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Sample records for elderly population results

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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…

  14. 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.

  15. 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,…

  16. 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)

  17. 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

  18. 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

  19. 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

  20. 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

  1. [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

  2. 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.

  3. 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

  4. 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.

  5. 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)

  6. 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.

  7. 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.

  8. 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.

  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. 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

  11. 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

  12. 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

  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. 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

  16. 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

  17. 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

  18. 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

  19. 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…

  20. [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.

  1. 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

  2. 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

  3. 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

  4. 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

  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. 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."

  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. 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.

  9. 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

  10. 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

  11. 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

  12. 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

  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. 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).

  15. [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

  16. 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…

  17. 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

  18. 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

  19. 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

  20. [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%.

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. Potential barriers in adoption of a medication compliance neckwear by elderly population.

    PubMed

    Choi, Young Mi; Olubanjo, Temiloluwa; Farajidavar, Aydin; Ghovanloo, Maysam

    2013-01-01

    This paper presents results of a study to understand potential barriers of geriatric population with chronic illnesses towards adoption of a wireless wearable medication compliance system in the form of a neckwear. The neck being a critical part of the body can serve as a good source to collect a range of health related information on an individual. The primary research question we investigate here is this: for individuals with chronic illnesses especially amongst the elderly population how willing are they to adopt a neckwear system if it can monitor and mitigate health complications? Elderly patients deal with constant prescription changes over time and this further degrades medication compliance and thereby complicates an already wavering health status. A semi-structured interview was conducted to better understand medication adherence, regimen and issues encountered using reminder devices with the goal of informing the design of a new compliance monitoring system. Results show that preserving health is one of the primary concerns of people living with chronic illnesses therefore there is a promising potential for seamless adoption of a neckwear medication compliance system with additional capabilities to monitor general health status.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. [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.

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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...

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

    EPA Science Inventory

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

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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

  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.

  20. 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.

  1. 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

  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. 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

  4. 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

  5. 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.

  6. 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.

  7. 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…

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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.…

  14. 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…

  15. [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.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. [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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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…

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  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. 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

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. Prevalence of lower gastrointestinal symptoms and associated consultation behaviour in a British elderly population determined by face-to-face interview.

    PubMed Central

    Chaplin, A; Curless, R; Thomson, R; Barton, R

    2000-01-01

    BACKGROUND: The incidence of organic lower gastrointestinal disease increases with age. However, the prevalence of lower gastrointestinal symptoms in a British elderly population is unclear, with previous epidemiological studies focusing on younger populations. Furthermore, there is little information about consultation behaviour associated with lower gastrointestinal symptoms. AIM: To determine the prevalence of lower gastrointestinal symptoms reported by randomly selected, elderly community subjects. METHODS: An age- and sex-stratified random sample of patients aged 65 years and over was drawn from a general practice register (n = 842). Those who had not refused to participate in an initial postal survey were invited to participate in a semi-structured physician interview at their own home to assess lower gastrointestinal symptomatology (n = 745). Non-participation bias and service use of all subjects were assessed from practice records. RESULTS: Five hundred and ninety-six (71%) patients were interviewed. Fifty-seven per cent of all participants had at least one lower gastrointestinal symptom. Individual symptoms and symptom complexes were common, affecting up to 32% of subjects. Only 24% of subjects with lower gastrointestinal symptoms consulted their general practitioner (GP) with such symptoms in the previous year. As few as 31% of subjects with new onset of the significant symptoms of rectal bleeding, abdominal pain, and a change in bowel habit consulted their GP. CONCLUSION: Lower gastrointestinal symptoms are common in a British elderly population and an important reason for GP consultation. PMID:11127169

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. 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.

  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. 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

  11. 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

  12. A Risk Score to Predict Type 2 Diabetes Mellitus in an Elderly Spanish Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Guasch-Ferré, Marta; Bulló, Mònica; Costa, Bernardo; Martínez-Gonzalez, Miguel Ángel; Ibarrola-Jurado, Núria; Estruch, Ramon; Barrio, Francisco; Salas-Salvadó, Jordi

    2012-01-01

    Introduction To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Materials and Methods A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample). Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample). The discrimination of Finnish Diabetes Risk Score (FINDRISC), German Diabetes Risk Score (GDRS) and our scores was assessed with the area under curve (AUC). Results The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%), and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. Discussion We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire. PMID:22442692

  13. A study of the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) in an Icelandic elderly population.

    PubMed

    Hannesdóttir, Kristin; Snaedal, Jón

    2002-01-01

    The Alzheimer's Disease Assessment Scale (ADAS) is designed for screening of cognitive and non-cognitive dysfunctions characteristic of persons with probable Alzheimer's disease (AD). The cognitive part of the scale (ADAS-Cog) is both convenient for screening of probable AD and as a measure of cognitive functioning during drug intervention. The aim of this study was to translate the ADAS-Cognitive sub-test (ADAS-Cog) into Icelandic and to study its application in an elderly Icelandic population. The Mini-Mental State Examination (MMSE) and the ADAS-Cog were administered to 20 AD patients and 20 controls. Each patient was also rated on the Global Deterioration Scale (GDS). The probable AD patients were divided into two groups based on their GDS: 3-4 and 5-6 points. The patients were also divided into two groups based on their MMSE score: very mild to mild (23-30 points) and mild to moderate (15-22 points). Furthermore, the subjects were divided into two age groups: 65-76 and 77-92 years. Results revealed a highly significant difference on MMSE (22.3 +/- 3.4; 26.8 +/- 1.6; P < 0.05) and ADAS-Cog (18.4 +/- 7.7; 7.3 +/- 3.5; P < 0.05) scores for patients and controls respectively. AD patients also performed significantly worse than the elderly control group on eight of the 11 sub-tests. Thus, the present findings are mainly in line with those of previous studies. The scale exceeds other screening tests such as the MMSE in that it addresses in more detail the symptoms of AD and is valuable for early detection of the illness and staging. ADAS-Cog plays an important role in the diagnostic makeup of AD along with other detailed investigations, such as neuropsychological assessment.

  14. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study

    PubMed Central

    Carrière, Isabelle; Fourrier-Reglat, Annie; Dartigues, Jean-François; Rouaud, Olivier; Pasquier, Florence; Ritchie, Karen; Ancelin, Marie-Laure

    2009-01-01

    Objective To examine the association between use of medications with anticholinergic properties, cognitive decline and incident dementia in a large community-based sample of subjects aged 65 years and over. Methods Participants were 4128 women and 2784 men from a population-based cohort recruited from three French cities. Cognitive performance, clinical diagnosis of dementia and anticholinergic use were evaluated at base-line, 2 and 4 year later. Results 7.5% of subjects reported anticholinergic drug use at base-line. Multivariate adjusted logistic regression indicated that women reporting anticholinergic drugs at base-line showed greater decline over four years in verbal fluency scores (OR=1.41, CI=1.11–1.79) and in global cognitive functioning (OR=1.22, CI=0.96–1.55) than women not using anticholinergic drugs. In men, an association was found with decline in visual memory (OR=1.63, CI=1.08–2.47) and to a lesser extent in executive function (OR=1.47, CI=0.89–2.44). Significant interactions were observed in women between anticholinergic use and age, apolipoprotein E, or hormone replacement therapy. A significantly 1.4–2 fold higher risk of cognitive decline was observed for continuous anticholinergic users but not for those having discontinued. The risk of incident dementia over the four-year followup was also increased in continuous users (HR=1.65, CI=1.00–2.73) but not in those having discontinued anticholinergic drugs (HR=1.28, CI=0.59–2.76). Conclusions Elderly people taking anticholinergic drugs were at increased risk for cognitive decline and dementia. Discontinuing anticholinergic treatment was associated with a decreased risk. Physicians should carefully consider prescription of anticholinergic drugs in elderly people especially in the oldest old and persons at high genetic risk of cognitive disorder. PMID:19636034

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

    PubMed

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

    2016-01-01

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

  16. Interleukin 6, soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population: a translational approach.

    PubMed

    de Gonzalo-Calvo, David; de Luxán-Delgado, Beatriz; Rodríguez-González, Susana; García-Macia, Marina; Suárez, Francisco Manuel; Solano, Juan José; Rodríguez-Colunga, María Josefa; Coto-Montes, Ana

    2012-05-01

    In the present investigation we have analyzed the association between functional dependence and inflammatory biomarkers using the Barthel Index (BI) and the Katz Index (KI). This analysis may contribute to translational medicine by incorporating the clinical and laboratory data to better understand the relationship between chronic inflammation and functional dependence in the elderly population. The ultimate goal of this study was to identify possible useful biomarkers of functional dependence in the elderly. Participants in this study consisted of 120 older subjects (90 women and 30 men; range 68-105 years) who were selected from the Santa Teresa nursing home (Oviedo, Spain). We studied functional status using the following tools to diagnose the functional dependence by clinicians: BI and KI for activities of daily living. We analyzed morbidity, sociodemographic characteristics and a panel of inflammatory and inflammatory-related markers. In linear regression models adjusted by age, sex, anti-inflammatory drug use and morbid conditions high levels of interleukin 6 (IL-6) and soluble TNF receptor-I (sTNF-RI) were associated with functional dependence as measured using BI and KI. Elevated levels of red blood cell distribution width (RDW) were also associated with functional dependence measured using the KI after adjusting for the same potential confounders. The current results suggest that high IL-6, sTNF-RI and RDW levels are associated with the functional dependence in the elderly population. The results are consistent with the presumed underlying biological mechanism, in which the up-regulation of inflammatory mediators is associated with functional dependence in elderly subjects.

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

    PubMed Central

    2011-01-01

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

  18. Mistreatment and Self-Reported Emotional Symptoms: Results from the National Elder Mistreatment Study

    PubMed Central

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

    2010-01-01

    Significant numbers of community-residing older adults in the United States report some form of past year mistreatment; however, little is known about mental health correlates of elder abuse. The present study represents an initial investigation of whether a recent history of emotional, physical, or sexual abuse is associated with self-reported emotional symptoms (e.g., anxiety and depression) among a nationally representative sample of 5,777 older adults residing in the continental United States. Results demonstrated that each abuse type independently increased likelihood of reporting emotional symptoms; however, when other known correlates (social support, physical health, traumatic event exposure) were controlled only emotional abuse remained a significant predictor. These results indicate a need for additional study of mistreatment-related correlates of depression and anxiety, with a particular focus on the often overlooked category of emotional mistreatment. PMID:22737973

  19. Bayesian Evidence for Two Populations of White Dwarfs: Preliminary Results

    NASA Astrophysics Data System (ADS)

    Valentim, R.; Romero, A. D.; Kepler, S. O.; Horvath, J. E.; Rangel, E. M.

    2017-03-01

    White dwarf (WD) populations are analyzed using Bayesian tools, which allows inferring possible evolutionary paths through the study of the mass values. We employed a sample of 2761 DA white dwarf stars from the SDSS, and obtained the central mass values and their corresponding standard deviations using a bimodal population as an ansatz. The results indicate a population with M1 = 0.60 M⊙ and σ1 = 0.06 M⊙, corresponding to a single stellar evolution, and a second population with M2 = 1.00 M⊙ and σ1 = 0.11 M⊙ possibly due to binary evolution resulting from mergers.

  20. Oral health status of older adults in Kentucky: results from the Kentucky Elder Oral Health Survey.

    PubMed

    Bush, Heather M; Dickens, Noel E; Henry, Robert G; Durham, Lisa; Sallee, Nancy; Skelton, Judith; Stein, Pam S; Cecil, James C

    2010-01-01

    The purpose of the Kentucky Elder Oral Health Survey (KEOHS) was to assess the oral health status of Kentuckians 65 and older. The KEOHS consisted of a self-administered questionnaire and a clinical examination. Recruitment occurred from May 2002 through March 2005 of persons aged 65 and older (n = 1,386) whose functional ability was classified by residential setting. Independent elders living in their own homes were designated as "well-elders," those who lived in skilled nursing facilities and who were functionally dependent were designated as "nursing home elders," and those older adults who were considered frail were designated as "homebound elders." Significant associations were found between the functional ability of the elders and demographic characteristics. While elders who were homebound reported the highest rate of barriers to care, dental insurance, affordability, and transportation were consistently reported as barriers for all groups of elders. This study has established the baseline oral health status of older adults in Kentucky and the data show differences that exist for various community living situations.

  1. Association between genetic variants of IL-1beta, IL-6 and TNF-alpha cytokines and cognitive performance in the elderly general population of the MEMO-study.

    PubMed

    Baune, Bernhard T; Ponath, Gerald; Rothermundt, Matthias; Riess, Olaf; Funke, Harald; Berger, Klaus

    2008-01-01

    This study is to investigate the associations between specific polymorphisms in three cytokine genes and domains of cognitive functioning in a population based study in the elderly. In a cross-sectional study of 369 community dwelling elderly subjects we examined the relationships between the polymorphisms IL-1beta-1418C-->T, IL-6-572G-->C and TNF-alpha-308G-->A and the cognitive function domains memory, processing speed and motor function using an extensive neuropsychological test battery. Linear regression models were used in the analysis and results adjusted for multiple comparisons. A significant association between the IL-1beta-1418C-->T polymorphism and memory performance was found with carriers of the T allele (dominant model) having worse memory performance than those with the C allele. In addition, a significant association between the TNF-alpha-308G-->A polymorphism and processing speed was observed, indicating better performance for heterozygous or homozygous carriers of the A allele. These results remained significant after adjustment for known confounders of cognitive function and additional Bonferroni correction for multiple comparisons. Our study provides first results on detrimental effects of the IL-1beta-1418C-->T polymorphism on memory performance and neuroprotective effects of the TNF-alpha-308G-->A polymorphism on processing speed in elderly individuals. Further research is needed to prospectively examine changes in cognitive performance in relation to cytokine genotypes.

  2. Are there associations between socio-economic status and known diabetes in an elderly Finnish population?

    PubMed

    Hiltunen, L A

    2005-12-01

    The aim of the study was to describe the associations between socio-economic status and type 2 diabetes in a non-institutionalised population aged 70 years or over. Diabetes was assessed on the basis of self-reports and additionally 2-h oral glucose tolerance test for the subjects on diet treatment. Socio-economic status was assessed by questions on marital status, number of residents in household, basic education, self-rated income and economic status. In the population of 379 subjects (141 men), 14% (n = 19) of men and 19% (n = 46) of women had known diabetes. Known diabetes was less common among married compared to unmarried, widowed or divorced subjects. Diabetes was also more common among men with higher compared to lower level of basic education, while a reverse trend was seen among women. Women, who had been engaged in manual labour, had diabetes more often compared to those engaged in administrative work. Diabetes was more common among men who rated their income as good, but the opposite was true of women. Higher income among men and lower income among women were the most powerful variables associated with known diabetes. Known diabetes was more common in elderly women with lower socio-economic status, whereas the opposite was true of men. This finding suggests that the impact of the socio-economic changes that have taken place in Finland in the 20th century on the risk factors for diabetes has been greater among men with higher and women with lower socio-economic status.

  3. Emergency department visits and resulting hospitalizations by elderly nursing home residents, 2001-2008.

    PubMed

    Hsiao, Chun-Ju; Hing, Esther

    2014-03-01

    This study examines emergency department (ED) visits by nursing home (NH) residents aged 65 and over, and factors associated with hospital admission from the ED visit using data from the 2001-2008 National Hospital Ambulatory Medical Care Survey. Cross-sectional analyses were conducted on patient characteristics, diagnosis, procedures received, and triage status. On average, elderly NH residents visited EDs at a rate of 123 visits per 100 institutionalized persons. Nearly 15% of all ED visits had ambulatory care sensitive condition diagnoses. Nearly half of these visits resulted in hospital admission; chronic obstructive pulmonary disease, congestive heart failure, kidney/urinary tract infection, and dehydration were associated with higher odds of admission. Previous studies suggested that adequate medical staffing and appropriate care in the NH could reduce ED visits and hospital admissions. Recent initiatives seek to reduce ED visits and hospitalizations by providing financial incentives to spur better coordination between NH and hospital.

  4. Risk of gastrointestinal bleeding and cardiovascular events due to NSAIDs in the diabetic elderly population

    PubMed Central

    Kim, Jungmee; Lee, Joongyub; Shin, Cheol Min; Lee, Dong Ho; Park, Byung-Joo

    2015-01-01

    Objective We assessed gastrointestinal bleeding (GIB) and cardiovascular (CV) risks such as myocardial infarction or stroke associated with non-steroidal anti-inflammatory drug (NSAID) use among elderly patients with diabetes. Methods Using a nationwide claims database covering 2008–2012, we conducted a cohort study of patients with diabetes aged ≥65 years. Among the 117 610 patients, NSAID users and non-users were propensity score matched, excluding any who had experienced a potentially confounding event in the year prior to cohort entry. Multivariate Cox regression models treating death as competing risk were used. Results There were 2184 (1.86%) cases of GIB and NSAID users had an adjusted HR (aHR) of 1.68 (95% CI 1.54 to 1.83) of GIB risk after adjusting for age, sex, comorbidities and recent medications compared to NSAID non-users. There were 9333 (7.94%) cases of myocardial infarction or stroke with an aHR of 1.20 (95% CI 1.15 to 1.25). The risk of GIB was higher in patients with liver disease and renal failure, while that of CV events was higher in patients who received anticoagulants, antiplatelet agents, aspirin and selective serotonin reuptake inhibitors. The number needed to harm was 111 for GIB and 77 for CV events. Among different NSAIDs, nimesulide increased the risk of GIB and ketorolac increased the risk of CV events compared to celecoxib (aHR 2.60 and 3.13, respectively). Conclusions Elderly patients with diabetes treating NSAIDs had a significantly higher risk of both upper GIB and CV events compared to NSAID non-users, and the risk varied among different NSAIDs regardless of cyclooxygenase-2 activity. PMID:26719806

  5. Denture acceptance among newly rehabilitated elderly population in old age homes in South India

    PubMed Central

    Shetty, Mallika S.; Panchaml, Ganesh Shenoy; Shenoy, K. Kamalakanth

    2015-01-01

    Introduction: Elders in old age homes are mainly those who have been abandoned by their family and have one or more physical or mental disabilities. It is a major challenge for the dental professional to plan oral health strategy for this group of patients. Aim of the Study: Aim of the present study is to observe and determine the acceptance of new dental prosthesis among the elderly residing as inmates of 3 old age homes in Mangalore City. Materials and Methods: This cross-sectional study was conducted using a survey proforma. Information regarding their experience with the new denture, 1-month, 3 months and 6 months after denture insertion was gathered. Statistical analysis of the data was done using the Chi-square test with the P < 0.05 considered significant. Results: One hundred and eighty-three residents out of a total of 400 residents in 3 old age homes were denture wearers. Among them, 101 (55.2%) were females, and 82 (44.8%) were males. Dental prosthesis whether worn regularly, discomfort, retention, cleansing of denture during a period of 1-month, 3 months and 6 months was found to be significant satisfaction with the prosthesis, denture adhesives used, food accumulation during a period of 1-month, 3 months and 6 months was found to be nonsignificant. Conclusion: The emotional makeup of the patient must be taken into consideration during the entire procedure. We must understand that the success of the prosthesis depends mainly on the patient's confidence in the dentist rather than the quality of the prosthesis. PMID:25821384

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

    PubMed Central

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

    2016-01-01

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

  7. Assessing cognitive ability in research: use of MMSE with minority populations and elderly adults with low education levels.

    PubMed

    Wood, Robin Y; Giuliano, Karen K; Bignell, Candace U; Pritham, Whitney W

    2006-04-01

    The Mini-Mental State Examination (MMSE), originally designed to screen for dementia, is an instrument currently used extensively to assess cognitive status in clinical and community settings. This descriptive study compares standard MMSE scores to MMSE scores adjusted for age and education in a sample of 414 elderly Black and White women living independently in communities. After scores were adjusted, 14 participants (all Black) were moved from categories of mild cognitive impairment to unimpaired cognitive ability. However, even after scores were adjusted for age and education, White elderly adults still had higher mean scores than Black elderly adults (p = .003), suggesting that racial differences may have an effect on MMSE performance independent of age and education. Further research is needed to better understand the interaction of race and culture on MMSE outcomes. Implications are offered for appropriate use of the MMSE considering factors of age, education, and racial differences to guide evidence-based practice by gerontological nurses engaged in work with elderly populations.

  8. The Effects of Cognitive Training for Elderly: Results from My Mind Project

    PubMed Central

    Papa, Roberta; Lattanzio, Fabrizia; Postacchini, Demetrio

    2016-01-01

    Abstract Cognitive decline and dementia represent very important public health problems that impact the ability to maintain social function and independent living. The aim of this study was to investigate the effects of a nonpharmacological intervention consisting of comprehensive cognitive training in elderly people having one of three different cognitive statuses. In all, 321 elderly people with a diagnoses of mild–moderate Alzheimer's disease (AD), with mild cognitive impairment (MCI) and without cognitive decline were randomly assigned to two groups: experimental group (EG, who underwent intervention) and control group (CG), according to a prospective randomized intervention study. In the three groups, immediately after the end of the intervention, we observed a significant effect on some cognitive and noncognitive outcomes in the EGs. At the end of the intervention, we found an intermediate intervention effect on the Alzheimer's Disease Assessment Scale (ADAS) score of subjects with AD, as well as on functional status, as measured by using the Instrumental Activities of Daily Living scale. A significant intervention effect was also observed on enhancement of auditory verbal short-term memory and subjective memory complaints of subjects with MCI. The group of subjects without cognitive decline obtained a significant intervention effect on subjective complaints outcomes. The obtained results demonstrated that participation in the intervention could improve performance with respect to specific cognitive functions and psychological statuses. The role of healthy lifestyle programs, such as the use of comprehensive interventions, has been shown to be efficient for enhancing memory and other abilities in aged individuals with and without cognitive decline. PMID:26952713

  9. Reproducibility and effect of tissue composition on cerebellar γ-aminobutyric acid (GABA) MRS in an elderly population.

    PubMed

    Long, Zaiyang; Dyke, Jonathan P; Ma, Ruoyun; Huang, Chaorui C; Louis, Elan D; Dydak, Ulrike

    2015-10-01

    MRS provides a valuable tool for the non-invasive detection of brain γ-aminobutyric acid (GABA) in vivo. GABAergic dysfunction has been observed in the aging cerebellum. The study of cerebellar GABA changes is of considerable interest in understanding certain age-related motor disorders. However, little is known about the reproducibility of GABA MRS in an aged population. Therefore, this study aimed to explore the feasibility and reproducibility of GABA MRS in the aged cerebellum at 3.0 T and to examine the effect of differing tissue composition on GABA measurements. MRI and (1)H MRS examinations were performed on 10 healthy elderly volunteers (mean age, 75.2 ± 6.5 years) using a 3.0-T Siemens Tim Trio scanner. Among them, five subjects were scanned twice to assess the short-term reproducibility. The MEGA-PRESS (Mescher-Garwood point-resolved spectroscopy) J-editing sequence was used for GABA detection in two volumes of interest (VOIs) in the left and right cerebellar dentate. MRS data processing and quantification were performed with LCModel 6.3-0L using two separate basis sets, generated from density matrix simulations using published values for chemical shifts and J couplings. Raw metabolite levels from LCModel outputs were corrected for cerebrospinal fluid contamination and relaxation. GABA-edited spectra yielded robust and stable GABA measurements with averaged intra-individual coefficients of variation for corrected GABA+ between 4.0 ± 2.8% and 13.4 ± 6.3%, and inter-individual coefficients of variation between 12.6% and 24.2%. In addition, there was a significant correlation between GABA+ obtained with the two LCModel basis sets. Overall, our results demonstrated the feasibility and reproducibility of cerebellar GABA-edited MRS at 3.0 T in an elderly population. This information might be helpful for studies using this technique to study GABA changes in normal or diseased aging brain, e.g. for power calculations and the interpretation of longitudinal

  10. Accidental falls, health-related quality of life and life satisfaction: a prospective study of the general elderly population.

    PubMed

    Stenhagen, Magnus; Ekström, Henrik; Nordell, Eva; Elmståhl, Sölve

    2014-01-01

    As the physical consequences of accidental falls in the elderly are well-researched, the long-term associations between falls and quality of life and related concepts are less known. The aim of this study was to prospectively examine the long-term relations between falls and health-related quality of life (HRQoL) and life satisfaction (LS) over six years in the general elderly population. One thousand three hundred and twenty-one subjects (aged 60-93 years), from the general population in the south of Sweden, were included in a baseline assessment and a follow-up after six years. HRQoL was measured with the SF-12 and LS with the life satisfaction index A (LSI-A). The differences in mean scores between fallers at baseline (n=113) and non-fallers were statistical analyzed. Furthermore, the prediction of falls on the outcomes was analyzed using a multivariate linear regression model adjusted for multiple confounding factors. Fallers scored significant lower in HRQoL and LS at baseline and after six years, compared to non-fallers, especially in the SF-12 physical component (p=<0.001). In the linear regression analysis, one or more falls at the baseline predicted a significant reduction in the SF-12 physical component at the follow-up assessment (B-Coefficient -1.8, 95% CI -3.4 to -0.2). In conclusion, falls predict a long-term reduction in the physical component of HRQoL in the general elderly population. Over six years, fallers had a notable chronic lowered score in both HRQoL and LS, compared to non-fallers. This long-term depression of elderly fallers in these aspects may be more extent than previous assumed.

  11. Assessing the Generalizability of Randomized Trial Results to Target Populations

    PubMed Central

    Stuart, Elizabeth A.; Bradshaw, Catherine P.; Leaf, Philip J.

    2014-01-01

    Recent years have seen increasing interest in and attention to evidence-based practices, where the “evidence” generally comes from well-conducted randomized trials. However, while those trials yield accurate estimates of the effect of the intervention for the participants in the trial (known as “internal validity”), they do not always yield relevant information about the effects in a particular target population (known as “external validity”). This may be due to a lack of specification of a target population when designing the trial, difficulties recruiting a sample that is representative of a pre-specified target population, or to interest in considering a target population somewhat different from the population directly targeted by the trial. This paper first provides an overview of existing design and analysis methods for assessing and enhancing the ability of a randomized trial to estimate treatment effects in a target population. It then provides a case study using one particular method, which weights the subjects in a randomized trial to match the population on a set of observed characteristics. The case study uses data from a randomized trial of School-wide Positive Behavioral Interventions and Supports (PBIS); our interest is in generalizing the results to the state of Maryland. In the case of PBIS, after weighting, estimated effects in the target population were similar to those observed in the randomized trial. The paper illustrates that statistical methods can be used to assess and enhance the external validity of randomized trials, making the results more applicable to policy and clinical questions. However, there are also many open research questions; future research should focus on questions of treatment effect heterogeneity and further developing these methods for enhancing external validity. Researchers should think carefully about the external validity of randomized trials and be cautious about extrapolating results to specific

  12. Brain tissue volumes in the general population of the elderly: the AGES-Reykjavik study.

    PubMed

    Sigurdsson, Sigurdur; Aspelund, Thor; Forsberg, Lars; Fredriksson, Jesper; Kjartansson, Olafur; Oskarsdottir, Bryndis; Jonsson, Palmi V; Eiriksdottir, Gudny; Harris, Tamara B; Zijdenbos, Alex; van Buchem, Mark A; Launer, Lenore J; Gudnason, Vilmundur

    2012-02-15

    Imaging studies have reported conflicting findings on how brain structure differs with age and sex. This may be explained by discrepancies and limitations in study population and study design. We report a study on brain tissue volumes in one of the largest cohorts of individuals studied to date of subjects with high mean age (mean ± standard deviation (SD) 76 ± 6 years). These analyses are based on magnetic resonance imaging (MRI) scans acquired at baseline on 4303 non-demented elderly, and 367 who had a second MRI, on average 2.5 ± 0.2 years later. Tissue segmentation was performed with an automatic image analysis pipeline. Total brain parenchymal (TBP) volume decreased with increasing age while there was an increase in white matter hyperintensities (WMH) in both sexes. A reduction in both normal white matter (NWM)- and gray matter (GM) volume contributed to the brain shrinkage. After adjusting for intra-cranial volume, women had larger brain volumes compared to men (3.32%, p < 0.001) for TBP volume in the cross-sectional analysis. The longitudinal analysis showed a significant age-sex interaction in TBP volume with a greater rate of annual change in men (-0.70%, 95%CI: -0.78% to -0.63%) than women (-0.55%, 95%CI: -0.61% to -0.49%). The annual change in the cross-sectional data was approximately 40% less than the annual change in the longitudinal data and did not show significant age-sex interaction. The findings indicate that the cross-sectional data underestimate the rate of change in tissue volumes with age as the longitudinal data show greater rate of change in tissue volumes with age for all tissues.

  13. Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population

    PubMed Central

    Kasukawa, Yuji; Miyakoshi, Naohisa; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Suzuki, Masazumi; Mizutani, Takashi; Kimura, Ryouta; Ono, Yuichi; Shimada, Yoichi

    2017-01-01

    Lumbar kyphosis and the decreased mobility of the lumbar spine increase the risk of falls and impair both the quality of life and the ability to perform activities of daily living. However, in the elderly Japanese population, little is known about the age-related changes and sex-related differences in muscle strength, including of the upper and lower extremities and back extensors. An adequate kyphotic or lordotic angle has also not been determined. In this study, we evaluated the age-related changes in muscle strength and spinal kyphosis in 252 males and 320 females ≥50 years of age. Grip, back extensor, hip flexor, and knee extensor strength; thoracic and lumbar kyphosis; and spinal inclination in the neutral standing position were assessed, together with the range of motion of the thoracic and lumbar spine and spinal inclination. Grip strength, back extensor strength, and the strength of the hip flexors and knee extensors decreased significantly with aging, both in males (P<0.0001) and in females (P=0.0015 to P<0.0001). The lumbar but not the thoracic kyphosis angle decreased significantly with aging, only in females (P<0.0001). Spinal inclination increased significantly with aging in both males (P=0.002) and females (P<0.0001). Back extensor strength and the thoracic kyphosis angle were significant variables influencing the lumbar kyphosis angle in both sexes. Spinal inclination correlated significantly with both the lumbar kyphosis angle and hip flexor strength in males, as well as with the lumbar kyphosis angle in females. PMID:28260870

  14. Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population.

    PubMed

    Kasukawa, Yuji; Miyakoshi, Naohisa; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Suzuki, Masazumi; Mizutani, Takashi; Kimura, Ryouta; Ono, Yuichi; Shimada, Yoichi

    2017-01-01

    Lumbar kyphosis and the decreased mobility of the lumbar spine increase the risk of falls and impair both the quality of life and the ability to perform activities of daily living. However, in the elderly Japanese population, little is known about the age-related changes and sex-related differences in muscle strength, including of the upper and lower extremities and back extensors. An adequate kyphotic or lordotic angle has also not been determined. In this study, we evaluated the age-related changes in muscle strength and spinal kyphosis in 252 males and 320 females ≥50 years of age. Grip, back extensor, hip flexor, and knee extensor strength; thoracic and lumbar kyphosis; and spinal inclination in the neutral standing position were assessed, together with the range of motion of the thoracic and lumbar spine and spinal inclination. Grip strength, back extensor strength, and the strength of the hip flexors and knee extensors decreased significantly with aging, both in males (P<0.0001) and in females (P=0.0015 to P<0.0001). The lumbar but not the thoracic kyphosis angle decreased significantly with aging, only in females (P<0.0001). Spinal inclination increased significantly with aging in both males (P=0.002) and females (P<0.0001). Back extensor strength and the thoracic kyphosis angle were significant variables influencing the lumbar kyphosis angle in both sexes. Spinal inclination correlated significantly with both the lumbar kyphosis angle and hip flexor strength in males, as well as with the lumbar kyphosis angle in females.

