Fitch, Margaret I.; McAndrew, Alison; Harth, Tamara
Objective: Cancer patients have reported that information plays a significant role in their capacity to cope with cancer and manage the consequences of treatment. This study was undertaken to identify the importance older adults receiving cancer treatment assign to selected types of cancer-related information, their satisfaction with the cancer-related information they received, and the barriers to effective information provision for this age group. Methods: This study was conducted in two phases with separate samples. Six hundred and eighty-four older cancer patients receiving treatment completed a standardized survey and 39 completed a semi-structured interview to gather perspectives about cancer-related information. Data were analyzed for 65-79 years and 80+ year groups. Results: Information topics about their medical condition, treatment options, and side effects of treatment were rated as most important by the older cancer patients. Women assigned a higher importance ratings than men to information overall (t = 4.8, P < 0.01). Although participants were generally satisfied with the information, they received many described challenges they experienced in communicating with health care professionals because of the medical language and fast pace of speaking used by the professionals. Conclusions: The older cancer patients in this study endorsed the same topics of cancer-related information as most important as has been reported in studies for other age groups. However, this older group recommended that, during their interactions with older individuals, health care professionals use fewer medical words, speak at a slower pace, and provide written information in addition to the actual conversation. PMID:27981110
Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.
Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…
Russell, David G.; Kimura, Melissa N.; Cowie, Harriet R.; de Groot, Caroline M.M.; McMinn, Elise A.P.; Sherson, Matthew W.
Objective The purpose of this case series is to report on symptomatic and quality of life (QoL) changes in 7 older adult chiropractic patients who were receiving care using Activator Methods Chiropractic Technique (AMCT). Clinical Features Seven patients were selected from 2 chiropractic offices in Auckland, New Zealand. Patients were included if they were older adults receiving AMCT care and for whom at least 2 QoL assessments had been performed. The patients, aged 69-80 years, primarily received care for a variety of musculoskeletal complaints. Intervention and Outcomes The patients reported improvements in their presenting complaints as well as a number of nonmusculoskeletal symptoms. Each patient demonstrated clinical improvements in their RAND 36-Item Short Form Health Survey (SF-36) results. The average improvement in QoL measured using a SF-36 questionnaire was 8.0 points in the physical component and 4.1 points in the mental component. Four cases had a second progress evaluation using the SF-36 and showed an overall improvement of 5.2 in the physical and 9.8 in the mental components from baseline. Conclusion This case series describes an improvement in QoL, as measured by the SF-36 instrument, as well as subjectively reported improvements in both musculoskeletal and nonmusculoskeletal symptoms in 7 older adults receiving chiropractic care. PMID:27069434
Chapin, Rosemary K.; Sergeant, Julie F.; Landry, Sarah; Leedahl, Skye N.; Rachlin, Roxanne; Koenig, Terry; Graham, Annette
Purpose: Stigma and lack of access to providers create barriers to mental health treatment for older adults living in the community. In order to address these barriers, we developed and evaluated a peer support intervention for older adults receiving Medicaid services. Design and Methods: Reclaiming Joy is a mental health intervention that pairs…
Lee, Den-Ching A.; Brown, Ted; Stolwyk, Rene; O'Connor, Daniel W.; Haines, Terry P.
Background: Older adults experience a high rate of falls when they transition to community-living following discharge from hospital. Objectives: To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe…
Tyler, Kimberly A.
The current study uses longitudinal data from the 1993 U.S. Midwest floods to examine the influence of support received and support provision on changes in perceived social support among older adults exposed to an acute stressor. Results indicated that flood exposure and higher levels of social support at Time 1 were positively associated with…
Klepin, Heidi D.; Geiger, Ann M.; Tooze, Janet A.; Kritchevsky, Stephen B.; Williamson, Jeff D.; Ellis, Leslie R.; Levitan, Denise; Pardee, Timothy S.; Isom, Scott; Powell, Bayard L.
OBJECTIVES To test the feasibility and utility of a bedside geriatric assessment (GA) to detect impairment in multiple geriatric domains in older adults initiating chemotherapy for acute myelogenous leukemia (AML). DESIGN Prospective observational cohort study. SETTING Single academic institution. PARTICIPANTS Individuals aged 60 and older with newly diagnosed AML and planned chemotherapy. MEASUREMENTS Bedside GA was performed during inpatient exmination for AML. GA measures included the modified Mini-Mental State Examination; Center for Epidemiologic Studies Depression Scale; Distress Thermometer, Pepper Assessment Tool for Disability (includes self- reported activities of daily living (ADLs), instrumental ADLs, and mobility questions); Short Physical Performance Battery (includes timed 4-m walk, chair stands, standing balance); grip strength, and Hematopoietic Cell Transplantation Comorbidity Index. RESULTS Of 54 participants (mean age 70.8 ± 6.4) eligible for this analysis, 92.6% completed the entire GA battery (mean time 44.0 ± 14 minutes). The following impairments were detected: cognitive impairment, 31.5%; depression, 38.9%; distress, 53.7%; impairment in ADLs, 48.2%; impaired physical performance, 53.7%; and comorbidity, 46.3%. Most were impaired in one (92.6%) or more (63%) functional domains. For the 38 participants rated as having good performance status according to standard oncologic assessment (Eastern Cooperative Oncology Performance Scale score ≤1), impairments in individual GA measures ranged from 23.7% to 50%. Significant variability in cognitive, emotional, and physical status was detected even after stratification according to tumor biology (cytogenetic risk group classification). CONCLUSION Inpatient GA was feasible and added new information to standard oncology assessment, which may be important for stratifying therapeutic risk in older adults with AML. PMID:22091497
... and Resources Clinical Trials Share Older Adults and Mental Health Overview It’s just as important for an older ... this helpline, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), to receive immediate counseling. Calling ...
Klepin, Heidi D; Geiger, Ann M; Tooze, Janet A; Kritchevsky, Stephen B; Williamson, Jeff D; Pardee, Timothy S; Ellis, Leslie R; Powell, Bayard L
We investigated the predictive value of geriatric assessment (GA) on overall survival (OS) for older adults with acute myelogenous leukemia (AML). Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution. Pretreatment GA included evaluation of cognition, depression, distress, physical function (PF) (self-reported and objectively measured), and comorbidity. Objective PF was assessed using the Short Physical Performance Battery (SPPB, timed 4-m walk, chair stands, standing balance) and grip strength. Cox proportional hazards models were fit for each GA measure as a predictor of OS. Among 74 patients, the mean age was 70 years, and 78.4% had an Eastern Cooperative Oncology Group (ECOG) score ≤ 1. OS was significantly shorter for participants who screened positive for impairment in cognition and objectively measured PF. Adjusting for age, gender, ECOG score, cytogenetic risk group, myelodysplastic syndrome, and hemoglobin, impaired cognition (Modified Mini-Mental State Exam < 77) and impaired objective PF (SPPB < 9) were associated with worse OS. GA methods, with a focus on cognitive and PF, improve risk stratification and may inform interventions to improve outcomes for older AML patients.
Geiger, Ann M.; Tooze, Janet A.; Kritchevsky, Stephen B.; Williamson, Jeff D.; Pardee, Timothy S.; Ellis, Leslie R.; Powell, Bayard L.
We investigated the predictive value of geriatric assessment (GA) on overall survival (OS) for older adults with acute myelogenous leukemia (AML). Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution. Pretreatment GA included evaluation of cognition, depression, distress, physical function (PF) (self-reported and objectively measured), and comorbidity. Objective PF was assessed using the Short Physical Performance Battery (SPPB, timed 4-m walk, chair stands, standing balance) and grip strength. Cox proportional hazards models were fit for each GA measure as a predictor of OS. Among 74 patients, the mean age was 70 years, and 78.4% had an Eastern Cooperative Oncology Group (ECOG) score ≤ 1. OS was significantly shorter for participants who screened positive for impairment in cognition and objectively measured PF. Adjusting for age, gender, ECOG score, cytogenetic risk group, myelodysplastic syndrome, and hemoglobin, impaired cognition (Modified Mini-Mental State Exam < 77) and impaired objective PF (SPPB < 9) were associated with worse OS. GA methods, with a focus on cognitive and PF, improve risk stratification and may inform interventions to improve outcomes for older AML patients. PMID:23550038
Tyler, Kimberly A
The current study uses longitudinal data from the 1993 U.S. Midwest floods to examine the influence of support received and support provision on changes in perceived social support among older adults exposed to an acute stressor. Results indicated that flood exposure and higher levels of social support at Time 1 were positively associated with both receiving social support and providing social support specific to the food. Individuals with higher levels of support provision and received support in turn reported higher levels of perceived support post disaster. Women were more likely to have received flood specific support and to have perceived higher social support post flood. This study provides support and elaboration of earlier findings that link disaster exposure to post-disaster changes in perceived social support.
While racial disparity in the use of hospice care by older African Americans is widely acknowledged, little is known about the values that they consider as important in receiving health care services along with direct experiences with having these values respected by hospice care providers. Using individual, face-to-face interviews, data were collected directly from 28 African American hospice patients about their experiences in hospice care. Content analysis was used to identify and categorize themes from multiple readings of the qualitative data. Resulting themes included: dying at home, open communications, independent decision-making, autonomy in daily life, unwillingness to be a burden, and relationships. Through the initial assessment, value preferences can be explored and then shared with hospice team members to ensure that services are provided in such a way that their values and preferences are respected.
Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret
Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support. PMID:19327033
Stickle, Fred; Onedera, Jill D.
The purpose of this article is to address selected aspects of depression in older adults. Specifically, symptoms, risk factors, diagnosis, and interventions for depression in older adults are reviewed.
Healy, Michael R.; Light, Leah L.; Chung, Christie
In 3 experiments, young and older adults studied lists of unrelated word pairs and were given confidence-rated item and associative recognition tests. Several different models of recognition were fit to the confidence-rating data using techniques described by S. Macho (2002, 2004). Concordant with previous findings, item recognition data were best…
Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.
For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…
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... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...
Kemper, Susan; And Others
Investigates older adults' reading comprehension skills through syntactic measures and measures of sentence content. Analyzes the apparent reading difficulties of older adults. Provides guidelines for the preparation of prose materials for older readers. (HB)
In an effort to improve the quality of life for area senior citizens, De Anza College has established an older adult education program which combines adaptive physical education with holistic health care principles to instruct students in relaxation, nutrition, and physical activity. Classes are held in convalescent hospitals, retirement homes,…
Pruett, Diane Milhan, Ed.; And Others
Dance programs for older adults that encourage exercise and socializing are described in six articles. Program guidelines of the American Alliance Committee on Aging are explained, and other articles emphasize a movement education approach that may involve intergenerational contact. A dance program held in a worship setting is also discussed. (PP)
... Children Newly Diagnosed: Older Adults Related Topics on AIDS.gov Aging with HIV/AIDS National HIV/AIDS ... an Emerging Challenge Last revised: 07/10/2015 AIDS.gov HIV/AIDS Basics • Federal Resources • Using New ...
Mutevedzi, Portia C.; Rodger, Alison J.; Kowal, Paul; Nyirenda, Makandwe; Newell, Marie-Louise
Background The association of HIV with chronic morbidity and inflammatory markers (cytokines) in older adults (50+years) is potentially relevant for clinical care, but data from African populations is scarce. Objective To examine levels of chronic morbidity by HIV and ART status in older adults (50+years) and subsequent associations with selected pro-inflammatory cytokines and body mass index. Methods Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina), arthritis, stroke, hypertension, asthma and diabetes) and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha) by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance. Results Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92) of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR) of having elevated inflammation markers of IL6 (>1.56pg/mL) was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21) and not on (aPOR 1.94; 95%CI: 1.11-3.41) ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004) of having non-clinically significant raised hsCRP levels(>1ug/mL); ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9ug/mL;p=0.008). Conclusions Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services
Petkus, Andrew J.; Wetherell, Julie Loebach
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…
Cloyd, Elizabeth; Dyer, Carmel B
The plight of older adults during catastrophic events is a societal concern. Older persons have an increased prevalence of cognitive disorders, chronic illnesses, and mobility problems that limit their ability to cope. These disorders may result in a lack of mental capacity and the ability to discern when they should evacuate or resolve problems encountered during a catastrophe. Some older persons may have limited transportation options, and many of the elderly survivors are at increased risk for abuse, neglect, and exploitation. Recommendations for future catastrophic events include the development of a federal tracking system for elders and other vulnerable adults, the designation of separate shelter areas for elders and other vulnerable adults, and involvement of gerontological professionals in all aspects of emergency preparedness and care delivery, including training of frontline workers. Preparation through preevent planning that includes region-specific social services, medical and public health resources, volunteers, and facilities for elders and vulnerable adults is critical. Elders need to be protected from abuse and fraud during catastrophic events. A public health triage system for elders and other vulnerable populations in pre- and postdisaster situations is useful, and disaster preparedness is paramount. Communities and members of safety and rescue teams must address ethical issues before an event. When older adults are involved, consideration needs to be given to triage decision making, transporting those who are immobile, the care of older adults who receive palliative care, and the equitable distribution of resources. Nurses are perfectly equipped with the skills, knowledge, and training needed to plan and implement disaster preparedness programs. In keeping with the tradition of Florence Nightingale, nurses can assume several crucial roles in disaster preparedness for older adults. Nurses possess the ability to participate and lead community
Chalise, Hom Nath; Saito, Tami; Takahashi, Miyako; Kai, Ichiro
Social support, subjective well-being (SWB), and loneliness are issues of central importance in research concerned with the quality of life (QOL) of elderly people in the 21st century. However, very little is known about the situation in low-income countries such as in Nepal. The purpose of this paper is to identify the relationships significant in social support (received (SSR) and provided (SSP)) and analyze their connections with loneliness and SWB. The subjects, not suffering from dementia, were 60 years and above living in Kathmandu city. The data was analyzed using logistic regression with some confounding variables controlled. The results indicate that loneliness is high and SWB is low amongst Nepalese older adults. SSR from children living together and SSP to spouse, children living together and friends and neighbors reduce loneliness. SSP to children living apart increases SWB-life satisfaction. SSR from children living together and SSP to children (living together and apart) increases SWB-life stability. However, SSP to relatives reduces SWB-life satisfaction and SSR from relatives reduces SWB-life stability in Nepalese older adult men.
... Quitting Smoking for Older Adults Quitting When You’re Older If you’re older, you may wonder if it’s too late ... it can be challenging to quit when you're older, there are proven ways to do it. ...
... training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet Share ... older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking steps ...
Tariq, Syed H
Fecal incontinence is an underreported and underappreciated problem in older adults. Although fecal incontinence is more common in women than in men, this difference narrows with aging. Risk factors that lead to the development of fecal incontinence include dementia, physical disability, and fecal impaction. Treatment options include medical or conservative therapy for older adults who have mild incontinence, and surgical options can be explored in selected older adults if surgical expertise is available.
Miller, Hayley J
Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further. [Journal of Gerontological Nursing, 41(9), 8-13.].
Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.
Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the…
Roberson, Donald N., Jr.
This summary of adult development covers a wide range of authors. Adult development is one way of understanding how the internal and external changes in our lives have an impact on learning. Of particular importance in this work are the developmental issues of older adults. I present various theories of adult development such as linear and…
Renvert, Stefan; Persson, G Rutger
Within the next 40 years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health-care providers and governments worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥ 80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio-economic factors, general health status and multiple-drug therapies will, in the future, be an important part of the management of periodontitis in older adults.
... Stroke Urinary Incontinence Related Documents PDF Choosing Wisely: Diabetes Tests and Treatments Download Related Video Join our e-newsletter! Aging & Health A to Z Diabetes Unique to Older Adults This section provides information ...
... of fractures if needed annual flu shots. Protein-Calorie Malnutrition Many older adults living at home eat ... so serious that a condition known as protein-calorie malnutrition (PCM) develops. Sometimes, PCM occurs after a ...
Teaster, Pamela B.; Roberto, Karen A.
Purpose: The purpose of this study was to develop a profile of sexual abuse cases among adults aged 60 and older receiving attention from Adult Protective Services units in Virginia over a 5-year period. Design and Methods: We used bivariate analysis to characterize older adults (n = 82) experiencing sexual abuse and the circumstances of the…
Umberger, Reba; Callen, Bonnie; Brown, Mary Lynn
Severe sepsis may be underrecognized in older adults. Therefore, the purpose of this article is to review special considerations related to early detection of severe sepsis in older adults. Normal organ changes attributed to aging may delay early detection of sepsis at the time when interventions have the greatest potential to improve patient outcomes. Systems are reviewed for changes. For example, the cardiovascular system may have a limited or absent compensatory response to inflammation after an infectious insult, and the febrile response and recruitment of white blood cells may be blunted because of immunosenescence in aging. Three of the 4 hallmark responses (temperature, heart rate, and white blood cell count) to systemic inflammation may be diminished in older adults as compared with younger adults. It is important to consider that older adults may not always manifest the typical systemic inflammatory response syndrome. Atypical signs such as confusion, decreased appetite, and unsteady gait may occur before sepsis related organ failure. Systemic inflammatory response syndrome criteria and a comparison of organ failure criteria were reviewed. Mortality rates in sepsis and severe sepsis remain high and are often complicated by multiple organ failures. As the numbers of older adults increase, early identification and prompt treatment is crucial in improving patient outcomes.
Schopfer, David W; Forman, Daniel E
The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy.
Gill, Lydia E.; Bartels, Stephen J.; Batsis, John A.
As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss must be considered critically given the dangers of sarcopenia (a condition that occurs when muscle mass and quality is lost), the increase risk of hip fracture with weight loss, and the association between reduced mortality and increased BMI in older adults. This overview highlights the challenges and implications of measuring adiposity in older adults, the dangers and benefits of weight loss in this population, and provides an overview of the new Medicare Obesity Benefit. In addition we provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice. PMID:26627496
Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole
Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488
... slowly than in younger adults. To better manage depression at home: Exercise regularly, if the provider says it is OK. Surround yourself with caring, positive people and do fun activities. ... signs of depression, and know how to react if these occur. ...
... the most ppular form of exercise among older adults and it's a great choice. What can walking do for you? strengthen muscles help prevent weight gain lower risks of heart disease, stroke, diabetes, and osteoporosis improve balance lower the likelihood of falling If ...
Bloesch, Emily K.; Abrams, Richard A.
Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in older adults. Although the…
Wingfield, Sarah A; Heflin, Mitchell T
Cancer screening is an important tool for reducing morbidity and mortality in the elderly. In this article, performance characteristics of commonly used screening tests for colorectal, lung, prostate, breast, and cervical cancers are discussed. Guidelines are emphasized and key issues to consider in screening older adults are highlighted.
According to recent census figures, 10% of today's population are over 65 years old. It has often been stated that individual learning needs and capabilities decline with age. To challenge this idea, a study was conducted to gather information about older adults, their learning interests, activities, and obstacles. Four hypotheses were tested…
Shulik, Richard N.
Introduces the faith development paradigm of James Fowler, describing six stages of faith development: intuitive-projective faith, mythic-literal faith, synthetic-conventional faith, individuating-reflective faith, conjunctive faith, and universalizing faith. Reviews one research project in which Fowler's paradigm was applied to older adults.…
Gammack, Julie K
Exposure to bright light suppresses the production of melatonin and contributes to the regulation of the circadian rhythm. Because of environmental and medical conditions, older adults are less likely than younger adults to receive the prolonged, high intensity, daily bright light needed to promote a satisfactory sleep-wake cycle. The best available evidence for bright light therapy is in the management of seasonal affective disorder, which is relatively infrequent in the elderly population. For older adults with chronic insomnia, dementia, and nonseasonal depression, there is no consensus on the optimum treatment protocol for bright light therapy. However, in addition to sleep improvement, bright light therapy may be used to reduce unwanted behavioral and cognitive symptoms associated with dementia and depression in the elderly.
... Talk to your doctor about whether you have osteoporosis. Read More "Preventing Falls" Articles Preventing Falls / Great Help for Older Adults / How Can Older Adults Prevent Falls? / Home Improvements ...
This paper uses the social cognitive theory model to review the literature on older adult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by older adults, followed by casino games. Older adults take trips to casinos to socialize, find excitement, and win…
Horwath, Caroline C.
Discusses specific goals of nutrition education for older adults and high-risk groups within the elderly population through review of three crucial areas: current knowledge of eating patterns, nutrient intake, and supplement use of older adults; existing information on multiple influences on eating habits of older adults; and potential benefits…
Alrwaily, Muhammad; Whitney, Susan L
The role of rehabilitation for treatment of older adults with dizziness and balance disorders is reviewed. Theories related to functional recovery from peripheral and central vestibular disorders are presented. Suggestions on which older adults might benefit from vestibular rehabilitation therapy are presented. Promising innovative rehabilitation strategies and technologies that might enhance recovery of the older adult with balance dysfunction are discussed.
Gonzales, Ernest; Morrow-Howell, Nancy; Gilbert, Pat
Given the growth in the number of older adults and the ageist attitudes many in the health care profession hold, interventions aimed at improving health professionals' attitudes toward older adults are imperative. Vital Visionaries is an intergenerational art program designed to improve medical students' attitudes toward older adults. Participants…
Lin, Frank R; Chien, Wade W; Li, Lingsheng; Clarrett, Danisa M; Niparko, John K; Francis, Howard W
Cochlear implants allow individuals with severe to profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation (CI) is approximately 150,000 and will continue to increase with the aging of the population. Should CI be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12-year experience with CI in adults aged ≥60 years (n = 445) at Johns Hopkins Medical Institutions to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that CI in adults aged ≥60 years consistently improved speech understanding scores, with a mean increase of 60.0% (SD 24.1) on HINT (Hearing in Noise Test) sentences in quiet. The magnitude of the gain in speech scores was negatively associated with age at implantation, such that for every increasing year of age at CI the gain in speech scores was 1.3 percentage points less (95% confidence interval [95% CI], 0.6-1.9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40% and 60%) had significantly greater post-CI speech scores by a mean of 10.0 percentage points (95% CI, 0.4-19.6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after CI, with possible implications for current United States Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take
Pelletier, Allen L; Rojas-Roldan, Ledy; Coffin, Janis
Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts. Vitamin supplements can delay the progression of age-related macular degeneration. Intravitreal injection of a vascular endothelial growth factor inhibitor can preserve vision in the neovascular form of macular degeneration. Medicated eye drops reduce intraocular pressure and can delay the progression of vision loss in patients with glaucoma, but adherence to treatment is poor. Laser trabeculoplasty also lowers intraocular pressure and preserves vision in patients with primary open-angle glaucoma, but long-term studies are needed to identify who is most likely to benefit from surgery. Tight glycemic control in adults with diabetes slows the progression of diabetic retinopathy, but must be balanced against the risks of hypoglycemia and death in older adults. Fenofibrate also slows progression of diabetic retinopathy. Panretinal photocoagulation is the mainstay of treatment for diabetic retinopathy, whereas vascular endothelial growth factor inhibitors slow vision loss resulting from diabetic macular edema. Preoperative testing before cataract surgery does not improve outcomes and is not recommended.
Olatayo, Adeoti Adekunle; Kubwa, Ojo Osaze; Adekunle, Ajayi Ebenezer
Introduction Oftentimes the older adults are assumed to be asexual as few studies explore into the sexuality of this age group worldwide and even in Nigeria. It is an important aspect of quality of life which is often neglected by people in this age group, attending physicians and the society as a whole. The study was aimed at determining the perception of older adults about sexuality, identify the factors that could militate against sexuality and fill any void in information in this regard. Methods Descriptive study conducted in one hundred older adults. A semi-structured questionnaire was administered to consenting participants between 1st of September 2013 and 31st of March 2014. Results Mean age of respondents was 66.42± 5.77 years. Seventy-eight percent of the male respondents considered engaging in sexual activity as safe compared to 45.8% of the female respondents. More of the women (33.3%) regarded sexuality in the older adults as a taboo when compared to the men (5.4%). However, the men were more favourably disposed to discussing sexual problems than the women with their spouses (42% vs 20%) and Physicians (23.2% vs 0.0%). Major factors responsible for sexual inactivity were participants’ medical ailments (65%), partners’ failing health (15%) as well as anxiety about sexual performance (25%) in the men and dyspareunia (25%) in women. Conclusion There is an urgent need to correct the misconception about sexuality in this age group especially among the women and for the physicians to explore the sexual history of every patient. PMID:26977224
Hermans, Heidi; Evenhuis, Heleen M
Multimorbidity may be related to the supposed early aging of people with intellectual disabilities (ID). This group may suffer more often from multimorbidity, because of ID-related physical health conditions, unhealthy lifestyle and metabolic effects of antipsychotic drug use. Multimorbidity has been defined as two or more chronic conditions. Data on chronic conditions have been collected through physical assessment, questionnaires, and medical files. Prevalence, associated factors and clusters of multimorbidity have been studied in 1047 older adults (≥ 50 years) with ID. Multimorbidity was prevalent in 79.8% and associated with age and severe/profound ID. Four or more conditions were prevalent in 46.8% and associated with age, severe/profound ID and Down syndrome. Factor analyses did not reveal a model for disease-clusters with good fit. Multimorbidity is highly prevalent in older adults with ID. Multimorbidity should receive more attention in research and clinical practice for targeted pro-active prevention and treatment.
Davis, Sara D; Meade, Michelle L
In the present study, we examined the impacts of participant age and confederate age on social memory processes. During a collaborative recall phase, young and older adult participants were exposed to the erroneous memory reports of a young or an older adult confederate. On a subsequent individual recall test, young and older adult participants were equally likely to incorporate the confederates' erroneous suggestions into their memory reports, suggesting that participant age had a minimal effect on social memory processes. However, confederate age did have a marked effect: Young adult participants were less likely to incorporate misleading suggestions from older adult confederates and less likely to report "remembering" items suggested by older adult confederates. Critically, older adult participants were also less likely to incorporate misleading information from fellow older adult confederates. Both young and older adult participants discounted older adult confederates' contributions to a memory test.
Sonni, Akshata; Spencer, Rebecca M C
In a recent study, we demonstrated that sleep-dependent consolidation of declarative memories is preserved in older adults. The present study examined whether this benefit of sleep for declarative learning in older adults reflects a passive role of sleep in protecting memories from decay or an active role in stabilizing them. Young and older adults learned a visuospatial task, and recall was probed after sleep or wake. Although a reduction in performance was observed after sleep and wake, task-related interference before recall had a larger detriment on performance in the wake condition. This was true for young and high performing older adults only. Low performing older adults did not receive a benefit of sleep on the visuospatial task. Performance changes were associated with early night nonrapid eye movement sleep in young adults and with early night rapid eye movement sleep in high performing older adults. These results demonstrate that performance benefits from sleep in older adults as a result of an active memory stabilization process; importantly, the extent of this benefit of sleep is closely linked to the level of initial acquisition of the episodic information in older adults.
Gonzales, Ernest; Morrow-Howell, Nancy; Gilbert, Pat
Given the growth in the number of older adults and the ageist attitudes many in the health care profession hold, interventions aimed at improving health professionals' attitudes toward older adults are imperative. Vital Visionaries is an intergenerational art program designed to improve medical students' attitudes toward older adults. Participants met for four 2-hour sessions at local art museums to create and discuss art. Three hundred and twenty-eight individuals (112 treatment group, 96 comparison, 120 older adults) in eight cities participated in the program and evaluation. Participants completed pre-and postsurveys that captured their attitude toward older adults, perception of commonality with older adults, and career plans. Findings suggest that medical students' attitudes toward old adults were positive at pretest. However, Vital Visionary students became more positive in their attitudes toward older adults at posttest (p < .001), with a moderate effect size, G = .60, and they felt they had more in common with older adults at posttest (p < .001), with a moderate effect size, G = .64. The program did not influence their career plans (p = .35). Findings from this demonstration project suggest that socializing medical students with healthy older adults through art programs can foster positive attitudes and enhance their sense of commonality with older adults.
Petkus, Andrew J; M.A; Wetherell, Julie Loebach
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for mental and behavioral health problems are empirically supported with older adults and that mental health professionals are aware of the special needs of older adult populations. Acceptance and Commitment Therapy (ACT) is an emerging approach to the treatment of distress. The purpose of this article is to provide a rationale for using ACT with older adults based on gerontological theory and research. We also review research on ACT-related processes in later life. We present a case example of an older man with depression and anxiety whom we treated with ACT. Finally, we describe treatment recommendations and important adaptations that need to be considered when using ACT with older adults and discuss important areas for future research. PMID:26997859
Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B
Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies.
Butrous, Hoda; Hummel, Scott L
Heart failure (HF) is a leading cause of morbidity, hospitalization, and mortality in older adults and a growing public health problem placing a huge financial burden on the health care system. Many challenges exist in the assessment and management of HF in geriatric patients, who often have coexisting multimorbidity, polypharmacy, cognitive impairment, and frailty. These complex "geriatric domains" greatly affect physical and functional status as well as long-term clinical outcomes. Geriatric patients have been under-represented in major HF clinical trials. Nonetheless, available data suggest that guideline-based medical and device therapies improve morbidity and mortality. Nonpharmacologic strategies, such as exercise training and dietary interventions, are an active area of research. Targeted geriatric evaluation, including functional and cognitive assessment, can improve risk stratification and guide management in older patients with HF. Clinical trials that enroll older patients with multiple morbidities and HF and evaluate functional status and quality of life in addition to mortality and cardiovascular morbidity should be encouraged to guide management of this age group.
In 1999 we proposed a Modified Food Guide Pyramid for 70+ Adults. It has been extensively used in a variety of settings and formats to highlight the unique dietary challenges of older adults. We now propose a Modified MyPyramid for Older Adults in a format consistent with the MyPyramid graphic. I...
Kalapatapu, Raj K; Sullivan, Maria A
The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This paper will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested.
Frederick, Delia E
This article elicits why critical care nurses need to become aware of the pulmonary issues of older adults. The population of older adults is increasing. Older adults undergo anatomic and physiologic changes of the protective mechanisms of the pulmonary system. These changes alter the rate and effort of breathing. Speech is slowed because of expiratory strength effort. Cognition changes may be the only indication of impaired oxygenation. Bedside nursing care provides protection from pulmonary complications. Health behaviors of smoking cessation, oral hygiene, and exercise promote pulmonary health even in older adults.
Manafo, Elizabeth; Wong, Sharon
Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…
Haber, David; Rhodes, Darson
Purpose: Health educators used health contracts with sedentary older adults for the purpose of increasing exercise or physical activity. Design and Methods: Two health educators helped 25 sedentary older adults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully…
Phillips, Louise H.; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley
Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are…
Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.
The Saskatchewan Older Adult Literacy Survey involved 16 literacy programs offered by the regional colleges, public libraries, and technical institutes throughout the province of Saskatchewan, Canada. The 2-month survey acquired information for an overview of the current state of older adults and literacy in Saskatchewan through mailed…
Lacks, Patricia; Storandt, Martha
Provides normative data on the Bender Gestalt Test (BGT) with a sample of 334 normal older adults. Showed that these older adults do not perform on the BGT in a manner that can be called brain damaged. Use of the cut-off score developed with younger persons appears appropriate. (Author)
Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel
This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…
Domina, Tanya; Koch, Kathryn
Results of a study to examine the recycling practices and needs of older adults (n=217) indicated that older adults do recycle traditional materials, but need accommodations for physical limitations. They report textile recycling as time consuming and difficult and used donations to religious organizations as their principal means of textile…
Wurtele, Sandy K.; Maruyama, LaRae
Research suggests that university students tend to hold negative attitudes about older adults. However, there is some evidence to suggest that these ageist attitudes can be challenged and changed through curricular intervention. The current study was designed to determine whether the "Activities of Older Adults" exercise as part of a…
Wolf, Mary Alice
This chapter examines the potential for personal growth, development, and learning of older adult women who will have many productive years in the workforce. What implications are there for adult education communities who will interact with these older women? How do they adapt to the educational environment, and what social support will enable…
Notes characteristics of older adults at high risk for suicide (male, living alone, living in low-income transient urban area, depression). Provides converging perspectives on death and suicide from standpoints of external observer and older adult. Interprets statistical pattern and critiques current policy proposals for limiting society's…
Kump, Sonja; Krasovec, Sabina Jelenc
Educating older adults (in the so-called third age) is becoming an increasingly important activity for the elderly, above all because it empowers them, while at the same time reducing their social exclusion. The aim of this paper is to closely examine the actual state of affairs and the education possibilities for older adults in Slovenia. The…
Decaria, J E; Sharp, C; Petrella, R J
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
Patel, Kushang V
Anemia is a common, multifactorial condition among older adults. The World Health Organization (WHO) definition of anemia (hemoglobin concentration <12 g/dL in women and <13 g/dL in men) is most often used in epidemiologic studies of older adults. More than 10% of community-dwelling adults age 65 years and older has WHO-defined anemia. After age 50 years, prevalence of anemia increases with advancing age and exceeds 20% in those 85 years and older. In nursing homes, anemia is present in 48% to 63% of residents. Incidence of anemia in older adults is not well characterized. Among older adults with anemia, approximately one third have evidence of iron, folate, and/or vitamin B(12) deficiency, another third have renal insufficiency and/or chronic inflammation, and the remaining third have anemia that is unexplained. Several studies demonstrate that anemia is associated with poorer survival in older adults. This review details the distribution and consequences of anemia in older adults and identifies future epidemiologic research needs.
Heinz, Melinda; Martin, Peter; Margrett, Jennifer A; Yearns, Mary; Franke, Warren; Yang, Hen-I; Wong, Johnny; Chang, Carl K
Changes and advancements in technology have the potential to benefit older adults by promoting independence and increasing the ability to age in place. However, older adults are less likely to adopt new technology unless they see benefits to themselves. This study assessed the perceptions of 30 older adults in the Midwest concerning technology via three separate focus groups (i.e., independent apartment complex, a rural community, exercise program participants), which addressed a need in the literature (i.e., inclusion of oldest-old and rural individuals). The focus group questions included items such as what technology older adults currently used, desired improvements in technology, and the greatest challenges participants were facing or would face in the future. Overall, older adults were enthusiastic about learning new forms of technology that could help them maintain their independence and quality of life. Five themes emerged from all three focus groups: (a) Frustrations, Limitations, and Usability Concerns; (b) Transportation; (c) Help and Assistance; (d) Self-Monitoring; and (e) Gaming. The themes have important implications for future technology developed for older adults; in particular, older adults were willing and eager to adopt new technology when usefulness and usability outweighed feelings of inadequacy.
Sullivan, Maria A.
The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This article will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested. PMID:20958847
Populations are aging and the prevalence of diabetes mellitus is increasing tremendously. The number of older people with diabetes is increasing unexpectedly. Aging and diabetes are both risk factors for functional disability. Thus, increasing numbers of frail or disabled older patients with diabetes will increase both direct and indirect health-related costs. Diabetes has been reported as an important risk factor of developing physical disability in older adults. Older people with diabetes have lower muscle mass and weaker muscle strength. In addition, muscle quality is poorer in diabetic patients. Sarcopenia and frailty have a common soil and may share a similar pathway for multiple pathologic processes in older people. Sarcopenia is thought to be an intermediate step in the development of frailty in patients with diabetes. Thus, early detection of sarcopenia and frailty in older adults with diabetes should be routine clinical practice to prevent frailty or to intervene earlier in frail patients. PMID:27098509
Leutwyler, Heather C.; Fox, Patrick J.; Wallhagen, Margaret
Older adults with schizophrenia are a growing segment of the population yet their physical and mental health status is extremely poor. The paper presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its affect on their health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia. PMID:23327119
Muzzarelli, Robert; Young, William H.
Given the implications of current trends showing the aging of the population, continuing education programs for older adults should focus on "retirement employment." A strategic planning approach can incorporate forecasting into program development. (SK)
Grimes, Galen A.; Hough, Michelle G.; Mazur, Elizabeth; Signorella, Margaret L.
