitation risks. Studying the population exposed to rainstorm hazard areas (RSHA) at the microscale is extremely urgent, due to the local characteristics of extreme precipitation events and regional diversity of the population. The spatial distribution of population density was mapped based on the national population census data from China in 1990, 2000 and 2010. RSHA were also identified using precipitation data from 1975 to 2015 in China, and the rainstorm tendency values were mapped using GIS in this paper. The spatial characteristics of the rainstorm tendencies were then analyzed. Finally, changes in the population in the RSHA are discussed. The results show that the extreme precipitation trends are increasing in southeastern China. From 1990 to 2010, the population in RSHA increased by 110 million, at a rate of 14.6%. The elderly in the region increased by 38 million at a rate of 86.4%. Studying the size of the population exposed to rainstorm hazards at the county scale can provide scientific evidence for developing disaster prevention and mitigation strategies from the bottom up. PMID:28846596

  12. Comparison of outpatient services between elderly people with intellectual disabilities and the general elderly population in Taiwan.

    PubMed

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

    2012-01-01

    This study aims to analyze the ambulatory visit frequency and medical expenditures of the general elderly population versus the elderly with intellectual disabilities in Taiwan, while examining the effects of age, gender, urbanization and copayment status on ambulatory utilization. A cross-sectional study was conducted to analyze data from 103,183 national health insurance claimants aged 65 or older. A total of 1469 had a principal diagnosis of mental retardation (intellectual disability) and claimed medical outpatient services in 2007. The average number of ambulatory visits was 30.1 ± 23.1, which is much higher than in the United States and other developed countries, and the mean annual visits of the elderly with intellectual disabilities was significantly higher than the general population in Taiwan (35.2 ± 28.7 vs. 30.0 ± 23.1). Age and copayment status affected outpatient visit frequency. The mean medical expenditure per visit and the mean annual outpatient cost were 1146.5 ± 4497.7 NT$ and 34,533.7 ± 115,891.7 NT$, respectively. Male beneficiaries tended to have higher average annual medical expenses and mean medical expenses per visit than female beneficiaries. The three most frequent principal diagnoses at ambulatory visits were circulatory system diseases, musculoskeletal system and connective tissue diseases and digestive system diseases. We conclude that the elderly with intellectual disabilities had higher demand than the general population for healthcare services, and the NHI program lowers the barrier to care for populations with special needs.

  13. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study.

    PubMed

    Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

    2010-06-01

    Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake. Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

  14. Obesity and health conditions in elderly Mexican Americans: the Hispanic EPESE. Established Population for Epidemiologic Studies of the Elderly.

    PubMed

    Ostir, G V; Markides, K S; Freeman, D H; Goodwin, J S

    2000-01-01

    The objective of this analysis was to determine the prevalence of obesity and its association with selected medical conditions in a non-institutionalized elderly Mexican-American population. Data employed are from a representative sample of 3050 elderly Mexican Americans from the five Southwestern states: Texas, California, Colorado, New Mexico, and Arizona. Complete Body Mass Index (BMI) data were available for 2769 individuals. The in-home survey obtained socio-demographic data, anthropometric measurements, including height and weight, blood pressure readings, self-reported health conditions and depressive symptomatology. It was found that 23% of men and 35% of women were obese (BMI > or =30 kg/m2). Using a weighted logistic regression model, a BMI of > or =26 kg/m2 was associated with a significantly higher risk of diabetes; a BMI of > or =30 kg/m2 was significantly associated with arthritis and measured hypertension and a BMI<22 kg/m2 was associated with a higher likelihood of self-reported cancer. In addition, the prevalence of obesity was found to be much higher in this elderly Mexican-American population than in the general population.

  15. Association of personality traits with elder self-neglect in a community-dwelling population.

    PubMed

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2011-08-01

    Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are as follows: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Population-based study conducted from 1993 to 2005 of community-dwelling older adults (N = 9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N = 1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity, and information processing. Logistic and linear regressions were used to assess these associations. In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Neuroticism, extraversion, rigidity, and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders.

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

    SciTech Connect

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

    1986-03-05

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

  17. Gastric bypass for obesity in the elderly: is it as appropriate as for young and middle-aged populations?

    PubMed

    Robert, Maud; Pasquer, Arnaud; Espalieu, Philippe; Laville, Martine; Gouillat, Christian; Disse, Emmanuel

    2014-10-01

    Obesity prevalence increases in elderly population. Bariatric surgery has been underused in patients over 60 because of fears of complications and lower weight loss. We postulated worse outcomes in the elderly in comparison to young and middle-aged population 1 year after gastric bypass. We retrospectively analyzed gastric bypass outcomes in young (<40 years), middle-aged (40 to 55 years), and elderly (>60 years) patients between 2007 and 2013. Each subject over 60 (n = 24) was matched with one subject of both the other groups according to gender, preoperative body mass index (BMI), surgical procedure, and history of previous bariatric surgery (n = 72). Older subjects demonstrated higher prevalence of preoperative metabolic comorbidities (70 vs 30 % in the <40-year-old group, p < 0.0001). Mean duration of the surgical procedure, mean length of stay, and early and late complication rates were similar between age groups. A trend towards fewer early complications and less-severe complications in the younger groups was noted. One-year weight loss results were similar between young, middle-aged, and elderly patients (percentage of excess BMI loss (EBL%), 74.4 ± 3.5; 78.9 ± 4.5, and 73.7 ± 4.5 respectively, p = 0.69). Age was not predictive of weight loss failure 1 year after surgery. Remission and improvement rates of comorbidities were similar between age groups 6 months after surgery. Our study confirms weight loss efficacy of gastric bypass in the elderly with acceptable risks. Further studies evaluating the benefit-risk balance of bariatric surgery in the elderly population will be required so as to confirm the relevance of increasing age limit.

  18. Aortic valve replacement in the elderly. Risk factors and long-term results.

    PubMed Central

    Tseng, E E; Lee, C A; Cameron, D E; Stuart, R S; Greene, P S; Sussman, M S; Watkins, L; Gardner, T J; Baumgartner, W A

    1997-01-01

    underwent AVR scored comparably to their age-matched population norms in seven of eight dimensions of overall health. The exception is mental health. CONCLUSIONS: Aortic valve replacement in the elderly can be performed with acceptable mortality. Significant preoperative risk factors for early mortality include poor left ventricular function and preoperative pacemaker insertion. Predictors of late mortality include chronic obstructive pulmonary disease and urgency of operation. These results stress the importance of operating on the elderly with aortic valve disease; both long-term survival and functional recovery are excellent. Images Figure 9. PMID:9230820

  19. Evaluation and management of pruritus and scabies in the elderly population.

    PubMed

    Panuganti, Bharat; Tarbox, Michelle

    2013-05-01

    Pruritus is the most common dermatologic complaint in individuals older than 65 years. The elderly comprise a demographic that seeks medical attention for itch with greater frequency than other age groups. Managing pruritus in elderly patients represents a unique therapeutic challenge attributable to a range of circumstances that are of particular importance in this population. Topical steroid therapy must be administered carefully, and other forms of treatment, including phototherapy, may be difficult to maintain. The challenge of treating pruritus in the elderly might also stem from communication barriers that prevent definitive identification of the itch's underlying etiology or severity.

  20. The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study

    PubMed Central

    2016-01-01

    Objectives Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. Methods From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. Results A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42). Conclusions Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population. PMID:27744668

  1. Hypercholesterolemia in elders is associated with slower cognitive decline: a prospective, population-based study (NEDICES).

    PubMed

    Benito-León, Julián; Vega-Quiroga, Saturio; Villarejo-Galende, Alberto; Bermejo-Pareja, Félix

    2015-03-15

    Studies investigating the association between hypercholesterolemia in the elderly and cognitive decline report discrepant outcomes. We determined in a prospective population-based cohort (NEDICES) in elders whether hypercholesterolemia was associated with slower cognitive decline. Participants were evaluated at baseline and 3 years later. Baseline demographic variables were recorded. Hypercholesterolemia was defined by total cholesterol of >200mg/dl or current use of lipid-lowering drugs. At baseline and at follow-up, a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered. The final sample, 2015 participants (72.9 ± 6.1 years), comprised 1166 (57.9%) hypercholesterolemic and 849 (42.1%) non-hypercholesterolemic participants (reference category). The mean follow-up was 3.4 ± 0.5 years. During the three year follow-up period, the 37-MMSE declined by 0.7 ± 4.3 points (median=0 point) in non-hypercholesterolemic participants vs. 0.3 ± 3.9 points in hypercholesterolemic participants (median=0 points) (Mann-Whitney test, p=0.007). In analyses adjusted for baseline age and other potential confounders, this difference remained robust. We also assessed the cognitive decline per unit time (i.e., the rate of cognitive decline). The rate of cognitive decline was 0.2 ± 1.3 (median=0.0) points/year for non-hypercholesterolemic participants and 0.1 ± 1.2 (median=0.0) points/year for hypercholesterolemic participants (Mann-Whitney test, p=0.028). In this prospective population-based cohort study, cognitive test scores among hypercholesterolemic elders declined more slowly than observed in their non-hypercholesterolemic counterparts. Additional studies are needed to confirm these results. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Helicobacter Pylori Infection and Metabolic Parameters: Is There an Association in Elderly Population?

    PubMed Central

    Sotuneh, Narges; Hosseini, Seyed Reza; Shokri-Shirvani, Javad; Bijani, Ali; Ghadimi, Reza

    2014-01-01

    Background: The association between Helicobacter pylori (HP), as one of the most prevalent infections, and serum glucose level was inconsistent with previous studies. Moreover, there are contradictory reports about the relationship between HP infection and lipid profile. The purpose of this study was to determine the relationship between HP infection with glycemic and lipid profiles in elderly people. Methods: This cross-sectional study was conducted on 1,300 subjects over 60 years in Amirkola Health and Ageing Project. After using a standard questionnaire, the venous sampling was done to determine FBS, triglyceride (TG), cholesterol, low density lipoprotein (LDL), high-density lipoprotein (HDL) and IgG anti-HP after a 12-h overnight fast. The information about the individuals was analyzed using SPSS-17. The P < 0.05 was considered statistically significant. Results: The prevalence of HP infection in diabetic and nondiabetic subjects was 77.5% and 75.7%, respectively, which had no statistically significant difference. Also, there was no significant difference between the serum lipid level including TG, LDL and HDL cholesterol with levels of anti-HP antibodies. The rate of HP infection in patients with hypertension was 75% and 78.3% in healthy patients, in which the difference was not statistically significant. In terms of body mass index (BMI), the prevalence of infection in the group with normal BMI was 77.3% and for the overweight and obese elderly population, it was 74.7%, and 77.5%, respectively (P = 0.445). Conclusions: The findings revealed that in a large population of elderly in the northern part of Iran, HP infection is not associated with BMI, serum glucose and lipid profile as well as blood pressure. PMID:25709789

  3. Screening for Depression among a Well Elderly Population.

    ERIC Educational Resources Information Center

    Dorfman, Rachelle A.; And Others

    1995-01-01

    Describes a geriatric wellness program in which social work practitioners played a major role. Compared results of a telephone screening test to detect depression with the clinical judgment of social workers. The screening instrument proved effective in assessing a population with a high rate of major depression. (RJM)

  4. CHARACTERISTIC OF ACTUAL FOOD AT ELDERLY AND SENILE AGED POPULATION OF YAKUTIA.

    PubMed

    Neustroeva, V; Kylbanova, E; Simonova, G; Tatarinova, O; Scherbakova, L

    2015-01-01

    To conduct estimation of actual food among in digenous and arrived population of Yakutia of elderly and senile ages. In the work results of epidemiological research with analysis of actual food of the population of Yakutia at the age of 60 years and over are presented. On the basis of a list of candidates with use of random selection a representative sample of men and women of Yakutsk at the age of 60 years and more has been generated. In total 775 foreheads were surveyed, the middle age has made 75.7 ± 9.4 years. For the analysis of actual food 575 people (244 men and 331 women) have been included. Among the surveyed there were 244 respondents of the in digenous population (the Yakuts) and 331 arrived respondents (the Russians, the Ukrainians, the Byelorussians, the Poles, the Germans, the Jews). The estimation of actual food is conducted by means of a frequency questionnaire. High content of general fat, sated fat acids, polyunsaturated fat acids and refined sugar due to low consumption of general carbohydrates is revealed. At the analysis of food package of the indigenous population in comparison with the newly arrived some distinctions in consumption of following products are revealed: fresh, tinned and frozen vegetables, potatoes, eggs, horsemeat, venison, koumiss, fresh fruit and berries, oil and fats, bean, juice and drinks, sugar, chocolate and confectionery products. daily food intake of the indigenous population of elderly and senile ages is notable for lower daily caloric content, greater general fat, SFA, less consumption of refined sugar on the background of significantly lower content of general carbohydrates, starch and food proteins. In diets at theYakuts there is considerably lower consumption of fresh and tinned vegetables, potatoes, eggs, fresh fruit and berries, bean, nuts, sugar, chocolate and confectionery products and higher consumption of meat products (horsemeat, venison), oil and fats.

  5. APOE-epsilon4 polymorphism and cognitive deficit among the elderly population of Fernando de Noronha.

    PubMed

    Garcia, Anália Nusya; Silva, Helker Albuquerque da; Silva, Renan Carlos; Leal, Eliane Maria Medeiros; Rodrigues, Lorena; Silva, Vanessa Cavalcante da; Dellalibera, Edileine; Freitas, Elizabete Malaquias; Ataíde, Luiz; Muniz, Maria Tereza Cartaxo

    2008-06-01

    Polymorphism of the gene for apolipoprotein E (APOE) is an important risk factor for the development of Alzheimer's disease. The epsilon4 allele of the APOE gene has been linked with a number of neuropsychiatric illnesses, and also with stress and depression among geriatric populations. To identify APOE-epsilon4 polymorphism and correlate this with cognitive deficit among the elderly population of the island of Fernando de Noronha. Neuropsychiatric tests (mini-mental state examination, verbal fluency test and clock drawing test) were applied to 52 elderly people without Alzheimer's disease. DNA was isolated from peripheral blood and genotyping of APOE was done by the PCR-RFLP method. 87% of the elderly population (mean age 69.6+/-7.0) had cognitive deficit. The observed frequency of the epsilon4 allele was 10%, but the correlation between the presence of epsilon4 and cognitive deficit in this population was not statistically significant.

  6. Normative data for the Pyramids and Palm Trees Test in the elderly Italian population.

    PubMed

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

    2009-12-01

    The Pyramids and Palm Tree Test (PPT) is a semantic memory test that measures the capacity to access detailed semantic information about words and pictures, necessary for the identification of the analogies, which link conceptually two perceptually, and functionally distinct entities. The present study aimed to provide normative data on a large sample of the elderly Italian population (N = 464; range of age = 49-94; range of education = 3-25) on both the word and the picture versions of the PPT. Results from multiple regression analyses showed that both age and education were significant predictors of performance in both the word and the picture versions of the PPT. Therefore, norms were calculated taking into account these demographic variables. The availability of normative data based on a large sample will allow a more reliable use of the PPT for clinical assessment in Italian-speaking dementia population.

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

    PubMed Central

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

    2015-01-01

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

  8. [Physical inactivity among non-institutionalized elderly individuals: a population-based study].

    PubMed

    Queiroz, Bruno Morbeck de; Coqueiro, Raildo da Silva; Leal Neto, João de Souza; Borgatto, Adriano Ferreti; Barbosa, Aline Rodrigues; Fernandes, Marcos Henrique

    2014-08-01

    The scope of this study is to assess the prevalence of physical inactivity among the elderly in Northeast Brazil and analyze the associated lifestyle and socio-demographic factors and health conditions. The work presented here is a descriptive and association-based study using secondary data derived from a population-based epidemiological study that included 316 elderly participants. The physical activity level of each participant was assessed using the International Physical Activity Questionnaire. The explanatory variables examined in this study were gender, age group, family set-up, ability to read and write, paid or voluntary employment, smoking, symptoms of depression, high blood pressure, fasting hyperglycemia and functional capacity. The prevalence of physical inactivity was 46.5. The results of the multivariate analysis indicated that physical inactivity was positively associated with the age group ≥ 80 years (PR = 2.37), with the lack of an occupation (PR = 4.86) and with dependence on instrumental activities of daily life (PR = 1.47) and basic activities of daily life (PR = 1.60). Physical inactivity was highly prevalent in the surveyed population, making it essential to discuss programs that encourage and enable increased physical activity to combat the risk factors of a sedentary lifestyle.

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

    PubMed Central

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

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

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

    PubMed

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

    2011-07-01

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

  11. Elder mistreatment and emotional symptoms among older adults in a largely rural population: The South Carolina Elder Mistreatment Study

    PubMed Central

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

    2010-01-01

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

  12. Prevalence and cost of hospital medical errors in the general and elderly United States populations.

    PubMed

    Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

    2013-12-01

    The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

  13. Prevalence, incidence and types of mild anemia in the elderly: the “Health and Anemia” population-based study

    PubMed Central

    Tettamanti, Mauro; Lucca, Ugo; Gandini, Francesca; Recchia, Angela; Mosconi, Paola; Apolone, Giovanni; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Savoia, Luigi; Fasolo, Gilberto; Ponchio, Luisa; Della Porta, Matteo G.; Riva, Emma

    2010-01-01

    Background Hemoglobin concentrations slightly below the lower limit of normal are a common laboratory finding in the elderly, but scant evidence is available on the actual occurrence of mild anemia despite its potential effect on health. The objectives of this study were to estimate the prevalence and incidence of mild grade anemia and to assess the frequency of anemia types in the elderly. Design and Methods This was a prospective, population-based study in all residents 65 years or older in Biella, Italy. Results Blood test results were available for analysis from 8,744 elderly. Hemoglobin concentration decreased and mild anemia increased steadily with increasing age. Mild anemia (defined as a hemoglobin concentration of 10.0–11.9 g/dL in women and 10.0–12.9 g/dL in men) affected 11.8% of the elderly included in the analysis, while the estimated prevalence in the entire population was 11.1%. Before hemoglobin determination, most mildly anemic individuals perceived themselves as non-anemic. Chronic disease anemia, thalassemia trait, and renal insufficiency were the most frequent types of mild anemia. The underlying cause of mild anemia remained unexplained in 26.4% of the cases, almost one third of which might be accounted for by myelodysplastic syndromes. In a random sample of non-anemic elderly at baseline (n=529), after about 2 years, the annual incidence rate of mild anemia was 22.5 per 1000 person-years and increased with increasing age. Conclusions The prevalence and incidence of mild anemia increase with age and mild anemia affects more than one out of ten elderly individuals. Unexplained anemia is common and may be due to myelodysplastic syndromes in some cases. PMID:20534701

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

    ERIC Educational Resources Information Center

    Fowles, Donald G.

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

  15. Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the Population Study of Chinese Elderly in Chicago study.

    PubMed

    Dong, XinQi

    2014-12-01

    This study aimed to examine the prevalence of self-neglect and its specific behaviors in an elderly community-dwelling U.S. Chinese population through a population-based cohort study (PINE Study) in the greater Chicago area. Community-dwelling population of older Chinese adults were interviewed from 2011 to 2013 (n = 3,159). The personal and home environment of participants was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented according to self-reported quality of life (QOL). It was found that the prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate to severe self-neglect. Unsanitary conditions (17.0%) was the most prevalent, followed by need for home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and of all types was higher in older adults with fair or poor QOL than in those with good or very good QOL. Poorer QOL was significantly associated with greater risk of self-neglect of all severities (mild self-neglect: odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.26-2.96, P < .001; moderate to severe self-neglect: OR = 3.58, 95% CI = 1.79-7.13, P < .001) and specific personal and environmental hazards. The study's authors conclude that elder self-neglect is prevalent, especially in elderly adults with poorer QOL. Future research is needed to examine risk and protective factors associated with elder self-neglect. © 2014, Copyright the Author Journal compilation © 2014, The American Geriatrics Society.

  16. Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population.

    PubMed

    Ma, Lina; Li, Yun; Wang, Jieyu; Zhu, Hong; Yang, Wei; Cao, Ruojin; Qian, Yuying; Feng, Ming

    2015-01-01

    To explore the association between quality of life and social support in elderly osteoporosis patients in a Chinese population. A total of 214 elderly patients who underwent bone mineral density screening were divided into two groups: elderly patients with primary osteoporosis (case group, n = 112) and normal elderly patients (control group, n = 102). Quality of life and social support were compared between the two groups. Quality of life and social support were significantly different between the case and control groups. The physical function, role-physical, bodily pain, general health, vitality, social-functioning, role-emotional and mental health scores in case group were significantly lower than those in the control group (P < 0.01). The objective support, subjective support, utilization of support, and total scores in case group were significantly lower than those in the control group (P < 0.01). Quality of life and social support were positively correlated in the case group (r = 0.672, P < 0.01). Quality of life and social support in elderly patients with osteoporosis in China were poorer than in elderly patients without osteoporosis and were positively correlated. Our findings indicate that increased efforts to improve the social support and quality of life in elderly osteoporosis patients are urgently needed in China. Further longitudinal studies should be conducted to provide more clinical evidence to determine causative factors for the observed association between risk factors and outcomes.

  17. Physical Function Decline and the Risk of Elder Self-neglect in a Community-Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa; Fulmer, Terry; Mendes de Leon, Carlos F.; Rajan, Bharat; Evans, Denis A.

    2010-01-01

    Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. Design and Methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The primary predictor was objectively assessed physical function using decline in physical performance testing. Secondary predictors were assessed using the decline in self-reported Katz, Nagi, and Rosow–Breslau scales. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these associations. Results: After adjusting for confounding factors, every 1-point decline in physical performance testing was associated with increased risk of reported elder self-neglect (odds ratio [OR], 1.05, confidence interval [CI], 1.03–1.07, p < .001). Decline in Katz (OR, 1.05, CI, 1.00–1.10, p < .05) and decline in Rosow–Breslau (OR, 1.19, CI, 1.11–1.27, p < .001) were associated with increased risk of reported elder self-neglect. Decline in physical performance testing (standardized parameter estimate [PE]: 0.19, SE: 0.06, p = .002), Katz (PE: 0.65, SE: 0.14, p < .001), Nagi (PE: 0.48, SE: 0.14, p < .001), and Rosow–Breslau (PE: 0.57, SE: 0.21, p = .006) scales were associated with increased risk of greater self-neglect severity. Implications: Decline in physical function was associated with increased risk of reported elder self-neglect and greater self-neglect severity in this community-dwelling population. PMID:20019180

  18. Sexual functioning among the elderly population in Tehran, Iran.

    PubMed

    Malakouti, Seyed Kazem; Salehi, Mansour; Nojomi, Marzieh; Zandi, Taher; Eftekhar, Mehrdad

    2012-01-01

    This study aims to demonstrate the sexual functioning of elderly Iranian retirees who reside in Tehran, Iran. The participants' sexual interests are also reviewed in association with their physical and mental health status. The authors recruited 390 elders (199 men, 191 women) by convenient sampling from 4 retirement organizations in Tehran from April 2007 to October 2008. Tools for evaluation included use of a demographic questionnaire, modified Brief Index of Sexual Functioning for Women, Brief Sexual Function Inventory for Men, and the General Health Questionnaire. Sexual activity was "important/very important" in 56.6% and 17.0% of men and women, respectively (p < .005), but their satisfaction from sexual life was similar. Sexual desire and activities were more common among men than among women (p < .05). Impotency and ejaculatory problems were 40% and 33%, respectively, among the male study participants. This study indicated that having a sexual partner was the most important variable for sexual activities. This study provides a profile of sexual behaviors among elderly people in Iran and shows that although sexual decline and dysfunction are seen in both genders, both groups express satisfaction with their sexual affairs when they have a partner available.

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

    PubMed Central

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

    2015-01-01

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

  20. [Status of health and oral health of the elderly population in Lebanon].

    PubMed

    Osta, N El; Hennequin, M; Osta, L El; Naaman, N Bou Abboud; Geahchan, N; Tubert-Jeannin, S

    2015-08-27

    Lebanon is in demographic transition as more people reach increasingly older age; 10% of the population in Lebanon is elderly. The incidence of chronic diseases and oral diseases increases significantly with age. However, 55% of the elderly have no health insurance and 82% have no dental insurance. Both noncommunicable diseases (NCDs) and oral diseases are a major health burden in the country and share the same risk factors. The WHO strategy for prevention and control of noncommunicable diseases should therefore be a new approach for the prevention and control of dental diseases among Lebanese elderly. This paper aims to increase the awareness of the medical community in Lebanon about the interrelationship between general and oral health in the elderly and concludes with the need for the Ministry of Health to develop policies and national action plans against NCDs to reduce not only mortality from NCDs but also morbidity from oral diseases.

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

    PubMed Central

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

    2016-01-01

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

  2. Prediagnostic Helicobacter pylori Antibodies and Colorectal Cancer Risk in an Elderly, Caucasian Population.

    PubMed

    Blase, Jennifer L; Campbell, Peter T; Gapstur, Susan M; Pawlita, Michael; Michel, Angelika; Waterboer, Tim; Teras, Lauren R

    2016-12-01

    Study results on overall seroprevalence of Helicobacter pylori and colorectal cancer risk have been inconsistent. However, one study found positive associations with antibodies to specific H. pylori proteins. To follow up on those findings, we assessed associations of 15 H. pylori specific proteins with colorectal cancer incidence in the prospective Cancer Prevention Study-II Nutrition Cohort. Participants in this nested case-control study included 392 cases and 774 controls who were predominantly elderly (median age at blood draw: 71 years) and Caucasian (98%). Seroreactivity against 15 H. pylori proteins was assessed by fluorescent bead-based multiplex serology and associations with colorectal cancer were estimated using conditional logistic regression. Helicobacter pylori serostatus was not associated with colorectal cancer incidence (odds ratio (OR), 1.17, 95% confidence interval (95% CI), 0.91-1.50). Among individual antigens, GroEl serostatus was associated with colorectal cancer risk (OR, 1.32, 95% CI: 1.03-1.70), whereas CagM was associated with colon cancer risk only (OR, 1.35, 95% CI: 1.01-1.80). No dose-response relationships were observed for any of the antigens, including GroEl and CagM. The results of our study do not support an association between H. pylori infection and colorectal cancer risk in this elderly, mostly Caucasian population. © 2016 John Wiley & Sons Ltd.

  3. Survival Trends in Elderly Patients with Glioblastoma in the United States: a Population-based Study.

    PubMed

    Shah, Binay Kumar; Bista, Amir; Sharma, Sandhya

    2016-09-01

    Concomitant and adjuvant temozolomide along with radiotherapy following surgery (the Stupp regimen) is the preferred therapy for young patients with glioblastoma as well as for elderly (>70 years) ones with favorable risk factors. This study investigated the survival trend since the introduction of the use of the Stupp regimen in elderly patients in a population-based setting. Surveillance, Epidemiology, and End Results 18 database was used to identify patients aged ≥70 years with glioblastoma as the first primary cancer diagnosed from 1999 to 2010. Chi-square test, Kaplan-Meier analysis with log-rank test and Cox proportional hazard method were used for analysis. A total of 5,575 patients were included in the survival analysis. Survival in Stupp era (year of diagnosis ≥2005) was significantly better compared to the pre-Stupp era with p<0.001 by log-rank test, with 1-, 2- and 3-year overall survival of 18.8% vs. 12.9%, 6.5% vs. 2.1% and 3.1% vs. 0.9% respectively, and hazard ratio for death in 3 years in the Stupp era was 0.87 (95% confidence interval=0.82-0.92; p<0.001) when compared with the pre-Stupp era. Factors such as younger age (<85 years), female sex, married status, Caucasian race and total resection favored better survival compared to their counterparts. This study shows that the survival of elderly patients with glioblastoma has improved since the introduction of the Stupp regimen. However, there are significant differences in survival rates among various cohorts. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  4. Elder mistreatment in underserved populations: Opportunities and challenges to developing a contemporary program of research

    PubMed Central

    Jervis, Lori L.; Hamby, Sherry; Beach, Scott R.; Williams, Mary L.; Maholmes, Valerie; Castille, Dorothy M.

    2017-01-01

    This article provides an overview of the status of research on elder mistreatment among underserved populations in the United States, including gaps in our current knowledge base, scientific and structural barriers to growing research on the exploitation, neglect, and abuse of older people from diverse and disadvantaged ethnic/racial, geographic, sexual identity, and socioeconomic groups. High priority areas in need of new elder mistreatment research with underserved populations are identified, and suggestions are given for how this research can be facilitated by researchers, university institutional review boards, and funding agencies. PMID:27739929

  5. Barriers, Attitudes, and Dietary Behaviors Regarding Sodium Reduction in the Elderly Korean–Chinese Population in Yanbian, China

    PubMed Central

    Lee, Jounghee; Cui, Wenying; Jin, Meixiang

    2017-01-01

    Objectives This research investigated the barriers, attitudes, and dietary behaviors related to sodium reduction among the elderly Korean–Chinese population in Yanbian, China. Methods We conducted this pilot study using both descriptive research and a focus group interview at the elderly community center in Yanbian. Results In total, 21 elderly Korean–Chinese (average age, 71 years) were examined. The findings showed that the top three barriers to sodium reduction were 1) the difficulties associated with having meals with others, 2) a preference for liquid based-dishes, and 3) the lack of taste in low-sodium dishes. Although the participants strongly believed that a reduced-sodium diet would improve their health, they were poorly aware of the amount of sodium in various foods and dishes. In particular, the focus group interviews with eight participants (mean age, 67 years) revealed that salt-preserved foods (e.g., Korean pickled cabbage called ‘kimchi’ and soybean paste) were frequently consumed as part of their food culture, and that very salty dishes were served at restaurants, both of which lead to a high sodium intake. Conclusion This study provides useful preliminary data to help design a nutrition intervention program for sodium reduction that targets the elderly Korean–Chinese population in China. PMID:28781941

  6. Predictors of falls and mortality among elderly adults with traumatic brain injury: A nationwide, population-based study.

    PubMed

    Fu, Wayne W; Fu, Terence S; Jing, Rowan; McFaull, Steven R; Cusimano, Michael D

    2017-01-01

    Elderly adults are at particular risk of sustaining a traumatic brain injury (TBI), and tend to suffer worse outcomes compared to other age groups. Falls are the leading cause of TBI among the elderly. We examined nationwide trends in TBI hospitalizations among elderly adults (ages 65 and older) between April 2006 and March 2011 using a population-based database that is mandatory for all hospitals in Canada. Trends in admission rates were analyzed using linear regression. Predictors of falls and in-hospital mortality were identified using logistic regression. Between 2006 and 2011, there were 43,823 TBI hospitalizations resulting in 6,939 deaths among elderly adults in Canada. Over the five-year study period, the overall rate of TBI admissions increased by an average of 6% per year from 173.2 to 214.7 per 100,000, while the rate of fall-related TBI increased by 7% annually from 138.6 to 179.2 per 100,000. There were significant trends towards increasing age and comorbidity level (p<0.001 and p = 0.002). Advanced age, comorbidity, and injury severity were independent predictors of both TBI-related falls and mortality on multivariate analysis. Prevention efforts should be targeted towards vulnerable demographics including the "older old" (ages 85 and older) and those with multiple medical comorbidities. Additionally, hospitals and long-term care facilities should be prepared to manage the burgeoning population of older patients with more complex comorbidities.

  7. Association of mitochondrial haplogroup J and mtDNA oxidative damage in two different North Spain elderly populations.

    PubMed

    Domínguez-Garrido, Elena; Martínez-Redondo, Diana; Martín-Ruiz, Carmen; Gómez-Durán, Aurora; Ruiz-Pesini, Eduardo; Madero, Pilar; Tamparillas, Manuel; Montoya, Julio; von Zglinicki, Thomas; Díez-Sánchez, Carmen; López-Pérez, Manuel J

    2009-08-01

    This work investigates the association between longevity, mitochondrial DNA (mtDNA) variants and oxidative DNA damage in an older than 85 years population. The participants, similar in genetic and cultural background as well as gender distribution, come from villages near to the Pyrenees Mountains (900-1,400 m altitude) (n = 69) and the Ebro's Valley (200-300 m altitude) (n = 69) in Spain. Our results show an accumulation of the haplogroup J in elderly individuals with an over-representation of J2 in Pyrenees group but not in the Ebro's Valley, the former associating with a diminished DNA damage. In conclusion, our results suggest that J mitochondrial variant, that induce lower mtDNA damage, could present a phenotypic survival advantage to environmental conditions and, thus, accumulate in elderly population.

  8. Incidence and types of preventable adverse events in elderly patients: population based review of medical records

    PubMed Central

    Thomas, Eric J; Brennan, Troyen A

    2000-01-01

    Objective To determine the incidence and types of preventable adverse events in elderly patients. Design Review of random sample of medical records in two stage process by nurses and physicians to detect adverse events. Two study investigators then judged preventability. Setting Hospitals in US states of Utah and Colorado, excluding psychiatric and Veterans Administration hospitals. Subjects 15 000 hospitalised patients discharged in 1992. Main outcome measures Incidence of preventable adverse events (number of preventable events per 100 discharges) in elderly patients (⩾65 years old) and non-elderly patients (16-64 years). Results When results were extrapolated to represent all discharges in 1992 in both states, non-elderly patients had 8901 adverse events (incidence 2.80% (SE 0.18%)) compared with 7419 (5.29% (0.37%)) among elderly patients (P=0.001). Non-elderly patients had 5038 preventable adverse events (incidence 1.58% (0.14%)) compared with 4134 (2.95% (0.28%)) in elderly patients (P=0.001). Elderly patients had a higher incidence of preventable events related to medical procedures (such as thoracentesis, cardiac catheterisation) (0.69% (0.14%) v 0.13% (0.04%)), preventable adverse drug events (0.63% (0.14%) v 0.17% (0.05%)), and preventable falls (0.10% (0.06%) v 0.01% (0.02%)). In multivariate analyses, adjusted for comorbid illnesses and case mix, age was not an independent predictor of preventable adverse events. Conclusions Preventable adverse events were more common among elderly patients, probably because of the clinical complexity of their care rather than age based discrimination. Preventable adverse drug events, events related to medical procedures, and falls were especially common in elderly patients and should be targets for efforts to prevent errors. PMID:10720355

  9. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry.