  15. Population attributable risks and costs of diabetogenic chemical exposures in the elderly

    PubMed Central

    Trasande, Leonardo; Lampa, Erik; Lind, Lars; Lind, P Monica

    2017-01-01

    Background A previous analysis examined the contribution of endocrine disruptor exposures (endocrine-disrupting chemicals, EDCs) to adult diabetes, but was limited to effects of phthalates in middle-aged women and did not simultaneously examine multiple EDCs which are known to coexist in the environment. We therefore endeavoured to quantify potential reductions in diabetes and disease costs that could result from reducing synthetic chemical diabetogenic exposures in the elderly in Europe. Methods We leveraged the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (∼1000 participants), which has measured exposure to phthalates; dichlorodiphenyltrichloroethylene; polychlorinated biphenyls (PCBs) and perfluoroalkyl substances to examine their independent contribution to diabetes. We estimated risk reductions assuming identical 25% reductions across levels of 4 selected compounds (PCB 153, monoethylphthalate, dichlorodiphenyldichloroethylene and perfluorononanoic acid), and diabetes costs saved in European men and women if diabetogenic exposures are limited. Results Reduction of chemical exposures was associated with a 13% (95% CI 2% to 22%) reduction in prevalent diabetes, compared with 40% resulting from an identical (25%) reduction in body mass index (BMI) in cross-sectional analyses. Extrapolating to Europe, 152 481 cases of diabetes in Europe and €4.51 billion/year in associated costs could be prevented, compared with 469 172 cases prevented by reducing BMI. Conclusions These findings support regulatory and individual efforts to reduce chemical exposures to reduce the burden and costs of diabetes. PMID:27789757

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. Prevalence and Risk Factors of Poor Sleep Quality among Chinese Elderly in an Urban Community: Results from the Shanghai Aging Study

    PubMed Central

    Zhao, Qianhua; Guo, Qihao; Meng, Haijiao; Hong, Zhen; Ding, Ding

    2013-01-01

    Background Sleep disorders causes a significant negative effect on mental and physical health, particularly among the elderly. The disease burden and risk factors of poor sleep quality of the elderly need to be verified using a validated form of measurement in urban mainland China. Methods This study included 1086 community residents aged ≥60 years who completed the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleeper was defined by a CPSQI global score of >5. Subjects also accepted the neurological and neuropsychological assessments, including the Mini-Mental State Examination, Center for Epidemiological Studies Depression Scale, and Zung Self-Rating Anxiety Scale (ZSAS). A history of chronic diseases was confirmed by the medical records of each participant. Results The prevalence of poor sleep quality in this population was 41.5% (95% confidence interval (CI) = 38.6–44.5%), with a higher rate observed in elderly females (45.8% [95% CI = 41.9–49.7%]) than that in elderly males (35.8% [95% CI = 31.4–40.1%]). The prevalence rate increased with age, from 32.1% (95% CI = 27.8–36.4%) in those aged 60–69 years to 52.5% (95% CI = 45.9–59.1%) in those aged ≥80 years (p value for trend<0.001). Multivariate logistic regression analysis indicated that age (OR = 1.03[95% CI = 1.01–1.05], p<0.001), less education duration (OR = 1.04 [95% CI = 1.01–1.08, p = 0.014), living alone (OR = 1.62 [95% CI = 1.02–2.58], p = 0.04), anxiety (ZSAS score: OR = 1.09 [95% CI = 1.05–1.12], p<0.001), number of chronic disease (OR = 1.18 [95% CI = 1.07–1.30], p = 0.14) and arthritis (OR = 1.45[95% CI = 1.05–2.01], p = 0.025) were risk factors of poor sleep quality. Conclusions Poor sleep quality is highly prevalent among elderly Chinese residents in urban Shanghai. Growing attention and comprehensive countermeasures involving psycho-social and personal activities

  20. Elevated Serum Uric Acid Levels Are Related to Cognitive Deterioration in an Elderly Japanese Population

    PubMed Central

    Suzuki, Kazushi; Koide, Daisuke; Fujii, Kurumi; Yamazaki, Tsutomu; Tsuji, Shoji; Iwata, Atsushi

    2016-01-01

    Aims The association between serum uric acid (UA) levels and cognitive function is controversial since UA can be a risk factor for cerebral ischemia as well as acting as a neuroprotective antioxidant. Methods We conducted a cross-sectional analysis of 228 elderly participants and examined neuropsychological test results, clinical data as well as brain magnetic resonance imaging data. Patients Overall, 64 participants were diagnosed with cognitive deterioration. To control for the effect of sex differences, 2 independent sets of single-variable and multivariate logistic regression analyses were performed with quartiles divided into non-sex-specific and sex-specific cutoff values for UA. Results In non-sex-specific quartiles, the participants in the highest quartiles of UA levels were found to be at a significantly higher risk of cognitive deterioration than those in the lowest quartiles. In sex-specific quartiles, the highest quartile showed an increased risk of cognitive deterioration, and a greater than fourfold increase in the risk in the highest quartiles was confirmed using multivariate regression models. However, no significant association was observed between serum UA levels and the presence of white matter lesions. Conclusions Elevated serum UA levels were independently associated with cognitive deterioration. UA might have unknown adverse effects on cognitive function, other than causing vascular pathology. PMID:28203247

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

    PubMed Central

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

    2014-01-01

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

  2. Validation of a Telephone-administered Geriatric Depression Scale in a Hispanic Elderly Population

    PubMed Central

    Carrete, Paula; Augustovski, Federico; Gimpel, Nora; Fernandez, Sebastian; Di Paolo, Rodolfo; Schaffer, Irene; Rubinstein, Fernando

    2001-01-01

    OBJECTIVE To develop and validate a Spanish version of the Geriatric Depression Scale (GDS) for telephone administration. DESIGN, SETTING, AND PATIENTS The original version of the GDS was translated into Spanish. A random sample of 282 ambulatory elderly individuals was contacted by phone. Those completing the phone GDS (GDS-T) were asked to schedule an appointment within two weeks in which we collected data on demographics, physical exam, functional and mental status, and a face-to-face version of the GDS (GDS-P). We estimated question-to-question κ statistics and the Pearson correlation coefficient between the GDS-T and GDS-P scores. We evaluated reliability of the GDS-T and GDS-P using the Cronbach's α coefficient. We estimated the sensitivity, specificity, and criterion validity of the GDS using the DSM IV criteria for depression as our gold standard. RESULTS Thirty patients (11%) refused to participate. Of the remaining 252 patients, 169 (67%) attended the personal interview. The Cronbach's α coefficient was 0.85 for GSD-P and 0.88 for GDS-T. Sensitivity and specificity were 88% and 82% for GDS-P and 84% and 79% for GDS-T. The prevalence of depression in the group completing both scales was 12.8% using the GDS-P and 14.9% using the GDS-T (P >.05). Among those who only completed the GDS-T, the prevalence was 22.7% (P <.05) suggesting that depressed patients kept their appointments less frequently. CONCLUSIONS The telephone GDS had high internal consistency and was highly correlated with the validated personal administration of the scale, suggesting that it could be a valid instrument for screening of depression among elderly ambulatory Spanish-speaking patients. Because the depression rate was significantly higher among those not presenting to the personal evaluation, the adoption of GDS-T may help detect and plan early interventions in patients who otherwise would not be identified. PMID:11520381

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  5. Increased utilization of influenza and pneumococcal vaccines in an elderly hospitalized population.

    PubMed

    Bloom, H G; Bloom, J S; Krasnoff, L; Frank, A D

    1988-10-01

    This study compared three interventions designed to increase acceptance of influenza and pneumococcal vaccines among elderly hospitalized patients. All individuals 65 and older able to give informed consent (73 patients) who were admitted to one medical floor of an acute care hospital were randomized to one of three groups. All groups received informational pamphlets explaining influenza and pneumococcal disease, their respective vaccines, and indications for their use. The first group received pamphlets only, the second received nursing follow-up, and the third received trained volunteer follow-up. Patients on another medical floor served as controls. The results showed a significant improvement in vaccine acceptance in all three study groups compared to controls for both influenza (78% vs 0%) and pneumococcal (75% vs 0%) vaccines. The differences among the three groups were not significant. No significant differences were found among patients accepting or refusing vaccination with regard to diagnosis, age, length of stay, sex, or having a private physician. We conclude that a simple educational program followed by offering vaccination before hospital discharge can be easily implemented, and dramatically increase immunization rates in this high risk group.

  6. Fire fatalities in elderly people.

    PubMed

    Elder, A T; Squires, T; Busuttil, A

    1996-05-01

    Fatal dwelling-house fires account for 10% of all accidental deaths in the United Kingdom with one-quarter of the deaths being of elderly people. No study had described the characteristics of elderly individuals who die in fires. We report results from a retrospective review of all fatal dwelling-house fires in Scotland from 1980 to 1990. Of 1096 people dying in fires, 243 (23%) were aged over 75. When compared with patients under the age of 75, older patients were significantly less likely to be smokers. Significantly more fires killing elderly people were caused by faulty or misused electrical items in the house, particularly electric blankets. These differences between elderly and younger individuals dying in dwelling-house fires may suggest that preventive strategies for the elderly population require a different emphasis from those for younger people.

  7. Association of serum lipid components and obesity with genetic ancestry in an admixed population of elderly women

    PubMed Central

    Lins, Tulio C.; Pires, Alause S.; Paula, Roberta S.; Moraes, Clayton F.; Vieira, Rodrigo G.; Vianna, Lucy G.; Nobrega, Otávio T.; Pereira, Rinaldo W.

    2012-01-01

    The prevalence of metabolic disorders varies among ethnic populations and these disorders represent a critical health care issue for elderly women. This study investigated the correlation between genetic ancestry and body composition, metabolic traits and clinical status in a sample of elderly women. Clinical, nutritional and anthropometric data were collected from 176 volunteers. Genetic ancestry was estimated using 23 ancestry-informative markers. Pearsons correlation test was used to examine the relationship between continuous variables and an independent samples t-test was used to compare the means of continuous traits within categorical variables. Overall ancestry was a combination of European (57.49%), Native American (25.78%) and African (16.73%). Significant correlations were found for European ancestry with body mass index (r = 0.165; p = 0.037) and obesity (mean difference (MD) = 5.3%; p = 0.042). African ancestry showed a significant correlation with LDL (r = 0.159, p = 0.035), VLDL (r = −0.185; p = 0.014), hypertriglyceridemia (MD = 6.4%; p = 0.003) and hyperlipidemia (MD = 4.8%; p = 0.026). Amerindian ancestry showed a significant correlation with triglyceride levels (r = 0.150; p = 0.047) and hypertriglyceridemia (MD = 4.5%; p = 0.039). These findings suggest that genetic admixture may influence the etiology of lipid metabolism-related diseases and obesity in elderly women. PMID:23055794

  8. [Demographic aspects of social security of elderly population in the Barents Euro-Arctic Region].

    PubMed

    Danilova, R I; Golubeva, E Iu; Emel'ianova, A S

    2010-01-01

    Social security of elderly people is discussed at different levels of the realization of the geronto-social policy in the Barents Euro-Arctic Region within the context of the Madrid Plan of Actions on Aging. There have been comparatively analyzed demographic indicators that show age structures of the regions which are parts of the Barents Euro-Arctic Region. There have been defined regional differences and trends of improvement of geronto-social policy for providing security of life activity of elderly people in the Russian part of the Barents Euro-Arctic Region.

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

    PubMed

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

    2013-12-01

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

  10. Systolic Blood Pressure Variability and Lower Extremity Amputation In a Non-Elderly Population with Diabetes

    PubMed Central

    Budiman-Mak, Elly; Epstein, Noam; Brennan, Meghan; Stuck, Rodney; Guihan, Marylou; Huo, Zhiping; Emanuele, Nicholas; Sohn, Min-Woong

    2016-01-01

    Objective Systolic blood pressure (SBP) variability is emerging as a new risk factor for cardiovascular diseases, diabetic nephropathy, and other atherosclerotic conditions. Our objective is to examine whether it has any prognostic value for lower-extremity amputations. Research Design and Methods This is a nested case-control study of a cohort of patients with diabetes aged < 60 years and treated in the US Department of Veterans Healthcare system in 2003. They were followed over five years for any above-ankle (major) amputations. For each case with a major amputation (event), we randomly selected up to five matched controls based on age, sex, race/ethnicity, and calendar time. SBP variability was computed using three or more blood pressure measures taken during the one-year period before the event. Patients were classified into quartiles according to their SBP variability. Results The study sample included 1038 cases and 2932 controls. Compared to Quartile 1 (lowest variability), Quartile 2 had 1.4 times (OR = 1.44, 95% CI = 1.00 – 2.07) and Quartiles 3 and 4 (highest) had 2.5 times (OR for Quartile 3 = 2.62, 95% CI = 1.85 – 3.72; OR for Quartile 4 = 2.50, 95% CI = 1.74 – 3.59) higher risk of major amputation (P for trend < 0.001). This gradient relationship held in both normotensive and hypertensive groups as well as for individuals without prior peripheral vascular disease. Conclusions This is the first study to show a significant graded relationship between SBP variability and risk of major amputation among non-elderly persons with diabetes. PMID:26809904

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  12. Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population.

    PubMed

    Karppi, Jouni; Laukkanen, Jari A; Kurl, Sudhir

    2012-07-14

    Oxidative stress plays an important role in cataractogenesis. Previous studies have shown that long-term dietary intake of antioxidants (lutein and zeaxanthin) may decrease the risk of age-related cataracts. The aim of the present study was to examine whether plasma concentrations of lutein and zeaxanthin are related to age-related nuclear cataract in the elderly population. Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and they were classified into tertiles according to plasma concentrations of lutein and zeaxanthin. The association of plasma lutein and zeaxanthin concentrations with age-related nuclear cataract in 1689 elderly subjects (aged 61-80 years) was investigated in the present cross-sectional study by using the Cox proportional hazards model. A total of 113 cases of incident age-related cataracts were confirmed, of which 108 cases were nuclear cataracts. After adjustment for age, examination year, sex, BMI, smoking, alcohol consumption, serum LDL-cholesterol, serum HDL-cholesterol, years of education, use of oral corticosteroids, history of diabetes and history of hypertension with current use of antihypertensive medication, subjects in the highest tertiles of plasma concentrations of lutein and zeaxanthin had 42 and 41 % lower risks of nuclear cataract, respectively, compared with those in the lowest tertiles (relative risk (RR) = 0·58, 95 % CI 0·35, 0·98; P = 0·041 for lutein and RR = 0·59, 95 % CI 0·35, 0·99; P = 0·046 for zeaxanthin). In conclusion, we suggest that high plasma concentrations of lutein and zeaxanthin were associated with a decreased risk of age-related nuclear cataract in the elderly population.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-07-23

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

  15. Dementia and lower urinary dysfunction: with a reference to anticholinergic use in elderly population.

    PubMed

    Sakakibara, Ryuji; Uchiyama, Tomoyuki; Yamanishi, Tomonori; Kishi, Masahiko

    2008-09-01

    Urinary incontinence is common in patients with dementia, and is more prevalent in demented than in non-demented older individuals. Neurogenic incontinence is common in multiple cerebral infarction and dementia with Lewy bodies, and in both diseases walking difficulty and falls are common. In contrast, functional incontinence is common in Alzheimer's disease due to cognitive disability and decreased motivation. Central cholinergic stimulation is the mainstay in the treatment of cognitive decline. In contrast, to date, the use of anticholinergic medications for detrusor overactivity in the elderly is still under consideration, since anticholinergic drugs may lead to undesirable events particularly in the central nervous system, although many studies have used severely demented cases. In the future, studies seeking treatment regimens for an elderly individual with both dementia and urinary dysfunction are warranted.

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

    PubMed

    Osako, M

    1982-12-01

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

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

    PubMed

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

    2014-12-01

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

  18. Validation of Static and Dynamic Balance Assessment using Microsoft Kinect for Young and Elderly Populations.

    PubMed

    Eltoukhy, Moataz; Kuenze, Christopher; Oh, Jeonghoon; Signorile, Joseph

    2017-03-22

    Reduction in balance is an indicator of fall risk, and therefore, an accurate and cost effective balance assessment tool is essential for prescribing effective postural control strategies. This study established the validity of the Kinect v2 sensor in assessing center of mass (CoM) excursion and velocity during single leg balance and voluntary ankle sway tasks among young and elderly subjects. We compared balance outcome measures (anteroposterior (AP) and mediolateral (ML) CoM excursion and velocity and average sway length) to a traditional three-dimensional motion analysis system. Twenty subjects (10 young: age = 20.5±2.3 y, height = 171.8±7.2 cm, weight = 70.7±11.6 kg; 10 elderly: age = 70.6±9.5 y, height = 169.1±8.7 cm, weight = 74.0±17.8 kg), with no history of lower extremity injury, participated in this study. Subjects performed six randomized trials; four single leg stand (SLS) and two ankle sway trials. SLS and voluntary ankle sway trials showed that consistency (ICC(2,k)) and agreement (ICC(3,k)) for all variables when all subjects were considered, as well as when the elderly and young groups were analyzed separately. Concordance between systems ranged from poor to nearly perfect depending on the group, task, and variable assessed.

  19. Elderly people's interaction with advanced technology.

    PubMed

    Blažun, Helena; Vošner, Janez; Kokol, Peter; Saranto, Kaija; Rissanen, Sari

    2014-01-01

    Aging of population is an inevitable process by which the number of elderly people is increasing. Rapid development of information and communication technology (ICT) is changing basic needs of elderly people; therefore society should ensure opportunities for elderly to learn and use ICT in a way to manage their daily life activities and in this way enable them participation in the information and knowledge society. The purpose of the study was to find out whether elderly are acquainted with the advanced technology and to what extent they use it or they desire to use it. Within the single point study we interviewed 100 randomly selected elderly people from different geographical regions in Slovenia. Results showed the differences in the use of advanced technology by Slovenian regions; therefore in the future activities should be focused on organizing promotional and demonstrational activities including ICT courses to increase elderly's motivation for ICT interaction.

  20. Disability rates for working-age adults and for the elderly have stabilized, but trends for each mean different results for costs.

    PubMed

    Kaye, H Stephen

    2013-01-01

    The aging of the baby-boom generation, as well as predicted growth in the number of people with disabilities, is expected to increase the demand for long-term services and supports dramatically. This study analyzed data from the Survey of Income and Program Participation from 1984 to 2010 to discern trends among noninstitutionalized working-age adults and the elderly who had some level of disability or need for help with activities of daily living. Some impairments among the elderly, such as in mobility and mental health, decreased. Meanwhile, some impairments among working-age adults, such as in cognitive ability, increased substantially. Of particular importance, the overall prevalence of disability for both age groups has largely stabilized since 2000. Among working-age adults, that stabilization is good news because it eases concern, fueled by prior research, that this population was becoming increasingly disabled and costly to public benefit programs such as Social Security Disability Insurance. However, the flattening of disability trends among the elderly is not good news, since it suggests that the number of elderly people with disabilities will continue to increase in direct proportion to the growing size of the elderly population. Among other implications, the need for both paid workers and unpaid caregivers to assist elderly people, especially those ages seventy-five and older, will continue to increase sharply.

  1. Presence of atrial fibrillation is associated with liver stiffness in an elderly Finnish population

    PubMed Central

    Käräjämäki, Aki Juhani; Kettunen, Olli; Lepojärvi, Samuli; Koivurova, Olli-Pekka; Kesäniemi, Y. Antero; Huikuri, Heikki; Ukkola, Olavi

    2017-01-01

    Background Chronic liver injury from different etiologies drives liver fibrosis. However, little is known about the associated factors, systemic factors in particular. Recently, non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation have been shown to be associated with each other. Thereby, we aimed to study the association between atrial fibrillation and liver stiffness. Study Extensive clinical measurements including echocardiography of the heart, transient elastography (TE) of the liver and the presence of atrial fibrillation were determined in elderly Finnish study subjects (n = 76, mean age 73 years) from OPERA (Oulu Project Elucidating the Risk of Atherosclerosis) study cohort. Half of the study subjects had non-alcoholic fatty liver disease, whereas others did not have any known hepatic morbidity. The present study was cross-sectional by nature. Results The subjects with atrial fibrillation had higher TE values (with atrial fibrillation TE = 9.3kPa, without atrial fibrillation TE = 6.3kPa, p = 0.018). When the cohort was divided to four subgroups (those without NAFLD or atrial fibrillation, with NAFLD but without atrial fibrillation, with both conditions, and with atrial fibrillation but without NAFLD), the TE value was the highest in the subjects with both conditions (5.3kPa, 7.4kPa, 10.8kPa and 7.8kPa, respectively, p = 0.019). Moreover, the higher the TE value, the more prevalent atrial fibrillation was (the atrial fibrillation prevalence by tertiles of TE 27% / 36% / 77%, p = 0.001). Likewise, the greater the TE value, the greater the left atrial diameter, a collateral of atrial fibrillation (left atrial diameters by tertiles of TE 39mm / 45mm / 48mm, p<0.001) was. All these p-values for continuous variables remained statistically significant even after adjustment for common clinically relevant risk factors. Conclusions There is an association between atrial fibrillation and liver stiffness. This novel association may have multiple

  2. Association of GRM7 Variants with Different Phenotype Patterns of Age-Related Hearing Impairment in an Elderly Male Han Chinese Population

    PubMed Central

    Jin, Xiaojie; Pang, Xiuhong; Li, Jiping; Chai, Yongchuan; Li, Lei; Zhang, Yi; Zhang, Luping; Zhang, Zhihua; Wu, Wenjing; Zhang, Qin; Hu, Xianting; Sun, Jingwen; Jiang, Xuemei; Fan, Zhuping; Huang, Zhiwu; Wu, Hao

    2013-01-01

    Several single nucleotide polymorphisms (SNPs) of the Glutamate metabotrophic receptor 7 gene (GRM7) have recently been identified by the genome-wide association study (GWAS) as potentially playing a role in susceptibility to age-related hearing impairment (ARHI), however this has not been validated in the Han Chinese population. The aim of this study was to determine if these SNPs are also associated with ARHI in an elderly male Han Chinese population. In this case-control candidate genes association study, a total of 982 men with ARHI and 324 normal-hearing controls subjects were studied. Using K-means cluster analysis, four audiogram shape subtypes of ARHI were identified in the case group: ‘‘flat shape (FL)’’, ‘‘sloping shape (SL)’’, ‘‘2-4 kHz abrupt loss (AL) shape’’ and ‘‘8 kHz dip (8D) shape’’. Results suggested that the SNP rs11928865 (A>T) of GRM7 was significantly associated with ARHI after adjusting for non-genetic factors (p= 0.000472, OR= 1.599, 95%CI= 1.229~2.081). Furthermore, frequency of TT genotype (rs11928865) were significant higher in the SL subgroup and AL subgroup with compared to controls group (p= 9.41E-05, OR= 1.945, 95%CI= 1.393~2.715; p= 0.000109, OR= 1.915, 95%CI= 1.378~2.661 adjusted, respectively) after Bonferroni correction. However, there wasn’t significant difference in the frequency of the TT genotype between cases in the FL subgroup or the 8D subgroup with when compared with controls. Results of the current study suggest that, in an elderly male Han Chinese population, GRM7 SNP rs11928865 (TT) occurs more frequently in ARHI patients with SL and AL phenotype patterns. PMID:24146964

  3. Examining the Role of Substance Abuse in Elder Mistreatment: Results From Mistreatment Investigations.

    PubMed

    Conrad, Kendon J; Liu, Pi-Ju; Iris, Madelyn

    2016-04-04

    Substance abuse has long been identified as a risk factor for elder mistreatment, yet research on the topic remains sparse. This study tested hypotheses whether perpetrator and victim substance use problems were associated with financial exploitation, physical abuse, emotional abuse, and neglect versus no abuse. Cross-sectional data were collected on 948 cases with yes/no substantiation decisions where 357 cases had no abuse in elder mistreatment investigations. Hypotheses were tested using odds ratios, bivariate, and multiple linear regression analyses including a control for victim vulnerability. Of 948 alleged victims, 42 (4.4%) exhibited signs of substance use problems. Among the 323 alleged perpetrators, 87 (26.9%) were reported to have substance use problems. Substance use problems by alleged perpetrators were associated (p< .01) with financial exploitation, physical abuse, and emotional abuse but not neglect. Substance use problems by alleged victims were associated with neglect, but not the other types. Alleged perpetrators with substance use problems tended to commit multiple forms of abuse, were male and not caregivers. Except for the findings on neglect, the associations with elder mistreatment were stronger for alleged perpetrators with substance use problems, than for alleged victims. Clarification of the role of perpetrator risk factors such as substance abuse should improve risk identification and subsequent intervention.

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

    PubMed Central

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

    2015-01-01

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

  5. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    PubMed

    Martins, Andréa Maria Eleutério de Barros Lima; Jardim, Lorena Amaral; Souza, João Gabriel Silva; Rodrigues, Carlos Alberto Quintão; Ferreira, Raquel Conceição; Pordeus, Isabela Almeida

    2014-01-01

    This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  6. Microvascular decompression for elderly patients with trigeminal neuralgia.

    PubMed

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

    2016-07-01

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

  7. Excess mortality after hip fracture among the elderly in Taiwan: a nationwide population-based cohort study.

    PubMed

    Wang, Chang-Bi; Lin, Chien-Fu Jeff; Liang, Wen-Miin; Cheng, Chi-Fung; Chang, Yu-Jun; Wu, Hsi-Chin; Wu, Trong-Neng; Leu, Tsai-Hsueh

    2013-09-01

    Osteoporotic hip fractures cause high mortality in the elderly population. However, few population studies reported the long-term mortality of hip fracture among the elderly in Asian population. This study assessed the incidence, excess mortality, and risk factors after osteoporotic hip fractures through inpatients aged 60 years or older. A total of 143,595 patients with hip fracture were selected from Taiwan National Health Insurance database in the years 1999 to 2009 and followed up until the end of 2010. Annual incidence, mortality and SMR, and mortality and SMR at different periods after fracture were measured. From 1999 to 2005, hip fracture incidence gradually increased and then fluctuated after 2006. From 1999 to 2009, the male-to-female ratio of annual incidence increased from 0.60 to 0.66, annual mortality for hip fracture decreased from 18.10% to 13.98%, male-to-female ratio of annual mortality increased from 1.38 to 1.64, and annual SMR decreased from 13.80 to 2.98. Follow-up SMR at one, two, five, and ten years post-fracture was 9.67, 5.28, 3.31, and 2.89, respectively. Females had higher follow-up SMR in the younger age groups (60-69 yr of age) but lower follow-up SMR in the older age groups (over 80 yr of age) compared with males. Among the studied patients, incidence is gradually decreasing along with annual mortality and SMR. Hip fracture affects short-term but not long-term mortality.

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

    PubMed

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

    2014-01-01

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

  9. The Association of Hypertriglyceridemic Waist Phenotype with Chronic Kidney Disease and Its Sex Difference: A Cross-Sectional Study in an Urban Chinese Elderly Population

    PubMed Central

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

    2016-01-01

    Background: The primary objective of this study was to explore the association of hypertriglyceridemic waist (HTGW) phenotype with chronic kidney disease (CKD) and its sex difference in an urban Chinese elderly population. Methods: In a cross-sectional study, a total of 2102 participants aged 60–95 years were recruited and classified into four phenotypes: normal waist-normal triglyceride (NWNT), normal waist-elevated triglycerides (NWET), elevated waist-normal triglycerides (EWNT), and HTGW. Logistic regression analysis was used to estimate the associations of interest. Results: Total prevalence of CKD was 12.6%, and the CKD prevalence in participants with EWNT and HTGW was higher than with NWNT and NWET without regard to sex. Compared to NWNT phenotype, the adjusted OR for CKD was 1.95 (95% CI: 1.32–2.88) in HTGW groups. In contrast with the null findings (OR: 1.66; 95% CI: 0.94–2.94) in women after additional adjustment for diabetes and hypertension, the OR with HTGW remained strong (OR: 1.88; 95% CI: 1.04–3.39) in men. Similar findings appeared with the EWNT phenotype. Conclusions: The HTGW phenotype is positively associated with CKD among Chinese community elderly and may have a greater impact on men. More attention should be paid to the association between triglycerides and waist circumference in clinical practice and to the further identification this uncertain sex-related association. PMID:27983610

  10. Homebound status increases death risk within two years in the elderly: results from a national longitudinal survey.

    PubMed

    Herr, Marie; Latouche, Aurélien; Ankri, Joël

    2013-01-01

    Homebound status is associated with poorer physical and mental health, as well as disability in the elderly. We aimed to examine the prevalence and the role of homebound status on mortality in a representative sample of the French non-institutionalized population. This study included 7497 people aged 65 and over who were interviewed in 1999 and 2001 about the consequences of health problems on activities of daily living. Homebound status was defined as staying permanently inside the home, excluding an accident or a temporary illness. The influence of the homebound status on two-year mortality was assessed in a logistic regression model adjusted for the main confounders (age, sex, living as a couple, physical and mental impairments). The prevalence of homebound status was 4.7% (95% CI: 3.9-5.4) in this study. The number of homebound elderly was estimated at 421000 in France. The prevalence of homebound status increases with age and reaches 33.9% in people aged 95-99 years (95% CI: 13.1-54.6). Compared to non-homebound subjects, homebound elderly were more likely to be female, widower, to live alone and to have had a former low level job. Homebound status was associated with a number of physical and mental impairments. It increased the risk of dying within two years with an adjusted OR 3.45 (95% CI: 2.66-4.46). Homebound status should be considered as an indicator of frailty and used in the identification of old people likely to benefit from preventive interventions.

  11. Hypertension in the elderly.

    PubMed

    Kendall, M J

    1998-01-01

    In those aged 65-85 years, the major causes of death and disability are cardiovascular diseases (myocardial infarction, sudden death and stroke). Clinical trials in elderly patients have demonstrated unequivocally that effective blood pressure reduction in hypertensive patients up to the age of 85 years significantly reduces this mortality and morbidity. The larger trials are referred to as the SHEP trial (chlorthalidone), the STOP trial (beta-blockers and/or diuretics), the MRC Elderly Trial (atenolol or diuretic) and the SYST-EUR trial (nitrendipine). Patients entered into clinical trials are a selected population; those with serious coexisting diseases and with a poor prognosis are usually excluded. For this reason one has to carefully consider whether the results of these trials would provide the best treatment for the next patient the doctor sees who would probably not meet the entry criteria. Elderly hypertensives may fall into one of three categories. The sick elderly with serious disorders such as cancer or dementia have a poor quality of life and a bad prognosis. They should not be given antihypertensive drugs. The medically complicated elderly have serious disorders, which usually require drug therapy and the medical condition and the drugs used in treatment may complicate the choice of antihypertensive drugs. The potential adverse effects of adding another form of drug treatment may outweigh the potential benefits. The fit elderly do derive considerable benefit from adequate blood pressure control and need an effective, well-tolerated antihypertensive drug. The choice of drug to control blood pressure in the elderly is difficult. An effective, well-tolerated antihypertensive with little potential to interact with coexisting disorders and other drugs is needed.

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Antibody response of an elderly population to a supplemental dose of influenza B vaccine.

    PubMed

    Peters, N L; Meiklejohn, G; Jahnigen, D W

    1988-07-01

    Recent reports have suggested that the antibody response of elderly persons to standard doses of influenza vaccine is depressed. We examined the effect of an additional threefold dose of influenza B vaccine on the antibody response in elderly, ambulatory veterans. One hundred thirty-one male subjects aged 70 years and older were randomized to receive one of three influenza vaccine regimens: Group I received standard trivalent influenza vaccine containing 15 micrograms of B/USSR/100/83 in one arm and placebo in the other; Group II received standard trivalent vaccine in one arm and a supplemental dose of 45 micrograms of B/USSR in the other; Group III received the same dose as group II combined in one arm with a placebo in the other. Antibody levels were measured at baseline, 1 month, and 5 months. Nearly 80% of the participants achieved levels of antibody to B/USSR considered protective; seroconversion rates varied from 40% to 61%. No significant differences in antibody response to B/USSR occurred among the vaccine groups, and there were more side effects at higher doses. The higher dose groups did, however, achieve greater antibody levels to the drifted influenza B virus which circulated during the year of the study. Response to the influenza A components of the vaccine, however, may have been blunted in Group III which received a large dose of A and B antigens all at one site.

  16. Crime and the Elderly.

    DTIC Science & Technology

    1978-01-01

    The elderly are differentially affected by crime and the fear of crime due to their increased vulnerability and, as such, warrant a certain degree of...specialized handling and understanding by the police. The information presented in this thesis will enhance police knowledge of the elderly and... elderly and, ideally, result in less elderly victimization and a better living environment and quality of life for the elderly .

  17. Arterial stiffness is not associated with bone parameters in an elderly hyperhomocysteinemic population.

    PubMed

    van Dijk, S C; de Jongh, R T; Enneman, A W; Ham, A C; Swart, K M A; van Wijngaarden, J P; van der Zwaluw, N L; Brouwer-Brolsma, E M; van Schoor, N M; Dhonukshe-Rutten, R A M; Lips, P; de Groot, C P G M; Smulders, Y M; Blom, H J; Feskens, E J; Geleijnse, J M; van den Meiracker, A H; Mattace Raso, F U S; Uitterlinden, A G; Zillikens, M C; van der Velde, N

    2016-01-01

    Several studies have observed positive associations between bone disease and cardiovascular disease. A potential common pathway is hyperhomocysteinemia; however, to date, there is a lack of data regarding hyperhomocysteinemic populations. Therefore, we examined both cross-sectionally and longitudinally, whether there is an association between bone parameters and arterial stiffness in a hyperhomocysteinemic population, and investigated the potential common role of homocysteine (hcy) level on these associations. Cross-sectional and longitudinal data of the B-PROOF study were used (n = 519). At both baseline and 2-year follow-up we determined bone measures-incident fractures and history of fractures, bone-mineral density (BMD) and quantitative ultrasound (QUS) measurement. We also measured arterial stiffness parameters at baseline-pulse wave velocity, augmentation index and aortic pulse pressure levels with applanation tonometry. Linear regression analysis was used to examine these associations and we tested for potential interaction of hcy level. The mean age of the study population was 72.3 years and 44.3 % were female. Both cross-sectionally and longitudinally there was no association between arterial stiffness measures and BMD or QUS measurements or with incident fractures (n = 16) within the 2-3 years of follow-up. Hcy level did not modify the associations and adjustment for hcy did not change the results. Arterial stiffness was not associated with bone parameters and fractures, and hcy neither acted as a pleiotropic factor nor as a mediator. The potential association between bone and arterial stiffness is therefore not likely to be driven by hyperhomocysteinemia.

