Executive functioning in older adults with hoarding disorder.

PubMed

Ayers, Catherine R; Wetherell, Julie Loebach; Schiehser, Dawn; Almklov, Erin; Golshan, Shahrokh; Saxena, Sanjaya

2013-11-01

Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear. The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy older adult comparison group (n = 25). We hypothesized that older adults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] ( Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]). Older adults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, older adults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group. Compared with demographically-matched controls, older adults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for older adults with HD. Copyright © 2013 John Wiley & Sons, Ltd.

Age-Related Locomotion Characteristics in Association with Balance Function in Young, Middle-Aged, and Older Adults.

PubMed

Lee, Hwang-Jae; Chang, Won Hyuk; Hwang, Sun Hee; Choi, Byung-Ok; Ryu, Gyu-Ha; Kim, Yun-Hee

2017-04-01

The purpose of this study was to examine age-related gait characteristics and their associations with balance function in older adults. A total of 51 adult volunteers participated. All subjects underwent locomotion analysis using a 3D motion analysis and 12-channel dynamic electromyography system. Dynamic balance function was assessed by the Berg Balance Scale. Older adults showed a higher level of muscle activation than young adults, and there were significant positive correlations between increased age and activation of the trunk and thigh muscles in the stance and swing phase of the gait cycle. In particular, back extensor muscle activity was mostly correlated with the dynamic balance in older adults. Thus, back extensor muscle activity in walking may provide a clue for higher falling risk in older adults. This study demonstrates that the back extensor muscles play very important roles with potential for rehabilitation training to improve balance and gait in older adults.

Obesity and Diabetes as Accelerators of Functional Decline; Can Lifestyle Interventions Maintain Functional Status in High Risk Older Adults?

PubMed Central

Anton, Stephen D.; Karabetian, Christy; Naugle, Kelly; Buford, Thomas W.

2013-01-01

Obesity and diabetes are known risk factors for the development of physical disability among older adults. With the number of seniors with these conditions rising worldwide, the prevention and treatment of physical disability in these persons has become a major public health challenge. Sarcopenia, the progressive loss of muscle mass and strength, has been identified as a common pathway associated with the initial onset and progression of physical disability among older adults. A growing body of evidence suggests that metabolic dysregulation associated with obesity and diabetes accelerates the progression of sarcopenia, and subsequently functional decline in older adults. The focus of this brief review is on the contributions of obesity and diabetes in accelerating sarcopenia and functional decline among older adults. We also briefly discuss the underexplored interaction between obesity and diabetes that may further accelerate sarcopenia and place obese older adults with diabetes at particularly high risk of disability. Finally, we review findings from studies that have specifically tested the efficacy of lifestyle-based interventions in maintaining the functional status of older persons with obesity and/or diabetes. PMID:23832077

Effects of using Nintendo Wii™ exergames in older adults: a review of the literature.

PubMed

Chao, Ying-Yu; Scherer, Yvonne K; Montgomery, Carolyn A

2015-04-01

The purpose of this review is to summarize and synthesize the impact of using the Nintendo Wii™ exergames in older adults. A database search was conducted to identify relevant studies. The search was limited to empirical studies, with particular attention paid to the effects of Wii exergames intervention on cognition, physical function, and psychosocial outcomes in older adults. A total of 22 empirical studies met inclusion criteria and were included in this review. Positive effects included improving physical function, decreasing depression, and increasing cognition and quality of life in older adults. Improved socialization and motivation to exercise were also reported. Using Wii exergames does show promise as an intervention to improve physical function, cognition, and psychosocial outcomes in older adults. Evidence supports that Wii exergames is a safe and feasible tool to encourage older adults to engage in exercise. © The Author(s) 2014.

Functional health status among rural and urban older adults in Taiwan: the effect of personal control and social control.

PubMed

Chiu, Tzu-I; Spencer, Gale A

2010-09-01

To assess the relationship between perceived social control/personal control and functional health status among older adults in rural and urban Taiwan. The ageing of the population is poised to emerge as a preeminent worldwide phenomenon. It is assumed that even though older adults experience many decades of autonomy and independence, the potential for illness or bodily decline will induce a serious reduction in the level of perceived control in older adult populations. This is a descriptive correlational study using a secondary data base, Social Environment and Biomarkers of Aging Study. Social Environment and Biomarkers of Aging Study is a nationally representative study of health outcomes in the Taiwanese population. Both perceived levels of social control and personal control had a statistically significant relationship with functional health status. Functional health status was significantly higher for urban older adults than their rural counterparts. Personal control and social control were both found to be predictors of functional health status. Major findings are supported by previous studies. Nurses should create programs and plan activities to assist older adults to enhance their perceptions of social control or personal control in order to improve the health status of older adults and minimize associated health care costs. © 2009 Blackwell Publishing Ltd.

Continuous Positive Airway Pressure Treatment for Sleep Apnea in Older Adults

PubMed Central

Weaver, Terri E; Chasens, Eileen

2007-01-01

Daytime sleepiness and sleep disordered breathing are increased in older compared to middle-aged adults. The cognitive and cardiovascular sequelae associated with obstructive sleep apnea (OSA) have significant implications for the older adult who may already be suffering from chronic illness. Most of the evidence supporting the utilization of continuous positive airway pressure (CPAP) for the treatment of OSA has been generated from studies employing samples consisting predominately of middle-aged adults. To examine the efficacy of CPAP for the treatment of obstructive sleep apnea in older adults with an emphasis on adherence and related treatment outcomes, this paper reviews findings from clinical trials including older individuals as well as those specifically targeting this population. These studies have demonstrated that following CPAP therapy, older adults have increased alertness, improved neurobehavioral outcomes in cognitive processing, memory, and executive function, decreased sleep disruption from nocturia and a positive effect on factors affecting cardiac function, including vascular resistance, platelet coagulability and other aspects of cardiovascular health. Physiological differences in respiratory structure and function between younger and older adults of similar disease severity are believed to result in older individuals requiring titration at lower CPAP levels. Once initiated, CPAP treatment is tolerated by older adults, including those with Alzheimer’s disease. Patterns of adherence in older individuals are consistent with that of middle-aged adults. PMID:17275370

The consequences of resistance training for movement control in older adults.

PubMed

Barry, Benjamin K; Carson, Richard G

2004-07-01

Older adults who undertake resistance training are typically seeking to maintain or increase their muscular strength with the goal of preserving or improving their functional capabilities. The extent to which resistance training adaptations lead to improved performance on tasks of everyday living is not particularly well understood. Indeed, studies examining changes in functional task performance experienced by older adults following periods of resistance training have produced equivocal findings. A clear understanding of the principles governing the transfer of resistance training adaptations is therefore critical in seeking to optimize the prescription of training regimes that have as their aim the maintenance and improvement of functional movement capacities in older adults. The degenerative processes that occur in the aging motor system are likely to influence heavily any adaptations to resistance training and the subsequent transfer to functional task performance. The resulting characteristics of motor behavior, such as the substantial decline in the rate of force development and the decreased steadiness of force production, may entail that specialized resistance training strategies are necessary to maximize the benefits for older adults. In this review, we summarize the alterations in the neuromuscular system that are responsible for the declines in strength, power, and force control, and the subsequent deterioration in the everyday movement capabilities of older adults. We examine the literature concerning the neural adaptations that older adults experience in response to resistance training, and consider the readiness with which these adaptations will improve the functional movement capabilities of older adults.

Cognitive Ability as a Resource for Everyday Functioning among Older Adults Who Are Visually Impaired

ERIC Educational Resources Information Center

Heyl, Vera; Wahl, Hans-Werner

2010-01-01

This article reports on a study that investigated the role of cognitive resources in the everyday functioning of 121 older adults who were visually impaired and 150 sighted older adults, with a mean age of 82 years. Cognitive performance and everyday functioning were most strongly related in the group who were visually impaired. The authors…

Comparing the effects of an acute bout of physical exercise with an acute bout of interactive mental and physical exercise on electrophysiology and executive functioning in younger and older adults.

PubMed

Dimitrova, Julia; Hogan, Michael; Khader, Patrick; O'Hora, Denis; Kilmartin, Liam; Walsh, Jane C; Roche, Richard; Anderson-Hanley, Cay

2017-10-01

Physical exercise has been shown to improve cognitive and neural functioning in older adults. The current study compared the effects of an acute bout of physical exercise with a bout of interactive mental and physical exercise (i.e., "exergaming") on executive (Stroop) task performance and event-related potential (ERP) amplitudes in younger and older adults. Results revealed enhanced executive task performance in younger and older adults after exercise, with no differences in performance between exercise conditions. Stroop (RT) performance in older adults improved more than in younger adults from pre- to post-exercise. A significant increase in EEG amplitude from pre- to post-exercise was found at the Cz site from 320 to 700 ms post-stimulus for both younger and older adults, with older adults demonstrating a larger Stroop interference effect. While younger adults exhibited overall greater EEG amplitudes than older adults, they showed no differences between congruent and incongruent trials (i.e., minimal interference). Compared to peers with higher BMI (body mass index), older adults with lower BMI showed a greater reduction in Stroop interference effects from pre- to post-exercise. The beneficial effects of an acute bout of physical exercise on cognitive and neural functioning in younger and older adults were confirmed, with no difference between standard exercise and exergaming. Findings suggest that BMI, sometimes used as a proxy for fitness level, may modulate benefits that older adults derive from an acute bout of exercise. Findings have implications for future research that seeks to investigate unique effects of exergaming when compared to standard physical exercise.

Functional food awareness and perceptions in relation to information sources in older adults.

PubMed

Vella, Meagan N; Stratton, Laura M; Sheeshka, Judy; Duncan, Alison M

2014-05-17

The functional food industry has experienced innovative and economic expansion, yet research into consumer perceptions of functional foods and their associated health claims is limited. Among consumers, older adults could benefit from functional foods due to age-related issues pertaining to food and health. The purpose of this research was to identify the need for information related to functional foods among older adults (≥60 years old) and to assess awareness and perceptions of health claims on functional food packages. Community-dwelling older adults (n = 200) completed a researcher administered questionnaire designed to collect information about functional foods including current consumption, motivating factors for consumption, perceived need for information, sources of information for functional foods and awareness of health claims. Prevalence of functional food consumption among participants was 93.0%. Increased awareness and knowledge was the most commonly reported factor that would promote functional food consumption (85.5%) and 63.5% of participants wanted more information about functional foods with preferred sources being newspapers/magazines/books (68.5%) and food labels (66.1%). Participants were predominately (93.5%) aware of health claims on functional foods and those with more education were more likely to report being aware of health claims (p = 0.045). Although functional food consumption among older adults in this sample is high, there is a need for further information regarding functional foods. These results inform stakeholders regarding the potential for information to influence functional food acceptance among older adult consumers.

Social welfare utilization and needs of older adults in Taiwan: survey research.

PubMed

Hsieh, Hsiu-Fen; Chen, Kuei-Min; Lin, Mei-Hui; Wang, Yueh-Chin; Huang, Hsin-Ting

2014-01-01

The demand for long-term care for older adults has escalated sharply. A good policy dedicated to the welfare of older adults has improved their quality of life. The purpose of this study was to explore the social welfare utilization and needs of older adults and compare their differences among age groups, genders, and functional dependency levels. Three hundred eighty-four stratified, random-sampled Taiwanese community-dwelling older adults were recruited for this survey research. Participants rated their utilization of and needs for the 30 social welfare services provided by the government on a Likert-type scale. The most widely used and needed social welfare services by the older adults were senior monetary stipend and a subsidy for the national health insurance premium. Young-old, male, and functionally independent older adults had more knowledge of the social welfare services than their counterparts. While designing a comprehensive social welfare system, differing needs of different age groups, genders, and functional dependency levels should be taken into consideration. Copyright © 2014 Elsevier Inc. All rights reserved.

Normative functional fitness standards and trends of Portuguese older adults: cross-cultural comparisons.

PubMed

Marques, Elisa A; Baptista, Fátima; Santos, Rute; Vale, Susana; Santos, Diana A; Silva, Analiza M; Mota, Jorge; Sardinha, Luís B

2014-01-01

This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence.

Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition.

PubMed

McGough, Ellen L; Kelly, Valerie E; Weaver, Kurt E; Logsdon, Rebecca G; McCurry, Susan M; Pike, Kenneth C; Grabowski, Thomas J; Teri, Linda

2018-04-01

This study aimed to examine differences in spatiotemporal gait parameters between older adults with amnestic mild cognitive impairment and normal cognition and to examine limbic and basal ganglia neural correlates of gait and executive function in older adults without dementia. This was a cross-sectional study of 46 community-dwelling older adults, ages 70-95 yrs, with amnestic mild cognitive impairment (n = 23) and normal cognition (n = 23). Structural magnetic resonance imaging was used to attain volumetric measures of limbic and basal ganglia structures. Quantitative motion analysis was used to measure spatiotemporal parameters of gait. The Trail Making Test was used to assess executive function. During fast-paced walking, older adults with amnestic mild cognitive impairment demonstrated significantly slower gait speed and shorter stride length compared with older adults with normal cognition. Stride length was positively correlated with hippocampal, anterior cingulate, and nucleus accumbens volumes (P < 0.05). Executive function was positively correlated with hippocampal, anterior cingulate, and posterior cingulate volumes (P < 0.05). Compared with older adults with normal cognition, those with amnestic mild cognitive impairment demonstrated slower gait speed and shorter stride length, during fast-paced walking, and lower executive function. Hippocampal and anterior cingulate volumes demonstrated moderate positive correlation with both gait and executive function, after adjusting for age. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) discuss gait performance and cognitive function in older adults with amnestic mild cognitive impairment versus normal cognition, (2) discuss neurocorrelates of gait and executive function in older adults without dementia, and (3) recognize the importance of assessing gait speed and cognitive function in the clinical management of older adults at risk for dementia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder.

PubMed

Semeijn, E J; Korten, N C M; Comijs, H C; Michielsen, M; Deeg, D J H; Beekman, A T F; Kooij, J J S

2015-09-01

Research illustrates cognitive deficits in children and younger adults with attention-deficit/hyperactivity disorder (ADHD). Few studies have focused on the cognitive functioning in older adults. This study investigates the association between ADHD and cognitive functioning in older adults. Data were collected in a cross-sectional side study of the Longitudinal Aging Study Amsterdam (LASA). A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60-94). ADHD symptoms and diagnosis were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Cognitive functioning was assessed with tests in the domains of executive functioning, information processing speed, memory, and attention/working memory. Regression analyses indicate that ADHD diagnosis and ADHD severity were only negatively associated with cognitive functioning in the attention/working memory domain. When adjusting for depression, these associations were no longer significant. The study shows that ADHD in older adults is associated with lower cognitive functioning in the attention/working memory domain. However, this was partly explained by depressive symptoms.

Optimizing the Benefits of Exercise on Physical Function in Older Adults

PubMed Central

Buford, Thomas W.; Anton, Stephen D.; Clark, David J.; Higgins, Torrance J.; Cooke, Matthew B.

2014-01-01

As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area. PMID:24361365

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder.

PubMed

Rolin, Stephanie A; Aschbrenner, Kelly A; Whiteman, Karen L; Scherer, Emily; Bartels, Stephen J

2017-09-01

The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Three community mental health centers in New Hampshire and Massachusetts. Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization. Copyright © 2017. Published by Elsevier Inc.

The Nature of Subjective Cognitive Complaints of Older Adults

ERIC Educational Resources Information Center

Newson, Rachel S.; Kemps, Eva B.

2006-01-01

The current study investigated the nature of subjective cognitive complaints of older adults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether older adults experience problems with these cognitive functions (problems with cognition); (2) the…

Carotid intima-media thickness and cognitive function in a middle-aged and older adult community: a cross-sectional study.

PubMed

Wang, Anxin; Chen, Guojuan; Su, Zhaoping; Liu, Xiaoxue; Yuan, Xiaodong; Jiang, Ruixuan; Cao, Yibin; Chen, Shuohua; Luo, Yanxia; Guo, Xiuhua; Wu, Shouling; Zhao, Xingquan

2016-10-01

The relationship between atherosclerosis and cognitive function is less well studied in Chinese populations. In addition, the results among middle-aged adults have been mixed. We aimed to investigate the association of atherosclerosis measured by carotid intima-media thickness (CIMT) and cognitive function in middle-aged and older adults from a Chinese community. Participants in the Asymptomatic Polyvascular Abnormalities in Community study (APAC) who had completed the CIMT detection and cognitive function measurements in 2012/2013 were included. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Multivariate linear regression analysis was used to analyze the association between CIMT and MMSE. Then, a stratified analysis was performed separately in middle-aged and older adults. A total of 3227 participants were included in this study (mean age 57.9 years, range 43-93 years); 56.6 % of them were men, 66.0 % were middle-aged adults. After adjusting for potential confounders, larger CIMT was associated with lower MMSE scores, with a 0.75-point decrease in MMSE score for every 1-mm increase in CIMT (β = - 0.75, P = 0.0020). The association remained statistically significant in middle-aged adults (β = - 0.57, P = 0.0390), and was stronger in older adults and adults with low education levels. There is a significant association between CIMT and cognitive function among middle-aged and older adults sampled from a Chinese population. This association was stronger in older adults and adults with low education levels.

Recognition of facial, auditory, and bodily emotions in older adults.

PubMed

Ruffman, Ted; Halberstadt, Jamin; Murray, Janice

2009-11-01

Understanding older adults' social functioning difficulties requires insight into their recognition of emotion processing in voices and bodies, not just faces, the focus of most prior research. We examined 60 young and 61 older adults' recognition of basic emotions in facial, vocal, and bodily expressions, and when matching faces and bodies to voices, using 120 emotion items. Older adults were worse than young adults in 17 of 30 comparisons, with consistent difficulties in recognizing both positive (happy) and negative (angry and sad) vocal and bodily expressions. Nearly three quarters of older adults functioned at a level similar to the lowest one fourth of young adults, suggesting that age-related changes are common. In addition, we found that older adults' difficulty in matching emotions was not explained by difficulty on the component sources (i.e., faces or voices on their own), suggesting an additional problem of integration.

Is the Optimal Level of Protein Intake for Older Adults Greater Than the Recommended Dietary Allowance?

PubMed Central

2013-01-01

Background. Protein is a macronutrient essential for growth, muscle function, immunity and overall tissue homeostasis. Suboptimal protein intake can significantly impact physical function and overall health in older adults. Methods. This article reviews the literature on the recommendations for protein intake in older adults in light of the new evidence linking protein intake with sarcopenia and physical function. Challenges and opportunities for optimal protein nutrition in older persons are discussed. Results. Recent metabolic and epidemiological studies suggest that the current recommendations of protein intake may not be adequate for maintenance of physical function and optimal health in older adults. Methodological limitations and novel concepts in protein nutrition are also discussed. Conclusion. We conclude that new research and novel research methodologies are necessary to establish the protein needs and optimal patterns of protein intake for older persons. PMID:23183903

Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults.

PubMed

Zhong, Yaqin; Wang, Jian; Nicholas, Stephen

2017-09-02

Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability. Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father's education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability. Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father's education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062-1.353). Current SES such as higher education and good economic situation are protective factors of functional disability. Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.

Older adults' perceptions of ageing and their health and functioning: a systematic review of observational studies.

PubMed

Warmoth, Krystal; Tarrant, Mark; Abraham, Charles; Lang, Iain A

2016-07-01

Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults' health. The aim of this review was to synthesise existing research on the relationship between older adults' perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults' perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.

Aging and the interaction of sensory cortical function and structure.

PubMed

Peiffer, Ann M; Hugenschmidt, Christina E; Maldjian, Joseph A; Casanova, Ramon; Srikanth, Ryali; Hayasaka, Satoru; Burdette, Jonathan H; Kraft, Robert A; Laurienti, Paul J

2009-01-01

Even the healthiest older adults experience changes in cognitive and sensory function. Studies show that older adults have reduced neural responses to sensory information. However, it is well known that sensory systems do not act in isolation but function cooperatively to either enhance or suppress neural responses to individual environmental stimuli. Very little research has been dedicated to understanding how aging affects the interactions between sensory systems, especially cross-modal deactivations or the ability of one sensory system (e.g., audition) to suppress the neural responses in another sensory system cortex (e.g., vision). Such cross-modal interactions have been implicated in attentional shifts between sensory modalities and could account for increased distractibility in older adults. To assess age-related changes in cross-modal deactivations, functional MRI studies were performed in 61 adults between 18 and 80 years old during simple auditory and visual discrimination tasks. Results within visual cortex confirmed previous findings of decreased responses to visual stimuli for older adults. Age-related changes in the visual cortical response to auditory stimuli were, however, much more complex and suggested an alteration with age in the functional interactions between the senses. Ventral visual cortical regions exhibited cross-modal deactivations in younger but not older adults, whereas more dorsal aspects of visual cortex were suppressed in older but not younger adults. These differences in deactivation also remained after adjusting for age-related reductions in brain volume of sensory cortex. Thus, functional differences in cortical activity between older and younger adults cannot solely be accounted for by differences in gray matter volume. (c) 2007 Wiley-Liss, Inc.

Functional food awareness and perceptions in relation to information sources in older adults

PubMed Central

2014-01-01

Background The functional food industry has experienced innovative and economic expansion, yet research into consumer perceptions of functional foods and their associated health claims is limited. Among consumers, older adults could benefit from functional foods due to age-related issues pertaining to food and health. The purpose of this research was to identify the need for information related to functional foods among older adults (≥60 years old) and to assess awareness and perceptions of health claims on functional food packages. Methods Community-dwelling older adults (n = 200) completed a researcher administered questionnaire designed to collect information about functional foods including current consumption, motivating factors for consumption, perceived need for information, sources of information for functional foods and awareness of health claims. Results Prevalence of functional food consumption among participants was 93.0%. Increased awareness and knowledge was the most commonly reported factor that would promote functional food consumption (85.5%) and 63.5% of participants wanted more information about functional foods with preferred sources being newspapers/magazines/books (68.5%) and food labels (66.1%). Participants were predominately (93.5%) aware of health claims on functional foods and those with more education were more likely to report being aware of health claims (p = 0.045). Conclusions Although functional food consumption among older adults in this sample is high, there is a need for further information regarding functional foods. These results inform stakeholders regarding the potential for information to influence functional food acceptance among older adult consumers. PMID:24886306

Can You Ride a Bicycle? The Ability to Ride a Bicycle Prevents Reduced Social Function in Older Adults With Mobility Limitation

PubMed Central

Sakurai, Ryota; Kawai, Hisashi; Yoshida, Hideyo; Fukaya, Taro; Suzuki, Hiroyuki; Kim, Hunkyung; Hirano, Hirohiko; Ihara, Kazushige; Obuchi, Shuichi; Fujiwara, Yoshinori

2016-01-01

Background The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function. Methods On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests. Results Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists. Conclusions The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults. PMID:26902165

Theory of mind through the ages: older and middle-aged adults exhibit more errors than do younger adults on a continuous false belief task.

PubMed

Bernstein, Daniel M; Thornton, Wendy Loken; Sommerville, Jessica A

2011-10-01

Theory of mind (ToM), or the ability to understand mental states, is a fundamental aspect of social cognition. Previous research has documented marked advances in ToM in preschoolers, and declines in ToM in older-aged adults. In the present study, younger (n=37), middle-aged (n=20), and older (n=37) adults completed a continuous false belief task measuring ToM. Middle-aged and older adults exhibited more false belief bias than did younger adults, irrespective of language ability, executive function, processing speed, and memory. The authors conclude that ToM declines from younger to older adulthood, independent of age-related changes to domain-general cognitive functioning.

Functional Assessments Used by Occupational Therapists with Older Adults at Risk of Activity and Participation Limitations: A Systematic Review

PubMed Central

Wales, Kylie; Clemson, Lindy; Lannin, Natasha; Cameron, Ian

2016-01-01

Introduction The use of functional assessments to evaluate patient change is complicated by a lack of consensus as to which assessment is most suitable for use with older adults. Objective: To identify and appraise the properties of assessments used to evaluate functional abilities in older adults. Methods A systematic review of randomised controlled trials of occupational therapy interventions was conducted up to 2012 to identify assessments used to measure function. Two authors screened and extracted data independently. A second search then identified papers investigating measurement properties of each assessment. Studies from the second search were included if: i) published in English, ii) the assessment was not modified from its original published form, iii) study aim was to evaluate the quality of the tool, iv) and was original research. Translated versions of assessments were excluded. Measurement quality was rated using the COSMIN checklist and Terwee criteria. Results Twenty-eight assessments were identified from the systematic search of occupational therapy interventions provided to older adults. Assessments were of varied measurement quality and many had been adapted (although still evaluated as though the original tool had been administered) potentially altering the conclusions drawn about measurement quality. Synthesis of best evidence established 15 functional assessments have not been tested in an older adult population. Conclusions The Functional Autonomy Measurement System (SMAF) appears to be a promising assessment for use with older adults. Only two tools (the SMAF and the Assessment of Motor and Process Skills (AMPS)) were deemed to be responsive to change when applied to older adults. Health professionals should use functional assessments that have been validated with their population and in their setting. There are reliable and valid assessments to capture the functional performance of older adults in community and hospital settings, although further refinement of these assessments may be necessary. PMID:26859678

Relationship of functional fitness with daily steps in community-dwelling older adults.

PubMed

de Melo, Lucelia Luna; Menec, Verena H; Ready, A Elizabeth

2014-01-01

Walking is the main type of physical activity among community-dwelling older adults and it is associated with various health benefits. However, there is limited evidence about the relationship between functional fitness and walking performed under independent living conditions among older adults. This study examined the relationship between functional fitness and steps walked per day among older adults, both assessed objectively, with performance-based measures accounting for the effect of age, gender, and chronic conditions. In this cross-sectional study, 60 participants aged 65 years or older (mean = 76.9 ± 7.3 years, range 65-92 years) wore pedometers for 3 consecutive days. Functional fitness was measured using the Functional Fitness Test (lower and upper body strength, endurance, lower and upper body flexibility, agility/balance). The outcome measure was the mean number of steps walked for 3 days with participants classified into tertiles: low walkers (<3000 steps), medium walkers (≥3000 < 6500 steps), and high walkers (≥6500 steps). After controlling for age, gender, and the number of chronic conditions, none of the functional fitness parameters was significantly associated with steps taken per day when comparing medium walkers with low walkers. In contrast, all functional fitness parameters, except upper body flexibility, were significantly associated with steps taken per day when comparing high walkers with low walkers. In this sample of older adults, greater functional fitness was associated only with relatively high levels of walking involving 6500 steps per day or more. It was not related to medium walking levels. The findings point to the importance of interventions to maintain or enhance functional fitness among older adults.

Depression, functional disability and quality of life among Nigerian older adults: Prevalences and relationships.

PubMed

Akosile, Christopher Olusanjo; Mgbeojedo, Ukamaka Gloria; Maruf, Fatai Adesina; Okoye, Emmanuel Chiebuka; Umeonwuka, Ifeanyi Chuka; Ogunniyi, Adesola

2018-01-01

Ageing is associated with increased morbidity, depression and decline in function. These may consequently impair the quality of life (QoL) of older adults. This study was used to investigate the prevalence of functional disability, depression, and level of quality of life of older adults residing in Uyo metropolis and its environs, Nigeria. This cross sectional survey involved 206 (116 females and 90 males) older adults with mean age of 69.8±6.7. The World Health Organization Quality of Life-OLD, Functional status Questionnaire (FSQ) and Geriatric Depression Scale (GDS) were used to measure quality of life, functional disability and depression respectively. Data was analysed using frequency counts and percentages and Spearman rank-order correlation coefficient, at 0.05 alpha level. 45.5% of participants had depression, and at least 30% had functional disability in at least one domain, but their quality of life was fairly good (>60.0%) across all domains. Significant correlation existed between depression scores and individual quality of life and functional disability domains and between overall QoL and each functional disability domain (p<0.001). Depression and functional disability were quite prevalent among sampled older adults but their QOL was not too severely affected. Since the constructs were interrelated, it seems interventions targeted at depression and functional status may invariably enhance the quality of life of the older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Examining the effects of an experiential interprofessional education activity with older adults.

PubMed

Conti, Gerry; Bowers, Cassandra; O'Connell, Mary Beth; Bruer, Stephen; Bugdalski-Stutrud, Carol; Smith, Geralynn; Bickes, Joan; Mendez, Jennifer

2016-01-01

The need for experienced healthcare professionals to work with older adults is great, yet educational training is limited. In this interprofessional education (IPE) study, 861 students from five professions made 293 visits in the homes or preferred community settings of 208 older adults. Surveys with quantitative and open-text feedback assessed attitudes towards older adults, IPE team functioning, and the value of home visits. Survey results showed strongly positive attitudes towards ageing and older adults. Students from all professions expressed surprise and admiration for the active lives led by these healthier older adults, lives clearly in contrast to stereotypes of ageing. They further acknowledged the value of collaborative team functioning in meeting older adult needs, learned more about the roles and responsibilities of other professions, and identified strengths of the home as a site for care. Students positively valued the experience as part of their professional training, with 82% of all students stating they would welcome additional IPE opportunities. Results suggest that an experiential IPE activity can positively shape student attitudes towards older adults, IPE, and interprofessional collaboration.

Self-reference enhances relational memory in young and older adults.

PubMed

Hou, Mingzhu; Grilli, Matthew D; Glisky, Elizabeth L

2017-11-27

The present study investigated the influence of self-reference on two kinds of relational memory, internal source memory and associative memory, in young and older adults. Participants encoded object-location word pairs using the strategies of imagination and sentence generation, either with reference to themselves or to a famous other (i.e., George Clooney or Oprah Winfrey). Both young and older adults showed memory benefits in the self-reference conditions compared to other-reference conditions on both tests, and the self-referential effects in older adults were not limited by low memory or executive functioning. These results suggest that self-reference can benefit relational memory in older adults relatively independently of basic memory and executive functions.

Meeting the Hearing Health Care Needs of the Oldest Older Adult.

PubMed

Weinstein, Barbara E

2015-06-01

The purpose of this article is to provide an overview of the auditory needs of and approaches to management of the oldest older adult. This article is an overview of principles of geriatric care and implications of untreated hearing loss for function, management, and care of the oldest older adult. Person-centered care is at the heart of health care delivery to the oldest older adult, who typically suffers from multimorbidity. Given the high prevalence of moderate to severe hearing loss in this cohort and the functional limitations of untreated hearing loss, audiologists must become proactive in educating stakeholders on the importance of identifying and referring the oldest older adult for management of hearing health care needs. Audiologists have an integral role to play in collaborating with health care professionals in optimizing health care for the oldest older adult.

Sepsis in Older Adults.

PubMed

Rowe, Theresa A; McKoy, June M

2017-12-01

Sepsis disproportionally affects older adults with more than 60% of sepsis diagnoses attributed to adults aged 65 years and older. Identifying, diagnosing, and treating sepsis in older individuals remain a challenge for clinicians, and few studies focus specifically on older adults with multiple medical comorbidities. Principles guiding management of sepsis for older adults are generally the same as in younger adults; however, unique considerations particularly pertinent to the care older adults include antimicrobial selection and dosing, delirium management, and goals of care discussions. Other factors, such as medical comorbidities, cognitive impairment, and functional status, impact outcomes more than age alone. Copyright © 2017 Elsevier Inc. All rights reserved.

The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

PubMed

Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

2015-01-01

The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most prevalent problems in community-living older adults.

Adequate proverb interpretation is associated with performance on the independent living scales.

PubMed

Ahmed, Fayeza S; Miller, L Stephen

2015-01-01

The purpose of this study was to examine proverb interpretation performance and functional independence in older adults. From the limited literature on proverb interpretation in aging and its conceptualization as an executive function, it was hypothesized that proverb interpretation would be related to functional independence similar to other executive functions. Tests of proverb interpretation, additional executive functions, and functional ability were administered to nondemented older adults. Results showed that proverb interpretation accounted for a significant amount of unique variance of functional ability scores. This supports including a measure of proverb interpretation to the assessment of older adults.

Older adult awareness of the influence of cardiovascular disease risk factors on cognitive function.

PubMed

Wright, Regina S; Ford, Cassandra; Sniscak, Courtney R

2017-03-01

The aims of the current study were to (i) assess older people's awareness of the association between CVD risk factors and cognitive function; and (ii) examine whether awareness varies as a function of demographic factors. Cardiovascular disease (CVD) risk factors have been linked to subtle deficits in cognitive function. CVD risk factors increase the risk of cognitive decline and dementia. The association between cardiovascular disease (CVD) risk factors and cognitive decrements has been well documented among older people; however, we are unaware of any studies that have measured older people's awareness of this relationship in an effort to assess educational needs. A descriptive, cross-sectional survey design was employed. Community-based older adults aged 60 and older completed a survey that assessed their knowledge of the association between CVD risk factors and cognitive function. One hundred fifty older adults, with a mean age of 72.88 years, completed the survey. Results showed that over 75% of the sample was aware that CVD risk factors affect cognitive function. White older adults and older adults with greater perceived financial well-being tended to be more aware of these relationships than non-White participants with less perceived financial well-being. Results suggest that many, but not all older people have awareness of this relationship. As such, there is a need for increased education about the cognitive effects of CVD risk factors, particularly among older people who are already at risk for developing CVD and those with lesser financial well-being. Appropriate educational strategies can expose older patients to the importance of healthy lifestyle and self-care to maintain cognitive function. Nurses can incorporate education into care by identifying patients that would benefit from tailored interventions and providing information to at-risk patients about how to maintain their cognitive function through management of specific CVD risk factors. © 2016 John Wiley & Sons Ltd.

Effects of spacing of item repetitions in continuous recognition memory: does item retrieval difficulty promote item retention in older adults?

PubMed

Kılıç, Aslı; Hoyer, William J; Howard, Marc W

2013-01-01

BACKGROUND/STUDY CONTEXT: Older adults exhibit an age-related deficit in item memory as a function of the length of the retention interval, but older adults and young adults usually show roughly equivalent benefits due to the spacing of item repetitions in continuous memory tasks. The current experiment investigates the seemingly paradoxical effects of retention interval and spacing in young and older adults using a continuous recognition memory procedure. Fifty young adults and 52 older adults gave memory confidence ratings to words that were presented once (P1), twice (P2), or three times (P3), and the effects of the lag length and retention interval were assessed at P2 and at P3, respectively. Response times at P2 were disproportionately longer for older adults than for younger adults as a function of the number of items occurring between P1 and P2, suggestive of age-related loss in item memory. Ratings of confidence in memory responses revealed that older adults remembered fewer items at P2 with a high degree of certainty. Confidence ratings given at P3 suggested that young and older adults derived equivalent benefits from the spacing between P1 and P2. Findings of this study support theoretical accounts that suggest that recursive reminding and/or item retrieval difficulty promote item retention in older adults.

DISTINCT FUNCTIONS OF SOCIAL SUPPORT AND COGNITIVE FUNCTION AMONG OLDER ADULTS

PubMed Central

Sims, Regina C.; Hosey, Megan; Levy, Shellie-Anne; Whitfield, Keith E.; Katzel, Leslie I.; Waldstein, Shari R.

2014-01-01

Background/Study Context Social support has been shown to buffer cognitive decline in older adults; however, few studies have examined the association of distinct functions of perceived social support and cognitive function. The current study examined the relations between distinct functions of social support and numerous cognitive domains in older adults. Methods Data were derived from a cross-sectional, correlational study of cardiovascular risk factors, cognitive function, and neuroimaging. The participants were 175 older adults with a mean age of 66.32. A number of neuropsychological tests and the Interpersonal Support Evaluation List were administered. Multiple linear regression analyses were conducted to determine cross-sectional relations of social support to cognitive function after controlling for age, gender, education, depressive symptomatology, systolic blood pressure, body-mass index, total cholesterol, and fasting glucose. Results No significant positive relations were found between distinct functions of social support and cognitive function in any domain; however, inverse relations emerged such that greater social support across several functions was associated with poorer nonverbal memory and response inhibition. Conclusion Results suggest that the receipt of social support may be a burden for some older adults. Within the current study, fluid cognitive abilities reflected this phenomenon. The mechanism through which social support is associated with poorer cognitive function in some domains deserves further exploration. PMID:24467699

The Functional Integration in the Sensory-Motor System Predicts Aging in Healthy Older Adults.

PubMed

He, Hui; Luo, Cheng; Chang, Xin; Shan, Yan; Cao, Weifang; Gong, Jinnan; Klugah-Brown, Benjamin; Bobes, Maria A; Biswal, Bharat; Yao, Dezhong

2016-01-01

Healthy aging is typically accompanied by a decrease in the motor capacity. Although the disrupted neural representations and performance of movement have been observed in older age in previous studies, the relationship between the functional integration of sensory-motor (SM) system and aging could be further investigated. In this study, we examine the impact of healthy aging on the resting-state functional connectivity (rsFC) of the SM system, and investigate as to how aging is affecting the rsFC in SM network. The SM network was identified and evaluated in 52 healthy older adults and 51 younger adults using two common data analytic approaches: independent component analysis and seed-based functional connectivity (seed at bilateral M1 and S1). We then evaluated whether the altered rsFC of the SM network could delineate trajectories of the age of older adults using a machine learning methodology. Compared with the younger adults, the older demonstrated reduced functional integration with increasing age in the mid-posterior insula of SM network and increased rsFC among the sensorimotor cortex. Moreover, the reduction in the rsFC of mid-posterior insula is associated with the age of older adults. Critically, the analysis based on two-aspect connectivity-based prediction frameworks revealed that the age of older adults could be reliably predicted by this reduced rsFC. These findings further indicated that healthy aging has a marked influence on the SM system that would be associated with a reorganization of SM system with aging. Our findings provide further insight into changes in sensorimotor function in the aging brain.

Modified automatic teller machine prototype for older adults: a case study of participative approach to inclusive design.

PubMed

Chan, Chetwyn C H; Wong, Alex W K; Lee, Tatia M C; Chi, Iris

2009-03-01

The goal of this study was to enhance an existing automated teller machine (ATM) human-machine interface in order to accommodate the needs of older adults. Older adults were involved in the design and field test of the modified ATM prototype. The design of the user interface and functionality took the cognitive and physical abilities of older adults into account. The modified ATM system included only "cash withdrawal" and "transfer" functions based on the task demands and needs for services of older adults. One hundred and forty-one older adults (aged 60 or above) participated in the field test by operating modified or existing ATM systems. Those who operated the modified system were found to have significantly higher success rates than those who operated the existing system. The enhancement was most significant among older adults who had lower ATM-related abilities, a lower level of education, and no prior experience of using ATMs. This study demonstrates the usefulness of using a universal design and participatory approach to modify the existing ATM system for use by older adults. However, it also leads to a reduction in functionality of the enhanced system. Future studies should explore ways to develop a universal design ATM system which can satisfy the abilities and needs of all users in the entire population.

Construct Validation of Physical Activity Surveys in Culturally Diverse Older Adults: A Comparison of Four Commonly Used Questionnaires

ERIC Educational Resources Information Center

Moore, Delilah S.; Ellis, Rebecca; Allen, Priscilla D.; Cherry, Katie E.; Monroe, Pamela A.; O'Neil, Carol E.; Wood, Robert H.

2008-01-01

The purpose of this study was to establish validity evidence of four physical activity (PA) questionnaires in culturally diverse older adults by comparing self-report PA with performance-based physical function. Participants were 54 older adults who completed the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), Physical…

Experiences of Habitual Physical Activity in Maintaining Roles and Functioning among Older Adults: A Qualitative Study

PubMed Central

Svantesson, Ulla; Willén, Carin

2016-01-01

Physically active older adults have reduced risk of functional restrictions and role limitations. Several aspects may interrelate and influence habitual physical activity (PA). However, older adults' own perspectives towards their PA need to be addressed. The aim of this study was to explore the experiences of habitual physical activity in maintaining roles and functioning among older adult Palestinians ≥60 years. Data were collected through in-depth interviews based on a narrative approach. Seventeen participants were recruited (aged 64–84 years). Data were analyzed using a narrative interpretative method. Findings. Three central narratives were identified, “keep moving, stay healthy,” “social connectedness, a motive to stay active,” and “adapting strategies to age-related changes.” Conclusion. Habitual physical activity was perceived as an important factor to maintain functioning and to preserve active roles in older adults. Walking was the most prominent pattern of physical activity and it was viewed as a vital tool to maintain functioning among the older adults. Social connectedness was considered as a contributing factor to the status of staying active. To adapt the process of age-related changes in a context to stay active, the participants have used different adapting strategies, including protective strategy, awareness of own capabilities, and modifying or adopting new roles. PMID:28078141

Depression and physical functioning among older Americans with diabesity: NHANES 2009-2010.

PubMed

Bowen, Pamela G; Lee, Loretta T; Martin, Michelle Y; Clay, Olivio J

2017-02-01

Caring for older adults with diabesity can be challenging for primary care nurse practitioners. The purpose of this study was to examine whether there would be an additive effect of diabesity on depressive symptoms and physical functioning of older adults. We hypothesized that there is an additive effect of diabesity on depressive symptoms and physical functioning among older adults with one or neither condition. We performed a cross-sectional analysis of data from National Health and Nutrition Examination Surveys collected from African-American and Caucasian adults aged 65 and over between 2009 and 2010. Multivariate linear regression models were utilized. The sample consisted of 918 participants. In covariate-adjusted models, participants with diabesity reported more depressive symptoms than people with neither condition. Individuals with diabesity and those with obesity alone reported significantly more difficulty with physical function when compared to participants with neither condition. Findings suggest that diabesity was more burdensome to older adults than either condition alone. More research is needed to understand the interplay between depression, physical function, and diabesity. To disrupt the adverse effects of diabesity burden, increased nurse practitioner awareness of this phenomenon may be beneficial in improving and maintaining physical and mental health among older adults. ©2016 American Association of Nurse Practitioners.

Scoping review report: obesity in older adults.

PubMed

Decaria, J E; Sharp, C; Petrella, R J

2012-09-01

Obesity is associated with an increased risk for early death, heart disease and stroke, disability and several other comorbidities. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base management strategies is conflicting for various reasons. The analytic framework for this review is based on a scoping review methodology, and was conducted to examine what is known about the diagnosis, treatment and management of obesity in older adults. A total of 492 relevant research articles were identified using PubMed, Scirus, EBSCO, Clinicaltrials.gov, Cochrane Reviews and Google Scholar. The findings of this review indicate that the current WHO (World Health Organization)-recommended body mass index, waist circumference and waist-to-hip ratio obesity thresholds for the general adult population may not be appropriate for older adults. Alternatively, weight change or physical fitness may be more useful measures of mortality and health risk in obese older adults. Furthermore, although obesity in older adults is associated with several disorders that increase functional disability, epidemiological evidence suggests that obesity is protective against mortality in seniors. Consequently, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs. The findings from this review also suggest that treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy. In conclusion, this review demonstrates the need for more research to clarify the definition of obesity in older adults, to establish criteria for evaluating when to treat older adults for obesity, and to develop effective treatment strategies focused on functional outcomes in obese older adults.

Not just a light fingertip touch: A facilitation of functional integration between body sway and visual search in older adults.

PubMed

Chen, Fu-Chen; Chu, Chia-Hua; Pan, Chien-Yu; Tsai, Chia-Liang

2018-05-01

Prior studies demonstrated that, compared to no fingertip touch (NT), a reduction in body sway resulting from the effects of light fingertip touch (LT) facilitates the performance of visual search, buttressing the concept of functional integration. However, previous findings may be confounded by different arm postures required between the NT and LT conditions. Furthermore, in older adults, how LT influences the interactions between body sway and visual search has not been established. (1) Are LT effects valid after excluding the influences of different upper limb configurations? (2) Is functional integration is feasible for older adults? Twenty-two young (age = 21.3 ± 2.0) and 22 older adults (age = 71.8 ± 4.1) were recruited. Participants performed visual inspection and visual searches under NT and LT conditions. The older group significantly reduced AP sway (p < 0.05) in LT compared to NT conditions, of which the LT effects on postural adaptation were more remarkable in older than young adults (p < 0.05). In addition, the older group significantly improved search accuracy (p < 0.05) from the LT to the NT condition, and these effects were equivalent between groups. After controlling for postural configurations, the results demonstrate that light fingertip touch reduces body sway and concurrently enhances visual search performance in older adults. These findings confirmed the effects of LT on postural adaptation as well as supported functional integration in older adults. Copyright © 2018 Elsevier B.V. All rights reserved.

Optimizing the benefits of exercise on physical function in older adults.

PubMed

Buford, Thomas W; Anton, Stephen D; Clark, David J; Higgins, Torrance J; Cooke, Matthew B

2014-06-01

As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

"It's good for me": physical activity in older adults with schizophrenia.

PubMed

Leutwyler, Heather; Hubbard, Erin M; Slater, Margaret; Jeste, Dilip V

2014-01-01

Physical activity (PA) interventions to improve the physical function of older adults with schizophrenia are necessary but not available. Older adults with schizophrenia may have unique barriers and facilitators to PA. The purpose of this study was to describe the perceptions of older adults with schizophrenia about barriers and facilitators to engage in physical activities that promote physical function. We conducted qualitative interviews with 16 older adults with schizophrenia. Data were collected and analyzed with grounded theory methodology. Participants expressed interest in becoming more physically active for a variety of perceived benefits including psychiatric symptom management and maintenance of basic function. Key barriers and facilitators to PA emerged in five broad categories: Mental Health, No longer a spring chicken, Pride and Sense of Well-being, Comfort and Safety, and Belonging. Interventions in this population should address negative attitudes towards aging and promote routine physical activities that enhance well-being and companionship.

Effects of Cable News Watching on Older Adults' Physiological and Self-Reported Stress and Cognitive Function.

PubMed

Deal, Caroline; Bogdan, Ryan; Miller, J Phil; Rodebaugh, Tom; Caburnay, Charlene; Yingling, Mike; Hershey, Tammy; Schweiger, Julia; Lenze, Eric J

2017-01-01

Older adults are the largest consumer of cable news, which includes negative and politicized content and may constitute a daily stressor. As older adults are also vulnerable to the negative consequences of stress, we hypothesized that cable news watching could induce a stress reaction and impair cognitive function. We tested exposures to cable news (i.e., Fox News and MSNBC) in a within-subject randomized controlled design in 34 healthy older adults. We also included negative (Public Broadcasting Station) and positive (trier social stress test) controls. Cable news watching had no effect on psychological stress, physiological stress, or cognitive function. This remained true even if the news exposures were discordant with participants' political affiliation. We conclude that brief cable news watching does not induce a physiological or subjective stress response or cognitive impairment among healthy older adults.

A characterization of pain in racially and ethnically diverse older adults: a review of the literature.

PubMed

Lavin, Robert; Park, Juyoung

2014-04-01

This article presents a critical review of the influence of interracial and ethnic variation on pain prevalence, intensity, interference/function/disability, and treatment in older adults. A search of scientific databases published from 1900 to 2011, using key words associated with pain, geriatrics, and race/ethnicity, identified 180 articles, of which 27 empirical studies met the inclusion criteria. Of the retained articles, 17 reported that race/ethnicity was a statistically significant factor at p < .05. Minority older adults reported a higher prevalence of pain and higher pain intensity, and variable responses regarding function/disability compared with responses by non-Hispanic White older adults. Minority older adults were less likely to receive prescription pharmacologic treatments and surgery, and they were more likely to use complementary and alternative medicine treatments. There are interracial/ethnic differences in pain assessment and treatment interventions among older adults.

Everyday Functioning and Cognitive Correlates in Healthy Older Adults with Subjective Cognitive Concerns

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2016-01-01

Objective Few studies have examined functional abilities and complaints in healthy older adults with subjective cognitive concerns (SCC). The aims of this study were to assess everyday functioning in healthy older adults reporting high and low amounts of SCC, and examine cognitive correlates of functional abilities. Method Twenty-six healthy older adults with high SCC, and 25 healthy older adults with low SCC, as well as their knowledgeable informants completed the Instrumental Activities of Daily Living-Compensation (IADL-C), a questionnaire measure of everyday functioning. Results After controlling for depression, the high SCC group self-reported significantly more everyday difficulties on the IADL-C, including all subdomains. Compared to the low SCC group, informants for the high SCC group endorsed more difficulties on the IADL-C and specifically the social skills subdomain. For the high SCC group, poorer self-report of everyday functioning was related to poorer executive functioning and temporal order memory. Conclusions These findings indicate that there may be subtle functional changes that occur early in the spectrum of cognitive decline in individuals with high SCC, and these functional changes are evident to informants. Further work is needed to investigate whether individuals with both SCC and functional difficulties are at an even higher risk for progression to mild cognitive impairment. PMID:27240886

Relationship between Objectively Measured Transportation Behaviors and Health Characteristics in Older Adults.

PubMed

Takemoto, Michelle; Carlson, Jordan A; Moran, Kevin; Godbole, Suneeta; Crist, Katie; Kerr, Jacqueline

2015-10-30

This study used objective Global Positioning Systems (GPS) to investigate the relationship between pedestrian and vehicle trips to physical, cognitive, and psychological functioning in older adults living in retirement communities. Older adults (N = 279; mean age = 83 ± 6 years) wore a GPS and accelerometer for 6 days. Participants completed standard health measures. The Personal Activity and Location Measurement System (PALMS) was used to calculate the average daily number of trips, distance, and minutes traveled for pedestrian and vehicle trips from the combined GPS and accelerometer data. Linear mixed effects regression models explored relationships between these transportation variables and physical, psychological and cognitive functioning. Number, distance, and minutes of pedestrian trips were positively associated with physical and psychological functioning but not cognitive functioning. Number of vehicle trips was negatively associated with fear of falls; there were no other associations between the vehicle trip variables and functioning. Vehicle travel did not appear to be related to functioning in older adults in retirement communities except that fear of falling was related to number of vehicle trips. Pedestrian trips had moderate associations with multiple physical and psychological functioning measures, supporting a link between walking and many aspects of health in older adults.

The Association between Belgian Older Adults' Physical Functioning and Physical Activity: What Is the Moderating Role of the Physical Environment?

PubMed

Van Holle, Veerle; Van Cauwenberg, Jelle; Gheysen, Freja; Van Dyck, Delfien; Deforche, Benedicte; Van de Weghe, Nico; De Bourdeaudhuij, Ilse

2016-01-01

Better physical functioning in the elderly may be associated with higher physical activity levels. Since older adults spend a substantial part of the day in their residential neighborhood, the neighborhood physical environment may moderate associations between functioning and older adults' physical activity. The present study investigated the moderating role of the objective and perceived physical environment on associations between Belgian older adults' physical functioning and transport walking, recreational walking, and moderate-to-vigorous physical activity. Data from 438 older adults were included. Objective physical functioning was assessed using the Short Physical Performance Battery. Potential moderators included objective neighborhood walkability and perceptions of land use mix diversity, access to recreational facilities, access to services, street connectivity, physical barriers for walking, aesthetics, crime-related safety, traffic speeding-related safety, and walking infrastructure. Transport and recreational walking were self-reported, moderate-to-vigorous physical activity was assessed through accelerometers. Multi-level regression analyses were conducted using MLwiN to examine two-way interactions between functioning and the environment on both walking outcomes. Based on a previous study where environment x neighborhood income associations were found for Belgian older adults' moderate-to-vigorous physical activity, three-way functioning x environment x income interactions were examined for moderate-to-vigorous physical activity. Objectively-measured walkability moderated the association between functioning and transport walking; this positive association was only present in high-walkable neighborhoods. Moreover, a three-way interaction was observed for moderate-to-vigorous physical activity. Only in high-income, high-walkable neighborhoods, there was a positive association between functioning and moderate-to-vigorous physical activity. No functioning x walkability interactions were observed for recreational walking, and none of the perceived environmental variables moderated the positive association between physical functioning and the physical activity outcomes. For older adults with better physical functioning, living in a high-walkable neighborhood could be beneficial to engage in more transport walking. Living in high-income, high-walkable neighborhoods and having better functioning might also be beneficial for more engagement in moderate-to-vigorous physical activity. This might suggest a protective role of neighborhood walkability for preventing declining physical functioning and consequently decreasing physical activity levels in older adults. However, given the cross-sectional design of the present study, this suggestion needs to be confirmed through longitudinal assessment investigating over-time changes in the observed associations.

Measuring personality functioning in older adults: construct validity of the Severity Indices of Personality Functioning - Short Form (SIPP-SF).

PubMed

Rossi, Gina; Debast, Inge; van Alphen, S P J

2017-07-01

The dimensional personality disorders model in the Diagnostic and Statistical Manual (DSM)-5 section III conceptually differentiates impaired personality functioning (criterion A) from the presence of pathological traits (criterion B). This study is the first to specifically address the measurement of criterion A in older adults. Moreover, the convergent/divergent validity of criterion A and criterion B will be compared in younger and older age groups. The Severity Indices of Personality Functioning - Short Form (SIPP-SF) was administered in older (N = 171) and younger adults (N = 210). The factorial structure was analyzed with exploratory structural equation modeling. Differences in convergent/divergent validity between personality functioning (SIPP-SF) and pathological traits (Personality Inventory for DSM-5; Dimensional Assessment of Personality Pathology-Basic Questionnaire) were examined across age groups. Identity Integration, Relational Capacities, Responsibility, Self-Control, and Social Concordance were corroborated as higher order domains. Although the SIPP-SF domains measured unique variation, some high correlations with pathological traits referred to overlapping constructs. Moreover, in older adults, personality functioning was more strongly related to Psychoticism, Disinhibition, Antagonism and Dissocial Behavior compared to younger adults. The SIPP-SF construct validity was demonstrated in terms of a structure of five higher order domains of personality functioning. The instrument is promising as a possible measure of impaired personality functioning in older adults. As such, it is a useful clinical tool to follow up effects of therapy on levels of personality functioning. Moreover, traits were associated with different degrees of personality functioning across age groups.

Is vision function related to physical functional ability in older adults?

PubMed

West, Catherine G; Gildengorin, Ginny; Haegerstrom-Portnoy, Gunilla; Schneck, Marilyn E; Lott, Lori; Brabyn, John A

2002-01-01

To assess the relationship between a broad range of vision functions and measures of physical performance in older adults. Cross-sectional study. Population-based cohort of community-dwelling older adults, subset of an on-going longitudinal study. Seven hundred eighty-two adults aged 55 and older (65% of living eligible subjects) had subjective health measures and objective physical performance evaluated in 1989/91 and again in 1993/95 and a battery of vision functions tested in 1993/95. Comprehensive battery of vision tests (visual acuity, contrast sensitivity, effects of illumination level, contrast and glare on acuity, visual fields with and without attentional load, color vision, temporal sensitivity, and the impact of dimming light on walking ability) and physical function measures (self-reported mobility limitations and observed measures of walking, rising from a chair and tandem balance). The failure rate for all vision functions and physical performance measures increased exponentially with age. Standard high-contrast visual acuity and standard visual fields showed the lowest failure rates. Nonstandard vision tests showed much higher failure rates. Poor performance on many individual vision functions was significantly associated with particular individual measures of physical performance. Using constructed combination vision variables, significant associations were found between spatial vision, field integrity, binocularity and/or adaptation, and each of the functional outcomes. Vision functions other than standard visual acuity may affect day-to-day functioning of older adults. Additional studies of these other aspects of vision and how they can be treated or rehabilitated are needed to determine whether these aspects play a role in strategies for reducing disability in older adults.

Coming of Age: Considerations in the Prescription of Exercise for Older Adults.

PubMed

Zaleski, Amanda L; Taylor, Beth A; Panza, Gregory A; Wu, Yin; Pescatello, Linda S; Thompson, Paul D; Fernandez, Antonio B

2016-01-01

Older adults represent the fastest-growing age demographic of the population. Physiological changes associated with primary aging and concurrent chronic disease adversely impact functional capacity, health outcomes, and quality of life. For these reasons, there is a national emphasis for healthcare providers to improve the health, function, and quality of life of older adults to preserve independent living and psychological well-being. The benefits of regular physical activity or exercise with regard to aging and disease are indisputable, yet many clinicians do not prescribe exercise to older adults. This reluctance may be attributable to a lack of knowledge regarding appropriate exercise prescription for older adults in light of the potential risks and benefits of various doses and types of exercise. In addition, clinicians and patients may have concerns about potential health considerations relevant to older adults such as comprehensive pre-exercise screening and exercise-drug interactions. In light of this, the following review presents (1) guidelines for exercise prescription in older adults and modification of these guidelines for patients with the most common age-associated comorbidities; (2) recommendations for pre-exercise screening prior to initiating an exercise program in older adults; (3) considerations for older adults on one or more medications; and (4) common barriers to adopting and maintaining exercise in an older population. Our goal is to provide a framework that clinicians can follow when prescribing exercise in older adults while considering the unique characteristics and concerns present in this population.

Perceptions of emotion and age among younger, midlife, and older adults.

PubMed

Santorelli, Gennarina D; Ready, Rebecca E; Mather, Molly A

2018-03-01

Older adults report greater emotional well-being than younger persons, yet negative stereotypes about aging are pervasive. Little is known about age group perceptions of emotion in adulthood, particularly for familiar persons. Thus, this project determined perceptions of general affect in familiar younger and older adults. In two studies, participants (Study 1, younger adult n = 123, older adult n = 43; Study 2, younger adult n = 34, midlife adult n = 41, older adult n = 16) provided self-report data about their affect in general, as well as reported on the affect of a familiar younger person (aged 18--34) and a familiar older person (aged 65 or older). Emotion scales assessed high- and low-arousal positive and negative affect. Results suggest a less favorable perception of emotion experiences of older adults compared to younger adults. Specifically, participants of all age groups rated older adults as having lower positive emotions and higher negative emotions than is found in self-report data. Perceptions of emotion in older adulthood reflect stereotypes of negative functioning. Older adult participants were not immune to holding negative views about older adults. Negative perceptions about emotion experiences in later life may be detrimental to the physical and mental health of older adults.

Neurophysiological and Behavioral Differences between Older and Younger Adults When Processing Violations of Tonal Structure in Music

PubMed Central

Lagrois, Marie-Élaine; Peretz, Isabelle; Zendel, Benjamin Rich

2018-01-01

Aging is associated with decline in both cognitive and auditory abilities. However, evidence suggests that music perception is relatively spared, despite relying on auditory and cognitive abilities that tend to decline with age. It is therefore likely that older adults engage compensatory mechanisms which should be evident in the underlying functional neurophysiology related to processing music. In other words, the perception of musical structure would be similar or enhanced in older compared to younger adults, while the underlying functional neurophysiology would be different. The present study aimed to compare the electrophysiological brain responses of younger and older adults to melodic incongruities during a passive and active listening task. Older and younger adults had a similar ability to detect an out-of-tune incongruity (i.e., non-chromatic), while the amplitudes of the ERAN and P600 were reduced in older adults compared to younger adults. On the other hand, out-of-key incongruities (i.e., non-diatonic), were better detected by older adults compared to younger adults, while the ERAN and P600 were comparable between the two age groups. This pattern of results indicates that perception of tonal structure is preserved in older adults, despite age-related neurophysiological changes in how melodic violations are processed. PMID:29487498

Neurophysiological and Behavioral Differences between Older and Younger Adults When Processing Violations of Tonal Structure in Music.

