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Sample records for older aged people

  1. The Meaning of "Aging in Place" to Older People

    ERIC Educational Resources Information Center

    Wiles, Janine L.; Leibing, Annette; Guberman, Nancy; Reeve, Jeanne; Allen, Ruth E. S.

    2012-01-01

    Purpose: This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with…

  2. Designing 'older' rather than denying ageing: problematizing anti-ageing discourse in relation to cosmetic surgery undertaken by older people.

    PubMed

    Garnham, Bridget

    2013-01-01

    This paper problematizes anti-ageing discourse and interpretations that cosmetic surgery is an ageist practice and older people who undergo cosmetic surgery are denying ageing. It argues that conceptions of cosmetic surgery as anti-ageing are premised on an essentialist conception of the 'naturally ageing body'. Interview data and media texts are used to demonstrate how, through the notion of "re" suggested by terms such as rejuvenation, reversal and renewal, anti-ageing discourses inscribe 'ageing' in the practice of cosmetic surgery by older people. The oppressive interpretation that older people who undergo cosmetic surgery are 'denying ageing,' and associated subjection to moral critique, are effects of this discourse. To counter interpretations of cosmetic surgery as 'anti-ageing', the paper takes up the idea that cosmetic surgery is undertaken to look better not younger. To advance this argument, the paper suggests that the forms of rationality associated with cosmetic surgery constitute a contemporary regimen of 'care of the self' which enable ethical agency and creative self-stylisation. Through this framework cosmetic surgery can be re-imagined as a practice for designing 'older' rather than denying ageing.

  3. The Housing and Support Needs of People with an Intellectual Disability into Older Age

    ERIC Educational Resources Information Center

    Shaw, K.; Cartwright, C.; Craig, J.

    2011-01-01

    Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…

  4. Age Identification in the Framework of Successful Aging: A Study of Older Finnish People

    ERIC Educational Resources Information Center

    Uotinen, Virpi; Suutama, Timo; Ruoppila, Isto

    2003-01-01

    A person-oriented approach was used in a study of age identification among community-dwelling older people. The study was based on 8-year follow-up data; 843 persons aged 65-84 were involved in the first phase of the study, and 426 persons aged 73-92, in the second phase. Loosely, on the basis of the distinction between successful, usual, and…

  5. Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla

    2009-01-01

    The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…

  6. Healthy ageing from the perspective of older people: a capability approach to resilience.

    PubMed

    Stephens, Christine; Breheny, Mary; Mansvelt, Juliana

    2015-01-01

    A policy focus on healthy ageing has been critiqued for homogenising, oppressing and neglecting the physical realities of older age. Current healthy ageing discourse places responsibility on individuals for achieving good physical health and ignores their broader circumstances. Sen's capability approach provides a basis for including the physical changes of ageing and the social environment by focusing on what older people themselves value in regards to healthy ageing. Accounts of desired living standards in 145 interviews with people aged 63-93 years in New Zealand were subjected to a thematic analysis which revealed six commonly valued 'functionings': physical comfort, social integration, contribution, security, autonomy and enjoyment. The capability to achieve the valued functionings was of high importance regardless of physical health status while this capability was often limited by social and material circumstances. The importance of an environment supportive of valued functionings provides a framework for understanding health for older adults, whatever their present physical abilities. We suggest that health psychology is in a good position to reflect critically on the impact of discourses promoting healthy ageing in the lives of older adults, and consider broader models that include understandings of resilience and capability.

  7. Healthy Aging from the Perspectives of 683 Older People with Multiple Sclerosis

    PubMed Central

    2016-01-01

    Purpose. The aim of this study was to determine what factors most greatly contributed to healthy aging with multiple sclerosis (MS) from the perspective of a large sample of older people with MS. Design and Methods. Participants (n = 683; >55 years of age with symptoms >20 years) provided answers to an open-ended question regarding healthy aging and were categorized into three groups, 55–64 (young), 65–74 (middle), and 75 and over (oldest old). Sociodemographic actors were compared using ANOVA. Two independent raters used the framework method of analyzing qualitative data. Results. Participants averaged 64 years of age (±6.2) with MS symptoms for 32.9 years (±9.4). 531 participants were female (78%). The majority of participants lived in their own home (n = 657) with a spouse or partner (n = 483). Participants described seven themes: social connections, attitude and outlook on life, lifestyle choices and habits, health care system, spirituality and religion, independence, and finances. These themes had two shared characteristics, multidimensionality and interdependence. Implications. Learning from the experiences of older adults with MS can help young and middle aged people with MS plan to age in their own homes and communities. Our data suggests that older people with MS prioritize factors that are modifiable through targeted self-management strategies. PMID:27504201

  8. Involving Older People in the Design, Development, and Delivery of an Innovative Module on Aging for Undergraduate Students

    ERIC Educational Resources Information Center

    Tullo, Ellen; Greaves, Laura; Wakeling, Luisa

    2016-01-01

    As the number of older people in society increases, gaining an awareness of the needs of an aging population is important for university students from all academic backgrounds. Using a multidisciplinary approach to aging, we developed a new teaching module (NU-AGE [Newcastle University Aging Generations Education]) aimed at students enrolled in…

  9. Factors Associated With Cancer Worry Among People Aged 50 or Older, Spain, 2012–2014

    PubMed Central

    Sotos, Joseba Rabanales; Herráez, María José Simarro; Rosa, Monchi Campos; López, Jaime López-Torres; Ortiz, María Pilar Sánchez

    2015-01-01

    Introduction Cancer worry varies among patients and may influence their participation in preventive activities. We tested whether sociodemographic characteristics, lifestyle, locus of control, comorbidity, and perceived health status were associated with the level of cancer worry among adults aged 50 or older. Methods We conducted an observational cross-sectional study of 666 adults in Spain aged 50 or older. Participants were selected by simple random sampling and asked to visit their designated health center for a personal interview. The study variables were level of cancer worry (measured by Cancer Worry Scale [CWS]), sociodemographic characteristics, lifestyle, personal history or family history of cancer, comorbidity, self-perceived health, locus of control, and social support. Results More than half of participants, 58.1%, were women; mean age was 60.5 years (standard deviation [SD], 6.8 y). Measurement of the frequency and severity of cancer worry (possible scale of 6–24 points) yielded a mean CWS score of 9.3 (95% confidence interval, 9.0–9.5); 31.9% of participants reported being concerned about cancer. Scores were higher among women (9.7 [SD, 3.3]) than men (8.7 [SD, 2.7]) (P < .001) and among participants in rural settings (10.0 [SD, 3.4]) than in urban settings (9.0 [SD, 3.0]) (P < .001). Multiple linear regression showed a greater degree of cancer worry among people with personal or family history of cancer, more health problems, worse self-perceived health, and lower social support. Conclusion Cancer worry is frequent among older adults, and the level of such concern is related not only to personal characteristics but also to lifestyle and health status. Further research is required to understand how contextual factors can influence cancer worry and how such concern changes behavior patterns related to cancer prevention activities. PMID:26704444

  10. Problem gambling and the circumstances facing older people : a study of gaming machine players aged 60+ in licensed clubs.

    PubMed

    Southwell, Jenni; Boreham, Paul; Laffan, Warren

    2008-06-01

    Local gambling venues are an important contemporary context for older people's gambling in many parts of the world typically being more accessible to this segment of the population than traditional, centralised gambling venues, such as casinos. This study, undertaken in South East Queensland, analyses older people's electronic gaming machine (EGM) behaviour and motivations, specifically in the context of licensed social and recreational clubs-a popular local gambling venue in many parts of Australia. The study gathered data via a postal survey of 80 managers of licensed clubs, interviews with Gambling Help services and a survey of 414 people aged 60+ who regularly play EGMs, self-administered on site at local clubs. The analysis undertaken suggests that certain age-related circumstances of older people-such as being without a partner, having a disability that impacts on everyday activities, having a low annual income, and no longer participating in the workforce-are associated with higher overall levels of motivation for playing EGMs and greater reliance on EGMs to meet social, recreational and mental health needs. Over a quarter of the older people surveyed (27%) reported drawing on their savings to fund their EGM gambling. Certain categories of older people, including those who were without a partner and those with a disability, were more likely to report drawing on their savings to fund EGM play and betting more than they could afford to lose, pointing to age-related vulnerabilities older people may experience to the negative impacts of gambling given the greater likelihood of their dependency on smaller, fixed incomes. The explanatory contribution of a range of demographic and motivational variables on problem/moderate risk gambling status was computed via a logistic regression model. Younger age (60-69), male gender, single marital status and being motivated to play EGMs to experience excitement and to win money all emerged as significant predictors in the

  11. A controlled study of suicide in middle-aged and older people: personality traits, age, and psychiatric disorders.

    PubMed

    Draper, Brian; Kõlves, Kairi; De Leo, Diego; Snowdon, John

    2014-04-01

    Personality traits were examined using the NEO Five-Factor Inventory-Revised in an Australian psychological autopsy study involving 259 suicide deaths and 181 sudden death controls aged 35 years and over. Interviews included the Structured Clinical Interview for DSM-IV to determine the presence of psychiatric disorder. Personality traits of suicide deaths differed significantly from those of controls, scoring higher in the Neuroticism and Openness to Experience domains and lower on the Agreeableness and Extraversion domains. These findings varied with the presence of psychiatric disorder and by age. High Neuroticism scores were the most consistent finding in people who died by suicide, although these scores decreased in older suicides.

  12. Ageing, Leisure, and Social Connectedness: How could Leisure Help Reduce Social Isolation of Older People?

    PubMed

    Toepoel, Vera

    2013-08-01

    This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people's social connectedness. Voluntary work, cultural activities, holiday, sports, reading books, hobbies and shopping are found to be successful predictors for social connectedness of older people. Watching TV, listening to the radio, and spending time behind the computer (passive activities) were not associated with social connectedness. Friends correlate positively to participation in leisure activities. Partners play a role in participation in cultural activities and sports; parents play a role in participation in voluntary work and holidays; siblings play a role in voluntary work and sports; and children play a role in cultural activities, reading books, and shopping. Local communities can use these close relationships and develop special programs to increase social connectedness and hence improve quality of life for older adults.

  13. Children's Views of Older People

    ERIC Educational Resources Information Center

    Robinson, Sally; Howatson-Jones, Lioba

    2014-01-01

    Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the…

  14. Learning Opportunities for Older People.

    ERIC Educational Resources Information Center

    MacKeracher, Dorothy

    1980-01-01

    The author summarizes a conference on learning opportunities for older people by discussing six issues: (1) perspectives of older people and service providers; (2) categorization of older learners; (3) learning needs of older people; (4) participation rates; (5) government policies; and (6) curriculum concerns. (SK)

  15. Drug trials for older people.

    PubMed

    Lindley, Richard I

    2012-02-01

    We are living in an era of unprecedented aging, with over a billion older people expected to be alive within a few decades. Despite this predictable demographic, drug trials have not kept pace with change and we now have significant evidence-practice gaps. These have arisen due to inappropriate age limits in randomized controlled trials and the near-universal exclusion of frail older people from studies. Suggested solutions include the abolition of age limits in new randomized controlled trials, and the routine measurement of frailty, with a new generation of randomized controlled trials to establish whether treatments remain effective and safe in old age and increasing frailty. We should all have a personal interest in ensuring that drugs used in our old age are truly effective.

  16. The National Service Framework for Older People: England's approach to ending age discrimination in services and therapeutics.

    PubMed

    Crome, Peter; Natarajan, Indira

    2004-01-01

    In 1997, the new Labour Government in the UK embarked on an ambitious programme of reform. One of the key changes has been the publication of a series of National Service Frameworks. The National Service Framework for Older People (NSFOP) sets out a 10-year programme that has as its principal standard rooting out age discrimination. Together with its companion documents, a series of robust milestones and standards are set out that have to be met. Although generally welcomed by the profession, the NSFOP has been criticised by some because it mandates the initiation of new 'intermediate care' services that may be seen as denying older people the opportunity for admission to mainstream hospital care. Monitoring tools covering both procedures and prescribing have been developed. The government-produced frameworks mirror guidelines produced by the profession and include a number of prescribing recommendations, e.g. the use of antihypertensives and aspirin (acetylsalicylic acid) in the prevention of stroke, and the use of calcium, vitamin D and bisphosphonates in the treatment of osteoporosis. In tackling age discrimination, both direct and indirect barriers to effective prescribing need to be considered. The evidence base on the effectiveness of medication in older people is more limited due to the previous systematic exclusion of older people from clinical trials. The consequent lack of evidence of efficacy, coupled with perhaps a natural reluctance to prescribe potentially toxic medication, may lead to underprescribing. Other indirect causes of age discrimination may include difficulties for older people attending hospitals for drug monitoring, and the difficulties of translating the results of trials into meaningful endpoints that older patients can understand and thus make valid decisions about whether they wish to take the particular drug or not. At the same time as the NSFOP argues against age discrimination, other government policies may operate in a

  17. U3A Online: A Virtual University of the Third Age for Isolated Older People.

    ERIC Educational Resources Information Center

    Swindell, Rick

    2002-01-01

    Data from 29 older adults in University of the Third Age Online in 1999 and 34 in 2001 indicated that women outnumbered men; more than 70% were from large urban areas; and 70% had professional, business, and managerial backgrounds. Many are unable to participate in mainstream adult education and derive purpose and enjoyment from virtual…

  18. How Older People Think about Images of Aging in Advertising and the Media.

    ERIC Educational Resources Information Center

    Bradley, Don E.; Longino, Charles F., Jr.

    2001-01-01

    A literature review documents distorted images of aging in mass media and advertising, including underrepresentation and stereotyping. Older consumers are dissatisfied with these images, and their growing purchasing power is forcing advertisers to make more effective appeals. (Contains 20 references.) (SK)

  19. Toward a typology of technology users: how older people experience technology's potential for active aging.

    PubMed

    Gjevjon, Edith Roth; Oderud, Tone; Wensaas, Gro H; Moen, Anne

    2014-01-01

    This paper outlines an emerging typology of older users of information and communication technology (ICT) to facilitate active aging. Through inductive data analysis from focus groups, iterative workshops, and personal interviews, we suggest three types of technology users. These types are "the Excluded," "the Entertained," and "the Networker." Clearly, ICT offers several benefits to those who are enthusiastic and frequent users, exemplified as the Entertained and the Networker. Hence, our findings support the notion of technology as a tool to maintain or increase an older person's engagement and activity level. Conversely, for those reluctant, uninterested, or incapable of using ICT, such potentials are limited and imply fewer opportunities for participation in activities.

  20. Changing the balance of social care for older people: simulating scenarios under demographic ageing in New Zealand.

    PubMed

    Lay-Yee, Roy; Pearson, Janet; Davis, Peter; von Randow, Martin; Kerse, Ngaire; Brown, Laurie

    2016-10-06

    The demographic ageing of New Zealand society, as elsewhere in the developed world, has dramatically increased the proportion of older people (aged 65 years and over) in the population. This has major policy implications for the future organisation of social care. Our objective was to test the effects on social care use, first, of putative changes in the overall disability profile of older people, and second, of alterations to the balance of their care, i.e. whether it was community-based or residential. In order to undertake these experiments, we developed a microsimulation model of the later life course using individual-level data from two official national survey series on health and disability, respectively, to generate a synthetic version which replicated original data and parameter settings. A baseline projection under current settings from 2001 to 2021 showed moderate increases in disability and associated social care use. Artificially decreasing disability levels, below the baseline projection, only moderately reduced the use of community care (both informal and formal). Scenarios implemented by rebalancing towards informal care use moderately reduced formal care use. However, only moderate compensatory increases in community-based care were required to markedly decrease the transition to residential care. The disability impact of demographic ageing may not have a major negative effect on system resources in developed countries like New Zealand. As well as healthy ageing, changing the balance of social care may alleviate the impact of increasing demand due to an expanding population of older people.

  1. Coming of Age: Arts Practice with Older People in Private and Domestic Spaces

    ERIC Educational Resources Information Center

    McAvinchey, Caoimhe

    2013-01-01

    Britain's ageing population reflects an international trend--more people are living for longer. Whilst government grapples with the economic and social impact of this demographic revolution, social justice and equality charities advocate for greater recognition of the contribution that an ageing population brings to society, not just the health,…

  2. Gerotechnology: a new kind of care for aging? An analysis of the relationship between older people and technology.

    PubMed

    Rodeschini, Giulia

    2011-12-01

    Healthcare systems in aging societies need to find new solutions in the provision of care and treatment of older people. Gerotechnologies play a crucial role in the "aging-in-place" process. This article offers a critical overview of gerotechnological studies and will suggest a new approach in the study of the relationship between aging and technologies. Some trajectories of analysis and theoretical models are presented to underline the different perspectives in the discipline. Critical positions highlight the lack of theoretical analysis, mainly in relation to the complex social phenomenon of aging related to technology. Conclusions outline a relational approach to gerotechnologies: an analysis of the interactions between technological artifacts, users, and the context in which technologies are used. This approach expands the view from the technical potential of the technology to the way elderly people use technology, and suggests innovative care and cure strategies for aging.

  3. Challenging cisgenderism in the ageing and aged care sector: Meeting the needs of older people of trans and/or non-binary experience.

    PubMed

    Ansara, Y Gavriel

    2015-10-01

    Recent Australian legislative and policy changes can benefit people of trans and/or non-binary experience (e.g. men assigned female with stereotypically 'female' bodies, women assigned male with stereotypically 'male' bodies, and people who identify as genderqueer, agender [having no gender], bi-gender [having two genders] or another gender option). These populations often experience cisgenderism, which previous research defined as 'the ideology that invalidates people's own understanding of their genders and bodies'. Some documented forms of cisgenderism include pathologising (treating people's genders and bodies as disordered) and misgendering (disregarding people's own understanding and classifications of their genders and bodies). This system of classifying people's lived experiences of gender and body invalidation is called the cisgenderism framework. Applying the cisgenderism framework in the ageing and aged care sector can enhance service providers' ability to meet the needs of older people of trans and/or non-binary experience.

  4. Sarcopenia in older people.

    PubMed

    Yu, Solomon; Umapathysivam, Kandiah; Visvanathan, Renuka

    2014-12-01

    Sarcopenia is the age-related loss of muscle mass and strength. It has been receiving international attention because of its increased prevalence in western societies, such as Australia, which have large and growing older populations. Adverse health consequences of sarcopenia are falls and loss of independence, increased health costs and reduced quality of life. Recently, there have been international attempts to come to a consensus with regards to a definition of the condition, and, increasingly, clinicians are being encouraged to screen and assess for sarcopenia. Screening pathways are being investigated and some are discussed in this review. There is an emphasis on early screening, as it is believed that early detection will allow early intervention. As with most conditions in older age, there are many environmental and medical factors that can contribute to the development and worsening of sarcopenia, and it is important that, when possible, these contributing factors be addressed. Pharmaceutical treatment strategies are under development with some early promise and there is the possibility of clinical trials in the near future. Currently, nutritional supplementation and physical therapy are the strategies advocated for the management of sarcopenia once it is diagnosed.

  5. Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects.

    PubMed

    Kangas, M; Vikman, I; Nyberg, L; Korpelainen, R; Lindblom, J; Jämsä, T

    2012-03-01

    Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls.

  6. Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

    PubMed

    Ibrahim, Joseph Elias; Bugeja, Lyndal; Ranson, David

    2013-12-01

    The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved. Despite substantive monitoring of the provision of aged care, no single entity is explicitly responsible for systematically analysing medico-legal death information. The data and skills for using information from medico-legal death investigations currently exist. Dispelling the myths removes one impediment to investing in this area of public health.

  7. Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation

    PubMed Central

    Pereira, Leani Souza Máximo; Sherrington, Catherine; Ferreira, Manuela L; Tiedemann, Anne; Ferreira, Paulo H; Blyth, Fiona M; Close, Jacqueline CT; Taylor, Morag; Lord, Stephen R

    2014-01-01

    Background/objectives The impact of pain on the physical performance of patients in aged care rehabilitation is not known. The study sought to assess 1) the prevalence of pain in older people being discharged from inpatient rehabilitation; 2) the association between self-reported pain and physical performance in people being discharged from inpatient rehabilitation; and 3) the association between self-reported pain and physical performance in this population, after adjusting for potential confounding factors. Methods This was an observational cross-sectional study of 420 older people at two inpatient aged care rehabilitation units. Physical performance was assessed using the Lower Limb Summary Performance Score. Pain was assessed with questions about the extent to which participants were troubled by pain, the duration of symptoms, and the impact of chronic pain on everyday activity. Depression and the number of comorbidities were assessed by questionnaire and medical file audit. Cognition was assessed with the Mini-Mental State Examination. Results Thirty percent of participants reported chronic pain (pain lasting more than 3 months), and 17% reported that this pain interfered with daily activities to a moderate or greater extent. Chronic pain (P=0.013) and chronic pain affecting daily activities (P<0.001) were associated with a poorer Lower Limb Summary Performance Score. The relationship between chronic pain affecting daily activities and Lower Limb Summary Performance Score remained significant (P=0.001) after adjusting for depression, age, comorbidities, and Mini-Mental State Examination score. This model explained 10% of the variability in physical performance. Conclusion One-third of participants reported chronic pain, and close to one-fifth reported that this pain interfered with daily activities. Chronic pain was associated with impaired physical performance, and this relationship persisted after adjusting for likely confounding factors. PMID:24523583

  8. Exploring attitudes towards older people's sexuality.

    PubMed

    Price, B

    2009-07-01

    Sexuality is an important part of life, for older people as well as for others. Sexual attitudes, beliefs and lifestyles may be as diverse among older people as they are among younger age groups. But for nurses to plan care with patients in ways that take issues of sexuality into account, they need to feel more comfortable talking about sexuality with older people. This article uses case studies to help readers explore their own attitudes and those of colleagues towards sexuality in later years, and prompts discussions on what this might signify for future nursing care so that staff are better equipped to assist patients with this subject.

  9. Time Trends in Self-Rated Health and Disability in Older Spanish People: Differences by Gender and Age

    PubMed Central

    GIRON, Pedro

    2016-01-01

    Background: To analyse time trends in self-rated health in older people by gender and age and examine disability in the time trends of self-rated health. Methods: The data used come from the Spanish National Health Surveys conducted in 2001, 2003, 2006 and 2011–12. Samples of adults aged 16 yr and older were selected. Multivariate logistic regression was used to assess the association between age, gender, socio-economic status, marital status, disability and self-rated health across period study. Results: Women exhibited lower (higher) prevalence of good self-rated health (disability) compared to men. The multivariate analysis for time trends found that good self-rated health increased from 2001 to 2012. Overall, variables associated with a lower likelihood of good self-rated health were: being married or living with a partner, lower educational level, and disability. Conclusion: Trends of good self-rated health differ by gender according to socio-demographic factors and the prevalence of disability. PMID:27141490

  10. Animalistic Dehumanization of Older People by Younger Ones: Variations of Humanness Perceptions as a Function of a Target's Age.

    PubMed

    Boudjemadi, Valérian; Demoulin, Stéphanie; Bastart, Jennifer

    2017-02-23

    The present work investigated associations of older people with humanness. Focusing on complementary approaches (attribute-based, metaphor-based, and target-based), 4 studies tested the hypothesis that older people are the targets of animalistic dehumanization. Using an emotional attribution task, Study 1 (N = 112) explored infrahumanization and shows that young participants attributed more uniquely human emotions to young people than to older ones. No such effect occurred with regards to nonuniquely human emotions. Results of Study 2 (N = 62) replicated this result using a lexical-decision task. Using the metaphor-based approach, Study 3 (N = 99) confirmed that older people's dehumanization is restricted to its animalistic form and does not extend to the mechanistic one. Finally, in Study 4 (N = 167), we used a target-based approach and showed that characteristics initially attributed to older people are perceived as denoting lesser humanness than when these same characteristics are associated with younger people. Results of the 4 studies provide evidence for an animalistic form of dehumanization of older people by younger ones. Limits, implications, and future research are discussed. (PsycINFO Database Record

  11. Barriers to eye care among people aged 40 years and older with diagnosed diabetes, 2006-2010.

    PubMed

    Chou, Chiu-Fang; Sherrod, Cheryl E; Zhang, Xinzhi; Barker, Lawrence E; Bullard, Kai McKeever; Crews, John E; Saaddine, Jinan B

    2014-01-01

    OBJECTIVE We examine barriers to receiving recommended eye care among people aged ≥40 years with diagnosed diabetes. RESEARCH DESIGN AND METHODS We analyzed 2006-2010 Behavioral Risk Factor Surveillance System data from 22 states (n = 27,699). Respondents who had not sought eye care in the preceding 12 months were asked the main reason why. We categorized the reasons as cost/lack of insurance, no need, no eye doctor/travel/appointment, and other (meaning everything else). We used multinomial logistic regression to control for race/ethnicity, education, income, and other selected covariates. RESULTS Among adults with diagnosed diabetes, nonadherence to the recommended annual eye examinations was 23.5%. The most commonly reported reasons for not receiving eye care in the preceding 12 months were "no need" and "cost or lack of insurance" (39.7 and 32.3%, respectively). Other reasons were "no eye doctor," "no transportation" or "could not get appointment" (6.4%), and "other" (21.5%). After controlling for covariates, adults aged 40-64 years were more likely than those aged ≥65 years (relative risk ratio [RRR] = 2.79; 95% CI 2.01-3.89) and women were more likely than men (RRR = 2.33; 95% CI 1.75-3.14) to report "cost or lack of insurance" as their main reason. However, people aged 40-64 years were less likely than those aged ≥65 years to report "no need" (RRR = 0.51; 95% CI 0.39-0.67) as their main reason. CONCLUSIONS Addressing concerns about "cost or lack of insurance" for adults under 65 years and "no perceived need" among those 65 years and older could help improve eye care service utilization among people with diabetes.

  12. Barriers to Eye Care Among People Aged 40 Years and Older With Diagnosed Diabetes, 2006–2010

    PubMed Central

    Chou, Chiu-Fang; Sherrod, Cheryl E.; Zhang, Xinzhi; Barker, Lawrence E.; Bullard, Kai McKeever; Crews, John E.; Saaddine, Jinan B.

    2016-01-01

    OBJECTIVE We examine barriers to receiving recommended eye care among people aged ≥40 years with diagnosed diabetes. RESEARCH DESIGN AND METHODS We analyzed 2006–2010 Behavioral Risk Factor Surveillance System data from 22 states (n = 27,699). Respondents who had not sought eye care in the preceding 12 months were asked the main reason why. We categorized the reasons as cost/lack of insurance, no need, no eye doctor/travel/appointment, and other (meaning everything else). We used multinomial logistic regression to control for race/ethnicity, education, income, and other selected covariates. RESULTS Among adults with diagnosed diabetes, nonadherence to the recommended annual eye examinations was 23.5%. The most commonly reported reasons for not receiving eye care in the preceding 12 months were “no need” and “cost or lack of insurance” (39.7 and 32.3%, respectively). Other reasons were “no eye doctor,” “no transportation” or “could not get appointment” (6.4%), and “other” (21.5%). After controlling for covariates, adults aged 40–64 years were more likely than those aged ≥65 years (relative risk ratio [RRR] = 2.79; 95% CI 2.01–3.89) and women were more likely than men (RRR = 2.33; 95% CI 1.75–3.14) to report “cost or lack of insurance” as their main reason. However, people aged 40–64 years were less likely than those aged ≥65 years to report “no need” (RRR = 0.51; 95% CI 0.39–0.67) as their main reason. CONCLUSIONS Addressing concerns about “cost or lack of insurance” for adults under 65 years and “no perceived need” among those 65 years and older could help improve eye care service utilization among people with diabetes. PMID:24009300

  13. What It's Like to Grow Older: The Aging Perceptions of People with an Intellectual Disability in Ireland

    ERIC Educational Resources Information Center

    Burke, Eilish; McCarron, Mary; Carroll, Rachael; McGlinchey, Eimear; McCallion, Philip

    2014-01-01

    The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing is a national longitudinal study on the aging of people with an intellectual disability (ID) using a randomly selected sample of people with ID over the age of 40. In total, 367 people with an ID completed the aging perception self-report only section. Over 57% of…

  14. Pulse Pressure Relation to Aortic and Left Ventricular Structure in Older People in the AGES-Reykjavik Study

    PubMed Central

    Torjesen, Alyssa A; Sigurđsson, Sigurđur; Westenberg, Jos JM; Gotal, John D; Bell, Vanessa; Aspelund, Thor; Launer, Lenore J; de Roos, Albert; Gudnason, Vilmundur; Harris, Tamara B; Mitchell, Gary F

    2014-01-01

    High pulse pressure, a major cardiovascular risk factor, has been attributed to medial elastic fiber degeneration and aortic dilation, which transfers hemodynamic load to stiffer collagen. However, recent studies suggest higher pulse pressure is instead associated with smaller aortic diameter. Thus, we sought to elucidate relations of pulse pressure with aortic stiffness and aortic and cardiac dimensions. We used magnetic resonance imaging to examine relations of pulse pressure with lumen area and wall stiffness and thickness in the thoracic aorta and left ventricular structure in 526 participants (72 to 94 years of age, 295 women) in the community-based Age, Gene/Environment Susceptibility-Reykjavik Study. In a multivariable model that adjusted for age, sex, height, weight, and standard vascular risk factors, central pulse pressure had a negative relation with aortic lumen area (all effects expressed as mm Hg/SD; B=−8.1±1.2, P<0.001) and positive relations with left ventricular end-diastolic volume (B=3.8±1.0, P<0.001), carotid-femoral pulse wave velocity (B=3.6±1.0, P<0.001), and aortic wall area (B=3.0±1.2, P=0.015). Higher pulse pressure in older people is associated with smaller aortic lumen area and greater aortic wall stiffness and thickness and left ventricular volume. Relations of larger ventricular volume and smaller aortic lumen with higher pulse pressure suggest mismatch in hemodynamic load accommodation by the heart and aorta in older people. PMID:25024287

  15. Older people and skin: challenging perceptions.

    PubMed

    Cowdell, Fiona; Garrett, Dawne

    In this article we set out to challenge perceptions about older people and skin. We examine current portrayals of older people and skin, both in the media and in the nursing literature. We describe the ‘normal’ process of skin ageing and highlight the importance of maintaining skin integrity and effective barrier function for health and wellbeing, particularly in older people. One element of maintaining skin integrity is ensuring that personal hygiene and emollient needs are met. Effective skin hygiene and emollient care will reduce the risk of breakdown, with all its burdensome and costly consequences. We therefore offer a summary of the current evidence base for skin-hygiene practice. We make a case for nurses considering skin health from a wider societal and human perspective, and identify opportunities to enhance nursing practice through skin-care advice and health education for all older people.

  16. [Functional decline in older people].

    PubMed

    Wada, Taizo

    2013-10-01

    World Health Organization(WHO) proposed to be used as an index of the health of elderly independence of functioning. Basic activities of daily living (BADL), such as bathing, dressing, toileting, transferring, continence, and feeding are well known as the functioning of the elderly. However, not only BADL, there are a variety of levels, such as the ability to play a social role, intellectual activities and instrumental activities of daily living (IADL), which are components of the Tokyo Metropolitan Institute of Gerontology Index of Competence(TMIG-IC). Functional decline in older people is associated with age, gender, depression, up and go test and manual dexterity. Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability.

  17. Multiple, but not traditional risk factors predict mortality in older people: the Concord Health and Ageing in Men Project.

    PubMed

    Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Gnjidic, Danijela; Stanaway, Fiona F; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Cumming, Robert G

    2014-01-01

    This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005-2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors delete time until of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of delete time to time to mortality included in the final model (p < 0.05) were older age, body mass index < 20 kg m(2), high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong non-drinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a

  18. Risk-Taking, Safety and Older People. Selected Bibliographies on Ageing 3.

    ERIC Educational Resources Information Center

    Jackson, Wendy, Comp.

    This annotated bibliography, which was developed as part of a series of selected bibliographies on aging for Great Britain's Centre for Policy on Ageing, contains a total of 368 entries organized under the following subject headings: risk (identification, nature, responsibilities, risk taking, security); environmental safety (hazards, design,…

  19. Student Knowledge and Attitudes toward Older People and Their Impact on Pursuing Aging Careers

    ERIC Educational Resources Information Center

    Lun, Man Wai Alice

    2011-01-01

    The international community is facing the pressure of aging societies. In the United States of America, we will shortly be facing the aging of baby boomers, a dramatically large population expected to peak as senior citizens in 2030 at 70 million. Global societies are facing a crisis: lack of adequately trained and emotionally oriented personnel…

  20. Using Older People's Life Stories to Teach Developmental Psychology and Aging: Benefits and Difficulties

    ERIC Educational Resources Information Center

    Villar, Feliciano; Fabà, Josep; Celdrán, Montserrat

    2013-01-01

    The goals of this study were to design and implement an experiential learning assignment in an undergraduate developmental psychology and aging course and to explore students' perceptions of it. One hundred and forty-three first-year students enrolled in an introductory course on developmental psychology across the life span recorded, transcribed,…

  1. Geriatrician interventions on medication prescribing for frail older people in residential aged care facilities

    PubMed Central

    Poudel, Arjun; Peel, Nancye M; Mitchell, Charles A; Gray, Leonard C; Nissen, Lisa M; Hubbard, Ruth E

    2015-01-01

    Objective In Australian residential aged care facilities (RACFs), the use of certain classes of high-risk medication such as antipsychotics, potent analgesics, and sedatives is high. Here, we examined the prescribed medications and subsequent changes recommended by geriatricians during comprehensive geriatric consultations provided to residents of RACFs via videoconference. Design This is a prospective observational study. Setting Four RACFs in Queensland, Australia, are included. Participants A total of 153 residents referred by general practitioners for comprehensive assessment by geriatricians delivered by video-consultation. Results Residents’ mean (standard deviation, SD) age was 83.0 (8.1) years and 64.1% were female. They had multiple comorbidities (mean 6), high levels of dependency, and were prescribed a mean (SD) of 9.6 (4.2) regular medications. Ninety-one percent of patients were taking five or more medications daily. Of total medications prescribed (n=1,469), geriatricians recommended withdrawal of 9.8% (n=145) and dose alteration of 3.5% (n=51). New medications were initiated in 47.7% (n=73) patients. Of the 10.3% (n=151) medications considered as high risk, 17.2% were stopped and dose altered in 2.6%. Conclusion There was a moderate prevalence of potentially inappropriate high-risk medications. However, geriatricians made relatively few changes, suggesting either that, on balance, prescription of these medications was appropriate or, because of other factors, there was a reluctance to adjust medications. A structured medication review using an algorithm for withdrawing medications of high disutility might help optimize medications in frail patients. Further research, including a broader survey, is required to understand these dynamics. PMID:26150708

  2. Theme: Pharmacology and Older People.

    ERIC Educational Resources Information Center

    Simonson, William; And Others

    1994-01-01

    This theme issue discusses maximizing the benefits and minimizing the risks of drug therapy for older people. It includes articles on psychoactive drugs, drug-related problems, medication compliance, geriatric psychopharmacotherapy, consumer guidelines, and outpatient prescriptions drug coverage as it relates to health care reform. (JOW)

  3. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group.

    PubMed

    Bauer, Jürgen; Biolo, Gianni; Cederholm, Tommy; Cesari, Matteo; Cruz-Jentoft, Alfonso J; Morley, John E; Phillips, Stuart; Sieber, Cornel; Stehle, Peter; Teta, Daniel; Visvanathan, Renuka; Volpi, Elena; Boirie, Yves

    2013-08-01

    New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ingested protein. They also need more protein to offset inflammatory and catabolic conditions associated with chronic and acute diseases that occur commonly with aging. With the goal of developing updated, evidence-based recommendations for optimal protein intake by older people, the European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥ 1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2-1.5 g/kg body weight/d). Older people with severe kidney disease (ie, estimated GFR <30 mL/min/1.73 m(2)), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. Protein quality, timing of ingestion, and intake of other nutritional supplements may be relevant, but evidence is not yet sufficient to support specific recommendations. Older people are vulnerable to losses in physical function capacity, and such losses predict loss of independence, falls, and even mortality. Thus, future studies aimed at pinpointing optimal protein intake in specific populations of older people

  4. Association between Frailty, Osteoporosis, Falls and Hip Fractures among Community-Dwelling People Aged 50 Years and Older in Taiwan: Results from I-Lan Longitudinal Aging Study

    PubMed Central

    Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Yu; Hwang, An-Chun; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Kung

    2015-01-01

    Background Association of frailty with adverse clinical outcomes has been reported in Western countries, but data from the Asian population are scarce. This study aimed to evaluate the epidemiology of frailty among community-dwelling middle-aged and elderly population and to explore its association with musculoskeletal health in Taiwan. Methods I-Lan Longitudinal Aging Study (ILAS) data were retrieved for this study. Frailty was defined by the Fried’s criteria; a comparison of demographic characteristics, physical performance, and body composition, including skeletal muscle mass and bone mineral density (BMD), as well as recent falls, history of hip fractures and the functional status of subjects with different frailty statuses were accomplished. Results Overall, the data of 1,839 participants (mean age: 63.9±9.3 years, male 47.5%) were obtained for analysis. The prevalence of pre-frailty was 42.3% in men and 38.8% in women, whereas the prevalence of frailty was 6.9% and 6.7% in men and women, respectively. Frailty was significantly associated with older age, the male gender, larger waist circumference, lower skeletal muscle index, lower hip BMD, poorer physical function, poorer nutritional status, and poorer cognitive function. Also, frailty was significantly associated with osteoporosis (OR: 7.73, 95% CI: 5.01–11.90, p<0.001), history of hip fractures (OR: 8.66, 95% CI: 2.47–30.40, p = 0.001), and recent falls (O.R: 2.53, 95% CI: 1.35–4.76, p = 0.004). Conclusions Frailty and pre-frailty, in Taiwan, was closely associated with recent falls, history of hip fractures and osteoporosis among community-dwelling people 50 years of age and older. Furthermore, frailty intervention programs should take an integrated approach towards strengthening both and muscle mass, as well as prevention of falls. PMID:26348034

  5. The Right to Health of Older People.

    PubMed

    Baer, Britta; Bhushan, Anjana; Taleb, Hala Abou; Vasquez, Javier; Thomas, Rebekah

    2016-04-01

    A focus on the right to the enjoyment of the highest attainable standard of health (hereinafter, "the right to health") draws attention to the health needs of older people, including the most marginalized among them. Many factors that influence vulnerability or impede the enjoyment of health and access to quality services result from an inability to freely exercise these human rights. A human rights approach can help to address the legal, social, and structural barriers to good health for older persons, clarifying the legal obligations of State and non-State actors to uphold and respect these rights. However, despite growing impetus for action, this area has historically received limited attention. Drawing on practice examples from different regions, this article unpacks the meaning of the right to health and other related human rights of older people in practice, covering both health care and underlying determinants of their health. Questions of availability, accessibility, acceptability, and quality are highlighted from the perspective of older people's health and well-being. The article brings together knowledge, principles, norms, and standards from the human rights law, health, and ageing arenas. By making links between these arenas, it is hoped that the article fills a gap in thinking on how to achieve the progressive realization of the right to health of older people and the effective promotion and protection of their other related human rights, which are crucial for the enjoyment of health.

  6. "Old People Are Cranky": Helping Professional Trainees' Knowledge, Attitudes, Aging Anxiety, and Interest in Working with Older Adults

    ERIC Educational Resources Information Center

    Boswell, Stefanie S.

    2012-01-01

    This study investigated the efficacy of a gerontology education course in decreasing ageism and aging anxiety and increasing knowledge and interest in working with older adults among undergraduates training for social services careers. Participants completed study measures at the beginning and end of semester. Analyses supported the study…

  7. Interface Design and Engagement with Older People

    ERIC Educational Resources Information Center

    Hawthorn, D.

    2007-01-01

    The current paper examines the design process that led to an unusually successful interactive tutorial for older people. The paper describes the issues that make designing for older people different. These include differences between the designer and the target population and the difficulty that older people have in interacting with low-fidelity…

  8. Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities.

    PubMed

    Street, Maryann; Ottmann, Goetz; Johnstone, Megan-Jane; Considine, Julie; Livingston, Patricia M

    2015-09-01

    The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2-6) vs. 6 days (2-10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan.

  9. Creating the right light for older people.

    PubMed

    Gardner, Carl

    2014-09-01

    In last month's HEJ first we ran the first of a two-part focus, by Carl Gardner, former editor of the Institution of Lighting Professionals' Lighting Journal, on the issues surrounding lighting and the ageing population, which focused particularly on effective task lighting. In the second part of the article, the author considers the important psychological, physiological, and biological effects of lighting on older people--and how improved lighting design can benefit this group in a number of ways.

  10. Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda

    PubMed Central

    Mugisha, Joseph O.; Schatz, Enid J.; Randell, Madeleine; Kuteesa, Monica; Kowal, Paul; Negin, Joel; Seeley, Janet

    2016-01-01

    Background Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa. Objectives In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability. Methods Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS. Results In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60–69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1–2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2–3.6). Sleep problems (coefficient 14.2, 95% CI 7.3–21.0) and depression (coefficient 9.4, 95% CI 1.2–17.0) were strongly associated with higher disability scores. Conclusion Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of

  11. Delirium and older people: repositioning nursing care.

    PubMed

    Neville, Stephen

    2006-06-01

    Aims.  To critically examine the nursing care offered to older people who have been delirious. Background.  Delirium occurs as a result of physiological imbalances resulting in an alteration in consciousness and cognitive impairment. Delirium is a prevalent and serious cognitive disorder experienced by older people. While there is a vast number of studies published utilizing quantitative methods, there remains a dearth of research relating to delirium in older people from a qualitative perspective. Design.  A qualitative research design that utilized a critical gerontological framework underpinned this study. This framework drew on aspects of postmodernism and Foucault's understanding of discourse. Methods.  Data sources included published documents on delirium, semi-structured taped interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, Registered Nurses and a hospital doctor. A postmodern discourse analytic approach was used to interrogate the 20 sets of data collected. Findings.  Textual analysis revealed the presence of two major discourses impacting on being an older person with delirium. These were identified as a nursing discourse of delirium and a personal discourse of delirium. A nursing discourse of delirium was largely focussed on the biomedical processes that resulted in a delirious episode. Conversely, a personal discourse of delirium highlights that there are other ways of 'knowing' about delirium through considering the narratives of older adults, and their families, when offering a nursing service to this group of people. Relevance to clinical practice.  Nursing needs to critically examine all aspects of nursing care as it applies to older people who have delirium to ensure the rhetorical claims of the profession become the reality for consumers of health services. The use of critical gerontology provides nurses with the tools to challenge the status quo and uncover the

  12. Antipsychotic prescribing in older people.

    PubMed

    Neil, Wendy; Curran, Stephen; Wattis, John

    2003-09-01

    older people. There is a need to redress this balance to ensure that the prescribing of antipsychotics in older people is evidence based.

  13. Insulin-like growth factor 1 and risk of depression in older people: the English Longitudinal Study of Ageing

    PubMed Central

    Chigogora, S; Zaninotto, P; Kivimaki, M; Steptoe, A; Batty, G D

    2016-01-01

    Depressive disorders are a leading cause of disability in older age. Although the role of psychosocial and behavioural predictors has been well examined, little is known about the biological origins of depression. Findings from animal studies have implicated insulin-like growth factor 1 (IGF-1) in the aetiology of this disorder. A total of 6017 older adults (mean age of 65.7 years; 55% women) from the English Longitudinal Study of Ageing provided serum levels of IGF-1 (mean=15.9 nmol l−1, s.d. 5.7) during a nurse visit in 2008. Depression symptoms were assessed in the same year and again in 2012 using the eight-item Center for Epidemiologic Studies Depression Scale. Self-reports of a physician-diagnosis of depression were also collected at both time points. In separate analyses for men and women, the results from both the cross-sectional and longitudinal analyses revealed a ‘U'-shaped pattern of association, such that lower and higher levels of IGF-1 were associated with a slightly elevated risk of depression, whereas the lowest risk was seen around the median levels. Thus, in men, with the lowest quintile of IGF-1 as the referent, the age-adjusted odds ratios (95% confidence interval) of developing depression symptoms after 4 years of follow-up, for increasing quintiles of IGF-1, were: 0.51 (0.28–0.91), 0.50 (0.27–0.92), 0.63 (0.35–1.15) and 0.63 (0.35–1.13) (P-value for quadratic association 0.002). Some attenuation of these effects was apparent after adjustment for co-morbidity, socioeconomic status and health behaviours. In conclusion, in the present study of older adults, there was some evidence that moderate levels of IGF-1 levels conferred a reduced risk of depression. PMID:27648920

  14. Individual and environmental factors underlying life space of older people – study protocol and design of a cohort study on life-space mobility in old age (LISPE)

    PubMed Central

    2012-01-01

    Background A crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) project is to examine how home and neighborhood characteristics influence people’s health, functioning, disability, quality of life and life-space mobility in the context of aging. In addition, examine whether a person’s health and function influence life-space mobility. Design This paper describes the study protocol of the LISPE project, which is a 2-year prospective cohort study of community-dwelling older people aged 75 to 90 (n = 848). The data consists of a baseline survey including face-to-face interviews, objective observation of the home environment and a physical performance test in the participant’s home. All the baseline participants will be interviewed over the phone one and two years after baseline to collect data on life-space mobility, disability and participation restriction. Additional home interviews and environmental evaluations will be conducted for those who relocate during the study period. Data on mortality and health service use will be collected from national registers. In a substudy on walking activity and life space, 358 participants kept a 7-day diary and, in addition, 176 participants also wore an accelerometer. Discussion Our study, which includes extensive data collection with a large sample, provides a unique opportunity to study topics of

  15. Taking older people's rights seriously: the role of international law.

    PubMed

    Tang, Kwong-leung

    2008-01-01

    Older people face many difficult challenges that amount to a deplorable violation of their basic human rights (poverty, discrimination, denial of social services, etc.). However, the world has been slow to react. Factors that limit global responses to the challenges of aging include: limited political will, the prevalence of neo-liberalism, and NGOs' longstanding advocacy for other seemingly "more" disadvantaged groups. Such oppression of and discrimination against older people require a concerted world-wide response. We contend that the introduction of an international convention on the human rights of older people is most relevant. Reinforced by a potent international monitoring system, the convention should contain comprehensive and legally binding provisions that require participating states to promote older people's rights. It is argued that international law would be a powerful force in defending and protecting older persons, operating as a baseline for establishing underlying values for national aging policies and linking older persons' concerns with other segments of society.

  16. Providing comfort and support to older people.

    PubMed

    Triggle, Nick

    2012-10-01

    This article reports on a scheme run by Age UK at Hillingdon Hospital, Middlesex, to help support emergency department (ED) staff with the care of older people. The A&E support-worker team assists patients with non-clinical activities, such as going to the toilet, eating meals and finding out care-related information. The support-worker scheme has been running for nine years and its success has prompted Age UK to consider expanding it nationally. It comes at a time when there is a growing focus on the care Solder patients receive in hospitals.

  17. Psychosocial barriers to sexual intimacy for older people.

    PubMed

    Garrett, Dawne

    A review of the literature relating to the psychosocial barriers to sexual intimacy in older people reveals wide-ranging influences on people aged 75-85 years. These influences include: a lack of positive social policy, a lack of research, partner availability, negative media portrayals, psychological factors, relationship factors, and difficulties in interactions with health professionals. Stereotypical attitudes about sexual intimacy and older people remain a cultural norm. A high value is placed on a gold standard of sexual performance, which can reinforce negative esteem and set unrealistic expectations and measures for older people. This article focuses on the majority of the older population who do not require residential care. It examines major influences emerging from a review of the literature from 1995 to 2013, which informs a working definition for sexual intimacy in people over the age of 75 years. The article concludes with key recommendations for nurses working with older adults.

  18. Does pain mediate or moderate the relationship between physical activity and depressive symptoms in older people? Findings from The Irish Longitudinal Study on Ageing (TILDA)

    PubMed Central

    Kelleher, C.; Hickey, A.; Conroy, R.; Doyle, F.

    2014-01-01

    Background. Depression is an increasing problem in older adults, which is exacerbated by under diagnosis and ineffective treatment options. Broadly speaking, as people age, their levels of regular physical activity (PA) decrease, while their experience of chronic pain increases. PA has been shown to be an effective, yet under-utilised, treatment for depression in this age-cohort although the influence of pain on the relationship between PA and depressive symptoms has not been considered. Methods. Secondary analysis of national data from The Irish Longitudinal Study on Ageing (TILDA, 2011) (n = 8163 participants aged 50 years and older) examined the mediating or moderating role of pain in the relationship between depressive symptoms and PA, and the impact of PA, pain and depressive symptoms on health-care utilisation. Results. Approximately 8.5% TILDA older adults were depressed. No mediating or moderating effects of pain were found in the association between PA and depressive symptoms. Higher levels of PA were found to be independently associated with lower depressive symptoms, while higher levels of pain significantly increased the likelihood of depressive symptoms supporting previous findings. Depressive symptoms and higher levels of pain were also found to significantly increase health-care utilisation. Conclusions. Consistent with previous findings in this field, both PA and pain were found to be independently associated with depressive symptoms in Irish older adults. Furthermore, pain does not play a mediating or moderating role in the relationship between PA and depressive symptoms. Continued support for ongoing initiatives in this area aimed at increasing PA in older adults as a means to improve both physical and mental well-being is advised. The absence of any synergistic effect between PA and pain suggests that clinicians and health service providers should continue to promote PA as a treatment for depression, irrespective of the pain levels of their

  19. Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change.

    PubMed

    Burkett, Ellen; Martin-Khan, Melinda G; Scott, Justin; Samanta, Mayukh; Gray, Leonard C

    2016-07-29

    Objectives The aim of the present study was to describe trends in and age and gender distributions of presentations of older people to Australian emergency departments (EDs) from July 2006 to June 2011, and to develop ED utilisation projections to 2050.Methods A retrospective analysis of data collected in the National Non-admitted Patient Emergency Department Care Database was undertaken to assess trends in ED presentations. Three standard Australian Bureau of Statistics population growth models, with and without adjustment for current trends in ED presentation growth and effects of climate change, were examined with projections of ED presentations across three age groups (0-64, 65-84 and ≥85 years) to 2050.Results From 2006-07 to 2010-11, ED presentations increased by 12.63%, whereas the Australian population over this time increased by only 7.26%. Rates of presentation per head of population were greatest among those aged ≥85 years. Projections of ED presentations to 2050 revealed that overall ED presentations are forecast to increase markedly, with the rate of increase being most marked for older people.Conclusion Growth in Australian ED presentations from 2006-07 to 2010-11 was greater than that expected from population growth alone. The predicted changes in demand for ED care will only be able to be optimally managed if Australian health policy, ED funding instruments and ED models of care are adjusted to take into account the specific care and resource needs of older people.What is known about the topic? Rapid population aging is anticipated over coming decades. International studies and specific local-level Australian studies have demonstrated significant growth in ED presentations. There have been no prior national-level Australian studies of ED presentation trends by age group.What does this paper add? The present study examined national ED presentation trends from July 2006 to June 2011, with specific emphasis on trends in presentation by age group

  20. Screening for Malnutrition in Older People.

    PubMed

    Guyonnet, Sophie; Rolland, Yves

    2015-08-01

    Malnutrition risk increases with age and level of care. Despite significant medical advances, malnutrition remains a significant and highly prevalent public health problem of developed countries. Earlier identification and appropriate nutrition support may help to reverse or halt the malnutrition trajectory and the negative outcomes associated with poor nutritional status. A nutrition screening process is recommended to help detect people with protein-energy malnutrition (PEM) or at malnutrition risk. Evidence supports that oral nutritional supplements and dietary counseling can increase dietary intake and improve quality of life in elderly with PEM or at malnutrition risk. This article examines nutritional screening and assessment tools designated for older adults.