  18. [Arterial blood pressure in persons of elderly, senile age and long-livers of Yakutsk: population screening].

    PubMed

    Tatarinova, O V; Nikitin, Iu P; Neustroeva, V N; Shcherbakova, L V; Gorokhova, Z P

    2013-01-01

    The values of arterial blood pressure according to the Yakutsk population screening at the age of 60 and older have been studied. The average values of systolic arterial pressure (both sexes--148, men--145, women--151 mm Hg) are higher than normal values specified by Society of Cardiology of Russian Federation. Long-living persons show its decrease that is more marked in men. The average values of diastolic arterial pressure (both sexes--87, men--88, women--87 mm Hg) correspond to the category of high normal pressure and are decreasing with age to more extent in men than in women. The average values of pulse pressure in elderly and senile age are higher than normal values (both sexes--61, men--57, women--64 mm Hg) with a tendency to grow by 90 years old. Differences in arterial blood pressure levels are educed in gerontic persons depending on presence of abdominal obesity, hypercholesterolemia, hyperglycemia, smoking and family anamnesis with cases of hypertension.

  19. Normative data for the Boston Naming Test and the Pyramids and Palm Trees Test in the elderly Spanish population.

    PubMed

    Rami, Lorena; Serradell, Mónica; Bosch, Beatriz; Caprile, Claudia; Sekler, Alejandra; Villar, Amparo; Canal, Ramón; Molinuevo, José Luis

    2008-01-01

    The objective of this study was to obtain normative data for naming and semantic memory (SM) tests in the elderly Spanish population. A total of 121 Spanish-speaking senior citizens were assessed with the Boston Naming Test (BNT). Of these, 79 were assessed with the Semantic Fluency Test (Sem-Flu) and 72 with the Pyramids and Palm Trees Test (PPT). Mean scores were 49.6 (SD = 5.6) for the BNT, 49.6 (SD = 2.2) for the PPT, and 16.9 (SD = 4.9) for the Sem-Flu. All SM tests were significantly influenced by participants' level of education (p < .01). The BNT was also significantly influenced by gender. A significant positive association was found between naming and SM tests (p < .01). Normative data for naming and SM tests could be useful in clinical assessment and research in Spanish-speaking dementia patients.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  1. Prevalence and correlates of somatoform disorders in the elderly: Results of a European study.

    PubMed

    Dehoust, Maria Christina; Schulz, Holger; Härter, Martin; Volkert, Jana; Sehner, Susanne; Drabik, Anna; Wegscheider, Karl; Canuto, Alessandra; Weber, Kerstin; Crawford, Mike; Quirk, Alan; Grassi, Luigi; DaRonch, Chiara; Munoz, Manuel; Ausin, Berta; Santos-Olmo, Anna; Shalev, Arieh; Rotenstein, Ora; Hershkowitz, Yael; Strehle, Jens; Wittchen, Hans-Ulrich; Andreas, Sylke

    2017-03-01

    Somatoform disorders have rarely been addressed in epidemiological and health care services studies of the elderly. The few existing studies vary considerably in their methodologies limiting comparability of findings. Data come from the MentDis_ICF65+ study, in which a total of 3142 community-dwelling respondents aged 65-84 years from six different countries were assessed by the Composite International Diagnostic Interview adapted to the needs of the elderly (CIDI65+). The 12-month prevalence rate for any somatoform disorders was found to be 3.8, whereby the prevalence for somatization disorder according to DSM-IV was 0%, the prevalence for abridged somatization was 1.7% and the rate for 12-months somatoform pain disorder was 2.6%. We found a significant variation by study centre (p < 0.005). There was a significant gender difference for pain disorder, but not for abridged somatization. Significant age-related effects revealed for both disorder groups. Somatoform disorders were found to be associated with other mental disorders [odds ratio (OR) anxiety =4.8, OR affective disorders 3.6], as well as with several impairments and disabilities. Somatoform disorders are prevalent, highly impairing conditions in older adults, which are often associated with other mental disorders and should receive more research and clinical attention.

  2. Clinical characteristics related to worsening of motor function assessed by the Unified Parkinson's Disease Rating Scale in the elderly population.

    PubMed

    Liepelt-Scarfone, Inga; Lerche, Stefanie; Behnke, Stefanie; Godau, Jana; Gaenslen, Alexandra; Pausch, Christoph; Fassbender, Klaus; Brockmann, Kathrin; Srulijes, Karin; Huber, Heiko; Wurster, Isabel; Berg, Daniela

    2015-02-01

    There is evidence that nigrostriatal pathology may at least partly underlie mild Parkinsonian signs. We evaluated whether an increase in the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) could be predicted by the presence of risk and prodromal markers for neurodegenerative diseases in elderly individuals without those diseases. Therefore, we analyzed the UPDRS-III score and various risk and prodromal markers known to antecede neurodegenerative diseases in a population-based cohort comprising 807 individuals free of neurodegenerative diseases at baseline. After 5 years, eight persons (1.0 %) were diagnosed with Parkinson's Disease (PD). Of those, seven (87.5 %) had motor worsening ≥3 points on the UPDRS-III from baseline to follow-up, one had two points increase. Of the 788 people without PD, 568 (72.1 %) showed no increase in the UPDRS-III scale, 220 (27.9 %) had ≥1 point increase and out of these 104 (13.2 %) had an increase of ≥3 points in the UPDRS-III score after 5 years. We identified an age >60 years (relative risk, RR = 1.7; confidence interval, CI 1.3-2.1) and the occurrence of ≥2 risk factors (RR = 1.5; CI 1.2-1.9) as possible predictors of motor progression. After 5 years, individuals with an increase in the UPDRS-III score had more often a one-sided reduced arm swing (p < 0.001) and identified less odors in the Sniffin' sticks test (p < 0.041) than persons with stable motor performance. Our data support the assumption that progression of Parkinsonian signs assessed by the UPDRS-III parallels the development of prodromal markers for neurodegenerative diseases in the elderly population.

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

    NASA Technical Reports Server (NTRS)

    Smith, Robert E.; Smuda, Ellen

    1993-01-01

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

  4. Bowel Obstruction in Elderly Ovarian Cancer Patients: A Population-Based Study

    PubMed Central

    Mooney, Stephen J.; Winner, Megan; Hershman, Dawn L.; Wright, Jason D.; Feingold, Daniel L.; Allendorf, John D.; Neugut, Alfred I.

    2013-01-01

    PURPOSE Bowel obstruction is a common pre-terminal event in abdominal/pelvic cancer that has mainly been described in small single-institution studies. We used a large, population-based database to investigate the incidence, management, and outcomes of obstruction in ovarian cancer patients. PATIENTS AND METHODS We identified patients with stages IC-IV ovarian cancer, aged 65 years or older, in the Surveillance, Epidemiology and End Results (SEER)-Medicare database diagnosed between January 1, 1991 and December 31, 2005. We modeled predictors of inpatient hospitalization for bowel obstruction after cancer diagnosis, categorized management of obstruction, and analyzed the associations between treatment for obstruction and outcomes. RESULTS Of 8607 women with ovarian cancer, 1518 (17.6%) were hospitalized for obstruction subsequent to cancer diagnosis. Obstruction at cancer diagnosis (HR=2.17, 95% CI: 1.86–2.52) and mucinous tumor histology (HR=1.45, 95% CI: 1.15–1.83) were associated with increased risk of subsequent obstruction. Surgical management of obstruction was associated with lower 30-day mortality (13.4% in women managed surgically vs. 20.2% in women managed non-surgically), but equivalent survival after 30 days and equivalent rates of post-obstruction chemotherapy. Median post-obstruction survival was 382 days in women with obstructions of adhesive origin and 93 days in others. CONCLUSION In this large-scale, population-based assessment of patients with advanced ovarian cancer, nearly 20% of women developed bowel obstruction after cancer diagnosis. While obstruction due to adhesions did not signal the end of life, all other obstructions were pre-terminal events for the majority of patients regardless of treatment. PMID:23274561

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

    PubMed Central

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

    2014-01-01

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

  6. Elder Mistreatment Predicts Later Physical and Psychological Health: Results from a National Longitudinal Study

    PubMed Central

    Wong, Jaclyn S.; Waite, Linda J.

    2017-01-01

    Stress process theory predicts that elder mistreatment leads to declines in health, and that social support buffers its ill effects. We test this theory using nationally representative, longitudinal data from 2,261 older adults in the National Social Life Health and Aging Project. We regress psychological and physical health in 2010/2011 on verbal and financial mistreatment experience in 2005/2006 and find that the mistreated have more anxiety symptoms, greater feelings of loneliness, and worse physical and functional health five years later, than those who did not report mistreatment. In particular, we show a novel association between financial mistreatment and functional health. Contrary to the stress buffering hypothesis, we find little evidence that social support moderates the relationship between mistreatment and health. Our findings point to the lasting impact of mistreatment on health, but show little evidence of a buffering role of social support in this process. PMID:27636657

  7. Prevalence and Burden of Gait Disorders in Elderly Men and Women Aged 60–97 Years: A Population-Based Study

    PubMed Central

    Mahlknecht, Philipp; Kiechl, Stefan; Bloem, Bastiaan R.; Willeit, Johann; Scherfler, Christoph; Gasperi, Arno; Rungger, Gregorio; Poewe, Werner; Seppi, Klaus

    2013-01-01

    Background Although gait disorders are common in the elderly, the prevalence and overall burden of these disorders in the general community is not well defined. Methods In a cross-sectional investigation of the population-based Bruneck Study cohort, 488 community-residing elderly aged 60–97 years underwent a thorough neurological assessment including a standardized gait evaluation. Gait disorders were classified according to an accepted scheme and their associations to falls, neuropsychological measures, and quality of life were explored. Results Overall, 32.2% (95% confidence interval [CI] 28.2%–36.4%) of participants presented with impaired gait. Prevalence increased with age (p<0.001), but 38.3% (95%CI 30.1%–47.3%) of the subjects aged 80 years or older still had a normally preserved gait. A total of 24.0% (95%CI 20.4%–28.0%) manifested neurological gait disorders, 17.4% (14.3%–21.0%) non-neurological gait problems, and 9.2% (6.9%–12.1%) a combination of both. While there was no association of neurological gait disorders with gender, non-neurological gait disorders were more frequent in women (p = 0.012). Within the group of neurological gait disorders 69.2% (95%CI 60.3%–76.9%) had a single distinct entity and 30.8% (23.1%–39.7%) had multiple neurological causes for gait impairment. Gait disorders had a significant negative impact on quantitative gait measures, but only neurological gait disorders were associated with recurrent falls (odds ratio 3.3; 95%CI 1.4–7.5; p = 0.005 for single and 7.1; 2.7–18.7; p<0.001 for multiple neurological gait disorders). Finally, we detected a significant association of gait disorders, in particular neurological gait disorders, with depressed mood, cognitive dysfunction, and compromised quality of life. Conclusions Gait disorders are common in the general elderly population and are associated with reduced mobility. Neurological gait disorders in particular are associated with recurrent falls, lower

  8. The diurnal profile of melatonin during delirium in elderly patients--preliminary results.

    PubMed

    Piotrowicz, Karolina; Klich-Rączka, Alicja; Pac, Agnieszka; Zdzienicka, Anna; Grodzicki, Tomasz

    2015-12-01

    Delirium is an acute-onset syndrome that exacerbates patients' condition and significantly increases consequential morbidity and mortality. There is no comprehensive, cellular and tissue-level, pathophysiological theory. The melatonin hormone imbalance has been shown to be linked to circadian rhythms, sleep-wake cycle disturbances, and delirium incidence. There has been relatively little research about melatonin in delirium, and there has been no such study done in the group of elderly patients of a general medicine ward yet. The aim of our study was to compare melatonin hormone concentration in relation to the presence of delirium in elderly patients hospitalized in the general medicine ward. Blood samples were collected four times a day for two days (at 12:00, 18:00, 00:00 and 6:00), on the day when delirium was diagnosed and 72 h after the delirium resolution. Delirium was diagnosed with the Confusion Assessment Method and the criteria of the Diagnostic and Statistic Manual of Mental Disorders, 4th Revision. The mean age of 30 patients (73.3% women) was 86.5 ± 5.2 years. Delirium was diagnosed most often on the second and third day of hospitalization. A lot of predisposing and precipitating factors for delirium were identified. There was a significant difference in the melatonin hormone concentration measurement at 12:00 when patients had acute delirium and after its resolution [18.5 (13.8, 27.5) vs 12.9 (9.8, 17.8), p<0.01]. Different patterns of the melatonin hormone concentration were shown in analyses in the subgroups defined according to the patients' diagnosis of dementia. We found that the delirium recovery was, in fact, associated with the alteration of the daily profile of melatonin.

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

    SciTech Connect

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

    2009-09-01

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

  10. Native Hawaiian and Pacific Islander Elders: What Gerontologists Should Know

    PubMed Central

    Braun, Kathryn L.; Kim, Bum Jung; Ka’opua, Lana Sue; Mokuau, Noreen; Browne, Colette V.

    2015-01-01

    Native Hawaiian and other Pacific Islanders (NHOPI) experience significant health disparities compared with other racial groups in the United States. Lower life expectancy has resulted in small proportions of elders in the population distribution of NHOPI, yet the number of NHOPI elders is growing. This article presents data on NHOPI elders and discusses possible reasons for continuing health disparities, including historical trauma, discrimination, changing lifestyle, and cultural values. We outline promising interventions with NHOPI and make suggestions for future research. PMID:25063936

  11. Intensive Care Unit (ICU) – Managed Elderly Hospitalizations with Dementia in Texas, 2001–2010: A Population-Level Analysis

    PubMed Central

    Oud, Lavi

    2016-01-01

    Background The demand for critical care services among elderly with dementia outpaces that of their non-dementia elderly counterparts. However, there are scarce data on the corresponding attributes among ICU-managed patients with dementia. Material/Methods We used the Texas Inpatient Public Use Data File to examine temporal trends of the demographics, burden of comorbidities, measures of severity of illness, use of healthcare resources, and short-term outcomes among hospitalizations aged 65 years or older with a reported diagnosis of dementia, who were admitted to ICU (D-ICU hospitalizations) between 2001 and 2010. Average annual percent changes (AAPC) were derived. Results D-ICU hospitalizations (n=276,056) had increasing mean (SD) Charlson comorbidity index [1.7 (1.5) vs. 2.6 (1.9)], with reported organ failure (OF) nearly doubling from 25% to 48.5%, between 2001–2001 and 2009–2010, respectively. Use of life support interventions was infrequent, but rose in parallel with corresponding changes in respiratory and renal failure. Median total hospital charges increased from $26,442 to $36,380 between 2001–2002 and 2009–2010. Routine home discharge declined (−5.2%/year [−6.2%– −4.1%]) with corresponding rising use of home health services (+7.2%/year [4.4–10%]). Rates of discharge to another hospital or a nursing facility remained unchanged, together accounting for 60.4% of discharges of hospital survivors in 2010. Transfers to a long-term acute care hospital increased 9.2%/year (6.9–11.5%). Hospital mortality (7.5%) remained unchanged. Conclusions Elderly D-ICU hospitalizations have increasing comorbidity burden, with rising severity of illness, and increasing use of health care resources. Though the majority survived hospitalization, most D-ICU hospitalizations were discharged to another facility. PMID:27764074

  12. Intensive Care Unit (ICU) - Managed Elderly Hospitalizations with Dementia in Texas, 2001-2010: A Population-Level Analysis.

    PubMed

    Oud, Lavi

    2016-10-20

    BACKGROUND The demand for critical care services among elderly with dementia outpaces that of their non-dementia elderly counterparts. However, there are scarce data on the corresponding attributes among ICU-managed patients with dementia. MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to examine temporal trends of the demographics, burden of comorbidities, measures of severity of illness, use of healthcare resources, and short-term outcomes among hospitalizations aged 65 years or older with a reported diagnosis of dementia, who were admitted to ICU (D-ICU hospitalizations) between 2001 and 2010. Average annual percent changes (AAPC) were derived. RESULTS D-ICU hospitalizations (n=276,056) had increasing mean (SD) Charlson comorbidity index [1.7 (1.5) vs. 2.6 (1.9)], with reported organ failure (OF) nearly doubling from 25% to 48.5%, between 2001–2001 and 2009–2010, respectively. Use of life support interventions was infrequent, but rose in parallel with corresponding changes in respiratory and renal failure. Median total hospital charges increased from $26,442 to $36,380 between 2001–2002 and 2009–2010. Routine home discharge declined (–5.2%/year [–6.2%– –4.1%]) with corresponding rising use of home health services (+7.2%/year [4.4–10%]). Rates of discharge to another hospital or a nursing facility remained unchanged, together accounting for 60.4% of discharges of hospital survivors in 2010. Transfers to a long-term acute care hospital increased 9.2%/year (6.9–11.5%). Hospital mortality (7.5%) remained unchanged. CONCLUSIONS Elderly D-ICU hospitalizations have increasing comorbidity burden, with rising severity of illness, and increasing use of health care resources. Though the majority survived hospitalization, most D-ICU hospitalizations were discharged to another facility.

  13. Association between light exposure at night and insomnia in the general elderly population: the HEIJO-KYO cohort.

    PubMed

    Obayashi, Kenji; Saeki, Keigo; Kurumatani, Norio

    2014-11-01

    significantly associated with both subjectively and objectively measured sleep quality in a community-based elderly population.

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

    PubMed

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

    2015-12-14

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

  15. Prevalence of Mental Disorders in the Elderly in the Community of Madrid: Results of the Mentdis_ICF65+ Study.

    PubMed

    Ausín, Berta; Muñoz, Manuel; Santos-Olmo, Ana Belén; Pérez-Santos, Eloísa; Castellanos, Miguel A

    2017-02-06

    The MentDis_ICF65+ Project is an epidemiological study of mental disorders in people 65 to 85 years old in several European cities, including Madrid. Its aim is to determine the lifetime, 12-month, and 1-month prevalence of the main mental disorders in the elderly. The relationship of age and sex with each mental disorder was examined. The sample was collected through random sampling of people over 65 in Madrid, and consisted of 555 persons between 65 and 85 years old. The CIDI65+ was administered. Estimates of prevalence and odds ratios (OR) were made using sample frequencies and according to sex and age. Excluding nicotine dependence, 40.12% of the sample was found to have suffered a mental disorder at some time in their lives, 29.89% in the past year, and 17.70% were currently suffering from a mental disorder. The disorders with the highest prevalence rates were anxiety disorders, alcohol-related disorders, and mood disorders. Elderly women had a higher risk of suffering an anxiety disorder (OR men/women 0.42; CI 0.25-0.68) with a significance level of p < .001, while elderly men were more affected by any substance-related disorder (OR men/women 3.96; CI 1.62-11.07) with a significance level of p < .001. Each disorder's prevalence decreased with age (OR 65-74/75-85, 1.85; CI 1.25-2.75) with a significance level of p < .01. Results show higher prevalence rates than previous studies reported. The main implications of this study, and the need to adapt mental health services for people over 65, are highlighted.

  16. Higher estimates of daily dietary net endogenous acid production (NEAP) in the elderly as compared to the young in a healthy, free-living elderly population of Pakistan.

    PubMed

    Alam, Iftikhar; Alam, Ibrar; Paracha, Parvez I; Pawelec, Graham

    2012-01-01

    Dietary intake has been shown to influence the acid-base balance in human subjects; however, this phenomenon is poorly understood and rarely reported for the least well-studied segment of older people in a developing country. The aims of the present study were to: (1) quantify estimates of daily net endogenous acid production (NEAP) (mEq/d) in a sample of otherwise healthy elderly aged 50 years and above; and (2) compare NEAP between the elderly and young to determine the effects of aging, which could contribute to changes in the acid-base balance. Analyses were carried out among 526 elderly and 131 young participants (aged 50-80 and 23-28 years, respectively), all of whom were free of discernible disease, nonsmokers, and not on any chronic medication. Selected anthropometric factors were measured and 24-hour dietary recall was recorded. We used two measures to characterize dietary acid load: (1) NEAP estimated as the dietary potential renal acid load plus organic acid excretion, the latter as a multiple of estimated body surface area; and (2) estimated NEAP based on protein and K. For the young and elderly, the ranges of NEAP were 12.1-67.8 mEq/d and 2.0-78.3 mEq/d, respectively. Regardless of the method used, the mean dietary acid-base balance (NEAP) was significantly higher for the elderly than the young (P = 0.0035 for NEAP [elderly, 44.1 mEq/d versus young 40.1 mEq/d]; and P = 0.0035 for the protein:potassium ratio [elderly, 1.4 mEq/d versus young 1.1 mEq/d]). A positive and significant correlation was found between NEAP and energy, protein, and phosphorus (P < 0.05 for all trends). The findings from this study provide evidence of the relatively higher production of NEAP in older people, possibly as an effect of higher consumption of certain acid-producing foods by the elderly.

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

    PubMed Central

    Rosero-Bixby, L; Coto-Yglesias, F; Dow, W H

    2016-01-01

    We studied the relationships between blood pressure (BP), pulse pressure (PP) and cardiovascular (CV) death in older adults using data from 2346 participants enrolled in the Costa Rican CRELES study, mean age 76 years (s.d. 10.2), 31% qualified as wide PP. All covariates included and analyzed were collected prospectively as part of a 4-year home-based follow-up; mortality was tracked for an additional 3 years, identifying 266 CV deaths. Longitudinal data revealed little change over time in systolic BP (SBP), a decline in diastolic BP, and widening of PP. Wide PP was associated with higher risk of CV death but only among individuals receiving antihypertensive drug therapy. Individuals with both wide PP and receiving therapy had 2.6 hazard rate of CV death relative to people with normal-PP plus not taking treatment (TRT), even adjusting for SBP. Increasing PP between visits was significantly associated to higher CV death independently of TRT status. SBP and DBP were not significantly associated to CV death when the effect of PP was controlled for. Conclusion: elderly hypertensive patients with wide or increasing PP, especially if receiving TRT, are the highest CV risk group, thus must be carefully assessed, monitored and treated with caution. PMID:26674758

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

    PubMed

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

    2015-09-01

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

  19. 2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations

    PubMed Central

    Krakoff, Lawrence R.; Gillespie, Robert L.; Ferdinand, Keith C.; Fergus, Icilma V.; Akinboboye, Ola; Williams, Kim A.; Walsh, Mary Norine; Merz, C. Noel Bairey; Pepine, Carl J.

    2014-01-01

    A report from panel members appointed to the Eighth Joint National Committee titled "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults" has garnered much attention due to its major change in recommendations for hypertension treatment for patients ≥60 years of age and for their treatment goal. In response, certain groups have opposed the decision to initiate pharmacologic treatment to lower blood pressure (BP) at systolic BP ≥150 mm Hg and treat to a goal systolic BP of <150 mm Hg in the general population age ≥60 years. This paper contains 3 sections–an introduction followed by the opinions of 2 writing groups–outlining objections to or support of maintaining this proposed strategy in certain at-risk populations, namely African Americans, women, and the elderly. Several authors argue for maintaining current targets, as opposed to adopting the new recommendations, to allow for optimal treatment for older women and African Americans, helping to close sex and race/ethnicity gaps in cardiovascular disease morbidity and mortality. PMID:25060376

  20. Risk of falls associated with antiepileptic drug use in ambulatory elderly populations

    PubMed Central

    Maximos, Mira; Chang, Feng; Patel, Tejal

    2017-01-01

    Background: Falls are a major cause of morbidity and mortality in older adults. About a third of those aged 65 years or older fall at least once each year, which can result in hospitalizations, hip fractures and nursing home admissions that incur high costs to individuals, families and society. The objective of this clinical review was to assess the risk of falls in ambulatory older adults who take antiepileptic drugs, medications that can increase fall risk and decrease bone density. Methods: PubMed, EMBASE, MEDLINE and the Cochrane Library electronic databases were searched from inception to July 2014. Case-control, quasi-experimental and observational design studies published in English that assessed quantifiable fall risk associated with antiepileptic drug use in ambulatory patient populations with a mean or median age of 65 years or older were eligible for inclusion. One author screened all titles and abstracts from the initial search. Two authors independently reviewed and abstracted data from full-text articles that met eligibility criteria. Results: Searches yielded 399 unique articles, of which 7 met inclusion criteria—4 prospective or longitudinal cohort studies, 1 cohort study with a nested case-control, 1 cross-sectional survey and 1 retrospective cross-sectional database analysis. Studies that calculated the relative risk of falls associated with antiepileptic drug use reported a range of 1.29 to 1.62. Studies that reported odds ratios of falls associated with antiepileptic drug use ranged from 1.75 to 6.2 for 1 fall or at least 1 fall and from 2.56 to 7.1 for more frequent falls. Discussion: Health care professionals should monitor older adults while they take antiepileptic drugs to balance the need for such pharmacotherapy against an increased risk of falling and injuries from falls.

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    1999-04-01

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

  3. Predictive Comprehensive Geriatric Assessment in elderly prostate cancer patients: the prospective observational scoop trial results.

    PubMed

    Della Pepa, Chiara; Cavaliere, Carla; Rossetti, Sabrina; Di Napoli, Marilena; Cecere, Sabrina C; Crispo, Anna; De Sangro, Carlo; Rossi, Emanuela; Turitto, Dino; Germano, Domenico; Iovane, Gelsomina; Berretta, Massimiliano; D'Aniello, Carmine; Pisconti, Salvatore; Maiorino, Luigi; Daniele, Bruno; Gridelli, Cesare; Pignata, Sandro; Facchini, Gaetano

    2017-01-01

    The Comprehensive Geriatric Assessment (CGA) represents the future of the geriatric oncology to reduce toxicities and treatment-related hospitalization in the elderly. Most patients receiving docetaxel for metastatic castration-resistant prostate cancer are in their seventies or older. We explored the efficacy of the CGA in predicting chemotherapy feasibility and response to docetaxel in a cohort of 24 patients aged at least 70. This was an observational, prospective study involving 24 patients who were 70 years of age or older and about to start chemotherapy with docetaxel for metastatic castration-resistant prostate cancer; we performed a CGA including five domains and divided our patients into 'healthy' and 'frail'; the relations between general condition and (i) early chemotherapy discontinuation and (ii) response to docetaxel were explored. We found a statistically significant relationship between frailty assessed by CGA and early docetaxel discontinuation; we also found an association between frailty and response to chemotherapy, but this did not reach statistical significance. A geriatric assessment before starting chemotherapy may help clinicians to recognize frail patients, and hence to reduce toxicities and early treatment discontinuation. Further analyses are required to simplify the CGA tools and to facilitate its incorporation into routine clinical practice.

  4. A population-based study of physical function and risk for elder abuse reported to social service agency: findings from the Chicago health and aging project.

    PubMed

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2014-10-01

    We examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse. The independent variable was objectively assessed physical function using both directly observed physical performance testing and self-reported physical function (Katz activity of daily living scale, Nagi physical activity scale, and Rosow Breslau mobility scales). Outcomes were elder abuse and specific subtypes of elder abuse. After adjusting for confounders, lower levels of physical performance testing (OR, 2.71[1.58-4.64]), Katz impairment (OR, 1.84[1.29-2.59]), Nagi impairment (OR, 1.65[1.15-2.37]) and Rosow Breslau (OR, 1.76[1.26-2.47]) were associated with increased risk for elder abuse. Lowest levels of physical performance testing were associated with increased risk for psychological abuse (OR, 2.69[1.27-5.71]), caregiver neglect (OR, 2.66[1.22-5.79]), and financial exploitation (OR, 2.35 [1.21-4.55]). Our results may have important implications to healthcare professional, social services and other disciplines to prevent and treat elder abuse.

  5. Blood pressure control and physicians' therapeutic behavior in a very elderly Spanish hypertensive population.

    PubMed

    Rodríguez-Roca, Gustavo C; Pallarés-Carratalá, Vicente; Alonso-Moreno, Francisco J; Escobar-Cervantes, Carlos; Barrios, Vivencio; Llisterri, José L; Valls-Roca, Francisco; Carrasco-Martín, José L; Fernández-Toro, José M; Banegas, José R

    2009-09-01

    This study sought to assess blood pressure (BP) control rates by determining the factors associated with poor BP control, therapeutic management and physicians' therapeutic behavior among elderly Spanish hypertensive patients in a primary care setting. This cross-sectional multicenter study included hypertensive patients at least 80 years of age in primary care settings throughout Spain who were on pharmacologic treatment. BP was considered well controlled at <140/90 mm Hg (<130/80 in patients with diabetes, chronic renal disease or cardiovascular disease). A total of 923 patients were included (83.3+/-3.5 years; 62.9% women). Almost two-thirds (64.0%) of the patients were taking a combined therapy (68.7%; 2 drugs) and approximately one-third (35.6%; 95% CI 32.6-38.7) of the patients attained BP goals. Physicians modified the antihypertensive treatment in 26.1% (95% CI 22.3-29.9) of patients with uncontrolled BP, which most frequently involved the addition of another drug (47.6%). Predictive factors for no BP control and no therapeutic modification in patients with uncontrolled BP included diabetes (OR 2.8 (95% CI 2.0-3.9); P<0.0001) and mistaken physician perceptions about BP control (OR 108.1 (95% CI 40.5-288.6); P<0.0001), respectively. Only three out of 10 hypertensive patients 80 years or older in Spain achieved the BP goals. Physicians only modified the treatment in one out of four patients with uncontrolled BP. Diabetes was associated with a threefold increase in the likelihood of uncontrolled BP, and the mistaken physician perceptions about BP control were associated with a 100-fold rise in the probability of not modifying antihypertensive therapy.

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

    PubMed Central

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

    2016-01-01

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

  7. The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study

    PubMed Central

    Tombak, Anıl; Uçar, Mehmet Ali; Akdeniz, Aydan; Tiftik, Eyüp Naci; Gören Şahin, Deniz; Akay, Olga Meltem; Yıldırım, Murat; Nevruz, Oral; Kis, Cem; Gürkan, Emel; Medeni Solmaz, Şerife; Özcan, Mehmet Ali; Yıldırım, Rahşan; Berber, İlhami; Erkurt, Mehmet Ali; Tuğlular, Tülin Fıratlı; Tarkun, Pınar; Yavaşoğlu, İrfan; Doğu, Mehmet Hilmi; Sarı, İsmail; Merter, Mustafa; Özcan, Muhit; Yıldızhan, Esra; Kaynar, Leylagül; Mehtap, Özgür; Uysal, Ayşe; Şahin, Fahri; Salim, Ozan; Sungur, Mehmet Ali

    2016-01-01

    Objective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of ≥60 years o ld who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment. Median overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (≥5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA. PMID:27095141

  8. Progress in the treatment of elderly/unfit chronic lymphocytic leukemia patients: results of the German CLL-11 trial.

    PubMed

    Molica, Stefano

    2015-01-01

    Chronic lymphocytic leukemia (CLL) is the most prevalent type of leukemia and affects mostly the elderly. Chemoimmunotherapy with fludarabine, cyclophosphamide and rituximab is generally considered a standard treatment for younger fit patients with CLL. In a recent randomized Phase III study of patients with newly diagnosed CLL and coexisting conditions, obinutuzumab, a humanized anti-CD20 glycoengineered type 2 antibody, used in combination with chlorambucil, demonstrated significant improvement in progression-free survival and several other outcome parameters, in comparison to rituximab plus chlorambucil. Grade 3-4 infusion-related reactions and neutropenia occurred more frequently in patients who received obinutuzumab compared with those who received rituximab; however, the rate of serious infections was similar. Results of this trial clearly established that obinutuzumab in combination with chlorambucil represent the new first-line standard of treatment in this setting. A broad range of novel agents with different mechanisms of action have already proven their efficacy in CLL. New drugs targeting specific molecular features, such as ibrutinib, idelalisib or ABT-199, are being tested at present, and their advent is very likely to change the future treatment paradigm of CLL that relies today on chemoimmunotherapy for both fit and elderly/unfit patients.

  9. CYP2B6 Genotype Guided Dosing of Propofol Anesthesia in the Elderly based on Nonparametric Population Pharmacokinetic Modeling and Simulations

    PubMed Central

    Eugene, Andy R.