PubMed

Lagrois, Marie-Élaine; Peretz, Isabelle; Zendel, Benjamin Rich

2018-01-01

Aging is associated with decline in both cognitive and auditory abilities. However, evidence suggests that music perception is relatively spared, despite relying on auditory and cognitive abilities that tend to decline with age. It is therefore likely that older adults engage compensatory mechanisms which should be evident in the underlying functional neurophysiology related to processing music. In other words, the perception of musical structure would be similar or enhanced in older compared to younger adults, while the underlying functional neurophysiology would be different. The present study aimed to compare the electrophysiological brain responses of younger and older adults to melodic incongruities during a passive and active listening task. Older and younger adults had a similar ability to detect an out-of-tune incongruity (i.e., non-chromatic), while the amplitudes of the ERAN and P600 were reduced in older adults compared to younger adults. On the other hand, out-of-key incongruities (i.e., non-diatonic), were better detected by older adults compared to younger adults, while the ERAN and P600 were comparable between the two age groups. This pattern of results indicates that perception of tonal structure is preserved in older adults, despite age-related neurophysiological changes in how melodic violations are processed.

Semantic and self-referential processing of positive and negative trait adjectives in older adults

PubMed Central

Glisky, Elizabeth L.; Marquine, Maria J.

2008-01-01

The beneficial effects of self-referential processing on memory have been demonstrated in numerous experiments with younger adults but have rarely been studied in older individuals. In the present study we tested young people, younger-older adults, and older-older adults in a self-reference paradigm, and compared self-referential processing to general semantic processing. Findings indicated that older adults over the age of 75 and those with below average episodic memory function showed a decreased benefit from both semantic and self-referential processing relative to a structural baseline condition. However, these effects appeared to be confined to the shared semantic processes for the two conditions, leaving the added advantage for self-referential processing unaffected These results suggest that reference to the self engages qualitatively different processes compared to general semantic processing. These processes seem relatively impervious to age and to declining memory and executive function, suggesting that they might provide a particularly useful way for older adults to improve their memories. PMID:18608973

Older Adults in Cardiac Rehabilitation: A New Strategy for Enhancing Physical Function.

ERIC Educational Resources Information Center

Rejeski, W. Jack; Foy, Capri Gabrielle; Brawley, Lawrence R.; Brubaker, Peter H.; Focht, Brian C.; Norris, James L., III; Smith, Marci L.

2002-01-01

Contrasted the effect of a group-mediated cognitive- behavioral intervention (GMCB) versus traditional cardiac rehabilitation (CRP) upon changes in objective and self-reported physical function of older adults after 3 months of exercise therapy. Both groups improved significantly. Adults with lower function at the outset of the intervention…

The Role of Nutrition and Literacy on the Cognitive Functioning of Elderly Poor Individuals.

PubMed

Leist, Anja K; Novella, Rafael; Olivera, Javier

2018-06-08

Maintaining cognitive function is a prerequisite of living independently, which is a highly valued component in older individuals' wellbeing. In this paper we assess the role of early-life and later-life nutritional status, education and literacy on the cognitive functioning of older adults living in poverty in Peru. We exploit the baseline sample of the Peruvian non-contributory pension program Pension 65 and find that current nutritional status and literacy are strongly associated with cognitive functioning for poor older adults. In a context of rising popularity of non-contributory pension programs around the world, our study intends to contribute to the discussion of designing accompanying measures to the pension transfer, such as adult literacy programs and monitoring of adequate nutrition of older adults.

The Long Arm of Childhood in China: Early-Life Conditions and Cognitive Function Among Middle-Aged and Older Adults.

PubMed

Zhang, Zhenmei; Liu, Jinyu; Li, Lydia; Xu, Hongwei

2017-06-01

This study examined the association between childhood conditions and cognitive function among middle-aged and older adults in China. We analyzed data from the 2011 China Health and Retirement Longitudinal Study ( N = 11,868). Cognitive function was measured by word recall, a test of episodic memory. We examined the association between childhood conditions and cognitive function among the middle-aged (45-59 years) and the older (60 years and older) adults separately, using multilevel linear regressions. Indicators of childhood socioeconomic status (SES) and nutrition were significantly associated with memory performance among the middle-aged and the older adults in China. Adulthood SES, education in particular, accounted for some but not all the associations. The protective effect of childhood urban residence was stronger for middle-aged women than for middle-aged men. Childhood conditions are significantly associated with mid- to late-life cognitive function in China. The strengths of the associations may vary by gender and cohort.

Intentional weight loss in older adults: useful or wasting disease generating strategy?

PubMed

Darmon, Patrice

2013-05-01

Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy. Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss. In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.

The relationship between executive function and fine motor control in young and older adults.

PubMed

Corti, Emily J; Johnson, Andrew R; Riddle, Hayley; Gasson, Natalie; Kane, Robert; Loftus, Andrea M

2017-01-01

The present study examined the relationship between executive function (EF) and fine motor control in young and older healthy adults. Participants completed 3 measures of executive function; a spatial working memory (SWM) task, the Stockings of Cambridge task (planning), and the Intra-Dimensional Extra-Dimensional Set-Shift task (set-shifting). Fine motor control was assessed using 3 subtests of the Purdue Pegboard (unimanual, bimanual, sequencing). For the younger adults, there were no significant correlations between measures of EF and fine motor control. For the older adults, all EFs significantly correlated with all measures of fine motor control. Three separate regressions examined whether planning, SWM and set-shifting independently predicted unimanual, bimanual, and sequencing scores for the older adults. Planning was the primary predictor of performance on all three Purdue subtests. A multiple-groups mediation model examined whether planning predicted fine motor control scores independent of participants' age, suggesting that preservation of planning ability may support fine motor control in older adults. Planning remained a significant predictor of unimanual performance in the older age group, but not bimanual or sequencing performance. The findings are discussed in terms of compensation theory, whereby planning is a key compensatory resource for fine motor control in older adults. Copyright © 2016 Elsevier B.V. All rights reserved.

Muscle performance and physical function are associated with voluntary rate of neuromuscular activation in older adults

USDA-ARS?s Scientific Manuscript database

Participants were recruited to three experimental groups: middle-aged healthy adults (MH), older healthy adults (OH), and older adults with mobility limitations (OML). OH and OML were primarily differentiated by performance on the Short Physical Performance Battery (SPPB). Muscle performance (accele...

Effects of Noise Level and Cognitive Function on Speech Perception in Normal Elderly and Elderly with Amnestic Mild Cognitive Impairment.

PubMed

Lee, Soo Jung; Park, Kyung Won; Kim, Lee-Suk; Kim, HyangHee

2016-06-01

Along with auditory function, cognitive function contributes to speech perception in the presence of background noise. Older adults with cognitive impairment might, therefore, have more difficulty perceiving speech-in-noise than their peers who have normal cognitive function. We compared the effects of noise level and cognitive function on speech perception in patients with amnestic mild cognitive impairment (aMCI), cognitively normal older adults, and cognitively normal younger adults. We studied 14 patients with aMCI and 14 age-, education-, and hearing threshold-matched cognitively intact older adults as experimental groups, and 14 younger adults as a control group. We assessed speech perception with monosyllabic word and sentence recognition tests at four noise levels: quiet condition and signal-to-noise ratio +5 dB, 0 dB, and -5 dB. We also evaluated the aMCI group with a neuropsychological assessment. Controlling for hearing thresholds, we found that the aMCI group scored significantly lower than both the older adults and the younger adults only when the noise level was high (signal-to-noise ratio -5 dB). At signal-to-noise ratio -5 dB, both older groups had significantly lower scores than the younger adults on the sentence recognition test. The aMCI group's sentence recognition performance was related to their executive function scores. Our findings suggest that patients with aMCI have more problems communicating in noisy situations in daily life than do their cognitively healthy peers and that older listeners with more difficulties understanding speech in noise should be considered for testing of neuropsychological function as well as hearing.

Multitasking in older adults with type 2 diabetes: A cross-sectional analysis

PubMed Central

McDowd, Joan M.; Mahnken, Jonathan D.; Burns, Jeffrey M.; Sabus, Carla H.; Britton-Carpenter, Amanda J.; Utech, Nora B.; Kluding, Patricia M.

2017-01-01

Background and purpose Deficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability. Methods We performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART) and seated Pursuit Rotor Test (PRT). Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI). Results Participants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group. Discussion and conclusions Older adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately. PMID:29045492

Multitasking in older adults with type 2 diabetes: A cross-sectional analysis.

PubMed

Rucker, Jason L; McDowd, Joan M; Mahnken, Jonathan D; Burns, Jeffrey M; Sabus, Carla H; Britton-Carpenter, Amanda J; Utech, Nora B; Kluding, Patricia M

2017-01-01

Deficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability. We performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART) and seated Pursuit Rotor Test (PRT). Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI). Participants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group. Older adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately.

Fasting glucose and glucose tolerance as potential predictors of neurocognitive function among nondiabetic older adults.

PubMed

Sims Wright, Regina; Levy, Shellie-Anne T; Katzel, Leslie I; Rosenberger, William F; Manukyan, Zorayr; Whitfield, Keith E; Waldstein, Shari R

2015-01-01

Significant evidence has demonstrated that Type 2 diabetes mellitus and related precursors are associated with diminished neurocognitive function and risk of dementia among older adults. However, very little research has examined relations of glucose regulation to neurocognitive function among older adults free of these conditions. The primary aim of this investigation was to examine associations among fasting glucose, glucose tolerance, and neurocognitive function among nondiabetic older adults. The secondary aim was to examine age, gender, and education as potential effect modifiers. The study employed a cross-sectional, correlational study design. Participants were 172 older adults with a mean age of 64.43 years (SD = 13.09). The sample was 58% male and 87% White. Participants completed an oral glucose tolerance test as part of a larger study. Trained psychometricians administered neuropsychological tests that assessed performance in the domains of response inhibition, nonverbal memory, verbal memory, attention and working memory, visuoconstructional abilities, visuospatial abilities, psychomotor speed and executive function, and motor speed and manual dexterity. Linear multiple regressions were run to test study aims. No significant main effects of fasting glucose and 2-hour glucose emerged for performance on any neurocognitive test; however, significant interactions were present. Higher fasting glucose was associated with poorer short-term verbal memory performance among men, but unexpectedly better response inhibition and long-term verbal memory performance for participants over age 70. Higher 2-hour glucose values were associated with reduced divided attention performance among participants with less than a high school education. Mixed findings suggest that glucose levels may be both beneficial and deleterious to neurocognition among nondiabetic older adults. Additional studies with healthy older adults are needed to confirm this unexpected pattern of associations; however, findings have implications for the importance of maintaining healthy glucose levels in older adulthood.

Community covariates of malnutrition based mortality among older adults.

PubMed

Lee, Matthew R; Berthelot, Emily R

2010-05-01

The purpose of this study was to identify community level covariates of malnutrition-based mortality among older adults. A community level framework was delineated which explains rates of malnutrition-related mortality among older adults as a function of community levels of socioeconomic disadvantage, disability, and social isolation among members of this group. County level data on malnutrition mortality of people 65 years of age and older for the period 2000-2003 were drawn from the CDC WONDER system databases. County level measures of older adult socioeconomic disadvantage, disability, and social isolation were derived from the 2000 US Census of Population and Housing. Negative binomial regression models adjusting for the size of the population at risk, racial composition, urbanism, and region were estimated to assess the relationships among these indicators. Results from negative binomial regression analysis yielded the following: a standard deviation increase in socioeconomic/physical disadvantage was associated with a 12% increase in the rate of malnutrition mortality among older adults (p < 0.001), whereas a standard deviation increase in social isolation was associated with a 5% increase in malnutrition mortality among older adults (p < 0.05). Community patterns of malnutrition based mortality among older adults are partly a function of levels of socioeconomic and physical disadvantage and social isolation among older adults. 2010 Elsevier Inc. All rights reserved.

Age-related reorganization of functional networks for successful conflict resolution: a combined functional and structural MRI study.

PubMed

Schulte, Tilman; Müller-Oehring, Eva M; Chanraud, Sandra; Rosenbloom, Margaret J; Pfefferbaum, Adolf; Sullivan, Edith V

2011-11-01

Aging has readily observable effects on the ability to resolve conflict between competing stimulus attributes that are likely related to selective structural and functional brain changes. To identify age-related differences in neural circuits subserving conflict processing, we combined structural and functional MRI and a Stroop Match-to-Sample task involving perceptual cueing and repetition to modulate resources in healthy young and older adults. In our Stroop Match-to-Sample task, older adults handled conflict by activating a frontoparietal attention system more than young adults and engaged a visuomotor network more than young adults when processing repetitive conflict and when processing conflict following valid perceptual cueing. By contrast, young adults activated frontal regions more than older adults when processing conflict with perceptual cueing. These differential activation patterns were not correlated with regional gray matter volume despite smaller volumes in older than young adults. Given comparable performance in speed and accuracy of responding between both groups, these data suggest that successful aging is associated with functional reorganization of neural systems to accommodate functionally increasing task demands on perceptual and attentional operations. Copyright © 2009 Elsevier Inc. All rights reserved.

Spouses of older adults with late-life drinking problems: health, family, and social functioning.

PubMed

Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

2010-07-01

This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits.

Spouses of Older Adults With Late-Life Drinking Problems: Health, Family, and Social Functioning*

PubMed Central

Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

2010-01-01

Objective: This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Method: Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. Results: At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Conclusions: Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits. PMID:20553658

Age-Related Differences in Reorganization of Functional Connectivity for a Dual Task with Increasing Postural Destabilization

PubMed Central

Huang, Cheng-Ya; Lin, Linda L.; Hwang, Ing-Shiou

2017-01-01

The aged brain may not make good use of central resources, so dual task performance may be degraded. From the brain connectome perspective, this study investigated dual task deficits of older adults that lead to task failure of a suprapostural motor task with increasing postural destabilization. Twelve younger (mean age: 25.3 years) and 12 older (mean age: 65.8 years) adults executed a designated force-matching task from a level-surface or a stabilometer board. Force-matching error, stance sway, and event-related potential (ERP) in the preparatory period were measured. The force-matching accuracy and the size of postural sway of the older adults tended to be more vulnerable to stance configuration than that of the young adults, although both groups consistently showed greater attentional investment on the postural task as sway regularity increased in the stabilometer condition. In terms of the synchronization likelihood (SL) of the ERP, both younger and older adults had net increases in the strengths of the functional connectivity in the whole brain and in the fronto-sensorimotor network in the stabilometer condition. Also, the SL in the fronto-sensorimotor network of the older adults was greater than that of the young adults for both stance conditions. However, unlike the young adults, the older adults did not exhibit concurrent deactivation of the functional connectivity of the left temporal-parietal-occipital network for postural-suprapostural task with increasing postural load. In addition, the older adults potentiated functional connectivity of the right prefrontal area to cope with concurrent force-matching with increasing postural load. In conclusion, despite a universal negative effect on brain volume conduction, our preliminary results showed that the older adults were still capable of increasing allocation of neural sources, particularly via compensatory recruitment of the right prefrontal loop, for concurrent force-matching under the challenging postural condition. Nevertheless, dual-task performance of the older adults tended to be more vulnerable to postural load than that of the younger adults, in relation to inferior neural economy or a slow adaptation process to stance destabilization for scant dissociation of control hubs in the temporal-parietal-occipital cortex. PMID:28446874

Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana.

PubMed

Amegbor, Prince M; Kuuire, Vincent Z; Robertson, Hamish; Kuffuor, Oscar A

2018-04-12

The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status. Copyright © 2018 Elsevier B.V. All rights reserved.

Participation in productive activities and health outcomes among older adults in urban China.

PubMed

Li, Yawen; Xu, Ling; Chi, Iris; Guo, Ping

2014-10-01

This study examined whether participating in productive activities was associated with better health outcomes among older adults in urban China, including analysis of potential gender differences. Using a sample of 10,016 urban Chinese adults aged 60 years or older from the 2006 Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of self-rated health, functional health, and depression on productive activities (paid employment, helping with family, and volunteering), controlling for sociodemographic variables. Those who provided assistance to family members or volunteered had significantly lower levels of depression and better functional and self-rated health than their counterparts. Older adults with paid job, providing family assistance, or volunteering reported significantly lower levels of depression and better functional and self-rated health than those without those activities. However, only older men with paid employment reported significantly less depression, and the effect of family assistance on functional health also differed by gender. As research increasingly demonstrates the role of productive activities in maintaining health among older adults, our findings can help practitioners or policy makers strategically select or develop health programs to promote productive activities among older adults in urban China. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Factorial structure and psychometric properties of a brief version of the Reminiscence Functions Scale with Chinese older adults.

PubMed

Lou, Vivian W Q; Choy, Jacky C P

2014-05-01

The current study aims to examine the factorial structure and psychometric properties of a brief version of the Reminiscence Functions Scale (RFS), a 14-item assessment tool of reminiscence functions, with Chinese older adults. The scale, covering four reminiscence functions (boredom reduction, bitterness revival, problem solving, and identity) was translated from English into Chinese and administered to older adults (N=675). Confirmatory factor analysis and hierarchical confirmatory factor analysis were conducted to examine its factorial structure, and its psychometric properties and criterion validity were examined. Confirmatory factor analysis supports a second-order model comprising one second-order factor and four first-order factors of RFS. The Cronbach's alpha of the subscales ranged from 0.75 to 0.90. The brief RFS contains a second-order factorial structure. Its psychometric properties support it as a sound instrument for measuring reminiscence functions among Chinese older adults.

Functional neuroimaging of the Iowa Gambling Task in older adults.

PubMed

Halfmann, Kameko; Hedgcock, William; Bechara, Antoine; Denburg, Natalie L

2014-11-01

The neural systems most susceptible to age-related decline mirror the systems linked to decision making. Yet, the neural processes underlying decision-making disparities among older adults are not well understood. We sought to identify neural response patterns that distinguish 2 groups of older adults who exhibit divergent decision-making patterns. Participants were 31 healthy older adults (ages 59-88, 53% female), defined as advantageous or disadvantageous decision-makers based on Iowa Gambling Task (IGT) performance, who completed an alternate version of the IGT while undergoing functional MRI. The groups were indistinguishable on neuropsychological testing. We contrasted the BOLD signal between groups during 3 phases of the decision-making process: Prechoice (preselection), Prefeedback (postselection), and Feedback (receipt of gains/losses). We further examined whether BOLD signal varied as a function of age in each group. We observed greater activation among the IGT-Disadvantageous relative to -Advantageous older adults in the prefrontal cortex during the early phases of the decision-making process (Prechoice), and in posterior brain regions (e.g., the precuneus) during the later phases (Prefeedback and Feedback). We also found that with increasing age, IGT-Advantageous older adults showed increasing activation in the prefrontal cortex during all phases and increasing activation in the posterior cingulate during earlier phases of the decision process. By contrast, the IGT-Disadvantageous older adults exhibited a reduced or reversed trend. These functional differences may be a consequence of altered reward processing or differing compensatory strategies between IGT-Disadvantageous and -Advantageous older adults. This supports the notion that divergent neurobiological aging trajectories underlie disparate decision-making patterns. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Factors affecting quality of life of older adults with cancer in Korea.

PubMed

Yoon, Hyunsook; Kim, Yojin; Lim, Yeon Ok; Lee, Hyun Joo; Choi, Kyoungwon

2015-08-01

The main objective of the present study was to examine the quality of life of older adults with cancer and investigate factors associated with it. Some practical problems experienced by older adults with cancer are introduced, such as changes in work situation, availability of caregivers and financial difficulties relative to medical expenditures. A total of 339 patients aged 65 years or older who were treated for five major cancer diseases--colorectal, stomach, lung, liver or kidney cancer--participated in the present study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used to measure the quality of life. Performance status (physical functioning) was assigned according to the Eastern Cooperative Oncology Group classification. The Life Orientation Test-Revised was used to assess future expectations. The multiple linear regression analysis was used to identify predictors of the quality of life of older persons with cancer. The results showed that physical functioning and optimism were significant predictors of all four functions (physical, role, emotional and social function) and global quality of life of older adults with cancer. Nearly 60% experienced changes in work situation and had financial burden on medical costs. The findings suggest that efforts to assess physical functioning with more attention and enhance optimism should be emphasized in interventions for older adults with cancer. © 2014 Japan Geriatrics Society.

Symptom distress in older adults following cancer surgery.

PubMed

Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

2013-01-01

Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Dog ownership, functional ability, and walking in community-dwelling older adults.

PubMed

Gretebeck, Kimberlee A; Radius, Kaitlyn; Black, David R; Gretebeck, Randall J; Ziemba, Rosemary; Glickman, Lawrence T

2013-07-01

Regular walking improves overall health and functional ability of older adults, yet most are sedentary. Dog ownership/pet responsibility may increase walking in older adults. Goals of this study were to identify factors that influence older adult walking and compare physical activity, functional ability and psychosocial characteristics by dog ownership status. In this cross-sectional study, older adults (65-95 years of age, n = 1091) completed and returned questionnaires via postal mail. Measures included: Physical Activity Scale for the Elderly, Physical Functioning Questionnaire and Theory of Planned Behavior Questionnaire. Dog owner/dog walkers (n = 77) reported significantly (P < .05) more total walking, walking frequency, leisure and total physical activity and higher total functional ability than dog owner/nondog walkers (n = 83) and nondog owners (n = 931). Dog owner/nondog walkers reported lower intention and perceived behavioral control and a less positive attitude than dog owner/dog walkers (P < .05). Dog owner/ dog walkers were significantly different than the nondog walker groups in nearly every study variable. Many dog owners (48.1%) reported walking their dogs regularly and the dog owner/dog walkers participated in nearly 50% more total walking than the 2 nondog walking groups, suggesting that pet obligation may provide a purposeful activity that motivates some older dog owners to walk.

Residential Mobility and Cognitive Function Among Middle-Aged and Older Adults in China.

PubMed

Xu, Hanzhang; Dupre, Matthew E; Østbye, Truls; Vorderstrasse, Allison A; Wu, Bei

2018-01-01

To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China. We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China ( N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function. Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates. Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China.

Successful physiological aging and episodic memory: a brain stimulation study.

PubMed

Manenti, Rosa; Cotelli, Maria; Miniussi, Carlo

2011-01-01

Functional neuroimaging studies have shown that younger adults tend to asymmetrically recruit specific regions of an hemisphere in an episodic memory task (Hemispheric Encoding Retrieval Asymmetry-HERA model). In older adults, this hemispheric asymmetry is generally reduced as suggested by the Hemispheric Asymmetry Reduction for OLDer Adults-HAROLD-model. Recent works suggest that while low-performing older adults do not show this reduced asymmetry, high-performing older adults counteract age-related neural decline through a plastic reorganization of cerebral networks that results in reduced functional asymmetry. However, the issue of whether high- and low-performing older adults show different degrees of asymmetry and the relevance of this process for counteracting aging have not been clarified. We used transcranial magnetic stimulation (TMS) to transiently interfere with the function of the dorsolateral prefrontal cortex (DLPFC) during encoding or retrieval of associated and non-associated word pairs. A group of healthy older adults was studied during encoding and retrieval of word pairs. The subjects were divided in two subgroups according to their experimental performance (i.e., high- and low-performing). TMS effects on retrieval differed according to the subject's subgroup. In particular, the predominance of left vs. right DLPFC effects during encoding, predicted by the HERA model, was observed only in low-performing older adults, while the asymmetry reduction predicted by the HAROLD model was selectively shown for the high-performing group. The present data confirm that older adults with higher memory performance show less prefrontal asymmetry as an efficient strategy to counteract age-related memory decline. Copyright © 2010 Elsevier B.V. All rights reserved.

Fine particulate matter air pollution and cognitive function among older US adults.

PubMed

Ailshire, Jennifer A; Crimmins, Eileen M

2014-08-15

Existing research on the adverse health effects of exposure to pollution has devoted relatively little attention to the potential impact of ambient air pollution on cognitive function in older adults. We examined the cross-sectional association between residential concentrations of particulate matter with aerodynamic diameter of 2.5 μm or less (PM2.5) and cognitive function in older adults. Using hierarchical linear modeling, we analyzed data from the 2004 Health and Retirement Study, a large, nationally representative sample of US adults aged 50 years or older. We linked participant data with 2000 US Census tract data and 2004 census tract-level annual average PM2.5 concentrations. Older adults living in areas with higher PM2.5 concentrations had worse cognitive function (β = -0.26, 95% confidence interval: -0.47, -0.05) even after adjustment for community- and individual-level social and economic characteristics. Results suggest that the association is strongest for the episodic memory component of cognitive function. This study adds to a growing body of research highlighting the importance of air pollution to cognitive function in older adults. Improving air quality in large metropolitan areas, where much of the aging US population resides, may be an important mechanism for reducing age-related cognitive decline. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Loss of olfactory function and nutritional status in vital older adults and geriatric patients.

PubMed

Toussaint, Nicole; de Roon, Margot; van Campen, Jos P C M; Kremer, Stefanie; Boesveldt, Sanne

2015-03-01

The aim of this cross-sectional study was to assess the association of olfactory function and nutritional status in vital older adults and geriatric patients. Three hundred forty-five vital (mean age 67.1 years) and 138 geriatric older adults (mean age 80.9 years) were included. Nutritional status was assessed using the mini nutritional assessment-short form. The Sniffin' Sticks was used to measure olfactory function. Eleven percentage of the vital older adults were at risk of malnutrition, whereas 60% of the geriatric participants were malnourished or at risk. Only 2% of the vital older adults were anosmic, compared with 46% of the geriatric participants. Linear regression demonstrated a significant association (P = 0.015) between olfactory function and nutritional status in the geriatric subjects. However, this association became insignificant after adjustment for confounders. Both crude and adjusted analysis in the vital older adults did not show a significant association. The results indicate that, in both groups of elderly, there is no direct relation between olfactory function and nutritional status. We suggest that a decline in olfactory function may still be considered as one of the risk-factors for malnutrition in geriatric patients-once co-occurring with other mental and/or physical problems that are more likely to occur in those patients experience. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Older-Adult Playfulness: An Innovative Construct and Measurement for Healthy Aging Research

ERIC Educational Resources Information Center

Yarnal, Careen; Qian, Xinyi

2011-01-01

Few studies of adult playfulness exist, but limited research on older adults and playfulness suggests that playfulness in later life improves cognitive, emotional, social, and psychological functioning and healthy aging overall. Older adults represent a rapidly growing segment of the U.S. population, underscoring the need to understand the aging…

Exploration of functional food consumption in older adults in relation to food matrices, bioactive ingredients, and health.

PubMed

Vella, Meagan N; Stratton, Laura M; Sheeshka, Judy; Duncan, Alison M

2013-01-01

The functional food industry is expanding, yet research into consumer perceptions of functional foods is limited. Older adults could benefit from functional foods due to age-related food and health issues. This research gathered information about functional foods from community-dwelling older adults (n = 200) who completed a researcher-administered questionnaire about consumption, food matrices, bioactive ingredients, and health areas addressed through functional foods. Overall prevalence of functional food consumption was found to be 93.0%. Commonly consumed foods included yogurt with probiotics (56.0%), eggs with omega-3 fatty acids (37.0%), and bread with fiber (35.5%). Functional food matrices primarily consumed were yogurt (51.5%), bread (44.0%), and cereal (40.0%). The primary functional food bioactive consumed was dietary fiber (79.5%). Most participants (86.2%) indicated that they consume functional foods to improve health, and the major areas specified were osteoporosis/bone health (67.5%), heart disease (61.0%), and arthritis (55.0%). These results inform health professionals regarding the potential of functional foods to support health among older adults.

Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity.

PubMed

Liu, Chiung-Ju; Marie, Deana; Fredrick, Aaron; Bertram, Jessica; Utley, Kristen; Fess, Elaine Ewing

2017-08-01

Hand function is critical for independence in activities of daily living for older adults. The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults. Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively. Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = -.25, p < .01) and manual dexterous coordination (β = -.52, p < .01) performed better on the time-based hand function test. In comparison, older adults with better grip strength (β = .40, p < .01), arm curl strength (β = .23, p < .05), and manual dexterous coordination (β = .23, p < .05) were associated with better self-report of upper extremity function. The relationship between grip strength and hand function may be test-specific. Grip strength becomes a significant factor when the test requires grip strength to successfully complete the test tasks. Arm curl strength independently contributed to hand function in both time-based and self-report assessments, indicating that strength of extrinsic muscles of the hand are essential for hand function.

An observational study identifying obese subgroups among older adults at increased risk of mobility disability: do perceptions of the neighborhood environment matter

USDA-ARS?s Scientific Manuscript database

BACKGROUND: Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitation...

Visuotactile interaction even in far sagittal space in older adults with decreased gait and balance functions.

PubMed

Teramoto, Wataru; Honda, Keito; Furuta, Kento; Sekiyama, Kaoru

2017-08-01

Spatial proximity of signals from different sensory modalities is known to be a crucial factor in facilitating efficient multisensory processing in young adults. However, recent studies have demonstrated that older adults exhibit strong visuotactile interactions even when the visual stimuli were presented in a spatially disparate position from a tactile stimulus. This suggests that visuotactile peripersonal space differs between older and younger adults. In the present study, we investigated to what extent peripersonal space expands in the sagittal direction and whether this expansion was linked to the decline in sensorimotor functions in older adults. Vibrotactile stimuli were delivered either to the left or right index finger, while visual stimuli were presented at a distance of 5 cm (near), 37.5 cm (middle), or 70 cm (far) from each finger. The participants had to respond rapidly to a randomized sequence of unimodal (visual or tactile) and simultaneous visuotactile targets (i.e., a redundant target paradigm). Sensorimotor functions were independently assessed by the Timed Up and Go (TUG) and postural stability tests. Results showed that reaction times to the visuotactile bimodal stimuli were significantly faster than those to the unimodal stimuli, irrespective of age group [younger adults: 22.0 ± 0.6 years, older adults: 75.0 ± 3.3 years (mean ± SD)] and target distance. Of importance, a race model analysis revealed that the co-activation model (i.e., visuotactile multisensory integrative process) is supported in the far condition especially for older adults with relatively poor performance on the TUG or postural stability tests. These results suggest that aging can change visuotactile peripersonal space and that it may be closely linked to declines in sensorimotor functions related to gait and balance in older adults.

Chemotherapy - Induced Alopecia and Symptom Distress in Younger and Older Women with Breast Cancer: Intergroup Differences and Impact on Functional Status

DTIC Science & Technology

2006-08-01

Gerontologist). Physical activity (PA) plays a major role in the health and functioning of older adults , yet few older adults engage in recommended...receiving 4-8 cycles of adjuvant BC chemotherapy. Older women trended towards greater declines in functional status from baseline to cycle 4. Age ...of Health (PI: Kathryn Schmitz, PhD), as well as two submitted foundation grants. 15. SUBJECT TERMS Breast Cancer, Aging , Chemotherapy, Symptom

Quality of life assessment software for computer-inexperienced older adults: multimedia utility elicitation for activities of daily living.

PubMed Central

Goldstein, M. K.; Miller, D. E.; Davies, S.; Garber, A. M.

2002-01-01

Functional status as measured by dependencies in the Activities of Daily Living (ADLs) is an important indicator of overall health for older adults. Methodologies for outcomes-based medical-decision-making for public policy, such as decision modeling and cost-effectiveness analysis, require utilities for outcome health states. Utilities have been reported for many disease states, but have not been indexed by functional status, which is a strong predictor of outcome in geriatrics. We describe here a utility elicitation program developed specifically for use with computer-inexperienced older adults: Functional Limitation And Independence Rating (FLAIR1). FLAIR1 design features address common physical problems of the aged and computer attitudes of inexperienced users that could impede computer acceptance. We interviewed 400 adults ages 65 years and older with FLAIR1. In exit interviews with 154 respondents, 118 (76%) found FLAIR1 easy to use. Design features in FLAIR1 can be applied to other software for older adults PMID:12463834

Does Older Adults' Cognitive Function Disrupt the Malleability of Their Attitudes toward Outgroup Members?: An fMRI Investigation.

PubMed

Krendl, Anne C; Kensinger, Elizabeth A

2016-01-01

In the current study we examine how individual differences in older adults' global cognitive function impacts the extent to which their attitudes toward stigmatized individuals are malleable. Because prior research has elucidated the neural processes that are involved in evaluating stigmatized individuals who are responsible or not responsible for their condition, a cognitive neuroscience approach may be well-suited to answer this question. In the current study, 36 older and 17 young adults underwent functional magnetic resonance imaging while evaluating images of homeless people who were described as being responsible or not responsible for their condition. They also indicated how much pity they felt for each of the individuals in order to determine the extent to which their attitudes were malleable (e.g., more pity for not-responsible as compared to responsible individuals). Participants' cognitive function and baseline measure of their attitudes toward stigmatized individuals (including homeless individuals) were assessed. Results revealed that although older adults' attitudes were malleable, the extent to which this was true varied due to individual differences in their global cognitive function. Specifically, the difference in the magnitude of older adults' self-reported pity for not-responsible as compared to responsible homeless individuals was predicted by their global cognitive function. Moreover, the difference in pity that older adults expressed toward not-responsible as compared to responsible homeless individuals was related to activity in the left insula and the anterior cingulate cortex (regions implicated in empathy). These results suggest that attitude malleability is affected by individual differences in global cognitive function.

Characteristics of walking, activity, fear of falling, and falls in community-dwelling older adults by residence.

PubMed

Wert, David M; Talkowski, Jaime B; Brach, Jennifer; VanSwearingen, Jessie

2010-01-01

Research focusing on community-dwelling older adults includes adults living in senior living residences (SLR) and independent community residences (ICR). Walking, physical activity, fear of falling, and fall history may differ on the basis of residence. We describe characteristics of walking, physical activity, fear of falling, and fall history between community-dwelling older adults by residence. Participants of this secondary analysis included community-dwelling older adults from independent living units within a senior life care community (SLR) and older adults recruited from the Pittsburgh community (ICR). Demographic information and physical (gait speed and physical activity), psychosocial (fear of falling and confidence in walking), and fall history measures were collected. Adults living in SLR compared with those in ICR were older, were more likely to live alone, and had greater disease burden. Compared with individuals in ICR, individuals in SLR reported less fear of falling (Survey of Activity and Fear of Falling in the Elderly tool fear results 0.24 and 0.50, respectively). Fewer older adults in SLR compared with those in ICR reported falling in the past year. Older adults living in SLR compared with those in ICR had similar physical function but differed in report of fear of falling and fall history. Recognizing the possible differences in psychosocial function by place of residence is important for health care providers and researchers conducting interventions and studies for community-dwelling older adults.

Memory for general and specific value information in younger and older adults: measuring the limits of strategic control.

PubMed

Castel, Alan D; Farb, Norman A S; Craik, Fergus I M

2007-06-01

The ability to selectively remember important information is a critical function of memory. Although previous research has suggested that older adults are impaired in a variety of episodic memory tasks, recent work has demonstrated that older adults can selectively remember high-value information. In the present research, we examined how younger and older adults selectively remembered words with various assigned numeric point values, to see whether younger adults could remember more specific value information than could older adults. Both groups were equally good at recalling point values when recalling the range of high-value words, but younger adults outperformed older adults when recalling specific values. Although older adults were more likely to recognize negative value words, both groups exhibited control by not recalling negative value information. The findings suggest that although both groups retain high-value information, older adults rely more on gist-based encoding and retrieval operations, whereas younger adults are able to remember specific numeric value information.

Age-Related Differences in Multiple Task Monitoring

PubMed Central

Todorov, Ivo; Del Missier, Fabio; Mäntylä, Timo

2014-01-01

Coordinating multiple tasks with narrow deadlines is particularly challenging for older adults because of age related decline in cognitive control functions. We tested the hypothesis that multiple task performance reflects age- and gender-related differences in executive functioning and spatial ability. Young and older adults completed a multitasking session with four monitoring tasks as well as separate tasks measuring executive functioning and spatial ability. For both age groups, men exceeded women in multitasking, measured as monitoring accuracy. Individual differences in executive functioning and spatial ability were independent predictors of young adults' monitoring accuracy, but only spatial ability was related to sex differences. For older adults, age and executive functioning, but not spatial ability, predicted multitasking performance. These results suggest that executive functions contribute to multiple task performance across the adult life span and that reliance on spatial skills for coordinating deadlines is modulated by age. PMID:25215609

Age-related differences in multiple task monitoring.

PubMed

Todorov, Ivo; Del Missier, Fabio; Mäntylä, Timo

2014-01-01

Coordinating multiple tasks with narrow deadlines is particularly challenging for older adults because of age related decline in cognitive control functions. We tested the hypothesis that multiple task performance reflects age- and gender-related differences in executive functioning and spatial ability. Young and older adults completed a multitasking session with four monitoring tasks as well as separate tasks measuring executive functioning and spatial ability. For both age groups, men exceeded women in multitasking, measured as monitoring accuracy. Individual differences in executive functioning and spatial ability were independent predictors of young adults' monitoring accuracy, but only spatial ability was related to sex differences. For older adults, age and executive functioning, but not spatial ability, predicted multitasking performance. These results suggest that executive functions contribute to multiple task performance across the adult life span and that reliance on spatial skills for coordinating deadlines is modulated by age.

Performance on a functional motor task is enhanced by sleep in middle-aged and older adults.

PubMed

Al-Sharman, Alham; Siengsukon, Catherine F

2014-07-01

Although sleep has been shown to enhance motor skill learning, it remains unclear whether sleep enhances learning of a functional motor task in middle-aged and older individuals. The purpose of this study was to examine whether sleep enhances motor learning of a functional motor task in middle-aged and older adults. Twenty middle-aged and 20 older individuals were randomly assigned to either the sleep condition or the no-sleep condition. Participants in the sleep condition practiced a novel walking task in the evening, and returned the following morning for retesting. Participants in the no-sleep condition practiced the walking task in the morning and returned the same day in the evening for a retest. Outcome measures included time around the walking path and spatiotemporal gait parameters. Only the middle-aged and older adults in the sleep condition demonstrated significant off-line improvement in performance, measured as a decline in time to walk around the novel path and improvement in spatiotemporal gait parameters. The middle-aged and older adults in the no-sleep condition failed to demonstrate off-line improvements in performance of this functional task. This is the first study to provide evidence that sleep facilitates learning a clinically relevant functional motor task in middle-aged and older adults. Because many neurologic conditions occur in the middle-aged and older adults and sleep issues are very prevalent in many neurologic conditions, it is imperative that physical therapists consider sleep as a factor that may impact motor learning and recovery in these individuals. (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A73) for more insights from the authors.

The relationship between nature-based tourism and autonomic nervous system function among older adults.

PubMed

Chang, Liang-Chih

2014-01-01

Nature-based tourism has recently become a topic of interest in health research. This study was aimed at examining relationships among nature-based tourism, stress, and the function of the autonomic nervous system (ANS). Three hundred and twenty-two older adults living in Taichung City, Taiwan, were selected as participants. Data were collected by a face-to-face survey that included measures of the frequency of participation in domestic and international nature-based tourism and the stress and ANS function of these participants. The data were analyzed using a path analysis. The results demonstrated that the frequency of participation in domestic nature-based tourism directly contributed to ANS function and that it also indirectly contributed to ANS function through stress reduction. Domestic nature-based tourism can directly and indirectly contribute to ANS function among older adults. Increasing the frequency of participation in domestic nature-based tourism should be considered a critical element of health programs for older adults. © 2014 International Society of Travel Medicine.

Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.

PubMed

Ihira, Hikaru; Furuna, Taketo; Mizumoto, Atsushi; Makino, Keitaro; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Shimada, Hiroyuki; Makizako, Hyuma

2015-01-01

The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p < 0.01). We also found that older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.

Comparing different types of source memory attributes in dementia of Alzheimer's type.

PubMed

Mammarella, Nicola; Fairfield, Beth; Di Domenico, Alberto

2012-04-01

Source monitoring (SM) refers to our ability to discriminate between memories from different sources. Twenty healthy high-cognitive functioning older adults, 20 healthy low-cognitive functioning older adults, and 20 older adults with dementia of Alzheimer's type (DAT) were asked to perform a series of SM tasks that varied in terms of the to-be-remembered source attribute (perceptual, spatial, temporal, semantic, social, and affective details). Results indicated that older DAT adults had greater difficulty in SM compared to the healthy control groups, especially with spatial and semantic details. Data are discussed in terms of the SM framework and suggest that poor memory for some types of source information may be considered as an important indicator of clinical memory function when assessing for the presence and severity of dementia.

Biopsychosocial Characteristics of Community-dwelling Older Adults with Limited Ability to Walk ¼ Mile

PubMed Central

Hardy, Susan E.; McGurl, David J.; Studenski, Stephanie A.; Degenholtz, Howard B.

2010-01-01

Objectives To establish nationally representative estimates of the prevalence of self-reported difficulty and inability to walk ¼ mile among older adults and to identify the characteristics independently associated with difficulty or inability to walk ¼ mile. Design Cross-sectional analysis of data from the 2003 Cost and Use Medicare Current Beneficiary Survey. Setting Community. Participants 9563 community-dwelling Medicare beneficiaries aged 65 years or older, representing an estimated total population of 34.2 million older adults. Measurements Self-reported ability to walk ¼ mile, sociodemographics, chronic conditions, body mass index, smoking, and functional status. Results In 2003, an estimated 9.5 million aged Medicare beneficiaries had difficulty walking ¼ mile and 5.9 million were unable. Among the 20.2 million older adults with no difficulty in basic or instrumental activities of daily living (ADL), an estimated 4.3 million (21%) had limited ability to walk ¼ mile. Having difficulty or being unable to walk ¼ mile was independently associated with older age, female sex, non-Hispanic ethnicity, lower educational level, Medicaid entitlement, most chronic medical conditions, current smoking, and being overweight or obese. Conclusion Almost half of older adults, and 20% of those reporting no ADL limitations, report limited ability to walk ¼ mile. Among functionally independent older adults, reported ability to walk ¼ mile can identify vulnerable older adults with greater medical problems and fewer resources, and may be a valuable clinical marker in planning their care. Future work is needed to determine the association between ¼ mile walk ability and subsequent functional decline and healthcare utilization. PMID:20210817

Age differences in default and reward networks during processing of personally relevant information.

PubMed

Grady, Cheryl L; Grigg, Omer; Ng, Charisa

2012-06-01

We recently found activity in default mode and reward-related regions during self-relevant tasks in young adults. Here we examine the effect of aging on engagement of the default network (DN) and reward network (RN) during these tasks. Previous studies have shown reduced engagement of the DN and reward areas in older adults, but the influence of age on these circuits during self-relevant tasks has not been examined. The tasks involved judging personality traits about one's self or a well known other person. There were no age differences in reaction time on the tasks but older adults had more positive Self and Other judgments, whereas younger adults had more negative judgments. Both groups had increased DN and RN activity during the self-relevant tasks, relative to non-self tasks, but this increase was reduced in older compared to young adults. Functional connectivity of both networks during the tasks was weaker in the older relative to younger adults. Intrinsic functional connectivity, measured at rest, also was weaker in the older adults in the DN, but not in the RN. These results suggest that, in younger adults, the processing of personally relevant information involves robust activation of and functional connectivity within these two networks, in line with current models that emphasize strong links between the self and reward. The finding that older adults had more positive judgments, but weaker engagement and less consistent functional connectivity in these networks, suggests potential brain mechanisms for the "positivity bias" with aging. Copyright © 2012 Elsevier Ltd. All rights reserved.

Age differences in default and reward networks during processing of personally relevant information

PubMed Central

Grady, Cheryl L.; Grigg, Omer; Ng, Charisa

2013-01-01

We recently found activity in default mode and reward-related regions during self-relevant tasks in young adults. Here we examine the effect of aging on engagement of the default network (DN) and reward network (RN) during these tasks. Previous studies have shown reduced engagement of the DN and reward areas in older adults, but the influence of age on these circuits during self-relevant tasks has not been examined. The tasks involved judging personality traits about one’s self or a well known other person. There were no age differences in reaction time on the tasks but older adults had more positive Self and Other judgments, whereas younger adults had more negative judgments. Both groups had increased DN and RN activity during the self-relevant tasks, relative to non-self tasks, but this increase was reduced in older compared to young adults. Functional connectivity of both networks during the tasks was weaker in the older relative to younger adults. Intrinsic functional connectivity, measured at rest, also was weaker in the older adults in the DN, but not in the RN. These results suggest that, in younger adults, the processing of personally relevant information involves robust activation of and functional connectivity within these two networks, in line with current models that emphasize strong links between the self and reward. The finding that older adults had more positive judgments, but weaker engagement and less consistent functional connectivity in these networks, suggests potential brain mechanisms for the “positivity bias” with aging. PMID:22484520

Early-life conditions and older adult health in low- and middle-income countries: a review

PubMed Central

McEniry, M.

2012-01-01

Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health. PMID:23316272

THE EFFECT OF PLAUSIBILITY ON SENTENCE COMPREHENSION AMONG OLDER ADULTS AND ITS RELATION TO COGNITIVE FUNCTIONS

PubMed Central

Yoon, Jungmee; Campanelli, Luca; Goral, Mira; Marton, Klara; Eichorn, Naomi; Obler, Loraine K.

2016-01-01

Background/Study Context Older adults show age-related decline in complex-sentence comprehension. This has been attributed to a decrease in cognitive abilities that may support language processing, such as working memory (e.g., Caplan, DeDe, Waters, & Michaud, 2011,Psychology and Aging, 26, 439–450). The authors examined whether older adults have difficulty comprehending semantically implausible sentences and whether specific executive functions contribute to their comprehension performance. Methods Forty-two younger adults (aged 18–35) and 42 older adults (aged 55–75) were tested on two experimental tasks: a multiple negative comprehension task and an information processing battery. Results Both groups, older and younger adults, showed poorer performance for implausible sentences than for plausible sentences; however, no interaction was found between plausibility and age group. A regression analysis revealed that inhibition efficiency, as measured by a task that required resistance to proactive interference, predicted comprehension of implausible sentences in older adults only. Consistent with the compensation hypothesis, the older adults with better inhibition skills showed better comprehension than those with poor inhibition skills. Conclusion The findings suggest that semantic implausibility, along with syntactic complexity, increases linguistic and cognitive processing loads on auditory sentence comprehension. Moreover, the contribution of inhibitory control to the processing of semantic plausibility, particularly among older adults, suggests that the relationship between cognitive ability and language comprehension is strongly influenced by age. PMID:25978447

The effect of plausibility on sentence comprehension among older adults and its relation to cognitive functions.

PubMed

Yoon, Jungmee; Campanelli, Luca; Goral, Mira; Marton, Klara; Eichorn, Naomi; Obler, Loraine K

2015-01-01

BACKGROUND/STUDY CONTEXT: Older adults show age-related decline in complex-sentence comprehension. This has been attributed to a decrease in cognitive abilities that may support language processing, such as working memory (e.g., Caplan, DeDe, Waters, & Michaud, 2011,Psychology and Aging, 26, 439-450). The authors examined whether older adults have difficulty comprehending semantically implausible sentences and whether specific executive functions contribute to their comprehension performance. Forty-two younger adults (aged 18-35) and 42 older adults (aged 55-75) were tested on two experimental tasks: a multiple negative comprehension task and an information processing battery. Both groups, older and younger adults, showed poorer performance for implausible sentences than for plausible sentences; however, no interaction was found between plausibility and age group. A regression analysis revealed that inhibition efficiency, as measured by a task that required resistance to proactive interference, predicted comprehension of implausible sentences in older adults only. Consistent with the compensation hypothesis, the older adults with better inhibition skills showed better comprehension than those with poor inhibition skills. The findings suggest that semantic implausibility, along with syntactic complexity, increases linguistic and cognitive processing loads on auditory sentence comprehension. Moreover, the contribution of inhibitory control to the processing of semantic plausibility, particularly among older adults, suggests that the relationship between cognitive ability and language comprehension is strongly influenced by age.

Functional aging impairs the role of feedback in motor learning.

PubMed

Liu, Yu; Cao, Chunmei; Yan, Jin H

2013-10-01

Optimal motor skill acquisition frequently requires augmented feedback or knowledge of results (KR). However, the effect of functional declines on the benefits of KR remains to be determined. The objective of this research was to examine how cognitive and motor deficits of older adults influence the use of KR for motor skill learning. A total of 57 older adults (mean 73.1 years; SD 4.2) received both cognitive and eye-hand coordination assessments, whereas 55 young controls (mean 25.8 years; SD 3.8) took only the eye-hand coordination test. All young and older participants learned a time-constrained arm movement through KR in three pre-KR and post-KR intervals. In the subsequent no-KR skill retests, absolute and variable time errors were not significantly reduced for the older learners who had KR during skill practice, especially for those with cognitive and motor dysfunctions. The finding suggests that KR results in no measureable improvement for older adults with cognitive and motor functional deficiencies. More importantly, for the older adults, longer post-KR intervals showed greater detrimental effects on feedback-based motor learning than shorter pauses after KR delivery. The findings support the hypothesis about the effects of cognitive and motor deficits on KR in motor skill learning of older adults. The dynamics of cognitive and motor aging, external feedback and internal control mechanisms collectively explain the deterioration in the sensory-motor learning of older adults. The theoretical implications and practical relevance of functional aging for motor skill learning are discussed. © 2013 Japan Geriatrics Society.

Folic Acid Supplements: Can They Slow Cognitive Decline?

MedlinePlus

... ve heard that folic acid supplements can improve cognitive function in older adults. Could those with Alzheimer's disease also benefit ... no conclusive evidence that folic acid supplements improve cognitive function in older adults or in people with ...

Spontaneous strategy use protects against visual working memory deficits in older adults infected with HIV.

PubMed

Woods, Steven Paul; Weber, Erica; Cameron, Marizela V; Dawson, Matthew S; Delano-Wood, Lisa; Bondi, Mark W; Grant, Igor

2010-12-01

Recent studies suggest that older human immunodeficiency virus (HIV)-infected adults are at particular risk for HIV-associated neurocognitive disorders (HAND), including dementia. Deficits in attention/working memory are posited to play a central role in the development of HAND among older adults. The aim of the present study was to examine the possible protective benefits of spontaneous strategy use during a visual working memory task in 46 older and 42 younger adults infected with HIV. Results revealed a significant interaction between age and strategy use, with older adults who used a meta-cognitive strategy demonstrating superior working memory performance versus non-strategy users. This effect was not observed in the younger HIV-infected sample and was not better explained by possible confounding factors, such as education, comorbid medical conditions, or HIV disease severity. Within the older group, strategy use was associated with better executive functions and higher estimated verbal intelligence. Findings from this study suggest that working memory declines in older HIV-infected adults are moderated by the use of higher-level mnemonic strategies and may inform cognitive neurorehabilitation efforts to improve cognitive and everyday functioning outcomes in older persons living with HIV infection.

Physical function assessment in a community-dwelling population of U.S. Chinese older adults.

PubMed

Dong, XinQi; Chang, E-Shien; Simon, Melissa A

2014-11-01

This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults' functional status. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Biopsychosocial characteristics of community-dwelling older adults with limited ability to walk one-quarter of a mile.

PubMed

Hardy, Susan E; McGurl, David J; Studenski, Stephanie A; Degenholtz, Howard B

2010-03-01

To establish nationally representative estimates of the prevalence of self-reported difficulty and inability of older adults to walk one-quarter of a mile and to identify the characteristics independently associated with difficulty or inability to walk one-quarter of a mile. Cross-sectional analysis of data from the 2003 Cost and Use Medicare Current Beneficiary Survey. Community. Nine thousand five hundred sixty-three community-dwelling Medicare beneficiaries aged 65 and older, representing an estimated total population of 34.2 million older adults. Self-reported ability to walk one-quarter of a mile, sociodemographics, chronic conditions, body mass index, smoking, functional status. In 2003, an estimated 9.5 million older Medicare beneficiaries had difficulty walking one-quarter of a mile, and 5.9 million were unable to do so. Of the 20.2 million older adults with no difficulty in activities of daily living (ADLs) or instrumental activities of daily living (IADLs), an estimated 4.3 million (21%) had limited ability to walk one-quarter of a mile. Having difficulty or being unable to walk one-quarter of a mile was independently associated with older age, female sex, non-Hispanic ethnicity, lower educational level, Medicaid entitlement, most chronic medical conditions, current smoking, and being overweight or obese. Almost half of older adults and 20% of those reporting no ADL or IADL limitations report limited ability to walk one-quarter of a mile. For functionally independent older adults, reported ability to walk one-quarter of a mile can identify vulnerable older adults with greater medical problems and fewer resources and may be a valuable clinical marker in planning their care. Future work is needed to determine the association between ability to walk one-quarter of a mile walk and subsequent functional decline and healthcare use.

Do Older Adults Need Sleep? A Review of Neuroimaging, Sleep, and Aging Studies.

PubMed

Scullin, Michael K

2017-09-01

Sleep habits, sleep physiology, and sleep disorders change with increasing age. However, there is a longstanding debate regarding whether older adults need sleep to maintain health and daily functioning (reduced-sleep-need view). An alternative possibility is that all older adults need sleep, but that many older adults have lost the ability to obtain restorative sleep (reduced-sleep-ability view). Prior research using behavioral and polysomnography outcomes has not definitively disentangled the reduced-sleep-need and reduced-sleep-ability views. Therefore, this review examines the neuroimaging literature to determine whether age-related changes in sleep cause-or are caused by-age-related changes in brain structure, function, and pathology. In middle-aged and older adults, poorer sleep quality, greater nighttime hypoxia, and shorter sleep duration related to cortical thinning in frontal regions implicated in slow wave generation, in frontoparietal networks implicated in cognitive control, and in hippocampal regions implicated in memory consolidation. Furthermore, poor sleep quality was associated with higher amyloid burden and decreased connectivity in the default mode network, a network that is disrupted in the pathway to Alzheimer's disease. All adults need sleep, but cortical thinning and amyloidal deposition with advancing age may weaken the brain's ability to produce restorative sleep. Therefore, sleep in older adults may not always support identical functions for physical, mental, and cognitive health as in young adults.

Older Adults' Motivation to Learn in Higher Education

ERIC Educational Resources Information Center

Lin, Yi-Yin

2011-01-01

A limited amount of literature has discussed older adults in formal education, especially their motivations to learn in higher education. This study aims to understand older adults' learning in the context of higher education. Specifically, this study argues that higher education can function as a stimulating learning environment that helps older…

Objectively-measured outdoor time and physical and psychological function among older adults.

PubMed

Harada, Kazuhiro; Lee, Sangyoon; Lee, Sungchul; Bae, Seongryu; Harada, Kenji; Suzuki, Takao; Shimada, Hiroyuki

2017-10-01

Objective measurements of outdoor time are essential to establishing evidence about the health benefits of going outdoors among older adults. To better understanding the health benefits of going outdoors, clarification of potential mediators to connect going outdoors with health benefits is necessary. The present study aimed to investigate associations of objectively-measured outdoor time with older adults' physical and psychological function, and examine the mediating role of physical activity on these associations. Baseline data from a randomized control trial of physical activity among older adults with global cognitive impairment was used. Data from 192 participants were analyzed. Measures included steps-per-day, objectively-measured outdoor time per day using global positioning systems, physical function (cardiorespiratory fitness, lower-extremity strength), psychological function (depression, well-being) and basic factors. Path analysis showed that outdoor time was significantly associated with steps-per-day (path coefficient = 0.23) and depression (path coefficient = -0.16). Outdoor time was not directly associated with cardiorespiratory fitness, lower-extremity strength and well-being. However, steps-per-day was associated with cardiorespiratory fitness (path coefficient = 0.18), lower-extremity strength (path coefficient = -0.22) and well-being (path coefficient = 0.14). We found that objectively-measured outdoor time was indirectly associated with physical function, and both directly and indirectly with psychological function through physical activity among older adults. This finding indicates that going outdoors influences older adults' health outcomes, and is mainly mediated by physical activity. Geriatr Gerontol Int 2017; 17: 1455-1462. © 2016 Japan Geriatrics Society.

Stakeholders' Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study.

PubMed

Sefcik, Justine S; Johnson, Michelle J; Yim, Mark; Lau, Tessa; Vivio, Nicholas; Mucchiani, Caio; Cacchione, Pamela Z

2018-02-01

Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults' needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers ( n = 6), one with interdisciplinary clinicians ( n = 8), and one with older adults residing in SAL ( n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the "use it or lose it" attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults.

Fine particulate matter air pollution and cognitive function among U.S. older adults.

PubMed

Ailshire, Jennifer A; Clarke, Philippa

2015-03-01

There is growing interest in understanding how exposures in the residential environment relate to cognitive function in older adults. The goal of this study is to determine if neighborhood-level exposure to fine particulate matter air pollution (PM2.5) is associated with cognitive function in a diverse, national sample of older U.S. adults. We use cross-sectional data on non-Hispanic black and white men and women aged 55 and older from the 2001/2002 Americans' Changing Lives Study (N = 780). EPA air monitoring data were linked to respondents using census tract identifiers. Cognitive function was assessed with tests of working memory and orientation. Negative binomial regression models were used to examine the association between PM2.5 and the number of errors on the cognitive assessment. Older adults living in areas with high concentrations of PM2.5 had an error rate 1.5 times greater than those exposed to lower concentrations, net of individual and neighborhood-level demographic and socioeconomic characteristics. This study adds to a growing body of research demonstrating the importance of air pollution to cognitive function in older adults. Improvements to air quality may be an important mechanism for reducing age-related cognitive decline. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults.

PubMed

Tait, Jamie L; Duckham, Rachel L; Milte, Catherine M; Main, Luana C; Daly, Robin M

2017-01-01

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people.

Correlates of post-hospital physical function at 1 year in skilled nursing facility residents.