  1. Can Caring Create Prejudice? An Investigation of Positive and Negative Intergenerational Contact in Care Settings and the Generalisation of Blatant and Subtle Age Prejudice to Other Older People.

    PubMed

    Drury, Lisbeth; Abrams, Dominic; Swift, Hannah J; Lamont, Ruth A; Gerocova, Katarina

    2017-01-01

    Caring is a positive social act, but can it result in negative attitudes towards those cared for, and towards others from their wider social group? Based on intergroup contact theory, we tested whether care workers' (CWs) positive and negative contact with old-age care home residents (CHRs) predicts prejudiced attitudes towards that group, and whether this generalises to other older people. Fifty-six CWs were surveyed about their positive and negative contact with CHRs and their blatant and subtle attitudes (humanness attributions) towards CHRs and older adults. We tested indirect paths from contact with CHRs to attitudes towards older adults via attitudes towards CHRs. Results showed that neither positive nor negative contact generalised blatant ageism. However, the effect of negative, but not positive, contact on the denial of humanness to CHRs generalised to subtle ageism towards older adults. This evidence has practical implications for management of CWs' work experiences and theoretical implications, suggesting that negative contact with a subgroup generalises the attribution of humanness to superordinate groups. Because it is difficult to identify and challenge subtle prejudices such as dehumanisation, it may be especially important to reduce negative contact. © 2016 The Authors. Journal of Community & Applied Social Psychology Published by John Wiley & Sons Ltd.

  2. Rural older people had lower mortality after accidental falls than non-rural older people

    PubMed Central

    Huang, Jen-Wu; Lin, Yi-Ying; Wu, Nai-Yuan; Chen, Yu-Chun

    2017-01-01

    Objective This study aimed to investigate the mortality rate after falls of rural and non-rural older people and to explore the risk factors of mortality after falls among older people. Patients and methods This population-based case–control study identified two groups from a nationwide claim database (National Health Insurance Research Database in Taiwan): a rural group and a non-rural group, which included 3,897 and 5,541 older people, respectively, who were hospitalized for accidental falls (The International Classification of Diseases, Ninth Revision, Clinical Modification: E880–E888) during 2006–2009. Both groups were followed up for 4 years after falls. Four-year cumulative all-cause mortality rate after falls was calculated, and the demographic factor, comorbidity, and medications were considered as the potential risk factors of mortality after falls. Results The rural group had a significantly higher frequency of fall-related hospitalizations (7.4% vs 4.3%, P<0.001), but a lower 4-year cumulative all-cause mortality rate after falls than the non-rural group (8.8% vs 23.4%, P<0.001). After adjusting for age, gender, comorbidity, and medication use, the rural group had a significantly lower risk of mortality after falls than the non-rural group (adjusted odds ratio =0.32, 95% confidence interval =0.28–0.37, P<0.001). Age, gender, place of residence, comorbidity, number of medications, and inappropriate medication use were independent risk factors of mortality after falls. Conclusion The rural older people had a higher frequency of fall-related hospitalizations but lower mortality after falls than the non-rural older people. Fall prevention programs should be adjusted for difference in place of residence. PMID:28123289

  3. Myths about older people's use of information and communication technology.

    PubMed

    Wandke, Hartmut; Sengpiel, Michael; Sönksen, Malte

    2012-01-01

    This paper discusses six myths common in the field of 'human-computer interaction (HCI) and older people'. These myths are widespread among computer scientists, engineers and programmers, as well as among the general public and even older individuals themselves. We can define these myths as follows. (1) Just wait and see. Future generations of older people will use computers without problems. This myth differs from those following, as it may lead to a (dangerous) conclusion of avoidance and inactivity by integrating myths 2-6. If the other myths are accepted as being true and one assumes that the problems will eventually solve themselves, it might not seem worthwhile to expend any effort on 'universal design' for older people's use of information and communication technology (ICT). However, we argue that if we do not actively and properly counteract these myths, we will perpetuate them and their grave consequences. (2) Older people are not interested in using computers. They are unaware of computer capabilities. (3) Older people consider computers as useless and unnecessary. (4) Older people lack the physical capabilities to use ICT. (5) Older people simply cannot understand interactive computing technology. (6) You can't teach an old dog new tricks. The problem of HCI for older people is that they do not learn to use new technologies and interaction techniques. In discussing these myths, we demonstrate that each one contains a grain of truth. However, the myths are improperly overgeneralized and, therefore, often wrong. Such myths are problematic. Designers and engineers often accept them as truths and neglect older users and/or apply information and communication technologies in an age-discriminating manner. Furthermore, the myths are problematic as they lead older people to avoid computer usage (i.e. a self-fulfilling prophecy). We present evidence to support the notion that these myths may often be largely - although not completely - wrong. We then demonstrate

  4. Body weight, anorexia, and undernutrition in older people.

    PubMed

    Soenen, Stijn; Chapman, Ian M

    2013-09-01

    Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people.

  5. Attitudes toward Older People and Coworkers' Intention to Work with Older Employees: A Taiwanese Study

    ERIC Educational Resources Information Center

    Lu, Luo

    2010-01-01

    The aim of this research was to examine attitudinal barriers to the employment of Taiwanese older workers (aged 60 and above). Face-to-face interviews were conducted to collect data using structured questionnaires from a sample of full-time employees (N = 258). We found that: (1) positive attitudes toward older people in general, perceived…

  6. Attitudes towards Older People and Managers' Intention to Hire Older Workers: A Taiwanese Study

    ERIC Educational Resources Information Center

    Lu, Luo; Kao, Shu-Fang; Hsieh, Ying-Hui

    2011-01-01

    The aim of this research was to examine attitudinal barriers to the managerial intention to hire older workers (aged 60 and above). Structured questionnaires were used to collect data from a sample of managers with hiring power (N = 305). We found that (a) positive attitudes towards older people in general, perceived subjective norm, personal…

  7. Older people, personal hygiene, and skin care.

    PubMed

    Cowdell, Fiona

    2011-01-01

    Skin health is essential for well being in older people. Personal hygiene is fundamental to skin health, but a lack of evidence exists about effective practices. An evidence base, disseminated through nursing education and patient health promotion, must be developed.

  8. Physical Activity among Older People and Related Factors

    ERIC Educational Resources Information Center

    Persson, Ann; While, Alison

    2012-01-01

    Objective: To investigate the duration, intensity and type of physical activity undertaken by people aged 60 years and over in relation to their reported levels of participation in social activities and their perceptions of their neighbourhood. Design: A cross-sectional questionnaire survey of older people attending two luncheon and eight social…

  9. Carotenoids and health in older people.

    PubMed

    Woodside, Jayne V; McGrath, Alanna J; Lyner, Natalie; McKinley, Michelle C

    2015-01-01

    As the proportion of older people increases, so will chronic disease incidence and the proportion of the population living with disability. Therefore, new approaches to maintain health for as long as possible in this age group are required. Carotenoids are a group of polyphenolic compounds found predominantly in fruit and vegetables that have been proposed to have anti-inflammatory and antioxidant effects. Such properties may impact on the risk diseases which predominate in older people, and also ageing-related physiological changes. Working out the effect of carotenoid intake versus fruit and vegetable intake is difficult, and the strong correlation between individual carotenoid intakes also complicates any attempt to examine individual carotenoid health effects. Similarly, research to determine whether carotenoids consumed as supplements have similar benefits to increased dietary intake through whole foods, is still required. However, reviewing the recent evidence suggests that carotenoid intake and status are relatively consistently associated with reduced CVD risk, although β-carotene supplementation does not reduce CVD risk and increases lung cancer risk. Increased lycopene intake may reduce prostate cancer progression, with a potential role for carotenoids at other cancer sites. Lutein and zeaxanthin have a plausible role in the maintenance of eye health, whilst an association between carotenoid intake and cognitive and physical health appears possible, although research is limited to date. Given this accruing evidence base to support a specific role for certain carotenoids and ageing, current dietary advice to consume a diet rich in fruit and vegetables would appear prudent, and efforts maintained to encourage increased intake.

  10. Inflammation and frailty measures in older people

    PubMed Central

    Hubbard, Ruth E; O’Mahony, M Sinead; Savva, George M; Calver, Brian L; Woodhouse, Ken W

    2009-01-01

    Inflammation in patients defined as frail by Fried’s phenotypic definition may be related to sarcopenia. This study aimed to investigate inflammation in older patients across different frailty criteria. Frailty status was determined in 110 patients aged over 75 years (mean 83.9 years) according to function (dependent, intermediate, independent); Fried (three or more items of exhaustion, weight loss, slow walking speed, low handgrip strength, low physical activity) and Frailty Index (a measure of accumulated deficits). With increasing patient frailty as defined by function and by Fried phenotype, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) increased significantly. Albumin was lowest in the frailest subjects by each definition. The greatest differences were seen between intermediate and dependent groups and between the pre-frail and frail. Adjustment for multiple covariates (age, sex, BMI category, smoking status, number of co-morbidities and number of prescribed medications) did not account for any of the observed differences in levels of inflammatory markers. The Frailty Index correlated significantly with log-transformed CRP (r= 0.221, P < 0.05), log-transformed IL-6 (r= 0.369, P < 0.01), TNF-α (r= 0.379, P < 0.01) and inversely with albumin (r=– 0.545, P < 0.01). This study provides further evidence linking inflammation and frailty in older people, an association that seems consistent across different frailty measures. PMID:19438806

  11. The welfare implications of disability for older people in Ireland.

    PubMed

    Cullinan, John; Gannon, Brenda; O'Shea, Eamon

    2013-04-01

    Recent data analysed for Ireland suggest a strong link between disability status and household poverty, while there exists substantial evidence to suggest that disability is highly prevalent among persons of older age. Within this context, this paper estimates the welfare implications of disability for older people in Ireland. We define and estimate models of the private costs borne by households with older persons who have a disability in Ireland, both in general and by severity of illness or condition. Our modelling framework is based on the standard of living approach to estimating the cost of disability. The model quantifies the extra costs of living associated with disability and is estimated by comparing the standard of living of households with and without disabled members at a given income, controlling for other sources of variation. The analysis suggests that the estimated economic cost of disability for older people in Ireland is significant and varies by severity of disability, as well as by household type. The results also suggest that the cost of disability increases in proportionate terms as the number of people in the household decreases. Our results are important when considering the effectiveness of policies that aim to address the economic problems associated with disability for older people, suggesting that current policy in Ireland does not go far enough. They indicate that older people face a double jeopardy through age and disability, which is not reflected in official poverty rates and support the case for the introduction of disability-adjusted poverty payments.

  12. Physical activity in older people: a systematic review

    PubMed Central

    2013-01-01

    Background Physical activity (PA) in older people is critically important in the prevention of disease, maintenance of independence and improvement of quality of life. Little is known about the physical activity of the older adults or their compliance with current physical activity guidelines. Methods A systematic literature search of the published literature was conducted. Included were published reports of original research that independently reported: the PA level of non-institutional older adults (aged 60 years and over); and the proportion of older adults in the different samples who met PA recommendations or guidelines. The review was restricted to studies published since 2000 to provide a current picture of older adults’ PA levels. Results Fifty three papers were included in the review. The percentage of older adults meeting recommended physical activity ranged from 2.4 – 83.0% across the studies. Definitions of “recommended” physical activity in older adults varied across the studies as did approaches to measurement which posed methodological challenges to data analysis. Older age groups were less likely than the reference group to be regularly active, and women were less likely than men to achieve regular physical activity, especially leisure time physical activity, when measured by both subjective and objective criteria. Conclusion The review highlights the need for studies which recruit representative random samples of community based older people and employ validated measurement methods consistently to enable comparison of PA levels over time and between countries. PMID:23648225

  13. Higher Lipoprotein (a) Levels Are Associated with Better Pulmonary Function in Community-Dwelling Older People - Data from the Berlin Aging Study II.

    PubMed

    Buchmann, Nikolaus; Kassner, Ursula; Norman, Kristina; Goldeck, David; Eckardt, Rahel; Pawelec, Graham; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja

    2015-01-01

    Reduced pulmonary function and elevated serum cholesterol levels are recognized risk factors for cardiovascular disease. Currently, there is some controversy concerning relationships between cholesterol, LDL-cholesterol, HDL-cholesterol, serum triglycerides and lung function. However, most previous studies compared patients suffering from chronic obstructive pulmonary disease (COPD) with healthy controls, and only a small number examined this relationship in population-based cohorts. Moreover, lipoprotein a [Lp(a)], another lipid parameter independently associated with cardiovascular diseases, appears not to have been addressed at all in studies of lung function at the population level. Here, we determined relationships between lung function and several lipid parameters including Lp(a) in 606 older community-dwelling participants (55.1% women, 68±4 years old) from the Berlin Aging Study II (BASE-II). We found a significantly lower forced expiration volume in 1 second (FEV1) in men with low Lp(a) concentrations (t-test). This finding was further substantiated by linear regression models adjusting for known covariates, showing that these associations are statistically significant in both men and women. According to the highest adjusted model, men and women with Lp(a) levels below the 20th percentile had 217.3ml and 124.2ml less FEV1 and 239.0ml and 135.2ml less FVC, respectively, compared to participants with higher Lp(a) levels. The adjusted models also suggest that the known strong correlation between pro-inflammatory parameters and lung function has only a marginal impact on the Lp(a)-pulmonary function association. Our results do not support the hypothesis that higher Lp(a) levels are responsible for the increased CVD risk in people with reduced lung function, at least not in the group of community-dwelling older people studied here.

  14. Higher Lipoprotein (a) Levels Are Associated with Better Pulmonary Function in Community-Dwelling Older People – Data from the Berlin Aging Study II

    PubMed Central

    Buchmann, Nikolaus; Kassner, Ursula; Norman, Kristina; Goldeck, David; Eckardt, Rahel; Pawelec, Graham; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja

    2015-01-01

    Reduced pulmonary function and elevated serum cholesterol levels are recognized risk factors for cardiovascular disease. Currently, there is some controversy concerning relationships between cholesterol, LDL-cholesterol, HDL-cholesterol, serum triglycerides and lung function. However, most previous studies compared patients suffering from chronic obstructive pulmonary disease (COPD) with healthy controls, and only a small number examined this relationship in population-based cohorts. Moreover, lipoprotein a [Lp(a)], another lipid parameter independently associated with cardiovascular diseases, appears not to have been addressed at all in studies of lung function at the population level. Here, we determined relationships between lung function and several lipid parameters including Lp(a) in 606 older community-dwelling participants (55.1% women, 68±4 years old) from the Berlin Aging Study II (BASE-II). We found a significantly lower forced expiration volume in 1 second (FEV1) in men with low Lp(a) concentrations (t-test). This finding was further substantiated by linear regression models adjusting for known covariates, showing that these associations are statistically significant in both men and women. According to the highest adjusted model, men and women with Lp(a) levels below the 20th percentile had 217.3ml and 124.2ml less FEV1 and 239.0ml and 135.2ml less FVC, respectively, compared to participants with higher Lp(a) levels. The adjusted models also suggest that the known strong correlation between pro-inflammatory parameters and lung function has only a marginal impact on the Lp(a)-pulmonary function association. Our results do not support the hypothesis that higher Lp(a) levels are responsible for the increased CVD risk in people with reduced lung function, at least not in the group of community-dwelling older people studied here. PMID:26421427

  15. Attitudes toward older people and coworkers' intention to work with older employees: a Taiwanese study.

    PubMed

    Lu, Luo

    2010-01-01

    The aim of this research was to examine attitudinal barriers to the employment of Taiwanese older workers (aged 60 and above). Face-to-face interviews were conducted to collect data using structured questionnaires from a sample of full-time employees (N= 258). We found that: (1) positive attitudes toward older people in general, perceived subjective norm, and traditional Chinese cultural values were all related to stronger intentions to work with older employees; (2) the model derived from the theory of reasoned action emerged the best model accounting for behavioral intention among competing structural models. The associations of positive attitudes and subjective norm with intention were found after controlling for demographics, cultural values, and personal contact experiences with older people. Our results highlight the importance and urgency of more concerted research to inform public and organizational policies to better promote and manage the careers of older employees in an aging, economically developing society.

  16. Pressure ulcer prevention in frail older people.

    PubMed

    Barry, Maree; Nugent, Linda

    2015-12-16

    Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

  17. Detecting dehydration in older people: useful tests.

    PubMed

    Hooper, Lee; Bunn, Diane

    Dehydration is common in older people, leading to longer hospital stays and increased disability and mortality. Health professionals can diagnose water-loss dehydration by taking a blood sample and measuring serum osmolality, but a less-invasive test would be useful. Evidence that tests, clinical signs or questions tested to date are useful when screening for dehydration in older people is limited. This article looks at known risk factors, signs and test for dehydration, and outlines evidence on how useful they have proven to be. Part 2 describes how a care home has used a multicomponent strategy to improve hydration.

  18. Caring for Older People. Public transport.

    PubMed Central

    Roper, T. A.; Mulley, G. P.

    1996-01-01

    Most older people are mobile and able to use public transport without any problems. Those who are hard of hearing or have poor vision and those with mobility problems need not be deterred from using public transport. Though the design and provision of suitable buses, taxis, and trains is not always optimum, many now have imaginative features to help older passengers. Travel by air and sea needs extra planning for disabled elderly people, but helpful advice is available and much can be done to enable even the most disabled traveller to make long journeys confidently and in comfort. Images p415-a Fig 1 Fig 2 Fig 3 PMID:8761236

  19. Frail Older People as Participants in Research

    ERIC Educational Resources Information Center

    Peel, Nancye M.; Wilson, Cecilia

    2008-01-01

    This article describes the experience of interviewing frail older people in a research project investigating hip fracture risk factors. Specific methodological strategies to maximize participation and data quality and to facilitate the interview process related to participant inclusion criteria, initial approach, questionnaire format, and…

  20. The Engagement of Older People in Civil Society Organizations

    ERIC Educational Resources Information Center

    Principi, Andrea; Chiatti, Carlos; Lamura, Giovanni; Frerichs, Frerich

    2012-01-01

    This article reviews recent international literature on the opportunities and restrictions experienced by older people to act as volunteers in civil society organizations. Our aim was to develop a conceptual framework applicable to the European ageing society. This aim was pursued through a computerized database search focused on studies analyzing…

  1. Physical Health Indicators Improve Prediction of Cardiovascular and All-cause Mortality among Middle-Aged and Older People: a National Population-based Study

    PubMed Central

    Lee, Wei-Ju; Peng, Li-Ning; Chiou, Shu-Ti; Chen, Liang-Kung

    2017-01-01

    The effectiveness of established methods for stratifying cardiovascular risk, for example, the Framingham risk score (FRS), may be improved by adding extra variables. This study evaluated the potential benefits of adding physical health indicators (handgrip strength, walking speed, and peak expiratory flow) to the FRS in predicting cardiovascular and all-cause mortality by using a nationwide population-based cohort study data. During median follow-up of 4.1 years, 67 of 911 study subjects had died. In Cox regression analysis, all additional physical health indicators, except walking speed, significantly predicted cardiovascular and all-cause mortality (P < 0.05). Compared with the conventional FRS, c statistics were significantly increased when dominant handgrip strength or relative handgrip strength (handgrip strength adjusted for body mass index), or combination with walking speed or peak expiratory flow were incorporated into the FRS prediction model, both in the whole cohort and also in participants who did not have prevalent cardiovascular diseases at baseline. In conclusion, dominant or relative handgrip strength are simple and inexpensive physical health indicators that substantially improve the accuracy of the FRS in predicting cardiovascular and all-cause mortality among middle-aged and older people. PMID:28079182

  2. ICT Interface Design for Ageing People and People with Dementia

    NASA Astrophysics Data System (ADS)

    Wallace, Jonathan; Mulvenna, Maurice D.; Martin, Suzanne; Stephens, Sharon; Burns, William

    Ageing population trends, rising healthcare costs and social and digital inclusion are all factors in the background to the problem of older adults interacting with technology. Approaches to address "physical accessibility" and "access to technology" issues, as well as training for existing systems are evident, yet a usability issue still prevails. The primary aim of this chapter is to provide an overview of the research and literature and discuss the differing contexts in which older people and people with dementia interact with computerised systems and their associated issues.

  3. Circadian temperature rhythms of older people

    NASA Technical Reports Server (NTRS)

    Monk, T. H.; Buysse, D. J.; Reynolds, C. F. 3rd; Kupfer, D. J.; Houck, P. R.

    1995-01-01

    This collection of studies had the aim of exploring whether older (77+ years) men and women have circadian body temperature rhythms different from those of younger adults. A total of 20 older men and 28 older women were compared with either 22 young men or 14 middle-aged men in four protocols; all but the first protocol using a subset of the sample. The four protocols were: 1) 24 h, and 2) 72 h data collections on a normal laboratory routine (sleeping at night); 3) between 36 h and 153 h of field data collection at home; and 4) 36 h of a constant conditions routine (wakeful bedrest under temporal isolation) in the laboratory. There was some evidence for an age-related phase advance in temperature rhythm, especially for the older men on a normal routine, though this was not present in the constant conditions protocol, where 5 of the older subjects showed major delays in the timing of the body temperature trough (10:00 or later). There was no statistically significant evidence from any of the protocols that older subjects generally had lower temperature rhythm amplitudes than younger adults. Only when older men were compared with younger men in 24-h rhythm amplitude by simple t-test did any comparison involving amplitude achieve statistical significance (p < 0.05).

  4. Transforming Practice with Older People through an Ethic of Care

    PubMed Central

    Ward, Lizzie; Barnes, Marian

    2016-01-01

    This article explores the relevance of deliberative practices framed by feminist care ethics to social work practice with older people. It draws on two connected projects which brought together older people: practitioners and academics. The first was a participatory research project in which the significance of care to well-being in old age emerged. The second was a knowledge exchange project which generated learning resources for social care practice based on the research findings of the first project. Here we analyse selected transcripts of recordings from meetings of both projects to consider the ways that discussions about lived experiences and everyday lives demonstrate care through this dialogue. Using this analysis, we propose that care ethics can be useful in transforming relationships between older people and those working with them through the creation of hybrid spaces in which ‘care-full deliberation’ can happen. We argue that such reflective spaces can enable transformative dialogue about care and its importance to older people and offer a counterbalance to the procedurally driven environments in which much social work practice takes place and can support practice more attuned to the circumstances and concerns of older people. PMID:27559205

  5. Protein Requirements and Recommendations for Older People: A Review

    PubMed Central

    Nowson, Caryl; O’Connell, Stella

    2015-01-01

    Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations. PMID:26287239

  6. What do older people think that others think of them, and does it matter? The role of meta-perceptions and social norms in the prediction of perceived age discrimination.

    PubMed

    Vauclair, Christin-Melanie; Lima, Maria Luísa; Abrams, Dominic; Swift, Hannah J; Bratt, Christopher

    2016-11-01

    Psychological theories of aging highlight the importance of social context. However, very little research has distinguished empirically between older people's perception of how others in their social context perceive them (personal meta-perceptions) and the shared perceptions in society (societal meta-perceptions). Drawing on theories of intergroup relations and stereotyping and using a multilevel perspective, this article examines how well older people's perceptions of age discrimination (PAD) are predicted by (a) older people's personal meta-perceptions, (b) societal meta-perceptions, and (c) social norms of intolerance toward age prejudice. Aging meta-perceptions are differentiated into the cognitive and affective components of ageism. Multilevel analyses of data from the European Social Survey (Nover 70 years of age = 8,123, 29 countries; European Social Survey (ESS) Round 4 Data, 2008) confirmed that older people's personal meta-perceptions of negative age stereotypes and specific intergroup emotions (pity, envy, contempt) are associated with higher PAD. However, at the societal-level, only paternalistic meta-perceptions were consistently associated with greater PAD. The results show that a few meta-perceptions operate only as a psychological phenomenon in explaining PAD, some carry consonant, and others carry contrasting effects at the societal-level of analysis. This evidence extends previous research on aging meta-perceptions by showing that both the content of meta-perceptions and the level of analysis at which they are assessed make distinct contributions to PAD. Moreover, social norms of intolerance of age prejudice have a larger statistical effect than societal meta-perceptions. Social interventions would benefit from considering these differential findings. (PsycINFO Database Record

  7. Efficacy of myringoplasty in older people.

    PubMed

    Migirov, Lela; Lipschitz, Noga; Slonimsky, Guy; Yakirevitch, Arkadi; Wolf, Michael

    2014-12-01

    The aim of current investigation was to analyze the efficacy of myringoplasty in an elderly population. The medical records of 12 males and 9 females, aged 65-90 years (mean 70.7 years), who underwent myringoplasty between 2007 and 2013 were retrospectively reviewed for age, gender, co-morbidities, perforation size and location, pre- and postoperative pure tone averages of air/bone thresholds at 500, 1,000, 2,000 and 3,000 Hz, graft material, postoperative complications and surgical outcome. The most frequent co-morbidities included hypertension (n = 8), hyperlipidemia (n = 7), diabetes mellitus (n = 5) and ischemic heart disease (n = 4). Fifteen patients had two or more co-morbidities. All surgeries were performed via a trans-canal approach. Seventeen patients had central perforations and four patients had marginal perforations. Temporalis fascia, perichondrium or chondro-perichondrial graft and fat were used as grafting material in 9, 11 and 1 patient, respectively. The post-operative complications were infection (n = 4) and tragal seroma (n = 1). Surgical outcome was successful in 16/21 patients with graft take rates of 89, 72 and 0% for temporalis fascia, perichondrium/cartilage, and fat, respectively. Pre-operative audiometric data were available for all 21 patients; however, the post-operative data were available for only 15 of them. Myringoplasty in older people was a safe procedure with a 76.2% surgical success rate in the current study. The choice of graft material, perforation size, gender and associated co-morbidities had no significant effect on achieving an intact tympanic membrane and a dry ear. The audiometric results did not show significant changes following myringoplasty.

  8. Older People's Views of Advice about Falls Prevention: A Qualitative Study

    ERIC Educational Resources Information Center

    Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.

    2006-01-01

    The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…

  9. Mental Health and Wellbeing and Lifelong Learning for Older People. NIACE Briefing Sheet 92

    ERIC Educational Resources Information Center

    National Institute of Adult Continuing Education, 2009

    2009-01-01

    This briefing sheet is about lifelong learning for people aged 50+ years and how participation in learning can help maintain and improve mental health and wellbeing in later life. There is no commonly agreed definition of "older" people, and clearly people age at different rates. However, by the mid 50s, for most people retirement is…

  10. Older People and Social Connectedness: How Place and Activities Keep People Engaged

    PubMed Central

    Yen, Irene H.; Shim, Janet K.; Martinez, Airin D.; Barker, Judith C.

    2012-01-01

    To understand how older adults perceive and navigate their neighborhoods, we examined the implications of activity in their neighborhoods for their health. We interviewed 38 adults (ages 62–85) who lived in San Francisco or Oakland, California. Seven key themes emerged: (1) people express a wide range of expectations for neighborliness, from “we do not bother each other” to “we have keys to each other's houses”, (2) social distance between “other” people impede a sense of connection, (3) ethnic differences in living arrangements affect activities and activity locations, (4) people try to stay busy, (5) people able to leave their homes do many activities outside their immediate residential neighborhoods, (6) access to a car is a necessity for most, and (7) it is unusual to plan for the future when mobility might become limited. Multiple locations influence older adults' health, including residential neighborhoods. Older adults value mobility, active lives, and social connections. PMID:22272374

  11. Sustainability Literacy of Older People in Retirement Villages

    PubMed Central

    Xia, Bo; Zuo, Jian; Skitmore, Martin; Buys, Laurie; Hu, Xin

    2014-01-01

    With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia's central business district (CBD). Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development. PMID:25587448

  12. Sustainability literacy of older people in retirement villages.

    PubMed

    Xia, Bo; Zuo, Jian; Skitmore, Martin; Buys, Laurie; Hu, Xin

    2014-01-01

    With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia's central business district (CBD). Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development.

  13. 10 Hz flicker improves recognition memory in older people

    PubMed Central

    Williams, Jonathan; Ramaswamy, Deepa; Oulhaj, Abderrahim

    2006-01-01

    Background 10 Hz electroencephalographic (EEG) alpha rhythms correlate with memory performance. Alpha and memory decline in older people. We wished to test if alpha-like EEG activity contributes to memory formation. Flicker can elicit alpha-like EEG activity. We tested if alpha-frequency flicker enhances memory in older people. Pariticpants aged 67–92 identified short words that followed 1 s of flicker at 9.0 Hz, 9.5 Hz, 10.0 Hz, 10.2 Hz, 10.5 Hz, 11.0 Hz, 11.5 Hz or 500 Hz. A few minutes later, we tested participants' recognition of the words (without flicker). Results Flicker frequencies close to 10 Hz (9.5–11.0 Hz) facilitated the identification of the test words in older participants. The same flicker frequencies increased recognition of the words more than other frequencies (9.0 Hz, 11.5 Hz and 500 Hz), irrespective of age. Conclusion The frequency-specificity of flicker's effects in our participants paralleled the power spectrum of EEG alpha in the general population. This indicates that alpha-like EEG activity may subserve memory processes. Flicker may be able to help memory problems in older people. PMID:16515710

  14. Older people's conceptualization of elder abuse and neglect.

    PubMed

    Taylor, Brian J; Killick, Campbell; O'Brien, Marita; Begley, Emer; Carter-Anand, Janet

    2014-01-01

    This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as peer researchers. Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent: some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests. Preventing abuse requires a wide-ranging approach including rebuilding respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviors that have occurred.

  15. Orthostatic hypotension and subjective sleep quality in older people.

    PubMed

    McHugh, Joanna E; Fan, Chie W; Kenny, Rose Ann; Lawlor, Brian A

    2012-01-01

    Poor sleep quality and orthostatic hypotension are common complaints in an older population, and both are related to factors such as polypharmacy and depression. However, it is not known whether there is a direct association between the two. Our objective is to investigate a potential association between orthostatic blood pressure response and subjective sleep quality in older people. A within-subjects, cross-sectional design embedded in a larger longitudinal study design. Participants were recruited from the community to visit the TRIL clinic at St James's Hospital, where they underwent a structured medical and psychosocial assessment. A total of 505 community dwelling adults aged 60+ (321 females, mean age 72.44) were participated in this study. Orthostatic blood pressure responses were recorded during an active stand using Finometer equipment, and health-related factors such as pain ratings, co-morbidities, polypharmacy, timed up and go, Mini-Mental State Examination score, body mass index, as well as depression, anxiety, age and gender, were also recorded. Self-reported sleep quality was also assessed using the Pittsburgh Sleep Quality Index. The results showed that timed up and go, polypharmacy, depression, anxiety, gender and delayed recovery of blood pressure at orthostasis were associated with subjective poor sleep quality. There is an association between subjective sleep quality and delayed recovery of blood pressure at orthostasis, independent of mental health or polypharmacy effects, in older adults. This link may have implications for the management of sleep disorders in older people.

  16. Older People Becoming Successful ICT Learners over Time: Challenges and Strategies through an Ethnographical Lens

    ERIC Educational Resources Information Center

    Sayago, Sergio; Forbes, Paula; Blat, Josep

    2013-01-01

    A growing ageing population and an increasing reliance on information and communication technologies (ICT) to conduct activities associated with daily living means that addressing how older people learn to use ICT is timely and important. By drawing on a four-year ethnographical study with 420 older people in two different environments, this paper…

  17. Not Quite Color Blind: Ethnic and Gender Differences in Attitudes toward Older People among College Students

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Laditka, James N.; Houck, Margaret M.; Olatosi, Bankole A.

    2011-01-01

    Attitudes toward older people can influence how they are treated and their cognitive and physical health. The populations of the United States and many other countries have become more ethnically diverse, and are aging. Yet little research examines how ethnic diversity affects attitudes toward older people. Our study addresses this research gap.…

  18. The Representation of Older People in East Asian Television Advertisements.

    PubMed

    Prieler, Michael; Ivanov, Alex; Hagiwara, Shigeru

    2016-11-15

    In this study, 432 television advertisements from Hong Kong, Japan, and South Korea were analyzed to determine their representations of older people. Findings demonstrate that in East Asian advertisements, older people are highly underrepresented, appear in major roles, mostly alongside younger people, and older men clearly outnumber older women. The other variables investigated (i.e., setting and product categories) led to no conclusive findings for the three societies. In short, our study, employing ethnolinguistic vitality theory to analyze television advertisements, demonstrates how East Asian societies greatly marginalize older people. Potential effects of such representations are discussed using social cognitive theory and cultivation theory.

  19. The Market for Community Services for Older People.

    ERIC Educational Resources Information Center

    Hereford, Russell W.

    The Supportive Services Program for Older Persons is designed to demonstrate that a private market for home and community-based health related services can be developed in response to the demand expressed by older people and their families. The objective of the program is to expand the service options available to older people by letting market…

  20. Association between low-grade albuminuria and frailty among community-dwelling middle-aged and older people: a cross-sectional analysis from I-Lan Longitudinal Aging Study

    PubMed Central

    Chang, Chun-Chin; Hsu, Chien-Yi; Chang, Ting-Yung; Huang, Po-Hsun; Liu, Li-Kuo; Chen, Liang-Kung; Chen, Jaw-Wen; Lin, Shing-Jong

    2016-01-01

    Frailty is characterized by decreased physiological reserve and increased vulnerability to atherosclerosis and subsequent mortality. Recently, low-grade albuminuria has been proposed as an atherosclerotic risk factor. We aimed to investigate the relationship between low-grade albuminuria and frailty by using cross-sectional data among community-dwelling middle-aged and older people. Totally, 1,441 inhabitants of I-Lan County with normal urinary albumin excretion (urine albumin to urine creatinine ratio [UACR] <30 mg/g) were enrolled (677 men; mean age 63 ± 9 years, range from 50 to 91 years old). Assessment of frailty was based on the ‘Fried frailty phenotype’ criteria, including weight loss, grip strength, exhaustion, slowness and low physical activity. The study population was stratified into quartiles according to UACR levels. Age, body mass index, hypertension, diabetes, systolic blood pressure, insulin resistance, fasting glucose and high-sensitivity C-reactive protein levels were increased with the increment of UACR (P for trend <0.05). The prevalence of prefrailty/frailty and its components increased across the UACR quartiles. A multivariate stepwise logistic regression analysis revealed that UACR was independently associated with the likelihood of prefrailty/frailty (odds ratio 1.13, 95% CI 1.01–1.27). In conclusion, low-grade albuminuria is associated with the increased prevalence of prefrailty/frailty. PMID:28000719

  1. What Do Older People Learn from Young People? Intergenerational Learning in "Day Centre" Community Settings in Malta

    ERIC Educational Resources Information Center

    Spiteri, Damian

    2016-01-01

    This study analyses what motivates older people to attend "day centres" in Malta and what they believe that they derive from young people who carry out their placements at these day "centres" These young people, who are aged 16-17, attend a vocational college in Malta and are studying health and social care. The study is based…

  2. Perceptions of disaster preparedness among older people in South Korea.

    PubMed

    Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

    2016-03-01

    Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy.

  3. Attitudes towards caring for older people: literature review and methodology.

    PubMed

    Kydd, Angela; Wild, Deidre

    2013-04-01

    Care of older people is often referred to as a 'Cinderella' service and is not seen as an attractive career option in health care, but with the global population continuing to age, caring for this group will become increasingly important. This article outlines the literature that formed the basis for two studies investigating the attitudes of healthcare staff towards working with older people, including respondents' perceptions of other healthcare professionals' attitudes toward this important area of work. The Multifactorial Attitudes Questionnaire was designed to examine five major themes identified from the literature: ageism; learning environment; working environment; professional esteem; and specialist status. This study is presented in two parts: this article discusses the literature and the design of the questionnaire. The second article, to be published in a subsequent issue of the journal, presents the results from two studies done in Scotland, the first in 1999, with a replication study in 2009.

  4. Financial inequality and gender in older people.

    PubMed

    Vlachantoni, Athina

    2012-06-01

    Gender inequalities in the financial resources in later life result from the combined effect of women's atypical life courses, which include interrupted employment records and periods of care provision, and the fact that pension systems have generally been slow in mitigating 'diversions' from continuous and full-time working lives. Gender differentials in financial resources can often result in a greater likelihood of facing poverty for older women compared to older men, and such risk can be experienced for longer periods for women, as a result of their higher life expectancy on average. For example, across the EU-27, 16% of men compared to 23% of women aged 65 and over faced a poverty risk, and at age 65, men can expect to live another 17 years on average, while women another 21 years. Although modern pension systems are increasingly recognising the diversity of women's patterns of paid and unpaid work, for example by accounting for periods of childcare in the calculation of the state pension, research continues to show a 'penalty' for women who have spent significant periods of their life providing care to children or dependent adults in and outside the household. Reducing such penalty is particularly important as population ageing and an increasing demand for formal and informal care are likely to present challenges with critical policy implications for societies and individuals alike.

  5. Costs of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS).

    PubMed

    McNamee, P; Gregson, B A; Buck, D; Bamford, C H; Bond, J; Wright, K

    1999-02-01

    The aim of this paper is to quantify service use and costs of supporting frail older people at home in the community, using data collected in a longitudinal multicentre stratified randomised study for 1055 mentally frail, physically frail, and mentally and physically frail subjects. Average costs per person per week were found to total 64.45 Pounds Sterling, with a small number of services accounting for a large proportion of the total costs. The level of services offered by the nonstatutory voluntary and private sectors was found to be small. To highlight issues for policy makers, the extent of cost variations between a number of different subgroups were calculated. These bivariate analyses revealed substantial variation in costs, especially according to household structure, type of frailty, whether admission to continuing care accommodation occurred and survival. Multiple regression analysis demonstrated that 26% of the variation in log average weekly costs could be explained by a number of socio-demographic and health status variables. A particularly close relationship was observed between costs and whether admission to continuing care accommodation occurred, highlighting a need for policy-makers to examine the nature and scale of provision of alternative community based care packages. The results demonstrate that descriptive cost data such as those presented can provide information useful to the planning process, enabling more informed choices to be made over the provision of services for particular groups of people.

  6. Guidance on the management of pain in older people.

    PubMed

    Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat

    2013-03-01

    This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided

  7. How Do Family Caregivers of Older People Give Up Caregiving?

    PubMed Central

    Mortazavi, Hamed; Peyrovi, Hamid; Joolaee, Soodabeh

    2015-01-01

    Background Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. Methods A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Results Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Conclusion Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers. PMID:26171407

  8. Detection of mild cognitive impairment in people older than 65 years of age and its relationship to cardiovascular risk factors (DECRIVAM)

    PubMed Central

    2011-01-01

    Background Studies centered on the detection of cognitive impairment and its relationship to cardiovascular risk factors in elderly people have gained special relevance in recent years. Knowledge of the cardiovascular risk factors that may be associated to cognitive impairment could be very useful for introducing treatments in early stages - thereby possibly contributing to improve patient quality of life. The present study explores cognitive performance in people over 65 years of age in Salamanca (Spain), with special emphasis on the identification of early symptoms of cognitive impairment, with the purpose of detecting mild cognitive impairment and of studying the relationships between this clinical situation and cardiovascular risk factors. Methods/Design A longitudinal study is contemplated. The reference population will consist of 420 people over 65 years of age enrolled through randomized sampling stratified by healthcare area, and who previously participated in another study. Measurement: a) Sociodemographic variables; b) Cardiovascular risk factors; c) Comorbidity; d) Functional level for daily life activities; and e) Study of higher cognitive functions based on a neuropsychological battery especially adapted to the evaluation of elderly people. Discussion We hope that this study will afford objective information on the representative prevalence of cognitive impairment in the population over 65 years of age in Salamanca. We also hope to obtain data on the relationship between cognitive impairment and cardiovascular risk factors in this specific population group. Based on the results obtained, we also will be able to establish the usefulness of some of the screening tests applied during the study, such as the Mini-Mental State Examination and the 7 Minute Screen test. Trial registration ClinicalTrials.gov: NCT01327196 PMID:21708036

  9. The Problems of Vitamin D Insufficiency in Older People

    PubMed Central

    Boucher, Barbara J

    2012-01-01

    This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and low-impact fractures. Vitamin D is provided by skin synthesis by UVB-irradiation from summer sunshine and to a small extent by absorption from food. However, these processes become less efficient with age. Loss of mobility or residential care restricts solar exposure. Reduced appetite and financial problems often add to these problems. Thus, hypovitaminosis D is common world-wide, but is more common and more severe in older people. Non-classical effects of vitamin D, depending on serum circulating 25-hydroxyvitamin D concentrations, are present in most non-bony tissues; disorders associated with hypovitaminosis D include increased risks of sepsis [bacterial, mycobacterial and viral], cardiovascular and metabolic disorders [e.g. hyperlipidemia, type 2 diabetes mellitus, acute vascular events, dementia, stroke and heart failure]. Many cancer risks are associated with vitamin D inadequacy, though causality is accepted only for colo-rectal cancer. Maintenance of repletion in healthy older people requires intakes of ≥800IU/day [20μg], as advised by the Institute of Medicine [IOM], but achieving such intakes usually requires supplementation. Excessive intakes are dangerous, especially in undiagnosed primary hyperparathyroidism or sarcoidosis, but the IOM finds doses <4000 IU/day are safe. Many experts suggest that ≥1000–2000 IU [25–50μg] of vitamin D daily is necessary for older people, especially when independence is lost, or hypovitaminosis D could add to the clinical problem[s]. Much higher doses than these are needed for treatment of established deficiency or insufficiency. PMID:23185713

  10. Hair cortisol and cognitive performance in healthy older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia

    2014-06-01

    Worse cognitive performance in older people has been associated with hypothalamic-pituitary-adrenal axis dysregulation (in particular, higher cortisol levels). Analysis of hair cortisol concentrations (HCC) is a novel method to measure long-term cortisol exposure, and its relationship with cognition in healthy older people has not yet been studied. We investigated whether HCC (measured in hair scalp) and diurnal salivary cortisol levels (awakening, 30min after awakening, and evening, across two days) were related to cognitive performance (assessed with the Trail-making Test A and B, Digit Span Forward and Backward, word list-RAVLT and Stories subtest of the Rivermead) in 57 healthy older people (mean age=64.75 years, SD=4.17). Results showed that lower HCC were consistently related to worse working memory, learning, short-term verbal memory (RAVLT first trial and immediate recall) and long-term verbal memory. In contrast, higher mean levels and higher diurnal area under the curve of diurnal salivary cortisol were related to worse attention and short-term verbal memory (immediate story recall), respectively. Interestingly, a higher ratio of mean levels of diurnal salivary cortisol over HCC were related to worse performance on working memory and short-term verbal memory, suggesting that those individuals with lower long-term cortisol exposure might be more vulnerable to the negative effect of HPA-axis dysregulation on these cognitive processes. Our findings suggest that both low long-term cortisol exposure and a possible dysregulation of the diurnal rhythm of the HPA-axis may account, at least in part, for the inter-individual variability in cognitive performance in healthy older people.

  11. Learning Choices, Older Australians and Active Ageing

    ERIC Educational Resources Information Center

    Boulton-Lewis, Gillian M.; Buys, Laurie

    2015-01-01

    This paper reports on the findings of qualitative, semistructured interviews conducted with 40 older Australian participants who either did or did not engage in organized learning. Phenomenology was used to guide the interviews and analysis to explore the lived learning experiences and perspectives of these older people. Their experiences of…

  12. Genome-wide Studies of Verbal Declarative Memory in Nondemented Older People: The Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium

    PubMed Central

    Debette, Stéphanie; Ibrahim Verbaas, Carla A.; Bressler, Jan; Schuur, Maaike; Smith, Albert; Bis, Joshua C.; Davies, Gail; Wolf, Christiane; Gudnason, Vilmundur; Chibnik, Lori B.; Yang, Qiong; deStefano, Anita L.; de Quervain, Dominique J.F.; Srikanth, Velandai; Lahti, Jari; Grabe, Hans J.; Smith, Jennifer A.; Priebe, Lutz; Yu, Lei; Karbalai, Nazanin; Hayward, Caroline; Wilson, James F.; Campbell, Harry; Petrovic, Katja; Fornage, Myriam; Chauhan, Ganesh; Yeo, Robin; Boxall, Ruth; Becker, James; Stegle, Oliver; Mather, Karen A.; Chouraki, Vincent; Sun, Qi; Rose, Lynda M.; Resnick, Susan; Oldmeadow, Christopher; Kirin, Mirna; Wright, Alan F.; Jonsdottir, Maria K.; Au, Rhoda; Becker, Albert; Amin, Najaf; Nalls, Mike A.; Turner, Stephen T.; Kardia, Sharon L.R.; Oostra, Ben; Windham, Gwen; Coker, Laura H.; Zhao, Wei; Knopman, David S.; Heiss, Gerardo; Griswold, Michael E.; Gottesman, Rebecca F.; Vitart, Veronique; Hastie, Nicholas D.; Zgaga, Lina; Rudan, Igor; Polasek, Ozren; Holliday, Elizabeth G.; Schofield, Peter; Choi, Seung Hoan; Tanaka, Toshiko; An, Yang; Perry, Rodney T.; Kennedy, Richard E.; Sale, Michèle M.; Wang, Jing; Wadley, Virginia G.; Liewald, David C.; Ridker, Paul M.; Gow, Alan J.; Pattie, Alison; Starr, John M.; Porteous, David; Liu, Xuan; Thomson, Russell; Armstrong, Nicola J.; Eiriksdottir, Gudny; Assareh, Arezoo A.; Kochan, Nicole A.; Widen, Elisabeth; Palotie, Aarno; Hsieh, Yi-Chen; Eriksson, Johan G.; Vogler, Christian; van Swieten, John C.; Shulman, Joshua M.; Beiser, Alexa; Rotter, Jerome; Schmidt, Carsten O.; Hoffmann, Wolfgang; Nöthen, Markus M.; Ferrucci, Luigi; Attia, John; Uitterlinden, Andre G.; Amouyel, Philippe; Dartigues, Jean-François; Amieva, Hélène; Räikkönen, Katri; Garcia, Melissa; Wolf, Philip A.; Hofman, Albert; Longstreth, W.T.; Psaty, Bruce M.; Boerwinkle, Eric; DeJager, Philip L.; Sachdev, Perminder S.; Schmidt, Reinhold; Breteler, Monique M.B.; Teumer, Alexander; Lopez, Oscar L.; Cichon, Sven; Chasman, Daniel I.; Grodstein, Francine; Müller-Myhsok, Bertram; Tzourio, Christophe; Papassotiropoulos, Andreas; Bennett, David A.; Ikram, Arfan M.; Deary, Ian J.; van Duijn, Cornelia M.; Launer, Lenore; Fitzpatrick, Annette L.; Seshadri, Sudha; Mosley, Thomas H.

    2015-01-01

    BACKGROUND Memory performance in older persons can reflect genetic influences on cognitive function and dementing processes. We aimed to identify genetic contributions to verbal declarative memory in a community setting. METHODS We conducted genome-wide association studies for paragraph or word list delayed recall in 19 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, comprising 29,076 dementia-and stroke-free individuals of European descent, aged ≥45 years. Replication of suggestive associations (p < 5 × 10−6) was sought in 10,617 participants of European descent, 3811 African-Americans, and 1561 young adults. RESULTS rs4420638, near APOE, was associated with poorer delayed recall performance in discovery (p = 5.57 × 10−10) and replication cohorts (p = 5.65 × 10−8). This association was stronger for paragraph than word list delayed recall and in the oldest persons. Two associations with specific tests, in subsets of the total sample, reached genome-wide significance in combined analyses of discovery and replication (rs11074779 [HS3ST4], p = 3.11 × 10−8, and rs6813517 [SPOCK3], p = 2.58 × 10−8) near genes involved in immune response. A genetic score combining 58 independent suggestive memory risk variants was associated with increasing Alzheimer disease pathology in 725 autopsy samples. Association of memory risk loci with gene expression in 138 human hippocampus samples showed cis-associations with WDR48 and CLDN5, both related to ubiquitin metabolism. CONCLUSIONS This largest study to date exploring the genetics of memory function in ~ 40,000 older individuals revealed genome-wide associations and suggested an involvement of immune and ubiquitin pathways. PMID:25648963

  13. Effects of digital engagement on the quality of life of older people.

    PubMed

    Damant, Jacqueline; Knapp, Martin; Freddolino, Paul; Lombard, Daniel

    2016-02-25

    It is often asserted that older people's quality of life (QOL) is improved when they adopt information and communication technology (ICT) such as the Internet, mobile phones and computers. Similar assumptions are made about older people's use of ICT-based care such as telecare and telehealth. To examine the evidence around these claims, we conducted a scoping review of the academic and grey literature, coving the period between January 2007 and August 2014. A framework analysis approach, based on six domains of QOL derived from the ASCOT and WHOQOL models, was adopted to deductively code and analyse relevant literature. The review revealed mixed results. Older people's use of ICT in both mainstream and care contexts has been shown to have both positive and negative impacts on several aspects of QOL. Studies which have rigorously assessed the impact of older people's use of ICT on their QOL mostly demonstrate little effect. A number of qualitative studies have reported on the positive effects for older people who use ICT such as email or Skype to keep in touch with family and friends. Overall, the review unearthed several inconsistencies around the effects of older people's ICT use on their QOL, suggesting that implicit agreement is needed on the best research methods and instrumentation to adequately describe older people's experiences in today's digital age. Moreover, the available evidence does not consider the large number of older people who do not use ICT and how non-use affects QOL.

  14. Physical Activity among Older People Living Alone in Shanghai, China

    ERIC Educational Resources Information Center

    Chen, Yu; While, Alison E; Hicks, Allan

    2015-01-01

    Objective: To investigate physical activity among older people living alone in Shanghai, People's Republic of China, and key factors contributing to their physical activity. Methods: A cross-sectional questionnaire survey was administered in nine communities in Shanghai, using a stratified random cluster sample: 521 community-dwelling older people…

  15. Media portrayal of older people as illustrated in Finnish newspapers

    PubMed Central

    Koskinen, Sanna; Salminen, Leena; Leino-Kilpi, Helena

    2014-01-01

    Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray older people in society, using Finland as an example. The data consist of articles selected from three of the main Finnish daily newspapers during a 3-month period in the spring of 2012. The findings show that, overall, the society regards older people and their care as important. However, there were suggestions of paternalistic attitudes towards older people. Furthermore, the perceptions regarding different groups of older people could lead to the possibility of inequality. The media portrayals of older people worldwide seem to share similarities, although the findings of this study are particularly in accordance with the cultural attributes of the Nordic countries and societies. PMID:25261872

  16. Intersectoral interagency partnerships to promote financial capability in older people.

    PubMed

    Hean, Sarah; Fenge, Lee Ann; Worswick, Louise; Wilkinson, Charlie; Fearnley, Stella

    2012-09-01

    From the second quarter of 2008, the UK economy entered a period of economic decline. Older people are particularly vulnerable during these times. To promote ways in which older people can be better supported to maintain their financial well-being, this study explored the sources older people utilize to keep themselves financially informed. Interviews with older people (n = 28) showed that older people access trusted sources of information (e.g. healthcare professionals) rather than specialist financial information providers (e.g. financial advisors) which highlighted the need for interagency working between financial services in the private, public and voluntary sectors. An example of how such interagency partnerships might be achieved in practice is presented with some recommendations on directions for future research into interagency working that spans public, private and voluntary sectors.