    2017-01-01

    Objective The primary aim of this article is to test the hypothesis that nonparametric pharmacometric modeling will accurately identify CYP2B6 genotype subgroups based on data from a study that reported results based on parametric pharmacokinetics (PK). Methods Propofol concentration-time data were originally reported in the Kansaku et al. 2011 publication. Nonparametric Nonlinear Mixed Effects Modeling (NLME) was conducted using the PMETRICS R package while population pharmacokinetic model parameters were estimated using a FORTRAN compiler. Finally, model-based dosing simulations were conducted in the MATLAB Simbiology. Results A total of 51 patients were included in the final PK analysis. A two-compartment gamma multiplicative error model adequately described the propofol concentration-time data. The precision of the goodness-of-fit plots resulted in an R2 of 0.927 and an R2 of 0.992 for the population prediction and individual predictions, respectively. Neither the UGT1A9 nor the CYP2B6 G516T gene variants resulted in statistically significant PK parameter differences while the CYP2B6 A785G gene variants resulted in statistically significant differences for the elimination rate. Model-based dosing-simulations comparing patients with the CYP2B6 AA & AG genotypes to both GG genotypes and patients from a multicenter trial suggest a 50% decrease in propofol infusion dose, to 25mg/kg/min, be made to result in approximately equivalent drug exposures. Conclusion Based on the pharmacometric modeling and simulation, if no dosage adjustments are made for the elderly CYP2B6 AA and AG genotypes, a 250% higher propofol blood exposure will be evident within 1-hour from the start of the infusion. Thus, based on the pharmacokinetic model, genotyping elderly patients for the CYP2B6 AA and AG gene variants will decrease the total propofol blood exposure during anesthesia and sedation when an infusion dose adjustment is made to 25mg/kg/min. PMID:28154789

  10. Conservation among Elderly Women.

    ERIC Educational Resources Information Center

    Hughston, George A.; Protinsky, Howard O.

    1979-01-01

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

  11. Physical activity and sex modulate obesity risk linked to 3111T/C gene variant of the CLOCK gene in an elderly population: the SUN Project.

    PubMed

    Galbete, Cecilia; Contreras, Rafael; Martínez, J Alfredo; Martínez-González, Miguel Ángel; Guillén-Grima, Francisco; Marti, Amelia

    2012-12-01

    Genetic factors may interact with physical activity levels to modify obesity risk. Our aim was to explore the influence of rs1801260 single-nucleotide polymorphism (SNP) (3111T/C) of CLOCK gene on obesity risk, and to examine its potential interaction with lifestyle factors in an elderly population within the SUN ("Seguimiento Universidad de Navarra") Project. Subjects (n = 903, aged 69 ± 6 yrs) were recruited from the SUN Project. DNA was obtained from saliva, whereas lifestyle and dietary data were collected by validated self-report questionnaires. Genotype was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) plus allele discrimination. A significant interaction was observed between the 3111T/C SNP of CLOCK gene and sex for overweight/obesity risk (p for sex × CLOCK interaction <.001). Our results showed that women carrying the C allele of CLOCK gene had a marginally significant lower risk of overweight/obesity compared with noncarrier-TT-subjects (odds ratio [OR]: .61, 95% confidence interval [CI]: .36-1.04; p = .069). Moreover, this association of the C allele with a decreased overweight/obesity risk might be enhanced in those women with a high physical activity level. Women practicing more than 16.8 metabolic equivalent tasks (hours per week) had a significantly lower overweight/obesity risk (OR: .36, 95% CI: .17-.79; p = .011). Furthermore, a significant interaction between the 3111T/C gene variant and physical activity (PA) for overweight/obesity risk was observed but only in women (p for PA × CLOCK interaction <.050). In conclusion, it appears that physical activity levels may act by modifying the association of the 3111T/C SNP (rs1801260) of the CLOCK gene with overweight/obesity risk in elderly women in the SUN Project.

  12. Prescribing pattern of anti-epileptic drugs in an Italian setting of elderly outpatients: a population-based study during 2004–07

    PubMed Central

    Oteri, Alessandro; Trifirò, Gianluca; Gagliostro, Maria Silvia; Tari, Daniele Ugo; Moretti, Salvatore; Bramanti, Placido; Spina, Edoardo; Caputi, Achille Patrizio; Arcoraci, Vincenzo

    2010-01-01

    AIMS The aims of the study were to assess the trend of older and newer anti-epileptic drugs (AEDs) in the elderly population and to analyze the effects of a health-policy intervention with regard to AED use in general practice in a setting in Southern Italy. METHODS Data were extracted from the ‘Caserta-1’ Local-Health-Unit Arianna database in the years 2004–07. Patients aged over 65 years, receiving at least one AED prescription and registered in the lists of 88 general practitioners, were selected. The use of older and newer AEDs was calculated as 1 year prevalence and incidence of use and defined daily dose (DDD) per 1000 inhabitants day−1. Sub-analyses by gender, age and indication of use were performed. RESULTS Most of AED users were treated because of neuropathic pain (64.8%). However, the main indication of use for older AEDs (57.8%) was epilepsy, whereas newer AEDs (79.5%) were used for neuropathic pain. Prevalence and incidence of newer AED use increased until 2006, followed by a reduction in 2007. Newer AEDs, particularly gabapentin and pregabalin, were used in the treatment of more patients than older AEDs. However phenobarbital, accounting for more than 50% of total AED volume, was the most prescribed medication during the entire study period. CONCLUSIONS An increasing use of AEDs has been observed during 2004–07, mostly due to the prescription of newer compounds for neuropathic pain. The fall in the use of newer AEDs during 2007 coincides with revised re-imbursement criteria for gabapentin and pregabalin. The large use of phenobarbital in the elderly should be considered in the light of a risk of adverse drug reactions. PMID:20840443

  13. Self-reported visual impairment and impact on vision-related activities in an elderly Nigerian population: report from the Ibadan Study of Ageing

    PubMed Central

    Bekibele, CO; Gureje, Oye

    2010-01-01

    Background Studies have shown an association between visual impairment and poor overall function. Studies from Africa and developing countries show high prevalence of visual impairment. More information is needed on the community prevalence and impact of visual impairment among elderly Africans. Methods A multi-stage stratified sampling of households was implemented to select persons aged 65 years and over in the south-western and north-central parts of Nigeria. Impairments of distant and near vision were based on subjective self-reports obtained with the use of items derived from the World Health Organization multi-country World Health Survey questionnaire. Impairment was defined as reporting much difficulty to questions on distant and near vision. Disabilities in activities of daily living (ADL) and instrumental activities of daily living (IADL) were evaluated by interview, using standardized scales. Results A total of 2054 subjects 957 (46.6%) males and 1097 (53.4) females responded to the questions on vision. 22% (n=453) of the respondents reported distant vision impairment, and 18% (n=377) reported near vision impairment (not mutually exclusive). 15% (n= 312) however reported impairment for both far and near vision. Impairment of distant vision increased progressively with age (P < 0.01). Persons with self reported near vision impairment had elevated risk of functional disability in several IADLs and ADLs than those with out. Distant vision impairment was less associated with role limitations in both ADLs and IADLs. Conclusion The prevalence of self reported distant visual impairment was high but that for near visual impairment was less than expected in this elderly African population. Impairment of near vision was found to carry with it a higher burden of functional disability than that of distant vision. PMID:18780258

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

    PubMed

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

    2016-01-13

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

  15. Inequities and psychiatry disability in transition among the elderly population from 1987 to 2006 in China

    PubMed Central

    Wang, Zhenjie; Li, Ning; Guo, Chao; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

    2016-01-01

    Abstract The world will be facing huge population aged 65 and older, accounting for 13% of the total population in the future. Significant disabilities rates reflect an accumulation of health risks. Psychiatry disability is one of the most significant disabilities, because it manifests in cognitive, affective, and behavior disorders that limit one's daily life and restrict their participations. Very few studies have explored the 20 years associations between demographic factors and psychiatry disability among older people in China. In this study, we investigated psychiatry disability transitional association behind China rapid development from 1987 to 2006 among the 60 and older population. Data used 2 nationally represented, population-based data from the China National Sample Surveys on Disability, conducted in 1987 and 2006. The sample size of the current study was 140,008 in 1987 and 354,859 in 2006, respectively. Associations between socioeconomic factors and psychiatry disability were determined by using a logistic regression model. The prevalence of psychiatric disabilities increased from 1987 to 2006. In both surveys, the most common psychiatric disabilities were schizophrenia, schizotypal, and delusional disorders, and they presented the same associations with age increase. Socioeconomic inequities, such as current employment status and marital status, were associated with psychiatry disability in both surveys. These associations remained even after these 2 surveys were combined. The rapidly rising prevalence of psychiatric disorders expected warrants strategies to reduce the burden of these disabilities among females and rural residents. PMID:27603379

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

    NASA Astrophysics Data System (ADS)

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

    2016-01-01

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

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

    PubMed Central

    Byeon, Haewon; Koh, Hyeung Woo

    2016-01-01

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

  18. The Issue of Age Estimation in a Modern Skeletal Population: Are Even the More Modern Current Aging Methods Satisfactory for the Elderly?

    PubMed

    Cappella, Annalisa; Cummaudo, Marco; Arrigoni, Elena; Collini, Federica; Cattaneo, Cristina

    2017-01-01

    The main idea behind age assessment in adults is related to the analysis of the physiological degeneration of particular skeletal structures with age. The main issues with these procedures are due to the fact that they have not been tested on different modern populations and in different taphonomic contexts and that they tend to underestimate the age of older individuals. The purpose of this study was to test the applicability and the reliability of these methods on a contemporary population of skeletal remains of 145 elderly individuals of known sex and age. The results show that, due to taphonomic influences, some skeletal sites showed a lower survival. Therefore, the methods with the highest percentage of applicability were Lovejoy (89.6%) and Rougé-Maillart (81.3%), followed by Suchey-Brooks (59.3%), and those with the lowest percentage of applicability were Beauthier (26.2%) and Iscan (22.7%). In addition, this research has shown how for older adults the study of both acetabulum and auricular surface may be more reliable for aging. This is also in accordance with the fact that auricular surface and the acetabulum are the areas more frequently surviving taphonomic insult.

  19. Elderly Mental Health: Needs*

    PubMed Central

    Parkar, Shubhangi R.

    2015-01-01

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

  20. Lung function parameters improve prediction of VO2peak in an elderly population: The Generation 100 study

    PubMed Central

    Stensvold, Dorthe; Halvorsen, Thomas; Wisløff, Ulrik; Langhammer, Arnulf; Steinshamn, Sigurd

    2017-01-01

    Peak oxygen uptake (VO2peak) is an indicator of cardiovascular health and a useful tool for risk stratification. Direct measurement of VO2peak is resource-demanding and may be contraindicated. There exist several non-exercise models to estimate VO2peak that utilize easily obtainable health parameters, but none of them includes lung function measures or hemoglobin concentrations. We aimed to test whether addition of these parameters could improve prediction of VO2peak compared to an established model that includes age, waist circumference, self-reported physical activity and resting heart rate. We included 1431 subjects aged 69-77 years that completed a laboratory test of VO2peak, spirometry, and a gas diffusion test. Prediction models for VO2peak were developed with multiple linear regression, and goodness of fit was evaluated. Forced expiratory volume in one second (FEV1), diffusing capacity of the lung for carbon monoxide and blood hemoglobin concentration significantly improved the ability of the established model to predict VO2peak. The explained variance of the model increased from 31% to 48% for men and from 32% to 38% for women (p<0.001). FEV1, diffusing capacity of the lungs for carbon monoxide and hemoglobin concentration substantially improved the accuracy of VO2peak prediction when added to an established model in an elderly population. PMID:28319189

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-05-01

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

  3. Word List Memory Predicts Everyday Function and Problem-Solving in the Elderly: Results from the ACTIVE Cognitive Intervention Trial

    PubMed Central

    Gross, Alden L.; Rebok, George W.; Unverzagt, Frederick W.; Willis, Sherry L.; Brandt, Jason

    2011-01-01

    Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial (N=2,802) were analyzed to examine whether word list learning predicts future everyday functioning. Using stepwise random effects modeling, measures from the modified administrations of the Hopkins Verbal Learning Test (HVLT) and the Auditory Verbal Learning Test (AVLT) were independently predictive of everyday IADL functioning, problem-solving, and psychomotor speed. Associations between memory scores and everyday functioning outcomes remained significant across follow-up intervals spanning five years. HVLT total recall score was consistently the strongest predictor of each functional outcome. Results suggest that verbal memory measures are uniquely associated with both current and future functioning and that specific verbal memory tests like the HVLT and AVLT have important clinical utility in predicting future functional ability among older adults. PMID:21069610

  4. Oral health-related quality of life in the elderly population receiving health care at the public hospital network in Medellín, Colombia, and its related factors.

    PubMed

    Meneses-Gómez, Edwin J; Posada-López, Adriana; Agudelo-Suarez, Andrés A

    2016-09-01

    Metrosalud is the largest public hospital network in the city of Medellin and one of the most important in Colombia providing health care to the most vulnerable population. The objective of the study was to determine the Oral HealthRelated Quality of Life (OHRQoL) and its related factors in the elderly population receiving health care at the public hospital network in Medellin (Colombia). A crosssectional design was used. Men and women ≥ 65 years old were considered for this research, selected from first consultation records by the institution's statistical unit for 2011, who accepted to participate after being contacted by telephone. Sampling was performed in two stages: simple random sampling for selecting Hospital Units HUand Health Centers HCthroughout the hospital network in the city, followed by random quota sampling in proportion to the number of elderly population assigned to each HU and HC. A total 342 patients (58.2% women) participated in the study. The project involved the use of a structured questionnaire and complete dental examination with information on sociodemographic data, selfperceived health variables (mental, general and oral), use of oral health services, Oral HealthRelated Quality of Life (OHRQoL as measured with GOHAI index), temporomandibular joint test, oral mucosa, soft tissue evaluation, periodontal, dental and prosthetic examination. Descriptive and bivariate analyses were conducted to determine statistically significant differences. Multivariate analysis was performed, using logistic regression, calculating crude and adjusted odds ratios (OR) with their 95% confidence intervals (95% CI). Impacts were found to be generated by education levels, differences in socioeconomic status and urban or rural housing conditions. The results of this research show low OHRQoL levels in the elderly population receiving health care services at the public hospital network in Medellin.

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

    SciTech Connect

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

    2012-01-10

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  7. A Pediatric Tumor Found Frequently in the Adult Population: A Case of Anaplastic Astroblastoma in an Elderly Patient and Review of the Literature

    PubMed Central

    Batouli, Ali; Stabingas, Kristen; Alcindor, Dunbar; Abdel Aziz, Khaled; Pu, Cunfeng; Williams, Robert; Yu, Alexander

    2017-01-01

    Astroblastomas are rare, potentially curable primary brain tumors which can be difficult to diagnose. We present the case of astroblastoma in a 73-year-old male, an atypical age for this tumor, more classically found in pediatric and young adult populations. Through our case and review of the literature, we note that this tumor is frequently reported in adult populations and the presentation of this tumor in the elderly is well described. This tumor is an important consideration in the differential diagnosis when managing both pediatric and adult patients of any age who present with the imaging findings characteristic of this rare tumor. PMID:28239500

  8. Peripapillary Retinal Nerve Fiber Layer Thickness and the Evolution of Cognitive Performance in an Elderly Population

    PubMed Central

    Méndez-Gómez, Juan Luis; Rougier, Marie-Bénédicte; Tellouck, Laury; Korobelnik, Jean-François; Schweitzer, Cédric; Delyfer, Marie-Noëlle; Amieva, Hélène; Dartigues, Jean-François; Delcourt, Cécile; Helmer, Catherine

    2017-01-01

    Retinal nerve fiber layer (RNFL) thickness is reduced in Alzheimer’s patients. However, whether it is associated with early evolution of cognitive function is unknown. Within 427 participants from the Three-City-Alienor longitudinal population-based cohort, we explored the relationship between peripapillary RNFL thicknesses and the evolution of cognitive performance. RNFL was assessed at baseline by spectral domain optical coherence tomography; cognitive performances were assessed at baseline and at 2 years, with the Mini–Mental State Examination, the Isaacs’ set test, and the Free and Cued Selective Reminding Test (FCSRT). Multivariate linear mixed models were performed. The RNFL was not associated with initial cognitive performance. Nevertheless, a thicker RNFL was significantly associated with a better cognitive evolution over time in the free delayed recall (p = 0.0037) and free + cued delayed recall (p = 0.0043) scores of the FCSRT, particularly in the temporal, superotemporal, and inferotemporal segments. No associations were found with other cognitive tests. The RNFL was associated with changes in scores that assess episodic memory. RNFL thickness could reflect a higher risk of developing cognitive impairment over time. PMID:28373855

  9. The ADAMTS9 gene is associated with cognitive aging in the elderly in a Taiwanese population

    PubMed Central

    Kuo, Po-Hsiu; Liu, Yu-Li; Yang, Albert C.; Kao, Chung-Feng; Yang, Cheng-Hung

    2017-01-01

    Evidence indicates that the pathophysiologic mechanisms associated with insulin resistance may contribute to cognitive aging and Alzheimer’s diseases. In this study, we hypothesize that single nucleotide polymorphisms (SNPs) within insulin resistance-associated genes, such as the ADAM metallopeptidase with thrombospondin type 1 motif 9 (ADAMTS9), glucokinase regulator (GCKR), and peroxisome proliferator activated receptor gamma (PPARG) genes, may be linked with cognitive aging independently and/or through complex interactions in an older Taiwanese population. A total of 547 Taiwanese subjects aged over 60 years from the Taiwan Biobank were analyzed. Mini-Mental State Examinations (MMSE) were administered to all subjects, and MMSE scores were used to measure cognitive functions. Our data showed that four SNPs (rs73832338, rs9985304, rs4317088, and rs9831846) in the ADAMTS9 gene were significantly associated with cognitive aging among the subjects (P = 1.5 x 10−6 ~ 0.0002). This association remained significant after performing Bonferroni correction. Additionally, we found that interactions between the ADAMTS9 rs9985304 and ADAMTS9 rs76346246 SNPs influenced cognitive aging (P < 0.001). However, variants in the GCKR and PPARG genes had no association with cognitive aging in our study. Our study indicates that the ADAMTS9 gene may contribute to susceptibility to cognitive aging independently as well as through SNP-SNP interactions. PMID:28225792

  10. Aging and differentiation in yeast populations: elders with different properties and functions.

    PubMed

    Palková, Zdena; Wilkinson, Derek; Váchová, Libuše

    2014-02-01

    Over the past decade, it has become evident that similarly to cells forming metazoan tissues, yeast cells have the ability to differentiate and form specialized cell types. Examples of yeast cellular differentiation have been identified both in yeast liquid cultures and within multicellular structures occupying solid surfaces. Most current knowledge on different cell types comes from studies of the spatiotemporal internal architecture of colonies developing on various media. With a few exceptions, yeast cell differentiation often concerns nongrowing, stationary-phase cells and leads to the formation of cell subpopulations differing in stress resistance, cell metabolism, respiration, ROS production, and others. These differences can affect longevity of particular subpopulations. In contrast to liquid cultures, where various cell types are dispersed within stationary-phase populations, cellular differentiation depends on the specific position of particular cells within multicellular colonies. Differentiated colonies, thus, resemble primitive multicellular organisms, in which the gradients of certain compounds and the position of cells within the structure affect cellular differentiation. In this review, we summarize and compare the properties of diverse types of differentiated chronologically aging yeast cells that have been identified in colonies growing on different media, as well as of those found in liquid cultures.

  11. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study.

    PubMed

    de Groot, Lisette C P M G; Verheijden, Marieke W; de Henauw, Stefaan; Schroll, Marianne; van Staveren, Wija A

    2004-12-01

    This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at baseline in 1988-1989 and were repeated in 1993 and 1999. Diet, physical activity, and smoking, as well as maintenance of health and survival, were assessed. At baseline, considerable differences in lifestyle factors existed among elderly people. Mealtime patterns as well as dietary intake varied across Europe, and geographical patterns were apparent. Similar results were found for engagement in sport or professional activities. The smoking prevalence among women was generally low. Distinct geographical differences were also observed in percentages of deaths during the SENECA study and in overall survival time. A healthy lifestyle was related to stable self-perceived health, a delay in functional dependence, and mortality. Inactivity and smoking, and to a lesser extent a low-quality diet, increased mortality risk. A combined effect of multiple unhealthy lifestyle factors was also observed. The SENECA study showed that a healthy lifestyle at older ages is related to a delay in the deterioration of health status and a reduced mortality risk. Improving and maintaining a healthy lifestyle in elderly people across Europe is a great challenge for the European Community.

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

    PubMed

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

    2015-09-01

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

  13. Serum levels of 25(OH)D are not associated with venous thromboembolism in the elderly population. A case-control study.

    PubMed

    Andro, Marion; Delluc, Aurélien; Moineau, Marie-Pierre; Tromeur, Cécile; Gouillou, Maelenn; Lacut, Karine; Carré, Jean-Luc; Gentric, Armelle; Le Gal, Grégoire

    2016-01-01

    The prevalence of both vitamin D deficiency and venous thromboembolism (VTE) is important in the elderly. Previous studies have provided evidence for a possible association between vitamin D status and the risk of VTE. Thus, we aimed to investigate the association between vitamin D levels and VTE in the population aged 75 and over included in the EDITH case-control study. The association between vitamin D status and VTE was analysed. We also analysed the monthly and seasonal variations of VTE and vitamin D. Between May 2000 and December 2009, 340 elderly patients (mean age 81.5 years, 32% men) with unprovoked VTE and their controls were included. The univariate and multivariate analysis found no significant association between serum levels of vitamin D and the risk of unprovoked VTE. In the unadjusted analysis, a higher BMI was statistically associated with an increased risk of VTE (OR 1.09; 95% CI 1.05-1.13) whereas a better walking capacity and living at home were associated with a decreased rate of VTE: OR 0.57; 95% CI 0.36-0.90 and 0.40; 95% CI 0.25-0.66, respectively. Although not significant, more VTE events occurred during winter (p=0.09). No seasonal variations of vitamin D levels were found (p=0.11). In conclusion, in contrast with previous reports our findings suggest that vitamin D is not associated with VTE in the elderly population.

  14. Higher ambulatory blood pressure is associated with aortic valve calcification in the elderly: a population-based study.

    PubMed

    Iwata, Shinichi; Russo, Cesare; Jin, Zhezhen; Schwartz, Joseph E; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Sacco, Ralph L; Di Tullio, Marco R

    2013-01-01

    Aortic valve calcification (AVC) without outflow obstruction (stenosis) is common in the elderly and increases the risk of cardiovascular morbidity and mortality. Although high blood pressure (BP) measured at the doctor's office is known to be associated with AVC, little is known about the association between 24-hour ambulatory BP (ABP) and AVC. Our objective was to clarify the association between ABP variables and AVC. The study population consisted of 737 patients (mean age, 71±9 years) participating in the Cardiovascular Abnormalities and Brain Lesions study who underwent 24-hour ABP monitoring. Each aortic valve leaflet was graded on a scale of 0 (normal) to 3 (severe calcification). A total valve score (values 0-9) was calculated as the sum of all leaflet scores. Advanced AVC (score ≥4) was present in 77 subjects (10.4%). All of the systolic ABP variables (except systolic BP nocturnal decline) and mean asleep diastolic BP were positively associated with advanced calcification, whereas normal dipping status and diastolic BP nocturnal decline were negatively associated. Multiple regression analysis indicated that mean awake diastolic BP (odds ratio, 1.31 [95% CI, 1.01-1.71]) and asleep diastolic BP (odds ratio, 1.34 [95% CI, 1.04-1.72]) remained independently associated with advanced calcification after adjustment for age, sex, cigarette smoking, diabetes mellitus, hypercholesterolemia, hypertension, serum creatinine, and any degree of aortic insufficiency. Diastolic ABP is independently associated with advanced calcification. This finding may have important implications in gaining further insight into the mechanism of AVC.

  15. Community-Level Social Capital and Psychological Distress among the Elderly in Japan: A Population-Based Study.

    PubMed

    Kobayashi, Tomoko; Suzuki, Etsuji; Noguchi, Masayuki; Kawachi, Ichiro; Takao, Soshi

    2015-01-01

    Despite accumulating evidence, previous studies have not clearly separated the contribution of community-level social capital on mental health from that of individual-level social support. We examined the association between community-level social capital and psychological distress in a sample of older Japanese individuals, taking into account the effects of individual-level social capital and social support. We collected data via a cross-sectional survey among all residents aged ≥65 in three rural municipalities in Okayama Prefecture. We measured two components of social capital in the questionnaire: perceptions of trust and reciprocity in the community. Community-level social capital was obtained by aggregating individual responses and calculating the proportion of subjects reporting mistrust and lack of reciprocity. Psychological distress was assessed by the Kessler Psychological Distress scale. We calculated rate ratios [corrected] (RRs) and 95% confidence intervals (CIs) for psychological distress using two-level Poisson regression models (9,761 individuals nested within 35 communities). The prevalence of psychological distress was 39.8%. Low community-level social capital was associated with psychological distress, even after controlling for individual-level social support, age, sex, educational attainment, frequency of alcohol consumption, smoking status, body mass index, marital status, socioeconomic status, and number of cohabiters. The adjusted RRs per 10% increase of the proportion of mistrust and lack of reciprocity in the communities were 1.23 (95% CI: 1.01-1.51) and 1.12 (95% CI: 1.02-1.24), respectively. Lower levels of community-level social capital are associated with psychological distress among the Japanese elderly population, even after adjusting for individual-level perceptions of social capital and social support.

  16. Isotretinoin therapy for acne vulgaris: results in an Irish population.

    PubMed

    Buckley, D; Rogers, S; Daly, P

    1990-01-01

    The results of treatment of cystic and antibiotic-resistant acne vulgaris in 96 consecutive patients with the oral retinoid isotretinoin (13-cis-retinoic acid; Roacentane) are reported retrospectively. The results show that the drug, while toxic in the short term, is highly effective in clearing acne.

  17. The use of a Swedish telephone medical advice service by the elderly – a population-based study

    PubMed Central

    Dahlgren, K.; Holzmann, M. J.; Carlsson, A. C.; Wändell, P.; Hasselström, J.; Ruge, T.

    2017-01-01

    Objective The present study aimed to describe contact made by the elderly to Sweden’s nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. Design De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group). Information about acute visits to emergency departments and to primary care reception was extracted from the patient administration system. Setting Västerbotten County, Sweden. Subjects Patients over 80 years. Main outcome measures Calling and visiting frequencies for different age groups as well as reasons for contact and individual recommendations. Results The utilisation rate of the telephone advice service for the oldest age group was high, with an incidence rate of 533 per 1000 person-years. Women had a 1.17 times higher incidence rate compared with men. The most common reason for contact was drug-related questions (17% of all contacts). Calls that were recommended to care by a medical specialist correlated with total emergency department visits (r = 0.30, p < 0.05) and calls that were given advice correlated with acute primary healthcare visits (r = 0.38, p = 0.005). Conclusion The high utilisation of the telephone advice service by the elderly gives the telephone advice service a unique ability to function as a gatekeeper to further healthcare. Our data suggest that with the telephone advice service’s present guidelines, a significant proportion of all calls are being directed to further medical help. The high frequency of drug-related questions raises concerns about the elderly’s medication regimens. Key points Patients over 80 years of age had a high utilisation of the telephone medical advice service compared with other age groups. Drug

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

    PubMed Central

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

    2014-01-01

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

  19. On the near space population from simulation results

    NASA Astrophysics Data System (ADS)

    Tischenko, V. I.

    A new computer technology module for studying meteoroid complexes is proposed. Space structure is represented by orbital fragments with their visualization from simulated cometary nucleus disintegration. The modelled section in the ecliptic is shown which presents the complex form and its inner structure. This representation can be used for analysing space filling to establish potentially dangerous regions near the complex and the concrete planet's orbits or other object routes. Main results for specific comets are given.

  20. Association of cerebral white matter lesions with cognitive function and mood in Japanese elderly people: a population-based study

    PubMed Central

    Yamawaki, Mika; Wada-Isoe, Kenji; Yamamoto, Mikie; Nakashita, Satoko; Uemura, Yusuke; Takahashi, Yoshimitsu; Nakayama, Takeo; Nakashima, Kenji

    2015-01-01

    Background To determine the relationships between regional white matter lesions (WMLs), lifestyle factors, and cognitive, motor function and mood. Methods A comprehensive evaluation, including brain MRI, blood tests, the Unified Parkinson's Disease Rating Scale, the Mini Mental State Examination, and the Geriatric Depression Scale, was performed for people aged 65 years or older living in Ama-cho on October 1, 2009. Participants were classified by severity of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) using the Fazekas score. Results Of 900 eligible participants, 688 (76.4%) were enrolled, including 303 men. Significant predictors of severe PVH were older age, lower low-density lipoprotein cholesterol (LDL-C) levels, elevated blood pressure (BP), cerebral infarction, and no current alcohol use. Significant predictors of severe DWMH were older age, lower 1,5-anhydroglucitol (1,5-AG) levels, elevated BP, cerebral infarction, and no current alcohol use. Higher cognitive function was associated with younger age, female sex, mild DWMH, more years of education, and higher high-density lipoprotein cholesterol levels. Depressive symptoms were associated with lower 1,5-AG levels, lower LDL-C levels, moderate to severe PVH, and no current alcohol use. Conclusions White matter lesions in elderly people were related to hypertension and impaired glucose tolerance. The severity of WMLs was associated with cognitive function and mood. PMID:25798332

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  3. New population synthesis model Preliminary results for close double white dwarf populations

    NASA Astrophysics Data System (ADS)

    Toonen, Silvia; Nelemans, Gijs; Portegies Zwart, Simon F.

    2010-11-01

    An update is presented to the software package SeBa (Portegies Zwart and Verbunt [1], Nelemans et al. [2]) for simulating single star and binary evolution in which new stellar evolution tracks (Hurley et al. [3]) have been implemented. SeBa is applied to study the population of close double white dwarf and the delay time distribution of double white dwarf mergers that may lead to Supernovae Type Ia.

  4. A New Population Synthesis Model: Preliminary Results for Close Double White Dwarf Populations

    NASA Astrophysics Data System (ADS)

    Toonen, Silvia; Nelemans, Gijs; Portegies Zwart, Simon F.

    2010-12-01

    An update is presented to the software package SeBa (Portegies Zwart and Verbunt [1], Nelemans et al. [2]) for simulating single star and binary evolution in which new stellar evolution tracks (Hurley et al. [3]) have been implemented. SeBa is applied to study the population of close double white dwarf and the delay time distribution of double white dwarf mergers that may lead to Supernovae Type Ia.

  5. Psychiatric assessment and screening for the elderly in primary care: design, implementation, and preliminary results

    PubMed Central

    Abrams, Robert C.; Boné, Blanca; Reid, M. Cary; Adelman, Ronald D.; Breckman, Risa; Goralewicz, Ronald; Palombo, Marlena; Stern, Amy; Shengelia, Rouzi; Teresi, Jeanne

    2015-01-01

    Introduction We describe the design and implementation of a psychiatric collaborative care model in a University-based geriatric primary care practice. Initial results of screening for anxiety and depression are reported. Methods and Materials Screens for anxiety and depression were administered to practice patients. A mental health team, consisting of a psychiatrist, mental health nurse practitioner and social worker, identified patients who on review of screening and chart data warranted evaluation or treatment. Referrals for mental health interventions were directed to members of the mental health team, primary care physicians at the practice, or community providers. Results Subjects (N=1505) comprised 38.2% of the 3940 unique patients seen at the practice during the 4-year study period. 37.1% (N=555) screened positive for depression, 26.9 % (N=405) for anxiety, and 322 (21.4%) screened positive for both. Any positive score was associated with age (p<0.033), female gender (p<0.006), and a non-significant trend toward living alone (p<0.095). 8.87% had suicidal thoughts. Conclusions Screening captured the most affectively symptomatic patients, including those with suicidal ideation, for intervention. The partnering of mental health professionals and primary care physicians offers a workable model for addressing the scarcity of expertise in geriatric psychiatry. PMID:25954771

  6. Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology

    PubMed Central

    Ratner, Elena S.; Erekson, Elisabeth A.; Minkin, Mary Jane; Foran-Tuller, Kelly A.