PubMed

Lee, Jia; Rantz, Marilyn

2008-05-01

This paper is a report of a study to examine the relationship between health-related admission factors and post-hospital physical function at 3, 6, 9 and 12 months in older adult nursing facility residents. Physical functional decline is a significant health problem for older adults and has far-reaching effects. In particular, the immediate post-hospital period is a high-risk time, because shortened hospital stays make it likely that older patients are discharged in a state of incomplete recovery. Data spanning from July 2002 to June 2005 were extracted from a comprehensive assessment tool, the Minimum Data Set, for 38,591 beneficiaries of a federal health insurance programme covering older adults in the Midwestern region of the United States of America. We investigated relationships between admission factors and post-hospital physical function at 3, 6, 9 and 12 months. The admission factors were health-related variables assessed at the time of skilled nursing facility admission from an acute care hospital. The most important admission factors related to post-hospital physical function at 3, 6, 9 and 12 months were baseline physical function, urinary incontinence and pressure ulcer. Cognitive impairment at admission demonstrated a stronger relationship with poor physical function as resident length of stay increased. Nurses in skilled nursing facilities should screen post-hospital older adults for risk of physical functional decline at admission using identified admission factors. For continuous nursing care, older adults need to be assessed at least once a month during the first 3 months after hospital discharge.

Cognitive health benefits of strengthening exercise for community-dwelling older adults.

PubMed

Anderson-Hanley, Cay; Nimon, Joseph P; Westen, Sarah C

2010-11-01

While aerobic exercise has been linked to improved performance on cognitive tasks of executive functioning among older adults, not all older adults can avail themselves of such exercise due to physical limitations. In this study, community-dwelling older adults were evaluated on tasks of executive functioning before and after a month-long strengthening, nonaerobic exercise program. A total of 16 participants who engaged in such exercise showed significantly improved scores on Digits Backward and Stroop C tasks when compared to 16 participants who were on an exercise waiting list. Positive benefits of strengthening exercise on cognition are supported. Additional research is needed to clarify the generalizability of these findings.

Fasting Glucose and Glucose Tolerance as Potential Predictors of Neurocognitive Function among Non-diabetic Older Adults

PubMed Central

Levy, Shellie-Anne T.; Katzel, Leslie I.; Rosenberger, William F.; Manukyan, Zorayr; Whitfield, Keith E.; Waldstein, Shari R.

2015-01-01

Introduction Significant evidence has demonstrated that Type 2 diabetes mellitus and related pre-cursors are associated with diminished neurocognitive function and risk of dementia among older adults. However, very little research has examined relations of glucose regulation to neurocognitive function among older adults free of these conditions. The primary aim of this investigation was to examine associations among fasting glucose, glucose tolerance, and neurocognitive function among non-diabetic older adults. The secondary aim was to examine age, gender, and education as potential effect modifiers. Methods The study employed a cross-sectional, correlational study design. Participants were 172 older adults with a mean age of 64.43 years (SD = 13.09). The sample was 58% male and 87% White. Participants completed an oral glucose tolerance test as part of a larger study. Trained psychometricians administered neuropsychological tests that assessed performance in the domains of response inhibition, nonverbal memory, verbal memory, attention and working memory, visuoconstructional abilities, visuospatial abilities, psychomotor speed and executive function, and motor speed and manual dexterity. Linear multiple regressions were run to test study aims. Results No significant main effects of fasting glucose and 2-hour glucose emerged for performance on any neurocognitive test; however, significant interactions were present. Higher fasting glucose was associated with poorer short-term verbal memory performance among men, but unexpectedly better response inhibition and long-term verbal memory performance for participants over age 70. Higher 2-hour glucose values were associated with reduced divided attention performance among participants with less than a high school education. Conclusions Mixed findings suggest that glucose levels may be both beneficial and deleterious to neurocognition among non-diabetic older adults. Additional studies with healthy older adults are needed to confirm this unexpected pattern of associations; however, findings have implications for the importance of maintaining healthy glucose levels in older adulthood. PMID:25562529

Functional abilities in older adults with mild cognitive impairment.

PubMed

Burton, Catherine L; Strauss, Esther; Bunce, David; Hunter, Michael A; Hultsch, David F

2009-01-01

A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised--SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test--EPT). Ratings of participants' IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults. However, the changes in IADL functioning observed in MCI may be too subtle to be detected by certain measures, such as the Lawton and Brody IADL Scale. Copyright 2009 S. Karger AG, Basel.

Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks - A Case Control Study.

PubMed

Batcir, Shani; Melzer, Itshak

2018-01-18

Older adults gain many health benefits from riding bicycles regularly. We aimed to explore whether older persons who ride bicycles regularly have better balance than controls. Balance control and voluntary stepping were assessed in 20 older adults aged 65 to 85 who live in an agricultural community village who regularly ride bicycles (BR), and 30 age- and gender-matched non-bicycle riders (NBR). Self-reported function and fear of fall were also assessed. Bicycle riders showed significantly better balance, faster voluntary stepping, and better self-reported advanced lower extremity function compared with NBR. The results might suggest that bicycling regularly preserves balance control and speed of voluntary stepping in older adults because bicycling might maintain specific balance coordination patterns. The results should be treated with caution since BR were older adults who selected an active life style (i.e., bicycling as well as living in an agricultural village) that may bias the results.

Does the greater involvement of executive control in memory with age act as a compensatory mechanism?

PubMed

Bouazzaoui, Badiâa; Angel, Lucie; Fay, Séverine; Taconnat, Laurence; Charlotte, Froger; Isingrini, Michel

2014-03-01

Recent behavioural and imaging data have shown that memory functioning seems to rely more on executive functions and on the prefrontal cortex (PFC) in older than in young adults. Using a behavioural approach, our objective was to confirm the hypothesis that young and older adults present different patterns of correlation between episodic memory performance and executive functioning. We report three studies comparing the correlations of young and older adults in a broad range of episodic memory and executive function tasks. The results indicated that memory and executive performance were consistently and significantly correlated in older but not in younger adults. Regression analyses confirmed that age-related differences in episodic memory performance could be explained by individual differences in executive functioning. The results are consistent with the view that memory functioning in aging is accompanied by a shift from automatic to controlled forms of processing. They also generalise the executive hypothesis of episodic memory aging and are in line with the idea that executive functions act as a compensatory mechanism against age-related memory decline.

The effect of Bikram yoga on endothelial function in young and middle-aged and older adults.

PubMed

Hunter, Stacy D; Dhindsa, Mandeep S; Cunningham, Emily; Tarumi, Takashi; Alkatan, Mohammed; Nualnim, Nantinee; Elmenshawy, Ahmed; Tanaka, Hirofumi

2017-01-01

The purpose of this investigation was to determine if Bikram yoga, a style of heated hatha yoga, would improve endothelial function in young and middle-aged and older, healthy adults. This trial was performed in 36 young (n = 17) and middle-aged and older adults (n = 19) who completed 3 weekly Bikram yoga classes for 8 weeks. Height, body weight and body composition were determined and endothelial function was measured noninvasively using brachial artery flow-mediated dilation (FMD) before and after the intervention. No changes in body weight, BMI or body fat percentage occurred as a result of the intervention in either group. Brachial artery FMD was significantly increased in middle-aged and older (P < 0.05) but not in young adults as a result of the intervention. The results demonstrate that a relatively short-term Bikram yoga practice might significantly improve vascular endothelial function in middle-aged and older adults. While apparently healthy individuals in this study experienced no adverse events, those with preexisting conditions should take caution and consult with a physician prior to engaging in this style of yoga. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sleep Disorders in the Older Adult – A Mini-Review

PubMed Central

Neikrug, Ariel B.; Ancoli-Israel, Sonia

2010-01-01

Approximately 50% of older adults complain of difficulty sleeping. Poor sleep results in increased risk of significant morbidity and mortality. The decrements seen in the sleep of the older adult are often due to a decrease in the ability to get needed sleep. However, the decreased ability is less a function of age and more a function of other factors that accompany aging, such as medical and psychiatric illness, increased medication use, advances in the endogenous circadian clock and a higher prevalence of specific sleep disorders. Given the large number of older adults with sleep complaints and sleep disorders, there is a need for health care professionals to have an increased awareness of these sleep disturbances to better enable them to assess and treat these patients. A thorough sleep history (preferably in the presence of their bed partner) is required for a proper diagnosis, and when appropriate, an overnight sleep recording should be done. Treatment of primary sleep problems can improve the quality of life and daytime functioning of older adults. This paper reviews the diagnoses and characteristics of sleep disorders generally found in the older adult. While aimed at the practicing geriatrician, this paper is also of importance for any gerontologist interested in sleep. PMID:19738366

Stakeholders’ Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study

PubMed Central

Sefcik, Justine S.; Johnson, Michelle J.; Yim, Mark; Lau, Tessa; Vivio, Nicholas; Mucchiani, Caio

2018-01-01

Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults’ needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers (n = 6), one with interdisciplinary clinicians (n = 8), and one with older adults residing in SAL (n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the “use it or lose it” attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults. PMID:28918654

Effect of a structured course involving goal management training in older adults: A randomised controlled trial

PubMed Central

van Hooren, Susan A.H.; Valentijn, Susanne A.M.; Bosma, Hans; Ponds, Rudolf W.H.M.; van Boxtel, Martin P.J.; Levine, Brian; Robertson, Ian; Jolles, Jelle

2007-01-01

Objective The objective of this study was to investigate the effects of a structured 6-week neuropsychological course on the executive functioning of older adults with cognitive complaints. Methods A randomised controlled design was used involving 69 community dwelling individuals aged 55 years and older. Both objective and subjective measures were included to assess executive functioning. General linear model with repeated measures analysis of variance was used to examine the intervention effects. Results After the intervention, the participants in the intervention group were significantly less annoyed by their cognitive failures, were better able to manage their executive failures and reported less anxiety symptoms than those in the waiting list control group. Conclusion These findings indicate that a combination of psycho-education and training has the potential to change the attitude of older individuals towards their cognitive functioning. Practice implications Because this training focussed on cognitive functions that are among the first to decline in older adults and the subjective evaluation of the people after training was quite favourable, the proposed intervention may be considered a valuable contribution to cognitive interventions for older adults. PMID:16956743

The effects of aging on the neural correlates of subjective and objective recollection.

PubMed

Duarte, Audrey; Henson, Richard N; Graham, Kim S

2008-09-01

High-functioning older adults can exhibit normal recollection when measured subjectively, via "remember" judgments, but not when measured objectively, via source judgments, whereas low-functioning older adults exhibit impairments for both measures. A potential explanation for this is that typical subjective and objective tests of recollection necessitate different processing demands, supported by distinct brain regions, and that deficits in these tests are observed according to the degree of age-related changes in these regions. Here, we used event-related functional magnetic resonance imaging to measure the effects of aging on neural correlates of subjective and objective measures of recollection, in young, high-functioning (Old-High) and low-functioning (Old-Low) older adults. Behaviorally, the Old-High group showed intact subjective ("remember" judgments) but impaired objective recollection (for 1 of 2 spatial or temporal sources), whereas the Old-Low group was impaired on both measures. Imaging data showed changes in parietal subjective recollection effects in the Old-Low group and in lateral frontal objective recollection effects in both older adult groups. Our results highlight the importance of examining performance variability in older adults and suggest that differential effects of aging on brain regions are associated with different patterns of performance on tests of subjective and objective recollection.

Living Arrangement and Life Satisfaction in Older Malaysians: The Mediating Role of Social Support Function

PubMed Central

Kooshiar, Hadi; Yahaya, Nurizan; Hamid, Tengku Aizan; Abu Samah, Asnarulkhadi; Sedaghat Jou, Vajiheh

2012-01-01

Background This cross-sectional and correlational survey examines the association between different types of living arrangements and life satisfaction in older Malaysians, while taking into account the mediating effects of social support function. Methodology and Findings A total of 1880 of older adults were selected by multistage stratified sampling. Life satisfaction and social support were measured with the Philadelphia Geriatric Center Morale Scale and Medical Outcomes Study Social Support Survey. The result shows living with children as the commonest type of living arrangement for older adults in peninsular Malaysia. Compared to living alone, living only with a spouse especially and then co-residency with children were both associated with better life satisfaction (p<.01) and social support function (p<.01). The mediating effect of social support function enhanced the relation between living arrangements and life satisfaction. Conclusion This study revealed that types of living arrangement directly, and indirectly through social support function, play an important role in predicting life satisfaction for older adults in Malaysia. This study makes remarkable contributions to the Convoy model in older Malaysians. PMID:22912806

Gender Differences in Performance of Script Analysis by Older Adults

ERIC Educational Resources Information Center

Helmes, E.; Bush, J. D.; Pike, D. L.; Drake, D. G.

2006-01-01

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical…

Evaluation of a dysphagia screening system based on the Mann Assessment of Swallowing Ability for use in dependent older adults.

PubMed

Ohira, Mariko; Ishida, Ryo; Maki, Yoshinobu; Ohkubo, Mai; Sugiyama, Tetsuya; Sakayori, Takaharu; Sato, Toru

2017-04-01

Dysphagia is common in dependent older adults. Thus, a method of evaluating eating and swallowing functions that can be used to diagnose and manage dysphagia in a simple and robust manner is required. In 2002, the Mann Assessment of Swallowing Ability (MASA) was introduced to identify dysphagia in acute-stage stroke patients. As the MASA enables easy screening, it might also be applicable to dependent older adults if appropriate MASA cut-off values and the most useful assessment items could be determined. In the present study, we attempted to determine suitable MASA cut-off values, and the most useful assessment items for predicting aspiration and pharyngeal retention in dependent older adults. Using the MASA, we evaluated the eating and swallowing functions of 50 dependent older adults with dysphagia. All of the patients also underwent videoendoscopic-based swallowing evaluations to detect aspiration and pharyngeal retention. The participants' characteristics and the utility of each assessment item were compared between various groups. Using the patients' videoendoscopic findings as a reference, receiver operating characteristic curve analysis was carried out to determine appropriate cut-off values for predicting aspiration and pharyngeal retention in dependent older adults. The optimal MASA cut-off values for predicting aspiration and pharyngeal retention were 122 points and 151 points, respectively. A total of 17 of the 24 clinical items assessed by the MASA were found to be associated with aspiration in dependent older adults. The MASA is a useful screening tool for evaluating eating and swallowing functions in dependent older adults. Geriatr Gerontol Int 2017; 17: 561-567. © 2016 Japan Geriatrics Society.

Physical activity in prefrail older adults: confidence and satisfaction related to physical function

USDA-ARS?s Scientific Manuscript database

We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 701 years of age who have deficits in mobility. We randomized a total of 412 adults aged 70–89 years at elevated risk...

Can training in a real-time strategy video game attenuate cognitive decline in older adults?

PubMed

Basak, Chandramallika; Boot, Walter R; Voss, Michelle W; Kramer, Arthur F

2008-12-01

Declines in various cognitive abilities, particularly executive control functions, are observed in older adults. An important goal of cognitive training is to slow or reverse these age-related declines. However, opinion is divided in the literature regarding whether cognitive training can engender transfer to a variety of cognitive skills in older adults. In the current study, the authors trained older adults in a real-time strategy video game for 23.5 hr in an effort to improve their executive functions. A battery of cognitive tasks, including tasks of executive control and visuospatial skills, were assessed before, during, and after video-game training. The trainees improved significantly in the measures of game performance. They also improved significantly more than the control participants in executive control functions, such as task switching, working memory, visual short-term memory, and reasoning. Individual differences in changes in game performance were correlated with improvements in task switching. The study has implications for the enhancement of executive control processes of older adults. Copyright (c) 2009 APA, all rights reserved.

Physical Function Assessment in a Community-Dwelling Population of U.S. Chinese Older Adults

PubMed Central

Chang, E-Shien; Simon, Melissa A.

2014-01-01

Background. This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. Methods. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. Results. A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. Conclusions. Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults’ functional status. PMID:25378446

Submaximal oxygen uptake kinetics, functional mobility, and physical activity in older adults with heart failure and reduced ejection fraction

PubMed Central

Hummel, Scott L; Herald, John; Alpert, Craig; Gretebeck, Kimberlee A; Champoux, Wendy S; Dengel, Donald R; Vaitkevicius, Peter V; Alexander, Neil B

2016-01-01

Background Submaximal oxygen uptake measures are more feasible and may better predict clinical cardiac outcomes than maximal tests in older adults with heart failure (HF). We examined relationships between maximal oxygen uptake, submaximal oxygen kinetics, functional mobility, and physical activity in older adults with HF and reduced ejection fraction. Methods Older adults with HF and reduced ejection fraction (n = 25, age 75 ± 7 years) were compared to 25 healthy age- and gender-matched controls. Assessments included a maximal treadmill test for peak oxygen uptake (VO2peak), oxygen uptake kinetics at onset of and on recovery from a submaximal treadmill test, functional mobility testing [Get Up and Go (GUG), Comfortable Gait Speed (CGS), Unipedal Stance (US)], and self-reported physical activity (PA). Results Compared to controls, HF had worse performance on GUG, CGS, and US, greater delays in submaximal oxygen uptake kinetics, and lower PA. In controls, VO2peak was more strongly associated with functional mobility and PA than submaximal oxygen uptake kinetics. In HF patients, submaximal oxygen uptake kinetics were similarly associated with GUG and CGS as VO2peak, but weakly associated with PA. Conclusions Based on their mobility performance, older HF patients with reduced ejection fraction are at risk for adverse functional outcomes. In this population, submaximal oxygen uptake measures may be equivalent to VO2 peak in predicting functional mobility, and in addition to being more feasible, may provide better insight into how aerobic function relates to mobility in older adults with HF. PMID:27594875

Submaximal oxygen uptake kinetics, functional mobility, and physical activity in older adults with heart failure and reduced ejection fraction.

PubMed

Hummel, Scott L; Herald, John; Alpert, Craig; Gretebeck, Kimberlee A; Champoux, Wendy S; Dengel, Donald R; Vaitkevicius, Peter V; Alexander, Neil B

2016-07-01

Submaximal oxygen uptake measures are more feasible and may better predict clinical cardiac outcomes than maximal tests in older adults with heart failure (HF). We examined relationships between maximal oxygen uptake, submaximal oxygen kinetics, functional mobility, and physical activity in older adults with HF and reduced ejection fraction. Older adults with HF and reduced ejection fraction (n = 25, age 75 ± 7 years) were compared to 25 healthy age- and gender-matched controls. Assessments included a maximal treadmill test for peak oxygen uptake (VO2peak), oxygen uptake kinetics at onset of and on recovery from a submaximal treadmill test, functional mobility testing [Get Up and Go (GUG), Comfortable Gait Speed (CGS), Unipedal Stance (US)], and self-reported physical activity (PA). Compared to controls, HF had worse performance on GUG, CGS, and US, greater delays in submaximal oxygen uptake kinetics, and lower PA. In controls, VO2peak was more strongly associated with functional mobility and PA than submaximal oxygen uptake kinetics. In HF patients, submaximal oxygen uptake kinetics were similarly associated with GUG and CGS as VO2peak, but weakly associated with PA. Based on their mobility performance, older HF patients with reduced ejection fraction are at risk for adverse functional outcomes. In this population, submaximal oxygen uptake measures may be equivalent to VO2 peak in predicting functional mobility, and in addition to being more feasible, may provide better insight into how aerobic function relates to mobility in older adults with HF.

Effects of Playback Theatre on cognitive function and quality of life in older adults in Singapore: A preliminary study.

PubMed

Chung, Krystal Shu Yi; Lee, Eleena Shi Lynn; Tan, Jia Qi; Teo, Dylan Jin Hao; Lee, Chris Ban Loong; Ee, Sharifah Rose; Sim, Sam Kim Yang; Chee, Chew Sim

2018-03-01

This study investigated the effects of Playback Theatre on older adults' cognitive function and well-being, specifically in the Singapore context. Eighteen healthy older adults, older than 50 years of age, participated in the study. Due to practical limitations, a single-group pre-post study design was adopted. Participants completed the outcome measures before and after the training program. There were six weekly sessions in total (about 1.5 hours, once weekly). Participants experienced a significant improvement in their emotional well-being after training. However, there were no significant changes in participants' cognitive function or health-related quality of life. Our results suggest that Playback Theatre as a community program has potential to improve the mental and emotional well-being of older people. © 2018 AJA Inc.

Neural Basis of Enhanced Executive Function in Older Video Game Players: An fMRI Study.

PubMed

Wang, Ping; Zhu, Xing-Ting; Qi, Zhigang; Huang, Silin; Li, Hui-Jie

2017-01-01

Video games have been found to have positive influences on executive function in older adults; however, the underlying neural basis of the benefits from video games has been unclear. Adopting a task-based functional magnetic resonance imaging (fMRI) study targeted at the flanker task, the present study aims to explore the neural basis of the improved executive function in older adults with video game experiences. Twenty video game players (VGPs) and twenty non-video game players (NVGPs) of 60 years of age or older participated in the present study, and there are no significant differences in age ( t = 0.62, p = 0.536), gender ratio ( t = 1.29, p = 0.206) and years of education ( t = 1.92, p = 0.062) between VGPs and NVGPs. The results show that older VGPs present significantly better behavioral performance than NVGPs. Older VGPs activate greater than NVGPs in brain regions, mainly in frontal-parietal areas, including the right dorsolateral prefrontal cortex, the left supramarginal gyrus, the right angular gyrus, the right precuneus and the left paracentral lobule. The present study reveals that video game experiences may have positive influences on older adults in behavioral performance and the underlying brain activation. These results imply the potential role that video games can play as an effective tool to improve cognitive ability in older adults.

The effects of HIV disease and older age on laboratory-based, naturalistic, and self-perceived symptoms of prospective memory: does retrieval cue type and delay interval matter?

PubMed

Avci, G; Loft, S; Sheppard, D P; Woods, S P

2016-11-01

There is a rising prevalence of older HIV+ adults who are at risk of deficits in higher order neurocognitive functions and associated problems in everyday functioning. The current study applied multiprocess theory to examine the effects of HIV and aging on measures of laboratory-based, naturalistic, and self-perceived symptoms of prospective memory (PM). Participants included 125 Younger (48 with HIV, age = 32 ± 4.6 years) and 189 Older (112 with HIV, age = 56 ± 4.9 years) adults. Controlling for global neurocognitive functioning, mood, and other demographics, older age and HIV had independent effects on long-delay time-based PM in the laboratory, whereas on a naturalistic PM task older HIV- adults performed better than older HIV+ adults and younger persons. In line with the naturalistic findings, older age, but not HIV, was associated with a relative sparing of self-perceived PM failures in daily life across longer delay self-cued intervals. Findings suggest that, even in relatively younger aging cohorts, the effects of HIV and older age on PM can vary across PM delay intervals by the strategic demands of the retrieval cue type, are expressed differently in the laboratory and in daily life, and are independent of other higher order neurocognitive functions (e.g., retrospective memory).

The Effects of HIV Disease and Older Age on Laboratory-based, Naturalistic, and Self-Perceived Symptoms of Prospective Memory: Does Retrieval Cue Type and Delay Interval Matter?

PubMed Central

Avci, G.; Loft, S.; Sheppard, D.P.; Woods, S.P.

2016-01-01

There is a rising prevalence of older HIV+ adults who are at risk of deficits in higher-order neurocognitive functions and associated problems in everyday functioning. The current study applied Multiprocess Theory to examine the effects of HIV and aging on measures of laboratory-based, naturalistic, and self-perceived symptoms of prospective memory (PM). Participants included 125 Younger (48 with HIV, age = 32±4.6 years) and 189 Older (112 with HIV, age = 56±4.9 years) adults. Controlling for global neurocognitive functioning, mood, and other demographics, older age and HIV had independent effects on long-delay time-based PM in the laboratory, whereas on a naturalistic PM task older HIV− adults performed better than older HIV+ adults and younger persons. In line with the naturalistic findings, older age, but not HIV, was associated with a relative sparing of self-perceived PM failures in daily life across longer delay self-cued intervals. Findings suggest that, even in relatively younger aging cohorts, the effects of HIV and older age on PM can vary across PM delay intervals by the strategic demands of the retrieval cue type, are expressed differently in the laboratory and in daily life, and are independent of other higher-order neurocognitive functions (e.g., retrospective memory). PMID:27002287

Executive function and functional and structural brain differences in middle-age adults with autism spectrum disorder.

PubMed

Braden, B Blair; Smith, Christopher J; Thompson, Amiee; Glaspy, Tyler K; Wood, Emily; Vatsa, Divya; Abbott, Angela E; McGee, Samuel C; Baxter, Leslie C

2017-12-01

There is a rapidly growing group of aging adults with autism spectrum disorder (ASD) who may have unique needs, yet cognitive and brain function in older adults with ASD is understudied. We combined functional and structural neuroimaging and neuropsychological tests to examine differences between middle-aged men with ASD and matched neurotypical (NT) men. Participants (ASD, n = 16; NT, n = 17) aged 40-64 years were well-matched according to age, IQ (range: 83-131), and education (range: 9-20 years). Middle-age adults with ASD made more errors on an executive function task (Wisconsin Card Sorting Test) but performed similarly to NT adults on tests of delayed verbal memory (Rey Auditory Verbal Learning Test) and local visual search (Embedded Figures Task). Independent component analysis of a functional MRI working memory task (n-back) completed by most participants (ASD = 14, NT = 17) showed decreased engagement of a cortico-striatal-thalamic-cortical neural network in older adults with ASD. Structurally, older adults with ASD had reduced bilateral hippocampal volumes, as measured by FreeSurfer. Findings expand our understanding of ASD as a lifelong condition with persistent cognitive and functional and structural brain differences evident at middle-age. Autism Res 2017, 10: 1945-1959. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. We compared cognitive abilities and brain measures between 16 middle-age men with high-functioning autism spectrum disorder (ASD) and 17 typical middle-age men to better understand how aging affects an older group of adults with ASD. Men with ASD made more errors on a test involving flexible thinking, had less activity in a flexible thinking brain network, and had smaller volume of a brain structure related to memory than typical men. We will follow these older adults over time to determine if aging changes are greater for individuals with ASD. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Intergenerational Perspectives on Autonomy Following a Transition to a Continuing Care Retirement Community.

PubMed

Ayalon, Liat

2016-02-01

The study evaluated the concept of autonomy from the perspective of older adults and their adult children following a transition of the older adult to a continuing care retirement community (CCRC). Overall, 70 interviews (with older adults and their adult children; 34 dyads) were analyzed, using a line-by-line open coding, followed by dyadic analysis. Autonomy was not portrayed as a uniform, homogenous construct, but rather encompassed four different domains: (a) the focus of one's attention or concerns: on others, on self, or not at all; (b) the ability to exercise decisions and make independent choices; (c) the degree of physical functioning and ability of the older adult; and (d) the financial ability of the older adult. The duality in the relationships between older adults and their adult children is discussed in relation to the give and take of autonomy that occur following a transition to a CCRC. © The Author(s) 2015.

Functional Limitations, Depression, and Cash Assistance are Associated with Food Insecurity among Older Urban Adults in Mexico City.

PubMed

Vilar-Compte, Mireya; Martínez-Martínez, Oscar; Orta-Alemán, Dania; Perez-Escamilla, Rafael

2016-01-01

To examine factors associated with food insecurity among urban older adults (65 years and older). Three hundred and fifty two older adults attending community centers in a neighborhood of Mexico City were surveyed for food insecurity, functional impairments, health and mental health status, cash-transfer assistance, socio-demographic characteristics, social isolation, and the built food environment. Having at least primary education and receiving cash-transfers were significantly associated with a lower probability of being moderately-severely food insecure (OR=0.478 and 0.597, respectively). The probability of moderate-severe food insecurity was significantly higher among elderly at risk of depression (OR=2.843), those with at least one activity of daily living impaired (OR=2.177) and those with at least one instrumental activity of daily living impaired (OR=1.785). Higher educational attainment and cash-transfers may have a positive influence on reducing food insecurity. Depression and functional limitations may increase the likelihood of food insecurity among older adults.

Financial Exploitation Is Associated With Structural and Functional Brain Differences in Healthy Older Adults

PubMed Central

Spreng, R. Nathan; Cassidy, Benjamin N; Darboh, Bri S; DuPre, Elizabeth; Lockrow, Amber W; Setton, Roni; Turner, Gary R

2017-01-01

Abstract Background Age-related brain changes leading to altered socioemotional functioning may increase vulnerability to financial exploitation. If confirmed, this would suggest a novel mechanism leading to heightened financial exploitation risk in older adults. Development of predictive neural markers could facilitate increased vigilance and prevention. In this preliminary study, we sought to identify structural and functional brain differences associated with financial exploitation in older adults. Methods Financially exploited older adults (n = 13, 7 female) and a matched cohort of older adults who had been exposed to, but avoided, a potentially exploitative situation (n = 13, 7 female) were evaluated. Using magnetic resonance imaging, we examined cortical thickness and resting state functional connectivity. Behavioral data were collected using standardized cognitive assessments, self-report measures of mood and social functioning. Results The exploited group showed cortical thinning in anterior insula and posterior superior temporal cortices, regions associated with processing affective and social information, respectively. Functional connectivity encompassing these regions, within default and salience networks, was reduced, while between network connectivity was increased. Self-reported anger and hostility was higher for the exploited group. Conclusions We observed financial exploitation associated with brain differences in regions involved in socioemotional functioning. These exploratory and preliminary findings suggest that alterations in brain regions implicated in socioemotional functioning may be a marker of financial exploitation risk. Large-scale, prospective studies are necessary to validate this neural mechanism, and develop predictive markers for use in clinical practice. PMID:28369260

Can You Imagine? The Effect of Mental Practice on the Acquisition and Retention of a Motor Skill as a Function of Age.

ERIC Educational Resources Information Center

Jarus, Tal; Ratzon, Navah Z.

2000-01-01

A study investigated the effect of age on mental practice in 30 children, 30 adults, and 30 older adults randomly participating in physical and mental-physical practice. Mental practice benefitted children and older adults in coordination tasks. Older adults especially benefitted from mental practice in retention tasks. (Contains 58 references.)…

Development of an Integrated Theory of Surgical Recovery in Older Adults.

PubMed

Ann DiMaria-Ghalili, Rose

2016-01-01

Experts argue the health care system is not prepared to meet the unique needs of older surgical patients, including how to provide the best care during the recovery phase. Nutrition plays a critical role in the recovery of surgical patients. Since older adults are at risk for malnutrition, examining the role of nutrition as a mediator for surgical recovery across the care continuum in older adults is critical. Presently there is a paucity of frameworks, models, and guidelines that integrate the role of nutrition on the trajectory of postoperative recovery in older surgical patients. The purpose of this article is to introduce the Integrated Theory of Surgical Recovery in Older Adults, an interdisciplinary middle-range theory, so that scholars, researchers, and clinicians can use this framework to promote recovery from surgery in older adults by considering the contribution of mediators of recovery (nutritional status, functional status, and frailty) unique to the older adults.

Cognitive and Neural Effects of Semantic Encoding Strategy Training in Older Adults

PubMed Central

Anderson, B. A.; Barch, D. M.; Jacoby, L. L.

2012-01-01

Prior research suggests that older adults are less likely than young adults to use effective learning strategies during intentional encoding. This functional magnetic resonance imaging (fMRI) study investigated whether training older adults to use semantic encoding strategies can increase their self-initiated use of these strategies and improve their recognition memory. The effects of training on older adults' brain activity during intentional encoding were also examined. Training increased older adults' self-initiated semantic encoding strategy use and eliminated pretraining age differences in recognition memory following intentional encoding. Training also increased older adults' brain activity in the medial superior frontal gyrus, right precentral gyrus, and left caudate during intentional encoding. In addition, older adults' training-related changes in recognition memory were strongly correlated with training-related changes in brain activity in prefrontal and left lateral temporal regions associated with semantic processing and self-initiated verbal encoding strategy use in young adults. These neuroimaging results demonstrate that semantic encoding strategy training can alter older adults' brain activity patterns during intentional encoding and suggest that young and older adults may use the same network of brain regions to support self-initiated use of verbal encoding strategies. PMID:21709173

Who Dares, Who Errs? Disentangling Cognitive and Motivational Roots of Age Differences in Decisions Under Risk.

PubMed

Pachur, Thorsten; Mata, Rui; Hertwig, Ralph

2017-04-01

We separate for the first time the roles of cognitive and motivational factors in shaping age differences in decision making under risk. Younger and older adults completed gain, loss, and mixed-domain choice problems as well as measures of cognitive functioning and affect. The older adults' decision quality was lower than the younger adults' in the loss domain, and this age difference was attributable to the older adults' lower cognitive abilities. In addition, the older adults chose the more risky option more often than the younger adults in the gain and mixed domains; this difference in risk aversion was attributable to less pronounced negative affect among the older adults. Computational modeling with a hierarchical Bayesian implementation of cumulative prospect theory revealed that the older adults had higher response noise and more optimistic decision weights for gains than did the younger adults. Moreover, the older adults showed no loss aversion, a finding that supports a positivity-focus (rather than a loss-prevention) view of motivational reorientation in older age.

Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review.

PubMed

Papa, Evan V; Dong, Xiaoyang; Hassan, Mahdi

2017-01-01

Human aging results in a variety of changes to skeletal muscle. Sarcopenia is the age-associated loss of muscle mass and is one of the main contributors to musculoskeletal impairments in the elderly. Previous research has demonstrated that resistance training can attenuate skeletal muscle function deficits in older adults, however few articles have focused on the effects of resistance training on functional mobility. The purpose of this systematic review was to 1) present the current state of literature regarding the effects of resistance training on functional mobility outcomes for older adults with skeletal muscle function deficits and 2) provide clinicians with practical guidelines that can be used with seniors during resistance training, or to encourage exercise. We set forth evidence that resistance training can attenuate age-related changes in functional mobility, including improvements in gait speed, static and dynamic balance, and fall risk reduction. Older adults should be encouraged to participate in progressive resistance training activities, and should be admonished to move along a continuum of exercise from immobility, toward the recommended daily amounts of activity.

Implementation intentions for physical activity behavior in older adult women: an examination of executive function as a moderator of treatment effects.

PubMed

Hall, Peter A; Zehr, Christopher; Paulitzki, Jeffrey; Rhodes, Ryan

2014-08-01

Implementation intentions are effective for enhancing physical activity, but it is unknown how well these effects extend to older adults and/or are modified by cognitive variables. Our objective is to examine (1) the efficacy of an implementation intentions intervention for physical activity in older adult women and (2) to examine the moderating effects of executive function. Participants (N = 75, M age = 73.72) completed measures of executive function and were randomly assigned to weekly implementation intentions for physical activity (experimental condition), implementation intentions for an unrelated behavior (control condition), or no treatment. Baseline activity was measured by accelerometer and self-report; follow-up activity was measured by weekly self-report. Findings indicated a significant treatment effect for the experimental condition and a treatment by executive function interaction. Specifically, participants with relatively stronger executive function benefited most from the experimental intervention. Implementation intentions are effective for enhancing physical activity among older adult women, and the effects may be especially pronounced for those with relatively stronger executive function.

Impacts of dance on non-motor symptoms, participation, and quality of life in Parkinson disease and healthy older adults

PubMed Central

McNeely, ME; Duncan, RP; Earhart, GM

2015-01-01

Evidence indicates exercise is beneficial for motor and non-motor function in older adults and people with chronic diseases including Parkinson disease (PD). Dance may be a relevant form of exercise in PD and older adults due to social factors and accessibility. People with PD experience motor and non-motor symptoms, but treatments, interventions, and assessments often focus more on motor symptoms. Similar non-motor symptoms also occur in older adults. While it is well-known that dance may improve motor outcomes, it is less clear how dance affects non-motor symptoms. This review aims to describe the effects of dance interventions on non-motor symptoms in older adults and PD, highlights limitations of the literature, and identifies opportunities for future research. Overall, intervention parameters, study designs, and outcome measures differ widely, limiting comparisons across studies. Results are mixed in both populations, but evidence supports the potential for dance to improve mood, cognition, and quality of life in PD and healthy older adults. Participation and non-motor symptoms like sleep disturbances, pain, and fatigue have not been measured in older adults. Additional well-designed studies comparing dance and exercise interventions are needed to clarify the effects of dance on non-motor function and establish recommendations for these populations. PMID:26318265

Physical activity behavior predicts endogenous pain modulation in older adults.

PubMed

Naugle, Kelly M; Ohlman, Thomas; Naugle, Keith E; Riley, Zachary A; Keith, NiCole R

2017-03-01

Older adults compared with younger adults are characterized by greater endogenous pain facilitation and a reduced capacity to endogenously inhibit pain, potentially placing them at a greater risk for chronic pain. Previous research suggests that higher levels of self-reported physical activity are associated with more effective pain inhibition and less pain facilitation on quantitative sensory tests in healthy adults. However, no studies have directly tested the relationship between physical activity behavior and pain modulatory function in older adults. This study examined whether objective measures of physical activity behavior cross-sectionally predicted pain inhibitory function on the conditioned pain modulation (CPM) test and pain facilitation on the temporal summation (TS) test in healthy older adults. Fifty-one older adults wore an accelerometer on the hip for 7 days and completed the CPM and TS tests. Measures of sedentary time, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were obtained from the accelerometer. Hierarchical linear regressions were conducted to determine the relationship of TS and CPM with levels of physical activity, while controlling for demographic, psychological, and test variables. The results indicated that sedentary time and LPA significantly predicted pain inhibitory function on the CPM test, with less sedentary time and greater LPA per day associated with greater pain inhibitory capacity. Additionally, MVPA predicted pain facilitation on the TS test, with greater MVPA associated with less TS of pain. These results suggest that different types of physical activity behavior may differentially impact pain inhibitory and facilitatory processes in older adults.

Executive Function Subcomponents and their Relations to Everyday Functioning in Healthy Older Adults

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2016-01-01

Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures relative to young-old participants. For the HOAs, after controlling for age and education, the neuropsychological measures of executive functioning, but not experimental measures, explained a significant amount of variance in the informant-report and both performance-based measures. Updating measures differentially predicted performance-based measures, while switching was important for questionnaire and performance-based measures. The contribution of executive functioning to functional status when measured with experimental measures specifically designed to isolate the executive subcomponent was not as strong as hypothesized. Further research examining the value of isolating executive function subcomponents in neuropsychological assessment and the prediction of functional abilities in older adults is warranted. PMID:27206842

Executive function subcomponents and their relations to everyday functioning in healthy older adults.

PubMed

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2016-10-01

Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures than did young-old participants. For the HOAs, after controlling for age and education, the neuropsychological measures of executive functioning, but not experimental measures, explained a significant amount of variance in the informant-report and both performance-based measures. Updating measures differentially predicted performance-based measures, while switching was important for questionnaire and performance-based measures. The contribution of executive functioning to functional status when measured with experimental measures specifically designed to isolate the executive subcomponent was not as strong as hypothesized. Further research examining the value of isolating executive function subcomponents in neuropsychological assessment and the prediction of functional abilities in older adults is warranted.

Naturalistic Assessment of Executive Function and Everyday Multitasking in Healthy Older Adults

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2013-01-01

Everyday multitasking and its cognitive correlates were investigated in an older adult population using a naturalistic task, the Day Out Task. Fifty older adults and 50 younger adults prioritized, organized, initiated and completed a number of subtasks in a campus apartment to prepare for a day out (e.g., gather ingredients for a recipe, collect change for a bus ride). Participants also completed tests assessing cognitive constructs important in multitasking. Compared to younger adults, the older adults took longer to complete the everyday tasks and more poorly sequenced the subtasks. Although they initiated, completed, and interweaved a similar number of subtasks, the older adults demonstrated poorer task quality and accuracy, completing more subtasks inefficiently. For the older adults, reduced prospective memory abilities were predictive of poorer task sequencing, while executive processes and prospective memory were predictive of inefficiently completed subtasks. The findings suggest that executive dysfunction and prospective memory difficulties may contribute to the age-related decline of everyday multitasking abilities in healthy older adults. PMID:23557096

Age-related differences in striatal, medial temporal, and frontal involvement during value-based decision processing.

PubMed

Su, Yu-Shiang; Chen, Jheng-Ting; Tang, Yong-Jheng; Yuan, Shu-Yun; McCarrey, Anna C; Goh, Joshua Oon Soo

2018-05-21

Appropriate neural representation of value and application of decision strategies are necessary to make optimal investment choices in real life. Normative human aging alters neural selectivity and control processing in brain regions implicated in value-based decision processing including striatal, medial temporal, and frontal areas. However, the specific neural mechanisms of how these age-related functional brain changes modulate value processing in older adults remain unclear. Here, young and older adults performed a lottery-choice functional magnetic resonance imaging experiment in which probabilities of winning different magnitudes of points constituted expected values of stakes. Increasing probability of winning modulated striatal responses in young adults, but modulated medial temporal and ventromedial prefrontal areas instead in older adults. Older adults additionally engaged higher responses in dorso-medio-lateral prefrontal cortices to more unfavorable stakes. Such extrastriatal involvement mediated age-related increase in risk-taking decisions. Furthermore, lower resting-state functional connectivity between lateral prefrontal and striatal areas also predicted lottery-choice task risk-taking that was mediated by higher functional connectivity between prefrontal and medial temporal areas during the task, with this mediation relationship being stronger in older than younger adults. Overall, we report evidence of a systemic neural mechanistic change in processing of probability in mixed-lottery values with age that increases risk-taking of unfavorable stakes in older adults. Moreover, individual differences in age-related effects on baseline frontostriatal communication may be a central determinant of such subsequent age differences in value-based decision neural processing and resulting behaviors. Copyright © 2018 Elsevier Inc. All rights reserved.

Executive function is necessary for the regulation of the stepping activity when stepping in place in older adults.

PubMed

Dalton, Christopher; Sciadas, Ria; Nantel, Julie

2016-10-01

To determine the effect of age on stepping performance and to compare the cognitive demand required to regulate repetitive stepping between older and younger adults while performing a stepping in place task (SIP). Fourteen younger (25.4 ± 6.5) and 15 older adults (71.0 ± 9.0) participated in this study. They performed a seated category fluency task and Stroop test, followed by a 60 s SIP task. Following this, both the cognitive and motor tasks were performed simultaneously. We assessed cognitive performance, SIP cycle duration, asymmetry, and arrhythmicity. Compared to younger adults, older adults had larger SIP arrhythmicity both as a single task and when combined with the Category (p < 0.001) and Stroop (p < 0.01) tasks. Older adults also had larger arrhythmicity when dual tasking compared to SIP alone (p < 0.001). Older adults showed greater SIP asymmetry when combined with Category (p = 0.006) and Stroop (p = 0.06) tasks. Finally, they had lower cognitive performance than younger adults in both single and dual tasks (p < 0.01). Age and type of cognitive task performed with the motor task affected different components of stepping. While SIP arrhythmicity was larger for all conditions in older compared to younger adults, cycle duration was not different, and asymmetry tended to be larger during SIP when paired with a verbal fluency task. SIP does not require a high level of control for dynamic stability, therefore demonstrating that higher-level executive function is necessary for the regulation of stepping activity independently of the regulation of postural balance. Furthermore, older adults may lack the cognitive resources needed to adequately regulate stepping activity while performing a cognitive task relying on the executive function.

Environmental Support Hypothesis in Designing Multimedia Training for Older Adults: Is Less Always More?

ERIC Educational Resources Information Center

Pachman, Mariya; Ke, Fengfeng

2012-01-01

This study explores younger and older adults learning of MS Publisher functionalities from a multimedia tutorial. Twenty younger and twenty three older adults assigned to a redundant (experimental) or non-redundant (control) condition were taught how to create a greeting card, while the results of their learning were assessed with immediate and…

"We're Not Just Sitting on the Periphery": A Staff Perspective of Physical Activity in Older Adults with Schizophrenia

ERIC Educational Resources Information Center

Leutwyler, Heather; Hubbard, Erin M.; Jeste, Dilip V.; Vinogradov, Sophia

2013-01-01

Targeted physical activity interventions to improve the poor physical function of older adults with schizophrenia are necessary but currently not available. Given disordered thought processes and institutionalization, it is likely that older adults with schizophrenia have unique barriers and facilitators to physical activity. It is necessary to…

Evaluation of a Peer-Led, Low-Intensity Physical Activity Program for Older Adults

ERIC Educational Resources Information Center

Werner, Danilea; Teufel, James; Brown, Stephen L.

2014-01-01

Background: Physical inactivity is a primary contributor to decreasing functional physical fitness and increasing chronic disease in older adults. Purpose: This study assessed the health-related benefits of ExerStart for Lay Leaders, a 20-week, community based, peer-led, low-impact exercise program for older adults. ExerStart focuses on aerobic…

Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community

PubMed Central

Burke, Robert E.; Malone, Daniel; Ridgeway, Kyle J.; McManus, Beth M.; Stevens-Lapsley, Jennifer E.

2016-01-01

Hospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions. PMID:26939601

Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community.

PubMed

Falvey, Jason R; Burke, Robert E; Malone, Daniel; Ridgeway, Kyle J; McManus, Beth M; Stevens-Lapsley, Jennifer E

2016-08-01

Hospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions. © 2016 American Physical Therapy Association.

Cognitive function and adherence of older adults undergoing hemodialysis.

PubMed

Hain, Debra J

2008-01-01

As the number of older adults undergoing hemodialysis increases, it is important for nurses to consider cognitive impairment as a contributing factor to non-adherence. The purpose of this exploratory study was to identify cognitive markers that nurses can use to alert them to potential problems with adherence among older adults undergoing hemodialysis. Stories of the health challenge of making lifestyle change were analyzed with a linguistic analysis software program. A standardized instrument (3MS) that measures global cognitive function was administered. Determination of adherence level was the last activity of data collection. In this sample (n=63), 39.7% of the participants had evidence of cognitive impairment (3MS score less than 80); 58.2% of the 39.7% had evidence of non-adherence. There was a significant relationship between word use and cognitive function (p < .01). Cognitive impairment is prevalent among older adults undergoing hemodialysis and words might be a proxy for recognizing this.

The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis.

PubMed

Arnold, Cathy M; Faulkner, Robert A

2010-07-01

To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis (OA). Seventy-nine adults, 65 years of age or older with hip OA and at least 1 fall risk factor, were randomly assigned to 1 of 3 groups: aquatics and education (AE; aquatic exercise twice a wk with once-a-wk group education), aquatics only (A; 2 wk aquatic exercise) and control (C; usual activity). Balance, falls efficacy, dual-task function, functional performance (chair stands), and walking performance were measured pre- and postintervention or control period. There was a significant improvement in fall risk factors (full-factorial MANCOVA, baseline values as covariates; p = .038); AE improved in falls efficacy compared with C and in functional performance compared with A and C. The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis.

Gardening Activities and Physical Health Among Older Adults: A Review of the Evidence

PubMed Central

Nicklett, Emily J.; Anderson, Lynda A.; Yen, Irene H.

2015-01-01

Few studies have examined the health-related consequences of gardening among older adults. This scoping review summarizes and characterizes current research that examines the relationship between physical health and participation in planned gardening activities, including establishing, maintaining, or caring for plants. Six databases were searched. Eligible studies were published between 2000 and 2013, were published in English, and assessed different aspects of physical health (e.g., functional ability, energy expenditure, injury) for older adults who had participated in a planned gardening activity. Of the eight eligible studies identified with these criteria, four assessed energy expenditures and four assessed physical functioning. Studies assessing energy expenditures documented that the majority of gardening tasks were classified into low-to-moderate intensity physical activity. The current literature does not provide sufficient evidence of the physical functioning consequences of gardening. Future studies should consider how specific gardening interventions help older adults meet physical activity guidelines. PMID:25515757

Age differences in brain activity during emotion processing: reflections of age-related decline or increased emotion regulation?

PubMed

Nashiro, Kaoru; Sakaki, Michiko; Mather, Mara

2012-01-01

Despite the fact that physical health and cognitive abilities decline with aging, the ability to regulate emotion remains stable and in some aspects improves across the adult life span. Older adults also show a positivity effect in their attention and memory, with diminished processing of negative stimuli relative to positive stimuli compared with younger adults. The current paper reviews functional magnetic resonance imaging studies investigating age-related differences in emotional processing and discusses how this evidence relates to two opposing theoretical accounts of older adults' positivity effect. The aging-brain model [Cacioppo et al. in: Social Neuroscience: Toward Understanding the Underpinnings of the Social Mind. New York, Oxford University Press, 2011] proposes that older adults' positivity effect is a consequence of age-related decline in the amygdala, whereas the cognitive control hypothesis [Kryla-Lighthall and Mather in: Handbook of Theories of Aging, ed 2. New York, Springer, 2009; Mather and Carstensen: Trends Cogn Sci 2005;9:496-502; Mather and Knight: Psychol Aging 2005;20:554-570] argues that the positivity effect is a result of older adults' greater focus on regulating emotion. Based on evidence for structural and functional preservation of the amygdala in older adults and findings that older adults show greater prefrontal cortex activity than younger adults while engaging in emotion-processing tasks, we argue that the cognitive control hypothesis is a more likely explanation for older adults' positivity effect than the aging-brain model. Copyright © 2011 S. Karger AG, Basel.

Accelerometer Assessment of Physical Activity and Its Association with Physical Function in Older Adults Residing at Assisted Care Facilities.

PubMed

Corcoran, M P; Chui, K K H; White, D K; Reid, K F; Kirn, D; Nelson, M E; Sacheck, J M; Folta, S C; Fielding, R A

2016-01-01

To describe levels of physical activity among older adults residing at assisted care facilities and their association with physical function. Cross-sectional analysis. Assisted care facilities within the greater Boston, MA area. Older adults aged 65 years and older (N = 65). Physical Activity Level (PAL) as defined by quartiles from accelerometry (counts and steps), Short Physical Performance Battery (SPPB) Score, gait speed, and handgrip strength. Participants in the most active accelerometry quartile engaged in 25 minutes/week of moderate to vigorous physical activity (MVPA) and walked 2,150 steps/day. These individuals had an SPPB score, 400 meter walk speed, and handgrip strength that was 3.7-3.9 points, 0.3-0.4 meters/second, and 4.5-5.1 kg greater respectively, than individuals in the lowest activity quartile, who engaged in less than 5 min/wk of MVPA or took fewer than 460 steps/day. Despite engaging in physical activity levels far below current recommendations (150 min/week of MVPA or > 7000 steps/day), the most active older adults in this study exhibited clinically significant differences in physical function relative to their less active peers. While the direction of causality cannot be determined from this cross-sectional study, these findings suggest a strong association between PAL and physical function among older adults residing in an assisted care facility.

Working memory training and transfer in older adults.

PubMed

Richmond, Lauren L; Morrison, Alexandra B; Chein, Jason M; Olson, Ingrid R

2011-12-01

There has been a great deal of interest, both privately and commercially, in using working memory training exercises to improve general cognitive function. However, many of the laboratory findings for older adults, a group in which this training is of utmost interest, are discouraging due to the lack of transfer to other tasks and skills. Importantly, improvements in everyday functioning remain largely unexamined in relation to WM training. We trained working memory in older adults using a task that encourages transfer in young adults (Chein & Morrison, 2010). We tested transfer to measures of working memory (e.g., Reading Span), everyday cognitive functioning [the Test of Everyday Attention (TEA) and the California Verbal Learning Test (CVLT)], and other tasks of interest. Relative to controls, trained participants showed transfer improvements in Reading Span and the number of repetitions on the CVLT. Training group participants were also significantly more likely to self-report improvements in everyday attention. Our findings support the use of ecological tasks as a measure of transfer in an older adult population.

High-speed power training: a novel approach to resistance training in older men and women. A brief review and pilot study.

PubMed

Sayers, Stephen P

2007-05-01

Over the past century, increases in both longevity and the number of older adults in the U.S.A. have given rise to greater numbers of functionally limited and disabled older adults. This has resulted in a decline in the quality of life of our elderly population, as well as an increased burden on our health care system. Resistance training (RT) with a strengthening component has traditionally been recommended to improve health and physical functioning in older adults. Muscle power (force x velocity), or the ability to produce force rapidly, has recently emerged as an important predictor of functioning in older men and women and has been the current focus of many RT studies. In this review, the physiological changes that contribute to the declines in muscle strength and power with aging will first be examined, followed by a discussion of the prevailing theories behind the use of traditional RT in older men and women. The rationale for high-velocity RT will then be explored, and the recent literature on novel training interventions designed to improve muscle power in older adults will be discussed. Finally, some preliminary evidence demonstrating the benefits of high-velocity power training in older men and women will be presented.

Prevalence of Ideal Cardiovascular Health and Its Association with Cognitive Function in Older Adults: The Chilean National Health Survey (2009-2010).

PubMed

García-Hermoso, Antonio; Ramírez-Vélez, Robinson; Ramírez-Campillo, Rodrigo; Izquierdo, Mikel

2017-10-23

Health behaviors and risk factors are independently related with cognitive function in older adults. This study aimed at examining the prevalence and relationship between cognitive function and a number of ideal cardiovascular health (CVH) metrics in older adults from the 2009 to 2010 Chilean National Health Survey. Data from 460 older adults (mean age 73.5 years old, 59.3% women) from the 2009 to 2010 Chilean Health Survey were analyzed. Ideal CVH was defined as meeting the ideal levels of the following components: four behaviors (smoking, body mass index, physical activity, and diet adherence) and three factors (total cholesterol, blood pressure, and fasting glucose). Older adults were grouped into three categories according to their number of ideal CVH metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). Cognitive function was assessed by using the modified Mini-Mental Status Examination (mMMSE). Of the 460 participants, 2% had 0 ideal metrics, 11.3% had 1, 23.9% had 2, 32.2% had 3, 20.7% had 4, 9.6% had 5, 0.4% had 6, and 0% had 7. Cognitive function was greater in older adults who met the ideal smoking, physical activity, and fasting blood glucose criteria. Logistic regression analysis suggested that ideal physical activity (Odds Ratio [OR] = 0.411 95% confidence interval [95% CI], 0.209-0.807) and smoking (OR = 0.429 95% CI, 0.095-0.941) behaviors reduced the likelihood of cognitive impairment. Moreover, compared with a poor profile (0-2 metrics), an intermediate (3-4 metrics) (OR = 0.221 95% CI, 0.024-0.911) and ideal CVH profile (5-7 metrics) (OR = 0.106 95% CI, 0.013-0.864) reduced the likelihood of cognitive impairment. We found that intermediate and ideal profiles were associated with a similarly low prevalence of cognitive impairment in Chilean older adults.

Methodological improvements in quantifying cognitive change in clinical trials: an example with single-dose administration of donepezil.

PubMed

Pietrzak, R H; Maruff, P; Snyder, P J

2009-03-01

Change in cognitive function in response to a pharmacologic challenge can be observed with greater sensitivity by employing cognitive tests with optimal psychometric properties and a statistical approach that more accurately accounts for individual variability in performance. To demonstrate this approach we examined the cognitive effects of a single acute dose administration of an acetylcholinesterase inhibitor, donepezil, in healthy older adults and in older adults with mild Alzheimer's disease (AD). Placebo-controlled crossover study with three separate testing days: baseline, placebo, and donepezil, with assessments at baseline, and 1-, 2-, 3-, 6-, and 8-hrs post-dosing on each day. Early phase I clinical trial. 15 healthy older adults; 14 older adults with mild Alzheimer's disease. Single acute dose of 5mg donepezil. Performance on the Groton Maze Learning Test (GMLT), a computerized neuropsychological measure of spatial working memory and error monitoring. A single acute dose of donepezil improved GMLT performance in healthy older adults (effect size: 0.83 at 6 hrs post-dosing) and older adults with mild AD (effect size: 0.58 at 3 hrs post-dosing). The GMLT detected cognitive improvement following a single, acute dose administration of donepezil in healthy older adults and older adults with mild AD. The choice of cognitive tests designed for repeated administration, as well as an analytic approach that emphasizes individual-level change in cognitive function, provides a sensitive approach to detecting central nervous system drug penetration and activity of cognitive-enhancing agents.

Elastic Band Exercises Improved Activities of Daily Living and Functional Fitness of Wheelchair-bound Older Adults with Cognitive Impairment: A Cluster Randomized Controlled Trial.

PubMed

Chen, Meng-Chun; Chen, Kuei-Min; Chang, Chu-Lin; Chang, Ya-Hui; Cheng, Yin-Yin; Huang, Hsin-Ting

2016-11-01

The purpose of this study was to test the effects of a 6-month Wheelchair-bound Senior Elastic Band (WSEB) exercise program on the activities of daily living (ADL) and functional fitness of wheelchair-bound older adults with cognitive impairment. Cluster randomized controlled trial was used. A convenience sample of 138 wheelchair-bound older adults with cognitive impairment were recruited from 8 nursing homes in southern Taiwan and were randomly assigned based on the nursing homes they lived to the experimental (4 nursing homes; n = 73) or the control group (4 nursing homes; n = 65). The experimental group performed WSEB exercises 3 times per week and 40 minutes per session for 6 months. The ADL and functional fitness (cardiopulmonary function, body flexibility, range of joint motion, and muscle strength and endurance) were examined at baseline, 3 months, and the end of 6-month study. The ADL and functional fitness indicators of participants in the experimental group showed significant improvements compared to the control group (all P < 0.05). The WSEB exercises have positive benefits for the ADL and functional fitness of wheelchair-bound older adults with cognitive impairment. It is suggested that WSEB exercises be included as a routine activity in nursing homes. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME OBJECTIVES:: Upon completion of this article the reader should be able to: (1) Understand the risk factors for functional decline in older adults with dementia; (2) Articulate the benefits of structured activities and exercises in the older adult with dementia; and (3) Incorporate elastic band exercises into the treatment plan of wheelchair bound older adults with dementia. AdvancedACCREDITATION:: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Effects of Gait Self-Efficacy and Lower-Extremity Physical Function on Dual-Task Performance in Older Adults

PubMed Central

Banducci, Sarah E.; Daugherty, Ana M.; Fanning, Jason; Awick, Elizabeth A.; Porter, Gwenndolyn C.; Burzynska, Agnieszka; Shen, Sa; Kramer, Arthur F.; McAuley, Edward

2017-01-01

Objectives. Despite evidence of self-efficacy and physical function's influences on functional limitations in older adults, few studies have examined relationships in the context of complex, real-world tasks. The present study tested the roles of self-efficacy and physical function in predicting older adults' street-crossing performance in single- and dual-task simulations. Methods. Lower-extremity physical function, gait self-efficacy, and street-crossing success ratio were assessed in 195 older adults (60–79 years old) at baseline of a randomized exercise trial. During the street-crossing task, participants walked on a self-propelled treadmill in a virtual reality environment. Participants crossed the street without distraction (single-task trials) and conversed on a cell phone (dual-task trials). Structural equation modeling was used to test hypothesized associations independent of demographic and clinical covariates. Results. Street-crossing performance was better on single-task trials when compared with dual-task trials. Direct effects of self-efficacy and physical function on success ratio were observed in dual-task trials only. The total effect of self-efficacy was significant in both conditions. The indirect path through physical function was evident in the dual-task condition only. Conclusion. Physical function can predict older adults' performance on high fidelity simulations of complex, real-world tasks. Perceptions of function (i.e., self-efficacy) may play an even greater role. The trial is registered with United States National Institutes of Health ClinicalTrials.gov (ID: NCT01472744; Fit & Active Seniors Trial). PMID:28255557

Geriatric Assessment and Tools for Predicting Treatment Toxicity in Older Adults With Cancer.