Older adults are less likely to be using computers and less knowledgeable about Internet security than are younger users. The two groups do not differ on trust of Internet information. The younger group shows no age or gender differences. Within the older group, computer users are more trusting of Internet information, and along with those with…
Clennell, Stephanie, Ed.; And Others
British students 60 years and older in 1985-86 were studied in order to learn about their age, sex, marital status, employment background, the subjects they study, their reasons for studying, how they study, and what they think about their studies. Considered by the researchers to be the largest survey of older students, the study involved 2,254…
da Silva, Henrique Salmazo; Yassuda, Monica Sanches
This study aimed to describe the benefits of memory training for older adults with low education. Twenty-nine healthy older adults with zero to two years of formal education participated. Sixteen participants received training based on categorization (categorization group = CATG) and 13 received training based on mental images (imagery…
Scott, Jean Pearson; Roberto, Karen A.
Compared rural and urban older adults on exchanges of assistance and social activities with children and friends. Found that illness prompted more giving and receiving of assistance for rural in comparison to urban informal supports. Rural widows were more actively involved in exchanges of assistance with friend networks than were urban widows.…
Krause, Neal; Borawski-Clark, Elaine
Tested for social class differences in social support among older adults. Data suggest social class differences emerge when measures of contact with friends, support provided to others, and satisfaction with support are examined. Significant differences failed to emerge with indicators of contact with family, support received from others, and…
Talley, Henry C; Talley, Costellia H
As life expectancy increases, the anesthetic management of older surgical patients has received increased attention. Current estimates suggest that approximately 20% or more of the surgical procedures performed in the United States are on persons 65 years or older, and if current trends continue, the number of older patients requiring anesthesia for surgical procedures is likely to increase. A thorough evaluation is required when planning for the anesthetic management of older adults. Older adults have specific management needs, and these demands continue to pose challenges to anesthesia providers. These challenges relate to the accrual of numerous and diverse anatomic and physiologic changes that occur in older adults throughout the course of aging.
Naugle, Kelly M; Cruz-Almeida, Yenisel; Fillingim, Roger B; Riley, Joseph L
Recent studies indicate that aging is associated with dysfunctional changes in pain modulatory capacity, potentially contributing to increased incidence of pain in older adults. However, age-related changes in offset analgesia (offset), a form of temporal pain inhibition, remain poorly characterized. The purpose of this study was to investigate age differences in offset analgesia of heat pain in healthy younger and older adults. To explore the peripheral mechanisms underlying offset, an additional aim of the study was to test offset at 2 anatomical sites with known differences in nociceptor innervation. A total of 25 younger adults and 20 older adults completed 6 offset trials in which the experimental heat stimulus was presented to the volar forearm and glabrous skin of the palm. Each trial consisted of 3 continuous phases: an initial 15-second painful stimulus (T1), a slight increase in temperature from T1 for 5 seconds (T2), and a slight decrease back to the initial testing temperature for 10 seconds (T3). During each trial, subjects rated pain intensity continuously using an electronic visual analogue scale (0-100). Older adults demonstrated reduced offset compared to younger adults when tested on the volar forearm. Interestingly, offset analgesia was nonexistent on the palm for all subjects. The reduced offset found in older adults may reflect an age-related decline in endogenous inhibitory systems. However, although the exact mechanisms underlying offset remain unknown, the absence of offset at the palm suggests that peripheral mechanisms may be involved in initiating this phenomenon.
Yamashita, Takashi; López, Erick B.; Keene, Jennifer R.; Kinney, Jennifer M.
Lifelong learning is receiving greater attention due to population aging in modern societies. Lifelong learning benefits individuals by supporting their physical, psychological, social, and economic well-being. However, older adults generally have lower motivation for learning than younger adults, and facilitating long-term participation in…
Kemper, Susan; Mcdowd, Joan; Metcalf, Kim; Liu, Chiung-Ju
Eye-tracking technology was employed to examine young and older adults' performance in the reading with distraction paradigm. Distracters of 1, 2, and 4 words that formed meaningful phrases were used. There were marked age differences in fixation patterns. Young adults' fixations to the distracters and targets increased with distracter length.…
Gross, Amy C.; Fuqua, Wayne; Merritt, Todd A.
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…
Hubbard, Joleen M
Treatment for colorectal cancer should not be based on age alone. Pooled analyses from clinical trials show that fit older adults are able to tolerate treatment well with similar efficacy as younger adults. When an older adult is considered for treatment, the clinical encounter must evaluate for deficits in physical and cognitive function, and assess comorbidities, medications, and the degree of social support, all which have may affect tolerance of treatment. Based on the degree of fitness of the patient, multiple alternatives to aggressive treatment regimens and strategies exist to minimize toxicity and preserve quality of life during treatment.
Rowe, Theresa A; Juthani-Mehta, Manisha
Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults. PMID:24391677
Rowe, Theresa A; Juthani-Mehta, Manisha
Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.
Stark, Susan L; Silianoff, Tara J; Kim, H Lyn; Conte, Jane W; Morris, John C
Although falls are a serious health risk for community-dwelling older adults, their ascertainment has been complicated by issues such as recall and reporting biases. We examined a novel method, individualized tailored calendars, to accurately ascertain falls in older adults. A convenience sample of 125 cognitively normal participants enrolled in longitudinal studies of healthy aging at the Knight Alzheimer's Disease Ressearch Center was followed prospectively for 12 months. Tailored calendar journal pages were used to document falls daily and returned by mail monthly. Participants received a US$5 gift card incentive for each month returned. Participants returned 1,487 of 1,500 calendar months over the 12-month follow-up for 99.1% compliance rate. There were 154 falls reported. Tailored calendar journals and incentives may be effective in ascertaining falls among community-dwelling older adults. This tool could improve the accuracy of outcome measures for occupational therapy interventions.
Lakin, K. Charlie; And Others
A national sample of 370 older persons with mental retardation in 235 facilities (foster care, small group homes, large private facilities, and state-operated facilities) was surveyed. Information is presented on resident characteristics, day program participation, services received, and differences in programs and services by facility type. The…
The "Guidelines for Psychological Practice With Older Adults" are intended to assist psychologists in evaluating their own readiness for working with older adults and in seeking and using appropriate education and training to increase their knowledge, skills, and experience relevant to this area of practice. The specific goals of these professional practice guidelines are to provide practitioners with (a) a frame of reference for engaging in clinical work with older adults and (b) basic information and further references in the areas of attitudes, general aspects of aging, clinical issues, assessment, intervention, consultation, professional issues, and continuing education and training relative to work with this group. The guidelines recognize and appreciate that there are numerous methods and pathways whereby psychologists may gain expertise and/or seek training in working with older adults. This document is designed to offer recommendations on those areas of awareness, knowledge, and clinical skills considered as applicable to this work, rather than prescribing specific training methods to be followed. The guidelines also recognize that some psychologists will specialize in the provision of services to older adults and may therefore seek more extensive training consistent with practicing within the formally recognized specialty of Professional Geropsychology (APA, 2010c).
Cresci, M Kay; Yarandi, Hossein N; Morrell, Roger W
Computers and the Internet offer older adults opportunities and resources for independent living. However, many urban older adults do not use computers. This study examined the demographic, health, and social activities of urban older adults to determine variables that might predict the use and nonuse of computers in this population. A secondary data analysis was performed using the 2001 Detroit City-Wide Needs Assessment of Older Adults (n = 1410) data set. Logistic regression was used to explore potential differences in predictor variables between computer users and nonusers. Overall, computer users were younger (27%), had a higher level of education, were more likely to be employed, had an annual income greater than $20,000, and were healthier and more active than nonusers. They also were more likely to have memberships in community organizations and do volunteer work. Preferred computer activities included conducting Internet searches, playing games, writing, and communicating with family members and friends. The results suggest significant differences in demographic and health-related characteristics between computer users and nonusers among urban older adults. Although about a quarter of participants in this study used computers, the Digital Divide continues to exist in urban settings for scores of others.
Lichtenstein, Alice H; Rasmussen, Helen; Yu, Winifred W; Epstein, Susanna R; Russell, Robert M
In 1999 we proposed a Modified Food Guide Pyramid for adults aged 70+ y. It has been extensively used in a variety of settings and formats to highlight the unique dietary challenges of older adults. We now propose a Modified MyPyramid for Older Adults in a format consistent with the MyPyramid graphic. It is not intended to substitute for MyPyramid, which is a multifunctional Internet-based program allowing for the calculation of individualized food-based dietary guidance and providing supplemental information on food choices and preparation. Pedagogic issues related to computer availability, Web access, and Internet literacy of older adults suggests a graphic version of MyPyramid is needed. Emphasized are whole grains and variety within the grains group; variety and nutrient density, with specific emphasis on different forms particularly suited to older adults' needs (e.g. frozen) in the vegetables and fruits groups; low-fat and non-fat forms of dairy products including reduced lactose alternatives in the milk group; low saturated fat and trans fat choices in the oils group; and low saturated fat and vegetable choices in the meat and beans group. Underlying themes stress nutrient- and fiber-rich foods within each group and food sources of nutrients rather than supplements. Fluid and physical activity icons serve as the foundation of MyPyramid for Older Adults. A flag to maintain an awareness of the potential need to consider supplemental forms of calcium, and vitamins D and B-12 is placed at the top of the pyramid. Discussed are newer concerns about potential overnutrition in the current food landscape available to older adults.
Vieira, Edgar Ramos; Brown, Ellen; Raue, Patrick
Depression is related to disability and affects rehabilitation participation, outcomes, and compliance with treatment. Improving older adult depression detection and referral requires knowledge, skills, supportive organizational policies, and access to mental health experts. This review provides a selected overview of evidence-based approaches for screening of suspected cases of depression in older adults by physical therapists and other non-mental health professionals and discusses procedures to refer suspected cases to primary care providers and/or mental health specialists for evaluation, including resources and a tool to assist in communicating depression-related information to the primary care provider or mental health specialist. We hope that this review will promote the incorporation of evidence-based screening and referral of suspected cases of depression in older adults into routine practice.
Hypothyroidism frequently affects older adults' general sense of health, their cognitive abilities, and quality of life. Management decisions regarding when to start treatment and at what dosage to begin medication are influenced by both laboratory values and patient symptoms. Although specific guidelines regarding management of hypothyroidism in older adults do not exist, general recommendations include initiating hormone replacement with levothyroxine (Levoxyl(®), Synthroid(®), and others) at 12.5 mcg to 25 mcg and titrating the dose slowly based on response at 6-week intervals. Multiple medications and certain foods can interact with levothyroxine; therefore, the best dosage time is when a person is fasting or 4 hours postprandial. Using a consistent brand-name drug for hormone replacement with levothyroxine is important due to variations in the active ingredient in generic formulations. Providers need to be aware of the prevalence of hypothyroidism and management issues when caring for older adults.
MacLeod, Stephanie; Musich, Shirley; Hawkins, Kevin; Alsgaard, Kathleen; Wicker, Ellen R
The purpose of this literature review was to provide an overview of resilience for the purpose of informing potential intervention designs that may benefit older adults. While numerous reviews have focused on various specific aspects of resilience, none have provided the necessary information required to design an effective resilience intervention. Research examining resilience suggests that older adults are capable of high resilience despite socioeconomic backgrounds, personal experiences, and declining health. Thus opportunities to inform interventions in this area exist. Research studies have identified the common mental, social, and physical characteristics associated with resilience. High resilience has also been significantly associated with positive outcomes, including successful aging, lower depression, and longevity. Interventions to enhance resilience within this population are warranted, but little evidence of success exists. Thus this review provides an overview of resilience that may aid in the design of resilience interventions for the often underserved population of older adults.
Estrada, M; Moliner, M A; Sánchez, J
In this study we will analyze the attitude of older adults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the empirical research, a total of 183 personal surveys were carried out with people aged over 65 taking as reference 2 products with different prices and durabilities. Analysis of the results indicated that in products involving little economic effort, older adults showed the same attitude toward both trope and explicit advertisements. However, with products requiring greater economic effort, older adults showed differences in their attitudes to trope ads and to explicit ads depending on their degree of involvement with the product. These differences had a strong effect on their attitudes to the brands of the products analyzed.
Bitar, Raoul; Dürsteler, Kenneth M; Rösner, Susanne; Grosshans, Martin; Herdener, Marcus; Mutschler, Jochen
In respect of demographic change, the number of older patients with substance abuse and addiction is on the raise. In this review we present important clinical and therapeutic aspects of substance abuse and addiction in the elderly and focus on alcohol, benzodiazepines and opioids. Daily and risky alcohol consumption is common among older people. They also have an increased risk getting alcohol-related complications. For early detection, laboratory parameters and questionnaires such as the AUDIT-C are suitable. Therapeutically brief interventions have been proved successful. Also, abuse of benzodiazepines, especially low-dose addiction, is widespread among older persons, although often overlooked, and patients often do not recognize their addiction. The physician has to know the correct indication, adequate dosage and pharmacological interactions. A slow-dose reduction is recommended in case of addiction. Thanks to opioid substitution therapy, patients with an opioidaddiction can reach a higher age. Age influences the effects of the substitute, which may require an adjustment of the dosage. Treatment of elderly patients should be based on their needs and resources and is usually very effective.
Liu, Chiung-Ju; Kemper, Susan; Bovaird, James A.
This study examined how Flesch Reading Ease and text cohesion affect older adults' comprehension of common health texts. All older adults benefited when high Flesh Reading Ease was combined with high cohesion. Older adults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, older adults…
Notthoff, Nanna; Carstensen, Laura L.
Walking is among the most cost-effective and accessible means of exercise. Mounting evidence suggests that walking may help to maintain physical and cognitive independence in old age by preventing a variety of health problems. However, older Americans fall far short of meeting the daily recommendations for walking. In two studies, we examined whether considering older adults’ preferential attention to positive information may effectively enhance interventions aimed at promoting walking. In Study 1, we compared the effectiveness of positive, negative, and neutral messages to encourage walking (as measured with pedometers). Older adults who were informed about the benefits of walking walked more than those who were informed about the negative consequences of failing to walk, whereas younger adults were unaffected by framing valence. In Study 2, we examined within-person change in walking in older adults in response to positively- or negatively-framed messages over a 28-day period. Once again, positively-framed messages more effectively promoted walking than negatively-framed messages, and the effect was sustained across the intervention period. Together, these studies suggest that consideration of age-related changes in preferences for positive and negative information may inform the design of effective interventions to promote healthy lifestyles. Future research is needed to examine the mechanisms underlying the greater effectiveness of positively as opposed to negatively framed messages and the generalizability of findings to other intervention targets and other subpopulations of older adults. PMID:24956001
Liu, Yu; Chan, John S. Y.; Yan, Jin H.
Falls, a common cause of injury among older adults, have become increasingly prevalent. As the world’s population ages, the increase in—and the prevalence of—falls among older people makes this a serious and compelling societal and healthcare issue. Physical weakness is a critical predictor in falling. While considerable research has examined this relationship, comprehensive reviews of neuropsychological predictors of falls have been lacking. In this paper, we examine and discuss current studies of the neuropsychological predictors of falls in older adults, as related to sporting and non-sporting contexts. By integrating the existing evidence, we propose that brain aging is an important precursor of the increased risk of falls in older adults. Brain aging disrupts the neural integrity of motor outputs and reduces neuropsychological abilities. Older adults may shift from unconscious movement control to more conscious or attentive motor control. Increased understanding of the causes of falls will afford opportunities to reduce their incidence, reduce consequent injuries, improve overall well-being and quality of life, and possibly to prolong life. PMID:24782761
Hogan, Teresita M; Constantine, Stephen Tyler; Crain, Aoko Doris
The older adult patient with syncope is one of the most challenging evaluations for the emergency physician. It requires clinical skill, patience, and knowledge of specific older adult issues. It demands care in the identification of necessary resources, such as medication review, and potential linkage with several multidisciplinary follow-up services. Excellent syncope care likely requires reaching out to ensure institutional resources are aligned with emergency department patient needs, thus asking emergency physicians to stretch their administrative talents. This is likely best done as preset protocols prior to individual patient encounters. Emergency physicians evaluate elders with syncope every day and should rise to the challenge to do it well.
Porter Starr, Kathryn N; Bales, Connie W
The health challenges prompted by obesity in the older adult population are poorly recognized and understudied. A defined treatment of geriatric obesity is difficult to establish, as it must take into account biological heterogeneity, age-related comorbidities, and functional limitations (sarcopenia/dynapenia). This retrospective article highlights the current understanding of the optimal body mass index (BMI) in later life, addressing appropriate recommendations based on BMI category, age, and health history. The findings of randomized control trials of weight loss/maintenance interventions help one to move closer to evidence-based and appropriately individualized recommendations for body weight management in older adults.
Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten
Background The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. Method A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. Results ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. Conclusion It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. PMID:26811680
de Almeida Tavares, João Paulo; da Silva, Alcione Leite; Sá-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth
Portugal is impacted by the rapid growth of the aging population, which has significant implications for its health care system. However, nurses have received little education focusing on the unique and complex care needs of older adults. This gap in the nurses' education has an enormous impact in their knowledge and attitudes and affects the quality of nursing care provided to older adults. A cross-sectional study was conducted among 1068 Portuguese nurses in five hospitals (northern and central region) with the following purposes: (i) explore the knowledge and attitudes of nurses about four common geriatric syndromes (pressure ulcer, incontinence, restraint use and sleep disturbance) in Portuguese hospitals; and (ii) evaluate the influence of demographic, professional and nurses' perception about hospital educational support, geriatric knowledge, and burden of caring for older adults upon geriatric nursing knowledge and attitudes. The mean knowledge and attitudes scores were 0.41 ± 0.15 and 0.40 ± 0.21, respectively (the maximum score was 1). Knowledge of nurses in Portuguese hospitals about the four geriatric syndromes (pressure ulcers, sleep disturbance, urinary incontinence and restraint use) was found inadequate. The nurses' attitudes towards caring for hospitalized older adults were generally negative. Nurses who work in academic hospitals demonstrated significantly more knowledge than nurses in hospital centers. The attitudes of nurses were significantly associated with the hospital and unit type, region, hospital educational support, staff knowledge, and perceived burden of caring for older adults. The study findings support the need for improving nurses' knowledge and attitudes towards hospitalized older adults and implementing evidence-based guidelines in their practice.
Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory
Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…
Although funds were not available to bring members of the Older Adults Network to the World Assembly of Adult Education in January 1990, there was, among the delegates, considerable interest in the subject and several meetings were arranged. The thing that struck me most was not how different were our situations, coming as we did from every corner of the earth, but how many problems and concerns we had in common. With the second Network Newsletter, sent out in the spring of 1991, questionnaires asked for brief details of schemes which involved older people in projects that were, in some way, conservational. They could be involved in conserving language, mythology or history. They might be working to improve and save their environment. The aim is to establish a small but useful register of such projects in sufficient detail to encourage contact and replication by others. For this purpose, small grants are being made available from the money given by CIDA. Slowly but surely, the Older Adults Network is gathering information about positive actions being taken to ensure that older people, in all countries, have the skills and opportunities they need to continue as fully participating citizens. With the rapidly increasing number of older people in all our countries, this small beginning will, hopefully, be a foundation on which much important work will be done in the years to come.
Johnson, Mary Ann
It is estimated that by 2050 there will be 2 billion people aged 60 years and older in the world. The evidence base for the health benefits of good nutrition and physical activity, as well as weight loss among overweight and obese adults, is growing and a number of policies and guidelines are available to guide health professionals in serving older people at various stages of the lifecycle. There are many potential influences on dietary habits including individual factors, families and friends, community characteristics, the food and supplement industry, and public policy. This review focuses on the evidence base for factors influencing diet in older adults, food insecurity, Na, vitamin D, vitamin B12, protein, obesity and the benefits of energy restriction in overweight and obese older adults. Research is needed to continue to increase the evidence base for appropriate ways to improve diet and health in older people. Also, much of the available information is from the US, so there is a need to conduct research in other areas of the world.
Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet
Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups.
Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.
Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485
Cimperman, Miha; Brenčič, Maja Makovec; Trkman, Peter; Stanonik, Mateja de Leonni
The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market.
Brenčič, Maja Makovec; Trkman, Peter; de Leonni Stanonik, Mateja
Abstract The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market. PMID:23931702
Webber, Sandra C.; Porter, Michelle M.; Menec, Verena H.
Mobility is fundamental to active aging and is intimately linked to health status and quality of life. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to comprehensively portray mobility, and research has to a large extent been discipline specific. In this article, a new…
This curriculum guide contains materials for a course that provides occupationally specific training designed to develop knowledge and skills for employment in the area of services for older adults. Contents include an introduction, the Texas Essential Knowledge and Skills (TEKS) covered; sample course outlines; instructional strategies organized…
La Rue, Asenath; Markee, Taryn
Methodological issues in geropsychological assessment research are discussed and illustrated through recent investigations. Cross-sectional studies are needed to extend and diversify age norms, and short-term longitudinal studies should be planned to assess the predictive validity of test outcomes and diagnostic profiles of older adults. (SLD)
The prevalence of dementia, in particular Alzheimer’s disease, is increasing with the expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to mitigate this public health problem. Blueberries contain polyphenolic compounds, most prominent...
Szwabo, Peggy; Thale, Thomas T.
Traditionally, the elderly have not been viewed as appropriate candidates for dynamic psychotherapy. To examine the effectiveness of a psycho-dynamically oriented group (focusing on the issues of aging, conflict resolution, and self-actualization) on 6 older adult participants, ages 63 to 87 years, systematic clinical observations of group…
Funderburk, Brooke; Damron-Rodriguez, JoAnn; Storms, Lene Levy; Solomon, David H.
This cross-sectional study assessed undergraduate attitudes toward older adults and attitude endurance 3 to 18 months after aging coursework. Survey respondents included 349 students who took an aging elective and 430 comparison students. Aging-elective students indicated more positive attitudes than comparison students. Attitudes did not vary…
Berkman, Susan C. J.
The Braille Institute's Community Outreach Program provides adventitiously blinded older adults with opportunities to volunteer in local community agencies, schools, and hospitals upon completion of the institute's special education program. Students use new independence skills in a functional social environment, thereby increasing their…
Kressig, Reto W.; Echt, Katharina V.
Purpose: The purpose of this study was to determine if older adults are capable and willing to interact with a computerized exercise promotion interface and to determine to what extent they accept computer-generated exercise recommendations. Design and Methods: Time and requests for assistance were recorded while 34 college-educated volunteers,…
This guide provides information and suggestions for developing programs that meet the needs of older adults at community colleges. Recommended procedures are presented for the following stages of program development: (1) leadership influences, highlighting the process of hiring effective leaders, key leadership skills, and leaders'…
Fanelli, Marie T.; Abernethy, Marilyn M.
Describes a questionnaire assessing nutritional knowledge and eating behaviors of older adults. The questionnaire consists of six sections: demographic and personal information, food resources, food consumption patterns, dietary practices related to health, activity patterns, and nutritional knowledge. Study results demonstrating the…
Estrada, M.; Moliner, M. A.; Sanchez, J.
In this study we will analyze the attitude of older adults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the…
Phillips, Louise H; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley
Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are age-related differences in the interpretation of sarcastic statements. Using both video and verbal materials, 116 participants aged between 18 and 86 completed judgments about whether statements should be interpreted literally or sarcastically. For the verbal stories task, older adults were poorer at understanding sarcastic intent compared with younger and middle-aged participants, but there was no age difference in interpreting control stories. For the video task, older adults showed poorer understanding of sarcastic exchanges compared with younger and middle-aged counterparts, but there was no age difference in understanding the meaning of sincere interactions. For the videos task, the age differences were mediated by the ability to perceive facial expressions of emotion. Age effects could not be explained in terms of variance in working memory. These results indicate that increased age is associated with specific difficulties in using nonverbal and contextual cues to understand sarcastic intent. (PsycINFO Database Record
Chen, Jen-Hao; Lauderdale, Diane S; Waite, Linda J
Sleep complaints are common among older adults, and poor sleep has been found to predict chronic diseases and mortality. Many studies suggest that social participation benefits healthy aging. We examined the relationships between older adults' social participation and their sleep using two waves (2005-2006, 2010-2011) of data from the National Social Life, Health, and Aging Project (NSHAP). The NSHAP recorded older adults' social participation (including religious attendance, volunteer work, and attendance at meetings of organized groups) over five years, and included self-reported sleep duration in both waves and, in the second wave, measures of insomnia symptoms and measures of sleep patterns and rhythms using actigraphy for a subsample. Cross-sectional analysis of the second wave indicates that those reporting higher levels of social participation had better actigraphic sleep but not better self-reported sleep. However, longitudinal analysis suggests that change in social participation was not associated with actigraphic or self-reported sleep characteristics in the second wave data. Further analysis using fixed-effects model showed no association between change in social participation and change in self-reported sleep duration. Thus, although older adults with greater social participation slept better, we did not find that increasing social participation improved sleep. These findings imply that a self-selection process may at work; or if social participation does affect sleep, the causal effect may be over a much shorter time frame than five years.
Van Schaik, Paul; Blake, Jonathan; Pernet, Fred; Spears, Iain; Fencott, Clive
This paper details the design, development, and testing of virtual augmented exercise (VAE) gaming for older adults. Three versions of an underwater VAE environment were tested with a sample of 22 healthy adults aged 50 or over. Participants strongly preferred VAE to traditional physical exercise, and adherence rate was 100%. The findings suggest that VAE with puzzles changes or negates the expected negative associations among exercise outcomes. Fitness level was not associated with performance in the game, irrespective of VAE type, indicating that persons who are less physically fit can expect to perform similarly to those who are more physically fit. In conclusion, the research found some evidence for the benefits of VAE with cognitive exercise (solving simple puzzles and hitting targets based on the answer). This type of exercise appears to be a promising method of exercise for older adults.
Behavior therapy has up to now, only been applied to a limited degree to elderly people. Operant learning paradigma receive special meaning within the framework of intervention as well as theoretical explanation. Publications will be presented for the areas of social behavior, self care, motoric ability etc. according to their different techniques. It is remarkable that interest has only focused institutionalized elderly people with a high degree of incapacitation. In the following discussion the necessity for stronger consideration of the newer behavioral approach as well the latest developments in gerontology will be made clear.
Batista, Marina Picazzio Perez; Barros, Juliana de Oliveira; de Almeida, Maria Helena Morgani; Mângia, Elisabete Ferreira; Lancman, Selma
OBJECTIVE To understand the job function of caregivers of older adults and contribute to the debate on the consolidation of this professional practice. METHODOLOGICAL PROCEDURES This is a descriptive, qualitative, and exploratory study. Four focal group sessions were performed in 2011 with 11 elderly companions, formal caregivers of older adults in the Programa Acompanhante de Idosos (Program for Caregivers of Older Adults), Sao Paulo, SP, Southeastern Brazil. These sessions, guided by a semi-structured script, were audio-recorded and fully transcribed. Data were analyzed using the Content Analysis technique, Thematic Modality. RESULTS In view of considering the caregivers of older adults as a new category of workers, it was difficult to define their duties. The elderly companions themselves as well as the care receivers, their families, and the professionals that comprised the team were unclear about their duties. The professional practice of these formal caregivers has been built on the basis of constant discussions and negotiations among them and other team members in Programa Acompanhante de Idosos during daily work. This was achieved via a recognition process of their job functions and by setting apart other workers’ exclusive responsibilities. CONCLUSIONS The delimitation of specific job functions for elderly companions is currently one of the greatest challenges faced by these workers to develop and consolidate their professional role as well as improve Programa Acompanhante de Idosos. PMID:25372163
... gov/news/fullstory_163198.html Could Obesity Undermine Memory Training in Older Adults? Study adds to growing ... 23, 2017 MONDAY, Jan. 23, 2017 (HealthDay News) -- Memory training is far less effective in older adults ...
What Older Adults Need to Know about Retail Clinics Expert Information from Healthcare Professionals Who Specialize in the Care of Older Adults Retail clinics are medical clinics based in pharmacies, supermarkets, ...
Gluchowski, Ashley; Harris, Nigel; Dulson, Deborah; Cronin, John
Eccentric exercise has gained increasing attention as a suitable and promising intervention to delay or mitigate the known physical and physiological declines associated with aging. Determining the relative efficacy of eccentric exercise when compared with the more conventionally prescribed traditional resistance exercise will support evidence-based prescribing for the aging population. Thus, original research studies incorporating chronic eccentric exercise interventions in the older adult population were included in this review. The effects of a range of eccentric exercise modalities on muscular strength, functional capacity, body composition, muscle architecture, markers of muscle damage, the immune system, cardiovascular system, endocrine system, and rating of perceived exertion were all reviewed as outcomes of particular interest in the older adult. Muscular strength was found to increase most consistently compared with results from traditional resistance exercise. Functional capacity and body composition showed significant improvements with eccentric endurance protocols, especially in older, frail or sedentary cohorts. Muscle damage was avoided with the gradual progression of novel eccentric exercise, while muscle damage from intense acute bouts was significantly attenuated with repeated sessions. Eccentric exercise causes little cardiovascular stress; thus, it may not generate the overload required to elicit cardiovascular adaptations. An anabolic state may be achievable following eccentric exercise, while improvements to insulin sensitivity have not been found. Finally, rating of perceived exertion during eccentric exercise was often significantly lower than during traditional resistance exercise. Overall, evidence supports the prescription of eccentric exercise for the majority of outcomes of interest in the diverse cohorts of the older adult population.
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.
Moore, Linda Weaver
Due to the frequency of eye disorders among older adults, qualitative researchers who involve older individuals in their work must be sensitive to the multiple ways in which visual deficits can influence the research process. The author addresses some of the difficulties encountered, insights gained, and strategies developed while conducting a phenomenological study in which all the participants were severely visually impaired. The author's insights, drawn from personal experiences, reflections, and log entries kept throughout the study, are shared to help other researchers design and implement studies in which the voices of individuals with severe visual impairments can be skillfully tapped.
Rowe, Theresa Anne; Juthani-Mehta, Manisha
Urinary tract infection (UTI) is a commonly diagnosed infection in older adults. Despite consensus guidelines developed to assist providers in diagnosing UTI, distinguishing symptomatic UTI from asymptomatic bacteriuria (ASB) in older adults is problematic, as many older adults do not present with localized genitourinary symptoms. This article summarizes the recent literature and guidelines on the diagnosis and management of UTI and ASB in older adults.
Smayda, Kirsten E.; Van Engen, Kristin J.; Maddox, W. Todd; Chandrasekaran, Bharath
Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18–35) and thirty-three older adults (ages 60–90) to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger adults when
Legriel, Stephane; Brophy, Gretchen M.
The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome. Stroke (acute or remote symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and brain injury are among the main causes of status epilepticus occurrence in this age category. The use of anticonvulsive agents can be problematic as well. Thus, it is important to take into account the specific aspects related to the pharmacokinetic and pharmacodynamic changes in older critically-ill adults. Beyond these precautions, the management may be identical to that of the younger adult, including prompt initiation of symptomatic and anticonvulsant therapies, and a broad and thorough etiological investigation. Such management strategies may improve the vital and functional prognosis of these patients, while maintaining a high overall quality of care. PMID:27187485
Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D
There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.
Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…
Kim, Young Sek
By searching the keywords of "older adult" and "computer" in ERIC, Academic Search Premier, and PsycINFO, this study reviewed 70 studies published after 1990 that address older adults' computer learning and usage. This study revealed 5 prominent themes among reviewed literature: (a) motivations and barriers of older adults' usage of computers, (b)…
Schmidt, Iris W.; Berg, Ina J.; Deelman, Betto G.
Twenty adults received training in prospective memory; 23 who received training in reducing worries about forgetfulness and 22 controls formed a comparison group. Results of a telephone task and a prospective categorization task revealed significant but small effects for the prospective memory group. After 3 months, the comparison group's…
Jump, Robin LP
Clostridium difficile infection, the most frequent cause of nosocomial diarrhea, disproportionately affects older adults. The two most important risk factors for developing C. difficile infection are antimicrobial exposure and age >65 years old. Risk factors specific to older adults are frequent interactions with healthcare systems and age-related changes in physiology, including immune senescence and changes to the gut microbiome. Metronidazole and oral vancomcyin are the mainstays of conventional treatment for C. difficile infection. Alternative therapies include fidaxomicin, a narrow-spectrum macrocyclic antibiotic, and fectal bacteriotherapy, which offers an excellent therapeutic outcome. Strategies to prevent C. difficile infections include enhanced infection control measures and reducing inappropriate antimicrobial use through stewardship. PMID:24955106
Grin, Daniel; Landsberg, Randall H.; Flude, Karen
Gerontology research continues to show that the adage "Use it or Lose it" is a clinical fact when it comes to cognitive engagement post-retirement. Here, I'll discuss a new program developed at the Kavli Institute for Cosmological Physics, bringing classes on astrophysics to older adults throughout the city, at retirement homes, at senior center, and at public libraries, bookended by an engaging trip to the Adler Planetarium. In my presentation, I'll present the gerontological and policy motivations for this program, the presenter training techniques, our partner collaboration strategy, and the results of our effort, which engaged hundreds of older adults throughout Chicago from a variety of socioeconomic strata.
Cavalieri, Thomas A
The elderly are often untreated or undertreated for pain. Barriers to effective management include challenges to proper assessment of pain; underreporting on the part of patients; atypical manifestations of pain in the elderly; a need for increased appreciation of the pharmacokinetic and pharmacodynamic changes of aging; and misconceptions about tolerance and addiction to opioids. Physicians can effectively manage pain in the elderly by understanding different types of pain (nociceptive and neuropathic), and appropriate use of nonopioid, opioid, and adjuvant medications. Opioids have become more widely accepted for treating older adults who have persistent pain, but their use requires physicians have an understanding of prevention and management of side effects, opioid titration and withdrawal, and careful monitoring. Placebo use is unwarranted and unethical. Nonpharmacologic approaches to pain management are essential and include osteopathic manipulative treatment, cognitive behavioral therapy, exercise, and spiritual interventions. The holistic and interdisciplinary approach of osteopathic medicine offers an approach that can optimize effective pain management in older adults.
Peach, Brian C.; Garvan, Gerard J.; Garvan, Cynthia S.; Cimiotti, Jeannie P.
Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care. PMID:28138493
Farage, Miranda A.; Miller, Kenneth W.; Ajayi, Funmi; Hutchins, Deborah
The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age. PMID:22980147
Farage, Miranda A; Miller, Kenneth W; Ajayi, Funmi; Hutchins, Deborah
The global population is aging. In many industrial countries, almost one in five people are over age 65. As people age, gradual changes ensue in vision, hearing, balance, coordination, and memory. Products, communication materials, and the physical environment must be thoughtfully designed to meet the needs of people of all ages. This article summarizes normal changes in sensory function, mobility, balance, memory, and attention that occur with age. It presents practical guidelines that allow design professionals to accommodate these changes and better meet the needs of older adults. Designing for older adults is inclusive design: it accommodates a range of physical and cognitive abilities and promotes simplicity, flexibility, and ease of use for people of any age.
Carr, David B.; Ott, Brian R.
Although automobiles remain the transportation of choice for older adults, late life cognitive impairment and dementia often impair the ability to drive safely. There is, however, no commonly utilized method of assessing dementia severity in relation to driving, no consensus on the assessment of older drivers with cognitive impairment, and no gold standard for determining driving fitness. Yet, clinicians are called upon by patients, their families, other health professionals, and often the Department of Motor Vehicles (DMV) to assess their patients' fitness-to-drive and to make recommendations about driving privileges. Using the case of Mr W, we describe the challenges of driving with cognitive impairment for both the patient and caregiver, summarize the literature on dementia and driving, discuss evidenced-based assessment of fitness-to-drive, and address important ethical and legal issues. We describe the role of physician assessment, referral to neuropsychology, functional screens, dementia severity tools, driving evaluation clinics, and DMV referrals that may assist with evaluation. Finally, we discuss mobility counseling (eg, exploration of transportation alternatives) since health professionals need to address this important issue for older adults who lose the ability to drive. The application of a comprehensive, interdisciplinary approach to the older driver with cognitive impairment will have the best opportunity to enhance our patients' social connectedness and quality of life, while meeting their psychological and medical needs and maintaining personal and public safety. PMID:20424254
Rippon, Isla; Kneale, Dylan; de Oliveira, Cesar; Demakakos, Panayotes; Steptoe, Andrew
Objectives: to examine perceived age discrimination in a large representative sample of older adults in England. Methods: this cross-sectional study of over 7,500 individuals used data from the fifth wave of the English Longitudinal Study of Ageing (ELSA), a longitudinal cohort study of men and women aged 52 years and older in England. Wave 5 asked respondents about the frequency of five everyday discriminatory situations. Participants who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. Multivariable logistic regression analysis was used to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. Results: approximately a third (33.3%) of all respondents experienced age discrimination, rising to 36.8% in those aged 65 and over. Perceived age discrimination was associated with older age, higher education, lower levels of household wealth and being retired or not in employment. The correlates of age discrimination across the five discriminatory situations were similar. Conclusion: understanding age discrimination is vital if we are to develop appropriate policies and to target future interventions effectively. These findings highlight the scale of the challenge of age discrimination for older adults in England and illustrate that those groups are particularly vulnerable to this form of discrimination. PMID:24077751
Maslow, Katie; Mezey, Mathy
Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.