    PubMed

    Hoeper, Marius M; Huscher, Doerte; Ghofrani, H Ardeschir; Delcroix, Marion; Distler, Oliver; Schweiger, Christian; Grunig, Ekkehard; Staehler, Gerd; Rosenkranz, Stephan; Halank, Michael; Held, Matthias; Grohé, Christian; Lange, Tobias J; Behr, Juergen; Klose, Hans; Wilkens, Heinrike; Filusch, Arthur; Germann, Martin; Ewert, Ralf; Seyfarth, Hans-Juergen; Olsson, Karen M; Opitz, Christian F; Gaine, Sean P; Vizza, C Dario; Vonk-Noordegraaf, Anton; Kaemmerer, Harald; Gibbs, J Simon R; Pittrow, David

    2013-09-30

    Originally reported to occur predominantly in younger women, idiopathic pulmonary arterial hypertension (IPAH) is increasingly diagnosed in elderly patients. We aimed to describe the characteristics of such patients and their survival under clinical practice conditions. Prospective registry in 28 centers in 6 European countries. Demographics, clinical characteristics, hemodynamics, treatment patterns and outcomes of younger (18-65 years) and elderly (>65 years) patients with newly diagnosed IPAH (incident cases only) were compared. A total of 587 patients were eligible for analysis. The median (interquartile, [IQR]) age at diagnosis was 71 (16) years. Younger patients (n=209; median age, 54 [16] years) showed a female-to-male ratio of 2.3:1 whereas the gender ratio in elderly patients (n=378; median age, 75 [8] years) was almost even (1.2:1). Combinations of PAH drugs were widely used in both populations, albeit less frequently in older patients. Elderly patients were less likely to reach current treatment targets (6 min walking distance>400 m, functional class I or II). The survival rates 1, 2, and 3 years after the diagnosis of IPAH were lower in elderly patients, even when adjusted for age- and gender-matched survival tables of the general population (p=0.006 by log-rank analysis). In countries with an aging population, IPAH is now frequently diagnosed in elderly patients. Compared to younger patients, elderly patients present with a balanced gender ratio and different clinical features, respond less well to medical therapy and have a higher age-adjusted mortality. Further characterization of these patients is required. NCT01347216. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. A Normative Study of Lexical Verbal Fluency in an Educationally-Diverse Elderly Population

    PubMed Central

    Kim, Bong Jo; Lee, Cheol Soon; Oh, Byoung Hoon; Hong, Chang Hyung; Lee, Kang Soo; Son, Sang Joon; Han, Changsu; Park, Moon Ho; Jeong, Hyun-Ghang; Kim, Tae Hui; Park, Joon Hyuk

    2013-01-01

    Objective Lexical fluency tests are frequently used to assess language and executive function in clinical practice. We investigated the influences of age, gender, and education on lexical verbal fluency in an educationally-diverse, elderly Korean population and provided its' normative information. Methods We administered the lexical verbal fluency test (LVFT) to 1676 community-dwelling, cognitively normal subjects aged 60 years or over. Results In a stepwise linear regression analysis, education (B=0.40, SE=0.02, standardized B=0.506) and age (B=-0.10, SE=0.01, standardized B=-0.15) had significant effects on LVFT scores (p<0.001), but gender did not (B=0.40, SE=0.02, standardized B=0.506, p>0.05). Education explained 28.5% of the total variance in LVFT scores, which was much larger than the variance explained by age (5.42%). Accordingly, we presented normative data of the LVFT stratified by age (60-69, 70-74, 75-79, and ≥80 years) and education (0-3, 4-6, 7-9, 10-12, and ≥13 years). Conclusion The LVFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy. PMID:24474982

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  13. Prosthetic Status, Needs and Oral Health Related Quality of Life (OHRQOL) in the Elderly Population of Aluva, India

    PubMed Central

    Joseph, Albin Geo; Mathew, Anil

    2016-01-01

    Introduction Oral Health Related Quality of Life (OHRQOL), being a patient-centred outcome has profound association with the existing prosthetic status and needs. Aim To assess the association between the prosthetic status and needs with OHRQOL in the elderly population of Aluva, Kochi, Kerala, India. Materials and Methods A cross-sectional study was conducted among the elderly residing in the municipal wards of Aluva municipality, Kochi, Kerala, India. A total of 539 subjects whose age was 60 years or above were considered for the study. Proforma utilizing a validated structured questionnaire of two sections; the first section noted with demographic details with WHO assessment of prosthetic needs and details regarding loss of teeth and denture wear and the second section consisted of Oral Health Impact Proflie (OHIP)-14 questions to measure the OHRQOL which was prepared in the local language. Type III oral examination (WHO Basic Oral Health Assessment 2013) was carried out on selected elderly subjects from house hold survey at municipal wards and recordings were done by the trained local health worker. ANOVA was used to find out the association between different domains of the OHIP and prosthetic status and need. Results The prosthetic status was 18.2% and 14.7% and the prosthetic needs 62.7% and 60.3% of the upper and lower jaws respectively for the population. The prosthetic status was found to have no impact on the OHRQOL. However, the prosthetic need was significantly related to various components of OHRQOL of the study population. Of all the domains in OHRQOL, physical pain was the most affected in this population. Conclusion There is high unmet prosthetic care for non-institutionalised elderly population in Aluva. PMID:28050494

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

    PubMed Central

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

    2009-01-01

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

  15. Participation in physical activity and back pain among an elderly population in South Asia.

    PubMed

    Bishwajit, Ghose; Tang, Shangfeng; Yaya, Sanni; Feng, Zhanchun

    2017-01-01

    Globally, chronic back pain is one of the most commonly encountered medical conditions among an elderly population with significant bearings on health, functional mobility and general well-being. To estimate the burden of chronic back pain and its association with physical activity (PA) among population aged 50 years and above in Bangladesh, India, Nepal, Pakistan and Sri Lanka. Cross-sectional data on 8502 men and women aged 50 years and above were collected from the World Health Survey (2002). Three forms of PA were considered - vigorous physical activity (VPA), moderate physical activity (MPA) and walking. Odds ratios (ORs) of the association between self-reported back pain and VPA, MPA and walking were calculated by using generalized estimating equations. The prevalence of back pain was, respectively, 64.8%, 19.8%, 69.5%, 40.6% and 36.2% in Bangladesh, India, Nepal, Pakistan and Sri Lanka. No significant association between back pain and VPA was observed among men in any of the countries. In India, Pakistan and Sri Lanka, the odds of suffering from back pain were, respectively, 29%, 2.5 times and 59% higher among women who almost never took MPA. In India, taking MPA for few days a week and almost never was associated with, respectively, 38% (OR=1.38; 95% confidence interval [CI]=1.017-1.876) and 56% (OR=1.564; 95% CI=1.003-2.438) higher odds of reporting back pain. Walking almost never was also associated with, respectively, 83% (OR=1.829; 95% CI=1.14-2.934) and 2.9 times (OR=2.854; 95% CI=1.419-5.738) higher odds of reporting back pain among men in Nepal and Pakistan, respectively. Though the relationship was not consistent across sex and countries, results indicate that inadequate or nonparticipation can substantially increase the likelihood of suffering from back pain among an elderly population in this region. Further research is needed to better understand this relationship and the potential of exercised-based strategies to prevent and treat back pain

  16. Increasing Prevalence of Metabolic Syndrome in a Chinese Elderly Population: 2001–2010

    PubMed Central

    Jiang, Bin; Sun, Dongling; Wu, Lei; Yang, Shanshan; Wang, Yiyan; Li, Xiaoying; He, Yao

    2013-01-01

    Objective The information on the changes of prevalence of MetS in China is limited. Our objective was to assess a 10-year’s change of the prevalence of MetS in a Chinese elderly population between 2001 and 2010. Methods We conducted two cross-sectional surveys in a representative sample of elderly population aged 60 to 95 years in Beijing in 2001 and 2010 respectively. MetS was defined according to the 2009 harmonizing definition. Results A total of 2,334 participants (943 male, 1,391 female) in 2001 and 2,102 participants (848 male, 1,254 female) in 2010 completed the survey. The prevalence of MetS was 50.4% (95%CI: 48.4%–52.4%) in 2001 and 58.1% (95%CI: 56.0%–60.2%) in 2010. The absolute change of prevalence of MetS was 7.7% over the 10-year’s period (p<0.001). The syndrome was more common in female than male in both survey years. Among the five components, hypertriglyceridemia and low HDL-C had increased most, with an increase of 14.8% (from 29.4% to 44.2%) and 9.9% (from 28.3% to 38.2%) respectively. The adjusted ORs of MetS for CHD, stroke and CVD were 1.67(95%CI: 1.39–1.99), 1.50(95%CI: 1.19–1.88) and 1.70(95%CI: 1.43–2.01) respectively in 2001, and were 1.74(95%CI: 1.40–2.17), 1.25(95%CI: 0.95–1.63) and 1.52(95%CI: 1.25–1.86) respectively in 2010. Conclusion The prevalence of MetS is high and increasing rapidly in this Chinese elderly population. Participants with Mets and its individual components are at significantly elevated ORs for CVD. Urgent public health actions are needed to control MetS and its components, especially for dislipidemia. PMID:23824753

  17. Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake

    PubMed Central

    2010-01-01

    Background The association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity. Methods A population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design. Results Compared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms. Conclusion Compared with the younger adults, the elderly survivors were more likely to develop PTSD and general psychiatric morbidity. More mental health services should be distributed to the elderly and groups at particular risk, to ensure their smooth mental health reconstruction after the earthquake. PMID:20353554

  18. Progressive disability in elderly population among tribals of Telangana: a cross sectional study.

    PubMed

    Katta, Ajitha; Krishna, Anil Kumar Indira; M, Bagavandas; Anegawa, Tomofumi; Munuswamy, Suresh

    2017-06-19

    The tribal population of Telangana, India, lives in remote and difficult conditions. This study was carried out to find out estimate, the prevalence and progression of disability in elderly population among tribals of Khammam District, Telangana state, India. A population based cross sectional survey was conducted in villages of Tribal Sub Plan area. Elderly people who are 60 years or older were chosen with a two stage sampling procedure: (1) probability proportion to size was used to select clusters and (2) in each selected cluster households were selected by systematic random sampling. The participants were interviewed with the 36 item Telugu version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire. Socio- demographic information, behavioral measurements, health and social benefit indicators were also assessed. Descriptive analytical methods were used for prevalence estimation and logistic regression was used to examine the associations of progressive age over disability among elderly. A total of 506 elderly people from 1349 households in 20 villages across 31mandals of Khammam were interviewed. Majority of elderly population among tribals were illiterate (men 88.94%; women 99.33%), used tobacco (men 81.25%; women 57.72%), consumed alcohol (men 80.77%; women 47.32%) and were hypertensive (men 53.85%; women 63.42%). The prevalence of disability was higher in women. Maximum disability in the interviewed elderly population was seen in domains of performing house hold activities, and mobility. In comparison with men, women expressed more disability for majority of domains. As age progressed, the disability for self-care domain increased to a maximum of 2.6 times in men and 6.6 times in women and for mobility domain increased to a maximum of 9.7 times in men and 7.2 times in women. Although present disability modifying mobility Assistive Devices (AD) can help elderly in overcoming disability, these are primarily designed for

  19. Lessons learned from our elders: how to study polypharmacy in populations with intellectual and developmental disabilities.

    PubMed

    Stortz, Jessica N; Lake, Johanna K; Cobigo, Virginie; Ouellette-Kuntz, Hélène M J; Lunsky, Yona

    2014-02-01

    Polypharmacy is the concurrent use of multiple medications, including both psychotropic and non-psychotropic drugs. Although it may sometimes be clinically indicated, polypharmacy can have a number of negative consequences, including medication nonadherence, adverse drug reactions, and undesirable drug-drug interactions. The objective of this paper was to gain a better understanding of how to study polypharmacy among people with intellectual and developmental disabilities (IDD). To do this, we reviewed literature on polypharmacy among the elderly and people with IDD to inform future research approaches and methods on polypharmacy in people with IDD. Results identified significant variability in methods used to study polypharmacy, including definitions of polypharmacy, samples studied, analytic strategies, and variables included in the analyses. Four valuable methodological lessons to strengthen future polypharmacy research in individuals with IDD emerged. These included the use of consistent definitions of polypharmacy, the implementation of population-based sampling strategies, the development of clinical guidelines, and the importance of studying associated variables.

  20. How well do elderly patients with cervical cancer tolerate definitive radiochemotherapy using RapidArc? Results from an institutional audit comparing elderly versus younger patients

    PubMed Central

    Chakraborty, Santam; Geetha, M; Dessai, Sampada; Patil, Vijay M

    2014-01-01

    Purpose Elderly patients (65 or older) with cervical cancer often receive suboptimal radio-chemotherapy. Intensity-modulated radiotherapy (IMRT) may improve tolerance to treatment in this setting. This study was designed to compare the treatment-related toxicities and compliance with treatment in patients of cervical cancer treated definitively with RapidArc IMRT in our institute. Methods and materials The treatment records of all patients treated with RapidArc IMRT between April 2012 and April 2014 were reviewed, retrospectively. Prospectively collected data regarding treatment toxicity (CTCAE 4.0), treatment outcomes and parameters related to treatment compliance were compared amongst two age groups (< 65 and ≥ 65 years). The results of 66 patients were identified, of whom 23 were found to be ≥ 65 years age. All patients completed planned external beam radiotherapy. However, significantly fewer patients in the elderly group received concurrent chemoradiation (98% versus 65%, p < 0.001). Old age (median 75 years, IQR: 74–78 years) was the commonest cause for non-receipt of chemotherapy. Incidence of grade 3 haematological toxicities (26.7% versus 16.7%) and gastrointestinal toxicity (16.7% versus 13.3%) were not significantly different between the two groups. Other treatment-related toxicities, breaks, treatment duration and early outcomes were also not significantly different between the two age groups. Conclusions The use of IMRT did not result in excess toxicities in the elderly population and was associated with equivalent compliance to treatment. Concurrent chemoradiation can be safely combined in elderly patients with perfect organ function and performance status. PMID:25525462

  1. Association of mild anemia with hospitalization and mortality in the elderly: the Health and Anemia population-based study

    PubMed Central

    Riva, Emma; Tettamanti, Mauro; Mosconi, Paola; Apolone, Giovanni; Gandini, Francesca; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Guala, Adriano; Fasolo, Gilberto; Lucca, Ugo

    2009-01-01

    Background Mild anemia is a frequent laboratory finding in the elderly usually disregarded in everyday practice as an innocent bystander. The aim of the present population-based study was to prospectively investigate the association of mild grade anemia with hospitalization and mortality. Design and Methods A prospective population-based study of all 65 to 84 year old residents in Biella, Italy was performed between 2003 and 2007. Data from a total of 7,536 elderly with blood tests were available to estimate mortality; full health information available to evaluate health-related outcomes was available for 4,501 of these elderly subjects. Mild grade anemia was defined as a hemoglobin concentration between 10.0 and 11.9 g/dL in women and between 10.0 and 12.9 g/dL in men. Results The risk of hospitalization in the 3 years following recruitment was higher among the mildly anemic elderly subjects than among subjects who were not anemic (adjusted hazard ratio: 1.32; 95% confidence interval: 1.09–1.60). Mortality risk in the following 3.5 years was also higher among the mildly anemic elderly (adjusted hazard ratio: 1.86; 95% confidence interval: 1.34–2.53). Similar results were found when slightly elevating the lower limit of normal hemoglobin concentration to 12.2 g/dL in women and to 13.2 g/dL in men. The risk of mortality was significantly increased in mild anemia of chronic disease but not in that due to β-thalassemia minor. Conclusions After controlling for many potential confounders, mild grade anemia was found to be prospectively associated with clinically relevant outcomes such as increased risk of hospitalization and all-cause mortality. Whether raising hemoglobin concentrations can reduce the risks associated with mild anemia should be tested in controlled clinical trials. PMID:19001283

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

    PubMed

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

    2009-08-22

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

  3. Asymmetric Dimethylarginine Levels are Highly Associated With Atrial Fibrillation in an Elderly Population

    PubMed Central

    Seljeflot, Ingebjorg; R. Ulimoen, Sara; Enger, Steve; Bratseth, Vibeke; Arnesen, Harald; Tveit, Arnljot

    2012-01-01

    Background The importance of endothelial dysfunction in atrial fibrillation (AF) is not clarified. The aim of this study was to evaluate endothelial dysfunction assessed by selected inflammatory and haemostatic endothelial markers and nitric oxide (NO) associated variables as related to the presence of AF in an elderly population. NO is known to express anti-thrombotic as well as vasoactive properties. Methods This is a cross sectional study of 75-year old subjects with AF (n = 62) and control subjects in sinus rhythm (n = 124), matched for gender. Fasting blood samples were collected for analyses of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO-synthase, L-arginine, E-selectin, vascular cell adhesion molecule-1 (VCAM-1) and von Willebrand factor (vWF). Results Levels of vWF and ADMA were significantly higher in AF patients vs controls (P = 0.023 and P < 0.001, respectively) and the L-arginine/ADMA ratios were lower (P = 0.015), the latters still significant after adjustment for relevant covariates (P = 0.007 and P = 0.037, respectively). No significant differences in the levels of VCAM-1 and E-selectin were observed between the groups. When dividing the ADMA levels into quartiles there was a significant trend for having AF with increasing levels of ADMA (P < 0.001) with a cut-off at the 25th percentile (< 0.54 µmol/L), giving an adjusted OR for having AF of 12.46 (95% CI 3.11 - 49.86) (P < 0.001) with higher levels. A similar inverse trend was seen for the L-arginine/ADMA ratio. Conclusion Our population of 75-year-old AF patients had significantly impaired endothelial function assessed by increased levels of vWF, and more pronounced by high levels of ADMA. The results indicate AF in the elderly to be closely associated with the regulatory pathway of NO. PMID:28352406

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  7. Mitral valve replacement in the elderly is associated with low mortality and similar survival to the general population.

    PubMed

    Dayan, Victor; Soca, Gerardo; Cura, Leandro

    2016-02-01

    With the increase of elderly population, cardiologists and surgeons are faced with an increased incidence of mitral regurgitation. Most of these patients are denied surgery due to a misconceived perception of ominous surgical results. Our objective was to analyze early and late survival in elderly patients after mitral valve surgery in a center in which replacement is the procedure of choice. We obtained clinical follow-up of patients older than 70 years who underwent first-time isolated replacement from January 2000 to January 2012. Observed survival was compared with expected survival in the general population of Uruguay. Independent predictors of operative mortality and survival were determined. A total of 127 patients were included. Global operative mortality was 9.4% (1.8% after year 2006 vs. 15.3% before 2006; P<0.05). Surgery performed before 2006, preoperative hematocrit and creatinine were independent predictors for operative mortality after multivariate analysis. 6-year survival was 70.2% for females (72.4% expected survival, P=ns) and 40.1% in males (63.5% expected survival, P<0.05). Independent predictors of survival were surgery performed before 2006 (HR=3.2) and female sex (HR=0.4). Mitral valve replacement is a feasible option for elderly patients with mitral valve disease in centers with lack expertise in valve repair. Actual surgical results provide low operative mortality and similar survival to general the population (mainly in females).

  8. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population.

    PubMed

    Schwab, Frank; Dubey, Ashok; Gamez, Lorenzo; El Fegoun, Abdelkrim Benchikh; Hwang, Ki; Pagala, Murali; Farcy, J-P

    2005-05-01

    the targeted selection of an elderly group. Although many patients with adult scoliosis have pain and dysfunction, there appears to be a large group (such as the volunteers in this study) that has no marked physical or social impairment. Previous reports note a prevalence of adult scoliosis up to 32%. In this study, results indicate a scoliosis rate of 68% in a healthy adult population, with an average age of 70.5 years. This study found no significant correlations between adult scoliosis and visual analog scale scores or nutritional status in healthy, elderly volunteers.

  9. Inverse association between cigarette and water pipe smoking and hypertension in an elderly population in Iran: Bushehr elderly health programme.

    PubMed

    Mehboudi, M B; Nabipour, I; Vahdat, K; Darabi, H; Raeisi, A; Mehrdad, N; Heshmat, R; Shafiee, G; Larijani, B; Ostovar, A

    2017-09-07

    The collected data in Bushehr Elderly Health (BEH) Program which had detailed the data on participants' smoking status and habits, was analysed to investigate the association between smoking of both water pipes and cigarettes and hypertension in an elderly population. Three thousand elderly men and women who participated in the baseline assessment of the BEH Program-a prospective population-based study being conducted in Bushehr, Iran-were selected randomly through a multistage, stratified cluster sampling method. Systolic and diastolic blood pressures were measured twice using a mercury sphygmomanometer, and researchers asked participants about medical history of hypertension as well as history of cigarette and water pipe smoking. Researchers used binary logistic regression models to assess the association of hypertension and smoking, and found an inverse, statistically significant association between current smoking and hypertension (odds ratio (OR)=0.50 (95% confidence interval (CI)=0.41, 0.60)). The association remained statistically significant after controlling for age, education and body mass index (OR=0.54 (95% CI=0.45, 0.66)). Findings were consistent for cigarette and water pipe smoking by sex (all ORs were inverse and statistically significant). Both cigarette and water pipe smoking were associated with reduced hypertension among older people, but the strength of association was different between men and women and also between cigarette and water pipe smoking. The reasons behind the association as well as the differences observed need to be investigated through more comprehensive, longitudinal studies.Journal of Human Hypertension advance online publication, 7 September 2017; doi:10.1038/jhh.2017.64.

  10. Rhinitis in a community elderly population: relationships with age, atopy, and asthma.

    PubMed

    Song, Woo-Jung; Kim, Mi-Yeong; Jo, Eun-Jung; Kim, Min-Hye; Kim, Tae-Hui; Kim, Sae-Hoon; Kim, Ki-Woong; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2013-11-01

    Rhinitis is one of the most frequent medical conditions. However, there is sparse epidemiologic evidence for rhinitis in the elderly population. To investigate the prevalence of rhinitis in elderly adults and its relations to asthma and other comorbidities. A cross-sectional analysis was performed using the baseline dataset of the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort in Korea (≥65 years old). Structured questionnaires were used to define rhinitis, asthma, and comorbidity, and allergen skin prick tests were used to define atopy. Health-related quality of life was assessed by short-form 36 questionnaires. In total, 982 elderly adults (98.2%) were included in the present study. The prevalence of rhinitis was 25.6% and did not decrease until 90 years of age. The prevalence of atopy was 17.2% (18.8% in participants with rhinitis), and atopy did not show a significant association with rhinitis. In multivariate logistic regression analyses, relations between asthma and rhinitis were significant. Among comorbid conditions, none were significantly associated with rhinitis. In the short-form 36 questionnaire analyses, rhinitis was independently related to a decrease in the physical aspects of quality of life. The present study found a high prevalence of nonallergic rhinitis in elderly participants, which was significantly related to asthma and quality of life. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. What is the point of guidelines? Benzodiazepine and z-hypnotic use by an elderly population.

    PubMed

    Neutel, C Ineke; Skurtveit, Svetlana; Berg, Christian

    2012-08-01

    According to published guidelines regarding the use of benzodiazepines or z-hypnotics (BZD-Z), the elderly should avoid hypnotic BZD, and use anxiolytic BZD and z-hypnotics only at low doses and for a short time. Our objective is to quantify inappropriate BZD-Z use in the elderly. The study population consisted of people aged 70-89 who filled at least two prescriptions in 2008 within one of three subgroups: anxiolytic BZD, hypnotics BZD, or z-hypnotics. Inappropriate use criteria used for this study were (1) any hypnotic BZD, (2) exceeding 300 DDD, or a dosage exceeding 9 DDD/week, or anxiolytic BZD and z-hypnotics use exceeding 30 weeks. 118,526 persons, or 25% of elderly Norwegians, filled at least two prescriptions for one of these medication subgroups. Inappropriate use was found for 25% of anxiolytic BZD users, 100% of hypnotic BZD users, and 65% of z-hypnotic users. Altogether 57,276 elderly Norwegians, or 12.3% of the elderly source population, used BZD-Z inappropriately as defined in this study. Clearly, inappropriate use of BZD-Z is widespread. An active response to such noncompliance with existing guidelines could consist of either (1) stricter enforcement of guidelines or (2) revamping guidelines through a fresh look at risks, benefits, and treatment practices. The implications of both options are discussed in some detail. Copyright © 2012. Published by Elsevier B.V.

  12. Assaults in the elderly--a population-based study with victim and perpetrator characteristics.

    PubMed

    Biermann, Teresa; Dippel, Olga; Bergner, Matthias; Keller, Jochen; Coffey, Claire; Sperling, Wolfgang; Bleich, Stefan; Kornhuber, Johannes; Reulbach, Udo

    2011-05-01

    The aim of the present epidemiological study was to investigate characteristics of assaults in the elderly aged 65 years and above from the perspective of the victim and perpetrator. This population-based study included 23,142 assaults (according to §§ 224/226 StGB of German criminal law) that were recorded in Bavaria, Germany, from 1999 to 2005. The population-based ratio of serious crimes of battery for the elderly in comparison with the reference population was markedly lower (0.10; 95% CI: 0.09-0.11) in suspects aged more than 65 years and 0.08 (95% CI: 0.07-0.09) for the injured above 65 years. Elderly perpetrators differed significantly concerning the manner of the assault (p < 0.001). They committed less crimes in urban areas (56.1% vs. 68.8%) and were victimized significantly more in rural areas (p < 0.001; 41.2% vs. 30.2%). Violence in the elderly differs from that of the younger population. Further research is warranted to establish prevention measures. © 2011 American Academy of Forensic Sciences.

  13. Laparoscopic Appendectomy Is Safer Than Open Appendectomy in an Elderly Population

    PubMed Central

    Ward, Nicholas T.; Chang, David C.; Parsons, J. Kellogg

    2014-01-01

    Background and Objectives: This study describes perioperative patient safety outcomes comparing laparoscopic appendectomy with open appendectomy in the elderly population (defined as age ≥65 years) during the diffusion of laparoscopic appendectomy into widespread clinical practice. Methods: We performed a cross-sectional analysis of patients undergoing open or laparoscopic appendectomy in the US Nationwide Inpatient Sample, a 20% sample of inpatient discharges from 1056 hospitals, from 1998 to 2009, and used weighted sampling to estimate national trends. Multivariate logistic regression modeling was used to examine the association of laparoscopy with perioperative outcomes. Results: Patients who met the inclusion criteria totaled 257 484. Of these, 87 209 (34%) underwent laparoscopic appendectomy. These patients were younger (P < .001); had lower Charlson comorbidity scores (P < .001); were more likely to be white (P < .001), to be privately insured (P = .005), and to undergo surgery in urban hospitals (P < .001); and were less likely to have appendiceal rupture (P < .001). Laparoscopic appendectomy was associated with a decreased length of stay (4.44 days vs 7.86 days, P < .001), fewer total patient safety indicator events (1.8% vs 3.5%, P < .001), and a decreased mortality rate (0.9% vs 2.8%, P < .001). On multivariate analyses, we observed a 32% (odds ratio, 0.68) decreased probability of patient safety events occurring in laparoscopic appendectomy cases versus open appendectomy cases as measured by patient safety indicators. Conclusion: The data suggest that laparoscopic appendectomy is associated with improved clinical outcomes in the elderly and that diffusion of laparoscopic appendectomy is not associated with adverse patient safety events in this population. PMID:25392668

  14. Prevalence and Causes of Functional Disability in an Elderly General Population of Japanese: The Hisayama Study

    PubMed Central

    Yoshida, Daigo; Ninomiya, Toshiharu; Doi, Yasufumi; Hata, Jun; Fukuhara, Masayo; Ikeda, Fumie; Mukai, Naoko; Kiyohara, Yutaka

    2012-01-01

    Background There are limited data on the prevalence and causes of disability in the elderly general population in Japan. Methods In a population-based cross-sectional study of 1550 Japanese aged 65 years or older, we examined the prevalence of functional disability (defined as a Barthel Index score of ≤95) and its causes. Results A total of 311 of the participants had a disability (prevalence 20.1%). The prevalence of disability increased with age and doubled with every 5-year increment in age. Prevalence was higher in women than in men, especially among those aged 85 years or older. With respect to the cause of functional disability, dementia accounted for 23.5%, stroke for 24.7%, orthopedic disease for 12.9%, and other disease for 38.9% of cases in men; in women, the respective values were 35.8%, 9.3%, 31.0%, and 23.9%. Regarding age, dementia was the most frequent cause of disability in subjects aged 75 years or older, whereas stroke was most common in subjects aged 65 to 74 years. Approximately two-thirds of cases of total dependence were attributed to dementia in both sexes, whereas the main cause of slight or moderate/severe dependence was stroke in men and orthopedic disease in women. Among participants with total dependence, 94.8% resided in a hospital or health care facility. Conclusions Our findings indicate that functional disability is common among Japanese elderly adults and that its major cause is stroke in men and dementia in women. PMID:22343328

  15. Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population

    PubMed Central

    Mazza, Alberto; Lenti, Salvatore; Schiavon, Laura; Del Monte, Alvise; Townsend, Danyelle M.; Ramazzina, Emilio; Rubello, Domenico; Casiglia, Edoardo

    2017-01-01

    Objective In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. Material and methods 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140 mmHg (systolic) and 90 mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8 mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. Results The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p < 0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49–10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06–9.1, p = 0.03) but not in men. Conclusions In elderly women from the general population, an SUA value of ≥6.8 mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH. PMID:28027534

  16. Atherosclerotic ischemic renal disease. Diagnosis and prevalence in an hypertensive and/or uremic elderly population

    PubMed Central

    Coen, Giorgio; Calabria, Santo; Lai, Silvia; Moscaritolo, Eleonora; Nofroni, Italo; Ronga, Giuseppe; Rossi, Michele; Ventroni, Guido; Sardella, Daniela; Ferrannini, Michele; Zaccaria, Alvaro; Cianci, Rosario

    2003-01-01

    Background Atherosclerotic ischemic renal disease is a frequent cause of end-stage renal failure leading to dialysis among the elderly; Its prevalence is inferred from autopsy or retrospective arteriographic studies. This study has been conducted on 269 subjects over 50 with hypertension and/or CRF, unrelated to other known causes of renal disease. Methods All 269 patients were studied either by color-flow duplex sonography (n = 238) or by renal scintigraphy (n = 224), and 199 of the 269 patients were evaluated using both of these techniques. 40 patients, found to have renal artery stenosis (RAS), were subjected to 3D-contrast enhancement Magnetic Resonance Angiography (MRA) and/or Selective Angiography (SA). An additional 23 cases, negative both to scintigraphy and to ultrasound study, underwent renal angiography (MRA and/or SA). Results Color-duplex sonography, carried out in 238 patients, revealed 49 cases of RAS. MR or SA was carried out in 35 of these 49 patients, and confirmed the diagnosis in 33. Color-duplex sonography showed a PPV value of 94.3% and NPV of 87.0% while renal scintigraphy, carried out in 224 patients, had a PPV of 72.2% and a NPV of 29.4%. Patients with RAS showed a higher degree of renal insufficiency compared to non stenotic patients while there were no differences in proteinuria. RAS, based on color-duplex sonography studies, was present in 11% of patients in the age group 50–59, 18% in the 60–69 and 23% at age 70 and above. Conclusions A relatively large percentage of the elderly population with renal insufficiency and/or hypertension is affected by RAS and is at risk of developing end-stage renal failure. Color-duplex ultrasonography is a valid routine method of investigation of population at risk for renal artery stenosis. PMID:12622875

  17. Prospective study of the elder self-neglect and ED use in a community population.

    PubMed

    Dong, Xinqi; Simon, Melissa A; Evans, Denis

    2012-05-01

    This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. A prospective population-based study is conducted in a geographically defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6864 participants in the Chicago Health and Aging Project, 1165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3), and for those with reported elder self-neglect, it was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, and cognitive and physical function, older people who self-neglect had significantly higher rates of emergency department utilization (rate ratio, 1.42; 95% confidence interval, 1.29-1.58). Greater self-neglect severity (mild: standardized parameter estimate [PE], 0.27; standard error [SE], 0.04; P < .001; moderate: PE, 0.41; SE, 0.03; P < .001; severe: PE, 0.55; SE, 0.09; P < .001) was associated with increased rates of emergency department utilization, after considering the same confounders. Elder self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Studies on health in elderly observation centers (abbreviated from Italian: COSA): a multidimensional evaluation (MDE) of an elderly population frequenting a diurnal center in Catania.

    PubMed

    Santangelo, Antonino; Testai', Manuela; Castelli, Roberta; Albani, Salvatore; Cappello, Antonella; Primavera, Grazia; Tomarchio, Marcello; Maugeri, Domenico

    2012-01-01

    The worldwide progressive aging of the population forces us to reconsider the strategies of evaluation the effects of the geriatric "tsunami" on the health politics. The present study on the COSA (abbreviated from the Italian name: "Centro Osservazione Salute Anziani") has the aim to investigate the effects of a new form called Specialistic Geriatric Assistance on the already existing geriatric services in our territory, like UVG (Unità Valutazione Geriatrica), ADI (Assistenza Domiciliare Integrata), MMG (Medici di Medicina Generale). The present preliminary studies were carried out a group of elderly people frequenting the elderly day center "Villa Angela" located in Catania. We enrolled 42 subjects, 29 females and 13 males, in the age-range of 65-89 years (mean=73.6 years). An evaluation protocol was used for the participants, having two parts. The first part was a general one performing an accurate anamnestic examination, while the second part evaluated the cognitive and affective spheres, and the levels of autonomy and autosufficiency. The data obtained show that that the elderly population of the daily center "Villa Angela" in Catania is affected by numerous pathologies and comorbidities, which all increase the total risk of disabilities. The subjects use a high number of medicines (sometimes more than 10), which is not always justified by the pathologies found in them. Considering the functional profiles of the patients, the sanitary services offered to them are appropriate, because almost all of the elderly people were autonomous and autosufficient, having still adequate physical performances. The higher cognitive performance seemed to be reduced in more than 50% of the patients, showing almost always a slight or moderate deterioration. The depressive state measured by the GDS seemed to reach the deflection of joy of life 54.8%, while the established depression was detected in 12%. These results emphasize the importance of the functional psychogeriatric

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

    PubMed

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

    2014-01-01

    This paper seeks to verify the association between falls and self-assessment of visual acuity in elderly people by means of a cross-sectional population-based study involving 1593 elderly people (aged 60 or over) from the urban zone of the municipality of Bagé-RS. Poisson regression was used for association analysis. Fall prevalence in the last year was 28.0% (95%CI: 25.8; 30.2), with 45.0% of these having suffered two or more falls in the same period. Elderly people self-assessing their eyesight as bad/very poor (10.0%) or regular (33.3%) showed a linear increase in fall occurrence when compared to individuals who considered their eyesight to be good/excellent. Self-assessment of eyesight showed itself to be an important factor associated with the occurrence of falls. This results entails the need to make progress with tracing elderly people with eyesight difficulties and its possible impact on actions to prevent the occurrence of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Exploring mental health service needs for the elderly: results of a modified Delphi study.

    PubMed

    Toward, Jeffrey I; Ostwald, Sharon K

    2002-04-01

    Identified key informants with professional experience in the broad domain of mental health services reported current and future mental health service needs of elderly Harris County residents as part of a three-round modified Delphi study. Forty-one professionals from various housing, psychosocial, medical, and protective service provider groups were surveyed during three consecutive rounds. The consensus achieved through the Delphi process served to describe the gaps in the mental health services currently available to elderly Harris County residents as well as identify the service needs of this population into the future, thereby providing direction for future service development.

  1. Economic impact of using fesoterodine for the treatment of overactive bladder with urge urinary incontinence in a vulnerable elderly population in the United States.

    PubMed

    Qin, Lei; Luo, Xuemei; Zou, Kelly H; Snedecor, Sonya J

    2016-01-01

    To assess the costs of treating overactive bladder (OAB) with fesoterodine compared to no OAB pharmacotherapy among vulnerable elderly from the US payer perspective. A decision analytic cost model was developed to estimate the 52-week costs of a cohort of vulnerable elderly with OAB initiating treatment with fesoterodine or no OAB pharmacotherapy. Vulnerable elderly OAB patients were defined as those aged ≥65 years with self-reported urge urinary incontinence (UUI) symptoms for ≥3 months, 2-15 UUI episodes/day, and at risk of deteriorating health by a score of ≥3 on the Vulnerable Elders Survey (VES)-13. Patients were evaluated for fesoterodine treatment response (defined as no UUI episodes) and persistence at weeks 12, 26, and 52. The model included a hypothetical health plan with 100,000 elderly members. A total of 7096 vulnerable elderly subjects were identified as the model target population based on the percentage of vulnerable elderly and annual prevalence of OAB among vulnerable elderly. OAB-related costs included fesoterodine drug acquisition costs, healthcare resource use (inpatient hospitalization, outpatient visits, and physician office visits), and OAB-related co-morbidities (falls/fractures, urinary tract infections, depression, and nursing home admissions). All costs were inflated to 2013 US$ using the medical care component of the consumer price index (CPI). When 7096 vulnerable elderly OAB patients were treated with fesoterodine, US healthcare payers could save $11,463,981 per year, or $1616 per patient vs no OAB pharmacotherapy. Univariate one-way sensitivity analyses supported the robustness of the findings and showed results were most sensitive to changes in fesoterodine efficacy followed by annual costs of inpatient hospitalization. From a US payer perspective, treating vulnerable elderly OAB patients with fesoterodine was cost-saving compared to no OAB pharmacotherapy.