PubMed

Li, Daneng; Soto-Perez-de-Celis, Enrique; Hurria, Arti

Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function. Among older patients with cancer, geriatric assessment has been shown to identify patients at risk of poorer overall survival, and geriatric assessment-based tools are significantly more effective in predicting chemotherapy toxicity than other currently utilized measures. In this review, we summarize the components of the geriatric assessment and provide information about existing tools used to predict treatment toxicity in older patients with cancer.

Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults

PubMed Central

Tait, Jamie L.; Duckham, Rachel L.; Milte, Catherine M.; Main, Luana C.; Daly, Robin M.

2017-01-01

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people. PMID:29163146

Poor Sleep Quality is Independently Associated with Physical Disability in Older Adults

PubMed Central

Chien, Meng-Yueh; Chen, Hsi-Chung

2015-01-01

Study Objective: We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. Methods: There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. Results: Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02–4.05). Conclusions: In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors. Citation: Chien MY, Chen HC. Poor sleep quality is independently associated with physical disability in older adults. J Clin Sleep Med 2015;11(3):225–232. PMID:25515275

Maximal, Not Habitual, Walking Velocity is More Highly Correlated to Functional Fitness of Community-Dwelling Older Adults.

PubMed

Gray, Michelle; Paulson, Sally; Powers, Melissa

2016-04-01

The aim of this investigation was to determine the relationship between usual and maximal walking velocities with measures of functional fitness (FF). Fifty-seven older adults (78.2 ± 6.6 years) were recruited from a local retirement community. All participants completed the following assessments: 10-m usual and maximal walk, Short Physical Performance Battery (SPPB), 6-min walk (6MW), 8-foot up-and-go (UPGO), and 30-s chair stand. Based on their SPPB performance, low (≤ 9) and high (≥ 10) FF groups were formed. Among all participants, maximal walking velocity, not usual walking velocity, was significantly correlated with SPPB (r = .35; p < .05 and r = .19; p > .05, respectively). In the high functioning group, both maximal and usual walking velocities were correlated, but correlation coefficients were stronger for all variables for maximal walking velocity. These results suggest different walking conditions may be necessary to use for high and low functioning older adults; specifically, maximal walking velocity may be a preferred measure among high functioning older adults.

Improving nursing students' assessment of fall risk in community-dwelling older adults.

PubMed

Patton, Susan K

2016-12-09

Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

A new perspective on loneliness in later life.

PubMed

Rane-Szostak, D; Herth, K A

1995-01-01

Loneliness in later life remains a serious problem despite extensive research across the life span. Unfortunately, most studies of loneliness that include older adults focus on individuals who are already lonely; findings suggest interventions dependent upon external factors such as socialization and functional status. Such interventions are not always feasible for older adults, who may have experienced social and functional losses. Nurses must adopt a new perspective in examining loneliness in later life. This new perspective should include a more positive approach that focuses on older adults who are not lonely even though they may have experienced decreased socialization or physical function. Identification of strategies employed by these older individuals may be used to help many elders avoid loneliness and help others cope with the related losses so frequent in later life.

A comparative study of negative life events and depressive symptoms among healthy older adults and older adults with chronic disease.

PubMed

Zhang, Han; Gao, Tingting; Gao, Jinglei; Kong, Yixi; Hu, Yueyang; Wang, Ruimei; Mei, Songli

2017-12-01

This study aims to study internal relations and functionary mechanism between social support, coping style, negative life events and depressive symptoms and compare these relations in healthy older adults and older adults with chronic disease. A cross-sectional study was conducted in 2015. In total, 1,264 older adults with chronic disease and 749 healthy older adults participated in this investigation which consist of socio-demographic characters, negative life events, social support, coping style and depressive symptoms. The path and direction of variable function in healthy older adults were inconsistent with older adults with chronic disease. Older adults with chronic disease had more severe depressive symptoms and negative life events, and lower social support and positive coping style. Negative life events, subjective support, positive coping style and negative coping style were significantly predicted depressive symptoms. Objective support may weaken the influence of negative life events on depressive symptoms in chronic disease group. Utilization of support and positive coping style worsen the effect of negative life events on depressive symptoms in healthy older adults. This study implied that to improve their mental health, attention should be paid to the role of biological, psychological and social stress factors and its inherent law of interaction.

A neuropsychological study of older adult first-time sex offenders.

PubMed

Rodriguez, Marcelo; Boyce, Philip; Hodges, John

2017-04-01

The issue of whether sex offenders have cognitive deficits remains controversial. The objective of this study was to compare the neuropsychological function of older adult first time sex-offenders (FTSO), who had not previously been charged with a sexual offence prior to the age of 50, to historical long-term sex offenders (HSO) and non-sex offenders (NSO). The hypotheses were (a) that FTSO would demonstrate greater deficits in executive function, decision-making, and memory compared to non-sex offenders; and (b) the HSOs would present similar neuropsychological deficits to non-sex offenders. A battery of neuropsychological measures was administered to 100 participants comprising 32 FTSOs, 36 HSOs, and 32 NSOs. Both FTSOs and HSOs showed significant impairment on tests of executive function (including verbal fluency, trail-making, and the Hayling test of response inhibition) as well as on tests of verbal and verbal memory compared to NSOs; however, there was no difference between the two sex offender groups. Older adult sex offenders, overall, demonstrated poorer neuropsychological performance than older adult non-sex offenders did, although there was no difference between older first-time and historical offenders. Cognitive deficits may increase the risk of sexual offending due to impaired capacity in self-regulation, planning, judgment, and inhibition. A proportion of older adult sex offenders may be harboring acquired frontal lobe pathology.

Wide range of body composition measures are associated with cognitive function in community-dwelling older adults.

PubMed

Won, Huiloo; Abdul Manaf, Zahara; Mat Ludin, Arimi Fitri; Shahar, Suzana

2017-04-01

Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults. A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass. The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P < 0.05), except for the Rey Auditory Verbal Learning Test. Waist-to-hip ratio was detected as a significant predictor for all cognitive tests among women (P < 0.05), but was only a significant predictor for the Bahasa Malaysia version of Montreal Cognitive Assessment among men (P < 0.05). These results suggest that there is a need to maintain muscle mass and lower adipose tissue among older adults for optimal cognitive function. Geriatr Gerontol Int 2017; 17: 554-560. © 2016 Japan Geriatrics Society.

Cognitive Benefits of Online Social Networking for Healthy Older Adults.

PubMed

Myhre, Janelle W; Mehl, Matthias R; Glisky, Elizabeth L

2017-09-01

Research suggests that older adults who remain socially active and cognitively engaged have better cognitive function than those who are isolated and disengaged. This study examined the efficacy of learning and using an online social networking website, Facebook.com, as an intervention to maintain or enhance cognitive function in older adults. Forty-one older adults were assigned to learn and use Facebook (n = 14) or an online diary website (active control, n = 13) for 8 weeks or placed on a waitlist (n = 14). Outcome measures included neuropsychological tests of executive functions, memory, and processing speed and self-report questionnaires about social engagement. The Facebook group showed a significant increase in a composite measure of updating, an executive function factor associated with complex working memory tasks, compared to no significant change in the control groups. Other measures of cognitive function and social support showed no differential improvement in the Facebook group. Learning and using an online social networking site may provide specific benefits for complex working memory in a group of healthy older adults. This may reflect the particular cognitive demands associated with online social networking and/or the benefits of social engagement more generally. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

PubMed Central

Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18–25), and middle adulthood (ages 26–49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

PubMed

Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

2016-01-01

Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

Changes of geriatric syndromes in older adults survived from Intensive Care Unit.

PubMed

Tang, Hsin-Ju; Tang, Hsin-Yi Jean; Hu, Fang-Wen; Chen, Ching-Huey

Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline. The three most prevalent geriatric syndromes were: functional decline, urination incontinence, and defecation incontinence. Polypharmacy was associated with functioning decline. Patients with delirium were six times more likely to be re-admitted to ICU. Copyright © 2016 Elsevier Inc. All rights reserved.

Curling for Confidence: Psychophysical Benefits of Curling for Older Adults.

PubMed

Stone, Rachael C; Rakhamilova, Zina; Gage, William H; Baker, Joseph

2018-04-01

While physical activity is increasingly promoted for older adults, there is a paucity of sport promotion, which has distinct benefits from exercise and remains stereotypically associated with younger age. Curling is a moderately intense and safe sport that continues to gain popularity; however, no research has investigated psychophysical benefits of curling for older adults. The present study compares high-experience (20+ years; n = 63) and low-experience (<20 years; n = 53) curlers (aged 60+ years) with older adult noncurlers (n = 44) on measures of daily functionality, balance confidence, and perceptions of the aging process. While no significant differences were found between high- and low-experience curlers, any level of experience reported significantly better functionality, physical confidence, and aging attitudes compared to noncurlers (p ≤ .05). Although further research is necessary, the results suggest that any level of curling experience can enhance older adult psychophysical well-being, and warrants consideration for physical activity promotion and falls prevention programs.

[An integrative model of the psychological benefits of gardening in older adults].

PubMed

Tournier, Isabelle; Postal, Virginie

2014-12-01

This review of the literature tackles the question of the psychological benefits linked to gardening in older adults. First, the current data on these benefits are reviewed, and the findings reveal that gardening is linked to feelings of accomplishment, well-being and peace, a decrease of depressive symptoms, a protective effect on cognitive functions as well as to the development of social links for community living older adults. In institutionalized older adults, gardening promotes internal locus of control and well-being, and is related to a decrease of sadness and anxiety. Second, several explanatory theories are discussed. All of them postulate an action on the cognitive and/or emotional spheres, which were included into a integrated model that must be tested in future research. In conclusion, gardening appears to be a beneficial activity for promoting older adults' functioning but the current knowledge still has to be extended to understand the specific mechanisms of action. This deeper understanding is necessary in order to improve the future actions depending on this activity.

Effect of the adapted Virtual Reality cognitive training program among Chinese older adults with chronic schizophrenia: a pilot study.

PubMed

Chan, Christopher L F; Ngai, Elena K Y; Leung, Paul K H; Wong, Stephen

2010-06-01

To examine the effect of the adapted virtual reality cognitive training program in older adults with chronic schizophrenia. Older adults with chronic schizophrenia were recruited from a long-stay care setting and were randomly assigned into intervention (n = 12) and control group (n = 15). The intervention group received 10-session of VR program that consisted of 2 VR activities using IREX. The control group attended the usual programs in the setting. After the 10-session intervention, older adults with chronic schizophrenia preformed significantly better than control in overall cognitive function (p .000), and in two cognitive subscales: repetition (p .001) and memory (p .040). These participants engaged in the VR activities volitionally. No problem of cybersickness was observed. The results of the current study indicate that engaging in the adapted virtual reality cognitive training program offers the potential for significant gains in cognitive function of the older adults with chronic schizophrenia.

The effects of exercise on muscle strength, body composition, physical functioning and the inflammatory profile of older adults: a systematic review.

PubMed

Liberman, Keliane; Forti, Louis N; Beyer, Ingo; Bautmans, Ivan

2017-01-01

This systematic review reports the most recent literature regarding the effects of physical exercise on muscle strength, body composition, physical functioning and inflammation in older adults. All articles were assessed for methodological quality and where possible effect size was calculated. Thirty-four articles were included - four involving frail, 24 healthy and five older adults with a specific disease. One reported on both frail and nonfrail patients. Several types of exercise were used: resistance training, aerobic training, combined resistance training and aerobic training and others. In frail older persons, moderate-to-large beneficial exercise effects were noted on inflammation, muscle strength and physical functioning. In healthy older persons, effects of resistance training (most frequently investigated) on inflammation or muscle strength can be influenced by the exercise modalities (intensity and rest interval between sets). Muscle strength seemed the most frequently used outcome measure, with moderate-to-large effects obtained regardless the exercise intervention studied. Similar effects were found in patients with specific diseases. Exercise has moderate-to-large effects on muscle strength, body composition, physical functioning and inflammation in older adults. Future studies should focus on the influence of specific exercise modalities and target the frail population more.

Physical Activity Is Positively Associated with Episodic Memory in Aging.

PubMed

Hayes, Scott M; Alosco, Michael L; Hayes, Jasmeet P; Cadden, Margaret; Peterson, Kristina M; Allsup, Kelly; Forman, Daniel E; Sperling, Reisa A; Verfaellie, Mieke

2015-11-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18-31 years) and older adults (n=31, ages 55-82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults.

Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries Among Community-Dwelling Older Adults.

PubMed

Taylor-Piliae, Ruth E; Peterson, Rachel; Mohler, Martha Jane

2017-09-01

Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life. For community-dwelling older adults, effective fall prevention has the potential to reduce serious fall-related injuries, emergency room visits, hospitalizations, institutionalization, and functional decline. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining a Brief Suicide Screening Tool in Older Adults Engaging in Risky Alcohol Use

ERIC Educational Resources Information Center

Ribeiro, Jessica D.; Braithwaite, Scott R.; Pfaff, Jon J.; Joiner, Thomas E.

2012-01-01

Alcohol misuse increases risk of suicidal behavior in older adults. The Depressive Symptom Inventory-Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for older adults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061)…

Age differences in everyday problem-solving effectiveness: older adults select more effective strategies for interpersonal problems.

PubMed

Blanchard-Fields, Fredda; Mienaltowski, Andrew; Seay, Renee Baldi

2007-01-01

Using the Everyday Problem Solving Inventory of Cornelius and Caspi, we examined differences in problem-solving strategy endorsement and effectiveness in two domains of everyday functioning (instrumental or interpersonal, and a mixture of the two domains) and for four strategies (avoidance-denial, passive dependence, planful problem solving, and cognitive analysis). Consistent with past research, our research showed that older adults were more problem focused than young adults in their approach to solving instrumental problems, whereas older adults selected more avoidant-denial strategies than young adults when solving interpersonal problems. Overall, older adults were also more effective than young adults when solving everyday problems, in particular for interpersonal problems.

Financial Exploitation Is Associated With Structural and Functional Brain Differences in Healthy Older Adults.

PubMed

Spreng, R Nathan; Cassidy, Benjamin N; Darboh, Bri S; DuPre, Elizabeth; Lockrow, Amber W; Setton, Roni; Turner, Gary R

2017-10-01

Age-related brain changes leading to altered socioemotional functioning may increase vulnerability to financial exploitation. If confirmed, this would suggest a novel mechanism leading to heightened financial exploitation risk in older adults. Development of predictive neural markers could facilitate increased vigilance and prevention. In this preliminary study, we sought to identify structural and functional brain differences associated with financial exploitation in older adults. Financially exploited older adults (n = 13, 7 female) and a matched cohort of older adults who had been exposed to, but avoided, a potentially exploitative situation (n = 13, 7 female) were evaluated. Using magnetic resonance imaging, we examined cortical thickness and resting state functional connectivity. Behavioral data were collected using standardized cognitive assessments, self-report measures of mood and social functioning. The exploited group showed cortical thinning in anterior insula and posterior superior temporal cortices, regions associated with processing affective and social information, respectively. Functional connectivity encompassing these regions, within default and salience networks, was reduced, while between network connectivity was increased. Self-reported anger and hostility was higher for the exploited group. We observed financial exploitation associated with brain differences in regions involved in socioemotional functioning. These exploratory and preliminary findings suggest that alterations in brain regions implicated in socioemotional functioning may be a marker of financial exploitation risk. Large-scale, prospective studies are necessary to validate this neural mechanism, and develop predictive markers for use in clinical practice. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Influence of direct computer experience on older adults' attitudes toward computers.

PubMed

Jay, G M; Willis, S L

1992-07-01

This research examined whether older adults' attitudes toward computers became more positive as a function of computer experience. The sample comprised 101 community-dwelling older adults aged 57 to 87. The intervention involved a 2-week computer training program in which subjects learned to use a desktop publishing software program. A multidimensional computer attitude measure was used to assess differential attitude change and maintenance of change following training. The results indicated that older adults' computer attitudes are modifiable and that direct computer experience is an effective means of change. Attitude change as a function of training was found for the attitude dimensions targeted by the intervention program: computer comfort and efficacy. In addition, maintenance of attitude change was established for at least two weeks following training.

Neighborhood Psychosocial Stressors, Air Pollution, and Cognitive Function among Older U.S. Adults

PubMed Central

Ailshire, Jennifer; Karraker, Amelia; Clarke, Philippa

2016-01-01

A growing number of studies have found a link between outdoor air pollution and cognitive function among older adults. Psychosocial stress is considered an important factor determining differential susceptibility to environmental hazards and older adults living in stressful neighborhoods may be particularly vulnerable to the adverse health effects of exposure to hazards such as air pollution. The objective of this study is to determine if neighborhood social stress amplifies the association between fine particulate matter air pollution (PM2.5) and poor cognitive function in older, community-dwelling adults. We use data on 779 U.S. adults ages 55 and older from the 2001/2002 wave of the Americans’ Changing Lives study. We determined annual average PM2.5 concentration in 2001 in the area of residence by linking respondents with EPA air monitoring data using census tract identifiers. Cognitive function was measured using the number of errors on the Short Portable Mental Status Questionnaire (SPMSQ). Exposure to neighborhood social stressors was measured using perceptions of disorder and decay and included subjective evaluations of neighborhood upkeep and the presence of deteriorating/abandoned buildings, trash, and empty lots. We used negative binomial regression to examine the interaction of neighborhood perceived stress and PM2.5 on the count of errors on the cognitive function assessment. We found that the association between PM2.5 and cognitive errors was stronger among older adults living in high stress neighborhoods. These findings support recent theoretical developments in environmental health and health disparities research emphasizing the synergistic effects of neighborhood social stressors and environmental hazards on residents’ health. Those living in socioeconomically disadvantaged neighborhoods, where social stressors and environmental hazards are more common, may be particularly susceptible to adverse health effects of social and physical environmental exposures. PMID:27886528

Daily Physical Activity and Cognitive Function Variability in Older Adults.

PubMed

Phillips, Christine B; Edwards, Jerri D; Andel, Ross; Kilpatrick, Marcus

2016-04-01

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

Anemia in Frailty

PubMed Central

Roy, Cindy N.

2010-01-01

Synopsis While anemia is regarded as a relatively common occurrence in older adults, the vigor with which the medical community should intervene to correct this common problem is disputed. Epidemiologic data clearly correlate anemia with functional decline, disability and mortality. Anemia may contribute to functional decline by restricting oxygen delivery to muscle, or to cognitive decline by restricting oxygen delivery to the brain. On the other hand, the erythron may be a separate target of the same biological mediators that influence deterioration of physiologic systems that contribute to weakness, functional and cognitive decline and mortality. Clinical trials aimed to treat anemia in older adults could assess whether physical performance is improved or whether mortality risk declines with improved hemoglobin, but sufficient evidence from such trials is currently lacking. With few guidelines regarding treatment for older adults and significant risk for adverse events associated with transfusion and erythroid stimulating agents (ESA), anemia often goes untreated or ignored in geriatric clinics. This article reviews the problem of anemia in older adults, with a particular emphasis on the frail elderly. We will review the gaps in our evidence base for the treatment of anemia in older adults and assess options for advancing the field. PMID:21093723

Dietary strawberry improves cognition in older adults: a randomized, double-blind, placebo-controlled study

USDA-ARS?s Scientific Manuscript database

Older adults experience a variety of functional changes that decrease their quality of life with age-related cognitive decline and reduced mobility being of particular concern. Pre-clinical research indicates that berry fruit offer a promising dietary approach to preserving nervous system function, ...

The Effectiveness of Community-Based Occupational Therapy Education and Functional Training Programs for Older Adults: A Critical Literature Review.

ERIC Educational Resources Information Center

Wilkins, Seanne; Jung, Bonny; Wishart, Laurie; Edwards, Mary; Norton, Shelley Gamble

2003-01-01

Results of a literature review describing the provision of education and occupational therapy training programs for older adults indicate that programs are effective in three areas: prevention of functional decline and falls, stroke, and rheumatoid arthritis. (Contains 37 references.) (JOW)

Functional near-infrared spectroscopy (fNIRS) brain imaging of multi-sensory integration during computerized dynamic posturography in middle-aged and older adults.

PubMed

Lin, Chia-Cheng; Barker, Jeffrey W; Sparto, Patrick J; Furman, Joseph M; Huppert, Theodore J

2017-04-01

Studies suggest that aging affects the sensory re-weighting process, but the neuroimaging evidence is minimal. Functional Near-Infrared Spectroscopy (fNIRS) is a novel neuroimaging tool that can detect brain activities during dynamic movement condition. In this study, fNIRS was used to investigate the hemodynamic changes in the frontal-lateral, temporal-parietal, and occipital regions of interest (ROIs) during four sensory integration conditions that manipulated visual and somatosensory feedback in 15 middle-aged and 15 older adults. The results showed that the temporal-parietal ROI was activated more when somatosensory and visual information were absent in both groups, which indicated the sole use of vestibular input for maintaining balance. While both older adults and middle-aged adults had greater activity in most brain ROIs during changes in the sensory conditions, the older adults had greater increases in the occipital ROI and frontal-lateral ROIs. These findings suggest a cortical component to sensory re-weighting that is more distributed and requires greater attention in older adults.

Effects of Androgen Blockade on Cognitive Function and Quality of Life in Men with Prostate Cancer

DTIC Science & Technology

2006-08-01

especially among older adults , for whom cognitive impairment may be associated with impaired performance of activities of daily living (ADL), instrumental...is needed for performance of concurrent tasks) is often impaired among older adults (Raz, 2000). Among older men, working memory has been shown to...in a number of populations--especially older adults , who will be the primary target of this study--and has some experience with the cognitive effects

Impacts of dance on non-motor symptoms, participation, and quality of life in Parkinson disease and healthy older adults.

PubMed

McNeely, M E; Duncan, R P; Earhart, G M

2015-12-01

Evidence indicates exercise is beneficial for motor and non-motor function in older adults and people with chronic diseases including Parkinson disease (PD). Dance may be a relevant form of exercise in PD and older adults due to social factors and accessibility. People with PD experience motor and non-motor symptoms, but treatments, interventions, and assessments often focus more on motor symptoms. Similar non-motor symptoms also occur in older adults. While it is well-known that dance may improve motor outcomes, it is less clear how dance affects non-motor symptoms. This review aims to describe the effects of dance interventions on non-motor symptoms in older adults and PD, highlights limitations of the literature, and identifies opportunities for future research. Overall, intervention parameters, study designs, and outcome measures differ widely, limiting comparisons across studies. Results are mixed in both populations, but evidence supports the potential for dance to improve mood, cognition, and quality of life in PD and healthy older adults. Participation and non-motor symptoms like sleep disturbances, pain, and fatigue have not been measured in older adults. Additional well-designed studies comparing dance and exercise interventions are needed to clarify the effects of dance on non-motor function and establish recommendations for these populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A battery of tests for assessing cognitive function in U.S. Chinese older adults--findings from the PINE Study.

PubMed

Chang, E-Shien; Dong, XinQi

2014-11-01

Existing methodological challenges in aging research has dampened our assessment of cognitive function among minority older adults. We aim to report the composite scores of five cognitive function tests among U.S. Chinese older adults, and examine the association between cognitive function and key sociodemographic characteristics. The Population Study of Chinese Elderly in Chicago Study enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults. We administered five cognitive function tests, including the Chinese Mini-Mental State Examination, the immediate and delayed recall of the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. We used Spearman correlation coefficients to examine the correlation between cognitive function and sociodemographic variables. Linear regression models were used to report the effect of sociodemographic and health variables including age, sex, education on cognitive function. Our multivariate analysis suggested that performance in each domain of cognitive function was inversely associated with age and positively related to education. With respect to sex, after adjusted for age, education and all key variables presented in the model, being male was positively related to global cognitive score and working memory. Being married, having fewer children, having been in the United States for fewer years, having been in the community for fewer years, and better self-reported health were positively correlated with all cognitive function domains. This population-based study of U.S. Chinese older adults is among the first to examine a battery of five cognitive function tests, which in aggregate enables researchers to capture a wide range of cognitive performance. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

PubMed

Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

2016-07-01

To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and tailored strategies to reduce the risk for unplanned admissions.

Predicting sarcopenia from functional measures among community-dwelling older adults.

PubMed

Gray, Michelle; Glenn, Jordan M; Binns, Ashley

2016-02-01

Sarcopenia is defined as age-related lean tissue mass (LTM) loss resulting in reduced muscular strength, physical function, and mobility. Up to 33 % of older adults currently are sarcopenic, with likely many more undiagnosed. The purpose of this investigation was to predict sarcopenia status from easily accessible functional measures of community-dwelling older adults. Forty-three community-dwelling older adults (n = 32 females and n = 11 males) participated in the present investigation. Inclusion criteria included ≥65 years of age, mini-mental state examination score ≥24, and no falls within previous 12 months. All subjects completed their appendicular skeletal mass (ASM) assessment via dual-energy X-ray absorptiometry (DXA) and were categorized as either sarcopenic or non-sarcopenic. Physical assessments included 10-m usual walk, hand-grip (HG) strength, 6-min walk, 8-ft up-and-go, 30-s chair stand, 30-s arm curl, and sit-to-stand muscular power. A forward, stepwise multiple regression analysis revealed that age, sex, weight, height, 10-m walk, HG, and sit-to-stand muscular power account for 96.1 % of the variance in ASM. The area under the curve was 0.92 for correctly identifying sarcopenic participants compared to their actual classification. This is the first prediction model used to identify sarcopenia based on parameters of demographic and functional fitness measures in community-dwelling older adults. The ability to accurately identify sarcopenia in older adults is imperative to their quality of life and ability to perform activities of daily living.

Visual processing speed.

PubMed

Owsley, Cynthia

2013-09-20

Older adults commonly report difficulties in visual tasks of everyday living that involve visual clutter, secondary task demands, and time sensitive responses. These difficulties often cannot be attributed to visual sensory impairment. Techniques for measuring visual processing speed under divided attention conditions and among visual distractors have been developed and have established construct validity in that those older adults performing poorly in these tests are more likely to exhibit daily visual task performance problems. Research suggests that computer-based training exercises can increase visual processing speed in older adults and that these gains transfer to enhancement of health and functioning and a slowing in functional and health decline as people grow older. Copyright © 2012 Elsevier Ltd. All rights reserved.

Case management for frail older adults through tablet computers and Skype.

PubMed

Berner, Jessica; Anderberg, Peter; Rennemark, Mikael; Berglund, Johan

2016-12-01

Frail older adults are high consumers of medical care due to their age and multiple chronic conditions. Regular contact with a case manager has been proven to increase well-being of frail older adults and reduce their number of health-care visits. Skype calls through tablet PCs can offer easier communication. This paper examines frail older adults' use of tablet computers and Skype, with their case managers. Interviews were conducted on 15 frail older adults. A content analysis was used to structure and analyze the data. The results indicate that tablet computers were experienced in a positive way for most frail older adults. Conflicting feelings did emerge, however, as to whether the frail elderly would adopt this in the long run. Skype needs to be tested further as to whether this is a good solution for communication with their case managers. Strong technical support and well-functioning technology are important elements to facilitate use. Using Skype and tablet PCs do have potential for frail older adults, but need to be tested further.

Association between the older adults' social relationships and functional status in Japan.

PubMed

Watanabe, Kumi; Tanaka, Emiko; Watanabe, Taeko; Chen, Wencan; Wu, Bailiang; Ito, Sumio; Okumura, Rika; Anme, Tokie

2017-10-01

Previous studies have shown that social relationships positively contribute to the functioning of older adults. However, the particular aspects of social relationships that are most predictive remain unknown. Consequently, the current study aimed to clarify what elements of social relationships impacted the maintenance of functioning among older adults. The present study used baseline data collected in 2011, and follow-up surveys were carried out 3 years later. Participants included individuals aged 65 years or older who lived in a suburban community in Japan. A total of 434 participants met inclusion criteria for the study and were included in analysis. The Index of Social Interaction measure consists of five subscales (independence, social curiosity, interaction, participation and feeling of safety), and was used to assess the multiple elements of social relationships. After controlling for age, sex, disease status and mobility in 2011, the results showed that the social curiosity subscale was significantly associated with functional status after 3 years (OR 1.29, 95% CI 1.02-1.63). Other Index of Social Interaction subscales were non-significant. The current study suggests that interaction with environment and multifaceted social relationships have the strongest impact on functional ability for older adults in Japan. Geriatr Gerontol Int 2017; 17: 1522-1526. © 2016 Japan Geriatrics Society.

Perceptual processing deficits underlying reduced FFOV efficiency in older adults.

PubMed

Power, Garry F; Conlon, Elizabeth G

2017-01-01

Older adults are known to perform more poorly on measures of the functional field of view (FFOV) than younger adults. Specific contributions by poor bottom-up and or top-down control of visual attention to the reduced FFOV of older adults were investigated. Error rates of older and younger adults were compared on a FFOV task in which a central identification task, peripheral localization task, and peripheral distractors were presented in high and low contrast. Older adults made more errors in all conditions. The effect of age was independent of the contrast of the peripheral target or distractors. The performance cost of including the central task was measured and found to be negligible for younger adults. For older adults performance costs were present in all conditions, greater with distractors than without, and greater for a low rather than high contrast central stimulus when the peripheral target was high contrast. These results are consistent with older adults compensating for reduced sensory input or bottom-up capture of attention by relying more heavily on top-down control for which they are resource limited.

Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults.

PubMed

Loprinzi, Paul D

2016-06-01

Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P < 0.001). Compared to those not engaging in aerobic exercise and not meeting muscle-strengthening activity guidelines, those doing 1 (βadjusted = 3.7; 95% CI: 1.9-5.4; P < 0.001) and both (βadjusted = 6.6; 95% CI: 4.8-8.3; P < 0.001) of these behaviors had a significantly higher executive cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults. © The Author(s) 2016.

Prevalence of malnutrition and its correlates in older adults living in long stay institutions situated in Beirut, Lebanon.

PubMed

El Zoghbi, Mohamad; Boulos, Christa; Awada, Sanaa; Rachidi, Samar; Al-Hajje, Amal; Bawab, Wafaa; Saleh, Nadine; Salameh, Pascale

2014-01-01

Malnutrition represents an important issue in older adults; unfortunately, there is lack of data concerning this topic in Lebanon. This paper aims to provide a description of nutritional status and its correlates in older adults living in long stay institutions situated in Beirut. This cross-sectional study was conducted in three long stay institutions in Beirut in 2012. The study population was composed of people aged 65 years and above, having a score of Folstein Mini Mental State Examination (MMSE) greater than 14 and without renal failure requiring dialysis. Subjects meeting inclusion criteria filled out a questionnaire consisting of nutritional status scale (Mini Nutritional Assessment: MNA) and several other parts (demographic, self-assessment of the state health, smoking and alcohol, physical dependence, quality of life, frailty, depression, social isolation and loneliness). Data were entered and analyzed using the statistical software SPSS (Statistical Package for Social Sciences), version 17.0 (Chicago, IL, USA). Among 111 older adults (55 men and 56 women), 14 (12.6%) were malnourished, 54 (48.7%) were at risk of malnutrition and 43 (38.7%) had an adequate nutritional status. Multivariate analysis showed that physical exercise, depression, frailty and cognitive function were independent correlates of nutritional status of older adults. This model explained 42.2% (adjusted R2 = 0.422) of the older adults nutritional status variability. We found a moderate percentage of malnutrition in older adults living in long stay institutions situated in Beirut, and the correlates of malnutrition in older adults were low physical exercise, depression, frailty and low cognitive function.

Background characteristics, resources and volunteering among older adults (aged ≥70 years) in the community: A longitudinal study.

PubMed

Cramm, Jane M; Nieboer, Anna P

2015-08-01

The aim of the present study was to describe (in)formal volunteering among older adults (aged ≥70 years) in the community, and the longitudinal relationships between background characteristics, resources (social, cognitive and physical functioning, social capital) and volunteering. At baseline, a total of 945 (out of 1440) independently living Dutch older adults (aged ≥70 years) completed the questionnaire (66% response). Two years later, these respondents were asked to complete a questionnaire again, of which 588 (62%) responded. Of 945 respondents (43% male; mean age 77.5 ± 5.8 years, range 70-101 years), 34.7% were married and 83.3% were born in the Netherlands. Social capital, social functioning and physical functioning were significantly higher among volunteering older adults. Being born in the Netherlands, higher educational level, social capital and social functioning were related to formal volunteering activities at baseline, and also predicted these activities 2 years later. Regarding informal volunteering activities, we found a significant association with age, being born in the Netherlands, marital status, educational level, social capital and social functioning at baseline. Examining their predictive nature, we found that younger age, being born in the Netherlands, social capital and physical functioning were associated with engagement in informal volunteering activities 2 years later. The present study shows that older adults remain engaged in volunteering activities, and that background characteristics (e.g. ethnic background, education) and resources (social functioning, social capital) contribute to this engagement. © 2014 Japan Geriatrics Society.

Aging, subjective experience, and cognitive control: dramatic false remembering by older adults.

PubMed

Jacoby, Larry L; Bishara, Anthony J; Hessels, Sandra; Toth, Jeffrey P

2005-05-01

Recent research suggests that older adults are more susceptible to interference effects than are young adults; however, that research has failed to equate differences in original learning. In 4 experiments, the authors show that older adults are more susceptible to interference effects produced by a misleading prime. Even when original learning was equated, older adults were 10 times as likely to falsely remember misleading information and were much less likely to increase their accuracy by opting not to answer under conditions of free responding. The results are well described by a multinomial model that postulates multiple modes of cognitive control. According to that model, older adults are likely to be captured by misleading information, a form of goal neglect or deficit in inhibitory functions. Copyright 2005 APA, all rights reserved.

Laryngeal Aerodynamics in Healthy Older Adults and Adults with Parkinson's Disease

ERIC Educational Resources Information Center

Matheron, Deborah; Stathopoulos, Elaine T.; Huber, Jessica E.; Sussman, Joan E.

2017-01-01

Purpose: The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method: Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and…

Beliefs about age-related changes in physical functioning across the adult life span and their relationship with physical activity levels of older adults.

PubMed

Lineweaver, Tara T; Kugler, Jennifer; Rabellino, Alessandra; Stephan, Yannick

2018-07-01

Physical activity declines across the adult life span despite the well-established links between physical activity and health-related, psychological, cognitive, and social benefits. We contrasted the beliefs young and older adults hold about how aging affects both physical abilities and physical activity and determined whether older adults' beliefs about physical aging relate to their engagement in physical activity. Using visual rating scales, 56 young and 49 community-dwelling older adults indicated the extent to which a typical woman or typical man aged 20-90 possesses six different physical abilities and engages in three different types of physical activity. Stereotypes of physical aging were ability- and activity-specific, and older adults endorsed more positive views than their younger peers. Stereotypical beliefs predicted older adults' engagement in moderate-intensity activity. This study offers intriguing avenues for future research and suggests that better understanding physical aging stereotypes may contribute toward designing interventions that promote lifelong physical activity.

Influenza vaccine-mediated protection in older adults: Impact of influenza infection, cytomegalovirus serostatus and vaccine dosage.

PubMed

Merani, Shahzma; Kuchel, George A; Kleppinger, Alison; McElhaney, Janet E

2018-07-01

Age-related changes in T-cell function are associated with a loss of influenza vaccine efficacy in older adults. Both antibody and cell-mediated immunity plays a prominent role in protecting older adults, particularly against the serious complications of influenza. High dose (HD) influenza vaccines induce higher antibody titers in older adults compared to standard dose (SD) vaccines, yet its impact on T-cell memory is not clear. The aim of this study was to compare the antibody and T-cell responses in older adults randomized to receive HD or SD influenza vaccine as well as determine whether cytomegalovirus (CMV) serostatus affects the response to vaccination, and identify differences in the response to vaccination in those older adults who subsequently have an influenza infection. Older adults (≥65years) were enrolled (n=106) and randomized to receive SD or HD influenza vaccine. Blood was collected pre-vaccination, followed by 4, 10 and 20weeks post-vaccination. Serum antibody titers, as well as levels of inducible granzyme B (iGrB) and cytokines were measured in PBMCs challenged ex vivo with live influenza virus. Surveillance conducted during the influenza season identified those with laboratory confirmed influenza illness or infection. HD influenza vaccination induced a high antibody titer and IL-10 response, and a short-lived increase in Th1 responses (IFN-γ and iGrB) compared to SD vaccination in PBMCs challenged ex vivo with live influenza virus. Of the older adults who became infected with influenza, a high IL-10 and iGrB response in virus-challenged cells was observed post-infection (week 10 to 20), as well as IFN-γ and TNF-α at week 20. Additionally, CMV seropositive older adults had an impaired iGrB response to influenza virus-challenge, regardless of vaccine dose. This study illustrates that HD influenza vaccines have little impact on the development of functional T-cell memory in older adults. Furthermore, poor outcomes of influenza infection in older adults may be due to a strong IL-10 response to influenza following vaccination, and persistent CMV infection. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of Healthy Aging and Mild Cognitive Impairment on a Real-Life Decision-Making Task.

PubMed

Pertl, Marie-Theres; Benke, Thomas; Zamarian, Laura; Delazer, Margarete

2017-01-01

In this study, we investigated the effects of age and of mild cognitive impairment (MCI) on decision making under risk by adopting a task representing real-life health-related situations and involving complex numerical information. Moreover, we assessed the relationship of real-life decision making to other cognitive functions such as number processing, executive functions, language, memory, and attention. For this reason, we compared the performance of 19 healthy, relatively younger adults with that of 18 healthy older adults and the performance of the 18 healthy older adults with that of 17 patients with MCI. Results indicated difficulties in real-life decision making for the healthy older adults compared with the healthy, relatively younger adults. Difficulties of patients with MCI relative to the healthy older adults arose in particular in difficult items requiring processing of frequencies and fractions. Significant effects of age and of MCI in processing frequencies were also evident in a ratio number comparison task. Decision-making performance of healthy participants and of the patient group correlated significantly with number processing. There was a further significant correlation with executive functions for the healthy participants and with reading comprehension for the patients. Our results suggest that healthy older individuals and patients with MCI make less advantageous decisions when the information is complex and high demands are put on executive functions and numerical abilities. Moreover, we show that executive functions and numerical abilities are not only essential in laboratory gambling tasks but also in more realistic and ecological decision situations within the health context.

Does yoga engender fitness in older adults? A critical review.

PubMed

Roland, Kaitlyn P; Jakobi, Jennifer M; Jones, Gareth R

2011-01-01

Interest in yoga is growing, especially among older adults. This review critically summarizes the current literature to investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults. A comprehensive search yielded 507 studies; 10 studies with 544 participants (69.6 ± 6.3 yr, 71% female) were included. Large variability in yoga styles and measurement outcomes make it challenging to interpret results across studies. Studies reported moderate improvements for gait (ES = 0.54, 0.80), balance (ES = 0.25-1.61), upper/lower body flexibility (ES = 0.25, 0.70), lower body strength (ES = 0.51), and weight loss (ES = 0.73, 0.99).Yoga may engender improvements in some components of fitness in older adults. However, more evidence is needed to determine its effectiveness as an alternative exercise to promote fitness in older adults. Further investigation into yoga as an exercise activity for older adults is warranted.

Load Modulation of BOLD Response and Connectivity Predicts Working Memory Performance in Younger and Older Adults

ERIC Educational Resources Information Center

Nagel, Irene E.; Preuschhof, Claudia; Li, Shu-Chen; Nyberg, Lars; Backman, Lars; Lindenberger, Ulman; Heekeren, Hauke R.

2011-01-01

Individual differences in working memory (WM) performance have rarely been related to individual differences in the functional responsivity of the WM brain network. By neglecting person-to-person variation, comparisons of network activity between younger and older adults using functional imaging techniques often confound differences in activity…

Poor sleep quality is independently associated with physical disability in older adults.

PubMed

Chien, Meng-Yueh; Chen, Hsi-Chung

2015-03-15

We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02-4.05). In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors. © 2014 American Academy of Sleep Medicine.

The benefits of endurance exercise and Tai Chi Chuan for the task-switching aspect of executive function in older adults: an ERP study.

PubMed

Fong, Dong-Yang; Chi, Li-Kang; Li, Fuzhong; Chang, Yu-Kai

2014-01-01

This study was designed to determine the relationship between physical activity and the task-switching aspect of executive function by investigating the modulating roles of age, modality of physical activity, and type of cognitive function using behavioral and event-related potential (ERP) assessments. Sixty-four participants were assigned to one of four groups based on age and history of physical activity: older adults performing endurance exercise (OEE), older adults practicing Tai Chi Chuan (OTC), older adults with a sedentary lifestyle (OSL), and young adults (YA). Study participants completed a task-switching task under homogeneous and heterogeneous conditions while ERPs were recorded. The results revealed that YA had shortest reaction times compared with the three older adults groups, with OSL exhibiting the longest reaction time. YA also exhibited shorter P3 latency than OSL. No differences were observed in P3 amplitude between YA, OEE, and OTC; however, all three groups had significantly larger P3 amplitude compared with OSL in both task conditions. In conclusion, age and participation in physical activity influence the relationship between physical activity and task-switching, and a positive relationship was observed regardless of the modality of physical activity and type of cognitive function. Our ERP findings support the model of the scaffolding theory of aging and cognition (STAC) and suggest that regular participation in endurance exercise and Tai Chi Chuan may have equivalent beneficial effects on cognition at the behavioral and neuroelectric levels.

The benefits of endurance exercise and Tai Chi Chuan for the task-switching aspect of executive function in older adults: an ERP study

PubMed Central

Fong, Dong-Yang; Chi, Li-Kang; Li, Fuzhong; Chang, Yu-Kai

2014-01-01

This study was designed to determine the relationship between physical activity and the task-switching aspect of executive function by investigating the modulating roles of age, modality of physical activity, and type of cognitive function using behavioral and event-related potential (ERP) assessments. Sixty-four participants were assigned to one of four groups based on age and history of physical activity: older adults performing endurance exercise (OEE), older adults practicing Tai Chi Chuan (OTC), older adults with a sedentary lifestyle (OSL), and young adults (YA). Study participants completed a task-switching task under homogeneous and heterogeneous conditions while ERPs were recorded. The results revealed that YA had shortest reaction times compared with the three older adults groups, with OSL exhibiting the longest reaction time. YA also exhibited shorter P3 latency than OSL. No differences were observed in P3 amplitude between YA, OEE, and OTC; however, all three groups had significantly larger P3 amplitude compared with OSL in both task conditions. In conclusion, age and participation in physical activity influence the relationship between physical activity and task-switching, and a positive relationship was observed regardless of the modality of physical activity and type of cognitive function. Our ERP findings support the model of the scaffolding theory of aging and cognition (STAC) and suggest that regular participation in endurance exercise and Tai Chi Chuan may have equivalent beneficial effects on cognition at the behavioral and neuroelectric levels. PMID:25389403

In Defense of Offering Educational Programs for Older Adults.

ERIC Educational Resources Information Center

Mehrotra, Chandra M.

2003-01-01

Older adults participate in education to fulfil coping, expressive, contributive, influence, and transcendence needs. Learning can promote sustained mental functioning and increase self-efficacy and social support. (Contains 15 references.) (SK)

Differential relationships of somatic and cognitive anxiety with measures of processing speed in older adults.

PubMed

Schoen, Chelsea B; Holtzer, Roee

2017-09-01

Research suggests a reciprocal relationship between late-life anxiety and cognition, particularly attention and executive functions. Whereas evidence supports a conceptual distinction between cognitive and somatic dimensions of anxiety, their differential relationship with cognitive outcomes has not been examined, particularly on tests of attention/executive functions that rely on processing speed. Study goals were threefold: (a) to describe levels of overall, cognitive, and somatic anxiety in a sample of older adults without dementia, (b) to determine if overall anxiety is associated with performance on select measures of attention/executive functions that rely on processing speed, and (c) to determine if a differential relationship exists between cognitive and somatic anxiety and cognitive performance. Participants were 368 community-dwelling older adults. Results showed that elevated levels of somatic, but not cognitive anxiety were associated with poorer performance across measures. Findings suggest that the nature of anxiety symptoms may have important implications for cognitive performance in older adults.

Gardening Activities and Physical Health Among Older Adults: A Review of the Evidence.

PubMed

Nicklett, Emily J; Anderson, Lynda A; Yen, Irene H

2016-06-01

Few studies have examined the health-related consequences of gardening among older adults. This scoping review summarizes and characterizes current research that examines the relationship between physical health and participation in planned gardening activities, including establishing, maintaining, or caring for plants. Six databases were searched. Eligible studies were published between 2000 and 2013, were published in English, and assessed different aspects of physical health (e.g., functional ability, energy expenditure, injury) for older adults who had participated in a planned gardening activity. Of the eight eligible studies identified with these criteria, four assessed energy expenditures and four assessed physical functioning. Studies assessing energy expenditures documented that the majority of gardening tasks were classified into low-to-moderate intensity physical activity. The current literature does not provide sufficient evidence of the physical functioning consequences of gardening. Future studies should consider how specific gardening interventions help older adults meet physical activity guidelines. © The Author(s) 2014.

Eye movements and the perceptual span during first- and second-language sentence reading in bilingual older adults.

PubMed

Whitford, Veronica; Titone, Debra

2016-02-01

This study addressed a central yet previously unexplored issue in the psychological science of aging, namely, whether the advantages of healthy aging (e.g., greater lifelong experience with language) or disadvantages (e.g., decreases in cognitive and sensory processing) drive L1 and L2 reading performance in bilingual older adults. To this end, we used a gaze-contingent moving window paradigm to examine both global aspects of reading fluency (e.g., reading rates, number of regressions) and the perceptual span (i.e., allocation of visual attention into the parafovea) in bilingual older adults during L1 and L2 sentence reading, as a function of individual differences in current L2 experience. Across the L1 and L2, older adults exhibited reduced reading fluency (e.g., slower reading rates, more regressions), but a similar perceptual span compared with matched younger adults. Also similar to matched younger adults, older adults' reading fluency was lower for L2 reading than for L1 reading as a function of current L2 experience. Specifically, greater current L2 experience increased L2 reading fluency, but decreased L1 reading fluency (for global reading measures only). Taken together, the dissociation between intact perceptual span and impaired global reading measures suggests that older adults may prioritize parafoveal processing despite age-related encoding difficulties. Consistent with this interpretation, post hoc analyses revealed that older adults with higher versus lower executive control were more likely to adopt this strategy. (c) 2016 APA, all rights reserved).

TRX Suspension Training: A New Functional Training Approach for Older Adults - Development, Training Control and Feasibility.

PubMed

Gaedtke, Angus; Morat, Tobias

Because of its proximity to daily activities functional training becomes more important for older adults. Sling training, a form of functional training, was primarily developed for therapy and rehabilitation. Due to its effects (core muscle activation, strength and balance improvements), sling training may be relevant for older adults. However, to our knowledge no recent sling training program for healthy older adults included a detailed training control which is indeed an essential component in designing and implementing this type of training to reach positive effects. The purpose of this study was to develop a TRX Suspension Training for healthy older adults (TRX-OldAge) and to evaluate its feasibility. Eleven participants finished the 12 week intervention study. All participants trained in the TRX-OldAge whole-body workout which consists of seven exercises including 3-4 progressively advancing stages of difficulty for every exercise. At each stage, intensity could be increased through changes in position. Feasibility data was evaluated in terms of training compliance and a self-developed questionnaire for rating TRX-OldAge. The training compliance was 85 %. After study period, 91 % of the participants were motivated to continue with the program. The training intensity, duration and frequency were rated as optimal. All participants noted positive effects whereas strength gains were the most. On the basis of the detailed information about training control, TRX-OldAge can be individually adapted for each older adult appropriate to its precondition, demands and preference.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana.

PubMed

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-09-27

Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

PubMed Central

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-01-01

Background Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people. PMID:20963186

Physical Activity Is Positively Associated with Episodic Memory in Aging

PubMed Central

Hayes, Scott M.; Alosco, Michael L.; Hayes, Jasmeet P.; Cadden, Margaret; Peterson, Kristina M.; Allsup, Kelly; Forman, Daniel E.; Sperling, Reisa A.; Verfaellie, Mieke

2016-01-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n = 29, age 18–31 years) and older adults (n = 31, ages 55–82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults. PMID:26581790

The influence of prior rape on the psychological and physical health functioning of older adults.

PubMed

Sachs-Ericsson, Natalie; Kendall-Tackett, Kathleen A; Sheffler, Julia; Arce, Darleine; Rushing, Nicole C; Corsentino, Elizabeth

2014-01-01

Older adults who have experienced traumatic events earlier in life may be especially vulnerable to additional challenges associated with aging. In a cross-sectional study of older females, the present study examines whether a history of rape is associated with current psychological and health problems. This study used existing data from the female respondents (N = 1228) in the National Social Life, Health, and Aging Project (NSHAP), a national probability sample of adults between the ages of 57 and 85 interviewed in their homes. It was determined whether or not the participant experienced forced sexual contact since the age of 18. Measures of psychological health (e.g., scales of depression, anxiety, and loneliness), the presence or absence of a number of serious health problems, and a one-item measure of self-esteem were obtained. Adult rape occurred in 7% of the sample. On average, 36 years had elapsed since the rape had occurred. Using structural equation modeling (SEM), rape was associated with lower self-esteem, psychological, and physical health functioning. Self-esteem partially mediated the association between rape and psychological functioning, but not health functioning. These associations were significant even after controlling for participant characteristics and risky health behaviors. Mechanisms linking prior rape to psychological and health problems in older age are discussed, as well as treatment recommendations for symptomatic older adults.

Evaluation of Verbal Behavior in Older Adults

ERIC Educational Resources Information Center

Gross, Amy C.; Fuqua, Wayne; Merritt, Todd A.

2013-01-01

Approximately 5% of older adults have a dementia diagnosis, and language deterioration is commonly associated with this disorder (Kempler, 2005). Several instruments have been developed to diagnose dementia and assess language capabilities of elderly adults. However, none of these instruments take a functional approach to language assessment as…

Developing and validating a localised, self-training mindfulness programme for older Singaporean adults: effects on cognitive functioning and implications for healthcare

PubMed Central

Tam, Bryan Wei Hoe; Lo, Dana Rui Ting; Seah, Daniel Wen Hao; Lee, Jun Xian; Foo, Zann Fang Ying; Poh, Zoe Yu Yah; Thong, Fionna Xiu Jun; Sim, Sam Kim Yang; Chee, Chew Sim

2017-01-01

There is a paucity of research available on the effect of mindfulness on cognitive function. However, the topic has recently gained more attention due to the ageing population in Singapore, catalysed by recent findings on brain function and cellular ageing. Recognising the potential benefits of practising mindfulness, we aimed to develop a localised, self-training mindfulness programme, guided by expert practitioners and usability testing, for older Singaporean adults. This was followed by a pilot study to examine the potential cognitive benefits and feasibility of this self-training programme for the cognitive function of older adults in Singapore. We found that the results from the pilot study were suggestive but inconclusive, and thus, merit further investigation. PMID:27868134

Developing and validating a localised, self-training mindfulness programme for older Singaporean adults: effects on cognitive functioning and implications for healthcare.

PubMed

Tam, Bryan Wei Hoe; Lo, Dana Rui Ting; Seah, Daniel Wen Hao; Lee, Jun Xian; Foo, Zann Fang Ying; Poh, Zoe Yu Yah; Thong, Fionna Xiu Jun; Sim, Sam Kim Yang; Chee, Chew Sim

2017-03-01

There is a paucity of research available on the effect of mindfulness on cognitive function. However, the topic has recently gained more attention due to the ageing population in Singapore, catalysed by recent findings on brain function and cellular ageing. Recognising the potential benefits of practising mindfulness, we aimed to develop a localised, self-training mindfulness programme, guided by expert practitioners and usability testing, for older Singaporean adults. This was followed by a pilot study to examine the potential cognitive benefits and feasibility of this self-training programme for the cognitive function of older adults in Singapore. We found that the results from the pilot study were suggestive but inconclusive, and thus, merit further investigation. Copyright: © Singapore Medical Association.

Sexual Behavior of Older Adults Living with HIV in Uganda.

PubMed

Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet

2016-02-01

Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.

The use of contextual cues to improve warning symbol comprehension: making the connection for older adults.

PubMed

Lesch, Mary F; Powell, W Ryan; Horrey, William J; Wogalter, Michael S

2013-01-01

This study teased apart the effects of comprehensibility and complexity on older adults' comprehension of warning symbols by manipulating the relevance of additional information in further refining the meaning of the symbol. Symbols were systematically altered such that increased visual complexity (in the form of contextual cues) resulted in increased comprehensibility. One hundred older adults, aged 50-71 years, were tested on their comprehension of these symbols before and after training. High comprehensibility-complexity symbols were found to be better understood than low- or medium-comprehensibility-complexity symbols and the effectiveness of the contextual cues varied as a function of training. Therefore, the nature of additional detail determines whether increased complexity is detrimental or beneficial to older adults' comprehension - if the additional details provide 'cues to knowledge', older adults' comprehension improves as a result of the increased complexity. However, some cues may require training in order to be effective. Research suggests that older adults have greater difficulty in understanding more complex symbols. However, we found that when the complexity of symbols was increased through the addition of contextual cues, older adults' comprehension actually improved. Contextual cues aid older adults in making the connection between the symbol and its referent.

The State-of-the-Science on Somatosensory Function and Its Impact on Daily Life in Adults and Older Adults, and Following Stroke: A Scoping Review.

PubMed

Carey, Leeanne M; Lamp, Gemma; Turville, Megan

2016-04-01

The aim was to identify and synthesize research evidence about how adults and older adults process somatosensory information in daily activities, and the interventions available to regain somatosensory function following stroke. We developed two interacting concept maps to address the research questions. The scoping review was conducted from 2005 to 2015 across Web of Science, AMED, CINAHL, Embase, Medline, and PsychInfo databases. Search terms included somatosensory, perception, performance, participation, older adult, stroke, intervention, discrimination, learning, and neuroplasticity. Contributions from 103 articles for Concept 1 and 14 articles for Concept 2 are reported. Measures of somatosensory processing, performance, and participation used are identified. Interventions available to treat somatosensory loss are summarized in relation to approach, outcome measures, and theory/mechanisms underlying. A gap exists in the current understanding of how somatosensory function affects the daily lives of adults. A multidisciplinary approach that includes performance and participation outcomes is recommended to advance the field. © The Author(s) 2016.

[Usefulness of the comprehensive geriatric assessment for evaluating the health of older adults].

PubMed

Gálvez-Cano, Miguel; Chávez-Jimeno, Helver; Aliaga-Diaz, Elizabeth

2016-06-01

Older adults comprise a heterogeneous population group that usually has a high disease burden, comorbidities, and, in many cases, subclinical conditions that compromise their health and quality of life. In addition to the physical component, the health conditions of elderly individuals are significantly influenced by cognitive and affective components, social and family factors such as abandonment, and functional factors including the ability to perform everyday activities. In response to this complex scenario, the comprehensive geriatric evaluation constitutes a multidimensional and interdisciplinary diagnostic tool that assesses the health of older adults in all of its complexity by considering the physical, mental, social/family, and functional needs to obtain full knowledge of older person's health status and creating a plan that consists of appropriate and individualized interventions that considers the preferences and values of older individuals and their families.

Reports on depressive symptoms in older adults with chronic conditions.

PubMed

Zauszniewski, Jaclene A; Morris, Diana L; Preechawong, Sunida; Chang, Hsiu-Ju

2004-01-01

Depression is the most common mental disorder among older adults in the United States and one of the most disabling conditions worldwide. Chronic conditions and related functional limitations are associated with late-life depression, but assessment of depression is complicated by the absence of measures that capture the range of depressive emotions older adults may express. This descriptive, correlational study of 314 older adults with chronic conditions examined three measures to assess depressive symptoms: the Center for Epidemiological Studies Depression Scale (CES-D), the short form of the Center for Epidemiological Studies Depression Scale (CES-D-10), and an Emotional Symptom Checklist (ESC). The measures were correlated with each other and with a number of chronic conditions and functional impairments. Men and women scored similarly on all measures, though correlations between depressive symptoms and negative emotions were stronger for men. About 12% of the older adults exceeded the CES-D criteria for severe depressive symptoms, with the greatest percentage among those aged 75 to 84. The most frequently reported negative emotions were sadness (by women and elders through age 84) and loneliness (by men and elders age 85 and over). The findings suggest the need for multiple assessment strategies to identify older adults at risk for late-life depression.

"We're not just sitting on the periphery": a staff perspective of physical activity in older adults with schizophrenia.

PubMed

Leutwyler, Heather; Hubbard, Erin M; Jeste, Dilip V; Vinogradov, Sophia

2013-06-01

Targeted physical activity interventions to improve the poor physical function of older adults with schizophrenia are necessary but currently not available. Given disordered thought processes and institutionalization, it is likely that older adults with schizophrenia have unique barriers and facilitators to physical activity. It is necessary to consider the perspective of the mental health staff about barriers and facilitators to physical activity to design a feasible intervention. To describe the perceptions of mental health staff about barriers and facilitators to engage in physical activities that promote physical function among older adults with schizophrenia. We conducted qualitative interviews with 23 mental health staff that care for older adults with schizophrenia. The data were collected and analyzed with grounded theory methodology. The participants were interested in promoting physical activity with older adults with schizophrenia. Facilitators and barriers to physical activity identified were mental health, role models and rewards, institutional factors, and safety. In order to design successful physical activity interventions for this population, the intervention may need to be a routine part of the mental health treatment program and patients may need incentives to participate. Staff should be educated that physical activity may provide the dual benefit of physical and mental health treatment.

Reminiscence, personality, and psychological functioning in older adults.

PubMed

Cully, J A; LaVoie, D; Gfeller, J D

2001-02-01

The present study examined the relationships between the frequency and functions of reminiscence, personality styles, and psychological functioning. There is little research on the psychological factors that correlate with reminiscence, especially in relationship to clinical constructs such as depression and anxiety. Research in the area of reminiscence functions may facilitate a better understanding of the factors affecting change in reminiscence therapies. Seventy-seven healthy older adults completed the following self-report scales: Reminiscence Functions Scale, NEO Five Factor Personality Inventory, Beck Depression Inventory-Second Edition, State-Trait Anxiety Inventory, and the Templer-McMordie Death Anxiety Scale. Using canonical correlation techniques, results indicated that individuals with negative psychological functioning frequently reminisce as a way to refresh bitter memories, reduce boredom, and prepare for death. The present study provides implications for both researchers and clinicians. Contrary to previous studies, results indicate that depressed and anxious older adults commonly use reminiscence and therefore may be appropriate candidates for reminiscence treatments.