  17. Omega 3 fatty acids and cognitive health in older people.

    PubMed

    Dangour, Alan D; Andreeva, Valentina A; Sydenham, Emma; Uauy, Ricardo

    2012-06-01

    Oily fish and other sources of long-chain n-3 polyunsaturated fatty acids (n-3 LCPs) have been proposed as protective against dementia and age related cognitive impairment. The basic mechanisms underlying these proposed benefits have been postulated and experimental studies supporting the plausibility of the putative effects have been published. Observational epidemiological and case control studies also largely support a protective role of fish consumption on cognitive function with advancing age, albeit with important unexplained heterogeneity in findings. In this review we report the findings of the latest Cochrane review on the benefits of n-3 LCP supplementation on cognitive function among cognitively healthy older people and expand the review by including trials conducted with individuals with prevalent poor cognitive function or dementia. We identified seven relevant trials, four among cognitively healthy older people, and three among individuals with pre-existing cognitive decline or dementia, and overall conclude that there is no evidence to support the routine use of n-3 LCPs supplements for the prevention, or amelioration, of cognitive decline in later life. We identified several challenges in the design of intervention studies for the prevention of dementia and cognitive decline in older people that require careful consideration especially in recruitment and retention in long-term trials. Whether the lack of agreement in findings from mechanistic and observational data and from intervention studies reflects a real absence of benefit on cognitive function from n-3 LCP supplementation, or whether it reflects intrinsic limitations in the design of published studies remains open to question.

  18. Mental health issues and discrimination among older LGBTI people.

    PubMed

    Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine

    2015-09-01

    LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people.

  19. Food safety and older people: the Kitchen Life study.

    PubMed

    Dickinson, Angela; Wills, Wendy; Meah, Angela; Short, Frances

    2014-05-01

    Foodborne illness (FBI) is a major public health problem in the UK. Recent increases in cases of listeriosis in older people have focused attention on consumer food-related practices. Previous studies highlight poor relationships between what people know, what they say they do and what they actually do in the kitchen. The aim of the Kitchen Life study was to examine what actually happens in the domestic kitchen to assess whether and how this has the potential to influence food safety in the home. Drawing on a qualitative ethnographic approach, methods included a kitchen tour, photography, observation, video observation, informal interviews and diary methods. Ten households with older people (aged 60+) were recruited across the UK. It was found that trust in the food supply, use of food-labelling (including use-by dates), sensory logics (such as the feel or smell of food) and food waste were factors with the potential to influence risk of foodborne illness. Practices shifted with changing circumstances, including increased frailty, bereavement, living alone, receiving help with care and acquiring new knowledge, meaning that the risk of and vulnerability to foodborne illness is not straightforward.

  20. 'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

    PubMed

    Grenier, Amanda; Sussman, Tamara; Barken, Rachel; Bourgeois-Guérin, Valerie; Rothwell, David

    2016-01-01

    Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

  1. Perceived age discrimination in older adults

    PubMed Central

    Rippon, Isla; Kneale, Dylan; de Oliveira, Cesar; Demakakos, Panayotes; Steptoe, Andrew

    2014-01-01

    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

  2. Older people's views of a good death in heart failure: implications for palliative care provision.

    PubMed

    Gott, M; Small, Neil; Barnes, Sarah; Payne, Sheila; Seamark, David

    2008-10-01

    Palliative care in the UK has been developed to meet the needs of predominantly middle aged and younger old people with cancer. Few data are available regarding the extent to which services respond to the specific needs of an older group of people with other illnesses. This paper draws on in-depth interviews conducted with 40 people (median age 77) with advanced heart failure and poor prognosis to explore the extent to which older people's views and concerns about dying are consistent with the prevalent model of the 'good death' underpinning palliative care delivery. That prevalent model is identified as the "revivalist" good death. Our findings indicate that older people's views of a 'good death' often conflict with the values upon which palliative care is predicated. For example, in line with previous research, many participants did not want an open awareness of death preceded by acknowledgement of the potential imminence of dying. Similarly, concepts of autonomy and individuality appeared alien to most. Indeed, whilst there was evidence that palliative care could help improve the end of life experiences of older people, for example in initiating discussions around death and dying, the translation of other aspects of specialist palliative care philosophy appear more problematic. Ultimately, the study identified that improving the end of life experiences of older people must involve addressing the problematised nature of ageing and old age within contemporary society, whilst recognising the cohort and cultural effects that influence attitudes to death and dying.

  3. Powerlessness of older people in Hong Kong: a political economy analysis.

    PubMed

    Kam, Ping-kwong

    2003-01-01

    Gerontologists agree that old age can be associated with an increase in powerlessness both in the personal domain and in the social and political fields. This paper is an attempt to understand the concept of powerlessness in old age within a political economy theoretical framework. The paper argues that the powerlessness of older people is not biologically determined. Rather, it is socially constructed. It has its roots in the social, economic, and political structure of society. For this reason, the paper argues that (a) the capitalist economic system discriminates against and marginalizes older people in the labor market. The current unfavorable economic climate will make the economic situation of older people worse. (b) The residual welfare system does not counteract the unfavorable impact of the economic system. Rather, it deprives older people of the necessary financial resources and social service supports that would enable them to lead independent and dignified lives. (c) The authoritarian political system creates adverse conditions that make it very difficult for older people to participate in the decision-making process on issues that affect their lives, as well as on broader political issues that affect the whole of society. It is the interplay among these economic, social, and political forces in Hong Kong that creates the political economy of powerlessness in old age and prevents older people from using their powers to master and control their lives.

  4. [Dissertations 25 year after date 41. Older people's adaptability].

    PubMed

    de Baat, C; Gerritsen, A E; van der Putten, G J; van der Maarel-Wierink, C D

    2015-09-01

    In 1990, the thesis 'Removable complete dentures in older people, an issue dealing with adaptability?' was published. Among other things, this thesis aimed at finding a method of measuring older people's adaptability to removable complete dentures. Its conclusion was that a subscale of the "Beoordelingsschaal voor Oudere Patiënten" (Rating scale for older patients) had predictive value. Subsequently, only a few research projects on this topic have been carried out. They dealt with demonstrated adaptation achieved after treatment, the realised adaptation. The results were disappointing. Ever since the availability of endosseous oral implants, research into adaptability to conventional removable complete dentures seems less relevant. During the last decades, inquiries into a method of measuring treatment effectiveness has focused on older people's quality of life and general health condition. However, to assess with respect to oral health care an older person's general health condition and load-taking capacity adequately, some experience is indispensable.

  5. Minimising barriers to dental care in older people

    PubMed Central

    Borreani, Elena; Wright, Desmond; Scambler, Sasha; Gallagher, Jennifer E

    2008-01-01

    Background Older people are increasingly retaining their natural teeth but at higher risk of oral disease with resultant impact on their quality of life. Socially deprived people are more at risk of oral disease and yet less likely to take up care. Health organisations in England and Wales are exploring new ways to commission and provide dental care services in general and for vulnerable groups in particular. This study was undertaken to investigate barriers to dental care perceived by older people in socially deprived inner city area where uptake of care was low and identify methods for minimising barriers in older people in support of oral health. Methods A qualitative dual-methodological approach, utilising both focus groups and individual interviews, was used in this research. Participants, older people and carers of older people, were recruited using purposive sampling through day centres and community groups in the inner city boroughs of Lambeth, Southwark and Lewisham in South London. A topic guide was utilised to guide qualitative data collection. Informants' views were recorded on tape and in field notes. The data were transcribed and analysed using Framework Methodology. Results Thirty-nine older people and/or their carers participated in focus groups. Active barriers to dental care in older people fell into five main categories: cost, fear, availability, accessibility and characteristics of the dentist. Lack of perception of a need for dental care was a common 'passive barrier' amongst denture wearers in particular. The cost of dental treatment, fear of care and perceived availability of dental services emerged to influence significantly dental attendance. Minimising barriers involves three levels of action to be taken: individual actions (such as persistence in finding available care following identification of need), system changes (including reducing costs, improving information, ensuring appropriate timing and location of care, and good patient

  6. Reluctant Learners: Social Work Students and Work with Older People.

    ERIC Educational Resources Information Center

    Quinn, Ann

    2000-01-01

    Studies show that social work students prefer work with children and families over older people. The Repertory Grid Technique was used with 13 students to provide a structure for reflection on attitudes. Dialog about work with older adults was stimulated. (SK)

  7. Older People as a Developing Market for Cultural Heritage Sites

    ERIC Educational Resources Information Center

    Hansen, Anna; Zipsane, Henrik

    2014-01-01

    Is it morally acceptable for the heritage sector to see the growing population of senior citizens as a developing market? Jamtli is an open air museum in the north of Sweden. The main target group is families with children, but an increasing number of activities for older adults are being offered. The growing population of older people is a…

  8. Epidemiology of Falls in Older Age

    ERIC Educational Resources Information Center

    Peel, Nancye May

    2011-01-01

    Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and fall-related injuries and the impact of…

  9. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    PubMed

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (p<0.05). Among 10 subjects, one scored 1-3 using the four evaluation criteria. Overall, no aspiration occurred and a significant improvement in the swallowing function score was observed (p<0.05) after taking the ginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

  10. Considering the benefits of egg consumption for older people at risk of sarcopenia.

    PubMed

    Smith, Alison; Gray, Juliet

    2016-06-01

    Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia.

  11. People with Intellectual Disabilities Living in Generic Residential Services for Older People in the UK

    ERIC Educational Resources Information Center

    Thompson, D. J.; Ryrie, I.; Wright, S.

    2004-01-01

    Background: As part of a UK programme of work focusing on older people with intellectual disabilities, the circumstance of those who reside in generic services for older people were investigated. Materials and methods: Questionnaires were sent to 2570 residential and nursing homes in 53 local authorities across the UK. Results: Five hundred and…

  12. Are Young People Biased against Older Teachers?

    ERIC Educational Resources Information Center

    Peterson, Candida C.

    1980-01-01

    Elementary school students and university students indicated they preferred younger male and female (under 35) to older teachers. Personality and competence were given as reasons for their preferences by sixth graders and university students. Younger children gave no explanation nor did they indicate teacher appearance or resemblance to well-known…

  13. Older People with Visual Impairment: Clinical Management and Care Watkinson Susan Older People with Visual Impairment: Clinical Management and Care 176pp £25 M&K Publishing 9781905539451 1905539452 [Formula: see text].

    PubMed

    2014-09-01

    ISSUES SURROUNDING the diagnosis, care and treatment of older people with visual impairment are examined in this book. It begins with a useful overview of ageing and the needs of older people. The second chapter considers demographics and health policy and care post-Francis and the chief nursing officer for England's strategy for compassionate care, including the 6Cs.

  14. Ageing and People with Learning Disabilities: In Search of Evidence

    ERIC Educational Resources Information Center

    Walker, Carol

    2015-01-01

    Background: Growing numbers of people with learning disabilities are now living into older age. This study aims to examine the state of knowledge about their lives and the challenges that ageing has for both family carers and policymakers and practitioners. Materials and Methods: The article synthesises existing research in the fields of learning…

  15. Factors associated with variations in older people's use of community-based continence services.

    PubMed

    Peters, Tim J; Horrocks, Sue; Stoddart, Helen; Somerset, Maggie

    2004-01-01

    Many people who have urinary incontinence and who may benefit from healthcare and professional advice do not currently access UK National Health Service services, even though effective treatments are available in the community. Older people have an increased prevalence of incontinence and a correspondingly increased need for continence services. Therefore, increasing older people's access to continence services has the potential to reduce inequalities and improve quality of life. The present study aimed to identify older people with urinary incontinence living in the community, to describe and compare the characteristics of users and non-users of continence services, and to identify factors which prevent older people seeking help. A cross-sectional postal survey of patients aged over 65 years registered with four general practices in an urban area found an overall prevalence of 39% of older people with urinary incontinence, only 15% of whom had accessed services. Two-thirds of respondents who reported that they experienced urinary leakage several times per week to all the time, and up to two-thirds of those reporting leakage of moderate or large volumes of leakage had not accessed services. The majority of older people are in regular contact with health professionals, and the greatest single influence on use of services was that of being asked whether there were continence problems by a health professional. Being married or having a partner, experiencing less pain generally, and suffering relatively high frequency and volumes of urinary leakage also appeared to be associated independently with continence service use. In conclusion, there appears to be considerable unmet need for continence services. Health professionals should be aware that incontinence is an important health problem for older people, and by asking older people specifically about urinary leakage, they could reduce inequalities in use of services.

  16. Older People Who Stutter: Barriers to Communication and Perceptions of Treatment Needs

    ERIC Educational Resources Information Center

    Bricker-Katz, Geraldine; Lincoln, Michelle; McCabe, Patricia

    2010-01-01

    Background: Little is known about the experience of stuttering for people over 55 years of age. Recent research has established that the same types of stuttering behaviours, cognitions, and emotional consequences experienced during young adulthood persist into older age. Aims: The aims were to investigate perceptions of limitations to activity and…

  17. Mental Health and Social Care Needs of Older People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Strydom, Andre; Hassiotis, Angela; Livingston, Gill

    2005-01-01

    Background: Older people with intellectual disabilities (ID) are a growing population but their age-related needs are rarely considered and community services are still geared towards the younger age group. We aimed to examine the mental health and social care needs of this new service user group. Methods: We identified all adults with ID without…

  18. Perception of vulnerability to HIV infection among older people in Nairobi, Kenya: a need for intervention.

    PubMed

    Chepngeno-Langat, Gloria

    2013-03-01

    It is evident that sexual activity tends to decrease with age. Nonetheless, it is still prevalent enough to be considered a risk factor for the spread of HIV among older people. This paper uses quantitative data for 2053 individuals to examine HIV risk perception and correlates of perceived risk among older people aged 50 years and older living in Nairobi slums. It emerged that a majority of older people did not consider themselves at risk of infection. Of those who felt at risk, a greater proportion sensed only a small chance of contracting HIV. Women cited 'no sexual activity' while men mentioned 'having only one and/or a faithful sexual partner' as the primary reasons for perceiving minimal risk of HIV infection. There were no differences by sex in the basis for perceiving moderate-to-great risk of infection. Religion is a key factor in risk perception with Muslims perceiving higher levels of risk and, conversely, devotees irrespective of faith perceiving lower levels of risk. Older people willing to be tested for HIV had a decreased likelihood of perceived risk compared with those unwilling to be tested. This paper recommends evaluation of older people's perception of risk in order to better inform interventions aimed at minimizing their vulnerability to HIV infection.

  19. Middle-Aged and Older Adult Health Care Selection.

    PubMed

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L

    2017-04-01

    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.

  20. The disaster flood experience: Older people's poetic voices of resilience.

    PubMed

    Miller, Evonne; Brockie, Lauren

    2015-08-01

    This paper explores the experiences of older community-dwelling Australians evacuated from their homes during the 2011 and 2013 Queensland floods, applying the novel creative methodology of poetic inquiry as an analysis and interpretative tool. As well as exploring how older adults managed during a natural disaster, the paper documents the process and potential of poetic inquiry in gerontological research. The first and second poems highlight the different social resources older people have to draw on in their lives, especially during a crisis. Poem 1 ("Nobody came to help me") illustrates how one older resident felt all alone during the flood, whereas Poem 2 ("They came from everywhere"), Poem 3 ("The Girls") and Poem 5 ("Man in Blue Shirt") shows how supported--from both family and the wider community--other older residents felt. Poem 4 ("I can't swim") highlights one participant's fear as the water rises. To date, few studies have explicitly explored older adult's disaster experience, with this paper the first to utilise a poetic lens. We argue that poetic presentation enhances understanding of older residents' unique experiences during a disaster, and may better engage a wider audience of policy-makers, practitioners, the general community and older people themselves in discussion about, and reflection on, the impact and experience of disasters.

  1. Social network characteristics and salivary cortisol in healthy older people.

    PubMed

    Lai, Julian C L; Chong, Alice M L; Siu, Oswald T; Evans, Phil; Chan, Cecilia L W; Ho, Rainbow T H

    2012-01-01

    Psychobiological research on aging in humans has been confounded by individual differences that have not been adequately characterized in the literature. This paper is an attempt to shed light on this issue by examining the impact of social network characteristics predictive of successful aging on salivary cortisol among 78 older Chinese people in Hong Kong. Eight salivary cortisol samples were collected each day for two consecutive days from immediately after awakening to 12 hours later. Two components of the cortisol diurnal cycle, response to awakening and diurnal decline, were examined in relation to social network characteristics including size, emotional support, and cultivation. ANOVAs with repeated measured were run to examine influences of the three social network characteristics on the cortisol awakening response and diurnal decline, with the effects of gender, age, socioeconomic status, and waking time controlled. Results indicated that those who spent more time and effort in developing and strengthening their social ties (i.e., those high in "cultivation") exhibited a significantly greater rise in cortisol in the morning and a significantly steeper decline over the day, thus attesting to more effective activation and deactivation of the HPA axis. Network cultivation reflected a positive motivation to nurture social relationships more than the other two network characteristics. Its effect on cortisol might stem from the positivity underlying the motivation.

  2. Families, social life, and well-being at older ages.

    PubMed

    Waite, Linda; Das, Aniruddha

    2010-01-01

    As people age, many aspects of their lives tend to change, including the constellation of people with whom they are connected, their social context, their families, and their health--changes that are often interrelated. Wave I of the National Social Life, Health, and Aging Project (NSHAP) has yielded rich information on intimate ties, especially dyads and families, and on social connections generally. Combined with extensive biological and other health measures, NSHAP enables researchers to address key questions on health and aging. We begin with recent findings on intimate dyads, then move to social participation, and finally to elder mistreatment. Among dyads, we find that whereas sexual activity drops sharply with age for both women and men, gender differences in partner loss as well as psychosocial and normative pressures constrain women's sex more than men's. However, surviving partnerships tend to be emotionally and physically satisfying and are marked by relatively frequent sex. In contrast to sex, nonsexual intimacy is highly prevalent at older ages, especially among women. Older adults are also socially resilient--adapting to the loss of social ties by increasing involvement with community and kin networks. Despite these social assets, older adults remain vulnerable to mistreatment. Overall, these findings yield a mixed picture of gender-differentiated vulnerabilities balanced by proactive adaptation and maintenance of social and dyadic assets.

  3. Optimizing footwear for older people at risk of falls.

    PubMed

    Menant, Jasmine C; Steele, Julie R; Menz, Hylton B; Munro, Bridget J; Lord, Stephen R

    2008-01-01

    Footwear influences balance and the subsequent risk of slips, trips, and falls by altering somatosensory feedback to the foot and ankle and modifying frictional conditions at the shoe/floor interface. Walking indoors barefoot or in socks and walking indoors or outdoors in high-heel shoes have been shown to increase the risk of falls in older people. Other footwear characteristics such as heel collar height, sole hardness, and tread and heel geometry also influence measures of balance and gait. Because many older people wear suboptimal shoes, maximizing safe shoe use may offer an effective fall prevention strategy. Based on findings of a systematic literature review, older people should wear shoes with low heels and firm slip-resistant soles both inside and outside the home. Future research should investigate the potential benefits of tread sole shoes for preventing slips and whether shoes with high collars or flared soles can enhance balance when challenging tasks are undertaken.

  4. Care for suicidal older people: current clinical–ethical considerations

    PubMed Central

    Vanlaere, Linus; Bouckaert, Filip; Gastmans, Chris

    2007-01-01

    This article opens by reviewing the state of the knowledge on the most current worldwide facts about suicide in older people. Next, a number of values that have a role in this problem are considered. Having a clear and current understanding of suicide and of the related self‐held and social values forms the framework for a number of clinical–ethical recommendations for care practice. An important aspect of caring for older people with suicidal tendencies is to determine whether their primary care fosters self‐esteem and affirms their dignity. In addition to providing a timely and appropriate diagnosis and treatment of suicidality, the caregiver is responsible for helping the patient to cope with stressful conditions, and for treating the patient with respect and consideration, thereby supporting the patient's dignity and giving the patient a reason to live. Paying attention to these central points will foster caring contact with suicidal older people. PMID:17601861

  5. Diagnosis, prevention and treatment of urinary tract infections in older people.

    PubMed

    Bardsley, Alison

    2017-02-28

    Urinary tract infections (UTIs) are common in older people, with the prevalence increasing with age in both sexes. UTI is a frequent reason for emergency admission to hospital. There are many conditions that contribute to older people being more at risk of UTI and the main preventive strategy is to avoid the use of indwelling urethral catheters. Where an indwelling catheter is inserted its continued use should be regularly reviewed and the catheter removed, especially if the reason for insertion is incontinence and the person becomes additionally incontinent of faeces. Diagnosis of UTI can be complex because older people do not always exhibit the signs and symptoms commonly associated with UTI. Diagnosis can be further complicated by a person's inability to provide a comprehensive history and by difficulties obtaining an uncontaminated, 'clean catch' urine specimen. Antibiotic therapy should not be used routinely for people with asymptomatic bacteriuria and, where antibiotics are required, healthcare professionals should follow local prescribing guidelines.

  6. Advertising Representations of Older People in the United Kingdom and Taiwan: A Comparative Analysis.

    PubMed

    Chen, Chin-Hui

    2015-01-01

    Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline.

  7. Measuring the value of older people's production: a diary study

    PubMed Central

    2012-01-01

    Background The productive capacity of retired people is usually not valued. However, some retirees produce much more than we might expect. This diary-based study identifies the activities of older people, and suggests some value mechanisms. One question raised is whether it is possible to scale up this diary study into a larger representative study. Methods Diaries kept for one week were collected among 23 older people in the north of Sweden. The texts were analysed with a grounded theory approach; an interplay between ideas and empirical data. Results Some productive activities of older people must be valued as the opportunity cost of time or according to the market value, and others must be valued with the replacement cost. In order to make the choice between these methods, it is important to consider the societal entitlement. When there is no societal entitlement, the first or second method must be used; and when it exists, the third must be used. Conclusions An explicit investigation of the content of the entitlement is needed to justify the choice of valuation method for each activity. In a questionnaire addressing older people's production, each question must be adjusted to the type of production. In order to fully understand this production, it is important to consider the degree of free choice to conduct an activity, as well as health-related quality of life. PMID:22230745

  8. Older people in the field of medication.

    PubMed

    2002-07-01

    Focus group methodology is becoming ever more popular in healthcare research. In this Finnish study, five focus group discussions were conducted with a total of 34 participants whose ages ranged from 65 to 85. Each group was facilitated by two researchers and the discussions were tape-recorded. Analysis of the data employed the concepts developed by Pierre Bourdieu.

  9. Protective factors in patients aged over 65 with stroke treated by physiotherapy, showing cognitive impairment, in the Valencia Community. Protection Study in Older People (EPACV)

    PubMed Central

    2012-01-01

    Background Family function may have an influence on the mental health deterioration of the caregivers of dependent family members and it could have a varying importance on the care of dependents. Little attention has been paid to the preparation of minor stroke survivors for the recovery trajectory or the spouse for the caregiving role. Therefore, this study protocol intends to analyze the influence of family function on the protection of patients with stroke sequels needing physiotherapy in the family environment. Methods/Design This is an analytical observational design, prospective cohort study and using a qualitative methodology by means of data collected in the “interviews of life”. The study will be carried out by the Rehabilitation Service at Hospital of Elda in the Valencia Community. All patients that have been diagnosed with stroke and need physiotherapy treatment, having a dependency grade assigned and consent to participate in the study, will undergo a monitoring of one year in order to assess the predictive factors depending on the dependence of the people affected. Discussion Our research aims to analyze the perception of caregivers, their difficulties to work, and the influence of family function. Moreover, it aims to register the perception of the patients with stroke sequel over the care received and whether they feel protected in their family environment. PMID:23039063

  10. Revisiting the role of neighbourhood change in social exclusion and inclusion of older people.

    PubMed

    Burns, Victoria F; Lavoie, Jean-Pierre; Rose, Damaris

    2012-01-01

    Objective. To explore how older people who are "aging in place" are affected when the urban neighbourhoods in which they are aging are themselves undergoing socioeconomic and demographic change. Methods. A qualitative case study was conducted in two contrasting neighbourhoods in Montréal (Québec, Canada), the analysis drawing on concepts of social exclusion and attachment. Results. Participants express variable levels of attachment to neighbourhood. Gentrification triggered processes of social exclusion among older adults: loss of social spaces dedicated to older people led to social disconnectedness, invisibility, and loss of political influence on neighbourhood planning. Conversely, certain changes in a disadvantaged neighbourhood fostered their social inclusion. Conclusion. This study thus highlights the importance of examining the impacts of neighbourhood change when exploring the dynamics of aging in place and when considering interventions to maintain quality of life of those concerned.

  11. Revisiting the Role of Neighbourhood Change in Social Exclusion and Inclusion of Older People

    PubMed Central

    Burns, Victoria F.; Lavoie, Jean-Pierre; Rose, Damaris

    2012-01-01

    Objective. To explore how older people who are “aging in place” are affected when the urban neighbourhoods in which they are aging are themselves undergoing socioeconomic and demographic change. Methods. A qualitative case study was conducted in two contrasting neighbourhoods in Montréal (Québec, Canada), the analysis drawing on concepts of social exclusion and attachment. Results. Participants express variable levels of attachment to neighbourhood. Gentrification triggered processes of social exclusion among older adults: loss of social spaces dedicated to older people led to social disconnectedness, invisibility, and loss of political influence on neighbourhood planning. Conversely, certain changes in a disadvantaged neighbourhood fostered their social inclusion. Conclusion. This study thus highlights the importance of examining the impacts of neighbourhood change when exploring the dynamics of aging in place and when considering interventions to maintain quality of life of those concerned. PMID:22013528

  12. Emergency care for older people in India.

    PubMed

    Goel, Ashish

    2013-01-01

    Increasing longevity has been hailed as a triumph of medicine in recent years. With increasing life expectancy all over the world, ageing has been seen to outpace social and economic development in many countries. Declining mortality rates and total fertility rates result in an increase in the proportion of elderly individuals. The impact of the ageing population is felt less in the developed world, and it has been estimated that by the year 2050 over 80% of the elderly world population would be living in the developing world. Despite a higher life expectancy in developing nations, there has also been an increase in the risk of having chronic ailments during the increased years; a reflection of life-long accumulation of risk factors.1.

  13. [Assessment of life expectancy in older people].

    PubMed

    Vaucher, Yves; Monod, Stéfanie; Büla, Christophe; Rochat, Stéphane

    2012-11-07

    Evaluation of the remaining life expectancy in elderly persons plays an important role in their care, most importantly when treatments are associated with severe side effects or when they reduce the quality of life. Prognostic scores, incorporating the functional status in addition to age and comorbidities, enable evaluation of the mortality risk during different periods of time. Despite some limitations, these scores are useful in establishing individualized treatment plans.

  14. Ageing with HIV: newly diagnosed older adults in Italy.

    PubMed

    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

    2008-04-01

    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

  15. Balance-Boosting Footwear Tips for Older People

    MedlinePlus

    ... Home » Learn About Feet » Tips for Healthy Feet Balance-Boosting Footwear Tips for Older People Balance in all aspects of life is a good ... mental equilibrium isn't the only kind of balance that's important in life. Good physical balance can ...

  16. Public Library Services to Older People in Pennsylvania: A Survey.

    ERIC Educational Resources Information Center

    Ling-nam, Leo Ip

    The purpose of this study was to establish a profile of services to older people in Pennsylvania public libraries. A survey was distributed to 50 district library centers and headquarters of the state library and 50 independent public libraries. The response rate was 65%. Major findings of the study were the following: (1) 66.15% of respondents…

  17. Full-Timing: A Housing Alternative for Older People.

    ERIC Educational Resources Information Center

    Hartwigsen, Gail; Null, Roberta

    Full-timing, living year-round in a recreational vehicle, may be a viable housing alternative for older people. Full-timers can enjoy life in recreational vehicles that are modern, convenient, and well-built. Full-timing can be as expensive or as economical as the individual circumstances are. The economic benefits of full-timing increase when the…

  18. Measures for Assessing Student Attitudes toward Older People

    ERIC Educational Resources Information Center

    Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer

    2011-01-01

    Measuring medical and allied health students' attitudes towards older people has been identified as an important research area. The present study compared the use of implicit and explicit attitude measures. Sixty-five undergraduates completed one explicit measure, the Fraboni Scale of Ageism (FSA), (Fraboni, Saltstone, & Hughes, 1990) and one…

  19. The Life-Course Origins of Mastery among Older People

    ERIC Educational Resources Information Center

    Pearlin, Leonard I.; Nguyen, Kim B.; Schieman, Scott; Milkie, Melissa A.

    2007-01-01

    In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past…

  20. Social Exclusion and Older People: Exploring the Connections.

    ERIC Educational Resources Information Center

    Phillipson, Chris; Scharf, Thomas; Kingston, Paul; Smith, Allison E.

    2001-01-01

    The effect of social exclusion on older people has not been examined. Three issues regarding their participation in community life can be discerned: (1) participation and integration beyond the labor market; (2) spatial segregation, including geographic, economic, and social isolation; and (3) exclusion through withdrawal of institutions from…

  1. Attitudes of Students in Health Professions toward Caring for Older People: Needed Curricula Revisions in Nigeria

    ERIC Educational Resources Information Center

    Fajemilehin, Boluwaji Reuben

    2004-01-01

    This descriptive study examined the conceptions and misconceptions students in health professions have regarding older people. The research was conducted in Ile-Ife, Nigeria. The findings revealed that students in health professions, as a whole, demonstrated a high degree of stereotypic misconceptions and poor knowledge about aging and older…

  2. Employment Status and Perceived Health Status in Younger and Older People with Multiple Sclerosis

    ERIC Educational Resources Information Center

    Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2012-01-01

    This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (less than 45 years) and an older (greater than or equal to 45 years) age…

  3. Selective Attention in Web Forms: An Exploratory Case Study with Older People

    ERIC Educational Resources Information Center

    Sayago, Sergio; Guijarro, Jose-Maria; Blat, Josep

    2012-01-01

    This article reports on an exploratory study aimed to identify which ways of marking required and optional fields help older people fill in web forms correctly. Drawing on a pilot study and selective attention research in ageing, modified versions of widely used forms were created, in which standard asterisks were replaced with one of three…

  4. Older people should be given practical support to effectively manage their stomas.

    PubMed

    Pearson, Trudi

    People who have had a stoma for many years and managed it effectively may encounter problems as they grow older as a result of physical and/or cognitive impairment. This article outlines some of the problems the ageing process can cause and offers potential management strategies.

  5. The Meaning of Learning Piano Keyboard in the Lives of Older Chinese People

    ERIC Educational Resources Information Center

    Li, Sicong; Southcott, Jane

    2015-01-01

    Across the globe populations are ageing and living longer. Older people seek meaningful ways of occupying and enjoying their later years. Frequently, this takes the form of learning a new skill, in this case playing the piano keyboard. From the initial act of commitment to learning comes a raft of related aspects that influence the learner, their…

  6. Distribution and correlates of plantar hyperkeratotic lesions in older people

    PubMed Central

    Spink, Martin J; Menz, Hylton B; Lord, Stephen R

    2009-01-01

    Background Plantar hyperkeratotic lesions are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people. Methods A medical history questionnaire was administered to a random sample of 301 people living independently in the community (117 men, 184 women) aged between 70 and 95 years (mean 77.2, SD 4.9), who also underwent a clinical assessment of foot problems, including the documentation of plantar lesion locations, toe deformities and the presence and severity of hallux valgus. Results Of the 301 participants, 180 (60%) had at least one plantar hyperkeratotic lesion. Those with plantar lesions were more likely to be female (χ2 = 18.75, p < 0.01; OR = 2.86), have moderate to severe hallux valgus (χ2 = 6.15, p < 0.02; OR = 2.95), a larger dorsiflexion range of motion at the ankle (39.4 ± 9.3 vs 36.3 ± 8.4°; t = 2.68, df = 286, p < 0.01), and spent more time on their feet at home (5.1 ± 1.0 vs 4.8 ± 1.3 hours, t = -2.46, df = 299, p = 0.01). No associations were found between the presence of plantar lesions and body mass index, obesity, foot posture, dominant foot or forefoot pain. A total of 53 different lesions patterns were observed, with the most common lesion pattern being "roll-off" hyperkeratosis on the medial aspect of the 1st metatarsophalangeal joint (MPJ), accounting for 12% of all lesion patterns. "Roll-off" lesions under the 1st MPJ and interphalangeal joint were significantly associated with moderate to severe hallux valgus (p < 0.05), whereas lesions under the central MPJs were significantly associated with deformity of the corresponding lesser toe (p < 0.05). Factor analysis indicated that 62% of lesion patterns could be grouped under three broad

  7. The assessment and management of pain among older people in care homes: current status and future directions.

    PubMed

    Cowan, David T; Fitzpatrick, Joanne M; Roberts, Julia D; While, Alison E; Baldwin, Julie

    2003-03-01

    Pain is highlighted as a significant, yet neglected problem among older people, particularly in long-term care settings. The effects of inadequate assessment and treatment of pain among older people may lead to multiple problems. Problems arise due to cognitive impairment of clients and inadequate assessment by healthcare professionals. Analgesics are under-used and there is a need for improved education of both healthcare professionals and older people regarding attitudes to pain and ageing. Research is needed into the prevalence of pain among older people in United Kingdom (UK) care homes, how best to further educate healthcare professionals regarding pain management and how to enable older people to be facilitative partners in this process.

  8. Older people and digital disengagement: a fourth digital divide?

    PubMed

    Olphert, Wendy; Damodaran, Leela

    2013-01-01

    Digital technologies are becoming more pervasive in all areas of society. Enabling everyone to have access and capability to use the Internet and associated digital technologies, summed up in the term 'digital inclusion', is seen to have wide-ranging benefits to the individual, to the economy and to society. For older people, being digitally included can help them to maintain their independence, social connectedness and sense of worth in the face of declining health or limited capabilities, as well as also offering new opportunities to improve their quality of life. At present however, access to the technology and to the benefits is not equally distributed either between or within nations, and older people tend to be on the 'wrong' side of what is termed the 'digital divide'. Governments globally are developing strategies to promote digital inclusion and indeed Internet uptake is increasing steadily, including amongst older people. However, such strategies have focussed on getting people online, and there appears to be an assumption that once someone is online they will remain 'digitally engaged'. In fact statistics show that some users give up using the Internet, and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome. The authors see this phenomenon as a potential but largely unrecognised 'fourth digital divide' which has serious implications for social inclusion. The objectives of this article are (a) to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence, (b) to explore some of the potential implications of not recognising and therefore not addressing the needs of the digitally disengaged older population, and (c) to reveal the prevailing gap in knowledge which future research should address.

  9. What are older people prepared to do to avoid falling? A qualitative study in London.

    PubMed

    Simpson, Janet M; Darwin, Cressida; Marsh, Nicola

    2003-04-01

    Falls prevention strategies form a significant part of recent government policy relating to older people. In this article we report a qualitative study to examine the extent to which older people are willing to adopt any of the following strategies in order to avoid falling; balance and lower limb strengthening exercises, home safety advice, and 'taking care'. A sample of community-dwelling inpatients who were more or less afraid of falling were interviewed. Some older people blamed their own unsafe behaviour rather than hazards in their home for falls, so taking care (moving slowly, holding on, being vigilant to and avoiding danger) was a widespread strategy. The benefits of exercise in falls prevention were poorly understood and there was little enthusiasm for exercising especially if it was perceived to be inappropriate in old age or painful. Awareness of home hazards and taking measures against them was common but home visits tended to be regarded as intrusive. Inadequate negotiation about adaptations was widespread and led to resentment and unwillingness to cooperate. Building on the widespread 'taking care' strategy may help educated older people in safe behaviour. Health professionals should encourage older people to exercise and when making home safety visits should confer with their clients, taking their preferences about adaptations into account.

  10. Inter-generational family support provided by older people in Indonesia.

    PubMed

    Schröder-Butterfill, Elisabeth

    2004-07-01

    Most social research on ageing in Asia has focused on the support provided by adult children to their parents, and thereby suggests that as a matter of course older people are in need of support. This paper offers a different perspective. Drawing on ethnographic and quantitative data from a village in East Java, it examines the extent of older people's dependence on others and highlights the material and practical contributions that they make to their families. It is shown that only a minority of older people are reliant on children or grandchildren for their daily survival. In the majority of cases, the net flow of inter-generational support is either downwards - from old to young - or balanced. Far from merely assisting with childcare and domestic tasks, older people are often the economic pillars of multi-generational families. Pension and agricultural incomes serve to secure the livelihoods of whole family networks, and the accumulated wealth of older parents is crucial for launching children into economic independence and underwriting their risks. Parental generosity does not generally elicit commensurate reciprocal support when it is needed, leaving many people vulnerable towards the end of their lives.

  11. Family, Close Relatives, Friends: Life Satisfaction among Older People

    ERIC Educational Resources Information Center

    Sener, Arzu; Oztop, Hulya; Dogan, Nuri; Guven, Seval

    2008-01-01

    This study examined the influence of socioeconomic (age, education, marital status, income, and health) and demographic variables and the quantity and quality of relationships with adult children, grandchildren, siblings and friends on life satisfaction of the elderly. Participants were 200 persons older than 60 years of age. Hierarchical…

  12. Herpes zoster correlates with increased risk of Parkinson's disease in older people

    PubMed Central

    Lai, Shih-Wei; Lin, Chih-Hsueh; Lin, Hsien-Feng; Lin, Cheng-Li; Lin, Cheng-Chieh; Liao, Kuan-Fu

    2017-01-01

    Abstract Little is known on the relationship between herpes zoster and Parkinson's disease in older people. This study aimed to explore whether herpes zoster could be associated with Parkinson's disease in older people in Taiwan. We conducted a retrospective cohort study using the claim data of the Taiwan National Health Insurance Program. There were 10,296 subjects aged 65 years and older with newly diagnosed herpes zoster as the herpes zoster group and 39,405 randomly selected subjects aged 65 years and older without a diagnosis of herpes zoster as the nonherpes zoster group from 1998 to 2010. Both groups were followed up until subjects received a diagnosis of Parkinson's disease. This follow-up design would explore whether subjects with herpes zoster were at an increased risk of Parkinson's disease. Relative risks were estimated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the multivariable Cox proportional hazards regression model. The incidence of Parkinson's disease was higher in the herpes zoster group than that in the nonherpes zoster group (4.86 vs 4.00 per 1000 person-years, 95% CI 1.14, 1.29). After adjustment for confounding factors, the multivariable Cox proportional hazards regression model revealed that the adjusted HR of Parkinson's disease was 1.17 for the herpes zoster group (95% CI 1.10, 1.25), compared with the nonherpes zoster group. Older people with herpes zoster confer a slightly increased hazard of developing Parkinson's disease when compared to those without herpes zoster. We think that herpes zoster correlates with increased risk of Parkinson's disease in older people. When older people with herpes zoster seek help, clinicians should pay more attention to the development of the cardinal symptoms of Parkinson's disease. PMID:28207515

  13. [A Community-Based Experience Model of Mental-Social Health Promotion for Older People in Taichung City].

    PubMed

    Tsay, Shwu-Feng; Hsu, Yuan-Nian; Chen, Shu-Fen; Shen, Shu-Hua; Lin, Hsiang-Yi

    2015-08-01

    Active ageing is one of the most important issues taken up by the WHO in regard to ageing societies. "Prolonging Healthy Life Expectance" and "Decreasing the Depression Rate Among Older People" are critical indicators for "2020 Healthy People in Taiwan". This paper conducts a trial run of the program planning and evaluation of mental-social health promotion using focus group research that surveys 29 administrative districts and a depression survey that randomly samples older individuals in Taichung City. We also introduce how we apply local characteristics to develop the 3-level and innovative-action plans to meet the needs of self-identity and social participation for older people. For example, the "Learning Mobile Classroom" program promotes health promotion using activities that are tailored to the lifestyle and culture characteristics of target individuals. Another example is the "Seniors Show", which uses community groups and annual active-ageing shows to promote a positive concept of aging and to promote social participation for older people. Finally, the "Navigator APP of Active Ageing", created using a geographic information system, addresses the resource information needs of older people. This experience in Taichung City uniquely empowers older people, allowing them to take the initiative to make a difference not only for mental-social wellness but also for the hope of life and for graceful ageing.

  14. Using narratives to understand older people's decision-making processes.

    PubMed

    Tetley, Josephine; Grant, Gordon; Davies, Susan

    2009-09-01

    Despite the availability of health and social care services designed to support people in their own homes, older people often underuse or refuse these services. It is now acknowledged that this phenomenon contributes to older people being admitted to hospital and long-term care in circumstances that could be avoided. To understand how the uptake of supportive and preventative services can be improved, the first author, supervised by the second and third authors, developed a constructivist inquiry to explore what factors enhance or bar service use. This article describes how narratives were used not only to help identify decision- and choice-making influences, but also as a way of enhancing the hermeneutic processes associated with constructivism.

  15. Nurses' and Physicians' Perceptions of Older People and Attitudes towards Older People: Ageism in a Hospital in Turkey.

    PubMed

    Polat, Ulkü; Karadağ, Ayişe; Ulger, Zekeriya; Demir, Nevra

    2014-06-27

    Abstract Nurses and physicians provide health care for a growing number of older people as a result of the rapid increase in the life expectancies of older people. Health professionals' negative attitudes towards older people affect the quality of health care offered to these individuals. The sample for this study included 110 nurses and 57 physicians working in the medical and surgical clinics of a university hospital. A questionnaire form and the Ageism Attitude Scale (AAS) were used to collect the data. A 5-point Likert-type format was utilised for the AAS. The AAS total mean score was 80.02±2.64 for nurses and 83.17±9.09 for physicians. The difference between these mean scores was statistically significant (p<0.05). For the AAS subdimension "limiting the life of the older people", the physicians' score (35.14±6.22) was significantly higher than the nurses' score (33.22±3.59). In this study, nurses' and physicians' attitudes, approaches, and considerations were found to be generally positive.

  16. Nurses' and physicians' perceptions of older people and attitudes towards older people: Ageism in a hospital in Turkey.

    PubMed

    Polat, Ulkü; Karadaǧ, Ayişe; Ulger, Zekeriya; Demir, Nevra

    2014-01-01

    Abstract Nurses and physicians provide health care for a growing number of older people as a result of the rapid increase in the life expectancies of older people. Health professionals' negative attitudes towards older people affect the quality of health care offered to these individuals. The sample for this study included 110 nurses and 57 physicians working in the medical and surgical clinics of a university hospital. A questionnaire form and the Ageism Attitude Scale (AAS) were used to collect the data. A five-point Likert-type format was utilised for the AAS. The AAS total mean score was 80.02 ± 2.64 for nurses and 83.17 ± 9.09 for physicians. The difference between these mean scores was statistically significant (p < 0.05). For the AAS sub-dimension 'limiting the life of the older people,' the physicians' score (35.14 ± 6.22) was significantly higher than the nurses' score (33.22 ± 3.59). In this study, nurses' and physicians' attitudes, approaches, and considerations were found to be generally positive.

  17. Evidence Informed Nursing with Older People Debbie Tolson Evidence Informed Nursing with Older People JO Booth Irene Schofield Wiley-Blackwell £26.99 264pp 9781444331134 1444331132 [Formula: see text].

    PubMed

    2012-03-30

    THE EDITORS preface this text with a definition of gerontological nursing, stating that it 'contributes to and often leads the interdisciplinary and multiagency care of older people... a relationship-centred approach that promotes healthy ageing and the achievement of wellbeing in the older person and their family carers, enabling them to adapt to the older person's health and life changes and to face ongoing life challenges'. This vision threads through each chapter, by providing guidance and advice on quality, evidence-based nursing care for older people and their families in all settings.

  18. Age and Adaptation: Stronger Decision Updating about Real World Risks in Older Age.

    PubMed

    Rolison, Jonathan J; Wood, Stacey; Hanoch, Yaniv

    2017-01-17

    In later life, people are faced with a multitude of risky decisions that concern their health, finance, and personal security. Older adults often exercise caution in situations that involve risk. In this research, we asked whether older adults are also more responsive to warnings about potential risk. An answer to this question could reveal a factor underlying increased cautiousness in older age. In Study 1, participants decided whether they would engage in risky activities (e.g., using an ATM machine in the street) in four realistic scenarios about which participants could be expected to have relevant knowledge or experience. They then made posterior decisions after listening to audio extracts of real reports relevant to each activity. In Study 2, we explored the role that emotions play in decision updating. As in Study 1, participants made prior and posterior decisions, with the exception that for each scenario the reports were presented in their original audio format (high emotive) or in a written transcript format (low emotive). Following each posterior decision, participants indicated their emotional valence and arousal responses to the reports. In both studies, older adults engaged in fewer risky activities than younger adults, indicative of increased cautiousness in older age, and exhibited stronger decision updating in response to the reports. Older adults also showed stronger emotional responses to the reports, even though emotional responses did not differ for audio and written transcript formats. Finally, age differences in emotional responses to the reports accounted for age differences in decision updating.

  19. Acute stress and working memory in older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia

    2015-01-01

    Several studies have shown that acute stress affects working memory (WM) in young adults, but the effect in older people is understudied. As observed in other types of memory, older people may be less sensitive to acute effects of stress on WM. We performed two independent studies with healthy older men and women (from 55 to 77 years old) to investigate the effects of acute stress (Trier Social Stress Test; TSST) and cortisol on WM. In study 1 (n = 63), after the TSST women (but not men) improved their performance on Digit Span Forward (a measure of the memory span component of WM) but not on Digit Span Backward (a measure of both memory span and the executive component of WM). Furthermore, in women, cortisol levels at the moment of memory testing showed a positive association with the memory span component of WM before and after the TSST, and with the executive component of WM only before the stress task. In study 2 (n = 76), although participants showed a cortisol and salivary alpha-amylase (sAA) response to the TSST, stress did not affect performance on Letter-Number Sequencing (LNS; a task that places a high demand on the executive component of WM). Cortisol and sAA were not associated with WM. The results indicate that circulating cortisol levels at the moment of memory testing, and not the stress response, affect memory span in older women, and that stress and the increase in cortisol levels after stress do not affect the executive component of WM in older men and women. This study provides further evidence that older people may be less sensitive to stress and stress-induced cortisol response effects on memory processes.

  20. "Healthy Aging at Older Ages: Are Income and Education Important?"

    ERIC Educational Resources Information Center

    Buckley, Neil J.; Denton, Frank T.; Robb, A. Leslie; Spencer, Byron G.

    2004-01-01

    Being higher on the socio-economic scale is correlated with being in better health, but is there is a causal relationship? Using 3 years of longitudinal data for individuals aged 50 and older from the Canadian Survey of Labour and Income Dynamics, we study the health transitions for those who were in good health in the first year, focusing…

  1. Relocation at older age: results from the Cognitive Function and Ageing Study

    PubMed Central

    Wu, Yu-Tzu; Prina, A. Matthew; Barnes, Linda E.; Matthews, Fiona E.; Brayne, Carol

    2015-01-01

    Background Community environment might play an important role in supporting ageing in place. This paper aims to explore relocation at older age and its associations with individual and community level factors. Methods The postcodes of the 2424 people in the year-10 interview of the Cognitive Function and Ageing Study (CFAS) in England were mapped onto Enumeration Districts and linked to their corresponding Townsend deprivation score and the 2011 rural/urban categories. Multilevel logistic regression was conducted to examine the influence of the baseline individual (age, gender, education and social class) and community (rural/urban categories and area deprivation) level factors on relocation over 10 years. Results One-third of people moved residence after the age of 65 years and over. Older age, low education, low social class and living in rural areas at baseline were associated with higher probability of moving later in life. The likelihood of relocation in later life increased from least to most deprived areas (odds ratio: 2.0, 95% confidence interval: 1.4, 2.8). Conclusions Urban/rural contexts and area deprivation are associated with relocation at older age and indicate that community environment may be relevant to ageing in place. PMID:25922369

  2. Images of older people in UK magazine advertising: toward a typology.

    PubMed

    Williams, Angie; Wadleigh, Paul Mark; Ylänne, Virpi

    2010-01-01

    The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an a priori framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait ascriptions, and similarity-between-images ratings of a representative sample of U.K. magazine advertisements featuring older characters. After a series of sorting task laboratory sessions, multidimensional scaling and hierarchical cluster analyses revealed four clearly defined groups representing types of portrayals. These types emerged from the advertisements and from the views of the consumers themselves. These emergent groupings are: (1) Frail and Vulnerable, (2) Happy and Affluent, (3) Mentors, (4) Active and Leisure-oriented older adults. These groupings seem to be a logical context-appropriate derivation from previous findings on generally held stereotypes of older persons. It is argued that the groupings have the potential to contribute to a reliable typology of advertising portrayals of older people, with potential heuristic leverage in social scientific research of intergenerational communication, lifespan concerns, and the aging process.

  3. Development of a Frailty Index for Older People with Intellectual Disabilities: Results from the HA-ID Study

    ERIC Educational Resources Information Center

    Schoufour, Josje D.; Mitnitski, Arnold; Rockwood, Kenneth; Evenhuis, Heleen M.; Echteld, Michael A.

    2013-01-01

    Background: Although there is no strict definition of frailty, it is generally accepted as a state of high vulnerability for adverse health outcomes at older age. Associations between frailty and mortality, dependence, and hospitalization have been shown. We measured the frailty level of older people with intellectual disabilities (ID).…

  4. Association of sleep-wake habits in older people with changes in output of circadian pacemaker

    NASA Technical Reports Server (NTRS)

    Czeisler, C. A.; Dumont, M.; Duffy, J. F.; Steinberg, J. D.; Richardson, G. S.; Brown, E. N.; Sanchez, R.; Rios, C. D.; Ronda, J. M.

    1992-01-01

    Many elderly people complain of disturbed sleep patterns but there is not evidence that the need to sleep decreases with age; it seems rather that the timing and consolidation of sleep change. We tried to find out whether there is a concurrent change in the output of the circadian pacemaker with age. The phase and amplitude of the pacemaker's output were assessed by continuous measurement of the core body temperature during 40 h of sustained wakefulness under constant behavioural and environmental conditions. 27 young men (18-31 years) were compared with 21 older people (65-85 years; 11 men, 10 women); all were healthy and without sleep complaints. The mean amplitude of the endogenous circadian temperature oscillation (ECA) was 40% greater in young men than in the older group. Older men had a lower mean temperature ECA than older women. The minimum of the endogenous phase of the circadian temperature oscillation (ECP) occurred 1 h 52 min earlier in the older than in the young group. Customary bedtimes and waketimes were also earlier in the older group, as was their daily alertness peak. There was a close correlation between habitual waketime and temperature ECP in young men, which may lose precision with age, especially among women. These findings provide evidence for systematic age-related changes in the output of the human circadian pacemaker. We suggest that these changes may underlie the common complaints of sleep disturbance among elderly people. These changes could reflect the observed age-related deterioration of the hypothalamic nuclei that drive mammalian circadian rhythms.