  2. Validation of the FRAIL scale in Mexican elderly: results from the Mexican Health and Aging Study

    PubMed Central

    Díaz de León González, Enrique; Gutiérrez Hermosillo, Hugo; Martinez Beltran, Jesus Avilio; Medina Chavez, Juan Humberto; Palacios Corona, Rebeca; Salinas Garza, Deborah Patricia; Rodriguez Quintanilla, Karina Alejandra

    2016-01-01

    Background The aging population in Latin America is characterized by not optimal conditions for good health, experiencing high burden of comorbidity, which contribute to increase the frequency of frailty; thus, identification should be a priority, to classify patients at high risk to develop its negative consequences. Aim The objective of this analysis was to validate the FRAIL instrument to measure frailty in Mexican elderly population, from the database of the Mexican Health and Aging Study (MHAS). Materials and methods Prospective, population study in Mexico, that included subjects of 60 years and older who were evaluated for the variables of frailty during the year 2001 (first wave of the study). Frailty was measured with the five-item FRAIL scale (fatigue, resistance, ambulation, illnesses, and weight loss). The robust, pre-frail or intermediate, and the frail group were considered when they had zero, one, and at least two components, respectively. Mortality, hospitalizations, falls, and functional dependency were evaluated during 2003 (second wave of the study). Relative risk was calculated for each complications, as well as hazard ratio (for mortality) through Cox regression model and odds ratio with logistic regression (for the rest of the outcomes), adjusted for covariates. Results The state of frailty was independently associated with mortality, hospitalizations, functional dependency, and falls. The pre-frailty state was only independently associated with hospitalizations, functional dependency, and falls. Conclusions Frailty measured through the FRAIL scale, is associated with an increase in the rate of mortality, hospitalizations, dependency in activities of daily life, and falls. PMID:26646253

  3. Prevalence of monoclonal gammopathy of undetermined significance in an elderly urban Korean population.

    PubMed

    Park, Hyun-Kyung; Lee, Kyoung-Ryul; Kim, Young-Jin; Cho, Han-Ik; Eun Kim, Jung; Woong Kim, Ki; Jung Kim, Yu; Lee, Keun-Wook; Hyun Kim, Jee; Bang, Soo-Mee; Lee, Jong-Seok

    2011-09-01

    Research on the epidemiology of monoclonal gammopathy of undetermined significance (MGUS) is limited in Korea. The aim of this study was to determine the prevalence and characteristics of MGUS in an elderly urban Korean population. A random sample of 1118 Korean elders was selected from residents aged 65 years or older living in Seongnam, Korea 1 year from August 2005. We obtained plasma samples remaining after scheduled tests for the Korean Longitudinal Study on Health and Aging. The mean age of the study population was 72 years (range, 65-97 years). To screen for MGUS, immunofixation and free light-chain (FLC) assays were performed. Age-adjusted and gender-adjusted MGUS prevalence rates in 680 responders were estimated as 3.3% [95% confidence interval (CI) = 2.0-4.6%], and the estimated age-adjusted prevalence of MGUS was 4.3% in men (95% CI = 1.9-6.6%) and 2.6% in women (95% CI = 1.0-4.2%). Abnormal FLC ratios were detected in 10% of MGUS cases. Multivariate analysis of 945 participants revealed that significant risk factors for MGUS included advanced age, male sex, hyperproteinemia, increased erythrocyte sedimentation rate, and abnormal FLC ratio. MGUS is less prevalent among elderly Koreans (3.3%) than other races. This is the first study to estimate the prevalence of MGUS in the Korean elderly population. Our findings should be confirmed with additional studies analyzing follow-up samples from 2010.

  4. Aging populations: the health and quality of life of the elderly.

    PubMed

    De Luca d'Alessandro, E; Bonacci, S; Giraldi, G

    2011-01-01

    The progressive tendency for the age structure of the population to shift towards the elderly has been observed in all developed countries and this has important implications for health, society, economics and epidemiology. According to the most recent estimates for the world, the number of persons aged over 60 years will double from the present number, 756 to 1400 millions by 2030. In Italy, by the year 2050, 34.6% of the population will be aged more than 65 years. This will have important implications for health. There are medical conditions that occur almost exclusively among the elderly and these are sometimes referred to as syndromes or geriatric pathologies; other conditions that can occur at younger ages, may present with different symptoms, and cause complications in the elderly. More than just the single pathologies, the presence of two or more conditions simultaneously may have a critical impact on the health status of the elderly. As their ages increase, the elderly may be considered "frail"; factors, not only physical but also psychological cognitive and social, contribute to this syndrome and all must be considered together in the diagnosis and treatment of the elderly patient. These subjects are at greater risk of physical and cognitive decline, disability and death. As the elderly are an increasing fraction of the total patient load, their problems require that the structure and organization of health services be accordingly adjusted and also that the cultural and professional training of doctors and other medical personnel is appropriate. As a consequence, the objective of governments should be to promote the health and the quality of life of the elderly and this would include primary secondary and tertiary prevention applied in a variety of different settings. The choice of the preventive measures should be determined by the general health status of the elderly individuals, of whom 60-75% are classified as healthy, 20-30% are diagnosed as suffering

  5. Clinical Practices and Outcomes in Elderly Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

    PubMed Central

    Tong, Lin; Tentori, Francesca; Akiba, Takashi; Karaboyas, Angelo; Gillespie, Brenda; Akizawa, Tadao; Pisoni, Ronald L.; Bommer, Juergen; Port, Friedrich K.

    2011-01-01

    Summary Background and objectives Demand for hemodialysis among elderly patients is increasing worldwide. Although clinical care of this high-risk group is complex and challenging, no guidelines exist to inform hemodialysis practices. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to assess dialysis practices and associated outcomes among elderly versus younger patients on chronic in-center hemodialysis in 12 countries. Design, setting, participants, & measurements Clinical characteristics, dialysis practices, and outcomes of elderly versus younger patients were compared among participants in four DOPPS regions in 2005 through 2007. Results Although participant mean age increased over time in all DOPPS countries, the percentage of elderly varied widely. Overall, comorbidities and malnutrition were more common in the elderly. Fistulae were used less frequently among elderly versus younger patients in Europe and North America but not in Australia, New Zealand, and Japan. No difference in treatment time was observed between elderly and younger patients after normalizing for body weight. In all regions, ultrafiltration rates were lower among elderly patients. Elderly patients reported poorer quality of life with respect to the physical but not mental component scores. Mortality risk was three- to sixfold higher in the elderly group, whereas causes of death overall were similar for elderly and younger patients. Conclusions Elderly patients represent a different proportion of DOPPS participants across countries, possibly reflecting differences in policies and clinical practices. In general, hemodialysis practices in the elderly reflected each region's clinical patterns, with some variation by age group depending upon the practice. PMID:21734085

  6. Cognitive Impairment in Rural Elderly Population in Ecuador

    PubMed Central

    Wong-Achi, Xavier; Egas, Gabriela; Cabrera, Dayana

    2017-01-01

    Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48), and 63% (CI: 62.1–63.94) of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3) and 47.2% (95% CI: 45.2–49.2) in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia. PMID:28936066

  7. Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population.

    PubMed

    Guerra, Ricardo O; Alvarado, Beatriz Eugenia; Zunzunegui, Maria Victoria

    2008-02-01

    To examine life course social, gender and ethnic inequalities in ADL disability in a Brazilian urban elderly population. We used the São Paulo-SABE study (health, well-being and aging in Latin America and the Caribbean) to assess the associations between ADL disability and gender, ethnicity and life course social conditions (childhood socio-economic and health status, education, lifetime occupation, current perception of income), controlling for current physical and mental health (cognitive impairment and comorbidity). ADL disability was defined as the presence of one or more difficulties with six tasks: bathing, toileting, dressing, walking across the room, eating, and getting out of bed. Results suggest that social inequalities during the life course (hunger and poverty in early life; illiteracy, a low skilled occupation, having been a housewife; insufficient income) tend to result in disability in later life. The prevalence of ADL disability was higher among women (22.4%) than among men (14.8%). Mestizo/ Native elders reported higher prevalence of disability compared with Whites and Blacks/Mulattos. Ethnic inequalities concerning ADL disability were explained by social and health conditions, but the gender gap persisted (OR women vs men= 2.16; 95% CI 1.32-3.55). Despite their higher rate of ADL disability in old age, women appear to be more resilient than men toward poor socio-economic conditions throughout the life course. Chronic conditions were more likely to result in ADL disability among men than women (OR= 1.83; 95% CI 1.41-2.38 in women; OR= 3.42; 95% CI 2.41-4.86 in men). Decreasing social inequalities during childhood and adulthood will reduce socio-economic inequalities in disability in old age, especially among men.

  8. Overview of community-based studies of depression screening interventions among the elderly population in Japan.

    PubMed

    Sakashita, Tomoe; Oyama, Hirofumi

    2016-01-01

    In most Western and Asian countries, a higher risk of suicide is found among elderly people than those in other age groups. However, the treatment needs of elderly people who are at risk of committing suicide are not well understood. We conducted an overview of studies that assessed the impact of suicide prevention interventions on suicide rates in elderly people in Japan. We interpreted the results of these studies, as well as prominent findings associated with other successful interventions, within a framework of the suicidal process and preventive strategies. We assessed six quasi-experimental studies of community-based interventions providing universal depression screening, subsequent care, and education to elderly people in Japan, and performed a combined analysis of outcome data. Screening interventions were associated with lower suicide rates. We also found a gender difference in the response to subsequent psychiatric or primary care. Two types of interventions decreased the rate of suicide among elderly people: crisis helplines and screening interventions. These interventions featured a close link between universal, selective, and indicated prevention strategies, which reflect different approaches tailored to the size and risk profile of the target individuals. Successful interventions appear to hinge on systematic links between multi-level prevention interventions. Multi-level interventions for depression screening may result in lower suicide rates among elderly individuals in communities, although primary care interventions alone appear to be insufficient in men. The benefit of linked multi-level prevention interventions may highlight the importance of the multiple steps and components of the suicidal process.

  9. Social Support and Leisure-Time Physical Activity Among the Elderly: A Population-Based Study.

    PubMed

    Böhm, Andrea Wendt; Mielke, Grégore Iven; da Cruz, Maurício Feijó; Ramirez, Virgílio Viana; Wehrmesister, Fernando C

    2016-06-01

    Physical inactivity in elderly is a public health problem. The purpose of this study is to describe and test the association between social support and leisure-time physical activity among the elderly. A cross-sectional, population-based study with 1,285 subjects (60+ years old) living in a city in southern Brazil was carried out in 2014. Physical activity practice was measured using the International Physical Activity Questionnaire [leisure domain: at least 150 minutes per week of walking + moderate physical activity + 2(vigorous physical activity)], while social support was measured using the Physical Activity Social Support Scale. The prevalence of elderly who reached the recommendations of leisure-time physical activity was 18.4%. The elderly persons who had the company of family or friends to walk had a 2.45 times higher prevalence of reaching the recommendations of physical activity in leisure than those who did not. Those who had company of friends to practice moderate-to-vigorous physical activity (MVPA) were 3.23 times more likely to reach physical activity recommendations than their counterparts. The least common social support was the joint practice for walking and for MVPA. Strategies that incentivize family members and friends to provide social support to the elderly for physical activity focusing on joint practice must be encouraged.

  10. Laparoscopic Radical Cystectomy in the ElderlyResults of a Single Center LRC only Series

    PubMed Central

    Hermans, Tom J. N.; Fossion, Laurent M. C. L.; Verhoeven, Rob; Horenblas, Simon

    2016-01-01

    ABSTRACT Objective: To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly (≥75 years) versus 51 younger (<75 years) patients. Materials and Methods: Analysis of prospectively gathered data of a single institution LRC only series was performed. Selection bias for LRC versus non-surgical treatments was assessed with data retrieved from the Netherlands Cancer Registry. Results: Median age difference between LRC groups was 9.0 years. (77.0 versus 68.0 years). Both groups had similar surgical indications, body mass index and gender distribution. Charlson Comorbidity Index score was 3 versus 4 in ≥50% of younger and elderly patients. Median operative time (340 versus 341 min) and estimated blood loss (<500 versus >500mL) did not differ between groups. Median total hospital stay was 12.0 versus 14.0 days for younger and elderly patients. Grade I-II 90-d complication rate was higher for elderly patients (68 versus 43%, p=0.05). Grade III-V 90-d complication rate was equal for both groups (23 versus 29%, p=0.557). 90-d mortality rate was higher for elderly patients (14 versus 4%, p=0.157). Median follow-up was 40.0 months for younger and 57.0 months for elderly patients. Estimated overall and cancer-specific survival at 5years. was 46% versus 35% and 64% versus 64% for younger and elderly patients respectively. Conclusions: Our results suggest that LRC is feasible in elderly patients, where a non-surgical treatment is usually favoured. PMID:27532116

  11. Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

    PubMed

    Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

    2017-06-01

    Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

  12. Robot-assisted surgery in elderly and very elderly population: our experience in oncologic and general surgery with literature review.

    PubMed

    Ceccarelli, Graziano; Andolfi, Enrico; Biancafarina, Alessia; Rocca, Aldo; Amato, Maurizio; Milone, Marco; Scricciolo, Marta; Frezza, Barbara; Miranda, Egidio; De Prizio, Marco; Fontani, Andrea

    2017-02-01

    Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥65 or 75 years is used. Nowadays most of malignancies requiring surgical treatment are diagnosed in old population. Comorbidities and frailty represent well-known problems during and after surgery in elderly patients. Minimally invasive surgery offers earlier postoperative mobilization, less blood loss, lower morbidity as well as reduction in hospital stay and as such represents an interesting and validated option for elderly population. Robot-assisted surgery is a recent improvement of conventional minimally invasive surgery. We provided a complete review of old and very old patients undergoing robot-assisted surgery for oncologic and general surgery interventions. A retrospective review of all patients undergoing robot-assisted surgery in our General Surgery Unit from September 2012 to June 2016 was conducted. Analysis was performed for the entire cohort and in particular for three of the most performed surgeries (gastric resections, right colectomy, and liver resections) classifying patients into three age groups: ≤64, 65-79, and ≥80. Data from these three different age groups were compared and examined in respect of different outcomes: ASA score, comorbidities, oncologic outcomes, conversion rate, estimated blood loss, hospital stay, geriatric events, mortality, etc. Using our in-patient robotic surgery database, we retrospectively examined 363 patients, who underwent robot-assisted surgery for different diseases (402 different robotic procedures): colorectal surgery, upper GI, HPB, etc.; the oncologic procedures were 81%. Male were 56%. The mean age was 65.63 years (18-89). Patients aged ≥65 years represented 61% and ≥80 years 13%. Overall conversion rate was of 6%, most in the group 65-79 years (59% of all conversions). The more frequent diseases treated were colorectal surgery 43%, followed by hepatobilopancreatic surgery 23.4%, upper gastro-intestinal 23

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

    PubMed Central

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

    2009-01-01

    Purpose The goal of this study was to determine the impact of age, gender and race on the prevalence and severity of hearing loss in elder adults, aged 72–96 years, after accounting for income, education, smoking, and clinical and subclinical cardiovascular disease. Methods Air-conduction thresholds for standard and extended high-frequency puretones were obtained from a cohort of 548 (out of 717) elderly adults (ages 72–96 years) who were recruited during the Year 11 clinical visit (1999–2000) of the Cardiovascular Health Study (CHS) at the Pittsburgh, Pennsylvania site. Participant smoking, income, education, and cardiovascular disease histories were obtained from the CHS database and were included as factors. Results Hearing loss was more common and more severe for the participants in their 80s than those in their 70s, the men more than the women, and the White participants more than the Black participants. The inclusion of education, income, smoking and cardiovascular disease (clinical and subclinical) histories as factors did not substantively impact the overall results. Conclusion Although the data reported in this paper were cross-sectional and a cohort phenomenon might have been operational, they suggested that hearing loss is more substantive in the eighth than the seventh decade of life, and that race and gender influence this decline in audition. Given the high prevalence in the aging population and the differences across groups there is a clear need to understand the nature and causes of hearing loss across various groups in order to improve prevention and develop appropriate interventions. PMID:19380605

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Fall Risk and Prevention Strategies in an Elderly Latino Population: A Global Health Partnership in a Local Community

    PubMed Central

    Hanlin, Erin R.; Delgado-Rendón, Angélica; Lerner, E. Brooke; Hargarten, Stephen; Farías, René

    2016-01-01

    Background The impact of falls in the elderly presents a significant public health burden throughout the country. Fall risk is not well described in Latino populations nor have fall prevention programs considered the needs of this population. Objectives The objectives of this study were to define the impact of falls in elderly Latinos at the United Community Center (UCC), to determine any possible barriers and recognize possible strengths in this elderly population with regards to fall prevention, to determine the level of interest within this population in various fall prevention methods and to provide medical students from the Medical College of Wisconsin (MCW) an opportunity for participation in a culturally-diverse community project. Methods A prospective survey was conducted by a medical student with a convenience sample of elderly program participants at the UCC. The fall-related survey was developed in collaboration with the community and academic partners in both English and Spanish and pilot tested with UCC staff members who were embedded in the community and were native Spanish speakers. Community center participants were approached by the interviewer during various UCC program activities and asked to participate. Those who agreed were read the survey questions by the medical student interviewer in their preferred language and their answers were recorded. Data was analyzed using descriptive statistics. Results 103 interviews were conducted. 54% of respondents had fallen in the last year, of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. 52% of all respondents had five or more of the 10 surveyed risk factors for falling, and only 4% had no risk factors. 75% of all respondents were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (preferred by 78% and 65%, respectively). Conclusion

  17. Components of change in the residential concentration of the elderly population: 1950-1975.

    PubMed

    Lichter, D T; Fuguitt, G V; Heaton, T B; Clifford, W B

    1981-07-01

    Changes in the absolute and relative size of the elderly population within metropolitan and nonmetropolitan areas are decomposed into the underlying demographic components for three time periods: 1950 to 1960, 1960 to 1970, 1970 to 1975. Specifically, we examine the components of net migration and natural increase of those aged 0 to 64 and those 64 or older. Using published migration estimates for the U.S., this study demonstrates that elderly migration has represented an increasingly important component of the absolute growth of the elderly population within nonmetropolitan areas and a corresponding decline in large SMSAs. Although "aging-in-place" was a dominant component of change in he elderly percentage irrespective of residence, we show that the demographic components of the young also exercise an important and often overlooked effect on the aging process. Most prominent was the slowing of relative aging in remote nonmetropolitan areas, due largely to the post-1970 changeover from net outmigration to net inmigration of those less than 65 years of age.

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

    PubMed

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

    2016-03-01

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

  19. Willingness to pay for health insurance among the elderly population in Germany.

    PubMed

    Bock, Jens-Oliver; Heider, Dirk; Matschinger, Herbert; Brenner, Hermann; Saum, Kai-Uwe; Haefeli, Walter E; König, Hans-Helmut

    2016-03-01

    All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans. Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card. Mean monthly WTP per capita for health insurance amounted to €260. This corresponded to about 20% of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly. The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.

  20. Association Between Elder Self-Neglect and Hospice Utilization in a Community Population

    PubMed Central

    Dong, XinQi; Simon, Melissa A.

    2012-01-01

    Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically-defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8,669 participants in the Chicago Health and Aging Project, a subset of 1,438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (Mild: (HR, 2.12 (1.61-2.79); Moderate: (HR, 2.36 (1.95-2.84); Severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, −0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, −0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death. PMID:22770866

  1. The health status of the elderly population of Iran in 2012.

    PubMed

    Tanjani, Parisa Taheri; Motlagh, Mohammad Esmaeil; Nazar, Mehdi Moradi; Najafi, Farid

    2015-01-01

    With advancing age comes dramatic increase in the incidence of chronic diseases, disabilities, and mental problems. This study was conducted to epidemiologically describe the health status of the elderly population of Iran. People aged ≥60 were selected. Mini-nutritional assessment, activity of daily living, geriatric depression scale questionnaires were administered. Physical diseases and risk factors were also investigated. For the purpose of this study, 1350 elderly individuals were randomly selected. The mean age of sample was 69.1±7.3 and 65.9% were illiterate. From total, 727 (53.8%) had vision problems. The most common problem was cataracts with a prevalence of 305 (22.6%) patients who were either suffering from cataracts or had undergone a surgery for it. From 634 individuals who used dentures, 446 (70.3%) wore the same first denture for over 10 years, without being examined. 524 (38.8%) of our seniors spent their free time alone at home. 13.2% of women and 12.6% of men were dependent on others for at least one daily activity. In terms of nutrition, 70 (5.5%) of the elderly (46 women and 24 men) were severely malnourished with 554 (41.3%) (243 men and 311 women) at risk of malnutrition. The health status of the elderly in Iran was similar to other countries in the world. However there continues to be room for improvement. Taking into account the rapidly aging population of Iran, health providers, and policy makers are required to take steps at a national level and direct more resources into supporting the elderly population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Association between elder self-neglect and hospice utilization in a community population.

    PubMed

    Dong, XinQi; Simon, Melissa A

    2013-01-01

    Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8669 participants in the Chicago Health and Aging Project, a subset of 1438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (mild: (HR, 2.12 (1.61-2.79); moderate: (HR, 2.36 (1.95-2.84); severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, -0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, -0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death.

  3. [Malnutrition in the elderly: clinical features, psychological and social determinants. Preliminary results].

    PubMed

    Morrone, A; Donini, L M; Scardella, P; Piombo, L; Pinto, A; Giusti, A M; Neri, B; Hagedorn, T; Proietti, A R; Cataldi, S; Cucinotta, D; Di Bella, G; Barbagallo, M; Cannella, C

    2011-01-01

    In industrialized Countries malnutrition is a very frequent condition in frail groups of the population, people with low income and elderly subjects above all if institutionalized. The aim of the study is to: analyse the prevalence of malnutrition in a sample of elderly people located in different geographical areas in Italy; identify the psychological, social, economic, environmental, cultural and demographic determinants of malnutrition. The prevalence of malnutrition (estimated through the MNA) is high in both sexes (28% of F and 21.9% of M. Age, institutionalisation, health status, autonomy status, cognitive status and education level are some of the factors that correlate with the presence of malnutrition. Loneliness and poverty seem to have a negative impact on nutritional status but further data are needed to confirm this hypothesis. The data collected confirm the need to activate services dedicated to assess the nutritional status of elderly people, to implement campaigns in particular on food education for the elderly population, to set tools and guide lines for caregivers.

  4. Severity of chronic pain in an elderly population in Sweden--impact on costs and quality of life.

    PubMed

    Bernfort, Lars; Gerdle, Björn; Rahmqvist, Mikael; Husberg, Magnus; Levin, Lars-Åke

    2015-03-01

    Chronic pain is associated with large societal costs, but few studies have investigated the total costs of chronic pain with respect to elderly subjects. The elderly usually require informal care, care performed by municipalities, and care for chronic diseases, all factors that can result in extensive financial burdens on elderly patients, their families, and the social services provided by the state. This study aims to quantify the societal cost of chronic pain in people of age 65 years and older and to assess the impact of chronic pain on quality of life. This study collected data from 3 registers concerning health care, drugs, and municipal services and from 2 surveys. A postal questionnaire was used to collect data from a stratified sample of the population 65 years and older in southeastern Sweden. The questionnaire addressed pain intensity and quality of life variables (EQ-5D). A second postal questionnaire was used to collect data from relatives of the elderly patients suffering from chronic pain. A total of 66.5% valid responses of the 10,000 subjects was achieved; 76.9% were categorized as having no or mild chronic pain, 18.9% as having moderate chronic pain, and 4.2% as having severe chronic pain. Consumed resources increased with the severity of chronic pain. Clear differences in EQ-5D were found with respect to the severity of pain. This study found an association between resource use and severity of chronic pain in elderly subjects: the more severe the chronic pain, the more extensive (and expensive) the use of resources.

  5. Physical Function Decline and the Risk of Elder Self-Neglect in a Community-Dwelling Population

    ERIC Educational Resources Information Center

    Dong, XinQi; Simon, Melissa; Fulmer, Terry; de Leon, Carlos F. Mendes; Rajan, Bharat; Evans, Denis A.

    2010-01-01

    Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. Design and Methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The…

  6. Physical Function Decline and the Risk of Elder Self-Neglect in a Community-Dwelling Population

    ERIC Educational Resources Information Center

    Dong, XinQi; Simon, Melissa; Fulmer, Terry; de Leon, Carlos F. Mendes; Rajan, Bharat; Evans, Denis A.

    2010-01-01

    Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. Design and Methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The…

  7. Quality of life (QOL) axiological profile of the elderly population served by the Family Health Program (FHP) in Brazil.

    PubMed

    Figueira, Helena A; Giani, Tania S; Beresford, Heron; Ferreira, Márcia A; Mello, Danielli; Figueira, Alan A; Figueira, Joana A; Dantas, Estélio H M

    2009-01-01

    With the purpose of optimizing the satisfaction of the elderly subjects, either existential or not, presenting their unique preference, this research aimed to evaluate the effects of aging on QOL of the aged persons, served by the FHP. The basic intention was to establish parameters of QOL-impact on aging. Our sample was a non-selected population of aged volunteers from Perequê-Mirim-I Family Health Unity, in Caraguatatuba, São Paulo, Brazil. In this correlational descriptive research, the elderly subjects answered a questionnaire on QOL, specific to the aged persons (WHOQOL-OLD). These answers revealed the degree to which of the six facets of WHOQOL-OLD was given priority. The dimensional techniques of descriptive statistics (mean+/-S.D., median, coefficient of variation) normality evaluation (Kolmogorov-Smirnov), and inferential statistical techniques (Z-score test, chi2) were adopted, considering the level-II error=10% and accepting level-I error=5%. The main results revealed a correlation between the income and QOL. Death and dying appeared to be a substantial preoccupation, opposed to intimacy that raised the QOL level. It is suggested that any works directed to the elderly population should take in consideration the self-evaluation of aging effects on QOL.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  10. What is the prevalence of musculoskeletal problems in the elderly population in developed countries? A systematic critical literature review.

    PubMed

    Fejer, René; Ruhe, Alexander

    2012-09-24

    The proportion of older people will be tripled by the year 2050. In addition, the incidence of chronic musculoskeletal (MSK) conditions will also increase among the elderly people. Thus, in order to prepare for future health care demands, the magnitude and impact of MSK conditions from this growing population is needed. The objective of this literature review is to determine the current prevalence of MSK disorders in the elderly population. A systematic literature search was conducted in Pubmed on articles in English, published between January 2000 and July 2011. Studies from developed countries with prevalence estimates on elderly people (60+) on the following MSK conditions were included: Non-specific extremity pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and back pain. The included articles were extracted for information and assessed for risk of bias. A total of 85 articles were included with 173 different prevalence estimates. Musculoskeletal disorders are common in the elderly population, but due to heterogeneity of the studies, no general estimate on the prevalence of MSK can be determined. Women report more often MSK pain than men. Overall, prevalence estimates either remain fairly constant or increase slightly with increasing age, but with a tendency to decrease in the oldest (80+) people. Musculoskeletal disorders remain prevalent in the elderly population. Given the increasing proportion of elderly population in the world population and the burden of MSK diseases among the elderly people, efforts must be made to maintain their functional capacity for as long as possible through optimal primary and secondary health care.

  11. Physical distress is associated with cardiovascular events in a high risk population of elderly men

    PubMed Central

    Einvik, Gunnar; Ekeberg, Øivind; Klemsdal, Tor O; Sandvik, Leiv; Hjerkinn, Elsa M

    2009-01-01

    Background Self-reported health perceptions such as physical distress and quality of life are suggested independent predictors of mortality and morbidity in patients with established cardiovascular disease. This study examined the associations between these factors and three years incidence of cardiovascular events in a population of elderly men with long term hyperlipidemia. Methods We studied observational data in a cohort of 433 men aged 64–76 years from a prospective, 2 × 2 factorial designed, three-year interventional trial. Information of classical risk factors was obtained and the following questionnaires were administered at baseline: Hospital Anxiety and Depression Scale, Physical Symptom Distress Index and Life Satisfaction Index. The occurrence of cardiovascular death, myocardial infarction, cerebrovascular incidences and peripheral arterial disease were registered throughout the study period. Continuous data with skewed distribution was split into tertiles. Hazard ratios (HR) were calculated from Cox regression analyses to assess the associations between physical distress, quality of life and cardiovascular events. Results After three years, 49 cardiovascular events were registered, with similar incidence among subjects with and without established cardiovascular disease. In multivariate analyses adjusted for age, smoking, systolic blood pressure, serum glucose, HADS-anxiety and treatment-intervention, physical distress was positively associated (HR 3.1, 95% CI 1.2 – 7.9 for 3rd versus 1st tertile) and quality of life negatively associated (HR 2.6, 95% CI 1.1–5.8 for 3rd versus 1st tertile) with cardiovascular events. The association remained statistically significant only for physical distress (hazard ratio 2.8 95% CI 1.2 – 6.8, p < 0.05) when both variables were evaluated in the same model. Conclusion Physical distress, but not quality of life, was independently associated with increased risk of cardiovascular events in an observational study

  12. Social Network Characteristics and Body Mass Index in an Elderly Korean Population

    PubMed Central

    Lee, Won Joon; Rhee, Yumie; Park, Yeong-Ran; Chu, Sang Hui; Kim, Hyeon Chang

    2013-01-01

    Objectives Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m2) in an elderly Korean population. Methods This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis. Results After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (β=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (β=0.885, p=0.049), but not in the men (p=0.140). Conclusions Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association. PMID:24349655

  13. Population based study of social and productive activities as predictors of survival among elderly Americans

    PubMed Central

    Glass, Thomas A; de Leon, Carlos Mendes; Marottoli, Richard A; Berkman, Lisa F

    1999-01-01

    Objectives To examine any association between social, productive, and physical activity and 13 year survival in older people. Design Prospective cohort study with annual mortality follow up. Activity and other measures were assessed by structured interviews at baseline in the participants’ homes. Proportional hazards models were used to model survival from time of initial interview. Setting City of New Haven, Connecticut, United States. Participants 2761 men and women from a random population sample of 2812 people aged 65 and older. Main outcome measure Mortality from all causes during 13 years of follow up. Results All three types of activity were independently associated with survival after age, sex, race/ethnicity, marital status, income, body mass index, smoking, functional disability, and history of cancer, diabetes, stroke, and myocardial infarction were controlled for. Conclusions Social and productive activities that involve little or no enhancement of fitness lower the risk of all cause mortality as much as fitness activities do. This suggests that in addition to increased cardiopulmonary fitness, activity may confer survival benefits through psychosocial pathways. Social and productive activities that require less physical exertion may complement exercise programmes and may constitute alternative interventions for frail elderly people. Key messagesLittle is known about predictors of survival among elderly peoplePhysical activity is clearly good for health, but the potential benefits of social activities have not been studiedSocial and productive activities are as effective as fitness activities in lowering the risk of deathEnhanced social activities may help to increase the quality and length of life PMID:10454399

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

    PubMed Central

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

    2008-01-01

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

  15. The Epidemiology of Depression in an Elderly Community Population.

    ERIC Educational Resources Information Center

    Blazer, Dan; And Others

    1987-01-01

    Screened community adults (N=1,300) 60 years of age or older for depressive symptomatology. Found a gap between significant depressive symptoms and major depression. Suggests that traditional Diagnostic and Statistical Manual of Mental Disorders (DSM III) depressive categories do not capture most depressed older adults in community populations.…

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

    PubMed Central

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

    2005-01-01

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

  17. A method for analyzing changing prison populations: explaining the growth of the elderly in prison.

    PubMed

    Luallen, Jeremy; Kling, Ryan

    2014-12-01

    For the past several decades, the U.S. prison system has witnessed a steady and persistent increase in the ages of prison populations. Given the additional costs and burdens placed on prisons as they house older inmates, this aging trend has generated intense interest among policy makers and academics who seek to understand why prison populations are getting older. This article presents a method for evaluating drivers influencing the change in age distributions among prisoners. We define a methodological approach and demonstrate its application using prison data from four states reporting to the Bureau of Justice Statistics' National Corrections Reporting Program. We find that since 2000, the primary driver of overall growth in the elderly populations in prison (defined as inmates over 50) is the increasing admission age of offenders entering prison. Moreover, changes in offense mix and sentence length/time served over the last decade have had significantly less influence on the age composition of prison populations. We also find that the impact of explanatory factors varies across states and offense types. For example, prison admission and exit rates explain much of the change in elderly drug offenders in New York, but not elderly violent offenders, where admission age plays a much stronger explanatory role. Our analysis offers an effective demonstration that supports the use of this method as an important and informative first step toward understanding components of change that affect the problem of prison aging. © The Author(s) 2014.

  18. [EPIDEMIOLOGY OF FALLS IN THE NON-INSTITUTIONALIZED SPANISH ELDERLY POPULATION, SYSTEMATIC REVIEW 2014].

    PubMed

    Pellicer García, Begoña; Juarez Vela, Raúl; Gracia Carrasco, Elías; Guerrero Portillo, Sandra; García Moyano, Loreto María; Azón Belarre, José Carlos

    2015-11-01

    OBJECTIVE To identify scientific publications about falls among non-institutionalized Spanish elderly population and to summarize the study findings which analysed the incidence, the risk factors and the consequences of the falls in the geriatric spanish population aged 65 years and over who lives institutionalized in our country. Systematic review of the epidemiological observational studies in Spain, with recording of falls, with temporary retrospective and published as scientific articles between the years 2003 and 2014 included. The articles search took place in July 2014, with the limit of language and publication year, in the electronic databases PubMed, Dialnet, RedALyC, SciELO, Enfispo and Google Scholar. The percentage of people who suffered falls depending on the publication year. The frequency of falls recorded varied from 14.9 % to 66.2 %. The mean intake of daily drugs was between 2.7 to 4.5 drugs per day. The fear of falling that had the elderly population non-institutionalized was between 44.7 % and 49.4 %. The vast majority of falls occurred at home, with percentages between 55.1 % and 61 %. Between 30 % and 55.1 % of people who suffered falls maintained health care contact immediately and the fractures prevalence was between 0 % and 26.1 %. CONCLUSTON: It can be confirmed that the falls prevalence in the spanish elderly population is high, so the need ofnew researches are appreciated.

  19. Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries

    PubMed Central

    Droguett, Daniel; Arenas-Márquez, María-Jesús

    2017-01-01

    Background The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. Material and Methods It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. Results The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). Conclusions The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words:Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review. PMID:28210449

  20. Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population.

    PubMed

    Dong, XinQi

    2016-01-01

    This study aimed to examine the socio-demographic and socioeconomic characteristics associated with prevalence and severity of elder self-neglect in an U.S. Chinese older population. The PINE study is a population-based epidemiological study in the greater Chicago area. In total, 3159 Chinese older adults were interviewed from 2011 to 2013. Elder self-neglect was assessed with systematic observations of a participant's personal and home environment across five domains: hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Elder self-neglect was prevalent among older adults aged 80 years or over (mild self-neglect: 34.6% 95% CI 30.9-38.4; moderate/severe: 15.6% 95% CI 12.8-18.6), men (mild: 28.6% 95% CI 26.1-31.3; moderate/severe: 13.1% 95% CI 11.2-15.1), those with 0-6 years of education (mild: 32.2% 95% CI 29.7-34.9; moderate/severe: 12.6% 95% CI 10.8-14.5), and those with an annual personal income between $5000 and $10,000 (mild: 30.8% 95% CI 28.4-33.2; moderate/severe: 11.8% 95% CI 10.2-13.5). Older age (mild self-neglect: OR 1.02, 95% CI 1.01-1.03; moderate/severe self-neglect: OR 1.02, 95% CI 1.00-1.03) and lower education levels (mild self-neglect: OR 1.06, 95% CI 1.03-1.08; moderate/severe self-neglect: OR 1.07, 95% CI 1.04-1.09) were associated with significantly increased odds of elder self-neglect. Women (moderate/severe self-neglect: OR 0.73, 95% CI 0.58-0.93) had significantly decreased odds of moderate/severe elder self-neglect. No significant association was found between levels of income and overall elder-self-neglect of all severities. Future research is needed to examine risk/protective factors associated with elder self-neglect in U.S. Chinese older populations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Survival and functional capacity: three year follow up of an elderly population in hospitals and homes.