Factors affecting aging cognitive function among community-dwelling older adults.

PubMed

Kim, Chun-Ja; Park, JeeWon; Kang, Se-Won; Schlenk, Elizabeth A

2017-08-01

The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. © 2017 John Wiley & Sons Australia, Ltd.

Expectations Regarding Aging, Physical Activity, and Physical Function in Older Adults

PubMed Central

Breda, Aili I.; Watts, Amber S.

2017-01-01

Objective: The present study examined how expectations regarding aging (ERA) influence physical activity participation and physical function. Method: We surveyed 148 older adults about their ERA (ERA-38), health-promoting lifestyles (HPLP-II), and self-rated health (RAND-36). We tested the mediating effect of physical activity on the relationships between ERA and physical function. Results: Positive expectations were associated with more engagement in physical activity (B = 0.016, p < .05) and better physical function (B = 0.521, p < .01). Physical activity mediated the relationship between ERA and physical function (B = 5.890, p < .01, indirect effect 0.092, CI = [0.015, 0.239]). Discussion: ERA play an important role in adoption of physically active lifestyles in older adults and may influence health outcomes, such as physical function. Future research should evaluate whether attempts to increase physical activity are more successful when modifications to ERA are also targeted. PMID:28491915

Intervention-induced enhancement in intrinsic brain activity in healthy older adults

PubMed Central

Yin, Shufei; Zhu, Xinyi; Li, Rui; Niu, Yanan; Wang, Baoxi; Zheng, Zhiwei; Huang, Xin; Huo, Lijuan; Li, Juan

2014-01-01

This study examined the effects of a multimodal intervention on spontaneous brain activity in healthy older adults. Seventeen older adults received a six-week intervention that consisted of cognitive training, Tai Chi exercise, and group counseling, while 17 older adults in a control group attended health knowledge lectures. The intervention group demonstrated enhanced memory and social support compared to the control group. The amplitude of low frequency fluctuations (ALFF) in the middle frontal gyrus, superior frontal gyrus, and anterior cerebellum lobe was enhanced for the intervention group, while the control group showed reduced ALFF in these three regions. Moreover, changes in trail-making performance and well-being could be predicted by the intervention-induced changes in ALFF. Additionally, individual differences in the baseline ALFF were correlated with intervention-related changes in behavioral performance. These findings suggest that a multimodal intervention is effective in improving cognitive functions and well-being and can induce functional changes in the aging brain. The study extended previous training studies by suggesting resting-state ALFF as a marker of intervention-induced plasticity in older adults. PMID:25472002

Social network types and functional dependency in older adults in Mexico.

PubMed

Doubova Dubova, Svetlana Vladislavovna; Pérez-Cuevas, Ricardo; Espinosa-Alarcón, Patricia; Flores-Hernández, Sergio

2010-02-27

Social networks play a key role in caring for older adults. A better understanding of the characteristics of different social networks types (TSNs) in a given community provides useful information for designing policies to care for this age group. Therefore this study has three objectives: 1) To derive the TSNs among older adults affiliated with the Mexican Institute of Social Security; 2) To describe the main characteristics of the older adults in each TSN, including the instrumental and economic support they receive and their satisfaction with the network; 3) To determine the association between functional dependency and the type of social network. Secondary data analysis of the 2006 Survey of Autonomy and Dependency (N = 3,348). The TSNs were identified using the structural approach and cluster analysis. The association between functional dependency and the TSNs was evaluated with Poisson regression with robust variance analysis in which socio-demographic characteristics, lifestyle and medical history covariates were included. We identified five TSNs: diverse with community participation (12.1%), diverse without community participation (44.3%); widowed (32.0%); nonfriends-restricted (7.6%); nonfamily-restricted (4.0%). Older adults belonging to widowed and restricted networks showed a higher proportion of dependency, negative self-rated health and depression. Older adults with functional dependency more likely belonged to a widowed network (adjusted prevalence ratio 1.5; 95%CI: 1.1-2.1). The derived TSNs were similar to those described in developed countries. However, we identified the existence of a diverse network without community participation and a widowed network that have not been previously described. These TSNs and restricted networks represent a potential unmet need of social security affiliates.

High definition-transcranial direct current stimulation changes older adults' subjective sleep and corresponding resting-state functional connectivity.

PubMed

Sheng, Jing; Xie, Chao; Fan, Dong-Qiong; Lei, Xu; Yu, Jing

2018-07-01

With advanced age, older adults show functional deterioration in sleep. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation, modulates individuals' behavioral performance in various cognitive domains. However, the modulation effect and neural mechanisms of tDCS on sleep, especially for the elderly population are not clear. Here, we aimed to investigate whether high-definition transcranial direct current stimulation (HD-tDCS) could modulate community-dwelling older adults' subjective sleep and whether these potential improvements are associated with the large-scale brain activity alterations recorded by functional magnetic resonance imaging. Thirty-one older adults were randomly allocated to the HD-tDCS group and the control group. HD-tDCS was applied for 25 min at 1.5 mA per day for two weeks. The anode electrode was placed over the left dorsolateral prefrontal cortex, surrounded by 4 cathodes at 7 cm radius. All participants completed sleep neuropsychological assessments and fMRI scans individually before and after intervention. Behaviorally, we observed a HD-tDCS-induced enhancement of older adults' sleep duration. On the aspect of the corresponding neural alterations, we observed that HD-tDCS decreased the functional connectivity between the default mode network (DMN) and subcortical network. More importantly, the decoupling connectivity of the DMN-subcortical network was correlated with the improvements of subjective sleep in the HD-tDCS group. Our findings add novel behavioral and neural evidences about tDCS-induced sleep improvement in community-dwelling older adults. With further development, tDCS may be used as an alternative treatment for sleep disorders and alleviate the dysfunction of brain networks induced by aging. Copyright © 2018 Elsevier B.V. All rights reserved.

Demographic Trends of Adults in New York City Opioid Treatment Programs--An Aging Population.

PubMed

Han, Benjamin; Polydorou, Soteri; Ferris, Rosie; Blaum, Caroline S; Ross, Stephen; McNeely, Jennifer

2015-01-01

The population of adults accessing opioid treatment is growing older, but exact estimates vary widely, and little is known about the characteristics of the aging treatment population. Further, there has been little research regarding the epidemiology, healt h status, and functional impairments in this population. To determine the utilization of opioid treatment services by older adults in New York City. This study used administrative data from New York State licensed drug treatment programs to examine overall age trends and characteristics of older adults in opioid treatment programs in New York City from 1996 to 2012. We found significant increases in utilization of opioid treatment programs by older adults in New York City. By 2012, those aged 50-59 made up the largest age group in opioid treatment programs. Among older adults there were notable shifts in demographic background including gender and ethnicity, and an increase in self-reported impairments. More research is needed to fully understand the specific characteristics and needs of older adults with opioid dependence.

Stressors, Coping Resources, and Depressive Symptoms among Rural American Indian Older Adults.

PubMed

Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Lawler, Michael J; Martin, James I

2015-01-01

The purpose of this study was to examine the associations of physical health stressors and coping resources with depressive symptoms among American Indian older adults age 50 years or older. The study used a convenience sample of 227 rural American Indian older adults. A hierarchical multiple regression tested three sets of predictors on depressive symptoms: (a) sociodemographics, (b) physical health stressors (functional disability and chronic medical conditions), and (c) coping resources (social support and spirituality). Most participants reported little difficulty in performing daily activities (e.g., eating, dressing, traveling, and managing money), while presenting over two types of chronic medical conditions. Depressive symptoms were predicted by higher scores on perceived social support and lower scores on functional disability; women and those having no health insurance also had higher levels of depressive symptoms. Findings suggest that social work practitioners should engage family and community support, advocate for access to adequate health care, and attend to women's unique circumstances and needs when working with American Indian older adults.

Is exercise used as medicine? Association of meeting strength training guidelines and functional limitations among older US adults.

PubMed

Kraschnewski, Jennifer L; Sciamanna, Christopher N; Ciccolo, Joseph T; Rovniak, Liza S; Lehman, Erik B; Candotti, Carolina; Ballentine, Noel H

2014-09-01

To determine the association between meeting strength training guidelines (≥2 times per week) and the presence of functional limitations among older adults. This cross-sectional study used data from older adult participants (N=6763) of the National Health Interview Survey conducted in 2011 in the United States. Overall, 16.1% of older adults reported meeting strength training guidelines. For each of nine functional limitations, those with the limitation were less likely to meet strength training recommendations than those without the limitation. For example, 20.0% of those who reported no difficulty walking one-quarter mile met strength training guidelines, versus only 10.1% of those who reported difficulty (p<.001). In sum, 21.7% of those with no limitations (33.7% of sample) met strength training guidelines, versus only 15.9% of those reporting 1-4 limitations (38.5% of sample) and 9.8% of those reporting 5-9 limitations (27.8% of sample) (p<.001). Strength training is uncommon among older adults and even less common among those who need it the most. The potential for strength training to improve the public's health is therefore substantial, as those who have the most to gain from strength training participate the least. Copyright © 2014 Elsevier Inc. All rights reserved.

The relationship between outdoor activity and health in older adults using GPS.

PubMed

Kerr, Jacqueline; Marshall, Simon; Godbole, Suneeta; Neukam, Suvi; Crist, Katie; Wasilenko, Kari; Golshan, Shahrokh; Buchner, David

2012-12-01

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for 7 days. They also completed assessments of physical, cognitive, and emotional functioning. Analyses of variance were employed with a main and interaction effect tested for ±30 min PA and outdoor time. Significant differences were found for those who spent >30 min in PA or outdoors for depressive symptoms, fear of falling, and self-reported functioning. Time to complete a 400 m walk was significantly different by PA time only. QoL and cognitive functioning scores were not significantly different. The interactions were also not significant. This study is one of the first to demonstrate the feasibility of using accelerometer and GPS data concurrently to assess PA location in older adults. Future analyses will shed light on potential causal relationships and could inform guidelines for outdoor activity.

The Relationship Between Outdoor Activity and Health in Older Adults Using GPS

PubMed Central

Kerr, Jacqueline; Marshall, Simon; Godbole, Suneeta; Neukam, Suvi; Crist, Katie; Wasilenko, Kari; Golshan, Shahrokh; Buchner, David

2012-01-01

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for 7 days. They also completed assessments of physical, cognitive, and emotional functioning. Analyses of variance were employed with a main and interaction effect tested for ±30 min PA and outdoor time. Significant differences were found for those who spent >30 min in PA or outdoors for depressive symptoms, fear of falling, and self-reported functioning. Time to complete a 400 m walk was significantly different by PA time only. QoL and cognitive functioning scores were not significantly different. The interactions were also not significant. This study is one of the first to demonstrate the feasibility of using accelerometer and GPS data concurrently to assess PA location in older adults. Future analyses will shed light on potential causal relationships and could inform guidelines for outdoor activity. PMID:23330225

Food Security in Older Adults: Community Service Provider Perceptions of Their Roles

ERIC Educational Resources Information Center

Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle

2007-01-01

Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food…

Crying and Depression Among Older Adults.

ERIC Educational Resources Information Center

Hastrup, Janice L.; And Others

1986-01-01

Self-reports of frequency of crying episodes are described for two nonclinical samples of younger and older adult men and women. Comparison of samples revealed no evidence for either a decreased or increased frequency of crying among the older sample. Crying episodes function as an adaptive coping response to and should not be automatically…

Can Training in a Real-Time Strategy Videogame Attenuate Cognitive Decline in Older Adults?

PubMed Central

Basak, Chandramallika; Boot, Walter R.; Voss, Michelle W.; Kramer, Arthur F.

2014-01-01

Declines in various cognitive abilities, particularly executive control functions, are observed in older adults. An important goal of cognitive training is to slow or reverse these age-related declines. However, opinion is divided in the literature regarding whether cognitive training can engender transfer to a variety of cognitive skills in older adults. Yet, recent research indicates that videogame training of young adults may engender broad transfer to skills of visual attention. In the current study, we used a real-time strategy videogame to attempt to train executive functions in older adults, such as working memory, task switching, short-term memory, inhibition, and reasoning. Older adults were either trained in a real-time strategy videogame for 23.5 hours (RON, n=20) or not (CONTROLS, n=20). A battery of cognitive tasks, including tasks of executive control and visuo-spatial skills, were assessed before, during, and after video game training. The trainees improved significantly in the measures of game performance. They also improved significantly more than the controls in a subset of the cognitive tasks, such as task switching, working memory, visual short term memory, and mental rotation. Trends in improvement were also observed, for the video game trainees, in inhibition and reasoning. Individual differences in changes in game performance were correlated with improvements in task-switching. The study has implications for the enhancement of executive control processes of older adults. PMID:19140648

Walking speed is associated with self-perceived hearing handicap in high-functioning older adults: The Fujiwara-kyo study.

PubMed

Tomioka, Kimiko; Harano, Akihiro; Hazaki, Kan; Morikawa, Masayuki; Iwamoto, Junko; Saeki, Keigo; Okamoto, Nozomi; Kurumatani, Norio

2015-06-01

The present study investigated whether physical performance and musculoskeletal pain (MSP) are associated with self-perceived hearing handicap (HH) among high-functioning older adults. We analyzed a total of 3982 community-dwelling high-functioning older adults (age 65 years and older). HH was assessed using the Hearing Handicap Inventory for Elderly-Screening. Self-reported hearing impairment (HI) was evaluated using a single question. We measured handgrip strength, walking speed (WS) and standing balance for assessments of physical performance. The severity of MSP assessed by interviews took into account its duration, limitation of daily activity and frequency. The prevalence of HH and HI in our sample was 22.2% and 28.1%, respectively. After adjusting for other two physical performance measures, MSP, sex, age, education, marital status, risk factors for hearing loss, instrumental activity of daily living, depression, cognitive function and self-reported HI, the odds ratios for HH in the second fastest, the second slowest, and the slowest WS quartile were 1.14 (95% CI = 0.81-1.58), 1.29 (95% CI = 0.92-1.79), and 1.58 (95% CI = 1.11-2.23), respectively, compared with the fastest WS quartile. A significant dose-response relationship was found between slower WS and HH (P for trend = 0.01). No significant association with HH was found in handgrip strength, standing balance and MSP. WS is associated with self-perceived HH in high-functioning older adults. The present study suggests that exercise programs to improve walking ability might be effective in preventing HH of self-sustainable older adults. © 2014 Japan Geriatrics Society.

Opinions of College Students and Independent-Living Adults Regarding Successful Aging.

ERIC Educational Resources Information Center

Charbonneau-Lyons, Dixie Lee; Mosher-Ashley, Pearl M.; Stanford-Pollock, Meredith

2002-01-01

Undergraduates (n=226), graduate students (n=44) and independent-living older adults (n=59) rated factors contributing to successful aging. Social/familial relationships, intrinsic values, financial concerns, accomplishments, and cognitive functioning rated highest. The only age differences were older adults' higher ratings of financial concerns…

Age differences in proactive interference, working memory, and abstract reasoning

PubMed Central

Emery, Lisa; Hale, Sandra; Myerson, Joel

2008-01-01

It has been hypothesized that older adults are especially susceptible to proactive interference (PI), and that this may contribute to age differences in working memory performance. In young adults, individual differences in PI affect both working memory and reasoning ability, but the relations between PI, working memory, and reasoning in older adults have not been examined. In the current study, young, old, and very old adults performed a modified operation span task that induced several cycles of PI buildup and release, as well as two tests of abstract reasoning ability. Age differences in working memory scores increased as PI built up, consistent with the hypothesis that older adults are more susceptible to PI, but both young and older adults showed complete release from PI. Young adults' reasoning ability was best predicted by working memory performance under high-PI conditions, replicating Bunting (2006). In contrast, older adults' reasoning ability was best predicted by their working memory performance under low-PI conditions, thereby raising questions regarding the general role of susceptibility to PI in differences in higher cognitive function among older adults. PMID:18808252

Age-Related Differences in Profiles of Mood-Change Trajectories

PubMed Central

Stanley, Jennifer Tehan; Isaacowitz, Derek M.

2010-01-01

As a group, older adults report positive affective lives. The extent to which there are subgroups of older adults whose moods are less positive, however, is unclear. The aim of the present study was to identify and characterize different subgroups of adults who exhibit distinct trajectories of mood-change across a relatively short time period. Seventy-nine young and 103 older adults continuously reported their moods while viewing emotional and neutral faces. Cluster analysis revealed four subgroups of mood-change trajectories. Both the most positive and the most negative subgroups included more older than younger adults (ps < .05), suggesting that not all older adults exhibit higher positive affect than young adults. Analyses of variance revealed that the most negative group exhibited slower processing speed, more state anxiety and neuroticism, and looked less at happy faces, than the other groups (ps < .05). The results are discussed from an adult developmental perspective, focusing on the increased variability of mood trajectories in the older adults and whether this is a reflection of adaptive functioning, or a potential harbinger of dysfunction. PMID:21171749

Executive functioning complaints and escitalopram treatment response in late-life depression.

PubMed

Manning, Kevin J; Alexopoulos, George S; Banerjee, Samprit; Morimoto, Sarah Shizuko; Seirup, Joanna K; Klimstra, Sibel A; Yuen, Genevieve; Kanellopoulos, Theodora; Gunning-Dixon, Faith

2015-05-01

Executive dysfunction may play a key role in the pathophysiology of late-life depression. Executive dysfunction can be assessed with cognitive tests and subjective report of difficulties with executive skills. The present study investigated the association between subjective report of executive functioning complaints and time to escitalopram treatment response in older adults with major depressive disorder (MDD). 100 older adults with MDD (58 with executive functioning complaints and 42 without executive functioning complaints) completed a 12-week trial of escitalopram. Treatment response over 12 weeks, as measured by repeated Hamilton Depression Rating Scale scores, was compared for adults with and without executive complaints using mixed-effects modeling. Mixed effects analysis revealed a significant group × time interaction, F(1, 523.34) = 6.00, p = 0.01. Depressed older adults who reported executive functioning complaints at baseline demonstrated a slower response to escitalopram treatment than those without executive functioning complaints. Self-report of executive functioning difficulties may be a useful prognostic indicator for subsequent speed of response to antidepressant medication. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Efficacy of whey protein supplementation on resistance exercise-induced changes in muscle strength, lean mass, and function in mobility-limited older adults

USDA-ARS?s Scientific Manuscript database

Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass. Further studies are required to determine whether this effect extends to functionally compromised older adults. The objectives of the study were to compare the effects of whey protein concent...

Effect of structured physical activity and nutritional supplementation on physical function in mobility-limited older adults: results from the VIVE2 randomized trial

USDA-ARS?s Scientific Manuscript database

Objectives: The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capaci...

Relation of Physical Activity to Memory Functioning in Older Adults: The Memory Workout Program.

ERIC Educational Resources Information Center

Rebok, George W.; Plude, Dana J.

2001-01-01

The Memory Workout, a CD-ROM program designed to help older adults increase changes in physical and cognitive activity influencing memory, was tested with 24 subjects. Results revealed a significant relationship between exercise time, exercise efficacy, and cognitive function, as well as interest in improving memory and physical activity.…

Lower Neurocognitive Function in U-2 Pilots: Relationship to White Matter Hyperintensities

DTIC Science & Technology

2014-07-09

dysfunction and cognition in older adults with heart failure. Cogn Behav Neurol 2008;21:65–72. 14. Gunstad J, Keary TA, Spitznagel MB, et al. Blood...pressure and cognitive function in older adults with cardiovascular disease. Int J Neurosci 2009;119:2228–2242. 15. Kantarci K, Weigand SD, Przybelski SA, et

Education, Functional Limitations, and Life Satisfaction among Older Adults in South Korea

ERIC Educational Resources Information Center

Lee, Eun-Kyoung Othelia; Lee, Jungui

2013-01-01

This study examined the associations of educational level with functioning and life satisfaction among community-dwelling older adults in South Korea ("n" = 4,152). The sample was drawn from Wave I of the Korean Longitudinal Study on Aging. To examine educational disparities, separate analyses were run to note predictors in less educated…

Interplay between Creativity, Executive Function and Working Memory in Middle-Aged and Older Adults

ERIC Educational Resources Information Center

Sharma, Shivani; Babu, Nandita

2017-01-01

Studies reveal inconclusive evidence of the relationship between executive function and creativity. Further, there is a dearth of studies investigating creativity in older adults in the Indian context. Three tests--namely, Torrance Test of Creative Thinking (Figural), the Stroop Test, and Mental Balance (PGI memory scale)--were administered on a…

The Association between Cardiovascular Disease and Cochlear Function in Older Adults

ERIC Educational Resources Information Center

Torre, Peter, III; Cruickshanks, Karen J.; Klein, Barbara E.K.; Klein, Ronald; Nondahl, David M.

2005-01-01

The purpose of this research was to evaluate the relation between self-reported cardiovascular disease (CVD) and cochlear function in older adults. The Epidemiology of Hearing Loss Study (EHLS) is an ongoing population-based study of hearing loss and its risk factors in Beaver Dam, Wisconsin. As part of the EHLS questionnaire, participants were…

The Revised Direct Assessment of Functional Status for Independent Older Adults

ERIC Educational Resources Information Center

McDougall, Graham J.; Becker, Heather; Vaughan, Phillip W.; Acee, Taylor W.; Delville, Carol L.

2010-01-01

Purpose: The original version of the Direct Assessment of Functional Status (DAFS), a measure of instrumental activities of daily living (IADLs), was found to have a ceiling effect in older adults living independently in the community. This suggested that the tasks measured, although relevant, do not require full use of this population's…

Interactive video dance games for healthy older adults.

PubMed

Studenski, S; Perera, S; Hile, E; Keller, V; Spadola-Bogard, J; Garcia, J

2010-12-01

Physical activity promotes health in older adults but participation rates are low. Interactive video dance games can increase activity in young persons but have not been designed for use with older adults. The purpose of this research was to evaluate healthy older adults' interest and participation in a dance game adapted for an older user. Healthy older adults were recruited from 3 senior living settings and offered three months of training and supervision using a video dance game designed for older people. Before and after the program, data was collected on vital signs, physical function and self reported quality of life. Feedback was obtained during and after training. Of 36 persons who entered (mean age 80.1 + 5.4 years, 83 % female), 25 completed the study. Completers were healthier than noncompleters. Completers showed gains in narrow walk time, self-reported balance confidence and mental health. While there were no serious adverse events, 4 of 11 noncompleters withdrew due to musculoskeletal complaints. Adapted Interactive video dance is feasible for some healthy older adults and may help achieve physical activity goals.

Exposure to ambient PM2.5 concentrations and cognitive function among older Mexican adults.

PubMed

Salinas-Rodríguez, Aarón; Fernández-Niño, Julián Alfredo; Manrique-Espinoza, Betty; Moreno-Banda, Grea Litai; Sosa-Ortiz, Ana Luisa; Qian, Zhengmin Min; Lin, Hualiang

2018-04-25

Recent epidemiological research has shown that exposure to fine particulate pollution (PM 2.5 ) is associated with a reduction in cognitive function in older adults. However, primary evidence comes from high-income countries, and no specific studies have been conducted in low and middle-income countries where higher air pollution levels exist. To estimate the association between the exposure to PM 2.5 and cognitive function in a nationally representative sample of older Mexican adults and the associated effect modifiers. Data for this study were taken from the National Survey of Health and Nutrition in Mexico carried out in 2012. A total of 7986 older adults composed the analytical sample. Cognitive function was assessed using two tests: semantic verbal fluency and three-word memory. The annual concentration of PM 2.5 was calculated using satellite data. Association between exposure to PM 2.5 and cognitive function was estimated using two-level logistic and linear regression models. In adjusted multilevel regression models, each 10 μg/m 3 increase in ambient PM 2.5 raised the odds of a poorer cognitive function using the three-word memory test (OR = 1.37, 95% CI: 1.08, 1.74), and reduced the number of valid animal named in the verbal fluency test (β = -0.72, 95% CI: -1.05, -0.40). Stratified analyses did not yield any significant modification effects of age, sex, indoor pollution, urban/rural dwelling, education, smoking and other factors. This study supports an association between exposure to PM 2.5 concentrations and cognitive function in older adults. This is particularly relevant to low- and middle-income countries, which are marked by a rapid growth of their aging population and high levels of air pollution. Copyright © 2018 Elsevier Ltd. All rights reserved.

Habitual attention in older and young adults.

PubMed

Jiang, Yuhong V; Koutstaal, Wilma; Twedell, Emily L

2016-12-01

Age-related decline is pervasive in tasks that require explicit learning and memory, but such reduced function is not universally observed in tasks involving incidental learning. It is unknown if habitual attention, involving incidental probabilistic learning, is preserved in older adults. Previous research on habitual attention investigated contextual cuing in young and older adults, yet contextual cuing relies not only on spatial attention but also on context processing. Here we isolated habitual attention from context processing in young and older adults. Using a challenging visual search task in which the probability of finding targets was greater in 1 of 4 visual quadrants in all contexts, we examined the acquisition, persistence, and spatial-reference frame of habitual attention. Although older adults showed slower visual search times and steeper search slopes (more time per additional item in the search display), like young adults they rapidly acquired a strong, persistent search habit toward the high-probability quadrant. In addition, habitual attention was strongly viewer-centered in both young and older adults. The demonstration of preserved viewer-centered habitual attention in older adults suggests that it may be used to counter declines in controlled attention. This, in turn, suggests the importance, for older adults, of maintaining habit-related spatial arrangements. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Functional connectivity associated with social networks in older adults: A resting-state fMRI study.

PubMed

Pillemer, Sarah; Holtzer, Roee; Blumen, Helena M

2017-06-01

Poor social networks and decreased levels of social support are associated with worse mood, health, and cognition in younger and older adults. Yet, we know very little about the brain substrates associated with social networks and social support, particularly in older adults. This study examined functional brain substrates associated with social networks using the Social Network Index (SNI) and resting-state functional magnetic resonance imaging (fMRI). Resting-state fMRI data from 28 non-demented older adults were analyzed with independent components analyses. As expected, four established resting-state networks-previously linked to motor, vision, speech, and other language functions-correlated with the quality (SNI-1: total number of high-contact roles of a respondent) and quantity (SNI-2: total number of individuals in a respondent's social network) of social networks: a sensorimotor, a visual, a vestibular/insular, and a left frontoparietal network. Moreover, SNI-1 was associated with greater functional connectivity in the lateral prefrontal regions of the left frontoparietal network, while SNI-2 was associated with greater functional connectivity in the medial prefrontal regions of this network. Thus, lateral prefrontal regions may be particularly linked to the quality of social networks while medial prefrontal regions may be particularly linked to the quantity of social networks.

Neuropsychological functioning in posttraumatic stress disorder following forced displacement in older adults and their offspring.

PubMed

Jelinek, Lena; Wittekind, Charlotte E; Moritz, Steffen; Kellner, Michael; Muhtz, Christoph

2013-12-15

The aim of the present study was to investigate neuropsychological performance in an untried trauma sample of older adults displaced during childhood at the end of World War II (WWII) with and without posttraumatic stress disorder (PTSD) as well as transgenerational effects of trauma and PTSD on their offspring. Displaced older adults with (n=20) and without PTSD (n=24) and nondisplaced healthy individuals (n=11) as well as one of their respective offspring were assessed with a large battery of cognitive tests (primarily targeting memory functioning). No evidence for deficits in neuropsychological performance was found in the aging group of displaced people with PTSD. Moreover, no group difference emerged in the offspring groups. Findings may be interpreted as first evidence for a rather resilient PTSD group of older adults that is available for assessment 60 years after displacement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The effect of chair yoga in older adults with moderate and severe Alzheimer's disease.

PubMed

McCaffrey, Ruth; Park, Juyoung; Newman, David; Hagen, Dyana

2014-01-01

Using a quasi-experimental single-group design, this study examined the feasibility of older adults with Alzheimer's disease (AD)-type dementia to complete the Sit 'N' Fit Chair Yoga Program. Physical function of participants who completed the program was measured. The nine older adults with AD (mean age = 83) participated in the 8-week Sit 'N' Fit Chair Yoga Program. To measure physical function, the Six-Minute Walk Test, the Gait Speed Test, and the Berg Balance Scale were administered at pre-intervention, 4 weeks, 8 weeks, and 1 month after program completion. All participants completed the program. Positive changes were seen across all physical measures. Further study, using a larger sample and including a control group, is needed to fully determine the effect of the Sit 'N' Fit Chair Yoga Program on older adults with moderate to severe AD. Copyright 2014, SLACK Incorporated.

Periodontal margin in the older adult: considerations for position, placement, and support.

PubMed

McVaney, T P; Ettinger, R L

1991-01-01

Some of the oral health problems of older adults arise from loss of function, which is catalyzed by changes in oral health induced by systemic disease and its treatment. The successful maintenance of a healthy gingival to root surface interface depends on the development of appropriate dental and gingival contours to facilitate self-cleansing and proper hygiene procedures by the patient. This article, with the use of case histories, discusses only one of the complications to restorative care in older adults, that is, loss of function and its relationship to marginal placement. Prevention of oral disease in the older adult may require modification of the long-held periodontal/restorative philosophy of placing margins above the tissue wherever possible. In addition, the professional prophylaxis of restorations adjacent to the gingival margin must address the problems of the creation of a roughened surface by abrasion to composites from pastes and polishing.

Resilience and amygdala function in older healthy and depressed adults.

PubMed

Leaver, Amber M; Yang, Hongyu; Siddarth, Prabha; Vlasova, Roza M; Krause, Beatrix; St Cyr, Natalie; Narr, Katherine L; Lavretsky, Helen

2018-09-01

Previous studies suggest that low emotional resilience may correspond with increased or over-active amygdala function. Complementary studies suggest that emotional resilience increases with age; older adults tend to have decreased attentional bias to negative stimuli compared to younger adults. Amygdala nuclei and related brain circuits have been linked to negative affect, and depressed patients have been demonstrated to have abnormal amygdala function. In the current study, we correlated psychological resilience measures with amygdala function measured with resting-state arterial spin-labelled (ASL) and blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) in older adults with and without depression. Specifically, we targeted the basolateral, centromedial, and superficial nuclei groups of the amygdala, which have different functions and brain connections. High levels of psychological resilience correlated with lower basal levels of amygdala activity measured with ASL fMRI. High resilience also correlated with decreased connectivity between amygdala nuclei and the ventral default-mode network independent of depression status. Instead, lower depression symptoms were associated with higher connectivity between the amygdalae and dorsal frontal networks. Future multi-site studies with larger sample size and improved neuroimaging technologies are needed. Longitudinal studies that target resilience to naturalistic stressors will also be a powerful contribution to the field. Our results suggest that resilience in older adults is more closely related to function in ventral amygdala networks, while late-life depression is related to reduced connectivity between the amygdala and dorsal frontal regions. Copyright © 2018 Elsevier B.V. All rights reserved.

Protocol for Fit Bodies, Fine Minds: a randomized controlled trial on the affect of exercise and cognitive training on cognitive functioning in older adults

PubMed Central

O'Dwyer, Siobhan T; Burton, Nicola W; Pachana, Nancy A; Brown, Wendy J

2007-01-01

Background Declines in cognitive functioning are a normal part of aging that can affect daily functioning and quality of life. This study will examine the impact of an exercise training program, and a combined exercise and cognitive training program, on the cognitive and physical functioning of older adults. Methods/Design Fit Bodies, Fine Minds is a randomized, controlled trial. Community-dwelling adults, aged between 65 and 75 years, are randomly allocated to one of three groups for 16 weeks. The exercise-only group do three 60-minute exercise sessions per week. The exercise and cognitive training group do two 60-minute exercise sessions and one 60-minute cognitive training session per week. A no-training control group is contacted every 4 weeks. Measures of cognitive functioning, physical fitness and psychological well-being are taken at baseline (0 weeks), post-test (16 weeks) and 6-month follop (40 weeks). Qualitative responses to the program are taken at post-test. Discussion With an increasingly aged population, interventions to improve the functioning and quality of life of older adults are particularly important. Exercise training, either alone or in combination with cognitive training, may be an effective means of optimizing cognitive functioning in older adults. This study will add to the growing evidence base on the effectiveness of these interventions. Trial Registration Australian Clinical Trials Register: ACTRN012607000151437 PMID:17915035

Sleep and Human Aging

PubMed Central

Mander, Bryce A.; Winer, Joseph R.; Walker, Matthew P.

2017-01-01

Older adults do not sleep as well as younger adults. Why? What alterations in sleep quantity and quality occur as we age, and are there functional consequences? What are the underlying neural mechanisms that explain age-related sleep disruption? This review tackles these questions. First, we describe canonical changes in human sleep quantity and quality in cognitively normal older adults. Second, we explore the underlying neurobiological mechanisms that may account for these human sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment as an exemplar. We conclude with a discussion of a still-debated question: do older adults simply need less sleep, or rather, are they unable to generate the sleep that they still need? PMID:28384471

Sleep and Human Aging.

PubMed

Mander, Bryce A; Winer, Joseph R; Walker, Matthew P

2017-04-05

Older adults do not sleep as well as younger adults. Why? What alterations in sleep quantity and quality occur as we age, and are there functional consequences? What are the underlying neural mechanisms that explain age-related sleep disruption? This review tackles these questions. First, we describe canonical changes in human sleep quantity and quality in cognitively normal older adults. Second, we explore the underlying neurobiological mechanisms that may account for these human sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment as an exemplar. We conclude with a discussion of a still-debated question: do older adults simply need less sleep, or rather, are they unable to generate the sleep that they still need? Copyright © 2017. Published by Elsevier Inc.

Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

PubMed

Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

2016-11-01

A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care.

Challenges and Opportunities for Developing and Implementing Incentives to Improve Health-Related Behaviors in Older Adults

PubMed Central

Klein, Eran; Karlawish, Jason

2010-01-01

There is growing interest in using patient-directed incentives to change health-related behaviors. Advocates of incentive programs have proposed an ambitious research agenda for moving patient incentive programs forward. Older adults may pose a challenge to such a research agenda. The cognitive and psychological features of this population, in particular, age-related changes in emotional regulation, executive function and cognitive capacities, and a preference for collaborative decision-making raise questions about the suitability of these programs, particularly the structure of current financial incentives, to older adults. Differences in decision-making in older adults need to be accounted for in the design and implementation of financial incentive programs. Financial incentive programs tailored to characteristics of older adult populations may be more likely to improve the lives of older persons and the economic success of programs that serve them. PMID:20863335

Physical activity during hospitalization: Activities and preferences of adults versus older adults.

PubMed

Meesters, Jorit; Conijn, D; Vermeulen, H M; Vliet Vlieland, Tpm

2018-04-16

Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.

Beliefs about behavior account for age differences in the correspondence bias.

PubMed

Stanley, Jennifer Tehan; Blanchard-Fields, Fredda

2011-03-01

Older adults tend to exhibit the correspondence bias to a greater extent than young adults. The current study examined whether these age differences are a function of the degree to which an individual subscribes to a lay theory of attitude-behavior consistency. First, participants responded to questions regarding their beliefs about attitude-behavior consistency. Approximately 2 weeks later, 144 (67 young adults and 77 older adults) participants completed the correspondence bias task. As expected, older adults were more biased than young adults. Analyses revealed that the degree to which an individual holds attitude-behavior consistency beliefs in the dishonesty domain accounted for age-related differences in the correspondence bias. The results of this study suggest that age differences in the correspondence bias task are in part driven by older adults holding stronger attitude-behavior consistency beliefs than young adults.

A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Nishiguchi, Shu; Yamada, Minoru; Tanigawa, Takanori; Sekiyama, Kaoru; Kawagoe, Toshikazu; Suzuki, Maki; Yoshikawa, Sakiko; Abe, Nobuhito; Otsuka, Yuki; Nakai, Ryusuke; Aoyama, Tomoki; Tsuboyama, Tadao

2015-07-01

To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults. Randomized controlled trial. Kyoto, Japan. Community-dwelling older adults (N = 48) were randomized into an exercise group (n = 24) and a control group (n = 24). Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase. Control group participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase. The outcome measures were global cognitive function, memory function, executive function, and brain activation (measured using functional magnetic resonance imaging) associated with visual short-term memory. Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group (P < .05). In addition, after the intervention, less activation was found in several brain regions associated with visual short-term memory, including the prefrontal cortex, in the exercise group (P < .001, uncorrected). A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults, which is associated with improvements in memory and executive function. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults.

PubMed

McHugh, Joanna Edel; Lawlor, Brian A

2016-01-01

Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.

Age-related changes in neural oscillations supporting context memory retrieval.

PubMed

Strunk, Jonathan; James, Taylor; Arndt, Jason; Duarte, Audrey

2017-06-01

Recent evidence suggests that directing attention toward single item-context associations during encoding improves young and older adults' context memory performance and reduces demands on executive functions during retrieval. In everyday situations, there are many event features competing for our attention, and our ability to successfully recover those details may depend on our ability to ignore others. Failures of selective attention may contribute to older adults' context memory impairments. In the current electroencephalogram (EEG) study, we assessed the effects of age on processes supporting successful context memory retrieval of selectively attended features as indexed by neural oscillations. During encoding, young and older adults were directed to attend to a picture of an object and its relationship to one of two concurrently presented contextual details: a color or scene. At retrieval, we tested their memory for the object, its attended and unattended context features, and their confidence for both the attended and unattended features. Both groups showed greater memory for attended than unattended contextual features. However, older adults showed evidence of hyper-binding between attended and unattended context features while the young adults did not. EEG results in the theta band suggest that young and older adults recollect similar amounts of information but brain-behavior correlations suggest that this information was supportive of contextual memory performance, particularly for young adults. By contrast, sustained beta desynchronization, indicative of sensory reactivation and episodic reconstruction, was correlated with contextual memory performance for older adults only. We conclude that older adults' inhibition deficits during encoding reduced the selectivity of their contextual memories, which led to reliance on executive functions like episodic reconstruction to support successful memory retrieval. Copyright © 2017 Elsevier Ltd. All rights reserved.

Feasibility study of an attention training application for older adults.

PubMed

Hill, Nikki L; Mogle, Jacqueline; Colancecco, Elise; Dick, Robert; Hannan, John; Lin, Feng Vankee

2015-09-01

Technology-based attention training has demonstrated promise in its potential to improve cognitive functioning in older people. Developing mobile applications, with older users specifically in mind, may support future dissemination of these interventions and integration into daily life. The purpose of this pilot study was to test the feasibility of an Attention Training Application (ATA) for community-dwelling older adults using mobile technology. A descriptive, mixed-methods design was used to capture older adults' feedback on the usability and acceptability of the ATA. A convenience sample of older adults (n = 9) from two independent living facilities participated in a 2-hour training and practice session with the ATA. Participants were given personally tailored instructions for using the mobile device and the ATA specifically. Following a practice session, participants provided ratings on multiple components of the ATA and completed an audio-recorded, semi-structured interview to provide detailed descriptions of their experience and perceptions. An iterative process of content analysis was used to characterise the open-ended responses. Participants rated the ATA favourably overall on several 0-10 scales including likeability [8.5 (1.6)], interest [8.8 (2.3)] and satisfaction [8.2 (1.9)]. The qualitative analyses revealed several issues relevant to the feasibility of the ATA among older people including the importance of the technological background of the user, limiting negative feedback, challenges with the touch screen interface, personal preferences for challenge, extending the practice period and the difficulty of the dual-task condition. The use of the ATA is feasible in the older adult population. Future development should specifically consider personal characteristics as well as preferences to maximise usability and acceptability among older people. Older adults enjoyed the ATA. This opens doors to user-friendly technological interventions that may be effective in assisting older adults maintain and possibly even improve their cognitive function. © 2015 John Wiley & Sons Ltd.

Development of a Multidimensional Functional Health Scale for Older Adults in China.

PubMed

Mao, Fanzhen; Han, Yaofeng; Chen, Junze; Chen, Wei; Yuan, Manqiong; Alicia Hong, Y; Fang, Ya

2016-05-01

A first step to achieve successful aging is assessing functional wellbeing of older adults. This study reports the development of a culturally appropriate brief scale (the Multidimensional Functional Health Scale for Chinese Elderly, MFHSCE) to assess the functional health of Chinese elderly. Through systematic literature review, Delphi method, cultural adaptation, synthetic statistical item selection, Cronbach's alpha and confirmatory factor analysis, we conducted development of item pool, two rounds of item selection, and psychometric evaluation. Synthetic statistical item selection and psychometric evaluation was processed among 539 and 2032 older adults, separately. The MFHSCE consists of 30 items, covering activities of daily living, social relationships, physical health, mental health, cognitive function, and economic resources. The Cronbach's alpha was 0.92, and the comparative fit index was 0.917. The MFHSCE has good internal consistency and construct validity; it is also concise and easy to use in general practice, especially in communities in China.

Pain and Cognitive Function Among Older Adults Living in the Community

PubMed Central

van der Leeuw, Guusje; Eggermont, Laura H. P.; Shi, Ling; Milberg, William P.; Gross, Alden L.; Hausdorff, Jeffrey M.; Bean, Jonathan F.

2016-01-01

Background. Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. Methods. We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. Results. Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. Conclusions. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. PMID:26433218

The Effects of 6 Months of Progressive High Effort Resistance Training Methods upon Strength, Body Composition, Function, and Wellbeing of Elderly Adults.

PubMed

Steele, James; Raubold, Kristin; Kemmler, Wolfgang; Fisher, James; Gentil, Paulo; Giessing, Jürgen

2017-01-01

The present study examined the progressive implementation of a high effort resistance training (RT) approach in older adults over 6 months and through a 6-month follow-up on strength, body composition, function, and wellbeing of older adults. Twenty-three older adults (aged 61 to 80 years) completed a 6-month supervised RT intervention applying progressive introduction of higher effort set end points. After completion of the intervention participants could choose to continue performing RT unsupervised until 6-month follow-up. Strength, body composition, function, and wellbeing all significantly improved over the intervention. Over the follow-up, body composition changes reverted to baseline values, strength was reduced though it remained significantly higher than baseline, and wellbeing outcomes were mostly maintained. Comparisons over the follow-up between those who did and those who did not continue with RT revealed no significant differences for changes in any outcome measure. Supervised RT employing progressive application of high effort set end points is well tolerated and effective in improving strength, body composition, function, and wellbeing in older adults. However, whether participants continued, or did not, with RT unsupervised at follow-up had no effect on outcomes perhaps due to reduced effort employed during unsupervised RT.

Muscle power failure in mobility-limited adults: preserved single muscle fibre function despite reduced whole muscle size, quality and neuromuscular activiation

USDA-ARS?s Scientific Manuscript database

This study investigated the physiological and gender determinants of the age-related loss of muscle power in 31 healthy middle-aged adults (aged 40-55 years), 28 healthy older adults (70-85 years) and 34 mobility-limited older adults (70-85 years). We hypothesized that leg extensor muscle power woul...

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review.

PubMed

Mowszowski, L; Lampit, A; Walton, C C; Naismith, S L

2016-09-01

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges' g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.

Neural basis for recognition confidence in younger and older adults.

PubMed

Chua, Elizabeth F; Schacter, Daniel L; Sperling, Reisa A

2009-03-01

Although several studies have examined the neural basis for age-related changes in objective memory performance, less is known about how the process of memory monitoring changes with aging. The authors used functional magnetic resonance imaging to examine retrospective confidence in memory performance in aging. During low confidence, both younger and older adults showed behavioral evidence that they were guessing during recognition and that they were aware they were guessing when making confidence judgments. Similarly, both younger and older adults showed increased neural activity during low- compared to high-confidence responses in the lateral prefrontal cortex, anterior cingulate cortex, and left intraparietal sulcus. In contrast, older adults showed more high-confidence errors than younger adults. Younger adults showed greater activity for high compared to low confidence in medial temporal lobe structures, but older adults did not show this pattern. Taken together, these findings may suggest that impairments in the confidence-accuracy relationship for memory in older adults, which are often driven by high-confidence errors, may be primarily related to altered neural signals associated with greater activity for high-confidence responses.

Effects of aging on neural connectivity underlying selective memory for emotional scenes.

PubMed

Waring, Jill D; Addis, Donna Rose; Kensinger, Elizabeth A

2013-02-01

Older adults show age-related reductions in memory for neutral items within complex visual scenes, but just like young adults, older adults exhibit a memory advantage for emotional items within scenes compared with the background scene information. The present study examined young and older adults' encoding-stage effective connectivity for selective memory of emotional items versus memory for both the emotional item and its background. In a functional magnetic resonance imaging (fMRI) study, participants viewed scenes containing either positive or negative items within neutral backgrounds. Outside the scanner, participants completed a memory test for items and backgrounds. Irrespective of scene content being emotionally positive or negative, older adults had stronger positive connections among frontal regions and from frontal regions to medial temporal lobe structures than did young adults, especially when items and backgrounds were subsequently remembered. These results suggest there are differences between young and older adults' connectivity accompanying the encoding of emotional scenes. Older adults may require more frontal connectivity to encode all elements of a scene rather than just encoding the emotional item. Published by Elsevier Inc.

Physical Health Conditions Associated with Posttraumatic Stress Disorder in U.S. Older Adults: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2011-01-01

Background/Objectives Trauma exposure and posttraumatic stress disorder (PTSD) may increase risk for medical conditions in older adults. We present findings on past-year medical conditions associated with lifetime trauma exposure, and full and partial PTSD, in a nationally representative sample of U.S. older adults. Design, Setting, Participants, and Measurements Face-to-face diagnostic interviews were conducted with 9,463 adults aged 60 and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses adjusting for sociodemographics and psychiatric comorbidity evaluated associations between PTSD status and past-year medical disorders; linear regression models evaluated associations with past-month physical functioning. Results After adjustment for sociodemographic characteristics and comorbid lifetime mood, anxiety, substance use, attention-deficit/hyperactivity, and personality disorders, respondents with lifetime PTSD were more likely than trauma controls to report being diagnosed by a healthcare professional with hypertension, angina pectoris, tachycardia, other heart disease, stomach ulcer, gastritis, and arthritis (odds ratios [ORs]=1.3–1.8); they also scored lower on a measure of physical functioning than controls and respondents with partial PTSD. Respondents with lifetime partial PTSD were more likely than controls to report past-year diagnoses of gastritis (OR=1.7), angina pectoris (OR=1.5), and arthritis (OR=1.4), and reported worse physical functioning. Number of lifetime traumatic event types was associated with most of the medical conditions assessed; adjustment for these events reduced the magnitudes of and rendered non-significant most associations between PTSD status and medical conditions. Conclusion Older adults with lifetime PTSD have elevated rates of several physical health conditions, many of which are chronic disorders of aging, and poorer physical functioning. Older adults with lifetime partial PTSD have elevated rates of gastritis, angina pectoris, and arthritis, and poorer physical functioning. PMID:22283516

Neighborhood social stressors, fine particulate matter air pollution, and cognitive function among older U.S. adults.

PubMed

Ailshire, Jennifer; Karraker, Amelia; Clarke, Philippa

2017-01-01

A growing number of studies have found a link between outdoor air pollution and cognitive function among older adults. Psychosocial stress is considered an important factor determining differential susceptibility to environmental hazards and older adults living in stressful neighborhoods may be particularly vulnerable to the adverse health effects of exposure to hazards such as air pollution. The objective of this study is to determine if neighborhood social stress amplifies the association between fine particulate matter air pollution (PM 2.5 ) and poor cognitive function in older, community-dwelling adults. We use data on 779 U.S. adults ages 55 and older from the 2001/2002 wave of the Americans' Changing Lives study. We determined annual average PM 2.5 concentration in 2001 in the area of residence by linking respondents with EPA air monitoring data using census tract identifiers. Cognitive function was measured using the number of errors on the Short Portable Mental Status Questionnaire (SPMSQ). Exposure to neighborhood social stressors was measured using perceptions of disorder and decay and included subjective evaluations of neighborhood upkeep and the presence of deteriorating/abandoned buildings, trash, and empty lots. We used negative binomial regression to examine the interaction of neighborhood perceived stress and PM 2.5 on the count of errors on the cognitive function assessment. We found that the association between PM 2.5 and cognitive errors was stronger among older adults living in high stress neighborhoods. These findings support recent theoretical developments in environmental health and health disparities research emphasizing the synergistic effects of neighborhood social stressors and environmental hazards on residents' health. Those living in socioeconomically disadvantaged neighborhoods, where social stressors and environmental hazards are more common, may be particularly susceptible to adverse health effects of social and physical environmental exposures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Resistance Training using Low Cost Elastic Tubing is Equally Effective to Conventional Weight Machines in Middle-Aged to Older Healthy Adults: A Quasi-Randomized Controlled Clinical Trial

PubMed Central

Lima, Fabiano F.; Camillo, Carlos A.; Gobbo, Luis A.; Trevisan, Iara B.; Nascimento, Wesley B. B. M.; Silva, Bruna S. A.; Lima, Manoel C. S.; Ramos, Dionei; Ramos, Ercy M. C.

2018-01-01

The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p < 0.05 for both), functional exercise capacity (ETG Δ4 ± 4% and CTG Δ6±8%; p < 0.05 for both). Improvement on “pain” domain of HRQOL could only be observed in the CTG (Δ21 ± 26% p = 0.037). CG showed no statistical improvement in any of the variables investigated. Resistance training using elastic tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults. Key points There is compeling evidence linking resistance training to health. Elastic resistance training improves the functionality of middle-aged to older healthy adults. Elastic resistance training was shown to be as effective as conventional resistence training in middle-aged to older healthy adults. PMID:29535589

Age-related structural alterations in human skeletal muscle fibers and mitochondria are sex specific: relationship to single-fiber function.

PubMed

Callahan, Damien M; Bedrin, Nicholas G; Subramanian, Meenakumari; Berking, James; Ades, Philip A; Toth, Michael J; Miller, Mark S

2014-06-15

Age-related loss of skeletal muscle mass and function is implicated in the development of disease and physical disability. However, little is known about how age affects skeletal muscle structure at the cellular and ultrastructural levels or how such alterations impact function. Thus we examined skeletal muscle structure at the tissue, cellular, and myofibrillar levels in young (21-35 yr) and older (65-75 yr) male and female volunteers, matched for habitual physical activity level. Older adults had smaller whole muscle tissue cross-sectional areas (CSAs) and mass. At the cellular level, older adults had reduced CSAs in myosin heavy chain II (MHC II) fibers, with no differences in MHC I fibers. In MHC II fibers, older men tended to have fewer fibers with large CSAs, while older women showed reduced fiber size across the CSA range. Older adults showed a decrease in intermyofibrillar mitochondrial size; however, the age effect was driven primarily by women (i.e., age by sex interaction effect). Mitochondrial size was inversely and directly related to isometric tension and myosin-actin cross-bridge kinetics, respectively. Notably, there were no intermyofibrillar or subsarcolemmal mitochondrial fractional content or myofilament ultrastructural differences in the activity-matched young and older adults. Collectively, our results indicate age-related reductions in whole muscle size do not vary by sex. However, age-related structural alterations at the cellular and subcellular levels are different between the sexes and may contribute to different functional phenotypes in ways that modulate sex-specific reductions in physical capacity with age. Copyright © 2014 the American Physiological Society.

The Model Human Processor and the Older Adult: Parameter Estimation and Validation Within a Mobile Phone Task

PubMed Central

Jastrzembski, Tiffany S.; Charness, Neil

2009-01-01

The authors estimate weighted mean values for nine information processing parameters for older adults using the Card, Moran, and Newell (1983) Model Human Processor model. The authors validate a subset of these parameters by modeling two mobile phone tasks using two different phones and comparing model predictions to a sample of younger (N = 20; Mage = 20) and older (N = 20; Mage = 69) adults. Older adult models fit keystroke-level performance at the aggregate grain of analysis extremely well (R = 0.99) and produced equivalent fits to previously validated younger adult models. Critical path analyses highlighted points of poor design as a function of cognitive workload, hardware/software design, and user characteristics. The findings demonstrate that estimated older adult information processing parameters are valid for modeling purposes, can help designers understand age-related performance using existing interfaces, and may support the development of age-sensitive technologies. PMID:18194048

The Model Human Processor and the older adult: parameter estimation and validation within a mobile phone task.

PubMed

Jastrzembski, Tiffany S; Charness, Neil

2007-12-01

The authors estimate weighted mean values for nine information processing parameters for older adults using the Card, Moran, and Newell (1983) Model Human Processor model. The authors validate a subset of these parameters by modeling two mobile phone tasks using two different phones and comparing model predictions to a sample of younger (N = 20; M-sub(age) = 20) and older (N = 20; M-sub(age) = 69) adults. Older adult models fit keystroke-level performance at the aggregate grain of analysis extremely well (R = 0.99) and produced equivalent fits to previously validated younger adult models. Critical path analyses highlighted points of poor design as a function of cognitive workload, hardware/software design, and user characteristics. The findings demonstrate that estimated older adult information processing parameters are valid for modeling purposes, can help designers understand age-related performance using existing interfaces, and may support the development of age-sensitive technologies.

Differences in Functional Fitness Among Older Adults With and Without Risk of Falling.

PubMed

Zhao, Yanan; Chung, Pak-Kwong

2016-03-01

This study aimed to identify the differences in functional fitness between older adults who were at risk of falling and those who were not. A total of 104 older adults aged 65-74 years were recruited from a local community senior center. They were independent older adults without a history of falls in the preceding 12 months. Falling risk status was assessed using the Fall Risk Test. Five dimensions of functional fitness with seven testing parameters (i.e., 30-second chair stand test, 30-second arm curl test, 2-minute step test, chair sit and reach test, back scratch test, 8-foot up and go test, and body mass index) were evaluated by the Senior Fitness Test. Only 78 participants completed all the tests, of which 48 participants were identified with risk of falling, and 30 participants were free from risk of falling. Results from multivariate analysis of variance found significant differences on the combined outcome variables, especially in the 8-foot up and go test, 2-minute step test, and 30-second arm curl test. Results from discriminant analysis found a significant discriminant function among all the seven testing parameters, where the 8-foot up and go test, and the 2-minute step test contributed most. Older adults who are at the early stage of risk of falling tend to have lower functional fitness capacities, especially in agility and dynamic balance, aerobic endurance as well as in a combined relationship among all the testing parameters. Copyright © 2016. Published by Elsevier B.V.

Evaluation of Verbal Behavior in Older Adults

PubMed Central

Gross, Amy C.; Fuqua, R. Wayne; Merritt, Todd A.

2013-01-01

Approximately 5% of older adults have a dementia diagnosis, and language deterioration is commonly associated with this disorder (Kempler, 2005). Several instruments have been developed to diagnose dementia and assess language capabilities of elderly adults. However, none of these instruments take a functional approach to language assessment as described by Skinner (1957). The purpose of this study was to develop and evaluate a function-based assessment for language deficits of older adults. Thirty-one participants were categorized into a control group (n  =  15) and a dementia group (n  =  16) based on their score on the Dementia Rating Scale-2. Individuals with dementia performed significantly worse on the tact assessment than those without dementia. Participants from both groups performed better on measures of tacts than intraverbals or mands, even though topographically identical responses were required in these assessments. The data provide support for Skinner's conceptualization of functionally independent verbal operants. PMID:23814369

Personality and physical functioning among older adults: the moderating role of education.

PubMed

Jaconelli, Alban; Stephan, Yannick; Canada, Brice; Chapman, Benjamin P

2013-07-01

Drawing upon a vulnerability model, this study tested whether low educational level would amplify the negative contribution of risky personality traits, such as high neuroticism and low conscientiousness, on older adults physical functioning. Five hundred and thirteen French-speaking community-dwelling older adults aged 60-91 years (mean age = 66.37, SD = 5.32) completed measures of physical functioning, education, personality traits, chronic conditions, and demographic variables. Results revealed that extraversion and conscientiousness were positively associated with physical functioning, whereas neuroticism was a negative predictor, beyond demographics, chronic conditions, and education. The negative relationship between neuroticism and physical functioning was stronger among individuals with low educational level and was nonsignificant among older people with higher level of education. This study is the first to support a vulnerability model, which entails an amplification of neuroticism risk at low education, but a diminishment of neuroticism risk for activity limitations at high education. As a whole, it appears that a focus on either personality or education without taking into account each other provides only a partial account of the predictors of basic daily physical activities in old age.

Factors associated with frailty in chronically ill older adults.

PubMed

Hackstaff, Lynn

2009-01-01

An ex post facto analysis of a secondary dataset examined relationships between physical frailty, depression, and the self-perceived domains of health status and quality-of-life in older adults. The randomized sample included 992 community-dwelling, chronically ill, and functionally impaired adults age 65 and older who received care from a Southern California Kaiser Permanente medical center between 1998 and 2002. Physical frailty represents a level of physiologic vulnerability and functional loss that results in dependence on others for basic, daily living needs (Fried et al., 2001). The purpose of the study was to identify possible intervention junctures related to self-efficacy of older adults in order to help optimize their functionality. Multivariate correlation analyses showed statistically significant positive correlations between frailty level and depression (r = .18; p = < .05), number of medical conditions (r = .09; p = < .05), and self-rated quality-of-life (r = .24; p = < .05). Frailty level showed a statistically significant negative correlation with self-perceived health status (r = -.25; p = < .05). Notably, no statistically significant correlation was found between age and frailty level (r = -.03; p = < .05). In linear regression, self-perceived health status had a partial variance with frailty level (part r = -.18). The significant correlations found support further research to identify interventions to help vulnerable, older adults challenge self-perceived capabilities so that they may achieve optimum functionality through increased physical activity earlier on, and increased self-efficacy to support successful adaptation to aging-related losses.

Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults.

PubMed

Straight, Chad R; Dorfman, Leah R; Cottell, Kathryn E; Krol, Julie M; Lofgren, Ingrid E; Delmonico, Matthew J

2012-08-01

Community-based interventions that incorporate resistance training (RT) and dietary changes have not been extensively studied in overweight and obese older adults. The purpose of this investigation was to determine the effects of a community-based RT and dietary intervention on physical function and body composition in overweight and obese older adults. Ninety-five overweight and obese (BMI=33.4±4.0 kg/m2) older adults aged 55-80 years completed an 8-week RT and dietary intervention at 4 Rhode Island senior centers. Participants performed RT twice-weekly using resistance tubing, dumbbells, and ankle weights. Participants also attended 1 weekly dietary counseling session on a modified Dietary Approaches to Stop Hypertension diet. Outcome measurements included anthropometrics, body composition, and physical function. There were small changes in body mass (-1.0±1.8 kg, P<.001), waist circumference (-5.2±3.8 cm, P<.001), and percent body fat (-0.5±1.4%, P<.001). In addition, significant improvements were observed in knee extensor torque (+7.9±19.1 N-m, P<.001), handgrip strength (+1.2±2.5 kg, P<.001), and 8-foot up-and-go test time (-0.56±0.89 s, P<.001). Community-based RT and dietary modifications can improve body composition, muscle strength, and physical function in overweight and obese older adults. Future investigations should determine if this intervention is effective for long-term changes.