Alvarenga, Jussara Mendonça; Giacomin, Karla Cristina; de Loyola, Antônio Ignácio; Uchoa, Elizabeth; Firmo, Josélia Oliveira Araújo
OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the “signs, meanings, and actions” model. RESULTS The main reasons pointed out for the use of benzodiazepines were “nervousness”, “sleep problems”, and “worry” due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life’s problems in old age. Although it relieves the “nerves”, the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population. PMID:26039388
Alvarenga, Jussara Mendonça; Giacomin, Karla Cristina; Loyola Filho, Antônio Ignácio de; Uchoa, Elizabeth; Firmo, Josélia Oliveira Araújo
OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the "signs, meanings, and actions" model. RESULTS The main reasons pointed out for the use of benzodiazepines were "nervousness", "sleep problems", and "worry" due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life's problems in old age. Although it relieves the "nerves", the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.
Bradley, Suzanne F
Antibiotic use is common in older adults, and much of it is deemed unnecessary. Complications of antibiotic use may occur as a consequence of changes in age-related physiology and dosing with resulting drug toxicity and secondary infection. Knowing when it is appropriate to initiate antibiotics may help reduce unnecessary antibiotic use and prevent adverse drug events. Careful attention to antibiotic selection, dosing adjustments, and drug-drug interactions may also help prevent antibiotic-related adverse events.
Nobre, Nuno Ribeiro; Kylmä, Jari; Kirsi, Tapio; Pereira, Marco
The aim of this study was to explore the social networks of older adults living with HIV. Interviews were conducted with nine individuals aged 50 or older living with HIV in Helsinki, Finland. Analysis of transcripts was analysed by inductive qualitative content analysis. Results indicated that these participants' networks tended to be large, including those both aware and unaware of the participants' health status. Analysis identified three main themes: large multifaceted social networks, importance of a support group, and downsizing of social networks. Support received appeared to be of great importance in coping with their health condition, especially since the time of diagnosis. Friends and family were the primary source of informal support. The majority of participants relied mostly on friends, some of whom were HIV-positive. Formal support came primarily from the HIV organisation's support group. In this study group, non-disclosure did not impact participants' well-being. In years to come, social networks of older adults living with HIV may shrink due to personal reasons other than HIV-disclosure. What is of primary importance is that healthcare professionals become knowledgeable about psychosocial issues of older adults living with HIV, identifying latent problems and developing adequate interventions in the early stages of the disease; this would help prevent social isolation and foster successful ageing with HIV.
Vahia, Ipsit V.; Ng, Bernardo; Camacho, Alvaro; Cardenas, Veronica; Cherner, Mariana; Depp, Colin A.; Palmer, Barton W.; Jeste., Dilip V.; Agha, Zia
As the population of older Latinos in the U.S. increases, availability of culturally-adapted geriatric psychiatry services is becoming a growing concern. This issue is exacerbated for rural Latino populations. In this study, we assessed whether neurocognitive assessment via telepsychiatry (TP) using a Spanish-language battery would be comparable to in-person (IP) testing using the same battery in a sample of Spanish-speaking older adults in a rural setting. Patients (N=22) received IP and TP testing 2 weeks apart. The order of IP and TP test administrations in individual subjects was determined randomly. Comparison of scores indicated that there were no significant differences between IP and TP test performance though both groups scored non-significantly higher at the second visit. This study demonstrates feasibility and utility of neurocognitive testing in Spanish using TP among older rural Latinos. PMID:25708655
Vahia, Ipsit V; Ng, Bernardo; Camacho, Alvaro; Cardenas, Veronica; Cherner, Mariana; Depp, Colin A; Palmer, Barton W; Jeste, Dilip V; Agha, Zia
As the population of older Latinos in the U.S. increases, availability of culturally adapted geriatric psychiatry services is becoming a growing concern. This issue is exacerbated for rural Latino populations. In this study, we assessed whether neurocognitive assessment via telepsychiatry (TP) using a Spanish-language battery would be comparable to in-person (IP) testing using the same battery in a sample of Spanish-speaking older adults in a rural setting. Patients (N = 22) received IP and TP testing 2 weeks apart. The order of IP and TP test administrations in individual subjects was determined randomly. Comparison of scores indicated that there were no significant differences between IP and TP test performance though both groups scored non-significantly higher at the second visit. This study demonstrates feasibility and utility of neurocognitive testing in Spanish using TP among older rural Latinos.
Chang, Esther; Chenoweth, Lynn; Hancock, Karen
The proportion of older adults is increasing in Australia, and the proportion of older adults requiring medical care is expected to increase in the future. At the same time, budget restrictions are a reality for Australia's health system. Increasing need and decreasing resources suggest the need to focus on the quality aspect of treatment and care for older adults. Little research has been conducted in the area of perceived nursing needs of elderly patients during hospitalization. This is an important area of research because it is increasingly recognized that elderly patients have specialized needs and are the major consumers of health care. Even less research has compared patient and carer perceptions with those of nursing staff. This article is a literature review and an investigation of the quality of care elderly patients receive, and of patient and nurse perceptions of the importance of various nursing activities. Quality of care is reviewed in terms of perceptions of nursing care priorities and elderly patients' satisfaction with the quality of nursing care they receive. Research examining nurses' perceptions related to why they are unable to consistently provide quality nursing care to all elderly patients is also reviewed. By identifying the nursing needs of elderly patients and educating nursing staff about these needs, professional practice can be guided and improvements in quality of care, patient satisfaction, and patient outcomes may occur.
Sitzman, Danielle M; Rhodes, Matthew G; Tauber, Sarah K; Liceralde, Van Rynald T
Previous work has demonstrated that, when given feedback, younger adults are more likely to correct high-confidence errors compared with low-confidence errors, a finding termed the hypercorrection effect. Research examining the hypercorrection effect in both older and younger adults has demonstrated that the relationship between confidence and error correction was stronger for younger adults compared with older adults. Their results demonstrated that the relationship between confidence and error correction was stronger for younger adults compared with older adults. However, recent work suggests that error correction is largely related to prior knowledge, while confidence may primarily serve as a proxy for prior knowledge. Prior knowledge generally remains stable or increases with age; thus, the current experiment explored how both confidence and prior knowledge contributed to error correction in younger and older adults. Participants answered general knowledge questions, rated how confident they were that their response was correct, received correct answer feedback, and rated their prior knowledge of the correct response. Overall, confidence was related to error correction for younger adults, but this relationship was much smaller for older adults. However, prior knowledge was strongly related to error correction for both younger and older adults. Confidence alone played little unique role in error correction after controlling for the role of prior knowledge. These data demonstrate that prior knowledge largely predicts error correction and suggests that both older and younger adults can use their prior knowledge to effectively correct errors in memory.
Dong, XinQi; Zhang, Manrui
Background Perceived stress influences the health and well-being of older adults. This study aims to examine the association between the expectation and the receipt of filial piety and perceived stress among U.S Chinese older adults. Methods Data were drawn from the PINE study, a population-based study of Chinese older adults aged 60 and above in the greater Chicago area. Perceived stress was assessed by the PSS-10 and was the dependent variable. Independent variables were the expectation and the receipt of filial piety examined in six domains. Negative Binomial Regression and Multivariable Logistic Regression analyses were conducted. Results Of the 3,159 Chinese older adults interviewed, the mean age was 72.8 (SD=8.3) and 58.9% were female. Compared with older adults who received a high level of filial piety, older adults who received a medium level of filial piety were 1.57 (1.29–1.93) times more likely to perceive stress as high, and older adults who received a low level of filial piety were 2.74 (2.26–3.33) times more likely to perceive stress as high, after controlling for the potential confounding variables. The expectation of filial piety was not significantly associated with perceived stress. Conclusion A low level of filial piety receipt may be a risk factor for perceived stress. Our findings suggest incorporating cultural contributors into the analyses of perceived stress. PMID:27642631
Przybyla, Andrzej; Haaland, Kathleen Y; Bagesteiro, Leia B; Sainburg, Robert L
While cerebral lateralization has previously been well documented for many neurobehavioral functions, recent research has shown that as people age, formerly lateralized processes recruit more symmetric patterns of neural activity. Such findings provide the foundation for the model of hemispheric asymmetry reduction in older adults, or "HAROLD". Previous studies that have measured reaction time and movement time have suggested that aging does not affect manual asymmetries. However, whether these findings can be extended to kinematic variables associated with motor coordination remains largely unknown. The purpose of the current study is to determine whether asymmetries in intralimb coordination are also reduced during the aging process. We examined multidirectional reaching in two different right handed age groups, a younger group from 20 to 40 years of age, and an older group, from 60 to 80 years of age. Measures of final position accuracy, precision, and trajectory linearity showed robust asymmetries between the left and right arm groups of young adults. However, the trajectories and accuracies of the older subjects were symmetric, such that our dependent measures were not significantly different between the right and left arm groups. Our findings extend the HAROLD model to motor behavior, suggesting that aging results in decrements in motor lateralization.
Nicholson, Nicholas R; Shellman, Juliette
Older adults reporting social isolation are at increased risk for numerous negative health outcomes, including depressive symptoms, decreased quality of life, and cardiovascular disease. The purpose of this study was to test the effects of a university student model of care intervention offered through the CARELINK program on social isolation in a sample of community-dwelling older adults (N = 56). Older adults in the comparison group, who had not yet received the CARELINK program, were nearly 12 times more likely to be socially isolated. Results indicate the empowerment intervention offered through the CARELINK program had positive effects on reducing social isolation in older adults. The CARELINK program has important implications for nursing as it provides an uncomplicated and inexpensive intervention to decrease social isolation for older adults in the community. Given the sample selection limitation in this study, a randomized controlled trial is warranted. Future research should examine specific aspects of the CARELINK program and the amount each aspect affects social isolation.
Meade, Michelle L; Geraci, Lisa D; Roediger, Henry L
In 2 experiments we examined the influence of frontal lobe function on older adults' susceptibility to false memory in a categorized list paradigm. Using a neuropsychological battery of tests developed by Glisky, Polster, and Routhieaux (1995), we designated older adults as having high- or low-frontal function. Young and older adults studied and were tested on categorized lists using free report cued recall and forced report cued recall instructions, with the latter requiring participants to produce responses even if they had to guess. Under free report cued recall instructions, frontal lobe function was a strong predictor of false memories in older adults: Older adults who scored low on tests of frontal functioning demonstrated much higher levels of false recall than younger adults, whereas levels of false recall in high-frontal older adults were more similar to those of young adults. However, after forced report cued recall, high- and low-frontal older adults performed similarly to each other, and both demonstrated higher levels of false recall than young adults. On a final recognition test, high-frontal older adults in both the free report cued recall and forced report cued recall conditions were more successful than low-frontal older adults in using source information to reduce memory errors. The results indicate that older adults show higher levels of false recall than younger adults, but type of test (free report or forced report) and neuropsychological status of older adults mediate these effects. Low-frontal older adults are particularly susceptible to producing false memories on free report tests that entail source monitoring.
Liu, Chiung-ju; Kemper, Susan; Bovaird, James A.
This study examined how Flesch Reading Ease and text cohesion affect older adults' comprehension of common health texts. All older adults benefited when high Flesh Reading Ease was combined with high cohesion. Older adults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, older adults with low verbal ability or older than 77 years of age had difficulty understanding texts high in text cohesion but low in Flesch Reading Ease. These results imply that writers must increase Flesch Reading Ease without disrupting text cohesion to ensure comprehension of health-related texts. PMID:19543546
Tang, Fengyan; Choi, Eunhee; Morrow-Howell, Nancy
Purpose: This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits older adults. Design and Methods: This is a 2-wave study of 253 older adult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling…
Keintz, Martha K.; And Others
The Cancer Program for Older Citizens is a program to improve the outcome of a possible cancer diagnosis for older adults by encouraging early detection of cancer. Program has achieved positive, though modest, changes in the cancer-related knowledge and beliefs of older adult participants, with these impacts sustained for months after the program.…
Gordon-Salant, Sandra; Friedman, Sarah A.
Purpose: To determine whether older blind participants recognize time-compressed speech better than older sighted participants. Method: Three groups of adults with normal hearing participated (n = 10/group): (a) older sighted, (b) older blind, and (c) younger sighted listeners. Low-predictability sentences that were uncompressed (0% time…
Viswanathan, Ravi K.; Mathur, Sameer K.
There is a common perception among physicians and patients that allergic diseases are not relevant in older adults. There is recognition that both innate and adaptive immune functions decline with aging. It is the function of a variety of immune cells in the form of allergic inflammation that is a hallmark of allergic diseases. In fact, there is a fairly consistent observation that measures of allergic sensitization, such as skin prick testing, specific IgE or total IgE decline with age. Nonetheless, the association between allergic sensitization and allergic diseases, particularly asthma and allergic rhinitis, remains robust in the elderly population. Consequently, an appropriate evaluation of allergic sensitivities is warranted and indicated in older asthma and rhinitis patients in order to provide optimal care for the individual and minimize any resultant morbidity and mortality. PMID:21667198
Baillargeon, Jacques; Urban, Randall J.; Kuo, Yong-Fang; Ottenbacher, Kenneth J.; Raji, Mukaila A.; Du, Fei; Lin, Yu-li; Goodwin, James S.
Background Testosterone therapy for older men has increased substantially over the past decade. Research on the effects of testosterone therapy on cardiovascular outcomes has yielded inconsistent results. Objective To examine the risk of myocardial infarction (MI) in a population-based cohort of older men receiving intramuscular testosterone. Method Using a 5% national sample of Medicare beneficiaries, we identified 6355 patients treated with at least 1 injection of testosterone between January 1, 1997, and December 31, 2005. We matched this cohort to 19 065 testosterone nonusers at a 1:3 ratio based on a composite MI prognostic score. Patients were followed until December 31, 2005, or until they lost coverage from Medicare, enrolled in a health maintenance organization, experienced a MI, or died. Result In a Cox regression analysis adjusting for demographic and clinical characteristics, receipt of testosterone therapy was not associated with an increased risk of MI (hazard ratio [HR] = 0.84; 95% CI = 0.69–1.02). In this analysis, there was an interaction between receipt of testosterone and quartile of risk of MI (P = 0.023). For men in the highest quartile of the MI prognostic score, testosterone therapy was associated with a reduced risk of MI (HR = 0.69; 95% CI = 0.53–0.92), whereas there was no difference in risk for the first (HR = 1.20; 95% CI = 0.88–1.67), second (HR = 0.94; 95% CI = 0.69–1.30), and third quartiles (HR = 0.78; 95% CI = 0.59–1.01). Conclusion Older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI. For men with high MI risk, testosterone use was modestly protective against MI. PMID:24989174
Nochajski, Thomas H; Waldrop, Deborah P; Davis, Elaine L; Fabiano, Jude A; Goldberg, Louis J
Our study considered dental students' general attitudes towards older persons using the Aging Semantic Differential. The influence of age, gender, cohort, education, and academic exposure on general attitudes towards older adults was evaluated using a total of 328 dental students across all four years of academic standing. Students were assessed in the fall and spring semesters. The results showed differential responding on the four subscales, with slight positive ratings on the autonomy, acceptability, and integrity subscales and a slight negative rating for instrumentality. Females expressed more negative attitudes than their male counterparts, with no age differences. There was also no significant impact from a specific, didactic educational component offered to the fourth-year students. However, the fourth-year students were the only group to show positive changes across the full academic year. The results suggest that general attitudes can be changed, but didactic (classroom) forms of education alone are insufficient to meaningfully modify students' perceptions of the elderly. Exposure to older adults in a clinical setting appears to be a critical element, as the fourth-year students received much greater exposure to older patients and more intensified interface with their mentors.
Ganong, Lawrence H; Coleman, Marilyn; Benson, Jacquelyn J; Snyder-Rivas, Linley A; Stowe, James D; Porter, Eileen J
Older adults who live alone are at risk for problems (e.g., falling, sudden illness). To maintain themselves safely at home they may benefit from planning to prevent problems. The purpose of this study was to evaluate an intervention designed to train family members or friends as to how to help older adults who were living alone make plans to maintain independence safely in their homes and to make behavioral and household changes to enhance safety. Support network members of 19 older adults randomly assigned to the intervention group were taught to use multiple segment vignettes to assist the older adults in creating plans for living safely. Older adults in the control group (n = 21) were asked to engage in an unstructured discussion about home safety with their network members. Older adults in the intervention group developed safer plans and made more household and behavioral changes than did control group adults.
Clifford, Kalin M.; Dy-Boarman, Eliza A.; Haase, Krystal K.; Maxvill, Kristen (Hesch); Pass, Steven; Alvarez, Carlos A.
Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharmacodynamic changes in the older adult, medications are absorbed, metabolized, and eliminated at different rates as compared to younger adults, which increases risk of adverse drug reactions due to use of drug therapy needed for sepsis management. This review provides information to aid in diagnosis as well as offers recommendations for monitoring and treating sepsis in the older adult population. PMID:26687340
Croston, Jami; Meuser, Thomas M.; Berg-Weger, Marla; Grant, Elizabeth A.; Carr, David B.
In order to characterize the driving and mobility status of older adults with dementia, a questionnaire was mailed to 527 informants; 119 were returned. The majority of patients were diagnosed with Dementia of the Alzheimer’s Type. Only 28% were actively driving at the time of survey. Informants rated 53% of current or recently retired drivers as potentially unsafe. Few informants reported using community/educational resources. Individuals with progressive dementia retire from driving for differing reasons, many subsequent to family recognition of impaired driving performance. Opportunities for education and supportive assistance exist but are underutilized. PMID:20161565
Sum, Shima; Mathews, R Mark; Hughes, Ian; Campbell, Andrew
Use of the Internet by seniors as a communication technology may lead to changes in older adult social relationships. This study used an online questionnaire to survey 222 Australians over 55 years of age on Internet use. Respondents primarily used the Internet for communication, seeking information, and commercial purposes. The results showed negative correlations between loneliness and well-being. Multiple regression analyses revealed that greater use of the Internet as a communication tool was associated with a lower level of social loneliness. In contrast, greater use of the Internet to find new people was associated with a higher level of emotional loneliness.
Posthauer, Mary Ellen; Dorner, Becky; Friedrich, Elizabeth K
Older adults living in healthcare communities (HCCs) have multiple comorbidities and are at increased risk of malnutrition and unintended weight loss. Aging affects nearly every system as well as body composition and structure, causing physiological changes that can affect nutrition status. A significant percentage (56%) of residents who live in nursing facilities require extensive help to eat and have dental problems such as ill-fitting dentures, missing teeth, and swallowing problems, which can lead to inadequate caloric intake and unintended weight loss. Alzheimer disease or dementia is prevalent in both nursing facilities and in assisted living/residential care communities, where it affects 45% of older adults. In cognitively impaired residents, most tube feeding placements occur in the acute care setting and result in significant use of additional healthcare resources, along with high postinsertion mortality rates within 60 days of insertion. Nursing facilities receiving Medicare or Medicaid funding must abide by state and federal regulations and undergo rigorous surveys while balancing complex decisions related to initial placement of feeding tubes. Healthcare professionals must recognize the importance of establishing nutrition treatment goals that are resident centered and that respect the unique values and personal decisions of the older adult. Informed choice, resident-centered care decisions, and the review of living wills and/or advance directives are essential in the decision-making process. After enteral nutrition is started, healthcare practitioners must carefully review the physician's orders and administer and monitor the resident's tolerance, checking for potential complications.
Chang, Dian-Fu; Lin, Sung-Po
This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of older adults. The finding revealed that the higher age or the lower education attainment of older adults, the lower their learning motivation. The…
Anderson, Keith A; Weber, Katherine V
Reminiscence can be beneficial for older adults and contribute to well-being and ego integrity. In this exploratory pilot study, researchers assessed the feasibility and tolerability of a novel reminiscence intervention using automobiles as the focal point. Nineteen older adults (N = 19) were asked to reminisce using photographs of automobiles from across their lifespan. The RE-AIM framework was used to assess the intervention in terms of reach, effectiveness, adoption, implementation, and maintenance. The intervention was well-received, quickly established rapport, and effectively fostered reminiscence. Social workers may find this intervention useful in helping older adults to explore their lives.
Kadell, Andria R.
Older adults are the fastest growing segment of the world population. Older adults are also at heightened risk of chronic conditions (such as diabetes, heart disease, and cancer) and specific geriatric conditions (such as cognitive impairment, frailty, and falls). Research studies have examined the relationship between fruit and vegetable intake and subsequent health outcomes and the correlates of fruit and vegetable intake in the U.S. population. However, relatively few studies have specifically examined health impacts and correlates of fruit and vegetable intake among older adults, who have unique biophysical and socioeconomic circumstances. Evidence is reviewed to (1) describe findings related to consumption and chronic, geriatric, and other health outcomes among older adults and (2) describe patterns in fruit and vegetable consumption among older adults and how these patterns vary within and among populations. This review addresses specific barriers faced by older adults in obtaining and consuming fruits and vegetables in community settings. Recommendations for practice and policy are discussed. PMID:23769545
Rush, Kathy L; Watts, Wilda E; Stanbury, Janice
The purpose of this secondary study was to describe the mobility adaptations of community-living older adults. The primary study, designed to understand weakness and aging from the perspective of older adults, revealed that older adults viewed weakness as a progression from inability to an end point of 'giving up,' which prompted the use of adaptation strategies to preserve mobility and to counter a self-identity of being weak. A qualitative descriptive design guided the primary study of 15 community-living older adults, who participated in in-depth interviews. A systematic secondary analysis using Baltes and Baltes' theory of Selective Optimization with Compensation (SOC) showed that older adults used selection, optimization, and compensation adaptations across a range of mobility behaviors. The SOC model offered a framework for profiling older adults' agency and motivations in meeting mobility challenges as they age and provided the basis for targeted interventions to maximize mobility with aging.
Goghari, Vina M.
The present study evaluated subjective and objective cognitive measures as predictors of fluid intelligence in healthy older adults. We hypothesized that objective cognitive measures would predict fluid intelligence to a greater degree than self-reported cognitive functioning. Ninety-three healthy older (>65 years old) community-dwelling adults participated. Raven's Advanced Progressive Matrices (RAPM) were used to measure fluid intelligence, Digit Span Sequencing (DSS) was used to measure working memory, Trail Making Test (TMT) was used to measure cognitive flexibility, Design Fluency Test (DFT) was used to measure creativity, and Tower Test (TT) was used to measure planning. The Cognitive Failures Questionnaire (CFQ) was used to measure subjective perceptions of cognitive functioning. RAPM was correlated with DSS, TT, and DFT. When CFQ was the only predictor, the regression model predicting fluid intelligence was not significant. When DSS, TMT, DFT, and TT were included in the model, there was a significant change in the model and the final model was also significant, with DFT as the only significant predictor. The model accounted for approximately 20% of the variability in fluid intelligence. Our findings suggest that the most reliable means of assessing fluid intelligence is to assess it directly. PMID:28250990
Martin, Jessica B.; Krč, Katarina M.; Mitchell, Emily A.; Eng, Janice J.; Noble, Jeremy W.
The purpose of this study was to determine pedometer accuracy during slow overground walking in older adults (Mean age = 63.6 years). A total of 18 participants (6 males, 12 females) wore 5 different brands of pedometers over 3 pre-set cadences that elicited walking speeds between 0.3 and 0.9 m/s and one self-selected cadence over 80 meters of indoor track. Pedometer accuracy decreased with slower walking speeds with mean percent errors across all devices combined of 56%, 40%, 19% and 9% at cadences of 50, 66, and 80 steps/min, and self selected cadence, respectively. Percent error ranged from 45.3% for Omron HJ105 to 66.9% for Yamax Digiwalker 200. Due to the high level of error across the slowest cadences of all 5 devices, the use of pedometers to monitor step counts in healthy older adults with slower gait speeds is problematic. Further research is required to develop pedometer mechanisms that accurately measure steps at slower walking speeds. PMID:24795762
Emlet, Charles A.
LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery. PMID:28366981
Clifford, Kalin M; Duncan, Nakia A; Heinrich, Krista; Shaw, Jennifer
With the recent updates to the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), there are many questions on how to care for older adults with generalized anxiety disorder (GAD) and other psychiatric conditions. The current article reviews the new changes to the DSM-5 for diagnosis of GAD, discusses new anxiety assessment scales that are validated in older adults, evaluates pharmacological agents that have been studied in older adults for GAD treatment, and provides monitoring recommendations to help those who provide care to older adults experiencing GAD.
Chang, Janet; McAllister, Carolyn; McCaslin, Rosemary
Older adults constitute the group with the greatest increase in Internet usage in the past decade; however, usage varies greatly within this population. Services to older adults require a current understanding of Internet-use trends. This study utilized a quantitative survey method to examine correlates of, and barriers to, current Internet use in a demographically diverse county in Southern California. Findings indicate that the presence of a computer at home, a job requiring computer use, age, education, and ethnicity are important factors in predicting Internet use in older adults. Implications for social work practice with older adults is discussed.
Seed, Sheila M; Dunican, Kaelen C; Lynch, Ann M
Osteoarthritis (OA) is the most common form of arthritis and the leading cause of disability among older adults in the United States. Treatment options such as acetaminophen and nonsteroidal anti-inflammatory drugs are the most widely used agents to manage mild-to-moderate pain. Treatment with tramadol or opioids is usually reserved for severe pain associated with OA. These agents do not come without risk, especially for older adults. Patient-specific parameters and comorbid conditions must be considered when evaluating treatment options for older adults. This article reviews pharmacological and nonpharmacological approaches to the management of OA in older adults.
Cnaan, Ram A; Boddie, Stephanie C; Kang, Jennifer
A large proportion of older adults are affiliated with congregations. The literature suggests that, in general, religious participation among the older adults enhances their quality of life and provides a network of social care. In this article, we explored the relevant literature on organized religion and social support for older adults. Based on a census study of congregations in Philadelphia (N = 1,393), we documented the following: (1) the number of congregations serving older adults, (2) the types of services provided, and (3) the number of beneficiaries. The study also identified the organizational factors that predict the provision of congregation-based services for older adults. The findings suggest that serving older adults is not a top priority for most congregations. Most senior programs are small and often informal. Approximately half (48%) of the congregations do not provide a formal social service. However, those congregations that are more likely to serve older adults have larger budgets, more members over 65-years-old, and a moderate political orientation. We recommend that congregations, social service providers, and older adults explore ways to maximize this underutilized resource of congregational services to meet the needs of the increasing number of older adults.
Clarke, Philippa; Hirsch, Jana A; Melendez, Robert; Winters, Meghan; Sims Gould, Joanie; Ashe, Maureen; Furst, Sarah; McKay, Heather
The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.
Bailey, Phoebe E; Slessor, Gillian; Rieger, Matthias; Rendell, Peter G; Moustafa, Ahmed A; Ruffman, Ted
In a series of 1-shot economic trust games in which participants could make real monetary profits, but also risked losing money, 2 studies compared young and older adults' trust (amount invested with trustees) and trustworthiness (amount returned to investors by trustees). In Study 1, young (n = 35) and older (n = 32) participants acted as investors, and the age of simulated trustees (young, older) was manipulated. In Study 2, young (n = 61) and older (n = 67) participants acted in real life as both investors and trustees. They completed 2 face-to-face trust games with same- and other-age partners, and 3 anonymous trust games with same-, other-, and unknown-age partners. Study 1 found that young and older participants rate older trustees as appearing more trustworthy than young trustees, but neither group invest more with older than young trustees. Rather, older participants were more likely than young participants to invest money averaged across trustee age. In Study 2, there were no age-related differences in trust, but older adults were more trustworthy than young adults in anonymous games with same- and unknown-age partners. It was also found that young adults demonstrate greater reputational concerns than older adults by reciprocating more trust when face-to-face than anonymous. We discuss the complex influences of age on trust game investing and reciprocation, as well as the implications for older adults' wellbeing and financial security.
There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults. PMID:22348431
Tauxe, William M.; Haydek, John P.; Rebolledo, Paulina A.; Neish, Emma; Newman, Kira L.; Ward, Angela; Dhere, Tanvi; Kraft, Colleen S.
Background: The objective of this study was to describe the safety of fecal microbiota transplant (FMT) for Clostridium difficile infection (CDI) among older adults. Methods: We performed a case review of all FMT recipients aged 65 or older treated at Emory University Hospital, a tertiary care and referral center for Georgia and surrounding states. Results: CDI resolved in 27 (87%) of 31 respondents, including three individuals who received multiple FMTs. Among four whose CDI was not resolved at follow up, three respondents did well initially before CDI recurred, and one individual never eradicated his CDI despite repeating FMT. During the study, five deaths and eight serious adverse events requiring hospitalization were reported within the study group during the follow-up period. Fecal transplant was not a causative factor in these events. The most common adverse event reported in 4 (13%) of 31 respondents was subjective worsening of arthritis. Conclusion: FMT is a generally safe and effective treatment option for older adults with CDI. PMID:27134658
Thompson, Ashley E; O'Sullivan, Lucia F; Byers, E Sandra; Shaughnessy, Krystelle
Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults' explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18-24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.
Jennings, Tezra; Perry, Tam E.; Valeriani, Julia
This article uses a qualitative, ethnographic approach to examine the experiences older adults and their kin, as the older adult engages in relocation. Studies looking at caregiving by kin for older adults highlight burdens for the adult child. This study offers a life course perspective on kinship care, analyzing older adults' decisions' to move. It was found that many older adults are strongly influenced by the desire to not be cared for by their kin as well as to select housing near their existing social network, which might exclude kin. In conclusion, policy implications are discussed. PMID:25278741
Memory suppression refers to the ability to exclude distracting memories from conscious awareness, and this ability can be assessed with the think/no-think paradigm. Recent research with older adults has provided evidence suggesting both intact and deficient memory suppression. The present studies seek to understand the conditions contributing to older adults’ ability to suppress memories voluntarily. We report 2 experiments indicating that the specificity of the think/no-think task instructions contributes to older adults’ suppression success: When older adults receive open-ended instructions that require them to develop a retrieval suppression strategy on their own, they show diminished memory suppression compared with younger adults. Conversely, when older adults receive focused instructions directing them to a strategy thought to better isolate inhibitory control, they show suppression-induced forgetting similar to that exhibited by younger adults. Younger adults demonstrate memory suppression regardless of the specificity of the instructions given, suggesting that the ability to select a successful suppression strategy spontaneously may be compromised in older adults. If so, this deficit may be associated with diminished control over unwanted memories in naturalistic settings if impeded strategy development reduces the successful deployment of inhibitory control. PMID:25602491
Geraci, Lisa; Miller, Tyler M
Holding negative aging stereotypes can lead older adults to perform poorly on memory tests. We attempted to improve older adults' memory performance by giving them task experience that would counter their negative performance expectations. Before participating in a memory experiment, younger and older adults were given a cognitive task that they could either successfully complete, not successfully complete, or they were given no prior task. For older adults, recall was significantly higher and self-reported anxiety was significantly lower for the prior task success group relative to the other groups. There was no effect of prior task experience on younger adults' memory performance. Results suggest that older adults' memory can be improved with a single successful prior task experience.
The Shyness Scale (SS) is a brief instrument for assessing shyness as a personality trait. The psychometric properties of the Chinese version of the SS were investigated in a random sample of 192 Macau Chinese older adults. The Chinese version of the SS possesses high internal consistency and exhibited satisfactory short-term test-retest reliability. The Chinese version of the SS exhibited acceptable convergent validity with other negative measures of psychological well-being including negative emotional states (assessed by the Negative Affect Scale), loneliness (assessed by the UCLA Loneliness Scale), and state anxiety and trait anxiety (assessed by STAI). The divergent validity of the Chinese version of the SS was demonstrated by the negative but significant association between the SS and self esteem (assessed by Rosenberg Self Esteem Inventory).
Cuijpers, Pim; Smit, Filip; Patel, Vikram; Dias, Amit; Li, Juan; Reynolds, Charles F
Prevention of depressive disorders is one of the most important challenges for health care in coming decades. Depressive disorders in all age groups have a high disease burden and are associated with huge economic costs, and current treatments are only capable of taking away one-third of the (nonfatal) disease burden of depression under optimal conditions. Prevention may be one alternative strategy that may help in further reducing the disease burden of depression. Because of the worldwide increase in the number of older adults, the number of depressed older adults will also increase considerably in the next few decades, making prevention of depression an important priority for research. Identifying the high-risk target groups for preventive interventions is complicated because most risk indicators have a low specificity, indicating that most people from these groups will not develop the disorder despite increased risk levels. We describe one promising method to identify the best target groups, based on the principle that the high-risk group should be as small as possible, should be responsible for as many new cases of depression as possible, and that intervention be as effective as possible. The number of trials examining the possibility to prevent the onset of depressive disorders in those who do not (yet) meet diagnostic criteria for depression is increasing rapidly. A recent meta-analysis identified more than 30 randomized trials and these studies showed that the incidence of depressive disorders was 21% lower in the prevention groups compared with the control groups who did not receive the preventive intervention. Most of these trials are aimed at adolescents and younger adults. Only six trials were specifically aimed at older adults. The development of evidence-based preventive interventions for major depression and other mental disorders should be an important scientific and public health objective for the 21st century.
Hoge, Michael A.; Karel, Michele J.; Zeiss, Antonette M.; Alegria, Margarita; Moye, Jennifer
Professional psychology faces an urgent crisis, which the following facts paint in stark relief. Adults over age 65 will rise to 20% of the U.S. population over the next 15 years and already account for a third of the country’s health care expenditures. Up to 8 million older adults experience mental health and substance use conditions in a given year, yet most psychologists receive no training in their assessment and treatment. No more than an estimated 4%, or 3,000, psychologists nationwide specialize in geropsychology; a ratio approaching 3,000 to 1. A small group of advocates within the profession have sounded the alarm and worked to strengthen geropsychology as a specialty, but this has had very limited impact on the actual supply of psychologists qualified to provide services to this population. In 2012, an Institute of Medicine (IOM) committee released a report on the crisis regarding the mental health and substance use workforce for older adults. Drawing on that report, a team composed of geropsychologists, along with psychologists who served on the IOM committee, identifies in this article priority areas for workforce development. The authors assess the progress of psychology in each of these areas and offer a set of recommendations for future efforts by this profession to develop its own workforce and to strengthen the ability of other caregivers to address the behavioral health needs of older adults. Strengthening its own workforce and responding to the needs of this population is imperative if psychology is to maintain its relevance as a health profession and meet its ethical obligations to an increasingly diverse society. PMID:25844650
Ryan, Ellen Bouchard; Anas, Ann P.; Mays, Heather
Within a communication predicament of aging and disability framework, this study examined the impact of two types of contextual variation on perceptions of older adult assertiveness within problematic service encounters. Young (N = 66) and older (N = 66) participants evaluated conversational scenarios in which a visually-impaired older woman…
This report, “Data Sources Available for Modeling Environmental Exposures in Older Adults,” focuses on information sources and data available for modeling environmental exposures in the older U.S. population, defined here to be people 60 years and older, with an emphasis on those...