    2013-01-01

    Sexual function in aging women Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology. A biopsychosocial approach utilizing brief strategies can be easily implemented in clinics to help women of all ages increase their sexual quality of life. The impact of female pelvic floor disorders on sexual function in older women Female pelvic floor disorders include urinary incontinence, pelvic organ prolapse, and fecal incontinence. These disorders increase dramatically with increasing age. Urinary incontinence has been demonstrated to have a negative impact on a woman’s sexual function. Among sexually active older women with urinary incontinence, 22% report being moderately or extremely worried that sexual activity would cause urine loss. An increased prevalence of sexual distress [9% (6/76) vs. 1.3% (2/216), p=0.005] has been reported in sexually active women over 40 years old with urinary incontinence. Treatment of urinary incontinence can improve sexual function in older women. Among sexually active women (N=53) who underwent midurethral slings procedures for the correction of urinary incontinence, increased coital frequency, decrease fear of incontinence with coitus, decreased embarrassment due to incontinence was reported six months after surgery. Pelvic organ prolapse, a hernia of the vagina resulting in a visible vaginal bulge, has also been associated with a negative impact on sexual function. Women with advanced pelvic organ prolapse (POP-Q stage III or IV) have been demonstrated to have decreased body image reporting that they are more self-conscious about their appearance [adjusted odds ratio (AOR) 4.7; 95% confidence interval (CI) 2.9, 51], feel less feminine (AOR 4.0; 95% CI 1.2, 15) and less sexually attractive (AOR 4.6; 95% CI 1.4, 17) compared with women who have normal pelvic

  7. Women surgeons. Results of the Canadian Population Study.

    PubMed Central

    Mizgala, C L; Mackinnon, S E; Walters, B C; Ferris, L E; McNeill, I Y; Knighton, T

    1993-01-01

    OBJECTIVE: A national survey of women surgeons in Canada was undertaken to evaluate their ability to combine career with personal and family life. SUMMARY BACKGROUND DATA: Despite increasing numbers of women entering the medical profession, women continue to select nonsurgical careers. Although there are many reports regarding women in medical specialties there is little information available regarding women who choose surgical careers. Such data will be useful in increasing the enrollment of women in surgical training programs. METHODS: A 93-item questionnaire was mailed in July 1990 to the 459 eligible female surgeons. The survey was conducted using a modified Dillman 5-step computerized method. The study was closed in May 1991. RESULTS: Of the 459 surgeons who were located, 419 (91.3%) responded. Most surgeons (65.5%) were married. Only 6.5% were separated or divorced. The majority married another professional (91.4%). One quarter married another surgeon. Of all women who married at least once, 70.9% had at least one child. Most surgeons delayed child bearing until after they had completed their surgical training. The majority of respondents were in active surgical practice (82.3% full-time, 6.0% part-time). The most common surgical subspecialty was obstetrics and gynecology (40.9%), followed by ophthalmology (21.2%), and general surgery (12.1%). Surgeons were rarely dissatisfied (4-9%) with career, marriage, health, friendships, financial status, and hobbies. Overall, 88.3% were happy with their decision to pursue a career in surgery. CONCLUSIONS: Women surgeons practicing in Canada are able to combine productive careers with rewarding family lives and are satisfied with their decision to do so despite the compromises involved. PMID:8328828

  8. Genetic variation in sex hormone genes influences heel ultrasound parameters in middle-aged and elderly men: results from the European Male Aging Study (EMAS).

    PubMed

    Limer, Kate L; Pye, Stephen R; Thomson, Wendy; Boonen, Steven; Borghs, Herman; Vanderschueren, Dirk; Huhtaniemi, Ilpo T; Adams, Judith E; Ward, Kate A; Platt, Hazel; Payne, Debbie; John, Sally L; Bartfai, Gyorgy; Casanueva, Felipe; Finn, Joseph D; Forti, Gianni; Giwercman, Aleksander; Han, Thang S; Kula, Krzysztof; Lean, Michael E; Pendleton, Neil; Punab, Margus; Silman, Alan J; Wu, Frederick C; O'Neill, Terence W

    2009-02-01

    Genes involved in sex hormone pathways are candidates for influencing bone strength. Polymorphisms in these genes were tested for association with heel quantitative ultrasound (QUS) parameters in middle-aged and elderly European men. Men 40-79 yr of age were recruited from population registers in eight European centers for the European Male Aging Study (EMAS). Polymorphisms were genotyped in AR, ESR1, ESR2, CYP19A1, CYP17A1, SHBG, SRD5A2, LHB, and LHCGR. QUS parameters broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured in the heel and used to derive BMD. The relationships between QUS parameters and polymorphisms were assessed using linear regression adjusting for age and center. A total of 2693 men, with a mean age of 60.1 +/- 11.1 (SD) yr were included in the analysis. Their mean BUA was 80.0 +/- 18.9 dB/Mhz, SOS was 1550.2 +/- 34.1 m/s, and BMD was 0.542 +/- 0.141 g/cm(2). Significant associations were observed between multiple SNPs in a linkage disequilibrium (LD) block within CYP19A1, peaking at the TCT indel with the deletion allele associating with reduced ultrasound BMD in heterozygotes (beta =-0.016, p = -0.005) and homozygotes (beta = -0.029, p = 0.001). The results for BUA and SOS were similar. Significant associations with QUS parameters were also observed for the CAG repeat in AR and SNPs in CYP17A1, LHCGR, and ESR1. Our data confirm evidence of association between bone QUS parameters and polymorphisms in CYP19A1, as well as modest associations with polymorphisms in CYP17A1, ESR1, LHCGR, and AR in a population sample of European men; this supports a role for genetically determined sex hormone actions in influencing male bone health.

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

    PubMed Central

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

    2015-01-01

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

  10. Probiotics and prebiotics in the elderly

    PubMed Central

    Hamilton-Miller, J

    2004-01-01

    Probiotics (usually lactobacilli and bifidobacteria) and prebiotics (non-digestible oligosaccharides) have been shown to be useful in preventing certain disease conditions as well as possibly promoting specific aspects of health. In the present review, the evidence from clinical trials for benefits from probiotics and prebiotics to elderly populations is presented and discussed, specifically in respect of three common conditions found in the elderly. Both probiotics and prebiotics may be helpful in malnutrition, particularly in lactose intolerance and calcium absorption, and in constipation. Probiotics have been shown clearly to boost immunity in the elderly, but the clinical significance of this remains to be clarified. These results are encouraging, and further large scale studies seem justified to establish the place of probiotic and prebiotic supplements in elderly subjects. PMID:15299153

  11. [The results of the surgical treatment of otosclerosis in the elderly subjects].

    PubMed

    Kulakova, L A; Poliakova, E P; Bodrova, I V; Lopatin, A S

    2014-01-01

    The objective of the present study was to evaluate the effectiveness of the surgical treatment of otosclerosis in the subjects of advanced age. The medical histories of 19 patients aged above 65 years (20 ears) presenting with otosclerosis were available for the retrospective analysis. All of them had undergone surgical interventions (a total of 22 ones or 4.49% of the 489 operations performed between 2001 and 2012). The audiometric assessment was made at four wavelengths (0.5, 1, 2, and 4 kHz). Primary surgery (n=18) was preceded by the determination of the high air and bone conductivity thresholds (76.18 dB and 42.15 dB respectively), with the mean bone to air interval (BAI) being 33.99 dB. The surgical treatment resulted in the improvement of hearing; in 83.33% of the cases, BAI was reduced to 10 dB or below this value. It is concluded that the surgical intervention on the stirrup bone for the treatment of otosclerosis in the patients above 65 years of age is a safe and efficacious method despite marked hearing impairment in this group of patients.

  12. The impact of chronic low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: A comparative study on Turkish elderly population

    PubMed Central

    Aslan Telci, Emine; Yagci, Nesrin; CAN, Tuba; Cavlak, Ugur

    2013-01-01

    Objectives: The purposes of this study were: (1) to show the impact of chronic low back pain (CLBP) on physical performance, fear avoidance behavior and depressive symptoms in older adults; (2) to describe the relationships between outcome measurements obtained in this study. Methodology: Ninety-one participants with or without chronic low back pain were included in this study. Only four tests in the Back Performance Scale were used to assess the physical performance of the participants. A Fear Avoidance Beliefs Questionnaire related to physical activity and the Geriatric Depression Scale were also used to examine each subject. Results: The level of performance shown by elderly adults with low back pain was worse than elders without low back pain in the sock test and the pick-up test (p < 0.05). Little correlation between the finger-to-floor test and fear avoidance behaviour related to physical activity was found (p < 0.05). There was little/poor correlation between all performance tests and depressive symptoms (p < 0.05). Conclusions: The findings indicate that CLBP decreases physical performance, but increases fear avoidance behavior and depressive symptoms in elderly adults. At the same time, it was determined that performance level of elderly adults with back pain was related especially with depressive symptoms. PMID:24353576

  13. Poverty variations among the elderly: the roles of income security policies and family co-residence.

    PubMed

    Kaida, Lisa; Boyd, Monica

    2011-03-01

    Despite a rapid overall decline in poverty among older people since the 1970s, poverty among elderly immigrants is persistently high in Canada. Using data from the 2006 Canadian Census of Population, this article presents results of a study on the poverty of elderly immigrants in comparison to the Canadian-born elderly population. Results from logistic regression analysis suggest that a large portion of the higher poverty rates among elderly immigrants can be explained by the lack or inadequacy of state income support. Nevertheless, the high poverty levels among elderly immigrants are mitigated by financial assistance from their kin. This article concludes by highlighting the role of family support as a coping strategy for escaping poverty and by assessing two mechanisms of state intervention that could improve the economic well-being of elderly immigrants.

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

    PubMed Central

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

    2015-01-01

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

  15. Health Related Quality of Life and Its Socio-Demographic Determinants among Iranian Elderly People: a Population Based Cross-Sectional Study

    PubMed Central

    Hajian-Tilaki, Karimollah; Heidari, Behzad; Hajian-Tilaki, Arefeh

    2017-01-01

    Introduction: In the stage of demographic transition, the rate of elderly is increasing and their health condition is a matter of concern. Thus, the objective of this study was to investigate the health related quality of life (QoL) and the associated socio-demographic determinants among Iranian elderly people. Methods: We conducted a cross-sectional study with a representative samples of 750 elderly people whom community dwelling in urban area of Babol, in the north of Iran. In a household survey, the demographic data were collected and the health related QoL was assessed with a validated standard short form questionnaire (SF-36). The multiple linear regression analysis was performed to determine the demographic characteristics in predicting QoL using SPSS ver 13. Results: The overall mean (SD) scores of QoL was 62.4(17.2) for men and 51.2 (17.9) for women. The mean scores of QoL in all dimensions in men had significantly higher than women. The adjusted regression coefficient of gender, age, educational level, being couple were significant on overall scores of QoL. Aging is inversely associated while male gender and education at high school or higher and being couple are positively associated in prediction of overall scores of QoL. Conclusion: The findings indicate that the health related QoL is rather poor in old people particular in women, elderly with low education level and being single. Therefore, healthcare policy makers should consider an urgent health interventional program among elderly people at present stage of demographic transition with emphasis on high risk demographic profiles. PMID:28299296

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Skrzek, Anna; Stefanska, Malgorzata

    2012-01-01

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

  18. Respiratory Syncytial Virus (RSV) Infection in Elderly Mice Results in Altered Antiviral Gene Expression and Enhanced Pathology

    PubMed Central

    Wong, Terianne M.; Boyapalle, Sandhya; Sampayo, Viviana; Nguyen, Huy D.; Bedi, Raminder; Kamath, Siddharth G.; Moore, Martin L.; Mohapatra, Subhra; Mohapatra, Shyam S.

    2014-01-01

    Elderly persons are more susceptible to RSV-induced pneumonia than young people, but the molecular mechanism underlying this susceptibility is not well understood. In this study, we used an aged mouse model of RSV-induced pneumonia to examine how aging alters the lung pathology, modulates antiviral gene expressions, and the production of inflammatory cytokines in response to RSV infection. Young (2–3 months) and aged (19–21 months) mice were intranasally infected with mucogenic or non-mucogenic RSV strains, lung histology was examined, and gene expression was analyzed. Upon infection with mucogenic strains of RSV, leukocyte infiltration in the airways was elevated and prolonged in aged mice compared to young mice. Minitab factorial analysis identified several antiviral genes that are influenced by age, infection, and a combination of both factors. The expression of five antiviral genes, including pro-inflammatory cytokines IL-1β and osteopontin (OPN), was altered by both age and infection, while age was associated with the expression of 15 antiviral genes. Both kinetics and magnitude of antiviral gene expression were diminished as a result of older age. In addition to delays in cytokine signaling and pattern recognition receptor induction, we found TLR7/8 signaling to be impaired in alveolar macrophages in aged mice. In vivo, induction of IL-1β and OPN were delayed but prolonged in aged mice upon RSV infection compared to young. In conclusion, this study demonstrates inherent differences in response to RSV infection in young vs. aged mice, accompanied by delayed antiviral gene induction and cytokine signaling. PMID:24558422

  19. Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan.

    PubMed

    Tsai, Alan C; Chang, Tsui-Lan; Wang, Yi-Chen; Liao, Chiu-Ying

    2010-09-01

    A simple, reliable, noninvasive, and easy-to-use instrument is important for successful monitoring of emerging nutrition problems in elderly people. The objectives of this study were to determine whether adoption of population-specific body mass index (BMI) cutpoints would improve the predictive ability of the short-form Mini Nutritional Assessment (MNA) and whether calf circumference could be an acceptable alternative to BMI in the short-form MNA without compromising its predictive ability. Using convenience sampling, the study recruited 301 community-living, 109 care center-living, and 68 nursing home-living elderly people, 65 years or older, as subjects. Subjects were evaluated with the short-form MNA in three versions: (a) the original, (b) Taiwan version 1 (T1), that adopted population-specific BMI cutpoints, and (c) Taiwan version 2 (T2), which substituted calf circumference for BMI, and with the long-form MNA-T2 as a reference. The ability of the short forms to predict the long-form MNA-T2 was evaluated with binary classification and analysis of receiver operating characteristic curves. Results were analyzed with an SPSS for Windows 12.0 software package (version 12.0.1C, 2000, SPSS Inc, Chicago, IL). Results showed that adoption of population-specific anthropometric BMI cutpoints improved the predictive ability of the short-form MNA, whereas replacement of BMI with calf circumference further improved the predictive ability of the scale (kappa values of the binary classification tests were 0.596, 0.742, and 0.843 for community-living; 0.560, 0.683, and 0.839 for care center-living; and 0.346, 0.454, and 0.522 for nursing home-living elderly for the original, T1, and T2 MNA short-form versions, respectively). These results suggest that modification of a measurement tool according to cultural or anthropometric features of the target population is necessary. The study also shows that calf circumference can be an acceptable alternative to BMI in the short

  20. Disparate health implications stemming from the propensity of elderly and medically fragile populations to shelter in place during severe storm events.

    PubMed

    Behr, Joshua G; Diaz, Rafael

    2013-01-01

    Chronic conditions, disability limitations (mobility, cognitive, and sensory), and the need for assistance with activities of daily living are characteristics of elderly and medically fragile populations. Theory suggests that households with these vulnerability attributes are more likely to suffer storm-induced adverse and prolonged health consequences and, therefore, ought to evidence an increased propensity to evacuate prior to a severe storm event. Yet despite being more sensitive to storm disruption, the elderly and medically fragile populations are only slightly more likely to evacuate in the face of impending storms. This suggests, for these groups, there may be other factors such as income, transportation, and social and familial networks that may be attenuating the propensity to evacuate. The public health significance is found in that the propensity to shelter in place, rather than evacuate, may contribute to disparate health outcomes. Data illustrating the prevalence of these conditions and the propensity to shelter in place are derived from a sampling of Hampton Roads households following the 2011 Hurricane Irene.

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

    PubMed

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

    2016-02-15

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

  2. Elderly deaths in Ankara, Turkey.

    PubMed

    Akar, Taner; Karapirli, Mustafa; Akcan, Ramazan; Demirel, Birol; Akduman, Barış; Dursun, Ahmet Zahit; Sari, Serhat; Özkök, Alper

    2014-01-01

    According to World Health Organization, the life expectancy at birth is increasing. An increase in life expectancy might result in increased morbidity and mortality in elderly. The increase in the elderly population also leads to an increase in medico-legal problems, as well. Autopsy is of high importance for determination of cause of death in clinical and forensic cases. The purpose of this study was to find out general characteristics elderly deaths by examining forensic autopsy records. Out of 7033 forensic autopsies performed between years of 2007 and 2011, 1324 were elderly deaths and were included in the scope of the study. The records of public prosecutor office, crime scene investigation and autopsy findings were examined. The majority of victims (70.6%) were male, while 29.4% were female, with a male to female ratio of 2.4/1. Victims' ages ranged between 65 and 96 years, and the mean age was 74.8 years. A great number of presented elderly deaths were due to unnatural causes, followed by natural deaths cases. Out of unnatural deaths, 63.2% were related to accidents, 23.7% were suicides, and remaining 13.1% were homicides. More than half (56.6%) of all suicidal deaths were due to hanging. Of natural deaths, the majority (82.7%) were due to cardiovascular system disease. In the presented series the cause of death was determined in 90.9% of all elderly deaths, which validates the need for a forensic autopsy. Data obtained through autopsy procedures is of high importance for death statistics.

  3. Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

    PubMed Central

    2014-01-01

    Objective To evaluate clinical outcome after accelerated partial breast irradiation (APBI) in the elderly after high-dose-rate interstitial multi-catheter brachytherapy (HIBT). Methods and materials Between 2005 and 2013, 70 patients underwent APBI using HIBT. Catheter implant was performed intra or post-operatively (referred patients) after lumpectomy and axillary sentinel lymph node dissection. Once the pathological results confirmed the indication of APBI, planification CT-scan was performed to deliver 34 Gy/10f/5d or 32 Gy/8f/4d. Dose-volume adaptation was manually achieved (graphical optimization). Dosimetric results and clinical outcome were retrospectively analyzed. Physician cosmetic evaluation was reported. Results With a median follow-up of 60.9 months [4.6 – 90.1], median age was 80.7 years [62 – 93.1]. Regarding APBI ASTRO criteria, 61.4%, 18.6% and 20% were classified as suitable, cautionary and non-suitable respectively. Axillary sentinel lymph node dissection was performed in 94.3%; 8 pts (11.5%) presented an axillary involvement. A median dose of 34 Gy [32 – 35] in 8 to 10 fractions was delivered. Median CTV was 75.2 cc [16.9 – 210], median D90 EQD2 was 43.3 Gy [35 – 72.6] and median DHI was 0.54 [0.19 – 0.74]. One patient experienced ipsilateral recurrence (5-year local free recurrence rate: 97.6%. Five-year specific and overall survival rates were 97.9% and 93.2% respectively. Thirty-four patients (48%) presented 47 late complications classified grade 1 (80.8%) and grade 2 (19.2%) with no grade ≥ 3. Cosmetic results were considered excellent/good for 67 pts (95.7%). Conclusion APBI using HIBT and respecting strict rules of implantation and planification, represents a smart alternative between no post-operative irradiation and whole breast irradiation delivered over 6 consecutive weeks. PMID:24886680

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

    PubMed

    Thorne, Deborah

    2010-04-01

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

  5. Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies

    PubMed Central

    Pillemer, Karl; Burnes, David; Riffin, Catherine; Lachs, Mark S.

    2016-01-01

    Purpose: Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention. Design and Methods: This article provides a scoping review of key issues in the field from an international perspective. Results: By drawing primarily on population-based studies, this scoping review provided a more valid and reliable synthesis of current knowledge about prevalence and risk factors than has been available. Despite the lack of scientifically rigorous intervention research on elder abuse, the review also identified 5 promising strategies for prevention. Implications: The findings highlight a growing consensus across studies regarding the extent and causes of elder mistreatment, as well as the urgent need for efforts to make elder mistreatment prevention programs more effective and evidence based. PMID:26994260

  6. Elderly patients and inflammatory bowel disease

    PubMed Central

    Nimmons, Danielle; Limdi, Jimmy K

    2016-01-01

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

  7. Hypertension in the Elderly

    PubMed Central

    Gil-Extremera, Blas; Cía-Gómez, Pedro

    2012-01-01

    Background. The incidence of hypertension in the Western countries is continuously increasing in the elderly population and remains the leading cause of cardiovascular and morbidity. Methods. we analysed some significant clinical trials in order to present the relevant findings on those hypertensive population. Results. Several studies (SYST-EUR, HYVET, CONVINCE, VALUE, etc.) have demonstrated the benefits of treatment (nitrendipine, hydrochrotiazyde, perindopril, indapamide, verapamil, or valsartan) in aged hypertensive patients not only concerning blood pressure values but also the other important risk factors. Conclusion. Hypertension is the most prevalent cardiovascular disorder in the Western countries, and the relevance of receiving pharmacological treatment of hypertension in aged patients is crucial; in addition, the results suggest that combination therapy—nitrendipine plus enalapril—could have more benefits than those observed with the use of nitrendipine alone. PMID:21876789

  8. Fall detection algorithms for real-world falls harvested from lumbar sensors in the elderly population: a machine learning approach.

    PubMed

    Bourke, Alan K; Klenk, Jochen; Schwickert, Lars; Aminian, Kamiar; Ihlen, Espen A F; Mellone, Sabato; Helbostad, Jorunn L; Chiari, Lorenzo; Becker, Clemens

    2016-08-01

    Automatic fall detection will promote independent living and reduce the consequences of falls in the elderly by ensuring people can confidently live safely at home for linger. In laboratory studies inertial sensor technology has been shown capable of distinguishing falls from normal activities. However less than 7% of fall-detection algorithm studies have used fall data recorded from elderly people in real life. The FARSEEING project has compiled a database of real life falls from elderly people, to gain new knowledge about fall events and to develop fall detection algorithms to combat the problems associated with falls. We have extracted 12 different kinematic, temporal and kinetic related features from a data-set of 89 real-world falls and 368 activities of daily living. Using the extracted features we applied machine learning techniques and produced a selection of algorithms based on different feature combinations. The best algorithm employs 10 different features and produced a sensitivity of 0.88 and a specificity of 0.87 in classifying falls correctly. This algorithm can be used distinguish real-world falls from normal activities of daily living in a sensor consisting of a tri-axial accelerometer and tri-axial gyroscope located at L5.

  9. [Do premarketing trials help to predict drug-related iatrogenic effects in elderly patients?].

    PubMed

    Bouvenot, Gilles; Villani, Patrick

    2004-01-01

    Premarketing trials contribute poorly to predicting drug-related iatrogenic effects in elderly patients. Since their main goal is the demonstration of drug efficacy, these trials are characterised by a simplistic design, they include a limited number of young participants (volunteers only), are of a short duration, and follow a strict protocol. Results of studies in young people cannot be extrapolated to elderly people. Although licensing authorities recommend the recruitment of a meaningful number of elderly people in clinical trials (with an age distribution comparable to that expected when the drug is in routine use), even in trials that are not devoted to geriatric illnesses, elderly people remain substantially under-represented in most instances for methodological reasons (to avoid increased variance introduced by a heterogenous population), safety reasons (at this stage of drug development, it could be deleterious to include patients with comorbid conditions and unfair with regard to the brand image of the products), and ethical reasons (the decision to participate could not be taken by the elderly people alone). Exclusion of elderly participants, who are particularly exposed to drug-related iatrogenic effects, influences the generalisability of study findings. The recruitment of elderly participants, a vulnerable population, is necessary to allow valid conclusions regarding elderly people, recommendations on the appropriate dosage adjustment for elderly individuals, the avoidance of prescribing decisions based on inadequate information (with respect to a more informative summary of the characteristics of the products), and the maximum benefit for elderly people from research.

  10. A cost-effectiveness analysis of the arthroplasty options for displaced femoral neck fractures in the active, healthy, elderly population.

    PubMed

    Slover, James; Hoffman, Michael V; Malchau, Henrik; Tosteson, Anna N A; Koval, Kenneth J

    2009-09-01

    This study was performed to explore the cost-effectiveness of total hip arthroplasty (THA) compared with hemiarthroplasty (HEMI) in the treatment of displaced femoral neck fractures in active otherwise healthy older patients in whom the optimum treatment is believed to be an arthroplasty procedure. A Markov decision model was used to determine whether THA or HEMI was most cost-effective for the management of a displaced femoral neck fracture in this patient population. Total hip arthroplasty was associated with an average cost $3000 more than HEMI, and the average quality-adjusted life year gain was 1.53. The incremental cost-effectiveness ratio associated with the THA treatment strategy is $1960 per quality-adjusted life year. Currently available data support the use of THA as the more cost-effective treatment strategy in this specific population. The increased upfront cost appears to be offset by the improved functional results when compared with HEMI in this select patient group.

  11. Are bisphosphonates the suitable anticancer drugs for the elderly?

    PubMed

    Santini, Daniele; Fratto, Maria Elisabetta; Galluzzo, Sara; Vincenzi, Bruno; Tonini, Giuseppe

    2009-01-01

    Bone metastases represent an important problem in the elderly. These patients are exposed to a higher risk of developing skeletal-related events (SREs) with a subsequent decrease in quality of life and survival. Bisphosphonates have demonstrated to reduce and delay the appearance of SREs and to improve the quality of life also in elderly bone metastatic patients. Moreover, in vitro and in vivo preclinical studies suggest that bisphosphonates exert direct as well as indirect antitumor effect. Interestingly, recent clinical data confirm these results in bone metastatic cancer patients. However, randomized trials restricted to elderly patients with metastatic bone disease and focused to evaluate survival benefits have not yet been planned even if elderly patients, especially multiple myeloma, prostate and lung cancer patients, have been often included in trials. This review will examine in detail the preclinical rationale for using bisphosphonates as anticancer agents in elderly patients and will critically explore the first retrospective and prospective clinical evidences of an increased survival in patients treated with bisphosphonates. Moreover, we will analyze the safety of bisphosphonates in elderly population and discuss the clinical recommendations expressed by the SIOG Society for the use of bisphosphonates in elderly patients. Randomized clinical trials to assess the role of bisphosphonate therapy in the adjuvant setting are currently in progress and will be described in this review. If the results of these ongoing clinical trials will be positive, the indications for bisphosphonates could increase, including also elderly patients.

  12. Recent trends of cancer mortality in Romanian adults: mortality is still increasing, although young adults do better than the middle-aged and elderly population.

    PubMed

    Tereanu, Carmen; Baili, Paolo; Berrino, Franco; Micheli, Andrea; Furtunescu, Florentina L; Minca, Dana G; Sant, Milena

    2013-05-01

    We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population. Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men-1.5% from 1997, women-1.2% 1997-2004 and -3.8% 2004-2009), male lung cancer (-2.8% from 1997), female breast (-3.5% from 1999) and cervical (-5.4% from 2004) cancers, mortality has increased in middle-aged and elderly patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians.

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

    PubMed

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

    2015-06-01

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

  14. Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: results of a multicenter phase 1/2 study.

    PubMed

    Mateos, María-Victoria; Hernández, José-M; Hernández, Miguel-T; Gutiérrez, Norma-C; Palomera, Luis; Fuertes, Marta; Díaz-Mediavilla, Joaquín; Lahuerta, Juan-J; de la Rubia, Javier; Terol, María-José; Sureda, Ana; Bargay, Joan; Ribas, Paz; de Arriba, Felipe; Alegre, Adrian; Oriol, Albert; Carrera, Dolores; García-Laraña, José; García-Sanz, Ramón; Bladé, Joan; Prósper, Felipe; Mateo, Gemma; Esseltine, Dixie-Lee; van de Velde, Helgi; San Miguel, Jesús-F

    2006-10-01

    Standard first-line treatment for elderly multiple myeloma (MM) patients ineligible for stem cell transplantation is melphalan plus prednisone (MP). However, complete responses (CRs) are rare. Bortezomib is active in patients with relapsed MM, including elderly patients. This phase 1/2 trial in 60 untreated MM patients aged at least 65 years (half older than 75 years) was designed to determine dosing, safety, and efficacy of bortezomib plus MP (VMP). VMP response rate was 89%, including 32% immunofixation-negative CRs, of whom half of the IF- CR patients analyzed achieved immunophenotypic remission (no detectable plasma cells at 10(-4) to 10(-5) sensitivity). VMP appeared to overcome the poor prognosis conferred by retinoblastoma gene deletion and IgH translocations. Results compare favorably with our historical control data for MP--notably, response rate (89% versus 42%), event-free survival at 16 months (83% versus 51%), and survival at 16 months (90% versus 62%). Side effects were predictable and manageable; principal toxicities were hematologic, gastrointestinal, and peripheral neuropathy and were more evident during early cycles and in patients aged 75 years or more. In conclusion, in elderly patients ineligible for transplantation, the combination of bortezomib plus MP appears significantly superior to MP, producing very high CR rates, including immunophenotypic CRs, even in patients with poor prognostic features.

  15. The benefit of dental care to an elderly population assessed using a sociodental measure of oral handicap.

    PubMed

    Fiske, J; Gelbier, S; Watson, R M

    1990-02-24

    The provision of dental care is based on the assumption that it contributes to quality of life. One hundred elderly people requesting dental care were interviewed and treated. Assessment was made using a sociodental index as well as clinical criteria. The index measured four categories of oral handicap (impairment of function, comfort, self-image and social interaction) prior to treatment and any benefit conferred by the treatment. Seventy-four per cent benefited from treatment. The greatest improvements were in self-image and social interaction. Function was the most difficult category to satisfy. One third of subjects whose oral function was compromised before treatment were still in this state after treatment.

  16. Guideline-concordant Timely Lung Cancer Care and Prognosis among Elderly Patients in the United States: A Population-based Study

    PubMed Central

    Nadpara, Pramit; Madhavan, S. Suresh; Tworek, Cindy

    2015-01-01

    Objectives Elderly carry a disproportionate burden of lung cancer in the US. Therefore, its important to ensure that these patients receive quality cancer care. Timeliness of care is an important dimension of cancer care quality but its impact on prognosis remains to be explored. This study evaluates the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. Materials and Methods Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2002-2007), we identified elderly patients with lung cancer (n = 48,850) and determined time to diagnosis and treatment. We categorized patients by receipt of timely care using guidelines from the British Thoracic Society and the RAND Corporation. Hierarchical generalized logistic model was constructed to identify variables associated with receipt of timely care. Kaplan-Meier analysis and Log Rank test was used for estimation and comparison of the three-year survival. Multivariable Cox proportional hazards model was constructed to estimate lung cancer mortality risk associated with receipt of delayed care. Results Time to diagnosis and treatment varied significantly among the elderly. However, majority of them (77.5%) received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with NSCLC disease, early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income. Paradoxically, survival outcomes were significantly worse among patients receiving timely care. Adjusted lung cancer mortality risk was also significantly lower among patients receiving delayed care, relative to those receiving timely care (Hazard ratio (HR) = 0.68, 95% Confidence interval (CI)= (0.66 - 0.71); p ≤ 0.05). Conclusion This study highlights the critical need to address disparities in receipt of guideline-concordant timely lung cancer care among elderly. Although timely care was not associated with better

  17. Estimating the lifetime risk of dementia in the Canadian elderly population using cross-sectional cohort survival data

    PubMed Central

    Carone, Marco; Asgharian, Masoud; Jewell, Nicholas P.

    2014-01-01

    Dementia is one of the world’s major public health challenges. The lifetime risk of dementia is the proportion of individuals who ever develop dementia during their lifetime. Despite its importance to epidemiologists and policy-makers, this measure does not seem to have been estimated in the Canadian population. Data from a birth cohort study of dementia are not available. Instead, we must rely on data from the Canadian Study of Heath and Aging, a large cross-sectional study of dementia with follow-up for survival. These data present challenges because they include substantial loss to follow-up and are not representatively drawn from the target population because of structural sampling biases. A first bias is imparted by the cross-sectional sampling scheme, while a second bias is a result of stratified sampling. Estimation of the lifetime risk and related quantities in the presence of these biases has not been previously addressed in the literature. We develop and study nonparametric estimators of the lifetime risk, the remaining lifetime risk and cumulative risk at specific ages, accounting for these complexities. In particular, we reveal the fact that estimation of the lifetime risk is invariant to stratification by current age at sampling. We present simulation results validating our methodology, and provide novel facts about the epidemiology of dementia in Canada using data from the Canadian Study of Health and Aging. PMID:26139951

  18. A Cost-effectiveness Analysis of the Arthroplasty Options for Displaced Femoral Neck Fractures in the Active, Healthy, Elderly Population

    PubMed Central

    Slover, James; Hoffman, Michael V.; Malchau, Henrik; Tosteson, Anna N.A.; Koval, Kenneth J.

    2009-01-01

    Purpose: This study was performed to explore the cost-effectiveness of total hip replacement compared with hemiarthroplasty in the treatment of displaced femoral neck fractures in active otherwise healthy older patients in whom the optimum treatment is believed to be an arthroplasty procedure. Methods: A Markov decision model was used to determine whether total hip arthroplasty or hemiarthroplasty was most cost-effective for the management of a displaced femoral neck fracture in this patient population. Results: Total hip arthroplasty was associated with an average cost $3,000 more than hemiarthroplasty, and the average quality-adjusted life year gain was 1.53. The incremental cost-effectiveness ratio associated with the total hip replacement treatment strategy is $1960 per quality-adjusted life-year. Conclusion: Currently available data support the use of total hip arthroplasty as the more cost-effective treatment strategy in this specific population. The increased upfront cost appears to be offset by the improved functional results when compared with hemiarthroplasty in this select patient group. PMID:18701245

  19. Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population.