Task-related functional connectivity of the caudate mediates the association between trait mindfulness and implicit learning in older adults.

PubMed

Stillman, Chelsea M; You, Xiaozhen; Seaman, Kendra L; Vaidya, Chandan J; Howard, James H; Howard, Darlene V

2016-08-01

Accumulating evidence shows a positive relationship between mindfulness and explicit cognitive functioning, i.e., that which occurs with conscious intent and awareness. However, recent evidence suggests that there may be a negative relationship between mindfulness and implicit types of learning, or those that occur without conscious awareness or intent. Here we examined the neural mechanisms underlying the recently reported negative relationship between dispositional mindfulness and implicit probabilistic sequence learning in both younger and older adults. We tested the hypothesis that the relationship is mediated by communication, or functional connectivity, of brain regions once traditionally considered to be central to dissociable learning systems: the caudate, medial temporal lobe (MTL), and prefrontal cortex (PFC). We first replicated the negative relationship between mindfulness and implicit learning in a sample of healthy older adults (60-90 years old) who completed three event-related runs of an implicit sequence learning task. Then, using a seed-based connectivity approach, we identified task-related connectivity associated with individual differences in both learning and mindfulness. The main finding was that caudate-MTL connectivity (bilaterally) was positively correlated with learning and negatively correlated with mindfulness. Further, the strength of task-related connectivity between these regions mediated the negative relationship between mindfulness and learning. This pattern of results was limited to the older adults. Thus, at least in healthy older adults, the functional communication between two interactive learning-relevant systems can account for the relationship between mindfulness and implicit probabilistic sequence learning.

Using virtual reality simulation to study navigation in a complex environment as a functional-cognitive task; A pilot study.

PubMed

Kizony, R; Zeilig, G; Krasovsky, T; Bondi, M; Weiss, P L; Kodesh, E; Kafri, M

2017-01-01

Navigation skills are required for performance of functional complex tasks and may decline due to aging. Investigation of navigation skills should include measurement of cognitive-executive and motor aspects, which are part of complex tasks. to compare young and older healthy adults in navigation within a simulated environment with and without a functional-cognitive task. Ten young adults (25.6±4.3 years) and seven community dwelling older men (69.9±3.8 years) were tested during a single session. After training on a self-paced treadmill to navigate in a non-functional simulation, they performed the Virtual Multiple Errands Test (VMET) in a mall simulation. Outcome measures included cognitive-executive aspects of performance and gait parameters. Younger adults' performance of the VMET was more efficient (1.8±1.0) than older adults (5.3±2.7; p < 0.05) and faster (younger 478.1±141.5 s, older 867.6±393.5 s; p < 0.05). There were no differences between groups in gait parameters. Both groups walked slower in the mall simulation. The shopping simulation provided a paradigm to assess the interplay between motor and cognitive aspects involved in the efficient performance of a complex task. The study emphasized the role of the cognitive-executive aspect of task performance in healthy older adults.

Health Literacy, Social Support, and Health Status among Older Adults

ERIC Educational Resources Information Center

Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

2009-01-01

The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

Mobile Application-Assisted Cognitive Behavioral Therapy for Insomnia in an Older Adult.

PubMed

Chen, Yong-Xiang; Hung, Yi-Ping; Chen, Hsi-Chung

2016-04-01

Current evidence suggests potential efficacy of cognitive behavioral therapy for insomnia (CBT-I) in older adults. Mobile applications (apps) have been developed to facilitate CBT-I in the general population. However, because of deteriorating perceptual and cognitive functioning, the effectiveness of mobile apps in older adults remains unknown. This case report aims to demonstrate the utilization, advantages, and limitations of mobile app-assisted CBT-I in an older female adult. An app ("Win-Win aSleep" [WWaS]) was applied in a six-session CBT-I treatment. The patient successfully discontinued her hypnotics and had restored sleep quality after the intervention with WWaS-assisted CBT-I. Several limitations of WWaS were summarized, and pertinent approaches for enhancing future work were discussed. Mobile apps integrating wearable devices might overcome the difficulty for applying WWaS in older adults. In addition to tailored design of mobile technology for older adults, psychosocial support for the utilization of apps may not only enhance the compliance but also provide additional connection to the environment.

Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden.

PubMed

Berner, Jessica; Rennemark, Mikael; Jogréus, Claes; Anderberg, Peter; Sköldunger, Anders; Wahlberg, Maria; Elmståhl, Sölve; Berglund, Johan

2015-09-01

Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet. © The Author(s) 2014.

Comparable Rest-related Promotion of Spatial Memory Consolidation in Younger and Older Adults

PubMed Central

Craig, Michael; Wolbers, Thomas; Harris, Mathew A.; Hauff, Patrick; Della Sala, Sergio; Dewar, Michaela

2017-01-01

Flexible spatial navigation depends on cognitive mapping, a function that declines with increasing age. In young adults, a brief period of post-navigation rest promotes the consolidation/integration of spatial memories into accurate cognitive maps. We examined (1) whether rest promotes spatial memory consolidation/integration in older adults and (2) whether the magnitude of the rest benefit changes with increasing age. Young and older adults learned a route through a virtual environment, followed by a 10min delay comprising either wakeful rest or a perceptual task, and a subsequent cognitive mapping task, requiring the pointing to landmarks from different locations. Pointing accuracy was lower in the older than younger adults. However, there was a comparable rest-related enhancement in pointing accuracy in the two age groups. Together our findings suggest that (i) the age-related decline in cognitive mapping cannot be explained by increased consolidation interference in older adults, and (ii) as we grow older rest continues to support the consolidation/integration of spatial memories. PMID:27689512

The effect of aging on the (mis)perception of intentionality - an ERP study.

PubMed

Pasion, R; Fernandes, C; Gonçalves, A R; Ferreira-Santos, F; Páscoa, R; Barbosa, F; Marques-Teixeira, J

2018-01-23

Despite the accumulated knowledge on moral decision-making in the early stages of development, empirical evidence is still limited in the old-aged adults. The current study contributes to unveil the neural correlates of judgments of moral transgressions as a function of aging, by examining the temporal dynamics of neural activation elicited by intentional and accidental harmful actions in three groups of healthy participants: young adults (18-35), adults (40-55), and older adults (60-75). Older adults were slower and less accurate in rating intentionality, compared to the younger groups. In ERP analysis, the older group showed increased P2 amplitude, which was predicted by poorer performance on neuropsychological tests. Reduced amplitudes were found on critical ERP components to moral cognition (N2 and LPP), namely while processing intentional harmful scenarios. Older adults seem to allocate more attentional resources (P2) to the task, probably to compensate the age-related decline in executive functioning, while younger groups show a pronounced negativity while detecting harm (N2) and increased neural activation to encode the intentions behind the acts (LPP).

Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults.

PubMed

Zhong, Selena; Pinto, Jayant M; Wroblewski, Kristen E; McClintock, Martha K

2018-04-01

The sexual experience is shaped by sensory function; with aging, sensory dysfunction may interfere with sexuality and sexual behavior between partners. Specifically, older adults with age-related sensory dysfunction may have less sexual activity than those with better sensory function. In addition, since sexual desire and attraction rests in part upon sensory function, sensory dysfunction may also be associated with less sexual motivation. To test the association between sexual activity and motivation in older adults and their sensory dysfunction. Sensory dysfunction was measured both by global sensory impairment (a validated measure of dysfunction shared among the 5 classic senses: olfaction, vision, taste, touch, hearing) and by total sensory burden (cumulative sensory loss). Sexual activity was quantified by frequency and type of sexual behavior. Sexual motivation was measured by the frequency of sexual ideation and the importance of sex to the respondent. We used cross-sectional data from a nationally representative sample of community-dwelling older adults (aged 57-85 years) in the United States (National Social Life, Health, and Aging Project, N = 3,005) in logistic regression analyses. Sexual activity, sexual motivation, and satisfaction with the sexual relationship were self-reported. Older adults with sensory dysfunction were less likely to be sexually active-an association that persisted when accounting for other factors that also affected sexual activity (age, gender, partnered status, mental and physical health, and relationship satisfaction). Nonetheless, sensory dysfunction did not impair sexual motivation, nor affect the physical and emotional satisfaction with the sexual relationship. Among currently sexually active older adults, sensory dysfunction did not affect the frequency of sex or the type of sexual activity (foreplay, vaginal intercourse, or oral sex). These results were the same for 2 different measures of sensory dysfunction. This is the first nationally representative study of sexuality and multisensory dysfunction in community-dwelling older adults. 4 of the 5 classic senses were measured with objective tests, and hearing was rated by interviewers in the context of their conversation. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression. Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. Zhong S, Pinto JM, Wroblewski KE, et al. Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018;15:502-509. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Association of Health and Functional Status with Private and Public Religious Practice among Rural, Ethnically Diverse, Older Adults with Diabetes

ERIC Educational Resources Information Center

Arcury, Thomas A.; Stafford, Jeanette M.; Bell, Ronny A.; Golden, Shannon L.; Snively, Beverly M.; Quandt, Sara A.

2007-01-01

Purpose: This analysis describes the association of health and functional status with private and public religious practice among ethnically diverse (African American, Native American, white) rural older adults with diabetes. Methods: Data were collected using a population-based, cross-sectional, stratified, random sample survey of 701…

The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

ERIC Educational Resources Information Center

Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

2013-01-01

The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

Activities of daily living in nursing home and home care settings: a retrospective 1-year cohort study.

PubMed

Lee, Tae Wha; Cho, Eunhee; Yim, Eun Shil; Lee, Hye Sun; Ko, Yu Kyung; Kim, Bok Nam; Kim, Sinhye

2015-02-01

Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. A retrospective 1-year cohort study using national LTCI data. This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t-test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P < .0001). After propensity-score matching, paired t-test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year (P < .0001). The ADLs of older adults who received home care showed significantly less deterioration than those of the older adults in nursing home care after 1 year. The ADLs of older adults could differ according to the type of LTC they receive, and home care could result in better maintenance of ADLs than nursing home care. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Age differences in risky choice: a meta-analysis

PubMed Central

Mata, Rui; Josef, Anika K.; Samanez-Larkin, Gregory R.; Hertwig, Ralph

2012-01-01

Does risk taking change as a function of age? We conducted a systematic literature search and found 29 comparisons between younger and older adults on behavioral tasks thought to measure risk taking (N =4,093). The reports relied on various tasks differing in several respects, such as the amount of learning required or the choice framing (gains vs. losses). The results suggest that age-related differences vary considerably as a function of task characteristics, in particular the learning requirements of the task. In decisions from experience, age-related differences in risk taking were a function of decreased learning performance: older adults were more risk seeking compared to younger adults when learning led to risk-avoidant behavior, but were more risk averse when learning led to risk-seeking behavior. In decisions from description, younger adults and older adults showed similar risk-taking behavior for the majority of the tasks, and there were no clear age-related differences as a function of gain/loss framing. We discuss limitations and strengths of past research and provide suggestions for future work on age-related differences in risk taking. PMID:22023565

The use of contextual cues to improve warning symbol comprehension: making the connection for older adults

PubMed Central

Lesch, Mary F.; Powell, W. Ryan; Horrey, William J.; Wogalter, Michael S.

2013-01-01

This study teased apart the effects of comprehensibility and complexity on older adults' comprehension of warning symbols by manipulating the relevance of additional information in further refining the meaning of the symbol. Symbols were systematically altered such that increased visual complexity (in the form of contextual cues) resulted in increased comprehensibility. One hundred older adults, aged 50–71 years, were tested on their comprehension of these symbols before and after training. High comprehensibility–complexity symbols were found to be better understood than low- or medium-comprehensibility–complexity symbols and the effectiveness of the contextual cues varied as a function of training. Therefore, the nature of additional detail determines whether increased complexity is detrimental or beneficial to older adults' comprehension – if the additional details provide ‘cues to knowledge’, older adults' comprehension improves as a result of the increased complexity. However, some cues may require training in order to be effective. Practitioner Summary: Research suggests that older adults have greater difficulty in understanding more complex symbols. However, we found that when the complexity of symbols was increased through the addition of contextual cues, older adults' comprehension actually improved. Contextual cues aid older adults in making the connection between the symbol and its referent. PMID:23767856

Age Differences in Brain Activity during Emotion Processing: Reflections of Age-Related Decline or Increased Emotion Regulation?

PubMed Central

Nashiro, Kaoru; Sakaki, Michiko; Mather, Mara

2012-01-01

Despite the fact that physical health and cognitive abilities decline with aging, the ability to regulate emotion remains stable and in some aspects improves across the adult life span. Older adults also show a positivity effect in their attention and memory, with diminished processing of negative stimuli relative to positive stimuli compared with younger adults. The current paper reviews functional magnetic resonance imaging studies investigating age-related differences in emotional processing and discusses how this evidence relates to two opposing theoretical accounts of older adults’ positivity effect. The aging-brain model [Cacioppo et al. in: Social Neuroscience: Toward Understanding the Underpinnings of the Social Mind. New York, Oxford University Press, 2011] proposes that older adults’ positivity effect is a consequence of age-related decline in the amygdala, whereas the cognitive control hypothesis [Kryla-Lighthall and Mather in: Handbook of Theories of Aging, ed 2. New York, Springer, 2009; Mather and Carstensen: Trends Cogn Sci 2005;9:496–502; Mather and Knight: Psychol Aging 2005;20:554–570] argues that the positivity effect is a result of older adults’ greater focus on regulating emotion. Based on evidence for structural and functional preservation of the amygdala in older adults and findings that older adults show greater prefrontal cortex activity than younger adults while engaging in emotion-processing tasks, we argue that the cognitive control hypothesis is a more likely explanation for older adults’ positivity effect than the aging-brain model. PMID:21691052

Effects of line dancing on physical function and perceived limitation in older adults with self-reported mobility limitations.

PubMed

Bennett, Crystal G; Hackney, Madeleine E

2018-06-01

Older adults with mobility limitations are at greater risk for aging-related declines in physical function. Line dancing is a popular form of exercise that can be modified, and is thus feasible for older adults with mobility limitations. The purpose of this study was to assess the effects of 8 weeks of line dancing on balance, muscle strength, lower extremity function, endurance, gait speed, and perceived mobility limitations. An experimental design randomly assigned older adults to either an 8-week line dancing or usual care group. The convenience sample consisted of 23 participants with mobility limitations (age range: 65-93 years). The intervention used simple routines from novice line dance classes. At baseline and at 8 weeks, balance, knee muscle strength, lower extremity function, endurance, gait speed, and mobility limitations were measured. ANCOVA tests were conducted on each dependent variable to assess the effects of the intervention over time. Results found significant positive differences for the intervention group in lower extremity function (p < 0.01); endurance (p < 0.01); gait speed (p < 0.001); and self-reported mobility limitations (p < 0.05). Eight weeks of line dancing significantly improved physical function and reduced self-reported mobility limitations in these individuals. Line dancing could be recommended by clinicians as a potential adjunct therapy that addresses mobility limitations. Implications for Rehabilitation Line dancing may be an alternative exercise for older adults who need modifications due to mobility limitations. Line dancing incorporates cognitive and motor control. Line dancing can be performed alone or in a group setting. Dancing improves balance which can reduce risk of falls.

Assessment of vulnerable older adults' physical function according to the Japanese Long-Term Care Insurance (LTCI) system and Fried's criteria for frailty syndrome.

PubMed

Nemoto, Miyuki; Yabushita, Noriko; Kim, Mi-Ji; Matsuo, Tomoaki; Seino, Satoshi; Tanaka, Kiyoji

2012-01-01

This study aimed to evaluate the physical frailty status of vulnerable older adults as classified in the Japanese LTCI system and to compare this with Fried's definition. A total of 444 older adults were classified based on the LTCI system as independent, vulnerable, or dependent, and 400 of these participants also fit Fried's criteria for not frail, pre-frail or frail. We evaluated their physical function with a 12 item physical function test. We derived a physical function score (PFS) from these 12 items and a principal component analysis was used to make comparisons. The receiver operating characteristic (ROC) curve analysis was performed to identify the sensitivity and specificity of the PFS cut-off points to distinguish the dependent category from the other categories. We found significant differences and a hierarchical order for the PFSs among the three groups of the LTCI system (the independent, 0.41 ± 0.54; the vulnerable, -0.40 ± 0.76; and the dependent, -1.49 ± 0.73) and of Fried's definition (not frail, 0.50 ± 0.51; pre frail, -0.11 ± 0.63; and frail, -1.25 ± 0.98). The optimal cut-off value (OCV) was -0.593. This study showed that the range of physical function of people considered frail category (pre-frail, vulnerable, and frail) is wide and overlapping. That is, the physical function of vulnerable older adults is worse than the pre-frail, but better than the frail. To better recognize older adults in need of greater support, the vulnerable should also receive assessment of their frailty status according to Fried's definition. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Singapore Healthy Older People Everyday (HOPE) Study: Prevalence of Frailty and Associated Factors in Older Adults.

PubMed

Merchant, Reshma A; Chen, Matthew Zhixuan; Tan, Linda Wei Lin; Lim, Moses YiDong; Ho, Han Kwee; van Dam, Rob M

2017-08-01

In the context of a rapidly ageing population, Singapore is anticipating a rise in multimorbidity, disability, and dependency, which are driven by physical frailty. Healthy Older People Everyday (HOPE) is an epidemiologic population-based study on community-dwelling older adults aged 65 years and older in Singapore. To investigate the prevalence of frail and prefrail states and their association with polypharmacy, multimorbidity, cognitive and functional status, and perceived health status among community-dwelling older adults in Singapore. Participants for HOPE were older adults aged 65 years and older recruited from a cohort study on the northwest region of Singapore. Analysis was performed on data collected from a combination of interviewer-administered questionnaires (including FRAIL scale, EQ-5D, Mini Mental State Examination, Barthel index, and Lawton IADL scale), clinical assessments, and physical measurements (including hand grip strength and Timed-Up-and-Go [TUG] test). A total of 1051 older adults (mean age 71.2 years) completed the study. More than half (57.2%) were female. The prevalence of frailty and prefrailty was 6.2% and 37%, respectively. Frailty was associated with older age, female gender, Indian (instead of Chinese) ethnicity, multimorbidity, polypharmacy, cognitive and functional impairment, weaker hand grip strength, longer TUG times, and poor perceived health status. Those with underlying cognitive impairment and frailty were at greater risk of adverse health outcome. Frailty is a complex health state with multiple domains and dimensions. In our study in a multiethnic Asian population, we identified nonmodifiable factors and modifiable risk factors (multimorbidity, polypharmacy, cognitive and functional impairment) that were associated with frailty. Interventions will have to be multipronged and will require a collaborated effort in order to effect change and improve the health span in rapidly ageing populations. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Age-related changes in trunk neuromuscular activation patterns during a controlled functional transfer task include amplitude and temporal synergies.

PubMed

Quirk, D Adam; Hubley-Kozey, Cheryl L

2014-12-01

While healthy aging is associated with physiological changes that can impair control of trunk motion, few studies examine how spinal muscle responses change with increasing age. This study examined whether older (over 65 years) compared to younger (20-45 years) adults had higher overall amplitude and altered temporal recruitment patterns of trunk musculature when performing a functional transfer task. Surface electromyograms from twelve bilateral trunk muscle (24) sites were analyzed using principal component analysis, extracting amplitude and temporal features (PCs) from electromyographic waveforms. Two PCs explained 96% of the waveform variance. Three factor ANOVA models tested main effects (group, muscle and reach) and interactions for PC scores. Significant (p<.0125) group interactions were found for all PC scores. Post hoc analysis revealed that relative to younger adults, older adults recruited higher agonist and antagonistic activity, demonstrated continuous activation levels in specific muscle sites despite changing external moments, and had altered temporal synergies within abdominal and back musculature. In summary both older and younger adults recruit highly organized activation patterns in response to changing external moments. Differences in temporal trunk musculature recruitment patterns suggest that older adults experience different dynamic spinal stiffness and loading compared to younger adults during a functional lifting task. Copyright © 2014 Elsevier B.V. All rights reserved.

Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa.

PubMed

Ramlagan, Shandir; Peltzer, Karl; Phaswana-Mafuya, Nancy

2014-01-07

Little is known about the prevalence, predictors and gender differences in hand grip strength of older adults in Africa. This study aims to investigate social and health differences in hand grip strength among older adults in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE wave 1) in 2008. We conducted a national population-based cross-sectional study with a sample of 3840 men and women aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric measurements. Linear multivariate regression analysis was performed to assess the association of social factors, health variables and grip strength. The mean overall hand grip strength was 37.9 kgs for men (mean age 61.1 years, SD = 9.1) and 31.5 kgs for women (mean age 62.0 years, SD = 9.7). In multivariate analysis among men, greater height, not being underweight and lower functional disability was associated with greater grip strength, and among women, greater height, better cognitive functioning, and lower functional disability were associated with greater grip strength. Greater height and lower functional disability were found for both older South African men and women to be significantly associated with grip strength.

Exploratory Decision-Making as a Function of Lifelong Experience, Not Cognitive Decline

PubMed Central

2016-01-01

Older adults perform worse than younger adults in some complex decision-making scenarios, which is commonly attributed to age-related declines in striatal and frontostriatal processing. Recently, this popular account has been challenged by work that considered how older adults’ performance may differ as a function of greater knowledge and experience, and by work showing that, in some cases, older adults outperform younger adults in complex decision-making tasks. In light of this controversy, we examined the performance of older and younger adults in an exploratory choice task that is amenable to model-based analyses and ostensibly not reliant on prior knowledge. Exploration is a critical aspect of decision-making poorly understood across the life span. Across 2 experiments, we addressed (a) how older and younger adults differ in exploratory choice and (b) to what extent observed differences reflect processing capacity declines. Model-based analyses suggested that the strategies used by the 2 groups were qualitatively different, resulting in relatively worse performance for older adults in 1 decision-making environment but equal performance in another. Little evidence was found that differences in processing capacity drove performance differences. Rather the results suggested that older adults’ performance might result from applying a strategy that may have been shaped by their wealth of real-word decision-making experience. While this strategy is likely to be effective in the real world, it is ill suited to some decision environments. These results underscore the importance of taking into account effects of experience in aging studies, even for tasks that do not obviously tap past experiences. PMID:26726916

Association between multiple geriatric syndromes and life satisfaction in community-dwelling older adults: A nationwide study in Taiwan.

PubMed

Yang, Deng-Chi; Lee, Jenq-Daw; Huang, Chi-Chang; Shih, Hsin-I; Chang, Chia-Ming

2015-01-01

Although previous studies have investigated the association between a single geriatric syndrome and life satisfaction in the older adults, the accumulated effects of multiple geriatric syndromes on life satisfaction remain unclear. We conducted a nationwide study by using data from the Taiwan Longitudinal Study on Aging database. A total of 2415 older adults were enrolled. Life satisfaction was evaluated according to the Life Satisfaction Index, and the geriatric syndromes included a depressive disorder, cognitive impairment, functional impairment, urine incontinence, pain, a fall, and polypharmacy. Other characteristics were age, sex, marital status, education level, self-rated health, and chronic diseases. Univariate analysis revealed that the older adults, who were illiterate, did not live with a partner, yet other issues such as stroke, malignancy, osteoarthritis, poor self-rated health, a depressive disorder, functional impairment, urine incontinence, or pain were associated with lower life satisfaction. In the multivariate regression model, the older adults who were male, illiterate, lived without a partner, had poor self-rated health, or had a depressive disorder were more likely to have lower life satisfaction. In addition, life satisfaction was unaffected in the older adults with only 1 geriatric syndrome, but among those with ≥2 geriatric syndromes, an increased number of geriatric syndromes were associated with lower life satisfaction. In addition to socio-demographic factors, cumulative effects of multiple geriatric syndromes might affect life satisfaction in the older adults. Further study of interventions for reducing geriatric syndromes to maintain life satisfaction is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

To boost or to CRUNCH? Effect of effortful encoding on episodic memory in older adults is dependent on executive functioning

PubMed Central

Fu, Li; Maes, Joseph H. R.; Kessels, Roy P. C.; Daselaar, Sander M.

2017-01-01

It is essential to develop effective interventions aimed at ameliorating age-related cognitive decline. Previous studies found that effortful encoding benefits episodic memory in older adults. However, to date it is unclear whether this benefit is different for individuals with strong versus weak executive functioning (EF). Fifty-one older adults were recruited and divided into low (N = 26) and high (N = 25) functioning groups, based on their EF capacity. All participants performed a semantic and a perceptual incidental encoding task. Each encoding task was performed under four difficulty levels to establish different effort levels. Encoding was followed by a recognition task. Results showed that the high EF group benefitted from increased effort in both tasks. However, the low EF group only showed a beneficial effect under low levels of effort. Results are consistent with the Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH) and suggest that future research directed at developing efficient memory strategies to reduce negative cognitive aging effects should take individual cognitive differences among older adults into account, such as differences in EF. PMID:28328979

The Effects of Pilates Training on Balance Control and Self-Reported Health Status in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Gabizon, Hadas; Press, Yan; Volkov, Ilia; Melzer, Itshak

2016-07-01

To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults. A single-blind, randomized, controlled trial. General community. A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44). The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention. Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period. Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status. The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

Gender differences in functional disability and self-care among seniors in Bangladesh.

PubMed

Tareque, Md Ismail; Tiedt, Andrew D; Islam, Towfiqua Mahfuza; Begum, Sharifa; Saito, Yasuhiko

2017-08-08

Disability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults' disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh. This research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh's 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group's short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit. Forty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences. Programs aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh.

American College of Sports Medicine position stand. Exercise and physical activity for older adults.

PubMed

Chodzko-Zajko, Wojtek J; Proctor, David N; Fiatarone Singh, Maria A; Minson, Christopher T; Nigg, Claudio R; Salem, George J; Skinner, James S

2009-07-01

The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.

Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

PubMed

Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care.

PubMed

Goodman, David W; Mitchell, Sara; Rhodewalt, Lauren; Surman, Craig B H

2016-01-01

Although previously considered a disorder of childhood, studies in the last decade have demonstrated that attention-deficit hyperactivity disorder (ADHD) continues to impair function into adulthood and responds to pharmacotherapy. Due to age-specific changes in roles and challenges, it is possible that presentation and response to intervention may differ between older and younger adults. A literature search for papers that identified older adults with ADHD, including papers describing its epidemiology, manifestation, and treatment, was the basis for this paper. There is a paucity of data on ADHD in older adults; however, small observational studies have characterized the presence, impact, and treatment of ADHD in adults over the age of 50 years, and larger epidemiologic studies have demonstrated that ADHD symptoms exist in older adulthood. Optimal criteria for diagnosis of ADHD and methods of treating ADHD in older individuals have not been systematically explored. In light of the limited data, this review discusses considerations for differential diagnosis and safe pharmacotherapy of ADHD in older adults.

Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

PubMed

Parker, Samantha J; Jessel, Sonal; Richardson, Joshua E; Reid, M Cary

2013-05-06

Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, mHealth devices for older persons with CP.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial.

PubMed

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

PubMed Central

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Background: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Methods: Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Results: Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Conclusion: Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments. PMID:21753869

Aging barriers influencing mobile health usability for older adults: A literature based framework (MOLD-US).

PubMed

Wildenbos, G A; Peute, Linda; Jaspers, Monique

2018-06-01

With the growing population of older adults as a potential user group of mHealth, the need increases for mHealth interventions to address specific aging characteristics of older adults. The existence of aging barriers to computer use is widely acknowledged. Yet, usability studies show that mHealth still fails to be appropriately designed for older adults and their expectations. To enhance designs of mHealth aimed at older adult populations, it is essential to gain insight into aging barriers that impact the usability of mHealth as experienced by these adults. This study aims to synthesize literature on aging barriers to digital (health) computer use, and explain, map and visualize these barriers in relation to the usability of mHealth by means of a framework. We performed a scoping review to synthesize and summarize reported physical and functional age barriers in relation to digital (mobile) health applications use. Aging barriers reported in the literature were mapped onto usability aspects categorized by Nielsen to explain their influence on user experience of mHealth. A framework (MOLD-US) was developed summarizing the evidence on the influence of aging barriers on mHealth use experienced by older adults. Four key categories of aging barriers influencing usability of mHealth were identified: cognition, motivation, physical ability and perception. Effective and satisfactory use of mHealth by older adults is complicated by cognition and motivation barriers. Physical ability and perceptual barriers further increase the risk of user errors and fail to notice important interaction tasks. Complexities of medical conditions, such as diminished eye sight related to diabetes or deteriorated motor skills as a result of rheumatism, can cause errors in user interaction. This research provides a novel framework for the exploration of aging barriers and their causes influencing mHealth usability in older adults. This framework allows for further systematic empirical testing and analysis of mHealth usability issues, as it enables results to be classified and interpreted based on impediments intrinsic to usability issues experienced by older adults. Importantly, the paper identifies a key need for future research on motivational barriers impeding mhealth use of older adults. More insights are needed in particular to disaggregating normal age related functional changes from specific medical conditions that influence experienced usefulness of mHealth by these adults. Copyright © 2018 Elsevier B.V. All rights reserved.

A positive association between active lifestyle and hemispheric lateralization for motor control and learning in older adults.

PubMed

Wang, Jinsung; D'Amato, Arthur; Bambrough, Jennifer; Swartz, Ann M; Miller, Nora E

2016-11-01

Physical activity (PA) is well known to have general health benefits for older adults, but it is unclear whether it can also positively affect brain function involved in motor control and learning. We have previously shown that interlimb transfer of visuomotor adaptation occurs asymmetrically in young adults, while that occurs symmetrically in older adults, which suggests that the lateralized function of each hemisphere during motor tasks is diminished with aging. Here, we investigated the association between the level of PA and hemispheric motor lateralization by comparing the pattern of interlimb transfer following visuomotor adaptation between physically active and inactive older adults. Subjects were divided into two groups based on their PA level (active, inactive). They were further divided into two groups, such that a half of the subjects in each group adapted to a 30° rotation during targeted reaching movements with the left arm first, then with the right arm; and the other half with the right arm first, then with the left arm. Results indicated asymmetrical transfer (from left to right only) in the active subjects, whereas symmetrical transfer (from left to right, and vice versa) was observed in the inactive subjects. These findings suggest that older adults who maintain active lifestyle have a central nervous system that is more intact in terms of its lateralized motor function as compared with those who are inactive. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of dance on cognitive function among older adults: a protocol for systematic review and meta-analysis.

PubMed

Borhan, Asm; Hewston, Patricia; Merom, Dafna; Kennedy, Courtney; Ioannidis, George; Santesso, Nancy; Santaguida, Pasqualina; Thabane, Lehana; Papaioannou, Alexandra

2018-01-27

Cognitive impairment is characterized by problems in thinking, memory, language, and judgment that are greater than cognitive changes in normal aging. Considering the unprecedented growth of the older adult population and the projected increase in the prevalence of cognitive impairment, it is imperative to find effective strategies to improve or maintain cognitive function in older adults. The objective of this review is to summarize the effects of dance versus any other control group on cognitive function, physical function, adverse events, and quality of life in older adults. We will search the following databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify the randomized controlled trials (RCTs) evaluating the effects of dance on cognitive function among older adults. Also, we will search http://apps.who.int/trialsearch , clinicaltrials.gov and conference abstracts to identify ongoing and unpublished studies. There will be no restrictions on language, date, or journal of publication. Reviewers will independently and in duplicate screen for eligible studies using pre-defined criteria. Data extraction from eligible studies will be performed independently and in duplicate. The Cochrane risk of bias tool will be used to assess the risk of bias of studies. Our primary outcome of interest is cognitive function, more specifically the executive function domain. We will include other domains as well such as processing speed and reaction time. Secondary outcomes of interest are physical function. The secondary outcomes also include adverse events including falls and quality of life. We will use Review Manager (RevMan 5.3) to pool the effect of dance for each outcome where possible. Results will be presented as relative risks along with 95% confidence intervals for dichotomous outcomes and as mean differences, or standardized mean differences along with 95% confidence intervals, for continuous outcomes. We will assess the certainty of the evidence using the GRADE approach and present findings in a Summary of Findings table. This systematic review, to our best knowledge the first-ever, will synthesize the available evidence on the effects of dance on cognitive function among older people. PROSPERO CRD42017057138.

Beliefs About Behavior Account for Age Differences in the Correspondence Bias

PubMed Central

Blanchard-Fields, Fredda

2011-01-01

Objectives. Older adults tend to exhibit the correspondence bias to a greater extent than young adults. The current study examined whether these age differences are a function of the degree to which an individual subscribes to a lay theory of attitude–behavior consistency. Methods. First, participants responded to questions regarding their beliefs about attitude–behavior consistency. Approximately 2 weeks later, 144 (67 young adults and 77 older adults) participants completed the correspondence bias task. Results. As expected, older adults were more biased than young adults. Analyses revealed that the degree to which an individual holds attitude–behavior consistency beliefs in the dishonesty domain accounted for age-related differences in the correspondence bias. Discussion. The results of this study suggest that age differences in the correspondence bias task are in part driven by older adults holding stronger attitude–behavior consistency beliefs than young adults. PMID:21071624

Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder among Older Adults in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2011-01-01

Objectives To present findings on the prevalence, correlates, and psychiatric comorbidity of DSM-IV posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults. Design, Setting, and Participants Face-to-face interviews with 9,463 adults aged 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Measurements Sociodemographic correlates, worst stressful experiences, comorbid lifetime mood, anxiety, substance use, and personality disorders, psychosocial functioning, and suicide attempts. Results Lifetime prevalences±standard errors of PTSD and partial PTSD were 4.5%±0.25 and 5.5%±0.27, respectively. Rates were higher in women (5.7%±0.37 and 6.5%±0.39) than men (3.1%±0.31 and 4.3%±0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders, and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders, and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD. Conclusions PTSD among older adults in the United States is slightly more prevalent than previously reported and associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders. PMID:22522959

Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions.

PubMed

Singh, Devinder K A; Manaf, Zahara A; Yusoff, Noor Aini M; Muhammad, Nur A; Phan, Mei Fang; Shahar, Suzana

2014-01-01

The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions. Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered. The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index. These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions.

Psychiatric comorbidity of full and partial posttraumatic stress disorder among older adults in the United States: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Pietrzak, Robert H; Goldstein, Risë B; Southwick, Steven M; Grant, Bridget F

2012-05-01

To present findings on the prevalence, correlates, and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults. Face-to-face interviews with 9,463 adults age 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Sociodemographic correlates; worst stressful experiences; comorbid lifetime mood, anxiety, substance use, and personality disorders; psychosocial functioning; and suicide attempts. Lifetime prevalences ± standard errors of PTSD and partial PTSD were 4.5% ± 0.25 and 5.5% ± 0.27, respectively. Rates were higher in women (5.7% ± 0.37 and 6.5% ± 0.39) than in men (3.1% ± 0.31 and 4.3% ± 0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and their own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD. PTSD among older adults in the United States is slightly more prevalent than previously reported and is associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders.

An elastic band exercise program for older adults using wheelchairs in Taiwan nursing homes: a cluster randomized trial.

PubMed

Chen, Kuei-Min; Li, Chun-Huw; Chang, Ya-Hui; Huang, Hsin-Ting; Cheng, Yin-Yin

2015-01-01

The number of older adults using wheelchairs in nursing homes is over 50% of that population, and many of them use wheelchairs due to muscle weakness in the lower extremities. Muscles of older adults are trainable, and progressive resistance exercises using elastic bands can increase muscle strength in older adults. To test the effectiveness of six-month Wheelchair-bound Senior Elastic Band exercises on the functional fitness of older adults in nursing homes. Cluster randomized trial. Ten nursing homes, southern Taiwan. 127 participants were recruited, and 114 of them completed the study. Inclusion criteria were: (1) aged 65 and over, (2) using wheelchairs for mobility, (3) living in the facility for at least three months, (4) cognitively intact, and (5) heavily or moderate dependency in their activities of daily living. The mean age of the participants was 79.15 (7.03) years, and 98.20% of them had chronic illnesses. Participants were randomly assigned to the experimental (five nursing homes, n=59) or the control (five nursing homes, n=55) group based on the nursing homes where they stayed. A 40-min Wheelchair-bound Senior Elastic Band exercise program was implemented three times per week for six months for the experimental group participants. The functional fitness (activities of daily living, lung capacity, body flexibilities, muscle power and endurance) of the participants was examined at baseline, after three months, and at the end of the six months study. The mixed-design, two-way analysis of variance was used to detect the interaction effects, and one-way repeated measures analysis of variance and analysis of covariance were performed to analyze the within-group and between-group differences. At the end of the six-month study, the Wheelchair-bound Senior Elastic Band group had better performances in all of the functional fitness indicators than the control group (all p<0.05). The Wheelchair-bound Senior Elastic Band exercises significantly improved the functional fitness of the older adults in wheelchairs. It is suggested that the program be incorporated as a part of daily activities for nursing home older adults in wheelchairs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mechanical energy transfers across lower limb segments during stair ascent and descent in young and healthy older adults.

PubMed

Novak, Alison C; Li, Qingguo; Yang, Shuozhi; Brouwer, Brenda

2011-07-01

Older adults present with altered movement patterns during stair negotiation although the extent to which modifications in pattern and speed influence mechanical efficiency is unknown. This study evaluated mechanical energy transfers attributed to active force production during stair negotiation in young and older adults to provide insight into age-related changes in mechanical efficiency. Secondary analysis on data obtained from 23 young (23.7±3.0 years) and 32 older adults (67.0±8.2 years) during self-paced stair ascent and descent was conducted. Mechanical energy expenditures (MEE) during concentric transfer, eccentric transfer and no-transfer phases were determined for the ankle, knee and hip power profiles in the sagittal plane. Mechanical energy compensations (MEC) were also determined at each joint. During ascent, MEEs were similar for young and older adults although older adults compensated ankle muscles to a lesser extent during concentric muscle action. Controlling for cadence eliminated this difference. During descent, older adults demonstrated lower energy expenditures at the ankle and hip and similar expenditures at the knee compared to young adults. Changes in joint MEE in the older group resulted in reduced energy compensation at the ankle during concentric and eccentric activity and at the knee during eccentric activity. These age-related differences in mechanical energy transfers and related adjustments in MEC were not a function of the slower cadence in older adults and suggest a loss in mechanical efficiency. These results provide a benchmark against which physical impairments in older adults may be explored. Copyright © 2011 Elsevier B.V. All rights reserved.

Lipids and physical function in older adults.

PubMed

Casas-Agustench, Patricia; Cherubini, Antonio; Andrés-Lacueva, Cristina

2017-01-01

Healthy aging is a public health priority. The maintenance of adequate physical function is recognized as a key element of healthy aging. In recent years, scientific evidence has increased concerning the ability of lipids, in particular omega 3 polyunsaturated fatty acids (n-3 PUFAs), to positively influence muscle and overall physical function in older patients. The article will critically review observational as well as intervention studies on this topic, and it will elucidate the potential biological mechanisms underlying the beneficial effects of n-3 PUFA on physical function. Observational studies and clinical trials performed in healthy older patients and in older patients with chronic diseases mostly found positive effects of n-3 PUFA on muscle metabolism, muscle strength and in general physical function. Although the use of n-3 PUFA might represent an important intervention to preserve physical function in older adults, several key questions still need to be answered. Above all, large randomized controlled trials should be performed to confirm the utility of n-3 PUFA as therapeutic agents to prevent and treat physical function decline in old age.

Optimal retraining time for regaining functional fitness using multicomponent training after long-term detraining in older adults.

PubMed

Lee, Minyoung; Lim, Taehyun; Lee, Jaehyuk; Kim, Kimyeong; Yoon, BumChul

2017-11-01

Little is known about the optimal retraining time for regaining functional fitness through multicomponent training following long-term detraining in older adults. This study first investigated the time course of functional fitness changes during 12-month multicomponent training, 12-month detraining, and 9-month retraining in 18 older adults (68.33±3.46) and then determined the optimal retraining time for regaining the post-training functional fitness level after a 12-month detraining period. Functional fitness, including lower and upper limb strength, lower and upper limb flexibility, aerobic endurance, and dynamic balance, was assessed at baseline, 12 months post-training, 12 months post-detraining, and 3, 6, and 9 months post-retraining. There were significant increases in all of the functional fitness components except upper limb flexibility at post-training and no significant decreases at post-detraining. For lower and upper limb strength and lower limb flexibility, a 3-month period was required to regain the post-training condition. For aerobic endurance and dynamic balance, a retraining period ≥9months was necessary to regain the post-training functional fitness condition. To regain the post-training condition of all functional fitness components, a retraining period ≥9months was required. This information might be useful for health professionals to encourage older adults not to interrupt retraining until they regain their post-training functional fitness condition. Copyright © 2017 Elsevier B.V. All rights reserved.

[Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

PubMed

Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

2015-04-01

The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

Age and Functional Health Status

DTIC Science & Technology

1989-06-01

age groups. However, decrements in functional health status occurred selectively among older individuals with many of the elderly scoring as well as...Illinois adults (18 and above) were asked to assess their health compared to others their age , only those 61 and older rated their health as better than...and more variable physical functioning, role functioning,, and perceived health in older age groups, particularly those groups aged 50 and

Effect of Footwear on Joint Pain and Function in Older Adults With Lower Extremity Osteoarthritis.

PubMed

Wagner, Amy; Luna, Sarah

Lower extremity osteoarthritis (OA) is a common condition among older adults; given the risks of surgical and pharmaceutical interventions, conservative, lower-cost management options such as footwear warrant further investigation. This systematic review investigated the effects of footwear, including shoe inserts, in reducing lower extremity joint pain and improving gait, mobility, and quality of life in older adults with OA. The CINAHL, SPORTDiscus, PubMed, RECAL, and Web of Knowledge databases were searched for publications from January 1990 to September 2014, using the terms "footwear," "shoes," "gait," "pain," and "older adult." Participants who were 50 years or older and those who had OA in at least one lower extremity joint narrowed the results. Outcomes of interest included measures of pain, comfort, function, gait, or quality of life. Exclusion criteria applied to participants with rheumatoid arthritis, amputation, diabetes, multiple sclerosis, use of modified footwear or custom orthotics, purely biomechanical studies, and outcomes of balance or falls only. Single-case studies, qualitative narrative descriptions, and expert opinions were also excluded. The initial search resulted in a total of 417 citations. Eleven articles met inclusion criteria. Two randomized controlled trials and 3 quasiexperimental studies reported lateral wedge insoles may have at least some pain-relieving effects and improved functional mobility in older adults at 4 weeks to 2 years' follow-up, particularly when used with subtalar and ankle strapping. Three randomized controlled trials with large sample sizes reported that lateral wedges provided no knee pain relief compared with flat insoles. Hardness of shoe soles did not significantly affect joint comfort in the foot in a quasiexperimental study. A quasiexperimental designed study investigating shock-absorbing insoles showed reduction in knee joint pain with 1 month of wear. Finally, a cross-sectional prognostic study indicated poor footwear at early ages exhibits an association with hindfoot pain later in life. Because of the limited number of randomized control trials, it is not possible to make a definitive conclusion about the long-term effects of footwear on lower extremity joint pain caused by OA. There is mounting evidence that shock-absorbing insoles, subtalar strapping, and avoidance of high heels and sandals early in life may prevent lower extremity joint pain in older adults, but no conclusive evidence exists to show that lateral wedge insoles will provide long-term relief from knee joint pain and improved mobility in older adults with OA. More high-quality randomized control trials are needed to study the effectiveness of footwear and shoe inserts on joint pain and function in older adults with OA.

Age-related differences in the neural bases of phonological and semantic processes

PubMed Central

Diaz, Michele T.; Johnson, Micah A.; Burke, Deborah M.; Madden, David J.

2014-01-01

Changes in language functions during normal aging are greater for phonological compared to semantic processes. To investigate the behavioral and neural basis for these age-related differences, we used functional magnetic resonance imaging (fMRI) to examine younger and older adults who made semantic and phonological decisions about pictures. The behavioral performance of older adults was less accurate and less efficient than younger adults’ in the phonological task, but did not differ in the semantic task. In the fMRI analyses, the semantic task activated left-hemisphere language regions, while the phonological task activated bilateral cingulate and ventral precuneus. Age-related effects were widespread throughout the brain, and most often expressed as greater activation for older adults. Activation was greater for younger compared to older adults in ventral brain regions involved in visual and object processing. Although there was not a significant Age x Condition interaction in the whole-brain fMRI results, correlations examining the relationship between behavior and fMRI activation were stronger for younger compared to older adults. Our results suggest that the relationship between behavior and neural activation declines with age and this may underlie some of the observed declines in performance. PMID:24893737

Glycerophospholipid Supplementation as a Potential Intervention for Supporting Cerebral Structure in Older Adults

PubMed Central

Reddan, Jeffery M.; White, David J.; Macpherson, Helen; Scholey, Andrew; Pipingas, Andrew

2018-01-01

Modifying nutritional intake through supplementation may be efficacious for altering the trajectory of cerebral structural decline evident with increasing age. To date, there have been a number of clinical trials in older adults whereby chronic supplementation with B vitamins, omega-3 fatty acids, or resveratrol, has been observed to either slow the rate of decline or repair cerebral tissue. There is also some evidence from animal studies indicating that supplementation with glycerophospholipids (GPL) may benefit cerebral structure, though these effects have not yet been investigated in adult humans. Despite this paucity of research, there are a number of factors predicting poorer cerebral structure in older humans, which GPL supplementation appears to beneficially modify or protect against. These include elevated concentrations of homocysteine, unbalanced activity of reactive oxygen species both increasing the risk of oxidative stress, increased concentrations of pro-inflammatory messengers, as well as poorer cardio- and cerebrovascular function. As such, it is hypothesized that GPL supplementation will support cerebral structure in older adults. These cerebral effects may influence cognitive function. The current review aims to provide a theoretical basis for future clinical trials investigating the effects of GPL supplementation on cerebral structural integrity in older adults. PMID:29563868

Functional compensation in the ventromedial prefrontal cortex improves memory-dependent decisions in older adults.

PubMed

Lighthall, Nichole R; Huettel, Scott A; Cabeza, Roberto

2014-11-19

Everyday consumer choices frequently involve memory, as when we retrieve information about consumer products when making purchasing decisions. In this context, poor memory may affect decision quality, particularly in individuals with memory decline, such as older adults. However, age differences in choice behavior may be reduced if older adults can recruit additional neural resources that support task performance. Although such functional compensation is well documented in other cognitive domains, it is presently unclear whether it can support memory-guided decision making and, if so, which brain regions play a role in compensation. The current study engaged younger and older humans in a memory-dependent choice task in which pairs of consumer products from a popular online-shopping site were evaluated with different delays between the first and second product. Using functional imaging (fMRI), we found that the ventromedial prefrontal cortex (vmPFC) supports compensation as defined by three a priori criteria: (1) increased vmPFC activation was observed in older versus younger adults; (2) age-related increases in vmPFC activity were associated with increased retrieval demands; and (3) increased vmPFC activity was positively associated with performance in older adults-evidence of successful compensation. Extending these results, we observed evidence for compensation in connectivity between vmPFC and the dorsolateral PFC during memory-dependent choice. In contrast, we found no evidence for age differences in value-related processing or age-related compensation for choices without delayed retrieval. Together, these results converge on the conclusion that age-related decline in memory-dependent choice performance can be minimized via functional compensation in vmPFC. Copyright © 2014 the authors 0270-6474/14/3415648-10$15.00/0.

Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people.

PubMed

Caetano, Maria Joana D; Lord, Stephen R; Brodie, Matthew A; Schoene, Daniel; Pelicioni, Paulo H S; Sturnieks, Daina L; Menant, Jasmine C

2018-01-01

Reduced ability to adapt gait, particularly under challenging conditions, may be an important reason why older adults have an increased risk of falling. This study aimed to identify cognitive, psychological and physical mediators of the relationship between impaired gait adaptability and fall risk in older adults. Fifty healthy older adults (mean±SD: 74±7years) were categorised as high or low fall risk, based on past falls and their performance in the Physiological Profile Assessment. High and low-risk groups were then compared in the gait adaptability test, i.e. an assessment of the ability to adapt gait in response to obstacles and stepping targets under single and dual task conditions. Quadriceps strength, concern about falling and executive function were also measured. The older adults who made errors on the gait adaptability test were 4.76 (95%CI=1.08-20.91) times more likely to be at high risk of falling. Furthermore, each standard deviation reduction in gait speed while approaching the targets/obstacle increased the odds of being at high risk of falling approximately three fold: single task - OR=3.10,95%CI=1.43-6.73; dual task - 3.42,95%CI=1.56-7.52. Executive functioning, concern about falling and quadriceps strength substantially mediated the relationship between the gait adaptability measures and fall risk status. Impaired gait adaptability is associated with high risk of falls in older adults. Reduced executive function, increased concern about falling and weaker quadriceps strength contribute significantly to this relationship. Training gait adaptability directly, as well as addressing the above mediators through cognitive, behavioural and physical training may maximise fall prevention efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

Aging, hypertension and physiological tremor: the contribution of the cardioballistic impulse to tremorgenesis in older adults.

PubMed

Morrison, Steven; Sosnoff, Jacob J; Heffernan, Kevin S; Jae, Sae Young; Fernhall, Bo

2013-03-15

For older adults, an increase in physiological tremor is a common motor feature. This increase is believed to primarily reflect a general decline in function of the neuromuscular system. However, given that tremor is derived from a number of intrinsic sources, age-related changes in other physiological functions like the cardiac system may also negatively alter tremor output. The aim of this study was to examine what impact age and increased cardiac input (hypertension) have on physiological tremor. Heart rate, blood pressure, and postural/resting tremor were recorded in three groups; 1) young, healthy adults, 2) old, normotensive adults, and 3) old, hypertensive adults. The results demonstrated that the old hypertensive adults had greater postural tremor compared to the young healthy individuals. Coherence analysis revealed significant coupling between blood pressure-tremor and between heart rate-tremor for all individuals. The strength of this coupling was greatest for the older, hypertensive individuals. Together these results show that, for older adults, the combined effects of age and cardiac disease have the greatest impact on physiological tremor rather than any single factor alone. Copyright © 2013 Elsevier B.V. All rights reserved.

Correlations of decision weights and cognitive function for the masked discrimination of vowels by young and old adults

PubMed Central

Lutfi, Robert A.

2014-01-01

Older adults are often reported in the literature to have greater difficulty than younger adults understanding speech in noise [Helfer and Wilber (1988). J. Acoust. Soc. Am, 859–893]. The poorer performance of older adults has been attributed to a general deterioration of cognitive processing, deterioration of cochlear anatomy, and/or greater difficulty segregating speech from noise. The current work used perturbation analysis [Berg (1990). J. Acoust. Soc. Am., 149–158] to provide a more specific assessment of the effect of cognitive factors on speech perception in noise. Sixteen older (age 56–79 years) and seventeen younger (age 19–30 years) adults discriminated a target vowel masked by randomly selected masker vowels immediately preceding and following the target. Relative decision weights on target and maskers resulting from the analysis revealed large individual differences across participants despite similar performance scores in many cases. On the most difficult vowel discriminations, the older adult decision weights were significantly correlated with inhibitory control (Color Word Interference test) and pure-tone threshold averages (PTA). Young adult decision weights were not correlated with any measures of peripheral (PTA) or central function (inhibition or working memory). PMID:25256580

Support vector machine classification and characterization of age-related reorganization of functional brain networks

PubMed Central

Meier, Timothy B.; Desphande, Alok S.; Vergun, Svyatoslav; Nair, Veena A.; Song, Jie; Biswal, Bharat B.; Meyerand, Mary E.; Birn, Rasmus M.; Prabhakaran, Vivek

2012-01-01

Most of what is known about the reorganization of functional brain networks that accompanies normal aging is based on neuroimaging studies in which participants perform specific tasks. In these studies, reorganization is defined by the differences in task activation between young and old adults. However, task activation differences could be the result of differences in task performance, strategy, or motivation, and not necessarily reflect reorganization. Resting-state fMRI provides a method of investigating functional brain networks without such confounds. Here, a support vector machine (SVM) classifier was used in an attempt to differentiate older adults from younger adults based on their resting-state functional connectivity. In addition, the information used by the SVM was investigated to see what functional connections best differentiated younger adult brains from older adult brains. Three separate resting-state scans from 26 younger adults (18-35 yrs) and 26 older adults (55-85) were obtained from the International Consortium for Brain Mapping (ICBM) dataset made publically available in the 1000 Functional Connectomes project www.nitrc.org/projects/fcon_1000. 100 seed-regions from four functional networks with 5 mm3 radius were defined based on a recent study using machine learning classifiers on adolescent brains. Time-series for every seed-region were averaged and three matrices of z-transformed correlation coefficients were created for each subject corresponding to each individual’s three resting-state scans. SVM was then applied using leave-one-out cross-validation. The SVM classifier was 84% accurate in classifying older and younger adult brains. The majority of the connections used by the classifier to distinguish subjects by age came from seed-regions belonging to the sensorimotor and cingulo-opercular networks. These results suggest that age-related decreases in positive correlations within the cingulo-opercular and default networks, and decreases in negative correlations between the default and sensorimotor networks, are the distinguishing characteristics of age-related reorganization. PMID:22227886

Support vector machine classification and characterization of age-related reorganization of functional brain networks.

PubMed

Meier, Timothy B; Desphande, Alok S; Vergun, Svyatoslav; Nair, Veena A; Song, Jie; Biswal, Bharat B; Meyerand, Mary E; Birn, Rasmus M; Prabhakaran, Vivek

2012-03-01

Most of what is known about the reorganization of functional brain networks that accompanies normal aging is based on neuroimaging studies in which participants perform specific tasks. In these studies, reorganization is defined by the differences in task activation between young and old adults. However, task activation differences could be the result of differences in task performance, strategy, or motivation, and not necessarily reflect reorganization. Resting-state fMRI provides a method of investigating functional brain networks without such confounds. Here, a support vector machine (SVM) classifier was used in an attempt to differentiate older adults from younger adults based on their resting-state functional connectivity. In addition, the information used by the SVM was investigated to see what functional connections best differentiated younger adult brains from older adult brains. Three separate resting-state scans from 26 younger adults (18-35 yrs) and 26 older adults (55-85) were obtained from the International Consortium for Brain Mapping (ICBM) dataset made publically available in the 1000 Functional Connectomes project www.nitrc.org/projects/fcon_1000. 100 seed-regions from four functional networks with 5mm(3) radius were defined based on a recent study using machine learning classifiers on adolescent brains. Time-series for every seed-region were averaged and three matrices of z-transformed correlation coefficients were created for each subject corresponding to each individual's three resting-state scans. SVM was then applied using leave-one-out cross-validation. The SVM classifier was 84% accurate in classifying older and younger adult brains. The majority of the connections used by the classifier to distinguish subjects by age came from seed-regions belonging to the sensorimotor and cingulo-opercular networks. These results suggest that age-related decreases in positive correlations within the cingulo-opercular and default networks, and decreases in negative correlations between the default and sensorimotor networks, are the distinguishing characteristics of age-related reorganization. Copyright © 2011 Elsevier Inc. All rights reserved.

Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

PubMed Central

2011-01-01

Background Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions. Methods This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology. Results A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection. Conclusions Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring the early stages of activity restriction in community-dwelling older adults. Several scales in this review were exceptional at reducing ceiling effects, reducing gaps in coverage along the construct, as well as establishing a formal hierarchy of functional decline. These instrument modifications make it plausible to detect minor changes in difficulty for IADL items positioned at the edge of the disability continuum, which can be used to signal the onset of progressive type disability in older adults. PMID:21846335

A bidirectional relationship between physical activity and executive function in older adults

PubMed Central

Daly, Michael; McMinn, David; Allan, Julia L.

2015-01-01

Physically active lifestyles contribute to better executive function. However, it is unclear whether high levels of executive function lead people to be more active. This study uses a large sample and multi-wave data to identify whether a reciprocal association exists between physical activity and executive function. Participants were 4555 older adults tracked across four waves of the English Longitudinal Study of Aging. In each wave executive function was assessed using a verbal fluency test and a letter cancelation task and participants reported their physical activity levels. Fixed effects regressions showed that changes in executive function corresponded with changes in physical activity. In longitudinal multilevel models low levels of physical activity led to subsequent declines in executive function. Importantly, poor executive function predicted reductions in physical activity over time. This association was found to be over 50% larger in magnitude than the contribution of physical activity to changes in executive function. This is the first study to identify evidence for a robust bidirectional link between executive function and physical activity in a large sample of older adults tracked over time. PMID:25628552

Keeping Older Adults with Vision Loss Safe: Chronic Conditions and Comorbidities that Influence Functional Mobility

ERIC Educational Resources Information Center

Riddering, Anne T.

2008-01-01

Age-related macular degeneration (AMD) is a leading cause of vision loss in Americans aged 60 and older. The loss of central vision from AMD can decrease visual acuity, contrast sensitivity, glare sensitivity, color discrimination, and the ability to adapt to changes in lighting conditions. Older adults with vision loss often have other chronic,…

Attenuated anticorrelation between the default and dorsal attention networks with aging: evidence from task and rest.

PubMed

Spreng, R Nathan; Stevens, W Dale; Viviano, Joseph D; Schacter, Daniel L

2016-09-01

Anticorrelation between the default and dorsal attention networks is a central feature of human functional brain organization. Hallmarks of aging include impaired default network modulation and declining medial temporal lobe (MTL) function. However, it remains unclear if this anticorrelation is preserved into older adulthood during task performance, or how this is related to the intrinsic architecture of the brain. We hypothesized that older adults would show reduced within- and increased between-network functional connectivity (FC) across the default and dorsal attention networks. To test this hypothesis, we examined the effects of aging on task-related and intrinsic FC using functional magnetic resonance imaging during an autobiographical planning task known to engage the default network and during rest, respectively, with young (n = 72) and older (n = 79) participants. The task-related FC analysis revealed reduced anticorrelation with aging. At rest, there was a robust double dissociation, with older adults showing a pattern of reduced within-network FC, but increased between-network FC, across both networks, relative to young adults. Moreover, older adults showed reduced intrinsic resting-state FC of the MTL with both networks suggesting a fractionation of the MTL memory system in healthy aging. These findings demonstrate age-related dedifferentiation among these competitive large-scale networks during both task and rest, consistent with the idea that age-related changes are associated with a breakdown in the intrinsic functional architecture within and among large-scale brain networks. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring factors associated with sexual activity in community-dwelling older adults.