McDougall, Graham J; Vance, David E; Wayde, Ernest; Ford, Katy; Ross, Jeremiah
Previous tests of the SeniorWISE intervention with community-residing older adults that were designed to improve affect and cognitive performance were successful and positively affected these outcomes. In this study, we tested whether adding yoga to the intervention would affect the outcomes. Using a quasiexperimental pre-post design, we delivered 12 hours of SeniorWISE memory training that included a 30-minute yoga component before each training session. The intervention was based on the four components of self-efficacy theory: enactive mastery experience, vicarious experience, verbal persuasion, and physiologic arousal. We recruited 133 older adults between the ages of 53 and 96 years from four retirement communities in Central Texas. Individuals were screened and tested and then attended training sessions two times a week over 4 weeks. A septuagenarian licensed psychologist taught the memory training, and a certified yoga instructor taught yoga. Eighty-three participants completed at least 9 hours (75%) of the training and completed the posttest. Those individuals who completed made significant gains in memory performance, instrumental activities of daily living, and memory self-efficacy and had fewer depressive symptoms. Thirteen individuals advanced from poor to normal memory performance, and seven improved from impaired to poor memory performance; thus, 20 individuals improved enough to advance to a higher functioning memory group. The findings from this study of a memory training intervention plus yoga training show that the benefits of multifactorial interventions had additive benefits. The combined treatments offer a unique model for brain health programs and the promotion of nonpharmacological treatment with the goals of maintaining healthy brain function and boosting brain plasticity.
Stein-Shvachman, Ifat; Karpas, Dikla Segel; Werner, Perla
Depression is a common disease among young and older adults. Although it can be treated, non-adherence is very common among individuals of different ages. The aim of the present paper is to review and summarize research findings regarding depression among young and older adults, with a special focus on the phenomenon of treatment non-adherence among young and older adults with depression. The first section of the review focuses on describing the characteristics of depression in young and older adults. The second section focuses on treatment non-adherence of young and older adults, the prevalence of this phenomenon, and its consequences. The third section focuses on several factors (illness beliefs, treatment beliefs, self-stigma, and self-esteem) that were identified as having a significant association with treatment non-adherence of individuals with depression, with special attention focused on age differences. Results of the review of the literature reveal that research in the area of depression treatment non-adherence and its predictors among young and older adults has received, to date, very minor and limited attention. Thus, there is a need to expand the current body of knowledge and promote future interventions geared towards the unique characteristics of depression among young and older adults, in order to increase their treatment adherence.
Carmichael, Anna M; Gutchess, Angela H
Warnings about memory errors can reduce their incidence, although past work has largely focused on associative memory errors. The current study sought to explore whether warnings could be tailored to specifically reduce false recall of categorical information in both younger and older populations. Before encoding word pairs designed to induce categorical false memories, half of the younger and older participants were warned to avoid committing these types of memory errors. Older adults who received a warning committed fewer categorical memory errors, as well as other types of semantic memory errors, than those who did not receive a warning. In contrast, young adults' memory errors did not differ for the warning versus no-warning groups. Our findings provide evidence for the effectiveness of warnings at reducing categorical memory errors in older adults, perhaps by supporting source monitoring, reduction in reliance on gist traces, or through effective metacognitive strategies.
Kullgren, Jeffrey T.; Harkins, Kristin A.; Bellamy, Scarlett L.; Gonzales, Amy; Tao, Yuanyuan; Zhu, Jingsan; Volpp, Kevin G.; Asch, David A.; Heisler, Michele; Karlawish, Jason
Background: Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. Methods: We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received a pedometer, daily walking goals, and weekly feedback on goal achievement. Participants…
The objective of this study was to determine if community based health education programs increased knowledge and health behavior in older adults. The study was a pretest-posttest design with a convenience sample of 111 independent community dwelling older adults. Participants received two disease prevention education presentations: type 2…
Connell, C M
A review of articles published in two health education journals is provided to examine the extent to which older adults were included in published research. The review suggests that older adults were included in about 15% of the research articles published in Health Education and Behavior and Health Education Research. Of the articles that include older adults, age differences in study processes and outcomes are rarely examined, and very few studies advance specific hypotheses based on a theoretical or conceptual model of aging or older adulthood. Several recommendations for health education research are suggested.
Tang, Fengyan; Morrow-Howell, Nancy; Hong, Songiee
As more nonprofit organizations rely on older adult volunteers to provide services, it is important to retain volunteers for an extended period of time to ensure service quality and the beneficial outcomes of volunteering. Nonprofit organizations are positioned to facilitate older adult volunteers' role performance. Based on an institutional…
Hardt, Jeffrey H.; Hollis-Sawyer, Lisa
Due to an aging population and increases in healthcare costs, particular attention needs to be focused on developing Internet sites that provide older adults with credible and accurate healthcare information. Present research findings suggest that motivation is only one factor that influences whether or not older adults utilize the World Wide Web…
This study investigated older adults' peer teaching experiences at a Lifelong Learning Institute through interviews with eight teachers and observations of their classes. Thematic analysis revealed themes of peer-to-peer teaching, volunteer teaching, and explorative teaching. Discussion of the themes examines the meaning of older adults' peer…
Leutwyler, Heather; Hubbard, Erin M; Vinogradov, Sophia; Dowling, Glenna A
Older adults with schizophrenia need physical activity interventions to improve their physical health. The purpose of this report is to describe the preliminary acceptability of a videogame-based physical activity program using the Kinect™ for Xbox 360 game system (Microsoft, Redmond, WA) in older adults with schizophrenia.
Clair, Alicia Ann; Memmott, Jenny
In this comprehensively updated second edition, written by Alicia Ann Clair and Jenny Memmott the extraordinary benefits of music therapy for older adults are detailed. "Therapeutic Uses of Music with Older Adults" not only examines these benefits but also clarifies the reasons that music is beneficial. This important book shows both informal and…
Holt, Elizabeth W.; Rung, Ariane L.; Leon, Kyla A.; Firestein, Catherine; Krousel-Wood, Marie
To effectively address medication adherence and improve cardiovascular health among older adults, a deeper understanding is needed of the barriers that this age group faces and of approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n = 25) in a diverse population of older adults with…
Story, Colleen D.
The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…
Bankoff, Sarah M.; Sandberg, Elisabeth Hollister
Previous research demonstrates that patients typically have difficulty remembering information presented during healthcare consultations. This study examined how older adults learn and remember verbally presented medical information. Healthy older adults were tested for recall in experimental and field settings. Participants viewed a five-minute…
Manafo, Elizabeth; Wong, Sharon
Older adults make up the fastest growing age group in North America. This has demanded increased attention in supporting the health and well-being of this population and, in particular, the role of health information in promoting the health and well-being of older adults. Increased availability and accessibility of information as well as a greater…
Hantman, Shira; Gimmon, Eli
The purpose of this article is to describe a project that aims to foster active aging through entrepreneurial activities among older adults. The project establishes the feasibility of implementing an intervention program that assimilates the concept and capabilities of entrepreneurship among older adults and supports them while launching new…
Margolin, Sara J.
The present research aimed to examine young and older adults' comprehension of negated text to determine the locus of older adults' difficulty in understanding this text construction. Participants were asked to read short passages at their own pace, complete a lexical decision task, and answer a comprehension question about what they had read.…
Klinger-Vartabedian, Laurel C.
Examines the "social interaction" of older adults as a communication phenomenon which influences self-concept. Explores older adult group processes, and gives specific applications of group methods. Suggests the importance of assessing and applying communication constructs to research on detection and prevention of social isolation through formal…
Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Anetzberger, Georgia J.
Purpose: This study tested key psychometric properties of the Older Adult Psychological Abuse Measure (OAPAM), one self-report scale of the Older Adult Mistreatment Assessment (OAMA). Design and Methods: Items and theory were developed in a prior concept mapping study. Subsequently, the measures were administered to 226 substantiated clients by 22…
Craig, Ford M.
With a declining pool of youth to draw from, community colleges need to be concerned about what can be done to serve the needs of a burgeoning older adult population. Recent research on the educational needs of older adults reveals that they are interested in: (1) information on such personal business and financial topics as social security…
Werth, James L., Jr.; Kopera-Frye, Karen; Blevins, Dean; Bossick, Brian
The increasing older adult population has implications for the training and practice of counseling psychologists because of the field's avowed dedication to lifespan development. The present study examined the degree to which older adults were represented in articles in the "Journal of Counseling Psychology" and "The Counseling Psychologist" from…
Noting that traditional physical education (PE) courses are geared toward healthy, younger students, this paper examines the need to provide adapted PE programs for older adults. The paper first discusses the growing number of older adults in the population and the concomitant need to overcome the materialistic values that relegate the elderly to…
Wayde, Ernest N; Black, Sheila R; Gilpin, Ansley
Age-related differences in purchasing decisions were examined as a function of age and familiarity. On each trial, participants received purchasing options which varied in quality but ultimately cost the same amount of money. On half the trials, participants made decisions about items familiar to younger adults and on the other half of the trials, participants made decisions about products familiar to older adults. The participants' task was to choose the option that provided the best value for the money. We were particularly interested in participants' performance when inferencing was required to select the optimal option from the two choices. Younger adults outperformed older adults in unfamiliar but not familiar domains. It appeared that both younger and older adults used inferencing and elaborative processing to make the best decision in familiar domains but that only younger adults used inferencing and elaborative processing in unfamiliar domains.
Keogh, Justin W L; Kilding, Andrew; Pidgeon, Philippa; Ashley, Linda; Gillis, Dawn
Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B-level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults' lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.
Hawley-Hague, Helen; Horne, Maria; Skelton, Dawn A; Todd, Chris
Exercise classes provide a range of benefits for older adults, but adherence levels are poor. We know little of instructors' experiences of delivering exercise classes to older adults. Semistructured interviews, informed by the Theory of Planned Behavior (TPB), were conducted with instructors (n = 19) delivering multicomponent exercise classes to establish their perspectives on older adults' uptake and adherence to exercise classes. Analysis revealed 'barriers' to uptake related to identity, choice/control, cost, and venue, and 'solutions' included providing choice/control, relating exercise to identity, a personal touch, and social support. Barriers to adherence included unrealistic expectations and social influences, and solutions identified were encouraging commitment, creating social cohesion, and an emphasis on achieving outcomes. Older adults' attitudes were an underlying theme, which related to all barriers and solutions. The instructor plays an important, but not isolated, role in older adults' uptake and adherence to classes. Instructors' perspectives help us to further understand how we can design successful exercise classes.
Ingvalson, Erin M; Nowicki, Casandra; Zong, Audrey; Wong, Patrick C M
Though there is an extensive literature investigating the ability of younger adults to learn non-native phonology, including investigations into individual differences in younger adults' lexical tone learning, very little is known about older adults' ability to learn non-native phonology, including lexical tone. There are several reasons to suspect that older adults would use different learning mechanisms when learning lexical tone than younger adults, including poorer perception of dynamic pitch, greater reliance on working memory capacity in second language learning, and poorer category learning in older adulthood. The present study examined the relationships among older adults' baseline sensitivity for pitch patterns, working memory capacity, and declarative memory capacity with their ability to learn to associate tone with lexical meaning. In older adults, baseline pitch pattern sensitivity was not associated with generalization performance. Rather, older adults' learning performance was best predicted by declarative memory capacity. These data suggest that training paradigms will need to be modified to optimize older adults' non-native speech sound learning success.
Carroll, Judith E.; Esquivel, Stephanie; Goldberg, Alyssa; Seeman, Teresa E.; Effros, Rita B.; Dock, Jeffrey; Olmstead, Richard; Breen, Elizabeth C.; Irwin, Michael R.
Study Objectives: Insomnia, particularly in later life, may raise the risk for chronic diseases of aging and mortality through its effect on cellular aging. The current study examines the effects of insomnia on telomere length, a measure of cellular aging, and tests whether insomnia interacts with chronological age to increase cellular aging. Methods: A total of 126 males and females (60–88 y) were assessed for insomnia using the Diagnostic and Statistical Manual IV criterion for primary insomnia and the International Classification of Sleep Disorders, Second Edition for general insomnia (45 insomnia cases; 81 controls). Telomere length in peripheral blood mononuclear cells (PBMC) was determined using real-time quantitative polymerase chain reaction (qPCR) methodology. Results: In the analysis of covariance model adjusting for body mass index and sex, age (60–69 y versus 70–88 y) and insomnia diagnosis interacted to predict shorter PBMC telomere length (P = 0.04). In the oldest age group (70–88 y), PBMC telomere length was significantly shorter in those with insomnia, mean (standard deviation) M(SD) = 0.59(0.2) compared to controls with no insomnia M(SD) = 0.78(0.4), P = 0.04. In the adults aged 60–69 y, PBMC telomere length was not different between insomnia cases and controls, P = 0.44. Conclusions: Insomnia is associated with shorter PBMC telomere length in adults aged 70–88 y, but not in those younger than 70 y, suggesting that clinically severe sleep disturbances may increase cellular aging, especially in the later years of life. These findings highlight insomnia as a vulnerability factor in later life, with implications for risk for diseases of aging. Citation: Carroll JE, Esquivel S, Goldberg A, Seeman TE, Effros RB, Dock J, Olmstead R, Breen EC, Irwin MR. Insomnia and telomere length in older adults. SLEEP 2016;39(3):559–564. PMID:26715231
Giesbrecht, Edward M.; Miller, William C.; Mitchell, Ian M.; Woodgate, Roberta L.
Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population. PMID:25276768
Giesbrecht, Edward M; Miller, William C; Mitchell, Ian M; Woodgate, Roberta L
Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population.
Luyster, Faith S.; Choi, JiYeon; Yeh, Chao-Hsing; Imes, Christopher C.; Johansson, Ann E. E.; Chasens, Eileen R.
The negative effects of impaired sleep on physical and mental well-being in older adults have recently been recognized by health care professionals. However, researchers and clinicians may be unaware of reliable and valid screening and evaluation tools for evaluating sleep disorders in older adults. The purpose of this article is to present subjective and objective instruments that measure sleep quality, excessive daytime sleepiness, obstructive sleep apnea, insomnia and restless leg syndrome that are appropriate for use in adult and older adult patients. PMID:26608435
Knight, Lucy; Hester, Marianne
Domestic violence affects every age group and is present throughout the life span, but, while the mental health impact of domestic violence is clearly established in working age adults, less is known about the nature and impact of domestic violence among older adults. This review, therefore, aimed to synthesize findings on the prevalence, nature, and impact of domestic violence among older adults, and its identification and management. Electronic searches were conducted of Medline, PsycINFO, Cinahl, and Embase to identify studies reporting on the mental health and domestic violence in older adults. Findings suggested that, although prevalence figures are variable, the likely lifetime prevalence for women over the age of 65 is between 20-30%. Physical abuse is suggested to decrease with age, but rates of emotional abuse appear to be stable over the lifespan. Among older adults, domestic violence is strongly associated with physical and mental health problems, and the scarce research comparing the impact of domestic violence across the age cohorts suggests that the physical health of older victims may be more severely affected than younger victims. In contrast, there is evidence that older victims may experience less psychological distress in response to domestic violence than younger victims. Internationally, evidence on the management of domestic violence in older adults is sparse. Findings suggest, however, that identification of domestic violence is poor among older adults, and there are very limited options for onwards referral and support.
Rosen, Daniel; Heberlein, Emily; Engel, Rafael J
Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from $2.1 million in 2000 to $9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs.
Illa, Lourdes; Echenique, Marisa; Saint Jean, Gilbert; Bustamante-Avellaneda, Victoria; Metsch, Lisa; Mendez-Mulet, Luis; Eisdorfer, Carl; Sanchez-Martinez, Mario
The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions…
Central tenets of Freirean philosophy and pedagogy are explored and applied to the emerging field of older adults' learning (educational gerontology), a sub-field of adult education. I argue that many of Freire's concepts and principles have direct applicability to the tasks of adult educators working alongside marginalized older adults. In…
While the literature widely acknowledges the importance of social support to the health, well-being and performance of older adults, little is known about the way in which occupational conditions affect older employees’ access to social support over time and whether these effects are maintained after retirement. Accordingly, in the current study we examine the degree to which work hours have longer term effects on the amount and type of support older individuals receive from intimate coworkers, family and non-work friends, and whether these effects are attenuated or intensified for those who retire. Longitudinal data were collected from a random sample of members of nine unions, 6 months prior to their retirement eligibility (T1) and approximately one year after Time 1 (T2). Our findings indicate that while retirement attenuates the positive association between Time 1 work hours and subsequent coworkers' support as well as the negative relationship between Time 1 work hours and subsequent non-work friends support, retirement fails to attenuate the negative effect of Time 1 work hours on subsequent family support. Policy implications are discussed. PMID:20485475
Fein, George; McGillivray, Shannon; Finn, Peter
This study tested the hypotheses that older adults make less advantageous decisions than younger adults on the Iowa gambling task (IGT). Less advantageous decisions, as measured by the IGT, are characterized by choices that favor larger versus smaller immediate rewards, even though such choices may result in long-term negative consequences. The IGT, and measures of neuropsychological function, personality, and psychopathology were administered to 164 healthy adults 18–85 years of age. Older adults performed less advantageously on the IGT compared with younger adults. Additionally, a greater number of older adult’s IGT performances were classified as ‘impaired’ when compared to younger adults. Less advantageous decisions were associated with obsessive symptoms in older adults and with antisocial symptoms in younger adults. Performance on the IGT was positively associated with auditory working memory and psychomotor function in young adults, and in immediate memory in older adults. PMID:17445297
Teoli, Dac A; Smith, Merideth D; Leys, Monique J; Jain, Priyanka; Odom, J Vernon
Eye-related pathological conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration commonly lead to decreased peripheral/central field, decreased visual acuity, and increased functional disability. We sought to answer if relationships exist between measures of visual function and reported prosocial behaviors in an older adult population with eye-related diagnoses. The sample consisted of adults, aged ≥ 60 years old, at an academic hospital's eye institute. Vision ranged from normal to severe impairment. Medical charts determined the visual acuities, ocular disease, duration of disease (DD), and visual fields (VF). Measures of giving help were via validated questionnaires on giving formal support (GFS) and giving informal support; measures of help received were perceived support (PS) and informal support received (ISR). ISR had subscales: tangible support (ISR-T), emotional support (ISR-E), and composite (ISR-C). Visual acuities of the better and worse seeing eyes were converted to LogMAR values. VF information converted to a 4-point rating scale of binocular field loss severity. DD was in years. Among 96 participants (mean age 73.28; range 60-94), stepwise regression indicated a relationship of visual variables to GFS (p < 0.05; Multiple R (2) = 0.1679 with acuity-better eye, VF rating, and DD), PS (p < 0.05; Multiple R (2) = 0.2254 with acuity-better eye), ISR-C (p < 0.05; Multiple R (2) = 0.041 with acuity-better eye), and ISR-T (p < 0.05; Multiple R (2) = 0.1421 with acuity-better eye). The findings suggest eye-related conditions can impact levels and perceptions of support exchanges. Our data reinforces the importance of visual function as an influence on prosocial behavior in older adults.
Tran, Thanh V.
Examined English language acculturation among older Vietnamese refugees (aged 40 and older). Found that age, sex, education in Vietnam, health, and length of residence in United States had some significant relationships with language acculturation. Older Vietnamese people had more problems with language acculturation than younger counterparts, and…
Emlet, Charles A
This study examined social networks and social isolation in older (50 years or more) and younger (ages 20 to 39) adults with HIV/AIDS. The author conducted interviews with 88 individuals living with HIV/AIDS in the Pacific Northwest. Both groups' social networks had similar patterns; however, older adults were more likely to live alone. More than 38 percent of older adults and 54 percent of older adults of color were at risk of social isolation compared with 25 percent of those 20 to 39 years of age. Older men and older adults of color had significantly lower scores on the social network scale than others. Having a confidant and receiving instrumental support were significantly correlated with reduced HIV stigma. Implications for social work practitioners are discussed.
Rafaely, Vered; Meyer, Joachim; Zilberman-Sandler, Ilena; Viener, Svetlana
The study examined differences in the perception of traffic risks for older and younger adults. Thirty-four younger participants (mean age 24.7 years) and 30 older participants (mean age 70 years) estimated the number of younger and older people (out of 100,000 people) that were injured in car and pedestrian crashes in a recent year. Both age groups viewed older adults' risks in pedestrian crashes as higher than those of younger adults, and saw older adults' risks in car crashes as identical to the risks for younger adults. Both age groups assessed the risks for their own group quite accurately, but erred in their assessment of the risk for the other group. Older participants tended to overestimate the risk for younger adults, and younger participants tended to underestimate the risk for older adults. These results point to the need to enhance awareness of the age-related increase in traffic risk, which could potentially promote more considerate driving behavior.
Du, Shichun; Rajjo, Tamim; Santosa, Sylvia; Jensen, Michael D.
Background The thermic effect of food accounts for ~ 10% of daily energy expenditure. A reduction in the thermic effect of food, which has been variably observed in the older adults, could predispose to fat gain. We tested whether the thermic effect of food is reduced in older adults compared with young adults by analyzing our database of standardized studies conducted at the Mayo Clinic between 1999 and 2009. Methods Data was available from 136 older adults volunteers age 60 to 88 (56 females) and 141 young adults ages 18 to 35 years (67 female). Basal energy expenditure was measured by indirect calorimetry to assess basal metabolic rate. Body fat, fat free mass and visceral fat were measured using a combination of dual energy x-ray absorptiometry and an abdominal CT scan. We measured the thermic effect of food and postprandial insulinemia in 123 older adults (52 female) and 86 young (38 female) of these volunteers. Results Basal metabolic rate adjusted for fat free mass was less in older adults (P = 0.01) and the thermic effect of food was ~ 1% (P = 0.02) less in the older adults. After controlling for meal size and fat free mass, body fat and fat distribution did not predict the thermic effect of food. Conclusions Both basal metabolic rate and the thermic effect of food are less in older adults than young adults, even when they have similar amounts of lean tissue and consume a similar size meal. These factors contribute to lower daily energy expenditure in the older adults. PMID:24155251
Koychev, Ivan; Ebmeier, Klaus P
Anxiety disorder in the elderly is twice as common as dementia and four to six times more common than major depression. Anxiety is associated with poorer quality of life, significant distress and contributes to the onset of disability. Mortality risks are also increased, through physical causes, especially cardiovascular disease, and suicide. Diagnosing anxiety disorders in older adults remains a challenge because of the significant overlap in symptoms between physical disorders (shortness of breath; abdominal and chest pain; palpitations) and depression (disturbed sleep; poor attention, concentration and memory; restlessness). Good history taking is crucial in elucidating whether the complaint is of new onset or a recurrence of a previous disorder. The presence of comorbid depression should be clarified. If present, its temporal relationship with the anxiety symptoms will indicate whether there is an independent anxiety disorder. A medication review is warranted, as a number of drugs may be causative (calcium channel blockers, alpha- and beta-blockers, digoxin, L-thyroxine, bronchodilators, steroids, theophylline, antihistamines) or may cause anxiety in withdrawal (e.g. benzodiazepines). Substance and alcohol abuse should be excluded, as withdrawal from either may cause anxiety. A new or exacerbated physical illness may be related to anxiety. Medical investigations will help clarify the extent to which a particular somatic symptom is the result of anxiety.
Verghese, Joe; Xue, Xiaonan
Presence of performance inconsistency during repeated assessments of gait may reflect underlying subclinical disease, and help shed light on the earliest stages of disablement. We studied inter-session fluctuations on three selected gait measures (velocity, stride length, and stride length variability) during normal pace walking as well as during a cognitively demanding ‘walking while talking’ condition using a repeated measurement burst design (six sessions within a 2-week period) in 71 nondisabled and nondemented community residing older adults, 40 with predisability (does activities of daily living unassisted but with difficulty). Subjects with predisability had slower gait velocity and shorter stride length on both the normal and walking while talking conditions at baseline compared to nondisabled subjects. However, there was no significant pattern of fluctuations across the six sessions on the three selected gait variables comparing the two groups during normal walking as well as on the walking while talking conditions. Our findings support consistency of gait measurements during the earliest stages of disability. PMID:21050762
Rich, Michael W.
Synopsis Heart failure is the quintessential cardiovascular syndrome of aging that results from common cardiovascular conditions in older adults in conjunction with age-associated changes in cardiovascular structure and function. To a large extent, heart failure is a geriatric syndrome in much the same way that dementia, falls, and frailty are geriatric syndromes. The incidence and prevalence of heart failure increase strikingly with age and make heart failure the most common reason for hospitalization among older adults. While outcomes for older adults with heart failure have improved over time, mortality, hospitalization, and rehospitalization rates remain high. PMID:17905375
Beeber, Anna Song
Current care of older adults focuses on maintenance of independence and frames assessment and decision making about when to intervene. This conceptualization focuses on older adults' deficits and how to compensate for loss of function. Instead of considering independence to continue community residence, an alternative-interdependence-provides a conceptualization that focuses on older adults in the family context and on supportive services, which are the main components of community residence. This article presents the concept of interdependence by analyzing the current research, practice, and policy literature. The article concludes with a discussion of the application of interdependence in gerontological nursing practice and research.
Averill, Jennifer B.
This article reports the findings from a recent study of older adults in the rural southwestern United States and discusses practice and research implications. The aim of the study was to analyze health disparities and strengths in the contexts of rurality, aging, a depressed economy, and limited health resources. Identified themes needing action included sustained access to prescriptions, transportation solutions for older adults in isolated communities, inadequate access to care, poor infrastructure and coordination of services, scarce assisted living and in-home care for frail older adults, and barriers related to culture, language, and economics. PMID:22929381
Flatt, Jason D; Agimi, Yll; Albert, Steve M
A common network phenomenon, homophily, involves developing relationships with others who are similar to you. The intent of this study was to determine if older adults' health behaviors were shared within social networks. We interviewed older adults from low-income senior housing (egos) on egocentric social network characteristics and key health behaviors for themselves and for named social ties (alters). Findings suggest strong effects for homophily, especially for those who smoked and were physically inactive. Public health interventions for older adults should consider the influence that social relationships have on personal health behaviors. Network-based interventions may be required.
McSweeney-Feld, Mary Helen
This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).
MacLeod, Ann; Skinner, Mark W; Wilkinson, Fay; Reid, Heather
Employing a participatory arts-based research approach, we examined an innovative program from rural Ontario, Canada, designed to address social isolation among older people. Older socially isolated adults were matched to trained volunteers, where in dyads, the eight pairs created expressive art in their home setting over the course of 10 home visits. With thematic and narrative inquiry, we analysed the experiences and perceptions of the program leader, older participants, and older volunteers via their artistic creations, weekly logs, evaluations, and field notes. The findings reveal a successful intervention that positively influenced the well-being of older adult participants and older volunteers, especially in regards to relationships, personal development, and creating meaning as well as extending the intervention's impact beyond the program's duration. We also discuss opportunities for similar programs to inform policy and enable positive community-based health and social service responses to rural social isolation.
Chen, Yen-Ting; Kwon, MinHyuk; Fox, Emily J; Christou, Evangelos A
Aging impairs the activation of muscle; however, it remains unclear whether it contributes to deficits in motor learning in older adults. The purpose of this study was to determine whether altered activation of antagonistic muscles in older adults during practice inhibits their ability to transfer a motor task ipsilaterally. Twenty young (25.1 ± 3.9 yr; 10 men, 10 women) and twenty older adults (71.5 ± 4.8 yr; 10 men, 10 women) participated. Half of the subjects practiced 100 trials of a rapid goal-directed task with ankle dorsiflexion and were tested 1 day later with elbow flexion (transfer). The rest did not perform any ankle practice and only performed the task with elbow flexion. The goal-directed task consisted of rapid movement (180 ms) to match a spatiotemporal target. For each limb, we recorded the EMG burst activity of the primary agonist and antagonist muscles. The rate of improvement during task acquisition (practice) was similar for young and older adults (P > 0.3). In contrast, only young adults were able to transfer the task to the upper limb. Specifically, young adults who practiced ankle dorsiflexion exhibited ∼30% (P < 0.05) lower movement error and ∼60% (P < 0.05) lower antagonist EMG burst activity compared with older adults who received equal practice and young adults who did not receive any ankle dorsiflexion practice. These results provide novel evidence that the deficient motor learning in older adults may be related to a differential activation of the antagonist muscle, which compromises their ability to acquire the task during practice.
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
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
Lum, Hillary D.; Flaten, Hanna K.; Betz, Marian E.
Background. Given high rates of gun ownership among older adults, geriatric providers can assess firearm safety practices using a “5 Ls” approach: Locked; Loaded; Little children; feeling Low; and Learned owner. This study describes gun access and the “5 Ls” among US older adults. Methods. Data on the “5 Ls” from the Second Injury Control and Risk Survey (ICARIS-2), a national telephone survey conducted by the Centers for Disease Control and Prevention, were analyzed. Weighted variables were used to generate national estimates regarding prevalence of gun ownership and associated gun safety among older adults (≥55 years). Results. Of 2939 older adults, 39% (95% CI 37%–42%) reported ≥1 gun stored at home. Among those with guns at home, 21% (95% CI 18–24%) stored guns loaded and unlocked; 9.2% (95% CI 6.6–12%) had ≥1 child in household; 5.1% (95% CI 3.5–6.8%) reported past-year suicidal ideation and 3.6% (95% CI 2.1–5.2%) reported history of a suicide attempt; and 55% (95% CI 51–59%) stated that ≥1 adult had attended firearm safety workshop. Conclusion. Some older adults may be at elevated risk of firearm injury because of storage practices, suicidal thoughts, or limited safety training. Future work should assess effective approaches to reduce the risk of gun-related injuries among older adults. PMID:26949391
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
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.
Goldenheim, Anna; Oates, Daniel; Parker, Victoria; Russell, Matthew; Winter, Michael
Abstract Background: Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals. Objective: To identify factors associated with 30-day readmission among older adults newly discharged to hospice. Design/Subjects: Medical record review of 59 patients, 19 readmitted within 30 days and 40 randomly selected controls not readmitted, from 206 patients newly discharged to home hospice care between February 1, 2005 and January 31, 2010. Measures/Analysis: Information was collected about hospital course, end-of-life planning, and posthospitalization follow-up. We calculated bivariate associations and developed a Cox Proportional Hazards model examining the relation between index admission characteristics and readmission. Results: Patients' mean age was 79.7±8.4; 74.6% were female; 52.5% were black. Among those readmitted, 25% had received a palliative care consultation, compared to 47.1% of those not readmitted (p=0.06). Patients without a participating decision-maker involved in their hospice decision had 3.5 times the risk of readmission within 30 days, compared to those with (hazard ratio [HR] 3.53, confidence interval [CI] 0.97, 12.82). Patients who had one or more telephone contacts with their primary care physician (PCP) during week 1 after discharge had 2.4 times the readmission risk within 30 days, compared to patients with no such contacts during this period (HR 2.35, CI 0.9, 6.1). Conclusions: Readmission within 30 days of initial discharge to hospice is associated with several measures of care and care planning. Further study of these measures may identify opportunities for interventions to improve the hospital-to-hospice transition and to decrease hospital readmissions. PMID:24708490
McCauley, Kathleen; Bradway, Christine; Hirschman, Karen B; Naylor, Mary D
Background Between one and two of every five hospitalized older adults have cognitive deficits, often not accurately assessed or well managed. Cognitive impairment adds substantially to the complexity of these patients’ care, places them at high risk for poor outcomes and increases the cost of health care. Methods We describe three evidence-based interventions, each capitalizing on the unique contributions of nurses and designed to improve outcomes of hospitalized older adults who have cognitive deficits. Interventions of varying intensity were compared across three hospitals (Phase I) and subsequently within the same hospitals (Phase II). All enrolled patients were screened during their index hospitalizations and cognitive deficits were communicated to relevant health care team members (Augmented Standard Care-ASC, lowest intensity). At one hospital, ASC was the only intervention. Patients at a second hospital also had care influenced by specially prepared registered nurses (Resource Nurse Care-RNC, medium intensity). Finally, patients at third hospital also received advanced practice nurse coordinated care (Transitional Care Model-TCM, higher intensity). In Phase II, newly enrolled patients at these same hospitals all received the TCM. We summarize major themes from review of multiple data sources and researcher recollections related to facilitators and barriers to implementing a complex research study. Findings Effective implementation of the three intervention strategies depended on clinician engagement and communication; degree of participation by nurses in the educational program with subsequent practice improvement; and success of advanced practice nurses in implementing the TCM with both with patients, family caregivers and clinicians. Implications Based on lessons learned in implementing complex research studies within the “real world” of clinical practice settings, recommendations focus on strengthening facilitators, minimizing barriers and gaining
Gosselin, Penny Anderson; Gagne, Jean-Pierre
Purpose: Listening in noisy situations is a challenging experience for many older adults. The authors hypothesized that older adults exert more listening effort compared with young adults. Listening effort involves the attention and cognitive resources required to understand speech. The purpose was (a) to quantify the amount of listening effort…
Corbin, David E.; Metal-Corbin, Josie
This article illustrates how old bicycle inner tubes, wire coat hangers, stockings, panty hose, and milk dispenser bladders can be used as part of an exercise program for older adults. Specific exercises and activities are suggested. (MT)
Nelson, Joan M; Good, Elliot
Overuse of urinalysis in older adults to investigate vague changes in condition such as confusion, lethargy, and anorexia, has led to overtreatment of asymptomatic bacteriuria and associated antibiotic resistance.
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Badham, Stephen P.; Maylor, Elizabeth A.
Schema-consistent material that is aligned with an individual’s knowledge and experience is typically more memorable than abstract material. This effect is often more extreme in older adults and schema use can alleviate age deficits in memory. In three experiments, young and older adults completed memory tasks where the availability of schematic information was manipulated. Specifying nonobvious relations between to-be-remembered word pairs paradoxically hindered memory (Experiment 1). Highlighting relations within mixed lists of related and unrelated word pairs had no effect on memory for those pairs (Experiment 2). This occurred even though related word pairs were recalled better than unrelated word pairs, particularly for older adults. Revealing a schematic context in a memory task with abstract image segments also hindered memory performance, particularly for older adults (Experiment 3). The data show that processing schematic information can come with costs that offset mnemonic benefits associated with schema-consistent stimuli. PMID:25980799
Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen
The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described.
Stevens, Judy A.
Provides an overview of the epidemiology of falls among older adults, describes current prevention strategies, and highlights key areas that need to be addressed, including risk assessments, exercise, and environmental changes. (Contains 50 references.) (JOW)
Diseases and Conditions Hyponatremia Why is low blood sodium a health concern for older adults? How is ... from Paul Y. Takahashi, M.D. Low blood sodium (hyponatremia) occurs when you have an abnormally low ...
Barber, Sarah J; Mather, Mara
Stereotype threat often incurs the cost of reducing the amount of information that older adults accurately recall. In the current research, we tested whether stereotype threat can also benefit memory. According to the regulatory focus account of stereotype threat, threat induces a prevention focus in which people become concerned with avoiding errors of commission and are sensitive to the presence or absence of losses within their environment. Because of this, we predicted that stereotype threat might reduce older adults' memory errors. Results were consistent with this prediction. Older adults under stereotype threat had lower intrusion rates during free-recall tests (Experiments 1 and 2). They also reduced their false alarms and adopted more conservative response criteria during a recognition test (Experiment 2). Thus, stereotype threat can decrease older adults' false memories, albeit at the cost of fewer veridical memories, as well.
... to content Office of Disease Prevention and Health Promotion Quick Guide to Health Literacy and Older Adults ... CONTACT US Office of Disease Prevention and Health Promotion U.S. Department of Health and Human Services
The rapid growth in the number of older Americans has many implications for public health, including the need to better understand the risks posed by environmental exposures to older adults. An important element for evaluating risk is the understanding of the doses of environment...
Roberson, Donald N., Jr.; Merriam, Sharan B.
Medical advances and lifestyle changes have resulted in older adults living longer and healthier lives. Nevertheless, older adulthood, as other life stages, requires change in work, family, and health. Self-directed learning (SDL) is one way of negotiating these transitions. The purpose of this study was to understand this process of learning.…
This rapid growth in the number of older Americans has many implications for public health, including the need to better understand the health risks posed by environmental exposures to older adults. This paper describes the need to link environmental exposures, the processing of...
Franz, John B.