  5. Inter-generational family support provided by older people in Indonesia

    PubMed Central

    SCHRÖDER-BUTTERFILL, ELISABETH

    2007-01-01

    Most social research on ageing in Asia has focused on the support provided by adult children to their parents, and thereby suggests that as a matter of course older people are in need of support. This paper offers a different perspective. Drawing on ethnographic and quantitative data from a village in East Java, it examines the extent of older people’s dependence on others and highlights the material and practical contributions that they make to their families. It is shown that only a minority of older people are reliant on children or grandchildren for their daily survival. In the majority of cases, the net flow of inter-generational support is either downwards – from old to young – or balanced. Far from merely assisting with childcare and domestic tasks, older people are often the economic pillars of multi-generational families. Pension and agricultural incomes serve to secure the livelihoods of whole family networks, and the accumulated wealth of older parents is crucial for launching children into economic independence and underwriting their risks. Parental generosity does not generally elicit commensurate reciprocal support when it is needed, leaving many people vulnerable towards the end of their lives. PMID:23750060

  6. Evaluation of older Chinese people's macronutrient intake status: results from the China Health and Nutrition Survey.

    PubMed

    Xu, Xiaoyue; Byles, Julie E; Shi, Zumin; Hall, John J

    2015-01-14

    Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older Chinese people (aged ≥ 60 years), investigated whether they had intake levels that met the Dietary Reference Intakes (DRI), and explored the associations between macronutrient intakes and age groups, sex, education levels, work status, BMI groups, urbanicity levels and four socio-economic regions of China (Northeast, East Coast, Central and Western). Dietary intake data of 2746 older Chinese with complete dietary intake data in the Longitudinal China Health and Nutrition Survey (2009 wave) carried out across four diverse regions were analysed. Dietary intake data were obtained by interviews using 24 h recalls over three consecutive days. The MUFA:SFA ratios were calculated based on the Chinese Food Composition Table. Less than one-third of the older Chinese people included in the present study had intake levels meeting the adequate intake for carbohydrate-energy and fat-energy; less than one-fifth had intake levels meeting the recommended nutrient intake for protein-energy; and more than half of the older people had fat-energy intakes higher than the DRI. There were strong associations between the proportions of energy from the three macronutrients and education levels, urbanicity levels and the four socio-economic regions of China, with older people living in the East Coast region having different patterns of macronutrient-energy intakes when compared with those living in the other three regions. Macronutrient intakes across different urbanicity levels in the four regions revealed considerable geographical variations in dietary patterns, which will affect the risk factors for non-communicable diseases. Clinical interventions and public health policies should recognise these regional differences in dietary patterns.

  7. Diagnosing and treating urinary tract infections in older people.

    PubMed

    Armstrong, Kirsty

    2015-05-01

    Even though diagnosing and treating urinary tract infections (UTIs) in older people can be difficult, it is essential to prevent reduction in the patients' wellbeing. Near-patient testing can be useful, but guidelines on this discuss the use of urine dipstick testing and laboratory culture in some detail. In addition, there are significant differences in the management of males and females, those with recurrent infections, and those with catheters. Community nurses are well placed to assess and manage this common condition, implementing correct treatment and resolution, owing to the close relationships they cultivate with service users. This article discusses the diagnosis and management of UTIs in older people, highlighting the differentials and red flags that need to be addressed urgently.

  8. Older people's participation in extra-cost disability benefits.

    PubMed

    Zantomio, Francesca

    2013-01-01

    The targeting of an UK extra-cost disability benefit for older people, Attendance Allowance, is analyzed using longitudinal data from the British Household Panel Survey. First, a binary model of benefit participation is used to investigate whether receipt is responsive to the onset of disability. Second, matching estimators are used to evaluate the consequences of missed participation on later financial wellbeing. Results indicate that participation is highly responsive to the onset of disability, although the chance of delays in receipt emerges. Personal characteristics unrelated to eligibility also appear to influence benefit receipt, translating into sizeable differences in the amount of cash support received. The comparison of recipients with observationally equivalent non-recipients confirms that timely participation reduces disabled older people's financial strain.

  9. The involvement of Spanish older people in nondegree educational programs: reasons for and barriers to participation.

    PubMed

    Villar, Feliciano; Celdrán, Montserrat

    2014-01-01

    This article examines the reasons older Spanish people participate in nondegree educational programs and the barriers they may face when they want to do so. Data were drawn from the 2007 Survey on Adults' Involvement in Learning Activities (Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje: EADA) and correspond to a nationally representative sample of Spanish people aged between 60 and 74 years old (n=4,559). Overall, only 8.7% of the sample participated in a nondegree educational program. Predictors of participation were being a woman, being younger, having a higher educational level, and being employed. The most frequent reason given for participation was of an intrinsic nature (e.g., interest in the topic), although instrumental motives (e.g., utility of the content for daily life) were more common than suggested by previous research. As for barriers to participation, the vast majority of older people (95.6% of those who did not participate) did not even express a desire to participate. The most frequent barriers were internal (e.g., age/health restrictions). This kind of barrier was ascribed a greater importance by older and less educated groups as well as by those who participate less in cultural activities. Policies to promote older people's participation in nonformal educational activities are discussed in light of the data.

  10. Loneliness and social support of older people living alone in a county of Shanghai, China.

    PubMed

    Chen, Yu; Hicks, Allan; While, Alison E

    2014-07-01

    China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross-sectional questionnaire survey with a stratified random cluster sample of 521 community-dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one-to-one 'befriending' and group activity programmes together with identification of vulnerable subgroups.

  11. Patterns of Somatic Diagnoses in Older People with Intellectual Disability: A Swedish Eleven Year Case-Control Study of Inpatient Data

    ERIC Educational Resources Information Center

    Sandberg, Magnus; Ahlström, Gerd; Kristensson, Jimmie

    2017-01-01

    Background: Knowledge about diagnoses patterns in older people with intellectual disabilities is limited. Methods: The case group (n = 7936) comprised people with intellectual disabilities aged 55 years and older. The control group (n = 7936) was age matched and sex matched. Somatic inpatient diagnoses (2002-2012) were collected retrospectively.…

  12. What Do Older People Think That Others Think of Them, and Does It Matter? The Role of Meta-Perceptions and Social Norms in the Prediction of Perceived Age Discrimination

    PubMed Central

    2016-01-01

    Psychological theories of aging highlight the importance of social context. However, very little research has distinguished empirically between older people’s perception of how others in their social context perceive them (personal meta-perceptions) and the shared perceptions in society (societal meta-perceptions). Drawing on theories of intergroup relations and stereotyping and using a multilevel perspective, this article examines how well older people’s perceptions of age discrimination (PAD) are predicted by (a) older people’s personal meta-perceptions, (b) societal meta-perceptions, and (c) social norms of intolerance toward age prejudice. Aging meta-perceptions are differentiated into the cognitive and affective components of ageism. Multilevel analyses of data from the European Social Survey (Nover 70 years of age = 8,123, 29 countries; European Social Survey (ESS) Round 4 Data, 2008) confirmed that older people’s personal meta-perceptions of negative age stereotypes and specific intergroup emotions (pity, envy, contempt) are associated with higher PAD. However, at the societal-level, only paternalistic meta-perceptions were consistently associated with greater PAD. The results show that a few meta-perceptions operate only as a psychological phenomenon in explaining PAD, some carry consonant, and others carry contrasting effects at the societal-level of analysis. This evidence extends previous research on aging meta-perceptions by showing that both the content of meta-perceptions and the level of analysis at which they are assessed make distinct contributions to PAD. Moreover, social norms of intolerance of age prejudice have a larger statistical effect than societal meta-perceptions. Social interventions would benefit from considering these differential findings. PMID:27831711

  13. Older people with dysphagia: transitioning to texture-modified food.

    PubMed

    Ullrich, Sandra; Crichton, Jonathan

    Older people with dysphagia are at high risk of malnutrition. To maintain safe oral and nutritional intake, solid food may be texture-modified. Little is known about the transition experiences of older people who move from normal to texture-modified foods. The aim of this study was to describe residents' experiences as they transitioned from normal food to texture-modified food. The study used a qualitative descriptive design and individual interviews were conducted with a study group of 28 participants (residents, family members, nursing and care staff, and speech and language therapists). The interviews were thematically analysed. The findings suggest that transition creates the risk of distress, reducing eating to a matter of necessity and hunger, and that the process is perceived as abrupt, and characterised by lack of communication and awareness of the need for change. A key finding is that the language used during transition can be adversely affected by the management of risk. This language promotes a culture of care that emphasises the limitations of residents, reduces their motivation to eat and hinders the delivery of person-centred care. The findings suggest that care facilities for older people need to revisit their dysphagia management protocols to ensure that they support a person-centred approach for recipients of texture-modified food.

  14. Direct and extended intergenerational contact and young people's attitudes towards older adults.

    PubMed

    Drury, Lisbeth; Hutchison, Paul; Abrams, Dominic

    2016-09-01

    Research suggests that positive intergenerational contact can improve young people's attitudes towards older adults. However, today's age-segregated society may not provide ample opportunities for positive contact between younger and older adults to occur on a regular basis. In three studies, we investigated whether the positive attitudinal outcomes associated with direct contact might also stem from a more indirect form of intergenerational relationship: extended contact. In Study 1 (N = 70), extended contact was associated with more positive attitudes towards older adults even when controlling for direct intergenerational contact (contact frequency and contact quality). In Study 2 (N = 110), the positive effects of direct and extended contact on young people's age-related attitudes were mediated by reductions in intergroup anxiety and ageing anxiety. The mediational effects of intergroup anxiety were replicated in Study 3 (N = 95) and ingroup norms additionally emerged as a mediator of the positive effects of extended contact on young people's attitudes towards older adults. Discussion focuses on the implications for strategies aimed at tackling ageism.

  15. Non-verbal communication of the residents living in homes for the older people in Slovenia.

    PubMed

    Zaletel, Marija; Kovacev, Asja Nina; Sustersic, Olga; Kragelj, Lijana Zaletel

    2010-09-01

    Aging of the population is a growing problem in all developed societies. The older people need more health and social services, and their life quality in there is getting more and more important. The study aimed at determining the characteristics of non-verbal communication of the older people living in old people's homes (OPH). The sample consisted of 267 residents of the OPH, aged 65-96 years, and 267 caregivers from randomly selected twenty-seven OPH. Three types of non-verbal communication were observed and analysed using univariate and multivariate statistical methods. In face expressions and head movements about 75% older people looked at the eyes of their caregivers, and about 60% were looking around, while laughing or pressing the lips together was rarely noticed. The differences between genders were not statistically significant while statistically significant differences among different age groups was observed in dropping the eyes (p = 0.004) and smiling (0.008). In hand gestures and trunk movements, majority of older people most often moved forwards and clenched fingers, while most rarely they stroked and caressed their caregivers. The differences between genders were statistically significant in leaning on the table (p = 0.001), and changing the position on the chair (0.013). Statistically significant differences among age groups were registered in leaning forwards (p = 0.006) and pointing to the others (p = 0.036). In different modes of speaking and paralinguistic signs almost 75% older people spoke normally, about 70% kept silent, while they rarely quarrelled. The differences between genders were not statistically significant while statistically significant differences among age groups was observed in persuasive speaking (p = 0.007). The present study showed that older people in OPH in Slovenia communicated significantly less frequently with hand gestures and trunk movements than with face expressions and head movements or different modes of speaking

  16. First- and third-person perceptions of images of older people in advertising: an inter-generational evaluation.

    PubMed

    Robinson, Tom; Umphery, Don

    2006-01-01

    With the baby boomers increasing in age, the number of older Americans is projected to increase to 82 million by 2050, an increase of 225% from the year 2000. But despite their growing numbers, older individuals continue to face negative attitudes toward them, their way of thinking, and their abilities. These negative attitudes result from the assumption that older people have diminished physical and mental abilities, when in fact, today's older adults are more active and in better physical and mental health than those in any previous generation. This study examines the relationship between first- and third-person perceptions and positive and negative images by determining how older people and younger people perceive each other. More specifically, when older and younger individuals look at positive and negative images of older people in advertisements, what is their perception of the effects those images will have on the other generation? Our findings show that both first- and third-person effects exist and that their perceptions depend on whether the images in the advertisements are positive or negative. The results also indicate that young people rely on the stereotypes they hold of older people when making their perceptions.

  17. The Effect of Aging Awareness Training on Knowledge of, and Attitudes towards, Older Adults.

    ERIC Educational Resources Information Center

    Stuart-Hamilton, Ian; Mahoney, Berenice

    2003-01-01

    Before and 1 month after age awareness workshops, 200 British participants took the Palmore Aging Quiz and Fraboni Scale of Ageism. Palmore scores significantly improved but Fraboni scores were unchanged. Results suggest that increased awareness improves factual knowledge but does not change attitudes toward aging and older people. (Contains 18…

  18. Healthy Aging in Community for Older Lesbians

    PubMed Central

    Putney, Jennifer M.; Shepard, Bonnie L.; Sass, Samantha E.; Rudicel, Sally; Ladd, Holly

    2016-01-01

    Abstract Purpose: In Boston and Outer Cape, Massachusetts, we explored the expectations of lesbians 60 years and older regarding healthy aging and community importance. Methods: Focus groups were conducted with participants after completing an anonymous demographic questionnaire. Thematic analysis was used to generate themes and identify how they varied by urban versus rural settings. Results: Group discussions focused on community, finances, housing, and healthcare. Primary concerns included continued access to supportive and lesbian communities as a source of resilience during aging. Conclusion: Concerns about discrimination and isolation mirror themes found in national research. The study findings suggest a need for more research into the housing and transportation needs of lesbians approaching later life, with a focus on how those needs relate to affordability, accessibility, and proximity to social support and healthcare. These findings also suggest the need for substantial investments in strengthening the LGBT-related cultural competence of providers of services for the elderly. PMID:27046541

  19. Acute stress does not impair long-term memory retrieval in older people.

    PubMed

    Pulopulos, Matias M; Almela, Mercedes; Hidalgo, Vanesa; Villada, Carolina; Puig-Perez, Sara; Salvador, Alicia

    2013-09-01

    Previous studies have shown that stress-induced cortisol increases impair memory retrieval in young people. This effect has not been studied in older people; however, some findings suggest that age-related changes in the brain can affect the relationships between acute stress, cortisol and memory in older people. Our aim was to investigate the effects of acute stress on long-term memory retrieval in healthy older people. To this end, 76 participants from 56 to 76 years old (38 men and 38 women) were exposed to an acute psychosocial stressor or a control task. After the stress/control task, the recall of pictures, words and stories learned the previous day was assessed. There were no differences in memory retrieval between the stress and control groups on any of the memory tasks. In addition, stress-induced cortisol response was not associated with memory retrieval. An age-related decrease in cortisol receptors and functional changes in the amygdala and hippocampus could underlie the differences observed between the results from this study and those found in studies performed with young people.

  20. Older People and Their Attitude to the Use of Information and Communication Technologies--A Review Study with Special Focus on the Czech Republic (Older People and Their Attitude to ICT)

    ERIC Educational Resources Information Center

    Klimova, Blanka; Simonova, Ivana; Poulova, Petra; Truhlarova, Zuzana; Kuca, Kamil

    2016-01-01

    Rising standards of living and good quality health care have contributed to people living longer. According to the Eurostat agency (Benácová & Valenta, 2009), in the next 50 years there will be twice as many older people worldwide. The aging process, however, brings about new economic and social issues. Therefore, there is constant effort to…

  1. Blood pressure lowering therapy in older people: Does it really cause postural hypotension or falls?

    PubMed

    Zia, Anam; Kamaruzzaman, Shahrul Bahyah; Tan, Maw Pin

    2015-03-01

    Hypertension is a highly prevalent condition among older people, but many physicians avoid aggressive treatment in this age group due to concerns about adverse effects such as orthostatic hypotension and falls. Orthostatic hypotension, which also increases in prevalence with increasing age, has been considered to be associated with antihypertensive therapy. Both orthostatic hypotension and antihypertensive medications are considered independent yet closely related predictors for falls among older people. The prescription of antihypertensive therapy among the elderly remains a long-standing controversy in geriatric medicine due to ongoing concerns about potential complications such as falls, despite conclusive evidence supporting the treatment of hypertension even among the very elderly. However, recent evidence suggests a dose-dependent relationship between blood pressure lowering therapy and falls among older individuals with preexisting risk factors for falls. In response to the spate of revisions in hypertension treatment targets for older patients in international guidelines and the recent evidence on antihypertensive therapy and falls, this review article examines the complex relationship between hypertension, antihypertensives, orthostatic hypotension, and falls among older patients.

  2. Adverse drug reactions in older people: detection and prevention.

    PubMed

    Petrovic, Mirko; van der Cammen, Tischa; Onder, Graziano

    2012-06-01

    Adverse drug reactions (ADRs) in older adults are an important healthcare problem since they are frequently a cause of hospitalization, occur commonly during admission, and are an important cause of morbidity and mortality. Older adults are particularly susceptible to ADRs because they are usually on multiple drug regimens and because age is associated with changes in pharmacokinetics and pharmacodynamics. The presentation of an ADR in older adults is often atypical, which further complicates its recognition. One potential strategy for improving recognition of ADRs is to identify those patients who are at risk of an ADR. The recently developed GerontoNet ADR Risk Score is a practical tool for identification of older patients who are at increased risk for an ADR and who may represent a target for interventions aimed at reducing ADRs. Provision of adequate education in the domain of clinical geriatric pharmacology can improve recognition of ADRs. Besides formal surveillance systems, built-in computer programs with electronic prescribing databases and clinical pharmacist involvement in patient care within multidisciplinary geriatric teams might help to minimize the occurrence of ADRs. In addition, a number of actions can be taken in hospitals to stimulate appropriate prescribing and to assure adequate communication between primary and hospital care. In older adults with complex medical problems and needs, a global evaluation obtained through a comprehensive geriatric assessment may be helpful in simplifying drug prescription and prioritizing pharmacological and healthcare needs, resulting in an improvement in quality of prescribing.

  3. Gaps in the Family Networks of Older People in Three Indonesian Communities

    PubMed Central

    Schröder-Butterfill, E.

    2007-01-01

    Family networks are widely assumed to be a key source of support for older people in Indonesia and Southeast Asia more generally, although empirical study of their composition and functioning is in its infancy. This paper draws on ethnographic and survey data collected in longitudinal research of ageing in three rural Indonesian communities, in order to identify demographic and social factors limiting the size of elders’ networks. Gaps in networks commonly emerge as a result of childlessness, migration and alienation, but their implications for older people’s vulnerability are shaped by socio-economic status, reputation and cultural norms. PMID:17072765

  4. Colour and inclusivity: a visual communication design project with older people.

    PubMed

    da Silva, Fernando Moreira

    2012-01-01

    In an ideal world, inclusive products and services would be the standard and not the exception. This paper presents a systematic approach to an overlap between Visual Communication Design, Printed Colour and Inclusive Design, for older people, with the aim to develop of a set of research-based ageing and ergonomics-centred communication design guidelines and recommendations for printed material (analogical displays). The approach included an initial extensive literature review in the area of colour, older people and ergonomics issues and vision common diseases, communication design. The second phase was the implementation of an experiment to measure the different colour experiences of the participants in two sample groups (one in UK and another one in Portugal), using printed material, to find out the colours one should use in analogical communication material, being aware of the colour contrast importance (foreground versus background) and the difficulties experienced by older people to read and understand lettering, signs. As main contribution of this research project, we developed a set of guidelines and recommendations based on the reviewed literature and the sample groups' findings, trying to demonstrate the importance of these guidelines when conceiving a new communicational design project in a way this project will achieve vision comfort and understandability, especially for older people, in an inclusive design perspective.

  5. Plantar pressures and relative lesser metatarsal lengths in older people with and without forefoot pain.

    PubMed

    Menz, Hylton B; Fotoohabadi, Mohammad R; Munteanu, Shannon E; Zammit, Gerard V; Gilheany, Mark F

    2013-03-01

    Forefoot pain is a common problem in older people. We determined whether plantar pressures during gait and the relative lengths of the lesser metatarsals differ between older people with and without plantar forefoot pain. Dynamic plantar pressure assessment during walking was undertaken using the Tekscan MatScan® system in 118 community-dwelling older people (44 males and 74 females), mean age 74 (standard deviation=5.9) years, 43 (36%) of whom reported current or previous plantar forefoot pain. The relative lengths of metatarsals 1-5 were determined from weightbearing X-rays. Participants with current or previous plantar forefoot pain exhibited significantly (p=0.032) greater peak plantar pressure under metatarsal heads 3-5 (1.93 ± 0.41 kg/cm(2) vs. 1.74 ± 0.48 kg/cm(2) ). However, no differences were found in relative metatarsal lengths between the groups. These findings indicate that older people with forefoot pain generate higher peak plantar pressures under the lateral metatarsal heads when walking, but do not exhibit relatively longer lesser metatarsals. Other factors may be responsible for the observed pressure increase, such as reduced range of motion of the metatarsophalangeal joints and increased stiffness of plantar soft tissues.

  6. Auditory rehabilitation of older people from the general population--the Leiden 85-plus study.

    PubMed Central

    Gussekloo, Jacobijn; de Bont, L E; von Faber, M; Eekhof, J A; de Laat, J A; Hulshof, J H; van Dongen, E; Westendorp, R G

    2003-01-01

    BACKGROUND: Very few older people with severe hearing loss use hearing aids to reduce the negative consequences of reduced hearing in daily functioning. AIM: Assessment of a screening test and a standardised auditory rehabilitation programme for older people from the general population with untreated severe hearing loss. DESIGN OF STUDY: Intervention study and qualitative exploration. SETTING: Leiden 85-Plus Study, a prospective population-based study of 85-year-old inhabitants of Leiden, the Netherlands. METHOD: Hearing loss was measured by pure-tone audiometry in 454 subjects aged 85 years. Subjects with hearing loss above 35 dB at 1, 2, and 4 kHz who did not use hearing aids were invited to participate in a standardised programme for auditory rehabilitation. In-depth interviews were held with participants to explore arguments for participating in this programme. RESULTS: Of the 367 participants with severe hearing loss (prevalence = 81%), 66% (241/367) did not use a hearing aid. Three out of four of these participants (n = 185) declined participation in the auditory rehabilitation programme. The most common reason given for not participating was the subjects' feeling that their current hearing loss did not warrant the use of a hearing aid. Subjects who participated in the programme were found to suffer from more severe hearing loss and experienced more hearing disability. Those who did not participate in the programme felt they could cope with their disabilities and considered a hearing aid unnecessary. CONCLUSION: Untreated hearing loss is prevalent among older people from the general population. The majority of older people decline auditory rehabilitation. For these people the use of a hearing aid is not perceived as necessary in order to function on a daily basis. Older people who have expected benefits from a hearing aid have already obtained them, marginalising the benefits of a rehabilitation (and screening) programme. PMID:14694666

  7. Health and quality of life among older rural people in Purworejo District, Indonesia

    PubMed Central

    Ng, Nawi; Hakimi, Mohammad; Byass, Peter; Wilopo, Siswanto; Wall, Stig

    2010-01-01

    Introduction Increasing life expectancy and longevity for people in many highly populated low- and middle-income countries has led to an increase in the number of older people. The population aged 60 years and over in Indonesia is projected to increase from 8.4% in 2005 to 25% in 2050. Understanding the determinants of healthy ageing is essential in targeting health-promotion programmes for older people in Indonesia. Objective To describe patterns of socio-economic and demographic factors associated with health status, and to identify any spatial clustering of poor health among older people in Indonesia. Methods In 2007, the WHO Study on global AGEing and adult health (SAGE) was conducted among 14,958 people aged 50 years and over in Purworejo District, Central Java, Indonesia. Three outcome measures were used in this analysis: self-reported quality of life (QoL), self-reported functioning and disability, and overall health score calculated from self-reported health over eight health domains. The factors associated with each health outcome were identified using multivariable logistic regression. Purely spatial analysis using Poisson regression was conducted to identify clusters of households with poor health outcomes. Results Women, older age groups, people not in any marital relationship and low educational and socio-economic levels were associated with poor health outcomes, regardless of the health indices used. Older people with low educational and socio-economic status (SES) had 3.4 times higher odds of being in the worst QoL quintile (OR = 3.35; 95% CI = 2.73–4.11) as compared to people with high education and high SES. This disadvantaged group also had higher odds of being in the worst functioning and most disabled quintile (OR = 1.67; 95% CI = 1.35–2.06) and the lowest overall health score quintile (OR = 1.66; 95% CI = 1.36–2.03). Poor health and QoL are not randomly distributed among the population over 50 years old in Purworejo District, Indonesia

  8. Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people.

    PubMed

    Price, Kay; Grimmer, Karen; Foot, Jan

    2016-11-18

    Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens.Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach.Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA.Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require.What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging.What does this paper add

  9. Later endogenous circadian temperature nadir relative to an earlier wake time in older people

    NASA Technical Reports Server (NTRS)

    Duffy, J. F.; Dijk, D. J.; Klerman, E. B.; Czeisler, C. A.

    1998-01-01

    The contribution of the circadian timing system to the age-related advance of sleep-wake timing was investigated in two experiments. In a constant routine protocol, we found that the average wake time and endogenous circadian phase of 44 older subjects were earlier than that of 101 young men. However, the earlier circadian phase of the older subjects actually occurred later relative to their habitual wake time than it did in young men. These results indicate that an age-related advance of circadian phase cannot fully account for the high prevalence of early morning awakening in healthy older people. In a second study, 13 older subjects and 10 young men were scheduled to a 28-h day, such that they were scheduled to sleep at many circadian phases. Self-reported awakening from scheduled sleep episodes and cognitive throughput during the second half of the wake episode varied markedly as a function of circadian phase in both groups. The rising phase of both rhythms was advanced in the older subjects, suggesting an age-related change in the circadian regulation of sleep-wake propensity. We hypothesize that under entrained conditions, these age-related changes in the relationship between circadian phase and wake time are likely associated with self-selected light exposure at an earlier circadian phase. This earlier exposure to light could account for the earlier clock hour to which the endogenous circadian pacemaker is entrained in older people and thereby further increase their propensity to awaken at an even earlier time.

  10. Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis.

    PubMed

    Oster, Candice; Henderson, Julie; Lawn, Sharon; Reed, Richard; Dawson, Suzanne; Muir-Cochrane, Eimear; Fuller, Jeffrey

    2016-05-04

    Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people's mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of 'risk', 'ageing as decline/dependence' and 'healthy ageing' were identified. Through these discourses, different neo-liberal governmental strategies are applied to 'target' groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people's mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers.

  11. Comprehensive medication management services influence medication adherence among Japanese older people

    PubMed Central

    Hirakawa, Yoshihisa; Hilawe, Esayas Haregot; Chiang, Chifa; Kawazoe, Nobuo; Aoyama, Atsuko

    2015-01-01

    Objective: Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan. Methods: Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (p-value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI). Results: Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99). Conclusion: Receipt of comprehensive medication management services for older people was associated with medication adherence. PMID:26705432

  12. Caregiving responsibilities and burden among older people by HIV status and other determinants in Uganda.

    PubMed

    Mugisha, Joseph; Scholten, Francien; Owilla, Sebastian; Naidoo, Nirmala; Seeley, Janet; Chatterji, Somnath; Kowal, Paul; Boerma, Ties

    2013-01-01

    Older caregivers have major caregiving responsibilities in countries severely affected by the HIV epidemic, but little is known about their own health and well-being. We conducted this study to assess the association of caregiving responsibilities and self-perceived burden with caregivers' health, HIV status, background characteristics and care-receiving among older people in South Western Uganda. Men and women aged 50 years and older were recruited from existing cohort studies and clinic registers and interviewed at home. Health was measured through a composite score of health in eight domains, anthropometry and handgrip strength. Summary measures of caregiving responsibilities and self-reported burden were used to analyse the main associations. There were 510 participants, including 198 living with HIV. Four fifths of women and 66% of men were caregivers. Older respondents with no care responsibility had poorer scores on all health indicators (self-reported health score, body mass index and grip strength). Having a caregiving responsibility was not associated with poorer health status or quality of life. Notably, HIV-infected people, whether on antiretroviral treatment (ART) or not, had similar caregiving responsibilities and health status as others. The self-reported burden associated with caregiving was significantly associated with a poorer health score. One third of female caregivers were the single adult in the household with larger caregiving responsibilities. Many of these women are in the poorest wealth quartile of the households in the study and are therefore more likely to need assistance. Physical and financial supports were received by 70% and 63%, respectively. Those with larger caregiving responsibilities more frequently received support. Caregiving responsibilities were associated with better health status, greater satisfaction and quality of life. Older HIV-infected people, whether on ART or not, had similar caregiving responsibilities and self

  13. Potential for community programs to prevent depression in older people.

    PubMed

    Bird, Michael J; Parslow, Ruth A

    2002-10-07

    Depression is one of the most common mental health disorders in older people. Sequelae include unnecessary suffering, excess physical and social disability, exacerbation of co-existing illness, earlier death, and overuse of services. There are currently no reported public health approaches to prevent late-life depression. Five risk factors appear susceptible to community-level prevention programs: recurrent depression, commonly undertreated precipitants, vascular disease, functional impairments, and metabolite abnormalities. We propose three broad but interacting prevention methods: increasing literacy about late-life depression, exercise, and dietary supplements.

  14. Physical Performance Is Associated with Working Memory in Older People with Mild to Severe Cognitive Impairment

    PubMed Central

    Volkers, K. M.; Scherder, E. J. A.

    2014-01-01

    Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years). Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. Results. The full models explain 49–57% of the variance in working memory and 40–43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3–7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. Conclusions. Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482. PMID:24757674

  15. Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

    PubMed Central

    2014-01-01

    Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p < .001), with 31.6% of women and 17.4% of men aged 80 years or older being affected by this condition. Higher education (odds ratio: 0.85; 95% CI: 0.74–0.98), lower insulin-like growth factor I (lowest vs highest tertile, odds ratio: 3.89; 95% CI: 1.03–14.1), and low bioavailable testosterone (odds ratio: 2.67; 95% CI: 1.31–5.44) were independently associated with the likelihood of being sarcopenic. Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

  16. Physical Fitness in Older People Recently Diagnosed with Cognitive Impairment Compared to Older People Recently Discharged from Hospital

    PubMed Central

    Hesseberg, Karin; Bergland, Astrid; Rydwik, Elisabeth; Brovold, Therese

    2016-01-01

    Background/Aims There is evidence of an association between cognitive function and physical fitness. The aim of this study was to compare physical fitness in patients with cognitive impairment with a group of older people recently discharged from hospital. Methods A cross-sectional study with 98 patients recently diagnosed with cognitive impairment and 115 patients recently discharged from hospital. Associations between the study group variable and different components in the Senior fitness test were examined, controlling for demographic factors and comorbidity. Results The group recently diagnosed with cognitive impairment indicated poorer results on three of six physical fitness components (p < 0.05). Conclusion Older adults with cognitive impairment are in need of individually tailored physical activity programs to increase the level of physical fitness. PMID:27703472

  17. Employment status and perceived health status in younger and older people with multiple sclerosis.

    PubMed

    Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W; van Dijk, Jitse P

    2012-03-01

    This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (<45 years) and an older (≥45 years) age group. Respondents underwent an interview, a neurological examination on disability [Expanded Disability Status Scale (EDSS)], and completed the Short Form-36 Health Survey. Of the respondents (mean age 40.5±6.2 years), 43.5% were employed. Significant differences between younger and older patients were found in employment, EDSS, disease duration, and five Short Form-36 Health Survey dimensions. Block-step multiple regression explained 32.4% of the variance in physical health and 14.5% in mental health in the younger group. Being employed was significantly related to good physical health, whereas EDSS diminished the effect of being employed on physical health. The most important variable for mental health was employment status in the younger group. For the older age group, 19.1% of the variance in physical health and 14.0% of the variance in mental health was explained by the studied variables. Male gender and a lower EDSS were significant explanatory variables of better physical health. Male gender significantly explained mental health in the older age group. In conclusion, employment status was an explanatory variable for physical health and mental health in the younger patients. EDSS played a significant role in physical health for all patients. A vocational rehabilitation program could prevent eventual nonemployment and improve health outcomes in older MS people.

  18. Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries

    PubMed Central

    Arsenijevic, Jelena; Pavlova, Milena; Rechel, Bernd; Groot, Wim

    2016-01-01

    Introduction It is well-known that the prevalence of chronic diseases is high among older people, especially those who are poor. Moreover, chronic diseases can result in catastrophic health expenditure. The relationship between chronic diseases and their financial burden on households is thus double-sided, as financial difficulties can give rise to, and result from, chronic diseases. Our aim was to examine the levels of catastrophic health expenditure imposed by private out-of-pocket payments among older people diagnosed with diabetes mellitus, cardiovascular diseases and cancer in 15 European countries. Methods The SHARE dataset for individuals aged 50+ and their households, collected in 2010–2012 was used. The total number of participants included in this study was N = 51,661. The sample consisted of 43.8% male and 56.2% female participants. The average age was 67 years. We applied an instrumental variable approach for binary instrumented variables known as a treatment-effect model. Results We found that being diagnosed with diabetes mellitus and cardiovascular diseases was associated with catastrophic health expenditure among older people even in comparatively wealthy countries with developed risk-pooling mechanisms. When compared to the Netherlands (the country with the lowest share of out-of-pocket payments as a percentage of total health expenditure in our study), older people diagnosed with diabetes mellitus in Portugal, Poland, Denmark, Italy, Switzerland, Belgium, the Czech Republic and Hungary were more likely to experience catastrophic health expenditure. Similar results were observed for diagnosed cardiovascular diseases. In contrast, cancer was not associated with catastrophic health expenditure. Discussion Our study shows that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe. The effect differs across chronic diseases and countries. This may be due to different socio

  19. Current Policy and Legislation in England Regarding Older People--What This Means for Older People with Learning Disabilities: A Discussion Paper

    ERIC Educational Resources Information Center

    Turner, Sue; Cooper Ueki, Madeline

    2015-01-01

    Background: This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Methods: Using the broad themes housing, employment, social inclusion and isolation, care and…

  20. Aging with HIV vs. HIV Seroconversion at Older Age: A Diverse Population with Distinct Comorbidity Profiles

    PubMed Central

    Guaraldi, Giovanni; Zona, Stefano; Brothers, Thomas D.; Carli, Federica; Stentarelli, Chiara; Dolci, Giovanni; Santoro, Antonella; Beghetto, Barbara; Menozzi, Marianna; Mussini, Cristina; Falutz, Julian

    2015-01-01

    Objective People aging with HIV might have different health conditions compared with people who seroconverted at older ages. The study objective was to assess the prevalence of, and risk factors for, individual co-morbidities and multimorbidity (MM) between HIV-positive patients with a longer duration of HIV infection, and patients who seroconverted at an older age. We compared estimates across both groups to a matched community-based cohort sampled from the general population. Methods We performed a case-control study including antiretroviral therapy (ART)–experienced patients who were HIV seropositive for ≥ 20.6 years (“HIV-Aging”), or who were seropositive for < 11.3 years (“HIV-Aged”) having access in 2013 at the Modena HIV Metabolic Clinic. Patients were matched in a 1:3 ratio with controls from the CINECA ARNO database. MM was defined as the concurrent presence of >2 NICM. Logistic regression models were constructed to evaluate associated predictors of NICM and MM. Results We analysed 404 HIV-Aging and 404 HIV-Aged participants in comparison to 2424 controls. The mean age was 46.7±6.2 years, 28.9% were women. Prevalence of HIV co-morbidities and MM were significantly higher in the HIV-positive groups compared to the general population (p<0.001) and a trend towards higher rates of MM was found in aging vs aged group. This difference turned to be significant in patients above the age of 45 years old (p<0.001). Conclusions People aging with HIV display heterogeneous health conditions. Host factors and duration of HIV infection are associated with increased risk of MM compared to the general population. PMID:25874806

  1. Improvement in the physiological function and standing stability based on kinect multimedia for older people.

    PubMed

    Chen, Chih-Chen

    2016-04-01

    [Purpose] The increase in the Taiwanese older population is associated with age-related inconveniences. Finding adequate and simple physical activities to help the older people maintaining their physiological function and preventing them from falls has become an urgent social issue. [Subjects and Methods] This study aimed to design a virtual exercise training game suitable for Taiwanese older people. This system will allow for the maintenance of the physiological function and standing stability through physical exercise, while using a virtual reality game. The participants can easily exercise in a carefree, interactive environment. This study will use Kinect for Windows for physical movement detection and Unity software for virtual world development. [Results] Group A and B subjects were involved in the exercise training method of Kinect interactive multimedia for 12 weeks. The results showed that the functional reach test and the unipedal stance test improved significantly. [Conclusion] The physiological function and standing stability of the group A subjects were examined at six weeks post training. The results showed that these parameters remained constant. This proved that the proposed system provide substantial support toward the preservation of the Taiwanese older people' physiological function and standing stability.

  2. Does socioeconomic inequality in health persist among older people living in resource-poor urban slums?

    PubMed

    Falkingham, Jane C; Chepngeno-Langat, Gloria; Kyobutungi, Catherine; Ezeh, Alex; Evandrou, Maria

    2011-06-01

    Using self-reported health that assesses functionality or disability status, this paper investigates whether there are any differences in health status among older people living in a deprived area of Nairobi, Kenya. Data from a cross-sectional survey of 2,037 men and women aged 50 years and older are used to examine the association between socioeconomic position and self-reported health status across 6 health domains. Education, occupation, a wealth index, and main source of livelihood are used to assess the presence of a socioeconomic gradient in health. All the indicators showed the expected negative association with health across some, but not all, of the disability domains. Nonetheless, differences based on occupation, the most commonly used indicators to examine health inequalities, were not statistically significant. Primary level of education was a significant factor for women but not for men; conversely, wealth status was associated with lower disability for both men and women. Older people dependent on their own sources of livelihood were also less likely to report a disability. The results suggest the need for further research to identify an appropriate socioeconomic classification that is sensitive in identifying poverty and deprivation among older people living in slums.

  3. From Loving Grandma to Working with Older Adults: Promoting Positive Attitudes towards Aging

    ERIC Educational Resources Information Center

    Goncalves, Daniela C.

    2009-01-01

    The steady increase of population aging requires not only more people working within the field of aging but also the creation of new services. However, current students from areas such as medicine, nursing, psychology, and social work frequently have low interest in working with older adults. The low interest relates to this task's lack of…

  4. Can a Website-Delivered Computer-Tailored Physical Activity Intervention Be Acceptable, Usable, and Effective for Older People?

    ERIC Educational Resources Information Center

    Ammann, Rahel; Vandelanotte, Corneel; de Vries, Hein; Mummery, W. Kerry

    2013-01-01

    Despite the numerous health benefits, population physical activity levels are low and declining with age. A continued increase of Internet access allows for website-delivered interventions to be implemented across age-groups, though older people have typically not been considered for this type of intervention. Therefore, the purpose of this study…

  5. Social connection, relationships and older lesbian and gay people1

    PubMed Central

    Barrett, Catherine; Whyte, Carolyn; Comfort, Jude; Lyons, Anthony; Crameri, Pauline

    2015-01-01

    This paper presents data from a small study exploring the impacts of homophobia on the lives of older lesbian and gay Australians. Eleven in-depth interviews were conducted with older lesbians (6) and gay men (5) ranging in age from 65 to 79 years. The study found that participants’ sense of self was shaped by the dominant medical, legal and religious institutions of their youth that defined them as sick, immoral or criminal. Participants described enforced “cure” therapies, being imprisoned, having employment terminated and being disowned and disinherited by family. In this context, intimate relationships and social networks provided refuge where trust was rebuilt and sexuality affirmed. Many created safe spaces for themselves. This equilibrium was threatened with increasing age, disability and the reliance on health and social services. Participants feared a return to institutional control and a need to “straighten up” or hide their sexuality. In response, partners stepped into the role of caregiver, at times beyond their capacity and at a cost to their relationship. The study describes the importance of understanding social connections in the lives of older lesbians and gay men. It highlights the need for inclusive services to ensure that social networks are supported and that health and well-being are promoted. PMID:25544830

  6. Aging: An Album of People Growing Old.

    ERIC Educational Resources Information Center

    Saul, Shura

    Written for teachers and students who expect to work with people in any field of human relationships and services, the document presents an anthology of vignettes on learning and aging. In addition to the author's vignettes are those of many others, chosen by a panel of 54 reader-judges consisting of students, professionals, and elderly people.…

  7. Ego Integrity of Older People with Physical Disability and Therapeutic Recreation

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Shim, Hye-Eun; Sia, Charmin Kathleen M.; Siazon, Wilbart Harvey S.; Sibal, Mary Joyce Ann P.; Siglos, Joanna Brigitte Lorraine C.; Simeon, Francis Marlo C.

    2011-01-01

    Ego integrity, the last developmental task in Erikson's psychological theory, develops naturally among older people. However, the presence of loss-like physical disability-can considerably affect the quality of life, interactions, and well being of older adults. Hence, older people with physical disabilities need more assistance in accomplishing…

  8. Factors Influencing Food Choice for Independently Living Older People-A Systematic Literature Review.

    PubMed

    Host, Alison; McMahon, Anne-Therese; Walton, Karen; Charlton, Karen

    2016-01-01

    Unyielding, disproportionate growth in the 65 years and older age group has precipitated serious concern about the propensity of health and aged-care services to cope in the very near future. Preservation of health and independence for as long as possible into later life will be necessary to attenuate demand for such services. Maintenance of nutritional status is acknowledged as fundamental for achievement of this aim. Determinants of food choice within this age group need to be identified and better understood to facilitate the development of pertinent strategies for encouraging nutritional intakes supportive of optimal health. A systematic review of the literature consistent with PRISMA guidelines was performed to identify articles investigating influences on food choice among older people. Articles were limited to those published between 1996 and 2014 and to studies conducted within countries where the dominant cultural, political and economic situations were comparable to those in Australia. Twenty-four articles were identified and subjected to qualitative analysis. Several themes were revealed and grouped into three broad domains: (i) changes associated with ageing; (ii) psychosocial aspects; and (iii) personal resources. Food choice among older people is determined by a complex interaction between multiple factors. Findings suggest the need for further investigations involving larger, more demographically diverse samples of participants, with the inclusion of a direct observational component in the study design.

  9. Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand.

    PubMed

    Manasatchakun, Pornpun; Chotiga, Pleumjit; Hochwälder, Jacek; Roxberg, Åsa; Sandborgh, Maria; Asp, Margareta

    2016-12-01

    The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand's aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthy aging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors.

  10. Patient safety and hydration in the care of older people.

    PubMed

    Burns, Julie

    2016-05-01

    Ensuring patients are adequately hydrated is a fundamental part of nursing care, however, it is clear from the literature that dehydration remains a significant problem in the NHS with implications for patient safety. The development of dehydration is often multifactorial and older age is an independent risk factor for the condition. However, the media often blame nursing staff for simply not giving patients enough to drink. This article discusses the scale of the problem in acute care settings and aims to raise awareness of the importance of hydration management and accurate documentation in nursing practice. It suggests that intentional hourly rounding may provide an opportunity for nurses to ensure older patients are prompted or assisted to take a drink.

  11. Expanding the Caring Lens: Nursing and Medical Students Reflecting on Images of Older People.

    PubMed

    Brand, Gabrielle; Miller, Karen; Saunders, Rosemary; Dugmore, Helen; Etherton-Beer, Christopher

    2016-01-01

    In changing higher education environments, health profession's educators have been increasingly challenged to prepare future health professionals to care for aging populations. This article reports on an exploratory, mixed-method research study that used an innovative photo-elicitation technique and interprofessional small-group work in the classroom to enhance the reflective learning experience of medical and nursing students. Data were collected from pre- and postquestionnaires and focus groups to explore shifts in perceptions toward older persons following the reflective learning session. The qualitative data revealed how using visual images of older persons provides a valuable learning space for reflection. Students found meaning in their own learning by creating shared storylines that challenged their perceptions of older people and themselves as future health professionals. These data support the use of visual methodologies to enhance engagement, reflection, and challenge students to explore and deepen their understanding in gerontology.

  12. Overweight and Obesity in Older People with Intellectual Disability

    ERIC Educational Resources Information Center

    de Winter, C. F.; Bastiaanse, L. P.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2012-01-01

    Overweight and obesity are major health problems associated with increased cardiovascular disease risk, which is not sufficiently studied in people with intellectual disability yet. The present study was part of the Healthy Ageing in Intellectual Disability (HA-ID) study. The aim of this study was to establish (1) the prevalence of overweight,…

  13. Living with companion animals after stroke: experiences of older people in community and primary care nursing.

    PubMed

    Johansson, Maria; Ahlström, Gerd; Jönsson, Ann-Cathrin

    2014-12-01

    Older people often have companion animals, and the significance of animals in human lives should be considered by nurses-particularly in relation to older people's health, which can be affected by diseases. The incidence of stroke increases with age and disabilities as a result of stroke are common. This study aimed to explore older people's experiences of living with companion animals after stroke, and their life situation with the animals in relation to the physical, psychological and social aspects of recovery after stroke. The study was performed using individual interviews approximately 2 years after stroke with 17 participants (10 women and 7 men) aged 62-88 years. An overarching theme arising from the content analysis was contribution to a meaningful life. This theme was generated from four categories: motivation for physical and psychosocial recovery after stroke; someone to care for who cares for you; animals as family members; and providers of safety and protection. The main conclusion was that companion animals are experienced as physical and psychosocial contributors to recovery and a meaningful life after stroke.

  14. Research on ethics in nursing care for older people: a literature review.

    PubMed

    Suhonen, Riitta; Stolt, Minna; Launis, Veikko; Leino-Kilpi, Helena

    2010-05-01

    The aim of this review was to analyse the empirical studies that focus on ethics in nursing care for older people, scoping the need and areas for further study. A search of the MEDLINE and CINAHL databases (earliest to August 2009) was conducted using the the keywords: ethic* and nursing or care or caring and elderly or aged or older. After a four-stage process, 71 empirical articles were included in the review, with informants ranging from elderly people to relatives, caregivers, managers and students in care settings. The review focuses on the concepts, contexts, methods and validity of these studies. Based on the analysis, the reviewed research seems to be fragmented and multifaceted, focussing on selected issues such as autonomy, self-determination and informed consent. No large research programs or research traditions were found so it was not possible to draw any conclusions about suitable methods, study designs or instruments of measurement for use in this research area.

  15. Hypoglycemia in Older People - A Less Well Recognized Risk Factor for Frailty

    PubMed Central

    Abdelhafiz, Ahmed H; Rodríguez-Mañas, Leocadio; Morley, John E.; Sinclair, Alan J

    2015-01-01

    Recurrent hypoglycemia is common in older people with diabetes and is likely to be less recognized and under reported by patients and health care professionals. Hypoglycemia in this age group is associated with significant morbidities leading to both physical and cognitive dysfunction. Repeated hospital admissions due to frequent hypoglycemia are also associated with further deterioration in patients’ general health. This negative impact of hypoglycemia is likely to eventually lead to frailty, disability and poor outcomes. It appears that the relationship between hypoglycemia and frailty is bidirectional and mediated through a series of influences including under nutrition. Therefore, attention should be paid to the management of under nutrition in the general elderly population by improving energy intake and maintaining muscle mass. Increasing physical activity and having a more conservative approach to glycemic targets in frail older people with diabetes may be worthwhile. PMID:25821643

  16. Osteoporosis and sarcopenia in older age.

    PubMed

    Edwards, M H; Dennison, E M; Aihie Sayer, A; Fielding, R; Cooper, C

    2015-11-01

    Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties include the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. This article is part of a Special Issue entitled "Muscle Bone Interactions".

  17. Health risk appraisal in older people 6: factors associated with self-reported poor vision and uptake of eye tests in older people

    PubMed Central

    2013-01-01

    Background Although free eye testing is available in the UK from a nation-wide network of optometrists, there is evidence of unrecognised, tractable vision loss amongst older people. A recent review identified this unmet need as a priority for further investigation, highlighting the need to understand public perceptions of eye services and barriers to service access and utilisation. This paper aims to identify risk factors for (1) having poor vision and (2) not having had an eyesight check among community-dwelling older people without an established ophthalmological diagnosis. Methods Secondary analysis of self-reported data from the ProAge trial. 1792 people without a known ophthalmological diagnosis were recruited from three group practices in London. Results Almost two in ten people in this population of older individuals without known ophthalmological diagnoses had self-reported vision loss, and more than a third of them had not had an eye test in the previous twelve months. In this sample, those with limited education, depressed mood, need for help with instrumental and basic activities of daily living (IADLs and BADLs), and subjective memory complaints were at increased risk of fair or poor self-reported vision. Individuals with basic education only were at increased risk for not having had an eye test in the previous 12 months (OR 1.52, 95% CI 1.17-1.98 p=0.002), as were those with no, or only one chronic condition (OR 1.850, 95% CI 1.382-2.477, p<0.001). Conclusions Self-reported poor vision in older people without ophthalmological diagnoses is associated with other functional losses, with no or only one chronic condition, and with depression. This pattern of disorders may be the basis for case finding in general practice. Low educational attainment is an independent determinant of not having had eye tests, as well as a factor associated with undiagnosed vision loss. There are other factors, not identified in this study, which determine uptake of eye

  18. 'I don't think they knew we could do these sorts of things': social representations of community and participation in community arts by older people.

    PubMed

    Murray, Michael; Crummett, Amanda

    2010-07-01

    As people age the character of their social relationships change. There is evidence that older people who reside in disadvantaged communities often experience social isolation, which in turn has been found to be associated with a variety of health problems. This article reports the initial findings from a participatory arts project with a group of older residents of a disadvantaged urban community. It describes how the older residents represented their community and how they perceived the community arts intervention.

  19. People with Learning Disabilities and "Active Ageing"

    ERIC Educational Resources Information Center

    Foster, Liam; Boxall, Kathy

    2015-01-01

    Background: People (with and without learning disabilities) are living longer. Demographic ageing creates challenges and the leading policy response to these challenges is "active ageing". "Active" does not just refer to the ability to be physically and economically active, but also includes ongoing social and civic engagement…

  20. ICT, Education and Older People in Australia: A Socio-Technical Analysis

    ERIC Educational Resources Information Center

    Tatnall, Arthur

    2014-01-01

    People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…

  1. A systematic narrative review of consumer-directed care for older people: implications for model development.

    PubMed

    Ottmann, Goetz; Allen, Jacqui; Feldman, Peter

    2013-11-01

    Consumer-directed care is increasingly becoming a mainstream option in community-based aged care. However, a systematic review describing how the current evaluation research translates into practise has not been published to date. This review aimed to systematically establish an evidence base of user preferences for and satisfaction with services associated with consumer-directed care programmes for older people. Twelve databases were searched, including MedLine, BioMed Central, Cinahl, Expanded Academic ASAP, PsychInfo, ProQuest, Age Line, Science Direct, Social Citation Index, Sociological Abstracts, Web of Science and the Cochrane Library. Google Scholar and Google were also searched. Eligible studies were those reporting on choice, user preferences and service satisfaction outcomes regarding a programme or model of home-based care in the United States or United Kingdom. This systematic narrative review retrieved literature published from January 1992 to August 2011. A total of 277 references were identified. Of these 17 met the selection criteria and were reviewed. Findings indicate that older people report varying preferences for consumer-directed care with some demonstrating limited interest. Clients and carers reported good service satisfaction. However, research comparing user preferences across countries or investigating how ecological factors shape user preferences has received limited attention. Policy-makers and practitioners need to carefully consider the diverse contexts, needs and preferences of older adults in adopting consumer-directed care approaches in community aged care. The review calls for the development of consumer-directed care programmes offering a broad range of options that allow for personalisation and greater control over services without necessarily transferring the responsibility for administrative responsibilities to service users. Review findings suggest that consumer-directed care approaches have the potential to empower older

  2. Healing determinants in older people with leg ulcers.

    PubMed

    Johnson, M

    1995-10-01

    A descriptive correlational design was used to identify the physiologic, therapeutic, and psychosocial determinants of leg ulcer healing in community-residing older people with venous and venous-arterial disease (N = 156). A regression model with healing rate as the dependent variable explained 49% of the variance. Increased pain when mobilizing, increased hours with limbs horizontal to the torso, and moderate and severe liposclerosis (hardening and induration of the skin) were associated with poorer healing rates. Higher wound status scores were associated with more rapid healing rates. Self-efficacy beliefs and social support were not significant factors. The findings suggest the need for early detection and management of limb pain that interferes with normal mobility. Limb position and edema assessment prior to the application of compression bandages is recommended, with bandages that provide clients with high compression when ambulant and low compression when resting being potentially beneficial.