PubMed

Killinger, Kim A; Boura, Judith A; Diokno, Ananias C

2014-01-01

Sexuality is an important, yet often overlooked, aspect of successful aging. The current article explores potential relationships between sexual activity in older adults and marital status, health, mobility, urinary incontinence, and caffeine and alcohol use, as well as sexual desire and erectile function in women and men, respectively. A survey was mailed to community-dwelling older adults 60 and older. Of 242 respondents (79% ages 60 to 74, 53% male), 159 (65.7%) were sexually active. A higher proportion of sexually active adults were married (p = 0.0005), had better health (p = 0.0003), and drank alcohol (p = 0.007). A lower proportion of sexually active adults had urinary incontinence (p = 0.006). Similar proportions of men and women were sexually active (62.8% and 68.2%, respectively; p = 0.38). Sexually active women had better sexual desire scores (p < 0.0001) and more drank alcohol (p = 0.0013). Sexually active men had better mobility (p = 0.012) and erectile function (p < 0.0001). Fewer sexually active men had incontinence (p < 0.0001). Only alcohol use and no urinary incontinence were predictors unique to women and men, respectively. Health care providers must be aware of factors that may impact sexual health in older adults. Copyright 2014, SLACK Incorporated.

Sources of Life Strengths Appraisal Scale: A Multidimensional Approach to Assessing Older Adults' Perceived Sources of Life Strengths

PubMed Central

Fry, Prem S.; Debats, Dominique L.

2014-01-01

Both cognitive and psychosocial theories of adult development stress the fundamental role of older adults' appraisals of the diverse sources of cognitive and social-emotional strengths. This study reports the development of a new self-appraisal measure that incorporates key theoretical dimensions of internal and external sources of life strengths, as identified in the gerontological literature. Using a pilot study sample and three other independent samples to examine older adults' appraisals of their sources of life strengths which helped them in their daily functioning and to combat life challenges, adversity, and losses, a psychometric instrument having appropriate reliability and validity properties was developed. A 24-month followup of a randomly selected sample confirmed that the nine-scale appraisal measure (SLSAS) is a promising instrument for appraising older adults' sources of life strengths in dealing with stresses of daily life's functioning and also a robust measure for predicting outcomes of resilience, autonomy, and well-being for this age group. A unique strength of the appraisal instrument is its critically relevant features of brevity, simplicity of language, and ease of administration to frail older adults. Dedicated to the memory of Shanta Khurana whose assistance in the pilot work for the study was invaluable PMID:24772352

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults.

PubMed

Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J; Wong, Christine; Wu, Jing; Duberstein, Paul; Wærn, Margda

2016-01-01

To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

PubMed Central

Fässberg, Madeleine Mellqvist; Cheung, Gary; Canetto, Silvia Sara; Erlangsen, Annette; Lapierre, Sylvie; Lindner, Reinhard; Draper, Brian; Gallo, Joseph J.; Wong, Christine; Wu, Jing; Duberstein, Paul; Wærn, Margda

2016-01-01

Objectives: To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Method: Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Results: Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Conclusion: Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults. PMID:26381843

Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

PubMed

Jørgensen, Martin Grønbech

2014-01-01

The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables in community-dwelling older adults. In Study I balance control was investigated using force plate analysis of Centre of Pressure (COP) excursion during static bilateral standing in 32 community-dwelling older adults at three different time-points (09:00, 12:30, and 16:00) throughout the day. An overall significant time-of-day effect was observed for all selected COP variables. The greatest change in all COP variables was observed (on average ~15%) between midday (12:30) and the afternoon (16:00), indicating that a systematic time-of-day influence on static postural balance exists in community-dwelling older adults. Consequently, longitudinal (i.e. pre-to-post training) comparisons of postural balance in in older adults with repeated assessments should be conducted at the same time-of-day. In Study II a novel approach for measuring postural balance (using the Nintendo Wii Stillness and Agility tests) was examined for reproducibility and concurrent validity in 30 community-dwelling older adults. While the Nintendo Wii Stillness test showed a high reproducibility, a systematic learning effect between successive sessions was observed for the Agility test. Moderate-to-excellent concurrent validity was seen for the Stillness test. In contrast, the Agility test revealed a poor concurrent validity. In conclusion, the Wii Stillness test seems to represent a low-cost objective reproducible test of postural balance in community-dwelling older adults and appears feasible in various clinical settings. A habituation (familiarization) period is necessary for the Wii Agility test to avoid a systematic learning effect between successive test sessions. Study III investigated the effect of ten weeks of biofeedback-based Nintendo Wii training on static postural balance, mechanical lower limb muscle function, and functional performance in 58 community-dwelling older adults. Additionally, the study investigated the participant motivation for this type of training (Exergaming). Marked improvements in maximal leg muscle strength, rapid force capacity and functional performance were observed following the period of biofeedback-based Nintendo Wii training. Unexpectedly, static bilateral postural balance remained unaltered following the period of intervention. The study participants perceived the Nintendo Wii training as enjoyable and highly motivating, which suggests that this type of exercise may be successfully implemented at senior citizens' centers and/or in the home of the elderly. The results presented in this thesis suggest that strict control of time-of-day is an important methodological aspect when evaluating postural balance in older adults, and an assessment protocol using the Nintendo Wii-Balance Board is reproducible and valid. Biofeedback-based Nintendo Wii exercise intervention appeared unsuccessful in improving static bilateral postural balance, most likely due to a test ceiling effect in the selected outcome measures, but the intervention elicited marked positive changes in various key risk factors associated to fall accidents. Notably, Wii based biofeedback exercise was perceived by the older adults as a highly motivating type of training.

Upper Extremity Muscle Volumes and Functional Strength After Resistance Training in Older Adults

PubMed Central

Daly, Melissa; Vidt, Meghan E.; Eggebeen, Joel D.; Simpson, W. Greg; Miller, Michael E.; Marsh, Anthony P.; Saul, Katherine R.

2014-01-01

Aging leads to a decline in strength and an associated loss of independence. The authors examined changes in muscle volume, maximum isometric joint moment, functional strength, and 1-repetition maximum (1RM) after resistance training (RT) in the upper extremity of older adults. They evaluated isometric joint moment and muscle volume as predictors of functional strength. Sixteen healthy older adults (average age 75 ± 4.3 yr) were randomized to a 6-wk upper extremity RT program or control group. The RT group increased 1RM significantly (p < .01 for all exercises). Compared with controls, randomization to RT led to greater functional pulling strength (p = .003), isometric shoulder-adduction moment (p = .041), elbow-flexor volume (p = .017), and shoulder-adductor volume (p = .009). Shoulder-muscle volumes and isometric moments were good predictors of functional strength. The authors conclude that shoulder strength is an important factor for performing functional reaching and pulling tasks and a key target for upper extremity RT interventions. PMID:22952203

Social disorder, APOE-E4 genotype, and change in cognitive function among older adults living in Chicago

PubMed Central

Boardman, Jason D.; Barnes, Lisa L.; Wilson, Robert S.; Evans, Denis A.; Mendes de Leon, Carlos F.

2013-01-01

The goal of this paper is to describe the simultaneous influence of social and genetic risk factors on declines in cognitive functioning among older American adults. We use detailed information about the social characteristics of older adults' neighborhoods from the Chicago Health and Aging Project (n = 1655; ages 65+) in conjunction with information about respondent's APOE genotype to predict changes in cognitive function over time. Results indicate that the presence of the ɛ4 allele is associated with a significantly lower cognitive function score at baseline and greater declines in cognitive function compared to those without this risk allele. Importantly, we also show significant variation in the effect of the ɛ4 allele across neighborhoods and our results indicate that this genotype is more strongly associated with cognitive function for residents of neighborhoods with the lowest levels of social disorder. Our findings support the non-causal social push gene–environment interaction model. PMID:22465377

Aging and Adult Education: A Challenge for Adult Educators.

ERIC Educational Resources Information Center

van der Kamp, Max

By the year 2000, at least 20 percent of Europeans will be over 60 years old. As the labor force ages, older employees will have to contribute more to the productivity of organizations. Due to rapid technological changes, more retraining will be required. Education can fulfill important functions for older adults, but their learning style must be…

Using the Natural Language Paradigm (NLP) to Increase Vocalizations of Older Adults with Cognitive Impairments

ERIC Educational Resources Information Center

LeBlanc, Linda A.; Geiger, Kaneen B.; Sautter, Rachael A.; Sidener, Tina M.

2007-01-01

The Natural Language Paradigm (NLP) has proven effective in increasing spontaneous verbalizations for children with autism. This study investigated the use of NLP with older adults with cognitive impairments served at a leisure-based adult day program for seniors. Three individuals with limited spontaneous use of functional language participated…

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults

PubMed Central

Giattino, Charles M.; Gardner, Jacob E.; Sbahi, Faris M.; Roberts, Kenneth C.; Cooter, Mary; Moretti, Eugene; Browndyke, Jeffrey N.; Mathew, Joseph P.; Woldorff, Marty G.; Berger, Miles; Berger, Miles

2017-01-01

Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8–12 Hz) electroencephalogram (EEG) power to decrease occipitally and increase frontally (known as “anteriorization”), and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction), and might be a useful measure of neurocognitive function in older adults. PMID:28533746

A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment.

PubMed

Suzuki, Takao; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Ito, Kengo; Shimokata, Hiroshi; Washimi, Yukihiko; Endo, Hidetoshi; Kato, Takashi

2013-01-01

To examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions. Subjects were 100 older adults (mean age, 75 years) with MCI. The subjects were classified to an amnestic MCI group (n = 50) with neuroimaging measures, and other MCI group (n = 50) before the randomization. Subjects in each group were randomized to either a multicomponent exercise or an education control group using a ratio of 1∶1. The exercise group exercised for 90 min/d, 2 d/wk, 40 times for 6 months. The exercise program was conducted under multitask conditions to stimulate attention and memory. The control group attended two education classes. A repeated-measures ANOVA revealed that no group × time interactions on the cognitive tests and brain atrophy in MCI patients. A sub-analysis of amnestic MCI patients for group × time interactions revealed that the exercise group exhibited significantly better Mini-Mental State Examination (p = .04) and logical memory scores (p = .04), and reducing whole brain cortical atrophy (p<.05) compared to the control group. Low total cholesterol levels before the intervention were associated with an improvement of logical memory scores (p<.05), and a higher level of brain-derived neurotrophic factor was significantly related to improved ADAS-cog scores (p<.05). The results suggested that an exercise intervention is beneficial for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amnestic MCI. Low total cholesterol and higher brain-derived neurotrophic factor may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of exercise on cognitive function in older adults with MCI. UMIN-CTR UMIN000003662 ctr.cgi?function = brows&action = brows&type = summary&recptno = R000004436&language = J.

Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: results of the HA-ID study.

PubMed

Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Schoufour, Josje D; Evenhuis, Heleen M

2014-10-01

A high incidence of limitations in daily functioning is seen in older adults with intellectual disabilities (ID), along with poor physical fitness levels. The aim of this study was to assess the predictive value of physical fitness for daily functioning after 3 years, in 602 older adults with borderline to profound ID (≥ 50 years). At baseline, physical fitness levels and daily functioning (operationalized as basic activities of daily living [ADL] and mobility) were assessed. After 3 years, the measurements of daily functioning were repeated. At follow-up, 12.6% of the participants were completely independent in ADL and 48.5% had no mobility limitations. More than half of the participants (54.8%) declined in their ability to perform ADL and 37.5% declined in their mobility. Manual dexterity, visual reaction time, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in ADL. For a decline in mobility, manual dexterity, balance, comfortable and fast walking speed, grip strength, muscular endurance, and cardiorespiratory fitness were all significant predictors. This proves the predictive validity of these physical fitness tests for daily functioning and stresses the importance of using physical fitness tests and implementing physical fitness enhancing programs in the care for older adults with ID. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluating physical and behavioral changes in older adults.

PubMed

Walton, J C; Miller, J M

1998-04-01

In older adults, subtle and sometime not so subtle physical or behavior changes can act as early warning signs of changing status. Nonspecific signs and symptoms occurring in older adults such as decline in previous functional capacity, urinary incontinence, anorexia, confusion, or unexplained falls may be signs of infection, medication interaction, dehydration, constipation, or sleep deprivation. Nurses, by critically assessing the situation early, may identify a developing problem. Prompt and early diagnosis of the underlying problem may save costly extended hospitalization or even prevent life-threatening complications.

Pain and Cognitive Function Among Older Adults Living in the Community.

PubMed

van der Leeuw, Guusje; Eggermont, Laura H P; Shi, Ling; Milberg, William P; Gross, Alden L; Hausdorff, Jeffrey M; Bean, Jonathan F; Leveille, Suzanne G

2016-03-01

Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning.

PubMed

Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet

2016-08-01

Chronic pain is prevalent among older adults and is usually associated with high levels of functional disability. Social support for the promotion of functional autonomy and dependence has been associated with pain-related disability and self-reported physical functioning. Nevertheless, these relationships need further inquiry. Our aims were to investigate: (1) the relationship between perceived promotion of autonomy/dependence and pain-related disability and (2) the extent to which self-reported physical functioning mediated these relationships. 118 older adults (Mage = 81.0) with musculoskeletal chronic pain completed the Portuguese versions of the revised formal social support for Autonomy and Dependence in Pain Inventory, the pain severity and interference scales of the Brief Pain Inventory, and the physical functioning scale of the Medical Outcomes Study-Short-Form 36 v2. Higher levels of perceived promotion of autonomy were associated with lower pain-related disability; this relationship was partially mediated by self-reported physical functioning (B = -.767, p < .001 decreasing to B' = -.485, p < .01). Higher perceived promotion of dependence was associated with higher pain-related disability; this effect was also partially accounted for by self-reported physical functioning (B = .889, p < .01 decreasing to B' = .597, p < .05). These results highlight the importance of perceived promotion of autonomy and dependence for managing older adults' experience of chronic pain.

Reasons for living, meaning in life, and suicide ideation: investigating the roles of key positive psychological factors in reducing suicide risk in community-residing older adults.

PubMed

Heisel, Marnin J; Neufeld, Eva; Flett, Gordon L

2016-01-01

To investigate the roles of reasons for living (RFL) and meaning in life (MIL) in potentially promoting mental health and well-being and protecting against suicide ideation among community-residing older adults and to investigate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA). Of 173 older adults initially recruited into a longitudinal study on late-life suicide ideation, 109 completed the RFL-OA and measures of cognitive and physical functioning and positive and negative psychological factors at a two-year follow-up assessment. We tested a model in which RFL and MIL protect against suicide ideation, controlling for demographic and clinical factors. We also assessed the psychometric properties of the RFL-OA in community-residing older adults, investigating its internal consistency and its convergent (MIL, perceived social support, and life satisfaction), divergent (loneliness, depressive symptom severity, and suicide ideation), and discriminant validity (cognitive and physical functioning). RFL-OA scores explained significant variance in suicide ideation, controlling for age, sex, depressive symptom severity, and loneliness. MIL explained significant unique variance in suicide ideation, controlling for these factors and RFL, and MIL significantly mediated the association between RFL and suicide ideation. Psychometric analyses indicated strong internal consistency (α = .94), convergent, divergent, and discriminant validity for the RFL-OA relative to positive and negative psychological factors and cognitive and physical functioning. These findings add to a growing body of literature suggesting merit in investigating positive psychological factors together with negative factors when assessing suicide risk and planning psychological services for older adults.

Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review.

PubMed

Laufer, Yocheved; Dar, Gali; Kodesh, Einat

2014-01-01

Exercise programs that challenge an individual's balance have been shown to reduce the risk of falls among older adults. Virtual reality computer-based technology that provides the user with opportunities to interact with virtual objects is used extensively for entertainment. There is a growing interest in the potential of virtual reality-based interventions for balance training in older adults. This work comprises a systematic review of the literature to determine the effects of intervention programs utilizing the Nintendo Wii console on balance control and functional performance in independently functioning older adults. STUDIES WERE OBTAINED BY SEARCHING THE FOLLOWING DATABASES: PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus, and Google Scholar, followed by a hand search of bibliographic references of the included studies. Included were randomized controlled trials written in English in which Nintendo Wii Fit was used to enhance standing balance performance in older adults and compared with an alternative exercise treatment, placebo, or no treatment. Seven relevant studies were retrieved. The four studies examining the effect of Wii-based exercise compared with no exercise reported positive effects on at least one outcome measure related to balance performance in older adults. Studies comparing Wii-based training with alternative exercise programs generally indicated that the balance improvements achieved by Wii-based training are comparable with those achieved by other exercise programs. The review indicates that Wii-based exercise programs may serve as an alternative to more conventional forms of exercise aimed at improving balance control. However, due to the great variability between studies in terms of the intervention protocols and outcome measures, as well as methodological limitations, definitive recommendations as to optimal treatment protocols and the potential of such an intervention as a safe and effective home-based treatment cannot be made at this point.

Assessing the Effects of Interpersonal and Intrapersonal Behavior Change Strategies on Physical Activity in Older Adults: a Factorial Experiment.

PubMed

McMahon, Siobhan K; Lewis, Beth; Oakes, J Michael; Wyman, Jean F; Guan, Weihua; Rothman, Alexander J

2017-06-01

Little is known about which behavior change strategies motivate older adults to increase their physical activity. The purpose of this study was to assess the relative effects of two sets of behavior change strategies to motivate increased physical activity among older adults: interpersonal and intrapersonal. Community-dwelling older adults (N = 102, mean age = 79) were randomized in a 2 × 2 factorial experiment to receive interpersonal (e.g., social support, friendly social comparison; no, yes) and /or intrapersonal (e.g., goal setting, barriers management; no, yes) behavior change strategies, combined with an evidence-based, physical activity protocol (Otago exercise program) and a physical activity monitor (Fitbit One™). Based on monitor data, participants who received interpersonal strategies, compared to those who did not, increased their average minutes of total physical activity (light, moderate, vigorous) per week, immediately (p = .006) and 6 months (p = .048) post-intervention. Similar, increases were observed on measures of functional strength and balance, immediately (p = .012) and 6 months (p = .003) post-intervention. The intrapersonal strategies did not elicit a significant increase in physical activity or functional strength and balance. Findings suggest a set of interpersonally oriented behavior change strategies combined with an evidence-based physical activity protocol can elicit modest, but statistically and clinically significant, increases in older adults' physical activity and functional strength and balance. Future research should replicate these findings and investigate the sustained quantity of physical activity elicited by these strategies and their impact on older adults' quality of life and falls. Trial Registration The ClinicalTrials.gov registration identifier is NCT02433249.

Older adults' preferences for formal social support of autonomy and dependence in pain: development and validation of a scale.

PubMed

Bernardes, Sónia F; Matos, Marta; Goubert, Liesbet

2017-09-01

Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain ( M age  = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors ( r  = .56): (a) preferences for autonomy support ( α  = .99) and (b) preferences for dependence support ( α  = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence ( r  = .33) and the lower the desire for independence ( r  = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.

Depressive symptoms, handgrip strength, and weight status in US older adults.

PubMed

Smith, Lee; White, Stephanie; Stubbs, Brendon; Hu, Liang; Veronese, Nicola; Vancampfort, Davy; Hamer, Mark; Gardner, Benjamin; Yang, Lin

2018-06-05

Handgrip strength is a valid indicator of broader physical functioning. Handgrip strength and weight status have been independently associated with depressive symptoms in older adults, but no study has yet investigated the relationships between all three in older US adults. This study investigated the relationship between physical function and depressive symptoms by weight status in older US adults. Cross-sectional data were analysed from the National Health and Nutrition Examination Survey waves 2011 to 2012 and 2013 to 2014. Physical function was assessed using a grip strength dynamometer. Depressive symptoms were assessed using the self-reported Patient Health Questionnaire-9. Weight status was assessed using Body Mass Index (BMI) and participants were categorised as normal weight (< 25 kg/m 2 ), overweight (25 to < 30 kg/m 2 ), and obese (≥ 30.0 kg/m 2 ). Associations between depressive symptoms and hand grip strength were estimated by gender-specific multiple linear regressions and BMI stratified multivariable linear regression. A total of 2,812 adults (54% female, mean age 69.2 years, mean BMI 29.2 kg/m 2 ) were included. Women with moderate to severe depressive symptoms had 1.60 kg (95% CI: 0.91 to 2.30) lower hand grip strength compared to women with minimal or no depressive symptoms. No such association was observed in men. Among those with obesity, men (-3.72 kg, 95% CI: -7.00 to -0.43) and women (-1.83 kg, 95% CI: -2.87 to -0.78) with moderate to severe depressive symptoms both had lower handgrip strength. Among older US adults, women and people who are obese and depressed are at the greatest risk of decline in physical function. Copyright © 2018 Elsevier B.V. All rights reserved.

The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints.

PubMed

Middleton, Laura E; Ventura, Maria I; Santos-Modesitt, Wendy; Poelke, Gina; Yaffe, Kristine; Barnes, Deborah E

2018-01-01

Older adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints. To investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes). Participants (n=126, age 73±6years, 65% women) were randomized to 12weeks of exercise (aerobic exercise or stretching/toning, 3×60min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3×60min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity). There were no differences between groups at baseline (p>0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time=0.001), arm curls (p-for-time<0.001), step test (p-for-time=0.003), sit & reach (p-for-time=0.01), and back scratch (p-for-time=0.04)] and in physical HRQOL (p-for-time=0.04). There were no differences in change between groups (group∗time p>0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes. Combined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach

PubMed Central

Lien, Laura L.; Steggell, Carmen D.; Iwarsson, Susanne

2015-01-01

Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants’ perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well. PMID:26404352

Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach.

PubMed

Lien, Laura L; Steggell, Carmen D; Iwarsson, Susanne

2015-09-23

Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants' perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well.

Antidepressant use and functional limitations in U.S. older adults.

PubMed

An, Ruopeng; Lu, Lingyun

2016-01-01

The upsurge in prevalence and long-term use of antidepressants among older adults might have profound health implications beyond depressive symptom management. This study examined the relationship between antidepressant use and functional limitation onset in U.S. older adults. Study sample came from 2006 and 2008 waves of the Health and Retirement Study, in combination with data from 2005 and 2007 Prescription Drug Study. Self-reported antidepressant use was identified based on the therapeutic classification of Cerner Multum's Lexicon. Functional limitations were classified into those pertaining to physical mobility, large muscle function, activities of daily living, gross motor function, fine motor function, and instrumental activities of daily living. Cox proportional hazard models were performed to assess the effects of antidepressant use on future functional limitation onset by limitation category, antidepressant type, and length of use, adjusted by depression status and other individual characteristics. Antidepressant use for one year and longer was associated with an increase in the risk of functional limitation by 8% (95% confidence interval=4%-12%), whereas the relationship between antidepressant use less than a year and function limitation was statistically nonsignificant. Antidepressant use was associated with an increase in the risk of functional limitation by 8% (3%-13%) among currently nondepressed participants but not currently depressed participants. Long-term antidepressant use in older adults should be prudently evaluated and regularly monitored to reduce the risk of functional limitation. Future research is warranted to examine the health consequences of extended and/or off-label antidepressant use in absence of depressive symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

Older Adults’ Functional Performance and Health Knowledge After a Combination Exercise, Health Education, and Bingo Game

PubMed Central

Crandall, K. Jason; Steenbergen, Katryn I.

2015-01-01

Combining exercise, health education, and the game of bingo may help older adults remain independent. The objective was to determine whether a 10-week health promotion program (Bingocize®) improves functional performance and health knowledge in older adults. Participants were assigned to experimental (n = 13) or control (n = 14) groups. The intervention was administered twice per week at two independent living facilities. Pre and postfunctional performance and health knowledge were measured. Mixed between–within subject ANOVA was used to detect differences between groups (p < .05). Improvements were found in all dependent variables except lower body flexibility, systolic blood pressure, and health knowledge. Adherence was 97.31% ± 2.59%. Bingocize® has the potential to help older adults remain independent by improving functional performance. Statistical improvements in health knowledge were not found, but future researchers may explore modifying the health education component or using a different measure of health knowledge to detect changes. PMID:28138476

Advances in Psychotherapy for Depressed Older Adults.

PubMed

Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

2017-09-01

We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

Decision-making in geriatric oncology: systemic treatment considerations for older adults with colon cancer.

PubMed

Moth, Erin B; Vardy, Janette; Blinman, Prunella

2016-12-01

Colon cancer is common and can be considered a disease of older adults with more than half of cases diagnosed in patients aged over 70 years. Decision-making about treatment with chemotherapy for older adults may be complicated by age-related physiological changes, impaired functional status, limited social supports, concerns regarding the occurrence of and ability to tolerate treatment toxicity, and the presence of comorbidities. This is compounded by a lack of high quality evidence guiding cancer treatment decisions for older adults. Areas covered: This narrative review evaluates the evidence for adjuvant and palliative systemic therapy in older adults with colon cancer. The value of an adequate assessment prior to making a treatment decision is addressed, with emphasis on the geriatric assessment. Guidance in making a treatment decision is provided. Expert commentary: Treatment decisions should consider goals of care, a patient's treatment preferences, and weigh up relative benefits and harms.

Spin exercise improves semantic fluency in previously sedentary older adults.

PubMed

Nocera, Joe R; McGregor, Keith M; Hass, Chris J; Crosson, Bruce

2015-01-01

Studies suggest improvements of neurocognitive function among older adults who undergo aerobic exercise training. This study sought to examine the impact of an aerobic exercise intervention on verbal fluency in sedentary older adults. Twenty community-dwelling older adults were recruited and enrolled in either a spin exercise group or a control condition. Participants were evaluated with an estimated V02max test and on measures of letter, category, and switching verbal fluency both before and after a 12-week intervention period. Spin exercise resulted in a significant improvement in category (semantic) verbal fluency when compared with the control group (15% vs. 2% increase, respectively; P = .001). Spin exercise also resulted in a significant improvement in estimated V02max (P = .005). Also important, the spin exercise group demonstrated a high level of adherence (mean adherence = 82.5%). Spin exercise can be an effective mode of aerobic exercise to improve semantic fluency in previously sedentary older adults.

Evidence-Based Practice Guideline: Depression Detection in Older Adults With Dementia.

PubMed

Brown, Ellen Leslie; Raue, Patrick J; Halpert, Karen

2015-11-01

Depression and dementia are the two most common psychiatric syndromes in the older adult population. Depression in older adults with and without dementia often goes unrecognized and untreated. The current guideline recommends a three-step procedure that can be used across health care settings to screen for the presence of depressive symptoms. Implementation of the evidence-based guideline requires administration of the Mini-Mental State Examination and either the Geriatric Depression Scale Short Form or Cornell Scale for Depression in Dementia, depending on level of cognitive functioning. The algorithm provided is designed to be used by nurses, physicians, and social workers for the purpose of depression screening in older adults with dementia. Detection of depression in individuals with dementia is hindered by a lack of a validated, brief screening tool. More research is needed on the use of such screenings among older adults with cognitive impairment. Copyright 2015, SLACK Incorporated.

Age and treatment of kidney failure.

PubMed

Elliott, Meghan J; Tam-Tham, Helen; Hemmelgarn, Brenda R

2013-05-01

This review discusses issues related to treatment of chronic kidney disease, and kidney failure in particular, among older adults. A substantial proportion of older adults have chronic kidney disease and progress to kidney failure. There is considerable variability in treatment practices for advanced kidney disease among older adults, and evidence that treatment decisions such as dialysis initiation may be made without adequate preparation. When initiated, survival among older adults on chronic dialysis remains poor, and is associated with a significant decline in functional status. There is also evidence to suggest that dialysis initiation may not reflect overall treatment goals of elderly patients, but rather a lack of clear communication between patients and health practitioners, and underdeveloped conservative care programs in many centers. Kidney failure is common among older adults. When considering treatment options for kidney failure, patient priorities, preferences, and symptoms should be taken into account, using a shared decision-making approach.

Definition of Unfit for Standard Acute Myeloid Leukemia Therapy.

PubMed

Klepin, Heidi D

2016-12-01

Determining who is fit or unfit for standard treatments among older adults with acute myeloid leukemia (AML) remains a challenge. However, available evidence can provide guidance on strategies to assess and categorize fitness. Evidence is strongest to guide identification of "frail" older adults at the time of diagnosis based on performance status, physical function, and comorbidity. Many older adults, with adequate performance status and comorbidity burden, however, may be better characterized as "vulnerable". These patients have subclinical impairments that limit resilience when stressed with intensive therapies. More sensitive assessment strategies are needed to differentiate fit and vulnerable older adults regardless of chronologic age. Research is ongoing to identify tools and approaches, such as geriatric assessment, that can enhance characterization of fitness for AML therapies. This review will highlight available evidence for assessment of fitness among older adults with AML and discuss implications for practice and research.

Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift

PubMed Central

Mangione, Kathleen K.; Stevens-Lapsley, Jennifer E.

2015-01-01

Physical therapists often treat older adults with marked deficits in physical function secondary to an acute hospitalization. These deficits are often collectively defined as hospital-associated deconditioning (HAD). However, there is a paucity of evidence that objectively demonstrates the efficacy of physical therapy for older adults with HAD. Older adults with HAD represent a highly variable and complex population and thus may be difficult to study and develop effective interventions for using our current rehabilitation strategies. This perspective article outlines an innovative framework to operationalize and treat older adults with HAD. This framework may help therapists apply emerging exercise strategies to this population and facilitate additional research to support the total value of physical therapy for older adults in postacute care settings—with value measured not only by improvements in physical performance but perhaps also by reduced rates of disability development, rehospitalization, and institutionalization. PMID:25908526

Acceptability of Novel Life Logging Technology to Determine Context of Sedentary Behavior in Older Adults.

PubMed

Harvey, Juliet A; Skelton, Dawn A; Chastin, Sebastien F M

2016-01-01

Lifelogging, using body worn sensors (activity monitors and time lapse photography) has the potential to shed light on the context of sedentary behaviour. The objectives of this study were to examine the acceptability, to older adults, of using lifelogging technology and indicate its usefulness for understanding behaviour. 6 older adults (4 males, mean age: 68yrs) wore the equipment (ActivPAL™ and Vicon Revue™/SenseCam™) for 7 consecutive days during free-living activity. The older adults' perception of the lifelogging technology was assessed through semi-structured interviews, including a brief questionnaire (Likert scale), and reference to the researcher's diary. Older adults in this study found the equipment acceptable to wear and it did not interfere with privacy, safety or create reactivity, but they reported problems with the actual technical functioning of the camera. This combination of sensors has good potential to provide lifelogging information on the context of sedentary behaviour.

Working memory predicts semantic comprehension in dichotic listening in older adults.

PubMed

James, Philip J; Krishnan, Saloni; Aydelott, Jennifer

2014-10-01

Older adults have difficulty understanding spoken language in the presence of competing voices. Everyday social situations involving multiple simultaneous talkers may become increasingly challenging in later life due to changes in the ability to focus attention. This study examined whether individual differences in cognitive function predict older adults' ability to access sentence-level meanings in competing speech using a dichotic priming paradigm. Older listeners showed faster responses to words that matched the meaning of spoken sentences presented to the left or right ear, relative to a neutral baseline. However, older adults were more vulnerable than younger adults to interference from competing speech when the competing signal was presented to the right ear. This pattern of performance was strongly correlated with a non-auditory working memory measure, suggesting that cognitive factors play a key role in semantic comprehension in competing speech in healthy aging. Copyright © 2014 Elsevier B.V. All rights reserved.

Age differences in the functional interactions among the default, frontoparietal control, and dorsal attention networks.

PubMed

Grady, Cheryl; Sarraf, Saman; Saverino, Cristina; Campbell, Karen

2016-05-01

Older adults typically show weaker functional connectivity (FC) within brain networks compared with young adults, but stronger functional connections between networks. Our primary aim here was to use a graph theoretical approach to identify age differences in the FC of 3 networks-default mode network (DMN), dorsal attention network, and frontoparietal control (FPC)-during rest and task conditions and test the hypothesis that age differences in the FPC would influence age differences in the other networks, consistent with its role as a cognitive "switch." At rest, older adults showed lower clustering values compared with the young, and both groups showed more between-network connections involving the FPC than the other 2 networks, but this difference was greater in the older adults. Connectivity within the DMN was reduced in older compared with younger adults. Consistent with our hypothesis, between-network connections of the FPC at rest predicted the age-related reduction in connectivity within the DMN. There was no age difference in within-network FC during the task (after removing the specific task effect), but between-network connections were greater in older adults than in young adults for the FPC and dorsal attention network. In addition, age reductions were found in almost all the graph metrics during the task condition, including clustering and modularity. Finally, age differences in between-network connectivity of the FPC during both rest and task predicted cognitive performance. These findings provide additional evidence of less within-network but greater between-network FC in older adults during rest but also show that these age differences can be altered by the residual influence of task demands on background connectivity. Our results also support a role for the FPC as the regulator of other brain networks in the service of cognition. Critically, the link between age differences in inter-network connections of the FPC and DMN connectivity, and the link between FPC connectivity and performance, support the hypothesis that FC of the FPC influences the expression of age differences in other networks, as well as differences in cognitive function. Copyright © 2016 Elsevier Inc. All rights reserved.

Gaps in nutritional research among older adults with cancer

PubMed Central

Presley, Carolyn J.; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G.; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D.; Wildes, Tanya M.; Mustian, Karen; Demark-Wahnefried, Wendy

2016-01-01

Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

Exergaming and older adult cognition: a cluster randomized clinical trial.

PubMed

Anderson-Hanley, Cay; Arciero, Paul J; Brickman, Adam M; Nimon, Joseph P; Okuma, Naoko; Westen, Sarah C; Merz, Molly E; Pence, Brandt D; Woods, Jeffrey A; Kramer, Arthur F; Zimmerman, Earl A

2012-02-01

Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation. To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase. Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011. 102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed. A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle. Executive function (Color Trails Difference, Stroop C, Digits Backward); clinical status (mild cognitive impairment; MCI); exercise effort/fitness; and plasma BDNF. Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function (p=0.002). Cybercycling yielded a medium effect over traditional exercise (d=0.50). Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant group X time interaction for BDNF (p=0.05) indicated enhanced neuroplasticity among cybercyclists. Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline. This study is registered at Clinicaltrials.gov NCT01167400. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Short stick exercises for fall prevention among older adults: a cluster randomized trial.

PubMed

Yokoi, Katsushi; Yoshimasu, Kouichi; Takemura, Shigeki; Fukumoto, Jin; Kurasawa, Shigeki; Miyashita, Kazuhisa

2015-01-01

To investigate the effects of short stick exercise (SSEs) on fall prevention and improvement of physical function in older adults. A cluster randomized trial was conducted in five residential care facilities. The intervention group (n = 51) practiced SSEs for six months, followed by routine care for six more months. The control group (n = 54) received ordinary care for 12 months. The primary outcome measure was the number of fallers, taking into account the time to first fall using the Kaplan-Meier method. The secondary outcome measures were physical and mental functions. The number of fallers was significantly lower in the intervention group (n = 6) than in the control group (n = 16) during the 12 months. The adjusted hazard ratio for a first fall in the intervention group compared with the control group was 0.15 (CI, 0.03 to 0.74, p = 0.02). The fall-free period was significantly longer in the intervention group than in controls (mean ± SD, 10.1 ± 3.0 versus 9.0 ± 4.1 months, p = 0.027). The functional reach and sit and reach tests were significantly improved at three and six months. The SSEs appeared effective for fall prevention and improvement of physical function in older adults. Implications for Rehabilitation The newly developed short stick exercises appear an effective means of reducing falls among older adults in residential care facilities. The short stick exercises seem to have an immediate effect on improving physical functions. Effects gained by performing the short stick exercises, such as static balance, flexibility and agility may last for six months. The short stick exercises were found to be easy for older adults to practice continuously in residential care facilities.

Association between Dietary Sodium Intake and Cognitive Function in Older Adults.

PubMed

Rush, T M; Kritz-Silverstein, D; Laughlin, G A; Fung, T T; Barrett-Connor, E; McEvoy, L K

2017-01-01

To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. Cross-sectional study. Southern California community. White men (n=373) and women (n=552), aged 50-96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. During the 1992-1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). Concluson: Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets.

Association between Dietary Sodium Intake and Cognitive Function in Older Adults

PubMed Central

Rush, Toni M; Kritz-Silverstein, Donna; Laughlin, Gail A; Fung, Teresa T; Barrett-Connor, Elizabeth L; McEvoy, Linda K

2016-01-01

OBJECTIVES To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. DESIGN Cross-sectional study SETTING Southern California community PARTICIPANTS White men (n=373) and women (n=552), aged 50–96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. MEASUREMENTS During the 1992–1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. RESULTS Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). CONCLUSION Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets. PMID:28244567

Older adults in jail: high rates and early onset of geriatric conditions.

PubMed

Greene, Meredith; Ahalt, Cyrus; Stijacic-Cenzer, Irena; Metzger, Lia; Williams, Brie

2018-02-17

The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions ("accelerated aging"), studies have not directly compared rates of geriatric conditions in this population to those found in the general population. The aims of this study were to compare the burden of geriatric conditions among older adults in jail to rates found in an age-matched nationally representative sample of community dwelling older adults. This cross sectional study compared 238 older jail inmates age 55 or older to 6871 older adults in the national Health and Retirement Study (HRS). We used an age-adjusted analysis, accounting for the difference in age distributions between the two groups, to compare sociodemographics, chronic conditions, and geriatric conditions (functional, sensory, and mobility impairment). A second age-adjusted analysis compared those in jail to HRS participants in the lowest quintile of wealth. All geriatric conditions were significantly more common in jail-based participants than in HRS participants overall and HRS participants in the lowest quintile of net worth. Jail-based participants (average age of 59) experienced four out of six geriatric conditions at rates similar to those found in HRS participants age 75 or older. Geriatric conditions are prevalent in older adults in jail at significantly younger ages than non-incarcerated older adults suggesting that geriatric assessment and geriatric-focused care are needed for older adults cycling through jail in their 50s and that correctional clinicians require knowledge about geriatric assessment and care.

Age and Gender Effects on Wideband Absorbance in Adults With Normal Outer and Middle Ear Function.

PubMed

Mazlan, Rafidah; Kei, Joseph; Ya, Cheng Li; Yusof, Wan Nur Hanim Mohd; Saim, Lokman; Zhao, Fei

2015-08-01

This study examined the effects of age and gender on wideband energy absorbance in adults with normal middle ear function. Forty young adults (14 men, 26 women, aged 20-38 years), 31 middle-aged adults (16 men, 15 women, aged 42-64 years), and 30 older adults (20 men, 10 women, aged 65-82 years) were assessed. Energy absorbance (EA) data were collected at 30 frequencies using a prototype commercial instrument developed by Interacoustics. Results showed that the young adult group had significantly lower EA (between 400 and 560 Hz) than the middle-aged group. However, the middle-aged group showed significantly lower EA (between 2240 and 5040 Hz) than the young adult group. In addition, the older adult group had significantly lower EA than the young adult group (between 2520 and 5040 Hz). No significant difference in EA was found at any frequency between middle-aged and older adults. Across age groups, gender differences were found with men having significantly higher EA values than women at lower frequencies, whereas women had significantly higher EA at higher frequencies. This study provides evidence of the influence of gender and age on EA in adults with normal outer and middle ear function. These findings support the importance of establishing age- and gender-specific EA norms for the adult population.

Building communities that promote successful aging.

PubMed Central

Fried, L P; Freedman, M; Endres, T E; Wasik, B

1997-01-01

Despite the fact that, in a few years, a fifth of the US population will be older than 65 years and people will be living a third of their lives after retirement, we have developed few avenues that would permit older adults to play meaningful roles as they age and few institutions to harness the experience that older adults could contribute to society. In fact, older adults constitute this country's only increasing natural resource--and the least used one. In this article we consider the rationale for developing institutions that harness the abilities and time of older adults, rather than focusing solely on their needs. Such an approach would decrease the structural lag between a social concept of retirement as unproductive leisure and an aging population that is larger, healthier, and with a need for more productive opportunities. Gerontologically designed opportunities for contribution on a large social scale could well provide a national approach to primary prevention to maintain health and function in older adults. PMID:9348750

Unstable Thyroid Function in Older Adults Is Caused by Alterations in Both Thyroid and Pituitary Physiology and Is Associated with Increased Mortality.

PubMed

Mammen, Jennifer S; McGready, John; Ladenson, Paul W; Simonsick, Eleanor M

2017-11-01

Average thyrotropin (TSH) levels are known to be higher in older adults when measured in cross-sectional populations. Possible etiologies include differential survival, neutral aging changes, or increased disease prevalence at older ages. This study aimed to elucidate the mechanisms underlying changing thyroid function during aging, and to determine the association of changes with survival, by analyzing the individual thyroid axis over time. Individual patterns of changing TSH and free thyroxine (fT4) were determined in 640 participants in the Baltimore Longitudinal Study of Aging who had at least three measures of serum TSH and fT4, not on medications, over an average of seven years of follow-up. Participants with changing phenotypes were identified based on quintiles for both slopes. Those with alterations in primary thyroid gland function demonstrated intact negative feedback (rising TSH with declining fT4 or declining TSH with rising fT4). Other participants had a parallel rise or fall of TSH and fT4 levels, consistent with pituitary dysfunction. Predictors of phenotype were analyzed by logistic regression. Differential survival between thyroid aging phenotypes was analyzed using multivariate Cox regression. While the majority of participants at all ages had stable thyroid function, changes were more common among older adults, with 32.3% of those aged >80 years but only 9.5% of those aged <60 years demonstrating thyroid function changes in the highest and lowest quintiles. Regression to the mean accounts for some of the changes, for example increased baseline TSH was associated with a falling TSH pattern (odds ratio = 1.4 [confidence interval 1.1-1.7] per 1 mIU/L). Importantly, changing thyroid function in either the upper or lower quintiles of slope for TSH and fT4 was associated with increased risk of death compared to stable thyroid status (hazard ratio = 5.4 [confidence interval 3.1-9.5]). Changing thyroid hormone function is increasingly common at older ages and is associated with decreased survival. Nonetheless, the tendency for abnormal thyroid function tests to resolve, along with altered pituitary responsiveness underlying some TSH elevations, suggests that an elevated TSH level should be not assumed to represent subclinical hypothyroidism in older adults. Thus, caution is appropriate when determining the need for thyroid hormone supplements in older adults.

Smartphone Text Input Method Performance, Usability, and Preference With Younger and Older Adults.

PubMed

Smith, Amanda L; Chaparro, Barbara S

2015-09-01

User performance, perceived usability, and preference for five smartphone text input methods were compared with younger and older novice adults. Smartphones are used for a variety of functions other than phone calls, including text messaging, e-mail, and web browsing. Research comparing performance with methods of text input on smartphones reveals a high degree of variability in reported measures, procedures, and results. This study reports on a direct comparison of five of the most common input methods among a population of younger and older adults, who had no experience with any of the methods. Fifty adults (25 younger, 18-35 years; 25 older, 60-84 years) completed a text entry task using five text input methods (physical Qwerty, onscreen Qwerty, tracing, handwriting, and voice). Entry and error rates, perceived usability, and preference were recorded. Both age groups input text equally fast using voice input, but older adults were slower than younger adults using all other methods. Both age groups had low error rates when using physical Qwerty and voice, but older adults committed more errors with the other three methods. Both younger and older adults preferred voice and physical Qwerty input to the remaining methods. Handwriting consistently performed the worst and was rated lowest by both groups. Voice and physical Qwerty input methods proved to be the most effective for both younger and older adults, and handwriting input was the least effective overall. These findings have implications to the design of future smartphone text input methods and devices, particularly for older adults. © 2015, Human Factors and Ergonomics Society.

Quality of life (QOL) of older adult community choral singers in Finland

PubMed Central

Johnson, Julene K; Louhivuori, Jukka; Stewart, Anita L; Tolvanen, Asko; Ross, Leslie; Era, Pertti

2013-01-01

Background Enhancing quality of life (QOL) of older adults is an international area of focus. Identifying factors and experiences that contribute to QOL of older adults helps promote optimal levels of functioning. This study examines the relationship between perceived benefits associated with choral singing and quality of life (QOL) among community-dwelling older adults. Methods One hundred and seventeen older adults who sing in community choirs in Jyväskylä, Finland completed self-report measures of QOL (WHOQOL-Bref), depressive symptoms, and a questionnaire about the benefits of singing in choir. Correlational analyses and linear regression models were used to examine the association between the benefits of singing in choir and QOL. Results Both correlation and regression analyses found significant relationships between the benefits of choral singing and three QOL domains: psychological, social relationships, and environment but not physical. These associations remained significant after adjusting for age and depressive symptoms. As hypothesized, older choral singers who reported greater benefits of choir singing had higher QOL in multiple domains. The older choral singers in the study also reported few symptoms of depression and high overall QOL and satisfaction with health. Conclusion Results suggest that singing in a community choir as an older adult may positively influence several aspects of QOL. These results suggest that community choral singing may one potential avenue for promoting quality of life in older adults. PMID:23574947

Educational status influences cognitive-motor learning in older adults: going to university provides greater protection against aging than going to high school.

PubMed

Voos, Mariana Callil; Piemonte, Maria Elisa Pimentel; Mansur, Letícia Lessa; Caromano, Fátima Aparecida; Brucki, Sonia Maria Dozzi; Valle, Luiz Eduardo Ribeiro do

2017-12-01

To investigate if middle-aged and older adults with a higher education would differ from those with an average education in cognitive-motor tasks involving lower limb function. A walking version of the Trail Making Test (Walking Executive Function Task, [WEFT]) was used. Eighty volunteers (40: 50-65 years; 40: 66-80 years) were subdivided into average (6-11years of education) and higher education (12-17 years). They received two training sessions (session 1: eight repetitions, session 2: four repetitions), with a one week-interval between them. The Timed Up and Go (TUG) test was performed before and after the training. Volunteers with an average education showed longer times on the WEFT than those with a higher education. Older adults showed lower retention than middle-aged adults (p < 0.001). The TUG was faster after the WEFT training (p < 0.001). The impact of education was observed when locomotion was associated with cognitive tasks. Average education resulted in poorer performance and learning than higher education, mainly in older adults. Gait speed increased after training.

Buddhist social networks and health in old age: A study in central Thailand.

PubMed

Sasiwongsaroj, Kwanchit; Wada, Taizo; Okumiya, Kiyohito; Imai, Hissei; Ishimoto, Yasuko; Sakamoto, Ryota; Fujisawa, Michiko; Kimura, Yumi; Chen, Wen-ling; Fukutomi, Eriko; Matsubayashi, Kozo

2015-11-01

Religious social networks are well known for their capacity to improve individual health, yet the effects of friendship networks within the Buddhist context remain largely unknown. The present study aimed to compare health status and social support in community-dwelling older adults according to their level of Buddhist social network (BSN) involvement, and to examine the association between BSN involvement and functional health among older adults. A cross-sectional survey was carried out among 427 Buddhist community-dwelling older adults aged ≥60 years in Nakhon Pathom, Thailand. Data were collected from home-based personal interviews using a structured questionnaire. Health status was defined according to the measures of basic and advanced activities of daily living (ADL), the 15-item Geriatric Depression Scale and subjective quality of life. Perceived social support was assessed across the four dimensions of tangible, belonging, emotional and information support. Multiple logistic regression was used for analysis. Older adults with BSN involvement reported better functional, mental and social health status, and perceived greater social support than those without BSN involvement. In addition, BSN involvement was positively associated with independence in basic and advanced ADL. After adjusting for age, sex, education, income, morbidity and depressive symptoms, BSN showed a strong association with advanced ADL and a weak association with basic ADL. The results show that involvement in BSN could contribute positively to functional health, particularly with regard to advanced ADL. Addressing the need for involvement in these networks by older adults might help delay functional decline and save on healthcare costs. © 2014 Japan Geriatrics Society.

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults.

PubMed

Brown, Laura J E; Adlam, Tim; Hwang, Faustina; Khadra, Hassan; Maclean, Linda M; Rudd, Bridey; Smith, Tom; Timon, Claire; Williams, Elizabeth A; Astell, Arlene J

2016-08-01

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two "NANA" cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.

TASK-RELATED FUNCTIONAL CONNECTIVITY OF THE CAUDATE MEDIATES THE ASSOCIATION BETWEEN TRAIT MINDFULNESS AND IMPLICIT LEARNING IN OLDER ADULTS

PubMed Central

Stillman, Chelsea M.; You, Xiaozhen; Seaman, Kendra L.; Vaidya, Chandan J.; Howard, James H.; Howard, Darlene V.

2016-01-01

Accumulating evidence shows a positive relationship between mindfulness and explicit cognitive functioning, i.e., that which occurs with conscious intent and awareness. However, recent evidence suggests that there may be a negative relationship between mindfulness and implicit types of learning, or those that occur without conscious awareness or intent. Here we examined the neural mechanisms underlying the recently reported negative relationship between dispositional mindfulness and implicit probabilistic sequence learning in both younger and older adults. We tested the hypothesis that the relationship is mediated by communication, or functional connectivity, of brain regions once traditionally considered to be central to dissociable learning systems: the caudate, medial temporal lobe (MTL), and prefrontal cortex (PFC). We first replicated the negative relationship between mindfulness and implicit learning in a sample of healthy older adults (60–90 years old) who completed three event-related runs of an implicit sequence learning task. Then, using a seed-based connectivity approach, we identified task-related connectivity associated with individual differences in both learning and mindfulness. The main finding was that caudate-MTL connectivity (bilaterally) was positively correlated with learning and negatively correlated with mindfulness. Further, the strength of task-related connectivity between these regions mediated the negative relationship between mindfulness and learning. This pattern of results was limited to the older adults. Thus, at least in healthy older adults, the functional communication between two interactive learning-relevant systems can account for the relationship between mindfulness and implicit probabilistic sequence learning. PMID:27121302

Can performance of daily activities discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment?

PubMed Central

Rodakowski, Juleen; Skidmore, Elizabeth R.; Reynolds, Charles F.; Dew, Mary Amanda; Butters, Meryl A.; Holm, Margo B.; Lopez, Oscar L.; Rogers, Joan C.

2014-01-01

OBJECTIVES Our primary aim was to examine whether preclinical disability in performance of cognitively-focused instrumental activities of daily living (C-IADL) tasks can discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment (MCI). The secondary purpose was to determine the two tasks with the strongest psychometric properties and assess their discriminative ability. Our goal was to generate diagnosis-relevant information about cognitive changes associated with MCI and DSM-5 Mild Neurocognitive Disorder. DESIGN Secondary analyses of cross-sectional data from a cohort of individuals diagnosed with normal cognitive function or MCI. SETTING Private home locations in Pittsburgh, PA. PARTICIPANTS Older adults with remitted major depression (N=157). MEASUREMENTS Diagnosis of cognitive status was made by the Alzheimer’s Disease Research Center at the University of Pittsburgh. Performance of 8 C-IADL was measured using the criterion-referenced, observation-based Performance Assessment of Self-Care Skills (PASS). RESULTS A total of 96 older adults with normal cognitive function (mean age=72.5, SD=5.9) and 61 older adults with MCI (mean age=75.5, SD=6.3) participated. The 8 C-IADL demonstrated 81% accuracy in discriminating cognitive status (area under curve 0.81, p<0.001). Two tasks (shopping and checkbook balancing) were the most discriminating (area under curve 0.80, p<0.001); they demonstrated similar ability, as the 8 C-IADL, to discriminate cognitive status. Assessing performance on these two C-IADL takes 10–15 minutes. CONCLUSION This is the first demonstration of the discriminative ability of preclinical disability in distinguishing MCI from cognitively normal older adults. These findings highlight potential tasks, when measured with the observation-based PASS, which demonstrate increased effort for individuals with MCI. These tasks may be considered when attempting to diagnose MCI or Mild Neurocognitive Disorder in clinical practice and research. PMID:24890517

Rehabilitation as "destination triage": a critical examination of discharge planning.

PubMed

Durocher, Evelyne; Gibson, Barbara E; Rappolt, Susan

2017-06-01

In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults' functional capabilities. Professionals' primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting "rehabilitation" stay was more akin to an extended process of "destination triage" biased towards the promotion of physical safety than optimizing functioning. The resulting reduction of rehabilitation into "destination triage" has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for Rehabilitation Current trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation. Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation. Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members.

Brain Responses to Emotional Images Related to Cognitive Ability in Older Adults

PubMed Central

Foster, Shannon M.; Davis, Hasker P.; Kisley, Michael A.

2013-01-01

Older adults have been shown to exhibit a positivity effect in processing of emotional stimuli, seemingly focusing more on positive than negative information. Whether this reflects purposeful changes or an unintended side-effect of declining cognitive abilities is unclear. For the present study older adults displaying a wide range of cognitive abilities completed measures of attention, visual and verbal memory, executive functioning, and processing speed, as well as a socioemotional measure of time perspective. Regression analyses examined the ability of these variables to predict neural responsivity to select emotional stimuli as measured with the late positive potential (LPP), an event-related brain potential (ERP). Stronger cognitive functioning was associated with higher LPP amplitude in response to negative images (i.e., greater processing). This does not support a voluntary avoidance of negative information processing in older adults for this particular measure of attentional allocation. A model is proposed to reconcile this finding with the extant literature that has demonstrated positivity effects in measures of later, controlled attentional allocation. PMID:23276213

Transitions in Loneliness Among Older Adults: A 5-Year Follow-Up in the National Social Life, Health, and Aging Project.

PubMed

Hawkley, Louise C; Kocherginsky, Masha

2018-04-01

A substantial portion of the older adult population suffers from frequent feelings of loneliness, but a large proportion remains relatively unscathed by loneliness. To date, research examining both protective and risk factors for loneliness has not included data from the United States. The present study used the first two waves of data from the National Social Life, Health, and Aging Project to examine sociodemographic, structural, and functional factors thought to be associated with loneliness in older adults. Functional limitations and low family support were associated with an increase in loneliness frequency (as were more strained friendships) and with transitioning from nonlonely to lonely status. Better self-rated health, higher levels of socializing frequency, and lower family strain were associated with transitioning from lonely to nonlonely status. Interventions that target these factors may be effective in preventing and reducing loneliness and its effects on health and well-being in older adults.

The Psychological Challenge of Late-Life Vision Impairment: Concepts, Findings, and Practical Implications

PubMed Central

Wahl, Hans-Werner

2013-01-01

The intention is to summarize the body of evidence speaking to the psychological challenges faced by visually impaired older adults, as well as their coping efforts. This evidence is substantiated by a rich set of concepts, theories, and empirical findings that have accumulated under the umbrella of age-related psychoophthalmology (APO). I introduce the field of APO and continue with a discussion of important concepts and theories for a better understanding of adaptational processes in visually impaired older adults. I then summarize the most relevant and most recent data from four areas: (1) everyday competence, (2) cognitive functioning, (3) social functioning, and (4) subjective well-being-related outcomes, depression, and adaptational processes. Thereafter, major insights related to the current state-of-the art psychosocial interventions with visuallyimpaired older adults are reviewed. I close with the need that the public health community should become more aware of and address the psychosocial needs of visually impaired older adults. PMID:23691277

The association between social support and cognitive function in Mexican adults aged 50 and older.

PubMed

Zamora-Macorra, Mireya; de Castro, Elga Filipa Amorin; Ávila-Funes, José Alberto; Manrique-Espinoza, Betty Soledad; López-Ridaura, Ruy; Sosa-Ortiz, Ana Luisa; Shields, Pamela L; Del Campo, Daniel Samano Martin

Social support networks are crucial for the health of older adults; however, personal characteristics and time of life may diminish the protective effect of social support. to determine if the presence of social support networks were associated with cognitive impairment among Mexican adults aged 50 or older and if this relationship was different based on age. This study analyzed data from the National Representation Survey performed in Mexico, Study on Global Ageing (SAGE) wave 1. Cognitive function was evaluated by a standardized test, social support was evaluated through latent class analysis (LCA). The LCA was run to obtain three subgroups of different Social Support Levels (SSL): low, medium, and high. Logistic regression models, stratified by age, were performed to analyze the association between SSL and cognitive function. For respondents ages 71-80 y/o, there was an inverse relationship with cognitive impairment for those with medium (OR 0.23, p=0.020) and high (OR 0.07, p=0.000) SSL in comparison with low SSL. While social support helped to improve cognitive function in older adults aged 71-80, this same association was not observed in adults of other ages. Those younger than 70 y/o may not need such a strong support network as a result of being more self-sufficient. After 80, social networks were not enough to help diminish the negative impact of cognitive impairment. Social support could improve the cognitive function of adults ages 71 and 80; suggesting there could be a window of opportunity to improve cognitive functioning for this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of familiar and unfamiliar settings on cooking task assessments in frail older adults with poor and preserved executive functions.

PubMed

Provencher, Véronique; Demers, Louise; Gagnon, Lise; Gélinas, Isabelle

2012-05-01

Hospitalized frail older patients are usually assessed for their ability to perform some daily living activities in a clinical setting prior to discharge. However, assessments that take place in this unfamiliar environment might not be as representative of their functional performance as assessments at home. This may be related to a decline in some cognitive components, such as executive functions (EF), which enable one to cope with new environments. This study thus aims to compare cooking task performance in familiar and unfamiliar settings in a population of frail older adults with poor and preserved EF. Thirty-seven frail older adults were assigned to one of two groups: poor EF or preserved EF. Participants performed two cooking tasks in familiar and unfamiliar settings, using a counterbalanced design. Their performance was assessed with a reliable tool based on observation of motor and process skills (Assessment of Motor and Process Skills). Thirty-three participants were retained for analysis. They demonstrated significantly better motor skills (F = 5.536; p = 0.025) and process skills (F = 8.149; p = 0.008) in the familiar setting. The difference between settings was particularly marked for process skills in participants with poor EF (F = 16.920; p < 0.001). This study suggests that a home setting may be preferable for a more accurate assessment of cooking task performance in frail older adults, especially those with poor EF. These findings highlight the risk of underestimating frail older adults' performance when assessed in an unfamiliar setting (e.g. hospital), which could lead to inefficient allocation of home care services.

Child's play: the creativity of older adults.