    PubMed Central

    Donaldson, L J; Jagger, C

    1983-01-01

    A three year mortality study was undertaken of a population of 4490 people aged 65 and over in all types of hospitals and homes provided within a defined geographical area. The rate of survival consistently fell with increasing incapacity in mobility, incontinence, washing/dressing, and feeding. The effect was independent of differences in age, sex, and duration of stay. Differences in survival between patients and residents of National Health Service hospitals (geriatric, psychiatric, acute) and homes for the elderly did not persist after adjustment for variations between populations in level of incapacity, age, and sex. An assessment based on ability to perform basic items of self care is easily undertaken and understood by staff in different settings. It allows homogeneous groups of elderly people to be identified despite a diverse range of underlying diseases and could provide the basis for planning and evaluating services and rehabilitation regimens. PMID:6619715

  2. A survey of self-reported skin disease in the elderly African-American population.

    PubMed

    Caretti, Katherine L; Mehregan, Darius R; Mehregan, David A

    2015-09-01

    In the USA, the geriatric population, almost 12% of which will be comprised of African-Americans, is expected to exceed 88 million by 2050. Data on dermatologic conditions in elderly African-Americans are deficient. This study aimed to identify prevalences of self-reported skin disease and skin-related concerns in elderly African-Americans, and to assess participants' perceptions of skin disease and awareness of skin cancer. Elderly African-Americans were recruited into a cross-sectional study and asked to complete a 17-item questionnaire. A total of 101 participants aged 60-91 years (median age: 71 years) completed the questionnaire. The majority (75.2%) of the subjects were female. The most common self-reported skin diseases were eczema/dermatitis (28.7%), fungal skin infections (16.8%), alopecia (6.9%), viral skin infections (4.9%), and urticaria (4.9%). The most common skin concerns were dry skin/pruritus (40.6%), moles (27.7%), hair loss (25.7%), skin discoloration (20.8%), and wrinkles (15.8%). Overall, 40.6% of participants reported concern about skin cancer, and 75.2% reported examining their skin regularly. However, 34.7% did not believe that people with darker skin types should be concerned about skin cancer. This study provides an important overview of the most common self-reported skin conditions in elderly African-Americans. Substantial age-related differences in the frequencies of skin disorders were apparent. It is important to include the elderly population within campaigns to educate minority group members on skin cancer. © 2014 The International Society of Dermatology.

  3. Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries.

    PubMed

    Rivera, César; Droguett, Daniel; Arenas-Márquez, María-Jesús

    2017-02-01

    The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words:Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review.

  4. Cross-Sectional Study of the Characteristics of Reported Elder Self-Neglect in a Community-Dwelling Population: Findings from a Population-Based Cohort

    PubMed Central

    Dong, Xin-Qi; Simon, Melissa; Evans, Denis

    2010-01-01

    Background Elder self-neglect is an important public health issue. However, little is known about the characteristics of self-neglect and its association with social factors among community-dwelling populations. Objectives: (1) To examine the sociodemographic, health-related and psychosocial characteristics of reported elder self-neglect; (2) to examine the association of social network and social engagement with reported self-neglect. Methods Population-based study conducted from 1993 to 2005 of community-dwelling subjects (n = 9,056) participating in the Chicago Health and Aging Project (CHAP). Subsets of the CHAP subjects (n = 1,812) were identified for suspected self-neglect by the social services agency, which also assessed the severity. This reported group was compared with the unreported group in the CHAP across the sociodemographic, health-related and psychosocial variables. Logistical regressions were used to assess the association of social factors and self-neglect. Results Older age, women, African-Americans, and those with lower education or lower income were more likely to be reported for self-neglect. Those reported for self-neglect were more likely to have lower levels of cognitive and physical function, nutritional status, psychosocial function and a higher number of medical comorbidities. After adjusting for confounders, lower levels of social network and social engagement were significantly associated with an increased risk of reported self-neglect. Among the reported cases of self-neglect, the study found increased trends of older age, women, African-American, lower income, lower cognitive and physical function, lower social engagement and a higher number of chronic medical conditions with self-neglect severity. Conclusion Reported self-neglect elders have multiple sociodemographic, health-related and psychosocial characteristics that are different than elders not reported. Lower levels of social network and social engagement were associated with

  5. Factors contributing to participation in food assistance programs in the elderly population.

    PubMed

    Hong, Seo Ah; Kim, Kirang

    2014-08-01

    The study objectives were to examine the participation rate in food assistance programs and explore the factors that contribute to such participation among the Korean elderly population. The study sample comprised 3,932 respondents aged 65 years or older who were selected from a secondary data set, the fourth Korean Welfare Panel Study (KoWePS). The factors, related to participation in programs were examined based on the predisposing, enabling and need factors of the help-seeking behavior model. Multiple logistic regression analysis was used to select the best contributors among the factors related to program participation. The predisposing rate in food assistance programs was 8.5% (7.1% for men and 10.4% for women). When all variables were included in the model, living without spouse, no formal education, low income, having social security benefits and food insecurity in elderly men, and age, low income, having social security benefits and feeling poor in elderly women were significantly related to a higher tendency to program participation. The predisposing and need factors, such as living without spouse, low education level, food insecurity and feeling poor were important for program participation, as well as enabling factors, such as household income and social security benefits. A comprehensive approach considering these factors to identify the target population for food assistance programs is needed to increase the effectiveness and target population penetration of these programs.

  6. Relationship between hyperuricemia and risk of coronary heart disease in a middle-aged and elderly Chinese population.

    PubMed

    Yang, Ye; Tian, Jian; Zeng, Chao; Wei, Jie; Li, Liang-Jun; Xie, Xi; Yang, Tuo; Li, Hui; Lei, Guang-Hua

    2017-02-01

    Objective To investigate the relationship between hyperuricemia and coronary heart disease (CHD) risk based on the Framingham risk score (FRS) in a middle-aged and elderly Chinese population. Methods This cross-sectional study enrolled patients undergoing routine check-ups at Xiangya Hospital between October 2013 and November 2014. Hyperuricemia was defined as uric acid ≥416 mmol/l for males and ≥360 mmol/l for females. A 10-year CHD risk was calculated from FRS. A multivariable logistic analysis model was used to evaluate associations. Results Of the 6347 patients, 3415 (53.8%) were male, 1543 (24.3%) had a CHD risk ≥10% (i.e. intermediate and high risk) and the prevalence of hyperuricemia was 18.1% ( n = 1148). After adjusting for potential confounding factors, the 10-year CHD risk was increased in patients with hyperuricemia compared with those without hyperuricemia by 0.28 times in the total population (odds ratio [OR] 1.28; 95% confidence interval [CI] 1.09, 1.48), by 0.25 times in the male population (OR 1.25; 95% CI 1.06, 1.47) and by 2.76 times in the female population (OR 3.76; 95% CI 2.08, 6.79). Conclusion Hyperuricemia was positively associated with a 10-year risk of CHD suggesting that it might be an independent CHD risk factor in middle-aged and elderly individuals.

  7. Waist circumference cutoff points for central obesity in the Korean elderly population.

    PubMed

    So, Eun Sun; Yoo, Kwang Soo

    2015-02-01

    The aim is to determine the appropriate cutoff values of waist circumference (WC) for an increased risk of the metabolic syndrome in the Korean elderly population. We analyzed the WC cutoff values of four groups divided according to sex and age with a total of 2,224 elderly participants aged 65 years old and above from the Fourth Korean National Health and Nutrition Examination Survey using the receiver operating characteristic curve and multiple logistic regression. The WC cutoff values associated with an increased risk of metabolic syndrome were 89.6 cm for men and 90.5 cm for women for those who were 65 to 74 years old, and 89.9 cm for men and 87.9 cm for women for those who were 75 years old or older. WC cutoff points for estimating metabolic risk are similar in elderly men and women. Age-specific optimal WC cutoff points should be considered especially for elderly women in screening for metabolic syndrome.

  8. Iron deficiency in the elderly population, revisited in the hepcidin era

    PubMed Central

    Busti, Fabiana; Campostrini, Natascia; Martinelli, Nicola; Girelli, Domenico

    2014-01-01

    Iron deficiency (ID) is relatively common among the elderly population, contributing substantially to the high prevalence of anemia observed in the last decades of life, which in turn has important implications both on quality of life and on survival. In elderly subjects, ID is often multifactorial, i.e., due to multiple concurring causes, including inadequate dietary intake or absorption, occult bleeding, medications. Moreover, because of the typical multimorbidity of aged people, other conditions leading to anemia frequently coexist and make diagnosis of ID particularly challenging. Treatment of ID is also problematic in elderly, since response to oral iron is often slow, with a substantial fraction of patients showing refractoriness and requiring cumbersome intravenous administration. In the last decade, the discovery of the iron regulatory hormone hepcidin has revolutionized our understanding of iron pathophysiology. In this review, we revisit ID among elderly people in the light of the impressive recent advances on knowledge of iron regulation, and discuss how hepcidin may help in diagnosis and treatment of this common clinical condition. PMID:24795637

  9. The Association in Elderly Hospitalized Patients, Between Psychotropic Drugs and Hip Fractures Resulting from Falls.

    PubMed

    Aizenberg, Dov; Weizman, Abraham; Weiss, Avraham; Akopian, Maria; Amitai, Maya; Beloosesky, Yichayaou

    2015-01-01

    Psychotropic drug treatment has been associated with increased risk for falls and hip fractures in elderly patients. The authors examined the association between drug treatment and hip fractures resulting from falls in elderly hospitalized patients, focusing on the medications' anticholinergic properties. This retrospective case-control study was conducted in an acute geriatric ward in a general medical center. Medical records, including demographic, clinical, biochemical, and pharmacological variables, of elderly patients with hip fractures from falls (N = 185), admitted during a 2-year period, were reviewed and compared with a control group (N = 187) of patients matched for age and gender and without hip fractures. The usage rates of antipsychotics, antidepressants, mood stabilizers, and various nonpsychiatric medications were similar in the two groups, except for hypnotics-anxiolytics (higher rates in hip-fracture patients). The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and diastolic blood pressure constituted very modest predictors of falls (R(2) = .038, p = .004). There were no significant differences in the anticholinergic burden values, clinical dementia ratings, and comorbidity burden between the two groups. The rate of psychotropic drug use in general and their anticholinergic burden are similar in acutely admitted elderly patients with or without hip fractures. However, higher usage rate of anxiolytics found in the patients with hip fractures may indicate that this is a risk factor for hip fractures related to falls in elderly patients living in the community.

  10. Prevalence of social phobia in non-demented elderly from a swedish population study.

    PubMed

    Karlsson, Björn; Klenfeldt, Isak Fredén; Sigström, Robert; Waern, Margda; Ostling, Svante; Gustafson, Deborah; Skoog, Ingmar

    2009-02-01

    To examine the prevalence of social phobia, and how the different Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic components of social phobia influence prevalence rates, among a population sample aged 70 years and older. A general population sample was investigated in 2000-2001 with semistructured psychiatric examinations, including the Comprehensive Psychopathological Rating Scale, the Mini International Neuropsychiatric Interview, the Global Assessment of Functioning (GAF) scale, and the Mini Mental State Examination. General population Participants: Randomized sample of 914 nondemented elderly, response rate 68%. The sample was stratified into two age groups: 70-year olds (N = 338 women and 224 men) and aged 78 and above (N = 352 women). Social phobia according to DSM-IV requiring: a) fearing social situations, b) experiencing the fear as unreasonable or excessive, c) avoiding feared social situations or enduring them with intense anxiety or distress, and d) that this causes social consequences. The 1-month prevalence of social phobia was 1.9% (N = 17), an additional 1.6% (N = 15) fulfilled criteria a, c, and d, but not b. Thus, 3.5% had "social phobia" that caused social consequences. This was related to lower GAF-score and concurrent depression,panic attacks, and agoraphobia. Almost one fourth (N = 220) of the total sample feared social situations. This was more common in 70-year-old women compared with 70-year-old men (29.9% versus 20.5%), and to women aged 78-92 years (21.0%). Our results indicate that DSM-IV criteria exclude a large group of individuals with social phobia. It could be discussed whether DSM-IV criteria should be revised to also encompass these individuals.

  11. Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

    PubMed Central

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

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

    PubMed Central

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

    2014-01-01

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

  13. Falls among the elderly: risk factors in a population-based study.

    PubMed

    Rodrigues, Iara Guimarães; Fraga, Gustavo Pereira; Barros, Marilisa Berti de Azevedo

    2014-01-01

    The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95% CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95% CI 1.61 - 3.88), widowed (PR = 1.74; 95% CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95% CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95% CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95% CI 1.09 - 2.74), headache (PR = 1.59; 95% CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95% CI 1.12 - 2.64), dizziness (PR = 2.82; 95% CI 1.98 - 4.02), insomnia (PR = 1.75; 95% CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95% CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95% CI 1.19 - 3,93). The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

  14. Predictability of Social-anamnestic Variables on Receptive Vocabulary and Cognitive Functioning of the Elderly Population

    PubMed Central

    Ibrahimagic, Amela; Zunic, Lejla Junuzovic; Rasidovic, Mirsada; Radic, Bojan; Kantic, Ahmet

    2016-01-01

    Introduction: Aging, as an irrepressible biological process involves a series of physiological and pathological changes. The main aim of this study was to examine the correlation and predictability of receptive vocabulary and cognitive functioning of elderly people with anamnestic variables: chronological age, sex, level of formal education, marital status, years of work and retirement and years spent in an institution for the elderly. Material and Methods: The sample of participants consisted of 120 elderly people, average age was 78 years, placed in institutional care for elderly people in four cities in Bosnia and Herzegovina. It was three groups of variables: anamnestic, receptive vocabulary assessment, and cognitive assessments. A Montreal Cognitive Assessment Scale (MoCA) was used for the assessment of cognitive abilities. In order to estimate the receptive vocabulary Peabody Picture Vocabulary Test (PPVT-III-HR) was used. Results: Results of multiple regression analysis show that part of the variance of receptive language which is explained by the model (anamnestic variables) was 44.0% and of cognitive functioning was 33.7%. The biggest single contribution to explaining the development of receptive vocabulary was given by predictor variable of college education (β = 0.417) then variable university education (β = 0.293), while the smallest single contribution was given by variable secondary education (β = 0.167). The biggest single contribution to explaining the results of tests of cognitive function was given by predictor variable College education (β = 0.328) and variable unskilled (β = -0.229), which has a negative effect on the increase in recent cognitive functioning. Conclusion: Anamnestic variables were valid predictors of receptive vocabulary and cognitive functioning of elderly people. The highest individual contribution was given by variables describing the level of formal education of elderly. PMID:28144192

  15. Cognitive Impairment in Rural Elderly Population in Ecuador.

    PubMed

    Wong-Achi, Xavier; Egas, Gabriela; Cabrera, Dayana

    2017-08-01

    The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32-27.48), and 63% (CI: 62.1-63.94) of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5-53.3) and 47.2% (95% CI: 45.2-49.2) in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

  16. Nutrition survey in an elderly population following admission to a tertiary care hospital

    PubMed Central

    Azad, N; Murphy, J; Amos, S S; Toppan, J

    1999-01-01

    BACKGROUND: Malnutrition in elderly patients in institutions has become an issue of clinical concern, but it remains largely unrecognized in acute care hospitals. The demonstrated benefits of intervention emphasize the need for routine nutritional assessment. The objectives of this study were to determine the prevalence of malnutrition in elderly patients admitted to a tertiary care centre and to test the sensitivity and specificity of 3 nutrition screening tools. METHODS: Between July and November 1996 patients 65 years and older were consecutively recruited from the general medicine, orthopedics, general surgery and neurosciences services of The Ottawa Hospital--General Campus within 72 hours of admission. They were interviewed using 3 nutritional screening tools: one developed by Chandra and colleagues (Chandra), the Nutrition Screening Initiative (NSI) and the Mini Nutritional Assessment (MNA). A detailed nutrition assessment was then undertaken, which included anthropometric assessment, laboratory tests, determination of risk factors and assessment of dietary intake. A dietitian blinded to the screening results classified each patient as being well nourished, at risk for malnutrition or malnourished. The prevalence of malnutrition was assessed, and screening results were compared with the results of the detailed nutrition assessment for sensitivity and specificity. RESULTS: In total, 160 patients (86 women) were recruited. Detailed nutrition assessments were completed for 152 patients, of which 62 (40.8%) were found to be well nourished, 67 (44.1%) at moderate risk for malnutrition and 23 (15.1%) malnourished. Matched comparisons showed that, of the 23 malnourished patients, 1 was found to be at high risk for malnutrition using the Chandra screening tool, 9 using the NSI and 4 using the MNA, giving sensitivities of 32%, 54% and 57%, and specificities of 85%, 61% and 69%, respectively. INTERPRETATION: Given the high rate of malnutrition or risk of malnutrition

  17. Predictability of Social-anamnestic Variables on Receptive Vocabulary and Cognitive Functioning of the Elderly Population.

    PubMed

    Ibrahimagic, Amela; Zunic, Lejla Junuzovic; Rasidovic, Mirsada; Radic, Bojan; Kantic, Ahmet

    2016-12-01

    Aging, as an irrepressible biological process involves a series of physiological and pathological changes. The main aim of this study was to examine the correlation and predictability of receptive vocabulary and cognitive functioning of elderly people with anamnestic variables: chronological age, sex, level of formal education, marital status, years of work and retirement and years spent in an institution for the elderly. The sample of participants consisted of 120 elderly people, average age was 78 years, placed in institutional care for elderly people in four cities in Bosnia and Herzegovina. It was three groups of variables: anamnestic, receptive vocabulary assessment, and cognitive assessments. A Montreal Cognitive Assessment Scale (MoCA) was used for the assessment of cognitive abilities. In order to estimate the receptive vocabulary Peabody Picture Vocabulary Test (PPVT-III-HR) was used. Results of multiple regression analysis show that part of the variance of receptive language which is explained by the model (anamnestic variables) was 44.0% and of cognitive functioning was 33.7%. The biggest single contribution to explaining the development of receptive vocabulary was given by predictor variable of college education (β = 0.417) then variable university education (β = 0.293), while the smallest single contribution was given by variable secondary education (β = 0.167). The biggest single contribution to explaining the results of tests of cognitive function was given by predictor variable College education (β = 0.328) and variable unskilled (β = -0.229), which has a negative effect on the increase in recent cognitive functioning. Anamnestic variables were valid predictors of receptive vocabulary and cognitive functioning of elderly people. The highest individual contribution was given by variables describing the level of formal education of elderly.

  18. [Body image perception and associated factors among elderly residents in a city in northeast Brazil: a population-based study].

    PubMed

    Menezes, Tarciana Nobre de; Brito, Kyonayra Quezia Duarte; Oliveira, Elaine Cristina Tôrres; Pedraza, Dixis Figueroa

    2014-08-01

    The article aims to verify body image perception and associated factors among elderly individuals in Campina Grande, State of Paraiba. It involves a cross-sectional, population and home-based study, with individuals 60 years or older of both sexes. Body image perception was considered the dependent variable for purposes of analysis and study of possible associations. The independent variables were: age group, nutritional status, number of diseases, health perception and regular practice of physical activities. To identify associated factors, univariate and multivariate regression analyses were carried out using SPSS 17.0 software. Overall, 806 elderly individuals were interviewed. Men showed greater satisfaction with body image when compared to women and older participants were more satisfied than younger participants. Among the factors related to dissatisfaction in women, underweight and overweight/obesity were associated with an increased risk of dissatisfaction. Among men, older age constituted a protective factor for dissatisfaction, while underweight and overweight/obesity were risk factors for dissatisfaction. The results of this study suggest a possible influence of nutritional status on body image perception among the elderly, negatively affecting their perception of body image.

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

    PubMed

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

    2011-09-01

    The aim of the present study was to evaluate the associations of metabolic disorders and anthropometric and biochemical biomarkers of lipid, glucose and oxidative metabolism and the habitual ingestion of guaraná (Paullinia cupana, Mart. Var. sorbilis) by an elderly population residing in the Amazon Riverine region of the Maués municipality (Brazil). A case-controlled study was performed that included 637 elderly (≥60 years of age) patients classified as either those who habitually drank guaraná (GI, n = 421) or those who never drank guaraná (NG, n = 239) based upon their self-reported intake of guaraná. Indeed, the prevalence of various metabolic disorders was associated with guaraná ingestion. The prevalence of hypertension, obesity and metabolic syndrome in the GI group was lower than the prevalence found in the NG group. The NG group exhibited lower systolic and diastolic blood pressure values. The males in the GI group exhibited a lower waist circumference, on average, than the circumference found in the NG group, whereas the females in the GI group had lower cholesterol (total and LDL-c) levels than the control cohort. Additionally, a significant association was found between lower levels of advanced oxidative protein product (AOPP) and habitual guaraná consumption. The results constitute the first epidemiological study to suggest a potentially protective effect of habitual guaraná ingestion against metabolic disorders in elderly subjects. Copyright © 2011 John Wiley & Sons, Ltd.

  20. Interest and limits of glomerular filtration rate (GFR) estimation with formulae using creatinine or cystatin C in the malnourished elderly population.

    PubMed

    Fabre, Emmanuelle E; Raynaud-Simon, Agathe; Golmard, Jean-Louis; Gourgouillon, Nadège; Beaudeux, Jean-Louis; Nivet-Antoine, Valérie

    2010-01-01

    Renal function is often altered in elderly patients. A lot of formulae are proposed to estimate GFR to adjust drug posology. French guidelines recommend the Cockcroft-Gault formula corrected with the body surface area (cCG), but the initially described unadjusted Cockcroft-Gault equation (CG) is mainly used in geriatric clinical practice. International recommendations have proposed the modification of diet in renal disease (MDRD) formula, since several authors recommended the Rule formula using cystatin C (cystC) in particular population. To appreciate the most accurate GFR estimation for posology adaptation in an elderly polypathological population, a cross-sectional study with prospective inclusion was carried out in Charles Foix Hospital. Plasma glucose levels (PGL), creatinine (CREA) levels and serum cystC, albumin (ALB), transthyretin (TTR), C-reactive protein (CRP), orosomucoid (ORO) total cholesterol (tCHOL) levels were determined among 193 elderly patients aged 70 and older. The results showed that in a malnourished, inflamed old population, CG, MDRD and Rule formulae resulted in different estimations of GFR, depending on nutritional and inflammatory parameters. Only cCG estimation was shown to be independent from these parameters. To conclude, cCG seems to be the most accurate and appropriate formula in a polypathological elderly population to evaluate renal function in order to adapt drug posology. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  1. [Prevalence of osteoporosis assessed by quantitative ultrasound calcaneus measurements in institutionalized elderly population].

    PubMed

    Navas Cámara, F J; Fernández de Santiago, F J; Bayona Marzo, I; Mingo Gómez, T; de la Fuente Sanz, M M; Cacho del Amo, A

    2006-08-01

    To analyze using quantitative ultrasound of calcaneus (QUS) the prevalence of osteoporosis in institutionalized elderly people, in order to contribute to state reliable criteria (T-score units) for the diagnosis of osteoporosis which allow advances in bone fracture prevention. Elderly people (n=171) were divided into separate groups according to sex and age criteria (three decades, from 70 to 90 years) and analyzed using QUS. Both globally and in the younger groups, women showed significantly lower values than men in all densitometry variables (p < 0.001). In the oldest group only T-score and BUA showed statistical differences (p = 0.039 y p = 0.025, respectively). The prevalence of osteoporosis in women was higher than in men whichever criteria were applied in all age groups. Applying the WHO criteria with QUS, the prevalence of osteoporosis in global population is close to that stated by DEXA using the same criteria. QUS could be useful to assess the bone mass evolution with age and for the diagnosis and monitoring of osteoporosis. In our elderly population, the WHO criteria for DEXA, are also the most suitable ones for QUS utilization.

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

    PubMed

    Suto, Takashi; Saito, Shigeru

    2014-03-01

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

  3. Tubular proteinuria is the dominant type of proteinuria in an elderly community population in China.

    PubMed

    Wang, Hua-Bin; Yang, Qing-Hong; Jiang, Xu; Cui, Xiao-Fan; Liu, Rui

    2015-09-01

    To explore the types of proteinuria in the elderly population in China. Seven hundred and fourteen elderly people (≥ 60 years old) from Tianjin, China, were selected for the study. The albumin-to-creatinine ratio and α1-microglobulin-to-creatinine ratio from morning urine samples were used as indicators of proteinuria. The prevalence of proteinuria was evaluated and the proportion of three different types of proteinuria (mixed, glomerular, and tubular) was assessed in the subjects by analyzing these indicators. Of the 714 subjects, 29.13 % had elevated ACR and 46.36 % had elevated MCR. The proportion of subjects with either elevated ACR or MCR was 53.78 %. The correlation between MCR and ACR was moderate (r = 0.58, R (2) = 0.34, P < 0.001). Overall, tubular proteinuria was dominant (45.83 %), followed by mixed glomerular and tubular proteinuria (35.68 %), and significantly higher than glomerular proteinuria. A diet high in salt was the independent risk factor for tubular proteinuria; physical activity was the independent risk factor for glomerular proteinuria. The risk of glomerular proteinuria was lower in males than in females, but the risk of tubular proteinuria was higher in males. The prevalence of tubular proteinuria was higher than that of glomerular proteinuria, and the risk factors are different, in the elderly in China; therefore, tubular damage markers should get more attention in the overall population.

  4. Use of the Rey 15-Item Test as a performance validity test in an elderly population.

    PubMed

    Fazio, Rachel L; Faris, Allison N; Yamout, Karim Z

    2017-08-29

    The objective of this study was to determine the effectiveness of the Rey 15-Item Test in elderly individuals with and without cognitive impairment and to develop new indices to function with this population, if needed. The sample consisted of 185 individuals referred for outpatient neuropsychological evaluation. All were clinically evaluated and administered the Rey 15-Item Test (RFIT) with recognition as part of this procedure. Significant differences were present between those passing and failing the RFIT on referral question; working status; age; and diagnosis of cognitive impairment. Individuals age 60+ failed the test at rates in excess of 35%. Diagnosis also played a role with those with more severe cognitive diagnosis failing at higher rates; even in those with no diagnosis, however, 19% of elderly individuals did not produce a passing score. The extant cutoff scores commonly used with the RFIT produce unacceptably high false positive error rates to be a useful freestanding Performance Validity Test (PVT) with individuals above age 59. The introduction of a new combination score and use of rare scores and patterns of scores improves the psychometric properties of the RFIT when used with elderly adults. Cautious use of PVTs is warranted until they have been validated with aged populations.

  5. Oral health conditions of the elderly in Ancona: a population-based study.

    PubMed

    Coccia, E; Santarelli, A; Ponzio, E; Procaccini, M; Rappelli, G

    2015-10-01

    Information currently available regarding the oral health of elderly people is poor, especially in Italy. The aim of this study was to evaluate oral health conditions in older people in the city of Ancona, Italy. The usefulness of a dedicated medical record, specifically designed for older people, was tested. A total of 124 elderly subjects aged between 65 and 95 years, all autonomous and self-sufficient, were recruited for this study. The specific medical/dental record, designed for older people, was used to collect data and was divided into three parts. The first part lists the patient's demographics. The second part was devoted to general medical history. The third part includes the dental history and the dental visit. As regards the oral conditions, injury to the soft tissues, degree of oral hygiene, presence of caries, periodontal diseases, missing teeth, presence of the prosthesis, and presence of xerostomia, were noticed. Among the examined subjects 53% were male and 47% were female. The most prevalent medical condition was hypertension (64.5%); 74.2% of the examined population took up to 3 drugs/day, while the 25.8% more than 3 drugs/day. Only 9.6% of patients had soft tissues lesions and only 33.3% had sufficient oral hygiene; 45.1% of patients suffered decayed teeth; 44% of patients had fewer than 8 missing teeth, the 33.4% had the number of missing teeth including between 9 and 15, and 22.6% had more than 16 missing teeth. Only 7 patients were completely edentulous; 32.3% of the patients had fixed partial dentures, 17.7% had removable partial dentures, 22.6% had both fixed partial dentures and removable partial dentures, 4% removable total dentures and 23.4% do not have any dentures. Only 29.1% patients had xerostomia. The most important data from this study are the following: 1) the majority of elderly patients is hypertensive; 2) the majority of elderly patients take up to 3 drugs/day; 3) the majority of elderly patients has insufficient oral hygiene

  6. Postural control and detection of slip/fall initiation in the elderly population.

    PubMed

    Kim, B J; Robinson, Charles J

    2005-07-15

    One of the common causes of morbidity and mortality in workplaces is related to slips or falls. Reaction to external disturbances, such as slips or falls, requires a process of perturbation detection and control of motion changes. Postural control is a common mechanism to compensate unexpected displacements of the body. The ability of postural control diminishes with ageing or neuropathy. In this study, two controlled groups, diabetics and non-diabetics in the elderly population, were investigated to compare how different postural control mechanisms would relate to the detection of perturbation and regain of balance. The ultra-low-vibration Sliding Linear Investigative Platform for Analyzing Lower Limb Stability SYSTEM was used to measure the biomechanical changes of posture and perturbation detection. In phase 1 of the analysis, static measures during quiet standing were considered to investigate the relationship between postural stability and perturbation detection capability. In phase 2 of the analysis, dynamic measures during an occurrence of perturbation were analysed. Statistical tests and linear logistic regression models were applied to find differences of postural control mechanisms and to build a predictive model for perturbation detection quantitatively. It is anticipated that the results of this study will contribute to more comprehensive understanding of postural control mechanisms and design of slip/fall prevention programmes.

  7. Colorectal cancer is reliably excluded in the frail and elderly population by minimal preparation CT.

    PubMed

    Saunders, J H; Miskovic, D; Bowman, C; Panto, P; Menon, A

    2014-02-01

    This study aimed to retrospectively assess the accuracy of minimal preparation computed tomography (MPCT) in the detection of colorectal cancer (CRC) within the frail and elderly population and to evaluate the relevance of extra-colonic findings (ECF). Radiology reports, clinical notes and follow-up reports from 207 patients who underwent MPCT to investigate for CRC between 2005 and 2009 were analysed. Patients were scanned following the administration of oral contrast for 48 h, without bowel preparation or colonic insufflation. MPCT results were measured against patient outcomes, with a minimum of 2 years of follow-up. Twelve cases of clinically relevant CRC were confirmed (5.8 %). MPCT correctly identified 11 of these lesions (sensitivity 91.6 %). Thirty-one patients had a possible CRC identified by MPCT, which was not confirmed by further examination (specificity 84.1 %). This results in a positive predictive value of 26.2 % and a negative predictive value of 99.4 %. Five of the patients with colon cancer underwent curative surgery. Sixty-eight clinically relevant ECF were confirmed, including 14 previously undiagnosed extra-colonic malignancies. ECF were considered to account for the presenting complaint in 15.0 % (31/207) of all patients. Minimal preparation computed tomography is an effective and reliable investigation for the exclusion of clinically relevant CRC in this population. It provides clinicians with a valuable and pragmatic alternative to colonoscopy and CT colonography when invasive examination or cathartic bowel preparation will be poorly tolerated and small polyps are of limited significance. MPCT has an advantage over purely luminal imaging in the detection of extra-colonic pathology and appears to have an equally important role in the detection of CRC.

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

    ERIC Educational Resources Information Center

    Bach, Paul J.

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

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

    PubMed Central

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

    2009-01-01

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

  10. Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998.

    PubMed

    Doblhammer, G; Kytir, J

    2001-02-01

    The aim of our study is to test the theories of compression or expansion of morbidity on the basis of data on the elderly population of Austria. Our data come from four microcensus surveys for the years 1978, 1983, 1991, and 1998. We use self-perceived health ratings to calculate healthy-life expectancy for the elderly population aged 60-89. Because our data are based on four cross-sectional surveys, we devote the first part of the paper to the consequences of possible sampling and non-sampling errors in our analysis of time trends. We come to the conclusion that, although the absolute number of years lived in good health may be overestimated, the time trend in healthy-life expectancy over the 20 years most probably is unbiased. The second part of the paper describes trends in healthy-life expectancy for the Austrian population. Our results suggest that both healthy-life expectancy and the ratio of healthy years to life expectancy increased between 1978 and 1998. Thus, in Austria ill health seems to be more and more compressed into the later years of life. Contrary to Fries's hypothesis, however, life expectancy does not seem to be approaching a maximum average life span in Austria, as mortality rates at older ages have been continuously decreasing over the last 20 years.

  11. The impact of folic acid fortification of enriched grains on an elderly population: the New Mexico Aging Process Study.

    PubMed

    Sisk, E R; Lockner, D W; Wold, R; Waters, D L; Baumgartner, R N

    2004-01-01

    Fortification of enriched grains with synthetic folic acid is a potential concern for the elderly population who is at higher risk for Vitamin B12 deficiency. Consuming excess amounts of naturally occurring folate or synthetic folic acid can precipitate a deficiency of Vitamin B12, resulting in neurological damage. The purpose of this study was to determine the increase in folate intake in an elderly population due to the fortification of enriched grains. Three-day diet records of 320 participants (average age 76.8 years) were evaluated for total folate intake from food and supplements before and after the fortification of enriched grains. There was a significant mean daily folate intake increase of 63.8 microg due to fortification (p < 0.0001), raising the intake of total folate to 359 microg (89.8% of RDA). Supplements containing folic acid were consumed by 66% of the participants, raising the average total folate intake of supplement users to 793 microg per day. Only 5 participants exceeded the UL of 1,000 microg folic acid per day, with all 5 of these individuals consuming more than 1,000 microg folic acid per day from supplements alone. Folic acid fortification of grains does not appear to have increased the risk of excess folic acid in this population.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed Central

    Pedersen, Agnes N.; Cederholm, Tommy

    2014-01-01

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

  14. Open versus laparoscopic approach in the treatment of abdominal emergencies in elderly population

    PubMed Central

    COCORULLO, G.; FALCO, N.; TUTINO, R.; FONTANA, T.; SCERRINO, G.; SALAMONE, G.; LICARI, L.; GULOTTA, G.

    2016-01-01

    Aim To evaluate the role of laparoscopy in the treatment of surgical emergency in old population. Patients and Methods Over-70 years-old patients submitted to emergency abdominal surgery from January 2013 to December 2014 were collected and grouped according to admission diagnoses. These accounted small bowel obstruction, colonic acute disease, appendicitis, ventral hernia, gastro-duodenal perforation, biliary disease. In each group it was analyzed the operation time (OT), the morbidity rate and the mortality rate comparing open and laparoscopic management using T-test and Chi-square test. Results 159 over 70-years-old patients underwent emergency surgery in the General and Emergency surgery Operative Unit (O.U.) of the Policlinic of Palermo. 75 patients were managed by a laparoscopic approach and 84 underwent traditional open emergency surgery. T-Test for OT and Chi-square test for morbidity rate and mortality rate showed no differences in small bowel emergencies (p=0,4; 0,250,9; p>0,95) and in gastro-duodenal perforation (p=0,9; p>0.9; p>0.95). In cholecystitis, laparoscopy group showed lower OT (T-Test: p= 0,0002) while Chi-square test for morbidity rate (0,1elderly population. PMID:27734793

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

    PubMed Central

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

    2009-01-01

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

  16. Increasing levels of restriction in pharmacoepidemiologic database studies of elderly and comparison with randomized trial results.