  3. Comprehension by older people of medication information with or without supplementary pharmaceutical pictograms.

    PubMed

    Ng, Annie W Y; Chan, Alan H S; Ho, Vincy W S

    2017-01-01

    This study examined the benefits of pharmaceutical pictograms for improving comprehension of medication information for older people. Fifty Hong Kong Chinese older people completed a medical information comprehension task for five drugs. Participants in the control group were presented with text labels while those in the experimental group were given the text labels plus supplementary pharmaceutical pictograms, and then all reported their understanding of the medication information conveyed. Lower educated older people had poorer understanding of medication information. The addition of pharmaceutical pictograms significantly improved the comprehension of medication information for older people. The majority of older people tested with pictograms favored adding pictograms to text and thought the pictograms were useful for conveying medical information rather than using written text alone. The findings suggested that pharmaceutical and health care professionals should include pharmaceutical pictograms on labels to better convey instructions on medication to older people.

  4. Improvement in the physiological function and standing stability based on kinect multimedia for older people

    PubMed Central

    Chen, Chih-Chen

    2016-01-01

    [Purpose] The increase in the Taiwanese older population is associated with age-related inconveniences. Finding adequate and simple physical activities to help the older people maintaining their physiological function and preventing them from falls has become an urgent social issue. [Subjects and Methods] This study aimed to design a virtual exercise training game suitable for Taiwanese older people. This system will allow for the maintenance of the physiological function and standing stability through physical exercise, while using a virtual reality game. The participants can easily exercise in a carefree, interactive environment. This study will use Kinect for Windows for physical movement detection and Unity software for virtual world development. [Results] Group A and B subjects were involved in the exercise training method of Kinect interactive multimedia for 12 weeks. The results showed that the functional reach test and the unipedal stance test improved significantly. [Conclusion] The physiological function and standing stability of the group A subjects were examined at six weeks post training. The results showed that these parameters remained constant. This proved that the proposed system provide substantial support toward the preservation of the Taiwanese older people’ physiological function and standing stability. PMID:27190480

  5. Why older people engage in physical activity: an exploratory study of participants in a community-based walking program.

    PubMed

    Capalb, Darren J; O'Halloran, Paul; Liamputtong, Pranee

    2014-01-01

    While older people experience substantial physical and mental health benefits from regular physical activity, participation rates among older people are low. There is a need to gather more information about why older people do and do not engage in physical activity. This paper aims to examine the reasons why older men and women chose to engage in a community-based physical activity program. Specific issues that were examined included reasons why older people who had been involved in a community-based program on a regular basis: commenced the program; continued with the program; and recommenced the program after they had dropped out. Ten participants (eight females and two males) aged between 62 and 75 years, who had been participating in a community-based physical activity program for a minimum of 6 months, were individually interviewed. Thematic analysis was used to analyse the data. Three major themes emerged, including 'time to bond: social interaction' with sub-themes 'bona fide friendships' and 'freedom from being isolated'; 'I want to be healthy: chronic disease management'; and 'new lease on life'. Two of the primary reasons why older people both commenced and recommenced the program were the promise of social interaction and to be able to better manage their chronic conditions.

  6. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness

    PubMed Central

    Chau, Allan T.; Menant, Jasmine C.; Hübner, Patrick P.; Lord, Stephen R.; Migliaccio, Americo A.

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51–92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1–2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s2 to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5–1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  7. Health screening - men age 65 and older

    MedlinePlus

    Health maintenance visit - men - over age 65; Physical exam - men - over age 65; Yearly exam - men - over age 65; Checkup - men - over age 65; Men's health - over age 65; Preventive care exam - men - over ...

  8. Exercise Intervention for Anti-Sarcopenia in Community-Dwelling Older People

    PubMed Central

    Miyazaki, Ryo; Takeshima, Taro; Kotani, Kazuhiko

    2016-01-01

    Sarcopenia is an age-related health problem in general communities. Effective exercise programs against sarcopenia remain necessary for community-dwelling older people. In order to summarize the available knowledge on this subject, we collected English articles from a MEDLINE/Pubmed database examining the effects of exercise interventions on sarcopenia-related outcome measures in community-dwelling older people. When nine articles, including eight randomized controlled trials, were reviewed, most studies demonstrated significant improvements in some outcome measures. Indeed, a significant improvement in the muscle mass in one study, muscle strength in two studies and physical performance in two studies was reported among five studies using exercise (E) alone. A significant improvement in the muscle mass in two studies, muscle strength in one study and physical performance in two studies was also reported among four studies using exercise plus nutritional supplementation (EN). Notably, the EN studies appeared to have less extensive exercise interventions than the E studies. One EN study further exhibited significant improvements in all outcome measures. Collectively, exercise could be used as anti-sarcopenic strategies and nutritional interventions when combined with exercise might play a compensated or perhaps a comprehensive role among community-dwelling older people. Limited studies exist and more studies are required for the optimum programs in the community settings. PMID:27829949

  9. Effects of shoe sole hardness on plantar pressure and comfort in older people with forefoot pain.

    PubMed

    Lane, Tamara J; Landorf, Karl B; Bonanno, Daniel R; Raspovic, Anita; Menz, Hylton B

    2014-01-01

    Plantar forefoot pain is common in older people and is related to increased peak pressures under the foot during gait. Variations in the hardness of the shoe sole may therefore influence both the magnitude of loading under the foot and the perceived comfort of the shoe in this population. The aim of this investigation was to determine the effect of varying shoe sole hardness on plantar pressures and comfort in older people with forefoot pain. In-shoe plantar pressures under the forefoot, midfoot and rearfoot were recorded from 35 older people (mean age 73.2, SD 4.5 years) with current or previous forefoot pain using the pedar-X(®) system. Participants walked at their normal comfortable speed along an 8m walkway in shoes with three different levels of sole hardness: soft (Shore A25), medium (Shore A40) and hard (Shore A58). Shoe comfort was measured on a 100mm visual analogue scale. There were statistically significant differences in peak pressure of between 5% and 23% across the forefoot, midfoot and rearfoot (p<0.01). The hard-soled shoe registered the highest peak pressures and the soft-soled shoe the lowest peak pressures. However, no differences in comfort scores across the three shoe conditions were observed. These findings demonstrate that as shoe sole hardness increases, plantar pressure increases, however this does not appear to have a significant effect on shoe comfort.

  10. Practical Problems with Medication Use that Older People Experience: A Qualitative Study

    PubMed Central

    Notenboom, Kim; Beers, Erna; van Riet-Nales, Diana A; Egberts, Toine C G; Leufkens, Hubert G M; Jansen, Paul A F; Bouvy, Marcel L

    2014-01-01

    Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews. Setting A community pharmacy and a geriatric outpatient ward. Participants Community-dwelling people aged 70 and older (N = 59). Measurements Participants were interviewed at home. Two researchers coded the reported problems and management strategies independently according to a coding scheme. An expert panel classified the potential clinical relevance of every identified practical problem and associated management strategy using a 3-point scale. Results Two hundred eleven practical problems and 184 management strategies were identified. Ninety-five percent of the participants experienced one or more practical problems with the use of their medicines: problems reading and understanding the instructions for use, handling the outer packaging, handling the immediate packaging, completing preparation before use, and taking the medicine. For 10 participants, at least one of their problems, in combination with the applied management strategy, had potential clinical consequences and 11 cases (5% of the problems) had the potential to cause moderate or severe clinical deterioration. Conclusion Older people experience a number of practical problems using their medicines, and their strategies to manage these problems are sometimes suboptimal. These problems can lead to incorrect medication use with clinically relevant consequences. The findings pose a challenge for healthcare professionals, drug developers, and regulators to diminish these problems. PMID:25516030

  11. A Comparison of Dance Interventions in People with Parkinson Disease and Older Adults

    PubMed Central

    McNeely, ME; Duncan, RP; Earhart, GE

    2015-01-01

    It is important for our aging population to remain active, particularly those with chronic diseases, like Parkinson disease (PD), which limit mobility. Recent studies in older adults and people with PD suggest dance interventions provide various motor benefits. The literature for dance in PD is growing, but many knowledge gaps remain, relative to what is known in older adults. The purpose of this review is to: 1) detail results of dance intervention studies in older adults and in PD, 2) describe limitations of dance research in these populations, and 3) identify directions for future study. Generally, a wide variety of dance styles have been investigated in older adults, while a more limited subset has been evaluated in PD. Measures vary widely across studies and a lack of standardized outcomes measures hinders cross-studies comparisons. Compared to the dance literature in older adults, there is a notable absence of evidence in the PD literature in outcome domains related to cardiovascular health, muscle strength, body composition, flexibility, and proprioception. As a whole, the dance literature supports substantial and wide-ranging benefits in both populations, but additional effort should be dedicated to well-designed comparative studies using standardized outcome measures to identify optimal treatment programs. PMID:25771040

  12. A comparison of dance interventions in people with Parkinson disease and older adults.

    PubMed

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

    2015-05-01

    It is important for our aging population to remain active, particularly those with chronic diseases, like Parkinson disease (PD), which limit mobility. Recent studies in older adults and people with PD suggest dance interventions provide various motor benefits. The literature for dance in PD is growing, but many knowledge gaps remain, relative to what is known in older adults. The purpose of this review is to: (1) detail results of dance intervention studies in older adults and in PD, (2) describe limitations of dance research in these populations, and (3) identify directions for future study. Generally, a wide variety of dance styles have been investigated in older adults, while a more limited subset has been evaluated in PD. Measures vary widely across studies and a lack of standardized outcomes measures hinders cross-studies comparisons. Compared to the dance literature in older adults, there is a notable absence of evidence in the PD literature in outcome domains related to cardiovascular health, muscle strength, body composition, flexibility, and proprioception. As a whole, the dance literature supports substantial and wide-ranging benefits in both populations, but additional effort should be dedicated to well-designed comparative studies using standardized outcome measures to identify optimal treatment programs.

  13. Memoirs: Workshops Inspire Lifestories from People of Different Ages.

    ERIC Educational Resources Information Center

    Eyerer, Judy

    1992-01-01

    At lifewriting workshops held in Maine schools and senior citizen centers, participants learn to turn their memories into written vignettes. Writing memoirs helps older people celebrate who they have been and helps younger people explore who they are. (LP)

  14. The impact of comprehensive geriatric assessment interventions on tolerance to chemotherapy in older people

    PubMed Central

    Kalsi, T; Babic-Illman, G; Ross, P J; Maisey, N R; Hughes, S; Fields, P; Martin, F C; Wang, Y; Harari, D

    2015-01-01

    Background: Although comorbidities are identified in routine oncology practice, intervention plans for the coexisting needs of older people receiving chemotherapy are rarely made. This study evaluates the impact of geriatrician-delivered comprehensive geriatric assessment (CGA) interventions on chemotherapy toxicity and tolerance for older people with cancer. Methods: Comparative study of two cohorts of older patients (aged 70+ years) undergoing chemotherapy in a London Hospital. The observational control group (N=70, October 2010–July 2012) received standard oncology care. The intervention group (N=65, September 2011–February 2013) underwent risk stratification using a patient-completed screening questionnaire and high-risk patients received CGA. Impact of CGA interventions on chemotherapy tolerance outcomes and grade 3+ toxicity rate were evaluated. Outcomes were adjusted for age, comorbidity, metastatic disease and initial dose reductions. Results: Intervention participants undergoing CGA received mean of 6.2±2.6 (range 0–15) CGA intervention plans each. They were more likely to complete cancer treatment as planned (odds ratio (OR) 4.14 (95% CI: 1.50–11.42), P=0.006) and fewer required treatment modifications (OR 0.34 (95% CI: 0.16–0.73), P=0.006). Overall grade 3+ toxicity rate was 43.8% in the intervention group and 52.9% in the control (P=0.292). Conclusions: Geriatrician-led CGA interventions were associated with improved chemotherapy tolerance. Standard oncology care should shift towards modifying coexisting conditions to optimise chemotherapy outcomes for older people. PMID:25871332

  15. Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People.

    PubMed

    Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn; de Craen, Anton J M; Slaets, Joris P J; Westendorp, Rudi G J

    Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self-rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms) were included as geriatric giants. Participants provided a score for life satisfaction and were followed up for vital status. Concordance of self-rated health with physician-rated (k = .3 [.0]) and nurse-rated health (k = .2 [.0]) was low. All three ratings were associated with the geriatric giants except for hearing loss (all p < 0.001). Associations were equal in strength, except for depressive symptoms, which showed a stronger association with self-rated health (.8 [.1] versus .4 [.1]). Self-rated health predicted mortality less well than the other ratings. Self-rated health related stronger to life satisfaction than physician's and nurse's ratings. We conclude that professionals' health ratings are more reflective of physical health whereas self-rated health reflects more the older person's mental health, but all three health ratings are useful in research.

  16. The relationship between serum TSH and free T4 in older people.

    PubMed

    Clark, Penny M; Holder, Roger L; Haque, Sayeed M; Hobbs, F D Richard; Roberts, Lesley M; Franklyn, Jayne A

    2012-11-01

    The frequency distribution of serum thyroid stimulating hormone (TSH) shows a skewed pattern that may change with age. The set point of the hypothalamic-pituitary-thyroid axis for an individual is thought to be genetically determined and has been described as a log-linear relationship of serum TSH to free thyroxine (T4); however, the validity of this hypothesis has yet to be established in older people. The aim of the study was to describe the relationship between serum TSH and free T4 in older people and define factors influencing this relationship. We conducted a cross-sectional, observational study of thyroid function in a community population of older subjects over 65 years of age. The relationship between serum TSH and free T4 was not linear as previously described, but is best described as a fourth-order polynomial. Both gender and smoking status affected the relationship. This suggests that more complex modelling is required when investigating the hypothalamic-pituitary-thyroid axis.

  17. The relationship between serum TSH and free T4 in older people.

    PubMed

    Clark, Penny M; Holder, Roger L; Haque, Sayeed M; Hobbs, F D Richard; Roberts, Lesley M; Franklyn, Jayne A

    2012-05-01

    The frequency distribution of serum thyroid stimulating hormone (TSH) shows a skewed pattern that may change with age. The set point of the hypothalamic-pituitary-thyroid axis for an individual is thought to be genetically determined and has been described as a log-linear relationship of serum TSH to free thyroxine (T4); however, the validity of this hypothesis has yet to be established in older people. The aim of the study was to describe the relationship between serum TSH and free T4 in older people and define factors influencing this relationship. We conducted a cross-sectional, observational study of thyroid function in a community population of older subjects over 65 years of age. The relationship between serum TSH and free T4 was not linear as previously described, but is best described as a fourth-order polynomial. Both gender and smoking status affected the relationship. This suggests that more complex modelling is required when investigating the hypothalamic-pituitary-thyroid axis.

  18. Assessment and management of nutrition in older people and its importance to health

    PubMed Central

    Ahmed, Tanvir; Haboubi, Nadim

    2010-01-01

    Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements. PMID:20711440

  19. Self-reported diabetes in older people: comparison of prevalences and control measures

    PubMed Central

    Stopa, Sheila Rizzato; César, Chester Luiz Galvão; Segri, Neuber José; Goldbaum, Moisés; Guimarães, Vanessa Martins Valente; Alves, Maria Cecília Goi Porto; Barros, Marilisa Berti de Azevedo

    2014-01-01

    OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson’s Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients. PMID:25210814

  20. The increasing burden of pelvic fractures in older people, New South Wales, Australia.

    PubMed

    Boufous, Soufiane; Finch, Caroline; Lord, Stephen; Close, Jacqueline

    2005-11-01

    Despite their significant health burden, epidemiological information regarding pelvic fractures is scarce. In this study, we examine trends in admission for pelvic fractures to acute hospitals in New South Wales, Australia, between July 1988 and June 2000, using routinely collected hospital separations statistics. Over this period, the number of admissions for pelvic fractures among those aged 50 years and over increased by 58.4% in men and 110.8% in women. Age-specific rates of admissions per 100,000 population for pelvic fracture also rose significantly, particularly for those aged at least 75 years. The number and proportion of transport related pelvic fractures fell significantly for both men (chi(2)=23.82, d.f.=1, p<0.001) and women (chi(2)=49.26, d.f.=1, p<0.001) while those resulting from falls increased significantly over the 12-year-period. Falls are increasingly becoming the single most important cause of pelvic injuries in older people, suggesting that preventive measures aimed at reducing the risk of falls need to be pursued. Factors contributing to the rise of fall-related pelvic fractures need to be investigated to inform strategies aimed at reversing the observed increase in the number and age-specific rates of pelvic fractures in older people.

  1. Cognitive behaviour therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults?

    PubMed

    Kishita, Naoko; Laidlaw, Ken

    2017-03-01

    The current meta-analysis compared the efficacy of CBT for GAD between adults of working age and older people. In addition, we conducted a qualitative content analysis of treatment protocols used in studies with older clients to explore potential factors that may enhance treatment outcomes with this particular client group. Applying the inclusion criteria resulted in the identification of 15 studies with 22 comparisons between CBT and control groups (770 patients). When examining overall effect sizes for CBT for GAD between older people and adults of working age there were no statistically significant differences in outcome. However, overall effect size of CBT for GAD was moderate for older people (g=0.55, 95% CI 0.22-0.88) and large for adults of working age (g=0.94, 95% CI 0.52-1.36), suggesting that there is still room for improvement in CBT with older people. The main difference in outcome between CBT for GAD between the two age groups was related to methodological quality in that no older people studies used an intention-to-treat design. The content analysis demonstrated that studies with older clients were conducted according to robust CBT protocols but did not take account of gerontological evidence to make them more age-appropriate.

  2. Factors Influencing the Quality of Life (Qol) Among Thai Older People in a Rural Area of Thailand

    PubMed Central

    HONGTHONG, Donnapa; SOMRONGTHONG, Ratana; WARD, Paul

    2015-01-01

    Background: The population prevalence of older people has been growing worldwide. Quality of Life (QoL) among older people is a significant public health concern. Hence, this study aimed to assess level of QoL and factors influencing QoL among rural Thai older people. Methods: The study was undertaken in Phayao Province where is one of the top ten provinces with the highest index of Thai aging. A district in this province was purposively selected to be the study area and the quota-sampling technique was used for sample collection, totally 400 older people participated according to Taro Yamane. The WHO QoL-Old was employed to interview elderly QoL. Multivariate linear regression was performed to determine the factors influencing QoL among the older people. Results: Over two-thirds of older people (68.5%) had QoL at fair level. The vast majority (96%) had high scores for Activity Daily Living (ADL). Approximately one-fifth (20.5%) reported current smoking and 31.7% reported ever drinking during previous year. Following univariate analysis, nine factors – gender, age, education, working, income, present illness, drinking, ADL, and participating in elderly club were identified as being significantly associated with QoL (P <0.05). Multivariate analysis revealed four factors predictive of QoL among elderly: ADL, income, alcohol drinking, and present illness (P < 0.01). Conclusion: Physical function, health status and financial were the predictor of QoL among elderly. Noticeably, drinking was one predictive factor of QoL but only among moderate drinkers. Hence, healthy life style should be considered as key areas in attempts to promote QoL among elderly people. PMID:26056666

  3. A Commentary on Age Segregation for Older Prisoners

    PubMed Central

    Kerbs, John J.; Jolley, Jennifer M.

    2014-01-01

    The growing number of older prisoners in state and federal prisons has fostered an important discussion in literature regarding the potential benefits of age-segregated living arrangements for older inmates. This article begins with a brief review of the reasons for America's aging prison population. Thereafter, it uses a multidisciplinary literature review to clarify a 4-point rationale for age-segregated prisons: (a) cost savings via centralized health care for older prisoners; (b) the reduction of civil liabilities for correctional systems that centralize disability services as per requirements of the Americans with Disabilities Act of 1990; (c) the advancement of prisoner safety for older inmates; and (d) the promotion of rehabilitation by advancing treatment opportunities with a group that is most likely to desist from future criminal activity (in part) due to age-related desistance from crime. Conclusions focus on age segregation within the historical context of segregation in prison based on sociodemographic characteristics. PMID:28316366

  4. How Do People with Learning Disabilities Experience and Make Sense of the Ageing Process?

    ERIC Educational Resources Information Center

    Newberry, Gayle; Martin, Carol; Robbins, Lorna

    2015-01-01

    Background: Not enough is currently known about how people with learning disabilities experience and understand the ageing process. This is particularly important as the population of older people with learning disabilities is growing due to increased life expectancy. This article draws on the first author's doctoral research study, which aimed to…

  5. Ischemic stroke patients are biologically older than their chronological age

    PubMed Central

    Soriano-Tárraga, Carolina; Giralt-Steinhauer, Eva; Mola-Caminal, Marina; Vivanco-Hidalgo, Rosa M.; Ois, Angel; Rodríguez-Campello, Ana; Cuadrado-Godia, Elisa; Sayols-Baixeras, Sergi; Elosua, Roberto; Roquer, Jaume; Jiménez-Conde, Jordi

    2016-01-01

    Ischemic stroke is associated with aging. It is possible to predict chronological age by measuring age-related changes in DNA methylation from multiple CpG sites across the genome, known as biological age. The difference between biological age and actual chronological age would indicate an individual's level of aging. Our aim was to determine the biological age of ischemic stroke patients and compare their aging with controls of the same chronological age. A total of 123 individuals, 41 controls and 82 patients with ischemic stroke were paired by chronological age, ranging from 39 to 82 years. Illumina HumanMethylation450 BeadChip array was used to measure DNA methylation in CpG sites in both groups, and biological age was estimated using methylation values of specific CpGs. Ischemic stroke patients were biologically an average 2.5 years older than healthy controls (p-value=0.010). Stratified by age tertiles, younger stroke patients (≤57 years old) were biologically older than controls (OR=1.19; 95%CI 1.00-1.41, p-value=0.046). The older groups showed no biological age differences between cases and controls, but were close to reaching the significance level. Ischemic stroke patients are biologically older than controls. Biological age should be considered as a potential new biomarker of stroke risk. PMID:27922817

  6. Assessing Subjective Well-Being in Chinese Older Adults: The Chinese Aging Well Profile

    ERIC Educational Resources Information Center

    Ku, Po-Wen; Fox, Kenneth R.; McKenna, Jim

    2008-01-01

    Subjective well-being has increasingly been used as a key indicator of quality of life in older people. Existing evidence shows that it is likely that eastern cultures carry different life values and so the Chinese Aging Well Profile was devised for measuring subjective well-being in Chinese adults (50+). Data was collected from 1,906…

  7. Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis

    PubMed Central

    Oster, Candice; Henderson, Julie; Lawn, Sharon; Reed, Richard; Dawson, Suzanne; Muir-Cochrane, Eimear; Fuller, Jeffrey

    2016-01-01

    Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people’s mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of ‘risk’, ‘ageing as decline/dependence’ and ‘healthy ageing’ were identified. Through these discourses, different neo-liberal governmental strategies are applied to ‘target’ groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people’s mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers. PMID:27147440

  8. Does Work Contribute to Successful Aging Outcomes in Older Workers?

    ERIC Educational Resources Information Center

    Sanders, Martha J.; McCready, Jack W.

    2010-01-01

    Older workers are the fastest growing segment of the labor force, yet little is known about designing jobs for older workers that optimize their experiences relative to aging successfully. This study examined the contribution of workplace job design (opportunities for decision-making, skill variety, coworker support, supervisor support) to…

  9. Effects of the Change in Working Status on the Health of Older People in Japan

    PubMed Central

    Hasebe, Masami; Nonaka, Kumiko; Koike, Takashi; Suzuki, Hiroyuki; Murayama, Yoh; Uchida, Hayato

    2015-01-01

    Background Working at old ages is regarded as a good way to keep one’s health according to the idea of productive aging. However, there is not enough evidence yet whether retirement is good or bad, or the kind of effects it has on the health of older adults aged 65 and over. We examined it by using a recent data of Wako city, a suburb area near Tokyo in Japan. Methods One thousand seven hundred sixty-eight participants answered to 3 waves of survey questionnaires: 2008, 2010, and 2012, successively. We considered 3 indicators of health; self-rated health, mental health (GDS15) and HLFC (Higher-Level Functional Capacity: TMIG-IC). In cross-sectional analysis, we compared these 3 indicators by three groups: full-time worker, part-time worker, and non-worker. In longitudinal analysis, we compared these three indicators by two groups: subjects who successively worked in 2008, 2010, 2012, and subjects who worked in 2008 but retired before 2010. We used one-way and two way repeated measures ANCOVA for these analyses, respectively. Results It was significantly clear that retirement worsened both mental health and HLFC in people aged 65 years and over; especially, mental health worsened rapidly and HLFC gradually. However, these indicators didn’t worsen in subjects who changed from full-time jobs to part-time jobs. Quitting from part-time jobs deteriorated mental health gradually and HLFC moderately compared to full-time jobs. Conclusion The results support the activity theory that older adults who quit from full-time jobs deteriorated both mental health and HLFC, though at different speeds. If they make a transit to part-time jobs, the deterioration would be moderate. It shows that working is an effective way of social participation for older people aged 65 years and over in Japan. PMID:26633033

  10. Active Ageing Level of Older Persons: Regional Comparison in Thailand

    PubMed Central

    Haque, Md. Nuruzzaman

    2016-01-01

    Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different (p < 0.001)). Mean AAI in Central region is lower than North, Northeast, and South regions but there is no significant difference in the latter three regions of Thailand. Special emphasis should be given to Central region and policy should be undertaken for increasing active ageing level. Implementation of an Integrated Active Ageing Package (IAAP), containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons' active ageing level in Thailand. PMID:27375903

  11. [Behavioral competence among community dwelling older people with disability in basic activities of daily living].

    PubMed

    Ishizaki, T; Watanabe, S; Suzuki, T; Shibata, H; Yoshida, H; Yasumura, S; Niino, N

    2000-07-01

    This study observed the status of independence in behavioral competence among older people who have any disability in basic activities of daily living (BADL) living in a rural community in Japan. Study participants (N = 76) who were regarded as bedridden were surveyed by means of a questionnaire in July to August 1996. The independence variables were age, sex, BADL status, hearing impairment, visual impairment, history of stroke, and cognitive impairment. The dependent variable was each item of the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence, which is a multidimensional 13-item index of behavioral competence. Percentages of subjects who were independent in each item of the TMIG Index of Competence varied from 1% to 36%. Multiple logistic regression analyses revealed that BADL status was independently associated with independence in using a telephone, being interested in news stories or programs dealing with health, being called on for advice, and initiating conversations with young people, after adjustment for age, sex, hearing impairment, visual impairment, history of stroke, and cognitive impairment. These findings suggest that programs for preventing decline in behavioral competence of older people with BADL disability might be important as well as physical therapy for them.

  12. The Aging Semantic Differential in Mandarin Chinese: Measuring Attitudes toward Older Adults in China.

    PubMed

    Gonzales, Ernest; Marchiondo, Lisa A; Tan, Jing; Wang, Yi; Chen, Huajuan

    2017-02-16

    The Aging Semantic Differential (ASD) is the most widely used instrument to measure young people's attitudes towards older adults. This study translated the ASD to Mandarin and examined its psychometric properties. The Mandarin-ASD contains three latent factors (Personality and Mental Health, Societal Participation, and Physical) that have high internal reliability and reasonable discriminate validity. Social work researchers, practitioners and allied professionals may utilize the ASD-Mandarin instrument to measure young people's attitudes towards older adults in China. We issue a call for a universal-ASD that can be applied across different cultural contexts.

  13. HIV Among People Aged 50 and Over

    MedlinePlus

    ... Prevention VIH En Español Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Email Updates on HIV Syndicated Content Website Feedback HIV Among People Aged 50 and Over Language: English ...

  14. An Exploration of Loneliness: Communication and the Social Networks of Older People with Cerebral Palsy

    ERIC Educational Resources Information Center

    Ballin, Liora; Balandin, Susan

    2007-01-01

    Background: There is a large body of research focusing on the experiences of loneliness of older adults, yet little is known about the loneliness experiences of older adults with lifelong disability. In this paper, the authors present some findings from a larger qualitative study on the loneliness experiences of older people with cerebral palsy.…

  15. Healthy ageing and home: the perspectives of very old people in five European countries.

    PubMed

    Sixsmith, J; Sixsmith, A; Fänge, A Malmgren; Naumann, D; Kucsera, C; Tomsone, S; Haak, M; Dahlin-Ivanoff, S; Woolrych, R

    2014-04-01

    This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated.

  16. Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

    PubMed Central

    2016-01-01

    Background The promotion and maintenance of higher physical activity (PA) levels in the older population is an imperative for cognitive and healthy ageing but it is unclear what approaches are best suited to achieve this for the increasing number of older people living in the community. Effective policies should be informed by robust, multi-disciplinary and multi-dimensional evidence, which not only seeks what works, but in ‘what context? In addition to evidence on the efficacy and effectiveness of PA for maintaining cognitive health, social contexts such as ‘how do we actually get older people to partake in PA?’ and ‘how do we sustain that activity long-term?’ also need highlighting. This review is part of a comprehensive evidence synthesis of preventive interventions in older age, with a focus on healthy behaviours to identify evidence gaps and inform policy relating to ageing well and cognitive health. An overview of systematic reviews of PA was conducted to explore three topics: (1) PA efficacy or effectiveness for primary prevention of cognitive decline in 55+; (2) Interventions efficacious or effective for increasing PA uptake and maintenance in 55+; (3) barriers and facilitators to PA in 55+. Methods Multiple databases were searched for studies in English from OECD countries between 2000 and 2016. Quality of included reviews in questions (1) and (2) were assessed using AMSTAR. Review protocols were registered on PROSPERO (CRD42014015554, 42014015584, CRD42014015557) and reviews follow PRISMA guideline. Findings Overall, 40 systematic reviews were included. Question 1 (n = 14). 8,360 participants. Evidence suggests that PA confer mild positive effects on cognition in older adults with and without previous cognitive impairment. However, there is insufficient evidence of a dose-response relationship. Evidence on the effects of PA on delay of dementia onset is inconclusive. Question 2 (n = 17). 79,650 participants. Evidence supports the effectiveness

  17. Integrating life themes of work in the care of older people.

    PubMed

    Ruler, A J

    1998-12-01

    This paper examines the role that work themes may play in helping the elderly person to improve integrity, self worth and esteem. The life themes of two older individuals who worked beyond retirement age are identified. One individual worked in paid employment and the other worked in a voluntary capacity. These people to review their life and the themes identified have enabled them to cope through their most difficult times. The themes are situated within psychological and narrative theory. The themes have added richness, variety and meaning to the participants' lives. Gender contrasts have been noted along with functional, personal and interpersonal meanings that their work has held for them.

  18. Herpes zoster correlates with increased risk of Parkinson's disease in older people: A population-based cohort study in Taiwan.

    PubMed

    Lai, Shih-Wei; Lin, Chih-Hsueh; Lin, Hsien-Feng; Lin, Cheng-Li; Lin, Cheng-Chieh; Liao, Kuan-Fu

    2017-02-01

    Little is known on the relationship between herpes zoster and Parkinson's disease in older people. This study aimed to explore whether herpes zoster could be associated with Parkinson's disease in older people in Taiwan.We conducted a retrospective cohort study using the claim data of the Taiwan National Health Insurance Program. There were 10,296 subjects aged 65 years and older with newly diagnosed herpes zoster as the herpes zoster group and 39,405 randomly selected subjects aged 65 years and older without a diagnosis of herpes zoster as the nonherpes zoster group from 1998 to 2010. Both groups were followed up until subjects received a diagnosis of Parkinson's disease. This follow-up design would explore whether subjects with herpes zoster were at an increased risk of Parkinson's disease. Relative risks were estimated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the multivariable Cox proportional hazards regression model.The incidence of Parkinson's disease was higher in the herpes zoster group than that in the nonherpes zoster group (4.86 vs 4.00 per 1000 person-years, 95% CI 1.14, 1.29). After adjustment for confounding factors, the multivariable Cox proportional hazards regression model revealed that the adjusted HR of Parkinson's disease was 1.17 for the herpes zoster group (95% CI 1.10, 1.25), compared with the nonherpes zoster group.Older people with herpes zoster confer a slightly increased hazard of developing Parkinson's disease when compared to those without herpes zoster. We think that herpes zoster correlates with increased risk of Parkinson's disease in older people. When older people with herpes zoster seek help, clinicians should pay more attention to the development of the cardinal symptoms of Parkinson's disease.

  19. Social isolation and loneliness among older people: issues and future challenges in community and residential settings.

    PubMed

    Grenade, Linda; Boldy, Duncan

    2008-08-01

    Although often associated with older age, loneliness and social isolation are not well understood in terms of their prevalence, risk and protective factors. Evidence suggests that only a minority of community-dwelling older people are "severely" lonely or isolated, however a number of factors need to be considered to fully understand the extent and significance of the problem. Community-based studies have identified a variety of risk factors for loneliness/isolation including widowhood, no (surviving) children, living alone, deteriorating health, and life events (eg, loss and bereavement). Having a confidant has been identified as a protective factor for loneliness. However, evidence is often unclear or inconclusive, especially within residential settings. We identified the need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated.

  20. Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial

    PubMed Central

    2013-01-01

    Background Plantar calluses are a common cause of foot pain, which can have a detrimental impact on the mobility and independence of older people. Scalpel debridement is often the first treatment used for this condition. Our aim was to evaluate the effectiveness of scalpel debridement of painful plantar calluses in older people. Methods This study was a parallel-group, participant- and assessor-blinded randomized trial. Eighty participants aged 65 years and older with painful forefoot plantar calluses were recruited. Participants were randomly allocated to one of two groups: either real or sham scalpel debridement. Participants were followed for six weeks after their initial intervention appointment. The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention. Results Both the real debridement and sham debridement groups experienced a reduction in pain when compared with baseline. Small, systematic between-group differences in pain scores were found at each time point (between 2 and 7 mm favoring real scalpel debridement); however, none of these were statistically significant and none reached a level that could be considered clinically worthwhile. Scalpel debridement caused no adverse events. Conclusions The benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement. When used alone, scalpel debridement has a limited effect in the short term, although it is relatively inexpensive and causes few complications. However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions. Trial registration Australian Clinical Trials Registry (ACTRN012606000176561). PMID:23915078

  1. Psychosocial Issues in Engaging Older People with Physical Activity Interventions for the Prevention of Falls

    ERIC Educational Resources Information Center

    Nyman, Samuel R.

    2011-01-01

    This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…

  2. A Comparative Study on the Governance of Education for Older People in Japan and Korea

    ERIC Educational Resources Information Center

    Choi, Ilseon; Hori, Shigeo

    2016-01-01

    This paper compares the governance of education for older people in Japan and Korea. The findings revealed that the overall mechanisms of governance for the education of older people shared a number of similar features such as the structure of relevant laws, ministries, and policies. However, differences were also found regarding independence of…

  3. Hospital admissions following presentations to emergency departments for a fracture in older people.

    PubMed

    Boufous, Soufiane; Finch, Caroline; Close, Jacqueline; Day, Lesley; Lord, Stephen

    2007-06-01

    The aim of this paper is to estimate the proportion of older people who are hospitalised following a presentation to an emergency department for hip, pelvic and wrist fractures. The findings indicate that hospitalisation data do not accurately reflect the incidence of low-trauma fractures, particularly wrist and pelvic fractures, in older people.

  4. Hospital admissions following presentations to emergency departments for a fracture in older people

    PubMed Central

    Boufous, Soufiane; Finch, Caroline; Close, Jacqueline; Day, Lesley

    2007-01-01

    The aim of this paper is to estimate the proportion of older people who are hospitalised following a presentation to an emergency department for hip, pelvic and wrist fractures. The findings indicate that hospitalisation data do not accurately reflect the incidence of low‐trauma fractures, particularly wrist and pelvic fractures, in older people. PMID:17567981

  5. Inquiry-Based Learning for Older People at a University in Spain

    ERIC Educational Resources Information Center

    Martorell, Ingrid; Medrano, Marc; Sole, Cristian; Vila, Neus; Cabeza, Luisa F.

    2009-01-01

    With the increasing number of older people in the world and their interest in education, universities play an important role in providing effective learning methodologies. This paper presents a new instructional methodology implementing inquiry-based learning (IBL) in two courses focused on alternative energies in the Program for Older People at…

  6. Images of Older People in UK Magazine Advertising: Toward a Typology

    ERIC Educational Resources Information Center

    Williams, Angie; Wadleigh, Paul Mark; Ylanne, Virpi

    2010-01-01

    The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an "a priori" framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106)…

  7. Older People and Poverty in Rural Britain: Material Hardships, Cultural Denials and Social Inclusions

    ERIC Educational Resources Information Center

    Milbourne, Paul; Doheny, Shane

    2012-01-01

    This paper explores the relations between older people, poverty and place in rural Britain. It develops previous work on rural poverty that has pointed both to the significance of older people within the rural poor population and to their denials of poverty. The paper also connects with recent discussions on the complexity of relations between…

  8. Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

    ERIC Educational Resources Information Center

    Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

    2010-01-01

    Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

  9. Older People and Learning--Some Key Statistics. NIACE Briefing Sheet.

    ERIC Educational Resources Information Center

    National Inst. of Adult Continuing Education, Leicester (England).

    This briefing sheet provides a summary of statistics (primarily from United Kingdom and Dutch surveys) that relate to the participation of older people in learning. It provides evidence of current participation, recent trends, types of learning in which older people are involved, future intentions, and correlation between learning in later life…

  10. Diagnosis and management of insomnia in older people.

    PubMed

    McCall, W Vaughn

    2005-07-01

    Insomnia is a common but underrecognized problem in elderly patients. Five basic steps can help clinicians identify and treat insomnia. The first step is to ask a single question about sleep at every new patient visit, which goes a long way toward detection of patients with insomnia. The second step is to perform an initial evaluation of the problem, including symptoms, contributing factors, and effects on daytime function. Step three is to determine whether the patient is in crisis. True sleep emergencies are rare, and in most cases, treatment can be delayed until another appointment can be made for a full evaluation of the problem. A sleep evaluation constitutes the fourth step and focuses mainly on a thorough sleep history; blood tests and polysomnography rarely have a role. The final step is intervention. Nonpharmacological strategies are a mainstay of treatment for chronic insomnia, but hypnotics have a role in treating transient insomnia and chronic insomnia that does not improve with nonpharmacological treatment or treatment of associated primary conditions. Pharmacological therapy usually consists of benzodiazepines with short half-lives or nonbenzodiazepines such as zolpidem and zaleplon, although lack of demonstrated efficacy against sleep maintenance difficulties, one of the primary symptoms of insomnia among older people, limits use of these agents. Emerging nonbenzodiazepine agents such as indiplon and eszopiclone may specifically address sleep maintenance problems in elderly patients and are pending Food and Drug Administration (FDA) approval. (Editor's note: Since preparation of this manuscript, the FDA has approved eszopiclone for treatment of insomnia.).

  11. Clinical features of venous insufficiency and the risk of venous thrombosis in older people.

    PubMed

    Engbers, Marissa J; Karasu, Alev; Blom, Jeanet W; Cushman, Mary; Rosendaal, Frits R; van Hylckama Vlieg, Astrid

    2015-11-01

    Venous thrombosis is common in older age, with an incidence of 0·5-1% per year in those aged >70 years. Stasis of blood flow is an important contributor to the development of thrombosis and may be due to venous insufficiency in the legs. The risk of thrombosis associated with clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, obtained with a standardized interview was assessed in the Age and Thrombosis Acquired and Genetic risk factors in the Elderly (AT-AGE) study. The AT-AGE study is a case-control study in individuals aged 70 years and older (401 cases with a first-time venous thrombosis and 431 control subjects). We calculated odds ratios (ORs) and corresponding 95% confidence intervals (CI) adjusted for age, sex and study centre. Varicose veins and leg ulcer were associated with a 1·6-fold (95% CI 1·2-2·3) and 3·3-fold increased risk of thrombosis (95% CI 1·6-6·7), respectively, while the risk was increased 3·0-fold (95% CI 2·1-4·5) in the presence of leg oedema. The risk of thrombosis was highest when all three risk factors occurred simultaneously (OR: 10·5; 95% CI 1·3-86·1). In conclusion, clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, are risk factors for venous thrombosis in older people.

  12. Preventive home visits to older people in Denmark--why, how, by whom, and when?

    PubMed

    Vass, M; Avlund, K; Hendriksen, C; Philipson, L; Riis, P

    2007-08-01

    In Denmark, political decisions improved the implementation of 'preventative thinking' into every-day clinical work. The potential benefits of preventive efforts have been supported by legislative and administrative incentives, and an ongoing effort to remain focused on the benefits of these initiatives towards older people is politically formulated and underlined as part of the new structured municipality reform. Evidence of beneficial effects of health promotion and prevention of disease in old age is well documented. In-home visits with individualised assessments make it possible to reach older persons not normally seen in the health care system. In-home assessment is not just a health check, but also an opportunity to meet individual needs that may be of importance for older people to stay independent. Preventive home visits may be part of an overall culture and strategy to avoid or prevent functional decline. There is an urgent need of an interdisciplinary teamwork and management for such programmes, incorporating flexible cooperation between the primary and secondary health care sector. The value and importance of geriatric and gerontological education is evidence based.

  13. Management of Cancer in the Older Age Person: An Approach to Complex Medical Decisions.

    PubMed

    Vallet-Regí, María; Manzano, Miguel; Rodriguez-Mañas, Leocadio; Checa López, Marta; Aapro, Matti; Balducci, Lodovico

    2017-03-01

    The management of cancer in older aged people is becoming a common problem due to the aging of the population. There are many variables determining the complex situation that are interconnected. Some of them can be assessed, such as risk of mortality and risk of treatment complications, but many others are still unknown, such as the course of disease, the host-related factors that influence cancer aggressiveness, and the phenotype heralding risk of permanent treatment-related damage.This article presents a dynamic and personalized approach to older people with cancer based on our experience on aging, cancer, and their biological interactions. Also, novel treatments and management approaches to older individuals, based on their functional age and their social and emotional needs, are thoughtfully explored here. The Oncologist 2017;22:335-342 IMPLICATIONS FOR PRACTICE: The goal of this article is to suggest a practical approach to complexity, a clinical situation becoming increasingly common with the aging of the population. Beginning with the analysis of two clinical cases, the authors offer an algorithm for approaching cancer in the older person that involves the assessment of life expectancy without cancer, the risk that cancer might compromise a patient's survival, function, or quality of life, and the potential benefits and risks of the treatments based on a clinical evaluation. The authors then review possible laboratory assessment of functional age and the importance of rapid-learning databases in the study of cancer and age.

  14. Measuring Successful Aging in Southern Black Older Adults

    ERIC Educational Resources Information Center

    Troutman, Meredith; Nies, Mary A.; Bentley, Monica

    2011-01-01

    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…

  15. Older Adults in Lifelong Learning: Participation and Successful Aging

    ERIC Educational Resources Information Center

    Sloane-Seale, Atlanta; Kops, Bill

    2008-01-01

    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…

  16. Life situation and identity among single older home-living people: A phenomenological–hermeneutic study

    PubMed Central

    Söderhamn, Ulrika; Söderhamn, Olle

    2012-01-01

    Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological–hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., “being able to do” and “being able to be”, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants. PMID:22848230

  17. Costs and economic consequences of a help-at-home scheme for older people in England.

    PubMed

    Bauer, Annette; Knapp, Martin; Wistow, Gerald; Perkins, Margaret; King, Derek; Iemmi, Valentina

    2017-03-01

    Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of well-being needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals' well-being and the economic consequences for local and central government can contribute to decisions about sustainable long-term care financing. This article presents results from a mixed-methods study of a voluntary sector-provided help-at-home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care-related quality of life was measured with the Adult Social Care Outcomes Toolkit for 24 service users (59% response rate) when they started using the scheme and 4-6 months later. A customised questionnaire that captured resource use and well-being information was sent to 1064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1568 per person from a local government and National Health Service (NHS) perspective and £3766 from the perspective of the individual. An expenditure of £2851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector-run help-at-home schemes to an affordable welfare system for ageing societies.

  18. [Pneumococcal vaccination for persons 65 years of age and older].

    PubMed

    van den Bosch, W J H M

    2002-05-04

    In the Netherlands, in contrast to other countries, pneumococcal vaccination for older people and people at risk is not routine, except for patients under special circumstances, such as after a splenectomy. Although pneumococcal vaccination is an effective way to prevent invasive pneumococcal disease in young healthy persons, there is no conclusive evidence that it is effective in older people and people at risk without a good immune response. Pneumococcal disease can be an important complication of an ordinary flu. Because there is a high level of vaccination against influenza in the Netherlands, the risk of pneumococcal disease is low compared to other countries in the world. Adding a pneumococcal vaccine to the influenza vaccination could decrease the degree of protection against influenza. The experimental introduction of pneumococcal vaccination does not seem to lead to an increase in the number of patients that refuse vaccination against influenza.

  19. Relationship Between Wealth and Age Trajectories of Walking Speed Among Older Adults: Evidence From the English Longitudinal Study of Ageing

    PubMed Central

    2013-01-01

    Background. Slow walking speed is associated with higher risk of accidents, disability, and mortality in older adults, with people in more disadvantaged socioeconomic positions being at higher risk. We explore the relationship between wealth and age trajectories of walking speed among older adults. Methods. Data come from three waves (2002–2003 to 2006–2007) of the English Longitudinal Study of Ageing. We use latent growth curve models and aging-vector graphs to explore individual changes and average population age trajectories of walking speed by wealth among 7,225 individuals aged 60 and older. Results. For someone aged 71 in the poorest wealth quintile, the baseline mean walking speed was 0.75 m/s, which decreased to 0.71 m/s 4 years later, whereas that of a person in the richest wealth quintile was 0.91 m/s, which decreased to 0.82 m/s. Although the decline in walking speed was faster among people in the richest wealth (net of covariates), the gaps in walking speed between richest and poorest did not close. Even after accounting for covariates, people in the richest wealth only reached critical values (0.60 m/s) of walking speed at the age of 90, whereas people in the poorest wealth reached that level 6 years earlier. Conclusions. Our findings showed continuing gaps in physical functioning by wealth, even among people with the same health, psychosocial, and demographic conditions. As wealth reflects both past and current socioeconomic status, the implications of our findings are that reducing socioeconomic inequalities at all stages of the life course may have a positive impact on functioning in old age. PMID:23682157

  20. Motor unit number estimates and neuromuscular transmission in the tibialis anterior of master athletes: evidence that athletic older people are not spared from age-related motor unit remodeling.

    PubMed

    Piasecki, Mathew; Ireland, Alex; Coulson, Jessica; Stashuk, Dan W; Hamilton-Wright, Andrew; Swiecicka, Agnieszka; Rutter, Martin K; McPhee, Jamie S; Jones, David A

    2016-10-01

    Muscle motor unit numbers decrease markedly in old age, while remaining motor units are enlarged and can have reduced neuromuscular junction transmission stability. However, it is possible that regular intense physical activity throughout life can attenuate this remodeling. The aim of this study was to compare the number, size, and neuromuscular junction transmission stability of tibialis anterior (TA) motor units in healthy young and older men with those of exceptionally active master runners. The distribution of motor unit potential (MUP) size was determined from intramuscular electromyographic signals recorded in healthy male Young (mean ± SD, 26 ± 5 years), Old (71 ± 4 years) and Master Athletes (69 ± 3 years). Relative differences between groups in numbers of motor units was assessed using two methods, one comparing MUP size and muscle cross-sectional area (CSA) determined with MRI, the other comparing surface recorded MUPs with maximal compound muscle action potentials and commonly known as a "motor unit number estimate (MUNE)". Near fiber (NF) jiggle was measured to assess neuromuscular junction transmission stability. TA CSA did not differ between groups. MUNE values for the Old and Master Athletes were 45% and 40%, respectively, of the Young. Intramuscular MUPs of Old and Master Athletes were 43% and 56% larger than Young. NF jiggle was slightly higher in the Master Athletes, with no difference between Young and Old. These results show substantial and similar motor unit loss and remodeling in Master Athletes and Old individuals compared with Young, which suggests that lifelong training does not attenuate the age-related loss of motor units.

  1. The Influence of Older Age Groups to Sustainable Product Design Research of Urban Public Facilities

    NASA Astrophysics Data System (ADS)

    Wen-juan, Zhang; Hou-peng, Song

    2017-01-01

    Through summarize the status quo of public facilities design to older age groups in China and a variety of factors what influence on them, the essay, from different perspective, is designed to put forward basic principle to sustainable design of public facilities for the aged in the city, and thus further promote and popularize the necessity of sustainable design applications in the future design of public facilities for elderly people.

  2. Human podocyte depletion in association with older age and hypertension.

    PubMed

    Puelles, Victor G; Cullen-McEwen, Luise A; Taylor, Georgina E; Li, Jinhua; Hughson, Michael D; Kerr, Peter G; Hoy, Wendy E; Bertram, John F

    2016-04-01

    Podocyte depletion plays a major role in the development and progression of glomerulosclerosis. Many kidney diseases are more common in older age and often coexist with hypertension. We hypothesized that podocyte depletion develops in association with older age and is exacerbated by hypertension. Kidneys from 19 adult Caucasian American males without overt renal disease were collected at autopsy in Mississippi. Demographic data were obtained from medical and autopsy records. Subjects were categorized by age and hypertension as potential independent and additive contributors to podocyte depletion. Design-based stereology was used to estimate individual glomerular volume and total podocyte number per glomerulus, which allowed the calculation of podocyte density (number per volume). Podocyte depletion was defined as a reduction in podocyte number (absolute depletion) or podocyte density (relative depletion). The cortical location of glomeruli (outer or inner cortex) and presence of parietal podocytes were also recorded. Older age was an independent contributor to both absolute and relative podocyte depletion, featuring glomerular hypertrophy, podocyte loss, and thus reduced podocyte density. Hypertension was an independent contributor to relative podocyte depletion by exacerbating glomerular hypertrophy, mostly in glomeruli from the inner cortex. However, hypertension was not associated with podocyte loss. Absolute and relative podocyte depletion were exacerbated by the combination of older age and hypertension. The proportion of glomeruli with parietal podocytes increased with age but not with hypertension alone. These findings demonstrate that older age and hypertension are independent and additive contributors to podocyte depletion in white American men without kidney disease.

  3. Older Adults' Online Dating Profiles and Successful Aging.

    PubMed

    Wada, Mineko; Mortenson, William Bennett; Hurd Clarke, Laura

    2016-12-01

    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.