Reviews recent research on the cognitive development and functioning of older adults in relation to vocational retraining. Proposes that retraining programs designed to facilitate the career adaptability and success of older persons should attempt to increase their complexity and flexibility. (JAC)
Cates, Sheryl C.; Kosa, Katherine M.; Moore, Christina M.; Jaykus, Lee-Ann; Ten Eyck, Toby A.; Cowen, Peter
Individuals aged 60 years and older are at an increased risk for listeriosis and other foodborne illnesses. They can reduce their risk by following recommended food safety practices. A total of 8 focus groups were conducted to characterize older adults' food safety knowledge and practices, their impressions of educational materials on listeriosis…
Goral, Mira; Libben, Gary; Obler, Loraine K.; Jarema, Gonia; Ohayon, Keren
Healthy monolingual older adults experience changes in their lexical abilities. Bilingual individuals immersed in an environment in which their second language is dominant experience lexical changes, or attrition, in their first language. Changes in lexical skills in the first language of older individuals who are bilinguals, therefore, can be…
Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.
Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…
Purpose: The purpose of this study is to examine the relationships among lifetime exposure to traumatic events, emotional support, and life satisfaction in three cohorts of older adults. Design and Methods: Face-to-face interviews were conducted with a nationwide sample of 1,518 older people in 2003. Approximately 500 elders were interviewed in…
This fact sheet provides an overview of the employment situation facing older adults. Statistics (Harris 1974 and 1979) are presented on the number of older Americans who are working, volunteering, or have an interest in working or volunteering; the attitudes of employers and employees about retirement and about working after age 65; and the…
Cooper, Jessica A.; Worthy, Darrell A.; Maddox, W. Todd
“Making an informed decision” implies that more information leads to better decisions, yet it may be the case that additional information biases decisions in a systematic and sometimes detrimental manner. In the present study we examined the effect of additional information on older adults' decision-making using a task for which available rewards were dependent on the participant's recent pattern of choices. The optimal strategy was to forego the immediately rewarding option in favor of the option that yielded larger delayed reward. We found that providing information about true foregone rewards— the reward that would have been received had the participant chosen the other option—significantly reduced older adults' decision-making performance. However, false foregone rewards— foregone rewards manufactured to make the long-term option appear more immediately rewarding, led older adults to perform at a level equal to younger adults. We conclude that providing information about foregone rewards biases older adults toward immediate rewards at a greater rate than younger adults, leading to poorer older adult performance when immediate rewards and long term rewards conflict, but intact performance when immediate rewards and long-term rewards appear to align. PMID:26033485
Wolf, Mary Alice
Older people grow and develop psychologically; they do not necessarily decline in intellectual functioning; and they are capable of learning and enriching their own lives and the lives of others with their wisdom and experience. However, in a fast-paced and impatient culture, little time is given to hearing what older people have to say. Older…
Baweja, Harsimran S; Kwon, MinHyuk; Onushko, Tanya; Wright, David L; Corcos, Daniel M; Christou, Evangelos A
We performed two experiments to determine whether amplified motor output variability and compromised processing of visual information in older adults impair short-term adaptations when learning novel fine motor tasks. In Experiment 1, 12 young and 12 older adults underwent training to learn how to accurately trace a sinusoidal position target with abduction-adduction of their index finger. They performed 48 trials, which included 8 blocks of 6 trials (the last trial of each block was performed without visual feedback). Afterward, subjects received an interference task (watched a movie) for 60 min. We tested retention by asking subjects to perform the sinusoidal task (5 trials) with and without visual feedback. In Experiment 2, 12 young and 10 older adults traced the same sinusoidal position target with their index finger and ankle at three distinct visual angles (0.25°, 1° and 5.4°). In Experiment 1, the movement error and variability were greater for older adults during the visual feedback trials when compared with young adults. In contrast, during the no-vision trials, age-associated differences in movement error and variability were ameliorated. Short-term adaptations in learning the sinusoidal task were similar for young and older adults. In Experiment 2, lower amount of visual feedback minimized the age-associated differences in movement variability for both the index finger and ankle movements. We demonstrate that although short-term adaptations are similar for young and older adults, older adults do not process visual information as well as young adults and that compromises their ability to control novel fine motor tasks during acquisition, which could influence long-term retention and transfer.
van Duin, David
Infections remain a major threat to the well-being of our growing aged population. The correct and timely diagnosis of infections in older adults is increasingly important in the current age of antimicrobial resistance. Urinary tract infection, pneumonia, and bacteremia present particular challenges. In older patients with bacteremia, blood cultures have comparable yield as compared with younger patients. However, the routine triggers for ordering blood cultures may not be appropriate in older adults. In addition, resistance patterns of isolated pathogens may change with age. The main difficulties in diagnosing urinary tract infections in older adults are caused by an increased prevalence of asymptomatic bacteriuria and frequent use of urinary catheters. However, a combined noninvasive approach that includes history, physical examination, urinary dipstick testing, urine cultures, and simple blood tests can provide direction. In addition, specific guidelines for specific populations are available. In older patients suspected of bacterial pneumonia, bedside pulse oximetry and urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila provide direction for the clinician. Although infected older adults pose specific and unique diagnostic challenges, a thorough history and physical examination combined with minimally invasive testing will lead to the correct diagnosis in most older adults with infectious diseases, limiting the need for empiric antibiotics in this age group.
Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika
Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425
Gilbertson, Rebecca; Ceballos, Natalie A.; Prather, Robert; Nixon, Sara Jo
Objective: Perceived impairment and psychomotor performance following acute alcohol administration in older (ages 50-74, n = 42; 22 male) and younger (ages 25-35, n = 26; 12 male) adults were investigated in this study. Method: Double-blind, placebo-controlled alcohol administration techniques were designed to produce peak levels of breath alcohol concentration consistent with an episode of social drinking (40 mg/100 ml). Behavioral measures (Trail Making Test, Forms A and B), as well as measures of self-reported perceived intoxication and impairment, were administered on the ascending and descending limbs at common time points after beverage ingestion. Results: Results indicated that psychomotor performance differences did not parallel self-reported levels of perceived impairment. Relative to younger adults, older adults exhibited performance deficits on the ascending limb while simultaneously reporting less perceived impairment. Conversely, on the descending limb, older adults who received alcohol reported more perceived impairment than did those who received placebo, although psychomotor performance between these two groups of older drinkers did not differ. For younger participants, a moderate dose of alcohol facilitated performance on the ascending limb; however, these differences were not reflected on the descending limb. Conclusions: These results reinforce the common knowledge that self-reported measures may not provide an accurate reflection of performance outcomes and, importantly, that older adults may be impaired even under a moderate dose of alcohol, although they may not be aware (i.e., report) of this impairment. PMID:19261236
Wright, Eric R
Although the importance of human mobility in the spread of infectious disease has been recognized for quite some time, surprisingly little attention has been given to older adults' travel-related HIV risk behavior. This essay discusses the importance of studying the role travel and tourism play in the spread of HIV infection in older adults, reviewing select research on travel/tourism and HIV risk and highlighting the theoretical and methodological challenges confronting researchers in this area.
Kouladjian, Lisa; Gnjidic, Danijela; Chen, Timothy F; Mangoni, Arduino A; Hilmer, Sarah N
Anticholinergic and sedative medications are commonly used in older adults and are associated with adverse clinical outcomes. The Drug Burden Index was developed to measure the cumulative exposure to these medications in older adults and its impact on physical and cognitive function. This narrative review discusses the research and clinical applications of the Drug Burden Index, and its advantages and limitations, compared with other pharmacologically developed measures of high-risk prescribing.
Skinner, Erin I; Fernandes, Myra A
The authors investigated the effect of divided attention, study-list repetition, and age on recollection and familiarity. Older and younger adults under full attention and younger adults under divided attention at study viewed word lists highly associated with a single unstudied word (critical lure) once or three times, and subsequently performed a remember-know recognition test. Younger adults made fewer false remember responses to critical lures from repeated study lists, whereas younger adults under divided attention and older adults both showed an increase with repetition. Findings suggest older adults' susceptibility to illusory memories is related to a deficit in available attention during encoding.
Gestuvo, Maria Kristina
There is increasing interest in maintaining health and delaying disability for older adults as this population segment expands. And instead of focusing on a traditional disease-specific approach to health maintenance, there is an ongoing shift to a patient-centered approach, and defining outcomes based on the older adults' goals. In this approach, their goals and preferences are central, and other factors such as their health status and prognosis help determine which goals may be realistic. These subjective goals and objective characteristics are then balanced with the risks, benefits, and harms of established evidence-driven health-maintenance recommendations. Hence, older adults share their goals and preferences with clinicians; while clinicians share information on risks, benefits, harms, and uncertainties of existing health-maintenance recommendations, and help guide the older adult through how existing evidence can respond to their health goals and preferences. In this article, the concept of patient-centered care in the context of health maintenance for older adults is discussed; and health maintenance recommendations for older adults are reviewed.
Klepin, Heidi D; Rao, Arati V; Pardee, Timothy S
Treatment of older adults with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) is challenging because of disease morbidity and associated treatments. Both diseases represent a genetically heterogeneous group of disorders primarily affecting older adults, with treatment strategies ranging from supportive care to hematopoietic stem-cell transplantation. Although selected older adults can benefit from intensive therapies, as a group they experience increased treatment-related morbidity, are more likely to relapse, and have decreased survival. Age-related outcome disparities are attributed to both tumor and patient characteristics, requiring an individualized approach to treatment decision making beyond consideration of chronologic age alone. Selection of therapy for any individual requires consideration of both disease-specific risk factors and estimates of treatment tolerance and life expectancy derived from evaluation of functional status and comorbidity. Although treatment options for older adults are expanding, clinical trials accounting for the heterogeneity of tumor biology and aging are needed to define standard-of-care treatments for both disease groups. In addition, trials should include outcomes addressing quality of life, maintenance of independence, and use of health care services to assist in patient-centered decision making. This review will highlight available evidence in treatment of older adults with AML or MDS and unanswered clinical questions for older adults with these diseases.
Klepin, Heidi D.; Rao, Arati V.; Pardee, Timothy S.
Treatment of older adults with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) is challenging because of disease morbidity and associated treatments. Both diseases represent a genetically heterogeneous group of disorders primarily affecting older adults, with treatment strategies ranging from supportive care to hematopoietic stem-cell transplantation. Although selected older adults can benefit from intensive therapies, as a group they experience increased treatment-related morbidity, are more likely to relapse, and have decreased survival. Age-related outcome disparities are attributed to both tumor and patient characteristics, requiring an individualized approach to treatment decision making beyond consideration of chronologic age alone. Selection of therapy for any individual requires consideration of both disease-specific risk factors and estimates of treatment tolerance and life expectancy derived from evaluation of functional status and comorbidity. Although treatment options for older adults are expanding, clinical trials accounting for the heterogeneity of tumor biology and aging are needed to define standard-of-care treatments for both disease groups. In addition, trials should include outcomes addressing quality of life, maintenance of independence, and use of health care services to assist in patient-centered decision making. This review will highlight available evidence in treatment of older adults with AML or MDS and unanswered clinical questions for older adults with these diseases. PMID:25071138
Sussman-Skalka, Carol J.; Cimarolli, Verena R.; Stuen, Cynthia
Vision impairment affects approximately 17% of Americans age 45 and older. Yet, 94% of adults with self-reported vision loss did not receive any type of vision rehabilitation services to help them retain independence. These findings underscore the need for promoting awareness about what can be done when vision fails. A national dissemination…
Floyd, Mark; Scogin, Forrest; McKendree-Smith, Nancy L.; Floyd, Donna L.; Rokke, Paul D.
Thirty-one community-residing older adults age 60 or over either received 16 sessions of individual cognitive psychotherapy (Beck, Rush, Shaw, & Emery, 1979) or read Feeling Good (Burns, 1980) for bibliotherapy. Posttreatment comparisons with the delayed-treatment control indicated that both treatments were superior to a delayed-treatment control.…
Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana
This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…
Smith, Barbara A.
Older adults (n=55) were divided into 2 groups: 1 group received preadjunct questions before viewing a blood pressure video; the second viewed the video only. A recall test immediately and seven days later revealed no significant differences, although the control group had slightly higher mean scores. Amount of cognitive resources to process…
Zelinski, Elizabeth M.; Miura, Shari A.
Evaluated adult age differences in language comprehension with groups of young adults (age 20-35), young old adults (age 55-69), and old old adults (age 70-87). The results suggest that speed of comprehension processes required to match related terms in sentence pairs is not impaired with age as long as terms do not have to be remembered.…
Zietz, Doerte; Hollands, Mark
The authors quantitatively described gaze behavior of young (n = 10) and older (n = 10) adults during stair negotiation, which is information that is crucial for understanding the underlying visuomotor control of stair walking and the effects of aging on this control. Both age groups spent the majority of time looking at central aspects of the stairs approximately 3 steps ahead. Older adults showed less variability in the extent to which they looked ahead (p < .05), and all participants fixated the stairs for briefer periods during descent as opposed to ascent (p < .001). Older adults fixated stairs significantly longer than did young adults before stepping onto the stairs (p < .05). The authors conclude that adults need central visual information describing future stepping locations and that there are age-related differences in visual sampling that reflect changes in the visuomotor control processes subserving locomotion.
Naugle, Kelly M; Ohlman, Thomas; Naugle, Keith E; Riley, Zachary A; Keith, NiCole R
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.
Ethier-Majcher, Catherine; Joubert, Sven; Gosselin, Frédéric
Little is known about how older persons determine if someone deserves their trust or not based on their facial appearance, a process referred to as "facial trustworthiness."In the past few years, Todorov and colleagues have argued that, in young adults, trustworthiness judgments are an extension of emotional judgments, and therefore, that trust judgments are made based on a continuum between anger and happiness (Todorov, 2008; Engell et al., 2010). Evidence from the literature on emotion processing suggest that older adults tend to be less efficient than younger adults in the recognition of negative facial expressions (Calder et al., 2003; Firestone et al., 2007; Ruffman et al., 2008; Chaby and Narme, 2009). Based on Todorov';s theory and the fact that older adults seem to be less efficient than younger adults in identifying emotional expressions, one could expect that older individuals would have different representations of trustworthy faces and that they would use different cues than younger adults in order to make such judgments. We verified this hypothesis using a variation of Mangini and Biederman's (2004) reverse correlation method in order to test and compare classification images resulting from trustworthiness (in the context of money investment), from happiness, and from anger judgments in two groups of participants: young adults and older healthy adults. Our results show that for elderly participants, both happy and angry representations are correlated with trustworthiness judgments. However, in young adults, trustworthiness judgments are mainly correlated with happiness representations. These results suggest that young and older adults differ in their way of judging trustworthiness.
Ingvalson, Erin M.; Nowicki, Casandra; Zong, Audrey; Wong, Patrick C. M.
Though there is an extensive literature investigating the ability of younger adults to learn non-native phonology, including investigations into individual differences in younger adults’ lexical tone learning, very little is known about older adults’ ability to learn non-native phonology, including lexical tone. There are several reasons to suspect that older adults would use different learning mechanisms when learning lexical tone than younger adults, including poorer perception of dynamic pitch, greater reliance on working memory capacity in second language learning, and poorer category learning in older adulthood. The present study examined the relationships among older adults’ baseline sensitivity for pitch patterns, working memory capacity, and declarative memory capacity with their ability to learn to associate tone with lexical meaning. In older adults, baseline pitch pattern sensitivity was not associated with generalization performance. Rather, older adults’ learning performance was best predicted by declarative memory capacity. These data suggest that training paradigms will need to be modified to optimize older adults’ non-native speech sound learning success. PMID:28239364
STUDENSKI, S.; PERERA, S.; HILE, E.; KELLER, V.; SPADOLA-BOGARD, J.; GARCIA, J.
Background 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. Methods 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. Results Of 36 persons who entered (mean age 80.1 ± 5.4 years, 83 % female), 25 completed the study. Completers were healthier than non completers. Completers showed gains in narrow walk time, self-reported balance confidence and mental health. While there were no serious adverse events, 4 of 11 non completers withdrew due to musculoskeletal complaints. Conclusions Adapted Interactive video dance is feasible for some healthy older adults and may help achieve physical activity goals. PMID:21125204
Sims, Tamara; Hogan, Candice; Carstensen, Laura
Findings based on studies of daily life consistently associate older ages with relatively positive emotional experience, suggesting that older adults may regulate emotions more effectively than younger adults. Findings from laboratory studies are equivocal, however, with mixed evidence for age-related improvements in use of emotion regulatory strategies. In the current paper, we propose that findings may reflect a failure of laboratory-based experiments to capture the regulatory strategies that older people use in their everyday lives. We argue that the advantages older people have are likely due to antecedent emotion regulation as opposed to response-focused strategies. Understanding the regulatory approaches that older people actually use may inform developmental models of emotion regulation throughout adulthood as well as interventions for improving emotional experience across the life span. PMID:25914897
Scott, Katie; DeBrew, Jacqueline Kayler
The purpose of this article is to describe a storytelling project that was designed to help community-dwelling older adults find meaning and purpose in their lives through reminiscing about the past. The storytelling project was successful not only for the older adults who participated but also for the nursing students, who were given an opportunity to learn about interviewing and communicating with older adults. The value of life review and storytelling as a nursing intervention became evident from this project. When time is taken to listen to the valuable stories and life lessons of the older population, nurses create a better understanding of their patients while their patients recall special memories and feel proud of their lives.
Schmitt, Anna; Soubeyran, Pierre
Follicular lymphoma is essentially a disease of the elderly, and the aging of the population in developed countries will increase patient numbers in coming years. Significant achievements have been made for treatment, but better understanding of the disease and major progress in biology now facilitate the development of many new drugs, which may have improved toxicity profiles making them appropriate for treatment of older adults. However, the increasing number of treatment possibilities, can also increase the toxicity risks, and unexpected toxicities specific to older adults may be encountered. Consequently, specific studies of older patients should be considered, using appropriate evaluation tools such as comprehensive geriatric assessment. This review will described the development of these new drugs, in the context of the treatment of older-adults with follicular lymphoma.
Weinger, Katie; Beverly, Elizabeth A.; Smaldone, Arlene
The prevalence of diabetes is highest in older adults, a population that is increasing. Diabetes self-care is complex with important recommendations for nutrition, physical activity, checking glucose levels, and taking medication. Older adults with diabetes have unique issues which impact self-care. As people age, their health status, support systems, physical and mental abilities, and nutritional requirements change. Furthermore, comorbidities, complications, and polypharmacy complicate diabetes self-care. Depression is also more common among the elderly and may lead to deterioration in self-care behaviors. Because of concerns about cognitive deficits and multiple comorbidities, adults older than 65 years are often excluded from research trials. Thus, little clinical evidence is available and the most appropriate treatment approaches and how to best support older patients’ self-care efforts are unclear. This review summarizes the current literature, research findings, and expert and consensus recommendations with their rationales. PMID:24510969
Dodson, John A; Maurer, Mathew S
Older adults represent a rapidly growing segment of the population in developed countries. Advancing age is the most powerful risk factor for the development of cardiovascular disease (CVD), and CVD-related mortality increases markedly in older individuals. Procedures for patients with CVD, including percutaneous coronary intervention, aortic valve replacement and implantable cardioverter defibrillators were all initially validated in younger individuals but are increasingly being applied in older adults who for the most part have been significantly understudied in clinical trials. While advanced age alone is not a contraindication to these procedures, with the advent of less invasive methods to manage CVD including percutaneous techniques to treat both coronary artery disease and valvular heart disease, future research will need to weigh the potential harms of intervention in a population of older adults with multiple medical comorbidities and complex physiologic phenotypes against outcomes that include preventing functional decline and improving quality of life. PMID:21743812
Mitzner, Tracy L.; Beer, Jenay M.; Prakash, Akanksha; Chen, Tiffany L.; Kemp, Charles C.; Rogers, Wendy A.
The population of older adults in America is expected to reach an unprecedented level in the near future. Some of them have difficulties with performing daily tasks and caregivers may not be able to match pace with the increasing need for assistance. Robots, especially mobile manipulators, have the potential for assisting older adults with daily tasks enabling them to live independently in their homes. However, little is known about their views of robot assistance in the home. Twenty-one independently living older Americans (65–93 years old) were asked about their preferences for and attitudes toward robot assistance via a structured group interview and questionnaires. In the group interview, they generated a diverse set of 121 tasks they would want a robot to assist them with in their homes. These data, along with their questionnaire responses, suggest that the older adults were generally open to robot assistance but were discriminating in their acceptance of assistance for different tasks. They preferred robot assistance over human assistance for tasks related to chores, manipulating objects, and information management. In contrast, they preferred human assistance to robot assistance for tasks related to personal care and leisure activities. Our study provides insights into older adults' attitudes and preferences for robot assistance with everyday living tasks in the home which may inform the design of robots that will be more likely accepted by older adults. PMID:25152779
Latham, Lesley P.; Ackroyd-Stolarz, Stacy
Background Emergency Departments (EDs) are playing an increasingly important role in the care of older adults. Characterizing ED usage will facilitate the planning for care delivery more suited to the complex health needs of this population. Methods In this retrospective cross-sectional study, administrative and clinical data were extracted from four study sites. Visits for patients aged 65 years or older were characterized using standard descriptive statistics. Results We analyzed 34,454 ED visits by older adults, accounting for 21.8% of the total ED visits for our study time period. Overall, 74.2% of patient visits were triaged as urgent or emergent. Almost half (49.8%) of visits involved diagnostic imaging, 62.1% involved lab work, and 30.8% involved consultation with hospital services. The most common ED diagnoses were symptom- or injury-related (25.0%, 17.1%. respectively). Length of stay increased with age group (Mann-Whitney U; p < .0001), as did the proportion of visits involving diagnostic testing and consultation (χ2; p < .0001). Approximately 20% of older adults in our study population were admitted to hospital following their ED visit. Conclusions Older adults have distinct patterns of ED use. ED resource use intensity increases with age. These patterns may be used to target future interventions involving alternative care for older adults. PMID:25452824
Macia, Enguerran; Duboz, Priscilla; Montepare, Joann M; Gueye, Lamine
Studies on correlates of subjective well-being of older adults are virtually non-existent in sub-Saharan Africa. Yet, understanding and improving the well-being of older adults should be a focal point of research and policy directed at this fast growing population. The aim of this study was to assess the links between socio-demographic factors, economic conditions, health, social relations, and the life satisfaction of older adults in Dakar. To this end, a survey was conducted on a sample of 500 dwellers of the Senegalese capital, aged 50 to 100, using the quota method for greater representativeness. Results revealed that with advancing age older adults expressed greater life satisfaction, and that older women were more satisfied than older men. As well, economic conditions were a main predictor of life satisfaction, along with good social relations. In contrast to findings with Western populations, neither self-rated health nor physical disabilities were associated with aging adults' life satisfaction. Findings suggest a number of avenues for future research.
Davitt, Joan K; Gellis, Zvi D
Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.
As in other countries, older adults in Australia could benefit from acquiring information technology (IT) skills in many ways, including improved access to information on health issues and development of the skills needed for employment in high-demand IT-related occupations. The research on adult learning and the problems faced by many older…
Moore, DeWayne; And Others
The Metacomprehension Scale was completed by 30 younger and 30 older adults. Younger adults reported greater use of strategies to resolve comprehension failures and valued good comprehension more. The regulation dimension of metacomprehension was a reliable predictor of comprehension performance. (SK)
Delahaye, Brian L.; Ehrich, Lisa C.
The research reported in this study concerns older adults from Australia who voluntarily chose to learn the craft of woodturning. The paper examines the literature of adult learning under the themes of presage factors, the learning environment, instructional methods, and techniques for facilitators. The paper then reports on the analysis of two…
This paper is based on a long-term ethnography of an adult creative writing class situated in a major urban art gallery in the United Kingdom. It takes the claims of one group of older adults--that creative writing made them "feel younger"--as the starting point for exploring this connection further. It places these claims broadly within…
Jancey, Jonine M.; Clarke, Ann; Howat, Peter; Maycock, Bruce; Lee, Andy H.
Objective: To identify issues and perceptions concerning physical activity in older adults. Design: Qualitative study. Setting: Perth, Western Australia. Methods: Sixteen adults aged 65 to 74 years were interviewed in their own homes using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology.…
Gandini, Delphine; Lemaire, Patrick; Michel, Bernard Francois
Forty young adults, 40 healthy older adults, and 39 probable AD patients were asked to estimate small (e.g., 25) and large (e.g., 60) collections of dots in a choice condition and in two no-choice conditions. Participants could choose between benchmark and anchoring strategies on each collection of dots in the choice condition and were required to…
Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel
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…
This article tells the story of policies relevant to education, ageism and older adults between 1999 and 2005. It follows an article published in a previous "New Zealand Journal of Adult Learning" that described and critiqued policy developments between the 1980s and 2001. The story is located in the context of ongoing historical…
Strydom, Andre; Chan, Trevor; King, Michael; Hassiotis, Angela; Livingston, Gill
Dementia may be more common in older adults with intellectual disability (ID) than in the general population. The increased risk for Alzheimer's disease in people with Down syndrome (DS) is well established, but much less is known about dementia in adults with ID who do not have DS. We estimated incidence rates from a longitudinal study of…
Pergolotti, Mackenzi; Cutchin, Malcolm P.; Muss, Hyman B.
Purpose Participation in activity that is personally meaningful leads to improved emotional and physical well-being and quality of life. However, little is known about what predicts participation in meaningful activity by older adults with cancer. Methods Seventy-one adults aged 65 years and older with a diagnosis of cancer were enrolled. All adults were evaluated with the following: a brief geriatric assessment, the meaningful activity participation assessment (MAPA), and the Possibilities for Activity Scale (PActS). The MAPA measures participation in meaningful activity, and the PActS measures what older adults believe they should and could be doing. A regression approach was used to assess the predictors of meaningful activity participation. Results The PActS (B = .56, p < .001) was the strongest predictor of meaningful activity participation. Conclusions What older adults with cancer feel they should and could do significantly predicted meaningful participation in activities above and beyond clinical and demographic factors. In future research, perceptions of possibilities for activity may be useful in the design of interventions targeted to improve meaningful participation in older adults with cancer. PMID:25381123
Plaks, Jason E; Chasteen, Alison L
The authors examined whether older adults' implicit theories regarding the modifiability of memory in particular (Studies 1 and 3) and abilities in general (Study 2) would predict memory performance. In Study 1, individual differences in older adults' endorsement of the "entity theory" (a belief that one's ability is fixed) or "incremental theory" (a belief that one's ability is malleable) of memory were measured using a version of the Implicit Theories Measure (Dweck, 1999). Memory performance was assessed with a free-recall task. Results indicated that the higher the endorsement of the incremental theory, the better the free recall. In Study 2, older and younger adults' theories were measured using a more general version of the Implicit Theories Measure that focused on the modifiability of abilities in general. Again, for older adults, the higher the incremental endorsement, the better the free recall. Moreover, as predicted, implicit theories did not predict younger adults' memory performance. In Study 3, participants read mock news articles reporting evidence in favor of either the entity or incremental theory. Those in the incremental condition outperformed those in the entity condition on reading span and free-recall tasks. These effects were mediated by pretask worry such that, for those in the entity condition, higher worry was associated with lower performance. Taken together, these studies suggest that variation in entity versus incremental endorsement represents a key predictor of older adults' memory performance.
Motl, Robert W; McAuley, Edward
This article provides an overview of physical activity and its association with function, disability, and quality of life (QOL) outcomes among older adults. The rationale and the associated onset of chronic disease conditions that influence function, disability, and QOL is embedded in the "Graying of America". The literature reviewed in this article yielded 3 general conclusions: (1) there is an alarming rate of physical inactivity among older adults, particularly those aging with a disability; (2) there is strong evidence for the beneficial effects of physical activity on impairment, function, and health-related aspects of QOL among older adults, but there is less conclusive evidence for positive effects of physical activity on disability and global QOL; and (3) there is emerging support for self-efficacy as a mediator of the association between physical activity and disability, and QOL outcomes in older adults. Researchers should consider designing and testing programs that incorporate strategies for enhancing self-efficacy along with the promotion of physical activity as a means of preventing disablement and improving QOL among older adults. Such work will go a long way in identifying practical approaches that can be applied for improving the later years of life and is critical because many Americans will soon be affected by the aging of adults in the United States.
Wais, Peter E; Gazzaley, Adam
The detrimental influence of distraction on memory and attention is well established, yet it is not as clear whether irrelevant information impacts categorization abilities and whether this impact changes in aging. We examined categorization with morphed prototype stimuli in both younger and older adults, using an adaptive staircase approach to assess participants' performance in conditions with and without visual distractors. Results showed that distraction did not affect younger adults, but produced a negative impact on older adults' categorization such that there was an interaction of age and distraction. These results suggest a relationship between the increased susceptibility to visual distraction in normal aging and impairment in categorization.
Kensinger, Elizabeth A
As adults age, they tend to have problems remembering the details of events and the contexts in which events occurred. This review presents evidence that emotion can enhance older adults' abilities to remember episodic detail. Older adults are more likely to remember affective details of an event (e.g., whether something was good or bad, or how an event made them feel) than they are to remember non-affective details, and they remember more details of emotional events than of non-emotional ones. Moreover, in some instances, emotion appears to narrow the age gap in memory performance. It may be that memory for affective context, or for emotional events, relies on cognitive and neural processes that are relatively preserved in older adults.
O'Brien, Tara; Troutman-Jordan, Meredith; Hathaway, Donna; Armstrong, Shannon; Moore, Michael
Wristband activity trackers have become widely used among young adults. However, few studies have explored their use for monitoring and improving health outcomes among older adults. The purpose of this study was to evaluate the feasibility and utility of activity tracker use among older adults for monitoring activity, improving self-efficacy, and health outcomes. A 12-week pilot study was conducted to evaluate the feasibility and utility of mobile wristband activity trackers. The sample (N = 34) was 65% women 73.5 ± 9.4 years of age who had a high school diploma or GED (38%) and reported an income ≤$35,000 (58%). Participants completing the study (95%) experienced a decrease in waist circumference (p > 0.009), however no change in self-efficacy. Participants found activity trackers easy to use which contributed to minimal study withdrawals. It was concluded that activity trackers could be useful for monitoring and promoting physical activity and improving older adults' health.
Nelson, Joan M; Robinson, Marylou V
Hyponatremia is a common disorder seen in the emergency department and is more prevalent in older adults than in other adult populations (Miller, 2009). Though often discovered by accident, through routine bloodwork, even mild hyponatremia has been shown to have potentially dangerous consequences for older adults, increasing their risks for falls, altered mental status, osteoporosis and fractures, and gastrointestinal disturbances (Soiza and Talbot, 2011). Optimal management of older adults with hyponatremia in the ED involves not only treatment of serum sodium levels and the immediate consequence of the disorder, but exploration and reversal of the causes of the hyponatremia to avoid recurrence. This case study illustrates the clinical presentation, complications and management of hyponatremia in the setting of the emergency department.
Zelle, Andraya; Arms, Tamatha
The 1.5 million older adults who self-identify as lesbian, gay, bisexual, and transgender (LGBT) are expected to double in number by 2030. Research suggests that health disparities are closely linked with societal stigma, discrimination, and denial of civil and human rights. More LGBT older adults struggle with depression, substance abuse, social isolation, and acceptance compared to their heterosexual counterparts. Despite individual preferences, most health care providers recognize the right of any individual to have access to basic medical services. The U.S. Department of Health and Human Services requires that all hospitals receiving funds from Medicare and Medicaid respect visitation and medical decision-making rights to all individuals identifying as LGBT. The Joint Commission also requires a non-discrimination statement for accreditation. The current literature review examines LGBT health disparities and the consequential psychosocial impact on LGBT older adults as well as brings awareness to the needs of this underserved and underrepresented population.
During the past decades, malnutrition has attracted increasing scientific attention and is by now regarded as a true geriatric syndrome characterized by multifactorial causality, identified by symptoms and accompanied by frailty, disability and poor outcome. This viewpoint summarizes our present knowledge and the usual current handling of malnutrition in older people and highlights the urgent need for action in this field. Age-related changes in the complex system of appetite regulation, resulting in the so-called anorexia of aging, predispose older adults to a decrease in food intake which may lead to malnutrition, if additional risk factors like health or social problems occur. Consequently, malnutrition is widespread in the older population, notably in those who are institutionalized. Despite the fact that effective interventions are available, prevention and treatment of malnutrition do not currently receive appropriate attention. As an important first step towards better awareness, screening for malnutrition should become a mandatory integral part of the comprehensive geriatric assessment. Furthermore, practical local guidelines should be implemented in all geriatric hospital wards and nursing homes in order to improve nutritional care in the daily routine. Important to note is that reasonable nutritional management is not possible without qualified staff in adequate numbers allowing appropriate individual nutritional care. Regarding future research, studies at the cellular, metabolic and clinical levels and the linking of information from different research approaches are required to better understand the transition from good nutritional health and independence of old people to malnutrition, functional impairment and poor health. In parallel to well-designed observational and intervention studies, standardized documentation of nutritional information in daily routine would enable the uniform collection of data for research as well as for political decisions
Today sedentary lifestyles are a major public health concern and there are many evidences related to physical inactivity. The well-documented evidence is that regular physical activity is an essential part for improving overall health with advancing aging and the most efficient means playing roles of rehabilitation and prehabilitation. However, there are few activity programs which could motivate older adults to continue and maintain their active lifestyles. The purpose of the current study was to describe experience of sport stacking which applied to Korean older adults in the first time. Eighteen older adults living in the community in Seoul which was the capital and largest metropolis of the Republic of Korea participated in the study. A qualitative interview and a survey were conducted and data were analyzed by interpretive content analysis. Individual, semistructured, face-to-face interviews were recorded, transcribed, condensed and coded to find themes. The main themes were identified regarding older adults’ experience of sport stacking: enjoyment of sport stacking, attitudes toward sport stacking as a physical activity program, and benefits from sport stacking. In conclusions, Korean older adults had positive experience of sport stacking and it was necessary for developing strategies to spread it as the physical activity program for older persons in Korea to improve their health and quality of life. PMID:28349032
Dabelko-Schoeny, Holly; Anderson, Keith A.; Spinks, Katie
Purpose: Past research has demonstrated the importance of civic engagement for older adults, yet previous studies have not focused specifically on the potential benefits of civic engagement for older adults with functional limitations. This pilot study explored the feasibility and effectiveness of an intervention designed to promote civic…
McDougall, Graham J.; Becker, Heather; Pituch, Keenan; Acee, Taylor W.; Vaughan, Phillip W.; Delville, Carol L.
We tested whether at-risk older adults receiving memory training showed better memory self-efficacy, metamemory, memory performance, and function in instrumental activities of daily living than participants receiving a health promotion training comparison condition. We followed participants for 26 months. The sample was mostly female (79%) and Caucasian (71%), with 17% Hispanics, and 12% African Americans; average age was 75 years and average education was 13 years. The memory training group made greater gains on global cognition and had fewer memory complaints, but both groups generally maintained their performance on the other cognitive measures and IADLs throughout the 24-month study period. Black and Hispanic participants made greater gains than Whites did on some memory performance measures but not on memory self-efficacy. The unexpected finding that minority elders made the largest gains merits further study. This study contributed to the knowledge base of geropsychiatric nursing by providing evidence for an effective psychosocial intervention that could be delivered by advanced practice nurses. Trial Registration ClinicalTrials.gov NCT00094731 PMID:20851321
Kasper, Judith D; Freedman, Vicki A; Spillman, Brenda C; Wolff, Jennifer L
The number of US adults ages sixty-five and older who are living with dementia is substantial and expected to grow, raising concerns about the demands that will be placed on family members and other unpaid caregivers. We used data from the 2011 National Health and Aging Trends Study and its companion study, the National Study of Caregiving, to investigate the role of dementia in caregiving. We found that among family and unpaid caregivers to older noninstitutionalized adults, one-third of caregivers, and 41 percent of the hours of help they provide, help people with dementia, who account for about 10 percent of older noninstitutionalized adults. Among older adults who receive help, the vast majority in both community and residential care settings other than nursing homes rely on family or unpaid caregivers (more than 90 percent and more than 80 percent, respectively), regardless of their dementia status. Caregiving is most intense, however, to older adults with dementia in community settings and from caregivers who are spouses or daughters or who live with the care recipient.