    PubMed

    Schneeweiss, Sebastian; Patrick, Amanda R; Stürmer, Til; Brookhart, M Alan; Avorn, Jerry; Maclure, Malcolm; Rothman, Kenneth J; Glynn, Robert J

    2007-10-01

    The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates. This article describes increasing levels of restrictions for use in pharmacoepidemiology and examines to what extent they change rate ratio estimates and reduce bias in a study of statin treatment and 1-year mortality. : The study cohort was drawn from a population of seniors age 65 years and older enrolled in both Medicare and the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE) between 1995 and 2002. We identified all users of statins during the study period and assessed the time until death within 1 year. The following progressive restrictions were applied: (1) study incident drug users only, (2) choose a comparison group most similar to the intervention group, (3) exclude patients with contraindications, (4) exclude patients with low adherence, and (5) restrict to specific high-risk/low-risk subgroups represented in randomized trails (RCTs). The basic cohort comprised 122,406 statin users, who were on average 78 years old and predominantly white (93%) and showed an unadjusted rate ratio of 0.32 for statin users. When all 5 restrictions were applied (N = 11,673), the unadjusted rate ratio had increased to 0.72. Multivariable Cox regression adjusted rate ratios increased from 0.62 [95% confidence interval (CI), 0.58-0.66] to 0.79 (95% CI, 0.60-1.03). However, after the first 3 restrictions the effect size changed little. The final estimate is similar to that obtained as a pooled estimate of 3 pravastatin RCTs in patients age 65 years and older. We argue that restrictions 1 through 4 compromised generalizability little. In our example of a large database study, restricting to incident drug users, similar comparison groups, patients without contraindication, and to adherent patients was a practical strategy, which limited the effect of confounding, as

  17. Similar reference intervals for total testosterone in healthy young and elderly men: results from the Odense Androgen Study.

    PubMed

    Frost, M; Wraae, K; Nielsen, T L; Hougaard, D M; Brixen, K; Hagen, C; Andersen, M

    2013-05-01

    Ageing in men is associated with changes in levels of sex hormones. To evaluate differences in sex hormones in young and elderly men and the significance of comorbidity and fat mass on sex hormones in elderly men. Cross-sectional. Seven hundred and eighty-three men aged 20-29 years and 600 men aged 60-74 years randomly recruited from the background population. Sex hormones and sex hormone-binding globulin (SHBG) were measured, and reference intervals were determined in healthy individuals in both groups and in elderly men stratified according to whether they were obese or lean (waist circumference ≥102 cm). Sex hormones were lower and SHBG higher in elderly men compared with the young cohort. Lower cut-offs for total testosterone (TT) in healthy, young and elderly men were similar [Lower cut-off (95% CI): Young: 11·7 (11·2-12·1) vs elderly: 11·2 (10·3-12·1) nmol/l], but lower and higher cut-offs of bioavailable testosterone (BT) and free testosterone (FT) were higher in young men. Higher levels of androgens were found in healthy elderly men compared with those with a chronic disease or obesity. Androgens were inversely associated with central fat mass (CFM), whereas SHBG was inversely and directly associated with CFM and lower extremity fat mass, respectively, in both young and elderly men. Reference intervals for TT were comparable in healthy young and elderly men, but reference intervals for FT and BT were lower in elderly men due to higher levels of SHBG. Androgens and SHBG were lower in elderly men with chronic disease and inversely associated with CFM. © 2012 Blackwell Publishing Ltd.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-01-01

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

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

    PubMed

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-08-01

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

  2. Health problems and disability of elderly individuals in two population groups from same geographical location.

    PubMed

    Medhi, G K; Hazarika, N C; Borah, P K; Mahanta, J

    2006-07-01

    To compare morbidity, disability (ADL-IADL disability) along with behavioral and biological correlates of diseases and disability of two elderly population groups (tea garden workers and urban dwellers) living in same geographical location. Two hundred and ninety three and 230 elderly from urban setting and tea garden respectively aged > 60 years were included in the study. Subjects were physical examined and activity of daily living instrumental activity of daily living (ADL-IADL) was assessed. Diagnosis of diseases was made on the basis of clinical evaluation, diagnosis and/or treatment of diseases done earlier elsewhere, available investigation reports, and electrocardiography. Hypertension was defined according to JNC-VI classification. BMI (weight/height2) was calculated. Logistic regression analysis was performed to see the impact of important background characteristics on non-communicable diseases (NCD) and disability. Hypertension (urban--68% and tea garden--81.4%), musculoskeletal diseases (urban--62.5% and tea garden--67.5%), COPD and other respiratory problems (urban--30.4% and tea garden--32.2%), cataract (urban 40.3% and tea garden--33%), gastro-intestinal problems (urban--13% and tea garden--6.5%) were more commonly observed health problems among community dwellings elderly across both the groups. However in contrast to urban group, serious NCDs like Ischaemic Heart Disease (IHD), diabetes were yet to emerge as health problems among tea garden dwellers. Infectious morbidities, undernutrition and disability (ADL-IADL disability) were more pronounced among tea garden dwellers. Utilization of health service by tea garden elderly was very low in comparison to the urban elderly. Both tea garden men and women had very high rates of risk factors like use of non-smoked tobacco and consumption of alcohol. On the other hand, smoking and obesity was more common in urban group. Most morbidities and disabilities were associated with identifiable risk factors, such

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

    PubMed Central

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

    2016-01-01

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

  4. Glucose intolerance, hyperinsulinaemia and cognitive function in a general population of elderly men.

    PubMed

    Kalmijn, S; Feskens, E J; Launer, L J; Stijnen, T; Kromhout, D

    1995-09-01

    Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95% confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04-1.46), newly-diagnosed diabetic patients of 1.16 (0.91-1.48) and subjects with impaired glucose tolerance of 1.18 (0.98-1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend = 0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03-1.50), after adjustment for confounding (p-trend = 0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment.

  5. Remote follow-up of pacemakers in a selected population of debilitated elderly patients.

    PubMed

    Folino, Antonio Franco; Breda, Roberto; Calzavara, Patrizia; Borghetti, Francesca; Comisso, Jennifer; Iliceto, Sabino; Buja, Gianfranco

    2013-03-01

    The majority of patients with pacemakers are very elderly, many being >85-years old. They often suffer from serious illnesses and have great difficulty in walking. The aim of our study was to compare remote pacemaker monitoring with in-home checks of pacemakers, in terms of applicability, efficacy, and cost in a selected population of debilitated elderly patients. We selected 72 subjects (mean age 87 ± 8 years) among elderly debilitated patients with Medtronic pacemakers, compatible with the Carelink(®) remote monitoring system (13 patients with DDD pacemaker; 59 patients with single-lead VDD pacemaker). Remote follow-up was compared with in-home checks performed by nurses in 326 patients in similar clinical conditions. A total of 190 transmissions were received by remote monitoring (mean transmissions per month: 7.0; mean per patient: 2.6; range 1-6) during 27 months of follow-up. In this period, seven pacemakers were replaced owing to battery exhaustion, after a mean of 6.7 years from implantation. The occurrence of atrial or ventricular high-rate episodes was reported in 98 transmissions (53%). Nineteen patients died (annual mortality: 11.7%). On comparing the costs borne by the hospital for in-home checks, both for medical personnel and transportation, the estimated average saving was €32 per year per patient. Our study shows that the remote follow-up of pacemakers is a reliable, effective, and cost-saving procedure in elderly, debilitated patients. Moreover, remote controls provided an accurate and early diagnosis of arrhythmia occurrence.

  6. Effects of food groups and dietary nutrients on bone loss in elderly Chinese population.

    PubMed

    Chan, R; Woo, J; Leung, J

    2011-04-01

    To examine the effects of food groups and dietary nutrients on bone loss in elderly Chinese population. Prospective cohort study. A longitudinal study started at 2001 in Hong Kong. 1225 Chinese men and 992 women aged 65 years and over in the community. Daily intake of food groups and dietary nutrients at baseline was assessed by a food frequency questionnaire. Nutrient intake was adjusted for energy intake by residual method. Linear regression was used to examine the association of BMD change and food group or energy-adjusted nutrient intake with adjustment for demographic, anthropometric, lifestyle factors, and daily energy intake (for food group only). Higher fish intake was associated with smaller bone loss in hip (B=-0.611, p=0.004) and femoral neck (B=-0.724, p=0.040) in men. None of the food groups were associated with bone loss in both measured sites in women. For men, lower intake of protein (B=-0.012, p=0.003), phosphorus (B=-0.0008, p=0.001), sodium (B=-0.0002, p=0.023) and isoflavone (B=-1.084, p=0.030) was associated with greater BMD loss in hip, whereas lower intake of protein (B=-0.018, p=0.006) and sodium (B=-0.0004, p=0.018) was associated with greater BMD loss in femoral neck. However, these significant associations disappeared after further adjustment for energy-adjusted calcium and vitamin D intakes. None of the nutrients were associated with BMD loss in both measured sites in women. Greater fish intake may help to reduce bone loss in this sample of elderly Chinese men. The significant association between various nutrients and bone loss in elderly Chinese men was likely due to the influence of dietary calcium and vitamin D intakes. The role of food groups and dietary nutrients on bone health in this sample of elderly Chinese women seems to be minimal.

  7. Urinary tract infection in elderly trauma patients: review of the Trauma Quality Improvement Program identifies the population at risk.

    PubMed

    Polites, Stephanie F; Habermann, Elizabeth B; Thomsen, Kristine M; Amr, Mahmoud A; Jenkins, Donald H; Zietlow, Scott P; Zielinski, Martin D

    2014-12-01

    Elderly trauma patients are at high risk for urinary tract infection (UTI). Despite this, UTI has been deemed a potentially preventable problem and therefore not reimbursable by the Centers for Medicare and Medicaid Services. Early identification of UTI in these patients should lead to prompt treatment, improved outcomes, and cost savings. Risk factors for UTI development in this population must be elucidated to realize these goals. The Trauma Quality Improvement Program (TQIP) database was used to analyze elderly patients (≥65 years) admitted as a result of injury during 2011. Patients with genitourinary injuries or undergoing dialysis before admission were excluded. Multivariable logistic regression analysis was conducted to identify UTI risk factors. Mean cost of UTI was calculated based on the assumption of $862 to $1,007 per UTI. In total, 33,257 patients were identified; 1,492 developed UTI (4.5%). Multiple significant risk factors were identified, including age greater than 75 years, female sex, ascites, moderate head injury, impaired sensorium, congestive heart failure, and duration of hospital stay (all p < 0.05). Assuming that UTIs diagnosed on hospital Day 1 were preexisting, the cost of UTI to TQIP hospitals ranged from $1,280,959 to $1,496,434 per year. Duration of stay has a profound impact on the development of UTIs in elderly trauma patients, but overall severity of injury does not. In addition, multiple nonmodifiable risk factors were identified, prompting the possibility for increased screening of occult UTIs. Reimbursement for care of UTI in this complicated patient population should be revisited. The TQIP database must improve urinary catheter data. Epidemiologic study, level III.

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

    PubMed Central

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

    2014-01-01

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

  9. A study of longitudinal data examining concomitance of pain and cognition in an elderly long-term care population

    PubMed Central

    Burfield, Allison H; Wan, Thomas TH; Sole, Mary Lou; Cooper, James W

    2012-01-01

    Purpose To examine if a concomitant relationship exists between cognition and pain in an elderly population residing in long-term care. Background/significance Prior research has found that cognitive load mediates interpretation of a stimulus. In the presence of decreased cognitive capacity as with dementia, the relationship between cognition and increasing pain is unknown in the elderly. Patients and methods Longitudinal cohort design. Data collected from the Minimum Data Set-Resident Assessment Instrument (MDS-RAI) from the 2001–2003 annual assessments of nursing home residents. A covariance model was used to evaluate the relationship between cognition and pain at three intervals. Results The sample included 56,494 subjects from nursing homes across the United States, with an average age of 83 ± 8.2 years. Analysis of variance scores (ANOVAs) indicated a significant effect (P < 0.01) for pain and cognition, with protected t test revealing scores decreasing significantly with these two measures. Relative stability was found for pain and cognition over time. Greater stability was found in the cognitive measure than the pain measure. Cross-legged effects observed between cognition and pain measures were inconsistent. A concomitant relationship was not found between cognition and pain. Even though the relationship was significant at the 0.01 level, the correlations were low (r ≤ 0.08), indicating a weak association between cognition and pain. Conclusion Understanding the concomitance of pain and cognition aids in defining additional frameworks to extend models to include secondary needs, contextual factors, and resident outcomes. Cognitive decline, as with organic brain diseases, is progressive. Pain is a symptom that can be treated and reduced to improve resident quality of life. However, cognition can be used to determine the most appropriate method to assess pain in the elderly, thereby improving accuracy of pain detection in this population. PMID:22536093

  10. Comparison of disease clusters in two elderly populations hospitalized in 2008 and 2010.

    PubMed

    Marengoni, A; Nobili, A; Pirali, C; Tettamanti, M; Pasina, L; Salerno, F; Corrao, S; Iorio, A; Marcucci, M; Franchi, C; Mannucci, P M

    2013-01-01

    As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Data were obtained from the multicenter 'Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. These findings strengthened the idea of an association other than by chance of diseases in the elderly population. Copyright © 2013 S. Karger AG, Basel.

  11. Prescription Patterns of Antidiabetic Treatment in the Elderly. Results from Southern Italy

    PubMed Central

    Orlando, Valentina; Guerriero, Francesca; Putignano, Daria; Monetti, Valeria M.; Tari, Daniele U.; Farina, Giuseppin; Illario, Maddalena; Iaccarino, Guido; Menditto, Enrica

    2016-01-01

    The treatment of diabetes in the elderly is a major challenge both in terms of clinical management and of public health. Evidence about prescribing patterns in the elderly diabetic population is limited. The aim was to describe trends in antidiabetic drug (AD) utilization patterns in the elderly in Southern Italy with a focus on drugs for cardiovascular prevention and pharmaceutical costs. The data used for this study were obtained from pharmacy records of Caserta Local Health Authority, a province in Southern Italy with 1 million of inhabitants, comprising urban and rural areas. Subjects above 65 years who received at least one dispensing of antidiabetic between January 2010 and December 2014 were selected. Prevalence and incidence rates (%) of AD use were calculated for each calendar year and stratified by class therapy and age group. Sub-analyses by cardiovascular co-medication therapy and pharmaceutical cost analysis were performed. The prevalence rate decreases from 22.0% in 2010 to 17.5% in 2014 (p<0.001). Proportion of subjects treated with monotherapy increases over the study period (33.9% in 2010; 38.6% in 2014; p<0.001). In particular, increases the proportion of users of metformin (18.2% in 2010; 23.7% in 2014; p<0.001), while the proportion of users of sulfonylureas dropped (11.0% in 2010; 7.2% in 2014; p< 0.001). About 90% of elderly diabetic patients are treated with drugs for cardiovascular prevention. The per/patient/yearly drug costs were 2,349 €: 28.5% for AD therapy and 71.5% for other treatments. Trend in drug utilization patterns showed a tendency towards treatment recommendations in older adults. PMID:26126718

  12. Functional disability among elderly Nigerians: results from the Ibadan Study of Ageing

    PubMed Central

    Gureje, Oye; Ogunniyi, Adesola; Kola, Lola; Afolabi, Ebenezer

    2010-01-01

    Functional disability is a common reason for loss of independence and need for informal care by elderly persons. There is little information on the profile of disability and the level of unmet need for care among elderly persons living in Sub-Sahara Africa. Using a multi-stage clustered sampling of households conducted in the Yoruba-speaking area of Nigeria (representing 22% of the national population), we assessed persons aged 65 years old and over (n = 2152) for disability in activities of daily living (ADL) and instrumental activities of daily living (IADL). Respondents were assessed for self-reports of physical health, for major depressive disorder, and for availability of informal care. The prevalence of any functional disability (defined as inability to independently perform any function) was 9.2% (s.e. 0.6). In logistic regression analysis, elevated risks of disability were associated with female gender, increasing age, and urban dwelling. Risks were also high for persons with chronic pain, those with poor self-reported overall health, and those with evidence of under nutrition. Disabled persons had poorer quality of life and were more likely to suffer from major depressive disorder. 19.8% of disabled elderly persons lacked any informal care and this unmet need for care increased the likelihood of having depression. The findings suggest a high burden of unmet need for care among a large section of disabled elderly persons in this African community undergoing demographic and social changes. Social factors relating to urbanization and poverty may be associated with both the occurrence of disability and inability to access informal care. PMID:17087709

  13. Safety and feasibility of biventricular devices reuse in general and elderly population – a single-center retrospective cohort study

    PubMed Central

    Şoşdean, Raluca; Mornoş, Cristian; Enache, Bogdan; Macarie, Răzvan I; Ianoş, Raluca; Ştefea, Ana-Maria; Pescariu, Sorin

    2015-01-01

    Introduction Cardiac resynchronization therapy (CRT) is known to have very important beneficial effects on heart failure patients. Unfortunately, biventricular implantable cardiac devices (CRT devices), through which this therapy is implemented, are very expensive and sometimes hard to achieve, especially in underdeveloped/developing economies, making this an important problem of public health. As a possible solution, CRT reuse is of great interest nowadays, but unlike simple devices, data in the literature are scarce about biventricular device reuse. Aim To address safety concerns, we aimed to analyze infection burden in the general and elderly population and also early battery depletion and generator malfunction of resterilized biventricular devices compared to new devices. Methods A cohort of 261 CRT patients (286 devices), who underwent implantation between 2000 and 2014, was retrospectively analyzed. The study group included 115 patients and 127 resterilized devices, that was divided into a subgroup of 69 elderly patients (≥60 years) and 74 devices and a subgroup of 47 younger patients (<60 years) and 53 devices, and the control group included 146 patients and 159 new devices. The groups were compared using a multivariate logistic regression model. Results A number of 12 (4.2%) infectious complications were encountered, five (3.9%) in the study group and seven (4.4%) in the control group (odds ratio, 2.83 [0.59–13.44], P=0.189), one (1.3%) in the elderly and four (7.5%) in the younger subgroup (odds ratio, 3.80 [0.36–40.30], P=0.266), with no statistically significant difference between them. There was only one case of early battery depletion, after 17 months, in one study group patient. No generator malfunction was detected. Conclusion Reuse of biventricular cardiac implantable electronics seems feasible and safe in both the general population and the elderly population, and it could be a promising alternative when new devices cannot be obtained in a

  14. Early result of hemiarthroplasty in elderly patients with fracture neck of femur

    PubMed Central

    Daniel, Mue; Mohammed, Salihu; Francis, Awonusi; William, Yongu; Joseph, Kortor; Cornilius, Elachi

    2015-01-01

    Background: Fractured neck of femur is a frequent and severe injury in elderly patients with consequent high morbidity and mortality. Hemiarthroplasty is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60 years. This study analysed the early functional outcome and complications of Austin Moore endoprosthesis in elderly patients above 60 years with fractured neck of femur. Materials and Methods: Retrospective data were obtained over a 5 year period from January 2007 to December 2012. Thirty-five elderly patients of 60 years and above with displaced intracapsular fracture neck of femur treated with hemiarthroplasty using Austin Moore endoprosthesis were included. Data were analysed using SPSS version 21. Results: A total of 35 patients were involved. The age-range was 60-90 years with mean age of 69.7 ± 7 years. The predominant mechanism of injury was trivial falls in 18 (66.7%) patients. The commonest complication was pressure sore in 2 (5.7%) patients, followed by surgical site infection in 1 (2.9%) patient and periprosthetic fracture in 1 (2.9%) patients. Early post-operative mortality was 2.9%. Post-operative hip functional status according to Postel and Merle d Aubigne revealed that majority (66.6%) of patients had satisfactory hip function. Conclusion: Functional outcome of Austin Moore in elderly patients above 60 years with fracture neck of femur was satisfactory in most of the cases with minimal morbidity. Careful patient selection for hemiarthroplasty is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures. PMID:25657497

  15. Safety of a tetanus-diphtheria-acellular pertussis vaccine when used off-label in an elderly population.

    PubMed

    Tseng, Hung Fu; Sy, Lina S; Qian, Lei; Marcy, S Michael; Jackson, Lisa A; Glanz, Jason; Nordin, Jim; Baxter, Roger; Naleway, Allison; Donahue, James; Weintraub, Eric; Jacobsen, Steven J

    2013-02-01

    Published data on the safety of tetanus-diphtheria-acellular pertussis vaccine (Tdap) in persons aged ≥65 years are limited. This study aims to examine a large cohort of Tdap users ≥65 years for evidence of increased risk of adverse events following vaccination. A matched cohort study design and a self-controlled case series (SCCS) design were used. The study population was adults aged ≥65 years who received the Tdap or tetanus and diphtheria (Td) vaccine during 1 January 2006-31 December 2010 at 7 health maintenance organizations in the United States. Seven major groups of prespecified events were identified electronically by diagnostic codes. The study included 119 573 Tdap vaccinees and the same number of Td vaccinees. The results indicated that the risk of the prespecified events following Tdap was comparable to that following Td vaccination in this elderly population. There was a small increased rate of codes suggesting medically attended inflammatory or allergic events in 1-6 days following Tdap in the SCCS analysis (incidence rate ratio, 1.59 [95% confidence interval, 1.40-1.81]). Although there is a small increased risk of medically attended inflammatory or allergic events in 1-6 days following Tdap compared to other time periods, it is no more common than that following Td. This study provides empirical safety data suggesting that immunizing adults aged ≥65 years with Tdap to reduce the risk of pertussis in the elderly and their contacts should not have untoward safety consequences.

  16. A retrospective analysis of hospital discharge records for S. pneumoniae diseases in the elderly population of Florence, Italy, 2010-2012.

    PubMed

    Bechini, Angela; Taddei, Cristina; Barchielli, Alessandro; Levi, Miriam; Tiscione, Emilia; Santini, Maria Grazia; Niccolini, Fabrizio; Mechi, Maria Teresa; Panatto, Donatella; Amicizia, Daniela; Azzari, Chiara; Bonanni, Paolo; Boccalini, Sara

    2015-01-01

    Invasive pneumococcal diseases (IPD) and community acquired pneumonia (CAP) represent two of the major causes of out-patient visits, hospital admissions and deaths in the elderly. In Tuscany (Italy), in the Local Health Unit of Florence, a project aimed at implementing an active surveillance of pneumococcal diseases in the hospitalized elderly population started in 2013. The aim of this study is to show the results of the retrospective analysis (2010-2012) on hospital discharge records (HDRs) related to diseases potentially due to S. pneumoniae, using a selection of ICD9-CM codes. All ordinary hospitalizations (primary and secondary diagnoses) of the elderly population were included (11 245 HDRs). Among a population of about 200 000 inhabitants ≥65 y, the hospitalization rate (HR) increased with increasing age and was higher in males in all age groups. Almost all hospitalizations (95%) were due to CAP, only 5% were invasive diseases. Only few cases of CAP were specified as related to S. pneumoniae, the percentage was higher in case of meningitis (100%) or septicemia (22%). In-hospital deaths over the three-year period were 1703 (case fatality rate: 15%). The risk of dying, being hospitalized for a disease potentially attributable to pneumococcus (as primary diagnosis) increased significantly with age (P < 0.001), the odds ratio (OR) per increasing age year was 1.06 (95% CI 1.05-1.07) and was higher in patients with co-existing medical conditions with respect to patients without comorbidities. Currently, an active surveillance system on S. pneumoniae diseases with the inclusion of bio-molecular tests (RT-PCR), is a key step to assess the effectiveness of the PCV13 vaccine (13-valent pneumococcal conjugate vaccine) in the elderly population after implementation of vaccination policies. The results of this study will provide the comparator baseline data for the evaluation of a possible immunization programme involving one or more cohorts of the elderly in

  17. Correlates of Death Anxiety in Elderly Persons.

    ERIC Educational Resources Information Center

    Wagner, Karen Dineen; Lorion, Raymond P.

    1984-01-01

    Studied the variables related to death anxiety in the elderly (N=122). Results indicated that death anxiety response patterns are a function of the population examined, rather than existing as general characteristics of the elderly, which explains the inconsistency of previous literature on death anxiety in elderly persons. (LLL)

  18. Correlates of Death Anxiety in Elderly Persons.

    ERIC Educational Resources Information Center

    Wagner, Karen Dineen; Lorion, Raymond P.

    1984-01-01

    Studied the variables related to death anxiety in the elderly (N=122). Results indicated that death anxiety response patterns are a function of the population examined, rather than existing as general characteristics of the elderly, which explains the inconsistency of previous literature on death anxiety in elderly persons. (LLL)

  19. Suicide mortality of young, middle-aged and elderly males and females in Japan for the years 1953-96: time series analysis for the effects of unemployment, female labour force, young and aged population, primary industry and population density.

    PubMed

    Yamasaki, Akiko; Araki, Shunichi; Sakai, Ryoji; Yokoyama, Kazuhito; Voorhees, A Scott

    2008-12-01

    Effects of nine social life indicators on age-adjusted and age-specific annual suicide mortality of male and female Japanese population in the years 1953-96 were investigated by multiple regression analysis on time series data. Unemployment rate was significantly related to the age-adjusted mortality in both males and females. Also, female labour force participation was positively related to the male mortality; persons and 65 and above was inversely related to the male mortality. Results on the age-specific mortality indicated that: during the 44 yr, (1) unemployment significantly related with the mortality of young, middle-aged and elderly males and young females; (2) female labour force participation significantly related with the mortality of young and elderly males and young females; aged population significantly related with the mortality of middle-aged and elderly males; (4) young population significantly related with the mortality of young and middle-aged males and females; (5) divorce significantly related with the mortality of middle-aged and elderly males and young males and females; (6) persons employed in primary industries significantly related with the mortality in middle-aged males and young males and females; and (7) population density significantly related with the mortality of middle-aged males and young females.

  20. The psychological impact of heavy drinking among the elderly on their co-residents: The 10/66 group population based survey in the Dominican Republic

    PubMed Central

    Nadkarni, Abhijit; Acosta, Daisy; Rodriguez, Guillermina; Prince, Martin; Ferri, Cleusa P.

    2011-01-01

    Background There is very limited literature on alcohol use among the elderly and little is known about the impact it has on family and caregivers, especially in low and middle income countries. Aim To estimate the independent effect of heavy alcohol use among the elderly on the psychological health of their co-residents. Methods This is a secondary analysis using data from the comprehensive cross-sectional survey of the 10/66 dementia research group population-based research programme in the Dominican Republic. The characteristics of the elderly participants as well as the co-residents were described. The independent association of heavy drinking among the participants with psychological morbidity in their co-residents was estimated. Different models were generated to rule out potential mediating effects of disability and behavioural symptoms. Results Prevalence of heavy alcohol use in the elderly in Dominican Republic was 10.6%. There was a statistically significant independent effect of heavy alcohol use by the elderly on their co-residents mental health (PR = 1.47; 95% CI 1.07–2.01) which was not accounted by disability (Sobel–Goodman test, p = 0.15). Severity of psychological and behavioural symptoms partially (29.1% of the total effect) explained this association (Sobel–Goodman mediation test, p = 0.006). Conclusions Health services for the elderly in low and middle income countries will have to be configured around detection of alcohol problems among the elderly as well as offering appropriate support to their co-residents. PMID:20970926

  1. Prevalence of obsessive-compulsive disorder in relation to depression and cognition in an elderly population.

    PubMed

    Klenfeldt, Isak Fredén; Karlsson, Björn; Sigström, Robert; Bäckman, Kristoffer; Waern, Margda; Östling, Svante; Gustafson, Deborah; Skoog, Ingmar

    2014-03-01

    We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population. Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women). Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV. The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample. We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union.

    PubMed

    Shields, Gemma E; Elvidge, Jamie; Davies, Linda M

    2017-06-10

    The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU. Electronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively. Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics. Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  5. Air pollution and diastolic function in elderly women - Results from the SALIA study cohort.

    PubMed

    Ohlwein, Simone; Klümper, Claudia; Vossoughi, Mohammad; Sugiri, Dorothea; Stolz, Sabine; Vierkötter, Andrea; Schikowski, Tamara; Kara, Kaffer; Germing, Alfried; Quass, Ulrich; Krämer, Ursula; Hoffmann, Barbara

    2016-07-01

    Studies linking particulate matter (PM) with heart failure (HF) show inconsistent results. However, the association of air pollution with diastolic function, an important determinant of heart failure, has not been studied yet and is addressed in the presented study. 402 women (69-79 years) of the clinical follow-up (2007-2010) of the ongoing population-based prospective SALIA (Study on the influence of Air pollution on Lung function, Inflammation and Ageing) cohort were examined using Doppler echocardiography: Of the 291 women with preserved ejection fraction, the ratio of peak early diastolic filling velocity and peak early diastolic mitral annulus velocity (E/E') was collected in 264 and left atrial volume index (LAVI) in 262 women. Residential long-term air pollution exposure (nitrogen oxides, size-fractioned PM) was modeled at baseline and at follow-up, applying land use regression models. We used linear regression to model the cross-sectional associations of air pollutants per interquartile range (IQR) with different measures of diastolic function, adjusting for personal risk factors. Median concentrations of annual NOx, NO2, PM2.5, and PM10 at follow-up were 37.7, 25.9, 17.4 and 26.4μg/m(3), respectively. In the fully adjusted models, LAVI was associated with an IQR increase in PM2.5 (1.05 [0.99; 1.12]) and NOx (1.04 [1.00; 1.09]) at follow-up, and with NOx and NO2 (both 1.05 [1.00; 1.11]) at baseline. None of the pollutants were clearly associated with E/E'. In this analysis of elderly women, we found suggestive evidence for an association of air pollution with impaired diastolic function. Copyright © 2016. Published by Elsevier GmbH.

  6. Loneliness among very old Mexican Americans: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly.

    PubMed

    Gerst-Emerson, Kerstin; Shovali, Tamar E; Markides, Kyriakos S

    2014-01-01

    Increasing numbers of researchers are finding that loneliness is a significant risk factor for morbidity and mortality, and several variables have been found to be closely related to the experience of loneliness among elders. However, much of the research has focused on the general older population, with no research to date focusing on minority populations. The objective of this study was to determine the prevalence and the correlates of loneliness among a community-dwelling older Mexican American population. This study used a three-item loneliness scale to determine the prevalence of loneliness. Pearson's correlation and linear regression analyses were used to determine the cross-sectional association between sociodemographic, interpersonal relationship and health variables with the scale. Data used came from the most recent wave (2011) of the Hispanic Established Populations for the Epidemiological Study of the Elderly (H-EPESE). A total of 873 Mexican Americans completed the loneliness scale. The age range was from 80 to 102, with a majority (65%) female. The mean score on the scale was 4.05 (range 3-9), indicating relatively low levels of loneliness. Regression results indicate that depressive symptoms, cognitive status, and living alone were significantly associated with higher loneliness scores. Being married and having a confidante were significantly associated with lower loneliness. Age, number of close relatives and frequency of contact were not associated with loneliness. Findings suggest that among community-dwelling Mexican American older adults, loneliness has multiple determinants. Loneliness is a significant public health topic and clinicians should be aware of the various factors that can affect loneliness.

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

    PubMed Central

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

    2002-01-01

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

  8. The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population.

    PubMed

    Woo, J; Ho, S C; Lau, J; Yuen, Y K; Chiu, H; Lee, H C; Chi, I

    1994-01-01

    In a survey of elderly Chinese aged 70 years and over living in Hong Kong selected by stratified random sampling, the prevalence of depression was determined using the 15-item Geriatric Depression Scale using a cut-off point of 8 (sensitivity 96.3% and specificity 87.5% for this population). Subjects with moderate to severe cognitive impairment (CAPE I/O score < or = 7) were excluded. There were 877 men and 734 women. The adjusted overall prevalence for this population was 29.2% for men and 41.1% for women. The prevalence increased with age in men and was higher in women than in men. Univariate analysis identified many factors in the following areas that were associated with depression: socioeconomic characteristics, functional ability, physical health and social support. Stepwise logistic regression identified 16 factors predictive of depression: socioeconomic characteristics, such as borderline living expenses and dissatisfaction with living arrangement; poor social support, such as absence of an informal carer when ill, few relatives to turn to, and infrequent contact with neighbours and friends; functional disability, as indicated by a Barthel Index < 15, urinary incontinence and inability to do housework; and poor physical health--poor self perceived health, poor vision, difficulty with chewing, history of mental illness, frequent hospital admissions and increased level of symptoms such as poor memory, constipation and dizziness. Some of these factors may be amenable to intervention, and such measures may be important in reducing the high prevalence of depression in elderly people.

  9. Dental caries: risk assessment and treatment solutions for an elderly population.

    PubMed

    Anusavice, Kenneth J

    2002-10-01

    Caries remains one of the top three most common infectious diseases in the world today. Although caries prevalence decreased markedly in children and in adults up to age 40 between 1975 and 2000, the overall risk for caries in older age groups (45 to 64, 65 to 84, and > 85 years of age) has not decreased appreciably. In fact, the risk for caries in individuals 70 years of age and older has increased. The increase in restorative work needed between 1990 and 2030 will be highest in adults over the age of 44 years. Root caries prevalence and the number of restored teeth will be greatest in the elderly population. Approximately 30% of individuals over the age of 65 will have no permanent teeth. It is also apparent that additional caries risk factors are associated with a significant proportion of the older population, including reduced saliva flow, inadequate oral hygiene, frequent sugar intake, Asian ethnicity, and the presence of partial dentures. The principles of modern caries management focus on risk assessment, risk reduction, monitoring noncavitated carious lesions, and the assignment of specific treatment options according to risk. Because a relatively high proportion of elderly patients will remain at high risk for caries, therapeutic regimens for managing caries as an infectious disease must focus on the use of antibacterial treatment; high-fluoride dentifrices; supplementary low-dose, high-frequency fluoride rinses; patient education; and shorter recall intervals.