  4. Dog-assisted therapy for older people with dementia: a review.

    PubMed

    Perkins, Jacqueline; Bartlett, Helen; Travers, Catherine; Rand, Jacquie

    2008-12-01

    This review summarises and critiques the published literature regarding dog therapy for older people with dementia living in residential aged care facilities. Nine studies were identified for inclusion and although the methodological variability of studies makes it difficult to draw firm conclusions, research suggests that dog therapy is beneficial for people with dementia. The most frequently reported findings were an increase in social behaviour and a decrease in agitated behaviour during dog contact. Improvement in social behaviour was found to be unrelated to the severity of dementia. Various improvements on measures of global function were also reported. No study adopted a randomised controlled trial design and a number of potentially important factors were not controlled for, including halo effects of animals on caregivers that may bias caregivers' responses when acting as proxies for their relatives or residents. The premorbid relationship with dogs may be an important variable influencing outcomes.

  5. Healthy ageing in Isan-Thai culture—A phenomenographic study based on older persons’ lived experiences

    PubMed Central

    Manasatchakun, Pornpun; Chotiga, Pleumjit; Roxberg, Åsa; Asp, Margareta

    2016-01-01

    Healthy ageing is a concept that concerns older persons’ quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons’ experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons’ qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: “being independent in dependence,” “being at peace,” and “being a valuable person.” This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people. PMID:26960686

  6. Functional decline and herpes zoster in older people: an interplay of multiple factors.

    PubMed

    2015-12-01

    Herpes zoster is a frequent painful infectious disease whose incidence and severity increase with age. In older people, there is a strong bidirectional link between herpes zoster and functional decline, which refers to a decrement in ability to perform activities of daily living due to ageing and disabilities. However, the exact nature of such link remains poorly established. Based on the opinion from a multidisciplinary group of experts, we here propose a new model to account for the interplay between infection, somatic/psychiatric comorbidity, coping skills, polypharmacy, and age, which may account for the functional decline related to herpes zoster in older patients. This model integrates the risk of decompensation of underlying disease; the risk of pain becoming chronic (e.g. postherpetic neuralgia); the risk of herpes zoster non-pain complications; the detrimental impact of herpes zoster on quality of life, functioning, and mood; the therapeutic difficulties due to multimorbidity, polypharmacy, and ageing; and the role of stressful life events in the infection itself and comorbid depression. This model underlines the importance of early treatment, strengthening coping, and vaccine prevention.

  7. More Daytime Sleeping Predicts Less Functional Recovery Among Older People Undergoing Inpatient Post-Acute Rehabilitation

    PubMed Central

    Alessi, Cathy A.; Martin, Jennifer L.; Webber, Adam P.; Alam, Tarannum; Littner, Michael R.; Harker, Judith O.; Josephson, Karen R.

    2008-01-01

    Study Objectives: To study the association between sleep/wake patterns among older adults during inpatient post-acute rehabilitation and their immediate and long-term functional recovery Design: Prospective, observational cohort study Setting: Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration) Participants: Older patients (aged ≥ 65 years, N = 245) admitted for inpatient post-acute rehabilitation Interventions: None Measurements and Results: Based on 7-day wrist actigraphy during the rehabilitation stay, mean nighttime percent sleep was only 52.2% and mean daytime percent sleep was 15.8% (16.3% based on structured behavioral observations). Using the Pittsburgh Sleep Quality Index (PSQI), participants reported their sleep was worse during rehabilitation compared to their premorbid sleep. Functional recovery between admission and discharge from rehabilitation (measured by the motor component of the Functional Independence Measure) was not significantly associated with reported sleep quality (PSQI scores) or actigraphically measured nighttime sleep. However, more daytime percent sleep (estimated by actigraphy and observations) during the rehabilitation stay was associated with less functional recovery from admission to discharge, even after adjusting for other significant predictors of functional recovery (mental status, hours of rehabilitation therapy received, rehospitalization, and reason for admission; adjusted R2 = 0.267, P < 0.0001). More daytime sleeping during rehabilitation remained a significant predictor of less functional recovery in adjusted analyses at 3-month follow-up. Conclusions: Sleep disturbance is common among older people undergoing inpatient post-acute rehabilitation. These data suggest that more daytime sleeping during the rehabilitation stay is associated with less functional recovery for up to three months after admission for rehabilitation. Citation: Alessi CA; Martin JL; Webber AP; Alam T

  8. Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study

    PubMed Central

    Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun

    2015-01-01

    Objective To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. Research design The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. Participants 20 HCPs who managed falls in older people. Setting This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Results Four categories of barriers emerged—these were related to perceived barriers for older people, HCPs’ barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. Conclusions This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. PMID:26546140

  9. Evaluation of a Medicine Information Training Program for Older People.

    ERIC Educational Resources Information Center

    Quine, Susan

    1998-01-01

    Australian older adults were trained to act as advocates and role models to inform peers on effective use of medicines. Trainees reported difficulties experienced by older learners when training is too concentrated. Many noted increased self-esteem and personal growth as a result of their involvement. (SK)

  10. [The association between paid or voluntary employment and neuropsychological test performance at an older age].

    PubMed

    Weghorst, Ronan B W M; Scherder, Erik J A; Oosterman, Joukje M

    2017-04-01

    Studies have convincingly shown that both physical and mental activity are positively associated with cognitive task performance in aging. Little is known, however, about whether still being employed or doing volunteer work, which obviously engages physical and/or mental activity, is similarly associated with cognitive ability at an older age. The current study explored this relationship in 28 volunteers aged sixty years and older. Participants completed a neuropsychological test battery, and data regarding the number of working hours (paid and voluntary) per week were collected. A total of 28 participants were included, 13 of whom worked three or more hours per week. As a group, these active participants achieved better episodic memory, sustained attention and psychomotor speed results. This study shows that older people who are still working demonstrate better neuropsychological task performance. An important question for future research concerns the causality of this relationship.

  11. Estimated Autism Risk and Older Reproductive Age

    PubMed Central

    King, Marissa D.; Fountain, Christine; Dakhlallah, Diana

    2009-01-01

    Objectives. We sought to estimate the risk for autism associated with maternal and paternal age across successive birth cohorts. Methods. We linked birth records and autism diagnostic records from the California Department of Developmental Services for children born in California between 1992 and 2000 to calculate the risk associated with maternal and paternal age for each birth cohort as well as for the pooled data. Results. The categorical risks associated with maternal age over 40 years ranged from a high of 1.84 (95% confidence interval [CI] = 1.37, 2.47) to a low of 1.27 (95% CI = 0.95, 1.69). The risk associated with paternal age ranged from 1.29 (95% CI = 1.03, 1.6) to 1.71 (95% CI = 1.41, 2.08). Conclusions. Pooling data across multiple birth cohorts inflates the risk associated with paternal age. Analyses that do not suffer from problems produced by pooling across birth cohorts demonstrated that advanced maternal age, rather than paternal age, may pose greater risk. Future research examining parental age as a risk factor must be careful to avoid the paradoxes that can arise from pooling data, particularly during periods of social demographic change. PMID:19608957

  12. Acute stress impairs recall after interference in older people, but not in young people.

    PubMed

    Hidalgo, Vanesa; Almela, Mercedes; Villada, Carolina; Salvador, Alicia

    2014-03-01

    Stress has been associated with negative changes observed during the aging process. However, very little research has been carried out on the role of age in acute stress effects on memory. We aimed to explore the role of age and sex in the relationship between hypothalamus-pituitary-adrenal axis (HPA-axis) and sympathetic nervous system (SNS) reactivity to psychosocial stress and short-term declarative memory performance. To do so, sixty-seven participants divided into two age groups (each group with a similar number of men and women) were exposed to the Trier Social Stress Test (TSST) and a control condition in a crossover design. Memory performance was assessed by the Rey Auditory Verbal Learning Test (RAVLT). As expected, worse memory performance was associated with age; but more interestingly, the stressor impaired recall after interference only in the older group. In addition, this effect was negatively correlated with the alpha-amylase over cortisol ratio, which has recently been suggested as a good marker of stress system dysregulation. However, we failed to find sex differences in memory performance. These results show that age moderates stress-induced effects on declarative memory, and they point out the importance of studying both of the physiological systems involved in the stress response together.

  13. Trajectories of the healthy ageing phenotype among middle-aged and older Britons, 2004–2013

    PubMed Central

    Tampubolon, Gindo

    2016-01-01

    Objectives Since the ageing population demands a response to ensure older people remain healthy and active, we studied the dynamics of a recently proposed healthy ageing phenotype. We drew the phenotype’s trajectories and tested whether their levels and rates of change are influenced by health behaviours, comorbidities and socioeconomic positions earlier in the life course. Design and outcomes The English Longitudinal Ageing Study, a prospective, nationally representative sample of people aged ≥50 years, measured a set of eight biomarkers which make up the outcome of the healthy ageing phenotype three times over nearly a decade (N2004 = 5009, N2008 = 5301, N2013 = 4455). A cluster of health behaviours, comorbidities and socioeconomic positions were also measured repeatedly. We assessed the phenotype’s distribution non-parametrically, then fitted linear mixed models to phenotypic change and further examined time interactions with gender and socioeconomic position. We ran additional analyses to test robustness. Results Women had a wider distribution of the healthy ageing phenotype than men had. The phenotype declined annually by −0.242 (95% confidence interval [CI]: −0.352, −0.131). However, there was considerable heterogeneity in the levels and rates of phenotypic change. Women started at higher levels, then declined more steeply by −0.293 (CI: −0.403, −0.183) annually, leading to crossover in the trajectories. Smoking and physical activity assessed on the Allied Dunbar scale were strongly associated with the trajectories. Conclusion Though marked by secular decline, the trajectories of the healthy ageing phenotype showed distinct socioeconomic gradients. The trajectories were also susceptible to variations in health behaviours, strengthening the case for serial interventions to attain healthy and active ageing. PMID:27105690

  14. Developing attributes for a generic quality of life measure for older people: preferences or capabilities?

    PubMed

    Grewal, Ini; Lewis, Jane; Flynn, Terry; Brown, Jackie; Bond, John; Coast, Joanna

    2006-04-01

    Current UK policy with respect to the provision of health and social care for older people suggests that greater integration is required. Economists' attempts to assist resource allocation decisions, however, are very health focused, with concentration on the use of health-related quality of life measures. This paper reports an attempt to determine attributes for a new index clearly focusing on quality of life for older people rather than health or other influences on quality of life. In-depth interviews were conducted with 40 purposively selected informants aged 65 and over in private households to explore their views about what is important to them in terms of quality of life. Data were analysed using Framework qualitative analysis. Initial discussions tended to concentrate upon factors influencing quality of life including activities, relationships, health, wealth and surroundings. Further probing and analysis suggested five conceptual attributes: attachment, role, enjoyment, security and control. The data also suggested that the quality of informants' lives was limited by the loss of ability to pursue these attributes. So, for example, it is not poor health in itself, which reduces quality of life, but the influence of that poor health upon each informant's ability to, say, be independent, that is important. Amartya Sen's work on functioning and capability is particularly pertinent here. Using this work, it is possible to interpret the five conceptual attributes as a set of functionings-important for older people in the UK in the 21st century-but noting that it is the capacity to achieve these functionings that appears to be of importance. This suggests that further development of this measure should focus on an index of capability rather than preference-based utility.

  15. Gender, aging, poverty and health: Survival strategies of older men and women in Nairobi slums

    PubMed Central

    Mudege, Netsayi N.; Ezeh, Alex C.

    2009-01-01

    This paper is based on data from focus group discussions and in-depth individual interviews carried out in two slum areas, Korogocho and Viwandani in Nairobi, Kenya. It discusses how the division between domestic sphere and public sphere impacts on survival during, and adaptation to old age. Although this paper adopts some of the tenets of the life course approach, it posits that women's participation in the domestic sphere may sometimes give them a ‘gender advantage’ over men in terms of health and adaptation to old age. The paper also discusses the impact of gender roles on the cultivation of social networks and how these networks in turn impact on health and social adjustment as people grow older. It investigates how older people are adjusting and coping with the new challenges they face as a result of high morbidity and mortality among adults in the reproductive age groups. PMID:19907648

  16. Age, stress, and isolation in older adults living with HIV.

    PubMed

    Webel, Allison R; Longenecker, Chris T; Gripshover, Barbara; Hanson, Jan E; Schmotzer, Brian J; Salata, Robert A

    2014-01-01

    People living with HIV (PLWH) have increasingly longer life spans. This age group faces different challenges than younger PLWH, which may include increased stress and social isolation. The purpose of this study was to determine whether the age and sex of PLWH are associated with measures of physiologic stress, perceived stress, and social isolation. In this cross-sectional study, we enrolled 102 PLWH equally into four groups divided by age (younger or older than 50 years) and gender. Participants completed well-validated survey measurements of stress and isolation, and their heart rate variability over 60 minutes was measured by Holter monitor. The mean (SD) Perceived Stress Scale score was 17.4 (6.94), mean Visual Analog Stress Scale score was 3.51 (2.79), and mean Hawthorne Friendship Scale score, a measure of social isolation, was 17.03 (4.84). Mean heart rate variability expressed as the SD of successive N-N intervals was 65.47 (31.16) msec. In multivariable regression models that controlled for selected demographic variables, there was no relationship between the Perceived Stress Scale and age (coefficient = -0.09, p =-0.23) or female gender (coefficient = -0.12, p = 0.93); however, there was a modest relationship between female gender and stress using the Visual Analog Stress Scale (coefficient = 1.24, p = 0.05). Perceived Stress was negatively associated with the Hawthorne Friendship score (coefficient = -0.34, p = 0.05). Hawthorne Friendship score was positively associated with younger age (coefficient = 0.11, p = 0.02). Age was the only independent predictor of physiologic stress as measured by heart rate variability (coefficient = -1.3, p < 0.01). Our findings suggest that younger PLWH may experience more social isolation; however, age-related changes in heart rate variability do not appear to be related to perceived stress or social isolation. Future longitudinal research is required to more thoroughly understand this relationship and its impact on the

  17. Nutraceuticals for older people: facts, fictions and gaps in knowledge.

    PubMed

    González-Sarrías, Antonio; Larrosa, Mar; García-Conesa, María Teresa; Tomás-Barberán, Francisco A; Espín, Juan Carlos

    2013-08-01

    In the last decades nutraceuticals have entered the health market as an easy and attractive means of preventing diseases. These products are of interest for an increasingly health-concerned society and may be especially relevant for preventing or delaying a number of age-related diseases, i.e. arthritis, cancer, metabolic and cardiovascular diseases, osteoporosis, cataracts, brain disorders, etc. Nutraceuticals are marketed in a variety of forms, composition and potential applications which have made their definition ambiguous and their use uncontrolled and poorly funded. Although epidemiological, animal and in vitro studies have given evidence of the potential benefits of some of these nutraceuticals or of their components, definitive proof of their effects in appropriate human clinical trials is still lacking in most cases, more critically among people above 65 years of age. We cover the well-established nutraceuticals (polyvitamins, omega-3 fatty acids, etc.) and will focus on many other 'novel' commercial nutraceuticals where the scientific evidence is more limited (food extracts, polyphenols, carotenoids, etc.). Solid scientific evidence has been reported only for a few nutraceuticals, which have some health claims approved by the European Food Safety Authority (EFSA). Further well-designed trials are needed to improve the current knowledge on the health benefits of nutraceuticals in the elderly. Overall, there are some facts, a lot of fiction and many gaps in the knowledge of nutraceutical benefits.

  18. Vision and falls in older people: risk factors and intervention strategies.

    PubMed

    Lord, Stephen R; Smith, Stuart T; Menant, Jasmine C

    2010-11-01

    Poor vision impairs balance and increases the risk of falls and fractures in older people. Multifocal glasses can add to this risk by impairing contrast sensitivity, depth perception, and ability to negotiate obstacles. Vision assessment and provision of new spectacles may not reduce, and may even increase, the risk of falls. Restriction of the use of multifocal glasses may reduce falls in active older people. Other effective fall prevention strategies include maximizing vision through cataract surgery and occupational therapy interventions in visually impaired older people.

  19. Older lesbians and work in the Australian health and aged care sector.

    PubMed

    Hughes, Mark; Kentlyn, Sujay

    2015-01-01

    While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace.

  20. Older People Going Online: Its Value and Before-After Evaluation of Volunteer Support

    PubMed Central

    Ashurst, Emily J; Atkey, Jo; Duffy, Barbara

    2015-01-01

    Background Although Internet usage can benefit older people by reducing social isolation, increasing access to services, and improving health and well-being, only a minority are online. Barriers to Internet uptake include attitude and a lack of knowledge and help. We have evaluated volunteer support in helping older people go online. Knowing what value the Internet has been to older people who have just gone online should guide how it is “sold” to those remaining offline. Objective Objectives of this study are (1) to assess the feasibility of recruiting volunteers aged 50 years and older and supporting them in helping people (ie, beneficiaries) aged 65 years and older go online, (2) to assess the impact of beneficiaries using the Internet on contacts with others, loneliness, and mental health, and (3) to assess the perceived value to beneficiaries of going online. Methods Beneficiaries received help in using the Internet from 32 volunteers in one of two ways: (1) one-on-one in their own homes, receiving an average of 12 hours of help over eight visits, or (2) in small group sessions, receiving 12 hours of help over six visits. We assessed, at registration and follow-up, the number of contacts with others, using Lubben’s 6-item Lubben Social Network Scale (LBNS-6), loneliness, using De Jong Gierveld’s 6-item De Jong Gierveld loneliness scale (DJG-6), and mental well-being, using Tennant’s Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). We also assessed how beneficiaries valued going online using a Social Return on Investment (SROI) approach by postal survey. Results A total of 144 beneficiaries were recruited with the aim of helping them go online via one-on-one (n=58) or small group (n=86) sessions. Data through to follow-up were available on 76.4% (110/144) of participants. From baseline to follow-up, the number of contacts with others was significantly increased—LBNS-6, mean 13.7 to mean 17.6—loneliness scores were reduced—DJG-6, mean 2

  1. Confidence and Expectations about Caring for Older People with Dementia: A Cross-Sectional Survey of Student Nurses

    ERIC Educational Resources Information Center

    Baillie, Lesley; Merritt, Jane; Cox, Janet; Crichton, Nicola

    2015-01-01

    Older people who are living with dementia often need healthcare, including hospital admissions, due to additional health conditions. Caring for older people who are living with dementia is, therefore, a core nursing role. This study investigated student nurses' expectations of, and confidence about, caring for older people with dementia and the…

  2. Low-trauma fractures indicate increased risk of hip fracture in frail older people.

    PubMed

    Chen, Jian Sheng; Cameron, Ian D; Simpson, Judy M; Seibel, Markus J; March, Lyn M; Cumming, Robert G; Lord, Stephen R; Sambrook, Philip N

    2011-02-01

    This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n = 953), the nonhip fracture group (n = 194), and the hip fracture group (n = 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p = .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture.

  3. Teaching about Older People with Mental Retardation: An Educational Model.

    ERIC Educational Resources Information Center

    Kropf, Nancy P.; And Others

    1993-01-01

    The University of Georgia model curriculum to prepare students to work with mentally retarded older adults has six units: population overview, physiological issues, mental health issues, social support systems, service delivery networks, and legal/ethical issues. (SK)

  4. Automated bone age assessment of older children using the radius

    NASA Astrophysics Data System (ADS)

    Tsao, Sinchai; Gertych, Arkadiusz; Zhang, Aifeng; Liu, Brent J.; Huang, Han K.

    2008-03-01

    The Digital Hand Atlas in Assessment of Skeletal Development is a large-scale Computer Aided Diagnosis (CAD) project for automating the process of grading Skeletal Development of children from 0-18 years of age. It includes a complete collection of 1,400 normal hand X-rays of children between the ages of 0-18 years of age. Bone Age Assessment is used as an index of skeletal development for detection of growth pathologies that can be related to endocrine, malnutrition and other disease types. Previous work at the Image Processing and Informatics Lab (IPILab) allowed the bone age CAD algorithm to accurately assess bone age of children from 1 to 16 (male) or 14 (female) years of age using the Phalanges as well as the Carpal Bones. At the older ages (16(male) or 14(female) -19 years of age) the Phalanges as well as the Carpal Bones are fully developed and do not provide well-defined features for accurate bone age assessment. Therefore integration of the Radius Bone as a region of interest (ROI) is greatly needed and will significantly improve the ability to accurately assess the bone age of older children. Preliminary studies show that an integrated Bone Age CAD that utilizes the Phalanges, Carpal Bones and Radius forms a robust method for automatic bone age assessment throughout the entire age range (1-19 years of age).

  5. Are neuroticism and extraversion related to morning cortisol release in healthy older people?

    PubMed

    Puig-Perez, Sara; Almela, Mercedes; Pulopulos, Matías M; Hidalgo, Vanesa; Salvador, Alicia

    2016-12-01

    The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis (HPA-axis) function that has been widely related to both health and some personality traits. There is evidence that neuroticism and extraversion affect health and well-being and play a damaging or protective role, respectively. In this study, we aimed to explore the relationship between these personality dimensions and morning cortisol concentrations in people aged 55 or older. To do so, morning saliva samples were collected on two consecutive weekdays from a total of 160 older men and women. Neuroticism and extraversion were assessed using the Eysenck Personality Questionnaire-Revised, short form (EPQ-RS). Our results showed that neuroticism was negatively related to overall morning cortisol concentrations (AUCG) (i.e., area under the curve with respect to the ground in cortisol levels), but not to the CAR. When we explored sex as a moderator, neuroticism was related to a CAR of increased magnitude in women, although this relationship was not significant in men. No significant relationships were found between extraversion and CAR or AUCG, regardless of sex. In conclusion, neuroticism - but not extraversion - was related to HPA-axis function in older adults, highlighting its potential relevance in health alterations associated with HPA-axis functioning.

  6. Development of hand phenotypes and changes in hand pain and problems over time in older people.

    PubMed

    Green, Daniel J; Jordan, Kelvin P; Protheroe, Joanne; van der Windt, Danielle A

    2016-03-01

    Hand disabilities are frequent causes of pain and disability in older people, yet knowledge regarding the characteristics and patterns of hand pain and problems over time is lacking. The main aim of this study was to identify subgroups of older individuals with distinct presentations (phenotypes) of hand pain and function, investigate how these might change over a 6-year period, and explore what characteristics and factors are associated with long-term status. The study population stemmed from the North Staffordshire Osteoarthritis Project, a large, general population-based, prospective, cohort study of adults aged 50 years and older. Information on hand pain and problems was collected using questionnaires at baseline, 3 years, and 6 years. Overall, 5617 participants responded at all time points and were included in the analysis. Five phenotypes were identified using latent transition analysis ("least affected," "high pain," "poor gross function," "high pain and poor gross function," and "severely affected") based on 8 hand pain and functional items. The most common transition between phenotypes was from "high pain" at baseline to "least-affected" group. There was a high level of stability in individuals in the "least-affected" or "severely affected" group at baseline. Individuals with widespread body pain, nodes, sleep problems, and pain in both hands at baseline were more likely to be in a severe hand phenotype at 6 years. The results provide clinically relevant information regarding the pattern of hand pain and problems over time and factors that predict transition to more severe hand phenotypes.

  7. Active social participation and mortality risk among older people in Japan: results from a nationally representative sample.

    PubMed

    Minagawa, Yuka; Saito, Yasuhiko

    2015-07-01

    A large literature suggests that active social participation contributes to the well-being of older people. Japan provides a compelling context to test this hypothesis due to its rapidly growing elderly population and the phenomenal health of the population. Using the Nihon University Japanese Longitudinal Study of Aging, this study examines how social participation, measured by group membership, is related to the risk of overall mortality among Japanese elders aged 65 and older. Results from Cox proportional hazards models show that group affiliation confers advantages against mortality risk, even after controlling for sociodemographic characteristics, physical health measures, and family relationship variables. In particular, activities geared more toward self-development, such as postretirement employment and lifelong learning, are strongly associated with lower levels of mortality. Findings suggest that continued social participation at advanced ages produces positive health consequences, highlighting the importance of active aging in achieving successful aging in the Japanese context.

  8. Unmet health care needs of older people: prevalence and predictors in a French cross-sectional survey

    PubMed Central

    Arvieu, Jean-Jacques; Aegerter, Philippe; Robine, Jean-Marie; Ankri, Joël

    2014-01-01

    Background: Unmet health care needs are associated with negative health outcomes, yet there is a paucity of data on this problem among older people. Objective: To identify unmet health care needs and associated factors among older people in France. Methods: This is a cross-sectional population study of people aged 70 years or older in which 2350 respondents were interviewed in 2008–10. During a standardized interview, a nurse examined health problems, functional abilities and use of health care resources. Unmet health care needs were defined as situations in which a participant needed health care and did not receive it. Results: The mean age was 83.2 ± 7.4 years. Almost all participants reporting a chronic disease (98.6%) had consulted a physician in the previous 6 months. Unmet health care needs were found in 23.0% of the sample and mainly consisted of lack of dental care (prevalence of 17.7%), followed by lack of management of visual or hearing impairments (prevalence of 4.4% and 3.1%, respectively). Age was the main factor associated with unmet health care needs [compared with people aged 70–79: odds ratio80–89 years = 2.26 (1.70–3.03), odds ratio90 years and over = 3.85 (2.71–5.45)]. Other associated factors were regular smoking, homebound status, poor socioeconomic conditions, depression, limitations in instrumental activities of daily living and low medical density. Conclusion: Unmet health care needs affect almost one-quarter of older people in France. Efforts should be made to improve oral health and develop home care, especially for the oldest-olds. PMID:24287029

  9. Does Bilingual Language Control Decline in Older Age?

    PubMed Central

    Ivanova, Iva; Murillo, Mayra; Montoya, Rosa I.; Gollan, Tamar H.

    2016-01-01

    We investigated age-related decline of bilingual language control. Thirteen older and 13 younger bilinguals performed a verbal fluency task (completing the same letter and semantic categories in each language and switching languages after every category), and a non-linguistic flanker task. In letter fluency, bilinguals produced fewer correct responses after switching languages, suggesting inhibition of the previously-used language. However, this testing-order effect did not differ between groups and older bilinguals produced few wrong-language intrusions, implying intact ability to apply inhibition in older age. In contrast, age-related deficits in the flanker task were robust, implying dissociations between language control and domain-general executive control. In semantic fluency, there were no testing-order effects but older bilinguals produced more intrusions than younger bilinguals, and more intrusions than in letter fluency. Thus, bilinguals may flexibly modulate the degree of inhibition when they can benefit from semantic priming between languages, but less efficiently so in older age. PMID:28090222

  10. Commentary response: Frailty, not just about old people: Reply to Smith GD & Kydd A (2017) Getting care of older people right: the need for appropriate frailty assessment?

    PubMed

    Jha, Sunita R; Mcdonagh, Julee; Ferguson, Caleb; Macdonald, Peter S; Newton, Phillip J

    2017-02-23

    As highlighted in a recent editorial, the ageing population and burden of frailty amongst those aged 60 years and older represents an impending challenge for individuals and health care systems globally (Smith & Kydd 2017). As frailty is largely considered a geriatric syndrome, research has primarily occurred within elderly community dwelling populations (Fried et al. 2001). However, it is important to highlight that not all older people are frail; and conversely not all younger people are non-frail. With frailty research expanding its scope beyond geriatrics over the last 2 decades, our understanding of this syndrome and its complexities has progressed. Notably the disparities in why individuals either 'thrive' or 'dive', is being attributed to frailty severity rather than age alone. This is especially true when assessing younger critically ill patients, where the impact of frailty is said to be analogous to that of frailty in older people (Bagshaw et al. 2016). These younger populations have some of the highest reported frailty prevalence rates; where frailty plays a key role in morbidity, mortality and health care utilization above that of other populations (Arora et al. 2016; Jha, Hannu, Chang, et al. 2016; McAdams-DeMarco et al. 2015). This article is protected by copyright. All rights reserved.

  11. The contribution of home-based technology to older people's quality of life in extra care housing

    PubMed Central

    2011-01-01

    Background British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT) devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH). Methods A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used. Results Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29) and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50) and p = 0.001 [CASP-19]. Conclusions The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies. PMID:22040111

  12. Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

    PubMed Central

    Veeravelli, Suhitha; Najafi, Bijan; Marin, Ivan; Blumenkron, Fernando; Smith, Shannon; Klotz, Stephen A.

    2016-01-01

    Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is aging. HIV-positive individuals have a high incidence of frailty (~20%) characterized by depression and sedentary behavior. Exercise would be healthy, but due to the frail status of many HIV-positive individuals, conventional exercise is too taxing. The aim of this study was to evaluate the effectiveness and acceptability of a novel game-based training program (exergame) in ameliorating some aspects of frailty in HIV-infected individuals. Ten older people living with HIV were enrolled in an exergame intervention. Patients performed balance exercises such as weight shifting, ankle reaching, and obstacle crossing. Real-time visual/audio lower-extremity joint motion feedback was provided using wearable sensors to assist feedback and encourage subjects to accurately execute each exercise task. Patients trained twice a week for 45 min for 6 weeks. Changes in balance, gait, psychosocial parameters and quality of life parameters were assessed at the beginning, midterm and at conclusion of the training program. Ten patients completed the study and their results analyzed. The mean age was 57.2 ± 9.2 years. The participants showed a significant reduction in center of mass sway (78.2%, p = .045) during the semi-tandem balance stance with eyes closed and showed a significant increase in gait speed during a dual task motor-cognitive assessment (9.3%, p = .048) with an increase in stride velocity of over 0.1 m/sec. A significant reduction in reported pain occurred (43.5%, p = .041). Preliminary results of this exergame intervention show promise in improving balance and mobility while requiring older people living with HIV to be more active. The exergame can be continued at home and may have long term as well as short-term benefits for ameliorating frailty associated with HIV infection. PMID:27768079

  13. Neighborhood Characteristics and Cardiovascular Risk among Older People in Japan: Findings from the JAGES Project

    PubMed Central

    Inoue, Yosuke; Stickley, Andrew; Yazawa, Aki; Shirai, Kokoro; Amemiya, Airi; Kondo, Naoki; Kondo, Katsunori; Ojima, Toshiyuki; Hanazato, Masamichi; Suzuki, Norimichi; Fujiwara, Takeo

    2016-01-01

    Previous studies have found an association between neighborhood characteristics (i.e., aspects of the physical and social environment) and the incidence of cardiovascular disease (CVD) and elevated CVD risk. This study investigated the relationship between neighborhood characteristics and CVD risk among older people in Japan where research on this association is scarce. Data came from the Japan Gerontological Evaluation Study project; questionnaire data collected from 3,810 people aged 65 years or older living in 20 primary school districts in Aichi prefecture, Japan, was linked to a computed composite CVD risk score based on biomarker data (i.e., hemoglobin A1c, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and estimated glomerular filtration rate). A sex-stratified multilevel linear regression analysis revealed that for male participants, living in neighborhoods with a higher perceived occurrence of traffic accidents and reduced personal safety was associated with an elevated CVD risk (coefficient = 1.08 per interquartile range increase, 95% confidence interval [CI] = 0.30 to 1.86) whereas males living in neighborhoods with a higher perceived proximity of exercise facilities had a lower risk (coefficient = −1.00, 95% CI = −1.78 to −0.21). For females, there was no statistically significant association between neighborhood characteristics and CVD risk. This study suggests that aspects of the neighborhood environment might be important for CVD morbidity and mortality in Japan, particularly among men. PMID:27716825

  14. The Experience of Older People in the Shared Decision-Making Process in Advanced Kidney Care

    PubMed Central

    Jenkins, Karen; McManus, Breeda; Gracey, Brian

    2016-01-01

    Introduction. This qualitative descriptive study was designed to understand the experiences of older people (>70 years) when making a decision about renal replacement therapy. This was a coproduced study, whereby patients and carers were involved in all aspects of the research process. Methods. A Patient and Carer Group undertook volunteer and research training. The group developed the interview questions and interviewed 29 people who had commenced dialysis or made a decision not to have dialysis. Interview data were transcribed and analysed, and common themes were identified. Results. 22 men and 7 women (mean age 77.4 yrs) from two hospitals were interviewed. 18 had chosen haemodialysis, 6 peritoneal dialysis, and 5 supportive care. The majority of patients were involved in the dialysis decision. Most were satisfied with the amount of information that they received, although some identified that the quality of the information could be improved, especially how daily living can be affected by dialysis. Conclusion. Our findings show that overall older patients were involved in the dialysis decision along with their families. Our approach is innovative because it is the first time that patients and carers have been involved in a coproduced study about shared decision-making. PMID:27990438

  15. Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes

    PubMed Central

    PILGRIM, A.L.; BAYLIS, D.; JAMESON, K.A.; COOPER, C.; SAYER, A.A.; ROBINSON, S.M.; ROBERTS, H.C.

    2016-01-01

    Objectives Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. Design Longitudinal observational with follow-up at six months. Setting Female acute Medicine for Older People wards at a University hospital in England. Participants 179 female inpatients. Measurements Age, weight, Body Mass Index (BMI), grip strength, SNAQ, Barthel Index Score, Mini Mental State Examination (MMSE), Geriatric Depression Scale: Short Form (GDS-SF), Malnutrition Universal Screening Tool (MUST), category of domicile and receipt of care were measured soon after admission and repeated at six month follow-up. The length of hospital stay (LOS), hospital acquired infection, readmissions and deaths by follow-up were recorded. Results 179 female participants mean age 87 (SD 4.7) years were recruited. 42% of participants had a low SNAQ score (<14, indicating poor appetite). A low SNAQ score was associated with an increased risk of hospital acquired infection (OR 3.53; 95% CI: 1.48, 8.41; p=0.004) and with risk of death (HR 2.29; 95% CI: 1.12, 4.68; p = 0.023) by follow-up. Conclusion Poor appetite was common among the older hospitalised women studied, and was associated with higher risk of poor healthcare outcomes. PMID:26728926

  16. Older Workers' Perspectives on Training and Retention of Older Workers: South Australian Aged Care Workers Study. Support Document

    ERIC Educational Resources Information Center

    Lundberg, David; Marshallsay, Zariah

    2007-01-01

    Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…

  17. Assisting adoptive families: children adopted at older ages.

    PubMed

    Singer, Ellen; Krebs, Madeleine

    2008-01-01

    Understanding the adoption experience can help health care providers develop sensitivity to the special tasks of adopted children and their families. Children who are adopted at older ages may face particular challenges. Age at adoptive placement, the burden of loss, pre-adoptive experiences, and the challenge of attachment are all significant issues in older-child adoption. Pediatric nurses demonstrate sensitivity and support to adopted children and their families by using appropriate language about adoption; understanding the significance of missing health information; providing appropriate referrals as needed; and displaying an open, caring attitude.

  18. In Hospital We Trust: Experiences of older peoples' decision to seek hospital care.

    PubMed

    Hallgren, Jenny; Ernsth Bravell, Marie; Dahl Aslan, Anna K; Josephson, Iréne

    2015-01-01

    The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.

  19. Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review.

    PubMed

    Burton, Elissa; Farrier, Kaela; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Airey, Phil; Bainbridge, Liz; Hill, Keith D

    2017-04-01

    Regular participation in resistance training is important for older people to maintain their health and independence, yet participation rates are low. The study aimed to identify motivators and barriers to older people participating in resistance training. A systematic review was conducted including quantitative, qualitative, and mixed-method studies. Searches generated 15,920 citations from six databases, with 14 studies (n = 1,937 participants) included. In total, 92 motivators and 24 barriers were identified. Motivators specific to participating in resistance training included preventing deterioration (disability), reducing risk of falls, building (toning) muscles, feeling more alert, and better concentration. Looking too muscular and thinking participation increased the risk of having a heart attack, stroke, or death, despite the minimal likelihood of these occurring, were barriers. The analysis indicates that increasing participation in resistance training among older people should focus on the specific benefits valued by older people and the dissemination of accurate information to counter misperceptions.

  20. Volunteering as reciprocity: beneficial and harmful effects of social policies to encourage contribution in older age.

    PubMed

    Stephens, Christine; Breheny, Mary; Mansvelt, Juliana

    2015-04-01

    Social policy applications of 'active ageing' ideals have recently focussed on volunteering as a beneficial and valuable contribution that older people can make to their communities. In this paper we draw attention to the positive and negative effects of a general imperative to contribute. Understanding the benefits of contribution in terms of the moral force of reciprocity recognises that older people do need and want to contribute to society and these contributions are beneficial for their sense of identity and wellbeing. However, older people vary greatly in their health, financial resources, and social networks and should not be seen as a homogenous group whose members must contribute in the same way. A policy focus on the imperative to contribute as a participating citizen can be oppressive and lead to withdrawal from social engagement by those who are the most in need of support to participate. Priorities for social and organisational policies must include support for the many ways older people are able to be involved in their communities and to provide structures necessary to support their preferences. A focus on individual responsibility for active engagement in society, which does not take account of individual circumstances or past contributions, can be harmful.

  1. Attitudes about Aging and Gender among Young, Middle Age, and Older College-Based Students

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Fischer, Mary; Laditka, James N.; Segal, David R.

    2004-01-01

    Using an updated version of the Aging Semantic Differential, 534 younger, middle age, and older participants from a college community rated female and male targets categorized as ages 21-34 and 75-85. Participants also provided views about their own aging. Repeated measures of analysis of variance examined attitudinal differences by age and gender…

  2. Seasonal Variation in Mortality, Medical Care Expenditure and Institutionalization in Older People: Evidence from a Dutch Cohort of Older Health Insurance Clients

    PubMed Central

    Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David; Westendorp, Rudi Gerardus Johannes

    2015-01-01

    Background The mortality rates of older people changes with the seasons. However, it has not been properly investigated whether the seasons affect medical care expenditure (MCE) and institutionalization. Seasonal variation in MCE is plausible, as MCE rises exponentially before death. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. Methods Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer and were linked with data from the Netherlands Institute for Social Research, and Statistics Netherlands (n = 61,495). The Seasonal and Trend decomposition using Loess (STL) method was used to divide mortality rates, MCE, and institutionalization rates into a long-term trend, seasonal variation, and remaining variation. For every season we calculated the 95% confidence interval compared to the long-term trend using Welch’s t-test. Results The mortality rates of older people differ significantly between the seasons, and are 21% higher in the winter compared to the summer. MCE rises with 13% from the summer to the winter; this seasonal difference is higher for the non-deceased than for the deceased group (14% vs. 6%). Seasonal variation in mortality is more pronounced in men and people in residential care. Seasonal variation in MCE is more pronounced in women. Institutionalization rates are significantly higher in the winter, but the other seasons show no significant impact. Conclusions Seasonal changes affect mortality and the level of MCE of older people; institutionalization rates peak in the winter. Seasonal variation in MCE exists independently from patterns in mortality. Seasonal variation in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of

  3. Imagery and Imaginary of Islander Identity: Older People and Migration in Irish Small-Island Communities

    ERIC Educational Resources Information Center

    Burholt, Vanessa; Scharf, Thomas; Walsh, Kieran

    2013-01-01

    This article examines the imagery and imaginaries of islander identity and makes an original contribution to the fields of gerontology and nissology. Drawing on data collected through in-depth interviews with 19 older residents of two small-island communities located off the island of Ireland, we address the central roles played by older people in…

  4. The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People

    ERIC Educational Resources Information Center

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

    This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…

  5. Cognitive reserve and neuropsychological functioning in older HIV-infected people.

    PubMed

    Milanini, Benedetta; Ciccarelli, Nicoletta; Fabbiani, Massimiliano; Limiti, Silio; Grima, Pierfrancesco; Rossetti, Barbara; Visconti, Elena; Tamburrini, Enrica; Cauda, Roberto; Di Giambenedetto, Simona

    2016-10-01

    Progress in treatments has led to HIV+ patients getting older. Age and HIV are risk factors for neurocognitive impairment (NCI). We explored the role of cognitive reserve (CR) on cognition in a group of virologically suppressed older HIV+ people. We performed a multicenter study, consecutively enrolling asymptomatic HIV+ subjects ≥60 years old during routine outpatient visits. A comprehensive neuropsychological battery was administered. Raw test scores were adjusted based on Italian normative data and transformed into z-scores; NCI was defined according to Frascati criteria. All participants underwent the Brief Intelligence Test (TIB) and the Cognitive Reserve Index (CRI) questionnaire as proxies for CR. Relationships between TIB, CRI, and NCI were investigated by logistic or linear regression analyses. Sixty patients (85 % males, median age 66, median education 12, 10 % HCV co-infected, 25 % with past acquired immunodeficiency syndrome (AIDS)-defining events, median CD4 cells count 581 cells/μL, median nadir CD4 cells count 109 cells/μL) were enrolled. Twenty-four patients (40 %) showed Asymptomatic Neurocognitive Impairment. At logistic regression analysis, only CRI (OR 0.94; 95 % CI 0.91-0.97; P = 0.001) and TIB (OR 0.80; 95 % CI 0.71-0.90; P < 0.001) were associated with a lower risk of NCI. Higher CRI and TIB were significantly correlated with a better performance (composite z-score) both globally and at individual cognitive domains. Our findings highlight the role of CR over clinical variables in maintaining cognitive integrity in a virologically suppressed older HIV-infected population. A lifestyle characterized by experiences of mental stimulation may help to cope aging and HIV-related neurodegeneration.

  6. Health issues of older people with intellectual disability in group homes†

    PubMed Central

    BOWERS, BARBARA; WEBBER, RUTH; BIGBY, CHRISTINE

    2014-01-01

    Background This paper explores how group home staff in Victoria, Australia, responded to residents with an intellectual disability (ID) as they developed age-related health conditions. Method The analysis was based on a longitudinal study that followed 17 ageing group home residents over a 3-year period. Eighty-three interviews were conducted with 30 group home staff in 17 group homes. Dimensional analysis, a variant of grounded theory, guided data collection and analysis. Results Findings revealed that the organisations all had systems in place to address health issues. However, the results also suggest an inability of staff to differentiate between significant health conditions and normal age-related changes, thus contributing to delays in care for serious medical conditions. Conclusions Lack of knowledge about normal ageing and an absence of organisational policies influence timeliness of diagnosis and treatment for people with ID. Group home staff could be more effective advocates for older residents, leading to improvements in health outcomes, if they had basic knowledge about normal ageing and symptoms of common age-related illnesses and if group home agencies provided clearer guidance to their staff. The study has implications for staff education and organisational policy development for group homes. PMID:25750581

  7. The association between subjective memory complaint and objective cognitive function in older people with previous major depression

    PubMed Central

    Begum, Aysha; Liu, Shen-Ing; Chang, Ching-Jui; Chiu, Wei-Che; Chen, Chin-Hsin; Tang, Hwang-Shen; Yang, Chia-Li; Lin, Ying-Chin; Stewart, Robert

    2017-01-01

    The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression–a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%). Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale score<7). The results suggest subjective memory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples. PMID:28267772

  8. Blood-Brain Barrier Dysfunction and Cerebral Small Vessel Disease (Arteriolosclerosis) in Brains of Older People

    PubMed Central

    Khoong, Cheryl H.L.; Poon, Wayne; Esiri, Margaret M.; Markus, Hugh S.; Hainsworth, Atticus H.

    2014-01-01

    The blood-brain barrier (BBB) protects brain tissue from potentially harmful plasma components. Small vessel disease ([SVD], arteriolosclerosis) is common in the brains of older people and is associated with lacunar infarcts, leukoaraiosis and vascular dementia. To determine whether plasma extravasation is associated with SVD, we immunolabeled the plasma proteins fibrinogen and IgG, which are assumed to reflect BBB dysfunction, in deep grey matter (anterior caudate-putamen, [DGM]) and deep subcortical white matter (DWM) in the brains of a well-characterized patient cohort with minimal Alzheimer disease pathology (Braak stage 0-II) (n = 84; age ≥65 years). Morphometric measures of fibrinogen labeling were compared between people with neuropathologically defined SVD and aged control subjects. Parenchymal cellular labeling with fibrinogen and IgG was detectable in DGM and DWM in many subjects (>70%). Quantitative measures of fibrinogen were not associated with SVD in DGM or DWM; SVD severity was correlated between DGM and DWM (p < 0.0001). Fibrinogen in DGM showed a modest association with a history of hypertension; DWM fibrinogen was associated with dementia and cerebral amyloid angiopathy (all p < 0.05). In DWM, SVD was associated with leukoaraiosis identified in life (p < 0.05), but fibrinogen was not. Our data suggest that in aged brains plasma extravasation and hence local BBB dysfunction is common but do not support an association with SVD. PMID:25289893

  9. Transport-Related Social Exclusion amongst Older People in Rural Southwest England and Wales

    ERIC Educational Resources Information Center

    Shergold, Ian; Parkhurst, Graham

    2012-01-01

    Rural dwelling and older age are both associated with a higher risk of social exclusion, with accessibility identified as having an important facilitating role. The interactions between transport-related exclusion and older age, particularly in a rural context, are considered though analysis of quantitative and qualitative data collected from over…

  10. Reasons Given by Older People for Limitation or Avoidance of Driving

    ERIC Educational Resources Information Center

    Ragland, David R.; Satariano, William A.; MacLeod, Kara E.

    2004-01-01

    Purpose: To understand the driving behavior of older adults, this study examines self-reported reasons for driving limitation or avoidance. Design and Methods: Baseline interviews were conducted (n = 2,046) as part of a community-based study of aging and physical performance in persons aged 55 years or older in Sonoma, California. Twenty-one…

  11. The epidemiology of dependency among urban-dwelling older people in the Dominican Republic; a cross-sectional survey

    PubMed Central

    Acosta, Daisy; Rottbeck, Ruth; Rodríguez, Guillermina; Ferri, Cleusa P; Prince, Martin J

    2008-01-01

    Background Demographic ageing, and the health transition will soon lead to large increases in the number of dependent older people in low and middle income countries. Despite its importance, this topic has not previously been studied. Methods A cross sectional catchment area one-phase survey of health conditions, dependency, care arrangements and caregiver strain among 2011 people aged 65 years and over in Santo Domingo, Dominican Republic Results 7.1% of participants required much care and a further 4.7% required at least some care. The prevalence of dependency increased sharply with increasing age. Dependent older people were less likely than others to have a pension and much less likely to have paid work, but no more likely to benefit from financial support from their family. Needing much care was strongly associated with comorbidity between cognitive, psychological and physical health problems. However, dementia made the strongest independent contribution. Among those needing care, those with dementia stood out as being more disabled, as needing more care (particularly support with core activities of daily living), and as being more likely to have paid caregivers. Dementia caregivers experienced more strain than caregivers of those with other health conditions, an effect mediated by behavioural and psychological symptoms. Conclusion Dependency among older people is nearly as prevalent in Dominican Republic as in developed western settings. Non-communicable diseases, particularly dementia are the main contributing factors. Attention needs to be directed towards the development of age-appropriate healthcare, a long-term care policy, and mechanisms for ensuring the social protection of older persons. PMID:18700967

  12. Socioeconomic variation in the financial consequences of ill health for older people with chronic diseases: a systematic review.

    PubMed

    Valtorta, Nicole K; Hanratty, Barbara

    2013-04-01

    Chronic disease has financial consequences for older adults, but it is unclear how this varies between conditions with different disease trajectories. The aim of this study was to review evidence on the financial burden associated with cancer, heart failure or stroke in older people, to identify those most at risk of financial adversity. We systematically searched nine databases for studies with data on the illness-related financial burden (objective), or on the perception of financial hardship (subjective), of older patients and/or their informal caregivers in high-income countries. We identified thirty-eight papers published in English between 1984 and 2012. Studies fell into three categories: those reporting direct, out of pocket, costs (medical and/or non-medical); studies of the indirect costs associated with illness (such as wage or income loss); and papers reporting general financial or economic burdens secondary to illness. Three out of four studies focused on people with cancer. More affluent people had greater out of pocket costs, but were less financially burdened by illness, compared with older adults from lower socioeconomic backgrounds. Disadvantaged patients and families were more likely to report experiences of financial hardship, and spend a higher proportion of their income on all expenses related to their diagnoses. This review illustrates how little is known about the financial adversity experienced by patients with some common chronic conditions. It raises the possibility that higher expenditure by more affluent older people may be creating inequalities in how chronic illness is experienced. The development of effective strategies for financial protection at older ages will require more information on who is affected and at which point in their illness trajectory.

  13. Dimensions of Housing Deprivation for Older People in Ireland

    ERIC Educational Resources Information Center

    Nolan, Brian; Winston, Nessa

    2011-01-01

    Housing is an important aspect of living standards and quality of life for older persons, but the housing-related problems they may face encompass rather different circumstances, relating to the condition of the dwelling, how well equipped it is, whether housing costs represent a serious burden, and whether the neighbourhood environment is…

  14. Intergenerational Contact, Attitudes, and Stereotypes of Adolescents and Older People

    ERIC Educational Resources Information Center

    Meshel, David; Mcglynn, Richard

    2004-01-01

    Contradictory findings characterize the literature on the efficacy of intergenerational programs that bring children and older persons together for joint activities to promote more positive attitudes and stereotypes. Nor is it clear whether cross-generational attitudes are negative to begin with. The research reported in this paper operationalized…

  15. Keeping It Safe: Aging in Place among Rural Older Adults

    ERIC Educational Resources Information Center

    Peek, Gina G.; Bishop, Alex J.

    2016-01-01

    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…

  16. Perspective Taking in Older Age Revisited: A Motivational Perspective

    ERIC Educational Resources Information Center

    Zhang, Xin; Fung, Helene H.; Stanley, Jennifer T.; Isaacowitz, Derek M.; Ho, Man Yee

    2013-01-01

    How perspective-taking ability changes with age (i.e., whether older adults are better at understanding others' behaviors and intentions and show greater empathy to others or not) is not clear, with prior empirical findings on this phenomenon yielding mixed results. In a series of experiments, we investigated the phenomenon from a motivational…

  17. Middle-Aged and Older Women in Print Advertisements.

    ERIC Educational Resources Information Center

    Hollenshead, Carol; Ingersoll, Berit

    1982-01-01

    Examined images of aging women depicted in periodical advertising over a 10-year period. Analyzed content for frequency, products involved, setting, value orientation, and change over time. Found older women in less than 1% of the advertisements, and no significant changes from 1967-1977. (Author/JAC)

  18. Perspective taking in older age revisited: a motivational perspective.

    PubMed

    Zhang, Xin; Fung, Helene H; Stanley, Jennifer T; Isaacowitz, Derek M; Ho, Man Yee

    2013-10-01

    How perspective-taking ability changes with age (i.e., whether older adults are better at understanding others' behaviors and intentions and show greater empathy to others or not) is not clear, with prior empirical findings on this phenomenon yielding mixed results. In a series of experiments, we investigated the phenomenon from a motivational perspective. Perceived closeness between participants and the experimenter (Study 1) or the target in an emotion recognition task (Study 2) was manipulated to examine whether the closeness could influence participants' performance in faux pas recognition (Study 1) and emotion recognition (Study 2). It was found that the well-documented negative age effect (i.e., older adults performed worse than younger adults in faux pas and emotion recognition tasks) was only replicated in the control condition for both tasks. When closeness was experimentally increased, older adults enhanced their performance, and they now performed at a comparable level as younger adults. Findings from the 2 experiments suggest that the reported poorer performance of older adults in perspective-taking tasks might be attributable to a lack of motivation instead of ability to perform in laboratory settings. With the presence of strong motivation, older adults have the ability to perform equally well as younger adults.