The baby boom generation is quickly becoming the geriatric generation. The over-65 age bracket hit 13% of Americans in 1997, and is expected to reach 20% by 2030 accounting for 73 million Americans. World-wide the total number of older people (>60years) is expected to double from...
Brock, Kaye; Clemson, Lindy; Cant, Rosemary; Ke, Liang; Cumming, Robert G.; Kendig, Hal; Mathews, Mark
With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n =…
Many randomized, controlled trials indicate that vitamin D will lower falls and fractures, so it was reasonable for Sanders et al. to hypothesize that a single annual 500,000 IU oral dose of vitamin D3 would be effective in reducing falls and fractures in older women with one or more risk factors fo...
Wu, Ya-Huei; Damnée, Souad; Kerhervé, Hélène; Ware, Caitlin; Rigaud, Anne-Sophie
Purpose In a society where technology progresses at an exponential rate, older adults are often unaware of the existence of different kinds of information and communication technologies (ICTs). To bridge the gap, we launched a 2-year project, during which we conducted focus groups (FGs) with demonstrations of ICTs, allowing older adults to try them out and to share their opinions. This study aimed at investigating how participants perceived this kind of initiative and how they reacted to different kinds of ICTs. Patients and methods In total, 14 FGs were conducted with community-dwelling older adults, with a frequency of two FGs on the same topic once per trimester. Twenty-three older adults (four men and 19 women) attended at least one FG but only nearly half of them were regular attendants (ten participating in at least five sessions). Age of participants ranged from 63 years to 88 years, with a mean of 77.1 years. All of them had completed secondary education. The analyses of the data were performed according to inductive thematic analysis. Results Four overarching themes emerged from the analysis. The first concerned participants’ motivation for and assessment of the project. The second theme identified the underlying factors of the “digital divide” between the younger and the older generations. The third theme concerned the factors of technology adoption among older adults. The fourth one identified participants’ attitudes toward assistive ICTs, designed specifically for older adults (“gerontechnologies”). Discussions and conclusion This project encouraging older adults to be informed about different kinds of ICTs was positively rated. With regard to ICTs, participants perceived a digital divide. The underlying factors are generation/cohort effects, cognitive and physical decline related to aging, and negative attitudes toward technologies. However, more and more older adults adopt different kinds of ICTs in order to fit in with the society
Li, Junxin; Gooneratne, Nalaka
Insomnia and other sleep complaints are highly prevalent in community-dwelling older adults yet often go under detected. Age-related physiological changes may affect sleep, but sleep disturbances and complaints should not be considered normal in this population. Various physiological, psychological, and social consequences have been associated with insomnia and sleep complaints. Treatment options are available so it is imperative to diagnose and treat these individuals to promote healthy aging. Exercise is known to have a wide variety of health benefits, but unfortunately most older adults engage in less exercise with advancing age. This paper describes age-related changes in sleep, clinical correlates of insomnia, consequences of untreated insomnia, and nonpharmacological treatments for insomnia in older adults, with a focus on the relationship between exercise and sleep in community-dwelling older adults with insomnia or sleep complaints. Possible mechanisms explaining the relationship between exercise and sleep are discussed. While the research to date shows promising evidence for exercise as a safe and effective treatment for insomnia and sleep complaints in community-dwelling older adults, future research is needed before exercise can be a first-line treatment for insomnia and sleep complaints in this population. PMID:27088071
Roland, Kaitlyn P; Jakobi, Jennifer M; Jones, Gareth R
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.
Greene, Meredith; Covinsky, Kenneth E.; Valcour, Victor; Miao, Yinghui; Madamba, Joy; Lampiris, Harry; Cenzer, Irena Stijacic; Martin, Jeffrey; Deeks, Steven G.
Background Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exists on these conditions in older HIV-infected adults and no studies have comprehensively examined these conditions. Methods Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression and cognitive impairment were measured in a cross-sectional study of HIV-infected adults age 50 and older who had an undetectable viral load on antiretroviral therapy (ART). We examined both HIV and non-HIV related predictors of geriatric syndromes including sociodemographics, number of co-morbidities and non-antiretroviral medications, and HIV specific variables in multivariate analyses. Results We studied 155 participants with a median age of 57 (IQR 54-62); (94%) were men. Pre-frailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir (IRR 1.16, 95% CI 1.06-1.26), non-white race (IRR 1.38, 95% CI 1.10-1.74), and increasing number of comorbidities (IRR 1.09, 95%CI 1.03-1.15) were associated with increased risk of having more geriatric syndromes. Conclusions Geriatric syndromes are common in older HIV infected adults. Treatment of comorbidities and early initiation of ART may help to prevent development of these age related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles. PMID:26009828
Pal, Sumanta K.; Vanderwalde, Ari; Hurria, Arti; Figlin, Robert A.
The introduction of targeted therapies has radically changed the treatment paradigm for metastatic renal cell carcinoma (mRCC). However, multiple clinical dilemmas have emerged. For instance, limited data are available to juxtapose the safety and efficacy profile of targeted therapies between older and younger adults. Herein, pivotal trials of vascular endothelial growth factor (VEGF)- and mammalian target of rapamycin (mTOR)-directed therapies are assessed in the context of their implications in treating older adults with mRCC. In general, subset analyses from these pivotal studies suggest similar efficacy of targeted therapies amongst older adults. Aging is accompanied by a multitude of physiological changes, as well as an increased prevalence of co-morbidities. The age-related toxicity profiles of targeted agents for mRCC are detailed to provide a framework for the risks and benefits of these therapies in older adults. Ultimately, tools such as the Comprehensive Geriatric Assessment (CGA) that account for physiological (as opposed to chronological) age may prove useful in the evaluation and treatment of older adults with mRCC. PMID:21812499
Naveh-Benjamin, Moshe; Kilb, Angela; Maddox, Geoffrey B.; Thomas, Jenna; Fine, Hope C.; Chen, Tina; Cowan, Nelson
Although working memory spans are, on average, lower for older adults than young adults, we demonstrate in 5 experiments a way in which older adults paradoxically resemble higher capacity young adults. Specifically, in a selective-listening task, older adults almost always failed to notice their names presented in an unattended channel. This is an…
McConatha, J T; Schnell, F; McKenna, A
Negative attitudes about aging have been widespread and films, television, radio, and print media may serve as an important source of socialization or reflect the current views of older adults. This study focused on examination of the frequency of depictions of older men and women in 765 advertisements appearing in Time and Newsweek national weekly news magazines, and on an analysis of their roles suggested in photographs depicting a total of 2,505 persons. These were collected over a one-year period and coded by three persons. Analysis indicated that older adults, especially older women, were not only presented infrequently but, when presented roles, were often passive or dependent as is consistent with social stereotypes.
Karlin, Bradley E; Norris, Margaret P
The present study examined the extent to which older adults began public mental health treatment throughout Texas in 1999, the types of services they used, and how they compared on demographic and clinical variables to younger consumers. Notwithstanding recent policy and related developments, older adults were found to use public mental health services at substantially low rates, as in past decades. Significantly, older consumers tended to be relatively healthy and independent. Among younger and, even more so, older consumers, there were relatively high proportions of rural residents and minorities, groups previously found to be unlikely to utilize private mental health services. Overall, the findings urge that greater attention be devoted to public mental health outreach and service delivery with the elderly, and raise the question of what role the public mental health system should have in nursing homes and other long-term care settings.
Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare
IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients
Background The increasing number of people living with HIV aged 50 years and older has been recognised around the world yet non-pharmacologic HIV behavioural and cognitive interventions specifically targeted to older adults are limited. Evidence is needed to guide the response to this affected group. Methods We conducted a systematic review of the available published literature in MEDLINE, Embase and the Education Resources Information Center. A search strategy was defined with high sensitivity but low specificity to identify behavioural interventions with outcomes in the areas of treatment adherence, HIV testing uptake, increased HIV knowledge and uptake of prevention measures. Data from relevant articles were extracted into excel. Results Twelve articles were identified all of which originated from the Americas. Eight of the interventions were conducted among older adults living with HIV and four for HIV-negative older adults. Five studies included control groups. Of the included studies, four focused on general knowledge of HIV, three emphasised mental health and coping, two focused on reduced sexual risk behaviour, two on physical status and one on referral for care. Only four of the studies were randomised controlled trials and seven – including all of the studies among HIV-negative older adults – did not include controls at all. A few of the studies conducted statistical testing on small samples of 16 or 11 older adults making inference based on the results difficult. The most relevant study demonstrated that using telephone-based interventions can reduce risky sexual behaviour among older adults with control reporting 3.24 times (95% CI 1.79-5.85) as many occasions of unprotected sex at follow-up as participants. Overall however, few of the articles are sufficiently rigorous to suggest broad replication or to be considered representative and applicable in other settings. Conclusions More evidence is needed on what interventions work among older adults to
Altgassen, Mareike; Rendell, Peter G; Bernhard, Anka; Henry, Julie D; Bailey, Phoebe E; Phillips, Louise H; Kliegel, Matthias
Efficient intention formation might improve prospective memory by reducing the need for resource-demanding strategic processes during the delayed performance interval. The present study set out to test this assumption and provides the first empirical assessment of whether imagining a future action improves prospective memory performance equivalently at different stages of the adult lifespan. Thus, younger (n = 40) and older (n = 40) adults were asked to complete the Dresden Breakfast Task, which required them to prepare breakfast in accordance with a set of rules and time restrictions. All participants began by generating a plan for later enactment; however, after making this plan, half of the participants were required to imagine themselves completing the task in the future (future thinking condition), while the other half received standard instructions (control condition). As expected, overall younger adults outperformed older adults. Moreover, both older and younger adults benefited equally from future thinking instructions, as reflected in a higher proportion of prospective memory responses and more accurate plan execution. Thus, for both younger and older adults, imagining the specific visual-spatial context in which an intention will later be executed may serve as an easy-to-implement strategy that enhances prospective memory function in everyday life.
Berntsen, Dorthe; Rasmussen, Anne S; Miles, Amanda N; Nielsen, Niels Peter; Ramsgaard, Stine B
Involuntary episodic memories are memories of past events that come to mind with no preceding attempt of retrieval. Such memories have received little attention in relation to aging compared with voluntary episodic memories (i.e., intentionally retrieved memories of past events). It is well documented that older compared with younger adults have reduced access to episodic memories, when retrieval is voluntary, but little is known about their involuntary episodic recall. Recent evidence suggests that involuntary autobiographical memories are at least as frequent as voluntary autobiographical memories in daily life, but this research has been limited to younger adults. Here older and younger adults recorded involuntary and voluntary episodic memories in relation to a film of a simulated event (Study 1) and during a normal day in their lives (Study 2). Across both studies, no age differences were found regarding the frequency of involuntary episodic memories, whereas older adults showed slower (Study 1) and less frequent (Study 2) voluntary remembering compared with younger adults. The findings suggest that involuntary relative to voluntary episodic remembering is enhanced in older adults, consistent with reduced executive functioning and increased processing of task irrelevant information with aging. Involuntary episodic remembering may provide an adaptive compensation for reductions in strategic retrieval in later adulthood. (PsycINFO Database Record
Porter Starr, Kathryn N.; McDonald, Shelley R.; Bales, Connie W.
A nutritionally vulnerable older adult has a reduced physical reserve that limits the ability to mount a vigorous recovery in the face of an acute health threat or stressor. Often this vulnerability contributes to more medical complications, longer hospital stays, and increased likelihood of nursing home admission. We have characterized in this review the etiology of nutritional vulnerability across the continuum of the community, hospital, and long term care settings. Frail older adults may become less vulnerable with strong, consistent, and individualized nutritional care. Interventions for the vulnerable older adult must take their nutritional needs into account to optimize resiliency in the face of the acute and/or chronic health challenges they will surely face in their life course. PMID:26042189
Wagner, Gabriela Arantes
This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet. PMID:25830872
Lessa, Helena Thofehrn; Chiviacowsky, Suzete
Providing learners with the chance to choose over certain aspects of practice has been consistently shown to facilitate the acquisition of motor skills in several populations. However, studies investigating the effects of providing autonomy support during the learning process of older adults remain scarce. The objective of the present study was to investigate the effects of self-controlled amount of practice on the learning of a sequential motor task in older adults. Participants in the self-control group were able to choose when to stop practicing a speed cup stacking task, while the number of practice trials for a yoked group was pre-determined, mirroring the self-control group. The opportunity to choose when stop practicing facilitated motor performance and learning compared to the yoked condition. The findings suggest that letting older adult learners choose the amount of practice, supporting their autonomy needs, has a positive influence on motor learning.
Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Wurm, Susanne
Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention.
Maisel, Jordana L
Built environment features can have varying impacts on user behavior depending on the perceptions of the opportunities and obstacles that the environments create. This study systematically evaluated the relationship between neighborhood perceptions and the specific types of self-reported walking behavior for 121 older adults who resided in urban, suburban, or rural neighborhoods. Perceptions of street connectivity, crime and traffic safety, and overall satisfaction were associated with specific types of walking behaviors, and the strength of the relationships differed by neighborhood type. Sociodemographic variables such as age and sex were associated with certain types and amounts of older adults' walking behaviors both across and within each neighborhood type. The results of this study support the importance of perceived street connectivity regardless of neighborhood type and perceived crime safety in rural neighborhoods to impact the walking behavior among older adults.
Ehlman, Katie; Ligon, Mary
Generativity is a concept first introduced by Erik Erikson as a part of his psychosocial theory which outlines eight stages of development in the human life. Generativity versus stagnation is the main developmental concern of middle adulthood; however, generativity is also recognized as an important theme in the lives of older adults. Building on the work of Erikson, McAdams and de St. Aubin (1992) developed a model explaining the generative process. The aims of this article are: (a) to explore the relationship between generativity and older adults as it appears in research literature; and (b) to examine McAdam's model and use it to explain the role of generativity in older adults who share life stories with gerontology students through an oral history project.
Eisenhower, Christine; Koronkowski, Michael; Marcum, Zachary
More than 100 medications were approved by the US Food and Drug Administration as new drugs or for new indications in 2014 and 2015. Several of the new drugs may benefit older adults, but adverse events and pharmacokinetic changes due to aging must be considered. This article will focus on three recently approved drugs that are marketed for chronic conditions that can affect older adults: suvorexant, for treatment of insomnia; edoxaban, for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation and for treatment of venous thromboembolism; and droxidopa, for treatment of symptomatic neurogenic orthostatic hypotension. Information about indications, mechanisms of action, dosing, efficacy, and safety are reviewed. The place of each agent in therapy for older adults is also discussed. PMID:27340374
Sani, Halima; Mahan, Rebecca J
Numerous factors, such as changes in gastrointestinal physiology, reduced mobility, decreased liquid and nutritional intake, and certain comorbidities, predispose older adults to constipation. Use of opioid medications further compounds this problem. Unlike other side effects associated with opioid use, patients do not develop tolerance to constipation and other opioid-induced bowel dysfunctions. Although opioid-induced constipation has a prevalence rate of 80% in this population, it remains highly undertreated. Despite this problem, there have been limited therapeutic options available for older adults suffering from opioid-induced constipation. On September 16, 2014, a new oral agent, naloxegol, a peripherally acting muopioid receptor antagonist (PAMORA), approved by the Food and Drug Administration, provides new hope for patients. This paper explores clinical complications associated with opioid-induced constipation in older adults, analyzes the efficacy and safety of laxatives and PAMORAs, and defines the future role of naloxegol in this vulnerable population.
Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L
This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the "outshopping theory," where respondents select services in larger regional economic centers rather than local "mom and pop" providers, now extends to older adult health care selection.
Porter Starr, Kathryn N; McDonald, Shelley R; Bales, Connie W
A nutritionally vulnerable older adult has a reduced physical reserve that limits the ability to mount a vigorous recovery in the face of an acute health threat or stressor. Often this vulnerability contributes to more medical complications, longer hospital stays, and increased likelihood of nursing home admission. We have characterized in this review the etiology of nutritional vulnerability across the continuum of the community, hospital, and long term care settings. Frail older adults may become less vulnerable with strong, consistent, and individualized nutritional care. Interventions for the vulnerable older adult must take their nutritional needs into account to optimize resiliency in the face of the acute and/or chronic health challenges they will surely face in their life course.
Wada, Mineko; Mortenson, William Bennett; Hurd Clarke, Laura
This study examined how relevant Rowe and Kahn's three criteria of successful aging were to older adults' self-portrayals in online dating profiles: low probability of disease and disability, high functioning, and active life engagement. In this cross-sectional study, 320 online dating profiles of older adults were randomly selected and coded based on the criteria. Logistic regression analyses determined whether age, gender, and race/ethnicity predicted self-presentation. Few profiles were indicative of successful aging due to the low prevalence of the first two criteria; the third criterion, however, was identified in many profiles. Native Americans were significantly less likely than other ethnic groups to highlight the first two criteria. Younger age predicted presenting the first criterion. Women's presentation of the third criterion remained significantly high with age. The findings suggest that the criteria may be unimportant to older adults when seeking partners, or they may reflect the exclusivity of this construct.
Gould, O N; McDonald-Miszczak, L; King, B
Fifty-one older adults (M age = 75.9 years, SD = 6.9) reported their use of memory strategies for taking of medication using the Prospective Memory for Medication Questionnaire. Older adults used internal strategies more often when the domain was restricted to medication taking but used external strategies more often when queried across a variety of everyday situations. Surprisingly, the hypothesis that medical factors would be the primary determinants of older adults' reports of memory strategy use and perceived adherence was not supported. Metamemorial variables of non-domain-specific memory self-efficacy and memory anxiety in everyday life were significant predictors of strategy use and perceived adherence over and above variables related to the domain of health.
Kang, Hee-Young; Bae, Yeong-Suk; Kim, Eun-Hee; Lee, Kap-Soon; Chae, Myeong-Jeong; Ju, Ree-Aie
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.
Asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are common in older community dwellers (ages 65 and older) and nursing home residents. The challenge involved in distinguishing ASB from UTI in this population results from other comorbid illnesses that may present with symptoms similar to UTI and from elderly adults who have cognitive impairment not being able to report their symptoms. This article reviews the most updated information on diagnosis, microbiology, management, and prevention of ASB and UTI as they pertain to older community dwellers and nursing home residents.
Liu, Hongjie; Lin, Xinqin; Xu, Yongfang; Chen, Shiyi; Shi, Jian; Morisky, Donald
The HIV/AIDS surveillance data indicates that the proportion of people living with HIV/AIDS (PLWHAs) who were 50 years old or older increased to 42.7% in 2011 from 16.5% in 2007 in Nanning, the capital city of Guangxi Province. A greater number of newly diagnosed HIV cases compared to clinical AIDS cases were identified from older adults. The dominant HIV transmission mode among older PLWHAs was heterosexual although approximately 30% of all PLWHAs acquired HIV through heterosexual contacts.
Vogel, Jody A.; Ginde, Adit A.; Lowenstein, Steven R.; Betz, Marian E.
Introduction: To describe the epidemiology and characteristics of emergency department (ED) visits by older adults for motor vehicle collisions (MVC) in the United States (U.S.). Methods: We analyzed ED visits for MVCs using data from the 2003–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Using U.S. Census data, we calculated annual incidence rates of driver or passenger MVC-related ED visits and examined visit characteristics, including triage acuity, tests performed and hospital admission or discharge. We compared older (65+ years) and younger (18–64 years) MVC patients and calculated odds ratios (OR) and 95% confidence intervals (CIs) to measure the strength of associations between age group and various visit characteristics. Multivariable logistic regression was used to identify independent predictors of admissions for MVC-related injuries among older adults. Results: From 2003–2007, there were an average of 237,000 annual ED visits by older adults for MVCs. The annual ED visit rate for MVCs was 6.4 (95% CI 4.6–8.3) visits per 1,000 for older adults and 16.4 (95% CI 14.0–18.8) visits per 1,000 for younger adults. Compared to younger MVC patients, after adjustment for gender, race and ethnicity, older MVC patients were more likely to have at least one imaging study performed (OR 3.69, 95% CI 1.46–9.36). Older MVC patients were not significantly more likely to arrive by ambulance (OR 1.47; 95% CI 0.76–2.86), have a high triage acuity (OR 1.56; 95% CI 0.77–3.14), or to have a diagnosis of a head, spinal cord or torso injury (OR 0.97; 95% CI 0.42–2.23) as compared to younger MVC patients after adjustment for gender, race and ethnicity. Overall, 14.5% (95% CI 9.8–19.2) of older MVC patients and 6.1% (95% CI 4.8–7.5) of younger MVC patients were admitted to the hospital. There was also a non-statistically significant trend toward hospital admission for older versus younger MVC patients (OR 1.78; 95% CI 0.71–4.43), and
Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet
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.
Onishi, Joji; Masuda, Yuichiro; Suzuki, Yusuke; Gotoh, Tadao; Kawamura, Takashi; Iguchi, Akihisa
This study aimed to clarify what pleasurable recreational activities older adults like to participate in, and to investigate the relationship between those activities and quality of life (QOL). Questionnaires were delivered to older residents (65 years and above) in a Japanese rural area. The residents' background information, the amount of pleasure for various activities, and the QOL were surveyed. The QOL was evaluated by the revised Philadelphia Geriatric Center (PGC) morale scale. The amount of pleasure taken in a majority of the activities, such as conversation with family or neighbors showed a significant association with the happiness score, but only a few activities showed significant association between the revised PGC morale scale and the amount of pleasure. The multiple regression analyses indicated that the amount of pleasure in exercise, the difficulty in managing finances, and amount of pleasure taken in watching TV were significant variables for predicting the happiness score. The results indicated that the amount of pleasure older adults experienced when engaging in activities such as conversation with family or neighbors showed significant association with the older adults' happiness. These results may be helpful in understanding contributions of various activities to the perception of pleasure in older adults.
A pilot study of adults ages 65 and older admitted to an acute care setting was conducted to compare nutritional risk as measured by hospital dieticians with two Nutrition Screening Initiative tools, the DETERMINE Your Nutritional Health Checklist and the Level I Screen, and to elicit from patients their own perceptions of nutritional health. Ten community-living older adults were interviewed. Although all 10 were at nutritional risk as measured by both hospital assessment and nutritional risk screening tools, none of these patients believed themselves to be at risk. One conclusion of this pilot is that interventions and education need to be tailored to the perceptions of targeted individuals.
Chu, Chien-Heng; Chen, Ai-Guo; Hung, Tsung-Min; Wang, Chun-Chih; Chang, Yu-Kai
This study investigated the effects of acute exercise on cognitive function and the modulatory role of fitness in the relationship between exercise and cognition. Forty-six healthy older adults, categorized into higher or lower fitness groups, completed the Stroop test after both 30 min of aerobic exercise and a reading control with a counterbalanced order. Our findings demonstrated that acute exercise leads to general improvements in 2 types of cognitive functions and to specific improvements in executive function. Additionally, older adults with initially higher fitness levels experienced greater beneficial effects from acute exercise.
Hajduk, Alexandra M; Chaudhry, Sarwat I
Sedentary behavior is an emerging risk factor for cardiovascular disease (CVD) and may be particularly relevant to the cardiovascular health of older adults. This scoping review describes the existing literature examining the prevalence of sedentary time in older adults with CVD and the association of sedentary behavior with cardiovascular risk in older adults. We found that older adults with CVD spend >75 % of their waking day sedentary, and that sedentary time is higher among older adults with CVD than among older adults without CVD. High sedentary behavior is consistently associated with worse cardiac lipid profiles and increased cardiac risk scores in older adults; the associations of sedentary behavior with blood pressure, CVD incidence, and CVD-related mortality among older adults are less clear. Future research with larger sample sizes using validated methods to measure sedentary behavior are needed to clarify the association between sedentary behavior and cardiovascular outcomes in older adults.
Chaudhry, Sarwat I.
Sedentary behavior is an emerging risk factor for cardiovascular disease (CVD) and may be particularly relevant to the cardiovascular health of older adults. This scoping review describes the existing literature examining the prevalence of sedentary time in older adults with CVD and the association of sedentary behavior with cardiovascular risk in older adults. We found that older adults with CVD spend >75 % of their waking day sedentary, and that sedentary time is higher among older adults with CVD than among older adults without CVD. High sedentary behavior is consistently associated with worse cardiac lipid profiles and increased cardiac risk scores in older adults; the associations of sedentary behavior with blood pressure, CVD incidence, and CVD-related mortality among older adults are less clear. Future research with larger sample sizes using validated methods to measure sedentary behavior are needed to clarify the association between sedentary behavior and cardiovascular outcomes in older adults. PMID:27375828
Waite, Linda J.
Objectives. To examine the relationships between loneliness, social and health behaviors, health, and mortality among older adults in China. Method. Data came from a nationally representative sample of 14,072 adults aged 65 and older from the 2002, 2005, and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged model combined with survival analysis was used to assess the relationships between loneliness, behavioral and health outcomes, and risk of mortality. Results. About 28% of older Chinese adults reported feeling lonely, and lonely adults faced increased risks of dying over the subsequent years. Some of the effect was explained by social and health behaviors, but most of the effect was explained by health outcomes. Loneliness both affects and is affected by social activities, solitary leisure activities, physical exercise, emotional health, self-rated health, and functional limitations over a 3-year period. Discussion. Loneliness is part of a constellation of poor social, emotional, and health outcomes for Chinese older adults. Interventions to increase the social involvement of lonely individuals may improve well-being and lengthen life. PMID:24550354
Cassidy, Brittany S; Gutchess, Angela H
Previous research has demonstrated that older adults have difficulty retrieving contextual material over items alone. Recent research suggests this deficit can be reduced by adding emotional context, allowing for the possibility that memory for social impressions may show less age-related decline than memory for other types of contextual information. Two studies investigated how orienting to social or self-relevant aspects of information contributed to the learning and retrieval of impressions in young and older adults. Participants encoded impressions of others in conditions varying in the use of self-reference (Experiment 1) and interpersonal meaningfulness (Experiment 2), and completed memory tasks requiring the retrieval of specific traits. For both experiments, age groups remembered similar numbers of impressions. In Experiment 1 using more self-relevant encoding contexts increased memory for impressions over orienting to stimuli in a non-social way, regardless of age. In Experiment 2 older adults had enhanced memory for impressions presented in an interpersonally meaningful relative to a personally irrelevant way, whereas young adults were unaffected by this manipulation. The results provide evidence that increasing social relevance ameliorates age differences in memory for impressions, and enhances older adults' ability to successfully retrieve contextual information.
Albert, Steven M.; Duffy, John
Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision-making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than younger adults (p < .05) and also had a higher discount rate (15.6-21.0% vs. 10.3-15.5%, p < .01), indicating lower expected utility from future income. Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision-making across the lifespan. PMID:24319671
Hyodo, Kazuki; Dan, Ippeita; Suwabe, Kazuya; Kyutoku, Yasushi; Yamada, Yuhki; Akahori, Mitsuya; Byun, Kyeongho; Kato, Morimasa; Soya, Hideaki
A growing number of reports state that regular exercise enhances brain function in older adults. Recently a functional near-infrared spectroscopy (fNIRS) study revealed that an acute bout of moderate exercise enhanced activation of the left dorsolateral prefrontal cortex (L-DLPFC) associated with Stroop interference in young adults. Whether this acute effect is also applicable to older adults was examined. Sixteen older adults performed a color-word matching Stroop task before and after 10 minutes of exercise on a cycle ergometer at a moderate intensity. Cortical hemodynamics of the prefrontal area was monitored with a fNIRS during the Stroop task. We analyzed Stroop interference (incongruent-neutral) as Stroop performance. Though activation for Stroop interference was found in the bilateral prefrontal area before the acute bout of exercise, activation of the right frontopolar area (R-FPA) was enhanced after exercise. In the majority of participants, this coincided with improved performance reflected in Stroop interference results. Thus, an acute bout of moderate exercise improved Stroop performance in older adults, and this was associated with contralateral compensatory activation.
Wroblewski, Kristen E.; Huisingh-Scheetz, Megan; Kern, David W.; Chen, Rachel C.; Schumm, L. Philip; Dale, William; McClintock, Martha K.; Pinto, Jayant M.
Objectives Age-related decline of the five classical senses (vision, smell, hearing, touch, and taste) poses significant burdens on older adults. The co-occurrence of multiple sensory deficits in older adults is not well characterized and may reflect a common mechanism resulting in global sensory impairment. Design, Setting, and Participants The National Social Life, Health, and Aging Project, a representative, population-based study of community dwelling older US adults (57-85 years of age), collected biomarkers, social and health history, and other physiological measures, including sensory function. Measurements We estimated the frequency with which impairment co-occurred across the five senses as an integrated measure of sensory aging. We hypothesized that multisensory deficits would be common and reflect global sensory impairment which would largely explain the effects of age, gender, and race on sensory dysfunction. Results Two thirds (67%) of the older US population suffer from two or more sensory deficits, 27% from just one, and only 6% had none. Impairment of the sense of taste was the most common (74%); 70% had a poor sense of touch; 22% had poor sense of smell; 20% had impaired corrected vision; and 18% had poor corrected hearing. Older adults, men, African Americans, and Hispanics had greater multisensory impairment (all P<0.01). Global sensory impairment largely accounted for the effects of age, gender, and race on the likelihood of impairment of each of the five senses. Conclusion Multisensory impairment is prevalent in older US adults. These data support the concept of a common process that underlies sensory aging across the five senses. Clinicians assessing patients with a sensory deficit should consider further evaluation for additional cooccurring sensory deficits. PMID:26889840
Santiago, Lívia Maria; Mattos, Inês Echenique
OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals. PMID:24897042
Chen, Tao; Liu, Lu-Lu; Cui, Ji-Fang; Chen, Xing-Jie; Wang, Ya
Time perspective is a fundamental dimension of the psychological time construct, with a pervasive and powerful influence on human behavior. However, the developmental trajectory of time perspective across a human lifespan remains unclear. The current study aimed to portray the developmental trajectory of all dimensions of time perspectives from children to older adults in a large sample. A total of 1,901 individuals (aged 9-84 years) completed measures of time perspective. They were then divided into five age groups: children, teenagers, young adults, middle-aged adults, and older adults. Results suggested that each time perspective showed a unique developmental pattern across the lifespan. Moreover, perceived economic situation and education were related to some dimensions of time perspective.
O'Connor, Kathryn W; Loughlin, Patrick J; Redfern, Mark S; Sparto, Patrick J
The purpose of this study is to understand the processes of adaptation (changes in within-trial postural responses) and habituation (reductions in between-trial postural responses) to visual cues in older and young adults. Of particular interest were responses to sudden increases in optic flow magnitude. The postural sway of 25 healthy young adults and 24 healthy older adults was measured while subjects viewed anterior-posterior 0.4 Hz sinusoidal optic flow for 45 s. Three trials for each of three conditions were performed: (1) constant 12 cm optic flow amplitude (24 cm peak-to-peak), (2) constant 4 cm amplitude (8 cm p-t-p), and (3) a transition in amplitude from 4 to 12 cm. The average power of head sway velocity (P(vel)) was calculated for consecutive 5s intervals during the trial to examine the changes in sway within and between trials. A mixed factor repeated measures ANOVA was performed to examine the effects of subject Group, Trial, and Interval on the P(vel). P(vel) was greater in older adults in all conditions (p<0.001). During the 12 cm constant amplitude trials, within-trial adaptation occurred for all subjects, but there were differences in the between-trial habituation. P(vel) of the older adults decreased significantly between all 3 trials, but decreased only between Trials 1 and 2 in young adults. While the responses of the young adults to the transition in optic flow from 4 to 12 cm did not significantly change, older adults had an increase in P(vel) following the transition, ranging from 6.5 dB for the first trial to 3.4 dB for the third trial. These results show that older adults can habituate to repeated visual perturbation exposures; however, this habituation requires a greater number of exposures than young adults. This suggests aging impacts the ability to quickly modify the relative weighting of the sensory feedback for postural stabilization.
Sheehan, K J; Greene, B R; Cunningham, C; Crosby, L; Kenny, R A
Higher functioning older adults rarely have their balance assessed clinically and as such early decline in balance is not captured. Early identification of declining balance would facilitate earlier intervention and improved management of the ageing process. This study sought to determine if (a) a once off inertial sensor measurement and (b) changes in inertial sensor measurements one year apart can identify declining balance for higher functioning older adults. One hundred and nineteen community dwelling older adults (58 males; 72.5±5.8 years) completed a timed up and go (TUG) instrumented with inertial sensors and the Berg balance scale (BBS) at two time points, one year apart. Temporal and spatio-temporal gait parameters as well as angular velocity and turn parameters were derived from the inertial sensor data. A change in balance from baseline to follow-up was determined by sub-components of the BBS. Changes in inertial sensor parameters from baseline to follow-up demonstrated strong association with balance decline in higher functioning older adults (e.g. mean medial-lateral angular velocity odds ratio=0.2; 95% CI: 0.1-0.5). The area under the Receiver operating characteristic curve (AUC) ranged from 0.8 to 0.9, a marked improvement over change in TUG time alone (AUC 0.6-0.7). Baseline inertial sensor parameters had a similar association with declining balance as age and TUG time. For higher functioning older adults, the change in inertial sensor parameters over time may reflect declining balance. These measures may be useful clinically, to monitor the balance status of older adults and facilitate earlier identification of balance deficits.
De Jong Gierveld, Jenny
Recently, rising numbers of mid-life and older adults are starting a "living apart together" (LAT) relationship following divorce or widowhood. LAT describes an intimate relationship wherein partners maintain separate households. This study investigated the characteristics of care arrangements in older long-term LAT couples and elicited personal comments about intra-couple care. We interviewed 25 LAT partners and a comparison group of 17 remarried older adults in the Netherlands in a side study of the Netherlands Kinship Panel Study. Results showed that about half of the LAT partners intended to exchange care if needed (partnership commitment); the other half had ambiguous feelings or intentions to refuse care (independence orientation). However, for those LAT partners already confronted with illness in their current relationship, all provided care to the partner in need. The minority of LAT partners who would not exchange care reciprocally are more likely to give as opposed to receive care.
White, Megan; Maxwell, Edward; Milteer, Warren E.; de Leon, Jose
Catatonia has been described in children with intellectual disabilities (IDs). These are the first three published cases of catatonia in adults older than 50 years of age with IDs. They were followed using the KANNER scale and, in one case, creatinine phosphokinase (CPK) monitoring. Case 1 is a 67-year-old Caucasian who probably had been having intermittent episodes of undiagnosed catatonia withdrawal for many years. His episodes of agitation and withdrawal behavior responded to lorazepam up to 8 mg/day. Case 2 is a 63-year-old Caucasian male who had probably had undiagnosed catatonic episodes since age 25. An agitation episode that rated 88 on Part 2 of the KANNER scale ended within minutes after he received 1 mg of intramuscular lorazepam. He had no symptom relapses for 4 years after getting stable oral lorazepam doses (3–8.5 mg/day). Case 3 is a 55-year-old African-American male with severe ID and bradycardia (with a pacemaker). He had been “institutionalized” since age 22 and his undiagnosed catatonic episodes appeared to have been intermittently present for at least the last ten years. As he became tolerant and experienced symptom relapse, oral lorazepam was slowly increased (1.5–18 mg/day). Electroconvulsive therapy was ruled out due to his pacemaker. PMID:26495148
Jones, Kevin T.; Stephens, Jaclyn A.; Alam, Mahtab; Bikson, Marom; Berryhill, Marian E.