    PubMed

    Park, Jung-Ho; Hong, Jae-Young; Han, Kyungdo; Suh, Seung-Woo; Park, Si-Young; Yang, Jae-Hyuk; Han, Seung-Woo

    2017-03-01

    Osteoarthritis is prominent among the elderly, with symptoms originating from multiple parts of the body. A cross-sectional study of a nationwide survey was performed to describe the prevalence of and identify factors related to symptomatic hip, knee, and spine osteoarthritis.This cross-sectional study collected data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-5; 2010-2012). After excluding ineligible subjects, there were 8976 subjects in this study (3830 males and 5146 females). All subjects reported symptoms and disabilities related to osteoarthritis. Plain radiographs of the spine, hip, and knee were taken in all subjects.Overall, 9.3% of male participants and 28.5% of female participants were diagnosed with symptomatic osteoarthritis according to survey criteria. Women showed a significantly higher prevalence in all age groups (P < 0.05). Multiple-joint osteoarthritis was diagnosed in 10.8% of male patients and 22.8% of female patients with osteoarthritis. Several demographic and lifestyle variables were related to osteoarthritis morbidity. Anthropometric and laboratory measurements were also related to osteoarthritis morbidity. In addition, mental distress and quality of life were significantly compromised in osteoarthritis. There were more significant relationships for these factors among women with a higher prevalence of multijoint osteoarthritis.A significant proportion of the elderly with single- or multiple-joint osteoarthritis had a variety of pain origins that were closely related. Osteoarthritis was also significantly related to several factors, including mental distress and quality of life.

  20. Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population

    PubMed Central

    Park, Jung-Ho; Hong, Jae-Young; Han, Kyungdo; Suh, Seung-Woo; Park, Si-Young; Yang, Jae-Hyuk; Han, Seung-Woo

    2017-01-01

    Abstract Osteoarthritis is prominent among the elderly, with symptoms originating from multiple parts of the body. A cross-sectional study of a nationwide survey was performed to describe the prevalence of and identify factors related to symptomatic hip, knee, and spine osteoarthritis. This cross-sectional study collected data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-5; 2010–2012). After excluding ineligible subjects, there were 8976 subjects in this study (3830 males and 5146 females). All subjects reported symptoms and disabilities related to osteoarthritis. Plain radiographs of the spine, hip, and knee were taken in all subjects. Overall, 9.3% of male participants and 28.5% of female participants were diagnosed with symptomatic osteoarthritis according to survey criteria. Women showed a significantly higher prevalence in all age groups (P < 0.05). Multiple-joint osteoarthritis was diagnosed in 10.8% of male patients and 22.8% of female patients with osteoarthritis. Several demographic and lifestyle variables were related to osteoarthritis morbidity. Anthropometric and laboratory measurements were also related to osteoarthritis morbidity. In addition, mental distress and quality of life were significantly compromised in osteoarthritis. There were more significant relationships for these factors among women with a higher prevalence of multijoint osteoarthritis. A significant proportion of the elderly with single- or multiple-joint osteoarthritis had a variety of pain origins that were closely related. Osteoarthritis was also significantly related to several factors, including mental distress and quality of life. PMID:28328825

  1. The proportion of elderly in Pennsylvania is slipping but....

    PubMed

    Waldman, H Barry; Cannella, Dolores; Perlman, Steven P

    2013-01-01

    Media reports describing the anticipated increase of tens of millions of elderly residents and their attendant billions of dollar costs for health services during the next decades are difficult for any person to place in proper perspective. As a result, these estimates become "just numbers" not actual people. Census Bureau reports are used at the national, state and county levels to provide an increased meaningful picture when the 65 and older population of Pennsylvania will increase to 22.6 percent of the state population. In 2000, 12.4 percent of the U.S. population was 65 years and older (15.6 percent in Pennsylvania, 1.9 million elderly). Only in the state of Florida was the proportion greater. In 2010, the proportion of elderly in the population of Pennsylvania ranked 4th (behind Florida, West Virginia and Maine). It was tied for 3rd (behind Florida and North Dakota) with 2.5 percent of the population 85 years and over. By 2030, the projected number of elderly in Pennsylvania (22.6 percent of the state population) will rank 11th. But ... "Starting on Jan 1, (2011) our 79-million-strong baby boomer generation will be turning 65 at the rate of one elderly every eight seconds.

  2. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  3. Influenza vaccination among the elderly in Italy.

    PubMed Central

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

    1999-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  5. Concurrent radiotherapy with gefitinib in elderly patients with esophageal squamous cell carcinoma: Preliminary results of a phase II study

    PubMed Central

    Xu, Yaping; Zheng, Yuanda; Sun, Xiaojiang; Yu, Xinmin; Gu, Jialei; Wu, Wei; Zhang, Gu; Hu, Jinlin; Sun, Wenyong; Mao, Weimin

    2015-01-01

    The survival rate associated with esophageal cancer is very poor due to diagnosis at advanced stages of disease and insensitivity to chemotherapy. This study investigated the efficacy of gefitinib combination with radiation in 20 elderly patients with esophageal squamous cell carcinoma (ESCC) who were not eligible for platinum-based chemotherapy. Immunohistochemistry was performed to analyze epidermal growth factor receptor (EGFR) expression, and the amplified refractory mutation system was used to detect EGFR mutations. Treatment response was assessed by endoscopy and computed tomography. Treatment toxicity was evaluated using the National Cancer Institute's Common Toxicity Criteria. The data showed that among these 20 patients, 5 experienced a complete response (CR), 13 a partial response (PR), and 2 had stable disease. The overall response rate (CR + PR) was 90%, the median overall survival (OS) was 14.0 months (95% confidence interval [CI]: 10.0–17.9 months), and the median progression-free survival was 7.0 months (95% CI: 0–17.2 months). Patients with good Eastern Cooperative Oncology Group performance status, never smoking, and EGFR mutated tumors had the best OS (14.0, 14.0, and 17.0 months, respectively). Treatment-related grade 3/4 toxicity occurred in five patients. No case of grade 3/4 impaired liver function or hematological toxicity was observed. Concurrent radiotherapy with gefitinib is effective and tolerable in elderly ESCC patients. PMID:26392415

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

  7. Vascular imaging in the elderly.

    PubMed

    Kalva, Sanjeeva P; Mueller, Peter R

    2008-07-01

    Though a myriad of vascular conditions affect the elderly, atherosclerosis remains the most common vascular disorder, followed by venous thromboembolism and varicose veins. In this article, the authors discuss the imaging of atherosclerosis affecting various vascular territories and pay special attention to the elderly population. The authors also discuss imaging findings of segmental arterial mediolysis, giant cell arteritis, and venous thromboembolism.

  8. Frontiers in the Education of the Elderly.

    ERIC Educational Resources Information Center

    Peterson, James A.

    Demographic trends indicate a continued population rise among the elderly, suggesting an expanded market for adult education efforts. Early retirement, unemployment due to technological change, as well as the need for older workers to stay current in their fields all point in the direction of education of the elderly. The elderly report great…

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

    PubMed Central

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

    2016-01-01

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

  10. Melanoma incidence increases in the elderly of Catalonia but not in the younger population: effect of prevention or consequence of immigration?

    PubMed

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

    2015-04-01

    All cases of MM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007 were recorded and melanoma incidence calculated and adjusted for the European standard population via the direct method. The age standardised rate/100,000 inhabitants varied from 6.74 in 2000 to 8.64 in 2007 for all melanomas and from 4.79 to 5.80 for invasive MMs; the Breslow thickness was stable during the period. The increase in invasive melanoma incidence in the elderly was remarkable, the crude rate/100,000 inhabitants increasing from 11.04 (2000) to 15.49 (2007) in the 60-64 year population, while remaining more stable in the 30-34 year range, from 3.97 in 2000 to 4.55 in 2007, and with a tendency to decrease from 5.1 in 2000 to 2.5 in 2007 for the age range of 25-29 years. These lower age ranges are much more affected by immigration. Despite the large immigrant population (nearly one million immigrants arrived in Catalonia during the study period from countries with a low melanoma incidence), melanoma incidence in our region has risen considerably and this trend is likely to persist in the near future.

  11. Bifurcation analysis of a population model and the resulting SIS epidemic model with delay

    NASA Astrophysics Data System (ADS)

    Wei, Junjie; Zou, Xingfu

    2006-12-01

    This paper deals with the model for matured population growth proposed in Cooke et al. [Interaction of matiration delay and nonlinear birth in population and epidemic models, J. Math. Biol. 39 (1999) 332-352] and the resulting SIS epidemic model. The dynamics of these two models are still largely undetermined, and in this paper, we perform some bifurcation analysis to the models. By applying the global bifurcation theory for functional differential equations, we are able to show that the population model allows multiple periodic solutions. For the SIS model, we obtain some local bifurcation results and derive formulas for determining the bifurcation direction and the stability of the bifurcated periodic solution.

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

    PubMed

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

    2016-01-01

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

  13. Exploratory study toward development of the French version of the questionnaire on personality traits (QPT/VKP-4) in an elderly population in comparison to young adults.

    PubMed

    Courtois, R; Enfoux, A; Plaisant, O; Coutard, N; Duijsens, I J; Réveillère, C; Camus, V; El-Hage, W

    2014-08-01

    This research is an exploratory study toward development of the French version of the Questionnaire on Personality Traits (QPT/VKP-4). The goal was to assess its association with the Big Five Inventory (BIG-5) and to explore the personality characteristics of the elderly compared to young adults. The 241 participants included 83 elderly people and 158 young adults. Borderline and anxious personality disorders were less frequent in elderly women than in young women, and depressive personality disorder was less frequent in elderly men. Dimension scores were higher for Conscientiousness in the elderly, Agreeableness in elderly women, and Extraversion in elderly men. Statistically significant correlations were found between personality dimension scores using the VKP-4 and the BIG-5.

  14. Frailty among rural elderly adults

    PubMed Central

    2014-01-01

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

  15. Risk of cardiovascular adverse events from trastuzumab (Herceptin(®)) in elderly persons with breast cancer: a population-based study.

    PubMed

    Tsai, H-T; Isaacs, C; Fu, A Z; Warren, J L; Freedman, A N; Barac, A; Huang, C-Y; Potosky, A L

    2014-02-01

    Randomized controlled trials have reported a 4-5 times increased risk of heart failure (HF) in breast cancer patients receiving trastuzumab (Herceptin (®) ) compared to patients who do not receive trastuzumab. However, data regarding the cardiac effects of trastuzumab on elderly patients treated in general practice remain very limited. Using the US surveillance, epidemiology, and end results (SEER)-Medicare database, we conducted a retrospective cohort study on the cardiac effects of trastuzumab use in all incident breast cancer patients diagnosed from 1998 to 2007 who were 66 years and older, had no prior recent claims for cardiomyopathy (CM) or HF, and were followed through 2009. We defined our outcome as the first CM/HF event after diagnosis. We performed Cox-proportional hazard models with propensity score adjustment to estimate CM/HF risk associated with trastuzumab use. A total of 6,829 out of 68,536 breast cancer patients (median age: 75) had an incident CM/HF event. Patients who received trastuzumab tended to be younger, non-white, diagnosed more recently, and had a stage IV diagnosis. Trastuzumab use was associated with an increased risk of CM/HF (HR = 2.08, 95 % CI 1.77-2.44, p < 0.001). The trastuzumab-associated CM/HF risk was stronger in patients who were younger (HR = 2.52 for 66-75 years and HR = 1.44 for 76 years and older, p < 0.001) and diagnosed in recent years (HR = 2.58 for 2006-2007 vs. 1.86 for 1998-2005, p = 0.01). The twofold risk of CM/HF associated with trastuzumab remained regardless of patients' diagnosis stage, presence of hypertension, cardiovascular comorbidities, or receipt of anthracyclines, taxanes, or radiation. Trastuzumab may double CM/HF risk among elderly breast cancer patients. Our findings reinforce the need to prevent and manage cardiac risk among elderly breast cancer patients receiving trastuzumab.

  16. Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: A Population-based Longitudinal Cohort Study

    PubMed Central

    Chen, Hung-Yi; Ma, Kai-Yan; Hsieh, Pei-Ling; Liou, Yi-Sheng; Jong, Gwo-Ping

    2016-01-01

    Background: Antihypertensive drugs have been linked to new-onset osteoporotic fracture (NOF), and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up. Methods: In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65–80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios (HRs) of NOF associated with antihypertensive use. Non-NOF controls served as the reference group. Results: A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme (ACE) inhibitors (HR, 1.64; 95% confidence interval [CI], 1.01–2.66) than among nonusers. Patients who took calcium channel blockers (CCBs) (HR, 0.70; 95% CI, 0.49–0.99) were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF. Conclusions: Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up. PMID:27958221

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

    PubMed Central

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

    1997-01-01

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

  18. Use of the Montreal Cognitive Assessment test to investigate the prevalence of mild cognitive impairment in the elderly elective surgical population.

    PubMed

    Smith, N A; Yeow, Y Y

    2016-09-01

    Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test. Secondarily, we wished to determine the proportion of patients with mild cognitive impairment who presented with this information available, the effect of increasing age on the prevalence of mild cognitive impairment and whether the timing and location of testing influenced results. We used the Montreal Cognitive Assessment test to screen preoperative patients aged 65 years and over. Our results suggested a potential prevalence of mild cognitive impairment of 56%, with prevalence increasing with age. No patients in the sample had a recorded diagnosis of mild cognitive impairment. Testing in either the preadmission clinic or on admission on the day of surgery yielded similar results. We found the Montreal Cognitive Assessment test to be a simple screening tool that was easily administered during the pre-admission visit.

  19. Disaggregating measurement uncertainty from population variability and Bayesian treatment of uncensored results

    SciTech Connect

    Strom, Daniel J.; Joyce, Kevin E.; Maclellan, Jay A.; Watson, David J.; Lynch, Timothy P.; Antonio, Cheryl L.; Birchall, Alan; Anderson, Kevin K.; Zharov, Peter

    2012-04-17

    In making low-level radioactivity measurements of populations, it is commonly observed that a substantial portion of net results are negative. Furthermore, the observed variance of the measurement results arises from a combination of measurement uncertainty and population variability. This paper presents a method for disaggregating measurement uncertainty from population variability to produce a probability density function (PDF) of possibly true results. To do this, simple, justifiable, and reasonable assumptions are made about the relationship of the measurements to the measurands (the 'true values'). The measurements are assumed to be unbiased, that is, that their average value is the average of the measurands. Using traditional estimates of each measurement's uncertainty to disaggregate population variability from measurement uncertainty, a PDF of measurands for the population is produced. Then, using Bayes's theorem, the same assumptions, and all the data from the population of individuals, a prior PDF is computed for each individual's measurand. These PDFs are non-negative, and their average is equal to the average of the measurement results for the population. The uncertainty in these Bayesian posterior PDFs is all Berkson with no remaining classical component. The methods are applied to baseline bioassay data from the Hanford site. The data include 90Sr urinalysis measurements on 128 people, 137Cs in vivo measurements on 5,337 people, and 239Pu urinalysis measurements on 3,270 people. The method produces excellent results for the 90Sr and 137Cs measurements, since there are nonzero concentrations of these global fallout radionuclides in people who have not been occupationally exposed. The method does not work for the 239Pu measurements in non-occupationally exposed people because the population average is essentially zero.

  20. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior

    PubMed Central

    Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-01-01

    Background The limited or uncertain access to adequate food in elderly people includes not only economic restrictions but also inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy. Objective The aim of this work is to present the protocol of the randomized controlled trial Saúde.Come Senior, an educational and motivational television (TV)-based intervention to promote healthy lifestyles and decrease food insecurity in elderly people. Methods A randomized controlled study will be conducted in subjects aged 60 years and older with food insecurity, identified at 17 primary care centers in the Lisboa e Vale do Tejo health region in Lisbon, Portugal. The primary outcome will be the changes in participants’ food insecurity score (evaluated by the Household Food Insecurity Scale) at 3 months. Change in other outcomes will be assessed (dietary habits, nutritional status, physical activity, health status, and clinical outcomes). Subjects will be followed over 6 months; the intervention will last 3 months. Data collection will be performed at 3 different time points (baseline, end of intervention at 3 months, and follow-up at 6 months). The intervention is based on an interactive TV app with an educational and motivational program specifically developed for the elderly that has weekly themes and includes daily content in video format: (1) nutrition and diet tips for healthy eating, (2) healthy, easy to cook and low-cost recipes, and (3) physical exercise programs. Furthermore, brief reminders on health behaviors will also be broadcasted through the TV app. The total duration of the study will be 6 months. The intervention is considered to be effective and meaningful if 50% of the individuals in the experimental group have a decrease of 1 point in the food insecurity score, all the remaining being unchanged. We expect to include and randomize 282 (141 experimental and 141 control) elderly with food insecurity. We will

  1. Relationship between employment status and obesity in a Korean elderly population, based on the 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES).

    PubMed

    Kang, Hee-Taik; Lee, Hye-Ree; Lee, Yong-Jae; Linton, John A; Shim, Jae-Yong

    2013-01-01

    We investigated the relationship between employment status and obesity prevalence in an elderly Korean, using a nationally representative sample. This cross-sectional study included 2991 participants (1396 men and 1595 women) aged 60 years or older. Employment status was categorized into full-time employees, part-time employees, and an unemployed group, based on a self-reported questionnaire. According to Asia Pacific regional guidelines from the World Health Organization (WHO) and International Obesity Task Force (IOTF), obesity was defined as a body mass index (BMI)≥25kg/m(2). Mean BMI in women was highest in the unemployed group, whereas the mean BMI in men did not differ significantly between employment groups. The obesity prevalence in full-time employees, part-time employees, and the unemployed group were 25.1%, 25.5%, and 27.1% in men and 36.0%, 37.9%, and 40.4% in women, respectively. Compared to the full-time employees, the odds ratios (ORs) (95% confidence intervals) for obesity were 1.172 (0.765-1.795) and 1.164 (0.843-1.609) in the part-time employees, and 1.451 (1.054-1.999) and 1.399 (1.090-1.795) in the unemployed group, for men and women, respectively, after adjusting for age, lifestyle factors (physical activity, alcohol consumption, smoking status, daily calorie intake), socioeconomic factors (education level and household income), and inflammatory factor (white blood cell (WBC) counts). Unemployment appears to be significantly related to a higher prevalence risk of obesity in an elderly Korean population, regardless of age, lifestyle, socioeconomic factors, and inflammatory factor.

  2. Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population.

    PubMed

    Cohen, C I; Teresi, J; Holmes, D

    1986-02-01

    Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year. Three different methods of determining buffering effects were examined: Dividing the sample into high- and low-stress groups and contrasting differences in percentage variance accounted for by social networks between the two groups; Examining the group as a whole to assess if any Network Variable X Stress interactional terms are significant; Examining the group as a whole to assess whether there is a reduction in the beta value of stress with respect to psychological symptoms when network variables are added to the analysis. Method 1 indicated a direct network effect, but none of the methods indicated a buffering effect. Of clinical relevance was the nonlinearity of the network effects, that is, depending upon a person's stressor level, different network dimensions must be emphasized and strengthened.

  3. Degree, but not direction of grip strength asymmetries, is related to depression and anxiety in an elderly population.

    PubMed

    Yu, Junhong; Rawtaer, Iris; Mahendran, Rathi; Kua, Ee-Heok; Feng, Lei

    2017-05-01

    Despite the abundance of studies on asymmetries in manual laterality, a marker for atypical brain lateralization in depression and anxiety, findings in this area are mixed. Traditionally, research have looked at individual differences in depression and anxiety as a function of the direction of asymmetry. However, recent research has emphasized on studying the degree of asymmetry in addition to its direction. To these ends, the present study aims to unravel the associations between the degree and direction of manual lateralization, and depression/anxiety. Cognitively healthy elderlies (N = 326, 91 males, Mage = 68) were administered grip strength assessments on both hands and self-report measures of depression and anxiety. Partial correlation analyses controlling for age, education and sex revealed significant positive associations between degree of lateralization and anxiety in the overall sample and among right-dominant participants, as well as a significant positive relationship between degree of lateralization and depression among right-dominant participants. None of the correlations involving the direction of lateralization yielded significance, neither was there significant differences between left- and right-dominant participants on depression and anxiety scores. These findings suggest that the degree of manual lateralization, but not direction, is related to depression and anxiety at least among right-dominant individuals.

  4. Patterns of ambulatory medical care utilization in elderly patients with special reference to chronic diseases and multimorbidity - Results from a claims data based observational study in Germany

    PubMed Central

    2011-01-01

    Background In order to estimate the future demands for health services, the analysis of current utilization patterns of the elderly is crucial. The aim of this study is to analyze ambulatory medical care utilization by elderly patients in relation to age, gender, number of chronic conditions, patterns of multimorbidity, and nursing dependency in Germany. Methods Claims data of the year 2004 from 123,224 patients aged 65 years and over which are members of one nationwide operating statutory insurance company in Germany were studied. Multimorbidity was defined as the presence of 3 or more chronic conditions of a list of 46 most prevalent chronic conditions based on ICD 10 diagnoses. Utilization was analyzed by the number of contacts with practices of physicians working in the ambulatory medical care sector and by the number of different physicians contacted for every single chronic condition and their most frequent triadic combinations. Main statistical analyses were multidimensional frequency counts with standard deviations and confidence intervals, and multivariable linear regression analyses. Results Multimorbid patients had more than twice as many contacts per year with physicians than those without multimorbidity (36 vs. 16). These contact frequencies were associated with visits to 5.7 different physicians per year in case of multimorbidity vs. 3.5 when multimorbidity was not present. The number of contacts and of physicians contacted increased steadily with the number of chronic conditions. The number of contacts varied between 35 and 54 per year and the number of contacted physicians varied between 5 to 7, depending on the presence of individual chronic diseases and/or their triadic combinations. The influence of gender or age on utilization was small and clinically almost irrelevant. The most important factor influencing physician contact was the presence of nursing dependency due to disability. Conclusion In absolute terms, we found a very high rate of

  5. Elderly health and literature therapy: a theoretical review.

    PubMed

    Eum, Yeongcheol; Yim, Jongeun; Choi, Wonjae

    2014-01-01

    Recently, the problems of old age have been discussed in terms of two aspects: preventive and therapeutic approach. The previous studies on the preventive aspect have been mostly concerned with the educational preparation for successful approach to elderly, directing focus toward the transitional period of the old age. Most research into the therapeutic aspect on the elderly diseases has focused on organic mental disorders such as dementia and functional mental diseases such as depression. This study aims to suggest the preventive and new therapeutic possibility in old people through combining the elderly health with literature. First, the research results regarding the social background for the elderly problems indicate that geriatric diseases increase in proportion to the increase of the population. Secondly, for the literature therapy, it is initially required to seek a comprehensive understanding about the health of the elderly through the phased consideration for the elderly problems. Thirdly, for the treatment of geriatric diseases by using literature, it is necessary to develop more active and integrative literature therapy than passive bibliotherapy. Literature therapy is the use of literature in the treatment of people with emotional or mental illness. Fourthly, theoretical approach should be considered for the health of the elderly and the literature therapy. From a literary approach, the literature therapy can help the study on geriatric diseases such as dementia and depression. Thus, the program for the health of geriatric issues and literature therapy should be developed as the next step in the future.

  6. Energy expenditure through physical activity in a population of community-dwelling Brazilian elderly: cross-sectional evidences from the Bambuí Cohort Study of Aging.

    PubMed

    Ramalho, Juciany Rodrigues de Oliveira; Lima-Costa, Maria Fernanda; Firmo, Josélia O A; Peixoto, Sérgio Viana

    2011-01-01

    The aim of this study was to estimate physical activity energy expenditure among older adults. The study comprised 1,585 residents in Bambuí, Minas Gerais State, Brazil, aged > 60 years (91% of the town's total elderly), and examined the frequency and duration of 23 types of physical activity among them. Median energy expenditure was 975 MET.min/week (1,195.8 among men and 803.1 among women), declining significantly with age in both sexes. The prevalence of sedentary lifestyles (< 450 MET.min/week) was 31.2%. Unhurried walking accounted for about 1/3 of total energy expenditure. Multivariate analysis based on ordinal logistic regression showed inverse associations between energy expenditure and age and hospitalizations in both sexes. Among men, inverse associations were observed with smoking, number of chronic diseases and number of medical appointments. These results emphasize the need for effective strategies to increase physical activity in older elderly, and underscore the high prevalence of walking in this group.

  7. [Stories by the elderly].

    PubMed

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

    2005-10-01

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

  8. Exoskeleton plantarflexion assistance for elderly.

    PubMed

    Galle, S; Derave, W; Bossuyt, F; Calders, P; Malcolm, P; De Clercq, D

    2017-02-01

    Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms(2)) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits.

  9. Chocolate Intake and Incidence of Heart Failure: A Population-Based, Prospective Study of Middle-Aged and Elderly Women

    PubMed Central

    Mostofsky, Elizabeth; Levitan, Emily B.; Wolk, Alicja; Mittleman, Murray A.

    2011-01-01

    Background Randomized clinical trials have shown that chocolate intake reduces systolic and diastolic blood pressure and observational studies have found an inverse association between chocolate intake and cardiovascular disease. The aim of this study was to investigate the association between chocolate intake and incidence of heart failure (HF). Methods and Results We conducted a prospective cohort study of 31,823 women 48–83 years old without baseline diabetes or a history of HF or myocardial infarction who were participants in the Swedish Mammography Cohort. In addition to health and lifestyle questions, participants completed a food-frequency questionnaire. Women were followed from January 1, 1998 through December 31, 2006 for HF hospitalization or death through the Swedish inpatient and cause-of-death registers. Over 9 years of follow-up, 419 women were hospitalized for incident HF (n =379) or died of HF (n = 40). Compared to no regular chocolate intake, the multivariate-adjusted rate ratio of HF was 0.74 (95%CI 0.58–0.95) for those consuming 1–3 servings of chocolate per month, 0.68 (95%CI 0.50–0.93) for those consuming 1–2 servings per week, 1.09 (95%CI .74–1.62) for those consuming 3–6 servings per week and 1.23 (95%CI 0.73–2.08) for those consuming one or more servings per day (p for quadratic trend = 0.0005). Conclusions In this population, moderate habitual chocolate intake was associated with a lower rate of HF hospitalization or death but the protective association was not observed with intake of one or more servings per day. PMID:20713904

  10. Serum bilirubin levels and risk of type 2 diabetes: results from two independent cohorts in middle-aged and elderly Chinese

    PubMed Central

    Wang, Jing; Li, Yaru; Han, Xu; Hu, Hua; Wang, Fei; Li, Xiulou; Yang, Kun; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Cheng, Weihong; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Yang, Handong; Yuan, Jianmin; Koh, Woon-Puay; Hu, Frank B.; Wu, Tangchun; Pan, An; He, Meian

    2017-01-01

    Serum bilirubin is a potent endogenous antioxidant and has been identified as cardiovascular risk in cohort studies, while the relation to type 2 diabetes (T2D) in the elderly remains unclear. We investigated both cross-sectional and prospective associations between serum bilirubin levels and T2D risk in the Dongfeng-Tongji (DFTJ) cohort, and replicated the prospective findings in a nested case-control study (509 cases and 509 controls) within the Singapore Chinese Health Study (SCHS). In the cross-sectional analysis of DFTJ cohort (15,575 participants with 2,532 diabetes cases), serum bilirubin levels (total, direct and indirect) increased in new on-set diabetes and decreased with the diabetic duration. In the longitudinal analysis of DFTJ cohort (772 incident diabetes cases during 4.5 years of follow-up among 12,530 diabetes-free participants at baseline), positive association was found between direct bilirubin and T2D risk comparing extreme quartiles, similar results were observed in the nested case-control study within SCHS. Total and indirect bilirubin levels were not significantly associated with T2D in either cohort. In conclusion, our findings do not support the protective association between serum bilirubin levels and incident T2D in the middle-aged and elderly adults; instead, direct bilirubin levels were associated with increased risk of T2D. PMID:28164994

  11. Serum bilirubin levels and risk of type 2 diabetes: results from two independent cohorts in middle-aged and elderly Chinese.

    PubMed

    Wang, Jing; Li, Yaru; Han, Xu; Hu, Hua; Wang, Fei; Li, Xiulou; Yang, Kun; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Cheng, Weihong; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Yang, Handong; Yuan, Jianmin; Koh, Woon-Puay; Hu, Frank B; Wu, Tangchun; Pan, An; He, Meian

    2017-02-06

    Serum bilirubin is a potent endogenous antioxidant and has been identified as cardiovascular risk in cohort studies, while the relation to type 2 diabetes (T2D) in the elderly remains unclear. We investigated both cross-sectional and prospective associations between serum bilirubin levels and T2D risk in the Dongfeng-Tongji (DFTJ) cohort, and replicated the prospective findings in a nested case-control study (509 cases and 509 controls) within the Singapore Chinese Health Study (SCHS). In the cross-sectional analysis of DFTJ cohort (15,575 participants with 2,532 diabetes cases), serum bilirubin levels (total, direct and indirect) increased in new on-set diabetes and decreased with the diabetic duration. In the longitudinal analysis of DFTJ cohort (772 incident diabetes cases during 4.5 years of follow-up among 12,530 diabetes-free participants at baseline), positive association was found between direct bilirubin and T2D risk comparing extreme quartiles, similar results were observed in the nested case-control study within SCHS. Total and indirect bilirubin levels were not significantly associated with T2D in either cohort. In conclusion, our findings do not support the protective association between serum bilirubin levels and incident T2D in the middle-aged and elderly adults; instead, direct bilirubin levels were associated with increased risk of T2D.

  12. Reduction in hospital admissions for pneumonia in non-institutionalised elderly people as a result of influenza vaccination: a case-control study in Spain.

    PubMed Central

    Puig-Barberà, J; Márquez-Calderón, S; Masoliver-Fores, A; Lloria-Paes, F; Ortega-Dicha, A; Gil-Martín, M; Calero-Martínez, M J

    1997-01-01

    OBJECTIVE: To estimate the effectiveness of influenza vaccine in preventing hospital admission for pneumonia in non-institutionalised elderly people. DESIGN: This was a case-control study. SETTING: All three public hospitals in the Castellón area of Spain. PARTICIPANTS: Cases were people aged 65 or more not living in an institution who were admitted to hospital for pneumonia between November 15, 1994 and March 31, 1995. Each case was matched with two sex matched control subjects aged 65 years or older admitted to hospital in the same week for acute abdominal surgical conditions or trauma. The sampling of incident cases was consecutive. Eighty three cases and 166 controls were identified and included in the study. MEASUREMENTS: Trained interviewers completed a questionnaire for each subject on the vaccination status, smoking habits, previous diseases, health care use, social contacts, family background, the vaccination status of the family carer, home characteristics, and socioeconomic status. RESULTS: The adjusted odds ratio of the influenza vaccination preventing admission to hospital for pneumonia was 0.21 (95% confidence interval 0.09, 0.55). The variables which best explained the risk of being a case were age, intensity of social contacts, health care use, previous diseases, and the existence of a vaccinated family carer. CONCLUSIONS: Influenza vaccination reduced significantly hospital admissions for pneumonia in non-institutionalised elderly people. PMID:9425463

  13. Welfare reform and elderly immigrants' health insurance coverage: the roles of federal and state medicaid eligibility rules.

    PubMed

    Nam, Yunju

    2011-11-01

    Immigrants' access to federally-funded Medicaid became limited after welfare reform imposed restrictive noncitizen eligibility rules. This study used a representative sample from the Current Population Survey (N = 105,873) and state-level data to examine the effects of these policy changes on elderly immigrants. Triple difference-in-differences analyses show that federal restriction of eligibility had a significantly negative association with elderly immigrants' Medicaid coverage, and generous state eligibility had significantly positive relationships with Medicaid and any health insurance coverage. Findings indicate the important role of eligibility on elderly immigrants' health insurance coverage. Results call for social workers' actions to expand elderly immigrants' Medicaid eligibility.

  14. Prevalence of cardiovascular pathologies in elderly population living in an industrialized area, compared to a control population residing in a rural area.

    PubMed

    Santangelo, Antonino; Albani, Salvatore; Atteritano, Marco; Cappello, Antonella; Malaguarnera, Mariano; Pavano, Salvatore; Primavera, Grazia; Testaì, Manuela; Tomarchio, Marcello; Maugeri, Domenico

    2012-01-01

    The development of cardiovascular pathologies is potentially connected to the surrounding environment, partly due to purely environmental factors, like exposition to pollutions, or anthropological ones, like the type of manual or stressing working activities. The relevant literature has already widely discussed the correlation between the acute and chronic exposition to atmospheric pollutants of different types and the pathogenetic events, such as the atherogenesis, thrombosis, and hypertension, The present study intends to verify this idea on a larger population exposed to different geographical conditions, comparing an agricultural village (Pachino-Siracusa) with an industrialized area (Augusta-Siracusa), both having identical sanitary services of basic importance. On the basis of the specific rates of hospitalizations, we compared the prevalence of cardiovasular pathologies in the resident populations. These studies confirmed the negative influence of the risk factors deriving from the environmental pollutions even on the cardiovascular aging, displaying an increased rate of hospitalization for angina pectoris, myocardial infarction and cardiac arrhytmias in the industrialized population.