  19. Caught between intending and doing: older people ideating on a self-chosen death

    PubMed Central

    van Wijngaarden, Els; Leget, Carlo; Goossensen, Anne

    2016-01-01

    Objectives The aim of this paper is to provide insight into what it means to live with the intention to end life at a self-chosen moment from an insider perspective. Setting Participants who lived independent or semidependent throughout the Netherlands. Participants 25 Dutch older citizens (mean age of 82 years) participated. They were ideating on a self-chosen death because they considered their lives to be no longer worth living. Inclusion criteria were that they: (1) considered their lives to be ‘completed’; (2) suffered from the prospect of living on; (3) currently wished to die; (4) were 70 years of age or older; (5) were not terminally ill; (6) considered themselves to be mentally competent; (7) considered their death wish reasonable. Design In this qualitative study, in-depth interviews were carried out in the participants’ everyday home environment (median lasting 1.56 h). Verbatim transcripts were analysed based on the principles of phenomenological thematic analysis. Results The liminality or ‘in-betweenness’ of intending and actually performing self-directed death (or not) is characterised as a constant feeling of being torn explicated by the following pairs of themes: (1) detachment and attachment; (2) rational and non-rational considerations; (3) taking control and lingering uncertainty; (4) resisting interference and longing for support; (5) legitimacy and illegitimacy. Conclusions Our findings show that the in-between period emerges as a considerable, existential challenge with both rational and non-rational concerns and thoughts, rather than a calculative, coherent sum of rational considerations. Our study highlights the need to take due consideration of all ambiguities and ambivalences present after a putatively rational decision has been made in order to develop careful policy and support for this particular group of older people. PMID:26781505

  20. Predictors of Prosocial Behavior: Differences in Middle Aged and Older Adults.

    PubMed

    Wenner, Jennifer R; Randall, Brandy A

    2016-10-01

    Generativity, contributing to the next generation, is important for well-being throughout middle and late life. Therefore, it is crucial to understand what contributes to generativity during these life stages. Parenting and work are common, but not the only, ways people engage generatively; prosocial behavior is another. A community connection may encourage generative contributions in adults. However, older adults may face obstacles to being generative, and may need an additional drive to engage in these behaviors. Given this, it was expected that community cohesion would predict prosocial behavior despite age, and that grit would provide motivation for older adults, so the current study examined whether age moderated the relation between grit and prosocial behavior. Data were used from 188 upper-Midwest adults (aged 37-89). Multiple regression analyses showed that age moderated the relation between grit and prosocial behavior such that grit predicted prosocial behavior in older adults but not middle age adults. A sense of community cohesion was predictive of prosocial behavior despite age. While grit may promote generative acts in different ways depending on age, a sense of community cohesion may foster community contributions despite age. The discussion focuses on future directions and ways to promote generativity using this research.

  1. The influence of cognition on self-management of type 2 diabetes in older people

    PubMed Central

    Tomlin, Ali; Sinclair, Alan

    2016-01-01

    value or implications of the research. This only allows speculation of their importance. Most studies do not separate out the influence of aging itself in altering diabetes self-care behavior. We conclude that older people with type 2 diabetes are at increased risk for cognitive dysfunction. Changes in cognition may negatively affect diabetes self-management behaviors, influencing self-care outcomes. Age and depression may exacerbate any cognitive impairment. PMID:26855601

  2. Prevalence, Types, Risk Factors and Clinical Correlates of Anaemia in Older People in a Rural Ugandan Population

    PubMed Central

    Mugisha, Joseph O.; Baisley, Kathy; Asiki, Gershim; Seeley, Janet; Kuper, Hannah

    2013-01-01

    Background Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. Methods Participants were aged (≥ 50) years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. Results In total, 1449 people participated (response rate 72.3%). The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%), and this was higher for males (24.1%, 95% CI=20.7-27.7%) than females (17.5%, 95% CI=15.0-20.1%). In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001). Unexplained anaemia was responsible for more than half of all cases (59.7%). Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82), HIV (OR 2.17, 1.32-3.57) heavy hookworm infection (OR 3.45, 1.73-6.91), low fruit consumption (OR 1.55, 1.05-2.29) and being unmarried (OR 1.37 , 95% CI 1.01-1.89). However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77). Conclusion Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict iron

  3. Understanding older peoples' decisions about the use of sleeping medication: issues of control and autonomy.

    PubMed

    Venn, Susan; Arber, Sara

    2012-11-01

    Poor sleep is known to impact on health and wellbeing in later life and has implications for the ability of older people to remain active during the day. Medical treatments for chronic poor sleep have primarily included the regular, long-term prescribing of hypnotics, which are known to impact on older people's health, cognitive function and quality of life. Therefore, recent policy and practice has focused on reducing such prescribing, on encouraging older people to stop taking long-term hypnotics and on finding alternative, non-pharmacological ways to manage poor sleep. However, little research has been undertaken to understand the perspectives of older people who choose not to seek professional help for their poor sleep, despite the potential impact of poor sleep on their health and ability to remain active. Through in-depth interviews with 62 older men and women living in their own homes in England, this article explores the factors that deter older people from seeking professional help for their poor sleep. We argue that these are located in their perceptions of the normativity of poor sleep in later life, their beliefs about prescription sleeping medications and their desire to maintain control and autonomy over their everyday and night lives.

  4. Warm homes for older people: aims and methods of a randomised community-based trial for people with COPD

    PubMed Central

    2013-01-01

    Background Chronic Obstructive Pulmonary Disease (COPD) is of increasing importance with about one in four people estimated to be diagnosed with COPD during their lifetime. None of the existing medications for COPD has been shown to have much effect on the long-term decline in lung function and there have been few recent pharmacotherapeutic advances. Identifying preventive interventions that can reduce the frequency and severity of exacerbations could have important public health benefits. The Warm Homes for Elder New Zealanders study is a community-based trial, designed to test whether a NZ$500 electricity voucher paid into the electricity account of older people with COPD, with the expressed aim of enabling them to keep their homes warm, results in reduced exacerbations and hospitalisation rates. It will also examine whether these subsidies are cost-beneficial. Methods Participants had a clinician diagnosis of COPD and had either been hospitalised or taken steroids or antibiotics for COPD in the previous three years; their median age was 71 years. Participants were recruited from three communities between 2009 to early 2011. Where possible, participants’ houses were retrofitted with insulation. After baseline data were received, participants were randomised to either ‘early’ or ‘late’ intervention groups. The intervention was a voucher of $500 directly credited to the participants’ electricity company account. Early group participants received the voucher the first winter they were enrolled in the study, late participants during the second winter. Objective measures included spirometry and indoor temperatures and subjective measures included questions about participant health and wellbeing, heating, medication and visits to health professionals. Objective health care usage data included hospitalisation and primary care visits. Assessments of electricity use were obtained through electricity companies using unique customer numbers. Discussion This

  5. Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review

    PubMed Central

    Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

    2016-01-01

    Objective The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. Design A realist review. Data sources MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Eligibility criteria for selecting studies Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. Analysis An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. Results 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Conclusions Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which

  6. Support networks for Chinese older immigrants accessing English health and social care services: the concept of Bridge People.

    PubMed

    Liu, Xiayang; Cook, Glenda; Cattan, Mima

    2017-03-01

    As Chinese immigrants in the United Kingdom age, they experience an increasing need to access health and care services. It has, however, been reported that older Chinese immigrants have difficulties in accessing these services. This study explored the experiences of this population in using health and care services and the strategies that they adopted to address their difficulties. A grounded theory method with a two-staged research design was used. Stage 1 explored the participants' experiences of ageing and use of health and social care services through focus group interviews. Stage 2 investigated the strategies individuals used to support access to and use of services through individual interviews. Forty-four older Chinese people and 15 supporters participated in interviews during August 2011 and May 2013. These older Chinese immigrants were challenged in knowing about and in accessing services. Their difficulties were attributed to language barriers, lack of information and instrumental support, and emotional and cultural issues regarding use of health and care services. Their supporters facilitated access to services and acted as a bridge between the service and the user; therefore, they were given the title 'Bridge People'. Bridge People have different backgrounds: family and friends, public sector workers and staff from community-based Chinese organisations. The defining attributes of these supporters were: bilinguality, bicultural, multifunctionality and accessibility. There is no charge for this support; and the relationship between the Bridge Person and recipient involves trust and influence over decisions regarding use of health and care services. Bridge People should be recognised and identified by health, social care and housing services to promote engagement and use of services by older immigrant Chinese people.

  7. The Role of Housing Space in Determining Freedom and Flourishing in Older People

    ERIC Educational Resources Information Center

    Gilroy, Rose

    2005-01-01

    This paper takes as its central thesis Martha Nussbaum's normative proposition that social arrangements should be evaluated primarily according to the extent of freedom people have to promote or achieve functionings they value. Using this as a lens the paper explores the housing circumstances of older people in the UK. The paper makes three…

  8. Relating to Older People Evaluation (ROPE): A Measure of Self-Reported Ageism

    ERIC Educational Resources Information Center

    Cherry, Katie E.; Palmore, Erdman

    2008-01-01

    The Relating to Older People Evaluation (ROPE) is a 20-item questionnaire that measures positive and negative ageist behaviors that people may engage in during everyday life. In this article, we report the first findings from several administrations of the ROPE along with initial psychometric information on the instrument. Respondents were college…

  9. Functional Balance and Its Determinants in Older People with Diabetes

    PubMed Central

    Tsai, Yi-Ju; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Pei-Yun; Lee, I-Ting; Lin, Sang-I

    2016-01-01

    Objective To determine functional balance abilities of older adults with diabetes, and identify determinants of these abilities. Methods Eighty diabetic and 67 healthy non-diabetic community-dwelling older adults completed the Mini Mental Status Examination (MMSE) and questionnaires about their medical and fall histories. Participants were also assessed for vision, plantar sensitivity, muscle strength, and functional balance, including Functional Reach (FR), Five Times Sit-to-Stand (FTSTS), and 180° turn (TURN). In addition to between-group comparisons, hierarchical regression analysis was conducted to identify the independent determinants for each of the individual balance tasks for the diabetes and control group separately. Results The diabetes group had significantly greater body mass index, higher rate of cardiac disease, and poorer plantar sensitivity, mental status, grip and lower limb strength. The diabetes group performed significantly poorer in FTSTS and TURN (both p<0.001), but not FR (p = 0.108). The significant determinants for the balance tasks varied substantially between tasks and groups. For the diabetes group, they included visual and plantar sensitivity and MMSE for FR (R2 = 0.39), ankle dorsiflexion strength for FTSTS (R2 = 0.377), and plantar sensitivity, knee extension strength and MMSE for TURN (R2 = 0.391). For the control group, knee extension strength emerged as the common and only significant determinant and only explained approximately 10% of the variance for FR and TURN. Conclusions Impairments in functional balance abilities were evident for older adults with diabetes. Their underpinning functional limitations were different for different tasks and were also different from those of the control group. Screening of functional balance and mental status, lower limb strength and sensory function, and interventions to address these impairments may be important to maintain function, independence and safety for older clients with diabetes

  10. The falling risk and physical fitness in older people.

    PubMed

    Toraman, Ayşe; Yildirim, Necmiye Un

    2010-01-01

    Aims of this study was to analyze the correlation between the falling risk and their physical fitness, determining the top parameters affecting the falling risk, and preparing an evaluation procedure for the medical department working on this issue for the old people in retirement homes. This study includes 60 persons whose mean age was 73.3+/-6.6 years. Their demographic characteristics, cognitive function, their balance, falling risk and their physical fitness level have been evaluated. A survey has been done to determine their demographic features. The cognitive function was determined using mini-mental state examination (MMSE) test; for falling risk the Berg balance test (BBT) and balance by standing on one foot test were used, and the physical fitness was determined by senior fitness test (SFT). While the BBT correlation between chair stand, arm curl and 2-min step test are positive; but the correlation between BBT and '8-foot up-and-go test' were negative. However, there was no correlation between the BBT and chair sit-and-reach test, back scratch test (p>0.05). Due to the results of logistic regression models in order to find out the variations affecting the falling risk most, it has been showed that '8-foot up-and-go test' was reliable. Additionally the subjects probability performing the '8-foot up-and-go' before 8.14s was OR=11 (95% confidence interval=95%CI=2.25-53.84) times more with maximum 56 points in BBT. We have shown that the falling risk increases with declining of upper and lower extremity muscle strength, aerobic endurance, agility and dynamic balance performance. Agility and dynamic balance performance were mostly relevant with falling risk. We concluded that the old persons' falling risk and physical fitness level should be evaluated in some intervals. According to their falling risks and physical fitness level, the rehabilitation programs should be programmed to decrease their falling risk, and to increase lower and upper extremity muscle

  11. The association between objectively measured physical activity and life-space mobility among older people.

    PubMed

    Tsai, L-T; Portegijs, E; Rantakokko, M; Viljanen, A; Saajanaho, M; Eronen, J; Rantanen, T

    2015-08-01

    The purpose of this cross-sectional study was to investigate the association between objectively measured physical activity and life-space mobility in community-dwelling older people. Life-space refers to the spatial area a person purposefully moves through in daily life (bedroom, home, yard, neighborhood, town, and beyond) and life-space mobility to the frequency of travel and the help needed when moving through different life-space areas. The study population comprised community-living 75- to 90-year-old people {n = 174; median age 79.7 [interquartile range (IQR) 7.1]}, participating in the accelerometer substudy of Life-Space Mobility in Old Age (LISPE) project. Step counts and activity time were measured by an accelerometer (Hookie "AM20 Activity Meter") for 7 days. Life-space mobility was assessed with Life-Space Assessment (LSA) questionnaire. Altogether, 16% had a life-space area restricted to the neighborhood when moving independently. Participants with a restricted life space were less physically active and about 70% of them had exceptionally low values in daily step counts (≤ 615 steps) and moderate activity time (≤ 6.8 min). Higher step counts and activity time correlated positively with life-space mobility. Prospective studies are needed to clarify the temporal order of low physical activity level and restriction in life-space mobility.

  12. Retirement or Just a Change of Pace: An Australian National Survey of Disability Day Services Used by Older People with Disabilities

    ERIC Educational Resources Information Center

    Bigby, Christine; Balandin, Susan; Fyffe, Chris; McCubbery, Jeffrey; Gordon, Meg

    2004-01-01

    The increasing number of people with disabilities surviving to old age raises questions regarding the type of day support programs necessary to meet their needs. In this paper the results of a national survey of specialist disability day programs used by older 2 Definitions of old age selected by researchers should reflect differences in culture…

  13. Social marketing strategies for reaching older people with disabilities: findings from a survey of centers for independent living participants.

    PubMed

    Moone, Rajean Paul; Lightfoot, Elizabeth

    2009-01-01

    Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities.

  14. "Studying the cutaneous microcirculatory response during upper-limb exercise in healthy, older, sedentary people".

    PubMed

    Klonizakis, Markos

    2012-01-01

    This study investigated changes incurred in cutaneous skin blood flux (SKBF) in the superficial veins of the lower limb by upper limb exercise training in the form of arm-cranking in 14 healthy participants over the age of 50 years. Changes in cutaneous microvascular function of the lower leg were assessed using laser Doppler Flowmetry (LDF) during a 30-minute exercise session undertaken over 4-exercise periods. Both SKBF and Time to reach Peak Perfusion (Tmax) were improved significantly during the 2nd (e.g. 121 (± 107.2) vs 280 (± 269.1) and 171 (± 34.4) vs. 247 (± 38.3) respectively) when compared to the first exercise period, while values approaching initial levels in the following stages. The results indicate that the thermoregulatory and vasodilation mechanisms observed during exercise in middle-aged and older healthy people are different to the one appearing in younger age groups, suggesting a more extensive effect of the age-related structural changes than it was previously thought.

  15. Prescribing selective serotonin reuptake inhibitors in older age.

    PubMed

    Topiwala, Anya; Chouliaras, Leonidas; Ebmeier, Klaus P

    2014-02-01

    Apart from commercial reasons, two motivations have led to the introduction of SSRIs to replace the first and second generation antidepressants already available. One was the search for a more rational treatment, based on specific mechanisms, the other the development of effective treatments with fewer side effects, particularly for older patients, who have a greater sensitivity to cardio-vascular and central nervous system effects. The first has been frustrated up to a point, in that SSRIs and other single mechanism drugs do not appear to be more effective than the earliest relatively non-specific antidepressants. The second has been fulfilled, in that SSRIs generally are better tolerated in older patients and in overdose. However, there is a spectrum of other side effects that are particularly relevant in older age and that need attention when treating depression in this particular patient group.

  16. Self-assessed driving behaviors associated with age among middle-aged and older adults in Japan.

    PubMed

    Arai, Asuna; Arai, Yumiko

    2015-01-01

    With the increasing number of older drivers, road traffic safety is an urgent public health issue. It is not easy for older drivers or their relatives to detect early signs of dangerous driving behaviors. We examine the types of driving behavior that increase in frequency with age. We surveyed people aged 40 and over among the general public in Japan using a self-administered questionnaire on sociodemographic factors, driving status, frequency of driving, 12-items on physical symptoms possibly related to driving performance, and 28-items on driving behaviors. Multiple logistic regression models were used to estimate the odds ratios (OR) of occurrence of each of the 28 driving behaviors for a 5-year increase in age. Significant associations with a 5-year increase in age after adjusting for confounding factors were found for the following directly unsafe driving behaviors: (1) little or no sign of attempts to avoid dangerous situations (OR for a 5-year increase in age=1.38, 95% CI: 1.18-1.63); (2) lack of attention to other people and cars (1.33, 1.12-1.60); (3) improper maneuvering around curves (1.33, 1.09-1.65); and (4) improper or no turn signals (1.33, 1.06-1.69). Information about these driving behaviors should be given to drivers and their stakeholders and used to caution participants when implementing educational programs for older drivers. Self-assessment of driving ability in older drivers provides useful information to raise awareness of their driving performance.

  17. Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: adding value to pathology laboratory reports

    PubMed Central

    Hooper, Lee; Abdelhamid, Asmaa; Ali, Adam; Bunn, Diane K; Jennings, Amy; John, W Garry; Kerry, Susan; Lindner, Gregor; Pfortmueller, Carmen A; Sjöstrand, Fredrik; Walsh, Neil P; Fairweather-Tait, Susan J; Potter, John F; Hunter, Paul R; Shepstone, Lee

    2015-01-01

    Objectives To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people. Design Diagnostic accuracy study. Participants Older people (≥65 years) in 5 cohorts: Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community), Dehydration Recognition In our Elders (DRIE, living in residential care), Fortes (admitted to acute medical care), Sjöstrand (emergency room) or Pfortmueller cohorts (hospitalised with liver cirrhosis). Reference standard for hydration status Directly measured serum/plasma osmolality: current dehydration (serum osmolality >300 mOsm/kg), impending/current dehydration (≥295 mOsm/kg). Index tests 39 osmolarity equations calculated using serum indices from the same blood draw as directly measured osmolality. Results Across 5 cohorts 595 older people were included, of whom 19% were dehydrated (directly measured osmolality >300 mOsm/kg). Of 39 osmolarity equations, 5 showed reasonable agreement with directly measured osmolality and 3 had good predictive accuracy in subgroups with diabetes and poor renal function. Two equations were characterised by narrower limits of agreement, low levels of differential bias and good diagnostic accuracy in receiver operating characteristic plots (areas under the curve >0.8). The best equation was osmolarity=1.86×(Na++ K+)+1.15×glucose+urea+14 (all measured in mmol/L). It appeared useful in people aged ≥65 years with and without diabetes, poor renal function, dehydration, in men and women, with a range of ages, health, cognitive and functional status. Conclusions Some commonly used osmolarity equations work poorly, and should not be used. Given costs and prevalence of dehydration in older people we suggest use of the best formula by pathology laboratories using a cutpoint of 295 mOsm/L (sensitivity 85%, specificity 59%), to report

  18. Known Well by No-One: Trends in the Informal Social Networks of Middle-Aged and Older People with Intellectual Disability Five Years after Moving to the Community

    ERIC Educational Resources Information Center

    Bigby, Christine

    2008-01-01

    Background: Informal relationships are central to conceptualisations of quality of life. Deinstitutionalisation studies consistently suggest a trend of increased contact with family and friends by people with intellectual disability (ID) following relocation from an institution to the community. In this study, changes in the nature of the informal…

  19. Central Auditory Dysfunction in Older People with Memory Impairment or Alzheimer's Dementia

    PubMed Central

    Gates, George A.; Anderson, Melissa L.; Feeney, M. Patrick; McCurry, Susan M.; Larson, Eric B.

    2009-01-01

    Central auditory function is commonly compromised in people with a diagnosis of Alzheimer's disease (AD) and may precede the onset of clinical dementia by several years. Given that screening for AD in its earliest stages might someday be useful for emerging therapies aimed at limiting progression, we inquired whether central auditory testing might be suitable for identifying people at risk for dementia. To address this question, we performed a battery of behavioral central auditory tests in a cohort of 313 older people enrolled in a dementia surveillance research program. The cohort consisted of three groups: controls without memory loss (N=232), targets with mild memory impairment but without dementia (N=64), and targets with a dementia diagnosis (N=17). The auditory tests were the Synthetic Sentence Identification with Ipsilateral Competing Message (SSI), the Dichotic Sentence Identification test (DSI), the Dichotic Digits Test (DDT), and the Pitch Pattern Sequence (PPS) test. Additional control was provided by electrophysiologic testing to assess the integrity of the primary auditory pathways. The mean score on each central auditory test worsened significantly across the three memory groups even after adjusting for age and peripheral hearing status, being poorest in the pAD group and moderately reduced in the memory-impaired group compared to the mean scores in the control group. Heterogeneity of results was noted in all three groups. The electrophysiologic tests did not differ across the three groups. Central auditory function was affected by mild memory impairment. The Dichotic Sentence Identification in the free report mode appears to be the central auditory test most sensitive to the presence of memory impairment. Although central auditory testing requires specialized equipment and training, the objectivity of these tests is appealing. We recommend that comprehensive auditory testing be considered and further evaluated for its potential value as a baseline

  20. Living with constipation—older people's experiences and strategies with constipation before and during hospitalization

    PubMed Central

    Munch, Lene; Tvistholm, Nina; Trosborg, Ingelise; Konradsen, Hanne

    2016-01-01

    Background Constipation is a common problem among older people. This study aimed to explore how older patients experience constipation and which strategies they used in handling the condition before and during hospitalization. Methods A qualitative exploratory research design was used. Fourteen semi-structured interviews were conducted with patients (61–91 years of age) during hospitalization. Data were analyzed by using content analysis. Results Themes concerning experiences were Bodily signs and symptoms of constipation; the participants described severe pain during constipation, as well as pronounced relief after bowel movements, Impact on well-being and social activities; being constipated negatively impacted their mood and limited social activities, Striving for bowel balance; the participants experienced an ongoing strive for balancing between constipation and diarrhea. Themes related to strategies were Struggling to find a solution; they were aware of different strategies to prevent and treat constipation, though the most common solution described was the use of laxatives, Wait and see; the participants were awaiting to take action until they experienced constipation symptoms, Constipation is a private problem being challenged during hospitalization; constipation was considered a private issue rarely discussed with health-care professionals. Conclusion This study illuminates the need for health-care professionals to be attentive to this issue and initiate the conversation with patients in order to advise on the management of constipation. PMID:27121271

  1. Age Differences in Prefrontal Surface Area and Thickness in Middle Aged to Older Adults

    PubMed Central

    Dotson, Vonetta M.; Szymkowicz, Sarah M.; Sozda, Christopher N.; Kirton, Joshua W.; Green, Mackenzie L.; O’Shea, Andrew; McLaren, Molly E.; Anton, Stephen D.; Manini, Todd M.; Woods, Adam J.

    2016-01-01

    Age is associated with reductions in surface area and cortical thickness, particularly in prefrontal regions. There is also evidence of greater thickness in some regions at older ages. Non-linear age effects in some studies suggest that age may continue to impact brain structure in later decades of life, but relatively few studies have examined the impact of age on brain structure within middle-aged to older adults. We investigated age differences in prefrontal surface area and cortical thickness in healthy adults between the ages of 51 and 81 years. Participants received a structural 3-Tesla magnetic resonance imaging scan. Based on a priori hypotheses, primary analyses focused on surface area and cortical thickness in the dorsolateral prefrontal cortex, anterior cingulate cortex, and orbitofrontal cortex. We also performed exploratory vertex-wise analyses of surface area and cortical thickness across the entire cortex. We found that older age was associated with smaller surface area in the dorsolateral prefrontal and orbitofrontal cortices but greater cortical thickness in the dorsolateral prefrontal and anterior cingulate cortices. Vertex-wise analyses revealed smaller surface area in primarily frontal regions at older ages, but no age effects were found for cortical thickness. Results suggest age is associated with reduced surface area but greater cortical thickness in prefrontal regions during later decades of life, and highlight the differential effects age has on regional surface area and cortical thickness. PMID:26834623

  2. Age Differences in Prefrontal Surface Area and Thickness in Middle Aged to Older Adults.

    PubMed

    Dotson, Vonetta M; Szymkowicz, Sarah M; Sozda, Christopher N; Kirton, Joshua W; Green, Mackenzie L; O'Shea, Andrew; McLaren, Molly E; Anton, Stephen D; Manini, Todd M; Woods, Adam J

    2015-01-01

    Age is associated with reductions in surface area and cortical thickness, particularly in prefrontal regions. There is also evidence of greater thickness in some regions at older ages. Non-linear age effects in some studies suggest that age may continue to impact brain structure in later decades of life, but relatively few studies have examined the impact of age on brain structure within middle-aged to older adults. We investigated age differences in prefrontal surface area and cortical thickness in healthy adults between the ages of 51 and 81 years. Participants received a structural 3-Tesla magnetic resonance imaging scan. Based on a priori hypotheses, primary analyses focused on surface area and cortical thickness in the dorsolateral prefrontal cortex, anterior cingulate cortex, and orbitofrontal cortex. We also performed exploratory vertex-wise analyses of surface area and cortical thickness across the entire cortex. We found that older age was associated with smaller surface area in the dorsolateral prefrontal and orbitofrontal cortices but greater cortical thickness in the dorsolateral prefrontal and anterior cingulate cortices. Vertex-wise analyses revealed smaller surface area in primarily frontal regions at older ages, but no age effects were found for cortical thickness. Results suggest age is associated with reduced surface area but greater cortical thickness in prefrontal regions during later decades of life, and highlight the differential effects age has on regional surface area and cortical thickness.

  3. Older Adults’ Perspectives on Successful Aging: Qualitative Interviews

    PubMed Central

    Reichstadt, Jennifer; Sengupta, Geetika; Depp, Colin A.; Palinkas, Lawrence A.; Jeste, Dilip V.

    2010-01-01

    OBJECTIVES Lay perceptions of “successful aging” are important for understanding this multifaceted construct and developing ways to assist older adults to age well. The purpose of this qualitative study was to obtain older adults’ individual perspectives on what constitutes successful aging, along with their views regarding activities and interventions to enhance its likelihood. METHODS Qualitative interviews were conducted with 22 community-dwelling adults over age 60. Participants were recruited from retirement communities, a low-income senior housing complex, and a continued learning center in San Diego County. Interview transcripts were analyzed using a “Coding Consensus, Co-occurrence, and Comparison” grounded theory framework. RESULTS The mean age of participants was 80 years (range: 64 to 96), with 59% being women. Two primary themes were identified as key to successful aging - i.e., self-acceptance/self-contentment (with sub-themes of realistic self-appraisal, a review of one’s life, and focusing on the present) and engagement with life/self-growth (with sub-themes of novel pursuits, giving to others, social interactions, and positive attitude). A balance between these two constructs appeared critical. A need for interventions that address support systems and personally tailored information to make informed decisions and enhance coping strategies were also emphasized. CONCLUSIONS Older adults viewed successful aging as a balance between self-acceptance and self-contentedness on one hand and engagement with life and self-growth in later life on the other. This perspective supports the concept of wisdom as a major contributor to successful aging. Interventions to enhance successful aging may include those that promote productive and social engagement along with effective coping strategies. PMID:20593536

  4. Cortisol awakening response and cognitive performance in hypertensive and normotensive older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Puig-Perez, Sara; Salvador, Alicia

    2016-07-01

    Healthy older people with a cortisol awakening response (CAR) of decreased magnitude show worse frontal cortex-related cognitive performance. Systemic hypertension has been related to a CAR of decreased magnitude. Additionally, worse executive function and processing speed have been observed in older people with systemic hypertension. This is the first study to examine the relationship between the CAR (measured with six saliva samples at home on two consecutive weekdays) and cognitive performance, in both hypertensive (n=26) and normotensive (n=28) older people (from 56 to 78years old). Hypertensive participants showed lower morning cortisol secretion, and they also woke up earlier. No differences in CAR were observed. A CAR of decreased magnitude was related to worse executive function in both hypertensive and normotensive participants, but to slower processing speed only in normotensive participants. Being treated with antihypertensive for a longer period of time was related to a CAR of increased magnitude and better performance on executive function. Our findings suggest that earlier awakening time in hypertensive older people might underlie the lower overall morning cortisol secretion observed in previous studies. Additionally, this study confirms that a dysregulation of the CAR is related to worse executive function, and it extends this association to hypertensive older people. Finally, it is worth noting that hypertension may moderate the relationship between CAR and processing speed.

  5. A qualitative geographical information systems approach to explore how older people over 70 years interact with and define their neighbourhood environment

    PubMed Central

    Milton, Sarah; Pliakas, Triantafyllos; Hawkesworth, Sophie; Nanchahal, Kiran; Grundy, Chris; Amuzu, Antoinette; Casas, Juan-Pablo; Lock, Karen

    2015-01-01

    A growing body of literature explores the relationship between the built environment and health, and the methodological challenges of understanding these complex interactions across the lifecourse. The impact of the neighbourhood environment on health and behaviour amongst older adults has received less attention, despite this age group being potentially more vulnerable to barriers in their surrounding social and physical environment. A qualitative geographical information systems (QGIS) approach was taken to facilitate the understanding of how older people over 70 in 5 UK towns interact with their local neighbourhood. The concept of neighbourhood changed seasonally and over the lifecourse, and was associated with social factors such as friends, family, or community activities, rather than places. Spaces stretched further than the local, which is problematic for older people who rely on variable public transport provision. QGIS techniques prompted rich discussions on interactions with and the meanings of ‘place’ in older people. PMID:26513597

  6. A qualitative geographical information systems approach to explore how older people over 70 years interact with and define their neighbourhood environment.

    PubMed

    Milton, Sarah; Pliakas, Triantafyllos; Hawkesworth, Sophie; Nanchahal, Kiran; Grundy, Chris; Amuzu, Antoinette; Casas, Juan-Pablo; Lock, Karen

    2015-11-01

    A growing body of literature explores the relationship between the built environment and health, and the methodological challenges of understanding these complex interactions across the lifecourse. The impact of the neighbourhood environment on health and behaviour amongst older adults has received less attention, despite this age group being potentially more vulnerable to barriers in their surrounding social and physical environment. A qualitative geographical information systems (QGIS) approach was taken to facilitate the understanding of how older people over 70 in 5 UK towns interact with their local neighbourhood. The concept of neighbourhood changed seasonally and over the lifecourse, and was associated with social factors such as friends, family, or community activities, rather than places. Spaces stretched further than the local, which is problematic for older people who rely on variable public transport provision. QGIS techniques prompted rich discussions on interactions with and the meanings of 'place' in older people.

  7. Development of hand phenotypes and changes in hand pain and problems over time in older people

    PubMed Central

    Green, Daniel J.; Jordan, Kelvin P.; Protheroe, Joanne; van der Windt, Danielle A.

    2015-01-01

    Abstract Hand disabilities are frequent causes of pain and disability in older people, yet knowledge regarding the characteristics and patterns of hand pain and problems over time is lacking. The main aim of this study was to identify subgroups of older individuals with distinct presentations (phenotypes) of hand pain and function, investigate how these might change over a 6-year period, and explore what characteristics and factors are associated with long-term status. The study population stemmed from the North Staffordshire Osteoarthritis Project, a large, general population–based, prospective, cohort study of adults aged 50 years and older. Information on hand pain and problems was collected using questionnaires at baseline, 3 years, and 6 years. Overall, 5617 participants responded at all time points and were included in the analysis. Five phenotypes were identified using latent transition analysis (“least affected,” “high pain,” “poor gross function,” “high pain and poor gross function,” and “severely affected”) based on 8 hand pain and functional items. The most common transition between phenotypes was from “high pain” at baseline to “least-affected” group. There was a high level of stability in individuals in the “least-affected” or “severely affected” group at baseline. Individuals with widespread body pain, nodes, sleep problems, and pain in both hands at baseline were more likely to be in a severe hand phenotype at 6 years. The results provide clinically relevant information regarding the pattern of hand pain and problems over time and factors that predict transition to more severe hand phenotypes. PMID:26529269

  8. Older Adults' Level of Knowledge about Old Age Using the Facts of Aging Quiz.

    ERIC Educational Resources Information Center

    Atkins, Arleen J.

    The Facts on Aging Quiz (FAQ) has been used in different studies to assess the level of knowledge about old age. It contains 25 factual statements concerning basic physical, mental, and social facts and the most common misconceptions about aging. One purpose of this study was to identify the most frequent misconceptions in a group of older adults…

  9. Coffee, Cake & Culture: Evaluation of an art for health programme for older people in the community.

    PubMed

    Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie

    2016-07-01

    Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted.

  10. Is there an association of vitamin B12 status with neurological function in older people? A systematic review.

    PubMed

    Miles, Lisa M; Mills, Kerry; Clarke, Robert; Dangour, Alan D

    2015-08-28

    Low vitamin B12 status is common in older people; however, its public health significance in terms of neurological manifestations remains unclear. The present systematic review evaluated the association of vitamin B12 status with neurological function and clinically relevant neurological outcomes in adults aged 50+ years. A systematic search of nine bibliographic databases (up to March 2013) identified twelve published articles describing two longitudinal and ten cross-sectional analyses. The included study populations ranged in size (n 28-2287) and mean/median age (range 65-81 years). Studies reported various neurological outcomes: nerve function; clinically measured signs and symptoms of nerve function; self-reported neurological symptoms. Studies were assessed for risk of bias, and results were synthesised qualitatively. Among the general population groups of older people, one longitudinal study reported no association, and four of seven cross-sectional studies reported limited evidence of an association of vitamin B12 status with some, but not all, neurological outcomes. Among groups with clinical and/or biochemical evidence of low vitamin B12 status, one longitudinal study reported an association of vitamin B12 status with some, but not all, neurological outcomes and three cross-sectional analyses reported no association. Overall, there is limited evidence from observational studies to suggest an association of vitamin B12 status with neurological function in older people. The heterogeneity and quality of the evidence base preclude more definitive conclusions, and further high-quality research is needed to better inform understanding of public health significance in terms of neurological function of vitamin B12 status in older people.

  11. The Path to Self-Management: A Qualitative Study Involving Older People with Multiple Sclerosis

    PubMed Central

    Austin, Mark W.; Murdoch, Michelle; Kearney, Anne; Godwin, Marshall; Stefanelli, Mark

    2012-01-01

    ABSTRACT Purpose: This qualitative study sought to explore older people's experience of ageing with multiple sclerosis (MS) and to describe the natural history of self-management from their points of view. Methods: Eighteen people over age 55 and living with MS for at least 20 years were recruited from an MS clinic and rehabilitation outpatient records. Interviews (60–80 min), using open-ended questions, explored participants' lifelong experiences of MS. Following interview transcription, data were coded and analyzed; themes, subthemes, and their relationships were described based on consensus. Results: Participants recounted their diagnosis process, their life experience with MS, and how they eventually accepted their disease, adapted, and moved toward self-management. The findings included vivid descriptions of social relationships, health care interactions, overcoming barriers, and the emotions associated with living with MS. A conceptual model of phases of self-management, from diagnosis to integration of MS into a sense of self, was developed. Conclusions: Study participants valued self-management and described its phases, facilitators, and inhibitors from their points of view. Over years and decades, learning from life experiences, trial and error, and interactions with health care professionals, participants seemed to consolidate MS into their sense of self. Self-determination, social support, strong problem-solving abilities, and collaborative relationships with health professionals aided adaptation and coping. Findings from this study make initial steps toward understanding how MS self-management evolves over the life course and how self-management programmes can help people with MS begin to manage wellness earlier in their lives. PMID:23277680

  12. Cognitive aging in older Black and White persons.

    PubMed

    Wilson, Robert S; Capuano, Ana W; Sytsma, Joel; Bennett, David A; Barnes, Lisa L

    2015-06-01

    During a mean of 5.2 years of annual follow-up, older Black (n = 647) and White (n = 647) persons of equivalent age and education completed a battery of 17 cognitive tests from which composite measures of 5 abilities were derived. Baseline level of each ability was lower in the Black subgroup. Decline in episodic and working memory was not related to race. Decline in semantic memory, perceptual speed, and visuospatial ability was slower in Black persons than White persons, and in semantic memory and perceptual speed this effect was stronger in older than younger participants. Racial differences persisted after adjustment for retest effects. The results suggest subtle cognitive aging differences between Black persons and White persons.

  13. Work, Health, and Family at Older Ages in Japan

    PubMed Central

    Raymo, James M.; Liang, Jersey; Kobayashi, Erika; Sugihara, Yoko; Fukaya, Taro

    2010-01-01

    In this paper, we investigate ways in which the relationship between health and labor force exit at older ages is moderated by family characteristics. Using two waves of data from a national sample of older Japanese men collected 1999 and 2002, we estimate logistic regression models for labor force exit beyond age 63 as a function of health change, family characteristics, and their interactions. We confirm that poor health is strongly associated with labor force exit and find evidence that moderating influences of family context depend upon the level of health. However, results are only partially consistent with hypotheses that the relationship between health and the likelihood of labor force exit should be stronger for (a) those with good health and family incentives to exit the labor force and (b) those with poor health and family incentives to remain in the labor force. PMID:23082037

  14. Social support network structure in older people: underlying dimensions and association with psychological and physical health.

    PubMed

    Golden, Jeannette; Conroy, Ronán M; Lawlor, Brian A

    2009-05-01

    Social networks have been associated with a wide variety of health outcomes in older people. We examined the dimensions underlying the Wenger social support network type assessment to identify dimensions associated with mental and physical health. We interviewed 1334 community-dwelling participants aged 65+. The Geriatric Mental State automated geriatric examination for computer-assisted taxonomy interview was used to rate psychiatric symptoms and quality of life. Cognitive impairment was defined as a score of <24 on the mini mental state examination. Clustering around latent variables identified two uncorrelated social support network domains: family (distance from and contact with relatives) and social engagement. Social engagement was associated with a lower age- and sex-adjusted prevalence of depression (odds ratio for a one-tertile increase 0.48), generalised anxiety disorder (OR 0.60), cognitive impairment (OR 0.68) and physical disability (OR 0.62) all p < 0.001. Adjusted for age, sex, depression, cognitive impairment and disability, the social engagement domain was also associated with better quality of life (OR 1.5) self-rated happiness (OR 1.3) and rating life as worth living (OR 1.4). The family domain, on the other hand, was not significantly associated with any health outcome. The results suggest that elective relationships and social engagement are the 'active ingredients' of social networks which promote health in later life.

  15. Developing a model of short-term integrated palliative and supportive care for frail older people in community settings: perspectives of older people, carers and other key stakeholders

    PubMed Central

    Bone, Anna E.; Morgan, Myfanwy; Maddocks, Matthew; Sleeman, Katherine E.; Wright, Juliet; Taherzadeh, Shamim; Ellis-Smith, Clare; Higginson, Irene J.; Evans, Catherine J.

    2016-01-01

    Background understanding how best to provide palliative care for frail older people with non-malignant conditions is an international priority. We aimed to develop a community-based episodic model of short-term integrated palliative and supportive care (SIPS) based on the views of service users and other key stakeholders in the United Kingdom. Method transparent expert consultations with health professionals, voluntary sector and carer representatives including a consensus survey; and focus groups with older people and carers were used to generate recommendations for the SIPS model. Discussions focused on three key components of the model: potential benefit of SIPS, timing of delivery and processes of integrated working between specialist palliative care and generalist practitioners. Content and descriptive analysis was employed and findings were integrated across the data sources. Findings we conducted two expert consultations (n = 63), a consensus survey (n = 42) and three focus groups (n = 17). Potential benefits of SIPS included holistic assessment, opportunity for end of life discussion, symptom management and carer reassurance. Older people and carers advocated early access to SIPS, while other stakeholders proposed delivery based on complex symptom burden. A priority for integrated working was the assignment of a key worker to co-ordinate care, but the assignment criteria remain uncertain. Interpretation key stakeholders agree that a model of SIPS for frail older people with non-malignant conditions has potential benefits within community settings, but differ in opinion on the optimal timing and indications for this service. Our findings highlight the importance of consulting all key stakeholders in model development prior to feasibility evaluation. PMID:27586857

  16. Visually Impaired OLder people's Exercise programme for falls prevenTion (VIOLET): a feasibility study protocol

    PubMed Central

    Skelton, Dawn A; Bailey, Cathy; Howel, Denise; Cattan, Mima; Deary, Vincent; Coe, Dot; de Jong, Lex D; Gawler, Sheena; Gray, Joanne; Lampitt, Rosy; Wilkinson, Jennifer; Adams, Nicola

    2016-01-01

    Introduction In the UK, 1 in 5 people aged 75 and over live with sight loss. Visually impaired older people (VIOP) have an above average incidence of falls and 1.3–1.9 times more likely to experience hip fractures, than the general population. Older people with eye diseases are ∼3 times more likely than those with good vision, to limit activities due to fear of falling. This feasibility study aims to adapt the group-based Falls Management Exercise (FaME) programme to the needs of VIOP and carry out an external pilot trial to inform the design of a future definitive randomised controlled trial. Methods and design A UK based 2-centre mixed methods, randomised, feasibility study will be conducted over 28 months. Stakeholder panels, including VIOP, will make recommendations for adaptations to an existing exercise programme (FaME), to meet the needs of VIOP, promoting uptake and adherence, while retaining required effective components of the exercise programme. 80 VIOP aged 60 and over, living at home, ambulant with or without a walking aid, will be recruited in Newcastle (n=40) and Glasgow (n=40) through National Health Service (NHS) Trusts and third sector partners. Participants randomised into the intervention arm will receive the adapted FaME programme. Participants randomised into the control arm will continue with usual activity. Outcomes are, recruitment rate, adherence and validated measures including fear of falling and quality of life. Postintervention in-depth qualitative interviews will be conducted with a purposive sample of VIOP (N=10). Postural stability instructors will be interviewed, before trial-specific training and following the intervention. Ethics and dissemination Ethics approval was secured through the National Research Ethics Service (NRES) Committee North East, Newcastle and North Tyneside 2. Glasgow Caledonian University was approved as a non-NHS site with local ethics approval. Findings will be disseminated through peer

  17. Pathophysiology, relevance and natural history of oropharyngeal dysphagia among older people.

    PubMed

    Clavé, Pere; Rofes, Laia; Carrión, Silvia; Ortega, Omar; Cabré, Mateu; Serra-Prat, Mateu; Arreola, Viridiana

    2012-01-01

    Oropharyngeal dysphagia (OD) is a very frequent condition among older people with a prevalence ranging from mild symptoms in 25% of the independently living to severe symptoms in more than 50% living in nursing homes. There are several validated methods of screening, and clinical assessment and videofluoroscopy are the gold standard for the study of the mechanisms of OD in the elderly. Oropharyngeal residue is mainly caused by weak bolus propulsion forces due to tongue sarcopenia. The neural elements of swallow response are also impaired in older persons, with prolonged and delayed laryngeal vestibule closure and slow hyoid movement causing oropharyngeal aspirations. OD causes malnutrition, dehydration, impaired quality of life, lower respiratory tract infections, aspiration pneumonia, and poor prognosis including prolonged hospital stay and enhanced morbidity and mortality in several phenotypes of older patients ranging from independently living older people, hospitalized older patients and nursing home residents. Enhancing bolus viscosity of fluids greatly improves safety of swallow in all these patients. We believe OD should be recognized as a major geriatric syndrome, and we recommend a policy of systematic and universal screening and assessment of OD among older people to prevent its severe complications.

  18. Effect of the conditional cash transfer program Oportunidades on vaccination coverage in older Mexican people

    PubMed Central

    2013-01-01

    Background Immunization is one of the most effective ways of preventing illness, disability and death from infectious diseases for older people. However, worldwide immunization rates are still low, particularly for the most vulnerable groups within the elderly population. The objective of this study was to estimate the effect of the Oportunidades -an incentive-based poverty alleviation program- on vaccination coverage for poor and rural older people in Mexico. Methods Cross-sectional study, based on 2007 Oportunidades Evaluation Survey, conducted in low-income households from 741 rural communities (localities with <2,500 inhabitants) of 13 Mexican states. Vaccination coverage was defined according to three individual vaccines: tetanus, influenza and pneumococcal, and for complete vaccination schedule. Propensity score matching and linear probability model were used in order to estimate the Oportunidades effect. Results 12,146 older people were interviewed, and 7% presented cognitive impairment. Among remaining, 4,628 were matched. Low coverage rates were observed for the vaccines analyzed. For Oportunidades and non-Oportunidades populations were 46% and 41% for influenza, 52% and 45% for pneumococcal disease, and 79% and 71% for tetanus, respectively. Oportunidades effect was significant in increasing the proportion of older people vaccinated: for complete schedule 5.5% (CI95% 2.8-8.3), for influenza 6.9% (CI95% 3.8-9.6), for pneumococcal 7.2% (CI95% 4.3-10.2), and for tetanus 6.6% (CI95% 4.1-9.2). Conclusions The results of this study extend the evidence on the effect that conditional transfer programs exert on health indicators. In particular, Oportunidades increased vaccination rates in the population of older people. There is a need to continue raising vaccination rates, however, particularly for the most vulnerable older people. PMID:23835202

  19. Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

    PubMed

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita

    2016-06-01

    A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future

  20. The effect of frailty should be considered in the management plan of older people with Type 2 diabetes.

    PubMed

    Abdelhafiz, Ahmed H; Koay, Luan; Sinclair, Alan J

    2016-03-01

    The prevalence of diabetes is increasing especially in older age due to increased life expectancy. In old age, diabetes is associated with high comorbidity burden and increased prevalence of geriatric syndromes including frailty in addition to micro- and macro-vascular complications. The emergence of frailty may change the natural history of Type 2 diabetes from a progressive to a regressive course with increased risk of hypoglycemia. This may result in normalization of blood glucose levels and lead to a state of burnt-out diabetes in frail older people with significant weight loss. Although guidelines suggest relaxed glycemic control in frail elderly with diabetes, complete withdrawal of hypoglycemic medications may be necessary in these frail populations to reduce the risk of hypoglycemia.

  1. Effectiveness of a Batteryless and Wireless Wearable Sensor System for Identifying Bed and Chair Exits in Healthy Older People

    PubMed Central

    Shinmoto Torres, Roberto Luis; Visvanathan, Renuka; Hoskins, Stephen; van den Hengel, Anton; Ranasinghe, Damith C.

    2016-01-01

    Aging populations are increasing worldwide and strategies to minimize the impact of falls on older people need to be examined. Falls in hospitals are common and current hospital technological implementations use localized sensors on beds and chairs to alert caregivers of unsupervised patient ambulations; however, such systems have high false alarm rates. We investigate the recognition of bed and chair exits in real-time using a wireless wearable sensor worn by healthy older volunteers. Fourteen healthy older participants joined in supervised trials. They wore a batteryless, lightweight and wireless sensor over their attire and performed a set of broadly scripted activities. We developed a movement monitoring approach for the recognition of bed and chair exits based on a machine learning activity predictor. We investigated the effectiveness of our approach in generating bed and chair exit alerts in two possible clinical deployments (Room 1 and Room 2). The system obtained recall results above 93% (Room 2) and 94% (Room 1) for bed and chair exits, respectively. Precision was >78% and 67%, respectively, while F-score was >84% and 77% for bed and chair exits, respectively. This system has potential for real-time monitoring but further research in the final target population of older people is necessary. PMID:27092506

  2. Effectiveness of a Batteryless and Wireless Wearable Sensor System for Identifying Bed and Chair Exits in Healthy Older People.

    PubMed

    Torres, Roberto Luis Shinmoto; Visvanathan, Renuka; Hoskins, Stephen; van den Hengel, Anton; Ranasinghe, Damith C

    2016-04-15

    Aging populations are increasing worldwide and strategies to minimize the impact of falls on older people need to be examined. Falls in hospitals are common and current hospital technological implementations use localized sensors on beds and chairs to alert caregivers of unsupervised patient ambulations; however, such systems have high false alarm rates. We investigate the recognition of bed and chair exits in real-time using a wireless wearable sensor worn by healthy older volunteers. Fourteen healthy older participants joined in supervised trials. They wore a batteryless, lightweight and wireless sensor over their attire and performed a set of broadly scripted activities. We developed a movement monitoring approach for the recognition of bed and chair exits based on a machine learning activity predictor. We investigated the effectiveness of our approach in generating bed and chair exit alerts in two possible clinical deployments (Room 1 and Room 2). The system obtained recall results above 93% (Room 2) and 94% (Room 1) for bed and chair exits, respectively. Precision was >78% and 67%, respectively, while F-score was >84% and 77% for bed and chair exits, respectively. This system has potential for real-time monitoring but further research in the final target population of older people is necessary.

  3. Factors associated with self-rated health in older people living in institutions

    PubMed Central

    Damián, Javier; Pastor-Barriuso, Roberto; Valderrama-Gama, Emiliana

    2008-01-01

    Background Although self-rated health has been extensively studied in community older people, its determinants have seldom been investigated in institutional settings. We carried out a cross-sectional study to describe the physical, mental, and social factors associated with self-rated health in nursing homes and other geriatric facilities. Methods A representative sample of 800 subjects 65 years of age and older living in 19 public and 30 private institutions of Madrid was randomly selected through stratified cluster sampling. Residents, caregivers, physicians, and nurses were interviewed by trained geriatricians using standardized instruments to assess self-rated health, chronic illnesses, functional capacity, cognitive status, depressive symptoms, vision and hearing problems, and social support. Results Of the 669 interviewed residents (response rate 84%), 55% rated their health as good or very good. There was no association with sex or age. Residents in private facilities and those who completed primary education had significantly better health perception. The adjusted odds ratio (95% confidence interval) for worse health perception was 1.18 (1.07–1.28) for each additional chronic condition, 2.37 (1.38–4.06) when comparing residents with moderate dependency to those functionally independent, and 10.45 (5.84–18.68) when comparing residents with moderate/severe depressive symptoms to those without symptoms. Visual problems were also associated with worse health perception. Similar results were obtained in subgroup analyses, except for inconsistencies in cognitively impaired individuals. Conclusion Chronic conditions, functional status, depressive symptoms and socioeconomic factors were the main determinants of perceived health among Spanish institutionalized elderly persons. Doubts remain about the proper assessment of subjective health in residents with altered cognition. PMID:18304308

  4. CDC Vital Signs: Heart Age - Is Your Heart Older Than You?

    MedlinePlus

    ... Digital Press Kit Read the MMWR Science Clips Heart Age Is Your Heart Older Than You? Language: ... that increase heart age. Problem US adults have hearts 7 years older than they should be. Though ...