PubMed

Capps, Donald

2012-09-01

In this article, I discuss Paul W. Pruyser's view presented in his article "An Essay on Creativity" (Pruyser in Bull Menninger Clin 43:294-353, 1979) that creative persons manifest early childhood qualities of playfulness, curiosity, and pleasure seeking and that adaptation is itself a form of creativity. I then discuss his article "Creativity in Aging Persons" (Pruyser in Bull Menninger Clin 51:425-435, 1987) in which he presents his view that aging itself is a potentially creative process, that creativity among older adults is not limited to the talented few, and that older adulthood has several specific features that are conducive to creativity. Significant among these features are object loss (especially involving human relationships) and functional loss (due to the vicissitudes of aging). Noting his particular emphasis on object loss and its role in late-life creativity, I focus on functional loss, and I emphasize the importance of adaptation in sustaining the creativity of older adults who experience such loss. I illustrate this adaptation by considering well-known painters who in late life suffered visual problems common to older adults. I suggest that in adapting to their visual problems these artists drew on the early childhood qualities (playfulness, curiosity and pleasure seeking) that all creative persons possess and that they are therefore illustrative for other older adults who are experiencing functional losses. I conclude with Erik H. Erikson's (Toys and reasons: stages in the ritualization of experience, W. W. Norton, New York, 1977) and Paul W. Pruyser's (Pastor Psychol 35:120-131, 1986) reflections on the relationship between seeing and hoping.

Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study

PubMed Central

Morone, Natalia E.; Greco, Carol M.; Weiner, Debra K.

2008-01-01

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, attention, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P = .008, P = .004) and SF-36 Physical Function (P = .03). An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function. PMID:17544212

Frontal, Striatal, and Medial Temporal Sensitivity to Value Distinguishes Risk-Taking from Risk-Aversive Older Adults during Decision Making.

PubMed

Goh, Joshua O S; Su, Yu-Shiang; Tang, Yong-Jheng; McCarrey, Anna C; Tereshchenko, Alexander; Elkins, Wendy; Resnick, Susan M

2016-12-07

Aging compromises the frontal, striatal, and medial temporal areas of the reward system, impeding accurate value representation and feedback processing critical for decision making. However, substantial variability characterizes age-related effects on the brain so that some older individuals evince clear neurocognitive declines whereas others are spared. Moreover, the functional correlates of normative individual differences in older-adult value-based decision making remain unclear. We performed a functional magnetic resonance imaging study in 173 human older adults during a lottery choice task in which costly to more desirable stakes were depicted using low to high expected values (EVs) of points. Across trials that varied in EVs, participants decided to accept or decline the offered stakes to maximize total accumulated points. We found that greater age was associated with less optimal decisions, accepting stakes when losses were likely and declining stakes when gains were likely, and was associated with increased frontal activity for costlier stakes. Critically, risk preferences varied substantially across older adults and neural sensitivity to EVs in the frontal, striatal, and medial temporal areas dissociated risk-aversive from risk-taking individuals. Specifically, risk-averters increased neural responses to increasing EVs as stakes became more desirable, whereas risk-takers increased neural responses with decreasing EV as stakes became more costly. Risk preference also modulated striatal responses during feedback with risk-takers showing more positive responses to gains compared with risk-averters. Our findings highlight the frontal, striatal, and medial temporal areas as key neural loci in which individual differences differentially affect value-based decision-making ability in older adults. Frontal, striatal, and medial temporal functions implicated in value-based decision processing of rewards and costs undergo substantial age-related changes. However, age effects on brain function and cognition differ across individuals. How this normative variation relates to older-adult value-based decision making is unclear. We found that although the ability make optimal decisions declines with age, there is still much individual variability in how this deterioration occurs. Critically, whereas risk-averters showed increased neural activity to increasingly valuable stakes in frontal, striatal, and medial temporal areas, risk-takers instead increased activity as stakes became more costly. Such distinct functional decision-making processing in these brain regions across normative older adults may reflect individual differences in susceptibility to age-related brain changes associated with incipient cognitive impairment. Copyright © 2016 the authors 0270-6474/16/3612498-12$15.00/0.

Regular group exercise contributes to balanced health in older adults in Japan: a qualitative study.

PubMed

Komatsu, Hiroko; Yagasaki, Kaori; Saito, Yoshinobu; Oguma, Yuko

2017-08-22

While community-wide interventions to promote physical activity have been encouraged in older adults, evidence of their effectiveness remains limited. We conducted a qualitative study among older adults participating in regular group exercise to understand their perceptions of the physical, mental, and social changes they underwent as a result of the physical activity. We conducted a qualitative study with purposeful sampling to explore the experiences of older adults who participated in regular group exercise as part of a community-wide physical activity intervention. Four focus group interviews were conducted between April and June of 2016 at community halls in Fujisawa City. The participants in the focus group interviews were 26 older adults with a mean age of 74.69 years (range: 66-86). The interviews were analysed using the constant comparative method in the grounded theory approach. We used qualitative research software NVivo10® to track the coding and manage the data. The finding 'regular group exercise contributes to balanced health in older adults' emerged as an overarching theme with seven categories (regular group exercise, functional health, active mind, enjoyment, social connectedness, mutual support, and expanding communities). Although the participants perceived that they were aging physically and cognitively, the regular group exercise helped them to improve or maintain their functional health and enjoy their lives. They felt socially connected and experienced a sense of security in the community through caring for others and supporting each other. As the older adults began to seek value beyond individuals, they gradually expanded their communities beyond geographical and generational boundaries. The participants achieved balanced health in the physical, mental, and social domains through regular group exercise as part of a community-wide physical activity intervention and contributed to expanding communities through social connectedness and mutual support. Health promotion through physical activity is being increasingly emphasized. The study results can help to develop effective physical activity programs for older adults in the community.

Development and Psychometric Evaluation of the Reasons for Living—Older Adults Scale: A Suicide Risk Assessment Inventory

PubMed Central

Edelstein, Barry A.; Heisel, Marnin J.; McKee, Deborah R.; Martin, Ronald R.; Koven, Lesley P.; Duberstein, Paul R.; Britton, Peter C.

2009-01-01

Purpose: The purposes of these studies were to develop and initially evaluate the psychometric properties of the Reasons for Living Scale—Older Adult version (RFL-OA), an older adults version of a measure designed to assess reasons for living among individuals at risk for suicide. Design and Methods: Two studies are reported. Study 1 involved instrument development with 106 community-dwelling older adults, and initial psychometric evaluation with a second sample of 119 community-dwelling older adults. Study 2 evaluated the psychometric properties of the RFL-OA in a clinical sample. One hundred eighty-one mental health patients 50 years or older completed the RFL-OA and measures of depression, suicide ideation at the current time and at the worst point in one's life, and current mental status and physical functioning. Results: Strong psychometric properties were demonstrated for the RFL-OA, with high internal consistency (Cronbach's alpha coefficient). Convergent validity was evidenced by negative associations among RFL-OA scores and measures of depression and suicide ideation. RFL-OA scores predicted current and worst-episode suicide ideation above and beyond current depression. Discriminant validity was evidenced with measures of current mental status and physical functioning. Criterion-related validity was also demonstrated with respect to lifetime history of suicidal behavior. Implications: These findings provide preliminary support for the validity and reliability of the RFL-OA. The findings also support the potential value of attending to reasons for living during clinical treatment with depressed older adults and others at risk for suicide. PMID:19546114

The Impact of Professionally Conducted Cultural Programs on the Physical Health, Mental Health, and Social Functioning of Older Adults

ERIC Educational Resources Information Center

Cohen, Gene D.; Perlstein, Susan; Chapline, Jeff; Kelly, Jeanne; Firth, Kimberly M.; Simmens, Samuel

2006-01-01

Purpose: The aim of this study was to measure the impact of professionally conducted community-based cultural programs on the physical health, mental health, and social activities of individuals aged 65 and older. Design and Methods: Participants in the study were 166 healthy, ambulatory older adults from the Washington, DC, area. We assigned them…

Daytime sleepiness, exercise, and physical function in older adults.

PubMed

Chasens, Eileen R; Sereika, Susan M; Weaver, Terri E; Umlauf, Mary Grace

2007-03-01

The purpose of this study was to describe the association between sleepiness, exercise, and physical function in older adults, testing the hypothesis that sleepiness predicts decreased exercise and impaired physical function in this population. We performed a secondary analysis of data from the National Sleep Foundation's Sleep in America Poll, comparing frequency of exercise and ability to perform functional tasks between sleepy and non-sleepy subjects. Trained interviewers administered a scripted telephone survey. Participants (n = 1506) were community-dwelling older Americans (55-84 years) randomly chosen from geographically representative households with listed telephone numbers. Sleepiness 'so severe that it interferes with daytime activity' was dichotomized as 'daily/frequently' or 'never/rare'. Exercise frequency was scored 1-4 ('less than once a week' to 'more than five times a week'). Responses to five questions (walk 0.5 mile, climb stairs, push/pull heavy object, stoop/crouch/or kneel, write, handle small objects), rated 1-5 ('no difficulty' to 'unable to do'), were summed; a mean score of > or = 2.5 was considered impaired physical function. Daytime sleepiness predicted low exercise frequency while controlling for age and body mass index (BMI) (OR = 1.40, 95% CI 1.031-1.897, P = 0.031). Frequent daytime sleepiness predicted impaired physical function (OR = 2.76, 95%CI = 0.237-0.553, P = 0.001) after controlling for age, BMI, income and number of co-morbid conditions. The conclusion was that daytime sleepiness in older adults is associated with physical functional impairments and decreased exercise frequency. The findings suggest that sleepiness in older adults is not benign but has implications for continued physical decline and warrants attention.

Knowledge Gaps in Cardiovascular Care of Older Adults: A Scientific Statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society: Executive Summary.

PubMed

Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

2016-11-01

The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease (CVD) is the leading cause of death and major disability in adults aged 75 and older. Despite the effect of CVD on quality of life, morbidity, and mortality in older adults, individuals aged 75 and older have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older adults with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in nursing homes and assisted living facilities. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older adults typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision-making, and recommend future research to close existing knowledge gaps. To achieve these objectives, a detailed review was conducted of current American College of Cardiology/American Heart Association (ACC/AHA) and American Stroke Association (ASA) guidelines to identify content and recommendations that explicitly targeted older adults. A pervasive lack of evidence to guide clinical decision-making in older adults with CVD was found, as well as a paucity of data on the effect of diagnostic and therapeutic interventions on outcomes that are particularly important to older adults, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older adults representative of those seen in clinical practice and that incorporate relevant outcomes important to older adults in the study design. The results of these studies will provide the foundation for future evidence-based guidelines applicable to older adults and enhance person-centered care of older individuals with CVD in the United States and around the world. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Management of multiple myeloma in older adults: Gaining ground with geriatric assessment.

PubMed

Wildes, Tanya M; Campagnaro, Erica

2017-01-01

Multiple myeloma increases in incidence with age. With the aging of the population, the number of cases of multiple myeloma diagnosed in older adults each year will nearly double in the next 20years. The novel therapeutic agents have significantly improved survival in older adults, but their outcomes remain poorer than in younger patients. Older adults may be more vulnerable to toxicity of therapy, resulting in decreased dose intensity and contributing to poorer outcomes. Data are beginning to emerge to aid in identifying which individuals are at greater risk for toxicity of therapy; comorbidities, functional limitations, and age over 80years are among the factors associated with greater risk. Geriatric assessment holds promise in the care of older adults with multiple myeloma, both to allow modification of treatment to prevent toxicity, and to identify vulnerabilities that may require intervention. Emerging treatments with low toxicity and attention to individualizing therapy based on geriatric assessment may aid in further improving outcomes in older adults with multiple myeloma. Copyright © 2016 Elsevier Inc. All rights reserved.

Falls Risk and Simulated Driving Performance in Older Adults

PubMed Central

Gaspar, John G.; Neider, Mark B.; Kramer, Arthur F.

2013-01-01

Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance. PMID:23509627

Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

PubMed

Solis, Guillermina R; Champion, Jane Dimmitt

2017-03-01

Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

Recruitment and Retention of Older Adults in Aging Research

PubMed Central

Mody, Lona; Miller, Douglas K.; McGloin, Joanne M.; Div, M; Freeman, Marcie; Marcantonio, Edward R.; Magaziner, Jay; Studenski, Stephanie

2009-01-01

Older adults continue to be underrepresented in clinical research despite their burgeoning population in the United States and worldwide. Physicians often propose treatment plans for older adults based on data from studies involving primarily younger, more-functional, healthier participants. Major barriers to recruitment of older adults in aging research relate to their substantial health problems, social and cultural barriers, and potentially impaired capacity to provide informed consent. Institutionalized older adults offer another layer of complexity that requires cooperation from the institutions to participate in research activities. This paper provides study recruitment and retention techniques and strategies to address concerns and overcome barriers to older adult participation in clinical research. Key approaches include early in-depth planning; minimizing exclusion criteria; securing cooperation from all interested parties; using advisory boards, timely screening, identification, and approach of eligible patients; carefully reviewing the benefit:risk ratio to be sure it is appropriate; and employing strategies to ensure successful retention across the continuum of care. Targeting specific strategies to the condition, site, and population of interest and anticipating potential problems and promptly employing predeveloped contingency plans are keys to effective recruitment and retention. PMID:19093934

Generating GPS activity spaces that shed light upon the mobility habits of older adults: a descriptive analysis.

PubMed

Hirsch, Jana A; Winters, Meghan; Clarke, Philippa; McKay, Heather

2014-12-12

Measuring mobility is critical for understanding neighborhood influences on older adults' health and functioning. Global Positioning Systems (GPS) may represent an important opportunity to measure, describe, and compare mobility patterns in older adults. We generated three types of activity spaces (Standard Deviation Ellipse, Minimum Convex Polygon, Daily Path Area) using GPS data from 95 older adults in Vancouver, Canada. Calculated activity space areas and compactness were compared across sociodemographic and resource characteristics. Area measures derived from the three different approaches to developing activity spaces were highly correlated. Participants who were younger, lived in less walkable neighborhoods, had a valid driver's license, had access to a vehicle, or had physical support to go outside of their homes had larger activity spaces. Mobility space compactness measures also differed by sociodemographic and resource characteristics. This research extends the literature by demonstrating that GPS tracking can be used as a valuable tool to better understand the geographic mobility patterns of older adults. This study informs potential ways to maintain older adult independence by identifying factors that influence geographic mobility.

Effects of aging on neural connectivity underlying selective memory for emotional scenes

PubMed Central

Waring, Jill D.; Addis, Donna Rose; Kensinger, Elizabeth A.

2012-01-01

Older adults show age-related reductions in memory for neutral items within complex visual scenes, but just like young adults, older adults exhibit a memory advantage for emotional items within scenes compared with the background scene information. The present study examined young and older adults’ encoding-stage effective connectivity for selective memory of emotional items versus memory for both the emotional item and its background. In a functional magnetic resonance imaging (fMRI) study, participants viewed scenes containing either positive or negative items within neutral backgrounds. Outside the scanner, participants completed a memory test for items and backgrounds. Irrespective of scene content being emotionally positive or negative, older adults had stronger positive connections among frontal regions and from frontal regions to medial temporal lobe structures than did young adults, especially when items and backgrounds were subsequently remembered. These results suggest there are differences between young and older adults’ connectivity accompanying the encoding of emotional scenes. Older adults may require more frontal connectivity to encode all elements of a scene rather than just encoding the emotional item. PMID:22542836

Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults.

PubMed

Anderson, Dennis E; Madigan, Michael L

2014-03-21

Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly <100%, and were higher than for other measures examined. Older adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multidimensional model of apathy in older adults using partial least squares--path modeling.

PubMed

Raffard, Stéphane; Bortolon, Catherine; Burca, Marianna; Gely-Nargeot, Marie-Christine; Capdevielle, Delphine

2016-06-01

Apathy defined as a mental state characterized by a lack of goal-directed behavior is prevalent and associated with poor functioning in older adults. The main objective of this study was to identify factors contributing to the distinct dimensions of apathy (cognitive, emotional, and behavioral) in older adults without dementia. One hundred and fifty participants (mean age, 80.42) completed self-rated questionnaires assessing apathy, emotional distress, anticipatory pleasure, motivational systems, physical functioning, quality of life, and cognitive functioning. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to the three different dimensions of apathy in our sample. Overall, the different facets of apathy were associated with cognitive functioning, anticipatory pleasure, sensitivity to reward, and physical functioning, but the contribution of these different factors to the three dimensions of apathy differed significantly. More specifically, the impact of anticipatory pleasure and physical functioning was stronger for the cognitive than for emotional apathy. Conversely, the impact of sensibility to reward, although small, was slightly stronger on emotional apathy. Regarding behavioral apathy, again we found similar latent variables except for the cognitive functioning whose impact was not statistically significant. Our results highlight the need to take into account various mechanisms involved in the different facets of apathy in older adults without dementia, including not only cognitive factors but also motivational variables and aspects related to physical disability. Clinical implications are discussed.

A Holistic approach to assess older adults' wellness using e-health technologies.

PubMed

Thompson, Hilaire J; Demiris, George; Rue, Tessa; Shatil, Evelyn; Wilamowska, Katarzyna; Zaslavsky, Oleg; Reeder, Blaine

2011-12-01

To date, methodologies are lacking that address a holistic assessment of wellness in older adults. Technology applications may provide a platform for such an assessment, but have not been validated. We set out to demonstrate whether e-health applications could support the assessment of older adults' wellness in community-dwelling older adults. Twenty-seven residents of independent retirement community were followed over 8 weeks. Subjects engaged in the use of diverse technologies to assess cognitive performance, physiological and functional variables, as well as psychometric components of wellness. Data were integrated from various e-health sources into one study database. Correlations were assessed between different parameters, and hierarchical cluster analysis was used to explore the validity of the wellness model. We found strong associations across multiple parameters of wellness within the conceptual model, including cognitive, functional, and physical. However, spirituality did not correlate with any other parameter studied in contrast to prior studies of older adults. Participants expressed overall positive attitudes toward the e-health tools and the holistic approach to the assessment of wellness, without expressing any privacy concerns. Parameters were highly correlated across multiple domains of wellness. Important clusters were noted to be formed across cognitive and physiological domains, giving further evidence of need for an integrated approach to the assessment of wellness. This finding warrants further replication in larger and more diverse samples of older adults to standardize and deploy these technologies across population groups.

The effect of rhythmic musical training on healthy older adults' gait and cognitive function.

PubMed

Maclean, Linda M; Brown, Laura J E; Astell, Arlene J

2014-08-01

Older adults' gait is disturbed when a demanding secondary cognitive task is added. Gait training has been shown to improve older adults' walking performance, but it is not clear how training affects their cognitive performance. This study examined the impact on gait, in terms of cost or benefit to cognitive performance, of training healthy older adults to walk to a rhythmic musical beat. In a mixed model design, 45 healthy older adults aged more than 65 years (M = 71.7 years) were randomly assigned to 3 groups. One group received a rhythmic musical training and their dual-task (DT) walking and cognitive performances were compared with a group who had music playing in the background but no training, and a third group who heard no music and received no training. Outcomes in single-task (ST) and DT conditions were step-time variability and velocity for gait and correct cognitive responses for the cognitive task. The Musical Training group's step-time variability improved in both the ST (p < .05) and the DT (p < .05) after training, without adversely affecting their cognitive performance. No change was seen in the control groups. Rhythmic musical training can improve gait steadiness in healthy older adults with no negative impact on concurrent cognitive functioning. This could potentially enhance "postural reserve" and reduce fall risk. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults.

PubMed

Tuntland, Hanne; Aaslund, Mona Kristin; Langeland, Eva; Espehaug, Birgitte; Kjeken, Ingvild

2016-01-01

The Canadian Occupational Performance Measure (COPM) is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations. To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline. The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed. Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists, physiotherapists, and nurses reported that they had the required expertise to conduct the COPM assessments. The results support the multidisciplinary use of the COPM in clinical practice and research in a home-dwelling, heterogeneous population of older adults. Based on the findings, 3 points are recommended as a cutoff point to distinguish between older adults who have a minimal important change in COPM performance and COPM satisfaction and those who have not.

Self-Reported Physical Activity within and outside the Neighborhood: Criterion-Related Validity of the Neighborhood Physical Activity Questionnaire in German Older Adults

ERIC Educational Resources Information Center

Bödeker, Malte; Bucksch, Jens; Wallmann-Sperlich, Birgit

2018-01-01

The Neighborhood Physical Activity Questionnaire allows to assess physical activity within and outside the neighborhood. Study objectives were to examine the criterion-related validity and health/functioning associations of Neighborhood Physical Activity Questionnaire-derived physical activity in German older adults. A total of 107 adults aged…

Predictors of Physical Functioning Trajectories among Chinese Oldest Old Adults: Rural and Urban Differences

ERIC Educational Resources Information Center

Sun, Fei; Park, Nan Sook; Klemmack, David L.; Roff, Lucinda L.; Li, Zhihong

2009-01-01

This article examined the differences between rural/urban older adults in their trajectories of activities of daily living (ADL) over a 4-year period. The sample included 2,490 community dwelling older adults who completed three waves (1998, 2000, and 2002) of the Chinese Longitudinal Healthy Longevity Survey. Among them, 63.5% were from rural…

Self-initiated object-location memory in young and older adults.

PubMed

Berger-Mandelbaum, Anat; Magen, Hagit

2017-11-20

The present study explored self-initiated object-location memory in ecological contexts, as aspect of memory that is largely absent from the research literature. Young and older adults memorized objects-location associations they selected themselves or object-location associations provided to them, and elaborated on the strategy they used when selecting the locations themselves. Retrieval took place 30 min and 1 month after encoding. The results showed an age-related decline in self-initiated and provided object-location memory. Older adults benefited from self-initiation more than young adults when tested after 30 min, while the benefit was equal when tested after 1 month. Furthermore, elaboration enhanced memory only in older adults, and only after 30 min. Both age groups used deep encoding strategies on the majority of the trials, but their percentage was lower in older adults. Overall, the study demonstrated the processes involved in self-initiated object-location memory, which is an essential part of everyday functioning.

Retrospective cues based on object features improve visual working memory performance in older adults.

PubMed

Gilchrist, Amanda L; Duarte, Audrey; Verhaeghen, Paul

2016-01-01

Research with younger adults has shown that retrospective cues can be used to orient top-down attention toward relevant items in working memory. We examined whether older adults could take advantage of these cues to improve memory performance. Younger and older adults were presented with visual arrays of five colored shapes; during maintenance, participants were presented either with an informative cue based on an object feature (here, object shape or color) that would be probed, or with an uninformative, neutral cue. Although older adults were less accurate overall, both age groups benefited from the presentation of an informative, feature-based cue relative to a neutral cue. Surprisingly, we also observed differences in the effectiveness of shape versus color cues and their effects upon post-cue memory load. These results suggest that older adults can use top-down attention to remove irrelevant items from visual working memory, provided that task-relevant features function as cues.

Aging, Nutritional Status and Health.

PubMed

Leslie, Wilma; Hankey, Catherine

2015-07-30

The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.

Role of sleep continuity and total sleep time in executive function across the adult lifespan.

PubMed

Wilckens, Kristine A; Woo, Sarah G; Kirk, Afton R; Erickson, Kirk I; Wheeler, Mark E

2014-09-01

The importance of sleep for cognition in young adults is well established, but the role of habitual sleep behavior in cognition across the adult life span remains unknown. We examined the relationship between sleep continuity and total sleep time as assessed with a sleep-detection device, and cognitive performance using a battery of tasks in young (n = 59, mean age = 23.05) and older (n = 53, mean age = 62.68) adults. Across age groups, higher sleep continuity was associated with better cognitive performance. In the younger group, higher sleep continuity was associated with better working memory and inhibitory control. In the older group, higher sleep continuity was associated with better inhibitory control, memory recall, and verbal fluency. Very short and very long total sleep time was associated with poorer working memory and verbal fluency, specifically in the younger group. Total sleep time was not associated with cognitive performance in any domains for the older group. These findings reveal that sleep continuity is important for executive function in both young and older adults, but total sleep time may be more important for cognition in young adults. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Strategies for Preventing Cognitive Decline in Healthy Older Adults

PubMed Central

2017-01-01

Objective: Many advances have been made in the understanding of age-related changes in cognition. As research details the cognitive and neurobiological changes that occur in aging, there is increased interest in developing and understanding methods to prevent, slow, or reverse the cognitive decline that may occur in normal healthy older adults. The Institute of Medicine has recently recognized cognitive aging as having important financial and public health implications for society with the increasing older adult population worldwide. Cognitive aging is not dementia and does not result in the loss of neurons but rather changes in neurotransmission that affect brain functioning. The fact that neurons are structurally intact but may be functionally affected by increased age implies that there is potential for remediation. Method and Results: This review article presents recent work using medication-based strategies for slowing cognitive changes in aging. The primary method presented is a hormonal approach for affecting cognition in older women. In addition, a summary of the work examining modifiable lifestyle factors that have shown promise in benefiting cognition in both older men and women is described. Conclusions: Much work remains to be done so that evidence-based recommendations can be made for slowing cognitive decline in healthy older adults. The success of some of these methods thus far indicates that the brains of healthy older adults are plastic enough to be able to respond to these cognitive decline prevention strategies, and further work is needed to define the most beneficial methods. PMID:28703016

Longitudinal Assessment of Cognitive and Psychosocial Functioning After Hurricanes Katrina and Rita: Exploring Disaster Impact on Middle-Aged, Older, and Oldest-Old Adults.

PubMed

Cherry, Katie E; Brown, Jennifer Silva; Marks, Loren D; Galea, Sandro; Volaufova, Julia; Lefante, Christina; Su, L Joseph; Welsh, David A; Jazwinski, S Michal

2011-12-01

The authors examined the effects of Hurricanes Katrina and Rita (HKR) on cognitive and psychosocial functioning in a lifespan sample of adults 6 to 14 months after the storms. Participants were recruited from the Louisiana Healthy Aging Study (LHAS). Most were assessed during the immediate impact period and retested for this study. Analyses of pre-and post-disaster cognitive data confirmed that storm-related decrements in working memory for middle-aged and older adults observed in the immediate impact period had returned to pre-hurricane levels in the post-disaster recovery period. Middle-aged adults reported more storm-related stressors and greater levels of stress than the two older groups at both waves of testing. These results are consistent with a burden perspective on post-disaster psychological reactions.

Endorsement of Interpersonal Strategies for Dealing with Hypothetical Everyday Arthritis Problems as a Function of Marital Status, Gender, and Problem Severity

ERIC Educational Resources Information Center

Strough, Jonell; McFall, Joseph P.; Schuller, Kelly L.

2010-01-01

We used hypothetical vignettes to examine whether older adults' endorsement of interpersonal strategies for dealing with health-related (arthritis) everyday problems varied as a function of marital status, gender, and the severity of the problem. Adults 60 years and older (N= 127, M= 71.40 years, SD = 7.21) rated interpersonal (i.e., discuss with…

Maintenance of youth-like processing protects against false memory in later adulthood.

PubMed

Fandakova, Yana; Lindenberger, Ulman; Shing, Yee Lee

2015-02-01

Normal cognitive aging compromises the ability to form and retrieve associations among features of a memory episode. One indicator of this age-related deficit is older adults' difficulty in detecting and correctly rejecting new associations of familiar items. Comparing 28 younger and 30 older adults on a continuous recognition task with word pairs, we found that older adults whose activation patterns deviate less from the average pattern of younger adults while detecting repaired associations show the following: (1) higher overall memory and fewer false recognitions; (2) stronger functional connectivity of prefrontal regions with middle temporal and parahippocampal gyrus; and (3) higher recall and strategic categorical clustering in an independently assessed free recall task. Deviations from the average young-adult network reflected underactivation of frontoparietal regions instead of overactivation of regions not activated by younger adults. We conclude that maintenance of youth-like task-relevant activation patterns is critical for preserving memory functions in later adulthood. Copyright © 2015 Elsevier Inc. All rights reserved.

Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa

PubMed Central

2014-01-01

Background Little is known about the prevalence, predictors and gender differences in hand grip strength of older adults in Africa. This study aims to investigate social and health differences in hand grip strength among older adults in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE wave 1) in 2008. Methods We conducted a national population-based cross-sectional study with a sample of 3840 men and women aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric measurements. Linear multivariate regression analysis was performed to assess the association of social factors, health variables and grip strength. Results The mean overall hand grip strength was 37.9 kgs for men (mean age 61.1 years, SD = 9.1) and 31.5 kgs for women (mean age 62.0 years, SD = 9.7). In multivariate analysis among men, greater height, not being underweight and lower functional disability was associated with greater grip strength, and among women, greater height, better cognitive functioning, and lower functional disability were associated with greater grip strength. Conclusions Greater height and lower functional disability were found for both older South African men and women to be significantly associated with grip strength. PMID:24393403

Factors associated with the use of potentially inappropriate medications by older adults with cancer.

PubMed

Reis, Cristiane Moreira; Dos Santos, Andrezza Gouvêa; de Jesus Souza, Paula; Reis, Adriano Max Moreira

2017-07-01

To determine the frequency and the factors associated with the use of potentially inappropriate medications (PIMs) by older adults with cancer at an onco-haematology ambulatory clinic of a teaching hospital in Brazil. Patients aged 60years or older (n=160) subjected to parenteral antineoplastic chemotherapy from May to December 2015 and treated with one or more medications in the ambulatory clinic were interviewed. Data on medications, comorbidities, oncological diagnosis, and functional status were recorded. Functionality was determined using the Vulnerable Elders Survey (VES-13). PIMs were determined using the 2015 Beers Criteria. Logistic regression was used to determine the factors associated with the use of PIMs. A total of 78 (48.1%) older adults used at least one PIM. The PIMs to be avoided by older adults were proton pump inhibitors (33.3%), antiemetics (10.5%), long-acting benzodiazepines (10.5%), and antidepressants (7.6%). Multivariate analysis indicated that PIMs were associated with the use of five or more medications (odds ratio, 3.14; 95% confidence interval, 1.4-6.6), after adjusting for the number of medications, number of comorbidities, depression, and arthritis/arthrosis. The frequency of use of PIMs by older adults at the investigated ambulatory clinic was high. Polypharmacy was positively associated with the use of PIMs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study.

PubMed

Tomita, Andrew; Burns, Jonathan K

2013-12-01

This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. Copyright © 2013 John Wiley & Sons, Ltd.

Depression, disability and functional status among community dwelling older adults in South Africa: Evidence from the first South African National Income Dynamics Study

PubMed Central

Tomita, Andrew; Burns, Jonathan K

2013-01-01

Objectives This study examined the relationship between depression and functional status among a community-dwelling elderly population of 65 years and older in South Africa. Method Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n=1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Functional status, pertaining to both difficulty and dependency in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Results Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependency in ADL (adjusted OR=2.57 [CI: 1.03-6.41]), IADL (adjusted OR=2.76 [CI: 1.89-4.04]) and PFM (adjusted OR=1.66 [CI: 1.18-2.33]) but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. Conclusion The relationship between depression symptoms and function is complex. Functional characteristics between older and younger older populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. PMID:23512338

Importance of social relationships in the association between sleep duration and cognitive function: data from community-dwelling older Singaporeans.

PubMed

Cheng, Grand H-L; Chan, Angelique; Lo, June C

2017-06-15

Aging is accompanied by cognitive decline that is escalated in older adults reporting extreme sleep duration. Social relationships can influence health outcomes and thus may qualify the association between sleep duration and cognitive function. The present study examines the moderating effects of marital status, household size, and social network with friends and relatives on the sleep-cognition association among older adults. Data (N = 4,169) came from the Social Isolation, Health, and Lifestyles Survey, a nationally representative survey of community-dwelling older Singaporeans (≥ 60 years). Sleep duration and social relationships were self-reported. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. Regression analysis revealed that the inverted U-shaped association between sleep duration and cognitive function was less profound among older adults who were married (vs. unmarried) and those who had stronger (vs. weaker) social networks. In contrast, it was more prominent among individuals who had more (vs. fewer) household members. Being married and having stronger social networks may buffer against the negative cognitive impact of extreme sleep duration. But larger household size might imply more stress for older persons, and therefore strengthen the sleep duration-cognitive function association. We discuss the potential biological underpinnings and the policy implications of the findings. Although our findings are based on a large sample, replication studies using objective measures of sleep duration and other cognitive measures are needed.

Cognitive predictors of everyday functioning in older adults: results from the ACTIVE Cognitive Intervention Trial.

PubMed

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

2011-09-01

The present study sought to predict changes in everyday functioning using cognitive tests. Data from the Advanced Cognitive Training for Independent and Vital Elderly trial were used to examine the extent to which competence in different cognitive domains--memory, inductive reasoning, processing speed, and global mental status--predicts prospectively measured everyday functioning among older adults. Coefficients of determination for baseline levels and trajectories of everyday functioning were estimated using parallel process latent growth models. Each cognitive domain independently predicts a significant proportion of the variance in baseline and trajectory change of everyday functioning, with inductive reasoning explaining the most variance (R2 = .175) in baseline functioning and memory explaining the most variance (R2 = .057) in changes in everyday functioning. Inductive reasoning is an important determinant of current everyday functioning in community-dwelling older adults, suggesting that successful performance in daily tasks is critically dependent on executive cognitive function. On the other hand, baseline memory function is more important in determining change over time in everyday functioning, suggesting that some participants with low baseline memory function may reflect a subgroup with incipient progressive neurologic disease.

Effects of strawberry supplementation on mobility and cognition in older adults

USDA-ARS?s Scientific Manuscript database

During aging, functional changes in the central and peripheral nervous system can alter mobility and cognition - in some cases leading to early cognitive decline, disability, or injurious falls among older adults. Previously, we have shown that two months of dietary supplementation with berry fruit...

Exploring Interhemispheric Collaboration in Older Compared to Younger Adults

ERIC Educational Resources Information Center

Cherry, Barbara J.; Yamashiro, Mariana; Anderson, Erin; Barrett, Christopher; Adamson, Maheen M.; Hellige, Joseph B.

2010-01-01

Physical and Name Identity letter-matching tasks were used to explore differences in interhemispheric collaboration in younger and older adults. To determine whether other factors might also be related to across/within-hemisphere processing or visual field asymmetries, neuropsychological tests measuring frontal/executive functioning were…

Charting the life course: age differences and validity of beliefs about lifespan development.

PubMed

Riediger, Michaela; Voelkle, Manuel C; Schaefer, Sabine; Lindenberger, Ulman

2014-09-01

This study examined how children (9 years), adolescents (13 to 15 years), younger adults (21 to 26 years), and older adults (70 to 76 years) chart age gradients of cognitive and social functioning from childhood to old age. Participants (N = 156) rated typical performance levels in different life phases for 10 aspects of cognitive and social functioning. Compared with older participants, children expected lower performance levels and higher temporal stability, particularly during adulthood and into old age, and showed lower interindividual consensus in their ratings. Individuals in all 4 age groups recognized that fluid cognitive abilities reach their developmental peak earlier in life and decline more steeply thereafter than crystallized cognitive abilities. Older adults and, to a lesser extent, children evaluated their own current functioning as being better than that of their typical age peers. Furthermore, older adults charted typical cognitive development in middle and earlier late adulthood more positively than the participants in the other 3 age groups, which possibly reflects a partial externalization of their own positive self-views and a self-enhancing bias. Comparisons with life span gradients of cognitive performance (McArdle, Ferrer-Caja, Hamagami, & Woodcock, 2002) suggest that the ratings of adolescents and younger adults were in better agreement with empirically observed average performance trajectories than the ratings of children and older adults. We conclude that beliefs about normative cognitive and social aspects of life span development emerge in late middle childhood, solidify into culturally shared scripts by mid-adolescence, and remain subject to further change into old age. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Influence of vision on head stabilization strategies in older adults during walking.

PubMed

Cromwell, Ronita L; Newton, Roberta A; Forrest, Gail

2002-07-01

Maintaining balance during dynamic activities is essential for preventing falls in older adults. Head stabilization contributes to dynamic balance, especially during the functional task of walking. Head stability and the role of vision in this process have not been studied during walking in older adults. Seventeen older adults (76.2 +/- 6.9 years) and 20 young adults (26.0 +/- 3.4 years) walked with their eyes open (EO), with their eyes closed (EC), and with fixed gaze (FG). Participants performed three trials of each condition. Sagittal plane head and trunk angular velocities in space were obtained using an infrared camera system with passive reflective markers. Frequency analyses of head-on-trunk with respect to trunk gains and phases were examined for head-trunk movement strategies used for head stability. Average walking velocity, cadence, and peak head velocity were calculated for each condition. Differences between age groups demonstrated that older adults decreased walking velocity in EO (p =.022). FG (p = .021), and EC (p = .022). and decreased cadence during EC (p = .007). Peak head velocity also decreased across conditions (p < .0001) for older adults. Movement patterns demonstrated increased head stability during EO. diminished head stability with EC, and improved head stability with FG as older adult patterns resembled those of young adults. Increased stability of the lower extremity outcome measures for older adults was indicated by reductions in walking velocity and cadence. Concomitant increases in head stability were related to visual tasks. Increased stability may serve as a protective mechanism to prevent falls. Further, vision facilitates the head stabilization process for older adults to compensate for age-related decrements in other sensory systems subserving dynamic balance.

CE: Can Your Older Patients Drive Safely?

PubMed

Staplin, Loren; Lococo, Kathy H; Mastromatto, Tia; Sifrit, Kathy J; Trazzera, Kathleen M

2017-09-01

: In many areas of the world, driving is an essential part of life and for reasons of comfort, convenience, and security remains the primary mode of transportation among older adults. Both normal aging and diseases that are more prevalent in advanced age can substantially reduce older drivers' functional abilities, elevating their risk of involvement in motor vehicle accidents and serious injury or death. Identifying and intervening with older drivers at increased crash risk is an important aspect of preventive medicine. The authors discuss the specific driving risks adults face as they age and how nurses can raise older patients' awareness of these risks. They also discuss the importance of connecting older adults to community resources that may help them continue driving safely for a longer period or find alternative transportation options.

Gene by Neuroticism Interaction and Cognitive Function among Older Adults

PubMed Central

Dar-Nimrod, Ilan; Chapman, Benjamin P.; Robbins, John A.; Porsteinsson, Anton; Mapstone, Mark; Duberstein, Paul R.

2012-01-01

Objectives Both ApoE (apolipoprotein E) ε-4 allele(s) and elevated trait neuroticism, the tendency to experience distress, are associated with cognitive function among older adults. We predicted that neuroticism moderates the association between ApoE and cognitive function and also explored whether other personality dimensions (openness to experience, agreeableness, extraversion, and conscientiousness) affect the association between ApoE status and cognitive function. Method Five-hundred and ninety-seven older adults (mean age of 78) enrolled in the Ginkgo Evaluation of Memory (GEM) study completed the NEO-Five Factor Inventory of personality. Cognitive function was assessed via the cognitive portion of the Alzheimer’s Disease Assessment Scale (ADAS-cog), and a blood sample for ApoE genotyping was drawn. Results As hypothesized, regression analysis indicated that neuroticism moderated the relationship between the presence of ApoE ε-4 and cognitive function. Individuals with high neuroticism scores had significantly lower ADAS-cog scores compared with individual with low neuroticism scores, but this was true only among carriers of ApoE ε-4 (interaction effect β = .124, p = .028). There was scant evidence that other personality dimensions moderate the association between ApoE ε-4 and cognitive function. Conclusions Cognitive function may be affected by ApoE and neuroticism acting in tandem. Research on the underlying physiological mechanisms by which neuroticism amplifies the effect of ApoE ε-4 is warranted. The study of genotype by phenotype interactions provides an important and useful direction for the study of cognitive function among older adults and for the development of novel prevention programs. PMID:23042108

A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias.

PubMed

McGough, Ellen L; Lin, Shih-Yin; Belza, Basia; Becofsky, Katie M; Jones, Dina L; Liu, Minhui; Wilcox, Sara; Logsdon, Rebecca G

2017-11-28

There is growing evidence that exercise interventions can mitigate functional decline and reduce fall risk in older adults with Alzheimer disease and related dementias (ADRD). Although physical performance outcome measures have been successfully used in older adults without cognitive impairment, additional research is needed regarding their use with individuals who have ADRD, and who may have difficulty following instructions regarding performance of these measures. The purpose of this scoping review was to identify commonly used physical performance outcome measures, for exercise interventions, that are responsive and reliable in older adults with ADRD. Ultimately, we aimed to provide recommendations regarding the use of outcome measures for individuals with ADRD across several domains of physical performance. A scoping review was conducted to broadly assess physical performance outcome measures used in exercise interventions for older adults with ADRD. Exercise intervention studies that included at least 1 measure of physical performance were included. All physical performance outcome measures were abstracted, coded, and categorized into 5 domains of physical performance: fitness, functional mobility, gait, balance, and strength. Criteria for recommendations were based on (1) the frequency of use, (2) responsiveness, and (3) reliability. Frequency was determined by the number of studies that used the outcome measure per physical performance domain. Responsiveness was assessed via calculated effect size of the outcome measures across studies within physical performance domains. Reliability was evaluated via published studies of psychometric properties. A total of 20 physical performance outcome measures were extracted from 48 articles that met study inclusion criteria. The most frequently used outcome measures were the 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, the Berg Balance Scale, and isometric strength measures. These outcome measures demonstrated a small, medium, or large effect in at least 50% of the exercise intervention studies. Good to excellent reliability was reported in samples of older adults with mild to moderate dementia. Fitness, functional mobility, gait, balance, and strength represent important domains of physical performance for older adults. The 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, Berg Balance Scale, and isometric strength are recommended as commonly used and reliable physical performance outcome measures for exercise interventions in older adults with mild to moderate ADRD. Further research is needed on optimal measures for individuals with severe ADRD. The results of this review will aid clinicians and researchers in selecting reliable measures to evaluate physical performance outcomes in response to exercise interventions in older adults with ADRD.

Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011.

PubMed

Kachan, Diana; Fleming, Lora E; Christ, Sharon; Muennig, Peter; Prado, Guillermo; Tannenbaum, Stacey L; Yang, Xuan; Caban-Martinez, Alberto J; Lee, David J

2015-09-24

Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics. National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant. Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88). A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.

Productive Activities and Development of Frailty in Older Adults

PubMed Central

Jung, Yunkyung; Gruenewald, Tara L.; Seeman, Teresa E.

2010-01-01

Objective. Our aim was to examine whether engagement in productive activities, including volunteering, paid work, and childcare, protects older adults against the development of geriatric frailty. Methods. Data from the first (1988) and second (1991) waves of the MacArthur Study of Successful Aging, a prospective cohort study of high-functioning older adults aged 70–79 years (n = 1,072), was used to examine the hypothesis that engagement in productive activities is associated with lower levels of frailty 3 years later. Results. Engagement in productive activities at baseline was associated with a lower cumulative odds of frailty 3 years later in unadjusted models (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.58–0.96) but not after adjusting for age, disability, and cognitive function (adjusted OR = 0.78, 95% CI = 0.60–1.01). Examination of productive activity domains showed that volunteering (but neither paid work nor childcare) was associated with a lower cumulative odds of frailty after adjusting for age, disability, and cognitive function. This relationship diminished and was no longer statistically significant after adjusting for personal mastery and religious service attendance. Discussion. Though high-functioning older adults who participate in productive activities are less likely to become frail, after adjusting for age, disability, and cognitive function, only volunteering is associated with a lower cumulative odds of frailty. PMID:20018794

Dynamic range of frontoparietal functional modulation is associated with working memory capacity limitations in older adults.

PubMed

Hakun, Jonathan G; Johnson, Nathan F

2017-11-01

Older adults tend to over-activate regions throughout frontoparietal cortices and exhibit a reduced range of functional modulation during WM task performance compared to younger adults. While recent evidence suggests that reduced functional modulation is associated with poorer task performance, it remains unclear whether reduced range of modulation is indicative of general WM capacity-limitations. In the current study, we examined whether the range of functional modulation observed over multiple levels of WM task difficulty (N-Back) predicts in-scanner task performance and out-of-scanner psychometric estimates of WM capacity. Within our sample (60-77years of age), age was negatively associated with frontoparietal modulation range. Individuals with greater modulation range exhibited more accurate N-Back performance. In addition, despite a lack of significant relationships between N-Back and complex span task performance, range of frontoparietal modulation during the N-Back significantly predicted domain-general estimates of WM capacity. Consistent with previous cross-sectional findings, older individuals with less modulation range exhibited greater activation at the lowest level of task difficulty but less activation at the highest levels of task difficulty. Our results are largely consistent with existing theories of neurocognitive aging (e.g. CRUNCH) but focus attention on dynamic range of functional modulation asa novel marker of WM capacity-limitations in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

Aerobic and Cognitive Exercise (ACE) Pilot Study for Older Adults: Executive Function Improves with Cognitive Challenge While Exergaming.

PubMed

Barcelos, Nicole; Shah, Nikita; Cohen, Katherine; Hogan, Michael J; Mulkerrin, Eamon; Arciero, Paul J; Cohen, Brian D; Kramer, Arthur F; Anderson-Hanley, Cay

2015-11-01

Dementia cases are increasing worldwide; thus, investigators seek to identify interventions that might prevent or ameliorate cognitive decline in later life. Extensive research confirms the benefits of physical exercise for brain health, yet only a fraction of older adults exercise regularly. Interactive mental and physical exercise, as in aerobic exergaming, not only motivates, but has also been found to yield cognitive benefit above and beyond traditional exercise. This pilot study sought to investigate whether greater cognitive challenge while exergaming would yield differential outcomes in executive function and generalize to everyday functioning. Sixty-four community based older adults (mean age=82) were randomly assigned to pedal a stationary bike, while interactively engaging on-screen with: (1) a low cognitive demand task (bike tour), or (2) a high cognitive demand task (video game). Executive function (indices from Trails, Stroop and Digit Span) was assessed before and after a single-bout and 3-month exercise intervention. Significant group × time interactions were found after a single-bout (Color Trails) and after 3 months of exergaming (Stroop; among 20 adherents). Those in the high cognitive demand group performed better than those in the low cognitive dose condition. Everyday function improved across both exercise conditions. Pilot data indicate that for older adults, cognitive benefit while exergaming increased concomitantly with higher doses of interactive mental challenge.

Some new food for thought: the role of vitamin D in the mental health of older adults.

PubMed

Cherniack, E Paul; Troen, Bruce R; Florez, Hermes J; Roos, Bernard A; Levis, Silvina

2009-02-01

Vitamin D, a multipurpose steroid hormone vital to health, has been increasingly implicated in the pathology of cognition and mental illness. Hypovitaminosis D is prevalent among older adults, and several studies suggest an association between hypovitaminosis D and basic and executive cognitive functions, depression, bipolar disorder, and schizophrenia. Vitamin D activates receptors on neurons in regions implicated in the regulation of behavior, stimulates neurotrophin release, and protects the brain by buffering antioxidant and anti-inflammatory defenses against vascular injury and improving metabolic and cardiovascular function. Although additional studies are needed to examine the impact of supplementation on cognition and mood disorders, given the known health benefits of vitamin D, we recommend greater supplementation in older adults.

An integrated dementia intervention for Korean older adults.

PubMed

Kang, Hee-Young; Bae, Yeong-Suk; Kim, Eun-Hee; Lee, Kap-Soon; Chae, Myeong-Jeong; Ju, Ree-Aie

2010-12-01

Called dotage in Korea, dementia is primarily characterized by cognitive impairments. Secondary manifestations include mental-emotional problems, including depression. This study was designed to examine the effects of an integrated dementia intervention for Korean older adults. The intervention is composed of cognitive stimulation training, exercise, music, art, and horticultural therapy. Participants included 38 older adults with mild dementia. Twenty were assigned to the experimental group and 18 to the control group. Participants in the experimental group attended 18 program sessions. Significant differences were found postintervention between the two groups in measures of cognitive function, depression levels, and mental-emotional health. The findings indicate that this integrated dementia intervention can be applied to help older adults with mild dementia. Copyright 2010, SLACK Incorporated.

Gender differences in performance of script analysis by older adults.

PubMed

Helmes, E; Bush, J D; Pike, D L; Drake, D G

2006-12-01

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

Effects of Aging on the Neural Correlates of Successful Item and Source Memory Encoding

PubMed Central

Dennis, Nancy A.; Hayes, Scott M.; Prince, Steven E.; Madden, David J.; Huettel, Scott A.; Cabeza, Roberto

2009-01-01

To investigate the neural basis of age-related source memory (SM) deficits, young and older adults were scanned with fMRI while encoding faces, scenes, and face-scene pairs. Successful encoding activity was identified by comparing encoding activity for subsequently remembered versus forgotten items or pairs. Age deficits in successful encoding activity in hippocampal and prefrontal regions were more pronounced for SM (pairs) compared to item memory (faces and scenes). Age-related reductions were also found in regions specialized in processing faces (fusiform face area) and scenes (parahippocampal place area), but these reductions were similar for item and SM. Functional connectivity between the hippocampus and the rest of the brain was also affected by aging; whereas connections with posterior cortices were weaker in older adults, connections with anterior cortices including prefrontal regions were stronger in older adults. Taken together, the results provide a link between SM deficits in older adults and reduced recruitment of hippocampal and prefrontal regions during encoding. The functional connectivity findings are consistent with a posterior-anterior shift with aging (PASA), previously reported in several cognitive domains and linked to functional compensation. PMID:18605869

Exercise and nutritional interventions for improving aging muscle health.

PubMed

Forbes, Scott C; Little, Jonathan P; Candow, Darren G

2012-08-01

Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.

Managing daily life with age-related sensory loss: cognitive resources gain in importance.

PubMed

Heyl, Vera; Wahl, Hans-Werner

2012-06-01

This paper investigates the role of cognitive resources in everyday functioning, comparing visually impaired, hearing impaired, and sensory unimpaired older adults. According to arguments that cognitive resources are of increased importance and a greater awareness of cognitive restrictions exists among sensory impaired individuals, in particular among visually impaired individuals, we hypothesized differential relationships between resources and outcomes when comparing sensory impaired and sensory unimpaired older adults. Findings are based on samples of 121 visually impaired, 116 hearing impaired, and 150 sensory unimpaired older adults (M = 82 years). Results from a sample of 43 dual sensory impaired older adults are reported for comparison. Assessment relied on established instruments (e.g., WAIS-R, ADL/IADL). Structural equation modeling showed that cognitive resources and behavior-related everyday functioning were more strongly related in the sensory impaired groups as compared to the sensory unimpaired group. Cognitive resources and evaluation of everyday functioning were significantly linked only among the sensory impaired groups. When medical condition was controlled for, these effects persisted. It is concluded that both cognitive training as well as psychosocial support may serve as important additions to classic vision and hearing loss rehabilitation. PsycINFO Database Record (c) 2012 APA, all rights reserved

Androgen effects on skeletal muscle: implications for the development and management of frailty

PubMed Central

O’Connell, Matthew DL; Wu, Frederick CW

2014-01-01

Androgens have potent anabolic effects on skeletal muscle and decline with age in parallel to losses in muscle mass and strength. This loss of muscle mass and function, known as sarcopenia, is the central event in development of frailty, the vulnerable health status that presages adverse outcomes and rapid functional decline in older adults. The potential role of falling androgen levels in the development of frailty and their utility as function promoting therapies in older men has therefore attracted considerable attention. This review summarizes current concepts and definitions in muscle ageing, sarcopenia and frailty, and evaluates recent developments in the study of androgens and frailty. Current evidence from observational and interventional studies strongly supports an effect of androgens on muscle mass in ageing men, but effects on muscle strength and particularly physical function have been less clear. Androgen treatment has been generally well–tolerated in studies of older men, but concerns remain over higher dose treatments and use in populations with high cardiovascular risk. The first trials of selective androgen receptor modulators (SARMs) suggest similar effects on muscle mass and function to traditional androgen therapies in older adults. Important future directions include the use of these agents in combination with exercise training to promote functional ability across different populations of older adults, as well as more focus on the relationships between concurrent changes in hormone levels, body composition and physical function in observational studies. PMID:24457838

Alcohol and older drivers' crashes.

DOT National Transportation Integrated Search

2014-09-01

Researchers have examined the effects of alcohol consumption : on older adults functioning, and some have : addressed alcohols effects on older drivers crash risk. : Generally, the findings have shown that alcohol is less : likely to be a fa...

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults' chronic pain experiences.

PubMed

Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet; Beyers, Wim

2017-12-01

This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The level of physical activity affects the health of older adults despite being active

PubMed Central

Fernandez-Alonso, Lorena; Muñoz-García, Daniel; La Touche, Roy

2016-01-01

Health care in the ageing population is becoming a crucial issue, due to the quality of life. Physical activity, is of primary importance for older adults. This report compared the physical activity in two active older adults population with functionality, quality of life, and depression symptoms. A cross-sectional study was developed with 64 older adults. Physical activity was assessed through the Yale Physical Activity Survey for classification into a less activity (LA) group and a more activity (MA) group. Afterwards, the other health variables were measured through specific questionnaires: the quality of life with the EuroQol (EuroQol five dimensions questionnaire, EQ-5D), functionality with the Berg balance scale (BBS) and depression symptoms with the geriatric depression scale (GDS). There is a statistical significant difference between groups for the BBS (t=2.21; P=0.03, d=0.27). The Pearson correlation analysis shows in LA group a moderate correlation between the BBS and age (r=−0.539; P<0.01) and EQ-5D (r=0.480; P<0.01). Moreover, both groups had a moderate negative correlation between GDS and the the EQ-5D time trade-off (r=−0.543; P=0.02). Active older adults with different amounts of physical activity differ in the BBS. This functional score was higher in the MA group. When observing to quality of life, only the LA group was negatively associated with age while in both groups were associated with depression index. PMID:27419115

Aging and Visual Attention

PubMed Central

Madden, David J.

2007-01-01

Older adults are often slower and less accurate than are younger adults in performing visual-search tasks, suggesting an age-related decline in attentional functioning. Age-related decline in attention, however, is not entirely pervasive. Visual search that is based on the observer’s expectations (i.e., top-down attention) is relatively preserved as a function of adult age. Neuroimaging research suggests that age-related decline occurs in the structure and function of brain regions mediating the visual sensory input, whereas activation of regions in the frontal and parietal lobes is often greater for older adults than for younger adults. This increased activation may represent an age-related increase in the role of top-down attention during visual tasks. To obtain a more complete account of age-related decline and preservation of visual attention, current research is beginning to explore the relation of neuroimaging measures of brain structure and function to behavioral measures of visual attention. PMID:18080001

Pioglitazone is equally effective for diabetes prevention in older versus younger adults with impaired glucose tolerance.

PubMed

Espinoza, Sara E; Wang, Chen-Pin; Tripathy, Devjit; Clement, Stephen C; Schwenke, Dawn C; Banerji, Mary Ann; Bray, George A; Buchanan, Thomas A; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Stentz, Frankie B; Reaven, Peter D; DeFronzo, Ralph A; Musi, Nicolas

2016-12-01

To determine the efficacy of pioglitazone to prevent type 2 diabetes in older compared to younger adults with pre-diabetes. Six hundred two participants with impaired glucose tolerance (IGT) were randomized in double blind fashion to placebo or pioglitazone for diabetes prevention in the ACT NOW study (NEJM 364:1104-1115, 2011). Cox proportional hazard regression was used to compare time to development of diabetes over a mean of 2 years between older (≥61 years) and younger participants. We compared effects of pioglitazone versus placebo on metabolic profiles, inflammatory markers, adipokines, β cell function (disposition index), insulin sensitivity (Matsuda index), and body composition by ANOVA. Diabetes incidence was reduced by 85 % in older and 69 % in younger subjects (p = 0.41). β cell function (disposition index) increased by 35.0 % in the older and 26.7 % in younger subjects (p = 0.83). Insulin sensitivity (Matsuda index) increased by 3.07 (5.2-fold) in older and by 2.54 (3.8-fold) in younger participants (p = 0.58). Pioglitazone more effectively increased adiponectin in older versus younger subjects (22.9 ± 3.2 μg/mL [2.7-fold] vs. 12.7 ± 1.4 μg/mL [2.2-fold], respectively; p = 0.04). Younger subjects tended to have a greater increase in whole body fat mass compared to older subjects (3.6 vs. 3.1 kg; p = 0.061). Younger and older subjects had similar decreases in bone mineral density (0.018 ± 0.0071 vs. 0.0138 ± 0.021 g/cm 2 ). Younger and older pre-diabetic adults taking pioglitazone had similar reductions in conversion to diabetes and older adults had similar or greater improvements in metabolic risk factors, demonstrating that pioglitazone is useful in preventing diabetes in older adults.

Identifying the Potential for Robotics to Assist Older Adults in Different Living Environments

PubMed Central

Mitzner, Tracy L.; Chen, Tiffany L.; Kemp, Charles C.; Rogers, Wendy A.

2014-01-01

As the older adult population grows and becomes more diverse, so will their needs and preferences for living environments. Many adults over 65 years of age require some assistance [1, 2]; yet it is important for their feelings of well-being that the assistance not restrict their autonomy [3]. Not only is autonomy correlated with quality of life [4], autonomy enhancement may improve functionality [2, 5]. The goal of this paper is to provide guidance for the development of technology to enhance autonomy and quality of life for older adults. We explore the potential for robotics to meet these needs. We evaluated older adults' diverse living situations and the predictors of residential moves to higher levels of care in the United States. We also examined older adults' needs for assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and medical conditions when living independently or in a long-term care residence. By providing support for older adults, mobile manipulator robots may reduce need-driven, undesired moves from residences with lower levels of care (i.e., private homes, assisted living) to those with higher levels of care (i.e., skilled nursing). PMID:24729800

Health Literacy, Health Disparities, and Sources of Health Information in U.S. Older Adults.

PubMed

Cutilli, Carolyn Crane; Simko, Lynn C; Colbert, Alison M; Bennett, Ian M

Low health literacy in older adults has been associated with poor health outcomes (i.e., mortality, decreased physical and cognitive functioning, and less preventive care utilization). Many factors associated with low health literacy are also associated with health disparities. Interaction with healthcare providers and sources of health information are influenced by an individual's health literacy and can impact health outcomes. This study examined the relationships between health literacy, sources of health information, and demographic/background characteristics in older adults (aged 65 years and older) related to health literacy and disparities. This descriptive, correlational study is a secondary analysis of the 2003 National Assessment of Adult Literacy, a large-scale national assessment. Older adults with lower health literacy have less income and education, rate their health as poor or fair, have visual or auditory difficulties, need help filling out forms, reading newspaper, or writing notes, and use each source of health information less (print and nonprint). Many of these characteristics and skills are predictive of health literacy and associated with health disparities. The results expand our knowledge of characteristics associated with health literacy and sources of health information used by older adults. Interventions to improve health outcomes including health disparities can focus on recognizing and meeting the health literacy demands of older adults.