An increasing concern affecting a growing aging population is working memory (WM) decline. Consequently, there is great interest in improving or stabilizing WM, which drives expanded use of brain training exercises. Such regimens generally result in temporary WM benefits to the trained tasks but minimal transfer of benefit to untrained tasks. Pairing training with neurostimulation may stabilize or improve WM performance by enhancing plasticity and strengthening WM-related cortical networks. We tested this possibility in healthy older adults. Participants received 10 sessions of sham (control) or active (anodal, 1.5 mA) tDCS to the right prefrontal, parietal, or prefrontal/parietal (alternating) cortices. After ten minutes of sham or active tDCS, participants performed verbal and visual WM training tasks. On the first, tenth, and follow-up sessions, participants performed transfer WM tasks including the spatial 2-back, Stroop, and digit span tasks. The results demonstrated that all groups benefited from WM training, as expected. However, at follow-up 1-month after training ended, only the participants in the active tDCS groups maintained significant improvement. Importantly, this pattern was observed for both trained and transfer tasks. These results demonstrate that tDCS-linked WM training can provide long-term benefits in maintaining cognitive training benefits and extending them to untrained tasks. PMID:25849358
Boyle, Jason B; Kennedy, Deanna M; Shea, Charles H
Two recent experiments have demonstrated that young adult participants were able to make faster and more harmonic movements in a typical reciprocal Fitts task (ID = 6) following a practice session of sine wave tracking (Boyle et al. in Exp Brain Res 223:377-387, 2012; J Mot Behav 46:277-285, 2014). The purpose of the present experiment was to replicate these findings with a young adult population (age 18-25) and determine whether sine wave tracking also enhances goal-directed limb movements in an older adult population (age 65-90). To establish a performance baseline, all participants were first pretested on a typical ID = 6 Fitts task. Participants in each age group were then randomly assigned to one of the two training conditions where they practiced (45 trials) on a typical Fitts task (ID = 6) or they were asked to track a sine wave template (45 trials). Following practice, all participants were then posttested under the ID = 6 Fitts conditions. The results demonstrated that both young and older adult participants that practiced under the sine wave conditions enhanced their Fitts task performance compared to participants in their respective age groups who practiced under the Fitts conditions. These enhancements included faster movement times, smaller dwell times, and more harmonic movements, all without decreases in movement accuracy. These results replicate our previous findings with young adults and extend the finding to older adult participants. Interestingly, the performances of the older adults following sine wave practice were as fast and as accurate as the young adults following Fitts task practice.
Murphy, Dennis T.; Achtziger, Mary Ann
A program for adult women reentry students at a Long Island campus of the C. W. Post Center is chronicled from the development of a rationale through formation of an advisory committee, institution of a series of workshops, addition of motivation through financial aid, and offering of child care and other needed services. (MSE)
Lin, Yi-Yin; Sandmann, Lorilee R.
Although existing literature addresses adults' motivation to learn, and some specifically focuses on older adults, it is now recognized that older adults are more heterogeneous and complex than other age groups. Therefore, this study seeks to provide an alternative theoretical framework to investigate motivation to learn for older adult learners…
Cameron, Duncan H; Rapoport, Mark J
With an increasing number of older drivers who are prescribed antidepressants, the potential consequences of antidepressant use on driving skills in an aging population are becoming a pressing issue. We conducted a systematic review using MEDLINE, targeting articles specifically pertaining to antidepressants and driving in a population or subgroup of older adults (≥ 55 years of age). The search yielded 267 references, nine of which pertained to the effects of antidepressants on driving in older adults. The single experimental study found imipramine to have detrimental effects on highway driving, whereas nefazodone did not. Seven of eight population-based studies reported a significant increased risk of involvement in a collision associated with antidepressant use. Although the studies indicated a negative effect of antidepressants on driving, the epidemiological designs cannot exclude the possibility that the underlying illness, generally major depression, is the culprit.
Wong, Carmen K M; Yeung, Dannii Y; Ho, Henry C Y; Tse, Kin-Po; Lam, Chun-Yiu
Technological advancement benefits Internet users with the convenience of social connection and information search. This study aimed at investigating the predictors of Internet use to search for online health information among Chinese older adults. The Technology Acceptance Model (TAM) was applied to examine the predictiveness of perceived ease of use, perceived usefulness, and attitudes toward Internet use on behavioral intention to search for health information online. Ninety-eight Chinese older adults were recruited from an academic institute for older people and community centers. Frequency of Internet use and physical and psychological health were also assessed. Results showed that perceived ease of use and attitudes significantly predicted behavioral intention of Internet use. The potential influences of traditional Chinese values and beliefs in health were also discussed.
Burckhardt, Carol S.
Poor health has been implicated as a suppressor of the life satisfaction of older adults. To clarify the contribution of arthritis to this process, functional disability, negative affect, pain, current severity of the disease, self-esteem, perception of general health, and internal health locus of control, were placed within a causal model as…
Anema, Inge; Obler, Loraine K.
The purpose of this study was to investigate whether hyphens that disambiguate phrasing in ambiguous sentences influence reading rate and reading comprehension for younger and older adults. Moreover, as working memory (WM) has been implicated in age-related changes in sentence comprehension for both auditory and written materials, we asked if it…
Gray-Graves, Amy; Turner, Keith W.; Swan, James H.
The issues of rising numbers of disasters, overwhelming increases in number of older adults, and historically flawed evacuations present real challenges. During the next two decades, the number of American baby boomers, who turn 65, will increase by 40%. As evidenced by recent disasters, the imperfections and vulnerabilities of flawed evacuations…
Leal, Stephanie L.; Noche, Jessica A.; Murray, Elizabeth A.; Yassa, Michael A.
Numerous studies have suggested that older adults preferentially remember positive information ("positivity effect"), however others have reported mixed results. One potential source of conflict is that aging is not a unitary phenomenon and individual differences exist. We modified a standard neuropsychological test to vary emotional…
Cummings, Sherry M.; Cooper, R. Lyle; Cassie, Kim McClure
This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among older adults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral…
Lo, June C.; Sim, Sam K. Y.; Chee, Michael W. L.
Study Objectives: To investigate the effects of post-learning sleep and sleep architecture on false memory in healthy older adults. Design: Balanced, crossover design. False memory was induced using the Deese-Roediger-McDermott (DRM) paradigm and assessed following nocturnal sleep and following a period of daytime wakefulness. Post-learning sleep structure was evaluated using polysomnography (PSG). Setting: Sleep research laboratory. Participants: Fourteen healthy older adults from the Singapore-Longitudinal Aging Brain Study (mean age ± standard deviation = 66.6 ± 4.1 y; 7 males). Measurements and Results: At encoding, participants studied lists of words that were semantically related to non-presented critical lures. At retrieval, they made “remember”/“know” and “new” judgments. Compared to wakefulness, post-learning sleep was associated with reduced “remember” responses, but not “know” responses to critical lures. In contrast, there were no significant differences in the veridical recognition of studied words, false recognition of unrelated distractors, discriminability, or response bias between the sleep and the wake conditions. More post-learning slow wave sleep was associated with greater reduction in false memory. Conclusions: In healthy older adults, sleep facilitates the reduction in false memory without affecting veridical memory. This benefit correlates with the amount of slow wave sleep in the post-learning sleep episode. Citation: Lo JC; Sim SK; Chee MW. Sleep reduces false memory in healthy older adults. SLEEP 2014;37(4):665-671. PMID:24744453
Chaudhuri, Shomir; Le, Thai; White, Cathy; Thompson, Hilaire; Demiris, George
This study aims to examine which resources older adults utilize for their health information needs, how trustworthy and reliable they find these resources, and the difficulties they face in obtaining health-related information. A 41-item survey designed to understand the information-seeking characteristics of older adults was developed and distributed to retirement communities. Some items were taken from the Health Information National Trends Survey. Of 1520 surveys, 403 were returned completed (26.6%). Respondents' mean age was 77.65 years. Average scores indicated respondents trusted particular sources of health information in the following order (highest to lowest): health care providers, pharmacists, friends and relatives, retirement community staff, newspapers, the Internet, television, and the radio. In conclusion, older adults have a greater amount of trust in a person with whom they are able to actively discuss their health as opposed to a nonliving source, which they have to access or manipulate, such as the Internet. Efforts must be made to help older adults better navigate and utilize the Internet and recognize dependable online sources so that they may increase their trust in its use, thereby increasing satisfaction with their own ability to seek and use sources of health information.
Lundervold, Duane A.; Poppen, Roger
Essential tremor (ET), the most prevalent movement disorder, has a peak prevalence in the sixth decade of life, primarily affecting the hands and head. Persons with ET are often significantly disabled and medical intervention often had limited effectiveness. Describes a biobehavioral rehabilitation model for older adults with ET. (Author/JBJ)
Leslie, David K., Ed.
This book on physical education for the older adult is divided into three parts. The first part contains a chapter that introduces the reader to the topic of aging in American society and ties that topic to the interests of health professionals. Chapters 2 through 6 address the foundation areas of health, physical education, recreation and dance…
Ahn, Young-Joo; Janke, Megan C.
The motivations and benefits of educational travel among individuals aged 55 years old and over were examined in this study. A total of 136 older adults enrolled in Elderhostel programs participated in this study and reported their perceived benefits and motivations for engaging in educational travel experiences. Correlation analyses were used to…
The author describes gerotranscendence as a process that occurs when older adults shift from a rational focus on the present-day, material world to a more universal and transcendent perspective. Accompanying this shift is a desire to move toward the end of life with a sense of integrity and acceptance of one's choices. By gaining an understanding…
Castillo, Jose-Luis Alvarez; Camara, Carmen Palmero; Eguizabal, Alfredo Jimenez
The present paper, drawing from the perspective of social cognition, examines and evaluates an intervention based on social-cognitive perspective-taking on the reduction of stereotyping and prejudice in older adults. Data were collected in a sample of Spanish participants with a mean age of 63.2 years. The intervention, aimed at reducing prejudice…
Coon, David W.; Thompson, Larry W.; Gallagher-Thompson, Dolores
There is growing evidence that psychosocial treatments incorporating behavioral intervention strategies can be effective in the treatment of depression in older adults with cognitive impairment. However, less work with such cases has focused on the use of cognitive interventions in tandem with these behavioral intervention strategies. This case…
Troutman, Meredith; Nies, Mary A.; Bentley, Monica
With the growing size of the population of aging Black individuals, it is important to understand successful aging in this group. This study, therefore, piloted the Successful Aging Inventory (SAI) with a convenience sample of Black older adults. Participants completed a demographic form, the SAI, Purpose in Life Test, Life Satisfaction…
Peek, Gina G.; Bishop, Alex J.
The purpose of the study addressed in this article was to identify ways to reduce risk and improve safe aging in place among rural older adults. Resident and Extension faculty and county educators visited study participants at home to assess functional capacity and the home environment. Extension professionals may be uniquely positioned to provide…
Blair, Thomas; Minkler, Meredith
Purpose: Although participatory action research (PAR) is increasingly viewed as an important complement to traditional investigator-driven research, relatively little PAR has taken place in which older adults have been prominent partners. This article provides a review of the literature on PAR in gerontology, highlighting key studies and their…
Dubno, Judy R.; Ahlstrom, Jayne B.; Horwitz, Amy R.
Purpose: Three experiments measured benefit of spatial separation, benefit of binaural listening, and masking-level differences (MLDs) to assess age-related differences in binaural advantage. Method: Participants were younger and older adults with normal hearing through 4.0 kHz. Experiment 1 compared spatial benefit with and without head shadow.…
Toner, Chelsea K.; Pirogovsky, Eva; Kirwan, C. Brock; Gilbert, Paul E.
Young and nondemented older adults were tested on a continuous recognition memory task requiring visual pattern separation. During the task, some objects were repeated across trials and some objects, referred to as lures, were presented that were similar to previously presented objects. The lures resulted in increased interference and an increased…
Holden, Heather M.; Toner, Chelsea; Pirogovsky, Eva; Kirwan, C. Brock; Gilbert, Paul E.
Young and nondemented older adults completed a visual object continuous recognition memory task in which some stimuli (lures) were similar but not identical to previously presented objects. The lures were hypothesized to result in increased interference and increased pattern separation demand. To examine variability in object pattern separation…
Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly
Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…
Cherry, Barbara J.; Yamashiro, Mariana; Anderson, Erin; Barrett, Christopher; Adamson, Maheen M.; Hellige, Joseph B.
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…
Belanger, Lynda; LeBlanc, Melanie; Morin, Charles M.
Insomnia is associated with significant morbidity and is often a persistent problem, particularly in older adults. It is important to attend to this complaint and not assume that it will remit spontaneously. In many cases, unfortunately, insomnia remains unrecognized and untreated, often because it is presumed that insomnia is an inevitable…
Trahan, Maranda A.; Kahng, SungWoo; Fisher, Alyssa B.; Hausman, Nicole L.
It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the "Journal of Applied Behavior Analysis" ("JABA") on behavioral gerontology (Iwata, 1986), there continues to be a paucity of…
Demeyer, Ineke; Romero, Nuria; De Raedt, Rudi
The interplay between actual and ideal self-esteem may be a key component in emotional disorders. Since automatic self-evaluations are not always consciously accessible, assessment through implicit measures is necessary. Given the lack of implicit self-esteem measures in late life, we aimed to identify a reliable measure and to clarify the role of actual and ideal self-esteem in mood and depressive symptoms in older adults. Forty-nine older adults completed two adapted Go/No go Association tasks measuring implicit actual and ideal self-esteem and measures of mood and depressive symptoms. The two Go/No go Association tasks showed satisfactory internal consistency. Moderation analyses revealed that lower actual self-esteem in older adults is related to higher levels of sad mood when ideal self-esteem is high. Moreover, lower actual self-esteem is related to more anxious mood. Given the role of self-esteem in emotional well-being, a reliable measure for older adults is crucial to improve age-appropriate diagnostics and treatment.
Friedman, Daniela B.; Laditka, Sarah B.; Laditka, James N.; Wu, Bei; Liu, Rui; Price, Anna E.; Tseng, Winston; Corwin, Sara J.; Ivey, Susan L.; Hunter, Rebecca; Sharkey, Joseph R.
This study examined diverse older adults' (n = 396, ages 50+) views about how to stay mentally sharp. We conducted 42 focus groups in four languages at nine United States locations using a standardized discussion guide and methods. The groups represented African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos,…
Sloane-Seale, Atlanta; Kops, Bill
This article examines the relationship between the participation of older adult learners in educational activities and successful aging. In partnership with seniors' organizations, focus-group interviews were conducted on seniors' involvement in learning and their perceptions of its influence on successful aging. Successful aging is defined in…
Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.
This student activity book and reference book, which are part of a family and consumer sciences education series focusing on a broad range of employment opportunities, are intended for use in 1- and 2- programs preparing Texas high school students for employment in occupations related to providing services for older adults. The reference book…
The purpose of this study was to explore the role of visual arts and its impact on successful aging and older adult learners in retirement. Retirement is one of the most important economic, psychological, and social transitions in most people's lives. Longevity has increased in the last sixty years such that in 2010, the average person can…
Andiel, C; Liu, L
Atkinson and Shiffrin's (1968) modal model of memory is still commonly used by rehabilitation professionals to evaluate memory impairment in older adults. However, research to date has been unable to indicate that short-term memory declines with age. These findings have led some rehabilitation professionals to mistakenly conclude that short-term memory is not affected by the aging process. This article reviews both the traditional concept of short-term memory, as outlined by Atkinson and Shiffrin, and the more recent conceptualization of short-term memory in terms of Baddeley and Hitch's (1974) model of working memory. The implications of the concept of working memory has implications for occupational therapy interventions for older adults. For example, clients with dementia may experience difficulties in performing tasks that require drawing inferences. Similarly, language that contains vague references may present problems for these clients. In addition, changes in working memory in older adults suggest that they may experience difficulties with medication management and what Rule, Milke, and Dobbs (1992) called wayfinding. Therefore, evaluations of working memory would provide a better indication of older adults' memory performance than the modal model.
Huber, Lesa; Watson, Carol
The impact of the global aging of the population on social, economic, political, and health care institutions is unequaled. Parallel to this, evolving developments in technology promise opportunities for sales and product development to support positive aging. Older adults are excited to utilize technologies that they perceive as practical.…
Gintner, Gary G.
Examines three common disorders, dementia, depression, and delirium, which can be particularly difficult to diagnose in older adults. Presents three aspects that are helpful in making a decision: age-related differences, medical issues that need to be ruled out, and assessment methods particularly useful in the diagnostic process. (JPS)
Meredith, William H.; Rowe, George P.
Because of the knowledge explosion in the field of gerontology and the increased coverage of the field in the popular press, a study was conducted to determine how accurate older adults and gerontologists think newspaper stories about aging are. A convenience sample of 95 persons in the midwest over 65 years old--similar to national demographic…
This document provides a step-by-step description of the planning and implementation of a two day consumer concerns conference for older adults held at Palomar Community College (California). The bulk of the document is made up of practical discussions of such planning phases as facility selection and decoration, conference publicity, snack and…
Sumner, Edward D.; Haight, Barbara K.
A method for increasing interaction between students and older adults in a geriatric pharmacy course uses an instructional module on stereotypes, age and personality, role changes, and nursing home living. The course requires students to conduct a life review of someone over age 65. The exercise improves student communication skills and…
Weed, Latricia Diane
The relationship between research and practice is increasingly important. The research interview is part of the foundation of quality research and evidence-based practice decisions. Thorough preparation and planning is required for a successful research interview with an older adult.
Ehlman, Katie; Ligon, Mary
Generativity is a concept first introduced by Erik Erikson as a part of his psychosocial theory which outlines eight stages of development in the human life. Generativity versus stagnation is the main developmental concern of middle adulthood; however, generativity is also recognized as an important theme in the lives of older adults. Building on…
This directory is designed to help its users locate colleges and universities in the United States that offer physical fitness programs for older adults. The directory's annotations include: program area, scope of activities comprising the program, target population, duration of program, and special comments. The focus of the listed programs is on…
The objective of this research was to identify the effects of participation in learning on the subjective wellbeing of older adults. Data were from the English Longitudinal Study of Ageing (ELSA), a large-scale, nationally representative survey of those aged 50 and above. The survey contains several wellbeing measures and information on three…
Mitzner, Tracy L.; Boron, Julie B.; Fausset, Cara Bailey; Adams, Anne E.; Charness, Neil; Czaja, Sara J.; Dijkstra, Katinka; Fisk, Arthur D.; Rogers, Wendy A.; Sharit, Joseph
Older adults (n = 113) participated in focus groups discussing their use of and attitudes about technology in the context of their home, work, and healthcare. Participants reported using a wide variety of technology items, particularly in their homes. Positive attitudes (i.e., likes) outnumbered negative attitudes (i.e., dislikes), suggesting that older adults perceive the benefits of technology use to outweigh the costs of such use. Positive attitudes were most frequently related to how the technology supported activities, enhanced convenience, and contained useful features. Negative attitudes were most frequently associated with technology creating inconveniences, unhelpful features, as well as security and reliability concerns. Given that older adults reported more positive than negative attitudes about the technologies they use, these results contradict stereotypes that older adults are afraid or unwilling to use technology. These findings also highlight the importance of perceived benefits of use and ease of use for models of technology acceptance. Emphasizing the benefits of technology in education and training programs may increase future technology adoption. PMID:20967133
Gilliam, Brian K.
Purpose: The purpose of this study was to identify future trends and barriers that will either facilitate or impede the narrowing of the digital skills divide among older adults during the next 10 years. Methodology: To address the research questions, this study used a modified version of the Delphi process using a panel of experts who…
Tremethick, Mary Jane; Hogan, Patricia I.; Coleman, Barb; Adams, Kady
One of the goals of "Healthy People 2010" is to decrease the incidence of limitation in physical activity due to arthritis. Physical education, recreation, and dance professionals can play an important role in meeting this objective by addressing barriers to physical activity and exercise in older adults with arthritis, and by successfully…
Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Wilber, Kathleen H.
Purpose: This study was designed to improve the measurement of financial exploitation (FE) by testing psychometric properties of the older adult financial exploitation measure (OAFEM), a client self-report instrument. Design and Methods: Rasch item response theory and traditional validation approaches were used. Questionnaires were administered by…
This qualitative research investigates the meaning of "keitai" (mobile phones) for older Japanese adults between the ages of 59 and 79. Participants' emails from keitai, handwritten daily logs, and audio and video recordings from meetings and interviews were collected during my stay of nearly seven months in one of the largest cities in…
Krause, Neal; Keith, Verna
Studies exposure to life stress as an explanation for gender differences in older adults' utilization of social support. Results suggest that, as stressful events increase, elderly men and women are equally likely to become more involved in their social network, while gender differences emerge in response to chronic financial strain. (JS)
Investigates social support for older adults in the computer-mediated environment. Finds that: satisfaction with Internet providers of social support was significantly higher for high Internet users than for low Internet users, whereas low Internet users were more satisfied with their non-Internet support networks than high Internet users; and…
Snyder, Marti M.
Describes the creation of SeniorSage, an eight week facilitated online learning community for older adult volunteers in a Florida learning center. Discusses how members were prepared to participate in the community, explains the instructional design theory that guided the development of SeniorSage, and recommends future research. (Author/LRW)
Marston, Hannah R.
There were two objectives to this study: (a) to establish flow and (2) to establish whether computer game interaction or content was important to the older adult, using the Nintendo Wii and the Sony PlayStation 2 consoles. An earlier study had identified the sports genre as a preference, and three games (golf, tennis, and boxing) were selected…
Goodrow, Bruce A.
A community based study of 268 randomly selected subjects over the age of 65 provided information concerning major limitations that prevent older adults from taking advantage of existing or future educational programs. The three most prevalent were poor vision, home responsibilities, and lack of transportation. (Author)
Obler, Loraine K.; Rykhlevskaia, Elena; Schnyer, David; Clark-Cotton, Manuella R.; Spiro, Avron, III; Hyun, JungMoon; Kim, Dae-Shik; Goral, Mira; Albert, Martin L.
To determine structural brain correlates of naming abilities in older adults, we tested 24 individuals aged 56-79 on two confrontation-naming tests (the Boston Naming Test (BNT) and the Action Naming Test (ANT)), then collected from these individuals structural Magnetic-Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) data. Overall,…
Mitzner, Tracy L; Boron, Julie B; Fausset, Cara Bailey; Adams, Anne E; Charness, Neil; Czaja, Sara J; Dijkstra, Katinka; Fisk, Arthur D; Rogers, Wendy A; Sharit, Joseph
Older adults (n = 113) participated in focus groups discussing their use of and attitudes about technology in the context of their home, work, and healthcare. Participants reported using a wide variety of technology items, particularly in their homes. Positive attitudes (i.e., likes) outnumbered negative attitudes (i.e., dislikes), suggesting that older adults perceive the benefits of technology use to outweigh the costs of such use. Positive attitudes were most frequently related to how the technology supported activities, enhanced convenience, and contained useful features. Negative attitudes were most frequently associated with technology creating inconveniences, unhelpful features, as well as security and reliability concerns. Given that older adults reported more positive than negative attitudes about the technologies they use, these results contradict stereotypes that older adults are afraid or unwilling to use technology. These findings also highlight the importance of perceived benefits of use and ease of use for models of technology acceptance. Emphasizing the benefits of technology in education and training programs may increase future technology adoption.
Bardach, Shoshana H; Schoenberg, Nancy E; Howell, Britteny M
Dietary intake and physical activity are lifestyle behaviors that are learned, developed, and practiced throughout an individual's lifetime. These lifestyle behaviors have a profound role on health and quality of life--with late-life changes still resulting in notable improvements. Despite well documented benefits of behavior change, such changes are extremely challenging. The purpose of this study is to better understand from the perspective of older adults themselves, the factors that may influence their likelihood of making lifestyle changes. Participants were recruited two primary care clinics. 104 older adults ranging in age from 65 to 95 were included. Participants were interviewed about their motivations and plans to change diet and physical activity behaviors following a routine primary care visit. All interviews were transcribed and transcripts were analyzed using a line-by-line coding approach. Older adults reported that their likelihood of making a lifestyle change related to perceptions of old age, personal motivation, and perceived confidence in the ability to make effective changes. These findings suggest the importance of creating more positive images of old age and tailoring health promotion efforts to older adults' motivations and confidence in their ability to make behavior changes.
Craig, Ford M.
Provides a literature review on community college services to older adults, focusing on studies of this population's needs (e.g., personal business and financial information, employment needs, physical fitness training, and maintaining self-esteem and a sense of the purpose and meaning in life) and courses and services that colleges offer. (DMM)
Gramss, Denise; Struve, Doreen
The study reported in this paper investigated the usefulness of different instructions for guiding inexperienced older adults through interactive systems. It was designed to compare different media in relation to their social as well as their motivational impact on the elderly during the learning process. Precisely, the video was compared with…
Bhar, Sunil S.; Brown, Gregory K.
This article describes a cognitive behavior therapy (CBT) intervention for suicide prevention in older adults. Although many studies have found that CBT interventions are efficacious for reducing depressive symptoms in the elderly, researchers have yet to evaluate the efficacy of such interventions for preventing suicide or reducing suicide risk…
Sloane-Seale, Atlanta; Kops, Bill
The University of Manitoba's Continuing Education Division (CED) and Creative Retirement Manitoba (CRM) formed a partnership to promote applied research on lifelong learning and older adults, to develop new and to complement existing educational activities, and to explore new program models and instructional methods to meet the educational needs…
Black, Barbara A.
This paper reports on a study conducted to assist the Wadsworth Public Library in future planning and refining of services to older adults especially in library outreach. A questionnaire was distributed to residents (n=350) of one nursing home, four apartment complexes for seniors, one assisted living complex, one senior center, and any patrons…
Pierce, John E.; Cotton, Susan; Perry, Alison
Background: Alternating motion rate (AMR) and sequential motion rate (SMR) are tests of articulatory diadochokinesis that are widely used in the evaluation of motor speech. However, there are no quality normative data available for adults aged 65 years and older. Aims: There were two aims: (1) to obtain a representative, normative dataset of…
Du Moulin, M F M T; Hamers, J P H; Ambergen, A W; Janssen, M A P; Halfens, R J G
We conducted a cross-sectional survey in 2005 to determine the prevalence of and factors associated with urinary incontinence (UI) in adults receiving home care. Of the 2,866 patients surveyed, 46% suffered from UI; 6.5% had stress, 16.6% had urge, 9% had mixed, and 17.6% had functional incontinence. No diagnosis regarding type of UI had been established in 50.2%. Factors associated with UI were advanced age, higher body mass index, and impaired mobility. UI is prevalent in older persons receiving home care, but the lack of diagnosis of type of UI in half of the participants surveyed impedes management of UI.
Madore, Kevin P; Schacter, Daniel L
Episodic memory plays an important role not only in remembering past experiences, but also in constructing simulations of future experiences and solving means-end social problems. We recently found that an episodic specificity induction-brief training in recollecting details of past experiences-enhances performance of young and older adults on memory and imagination tasks. Here we tested the hypothesis that this specificity induction would also positively impact a means-end problem-solving task on which age-related changes have been linked to impaired episodic memory. Young and older adults received the specificity induction or a control induction before completing a means-end problem-solving task, as well as memory and imagination tasks. Consistent with previous findings, older adults provided fewer relevant steps on problem solving than did young adults, and their responses also contained fewer internal (i.e., episodic) details across the 3 tasks. There was no difference in the number of other (e.g., irrelevant) steps on problem solving or external (i.e., semantic) details generated on the 3 tasks as a function of age. Critically, the specificity induction increased the number of relevant steps and internal details (but not other steps or external details) that both young and older adults generated in problem solving compared with the control induction, as well as the number of internal details (but not external details) generated for memory and imagination. Our findings support the idea that episodic retrieval processes are involved in means-end problem solving, extend the range of tasks on which a specificity induction targets these processes, and show that the problem-solving performance of older adults can benefit from a specificity induction as much as that of young adults.
Madore, Kevin P.; Schacter, Daniel L.
Episodic memory plays an important role not only in remembering past experiences, but also in constructing simulations of future experiences and solving means-end social problems. We recently found that an episodic specificity induction- brief training in recollecting details of past experiences- enhances performance of young and older adults on memory and imagination tasks. Here we tested the hypothesis that this specificity induction would also positively impact a means-end problem solving task on which age-related changes have been linked to impaired episodic memory. Young and older adults received the specificity induction or a control induction before completing a means-end problem solving task as well as memory and imagination tasks. Consistent with previous findings, older adults provided fewer relevant steps on problem solving than did young adults, and their responses also contained fewer internal (i.e., episodic) details across the three tasks. There was no difference in the number of other (e.g., irrelevant) steps on problem solving or external (i.e., semantic) details generated on the three tasks as a function of age. Critically, the specificity induction increased the number of relevant steps and internal details (but not other steps or external details) that both young and older adults generated in problem solving compared with the control induction, as well as the number of internal details (but not external details) generated for memory and imagination. Our findings support the idea that episodic retrieval processes are involved in means-end problem solving, extend the range of tasks on which a specificity induction targets these processes, and show that the problem solving performance of older adults can benefit from a specificity induction as much as that of young adults. PMID:25365688
Stott, David J; Rodondi, Nicolas; Kearney, Patricia M; Ford, Ian; Westendorp, Rudi G J; Mooijaart, Simon P; Sattar, Naveed; Aubert, Carole E; Aujesky, Drahomir; Bauer, Douglas C; Baumgartner, Christine; Blum, Manuel R; Browne, John P; Byrne, Stephen; Collet, Tinh-Hai; Dekkers, Olaf M; den Elzen, Wendy P J; Du Puy, Robert S; Ellis, Graham; Feller, Martin; Floriani, Carmen; Hendry, Kirsty; Hurley, Caroline; Jukema, J Wouter; Kean, Sharon; Kelly, Maria; Krebs, Danielle; Langhorne, Peter; McCarthy, Gemma; McCarthy, Vera; McConnachie, Alex; McDade, Mairi; Messow, Martina; O'Flynn, Annemarie; O'Riordan, David; Poortvliet, Rosalinde K E; Quinn, Terence J; Russell, Audrey; Sinnott, Carol; Smit, Jan W A; Van Dorland, H Anette; Walsh, Kieran A; Walsh, Elaine K; Watt, Torquil; Wilson, Robbie; Gussekloo, Jacobijn
Background The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. Methods We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment. The two primary outcomes were the change in the Hypothyroid Symptoms score and Tiredness score on a thyroid-related quality-of-life questionnaire at 1 year (range of each scale is 0 to 100, with higher scores indicating more symptoms or tiredness, respectively; minimum clinically important difference, 9 points). Results The mean age of the patients was 74.4 years, and 396 patients (53.7%) were women. The mean (±SD) thyrotropin level was 6.40±2.01 mIU per liter at baseline; at 1 year, this level had decreased to 5.48 mIU per liter in the placebo group, as compared with 3.63 mIU per liter in the levothyroxine group (P<0.001), at a median dose of 50 μg. We found no differences in the mean change at 1 year in the Hypothyroid Symptoms score (0.2±15.3 in the placebo group and 0.2±14.4 in the levothyroxine group; between-group difference, 0.0; 95% confidence interval [CI], -2.0 to 2.1) or the Tiredness score (3.2±17.7 and 3.8±18.4, respectively; between-group difference, 0.4; 95% CI, -2.1 to 2.9). No beneficial effects of levothyroxine were seen on secondary-outcome measures. There was no significant excess of serious adverse events prespecified as being of special interest
Alonso, Irene; Dellacherie, Delphine; Samson, Séverine
The emotions evoked by music can enhance recognition of excerpts. It has been suggested that memory is better for high than for low arousing music (Eschrich et al., 2005; Samson et al., 2009), but it remains unclear whether positively (Eschrich et al., 2008) or negatively valenced music (Aubé et al., 2013; Vieillard and Gilet, 2013) may be better recognized. Moreover, we still know very little about the influence of age on emotional memory for music. To address these issues, we tested emotional memory for music in young and older adults using musical excerpts varying in terms of arousal and valence. Participants completed immediate and 24 h delayed recognition tests. We predicted highly arousing excerpts to be better recognized by both groups in immediate recognition. We hypothesized that arousal may compensate consolidation deficits in aging, thus showing more prominent benefit of high over low arousing stimuli in older than younger adults on delayed recognition. We also hypothesized worst retention of negative excerpts for the older group, resulting in a recognition benefit for positive over negative excerpts specific to older adults. Our results suggest that although older adults had worse recognition than young adults overall, effects of emotion on memory do not seem to be modified by aging. Results on immediate recognition suggest that recognition of low arousing excerpts can be affected by valence, with better memory for positive relative to negative low arousing music. However, 24 h delayed recognition results demonstrate effects of emotion on memory consolidation regardless of age, with a recognition benefit for high arousal and for negatively valenced music. The present study highlights the role of emotion on memory consolidation. Findings are examined in light of the literature on emotional memory for music and for other stimuli. We finally discuss the implication of the present results for potential music interventions in aging and dementia. PMID
Ashe, Maureen C.; Miller, William C.; Eng, Janice J.; Noreau, Luc
Background Participating in regular physical activity is an important part of healthy aging. There is an increased risk for inactivity associated with aging and the risk becomes greater for adults who have a chronic disease. However, there is limited information on current physical activity levels for older adults and even less for those with chronic diseases. Objective Our primary objective was to determine the proportion of older adults who achieved a recommended amount of weekly physical activity (≥1000 kcal/week). The secondary objectives were to identify variables associated with meeting guideline leisure-time physical activity (LTPA), and to describe the type of physical activities that respondents reported across different chronic diseases. Methods In this study we used the Canadian Community Health Survey Cycle 1.1 (2000/2001) to report LTPA for adults aged 65 years and older. This was a population-based self-report telephone survey. We used univariate logistic regression to provide odds ratios to determine differences in activity and the likelihood of meeting guideline recommendations. Results For adults over 65 years of age with no chronic diseases, 30% reported meeting guideline LTPA, while only 23% met the recommendations if they had one or more chronic diseases. Factors associated with achieving the guideline amount of physical activity included a higher level of education, higher income and moderate alcohol consumption. Likelihood for not achieving the recommended level of LTPA included low BMI, pain and the presence of mobility and dexterity problems. Walking, gardening and home exercises were the three most frequent types of reported physical activities. Conclusion This study provides the most recent evidence to suggest that older Canadians are not active enough and this is accentuated if a chronic disease is present. It is important to develop community-based programs to facilitate LTPA, in particular for older people with a chronic disease. PMID
Ryan, Cormac G; Schofield, Patricia; Martin, Denis J
Negative views of older adults can lead to suboptimal care. For older adults with persistent low back pain (LBP), promotion of physical activity by health care professionals is important. Health care professionals' views of older adults are influenced by their training. This study aimed to compare recommendations for physical activity for managing persistent LBP offered by students in physiotherapy and occupational therapy to an older person vs. a younger person. In a cross-sectional online survey, participants (N = 77) randomly received a vignette of either a 40-yr-old or 70-yr-old patient with persistent LBP. Other than age, the vignettes were identical. There was no difference between the younger and older vignettes in the likelihood of participants making overall appropriate physical activity recommendations--63% vs. 59%, OR (95% CI) = 1.19 (0.48-2.99), p = .71--although there was a trend toward age bias on recommendations specific to daily activity. Postqualification education may be where ageist views need to be addressed.
Smith, Judith R.
This article uses qualitative research and narrative analysis to examine the experience of women age 55 and older who are parents caring for adult children with mental illness. Knowledge about the conflicts of older parents with dependent children is underdeveloped. In this study, analysis of women's stories about parenting in later life reveal…
Phelan, A; Fealy, G; Downes, C
Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse.
Schwebel, David C.; Ball, Karlene K.; Severson, Joan; Barton, Benjamin K.; Rizzo, Matthew; Viamonte, Sarah M.
Introduction Motor-vehicle crashes kill roughly 4,500 American adults over the age of 75 annually. Among younger adults, one behavioral factor consistently linked to risky driving is personality, but this predictor has been overshadowed by research on cognitive, perceptual, and motor processes among older drivers. Method In this study, a sample of 101 licensed drivers, all age 75 and over, were recruited to complete self-report measures on personality, temperament, and driving history. Participants also completed a virtual environment (VE) course designed to assess risk-taking driving behavior. State records of motor-vehicle crashes were collected. Results Results suggest both a sensation-seeking personality and an undercontrolled temperament are related to risky driving among older adults. Sensation-seeking was particularly related to history of violations and tickets, while temperamental control was more broadly related to a number of risky driving measures. Methodological and crash prevention issues are discussed. PMID:18023635
Pergolotti, Mackenzi; Cutchin, Malcolm P; Weinberger, Morris; Meyer, Anne-Marie
Occupational therapy may significantly improve cancer survivors' ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer.