  10. Prevalence of oral mucosal lesions in an elderly population in the city of Valparaiso, Chile.

    PubMed

    Cueto, Alfredo; Martínez, René; Niklander, Sven; Deichler, Javiera; Barraza, Alan; Esguep, Alfredo

    2013-09-01

    Chilean population is ageing, which means an increase in the prevalence of multiple pathologies, including those located in the oral cavity. To measure the prevalence and distribution of oral mucosal lesions and to identify associated risk factors in elderly patients in the city of Valparaiso. This study includes 126 patients over 60 years. The sample was calculated with a sampling error of 3.7% from a population size of 6000 file cards. Frequency and contingency tables were made together with odds ratios, with a confidence interval of 95%. Finally, we built a predictive model based on a binary logistic regression. From the whole sample, 85 patients (67.5%) had some oral mucosal lesion. The most frequent lesions were denture-induced stomatitis (37.1%). It was noted that there is a statistically significant association between the use of denture and the presence of oral candidiasis. The consumption of drugs and the use of denture increase the likelihood of having oral mucosal lesions. There is a high prevalence of oral lesions in the elderly patients of Valparaiso. The use of drugs and /or denture increases significantly the likelihood that a person over 60 years presents lesions in the oral mucosa. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  11. Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the National Health Insurance claims data

    PubMed Central

    2010-01-01

    Background The lack of epidemiologic information on osteoporotic hip fractures hampers the development of preventive or curative measures against osteoporosis in South Korea. We conducted a population-based study to estimate the annual incidence of hip fractures. Also, we examined factors associated with post-fracture mortality among Korean elderly to evaluate the impact of osteoporosis on our society and to identify high-risk populations. Methods The Korean National Health Insurance (NHI) claims database was used to identify the incidence of hip fractures, defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation during 2003. The 6-month period prior to 2003 was set as a 'window period,' such that patients were defined as incident cases only if their first record of fracture was observed after the window period. Cox's proportional hazards model was used to investigate the relationship between survival time and baseline patient and provider characteristics available from the NHI data. Results The age-standardized annual incidence rate of hip fractures requiring operation over 50 years of age was 146.38 per 100,000 women and 61.72 per 100,000 men, yielding a female to male ratio of 2.37. The 1-year mortality was 16.55%, which is 2.85 times higher than the mortality rate for the general population (5.8%) in this age group. The risk of post-fracture mortality at one year is significantly higher for males and for persons having lower socioeconomic status, living in places other than the capital city, not taking anti-osteoporosis pharmacologic therapy following fracture, or receiving fracture-associated operations from more advanced hospitals such as general or tertiary hospitals. Conclusion This national epidemiological study will help raise awareness of osteoporotic hip fractures among the elderly population and hopefully motivate public health policy makers to develop effective national prevention strategies

  12. Evaluation of dental care and the prevalence of tooth decay among middle-aged and elderly population of Kaunas city.

    PubMed

    Zubiene, Jurate; Milciuviene, Simona; Klumbiene, Jurate

    2009-01-01

    The aim of the study was to evaluate the prevalence and the intensity of tooth decay among the middle-aged and elderly population of Kaunas, city, and to assess the need for prostheses as well as the possibilities for oral care. During 2006-2008, we studied 1,141 inhabitants of Kaunas city; the subjects' age was 45-72 years. Oral evaluation technique proposed by the WHO was used in the investigation. We evaluated the prevalence of tooth decay, and its intensity was evaluated using the DMF-T index. We also evaluated dental prostheses, the need for prosthetics, and asked the subjects how they took care of their oral health. The prevalence of tooth decay among middle-aged and elderly population of Kaunas city was 99.9%. The DMF-T index was 21.01+/-0.3 in the age group of 45-54 years, 23.52+/-0.4 - in the age group of 55-64 years, and 25.63+/-0.3 - in the elderly subjects. Full removable dentures were found in 14.0% of the elderly subjects, while 1.0% of the middle-aged subjects and 1.2% of the elderly subjects required full dentures. 57.7% of the subjects aged 45-54 years, 53.1% of the subjects aged 55-64 years, and 43.4% of the elderly subjects brushed their teeth twice daily. The intensity of tooth decay in middle-aged and elderly population of Kaunas city significantly increased with age (21.01-25.63). A relationship was found between oral hygiene status and the DMF-T index. In the middle-aged and elderly population of Kaunas city, the intensity of tooth decay was significantly lower (DMF-T 23.04%) among those who brushed their teeth twice daily than among those who brushed their teeth once daily or less frequently (DMF-T 24.01%). Reduction of the prevalence of tooth decay among middle-aged and elderly population of Kaunas city necessitates alterations in people's attitudes towards dental care, implementation of suitable hygiene habits, and creation and implementation of the dental disease prevention program for adults and the elderly, based on the strategy

  13. Processing of population census results, by settlements.

    PubMed

    Anderle, A

    1983-01-01

    In Czechoslovakia, the census bureau began compiling population statistics by settlements, a term equivalent to localities, in 1970 and 1980. The 1980 census further elaborated data by settlement unit, or ward. During data processing, each individual settlement received a code. Settlement statistics available for 1980 include population structure, housing, service facilities, environment, and agricultural and forest land stock. Compiling statistics by settlement works much better than the old method of compiling statistics by commune, with its problems of instability. Settlements, which are not territorial or administrative units, cover very small as well as large and medium-sized towns. As of 1980, Czechoslovakia contains 21,199 settlements, 15,291 in the Czech Socialist Republic and 5908 in the Slovak Socilaist Republic, a relatively dense network of settlements. 20,204 settlements, however, contain fewer than 2000 permanent residents, 825 have 2000-10,000 inhabitants, and 172 have more than 10,000 residents. This dense pattern of small towns was already established in the Middle Ages. Now, however, even residents of very small towns often work in larger settlements and commute to their jobs. The standard of living in the very small settlements is often higher than that of larger settlements. These differences are not changing but have remained the same over time.

  14. [Health related quality of life of the elderly population in a rural and urban area of Peru].

    PubMed

    Hernandez-Huayta, Jean; Chavez-Meneses, Sofía; Carreazo, Nilton Yhuri

    2016-01-01

    To assess the health related quality of life in a sample of elderly population in a rural and urban Peruvian area. A cross-sectional study was performed in elderly population from four rural districts and one urban from the period October 2014 to January 2016. The association between the area of residence and five sociodemographic variables was assessed with the chi square test. Using the Wilcoxon rank sum test and assessing size effect, WHOQoL-OLD and WHOQoL-BREF domain scores and global score of the former obtained in the survey were measured and compared. Then, simple and multiple regressions were performed to adjust values to the sociodemographic differences. A total of 447 elderly people were surveyed with a mean age of 69 (DE=6,46), 207 from the rural area, most of whom worked and had less years of education.. The elderly population from the rural area had a higher quality of life in the domains "Physical", "Psychological" and "Environment" from WHOQoL-BREF and in "Sensory abilities", "Autonomy", "Past, Present and Future Activities", "Social participation" and the total score from WHOQoL-OLD, while those from the urban area only had a higher quality of life in "Intimacy". The area of residency exerts a differential effect on the distinct domains of health related quality of life in the evaluated elderly population.

  15. The health and functional status of US veterans aged 65+: implications for VA health programs serving an elderly, diverse veteran population.

    PubMed

    Villa, Valentine M; Harada, Nancy D; Washington, Donna; Damron-Rodriguez, JoAnn

    2003-01-01

    As the US population is aging, so too is the US veteran population. Chief among the challenges facing the Department of Veterans Affairs (VA) is developing health programs and services that mesh with the needs of an aging veteran population and therefore improve the health status of elderly veterans. Meeting this challenge requires an understanding of the health needs of the older veteran population, including health disparities that exist across racial ethnic populations. This study examines the self-rated health and functioning of a national sample of veterans aged 65+ participating in the National Survey of Veterans. The results show that over one half of elderly veterans report difficulty in functioning and rate their health status as fair or poor. Additionally, elderly African American and Hispanic veterans report worse health than non-Hispanic white veterans across the majority of health indicators. Given the health profile of older veterans found in this study, it would seem necessary that programs serving older veterans be adept at the ongoing medical management of chronic disease and the provision of long-term care services.

  16. The Social Breakdown syndrome in the elderly population living in the community: the Helping Study.

    PubMed

    Radebaugh, T S; Hooper, F J; Gruenberg, E M

    1987-09-01

    A representative sample of elderly people residing in the community was examined to establish their psychiatric status. An interview with a close friend or relative, focusing on a one-week period in 1981, was used to investigate each subject's functional limitations and troublesome behaviour, these being the two components of the Social Breakdown Syndrome. The data from the sample were weighted to allow estimates of the characteristics of the general population. No cases of SBS at its most extreme were identified, and almost the entire population was found to be functioning at an adequate or near-adequate level: all cases of severe SBS were attributable to troublesome behaviour. Severe SBS was shown to increase with age and to be most common in non-white males. Persons with dementing disorders were more likely than their non-demented counterparts to show severe/moderate SBS, but in the majority of cases of SBS there was no mental disorder.

  17. Prevalence and correlates of elder mistreatment in a community-dwelling population of U.S. Chinese older adults.

    PubMed

    Dong, XinQi; Chen, Ruijia; Fulmer, Terry; Simon, Melissa A

    2014-10-01

    This study aimed to examine the prevalence and correlates of elder mistreatment among U.S. Chinese older adults. Data were drawn from the Population-Based Study of ChINese Elderly (PINE) study, a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area. The study design was guided by a community-based participatory research approach. This study found a prevalence of 15.0% for elder mistreatment among community-dwelling Chinese older adults. In addition, higher levels of education (r = .16, p< .001), fewer children (r = .1, p< .001), lower health status (r = .11, p< .001), poorer quality of life (r = .05, p< .01), and worsening health over the past year (r = .08, p< .001) were positively correlated with any elder mistreatment. Elder mistreatment is prevalent among U.S. Chinese older adults. The findings point to a pressing need for researchers, community service workers, health care providers, and policy makers to increase efforts on reducing elder mistreatment in U.S. Chinese communities. © The Author(s) 2014.

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

    PubMed Central

    Avvenuti, Marco

    2014-01-01

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

  19. Lumbar discal herniation in the elderly: long-term results of chymopapain chemonucleolysis.

    PubMed

    Benoist, M; Parent, H; Nizard, M; Lassale, B; Deburge, A

    1993-10-01

    Very few reports in the literature have dealt with lumbar disc herniation in the elderly and its treatment by chymopapain chemonucleolysis. Between September 1981 and May 1991, 42 patients aged between 60 and 80 years were treated by chemonucleolysis for lumbar disc herniation. The clinical symptoms and signs, similar to those observed in younger patients, were well correlated with a clear picture of discal herniation on the CT scan without any associated stenosis. At the last follow-up (mean 4.5 years) satisfactory results were obtained in 78% of the patients. No complication were observed. It is concluded that in the rare cases of discal herniation in the elderly, chymopapain chemonucleolysis should be considered as a safe and efficacious alternative to surgery.

  20. Different associations of apolipoprotein E polymorphism with metabolic syndrome by sex in an elderly Chinese population.

    PubMed

    Tao, Meng Hua; Liu, Jian Wei; LaMonte, Michael J; Liu, Jing; Wang, Lei; He, Yao; Li, Xiao Ying; Wang, Lu Ning; Ye, Ling

    2011-10-01

    The metabolic syndrome (MetS) is characterized by a cluster of metabolic disorders including abnormal lipid and lipoprotein metabolism. Apolipoprotein E (ApoE) is involved in the regulation of the metabolism of cholesterol, lipoproteins, and triglycerides. The common ApoE polymorphism has been found to be associated with cardiovascular disease and diabetes. This study evaluated the ApoE genetic polymorphism and its relation to MetS defined by the modified National Cholesterol Education Program and International Diabetes Federation criteria in a population-based cross-sectional survey of an elderly Chinese population in Beijing, China. Genotypes of 937 men and 1385 women were included in the study. All participants were measured for blood pressure, anthropometric measurements, and fasting concentrations of glucose, triglycerides, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. We applied a logistic regression model to derive adjusted odds ratios (ORs) and their 95% confidence intervals. In this Chinese population, the ɛ2, ɛ3, and ɛ4 allele frequencies were 8.3%, 83.4%, and 8.3% for men and 8.7%, 82.9%, and 8.4% for women, respectively. In men, concentrations of fasting triglycerides were higher among the APOE2 and E4 subjects; and a lower level of high-density lipoprotein cholesterol was observed in the APOE4 group. There were approximately linear associations of low-density lipoprotein cholesterol levels with APOE genotype groups in both men and women. We observed that the ɛ4 allele was associated with a significantly increased OR of MetS defined by the modified National Cholesterol Education Program criteria in men (OR, 1.75; 95% confidence interval, 1.17-2.63). In summary, our data show that common polymorphism of ApoE gene is associated with the presence of MetS in an elderly Chinese population. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

    PubMed

    Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

    2017-06-01

    Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

  2. Dependence of the Geriatric Depression on Nutritional Status and Anthropometric Indices in Elderly Population

    PubMed Central

    Ahmadi, Seyed Mehdi; Mohammadi, Mohammad Reza; Mostafavi, Seyed-Ali; Keshavarzi, Sareh; Kooshesh, Seyed-Mohammad-Ali; Sarikhani, Yaser; Peimani, Payam; Heydari, Seyed Taghi; Lankarani, Kamran Bagheri

    2013-01-01

    Objective Malnutrition and depression are highly prevalent in the elderly and can lead to unfavorable outcomes. The aims of the current study were to determine the association between malnutrition and depression and also to find any correlation of depression with some anthropometric indices in free living elderly. Method In this cross-sectional study, 337 elderly subjects (193 females) were selected using cluster sampling. Depressive symptoms and nutritional status were determined by the Geriatric Depression Scale (GDS) and the Mini-Nutritional Assessment (MNA) scores questionnaires, respectively. Anthropometric indices were measured all in standard situations. Chi squared test and t-test were used when necessary. Pearson correlation coefficients were calculated for linear relations between variables. Results Of all the total subjects, 43.62% were depressed; and of whom, 48.01% were malnourished or at risk of malnutrition. GDS had a significant negative dependence with the MNA for the entire sample (r=-0.58, p <0.0001). However, there was no significant correlation between age and GDS or MNA scores. Moreover, the mean GDS scores differed significantly between men and women (p <0.05), and women were more depressed than men (27.9% vs. 15%, respectively). The elderly subjects living in urban areas were more depressed than those living in rural areas (39.46% vs. 3.85% respectively). Conclusion The results of the present study revealed a high prevalence of depression and malnutrition among old subjects. Moreover, depression was associated with worsening of nutritional status. The mechanism of this association needs further study. PMID:24130608

  3. Therapeutic results in elderly patients with prostate cancer: chronological comparison in a single community hospital

    PubMed Central

    Okamura, Takehiko; Akita, Hidetoshi; Yamada, Kenji; Kobayashi, Daichi; Hirose, Yasuhiko; Kobayashi, Takahiro; Tanaka, Yutaro; Naiki, Taku; Yasui, Takahiro

    2016-01-01

    Objective: There are few reports of the long-term outcomes of elderly patients with prostate cancer. We analyzed data from our institution from the past 12 years, including the patient history, treatment methods, and prognosis of patients with prostate cancer aged 80 years or more. Patients and Methods: A total of 179 cases of prostate cancer in patients aged 80 years or more were retrospectively evaluated. We divided them chronologically into groups A, B, C, and D: Group A included 40 cases from 2002–2004; Group B, 48 cases from 2005–2007; Group C, 46 cases from 2008–2010; and Group D, 45 cases from 2011–2013. Results: Sixty-one (30%) patients changed treatment course. Interestingly, no cancer deaths occurred in the patients who changed treatment course. Although 14 (7.8%) cancer deaths occurred (A: B: C: D = 4: 4: 6: 0, respectively), all occurred in 2011 or later. Conclusion: In our study, over 50 patients who underwent treatment survived for 5 years or more. By treating prostate cancer in elderly patients when appropriate, we can lower the mortality rate due to prostate cancer. Our results support the active treatment of prostate cancer in elderly patients. PMID:27928457

  4. Persistence with antihypertensives in uncomplicated treatment-naïve very elderly patients: a nationwide population-based study.

    PubMed

    Choi, Kyung Hee; Yu, Yun Mi; Ah, Young-Mi; Chang, Min Jung; Lee, Ju-Yeun

    2017-08-24

    Limited studies have evaluated the medication-taking behavior in very elderly hypertensive patients. The aim of this study was to evaluate the persistence and adherence with antihypertensive agents in treatment-naïve patients, along with other related factors, according to age. Adult (19-64 years), elderly (65-79 years), and very elderly (≥80 years) uncomplicated hypertensive patients starting antihypertensive monotherapy were identified from the National Health Insurance claims database. The first-year treatment persistence and adherence rates measured using the medication possession ratio were assessed and compared in these three age cohorts. After propensity score matching, three age cohorts with 6689 patients each were assembled from 228,925 uncomplicated hypertensive patients who began antihypertensive monotherapy in 2012. The treatment persistence and adherence rates over the first year were the lowest in the very elderly (59.5% and 62.8%, respectively) and highest in the elderly (65.2% and 67.9%, respectively) patients among the three age cohorts (p < 0.001). The adjusted risk for treatment non-persistence was significantly higher in the very elderly (adjusted hazard ratio, 1.20; 95% confidence interval, 1.13-1.27) compared with the elderly. Having more comorbidities, being a beneficiary of medical aid, and having a diagnosis of dementia were unique positive predictors for treatment persistence in the very elderly, along with common predictors such as female sex, dyslipidemia, and an initially chosen antihypertensive therapeutic class other than beta blockers and thiazide diuretics. Very elderly patients were less likely to continue antihypertensive therapy over the first year compared with their younger counterparts. Our findings suggest that a low comorbidity index and lack of medical aid support negatively affect the treatment persistence in this population.

  5. Elder-clowning in long-term dementia care: Results of a pilot study

    PubMed Central

    Kontos, Pia; Miller, Karen-Lee; Colobong, Romeo; Lazgare, Luis Ivan Palma; Binns, Malcolm; Low, Lee-Fay; Surr, Claire; Naglie, Gary

    2016-01-01

    Objectives To assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer’s type. Design Before-after study. Setting Nursing home. Participants Twenty-three nursing home residents with moderate to severe BPSD defined by the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of ≥10, and their care aides. Intervention A pair of elder-clowns visited all residents twice weekly (approximately 10 minutes per visit) for 12 weeks. They utilized improvisation, humor and empathy, as well as expressive modalities such as song, musical instruments, and dance to individualize resident engagement. Measurements Primary outcomes were BPSD measured by the NPI-NH, quality of life measured by Dementia Care Mapping (DCM), and nursing burden of care measured by the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes included occupational disruptiveness measured by the NPI-NH, agitation measured by the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use. Results Over 12 weeks, NPI-NH scores significantly declined (t22 = −2.68, p = 0.01) and DCM quality of life scores significantly improved (F1,50 = 23.09, p < 0.001). CMAI agitation scores decreased nominally, but was not statistically significant (t22 = −1.86, p = 0.07). The occupational disruptiveness score significantly improved (t22 = −2.58, p = 0.02), yet there was no appreciable change in M-NCAS scores of staff burden of care. Conclusion Results suggest that elder-clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer’s type. Elder-clowning is a promising intervention that may improve Alzheimer’s dementia care for nursing home residents. PMID:26889843

  6. [Pneumonia in the elderly population over 70 years with limited functional condition: case-control study of institutionalized patients].

    PubMed

    Serra Sanchis, B; Martínez Moragón, E; Aguar, M; Fernández Fabrellas, E; Sanz, F; Blanquer, J

    2007-12-01

    Community acquired pneumonia (CAP) of the elderly is an increasingly important growing health problem due to its prevalence and mortality. Among the factors that are usually related with poor evolution are advanced age, poor functional status and coming from a socio-health care institution such as residential homes for the elderly. In this study, we have chosen a population over 70 years of age with limited functional capacity (Barthel Index < 50) in order to know if coming from a residential home for the elderly is an isolated factor that is associated to worse prognosis of CAP. We selected 87 patients over 70 years from a prospective and multicenter study of the hospitalized CAPs during one year. We analyzed the evolution and course of the CAP based on place or origin and then conducted a case-control study of the elderly over 70 years with the Barthel under 50, including 21 elderly from residences and 21 from the own home. In elderly patients over 70 years with CAP, those coming from the residence have a confusional picture more often and come to emergency with lower values of systolic and diastolic blood pressure, lower arterial oxygen saturation, greater involvement on the x-ray, Fine Index is worse and die more often. When we limit the population to those over 70 years with Barthel under 50, we do not find differences in institutionalized patients versus the others. In the elderly over 70 years with CAP, patients from assisted living residences have greater mortality. However, when functional capacity is bad (Barthel < 50), place or origin (community or elderly residence) loses importance and becomes a variable that has no more influence than others in the clinical evolution and course of the CAP.

  7. Trends in hospital and intensive care admissions in the Netherlands attributable to the very elderly in an ageing population.

    PubMed

    Haas, Lenneke E M; Karakus, Attila; Holman, Rebecca; Cihangir, Sezgin; Reidinga, Auke C; de Keizer, Nicolette F

    2015-09-30

    The Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly. We present data on the percentage of the very elderly in the general population and the percentage of hospital admissions attributable to the very elderly. We subsequently performed a longitudinal cross-sectional study on ICU admissions from hospitals participating in the National Intensive Care Evaluation registry for the period 2005 to 2014. We modeled the percentage of adult ICU admissions and treatment days attributable to the very elderly separately for ICU admissions following cardiac surgery and other reasons. The percentage of Dutch adults aged 80 years and older, increased from 4.5 % in 2005 to 5.4 % in 2014 (p-value < 0.0001) and with this ageing of the population, the percentage of hospital admissions attributable to very elderly increased from 9.0 % in 2005 to 10.6 % in 2014 (p-value < 0.0001). The percentage of ICU admissions following cardiac surgery attributable to the very elderly increased from 6.7 % in 2005 to 11.0 % in 2014 in nine hospitals (p-value < 0.0001), while the percentage of treatment days attributable to this group rose from 8.6 % in 2005 to 11.7 % in 2014 (p-value = 0.0157). In contrast, the percentage of very elderly patients admitted to the ICU for other reasons than following cardiac surgery remained stable at 13.8 % between 2005 and 2014 in 33 hospitals (p-value = 0.1315). The number of treatment days attributable to the very elderly rose from 11,810 in 2005 to 15,234 in 2014 (p-value = 0.0002), but the percentage of ICU treatment days attributable to this group remained stable at 12.0 % (p-value = 0.1429). As in many European countries the Dutch population is ageing and the percentage of hospital admissions attributable to the very elderly rose between 2005 and 2014. However, the percentage

  8. Chronic Sinusitis and Risk of Head and Neck Cancer in the US Elderly Population.

    PubMed

    Beachler, Daniel C; Engels, Eric A

    2017-01-01

    Chronic sinusitis may be involved in the etiology of certain head and neck cancers (HNCs), due to immunodeficiency or inflammation. However, the risk of specific HNCs among people with chronic sinusitis is largely unknown. To evaluate the associations of chronic sinusitis with subsequent HNC, including nasopharyngeal cancer (NPC), human papillomavirus-related oropharyngeal cancer (HPV-OPC), and nasal cavity and paranasal sinus cancer (NCPSC), in an elderly US population. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to conduct a case-cohort study of US individuals aged 65 years or older during 2004 through 2011. The study included 483 546 Medicare beneficiaries from SEER areas in a 5% random subcohort, and 826 436 from the entire source population who developed cancer (including 21 716 with HNC). Incidence of HNCs including NPC, HPV-OPC, and NCPSC. Most individuals were female (57.7%), and the mean (SD) age at entry was 72.6 (8.0) years. Chronic sinusitis was associated with risk of developing HNC (adjusted hazard ratio [aHR], 1.37; 95% CI, 1.27-1.48), particularly NPC (aHR, 3.71; 95% CI, 2.75-5.02), HPV-OPC (aHR, 1.33; 95% CI, 1.13-1.57), and NCPSC (aHR, 5.49; 95% CI, 4.56-6.62). Most of this increased risk was limited to risk within 1 year of the chronic sinusitis diagnosis, as associations were largely attenuated 1 year or more after chronic sinusitis (NPC: aHR, 1.60; 95% CI, 0.96-2.65; HPV-OPC: aHR, 1.07; 95% CI, 0.86-1.32; NCPSC: aHR, 2.47; 95% CI, 1.84-3.31). All 3 HNC subtypes had cumulative incidence of less than 0.07% 8 years after chronic sinusitis diagnosis. Chronic sinusitis is associated with certain HNCs, particularly NPC and NCPSC. These HNCs are rare, and most of the increased HNC risk is limited to within 1 year of chronic sinusitis diagnosis, consistent with surveillance or detection bias. The associations were weaker over longer intervals, suggesting at most a modest role for sinusitis-related inflammation

  9. Plasma copper/zinc ratio: an inflammatory/nutritional biomarker as predictor of all-cause mortality in elderly population.

    PubMed

    Malavolta, Marco; Giacconi, Robertina; Piacenza, Francesco; Santarelli, Lory; Cipriano, Catia; Costarelli, Laura; Tesei, Silvia; Pierpaoli, Sara; Basso, Andrea; Galeazzi, Roberta; Lattanzio, Fabrizia; Mocchegiani, Eugenio

    2010-06-01

    Associations have been reported between plasma Cu and Zn levels and the incidence of the most important age-related diseases. Previously proposed methods of using plasma Cu/Zn as a predictor of all-cause mortality have been derived from populations in which old and very old subjects were underrepresented. The purpose of this paper is to estimate the usefulness of plasma Cu/Zn as a sensitive biomarker of harmful inflammatory or nutritional changes in the elderly and its incremental prognostic utility as a predictor of all-cause mortality in a functionally independent elderly Italian cohort. The association between plasma Cu/Zn and inflammatory (CRP, ESR, IL-6) or nutritional (albumin, BMI) markers was studied in 498 elderly subjects. Blood samples were taken from 164 healthy 20- to 60-year-old volunteer controls. A 3.5 years prospective follow-up study of mortality by age-related diseases was performed in n = 218 over 70-year-olds. Plasma Cu/Zn ratio was associated with all the inflammatory markers studied, as well as with serum albumin, and predicted 3.5 years mortality in subjects over 70. Plasma Cu/Zn was higher in women than men and increased with advancing age. Subjects with stable cardiovascular disease (CVD) displayed higher plasma Cu/Zn than those without, due mainly to increased plasma Cu. However, most of the age-related changes of Cu/Zn resulted from a progressive decline of plasma Zn. Cu/Zn ratio may be considered an important clinical inflammatory-nutritional biomarker as well as a significant predictor of all-cause mortality in over 70-year-olds.

  10. Blood mercury concentrations are associated with decline in liver function in an elderly population: a panel study.

    PubMed

    Lee, Mee-Ri; Lim, Youn-Hee; Lee, Bo-Eun; Hong, Yun-Chul

    2017-03-04

    Mercury is a toxic heavy metal and is known to affect many diseases. However, few studies have examined the effects of mercury exposure on liver function in the general population. We examined the association between blood mercury concentrations and liver enzyme levels in the elderly. We included 560 elderly participants (60 years or older) who were recruited from 2008 to 2010 and followed up to 2014. Subjects visited a community welfare center and underwent a medical examination and measurement of mercury levels up to five times. Analyses using generalized estimating equations model were performed after adjusting for age, sex, education, overweight, alcohol consumption, smoking, regular exercise, high-density lipoproteins cholesterol, and total calorie intake. Additionally, we estimated interaction effects of alcohol consumption with mercury and mediation effect of oxidative stress in the relationship between mercury levels and liver function. The geometric mean (95% confidence interval (CI)) of blood mercury concentrations was 2.81 μg/L (2.73, 2.89). Significant relationships were observed between blood mercury concentrations and the level of liver enzymes, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT), after adjusting for potential confounders (P < 0.05). The odds ratios of having abnormal ALT levels were statistically significant in the highest mercury quartile compared to those with the lowest quartile. Particularly, regular alcohol drinkers showed greater effect estimates of mercury on the liver function than non-drinkers groups. There was no mediation effect of oxidative stress in the relationship between blood mercury concentrations and liver function. Our results suggest that blood mercury levels are associated with elevated liver enzymes and interact with alcohol consumption for the association in the elderly.

  11. Examination of useful items for the assessment of fall risk in the community-dwelling elderly Japanese population.

    PubMed

    Demura, Shinichi; Sato, Susumu; Yokoya, Tomohisa; Sato, Toshiro

    2010-05-01

    The aim of this study was to select useful items for assessing fall risk in healthy elderly Japanese individuals. A total of 965 healthy elderly Japanese subjects aged ≥60 years (349 males 70.4 ± 7.1 years, 616 females 69.9 ± 7.1 years) participated in this study. Of these, 16.6% had suffered from a previous fall. We assumed five fall risk factors: symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character. Eighty-six items were selected to represent these factors. To confirm the component items for each risk factor, we performed factor analysis (principle factor solution and varimax rotation). The high-fall risk response rate was also calculated for each item, and significant differences in this rate were examined between groups of those who had and not had experienced a fall. Useful items were selected using the following criteria: (1) items showing a significant difference in high fall risk response rate between faller and non-faller groups were selected as useful items; (2) items showing low factor loading (<0.4) for any factor were deleted as inappropriate items; (3) the top two items showing a greater amount of the difference in high fall risk response rate among the representative items for each factor. A total of 50 items were selected from each fall risk factor (symptoms of falling, 3 items; physical function, 22 items; disease and physical symptom, 13 items; environment, 4 items; behavior and character, 8 items). Based on our results, the selected items can comprehensively assess the fall risk of a healthy elderly Japanese population. In addition, the assessment items for physical function comprised items of different levels of difficulty, and these are able to gradually and comprehensively assess physical function.

  12. [The Goblets test: Norms in the elderly population and properties in the detection of cognitive impairment in elderly individuals selected from the general population].

    PubMed

    Mokri, H; Matharan, F; Pérès, K; Bouisson, J; Dartigues, J-F; Amieva, H; Dubois, B

    2013-11-01

    Most current tools exploring visuospatial memory abilities are poorly adapted to the elderly population. The Goblets test allows a brief evaluation of visuospatial memory abilities through an encoding phase in which the participant has to learn a particular sequence and a further delayed recall phase. The aim of the present work was to produce normative scores for this test and to study its properties in the detection of dementia. Data were collected in a sample of 1002 agricultural retirees aged 65 years and over included in the AMI study, a population-based cohort study conducted in Gironde (southwestern France). The sample analyzed to establish normative data included 795 non-institutionalized and non-demented participants. Regarding the validity study, the sample analyzed included 912 participants of whom 76 subjects with a diagnosis of Alzheimer's disease. Normative scores were calculated according to age (65-74 years and 75 years and over) and educational level (primary school level not validated by a diploma, primary school level validated by a diploma and more than a primary school level). The normative scores of the learning phase were described using the percentiles while rates of success were reported for the delayed recall. Regarding the properties of the test, the Goblets test seemed to be more specific than sensitive and presented high negative predictive values. The Youden index showed that the better cut-off score was two trials (with 75.0% sensitivity and 83.0% specificity). The Goblets test can be a helpful tool in screening for dementia. Nevertheless, like many other simple and quick cognitive tests, it cannot be used alone to establish the diagnosis of dementia. This test has the advantage to be easy to administer in clinical situations; the normative scores presented in this study could be used as an aid to interpret a patient's performance. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  13. [Consumption of nutrients among the elderly living in Porto Alegre in the State of Rio Grande do Sul, Brazil: a population-based study].

    PubMed

    Venturini, Carina Duarte; Engroff, Paula; Sgnaolin, Vanessa; El Kik, Raquel Milani; Morrone, Fernanda Bueno; da Silva Filho, Irenio Gomes; De Carli, Geraldo Attilio

    2015-12-01

    A cross-sectional, population-based study was conducted on a random sample of 427 elderly individuals living in Porto Alegre, Brazil, to establish the nutrient consumption profile and verify its association with sociodemographic and health variables. Dietary intake was assessed using the 24-hour Food Recall Survey and the Dietetic Research Investigation technique. Seventy percent of the elderly respondents were women: 48.5% were between 60 and 69 years old; 68.8% had less than 8 years of schooling; 39% had a family income of between 2 and 5 minimum wages and 58.4% took no physical exercise. Hypertension was the most prevalent disease among the elderly and 54.9% were underweight. Men consumed more calories, protein, fiber, minerals and vitamins than women. Carbohydrate and calcium intake increases with advancing age, while zinc intake decreases. Physical exercise increased the intake of calories, magnesium, potassium and phosphorus. The higher the schooling the greater the intake of vitamins B6 and B12; the higher the family income, the greater the consumption of vitamin B6 and folic acid. The results show that there are nutritional deficiencies in the daily diet of the Brazilian elderly population, especially among women and individuals over 80 years of age.

  14. Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India.

    PubMed

    Kshetrimayum, Nandita; Reddy, Chavva Venkata Konda; Siddhana, Sunitha; Manjunath, Maurya; Rudraswamy, Sushma; Sulavai, Sibyl

    2013-06-01

    To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores.  Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  15. Use of Surveillance, Epidemiology, and End Results-Medicare Data to Conduct Case-Control Studies of Cancer Among the US Elderly

    PubMed Central

    Engels, Eric A.; Pfeiffer, Ruth M.; Ricker, Winnie; Wheeler, William; Parsons, Ruth; Warren, Joan L.

    2011-01-01

    Cancer is an important cause of morbidity in the elderly, and many medical conditions and treatments influence cancer risk. The Surveillance, Epidemiology, and End Results (SEER)-Medicare database can be used to conduct population-based case-control studies that elucidate the etiology of cancer among the US elderly. SEER-Medicare links data on malignancies ascertained through SEER cancer registries to claims from Medicare, the US government insurance program for people over age 65 years. Under one approach described herein, elderly cancer cases are ascertained from SEER data (1987–2005). Matched controls are selected from a 5% random sample of Medicare beneficiaries. Risk factors of interest, including medical conditions and procedures, are identified by using linked Medicare claims. Strengths of this design include the ready availability of data, representative sampling from the US elderly population, and large sample size (e.g., under one scenario: 1,176,950 cases, including 221,389 prostate cancers, 185,853 lung cancers, 138,041 breast cancers, and 124,442 colorectal cancers; and 100,000 control subjects). Limitations reflect challenges in exposure assessment related to Medicare claims: restricted range of evaluable risk factors, short time before diagnosis/selection for ascertainment, and inaccuracies in claims. With awareness of limitations, investigators have in SEER-Medicare data a valuable resource for epidemiologic research on cancer etiology. PMID:21821540

  16. Sex differences in subjective and actigraphic sleep measures: a population-based study of elderly persons.

    PubMed

    van den Berg, Julia F; Miedema, Henk M E; Tulen, Joke H M; Hofman, Albert; Neven, Arie Knuistingh; Tiemeier, Henning

    2009-10-01

    To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Cross-sectional study. The study was embedded in the Rotterdam Study, a population-based study. Nine hundred fifty-six participants aged 59 to 97 years. N/A. Participants wore an actigraph and kept a sleep diary for an average of 6 consecutive nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Unadjusted sex differences in sleep parameters were assessed with t tests. Women reported shorter total sleep time, a less favorable sleep-onset latency, lower sleep efficiency, and worse global sleep quality, as compared with men. When assessed with actigraphy, however, women were found to have longer and less-fragmented sleep than men. Sex differences in diary-reported sleep duration and other subjective sleep parameters were attenuated by adjustment for marital status, the use of sleep medication, and other covariates, but all sex differences remained significant in a multivariate-adjusted model. Sex differences in actigraphic sleep parameters were barely attenuated by multivariate adjustment, although the shorter actigraphically measured sleep duration in men was partly explained by their higher alcohol consumption. Some covariates (eg, sleep medication) had a different relationship with diary-reported or actigraphic total sleep time in men and women. If assessed by diary or interview, elderly women consistently reported shorter and poorer sleep than elderly men. In contrast, actigraphic sleep measures showed poorer sleep in men. These discrepancies are partly explained by determinants of sleep duration, such as sleep medication use and alcohol consumption.

  17. Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil.

    PubMed

    Danielewicz, Ana Lúcia; Barbosa, Aline Rodrigues; Del Duca, Giovâni Firpo

    2014-01-01

    To investigate the association between nutritional status and functional limitation and disability in an elderly population in southern Brazil. Epidemiological, cross-sectional household-based study carried out with 477 elderly of both sexes (60 to 100 years). Body mass index (BMI) served to assess the nutritional status: underweight (BMI < 22 kg/m2) and overweight (BMI > 27 kg/m2). The sum score (0-5) obtained in three tests: "chair stand" and "pick up a pen" (measured by time) and standing balance (four static measurements) assessed the functional limitation. The disability was evaluated by the difficulty in performing one or more self-reported tasks related to basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Crude and adjusted analyzes (3 models) were carried out using Poisson regression; prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. Crude analyzes showed a positive association between underweight and functional limitation (PR = 2.71, 95% CI = 1.63 to 4.51); overweight and disability in ADLs (PR = 2.20, CI 95% = 1.44 to 3.35); overweight and disability in IADLs (PR = 1.56, CI 95% = 1.20 to 2.03). The additional adjustments for gender, age, level of education, living arrangements, current work, cognitive function and number of morbidities reduced the strength of the associations, without changing the statistical strength. Nutritional status is a factor that is independently and positively associated with functional limitation and disability. We recommend the use of this indicator to monitor the health of the elderly.