  15. Management of Anemia of Inflammation in the Elderly

    PubMed Central

    Macciò, Antonio; Madeddu, Clelia

    2012-01-01

    Anemia of any degree is recognized as a significant independent contributor to morbidity, mortality, and frailty in elderly patients. Among the broad types of anemia in the elderly a peculiar role seems to be played by the anemia associated with chronic inflammation, which remains the most complex form of anemia to treat. The origin of this nonspecific inflammation in the elderly has not yet been clarified. It seems more plausible that the oxidative stress that accompanies ageing is the real cause of chronic inflammation of the elderly and that the same oxidative stress is actually a major cause of this anemia. The erythropoietic agents have the potential to play a therapeutic role in this patient population. Despite some promising results, rHuEPO does not have a specific indication for the treatment of anemia in the elderly. Moreover, concerns about their side effects have spurred the search for alternatives. Considering the etiopathogenetic mechanisms of anemia of inflammation in the elderly population, an integrated nutritional/dietetic approach with nutraceuticals that can manipulate oxidative stress and related inflammation may prevent the onset of this anemia and its negative impact on patients' performance and quality of life. PMID:23091709

  16. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey

    PubMed Central

    Sousa, Renata M; Ferri, Cleusa P; Acosta, Daisy; Albanese, Emiliano; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Jotheeswaran, AT; Rodriguez, Juan J Llibre; Pichardo, Guillermina Rodriguez; Rodriguez, Marina Calvo; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Zuniga, Tirso; Prince, Martin

    2009-01-01

    Summary Background Disability in elderly people in countries with low and middle incomes is little studied; according to Global Burden of Disease estimates, visual impairment is the leading contributor to years lived with disability in this population. We aimed to assess the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability. Methods We undertook cross-sectional surveys of residents aged older than 65 years (n=15 022) in 11 sites in seven countries with low and middle incomes (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Disability was assessed with the 12-item WHO disability assessment schedule 2.0. Dementia, depression, hypertension, and chronic obstructive pulmonary disease were ascertained by clinical assessment; diabetes, stroke, and heart disease by self-reported diagnosis; and sensory, gastrointestinal, skin, limb, and arthritic disorders by self-reported impairment. Independent contributions to disability scores were assessed by zero-inflated negative binomial regression and Poisson regression to generate population-attributable prevalence fractions (PAPF). Findings In regions other than rural India and Venezuela, dementia made the largest contribution to disability (median PAPF 25·1% [IQR 19·2–43·6]). Other substantial contributors were stroke (11·4% [1·8–21·4]), limb impairment (10·5% [5·7–33·8]), arthritis (9·9% [3·2–34·8]), depression (8·3% [0·5–23·0]), eyesight problems (6·8% [1·7–17·6]), and gastrointestinal impairments (6·5% [0·3–23·1]). Associations with chronic diseases accounted for around two-thirds of prevalent disability. When zero inflation was taken into account, between-site differences in disability scores were largely attributable to compositional differences in health and sociodemographic characteristics. Interpretation On the basis

  17. Design, methodology and baseline characteristics of Tai Chi and its protective effect against ischaemic stroke risk in an elderly community population with risk factors for ischaemic stroke: a randomised controlled trial

    PubMed Central

    Zheng, Guohua; Zheng, Xin; Li, Junzhe; Duan, Tingjin; Qi, Dalu; Ling, Kun; He, Jian; Chen, Lidian

    2015-01-01

    Introduction Controlling risk factors with regular exercise is effective and cost-effective for the primary prevention of ischaemic stroke. As a traditional Chinese form of exercise, Tai Chi might be beneficial in decreasing ischaemic stroke, but the evidence remains insufficient. We hypothesise that elderly community adults with risk factors for ischaemic stroke will decrease their ischaemic stroke risk by improving cerebral haemodynamic parameters, cardiopulmonary function, motor function, plasma risk indices, physical parameters or psychological outcomes after receiving 12 weeks of regular Tai Chi training compared with those who maintained their original physical activities. Therefore, we designed a randomised controlled trial that will systematically evaluate the protective effects of Tai Chi exercise on ischaemic stroke risk in an elderly community population with risk factors for ischaemic stroke. Methods and analysis A total of 170 eligible participants were randomly allocated into either the Tai Chi training group or the usual physical activity group. This paper reports on the design, intervention development and baseline characteristics of the participants. There were no significant differences between comparison groups in demographic characteristics or the baseline data of primary or secondary outcomes. Participants in the Tai Chi training group will receive 12 weeks of Tai Chi training with a frequency of 5 days/week and 60 min/day, while those in the usual physical activities group will maintain their original activities. Primary and secondary outcomes will be measured at the 12-week and 24-week follow-ups. Ethics and dissemination Ethical approval has been obtained from the Medical Ethics Committee of The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine (number 2013-020-02). The findings of this study will be communicated to healthcare professionals, participants and the public through peer

  18. Population studies: return of research results and incidental findings Policy Statement.

    PubMed

    Knoppers, Bartha Maria; Deschênes, Mylène; Zawati, Ma'n H; Tassé, Anne Marie

    2013-03-01

    The Public Population Project in Genomics and Society (P³G) is a not-for profit international consortium with members from more than 40 countries. Its objective is to lead, catalyze, and co-ordinate international efforts and expertise in order to optimize the use of population studies, biobanks, research databases, and other similar health and social science research infrastructures. The year 2011-2012 witnessed a plethora of special issues of journals on the return of results but few discussed the particular situation of population studies that serve as resources for future unspecified research. P³G considers it important to propose a policy that distinguishes between the contexts of population research and disease (clinical) research involving patients and then delineates actual and future obligations. The objectives of this Policy Statement are to: (1) delineate the particular characteristics of population studies, (2) distinguish the circumstances surrounding access by researchers to such studies, and (3) develop a framework for the return of research results and incidental findings.

  19. The Solid Rocket Motor Slag Population: Results of a Radar-based Regressive Statistical Evaluation

    NASA Technical Reports Server (NTRS)

    Horstman, Matthew F.; Xu, Yu-Lin

    2008-01-01

    Solid rocket motor (SRM) slag has been identified as a significant source of man-made orbital debris. The propensity of SRMs to generate particles of 100 m and larger has caused concern regarding their contribution to the debris environment. Radar observation, rather than in-situ gathered evidence, is currently the only measurable source for the NASA/ODPO model of the on-orbit slag population. This simulated model includes the time evolution of the resultant orbital populations using a historical database of SRM launches, propellant masses, and estimated locations and times of tail-off. However, due to the small amount of observational evidence, there can be no direct comparison to check the validity of this model. Rather than using the assumed population developed from purely historical and physical assumptions, a regressional approach was used which utilized the populations observed by the Haystack radar from 1996 to present. The estimated trajectories from the historical model of slag sources, and the corresponding plausible detections by the Haystack radar, were identified. Comparisons with observational data from the ensuing years were made, and the SRM model was altered with respect to size and mass production of slag particles to reflect the historical data obtained. The result is a model SRM population that fits within the bounds of the observed environment.

  20. Associations between Safety from Crime, Cycling, and Obesity in a Dutch Elderly Population: Results from the Longitudinal Aging Study Amsterdam

    PubMed Central

    Kremers, Stef P. J.; de Bruijn, Gert-Jan; Visscher, Tommy L. S.; Deeg, Dorly J. H.; Thomése, G. C. Fleur; Visser, Marjolein; van Mechelen, Willem; Brug, Johannes

    2012-01-01

    The objective of this cross-sectional study was to investigate differences in associations between crime rates, cycling, and weight status between people living in low and high socioeconomic status (SES) neighbourhoods. In total, 470 participants in the Longitudinal Aging Study Amsterdam were included (age: 63–70 y). Body height and weight were measured using a stadiometer and calibrated weight scale, respectively. Cycling behaviour was assessed in a face-to-face interview, and neighbourhood crime rates were assessed using data from police reports. Men residing in high SES neighbourhoods cycled more than males residing in low SES neighbourhoods. Cycling was negatively related to crime rates among both men and women living in low SES neighbourhoods. Among men living in low SES neighbourhoods, more cycling was associated with lower BMI. Interventions aiming to prevent obesity in older people may consider aiming at increasing bicycle use in lower SES neighbourhoods, but neighbourhood safety issues should be considered. PMID:22523503

  1. Associations between safety from crime, cycling, and obesity in a Dutch elderly population: results from the Longitudinal Aging Study Amsterdam.

    PubMed

    Kremers, Stef P J; de Bruijn, Gert-Jan; Visscher, Tommy L S; Deeg, Dorly J H; Thomése, G C Fleur; Visser, Marjolein; van Mechelen, Willem; Brug, Johannes

    2012-01-01

    The objective of this cross-sectional study was to investigate differences in associations between crime rates, cycling, and weight status between people living in low and high socioeconomic status (SES) neighbourhoods. In total, 470 participants in the Longitudinal Aging Study Amsterdam were included (age: 63-70 y). Body height and weight were measured using a stadiometer and calibrated weight scale, respectively. Cycling behaviour was assessed in a face-to-face interview, and neighbourhood crime rates were assessed using data from police reports. Men residing in high SES neighbourhoods cycled more than males residing in low SES neighbourhoods. Cycling was negatively related to crime rates among both men and women living in low SES neighbourhoods. Among men living in low SES neighbourhoods, more cycling was associated with lower BMI. Interventions aiming to prevent obesity in older people may consider aiming at increasing bicycle use in lower SES neighbourhoods, but neighbourhood safety issues should be considered.

  2. Population sinks resulting from degraded habitats of an obligate life-history pathway.

    PubMed

    Hickford, Michael J H; Schiel, David R

    2011-05-01

    Many species traverse multiple habitats across ecosystems to complete their life histories. Degradation of critical, life stage-specific habitats can therefore lead to population bottlenecks and demographic deficits in sub-populations. The riparian zone of waterways is one of the most impacted areas of the coastal zone because of urbanisation, deforestation, farming and livestock grazing. We hypothesised that sink populations can result from alterations of habitats critical to the early life stages of diadromous fish that use this zone, and tested this with field-based sampling and experiments. We found that for Galaxias maculatus, one of the most widely distributed fishes of the southern hemisphere, obligate riparian spawning habitat was very limited and highly vulnerable to disturbance across 14 rivers in New Zealand. Eggs were laid only during spring tides, in the highest tidally influenced vegetation of waterways. Egg survival increased to >90% when laid in three riparian plant species and where stem densities were great enough to prevent desiccation, compared to no survival where vegetation was comprised of other species or was less dense. Experimental exclusion of livestock, one of the major sources of riparian degradation in rural waterways, resulted in quick regeneration, a tenfold increase in egg laying by fish and a threefold increase in survival, compared to adjacent controls. Overall, there was an inverse relationship between river size and egg production. Some of the largest rivers had little or no spawning habitat and very little egg production, effectively becoming sink populations despite supporting large adult populations, whereas some of the smallest pristine streams produced millions of eggs. We demonstrate that even a wide-ranging species with many robust adult populations can be compromised if a stage-specific habitat required to complete a life history is degraded by localised or more diffuse impacts.

  3. Projection of Young-Old and Old-Old with Functional Disability: Does Accounting for the Changing Educational Composition of the Elderly Population Make a Difference?

    PubMed Central

    Ansah, John P.; Malhotra, Rahul; Lew, Nicola; Chiu, Chi-Tsun; Chan, Angelique; Bayer, Steffen; Matchar, David B.

    2015-01-01

    This study compares projections, up to year 2040, of young-old (aged 60-79) and old-old (aged 80+) with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education)-specific transition probabilities (between active, functional disability and death states) estimated from two waves (2009 and 2011) of a nationally representative survey of community-dwelling Singaporeans aged ≥60 years (N=4,990). Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy. PMID:25974069

  4. Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference?

    PubMed

    Ansah, John P; Malhotra, Rahul; Lew, Nicola; Chiu, Chi-Tsun; Chan, Angelique; Bayer, Steffen; Matchar, David B

    2015-01-01

    This study compares projections, up to year 2040, of young-old (aged 60-79) and old-old (aged 80+) with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education)-specific transition probabilities (between active, functional disability and death states) estimated from two waves (2009 and 2011) of a nationally representative survey of community-dwelling Singaporeans aged ≥ 60 years (N=4,990). Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy.

  5. Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review.

    PubMed

    Corrêa, Márcia Mara; Thumé, Elaine; De Oliveira, Elizabete Regina Araújo; Tomasi, Elaine

    2016-01-01

    A systematic review was carried out aiming to collect evidence on the use of the waist-to-height ratio (WHtR) on the elderly population, focusing on validity measures to identify the best anthropometric indicator in assessing obesity associated with non-communicable diseases. The review consisted in a search of papers published on the databases Pubmed, Web of Science, and Lilacs, with no restriction regarding period of publication, using the following combinations: abdominal fat or overweight or obesity and waist-to-height ratio or waist height or waist ht or WHtR or waist to stature ratio or wst stature or WSR or stature and girth. Sixteen papers were selected, most of which with high methodological quality. The receiver-operating characteristic (ROC) curves was the validity measure explored in 13 papers, followed by sensitivity and specificity measures. In all studies, the body mass index (BMI) and waist circumference (WC) received special attention for analysis along with WHtR. Five manuscripts showed evidence of WHtR being the best anthropometric index when used alone, four showed that both WHtR and WC had the best discriminatory power in predicting cardiovascular risk factors compared to the other indices, and two ranked WHtR at the same performance level as waist-to-hip ratio (WHR) and BMI. An association was shown of the obesity assessed by WHtR in predicting risk factors for cardiovascular diseases, metabolic syndrome, and diabetes compared to other anthropometric parameters.

  6. Vaccines for the elderly.

    PubMed

    Del Giudice, Giuseppe; Weinberger, Birgit; Grubeck-Loebenstein, Beatrix

    2015-01-01

    The aging of the human population is posing serious challenges to research and to public health authorities in order to prevent diseases that more frequently affect the elderly, a portion of the population that will increase more and more in the coming years. While some vaccines exist and are used in the elderly to effectively fight against some infections (e.g. influenza, pneumococci, varicella-zoster virus, diphtheria, and tetanus), still a lot of work remains to be done to better adapt these vaccines and to develop new ones for this age group. The prevention of infectious diseases affecting the elderly can be successful only through a holistic approach. This approach will aim at the following: (1) a deeper understanding of the mechanisms leading to the senescence of the immune system, (2) a better and broader use of vaccines recommended for the elderly, (3) the use of vaccines currently considered only for other age groups and (4) actively priming the population when they are immunological competent, before the physiological waning of immune responsiveness may affect the beneficial effects of vaccination.

  7. Postoperative mortality and need for transitional care following liver resection for metastatic disease in elderly patients: a population-level analysis of 4026 patients

    PubMed Central

    Orcutt, Sonia T; Artinyan, Avo; Li, Linda T; Silberfein, Eric J; Berger, David H; Albo, Daniel; Anaya, Daniel A

    2012-01-01

    Objectives The goal of this study was to characterize the association of age with postoperative mortality and need for transitional care following hepatectomy for liver metastases. Methods A retrospective cohort study using the Nationwide Inpatient Sample (2005–2008) was performed. Patients undergoing hepatectomy for liver metastases were categorized by age as: Young (aged <65 years); Old (aged 65–74 years), and Oldest (aged ≥75 years). Multivariate logistic regression analyses were performed to identify predictors of in-hospital mortality and need for transitional care (non-home discharge). Results A total of 4026 patients were identified; 36.6% (n = 1475) were elderly (aged ≥65 years). Rates of in-hospital mortality and non-home discharge increased with advancing age group [1.3% vs. 2.2% vs. 3.3% (P = 0.005) and 2.1% vs. 6.1% vs. 18.3% (P < 0.001), respectively]. Independent predictors of in-hospital mortality were age within the Oldest category [odds ratio (OR) 2.21, 95% confidence interval (CI) 1.19–4.12] and a Deyo Comorbidity Index score of ≥3 (OR 6.95, 95% CI 3.55–13.60). Independent predictors for need for transitional care were age within the Old group (OR 2.44, 95% CI 1.66–3.58), age within the Oldest group (OR 8.48, 95% CI 5.87–12.24), a Deyo score of 1 (OR 2.00, 95% CI 1.40–2.85), a Deyo score of 2 (OR 4.70, 95% CI 2.93–7.56), a Deyo score of ≥3 (OR 6.41, 95% CI 3.67–11.20), and female gender (OR 1.56, 95% CI 1.15–2.11). Conclusions Although increasing age was associated with higher risk for in-hospital mortality, the absolute risk was low and within accepted ranges, and comorbidity was the primary driver of mortality. Conversely, need for transitional care was significantly more common in elderly patients. Therefore, liver resection for metastases is safe in well-selected elderly patients, although consideration should be made for potential transitional care needs. PMID:23134189

  8. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis

    PubMed Central

    Wang, Chuanling; Tian, Fuming; Zhou, Yingjun; He, Wenbo; Cai, Zhiyou

    2016-01-01

    Background and purpose Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. Methods In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. Results The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. Conclusion A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of

  9. Evaluation of Observation-Fused Regional Air Quality Model Results for Population Air Pollution Exposure Estimation

    PubMed Central

    Chen, Gang; Li, Jingyi; Ying, Qi; Sherman, Seth; Perkins, Neil; Rajeshwari, Sundaram; Mendola, Pauline

    2014-01-01

    In this study, Community Multiscale Air Quality (CMAQ) model was applied to predict ambient gaseous and particulate concentrations during 2001 to 2010 in 15 hospital referral regions (HRRs) using a 36-km horizontal resolution domain. An inverse distance weighting based method was applied to produce exposure estimates based on observation-fused regional pollutant concentration fields using the differences between observations and predictions at grid cells where air quality monitors were located. Although the raw CMAQ model is capable of producing satisfying results for O3 and PM2.5 based on EPA guidelines, using the observation data fusing technique to correct CMAQ predictions leads to significant improvement of model performance for all gaseous and particulate pollutants. Regional average concentrations were calculated using five different methods: 1) inverse distance weighting of observation data alone, 2) raw CMAQ results, 3) observation-fused CMAQ results, 4) population-averaged raw CMAQ results and 5) population-averaged fused CMAQ results. It shows that while O3 (as well as NOx) monitoring networks in the HRR regions are dense enough to provide consistent regional average exposure estimation based on monitoring data alone, PM2.5 observation sites (as well as monitors for CO, SO2, PM10 and PM2.5 components) are usually sparse and the difference between the average concentrations estimated by the inverse distance interpolated observations, raw CMAQ and fused CMAQ results can be significantly different. Population-weighted average should be used to account spatial variation in pollutant concentration and population density. Using raw CMAQ results or observations alone might lead to significant biases in health outcome analyses. PMID:24747248

  10. Regional, age and gender differences in architectural measures of bone quality and their correlation to bone mechanical competence in the human radius of an elderly population.

    PubMed

    Mueller, Thomas L; van Lenthe, G Harry; Stauber, Martin; Gratzke, Christian; Eckstein, Felix; Müller, Ralph

    2009-11-01

    An accurate prediction of bone strength in the human radius is of major interest because distal radius fractures are amongst the most common in humans. The objective of this study was to determine gender and age-related changes in bone morphometry at the radius and how these relate to bone strength. Specifically, our aims were to (i) analyze gender differences to get an insight into different bone quantities and qualities between women and men, (ii) to determine which microarchitectural bone parameters would best correlate with strength, (iii) to find the region of interest for the best assessment of bone strength, and (iv) to determine how loss of bone quality depends on age. Intact right forearms of 164 formalin-fixed cadavers from a high-risk elderly population were imaged with a new generation high-resolution pQCT scanner (HR-pQCT). Morphometric indices were derived for six different regions and were related to failure load as assessed by experimental uniaxial compression testing. Significant gender differences in bone quantity and quality were found that correlated well with measured failure load. The most relevant region to determine failure load based on morphometric indices assessed in this study was located just below the proximal end of the subchondral plate; this region differed from the one measured clinically today. Trends in bone changes with increasing age were found, even though for all morphometric indices the variation between subjects was large in comparison to the observed age-related changes. We conclude that HR-pQCT systems can determine how gender and age-related changes in morphometric parameters relate to bone strength, and that HR-pQCT is a promising tool for the assessment of bone quality in patient populations.

  11. Estimating the Error in Statistical HAMR Object Populations Resulting from Simplified Radiation Pressure Modeling

    NASA Astrophysics Data System (ADS)

    Flegel, S.; Vörsmann, P.; Wiedemann, C.; Kebschull, C.; Braun, V.; Möckel, M.; Gelhaus, J.; Krag, H.; Klinkrad, H.

    2012-09-01

    The high-area-to-mass ratio (HAMR) object population in ESA's MASTER-2009 software (Meteoroid and Space Debris Terrestrial Environment Reference) is dominated by Multi-Layer Insulation debris at large sizes. The underlying model employs two independent mechanisms whereby Multi-Layer Insulation debris is created. These mechanisms are fragmentation events on the one hand and a deterioration process leading to the continuous release of larger objects on the other hand. All debris source models used to create the MASTER debris population rely on a semi-analytical propagator to model the major secular and long periodic orbit perturbations. The orbit parameters of HAMR objects are highly susceptive to radiation pressure effects which can result in fast secular and periodic changes for area-to-mass ratios above about 1 square meter per kilogram. The implementation of radiation pressure in this propagator is limited to the effects of solar irradiation on a spherical object and using a cylindrical Earth shadow. The current paper discusses the applicability of such a simplified theory to large statistical HAMR object populations where the main objective is not to predict the exact future location of a single object but rather to give a correct representation of the overall distribution of all HAMR objects. The basis for the current study is given by a numerical propagator which is supported by published observation results. Initially, the effects of object orientation, Earth albedo and thermal radiation on the orbit evolution are discussed. Results from published observations and simulation results give insight into the validity of the implemented model. Fundamental differences between the orbit prediction of this refined numerical propagator and the semi-analytical propagator are looked at with a view towards large statistical populations. To this end, a plausible, statistical, population of HAMR objects is propagated over an extended time period using both propagation

  12. Aging and environmental factors: an estimation of the health state of the elderly population residing in industrialized vs. rural areas.

    PubMed

    Santangelo, Antonino; Albani, Salvatore; Beretta, Massimiliano; Cappello, Antonella; Mamazza, Grazia; Pavano, Salvatore; Testaì, Manuela; Tomarchio, Marcello; Zuccaro, Carmela; Maugeri, Domenico

    2011-01-01

    The possibilities have already been discussed that the environment of the living beings may influence the aging process, by causing alterations of the homeostatic capacities to such an extent that definitive pathologies will come into being. Therefore, the aim of the present study was at estimating the effective impact of the environmental pollution on the health state of the subjects residing in highly industrialized areas. For this purpose, we compared 2 populations over the age of 56 years, one from the industrialized areas and the other of agricultural character. The health indicator we utilized was the rate of hospitalization calculated for the main geriatric pathologies. It has been observed that among the residents of highly polluted areas, the hospitalizations were more frequent for the screened pathologies. This finding could be an indicator of an interference of the environmental pollution with the physiological process of aging. One can also suspect that for the cardiovascular pathologies also the factor of physical fatigue being more prevalent in the rural population might play an important role in the high occurrence of this type of diseases. On the basis of these findings we intend to emphasize that the sanitary programs of a given territory should consider in the development and application of a sanitary service the intrinsic characteristics of the given area, when designing the possibly most adequate health care service.

  13. Meals for the Elderly

    NASA Technical Reports Server (NTRS)

    1977-01-01

    NASA is drawing upon its food-preparation expertise to assist in solving a problem affecting a large segment of the American population. In preparation for manned space flight programs, NASA became experienced in providing astronauts simple, easily-prepared, nutritious meals. That experience now is being transferred to the public sector in a cooperative project managed by Johnson Space Center. Called Meal System for the Elderly, the project seeks to fill a gap by supplying nutritionally balanced meal packages to those who are unable to participate in existing meal programs. Many such programs are conducted by federal, state and private organizations, including congregate hot meal services and home-delivered "meals on wheels." But more than 3.5 million elderly Americans are unable to take advantage of these benefits. In some cases, they live in rural areas away from available services; in others, they are handicapped, temporarily ill, or homebound for other reasons. Meal System for the Elderly, a cooperative program in which the food-preparation expertise NASA acquired in manned space projects is being utilized to improve the nutritional status of elderly people. The program seeks to fill a gap by supplying nutritionally-balanced food packages to the elderly who are unable to participate b existing meal service programs.

  14. Cross-National Trends in Mortality Rates among the Elderly.

    ERIC Educational Resources Information Center

    Myers, GeorgeC.

    1978-01-01

    An examination of death rates among the elderly and trends over the period 1950-1975 and 1970-1975 for selected developed nations provides evidence of continued strong mortality declines for females and somewhat mixed results for males. Implications of these trends for forecasting the mortality component of U.S. population projections are…

  15. Tracing X-ray Binary Population Evolution By Galaxy Dissection: First Results from M51

    NASA Astrophysics Data System (ADS)

    Lehmer, Bret; Eufrasio, Rafael T.; Markwardt, Larissa; Zezas, Andreas; Basu-Zych, Antara; Fragos, Tassos; Hornschemeier, Ann E.; Kalogera, Vassiliki; Ptak, Andrew; Tzanavaris, Panayiotis; Yukita, Mihoko

    2017-01-01

    Recently, we have found, in the Chandra Deep Field-South, that the emission from X-ray binary (XRB) populations in galaxies evolves significantly with cosmic time, most likely due to changes in the physical properties of galaxies like star-formation rate, stellar mass, stellar age, and metallicity. However, it has been challenging to directly show that these same physical properties are connected to XRB populations using data from nearby galaxies. We present a new technique for empirically calibrating how X-ray binary (XRB) populations evolve following their formation in a variety of environments. We first utilize detailed stellar population synthesis modeling of far-UV to far-IR broadband data of nearby (< 10 Mpc) face-on spiral galaxies to construct maps of the star-formation histories on subgalactic scales. Using Chandra data, we then identify the locations of the XRBs within these galaxies and correlate their formation frequencies with local galaxy properties. In this talk, I will show promising first results for the Whirlpool galaxy (M51), and will discuss how expanding our sample to an archival sample of 20 face-on spirals will lead to a detailed empirical timeline for how XRBs form and evolve in various environments.

  16. Individual specialists in a generalist population: results from a long-term stable isotope series

    PubMed Central

    Vander Zanden, Hannah B.; Bjorndal, Karen A.; Reich, Kimberly J.; Bolten, Alan B.

    2010-01-01

    Individual variation in resource use has often been ignored in ecological studies, but closer examination of individual patterns through time may reveal significant intrapopulation differences. Adult loggerhead sea turtles (Caretta caretta) are generalist carnivores with a wide geographical range, resulting in a broad isotopic niche. We microsampled scute, a persistent and continuously growing tissue, to examine long-term variation in resource use (up to 12 years) in 15 nesting loggerhead turtles. Using stable isotopes of nitrogen and carbon, we examined the resource use patterns (integration of diet, habitat and geographical location) and demonstrate that individual loggerheads are long-term specialists within a generalist population. We present our results in the context of a conceptual model comparing isotopic niches in specialist and generalist populations. Individual consistency may have important ecological, evolutionary and conservation consequences, such as the reduction of intraspecific competition. PMID:20335202

  17. Prevalence and Risk Factors of Abuse among Community Dwelling Elderly of Guwahati City, Assam

    PubMed Central

    Saikia, Anku Moni; Mahanta, Neelakshi; Mahanta, Ajaya; Deka, Ashok Jyoti; Kakati, Arupjyoti

    2015-01-01

    Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above) were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST). Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population. PMID:26435603

  18. [Chronic obstructive pulmonary disease (COPD) in the elderly].

    PubMed

    Orvoen-Frija, E; Benoit, M; Catto, M; Chambouleyron, M; Duguet, A; Emeriau, J-P; Ferry, M; Hayot, M; Jeandel, C; Morize, V; Nassih, K; Ouksel, H; Piette, F; Prefaut, C; Roche, N; de Wazieres, B; Zureik, M

    2010-10-01

    Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by incompletely reversible airflow limitation, measured by a decrease of FEV(1)/FVC ratio. International consensus does not agree on a single threshold for this ratio, which can define airflow obstruction. Although the prevalence of COPD in the elderly population varies according to the definition used, it definitely increases with age and could reach 15% in those over 65 years of age. Therefore, ageing of the population should result in increased prevalence and socioeconomical costs of COPD during coming years. In France, diagnosis of COPD in the elderly is difficult, late and insufficient. Management, which has the same goals as in younger populations, has to be global and coordinated. Some points should be considered with particular attention considering the cumulative risks related on the one hand to COPD and on the other to ageing: pharmacological side-effects, decreased physical and social autonomy, nutritional impairment, comorbidities. Given the lack of specific data in elderly populations, pharmacological indications are generally considered to be the same as in younger populations, but some additional precautionary measures are necessary. Pulmonary rehabilitation seems to be beneficial at any age. Palliative care comes up against important difficulties: an indefinite beginning of the palliative stage in COPD; insufficient palliative care resources; insufficient communication; insufficient utilization of palliative care resources. Global COPD management in elderly requires coordination, best reached in health care network organizations involving medical and/or social professionals.

  19. Varying performance in mammographic interpretation across two countries: Do results indicate reader or population variances?

    NASA Astrophysics Data System (ADS)

    Soh, BaoLin P.; Lee, Warwick B.; Wong, Jill; Sim, Llewellyn; Hillis, Stephen L.; Tapia, Kriscia A.; Brennan, Patrick C.

    2016-03-01

    Aim: To compare the performance of Australian and Singapore breast readers interpreting a single test-set that consisted of mammographic examinations collected from the Australian population. Background: In the teleradiology era, breast readers are interpreting mammographic examinations from different populations. The question arises whether two groups of readers with similar training backgrounds, demonstrate the same level of performance when presented with a population familiar only to one of the groups. Methods: Fifty-three Australian and 15 Singaporean breast radiologists participated in this study. All radiologists were trained in mammogram interpretation and had a median of 9 and 15 years of experience in reading mammograms respectively. Each reader interpreted the same BREAST test-set consisting of sixty de-identified mammographic examinations arising from an Australian population. Performance parameters including JAFROC, ROC, case sensitivity as well as specificity were compared between Australian and Singaporean readers using a Mann Whitney U test. Results: A significant difference (P=0.036) was demonstrated between the JAFROC scores of the Australian and Singaporean breast radiologists. No other significant differences were observed. Conclusion: JAFROC scores for Australian radiologists were higher than those obtained by the Singaporean counterparts. Whilst it is tempting to suggest this is down to reader expertise, this may be a simplistic explanation considering the very similar training and audit backgrounds of the two populations of radiologists. The influence of reading images that are different from those that radiologists normally encounter cannot be ruled out and requires further investigation, particularly in the light of increasing international outsourcing of radiologic reporting.

  20. Abuse against elderly in India – The role of education

    PubMed Central

    2014-01-01

    Background Abuse against the elderly is recognized as an important challenge to elderly health, but its determinants are not yet well understood. We present findings from a new dataset which covers a representative sample of the population aged 60 years and above from seven Indian states across India – all of which have a higher proportion aged 60 plus compared to the national average. Earlier studies suggest that schooling levels can be relevant in determining the level of abuse against seniors. This study focuses on the role of education on the prevalence of elderly abuse in India. Methods We conduct an analysis of cross sectional primary data that contains information on elderly abuse. The households in the sample were randomly selected from the seven demographically oldest states in India. These states are Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu and West Bengal. A total of 9852 elderly from 8329 households were interviewed. The statistical analysis is based on logistic regression to understand the independent relation of education with abuse against the elderly. Results Our findings reveal that 11% of 60+ year olds have experienced at least one type of elderly abuse (Physical 5.3%, Verbal 10.2%, Economic 5.4%, Disrespect 6%, Neglect 5.2%). The most common perpetrator is the son, who is reported to be responsible for the abuse among 41% of male victims and 43% of female victims. Formal education among elderly beyond a certain level (8 years) has a strong relation with reduced violence against elderly. Conclusions Our findings suggest that level of schooling among elderly is strongly negatively related to abuse against them. More members in the household reduces the chance of abuse while having a greater number of children increases the chance of abuse (neglect and verbal abuse). We find that education even after controlling for wealth and other relevant variables is the factor that most consistently lowers elderly abuse. However

  1. Diagnostic value of osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) in detecting high-risk populations for osteoporosis among elderly Chinese men.

    PubMed

    Zha, Xiao-Yun; Hu, Yu; Pang, Xiao-Na; Chang, Gui-Lin; Li, Li

    2015-03-01

    This study aims to evaluate an osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) and their combination in detecting populations at high risk for osteoporosis, and to determine the best cutoff value for the diagnosis of osteoporosis among elderly Chinese men. A group of Chinese men, aged ≥ 60 years, recruited from the health checkup population of Zhongshan Hospital, Fudan University, were included. The OSTA index was calculated from age and weight. Bone mineral density (BMD) at left hip (femoral neck, internal, and total hip) and lumbar spine (L1-L4, L-Total) was measured with dual-energy X-ray absorptiometry (DXA), and calcaneal BMD was measured with QUS. Receiver operating characteristic analysis was used to determine the best cutoff values, sensitivity, and specificity. The area under the curve (AUC) between the different screening tools was compared. Our study included 472 men with mean age of 78.0 years. The prevalence of osteoporosis was 27.7%.The best cutoff for OSTA was -3.5 for predicting men with osteoporosis at any site; this yielded a sensitivity and specificity of 47.3% and 76.8%, respectively. The AUC for OSTA was 0.676. The optimal cutoff for QUS-T score was -1.25, with a sensitivity of 80.4% and specificity of 59.7%. The AUC for QUS-T score was 0.762. Combining QUS with OSTA improved the specificity to 92.9% but reduced sensitivity to 36.1%. A new variable derived from a combination of OSTA and the QUS-T score gave a better performance, with sensitivity of 70.1% and specificity of 72.1%; the AUC for this variable was 0.771, which was greater than OSTA but not different from QUS alone. In conclusion, OSTA and QUS, respectively, and their combination may help find populations at high risk for osteoporosis, which could be an alternative method for diagnosing osteoporosis, especially in areas where DXA measurement is not accessible.