Joshi, Spruha; Mooney, Stephen J; Rundle, Andrew G; Quinn, James W; Beard, John R; Cerdá, Magdalena
The pathways through which neighborhood poverty can affect resident depression are still unknown. We investigated mechanisms through which neighborhood poverty may influence depression among older adults. Participants were drawn from the New York City Neighborhood and Mental Health in the Elderly Study II, a 3-wave study of adults aged 65-75 (n=3,497) at baseline. Neighborhood poverty and homicide were associated with depressive symptoms at follow-up waves (RR:1.20, 95%CI: 1.05, 1.36; RR: 1.09, 95%CI: 1.02, 1.17, respectively). Homicide accounted for 30% of the effect of neighborhood poverty on depressive symptoms. Neighborhood exposure to violence may be a key mechanism through which neighborhood poverty influences depression among older adults.
Belchior, Patrícia; Marsiske, Michael; Sisco, Shannon M; Yam, Anna; Bavelier, Daphne; Ball, Karlene; Mann, William C
The current study investigated the effect of video game training on older adult's useful field of view performance (the UFOV® test). Fifty-eight older adult participants were randomized to receive practice with the target action game (Medal of Honor), a placebo control arcade game (Tetris), a clinically validated UFOV training program, or into a no contact control group. Examining pretest-posttest change in selective visual attention, the UFOV improved significantly more than the game groups; all three intervention groups improved significantly more than no-contact controls. There was a lack of difference between the two game conditions, differing from findings with younger adults. Discussion considers whether games posing less challenge might still be effective interventions for elders, and whether optimal training dosages should be higher.
Raw, Rachael K; Wilkie, Richard M; Culmer, Peter R; Mon-Williams, Mark
Handedness, a preference towards using the right or left hand, is established in early childhood. Such specialisation allows a higher level of skill to be maintained in the preferred hand on specific tasks through continuous practice and performance. Hand asymmetries might be expected to increase with age because of the time spent practising with the preferred hand. However, neurophysiological work has suggested reduced hemispheric function lateralisation in the ageing brain, and behavioural studies have found reduced motor asymmetries in older adults (Przybyla et al., in Neurosci Lett 489:99-104, 2011). We therefore tested the predictions of behavioural change from reduced hemispheric function by measuring tracing performance (arguably one of the most lateralised of human behaviours) along paths of different thickness in a group of healthy young and older adults. Participants completed the task once with their preferred (right) hand and once with their non-preferred (left) hand. Movement time (MT) and shape accuracy (SA) were dependant variables. A composite measure of MT and SA, the speed accuracy cost function (SACF) provided an overall measure of motor performance. Older participants were slower and less accurate when task demands were high. Combined analyses of both hands revealed reduced asymmetries in MT and SACF in the older group. The young were significantly faster when tracing with their preferred hand, but older participants were equally slow with either hand. Our results are consistent with the growing literature reporting decreased hemispheric function lateralisation in the ageing brain.
Özen Tunay, Zuhal; İdil, Aysun; Seza Petriçli, İkbal; Özdemir, Özdemir
Objectives: To evaluate the diagnosis distribution, low vision rehabilitation methods and utilization of low vision rehabilitation in partially sighted persons over 65 years old. Materials and Methods: One hundred thirty-nine partially sighted geriatric patients aged 65 years or older were enrolled to the study between May 2012 and September 2013. Patients’ age, gender and the distribution of diagnosis were recorded. The visual acuity of the patients both for near and distance were examined with and without low vision devices and the methods of low vision rehabilitation were evaluated. Results: The mean age of the patients was 79.7 years and the median age was 80 years. Ninety-six (69.1%) of the patients were male and 43 (30.9%) were female. According to the distribution of diagnosis, the most frequent diagnosis was senile macular degeneration for both presenile and senile age groups. The mean best corrected visual acuity for distance was 0.92±0.37 logMAR and 4.75±3.47 M for near. The most frequently used low vision rehabilitation methods were telescopic glasses (59.0%) for distance and hyperocular glasses (66.9%) for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids. Conclusion: The causes of low vision in presenile and senile patients in our study were similar to those of patients from developed countries. A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted geriatric patients. It is important to guide them to low vision rehabilitation. PMID:27800274
Chan, Micaela Y.; Haber, Sara; Drew, Linda M.; Park, Denise C.
Purpose of the Study: Recent evidence shows that engaging in learning new skills improves episodic memory in older adults. In this study, older adults who were computer novices were trained to use a tablet computer and associated software applications. We hypothesize that sustained engagement in this mentally challenging training would yield a dual benefit of improved cognition and enhancement of everyday function by introducing useful skills. Design and Methods: A total of 54 older adults (age 60-90) committed 15 hr/week for 3 months. Eighteen participants received extensive iPad training, learning a broad range of practical applications. The iPad group was compared with 2 separate controls: a Placebo group that engaged in passive tasks requiring little new learning; and a Social group that had regular social interaction, but no active skill acquisition. All participants completed the same cognitive battery pre- and post-engagement. Results: Compared with both controls, the iPad group showed greater improvements in episodic memory and processing speed but did not differ in mental control or visuospatial processing. Implications: iPad training improved cognition relative to engaging in social or nonchallenging activities. Mastering relevant technological devices have the added advantage of providing older adults with technological skills useful in facilitating everyday activities (e.g., banking). This work informs the selection of targeted activities for future interventions and community programs. PMID:24928557
Lyons, Beverly P; Hall, Raphael J
In Latin America and the Caribbean, there is a scarcity of data on falls, the leading cause of death as a result of unintentional injuries, among older adults aged 65+ years of age. By 2050, 80 % of the 2 billion older adults worldwide are expected to be living in this region; therefore, it is imperative that this issue receive urgent attention from community health practitioners, health educators and policy makers. Guided by Pillar 1-awareness of the WHO fall prevention model for community-dwelling older adults, the purpose of this paper was to describe the feasibility of implementing a falls prevention awareness educational initiative in the Eastern Caribbean Island of Grenada. Sixty-two older adults, average age 67, participated in a falls awareness workshop. An anonymous pre-workshop falls assessment checklist was distributed to establish baseline information followed by an interactive workshop. Eight fall risks were identified and 52 % of the participants reported a history of falls. Based on the group's eagerness to participate, we are encouraged that falls prevention intervention initiatives are feasible among others of similar characteristics in Grenada and plan to implement Pillar II-objective falls assessment and Pillar III-on-going interventions.
Toril, Pilar; Reales, José M.; Mayas, Julia; Ballesteros, Soledad
In this longitudinal intervention study with experimental and control groups, we investigated the effects of video game training on the visuospatial working memory (WM) and episodic memory of healthy older adults. Participants were 19 volunteer older adults, who received 15 1-h video game training sessions with a series of video games selected from a commercial package (Lumosity), and a control group of 20 healthy older adults. The results showed that the performance of the trainees improved significantly in all the practiced video games. Most importantly, we found significant enhancements after training in the trained group and no change in the control group in two computerized tasks designed to assess visuospatial WM, namely the Corsi blocks task and the Jigsaw puzzle task. The episodic memory and short-term memory of the trainees also improved. Gains in some WM and episodic memory tasks were maintained during a 3-month follow-up period. These results suggest that the aging brain still retains some degree of plasticity, and that video game training might be an effective intervention tool to improve WM and other cognitive functions in older adults. PMID:27199723
Toril, Pilar; Reales, José M; Mayas, Julia; Ballesteros, Soledad
In this longitudinal intervention study with experimental and control groups, we investigated the effects of video game training on the visuospatial working memory (WM) and episodic memory of healthy older adults. Participants were 19 volunteer older adults, who received 15 1-h video game training sessions with a series of video games selected from a commercial package (Lumosity), and a control group of 20 healthy older adults. The results showed that the performance of the trainees improved significantly in all the practiced video games. Most importantly, we found significant enhancements after training in the trained group and no change in the control group in two computerized tasks designed to assess visuospatial WM, namely the Corsi blocks task and the Jigsaw puzzle task. The episodic memory and short-term memory of the trainees also improved. Gains in some WM and episodic memory tasks were maintained during a 3-month follow-up period. These results suggest that the aging brain still retains some degree of plasticity, and that video game training might be an effective intervention tool to improve WM and other cognitive functions in older adults.
Altman, Brian A; Gulley, Kelly H; Rossi, Carlo; Strauss-Riggs, Kandra; Schor, Kenneth
The National Center for Disaster Medicine and Public Health (NCDMPH), in collaboration with over 20 subject matter experts, created a competency-based curriculum titled Caring for Older Adults in Disasters: A Curriculum for Health Professionals. Educators and trainers of health professionals are the target audience for this curriculum. The curriculum was designed to provide breadth of content yet flexibility for trainers to tailor lessons, or select particular lessons, for the needs of their learners and organizations. The curriculum covers conditions present in the older adult population that may affect their disaster preparedness, response, and recovery; issues related to specific types of disasters; considerations for the care of older adults throughout the disaster cycle; topics related to specific settings in which older adults receive care; and ethical and legal considerations. An excerpt of the final capstone lesson is included. These capstone activities can be used in conjunction with the curriculum or as part of stand-alone preparedness training. This article describes the development process, elements of each lesson, the content covered, and options for use of the curriculum in education and training for health professionals. The curriculum is freely available online at the NCDMPH website at http://ncdmph.usuhs.edu (Disaster Med Public Health Preparedness. 2016;10:633-637).
Beegan, Leah; Messinger-Rapport, Barbara J
About one-third of community-dwelling adults age 65 and older fall each year, and some suffer fractures, traumatic brain injury, and even death. Therefore, it is important to identify older adults at risk and recommend helpful interventions.
Orchi, N; Balzano, R; Scognamiglio, P; Navarra, A; De Carli, G; Elia, P; Grisetti, S; Sampaolesi, A; Giuliani, M; De Filippis, A; Puro, V; Ippolito, G; Girardi, E
The prevalence of HIV/AIDS among people in midlife and late adulthood has been increasing in Western countries over the last decade. We analyzed data from a prospective, observational multi-centre study on individuals newly diagnosed with HIV between January 2004 and March 2007 in 10 public counselling and testing sites in Latium, Italy. At diagnosis, routine demographic, epidemiological, clinical and laboratory data are recorded, and patients are asked to complete a questionnaire investigating socio-demographic and psycho-behavioural aspects. To analyze the association of individual characteristics with age, we compared older adults (> or = 50 years) with their younger counterpart (18-49 years). To adjust for potential confounding effect of the epidemiological, clinical and behavioural characteristics, to identify factors associated with older age at HIV diagnosis, multivariate logistic regression analysis was performed. Overall, 1073 individuals were identified, 125 of whom (11.6%) were aged 50 years or above. The questionnaire was completed by 41% (440/1073). Compared with their younger counterparts, a higher proportion of older patients were males, born in Italy, reported heterosexual or unknown HIV risk exposure, were never tested for HIV before and were in a more advanced stage of HIV infection at diagnosis. In addition, older adults had a lower educational level and were more frequently living with their partners or children. With respect to psycho-behavioural characteristics, older patients were more likely to have paid money for sex and have never used recreational drugs. Interestingly, no differences were found regarding condom use, which was poor in both age groups. These findings may have important implications for the management of older adults with HIV, who should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare. Moreover, strategies including information on HIV and prevention of risk
Heffner, Kathi L.; Ng, H. Mei; Suhr, Julie A.; France, Christopher R.; Marshall, Gailen D.; Pigeon, Wilfred R.; Moynihan, Jan A.
Objectives Poor sleep diminishes mental and physical health. The objective of this study was to examine associations between sleep disturbance and interleukin-6 (IL-6) responses to acute mental stress in older adults. Design Observational study of community-dwelling, healthy older adults. Setting Participants completed the study in a clinical research laboratory of a mid-sized university. Participants Generally healthy, community-dwelling men and women 50 years of age and older. Measurements IL-6 and negative affect at rest and following a series of challenging cognitive tests; sleep quality; depressive symptoms; perceived stress; loneliness. Results Participants categorized as poor sleepers based on Pittsburgh Sleep Quality Index scores had significantly larger IL-6 responses to the cognitive stressors compared to good sleepers. The association between poor sleep and heightened IL-6 response to acute stress was not explained by other psychosocial factors previously linked to immune dysregulation, including depressive symptoms, perceived stress, and loneliness. Conclusions Findings add to the growing evidence for poor sleep as an independent risk factor for poor mental and physical health. Older adults may be particularly vulnerable to effects of sleep disturbance due to significant age-related changes in both sleep and inflammatory regulation. PMID:22327621
Marshall, Simon; Kerr, Jacqueline; Carlson, Jordan; Cadmus-Bertram, Lisa; Patterson, Ruth; Wasilenko, Kari; Crist, Katie; Rosenberg, Dori; Natarajan, Loki
The purpose of this study was to compare estimates of sedentary time on weekdays vs. weekend days in older adults and determine if these patterns vary by measurement method. Older adults (N = 230, M = 83.5, SD = 6.5 years) living in retirement communities completed a questionnaire about sedentary behavior and wore an ActiGraph accelerometer for seven days. Participants engaged in 9.4 (SD = 1.5) hours per day of accelerometer-measured sedentary time, but self-reported engaging in 11.4 (SD = 4.9) hours per day. Men and older participants had more accelerometer-measured sedentary time than their counterparts. The difference between accelerometer-measured weekday and weekend sedentary time was non-significant. However, participants self-reported 1.1 hours per day more sedentary time on weekdays compared to weekend days. Findings suggest self-reported but not accelerometer-measured sedentary time should be investigated separately for weekdays and weekend days, and that self-reports may overestimate sedentary time in older adults. PMID:25415205
Christy, Annette; Bond, Jennifer; Young, M Scott
The elder population continues to grow rapidly in many countries. Florida's elder population is growing faster than most states', with over one-quarter of the Florida population projected to be aged 65 and over by 2025. Involuntary examination (i.e. emergency commitment) under a state's civil commitment law is one means by which older adults experience assessment for acute mental health care. In Florida, the civil commitment law permits the involuntary examination of an individual for up to 72 hours to determine whether the person meets standards for involuntary treatment. From calendar year 2001 through 2005, there were 531,091 involuntary examinations in Florida for 301,886 people of all ages. Thirteen percent were 60 years and older at the time of their examination. The purpose of this paper is to describe the characteristics of older adults subject to involuntary examination and the nature of their examinations. While these data permit a number of inferences, there is an expansive area of research and policy analysis that remains untapped and would permit better understanding of how older adults experience such examinations. These research and policy issues will also be discussed.
Lum, Hillary D.; Ginde, Adit A.; Betz, Marian E.
Residential care facilities (RCF) provide assistance to older adults who cannot live independently, but it is unclear whether these residents have retired from driving. Here, we characterize older adults living in RCFs who still drive from a national cross-sectional survey of residents (2010 National Survey of Residential Care Facilities), representing ~733,000 adults living in RCFs such as assisted living facilities and personal care homes. Key resident characteristics were health, function, mobility and community activity indicators, which could be associated with increased driving risk. Of 8,087 residents, 4.5% (95%CI=3.9-5.1) were current drivers. Many drivers were older than 80 years (74%, 95%CI=67-79), in very good health (31%, 95%CI=25-38) or good health (35%, 95%CI=29-42), and had a median of two medical conditions. Most were independent with activities of daily living, though some needed assistance with walking and used gait devices. Given these results, RCF staff and healthcare providers need a heightened awareness of factors associated with driving risk to promote safety of older drivers and provide resources for likely transition to other transportation. PMID:26366125
Shimada, Hiroyuki; Park, Hyuntae; Makizako, Hyuma; Doi, Takehiko; Lee, Sangyoon; Suzuki, Takao
Many longitudinal studies have found that older adults with depressive symptoms or depression have increased risk of cognitive impairment. We investigated the relationships between depressive symptoms or depression, cognitive function, serum brain-derived neurotrophic factor (BDNF), and volumetric MRI measurements in older adults. A total of 4352 individuals aged 65 years or older (mean age 72 years) participated in the study. We investigated medical history and geriatric depression scale-15 (GDS-15) items to determine depression and depressive symptoms. Cognitive tests included the mini-mental state examination (MMSE), story memory, word list memory, trail-making tests, and the symbol digit substitution task. Of the 4352 participants, 570 (13%) fulfilled the criteria for depressive symptoms (GDS-15: 6 + points) and 87 (2%) were diagnosed with depression. All cognitive tests showed significant differences between the 'no depressive symptoms', 'depressive symptoms', and 'depression' groups. The 'depressive symptoms' and 'depression' groups showed lower serum BDNF (p < 0.001) concentrations than the 'no depressive symptoms' group. The 'depressive symptoms' group exhibited greater atrophy of the right medial temporal lobe than did the 'no depressive symptoms' group (p = 0.023). These results suggest that memory, executive function, and processing speed examinations are useful to identify cognitive decline in older adults who have depressive symptoms and depression. Serum BDNF concentration and atrophy of the right medial temporal lobe may in part mediate the relationships between depressive symptoms and cognitive decline.
Jackey, Beverly A; Cotugna, Nancy; Orsega-Smith, Elizabeth
Few recent studies have investigated food label practices in older adults. This cross-sectional study surveyed adults, 60 years and older in Delaware (n = 100, 82% female, 74% between 60 and 79 years, 49% Caucasian, 45% African Americans) to examine associations between food label knowledge, attitudes, and usage patterns. A 28-item questionnaire assessed knowledge, attitudes, usage, and demographic information. Bivariate analysis results showed food label knowledge was associated with education and monthly income. Those reporting a high school education or less incorrectly identified calorie (P < 0.05) and carbohydrate information (P < 0.03). Monthly income ≤$2000 was associated with incorrectly interpreting carbohydrate information (P < 0.03). Label usage was associated with being female (P < 0.001), having a high school education or less (P < 0.000), being 70 years or older (P < 0.05), and having a monthly income ≤$2000 (P < 0.001). Respondent's usage and perceived label comprehension was high; however less than half could correctly interpret label information. When shown samples of the US Food and Drug Administration's proposed new labels, subjects had a very favorable attitude toward the new changes. Increasing nutrition knowledge through education interventions appropriate for older adult consumers may improve comprehension of information on the food labels.
Sahyoun, Nadine R; Vaudin, Anna
The trend among older adults in the United States is to "age in place" instead of opting for institutionalization. To maintain older adults with chronic conditions in their homes and to improve health after hospitalization, comprehensive social, health, and nutrition services are essential. Quality of dietary intake is crucial and yet often underestimated. Calorie needs decrease with age while nutrient needs remain the same, even increasing for some nutrients. This poses difficulties for individuals with functional disabilities who are unable to shop and cook due to physical or mental limitations or on a limited budget. The Older American Act home-delivered meal (HDM) program offers at least 1 healthy meal per day, 5 or more days per week, and targets individuals homebound due to illness, disability, or social isolation and those with greatest economic or social need. This review summarizes the available literature on the relationship between HDM and health outcomes. The HDM program is difficult to evaluate because of the multifactorial effect on health status. However, national surveys and smaller studies show that it is well targeted, efficient, and well liked; provides quality food to needy individuals; and helps individuals remain living independently. Studies show that HDMs improve dietary intake, with greater health benefits when more meals reach the neediest individuals. HDMs also decrease institutionalization of older adults and resulting healthcare expenditures. However, funding has not kept up with increased demand for this program. More studies with improved designs may provide more information supporting the program's impact on nutrition status and decreased health expenditures.
Arthur, Heather M
Research evidence related specifically to psychosocial issues in older adults with cardiovascular disease remains sparse; however, widespread recognition of the impact of the changing population demographic is spurring new research in this important area. National guidelines for cardiac rehabilitation and secondary prevention in several countries include recommendations related to psychosocial issues; authors are beginning to address the older cardiac patient in their recommendations. The purpose of this article is to highlight some key psychosocial factors that have been independently associated with coronary heart disease but to do so with a focus on the older adult in the secondary prevention setting. The selected psychosocial factors are social support, social isolation, and depression. Although evidence supports a relationship between psychosocial factors and coronary heart disease, the issue addressed in this article is whether such relationships hold true in the older adult and whether rehabilitation and secondary prevention interventions are targeted to address these factors. As much as possible, current recommendations (related to psychosocial issues) from worldwide Clinical Practice Guidelines are highlighted. Finally, any examination of psychosocial factors and coronary heart disease must consider the possibility of sex and/or gender differences. Therefore, a commentary on reported differences between men and women with respect to social support, social isolation, and depression is included.
Yanada, Masamitsu; Yamamoto, Yukiya; Iba, Sachiko; Okamoto, Akinao; Inaguma, Yoko; Tokuda, Masutaka; Morishima, Satoko; Kanie, Tadaharu; Mizuta, Shuichi; Akatsuka, Yoshiki; Okamoto, Masataka; Emi, Nobuhiko
The net benefits of induction therapy for older adults with acute myeloid leukemia (AML) remain controversial. Because AML in older adults is a heterogeneous disease, it is important to identify those who are unlikely to benefit from induction therapy based on information available at the initial assessment. We used next-generation sequencing to analyze TP53 mutation status in AML patients aged 60 years or older, and evaluated its effects on outcomes. TP53 mutations were detected in 12 of 77 patients (16 %), and there was a significant association between TP53 mutations and monosomal karyotype. Patients with TP53 mutations had significantly worse survival than those without (P = 0.009), and multivariate analysis identified TP53 mutation status as the most significant prognostic factor for survival. Neverthelsess, TP53-mutated patients had a 42 % chance of complete remission and a median survival of 8.0 months, which compares favorably with those who did not undergo induction therapy, even in the short term. These results suggest that screening for TP53 mutations at diagnosis is useful for identifying older adults with AML who are least likely to respond to chemotherapy, although the presence of this mutation alone does not seem to justify rejecting induction therapy.
Squires, Susan Elaine
Loneliness can play a significant role in the wellbeing of older adults. This article describes a qualitative method for using case notes from the clinical records of older individuals in order to investigate the priority concerns spontaneously reported by older adults to deepen our understanding of both the context in which reported loneliness occurs in Ireland and the potential triggers. The participants in this study represent a cross-section of older adults who participated in the Technology Research for Independent Living Clinic (TRIL). Data were collected from participants through interviewer case notes at the TRIL centre in St James's hospital, Dublin. 624 participants (431 females; 193 males) ranging in age from 60-92 years (Mean 73 years, SD 7 years) took part in the study. All were community dwelling and provided consent. A thematic analysis from grounded theory was used to evaluate the case notes for each participant. Preliminary results highlight the richness of phenomenological experience to enhance our understanding of loneliness and provide an opportunity to better understand the precursors and variability that loneliness may take. In this study we found themes in the case note analysis linking social loneliness with self-imposed limitations on social engagement due to declining health while predominate themes for emotionally lonely focused on psychological issues of stress and anxiety associated with adverse life events. The results suggest the importance of case notes to inform clinical practice. Qualitative results provided insights into differing live events of older Irish adults, which help distinguish the causal differences between social and emotional loneliness.
Effects of Repetition on Associative Recognition in Young and Older Adults : Item and Associative Strengthening Norbou G. Buchler Carnegie Mellon...College Lynne M. Reder Carnegie Mellon University Young and older adults studied word pairs and later discriminated studied pairs from various types of...older adults were not more susceptible to interference than young adults when one or both words of the pair had multiple competing associates. Older
Strobach, Tilo; Woszidlo, Alesia
In the present study, we investigated discrepancies between two components of stereotyping by means of the popular notion that women are better at multitasking behaviors: the cognitive structure in individuals (personal belief) and the perceived consensus regarding certain beliefs (perceived belief of groups). With focus on this notion, we examined whether there was empirical evidence for the stereotype's existence and whether and how it was shared among different age groups. Data were collected from 241 young (n = 129) and older (n = 112) German individuals. The reported perceptions of gender effects at multitasking were substantial and thus demonstrated the existence of its stereotype. Importantly, in young and older adults, this stereotype existed in the perception of attributed characteristics by members of a collective (perceived belief of groups). When contrasting this perceived belief of groups and the personal belief, older adults showed a similar level of conformation of the gender stereotype while young adults were able to differentiate between these perspectives. Thus, young adults showed a discrepancy between the stereotype's components cognitive structure in individuals and perceived consensus regarding certain beliefs.
Strobach, Tilo; Woszidlo, Alesia
In the present study, we investigated discrepancies between two components of stereotyping by means of the popular notion that women are better at multitasking behaviors: the cognitive structure in individuals (personal belief) and the perceived consensus regarding certain beliefs (perceived belief of groups). With focus on this notion, we examined whether there was empirical evidence for the stereotype's existence and whether and how it was shared among different age groups. Data were collected from 241 young (n = 129) and older (n = 112) German individuals. The reported perceptions of gender effects at multitasking were substantial and thus demonstrated the existence of its stereotype. Importantly, in young and older adults, this stereotype existed in the perception of attributed characteristics by members of a collective (perceived belief of groups). When contrasting this perceived belief of groups and the personal belief, older adults showed a similar level of conformation of the gender stereotype while young adults were able to differentiate between these perspectives. Thus, young adults showed a discrepancy between the stereotype's components cognitive structure in individuals and perceived consensus regarding certain beliefs. PMID:26733913
Petry, Nancy M.; Andrade, Leonardo F.; Barry, Danielle; Byrne, Shannon
Many older adults do not meet physical activity recommendations and suffer from health-related complications. Reinforcement interventions can have pronounced effects on promoting behavior change; this study evaluated the efficacy of a reinforcement intervention to enhance walking in older adults. Forty-five sedentary adults with mild to moderate hypertension were randomized to 12-week interventions consisting of pedometers and guidelines to walk 10,000 steps/day or that same intervention with chances to win $1-$100 prizes for meeting recommendations. Patients walked an average of about 4,000 steps/day at baseline. Throughout the intervention, participants in the reinforcement intervention met walking goals on 82.5% ± 25.8% of days versus 55.3% ± 37.1% of days in the control condition, p < .01. Even though steps walked increased significantly in both groups relative to baseline, participants in the reinforcement condition walked an average of about 2,000 more steps/day than participants in the control condition, p < .02. Beneficial effects of the reinforcement condition relative to the control condition persisted at a 24-week follow-up evaluation, p < .02, although steps/day were lower than during the intervention period in both groups. Participants in the reinforcement intervention also evidenced greater reductions in blood pressure and weight over time and improvements in fitness indices, ps < .05. This reinforcement-based intervention substantially increased walking and improved clinical parameters, suggesting that larger-scale evaluations of reinforcement-based interventions for enhancing active lifestyles in older adults are warranted. Ultimately, economic analyses may reveal reinforcement interventions to be cost-effective, especially in high-risk populations of older adults. PMID:24128075
Nour, Kareen; Laforest, Sophie; Gignac, Monique; Gauvin, Lise
This paper draws a socio-demographic, physical, psychosocial, and behavioural profile of housebound older adults with arthritis and compares older adults with rheumatoid arthritis to those with osteoarthritis. Data from 125 housebound older adults with osteoarthritis (65%) or rheumatoid arthritis (35%) were compared to published samples and to…
Lazzari, Claudia; Egan, Sarah J.; Rees, Clare S.
Depression affects up to 25% of older adults. Underdetection and subsequent undertreatment of depression in older adults has been attributed in part to difficulties in older adults being able to access treatment. This uncontrolled pilot study, N = 3, explored the acceptability and efficacy of a brief behavioral activation treatment delivered via…
Zheng, Robert; Spears, Jeffrey; Luptak, Marilyn; Wilby, Frances
The current study examined factors related to older adults' perceptions of Internet use. Three hundred ninety five older adults participated in the study. The factor analysis revealed four factors perceived by older adults as critical to their Internet use: social connection, self-efficacy, the need to seek financial information, and the need to…
Shepherd, Craig E.; Aagard, Steven
This article describes how Web 2.0 technologies may facilitate journaling and related inquiry methods among older adults. Benefits and limitations of journaling are summarized as well as computer skills of older adults. We then describe how Web 2.0 technologies can enhance journaling among older adults by diminishing feelings of isolation,…
Getz, Irith; Weissman, Gabriella
Based on Nicholas' framework for assessing information needs, this research aims to construct a profile of both Israeli older adults and their information needs regarding laws and social services. Data were collected by questionnaires answered by 200 older adults, born in Europe, Asia and Africa, who attended social clubs for older adults. The…
Hanoch, Yaniv; Wood, Stacey; Rice, Thomas
Herbert Simon's work on bounded rationality has had little impact on researchers studying older adults' decision making. This omission is surprising, as human constraints on computation and memory are exacerbated in older adults. The study of older adults' decision-making processes could benefit from employing a bounded rationality perspective,…
Wang, Donna; Chonody, Jill
Ageist attitudes toward older adults have been recognized as barriers to recruiting and training competent social workers. This article provides a systematic review of the literature that focused on social workers' and social work students' attitudes toward older adults and working with older adults. The authors sought empirical studies…
Cohen-Mansfield, Jiska; Jensen, Barbara
This study explored dressing and grooming habits and preferences of older adults. Fifty-eight community-dwelling older persons (mean age = 80 years) in suburban Maryland responded to the Self-maintenance Habits and Preferences in Elderly (SHAPE) questionnaire. There was a large variability in preferences, and all items were very important for at least some of the participants. Women attributed higher levels of importance to dressing and grooming than did men. Importance ratings increased with level of education and were higher for unmarried persons, but were not related to age or need for assistance with instrumental activities of daily living (IADLs). On an individual basis, this information can be used to suggest items for interventions or to structure a personal care environment. Alternately, it can be used in the aggregate as a guideline for designing programs of care to reflect the preferences of a majority of older persons.
Mills, Angela M.; Edwards, J. Matthew; Shofer, Frances S.; Holena, Daniel N.; Abbuhl, Stephanie B.
Objective: To determine the association between age and analgesia for emergency department (ED) patients with abdominal or back pain. Methods: Using a fully electronic medical record, we performed a retrospective cohort study of adults presenting with abdominal or back pain to two urban EDs. To assess differences in analgesia administration and time to analgesia between age groups, we used chi-square and Kruskal-Wallis test respectively. To adjust for potential confounders, we used a generalized linear model with log link and Gaussian error. Results: Of 24,752 subjects (mean age 42 years, 65% female, 69% black, mean triage pain score 7.5), the majority (76%) had abdominal pain and 61% received analgesia. The ≥80 years group (n=722; 3%), compared to the 65–79 years group (n=2,080; 8%) and to the <65 years group (n=21,950; 89%), was more often female (71 vs. 61 vs. 65%), black (72 vs. 65 vs. 69%), and had a lower mean pain score (6.6 vs. 7.1 vs. 7.6). Both older groups were less likely to receive any analgesia (48 vs. 59 vs. 62%, p<0.0001) and the oldest group less likely to receive opiates (35 vs. 47 vs. 44%, p<0.0001). Of those who received analgesia, both older groups waited longer for their medication (123 vs. 113 vs. 94 minutes; p<0.0001). After controlling for potential confounders, patients ≥80 years were 17% less likely than the <65 years group to receive analgesia (95% CI 14–20%). Conclusion: Older adults who present to the ED for abdominal or back pain are less likely to receive analgesia and wait significantly longer for pain medication compared to younger adults. PMID:21691471
Background 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. Methods 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. Results 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). Conclusion 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. PMID:20187973
McDougall, Graham J; Morgan, Stephanie; Vaughan, Phillip W.
We examined the prevalence of depressive symptoms over time in a sample of community-residing older adults at baseline, two months, six months, and fourteen months. The nonprobability sample (N = 222), was 90% female, 87% Caucasian, 15% Hispanic, and 12% African-American with an average age of 75 years. If depressive symptoms had been measured at only one time, 19% of the sample would have scored above the cutoff, versus 39% scoring above the cutoff when measured at all four time periods. The findings provide evidence that depressive symptoms in older adults are variable and fluctuate over time. The significance of this research was the longitudinal evaluation of depressive symptoms in community-residing elders. PMID:22449566
Peach, Brian C; Garvan, Gerard J; Garvan, Cynthia S; Cimiotti, Jeannie P
Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care.
Sörensen, Silvia; Hirsch, Jameson K.; Lyness, Jeffrey M.
Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts. PMID:26045699
Semba, Richard D.; Lauretani, Fulvio; Ferrucci, Luigi
Sarcopenia, or loss of muscle mass and strength, plays a major role in the disablement process in older adults and increases the risk of impaired physical performance, falls, physical disability, frailty, and death. Oxidative stress is a major mechanism implicated in the pathogenesis of sarcopenia; aging muscle shows increased oxidative damage to DNA, protein, and lipids. Carotenoids quench free radicals, reduce damage from reactive oxygen species, and appear to modulate redox-sensitive transcription factors such as NF-κB that are involved in the upregulation of IL-6 and other proinflammatory cytokines. Recent epidemiological studies in community-dwelling older adults show that low serum/plasma carotenoids are independently associated with low skeletal muscle strength and the development of walking disability. These observations are consistent with a growing number of studies showing that a diet with high intake of fruits and vegetables is associated with a reduced risk of inflammation, hypertension, diabetes, cardiovascular disease, and mortality. PMID:17196927
Finoccchiaro, Darlene; Hook, Jane
Nutrition continues to be a concern for the older adult in the intensive care setting despite widespread knowledge of the benefits of adequate nutrition and existing evidence-based protocols. The incidence of malnutrition in hospitalized patients ranges between 22% and 43% with the highest probability of occurrence, 50% or more, in the intensive care unit patient. The deleterious effects of malnutrition for the critically ill older adult are described with suggested and accepted screening tools for existing or acquired malnutrition. A discussion of early oral and enteral feeding interventions and strategies for overcoming barriers is explored. Enteral feeding complications are delineated, and perceived barriers or risks are disputed. This paper concludes with suggestions for future research and a definitive role for advanced nursing nutrition champions.
The body of evidence on older adults' sexual health is beginning to grow. However, it remains an under-researched area particularly within the social sciences. This viewpoint outlines four considerations for those who carry out social science research in this area: 1. defining the age category "older adults"; 2. being clear about the types of sex under research; 3. capturing a range of diverse voices; and 4. considering the use of qualitative research methods to explore the topic in depth. These suggestions are aimed at helping researchers to avoid some of the pitfalls of research in this area, as well as improving the evidence base in order to advance recognition of the issues and drive change in service provision.
Chiba, Shigeru; Tamura, Yoshiyuki
There are three major neurophysiological mechanisms underlying the sleep-waking cycle: the sleep system, the waking system, and the system that determines sleep-waking timing. Sleep dlisorders of older adults seem to be caused by functional or organic changes in one or more of the three systems, and are roughly classified into two categories: (i) normal age-related, and (ii) pathological. The former includes decreased amplitude and advanced phase of circadian rhythms (body temperature, melatonin secretion, and sleep-waking), as well as reduced sleep duration, sleep fragmentation, and a decrease of slow-wave sleep in sleep architecture. Pathological sleep disorders include medical and psychiatric diseases (e.g., lifestyle-related diseases, dementia, delirium, and depression) and primary age-related sleep disorders (e.g., REM sleep behavior disorder and periodic limb move- ment disorders). This mini-review delineates the clinical features of sleep disorders in older adults.
Erosheva, Elena A.; Kim, Hyun-Jun; Emlet, Charles; Fredriksen-Goldsen, Karen I.
Purpose This study examines global social networks—including friendship, support, and acquaintance networks—of lesbian, gay, bisexual, and transgender (LGBT) older adults. Design and Methods Utilizing data from a large community-based study, we employ multiple regression analyses to examine correlates of social network size and diversity. Results Controlling for background characteristics, network size was positively associated with being female, transgender identity, employment, higher income, having a partner or a child, identity disclosure to a neighbor, engagement in religious activities, and service use. Controlling in addition for network size, network diversity was positively associated with younger age, being female, transgender identity, identity disclosure to a friend, religious activity, and service use. Implications According to social capital theory, social networks provide a vehicle for social resources that can be beneficial for successful aging and well-being. This study is a first step at understanding the correlates of social network size and diversity among LGBT older adults. PMID:25882129