  18. REM sleep behavior disorder in the Korean elderly population: prevalence and clinical characteristics.

    PubMed

    Kang, Suk-Hoon; Yoon, In-Young; Lee, Sang Don; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

    2013-08-01

    To examine the prevalence and clinical characteristics of REM sleep behavior disorder (RBD) and subclinical RBD in the Korean elderly population. A community-based Korean Longitudinal Study on Cognitive Aging and Dementia and time-synchronized video-polysomnography (vPSG) in a laboratory. Sleep laboratory in a university hospital. 348 individuals aged 60 years or older. N/A. Among 696 subjects who were invited to participate in a vPSG study, 348 completed the vPSG. RBD was diagnosed when subjects showed REM sleep without atonia (RSWA) in the vPSG, and had history of complex and vigorous behaviors during sleep or abnormal REM sleep behaviors in the vPSG. Subjects with RSWA but no abnormal REM sleep behaviors were diagnosed with subclinical RBD. Seven subjects (5 male, 2 female) had RBD, three of whom (1 male, 2 female) had Parkinson disease. Two subjects reported history of sleep-related injury. The crude prevalence of RBD and idiopathic RBD was 2.01% (95% confidence interval [CI] = 0.54% to 3.49%) and 1.15% (95% CI = 0.03% to 2.27%). An age and sex-adjusted prevalence estimate of RBD and idiopathic RBD in the Korean elderly was 2.01% and 1.34%. Eighteen subjects were diagnosed with subclinical RBD, and the prevalence of subclinical RBD was estimated to be 4.95%. RBD and subclinical RBD are not rare in the elderly in the community with abnormal REM sleep behaviors of RBD being mild to injurious and violent. The clinical significance and long-term progression of subclinical RBD needs to be further explored, given the prevalence and its possible relation to RBD.

  19. Elder-Clowning in Long-Term Dementia Care: Results of a Pilot Study.

    PubMed

    Kontos, Pia; Miller, Karen-Lee; Colobong, Romeo; Palma Lazgare, Luis I; Binns, Malcolm; Low, Lee-Fay; Surr, Claire; Naglie, Gary

    2016-02-01

    To assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer's type. Before-and-after study. Nursing home. Nursing home residents with moderate to severe BPSD, as defined according to a Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of 10 or greater (N = 23), and their care aides. A pair of elder-clowns visited all residents twice weekly (~10 minutes per visit) for 12 weeks. They used improvisation, humor, empathy, and expressive modalities such as song, musical instruments, and dance to individualize resident engagement. Primary outcomes were BPSD measured using the the NPI-NH, quality of life measured using Dementia Care Mapping (DCM), and nursing burden of care measured using the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes were occupational disruptiveness measured using the NPI-NH, agitation measured using the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use. Over 12 weeks, NPI-NH scores declined significantly (t22 = -2.68, P = .01), and DCM quality-of-life scores improved significantly (F1,50 = 23.09, P < .001). CMAI agitation scores decreased nominally, but the difference was not statistically significant (t22 = -1.86, P = .07). Occupational disruptiveness score significantly improved (t22 = -2.58, P = .02), but there was no appreciable change in M-NCAS scores of staff burden of care. Results suggest that elder-clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer's type. Elder-clowning is a promising intervention that may improve Alzheimer's disease care for nursing home residents. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

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

    PubMed

    Jerliu, Naim; Toçi, Ervin; Burazeri, Genc; Ramadani, Naser; Brand, Helmut

    2013-03-01

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

  1. Attempted suicide in the elderly: characteristics of suicide attempters 70 years and older and a general population comparison group.

    PubMed

    Wiktorsson, Stefan; Runeson, Bo; Skoog, Ingmar; Ostling, Svante; Waern, Margda

    2010-01-01

    To identify factors associated with attempted suicide in the elderly. Social, psychological, and psychiatric characteristics were compared in suicide attempters (70 years and older) and a representative population sample. Emergency departments at five hospitals in western Sweden and a representative sample of the elderly population. Persons with Mini Mental State Examination (MMSE) score <15 were excluded. One hundred forty persons who sought hospital treatment after a suicide attempt were eligible and 103 participated (57 women, 46 men, and mean age 80 years). Comparison subjects matched for gender and age group (N = 408) were randomly selected among participants in our general population studies. Symptoms were rated with identical instruments in cases and comparison subjects. The examination included the MMSE and tests of short- and long-term memory, abstract thinking, aphasia, apraxia, and agnosia. Depressive symptomatology was measured using the Montgomery-Asberg Depression Rating Scale, and major and minor depressions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using symptom algorithms. Factors associated with attempted suicide included being unmarried, living alone, low education level, history of psychiatric treatment, and previous suicide attempt. There was no association with dementia. Odds ratios were increased for both major (odds ratio [OR]: 47.4, 95% confidence interval [CI]: 19.1-117.7) and minor (OR: 2.6, 95% CI: 1.5-4.7) depressions. An association was observed between perceived loneliness and attempted suicide; this relationship was independent of depression (OR: 2.8, 95% CI: 1.3-6.1). Observed associations mirrored those previously shown for completed suicide. Results may help to inform clinical decisions regarding suicide risk evaluation in this vulnerable and growing age group.

  2. Evaluation of Femoral Neck Bone Mineral Density and Radiographic Hand and Knee Osteoarthritis in a Korean Elderly Population

    PubMed Central

    Bae, Kee Jeong; Kim, Ki Woong; Kim, Tae Kyun; Chang, Chong Bum; Jang, Hak Chul; Baek, Goo Hyun

    2014-01-01

    Background Reports on the relationship between osteoporosis and osteoarthritis (OA) have tended to disagree, especially in non-weight bearing joints such as the hand joints. We aimed to investigate the relationship between bone mineral density (BMD) and hand and knee OA in a general Korean elderly population. Methods We evaluated femur neck BMD and the hand and knee radiographs of 143 men and 123 women over 65 years of age who participated in a population-based cohort study. The Kellgren-Lawrence criteria for grading OA were implemented, and grade 2 or higher were categorized as radiographic OA. BMD was compared according to the existence of radiographic OA in the hand and knee using analysis of covariance, and correlation analyses were performed to explore the relationship between BMD and radiographic OA grade. Results After controlling for age and body mass index, there was no significant difference in BMD between participants with and without hand OA (p = 0.717 in male and p = 0.862 in female), between those with and without knee OA (p = 0.974 in male and p = 0.563 in female), and between those with only hand OA and those with only knee OA (p = 0.920 in male and p = 0.961 in female). Furthermore, there was no significant correlation between BMD and the radiographic OA grade of the hands (p = 0.182 in male and p = 0.897 in female) and knees (p = 0.245 in male and p = 0.098 in female). Conclusions In our cohort of the general Korean elderly population, no association was found between osteoporosis and OA, regardless of the weight bearing status of the joints. PMID:25177462

  3. Tolerability in the elderly population of high-dose alpha lipoic acid: a potential antioxidant therapy for the eye

    PubMed Central

    Sarezky, Daniel; Raquib, Aaishah R; Dunaief, Joshua L; Kim, Benjamin J

    2016-01-01

    Purpose Alpha lipoic acid (ALA) is an antioxidant and iron-chelating supplement that has potential benefits for geographic atrophy in dry age-related macular degeneration as well as other eye diseases. The purpose of this study was to determine the tolerability of ALA in the elderly population. Patients and methods Fifteen subjects, age ≥65 years, took sequential ALA doses of 600, 800, and 1,200 mg. Each dose was taken once daily with a meal for 5 days. After each dose was taken by the subjects for 5 days, the subjects were contacted by phone, a review of systems was performed, and they were asked if they thought they could tolerate taking that dose of ALA for an extended period of time. Results The 600 mg dose was well tolerated. At the 800 mg dose, one subject had an intolerable flushing sensation. At the 1,200 mg dose, two subjects had intolerable upper gastrointestinal side effects and one subject had an intolerable flushing sensation. Subjects taking gastrointestinal prophylaxis medications had no upper gastrointestinal side effects. Conclusion High-dose ALA is not completely tolerated by the elderly. These preliminary data suggest that gastrointestinal prophylaxis may improve tolerability. (ClinicalTrials.gov, NCT02613572). PMID:27729766

  4. The importance of monitoring adverse drug reactions in elderly patients: the results of a long-term pharmacovigilance programme.

    PubMed

    Carnovale, Carla; Gentili, Marta; Fortino, Ida; Merlino, Luca; Clementi, Emilio; Radice, Sonia; ViGer Group

    2016-01-01

    To recognise and prevent ADRs (including DDIs) in the elderly through a 4-year post-marketing active pharmacovigilance programme. The programme was designed to enhance high quality spontaneous reporting of ADRs in elderly patients by sampling the Italian population and was termed 'Pharmacovigilance in Geriatry (ViGer)'. ADRs were collected for adults aged over 65 years of age treated in nursing homes, continuing care retirement communities and territorial health services in Lombardy. ADRs were evaluated using the Adverse Drug Reaction Probability Scale (Naranjo) and analysed with respect to time, sex, category of ADR, seriousness, suspected medicines, notoriety. We analysed all the potential DDIs. We detected 1073 cases reports corresponding to 2110 ADRs. Vaccines, antibacterials for systemic use and antineoplastic agents were the pharmacotherapeutic subgroups most frequently involved. 18% of ADRs reports were classified as serious. In 752 reports patients were described as in polytherapy; in 55 patients (7.3%) the reported ADR were probably preventable because of DDIs involvement. The ViGer project demonstrated that active pos-marketing pharmacovigilance programmes are a valid strategy to increase awareness on geriatrics pharmacology, reduce underreporting and provide important information on previous unknown ADRs and DDIs, resulting in a therapy optimisation in clinical practice in the geriatric setting.

  5. The reliability of dietary and lifestyle information obtained from spouses in an elderly chinese population.

    PubMed

    Liang, Wenbin; Binns, Colin; Lee, Andy H; Huang, Rongsheng; Hu, Delong

    2008-01-01

    In many health studies of the elderly population, the subjects have cognitive or linguistic impairments, so data need to be collected from surrogates. This study compares dietary and lifestyle information reported by elderly Chinese with those provided by their spouses. Community couples 60 years and older were recruited to participate in an interview. One person from each couple was randomly chosen as the index person. Characteristics concerning the index person were then solicited from that person and separately from his or her spouse using validated questionnaires. For the 128 food items considered, the mean kappa was 0.73 for both frequency (SD 0.18) and amount (SD 0.22) of intake, and more than 70% of the couples had kappa statistics exceeding 0.61. Food items exhibiting high agreement between the spouses include rice, apples, tomatoes, and pork chops. The proportion of perfect agreement was higher than 80% for physical activity, smoking, and tea drinking behaviors. In conclusion, the spouse can serve as a proxy to provide reliable information when his or her partner is unavailable.

  6. Number of existing permanent teeth is associated with chronic kidney disease in the elderly Korean population.

    PubMed

    Shin, Hye-Sun

    2017-04-14

    The aim of this study was to assess the association between the number of existing permanent teeth and chronic kidney disease (CKD) in a representative sample of the elderly Korean population. A total of 2,519 subjects who participated in the Korean National Health and Nutrition Examination Survey were cross-sectionally examined. The number of existing permanent teeth was evaluated by clinical oral examination. CKD was defined based on definition and classification by Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines. Multivariable logistic regression analyses were performed controlling for age, gender, income, education, tooth-brushing frequency, periodontitis, state of dentition, smoking, alcohol consumption, hypertension, obesity, diabetes mellitus, and hypercholesterolemia. Subgroup analyses by age and gender were also performed. The number of teeth was significantly associated with CKD after controlling for all potential confounders (adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.04 to 2.70 for lower number of teeth; AOR, 1.59; 95% CI, 1.14 to 2.23 for moderate number of teeth). In the subgroup analyses, the association was highlighted in females aged 75 years over (AOR, 2.55; 95% CI, 1.05 to 6.20 for lower number of teeth; AOR, 1.95; 95% CI, 1.01 to 3.80 for moderate number of teeth). Our findings suggest that the number of existing permanent teeth may be associated with CKD among Korean elderly.

  7. Predicting tooth color from facial features and gender: results from a white elderly cohort.

    PubMed

    Hassel, Alexander J; Nitschke, Ina; Dreyhaupt, Jens; Wegener, Ina; Rammelsberg, Peter; Hassel, Jessica C

    2008-02-01

    Clinicians providing edentulous patients with complete dentures are often confronted with the problem of not knowing the patient's natural tooth color. It would be valuable to be able to determine this from other facial features. The purpose of this study was to assess the possibility of predicting tooth color in the elderly from hair and eye color, facial skin complexion, and gender. The lightness (L*), chroma (C*), and hue (h*) of the color of 541 natural teeth were measured for a white study population (94 subjects, 75 to 77 years old, 55.3% male) by means of a single measurement with a clinically applicable spectrophotometer. Hair and eye color and facial skin complexion were recorded in categories. Mixed-effects regression models were calculated for each L*, C*, and h* value with hair and eye color, facial skin complexion, and gender as independent variables (alpha=.05). Only gender and hair color in univariate analysis and, additionally, eye color in multivariate analysis, were significant predictors of tooth color. Higher L* values (lighter color) were associated with lighter eye color and with female gender. The C* value was lower (less saturated) for women. More yellow/green than yellow/red h* values were associated with hair colors other than black and with female gender. However, the parameter estimates of the variables were rather low. Determination of tooth color from hair and eye color and from gender in the white elderly was only partially possible.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Mathews, Mathew

    2016-09-01

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

  11. Socio-economic factors and health care system characteristics related to cancer survival in the elderly. A population-based analysis in 16 European countries (ELDCARE project).

    PubMed

    Quaglia, Alberto; Vercelli, Marina; Lillini, Roberto; Mugno, Eugenio; Coebergh, Jan Willem; Quinn, Mike; Martinez-Garcia, Carmen; Capocaccia, Riccardo; Micheli, Andrea

    2005-05-01

    The ELDCARE study aims to investigate, at the ecological level, the relationships between socio-economic variables and cancer survival in patients aged 65 years and over. Survival data for patients diagnosed during the period 1985-1989 and followed up to 1994 were provided by 43 European Cancer Registries in 16 countries participating in the EUROCARE 2 project. Relative survival was computed by Hakulinen's methods. Data on socio-economic factors were collected by national statistics offices for the years around 1991. Pearson's correlation was used to study the relationships between cancer survival and socio-economic factors. We selected four groups of variables. The first group included macro-economic variables (such as Gross Domestic Product, GDP; Total Health Expenditure, THE); the second, the main characteristics of national health care systems; the third, demographic factors; and the fourth, variables on labour market organisation. The countries with the largest proportions of elderly populations, in Northern and Western Europe, spent more on health than the less affluent countries of Eastern Europe. GDP was strongly related to THE but a very high variability in Computed Tomography Scanners (CTS) among countries with similar THE was observed. Indeed, those countries with THE around US 1500 dollars per capita had survival rates for breast cancer ranging from 67 to 82%. Cancer survival in elderly patients in Europe was most strongly related to GDP and THE, especially for good prognosis cancers. Survival was strongly correlated with health care technologies, particularly CTS, but not with health employment. Survival was positively correlated with proportion of married elderly people (and negatively with widowed elderly), suggesting a role played by social support in influencing the prognosis of elderly patients. These results highlight how health outcomes in the elderly are a complex phenomenon, not determined only by GDP and THE, but affected by social

  12. Overutilization of ambulatory medical care in the elderly German population?--An empirical study based on national insurance claims data and a review of foreign studies.

    PubMed

    van den Bussche, Hendrik; Kaduszkiewicz, Hanna; Schäfer, Ingmar; Koller, Daniela; Hansen, Heike; Scherer, Martin; Schön, Gerhard

    2016-04-14

    By definition, high utilizers receive a large proportion of medical services and produce relatively high costs. The authors report the results of a study on the utilization of ambulatory medical care by the elderly population in Germany in comparison to other OECD countries. Evidence points to an excessive utilization in Germany. It is important to document these utilization figures and compare them to those in other countries since the healthcare system in Germany stopped recording ambulatory healthcare utilization figures in 2008. The study is based on the claims data of all insurants aged ≥ 65 of a statutory health insurance company in Germany (n = 123,224). Utilization was analyzed by the number of contacts with physicians in ambulatory medical care and by the number of different practices contacted over one year. Criteria for frequent attendance were ≥ 50 contacts with practices or contacts with ≥ 10 different practices or ≥ 3 practices of the same discipline per year. Descriptive statistical analysis and logistic regression were applied. Morbidity was analyzed by prevalence and relative risk for frequent attendance for 46 chronic diseases. Nineteen percent of the elderly were identified as high utilizers, corresponding to approximately 3.5 million elderly people in Germany. Two main types were identified. One type has many contacts with practices, belongs to the oldest age group, suffers from severe somatic diseases and multimorbidity, and/or is dependent on long-term care. The other type contacts large numbers of practices, consists of younger elderly who often suffer from psychiatric and/or psychosomatic complaints, and is less frequently multimorbid and/or nursing care dependent. We found a very high rate of frequent attendance among the German elderly, which is unique among the OECD countries. Further research should clarify its reasons and if this degree of utilization is beneficial for elderly people.

  13. BARIATRIC SURGERY IN THE ELDERLY: RESULTS OF A MEAN FOLLOW-UP OF FIVE YEARS

    PubMed Central

    PAJECKI, Denis; SANTO, Marco Aurelio; JOAQUIM, Henrique Dametto Giroud; MORITA, Flavio; RICCIOPPO, Daniel; de CLEVA, Roberto; CECCONELLO, Ivan

    2015-01-01

    Background : Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; it is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population. Aim : To evaluate the results of surgical treatment of obesity in patients over 60 years, followed for an average period of five years. Method : This was a retrospective study evaluating 46 patients, 60 years or older, who underwent surgical treatment of obesity, by conventional gastric bypass technique (laparotomy). The average age was 64 years (60-71), mean BMI of 49.6 kg/m2 (38-66), mean follow-up of 5.9 years; 91% of patients were hypertensive, 56% diabetics and 39% had dyslipidemia. Results : The incidence of complications (major and minor) in patients under 65 years was 26% and over 65 years 37% (p=0.002). There were no deaths in the group with less than 65 years and there were two deaths (12.5%) over 65 years. The average loss of overweight over 65 years or less was 72% vs 68% (p=0.56). There was total control of the diabetes mellitus in 77% and partial in 23%, with no difference between groups. There was improvement in arterial hypertension in 56% of patients, also no difference between groups. The average LDL levels did not differ between the pre and postoperative (106 mg/dl to 102 mg/dl), an increase of HDL (56 mg/dl to 68 mg/dL) and reduced triglyceride levels (136 mg/dl to 109 mg/dl). There was no statistical difference in the variation of the cholesterol fractions and triglycerides between the groups. Two patients in the group with less than 65 years died in late follow-up, of brain tumor and pneumonia, three and five years after bariatric surgery, respectively. Conclusions : Surgical morbidity and mortality were higher in patients over 65 years, and this group had the same benefits observed in patients lower 65 years for weight loss and comorbidities control

  14. Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study.

    PubMed

    Durante-Mangoni, Emanuele; Bradley, Suzanne; Selton-Suty, Christine; Tripodi, Marie-Françoise; Barsic, Bruno; Bouza, Emilio; Cabell, Christopher H; Ramos, Auristela Isabel de Oliveira; Fowler, Vance; Hoen, Bruno; Koneçny, Pam; Moreno, Asuncion; Murdoch, David; Pappas, Paul; Sexton, Daniel J; Spelman, Denis; Tattevin, Pierre; Miró, José M; van der Meer, Jan T M; Utili, Riccardo

    2008-10-27

    Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. In this multinational, prospective, observational cohort study within the International Collaboration on Endocarditis, 2759 consecutive patients were enrolled from June 15, 2000, to December 1, 2005; 1056 patients with IE 65 years or older were compared with 1703 patients younger than 65 years. Risk factors, predisposing conditions, origin, clinical features, course, and outcome of IE were comprehensively analyzed. Elderly patients reported more frequently a hospitalization or an invasive procedure before IE onset. Diabetes mellitus and genitourinary and gastrointestinal cancer were the major predisposing conditions. Blood culture yield was higher among elderly patients with IE. The leading causative organism was Staphylococcus aureus, with a higher rate of methicillin resistance. Streptococcus bovis and enterococci were also significantly more prevalent. The clinical presentation of elderly patients with IE was remarkable for lower rates of embolism, immune-mediated phenomena, or septic complications. At both echocardiography and surgery, fewer vegetations and more abscesses were found, and the gain in the diagnostic yield of transesophageal echocardiography was significantly larger. Significantly fewer elderly patients underwent cardiac surgery (38.9% vs 53.5%; P < .001). Elderly patients with IE showed a higher rate of in-hospital death (24.9% vs 12.8%; P < .001), and age older than 65 years was an independent predictor of mortality. In this large prospective study, increasing age emerges as a major determinant of the clinical characteristics of IE. Lower rates of surgical treatment and high mortality are the most prominent features of elderly patients with IE. Efforts should be made to prevent health care-associated acquisition and improve outcomes in this major subgroup

  15. Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients.

    PubMed

    Brokinkel, Benjamin; Holling, Markus; Spille, Dorothee Cäcilia; Heß, Katharina; Sauerland, Cristina; Bleimüller, Caroline; Paulus, Werner; Wölfer, Johannes; Stummer, Walter

    2017-04-01

    OBJECTIVE The purpose of this study was to compare long-term prognosis after meningioma surgery in elderly and younger patients as well as to compare survival of elderly patients with surgically treated meningioma to survival rates for the general population. METHODS Five hundred meningioma patients (median follow-up 90 months) who underwent surgery between 1994 and 2009 were subdivided into "elderly" (age ≥ 65 years, n = 162) and "younger" (age < 65 years, n = 338) groups for uni- and multivariate analyses. Mortality was compared with rates for the age- and sex-matched general population. RESULTS The median age at diagnosis was 71 in the elderly group and 51 years in the younger group. Sex, intracranial tumor location, grade of resection, radiotherapy, and histopathological subtypes were similar in the 2 groups. High-grade (WHO Grades II and III) and spinal tumors were more common in older patients than in younger patients (15% vs 8%, p = 0.017, and 12% vs 4%, p = 0.001, respectively). The progression-free interval (PFI) was similar in the 2 groups, whereas mortality at 3 months after surgery was higher and median overall survival (OS) was shorter in older patients (7%, 191 months) than in younger patients (1%, median not reached; HR 4.9, 95% CI 2.75-8.74; p < 0.001). Otherwise, the median OS in elderly patients did not differ from the anticipated general life expectancy (HR 1.03, 95% CI 0.70-1.50; p = 0.886). Within the older patient group, PFI was lower in patients with high-grade meningiomas (HR 24.74, 95% CI 4.23-144.66; p < 0.001) and after subtotal resection (HR 10.57, 95% CI 2.23-50.05; p = 0.003). Although extent of resection was independent of perioperative mortality, the median OS was longer after gross-total resection than after subtotal resection (HR 2.7, 95% CI 1.09-6.69; p = 0.032). CONCLUSIONS Elderly patients with surgically treated meningioma do not suffer from impaired survival compared with the age-matched general population, and their PFI is

  16. Validity and applicability of a video-based animated tool to assess mobility in elderly Latin American populations

    PubMed Central

    Guerra, Ricardo Oliveira; Oliveira, Bruna Silva; Alvarado, Beatriz Eugenia; Curcio, Carmen Lucia; Rejeski, W Jack; Marsh, Anthony P; Ip, Edward H; Barnard, Ryan T; Guralnik, Jack M; Zunzunegui, Maria Victoria

    2016-01-01

    Aim To assess the reliability and the validity of Portuguese- and Spanish-translated versions of the video-based short-form Mobility Assessment Tool in assessing self-reported mobility, and to provide evidence for the applicability of these videos in elderly Latin American populations as a complement to physical performance measures. Methods The sample consisted of 300 elderly participants (150 from Brazil, 150 from Colombia) recruited at neighborhood social centers. Mobility was assessed with the Mobility Assessment Tool, and compared with the Short Physical Performance Battery score and self-reported functional limitations. Reliability was calculated using intraclass correlation coefficients. Multiple linear regression analyses were used to assess associations among mobility assessment tools and health, and sociodemographic variables. Results A significant gradient of increasing Mobility Assessment Tool score with better physical function was observed for both self-reported and objective measures, and in each city. Associations between self-reported mobility and health were strong, and significant. Mobility Assessment Tool scores were lower in women at both sites. Intraclass correlation coefficients of the Mobility Assessment Tool were 0.94 (95% confidence interval 0.90–0.97) in Brazil and 0.81 (95% confidence interval 0.66–0.91) in Colombia. Mobility Assessment Tool scores were lower in Manizales than in Natal after adjustment by Short Physical Performance Battery, self-rated health and sex. Conclusions These results provide evidence for high reliability and good validity of the Mobility Assessment Tool in its Spanish and Portuguese versions used in Latin American populations. In addition, the Mobility Assessment Tool can detect mobility differences related to environmental features that cannot be captured by objective perfor mance measures. PMID:24666718

  17. Musculoskeletal Disorders in the Elderly

    PubMed Central

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

    2012-01-01

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

  18. [Drug consumption and cognitive function in non-institutionalized elderly: a population-based study].

    PubMed

    Planas-Pujol, X; López-Pousa, S; Vilalta-Franch, J; Monserrat-Vila, S; Garre-Olmo, J

    2010-10-01

    Drug consumption in the general population is concentrated in the elderly. The aim of this study was to assess the pharmacological profile of elderly people 75 years of age and older, to assess the relationship with the cognitive function and the variables associated with drug consumption. This is an epidemiological, cross-sectional, door-to-door study among the non-institutionalised population in a rural area. Participants were inhabitants aged 75 and older from the Anglès Primary Healthcare Area (Girona). Drug prescriptions were recorded from participants' medicine chest. Cognitive function was assessed using the Mini-Mental State Examination. A total of 875 individuals took part (82%). Participants with mild and moderate cognitive impairment consumed an average of 4.6 (SD=2.9) and 5.2 (SD=3.2) drugs, participants without cognitive impairment consumed an average of 4 (SD=2.7) drugs (P < 0.005). In the bivariate analysis, taking into account the degree of cognitive impairment, there was a change in drugs acting on the digestive tract and metabolism (P=0.003) and nervous system (P=0.001). Multivariate analysis identified four variables associated with the central nervous system drugs: age, sex, comorbidity and suspicion of depression (P <0.05). Participants with severe cognitive impairment had a higher frequency of anti-psychotic and antidepressant drug consumption. However, the multivariate analysis shows that advanced age, female sex and suspicion of depression are variables associated with a higher central nervous system drug consumption.

  19. The association between physical activity and dementia in an elderly population: the Rotterdam Study.

    PubMed

    de Bruijn, Renée F A G; Schrijvers, Elisabeth M C; de Groot, Karen A; Witteman, Jacqueline C M; Hofman, Albert; Franco, Oscar H; Koudstaal, Peter J; Ikram, Mohammad Arfan

    2013-03-01

    Several studies have associated physical activity with the risk of dementia, but mostly did so during short follow-up. It remains unclear whether physical activity also affects dementia during longer follow-up. We examined the association between physical activity and risk of dementia during a follow-up period up to 14 years. From 1997 to 1999, physical activity was assessed using a validated questionnaire in 4,406 elderly persons (age range 61-97) from the prospective, population-based Rotterdam Study. Follow-up for dementia was complete until January 1, 2011. We used Cox proportional hazards models to assess the association between physical activity and incident dementia. Next, we stratified follow-up time using a cut-off of 4 years. We separately investigated dementia due to Alzheimer disease. During 38,631 person-years, 583 participants developed dementia. When adjusting for age and sex, we found a borderline significant association between higher physical activity and lower risk of dementia (HR 0.95; 95% CI 0.87-1.04). This association was confined to follow-up up to 4 years (HR 0.82; 95% CI 0.71-0.95), and not to follow-up of at least 4 years (HR 1.04; 95% CI 0.93-1.16). Additional adjustments only slightly attenuated the associations. A similar pattern was present for Alzheimer disease. We found a higher level of physical activity to be associated with a lower risk of dementia. This association was confined to follow-up for up to 4 years and not to longer follow-up, suggesting either a role for reverse causality or only a short term effect of late-life physical activity in an elderly population.

  20. Lumbar Lordosis Minus Thoracic Kyphosis: A Novel Regional Predictor for Sagittal Balance in Elderly Populations.

    PubMed

    Yang, Changwei; Yang, Mingyuan; Wei, Xianzhao; Shao, Jie; Chen, Yuanyuan; Zhao, Jian; Zhu, Xiaodong; He, Dawei; Li, Ming

    2016-03-01

    A retrospective study. The aim of this study is to introduce a novel regional predictor for sagittal balance in elderly populations and explore its effectiveness of evaluating sagittal balance. Sagittal balance is getting increasing recognition of importance due to its significant association of health-related quality of life. However, no regional parameters could well reflect and predict the whole sagittal balance. Medical records of elderly patients in our outpatient clinic from January 2012 to January 2014 were reviewed with standing full-spine lateral radiograph. Radiological parameters were evaluated, including max thoracic kyphosis (maxTK), max lumbar lordosis (maxLL), LL minus TK(LL-TK), PI minus LL (PI-LL), sacrum slope (SS), pelvic tilt (PT), pelvic incidence (PI), and SVA (sagittal vertical axis). Correlation analysis between SVA, LL-TK, and other radiological spinopelvic parameters and was pursued. Patients were divided into two groups according to whether patients were well-aligned in sagittal plane: Group A (well-aligned, SVA ≤50  mm) and Group B (poorly aligned, SVA >50  mm), and demographic and sagittal parameters were compared. LL-TK ≥0° and PI-LL ≤13° were used as a threshold value to evaluate their effectiveness of prediction for sagittal balance. A total of 129 patients (M: 25 and F: 104) were included in this study. SVA was significantly correlated with NRS (numeric rating scales), age, maxLL, PT, LL-TK, and PI-LL (all, P < 0.05). Age, maxTK, maxLL, SS, PT, PI, SVA, and NRS were significantly correlated with LL-TK (all P < 0.05). Significant differences were found in age, maxLL, PT, LL-TK, PI-LL, SVA, and NRS between Group A (M: 15 and F: 72) and Group B (M: 10 and F: 32) (all P < 0.05). Furthermore, both LL-TK ≥0° and PI-LL ≤13° were observed in 75 patents, among which SVA ≤50 mm was found in 67 patients (89%). Among patients whose LL-TK and PI-LL were <0° and >13°, 34 patients were poorly aligned (34/39, 87

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

    PubMed Central

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

    2010-01-01

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

  2. Effects of Osteoarthritis on Quality of life in Elderly Population of Bhubaneswar, India

    PubMed Central

    Chandel, Sidharth Singh; Dash, Sunil. K.; Arora, Geetanjali; Kumar, Mithilesh; Biswal, Manas Ranjan

    2015-01-01

    Introduction: Osteoarthritis (OA) is the most common age-related joint disease affecting >80% people beyond 55 years of age. It is a leading cause of elderly visit to outpatient departments and accounts for almost half of all nonsteroidal anti-inflammatory drug prescriptions. The burden and impact of knee OA in Indian population and extent of public health services usage by people with OA are not known. Methods: We performed a prospective blinded multicenter screening and therapeutic study from June 2013 to June 2014 at 3 centers to screen patients >55 years with knee OA to assess quality of life, functional disability, and limitation of functions and to compare the effectiveness of hip and leg strengthening exercise programs in these patients. Functional disability was assessed by Western Ontario and McMaster’s Universities OA index (WOMAC), Friedman, and Wyman Scores; locomotor function was assessed by walking status, Visual Analog Scale (VAS), and 30-second timed chair stand tests; and quality of life was assessed by Short Form-36 (SF-36). Results: Of 2854 patients screened, 2054 (72%) patients had OA (male:female-1.9:1) with mean age of 63 years and standard deviation of 8. Of 2054 patients, 226 patients were randomly selected for therapeutic study. In remaining 1828 patients, baseline 10-meter walk test (10MWT) was 0.3 m/s, mean SF-36 Physical Component Score (PCS) was 31.3, and Mental Component Score (MCS) was 34.2. At 3 months, 79% patients were comfortable with significant VAS, WOMAC, Friedman-Wyman Scores, 10MWT, and timed chair test improvements in patients who performed lifestyle modifications and exercises (P = .04). Short Form-36 improved, mean PCS was 43.6, and MCS was 54.2. At 3 months, 274 (15%) patients were unsatisfied among whom 26% and 74% were treated with arthroscopic procedures and arthroplasty, respectively. Isolated hip and leg strengthening exercise programs similarly improved knee pain, function, and quality of life. Conclusion

  3. Movement Disorders in Elderly Users of Risperidone and First Generation Antipsychotic Agents: A Canadian Population-Based Study

    PubMed Central

    Vasilyeva, Irina; Biscontri, Robert G.; Enns, Murray W.; Metge, Colleen J.; Alessi-Severini, Silvia

    2013-01-01

    Background Despite concerns over the potential for severe adverse events, antipsychotic medications remain the mainstay of treatment of behaviour disorders and psychosis in elderly patients. Second-generation antipsychotic agents (SGAs; e.g., risperidone, olanzapine, quetiapine) have generally shown a better safety profile compared to the first-generation agents (FGAs; e.g., haloperidol and phenothiazines), particularly in terms of a lower potential for involuntary movement disorders. Risperidone, the only SGA with an official indication for the management of inappropriate behaviour in dementia, has emerged as the antipsychotic most commonly prescribed to older patients. Most clinical trials evaluating the risk of movement disorders in elderly patients receiving antipsychotic therapy have been of limited sample size and/or of relatively short duration. A few observational studies have produced inconsistent results. Methods A population-based retrospective cohort study of all residents of the Canadian province of Manitoba aged 65 and over, who were dispensed antipsychotic medications for the first time during the time period from April 1, 2000 to March 31, 2007, was conducted using Manitoba's Department of Health's administrative databases. Cox proportional hazards models were used to determine the risk of extrapyramidal symptoms (EPS) in new users of risperidone compared to new users of FGAs. Results After controlling for potential confounders (demographics, comorbidity and medication use), risperidone use was associated with a lower risk of EPS compared to FGAs at 30, 60, 90 and 180 days (adjusted hazard ratios [HR] 0.38, 95% CI: 0.22–0.67; 0.45, 95% CI: 0.28–0.73; 0.50, 95% CI: 0.33–0.77; 0.65, 95% CI: 0.45–0.94, respectively). At 360 days, the strength of the association weakened with an adjusted HR of 0.75, 95% CI: 0.54–1.05. Conclusions In a large population of elderly patients the use of risperidone was associated with a lower risk of EPS compared

  4. Oral Health-Related Quality of Life in the Elderly in Israel--Results from the National Health and Nutrition Survey of the Elderly 2005-2006.

    PubMed

    Zusman, Shlomo Paul; Kushnir, Daniel; Natapov, Lena; Goldsmith, Rebecca; Dichtiar, Rita

    2016-01-01

    To assess the oral health-related quality of life of the Israeli elderly. Data were collected from a subsample of those interviewed for the cross-sectional Mabat Zahav National Health and Nutrition Survey of the Elderly, carried out in 2005 and 2006 by the Ministry of Health in Israel. In-person interviews were conducted in the interviewees' homes using a structured questionnaire which included 7 questions on subjective dental health status and the 14 questions of the Oral Health Impact Profile 14 (OHIP-14). Statistical significance of continuous variables was assessed with the Student t-test; categorical variables with normal distribution were analysed using the chi-square test and those with non-normal distribution with the Wilcoxon Mann-Whitney two-sample test. 828 Jews and 159 Arabs from the total survey population of 1852 elderly (1536 Jews and 316 Arabs) completed the OHIP-14 questionnaire. An impact of oral health on the quality of life was reported by 16.6% of the respondents, 19.2% of females and 13.9% of males (p<0.05). There were statistically significant differences in impact prevalence by gender, place of birth and economic status. No such differences were found by age group, population group or education. Significant statistical correlation was found between subjective assessment of general and dental health and OHIP impact prevalence, with poorer assessment correlated with increased prevalence of impact. The quality of life of 17% of Israeli elderly is affected by oral health. The OHIP-14 findings emphasise the importance of including basic dental treatment (treatment of dental pain and infections) in the range of services covered by the National Health Insurance Law.