  2. Renal Cancer in the Elderly.

    PubMed

    González León, Tania; Morera Pérez, Maricela

    2016-01-01

    The increase of the aging population corresponds with the rise of renal cancer in elderly patients. The distinction between functional and chronological age, quality of life, and survival estimate are important issues, among others, that should be considered in the management of renal cancer in elderly patients. We made this review with the purpose of synthesizing the most updated criteria regarding indications and outcomes of the different therapeutic options in the management of elderly patients with renal cancer, beginning from the physiologic considerations that characterize them, their capacity to tolerate different therapeutic possibilities, and the prognosis of the patients' risks and comorbidity assessment.

  3. [Liver diseases in the elderly].

    PubMed

    Bruguera, Miguel

    2014-11-01

    Liver diseases in the elderly have aroused less interest than diseases of other organs, since the liver plays a limited role in aging. There are no specific liver diseases of old age, but age-related anatomical and functional modifications of the liver cause changes in the frequency and clinical behavior of some liver diseases compared with those in younger patients. This review discusses the most important features of liver function in the healthy elderly population, as well as the features of the most prevalent liver diseases in this age group, especially the diagnostic approach to the most common liver problems in the elderly: asymptomatic elevation of serum transaminases and jaundice.

  4. Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

    PubMed Central

    Walcher, Thomas; Haenle, Mark Martin; Kron, Martina; Hay, Birgit; Mason, Richard Andrew; von Schmiesing, Alexa Friederike Alice; Imhof, Armin; Koenig, Wolfgang; Kern, Peter; Boehm, Bernhard Otto; Kratzer, Wolfgang

    2005-01-01

    AIM: To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS: A total of 2 147 persons (1 111 females, age 42.8 ± 12.7 years; 1 036 males, age 42.3 ± 13.1 years) participating in an investigation on the prevalence of Echinococcus multilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index (BMI). A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS: Gallbladder stones were detected in 171 study participants (8.0%, n = 2 147). Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy (yes/no) and number of pregnancies did not exert any influence. CONCLUSION: Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations. PMID:16425387

  5. Great bustard population structure in central Spain: concordant results from genetic analysis and dispersal study.

    PubMed

    Martín, Carlos A; Alonso, Juan C; Alonso, Javier; Pitra, Christian; Lieckfeldt, Dietmar

    2002-01-22

    We found significant sex differences in the mtDNA genetic structure and dispersal patterns of great bustards in a population of 11 breeding groups, "leks", in central Spain. The analysis of genetic distances showed that the female population was divided into three groups of leks separated by ca. 50 km, whereas male haplotypes were randomly distributed among leks. Genetic distances among pairs of leks were positively correlated with geographical distances in females but not in males. While female haplotype distributions were homogeneous among leks at close distances, differences in male genetic structure were highly variable even between two close leks. These results from genetic analyses were concordant with those from a radiotracking study on natal dispersal. Natal dispersal distances were higher in males than in females. Also, the frequency of movement of a female between two leks was positively correlated with their genetic affinity and geographical proximity. In males, the frequency of movement was correlated with geographical proximity but not with genetic affinity. Males dispersed among genetically unrelated leks, contributing to keep nuclear genetic diversity in the population, whereas females tended to be philopatric. These results suggest that isolation-by-distance influences the distribution of maternal lineages at a regional level.

  6. [Health examination survey of the Lausanne population: first results of the CoLaus study].

    PubMed

    Vollenweider, P; Hayoz, D; Preisig, M; Pécoud, A; Warterworht, D; Mooser, V; Paccaud, F; Waeber, G

    2006-11-08

    Cardiovascular diseases (CVD) remain the main cause of morbidity and mortality in our society. CoLaus is a population-based health examination survey started in 2003 in Lausanne in order to assess: 1. Prevalence of cardiovascular risk factors, 2. New genetic determinants of cardiovascular risk factors such as hypertension, 3. Association of mood disorders with incidence of cardiovascular events and 4. Trends in prevalence of cardiovascular risk factors. In order to do so, over 6000 subjects (ages 35-75 years) provided data on CVD risk factors. Herein we provide preliminary results of this study, in particular on classical risk factors such as hypertension, obesity and diabetes. Implications and perspectives of this population based-study for public health and genetic studies are also discussed.

  7. Divergence Effect at Alaska's Treelines a Result of Sub-Population Behavior?

    NASA Astrophysics Data System (ADS)

    Wilmking, M.; Singh, J.

    2007-12-01

    The "divergence effect" (off-set between tree-ring based temperature reconstruction and measured temperatures) in northern forest poses a serious question to tree-ring based climate reconstructions, since it seems to violate the uniformitarian principle of dendroclimatology. Several possible reasons emerge, among them false assumptions about 1) climate data (e.g. which climate parameter can be modeled most effectively), 2) tree-ring data (e.g. shift in climate sensitivity of tree growth) or 3) a truly new and unprecedented phenomenon (e.g. rapid climate warming exceeding the adaptive capacity of trees). Here we test, if undetected emergent sub-population behavior at Alaska's treelines might result in a divergence effect. We reanalyzed seven data sets spanning the entire northern treeline in the Brooks Range, Alaska, which showed populations of trees responding positively, non-significant and negatively to recent warming. There is no effect of standardization (i.e. conventional versus RCS) technique on the grouping and we thus used RCS for the following analysis. Without grouping into sub- populations, a clear divergence between tree-ring based temperature reconstruction and actual climate data emerged. However, if only those trees were used for the climate reconstruction, which showed a consistent positive response to the target temperatures (June/July), tree growth modeled climate data extremely well following the rise in temperature during the last decades (actual climate data 0.53°/decade versus tree-ring based reconstruction 0.44°/decade over 1970-2000 period). This result hints at the possibility that some of the reported divergence might be eliminated (at least at Alaska's treelines) through careful test of sub-population behavior.

  8. Smaller, Scale-Free Gene Networks Increase Quantitative Trait Heritability and Result in Faster Population Recovery

    PubMed Central

    Malcom, Jacob W.

    2011-01-01

    One of the goals of biology is to bridge levels of organization. Recent technological advances are enabling us to span from genetic sequence to traits, and then from traits to ecological dynamics. The quantitative genetics parameter heritability describes how quickly a trait can evolve, and in turn describes how quickly a population can recover from an environmental change. Here I propose that we can link the details of the genetic architecture of a quantitative trait—i.e., the number of underlying genes and their relationships in a network—to population recovery rates by way of heritability. I test this hypothesis using a set of agent-based models in which individuals possess one of two network topologies or a linear genotype-phenotype map, 16–256 genes underlying the trait, and a variety of mutation and recombination rates and degrees of environmental change. I find that the network architectures introduce extensive directional epistasis that systematically hides and reveals additive genetic variance and affects heritability: network size, topology, and recombination explain 81% of the variance in average heritability in a stable environment. Network size and topology, the width of the fitness function, pre-change additive variance, and certain interactions account for ∼75% of the variance in population recovery times after a sudden environmental change. These results suggest that not only the amount of additive variance, but importantly the number of loci across which it is distributed, is important in regulating the rate at which a trait can evolve and populations can recover. Taken in conjunction with previous research focused on differences in degree of network connectivity, these results provide a set of theoretical expectations and testable hypotheses for biologists working to span levels of organization from the genotype to the phenotype, and from the phenotype to the environment. PMID:21347400

  9. Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain.

    PubMed

    Fernández-Ballart, Joan D; Piñol, Josep Lluís; Zazpe, Itziar; Corella, Dolores; Carrasco, Paula; Toledo, Estefanía; Perez-Bauer, Manuel; Martínez-González, Miguel Angel; Salas-Salvadó, Jorge; Martín-Moreno, José M

    2010-06-01

    The aim of the present study was to assess reproducibility and relative validity of a self-administered FFQ used in the PREDIMED Study, a clinical trial for primary prevention of CVD by Mediterranean diet in a population at high cardiovascular risk. The FFQ was administered twice (FFQ1 and FFQ2) to explore reproducibility at 1 year. Four 3 d dietary records (DR) were used as reference to explore validity; participants therefore recorded their food intake over 12 d in the course of 1 year. The degree of misclassification in the FFQ was also evaluated by a contingency table of quintiles comparing the information from the FFQ2 and the DR. A total of 158 men and women (aged 55-80 years) were asked not to modify their dietary habits during the study period. Reproducibility for food groups, energy and nutrient intake, explored by the Pearson correlation coefficient (r) ranged 0.50-0.82, and the intraclass correlation coefficient (ICC) ranged from 0.63 to 0.90. The FFQ2 tended to report higher energy and nutrient intake than the DR. The validity indices of the FFQ in relation to the DR for food groups and energy and nutrient intake ranged (r) from 0.24 to 0.72, while the range of the ICC was between 0.40 and 0.84. With regard to food groups, 68-83 % of individuals were in the same or adjacent quintile in both methods, a figure which decreased to 55-75 % for energy and nutrient intake. We concluded that FFQ measurements had good reproducibility and a relative validity similar to those of FFQ used in other prospective studies.

  10. Natural history of mild subclinical hypothyroidism in a middle-aged and elderly Chinese population: a prospective study.

    PubMed

    Li, Xiang; Zhen, Donghu; Zhao, Meng; Liu, Lu; Guan, Qingbo; Zhang, Haiqing; Ge, Shujian; Tang, Xulei; Gao, Ling

    2017-03-07

    Subclinical hypothyroidism (SCH) has a high global prevalence. Most SCH patients have mild cases (thyrotropin ≤10 mIU/L). Treatment recommendations for mild SCH are controversial, which raises concerns about the natural history of mild SCH. We aimed to clarify the natural history of mild SCH. This is a prospective population-based study. We measured thyroid function in 11,000 participants in the REACTION study and followed 505 newly diagnosed mild SCH patients aged 40-years or older between 2011 and 2014. Logistic regression analysis was used to seek baseline parameters associated with the natural outcomes of mild SCH. Among 505 mild SCH patients, 221 (43.8%) had persistent SCH, 251 (49.7%) reverted to euthyroidism, and 17 (3.4%) progressed to overt hypothyroidism (OH). Patients with higher baseline total cholesterol (TC, between 201.0-240.0 mg/dL or >240.0 mg/dL vs. <201.0 mg/dL, p = 0.048 and 0.006, respectively) or positive thyroid peroxidase antibodies (TPOAb, p = 0.009) had higher risks of progression to OH, while those with higher baseline creatinine (CR, between 0.71-0.80 mg/dL or >0.80 mg/dL vs. ≤0.65 mg/dL, p = 0.031 and 0.004, respectively), higher baseline thyrotropin (≥7 mIU/L, p < 0.001) or older (>60 years vs. ≤50 years, p = 0.012) had lower odds of reverting to euthyroidism. In conclusion, TPOAb and TC seem to be more important predictors of progression to OH than initial thyrotropin, whereas high baseline thyrotropin or CR were negative correlated with reversion to euthyroidism. The prognostic value of TC and CR in mild SCH should be considered.

  11. Elderly Suicide

    MedlinePlus

    ... peaking in the middle adulthood, ages 45-49). • Firearms were the most common means (72.1%) used for completing suicide among the elderly. Men use firearms more often than women. • Alcohol or substance abuse ...

  12. Elder Abuse

    MedlinePlus

    ... mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...

  13. The Solid Rocket Motor Slag Population: Results of a Radar-Based Regressive Statistical Evaluation

    NASA Astrophysics Data System (ADS)

    Horstman, Matthew

    estimated locations and times of tail-off to produce and propagate the SRM debris clouds. Comparisons with radar data from the ensuing years were made, and the SRM model was altered with respect to size and mass production of slag particles to reflect the populations estimated from the data. The result is a model SRM population that fits within the bounds of the observed environment and estimates of the production and contribution of SRM debris to the environment.

  14. The Solid Rocket Motor Slag Population: Results of a Radar-Based Regressive Statistical Evaluation

    NASA Technical Reports Server (NTRS)

    Horstman, Matthew F.; Xu, Yu-Lin

    2008-01-01

    estimated locations and times of tailoff to produce and propagate the SRM debris clouds. Comparisons with radar data from the ensuing years were made, and the SRM model was altered with respect to size and mass production of slag particles to reflect the populations estimated from the data. The result is a model SRM population that fits within the bounds of the observed environment and estimates of the production and contribution of SRM debris to the environment.

  15. Association of serum fatty acid and estimated desaturase activity with hypertension in middle-aged and elderly Chinese population

    PubMed Central

    Yang, Bo; Ding, Fang; Wang, Feng-Lei; Yan, Jing; Ye, Xiong-Wei; Yu, Wei; Li, Duo

    2016-01-01

    We aimed to investigate the cross-sectional associations of serum fatty acid (FA) and related Δ-desaturase with hypertension among 2,447 community-dwellers aged 35–79 years living in Zhejiang Province, China. Individual FA was determined in serum, Δ5-desaturase (D5D) and Δ6-desaturase (D6D) activities were indirectly estimated by FA product/precursor ratios. Participants in the highest quartile of D5D component scores (20:4n–6, 20:5n–3, 22:6n–3 and D5D) have significantly lower odds of hypertension compared with individuals in the lowest (multivariate-adjusted odds ratio (OR) = 0.68, 95% CI: 0.46–0.98). When further stratified by gender, high D5D component scores were significantly associated with lower odds of hypertension in women (OR = 0.53, 95% CI: 0.35–0.80), but not in men (OR = 0.78, 95% CI: 0.52-1.18). Multivariate-adjusted prevalent OR for an interquartile increment of individual FA and estimated desaturase was 1.27 (95% CI: 1.08–1.50) for 16:0, 1.15 (95% CI: 1.01–1.30) for 16:1n–7, 0.89 (95% CI: 0.80–0.99) for 22:6n–3, 1.32 (95% CI: 1.01–1.72) for D6D (18:3n–6/18:2n–6), and 0.74 (95% CI: 0.56, 0.98) for D5D (20:4n–6/20:3n–6). Present findings suggested that high serum 22:6n–3 and D5D as well as low 16:0, 16:1n–7 and D6D were associated with a low prevalence of hypertension in this Chinese population. PMID:27006169

  16. First results on resolved stellar population in three Galactic globular cluster from LBC@LBT imaging.

    NASA Astrophysics Data System (ADS)

    Beccari, G.; Ferraro, L. Pulone F. R.; Lanzoni, B.; Fusi Pecci, F.; Rood, R. T.; Giallongo, E.; Ragazzoni, R.; Grazian, A.; Baruffolo, A.; De Santis, C.; Diolaiti, E.; Di Paola, A.; Farinato, J.; Fontana, A.; Gallozzi, S.; Gasparo, F.; Gentile, G.; Green, R.; Hill, J.; Kuhn, O.; Menci, N.; Pasian, F.; Pedichini, F.; Smareglia, R.; Speziali, R.; Testa, V.; Thompson, D.; Vernet, E.; Wagner, R. M.

    We present first results on resolved stellar population by wide-field imaging obtained at the Large Binocular Telescope. The data presented were obtained through the blue channel of the Large Binocular Camera, during the commissioning and the science demonstration time of the camera. The scientific cases presented are deep multiband observations of three galactic globular clusters namely NGC5053 (M53), NGC6341 (M92) and NGC5466. The colour-magnitude diagrams of these clusters, spanning all the canonical sequences from the tip of the red giant brunch down to 4 magnitudes below the main sequence Turn Off, combined with high resolution ACS@HST archive images of the central region of the clusters, allow us to study the population radial distribution. In particular the population of blue stragglers stars in M53 and NGC5466 was found to have a bimodal radial distribution. Moreover we determined the binary frequency in the outer regions (r>200 arcsec ) of M53, finding that about 14% of the stars in these regions are in binary systems.

  17. Engaging Elderly People in Telemedicine Through Gamification

    PubMed Central

    Tabak, Monique; Dekker - van Weering, Marit; Vollenbroek-Hutten, Miriam

    2015-01-01

    Background Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. Objective This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. Methods We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Results Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great

  18. AT-09BEVACIZUMAB AND GLIOBASTOMA OF THE ELDERLY: A SINGLE-CENTER RETROSPECTIVE ANALYSIS

    PubMed Central

    Barrascout, Eduardo; Lamuraglia, Michele; Gervais, Claire; Tiako, Manuela; Gaillard, Stephan; Aldea, Sorin; Mabro, May; Gachet, Julie; Theodore, Christine

    2014-01-01

    PURPOSE: The primary objective of this study was to determine any difference in progression free survival (PFS), overall survival (OS), clinical benefit and tolerability between elderly and non-elderly patients receiving bevacizumab at recurrence for glioblastoma in a single center. PATIENTS AND METHODS: We retrospectively analyzed 32 patients with recurrent glioblastoma receiving bevacizumab (10 mg/kg every 14 days) between January 2011 and December 2013 in second line. Bevacizumab was introduced for all patients at recurrence after a treatment of first line by temozolomide. A cohort of 14 patients was older than 70 years against 18 patients were under 70 years. RESULTS: No statistically significant difference was detected in terms of PFS and OS. PFS was 2.8 months for elderly patients against 2.9 for non-elderly patients (p >0.5). OS from recurrence in elderly and non-elderly patients was respectively 4.3 and 5.5 months (p >0,5). Clinical improvement in neurological symptoms was observed in 3 of 14 elderly patients (21.1%) and 11 of 18 young patients (61.1%). A more important improvement in performance status was observed in young patients. Regarding toxicity, 3 of the 14 elderly patients experienced grade II or III hypertension. In younger patients, 5 adverse events have been observed (2 proteinuria, 1 hypertension, 1 hemorrhage and 1 anal abscess). CONCLUSION: Despite small number of patients in this retrospective study, the efficacy and safety of bevacizumab in recurrent glioblastoma appears similar in elderly and non-elderly patients. However, clinical benefit seemed to be less important in elderly patients. A prospective multicentric study integrating geriatric assessment tools and quality of life would be interesting in this patient's population.

  19. Remote Safety Monitoring for Elderly Persons Based on Omni-Vision Analysis

    PubMed Central

    Xiang, Yun; Tang, Yi-ping; Ma, Bao-qing; Yan, Hang-chen; Jiang, Jun; Tian, Xu-yuan

    2015-01-01

    Remote monitoring service for elderly persons is important as the aged populations in most developed countries continue growing. To monitor the safety and health of the elderly population, we propose a novel omni-directional vision sensor based system, which can detect and track object motion, recognize human posture, and analyze human behavior automatically. In this work, we have made the following contributions: (1) we develop a remote safety monitoring system which can provide real-time and automatic health care for the elderly persons and (2) we design a novel motion history or energy images based algorithm for motion object tracking. Our system can accurately and efficiently collect, analyze, and transfer elderly activity information and provide health care in real-time. Experimental results show that our technique can improve the data analysis efficiency by 58.5% for object tracking. Moreover, for the human posture recognition application, the success rate can reach 98.6% on average. PMID:25978761

  20. A critical appraisal of lubiprostone in the treatment of chronic constipation in the elderly.

    PubMed

    Gras-Miralles, Beatriz; Cremonini, Filippo

    2013-01-01

    Chronic constipation is a common disorder in the general population, with higher prevalence in the elderly, and is associated with worse quality of life and with greater health care utilization. Lubiprostone is an intestinal type-2 chloride channel activator that increases intestinal fluid secretion, small intestinal transit, and stool passage. Lubiprostone is currently approved by the US Food and Drug Administration for the treatment of chronic idiopathic constipation and of irritable bowel syndrome with predominant constipation. This review outlines current approaches and limitations in the treatment of chronic constipation in the elderly and discusses the results, limitations, and applicability of randomized, controlled trials of lubiprostone that have been conducted in the general and elderly population, with additional focus on the use of lubiprostone in constipation in Parkinson's disease and in opioid-induced constipation, two clinical entities that can be comorbid in elderly patients.

  1. The Comparison of the Minimum Data Set for Elderly Health in Selected Countries

    PubMed Central

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2015-01-01

    Introduction: Ongoing increase in the elderly population in many developed countries has drawn attention to health of this age group. Recording adequate and relevant data for the elderly is considered as the basis for future planning for this segment of society. So this study was conducted to compare minimum data about elderly health in selected countries. Methods: This review study was conducted through Internet and library studies. Key words were extracted from search engines and data bases including Google, Yahoo, Google Scholar, PubMed, ProQuest and Iranian National Medical Digital Library. Inclusion criteria included English language with no time limits. All articles, research projects, theses, guidelines and progress reports were retrieved from the United States, Sweden, Japan and Iran and reviewed. Also, websites of organizations responsible for elderly health in selected countries were visited and their documents were reviewed. Results from this search were provided narratively and finally were presented within comparison tables. Findings: The findings of this study showed that elderly data in the selected countries are collected around four axis including minimum demographic data, medical histories, health assessment and financial data of elderly health. Discussion and Conclusion: Given the importance of the minimum data set of elderly health for future planning, the use of experiences of leading countries in elderly health seems necessary; however, localization of it according to the country’s needs is inevitable. PMID:26862252

  2. The burden of musculoskeletal diseases in the general population of Spain: results from a national survey

    PubMed Central

    Carmona, L; Ballina, J; Gabriel, R; Laffon, A

    2001-01-01

    OBJECTIVE—The objective of the EPISER study was to estimate the prevalence of rheumatoid arthritis (RA), low back pain, hand and knee osteoarthritis (OA), and fibromyalgia in the adult Spanish population, and to assess the impact of these diseases on function and quality of life, and use of health and social resources.
METHODS—2998 subjects aged 20 years or above were randomly selected by stratified multistage cluster sampling from the censuses of 20 municipalities. Trained rheumatologists carried out structured visits at which subjects were asked about rheumatic symptoms and sociodemographic characteristics, completed validated instruments for measuring function (HAQ) and quality of life (SF-12), and underwent a standardised physical examination. Cases were defined by previously validated criteria.
RESULTS—The estimated prevalences with 95% confidence intervals were as follows: RA lifetime cumulative: 0.5% (0.3 to 0.9); low back pain: 14.8% (12.2 to 17.4); symptomatic knee OA: 10.2% (8.5 to 11.9); hand OA: 6.2% (5.9 to 6.5); fibromyalgia: 2.4% (1.5 to 3.2). Most conditions significantly impaired function and quality of life.
CONCLUSIONS—The EPISER study has internal and external validity for application of the results to the adult Spanish population. The diseases studied affect a significant proportion of the population, with various degrees of impact on disability and quality of life resulting in a significant number of physician visits, work disability, and medication use.

 PMID:11602475

  3. Simple Stellar Population Modeling of Quasar Host Galaxies with Diffusion K-Means Test Results

    NASA Astrophysics Data System (ADS)

    Mosby, Gregory; Moravec, E. A.; Tremonti, C. A.; Wolf, M. J.

    2013-01-01

    In the last decade, the correlation of the masses of supermassive black holes (SMBHs) and their host galaxy stellar spheroid velocity dispersions (the M-sigma relation) was greeted as clear evidence for the co-evolution of host galaxies and their SMBHs. However, studies in the last five years have posited that this relation could arise from central-limit properties of hierarchical formation alone. To address the question of whether and how often the SMBHs evolve with their host galaxies, it is necessary to look at galaxies whose SMBHs are actively growing—quasars—and determine the host galaxy properties. The central nuclei of quasar host galaxies complicate this type of study because their high luminosity tends to wash out their host galaxies. But, by using 3-D spectroscopy with the integral field unit (IFU) Sparsepak on the WIYN telescope, we have shown that the quasar light can be mostly isolated to one fiber in order to obtain the spectra of the quasar and the host galaxy concurrently. We can then model simultaneously the scattered quasar light and the stellar populations in the host galaxy fiber using a new simple stellar population (SSP) modeling method called diffusion k-means (DFK). The objectives of the research presented in this poster are to model synthetic quasar host galaxies using a DFK basis and a more traditional basis, compare the accuracy of both modeling methods, and test the affects of various prescriptions for masking the quasar lines in the host galaxy fiber. We present results from our SSP modeling and Markov Chain Monte Carlo (MCMC) results for DFK and traditional modeling schemes using synthetic data. By determining and then using the more robust stellar population modeling method, we can more confidently study quasar host galaxies to answer remaining questions in galaxy evolution. This work was partially supported by a National Science Foundation Graduate Fellowship (NSF Grant DGE-0718123) and through the NSF's REU program (NSF Award

  4. America's elderly: policy implications.

    PubMed

    Barberis, M

    1981-01-01

    Senior citizens, particularly those aged 75 or older, are the fastest growing group in the US today. 25 million strong, the elderly make up 11% of the total population, the proportion ranging from 18.1% in Florida to 2.6% in Alaska. 1/4 of the federal budget, $155 billion in 1980, now goes to their support yet many face difficulty in gaining access to the programs designed to benefit them. The elderly, especially those who rely solely on Social Security, comprise a disproportionate share of all poor households. The retirement system itself is facing financing challenges that promise to grow as the baby boom generation swells the number of senior citizens to 55 million in 2030. Plans to coordinate government programs and improve the method of financing the retirement system are receiving increasing attention. Financing Social Security from revenue funds, or with actuarial reserves, are 2 alternatives to the present pay-as-you-go system. Another area of concern to policymakers is America's health care system, which is now crisis oriented and heavily biased toward institutionalization. Health care must be made more responsive to the long-term needs of the oldest segment of the population, many of whom suffer from chronic illnesses. Impaired elderly receive most of their care from family or friends, and private organizations, but this natural support network largely has been ignored by government. New program initiatives might emphasize homemaker services, geriatric day care, compensation for families that provide for the needs of an elderly relative, and the strengthening of the informal partnership between the elderly themselves, their families and friends, community groups, private organizations, and government at the state and local as well as the federal level.

  5. Institutional trust in the national social security and municipal healthcare systems for the elderly in Japan.

    PubMed

    Murayama, Hiroshi; Taguchi, Atsuko; Ryu, Shuhei; Nagata, Satoko; Murashima, Sachiyo

    2012-09-01

    Japanese social security systems and institutions for the elderly, as well as the general attitude toward elderly care services among the Japanese population, have been undergoing a dramatic change. By examining the association between institutional trust, which is a representative element of social capital, and anxiety regarding receiving elderly care, we can uncover clues toward building a more robust social security system for the elderly. This study examines the relationship between institutional trust, in the national social security and municipal healthcare systems for the elderly, and anxiety with respect to receiving elderly care among the general Japanese population. A cross-sectional survey was conducted using a self-administered questionnaire that was returned by mail in January and February 2005. The target population was 4735 community residents aged 20-75 years, who lived in the city of Koka, Shiga, Japan. A total of 2264 questionnaires were included in the analysis. A binominal logistic regression analysis showed that responses of 'trust' [odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.01-4.30] and 'strongly trust' (OR: 3.80, 95% CI: 1.55-9.31) for the national system were associated with not having anxiety regarding elderly care, compared with the reference category of feeling strongly distrust. However, trust in the municipal system showed no association with this anxiety. These results indicate the importance of developing strategies to increase a common trust in the national care services for the elderly to reduce the anxiety people feel regarding whether they will be able to receive elderly care when required.

  6. Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression.

    PubMed

    de Araújo, Aurigena Antunes; Rebouças Barbosa, Rosa Angélica Silveira; de Menezes, Marília Stefani Souza; de Medeiros, Ingrid Iana Fernandes; de Araújo, Raimundo Fernandes; de Medeiros, Caroline Addison Carvalho Xavier

    2016-06-01

    The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders.

  7. Socio-Demographic Variables and Successful Aging of the Angolan Elderly

    PubMed Central

    Galiana, Laura; Gutiérrez, Melchor; Sancho, Patricia; Francisco, Elizabeth-Hama; Tomás, José M.

    2016-01-01

    The proportion of elderly people is growing faster than any other age group. Amongst them, the group of oldest old is indeed the segment of the elderly population with the fastest growth rate. The increase in the proportion of elderly in the Angolan population makes research on this area badly needed. Within the theoretical framework of successful aging, the study aims to test for sociodemographic group differences in perceived health, life satisfaction, and social relations in Angolan elderly. The dependent variables are three of the components of what has been called successful aging. Data came from a cross-sectional survey of elderly people living in Luanda. 1003 Angolan elderly were surveyed on sociodemographic information, perceived health, life satisfaction, and social support. MANOVAs were calculated to test for mean differences in the dependent variables. Results permit to conclude that the factors associated with the largest differences on the Angolan elderly's quality of life and social relations were age (becoming oldest old) and institutionalization. The interactions of several factors with age pointed out that the oldest old were clearly a group in which the decreased quality of life due to becoming oldest old could not be compensated by other factors, as it was the case in the group of young old. PMID:27088039

  8. Population.

    ERIC Educational Resources Information Center

    King, Pat; Landahl, John

    This pamphlet has been prepared in response to a new problem, a rapidly increasing population, and a new need, population education. It is designed to help teachers provide their students with some basic population concepts with stress placed on the elements of decision making. In the first section of the pamphlet, some of the basic concepts of…

  9. [Population].

    PubMed

    1979-01-01

    Data on the population of Venezuela between 1975 and 1977 are presented in descriptive tables and graphs. Information is included on the employed population according to category, sex, and type of economic activity, and by sex, age, and area on the employment rate and the total, the economically active, and the unemployed population.

  10. Effect of Tai Chi Exercise Combined with Mental Imagery Theory in Improving Balance in a Diabetic and Elderly Population

    PubMed Central

    Alsubiheen, Abdulrahman; Petrofsky, Jerrold; Daher, Noha; Lohman, Everett; Balbas, Edward

    2015-01-01

    Background One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Material/Methods Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), functional reach test (FRT) and hemoglobin A1C. These measures were taken twice, pre and post-study, for both groups. Results Both groups experienced significant improvements in ABC, OLS, FRT (P<0.01) after completing 8 weeks of TC exercise with no significant improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant change between groups. There was no significant change in HbA1C for the diabetic group. Conclusions All results showed an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Since the DM group had more problems with balance impairment at baseline than the control, the diabetic group showed the most benefit from the TC exercise. PMID:26454826

  11. Belief Discrepancy Reasoning in the Elderly.

    ERIC Educational Resources Information Center

    Enright, Robert D.; And Others

    1983-01-01

    Examined the development of belief discrepancy reasoning, or how people evaluate disagreeing others, with 44 college and elderly respondents. Results showed the elderly were significantly lower in belief discrepancy reasoning and higher in dogmatism than the college sample. The elderly sample did not evidence intolerance, but rather relativism.…

  12. Differentiating medicinal from illicit use in positive methamphetamine results in a pain population.

    PubMed

    West, Robert; Pesce, Amadeo; West, Cameron; Mikel, Charles; Velasco, Javier; Gonzales, Elizabeth; Dizon, Zenaida; Almazan, Perla; Latyshev, Sergey

    2013-03-01

    In addition to illicit methamphetamine, there are prescription and over-the-counter medications that, if ingested, may yield positive methamphetamine (MAMP) results on laboratory urine drug tests. The purpose of the study is to estimate the prevalence of medicinal and illicit MAMP in the pain population using chiral analysis to determine the relative amounts of the d and l-MAMP enantiomers. This retrospective analysis included the LC-MS/MS results and prescriber provided medication histories of 485,889 de-identified urine specimens from patients treated for pain. Two groups of 100 specimens each were subjected to chiral analysis. Group 1 contained specimens that were MAMP positive and amphetamine negative. Group 2 contained randomly selected MAMP positive specimens. The overall MAMP positivity rate of the 485,889 specimens tested was 1.6%. The prevalence of MAMP medications based on reported medications and detection of l-MAMP in Group 1 and Group 2 was 44% and 6%, respectively. These data indicate that the use of both illicit and medicinal MAMP is found in this patient population, and that medicinal use is underreported in clinical histories. Therefore, clinical laboratories should provide on request chiral analysis to aid in differentiating illicit and medicinal MAMP.

  13. Differential influence of physical activity on lumbar spine and femoral neck bone mineral density in the elderly population.

    PubMed

    Vuillemin, A; Guillemin, F; Jouanny, P; Denis, G; Jeandel, C

    2001-06-01

    This study investigates the relationship between lifetime physical activity and bone mineral density (BMD) at various sites in 129 healthy men and women aged 72.1 +/- 6.5 years. BMD was measured by dual energy x-ray absorptiometry, and physical activity was assessed by using the QU