  5. Combining music and reminiscence therapy interventions for wellbeing in elderly populations: A systematic review.

    PubMed

    Istvandity, Lauren

    2017-08-01

    Both music therapy and reminiscence therapy are currently being used to increase aspects of wellbeing in older people, including those with memory diseases such as dementia, as alternatives to pharmacological treatments. There is growing evidence that combining these therapies in a focused way would provide unique wellbeing outcomes for this population. This review aims to report on the existing intervention studies that utilize both music and reminiscence activities in equal measure in elderly adult populations. A systematic review of intervention-based studies published between 1996 and 2016 was carried out: five studies were included in this review. Included studies were predominantly carried out in aged care facilities with aged populations affected by a range of conditions; all studies assessed aspects of mental well-being. The review found music reminiscence therapy to have positive effects for participants in four out of five studies. Further research incorporating qualitative methods and mapping of intervention procedures would complement existing findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Relationship between Sensory Perception and Frailty in a Community-Dwelling Elderly Population.

    PubMed

    Somekawa, S; Mine, T; Ono, K; Hayashi, N; Obuchi, S; Yoshida, H; Kawai, H; Fujiwara, Y; Hirano, H; Kojima, M; Ihara, K; Kim, H

    2017-01-01

    Aging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging. To evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas. Data from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried's frailty criteria. The area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63). Taste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

  7. Epidemic trend of periodontal disease in elderly Chinese population, 1987–2015: a systematic review and meta-analysis

    PubMed Central

    Yang, Hongmei; Xiao, Li; Zhang, Lei; Deepal, Stacytabi; Ye, Guo; Zhang, Xiaonan

    2017-01-01

    Periodontal disease is a common oral health problem in the elderly population. The prevalence varied substantially due to absence of a universal diagnostic criteria. We conducted a systematic review to identify the epidemiological characteristics of periodontal diseases among Chinese elderly people. A total of 19 articles were included. The pooled detection rates for three indicators, including bleeding on probing (BOP), pocket depth (PD) and clinical attachment loss (CAL), were 53.9% (95% CI: 43.8–63.9%), 57.0% (50.8–63.2%), and 70.1% (65.4–74.8%), respectively. No significant differences in these indicators between urban and rural population. When stratified by gender, BOP (+) detection rates did not show any differences, but the detection rates of PD ≥ 4 mm and CAL ≥ 4 mm were significantly higher in males than in females (59.3% [53.4–65.2%] versus 50.8% [43.5–58.0%], RRPD = 1.13 [1.01–1.26]; 73.8% [70.0–77.7%] versus 65.2% [60.2–70.2%], RRCAL = 1.21 [1.11–1.32]). No statistically significant differences were observed between CAL ≥ 4 mm and PD ≥ 4 mm (RR = 1.12, [0.83–1.50]). A geographical map based on available data during 1987–2015 showed wide variations of periodontal disease across the mainland China. Some factors such as heterogeneity of case definitions, no specific diagnosis of periodontitis, and variable quality of the included studies could affect the final results. Hence, further high-quality epidemiological studies with standardized diagnostic criteria are needed. PMID:28358004

  8. Validity and applicability of a video-based animated tool to assess mobility in elderly Latin American populations.

    PubMed

    Guerra, Ricardo Oliveira; Oliveira, Bruna Silva; Alvarado, Beatriz Eugenia; Curcio, Carmen Lucia; Rejeski, W Jack; Marsh, Anthony P; Ip, Edward H; Barnard, Ryan T; Guralnik, Jack M; Zunzunegui, Maria Victoria

    2014-10-01

    To assess the reliability and the validity of Portuguese- and Spanish-translated versions of the video-based short-form Mobility Assessment Tool in assessing self-reported mobility, and to provide evidence for the applicability of these videos in elderly Latin American populations as a complement to physical performance measures. The sample consisted of 300 elderly participants (150 from Brazil, 150 from Colombia) recruited at neighborhood social centers. Mobility was assessed with the Mobility Assessment Tool, and compared with the Short Physical Performance Battery score and self-reported functional limitations. Reliability was calculated using intraclass correlation coefficients. Multiple linear regression analyses were used to assess associations among mobility assessment tools and health, and sociodemographic variables. A significant gradient of increasing Mobility Assessment Tool score with better physical function was observed for both self-reported and objective measures, and in each city. Associations between self-reported mobility and health were strong, and significant. Mobility Assessment Tool scores were lower in women at both sites. Intraclass correlation coefficients of the Mobility Assessment Tool were 0.94 (95% confidence interval 0.90-0.97) in Brazil and 0.81 (95% confidence interval 0.66-0.91) in Colombia. Mobility Assessment Tool scores were lower in Manizales than in Natal after adjustment by Short Physical Performance Battery, self-rated health and sex. These results provide evidence for high reliability and good validity of the Mobility Assessment Tool in its Spanish and Portuguese versions used in Latin American populations. In addition, the Mobility Assessment Tool can detect mobility differences related to environmental features that cannot be captured by objective performance measures. © 2013 Japan Geriatrics Society.

  9. Self-medication with over-the-counter drugs and complementary medications in South Australia's elderly population

    PubMed Central

    2009-01-01

    Background A number of surveys have examined use of complementary and alternative medicines (CAM) in Australia. However, there are limited Australian data on use of CAM and over-the-counter (OTC) medicines in the elderly population. The main aims of this study were to examine self-medication practices with CAM and OTC medicines among older Australians and variables associated with their use. Methods The Australian Longitudinal Study of Ageing (ALSA) is an ongoing multidisciplinary prospective study of the older population which commenced in 1992 in South Australia. Data collected in 4 waves of ALSA between 1992 and 2004 were used in this study with a baseline sample of 2087 adults aged 65 years and over, living in the community or residential aged care. OTC medicines were classified according to the World Health Organization Anatomical Therapeutic Chemical (ATC) classification. CAM were classified according a modified version of the classification adopted by the Therapeutics Goods Administration (TGA) in Australia. Results The prevalence of CAM or OTC use ranged from 17.7% in 2000-2001 to 35.5% in 2003-2004. The top classes of CAM and OTC medicines used remained relatively constant over the study period. The most frequent classes of CAM used were vitamins and minerals, herbal medicines and nutritional supplements while the most commonly used OTC were analgesics, laxatives and low dose aspirin. Females and those of younger age were more likely to be CAM users but no variable was associated with OTC use. Conclusion Participants seemed to self-medicate in accordance with approved indications, suggesting they were informed consumers, actively looking after their own health. However, use of analgesics and aspirin are associated with an increased risk of adverse drug events in the elderly. Future work should examine how self-medication contributes to polypharmacy and increases the risk of adverse drug reactions. PMID:19906314

  10. Statin treatment is associated with survival in a nationally representative population of elderly women with epithelial ovarian cancer.

    PubMed

    Vogel, Tilley Jenkins; Goodman, Marc T; Li, Andrew J; Jeon, Christie Y

    2017-08-01

    Observational studies suggest that statin therapy for cardio-protection is associated with improved survival in cancer patients. We sought to evaluate the impact of statin treatment on ovarian cancer survival in a nationally representative elderly population. The linked Surveillance, Epidemiology, and End Results (SEER) registries and Medicare claims data on patients diagnosed with epithelial ovarian cancer in 2007-2009 were used to extract data on statin prescription fills, population characteristics, primary treatment, comorbidity and survival. Cox regression models were used to examine the association between statin treatment and overall survival. Among the 1431 ovarian cancer patients who underwent surgical resection, 609 (42.6%) filled prescriptions for statin. The majority of statin-users (89%) were prescribed a lipophilic formulation. Mean overall survival among statin-users was 32.3months compared to 28.8months for non-users (p<0.0001). A 34% reduction in death was associated with statin therapy, independent of age, race, neighborhood median household income, stage, platinum therapy and comorbid conditions (HR=0.66, 95% CI 0.55-0.81). Improved overall survival with statin use was observed for both serous (HR=0.69, 95% CI 0.54-0.87) and non-serous (HR=0.63, 95% CI 0.44-0.90) histologies. When statin treatment was categorized by lipophilicity and intensity, a significant survival benefit was limited to lipophilic statin users and those who took statins of moderate intensity. This SEER-Medicare analysis demonstrates improvement in overall survival with lipophilic statin use after surgery in elderly patients with epithelial ovarian cancer. A clinical trial to evaluate the impact of statin treatment in ovarian cancer survival is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Long-term drug use and polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina.

    PubMed

    Marković-Peković, Vanda; Škrbić, Ranko

    2016-05-01

    Prescription of drugs is a fundamental care component of the elderly. Elderly patients often take multiple drugs, and it is known that polypharmacy may lead to drug interactions and adverse events. The aim of this study was to analyze the long-term drug use and the prevalence of polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina. METHODS; A retrospective study of outpatient drug use in 2005 and 2010 was conducted, analyzing prescriptions for patients aged ≥ 65 years reimbursed by the Health Insurance Fund. The study population was stratified by gender and age. Long-term drug use was defined as continuous drug dispensing for a whole year or at least two thirds of the year. Polypharmacy was defined as the use of 5 or more different reimbursed drugs. Of all insured people aged ≥ 65 years, long-term drug use was identified in 10% (2005) and in 19% (2010), of whom 62% were women. Two to four different drugs were used by almost 49% (2005) and 54% (2010) of the elderly patients. The polypharmacy prevalence increased from 1.4% (2005) to 3.6% (2010); it increased in all the age groups of both genders. The largest increase was observed in the age group 65-74 years. Polypharmacy prevalence increase was higher in women. The most commonly used drugs were those for to treatment of cardiovascular diseases, in particular drugs for hypertension and cardiac treatment. The study findings point out to the increase of elderly population with a long-term drug use. Over a half of elderly patients use 2-4 different drugs on the long-term basis. The polypharmacy prevalence was low. It increased in the period of 5 years in both genders. The increase was more prominent in women of all the age groups. The use of multiple drugs and polypharmacy increased with ageing.

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

    PubMed

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

    2016-04-01

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

  13. Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools

    PubMed Central

    Yaxley, Alison; Crotty, Maria; Miller, Michelle

    2015-01-01

    Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ), were completed by 185 ambulatory rehabilitation patients (48% male; median age 78 years) and results compared to the full MNA as a reference technique. Prevalence of risk of malnutrition was 63% according to the MNA. For identification of risk of malnutrition the CNAQ had sensitivity of 54%, specificity 81%, positive predictive value 83% and negative predictive value 51%, compared to 28%, 94%, 89% and 44%, respectively, using SNAQ. Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population. PMID:27417799

  14. Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools.

    PubMed

    Yaxley, Alison; Crotty, Maria; Miller, Michelle

    2015-09-11

    Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ), were completed by 185 ambulatory rehabilitation patients (48% male; median age 78 years) and results compared to the full MNA as a reference technique. Prevalence of risk of malnutrition was 63% according to the MNA. For identification of risk of malnutrition the CNAQ had sensitivity of 54%, specificity 81%, positive predictive value 83% and negative predictive value 51%, compared to 28%, 94%, 89% and 44%, respectively, using SNAQ. Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population.

  15. Pharmacokinetics in the elderly.

    PubMed Central

    Mayersohn, M

    1994-01-01

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

  16. Prevalence of headache in an elderly population: attack frequency, disability, and use of medication

    PubMed Central

    Prencipe, M; Casini, A; Ferretti, C; Santini, M; Pezzella, F; Scaldaferri, N; Culasso, F

    2001-01-01

    OBJECTIVES—To assess the 1 year prevalence of tension-type headache (TTH), migraine headache (MH), and chronic daily headache (CDH), as well as of headache in general in a rural elderly population.
METHODS—A door to door two phase survey was carried out on all elderly (⩾65 years) residents in three villages in central Italy. Participants completed a standardised headache questionnaire and underwent a clinical evaluation by a neurologist. Headache diagnosis was made according to the classification of the International Headache Society, with minor modifications for the classification of patients with MH with⩾15 attacks/month.
RESULTS—Eight hundred and thirty three (72.6%) of the 1147 eligible persons completed the study protocol. One year prevalence rates were respectively 44.5% for TTH, 11.0% for MH, 2.2% for symptomatic headaches, and 0.7% for the remaining types of headache. The prevalence of headache in general was 51.0% because 62 residents had both TTH and MH attacks. Prevalence rates of patients with headache were higher in women than men (62.1% and 36.6% respectively) and decreased steadily with age for the 65-74, 75-84, and 85-96 age groups (56.7%, 45.2% and 26.1% respectively). Prevalence rates were 20.4% for patients with moderate to severe attacks, 18.0% for those with ⩾1 attacks a month, and 4.4% for those with CDH. Of the 425 with headache 52 (12.2%) had not taken any drugs for their attacks in the previous year, 195 (45.9%) had taken them regularly, and 178 (41.9%) had taken them only when the headache pain interfered with activities that could not be postponed. Medication overuse was reported by 37.8% of patients with CDH with higher proportions for transformed migraine than for patients with chronic TTH (69.2% and 23.8% respectively, p=0.009)
CONCLUSIONS—A consistent proportion of elderly people have primary headaches and consultation with a specialist is particularly recommended for patients with moderate or severe attacks, or

  17. Description of a mixed ethnic, elderly population. II. Food group behavior and related nonfood characteristics.

    PubMed

    Prothro, J W; Rosenbloom, C A

    1999-06-01

    Elderly persons 60-103 years of age, who were participants in a Title III-C Nutrition Program, provided information regarding weekly frequencies of food group consumption, weekend meals and snack patterns, and several nonfood items that may affect food intakes. Nonrandomized volunteers were interviewed in senior centers or in their homes. Chi-square, t test, and Pearson's product moment correlations were used to assess differences in the population sample with regard to six independent variables: ethnicity, gender, type meal (congregate or home delivered), age, proportion of noon meal usually eaten, and socialization factor (lived alone or with others). White subjects ate more fruits, dairy products, and weekend snacks than black subjects. White elders also consumed more caffeine, had larger incomes, and more often had sufficient money to buy food. Black subjects ate more pasta and desserts, and in sickness more often had help available. Men consumed more meats, dairy products, eggs, and starchy foods than women. There were no gender differences in income, but men ate more weekend meals in restaurants, spent more money weekly for food, more often were able to shop for food and leave home without assistance, and reported greater pleasure associated with eating. Home delivery clients ate more desserts and Sunday snacks and more frequently ate breakfast on the weekend than congregate clients. Congregate clients had more money to buy food, were better able to shop for and prepare food, and more frequently had help available in sickness. Young-old (<75 yr) and old-old (> r =75 yr) clients showed no difference in consumption of any of the food groups. Persons who usually ate all or most of the noon meal more frequently experienced pleasurability in eating, reported less anorexia, and had larger intakes of the vegetable and pasta groups. Persons living with others ate more meats, pasta, and desserts, spent more weekly for food, and ate more weekend meals in restaurants

  18. Built environment attributes and walking patterns among the elderly population in Bogotá.

    PubMed

    Gómez, Luis F; Parra, Diana C; Buchner, David; Brownson, Ross C; Sarmiento, Olga L; Pinzón, José D; Ardila, Mauricio; Moreno, José; Serrato, Mauricio; Lobelo, Felipe

    2010-06-01

    There is increasing evidence that the built environment has an influence on physical activity; however, little is known about this relationship in developing countries. This study examined the associations between attributes of the built environment and walking patterns among the elderly. A multilevel cross-sectional study was conducted in 2007. Fifty neighborhoods were selected and 1966 participants aged > or =60 years were surveyed. Objective built environment measures were obtained in a buffer of 500 m using GIS. Environmental perceptions were assessed via questionnaire. People who lived in areas with middle park area (4.53%-7.98% of land) were more likely to walk for at least 60 minutes during a usual week (prevalence OR [POR]=1.42, 95% CI=1.02, 1.98). Those who lived in areas with the highest connectivity index (1.81-1.99) were less likely to report walking for at least 60 minutes (POR=0.64, 95% CI=0.44, 0.93). Participants who reported feeling safe or very safe from traffic were more likely to report walking for at least 60 minutes (POR=1.50, 95% CI=1.11, 2.03). The presence of Ciclovía (recreational program) was marginally associated with having walked at least 150 minutes in a usual week (POR=1.29, 95% CI=0.97, 1.73). This study showed that certain built and perceived environment characteristics were associated with walking among older adults living in Bogotá. Further studies should be conducted to better understand the potential influence of the built environment on physical activity among the elderly population in the context of Latin American cities. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Determinants of the utilization of dental services in a community-dwelling elderly Japanese population.

    PubMed

    Ohi, Takashi; Sai, Motoyuki; Kikuchi, Masahiko; Hattori, Yoshinori; Tsuboi, Akito; Hozawa, Atsushi; Ohmori-Matsuda, Kaori; Tsuji, Ichiro; Watanabe, Makoto

    2009-07-01

    Oral health care is not only an effective strategy for the prevention, early diagnosis, and treatment of orofacial disease and disorders, but also an essential component of general health promotion programs. The current study aimed to identify the determinants of the utilization of dental services in an elderly population in Japan. A community-based comprehensive geriatric assessment, including the measurements of physical, mental, and social functioning, was conducted among elderly people aged >or= 70 years residing in a suburban area of Sendai, Japan. Oral health status and functioning, their impact on the quality of life, and dental utilization were also surveyed. Of the 1,170 participants, 418 subjects who had specific treatment needs for dental problems and reported irregular dental attendance were recommended a dental visit, and 1 year later, their compliance with the recommendation was assessed by using questionnaire. Multiple logistic regression analysis demonstrated that a higher number of remaining teeth and the use of removable dentures were significant predictors of dental utilization within 1 year. Regular utilization was associated with a higher number of remaining teeth, younger age, presence of systemic disease, absence of depressive symptoms, and higher educational attainment. Conversely, non-compliance with the treatment recommendations was associated with fewer remaining teeth, smoking, and non-utilization of dental services during the previous year. The differences in the determinants of dental attendance behavior, which may be partially associated with the insurance coverage for dental services, suggest the need for specific strategies for oral health promotion for different behavior of dental utilization.

  20. Social network characteristics and body mass index in an elderly Korean population.

    PubMed

    Lee, Won Joon; Youm, Yoosik; Rhee, Yumie; Park, Yeong-Ran; Chu, Sang Hui; Kim, Hyeon Chang

    2013-11-01

    Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m(2)) in an elderly Korean population. This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis. After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (β=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (β=0.885, p=0.049), but not in the men (p=0.140). Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.

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

    PubMed

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

    2016-08-01

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

  2. [Falls in the Spanish elderly population: Incidence, consequences and risk factors].

    PubMed

    Rodríguez-Molinero, Alejandro; Narvaiza, Leire; Gálvez-Barrón, César; de la Cruz, Juan José; Ruíz, Jorge; Gonzalo, Natalia; Valldosera, Esther; Yuste, Antonio

    2015-01-01

    Falls in the elderly constitute a public health concern. The objective of the present study was to collect updated data on the frequency of falls in the Spanish elderly population, as well as to analyse their consequences and associated risk factors. This prospective study was conducted on a probabilistic sample of 772 Spanish, community dwelling, older adults. During the baseline visit, data were collected on functional capacity, history of falls, disease background, number of medications used, balance impairment, use of walking aids, cognitive capacity and depression symptoms. Participants were followed up for one year by means of quarterly phone calls, where they were asked about the number of falls occurred in that period, as well as their consequences and associated use of healthcare resources. During the one-year follow up period, 28.4% (95%CI 24.9-32.1) of participants suffered one or more falls, while 9.9% (95%CI 7.4-11.4) suffered multiple falls. One-third of the falls were due to accidental extrinsic causes. Among participants who had suffered falls, 9.3% suffered a fracture (3.1% hip fracture), and 55.4% required healthcare services (29% were managed in the hospital emergency room, and 7.3% were admitted to hospital). Risk factors identified through multivariate analysis were: advanced age (>79 years), not having a companion, using more than 2 drugs, dependency in BADLs, impaired strength or balance, and use of walking aids. Falls continue to be a major public health concern in Spain. Given that some of the associated risk factors may be modified, introducing programs aimed at tackling this problem should be regarded as a priority. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  3. Gender-specific association between metabolic syndrome and decreased glomerular filtration rate in elderly population.

    PubMed

    Wen, Jia; Guo, Chen-Xian; Lu, Ming-Gen; Lu, Yao; Huang, Yun; Liu, Xing; Li, Ying; Huang, Zhi-Jun; Zhang, Ya-Ping; Yuan, Hong

    2016-03-01

    Few studies have investigated the association between metabolic syndrome (MS) and chronic kidney disease in the elderly. Accordingly, the aim of this study was to examine the sex-specific association between MS and decreased glomerular filtration rate (GFR) in a Chinese elderly population. We performed cross-sectional analyses of older (age ≥60 years) males (n = 19,015) and females (n = 23,310) classified as 0, 1, 2, 3, 4, and 5 component(s) or MS group based on the presenting MS component(s). Sex-specific relationship of decreased GFR with MS component(s) was analyzed by logistic regression models. Compared with participants with 0 component of MS, males with 1, 2, 3, 4, and 5 component(s) had 1.40-, 1.79-, 2.41-, 3.29-, and 4.09-fold risks for decreased GFR; females with 1, 2, 3, 4, and 5 component(s) had 1.65-, 1.71-, 1.88-, 2.32-, and 1.96-fold risks for decreased GFR, respectively. The multivariate-adjusted odds ratios for decreased GFR in males and females with MS compared with those without MS were 1.79 and 1.25, respectively. For participants without hypertension and diabetes, the association of MS with decreased GFR was still significant. In this study of 42,325 Chinese participants aged ≥60 years, MS was significantly associated with decreased GFR, and the association was more profound for males than females.

  4. Diabetes and cognitive function in a population-based study of elderly women and men.

    PubMed

    Debling, Desiree; Amelang, Manfred; Hasselbach, Petra; Stürmer, Til

    2006-01-01

    The aim of this study was to examine the association between diabetes and cognitive function in the elderly. From January to December 2003, all 740 participants, aged 70 years or more, of an ongoing population-based cohort study were eligible for a telephone interview on cognitive function. Cognitive function was assessed using validated instruments, including the Telephone Interview of Cognitive Status (TICS) and the East Boston Memory Test (EBMT). Information on diabetes was available from prior questionnaires and was validated in 2002. We used multivariable logistic regression to estimate odds ratios (OR) of an impaired cognitive function (below 25th percentile) and their 95% confidence intervals (CI) adjusting for age, gender, smoking, alcohol consumption, body mass index (BMI), physical exercise, educational level, and depressive symptoms. Out of 473 participants interviewed (64.9%), 66 had diabetes (14.1%). The adjusted OR for diabetes and impaired cognitive function assessed by TICS was 2.3 (95% CI: 1.2-4.3). Diabetes was also associated with performance on delayed recall EBMT (adjusted OR=2.0; 95% CI: 1.0-4.1), but not immediate EBMT recall (adjusted OR=1.0; 95% CI: 0.5-2.1). The association between diabetes and cognitive function was a bit more pronounced in participants in whom diabetes was diagnosed 12 (median) or more years prior (adjusted OR with TICS=2.4; 95% CI: 1.0-5.8) and in those without antidiabetic treatment (age- and sex-adjusted OR=3.4; 95% CI: 1.7-6.5). Diabetes should be considered to be a risk factor for cognitive impairment in the elderly, which might be attenuated by antidiabetic treatment.

  5. Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study.

    PubMed

    Charpentier, Cloé; Salleron, Julia; Savoye, Guillaume; Fumery, Mathurin; Merle, Véronique; Laberenne, Jean-Eric; Vasseur, Francis; Dupas, Jean-Louis; Cortot, Antoine; Dauchet, Luc; Peyrin-Biroulet, Laurent; Lerebours, Eric; Colombel, Jean-Frédéric; Gower-Rousseau, Corinne

    2014-03-01

    Data on the natural history of elderly-onset inflammatory bowel disease (IBD) are scarce. In a French population-based cohort we identified 841 IBD patients >60 years of age at diagnosis from 1988 to 2006, including 367 Crohn's disease (CD) and 472 ulcerative colitis (UC). Median age at diagnosis was similar for CD (70 years (IQR: 65-76)) and UC (69 years (64-74)). Median follow-up was 6 years (2-11) for both diseases. At diagnosis, in CD, pure colonic disease (65%) and inflammatory behaviour (78%) were the most frequent phenotype. At maximal follow-up digestive extension and complicated behaviour occurred in 8% and 9%, respectively. In UC, 29% of patients had proctitis, 45% left-sided and 26% extensive colitis without extension during follow-up in 84%. In CD cumulative probabilities of receiving corticosteroids (CSs), immunosuppressants (ISs) and anti tumor necrosis factor therapy were respectively 47%, 27% and 9% at 10 years. In UC cumulative probabilities of receiving CS and IS were 40% and 15%, respectively at 10 years. Cumulative probabilities of surgery at 1 year and 10 years were 18% and 32%, respectively in CD and 4% and 8%, respectively in UC. In CD complicated behaviour at diagnosis (HR: 2.6; 95% CI 1.5 to 4.6) was associated with an increased risk for surgery while CS was associated with a decreased risk (HR: 0.5; 0.3 to 0.8). In UC CS was associated with an increased risk (HR: 2.2; 1.1 to 4.6) for colectomy. Clinical course is mild in elderly-onset IBD patients. This information would need to be taken into account by physicians when therapeutic strategies are established.

  6. Cataract Surgery and Visual Acuity in Elderly Japanese: Results of Fujiwara-kyo Eye Study

    PubMed Central

    Miyata, Kimie; Yoshikawa, Tadanobu; Mine, Masashi; Nishi, Tomo; Okamoto, Nozomi; Ueda, Tetsuo; Kawasaki, Ryo; Kurumatani, Norio; Ogata, Nahoko

    2017-01-01

    Abstract The aim of this study was to determine the presence of prior cataract surgery and best-corrected visual acuity (BCVA) in an elderly Japanese cohort. The Fujiwara-kyo Eye Study was a prospective, population-based, cross-sectional epidemiological study. The subjects were ≥68 years who lived in the Nara Prefecture and responded to recruitment notices. All of the subjects underwent comprehensive ophthalmological examinations, and the sociodemographic information and medical history, including prior cataract surgery, were obtained by answers to a questionnaire. The associations between the BCVA, age, sex, and history of cataract surgery were determined. A total of 2,873 subjects whose mean age was 76.3 ± 4.9 (mean ± standard deviation) years were studied. The mean BCVA was −0.020 ± 0.14 logarithm of the minimum angle of resolution units, and it was significantly better in the group with education ≥13 years (p < 0.01). Overall, 24.2% of the subjects had undergone cataract surgery, and 41.7% of the subjects ≥80 years had undergone cataract surgery. The incidence of prior cataract surgery increased with increasing age (p < 0.001 for trend). The mean BCVA of eyes with cataract surgery was significantly better than that of eyes without cataract surgery in subjects ≥80 years (p < 0.01). Visual acuity was generally good in this cohort of elderly Japanese subjects. In this cohort, 24.2% of the subjects had undergone cataract surgery, and the subjects ≥80 years had better BCVA than those without cataract surgery. PMID:28451472

  7. Risk for progression to overt hypothyroidism in an elderly Japanese population with subclinical hypothyroidism.

    PubMed

    Imaizumi, Misa; Sera, Nobuko; Ueki, Ikuko; Horie, Ichiro; Ando, Takao; Usa, Toshiro; Ichimaru, Shinichiro; Nakashima, Eiji; Hida, Ayumi; Soda, Midori; Tominaga, Tan; Ashizawa, Kiyoto; Maeda, Renju; Nagataki, Shigenobu; Akahoshi, Masazumi

    2011-11-01

    Few population-based studies report the changes with time in thyroid function tests in patients with subclinical hypothyroidism. We compared the risk for developing overt hypothyroidism in patients with subclinical hypothyroidism and euthyroid controls from the same population of elderly Japanese. We also sought associations of selected parameters with the development of overt hypothyroidism in the subclinical hypothyroid and euthyroid groups. We measured thyrotropin (TSH) and free thyroxine (T4) levels at baseline examinations performed from 2000 to 2003 in the cohort of Japanese atomic-bomb survivors and identified 71 patients with spontaneous subclinical hypothyroidism (normal free T4 and TSH >4.5 mIU/L without a history of thyroid treatment, mean age 70 year) and 562 euthyroid controls. We re-examined TSH and free T4 levels an average of 4.2 years later (range, 1.9-6.9). The risk for progression to overt hypothyroidism was significantly increased in subclinical hypothyroid patients (7.0%) compared with control subjects (1.6%) after adjusting for age and sex (odds ratio, 4.56; p=0.009). Higher baseline TSH levels were associated with progression from subclinical to overt hypothyroidism (p=0.02) in the multivariate analysis, including age, sex, antithyroid peroxidase antibody, and ultrasonography (US) findings. The analysis using binary TSH data suggested that a TSH level >8 mIU/L was a predictive value for development of overt hypothyroidism (p=0.005). On the other hand, serum TSH levels spontaneously normalized in 38 (53.5%) of the patients with subclinical hypothyroidism. In the multivariate analysis, normalization of TSH levels was associated with lower baseline TSH levels (p=0.004) and normal and homogenous thyroid US findings (p=0.04). Atomic-bomb radiation dose was not associated with subclinical hypothyroidism or its course. Subclinical hypothyroidism was four times more likely to be associated with development of overt hypothyroidism than euthyroid

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

    PubMed Central

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

    2006-01-01

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

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

    PubMed

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

    2011-05-01

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

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

    PubMed

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

    2016-01-01

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

  11. Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study ‘Good ageing in Skane’

    PubMed Central

    2013-01-01

    Background Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design. Methods The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60–93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls. Results The use of neuroleptics (OR 3.30, 95% CI: 1.15–9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17–3.04) and low walking speed (OR 1.77, 95% CI: 1.28–2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54–2.91), heart dysfunction, OR 1.66 (95% CI 1.26–2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88). Conclusions Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the

  12. Kinesiophobia is not associated with disability in elderly women with acute low back pain: Back Complaints in the Elders (BACE) Brazil study results.

    PubMed

    Felício, Diogo C; Pereira, Daniele S; de Queiroz, Barbara Z; da Silva, Juscelio P; Leopoldino, Amanda A O; Pereira, Leani S M

    2016-05-01

    The study of low back pain (LBP) is complex, and the physical and psychological aspects, including kinesiophobia, should be considered. Several studies have investigated the relationship between kinesiophobia and functionality in patients with chronic LBP. However, to the best of the authors' knowledge, no studies have investigated the association between kinesiophobia and self-reported assessments of disability and physical performance in elderly patients with acute LBP. The study aimed to investigate the association between kinesiophobia and self-reported and physical performance measures among the elderly with acute LBP. This was an observational, cross-sectional, ancillary study of the Back Complaints in the Elders study, a longitudinal observational epidemiologic research project by an international consortium involving Brazil, the Netherlands, and Australia. Sample selection was carried out by convenience. The study included women from the community aged 60 years old and older who presented with a new episode of LBP. Volunteers with severe diseases, as well as visual, hearing, and mobility losses, or cognitive dysfunction, were excluded. Four hundred fifty nine elderly women (mean age: 69.0±6.1 years) were included. Kinesiophobia was evaluated by Fear Avoidance Beliefs Questionnaire (FABQ), subscale FABQ-Phys. Functionality was investigated by the Roland-Morris Questionnaire and the gait speed test. Statistical analysis was performed using hierarchical linear regression model. Statistical significance was established at the level of .05. The additional predictive value because of the inclusion of the FABQ-Phys was 0.1%, using the Roland-Morris score, and 0.2% for the gait speed test. This was the first study to investigate the association between the FABQ-Phys and functionality in elderly patients with acute LBP. The results provide preliminary evidence that kinesiophobia assessed by the FABQ-Phys cannot be generalized to disability. Copyright © 2016

  13. Higher rate of microscopic hematuria in elderly patients who take regular doses of aspirin: Result from AHAP Study

    PubMed Central

    Moudi, Emadouddin; Hosseini, Seyed-Reza; Bijani, Ali

    2016-01-01

    Background: Aspirin is the most widely used drug in medicine for cardiovascular and as recently for its role in cancer prevention. Although the risk of bleeding events increased following regular use of aspirin, little is known about the association of aspirin and hematuria. The present study aimed to evaluate the association of regular aspirin use and microscopic hematuria in elderly. Methods: In this study, we have extracted the data of elderly people who participated in Amirkola Health and Aging Project (AHAP) and taking regular doses of aspirin. The prevalence of microscopic hematuria was compared between the elderly who took aspirin regularly and those who did not take it. Results: A total of 1243 individuals (54.22% males, 45.78% females) were entered in to the study. Two hundred and eighty-four (23%) elderly took regular doses of aspirin. Microscopic hematuria was seen in 305 (24.54%) elderly. The prevalence of microscopic hematuria was 27.27% in regular users of aspirin and 23.72% in non-users of aspirin (P=0.126). The prevalence of microscopic hematuria was significantly higher among the regular users of aspirin compared to non-users in multiple logistic regression analysis (P=0.035, OR=1.40, 95%CI: 1.02-1.92). Conclusion: Taking regular doses of aspirin was accompanied with higher rate of microscopic hematuria in the elderly. PMID:27999646

  14. Adherence to the Mediterranean diet pattern, cognitive status and depressive symptoms in an elderly non-institutionalized population.

    PubMed

    Hernández-Galiot, Ana; Goñi, Isabel

    2017-03-30

    Scientific evidence indicates that adherence to the Mediterranean diet protects against the deterioration of cognitive status and depressive symptoms during aging. However, few studies have been conducted in elderly non-institutionalized subjects. This study evaluated the relation between the adherence to the Mediterranean dietary pattern and cognitive status and depressive symptoms in an elderly population over 75 years. A cross-sectional study was conducted in a Mediterranean city (Garrucha, Spain) in 79 elderly people over 75 (36 men and 41 women). Adherence to the Mediterranean dietary pattern was determined using the Mediterranean Diet Adherence Screener (MEDAS). Cognitive function was determined by the Mini Mental State Examination (MMSE), and depressive symptoms were assessed by the Geriatric Depression Scale (GDS). Most of population showed a very high adherence to the Mediterranean diet pattern and optimal cognitive and affective status. They consumed olive oil as their main source of fat, high levels of fish and fruit, low levels of foods with added sugars, and a low consumption of red meat. A significant relation between the MEDAS and MMSE scores was found. However, no relationship was observed between the MEDAS and GDS. The Mediterranean diet pattern was positively related with the cognitive function, although the infl uence of a healthy dietary pattern on the symptomatology of depression was unclear. However, an effective strategy against cognitive function and depression would be to improve physical activity rates, establish lifelong healthy eating habits, and consume a nutritionally-rich diet in order to enhance quality of life of the elderly.

  15. Barriers, Attitudes, and Dietary Behaviors Regarding Sodium Reduction in the Elderly Korean-Chinese Population in Yanbian, China.

    PubMed

    Lee, Jounghee; Cui, Wenying; Jin, Meixiang

    2017-06-01

    This research investigated the barriers, attitudes, and dietary behaviors related to sodium reduction among the elderly Korean-Chinese population in Yanbian, China. We conducted this pilot study using both descriptive research and a focus group interview at the elderly community center in Yanbian. In total, 21 elderly Korean-Chinese (average age, 71 years) were examined. The findings showed that the top three barriers to sodium reduction were 1) the difficulties associated with having meals with others, 2) a preference for liquid based-dishes, and 3) the lack of taste in low-sodium dishes. Although the participants strongly believed that a reduced-sodium diet would improve their health, they were poorly aware of the amount of sodium in various foods and dishes. In particular, the focus group interviews with eight participants (mean age, 67 years) revealed that salt-preserved foods (e.g., Korean pickled cabbage called 'kimchi' and soybean paste) were frequently consumed as part of their food culture, and that very salty dishes were served at restaurants, both of which lead to a high sodium intake. This study provides useful preliminary data to help design a nutrition intervention program for sodium reduction that targets the elderly Korean-Chinese population in China.

  16. Burden and correlates of geriatric depression in the Uyghur elderly population, observation from Xinjiang, China.

    PubMed

    Feng, Lei; Li, Ping; Lu, Chen; Tang, Weiming; Mahapatra, Tanmay; Wang, Yu; Wang, Xihua; Ma, Ying; Ben, Yanli; Cao, Xiaolin; Mahapatra, Sanchita; Ling, Min;