  5. Social support and the self-rated health of older people

    PubMed Central

    Dai, Yue; Zhang, Chen-Yun; Zhang, Bao-Quan; Li, Zhanzhan; Jiang, Caixiao; Huang, Hui-Ling

    2016-01-01

    Abstract The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors. We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ2 test, a linear regression analysis, and a multiple-level model were performed to analyze the results. The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068–6.516, P = 0.000), age (−0.805, 95% CI: −1.394 to −0.135, P = 0.013), marital status (−1.260, 95% CI: −1.891 to −0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022–5.116, P = 0.000), and SRH −1.941, 95% CI: −3.194 to −0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ2 = 5.103, P < 0.001). Marital status (−2.133, 95

  6. Aging in Place vs. Relocation for Older Adults with a Neurocognitive Disorder: Applications of Wiseman’s Behavioral Model

    PubMed Central

    Kaplan, Daniel; Andersen, Troy; Lehning, Amanda; Perry, Tam Elisabeth

    2015-01-01

    Some older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman’s (1980) Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. It remains unclear, however, the extent to which this conceptual work informs services and supports for older adults, and the Wiseman model has not been applied to people with a neurocognitive disorder. Understanding Wiseman’s model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs. PMID:26016530

  7. Effectiveness of home based support for older people: systematic review and meta-analysis

    PubMed Central

    Elkan, Ruth; Kendrick, Denise; Dewey, Michael; Hewitt, Michael; Robinson, Jane; Blair, Mitch; Williams, Deb; Brummell, Kathy

    2001-01-01

    Objective To evaluate the effectiveness of home visiting programmes that offer health promotion and preventive care to older people. Design Systematic review and meta-analysis of 15 studies of home visiting. Participants Older people living at home, including frail older people at risk of adverse outcomes. Outcome measures Mortality, admission to hospital, admission to institutional care, functional status, health status. Results Home visiting was associated with a significant reduction in mortality. The pooled odds ratio for eight studies that assessed mortality in members of the general elderly population was 0.76 (95% confidence interval 0.64 to 0.89). Five studies of home visiting to frail older people who were at risk of adverse outcomes also showed a significant reduction in mortality (0.72; 0.54 to 0.97). Home visiting was associated with a significant reduction in admissions to long term care in members of the general elderly population (0.65; 0.46 to 0.91). For three studies of home visiting to frail, “at risk” older people, the pooled odds ratio was 0.55 (0.35 to 0.88). Meta-analysis of six studies of home visiting to members of the general elderly population showed no significant reduction in admissions to hospital (odds ratio 0.95; 0.80 to 1.09). Three studies showed no significant effect on health (standardised effect size 0.06; –0.07 to 0.18). Four studies showed no effect on activities of daily living (0.05; –0.07 to 0.17). Conclusion Home visits to older people can reduce mortality and admission to long term institutional care. What is already known on this topicThe benefits of regular, preventive home visits to older people are the subject of controversyA recent systematic review found no clear evidence that preventive home visits were effectiveWhat this study addsThis meta-analysis of 15 trials shows that home visiting can reduce mortality and admission to institutional care among older people PMID:11576978

  8. [Medicines and frailty in older people. Towards a new nosological entity: A pharmacological frailty?].

    PubMed

    Nessighaoui, Hichem; Géniaux, Hélène; Dantoine, Thierry; Laroche, Marie-Laure

    2016-06-01

    Frailty is a complex geriatric syndrome linked to the overall decrease of physiological reserves. It could lead to disability and to an increase in mortality. Frailty could have an impact on the effect and on the use of medications. Drugs could also affect the frailty process. Currently, no specific guidelines exist for appropriately prescribing medications to frail older people. The aim of this paper is to explore the body of current knowledge about the relationship between drugs and frailty in older people and to introduce a new nosological entity: pharmacological frailty.

  9. Predictors of exercise participation in ambulatory and non-ambulatory older people with multiple sclerosis

    PubMed Central

    Harris, Chelsea; Wallack, Elizabeth M.; Drodge, Olivia; Beaulieu, Serge; Mayo, Nancy

    2015-01-01

    Background. Exercise at moderate intensity may confer neuroprotective benefits in multiple sclerosis (MS), however it has been reported that people with MS (PwMS) exercise less than national guideline recommendations. We aimed to determine predictors of moderate to vigorous exercise among a sample of older Canadians with MS who were divided into ambulatory (less disabled) and non-ambulatory (more disabled) groups. Methods. We analysed data collected as part of a national survey of health, lifestyle and aging with MS. Participants (n = 743) were Canadians over 55 years of age with MS for 20 or more years. We identified ‘a priori’ variables (demographic, personal, socioeconomic, physical health, exercise history and health care support) that may predict exercise at moderate to vigorous intensity (>6.75 metabolic equivalent hours/week). Predictive variables were entered into stepwise logistic regression until best fit was achieved. Results. There was no difference in explanatory models between ambulatory and non-ambulatory groups. The model predicting exercise included the ability to walk independently (OR 1.90, 95% CI [1.24–2.91]); low disability (OR 1.50, 95% CI [1.34–1.68] for each 10 point difference in Barthel Index score), perseverance (OR 1.17, 95% CI [1.08–1.26] for each additional point on the scale of 0–14), less fatigue (OR 2.01, 95% CI [1.32–3.07] for those in the lowest quartile), fewer years since MS diagnosis (OR 1.58, 95% CI [1.11–2.23] below the median of 23 years) and fewer cardiovascular comorbidities (OR 1.55 95% CI [1.02–2.35] one or no comorbidities). It was also notable that the factors, age, gender, social support, health care support and financial status were not predictive of exercise. Conclusions. This is the first examination of exercise and exercise predictors among older, more disabled PwMS. Disability is a major predictor of exercise participation (at moderate to vigorous levels) in both ambulatory and non

  10. Factors influencing adherence among older people with osteoarthritis.

    PubMed

    Loew, Laurianne; Brosseau, Lucie; Kenny, Glen P; Durand-Bush, Natalie; Poitras, Stéphane; De Angelis, Gino; Wells, George A

    2016-09-01

    This study aims to identify potential factors that could affect adherence and influence the implementation of an evidence-based structured walking program, among older adults diagnosed with knee osteoarthritis. A total of 69 participants with mild to moderate osteoarthritis of the knee fulfilled an online survey on potential factors that could affect their adherence to an evidence-based structured walking program. Adherence with regard to the influencing factors was explored using a logistic regression model. Results tend to show higher odds of adhering to the evidence-based walking program if the participants were supervised (more than 2.9 times as high), supported by family/friends (more than 3.7 times as high), and not influenced by emotional involvement (more than 11 times as high). The odds of adhering were 3.6 times lower for participants who indicated a change in their medication intake and 3.1 times lower for individuals who considered themselves as less physically active (95 % confidence interval (CI)). Our exploratory findings identified and defined potential adherence factors that could guide health professionals in their practice to better identify positive influences and obstacles to treatment adherence, which would lead to the adoption of a more patient-centered approach. A large-scale study is required to clearly delineate the key factors that would influence adherence. We addressed a new knowledge gap by identifying the main strategies to promote the long-term adherence of community-based walking program.

  11. Aging 5 years in 5 minutes: the effect of taking a memory test on older adults' subjective age.

    PubMed

    Hughes, Matthew L; Geraci, Lisa; De Forrest, Ross L

    2013-12-01

    How old one feels-one's subjective age-has been shown to predict important psychological and health outcomes. The current studies examined the effect of taking a standard memory test on older adults' subjective age. Study 1 showed that older adults felt older after taking a standard neuropsychological screening test and participating in a free-recall experiment than they felt at baseline. Study 2 showed that the effect was selective to older adults: Younger adults' subjective age was not affected by participating in the memory experiment. Study 3 showed that the subjective-aging effect was specific to memory, as taking a vocabulary test for a similar amount of time did not affect older adults' subjective age. Finally, Study 4 showed that simply expecting to take a memory test subjectively aged older adults. The results indicate that being in a memory-testing context affects older adults' self-perception by making them feel older.

  12. Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

    PubMed Central

    Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

    2015-01-01

    Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. Results: of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

  13. Enhancing Connectedness Through Peer Training for Community-Dwelling Older People: A Person Centred Approach.

    PubMed

    Burmeister, Oliver K; Bernoth, Maree; Dietsch, Elaine; Cleary, Michelle

    2016-06-01

    Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia.

  14. The family and community lives of older people after the Second World War: new evidence from York.

    PubMed

    Freeman, Mark; Wannell, Louise

    2009-01-01

    This article uses the findings of a detailed and unpublished survey, carried out in York in 1947 and 1948, to examine the support networks, social lives and economic conditions of older people in a period when considerable sociological attention was being paid to this section of the population. It is argued that the sociology of old age in this period overstated the role of families, and downplayed the involvement of the wider community, in the social networks of older people. The article also shows that even many of those who were physically restricted in some way could participate fully in social activities. Friends, visiting and social clubs played an important role in many lives. However, the financial circumstances of many older people restricted many areas of social participation, and contemporaneous poverty surveys probably understated the real extent of poverty among the elderly. These high levels of poverty themselves underscore the importance of the family and community support networks that are uncovered using the York data.

  15. Nonsteroidal anti-inflammatory drugs (NSAIDs) in older people: prescribing patterns according to pain prevalence and adherence to clinical guidelines.

    PubMed

    Gnjidic, Danijela; Blyth, Fiona M; Le Couteur, David G; Cumming, Robert G; McLachlan, Andrew J; Handelsman, David J; Seibel, Markus; Waite, Louise; Naganathan, Vasi

    2014-09-01

    The evidence on the patterns of nonsteroidal anti-inflammatory drug (NSAID) use according to pain prevalence and clinical guidelines in older people is sparse. This cross-sectional study examined the patterns of NSAID use according to pain prevalence and concordance with clinical guideline recommendations for safe NSAID use in older people, in relation to duration of use, patterns of use, concomitant use of proton pump inhibitors (PPIs), and prevalence of specific drug interactions. Community-dwelling men (n=1696) age ≥ 70 years living in Sydney were studied. 8.2% (n=139) of participants reported regular NSAID use compared with 2.9% (n=50) reporting as-needed use. The mean treatment duration for regular NSAID use was 4.9 years, suggesting long-term rather than short-term use as recommended by the guidelines. Although guidelines recommend use of PPIs together with an NSAID, only 25.2% of regular NSAID users reported PPI use. Regular NSAID users were significantly more likely to report use of opioid analgesics (P<.0001) compared with nonregular users. In relation to pain prevalence, regular NSAID users were significantly more likely to report chronic pain (P<.0001), recent pain (P=.0001), and chronic intrusive pain (P<.0001) compared with nonregular users. The findings of this study indicate that NSAID prescribing practices do not align with clinical guidelines for safe use in older people. This difference between the guideline recommendations and what is happening in the real world should be explored further.

  16. Local Area Deprivation and Urban–Rural Differences in Anxiety and Depression Among People Older Than 75 Years in Britain

    PubMed Central

    Walters, Kate; Breeze, Elizabeth; Wilkinson, Paul; Price, Gill M.; Bulpitt, Chris J.; Fletcher, Astrid

    2004-01-01

    Objectives. We sought to determine the association of depression and anxiety with “area deprivation” (neighborhood socioeconomic deprivation) and population density among people older than 75 years in Britain. Methods. Postal codes were used to link census area information to individual data on depression and anxiety in 13349 people aged 75 years and older taking part in a trial of health screening. Results. Living in the most socioeconomically deprived areas was associated with depression (OR=1.4), but this relation disappeared after adjusting for individual deprivation characteristics. There was no association with anxiety. Living in the highest density and intermediate low-density areas was associated with depression (OR=1.6 and 1.5) and anxiety (OR=1.5 and 1.3) compared with the lowest density areas. Conclusions. An association between area deprivation and depression in older people was explained by individual health, demographic, and socioeconomic factors. Higher population density was consistently associated with increased depression and anxiety. PMID:15451748

  17. Napping in older people 'at risk' of dementia: relationships with depression, cognition, medical burden and sleep quality.

    PubMed

    Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2015-10-01

    Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes.

  18. Vitamin D and bone health outcomes in older age.

    PubMed

    Hill, Tom R; Aspray, Terence J; Francis, Roger M

    2013-11-01

    The aim of this review is to summarise the evidence linking vitamin D to bone health outcomes in older adults. A plethora of scientific evidence globally suggests that large proportions of people have vitamin D deficiency and are not meeting recommended intakes. Older adults are at particular risk of the consequences of vitamin D deficiency owing to a combination of physiological and behavioural factors. Epidemiological studies show that low vitamin D status is associated with a variety of negative skeletal consequences in older adults including osteomalacia, reduced bone mineral density, impaired Ca absorption and secondary hyperparathyroidism. There seems to be inconsistent evidence for a protective role of vitamin D supplementation alone on bone mass. However, it is generally accepted that vitamin D (17·5 μg/d) in combination with Ca (1200 mg/d) reduces bone loss among older white subjects. Evidence for a benefit of vitamin D supplementation alone on reducing fracture risk is varied. According to a recent Agency for Healthcare Research and Quality review in the USA the evidence base shows mixed results for a beneficial effect of vitamin D on decreasing overall fracture risk. Limitations such as poor compliance with treatment, incomplete assessment of vitamin D status and large drop-out rates however, have been highlighted within some studies. In conclusion, it is generally accepted that vitamin D in combination with Ca reduces the risk of non-vertebral fractures particularly those in institutional care. The lack of data on vitamin D and bone health outcomes in certain population groups such as diverse racial groups warrants attention.

  19. Perceptions of participating in high-intensity functional exercise among older people dependent in activities of daily living (ADL).

    PubMed

    Lindelöf, N; Rosendahl, E; Gustafsson, S; Nygaard, J; Gustafson, Y; Nyberg, L

    2013-01-01

    The purpose of the study was to evaluate how older people, dependent in ADL perceive their participation in a high-intensity, functional exercise program compared to the perceptions of those participating in a control activity. Forty-eight older people living in residential care facilities answered a questionnaire about their perceptions of participating in an activity for three months. They were aged 65-98, had a mean score of 24 on Mini Mental State Examination (MMSE) and 14 on Barthel ADL Index. The participants had been randomized to exercise (n=20) or control activity (n=28). Differences in responses between exercise and control activity were evaluated using logistic and ordinal regression analyses. The results show that a majority of the exercise group perceived positive changes in lower limb strength, balance, and in the ability to move more safely and securely compared to a minority of the control group (p<0.001). Significantly more respondents in the exercise activity answered that they felt less tired due to the activity (p=0.027) and that they prioritized this activity above other activities (p=0.010). More exercise participants reported that meeting for three months was too short, and fewer that it was too long compared to the control group (p=0.038). This study shows that older people living in residential care facilities, dependent in ADL, and with mild or no cognitive impairment had positive perceptions about participating in high-intensity functional exercise. The findings support the use of a high-intensity exercise program in this population of older people.

  20. Investigating the ways that older people cope with dementia: a qualitative study.

    PubMed

    Preston, Laura; Marshall, Ann; Bucks, Romola S

    2007-03-01

    Understanding the way that older people cope with dementia has important implications for the enhancement of the psychological well-being and quality of life of this group of people. This qualitative study explored how older people cope with dementia, by engaging 12 people with early-stage dementia in semi-structured interviews. Interpretative phenomenological analysis (IPA) was used to identify the shared themes in participants' accounts. Three major themes emerged: "managing identity in relation to dementia", "making sense of dementia", and "coping strategies and mechanisms" (the latter theme divided into "everyday, individual strategies", "coping in relation to others", and "personal attitude/approach"). There were also two additional themes in relation to process issues: issues of "conflict and control" which were evident across all other themes, as was individuality and the importance of "context" in coping with dementia. These findings are discussed in the relation to previous research in this field, and suggestions for further research and clinical practice are outlined.

  1. Herbal medications and other dietary supplements. A clinical review for physicians caring for older people.

    PubMed

    Pitkälä, Kaisu H; Suominen, Merja H; Bell, J Simon; Strandberg, Timo E

    2016-12-01

    Evidence for the safety and effectiveness of dietary supplements is mixed. The extent to which older people use dietary supplements concomitantly with conventional medications is often under-appreciated by physicians. We conducted a literature review on clinical considerations associated with dietary supplement use, focusing on benefits and harms, motivations for use and contribution to polypharmacy among older people. Vitamin D ≥ 800 IU has demonstrated benefits in fracture prevention. Vitamins A, E, and β-carotene have been associated with an increase in total mortality in several meta-analyses. A range of non-vitamin dietary supplements have been studied in randomized controlled trials but their efficacy remains largely unclear. Supplement use has been associated with a range of adverse events and drug interactions yet physicians rarely initiate discussions about their use with older patients. Older people may take dietary supplements to exercise control over their health. Given the contribution of supplements to polypharmacy, supplements may be targeted for "deprescribing" if the risk of harm is judged to outweigh benefits. This is best done as part of a comprehensive, patient-centered approach. A respectful and non-judgmental discussion may result in a shared decision to reduce polypharmacy through cessation of dietary supplements. KEY MESSAGES Herbal medications and other dietary supplements are highly prevalent among older people. Physicians are often unaware that their patients use herbal medications and other dietary supplements concomitantly with conventional medications. Herbal medications and other dietary supplements contribute to high rates of polypharmacy, particularly among older people with multimorbidity. Herbal medications and other dietary supplements can interact with conventional medications and be associated with a range of adverse events. Physicians need to be patient-centered and non-judgmental when initiating discussions about

  2. The epidemiology of hospitalised wrist fractures in older people, New South Wales, Australia.

    PubMed

    Boufous, Soufiane; Finch, Caroline; Lord, Stephen; Close, Jacqueline; Gothelf, Todd; Walsh, William

    2006-11-01

    The epidemiology and trends in wrist fracture admissions to public and private acute hospitals in New South Wales (NSW), Australia, between July 1993 and June 2003 were examined using routinely collected hospital separations statistics. During the study period, the number of hospital separations for wrist fractures increased by 71% in men, an average yearly increase of 6.5%, and by 43% in women, an average yearly increase of 3.9%. A modest, but significant, increase in age-specific and age-standardised hospitalisation rates for wrist fractures was also observed. Whilst the majority of wrist fractures were due to falls, the proportion of falls-related wrist fractures decreased significantly over time. This decrease was more pronounced in males and was accompanied by a rise in the proportion of wrist fractures resulting from high energy mechanisms such as transport, violence and machinery-related incidents. The difference in hospitalised wrist fracture rates between men and women could not be explained solely on the basis of the role played by osteoporosis, indicating the need for more research to improve our understanding of the underlying factors of this type of fracture in older people.

  3. Zarit Burden Interview Psychometric Indicators Applied in Older People Caregivers of Other Elderly 1

    PubMed Central

    Bianchi, Mariana; Flesch, Leticia Decimo; Alves, Erika Valeska da Costa; Batistoni, Samila Sathler Taveres; Neri, Anita Liberalesso

    2016-01-01

    ABSTRACT Objective: to derive psychometric indicators of construct validity and internal consistence of the Zarit Burden Interview scale for caregivers, describing associations of the scale with metrics related to care demands, coping strategies and depression in aged caregivers. Method: crosscutting descriptive and correlational study. The convenience sample was composed by a hundred and twenty one senior caregivers (Avg=70.5 ± 7.2 years, 73% women). They answered a questionnaire to check the physical and cognitive demands of care, the Zarit Burden Interview (ZBI), the California Inventory of Coping Strategies and the Geriatric Depression Scale (GDS-15). Results: ZBI showed good internal consistency and also for the three factors emerging from factor analysis, explaining 44% of variability. ZBI is positively related with objective care demands (p < 0.001), depression (p = 0.006) and use of dysfunctional coping strategies (p = 0.0007). Conclusion: ZBI is of interest to be applied to aged caregivers and the association of higher degrees of burden, dysfunctional coping and depression show a vulnerability scenario that may affect to older people taking care of other elderly. PMID:27901220

  4. Entitlement to concessionary public transport and wellbeing: a qualitative study of young people and older citizens in London, UK.

    PubMed

    Jones, Alasdair; Goodman, Anna; Roberts, Helen; Steinbach, Rebecca; Green, Judith

    2013-08-01

    Access to transport is an important determinant of health, and concessionary fares for public transport are one way to reduce the 'transport exclusion' that can limit access. This paper draws on qualitative data from two groups typically at risk of transport exclusion: young people (12-18 years of age, n = 118) and older citizens (60+ years of age, n = 46). The data were collected in London, UK, where young people and older citizens are currently entitled to concessionary bus travel. We focus on how this entitlement is understood and enacted, and how different sources of entitlement mediate the relationship between transport and wellbeing. Both groups felt that their formal entitlement to travel for free reflected their social worth and was, particularly for older citizens, relatively unproblematic. The provision of a concessionary transport entitlement also helped to combat feelings of social exclusion by enhancing recipients' sense of belonging to the city and to a 'community'. However, informal entitlements to particular spaces on the bus reflected less valued social attributes such as need or frailty. Thus in the course of travelling by bus the enactment of entitlements to space and seats entailed the negotiation of social differences and personal vulnerabilities, and this carried with it potential threats to wellbeing. We conclude that the process, as well as the substance, of entitlement can mediate wellbeing; and that where the basis for providing a given entitlement is widely understood and accepted, the risks to wellbeing associated with enacting that entitlement will be reduced.

  5. Age Preferences: How Old Is "Too Old" for Selected Service Providers among Young, Middle-Aged, and Older Adults?

    ERIC Educational Resources Information Center

    Farney, Lori; Aday, Ronald H.; Breault, Kevin D.

    2006-01-01

    This study investigated age preferences for 11 different service providers and the age at which workers in these occupational roles were considered to be "too old" by three age groups: young (18-24), middle-aged (35-55), and older adults (65+). Results indicate that in comparison to middle-aged and older adults, young adults continue to have…

  6. Spain: promoting the welfare of older adults in the context of population aging.

    PubMed

    Serrano, Juan P; Latorre, José M; Gatz, Margaret

    2014-10-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain.

  7. Spain: Promoting the Welfare of Older Adults in the Context of Population Aging

    PubMed Central

    Serrano, Juan P.; Latorre, José M.; Gatz, Margaret

    2014-01-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain. PMID:24632624

  8. Age Stereotypes of Older Primary Teachers in Taiwan

    ERIC Educational Resources Information Center

    Chen, Hsin-Jen; Wang, Ya-Hsaun

    2012-01-01

    Elder respect in East Asia has a long history that could be derived from Confucian philosophy. However, with the rapid development of westernization, younger people have gradually depreciated the value of elder respect and seek a reciprocal relationship with the elderly. A literature search revealed that age stereotypes would be both negative and…

  9. Factors that influence intent to adopt a hearing aid among older people in Italy.

    PubMed

    Cobelli, Nicola; Gill, Liz; Cassia, Fabio; Ugolini, Marta

    2014-11-01

    Hearing loss is one of the most prevalent health impairments associated with ageing in developed countries, and it can result in social, emotional and communication dysfunction. Hearing loss in Italy is increasing, yet, despite the availability of free hearing aids and access to qualified community-based health professionals specialising in audiology services, their uptake remains low (about 15%-20%). This paper presents an investigation of the possible reasons why older people in Italy resist adopting a hearing aid. We used the literature to identify factors influencing people with hearing loss's decision-making, and drew on the theory of reasoned action to create an explanatory model. To test our hypotheses, we applied a cross-sectional design. We developed a questionnaire including 13 items related to adopting a hearing aid. Health professionals identified 400 persons aged 60-90 who were candidates for a free hearing aid. Those willing to participate were sent a copy of the questionnaire and telephoned between August and September 2009; a total of 243 responded (response rate of 60.8%). Linear regression analysis highlighted that a person's intention to adopt a hearing aid was positively related to their attitude towards its adoption, but negatively linked to their perceived subjective norms. It was found that trust in the health professional does not moderate the relationship between a person's attitude and their intention to adopt a hearing aid, but trust mitigates the relationship between a person's perceived subjective norms and their intentions. These findings underline the importance of the potential role that the healthcare professional could play in reducing the uncertainty created by external social pressures. For this purpose, stronger collaboration between the various health professionals involved in hearing aid provision, from diagnosis to fitting, is recommended.

  10. Musculoskeletal foot problems in primary care: what influences older people to consult?

    PubMed Central

    Jordan, Kelvin P.; Roddy, Edward; Croft, Peter R.

    2010-01-01

    Objective. To estimate the incidence of, and factors associated with, consultation for musculoskeletal foot problems in primary care. Methods. Survey data from 13 986 people aged ≥50 years who took part in the North Staffordshire Osteoarthritis Project were linked to a database of primary care consultations. Foot problems were defined as responding affirmatively to the questions: ‘Have you had any problems with your feet over the last year?’ or ‘Have you had pain in the last year in and around the foot?’. The main outcome measure was a record of a musculoskeletal foot-related consultation within 18 months following the survey. Results. Of the 3858 participants with foot problems who had not consulted before the survey, 350 (9.1%) consulted in the 18 months following the survey. Age, sex, education, general health and pain in other regions were not associated with future consultation. However, those who consulted were more likely to have reported foot pain [adjusted odds ratio (OR) 2.04; 95% CI 1.22, 3.42) and to consider treatments to be effective in controlling disease (OR 1.54; 95% CI 1.07, 2.21) in the baseline survey, and to have been a frequent consulter in the 18 months before the survey (OR 1.65; 95% CI 1.30, 2.09). Conclusions. Only a minority of older people with musculoskeletal foot problems consult their general practitioner about them. Foot pain, frequent consultation for other problems and positive perceptions of treatment efficacy appear to be the strongest factors influencing future consultation. PMID:20660499

  11. Law and older people--the rise and fall of Israel's Senior Citizens' Act.

    PubMed

    Doron, Israel

    2008-01-01

    Within the broad and complex framework of those Israeli laws that relate to the social welfare of the older population, this article uses a case study approach to focus on Israel's Senior Citizens' Act of 1989. During its hitherto brief life, this law has undergone numerous transformations, additions, and deletions as well as successes and failures. At the time of its enactment, many hoped that this law would considerably bolster the rights of older people. Echoing legal and political theories of the 1980s, it seemed to reflect the fact that politicians were sensitive to the potential power of the pensioner vote, while echoing the approach to social engineering that advocated the use of the law both as a means for social change and a symbol of power. As of today, however, this article argues that the law has failed to realize what were declared to be its objectives. Instead of promoting social change and providing older people with political power, the Senior Citizens' Act has become an empty symbol that hides the fact that the older generation in Israel still lacks the real political power it needs in order to use the law to improve society's treatment of older people.

  12. Nocturnal Enuresis in Older People: Where Is the Evidence and What Are the Gaps?

    PubMed

    Howlett, Megan; Gibson, William; Hunter, Kathleen F; Chambers, Thane; Wagg, Adrian

    2016-01-01

    While there is extensive literature regarding nocturnal enuresis in children and young adults, relatively little research explores this problem in older people. This scoping review sought to identify knowledge gaps and provide research direction specifically for older, institutionalized adults with nocturnal enuresis. A comprehensive search of 8 electronic databases and the gray literature was undertaken. Studies focusing on the causes, symptoms, and treatment of nocturnal enuresis in older people were retrieved. A broad search strategy including all adults was employed in order to capture all relevant publications. Articles were then excluded by title and abstract such that only those relevant to the older adult and institutionalized populations remained. Relevant articles were identified by title and language. Further reading of the abstract allowed inclusion and a final full reading of the articles allowed all authors to map research activity and identify knowledge gaps. After duplicates and nonrelevant articles were eliminated, we identified 7 articles on nursing home residents and 2 involving older people living in psychiatric institutions. Published literature focused on causes and treatment with either desmopressin or aversive behavioral therapy. No study included a comprehensive continence assessment or controlled for comorbid conditions. Identified gray literature focused on general continence information for the public and nonspecialist clinicians. We conclude that there is a dearth of evidence relevant to this troublesome condition. Gaps in the evidence base include a lack of standardized terminology and limited research focusing on the epidemiology, pathophysiology, and treatment of nocturnal enuresis, all of which suggest a rich research agenda for future investigation.

  13. Population aging in local areas and subjective well-being of older adults: Findings from two studies in Japan.

    PubMed

    Saito, Tami; Sugisawa, Hidehiro; Harada, Ken; Kai, Ichiro

    2016-05-23

    Subjective well-being (SWB) of older adults could be affected by both individual and community characteristics. However, the effect of community characteristics, such as population aging in local areas, remains unclear. This study examined the cross-sectional and longitudinal associations between the area-level population aging and SWB of older individuals from two distinct surveys. Those analyzed were 572 respondents aged 75 years and older for a cross-sectional survey in a metropolitan area in Tokyo, Japan (Study 1) and 1,257 and 859 respondents for a cross-sectional and longitudinal analysis, respectively, for a 2-year longitudinal survey project in urban and rural areas of Fukui Prefecture (Study 2). Area-level population aging was assessed by the number of people aged 65 years or older per 100 residents. SWB was assessed with the Life Satisfaction Index-A (LSIA). Multilevel analysis was performed to examine unconditional and conditional associations between the area-level number of older adults per 100 residents and the individual-level LSIA scores. The area-level number of older adults per 100 residents was significantly and positively associated with the LSIA scores in Study 1 (p = 0.042), even after controlling for the area- and individual-level covariates. In Study 2, we also found a significant effect of the area-level number of older adults per 100 residents on LSIA scores in the longitudinal multivariate analysis (p = 0.049). Findings from two survey projects suggested cross-validity in the positive effect of area-level population aging on older adults' SWB. Policymakers should consider older citizens' SWB in the recent urban-to-rural migration governmental policy as well as in urban renovation planning.

  14. Cognitive Functioning and Driving Simulator Performance in Middle-aged and Older Adults with HIV

    PubMed Central

    Vance, David E.; Fazeli, Pariya L.; Ball, David A.; Slater, Larry Z.; Ross, Lesley A.

    2014-01-01

    Nearly half of people living with HIV experience cognitive deficits that may impact instrumental activities of daily living. As the number of people aging with HIV increases, concerns mount that disease-related cognitive deficits may be compounded by age-related deficits, which may further compromise everyday functions such as driving. In this cross-sectional pilot study, during a 2.5-hour visit, 26 middle-aged and older adults (40+ years) were administered demographic, health, psychosocial, and driving habits questionnaires; cognitive assessments; and driving simulator tests. Although CD4+T lymphocyte count and viral load were unrelated to driving performance, older age was related to poorer driving. Furthermore, poorer visual speed of processing performance (i.e., Useful Field of View) was related to poorer driving performance (e.g., average gross reaction time). Mixed findings were observed between driving performance and cognitive function on self-reported driving habits of participants. Implications for these findings on nursing practice and research are posited. PMID:24513104

  15. Promoting Autonomy and Independence among Older People: An Evaluation of Educational Programmes in Nursing.

    ERIC Educational Resources Information Center

    Brooker, Charles; Davies, Sue; Ellis, Lorraine; Laker, Sara; Philp, Ian; Walker, Alan; Warnes, Anthony

    A study explored the relationship between the content of educational programs in nursing and the quality of nursing care for older people, especially the extent to which nurses promote autonomy and independence. Activities included an analysis of curricula for pre- and postregistration nursing education programs in Britain, investigation of…

  16. Improving the Attitudes of 4th Graders toward Older People through a Multidimensional Intergenerational Program

    ERIC Educational Resources Information Center

    Lynott, Patricia P.; Merola, Pamela R.

    2007-01-01

    The purpose of this study was to examine the effects of an intergenerational program on children's attitudes toward older people. Four 4th grade classes, one each during the years 2002 through 2005, participated in the study. The elders and school children engaged in meaningful activities over a 5 month period, including the performance of a play…

  17. Technology in Community-Based Organizations that Serve Older People: High Tech Meets High Touch

    ERIC Educational Resources Information Center

    Renold, Carl; Meronk, Cheryl; Kelly, Christopher

    2005-01-01

    Appropriate implementation of information technology (IT) can help create a more efficient, less costly, and higher-quality service-delivery environment for community-based organizations that serve older people. Relevant studies and reports on technology in healthcare can be compared and applied to these organizations. This study is the result of…

  18. Older People Learning through Contemporary Visual Art--Engagement and Barriers

    ERIC Educational Resources Information Center

    Goulding, Anna

    2013-01-01

    This article addresses how older people understand and engage with contemporary art in the gallery context--whether there is something unique to the art, the format of the visits, the pedagogical approaches used by gallery educators, the social contact, or a combination of all these factors. It also addresses the psychosocial barriers to…

  19. An Innovative Continuing Nursing Education Program Targeting Key Geriatric Conditions for Hospitalized Older People in China

    ERIC Educational Resources Information Center

    Xiao, Lily Dongxia; Shen, Jun; Wu, Haifeng; Ding, Fu; He, Xizhen; Zhu, Yueping

    2013-01-01

    A lack of knowledge in registered nurses about geriatric conditions is one of the major factors that contribute to these conditions being overlooked in hospitalized older people. In China, an innovative geriatric continuing nursing education program aimed at developing registered nurses' understanding of the complex care needs of hospitalized…

  20. The case for Tai Chi in the repertoire of strategies to prevent falls among older people

    PubMed Central

    Nyman, Samuel R.; Skelton, Dawn A.

    2016-01-01

    Falls among older people is a global public health issue. In this article, Dr Samuel Nyman of Bournemouth University Dementia Institute, and Professor Dawn Skelton, Institute for Applied Health Research, Glasgow Caledonian University highlight the effectiveness of Tai Chi as an alternative strategy to physiotherapy to combat this issue. PMID:28244837

  1. Keeping in Touch: Talking to Older People about Computers and Communication

    ERIC Educational Resources Information Center

    Dickinson, Anna; Hill, Robin L.

    2007-01-01

    Computer-based communication has tremendous potential to support older adults. But if people are to use such systems autonomously, it is necessary to move beyond current interfaces and systems and develop devices that fit into the environment of the user. Using a Grounded Theory approach, three focus groups were held and, subsequently, 9 older…

  2. Try to be a skilled companion to older people this Christmas.

    PubMed

    2016-11-30

    Nurses are usually busy at this time of year, as pressure on health and social care services rises for the holiday season. Yet for some frail, older people, especially those who have outlived many of their generation of family and friends, this can be an especially lonely time.

  3. Leisure Experiences and Depressive Symptoms among Chinese Older People: A National Survey in Taiwan

    ERIC Educational Resources Information Center

    Lu, Luo

    2011-01-01

    We aimed to explore older people's subjective leisure experiences and to further examine associations of such experiences with their depressive symptoms in Taiwan. Known correlates of depression, such as demographics, physical health, and social support, were taken into account. Face-to-face interviews were conducted to collect data using…

  4. Learning, Identity and Citizenship: Researching Older People's Use of ICT in Scotland.

    ERIC Educational Resources Information Center

    Crossan, Beth; Martin, Ian; Whittaker, Susan

    Information and communication technology (ICT) within the lifelong learning agenda has the potential to maintain or activate citizenship, in both social and political terms, among older people in a Scottish context. Within recent government documents at both the United Kingdom and the Scottish level, the aims of the two major traditions of…

  5. A community-engaged art program for older people: fostering social inclusion.

    PubMed

    Moody, Elaine; Phinney, Alison

    2012-03-01

    Social inclusion is an important factor in promoting optimum health and wellness for older adults. Community-engaged arts (CEA) have been promoted as a means to support social inclusion for this population, but little empirical evidence has been reported. The objective of this study was to explore the role of a CEA program in the social inclusion of older, community-dwelling adults. Sixteen hours of participant observation, nine interviews, and document analyses were conducted with 20 older adults participating in the Arts, Health and Seniors (AHS) Program in Vancouver. Results indicated that the program supported seniors' capacity to connect to community in new ways by helping them forge connections beyond the seniors centre. Participants also developed a stronger sense of community through collaboration as a group, working together on the arts project towards a final demonstration to the larger community. The results suggest that CEA programs contribute to social inclusion for older people.

  6. Cardiovascular Risk Factors (Diabetes, Hypertension, Hypercholesterolemia and Metabolic Syndrome) in Older People with Intellectual Disability: Results of the HA-ID Study

    ERIC Educational Resources Information Center

    de Winter, C. F.; Bastiaanse, L. P.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2012-01-01

    Hypertension, diabetes, hypercholesterolemia and the metabolic syndrome are important risk factors for cardiovascular disease (CVD). In older people with intellectual disability (ID), CVD is a substantial morbidity risk. The aims of the present study, which was part of the Healthy Ageing in Intellectual Disability (HA-ID) study, were (1) to…

  7. Residential relocations among older people over the course of more than ten years

    PubMed Central

    Buurman, Bianca M.; Trentalange, Mark; Nicholson, Nicholas; McGloin, Joanne M.; Gahbauer, Evelyne A.; Allore, Heather G.; Gill, Thomas M.

    2014-01-01

    Objective To describe the rates of residential relocations over the course of 10.5 years and evaluate differences in these relocation rates according to gender and decedent status. Design Prospective, longitudinal study with monthly telephone follow-up for up to 126 months. Setting Greater New Haven, Connecticut. Participants 754 persons, aged 70 years or older, who were initially community-living and nondisabled in their basic activities of daily living. Measurements Residential location was assessed during monthly interviews and included: community, assisted living facility (AL) and nursing home (NH). A residential relocation was defined as a change of residential location for at least one week and included relocations within (e.g. community-community) or between (community-assisted living) locations. We calculated the rates of relocations/1000 patient-months and evaluated differences by gender and decedent status. Results Sixty-six percent of participants had at least one residential relocation (range 0–12). Women had lower rates of relocations from NH to community (rate ratio (RR) 0.59, p=.02); otherwise, there were no gender differences. Decedents had higher rates of relocation from community to AL (RR 1.71, p=0.002), from community to NH (RR 3.64, p<.001), between ALs (RR 3.65, p<.001) and from AL to NH (RR 2.5, p<0.001). In decedents, relocations from community to NH (RR 3.58, p<.001) and from AL to NH (RR 3.3, p<.001) were most often observed in the last year of life. Conclusions A majority of older people relocated at least once during 10.5 years follow-up. Women had lower rates of relocation from NH to community. Decedents were more likely to relocate to a residential location providing a higher level of assistance, compared with non-decedents. Residential relocations were most common in the last year of life. PMID:24794829

  8. Care practices of older people with dementia in the surgical ward: A questionnaire survey

    PubMed Central

    Hynninen, Nina; Saarnio, Reetta; Elo, Satu

    2016-01-01

    Objectives: The objective of this study was to describe the care practices of nursing staff caring older people with dementia in a surgical ward. Methods: The data were collected from nursing staff (n = 191) working in surgical wards in one district area in Finland during October to November 2015. Data were collected using a structured questionnaire and analyzed statistically. The instrument consists of a total number of 141 items and four dimensions. The dimensions were as follows: background information (12 of items), specific characteristics of older people with dementia in a surgical ward (24 of items), specific characteristics of their care in a surgical ward (66 of items) and use of physical restraints and alternative models for use of restraints for people with dementia (39 of items). Results: The questions which measure the nursing staff’s own assessment of care practices when caring for people with dementia in surgical wards were selected: counseling people with dementia, reaction when a surgical patient with dementia displays challenging behavior and use of alternative approach instead of physical restraints. Most commonly the nursing staff pay attention to patient’s state of alertness before counseling older people with dementia. Instead of using restraints, nursing staff gave painkillers for the patient and tried to draw patients’ attention elsewhere. The nursing staff with longer work experience estimate that they can handle the patients’ challenging behavior. They react by doing nothing more often than others. They pretend not to hear, see or notice anything. Conclusion: The findings of this study can be applied in nursing practice and in future studies focusing on the care practices among older people with dementia in acute care environment. The results can be used while developing patient treatments process in surgical ward to meet future needs. PMID:27895915

  9. Hip fracture causes excess mortality owing to cardiovascular and infectious disease in institutionalized older people: a prospective 5-year study.

    PubMed

    Cameron, Ian D; Chen, Jian Sheng; March, Lyn M; Simpson, Judy M; Cumming, Robert G; Seibel, Markus J; Sambrook, Philip N

    2010-04-01

    An increasing risk of death after hip fracture has been well documented, but the duration and causes remain unclear, especially in very frail older people. This is a nested case-control study of 229 hip fracture cases and 229 controls matched by age, gender, institution type, and follow-up period from a cohort of 2005 institutionalized older people. The residents were assessed at baseline and followed up for hip fracture and death for at least 5 years. Time to death was measured from the same time for each case (time of the hip fracture) and the matched control. The study sample consisted of 90 males and 368 females with a mean age of 86 years (range 67 to 102 years). The hazard ratio (HR) of death for the cases compared with the controls was 3.09 [95% confidence interval (CI) 1.83-5.22, p < .001] for the first 3 months, 1.99 (95% CI 1.13-3.51, p = .02) for the period of 3 to 9 months, and 0.88 (95% CI 0.64-1.22, p = .46) for the period beyond 9 months following a fracture, after adjusting for age, gender, institution type, weight, immobility, cognitive function, comorbidities, and number of medications. The main causes of the excess mortality in the first 9 months were infections (HR = 6.66, 95% CI 1.95-22.77, p = .002) for females and cardiac disease (HR = 2.68, 95% CI 1.39-5.15, p = .003) for both males and females. Bisphosphonate use was associated with a reduction in mortality after hip fracture (p = .002). Intensive medical supervision to reduce cardiovascular and infective complications should be provided for frail older people with recent hip fracture to reduce mortality.

  10. Carotid Endarterectomy in the Community Hospital in Patients Age 80 and Older

    PubMed Central

    Maxwell, J. Gary; Taylor, Andrew J.; Maxwell, Bryan G.; Brinker, Carla C.; Covington, Deborah L.; Tinsley, Ellis

    2000-01-01

    Objective To determine whether the rates of death and complications of carotid endarterectomy (CE) were different in the octogenarian population than in patients younger than age 80. Summary Background Data The utility of CE depends on the ability of the surgeon and hospital to attain low rates of death and complications, including all subgroups of the patient population. In the past 30 years, the number of people age 85 and older has increased 274%. Methods Detailed chart review was carried out on all CE procedures done from 1979 through 1998. Descriptive demographic data, risk factors, surgical details, length of stay, deaths, and complications were recorded. Results A total of 2,398 CEs were performed in 1,970 patients; 2,180 procedures were performed in 1,783 patients younger than 80, and 218 CEs were performed in 187 patients age 80 and older. Sixty-five percent of the octogenarians and 67% of patients younger than age 80 had neurologic symptoms. Among asymptomatic patients, 89% had stenosis of 75% or more. There were 62 strokes in the 2,180 procedures in the younger group, for a stroke rate of 2.8%, and 7 strokes in the 218 procedures in the older group, for a stroke rate of 3.2%. The death rates were 0.9% for the octogenarians and 1.4% for the younger group. Conclusions Carotid endarterectomy can be safely performed in a community hospital in patients age 80 and older. Outcomes in octogenarians were not significantly different than those of younger patients and were within the range required for CE to be considered beneficial in the prevention of stroke. PMID:10816620

  11. GPs’ perspectives on secondary cardiovascular prevention in older age: a focus group study in the Netherlands

    PubMed Central

    van Peet, Petra G; Drewes, Yvonne M; Gussekloo, Jacobijn; de Ruijter, Wouter

    2015-01-01

    Background Although guidelines recommend secondary cardiovascular prevention irrespective of age, in older age the uptake of treatment is lower than in younger age groups. Aim To explore the dilemmas GPs in the Netherlands encounter when implementing guidelines for secondary cardiovascular prevention in older age. Design and setting Qualitative study in four focus groups consisting of GPs (n = 23, from the northern part of the province South Holland) and a fifth focus group consisting of GP trainees (n = 4, from the Leiden University Medical Center). Method Focus group discussions were organised to elicit perspectives on the implementation of secondary cardiovascular prevention for older people. The 14 theoretical domains of the refined Theoretical Domains Framework (TDF) were used for (deductive) coding of the focus group discussions. The coded texts were analysed, content was discussed, and barriers and facilitators were identified for each domain of the TDF. Results The main theme that emerged was ‘uncertainty’. Identified barriers were guideline-related, patient-related, and organisation-related. Identified facilitators were doctor-related, patient-related, and organisation-related. The main aim of secondary preventive treatment was improvement in quality of life. Conclusion GPs in the Netherlands are uncertain about many aspects of secondary cardiovascular prevention in older age; the guidelines themselves, their own role, patient factors, and the organisation of care. In view of this uncertainty, GPs consciously weigh all aspects of the situation in close dialogue with the individual patient, with the ultimate aim of improving quality of life. This highly-individualised care may largely explain the reduced prescription rates. PMID:26500321

  12. Substance Misuse Education for Physicians: Why Older People are Important

    PubMed Central

    De Jong, Cornelis A.J.; Goodair, Christine; Crome, Ilana; Jokubonis, Darius; el-Guebaly, Nady; Dom, Geert; Schellekens, Arnt; Broers, Barbara; Subata, Emilis; Welle-Strand, Gabrielle Katrine; Luycks, Lonneke; Wolters, Michel; Schoof, Tamara

    2016-01-01

    This perspective article focuses on the need for training and education for undergraduate medical students on substance-related disorders, and describes initiatives undertaken in the United Kingdom (UK), Netherlands, United States (US), and Norway to develop the skills, knowledge, and attitudes needed by future doctors to treat patients adequately. In addition, we stress that in postgraduate training, further steps should be taken to develop Addiction Medicine as a specialized and transverse medical domain. Alcohol use disorder is a growing public health problem in the geriatric population, and one that is likely to continue to increase as the baby boomer generation ages. Prescription drug misuse is a major concern, and nicotine misuse remains problematic in a substantial minority. Thus, Addiction Medicine training should address the problems for this specific population. In recent years, several countries have started an Addiction Medicine specialty. Although addiction psychiatry has been a subspecialty in the UK and US for more than 20 years, in most countries it has been a more recent development. Additional courses on addiction should be integrated into the curriculum at both undergraduate and postgraduate levels, as well as form part of the continuous training of other medical specialists. It is recommended that further research and mapping of what is currently taught in medical programs be undertaken, so as to enhance medical education in addiction and improve treatment services. PMID:27505022

  13. Advanced technology care innovation for older people in Italy: necessity and opportunity to promote health and wellbeing.

    PubMed

    Lattanzio, Fabrizia; Abbatecola, Angela M; Bevilacqua, Roberta; Chiatti, Carlos; Corsonello, Andrea; Rossi, Lorena; Bustacchini, Silvia; Bernabei, Roberto

    2014-07-01

    Even though there is a constant and accelerating growth of the aging population worldwide, such a rapid rise is negatively impacting available home and community services not able to encompass the necessities associated with the increased number of older people. In particular, there are increasing demands on e-health care services and smart technologies needed for frail elders with chronic diseases and also for those experiencing active aging. Advanced Technology Care Innovation for older persons encompasses all sectors (assistive technology, robotics, home automation, and home care- and institution-based healthcare monitoring, telemedicine) dedicated to promoting health and wellbeing in all types of living environments. Considering that there is a large concern and demand by older persons to remain in familiar social living surroundings, study projects joined with industries have been currently initiated, especially across Europe to improve health and wellbeing. This article will highlight the latest updates in Europe and, in particular in Italy, regarding scientific projects dedicated to unraveling how diverse needs can be translated into an up-to-date technology innovation for the growing elder population. We will provide information regarding advanced technology designed for those with specific geriatric-correlated conditions in familiar living settings and for individuals aging actively. This is an important action because numerous emerging developments are based on user needs identified by geriatricians, thus, underlining the indispensable role of geriatric medicine toward future guidelines on specific technology.

  14. Inducing jet-lag in older people: directional asymmetry

    NASA Technical Reports Server (NTRS)

    Monk, T. H.; Buysse, D. J.; Carrier, J.; Kupfer, D. J.

    2000-01-01

    Twenty healthy elderly subjects (12 female, 8 male; mean age 81 years, range 67-87 years) each experienced a 15-day time isolation protocol in which they lived individually in a special laboratory apartment in which sleep and circadian rhythm measures could be taken. There were two experiments: one (6 females, 4 males) involved a 6-h phase advance of the sleep/wake cycle, and the other (6 females, 4 males) a 6-h phase delay. Each started with 5 baseline days, immediately followed by the phase shift. The subject was then held to the phase shifted routine for the remainder of the study. Rectal temperatures were recorded minute-by-minute throughout the entire experiment and each night of sleep was recorded using polysomnography. A directional asymmetry in phase-shift effects was apparent, with significantly more sleep disruption and circadian rhythm amplitude disruption after the phase advance than after the phase delay. Sleep disruption was reflected in reduced time spent asleep, and in changed REM latency, which increased in the phase advance direction but decreased in the phase delay direction. Although the phase advance led to a significant increase in wakefulness in the first half of the night, the phase delay did not lead to an equivalent increase in wakefulness during the second half of the night. Examination of both raw and 'demasked' circadian rectal temperature rhythms confirmed that phase adjustment was slow in both directions, but was less slow (and more monotonic) after the phase delay than after the phase advance. Subjective alertness suffered more disruption after the phase advance than after the phase delay.

  15. Biological markers in older people at risk of mobility limitations.

    PubMed

    Lippi, Giuseppe; Sanchis-Gomar, Fabian; Montagnana, Martina

    2014-01-01

    Due to the progressive ageing of the worldwide population, prevention and treatment of late-life dysfunctions, including functional decline and mobility limitations, represent leading targets of scientists and clinicians, but are also receiving growing attention from governments and healthcare systems. The early identification of elderly patients more prone to physical decline represents a crucial step for establishing preventive measures. Although functional capacity can easily be assessed, the use of additional criteria that anticipate the onset of mobility limitations seems much more advantageous. The most challenging issues in the identification of biological markers for assessing the risk of functional decline in the elderly originates from the complex and multifaceted pathogenesis of sarcopenia and the resulting physiological decrement, so that bridging the gap between basic research and clinical practice may appear intricate. Nevertheless, several lines of evidence now confirm the existence of negative associations between functional mobility and values of hemoglobin, total and HDL-cholesterol, vitamin D, testosterone, adiponectin and antioxidants such carotenoids, vitamin C and E, selenium and magnesium, whereas positive associations have been reported with the values of uric acid, white blood cells, plasma and blood viscosity, erythrocyte sedimentation rate (ESR), triglycerides, homocysteine, plasma glucose, glycated hemoglobin (HbA1c), markers of renal functions (i.e., creatine and cystatin C), insulin-like growth factor-1 (IGF-1), as well as several inflammatory (e.g., C reactive protein, Intereleukin-6, Interleukin- 1 receptor antagonist), hemostatic (e.g., fibrinogen, Von Willebrand Factor, factors VIII and IX) and oxidative (oxidized lipoproteins, 8-oxo-7,8-2'-deoxyguanosine, protein carbonylation) biomarkers. In the foreseeable future, proteomic studies might predictably help identify novel associations between putative biomarkers and functional

  16. Does the level of wealth inequality within an area influence the prevalence of depression amongst older people?

    PubMed Central

    Marshall, Alan; Jivraj, Stephen; Nazroo, James; Tampubolon, Gindo; Vanhoutte, Bram

    2016-01-01

    This paper considers whether the extent of inequality in house prices within neighbourhoods of England is associated with depressive symptoms in the older population using the English Longitudinal Study of Ageing. We consider two competing hypotheses: first, the wealth inequality hypothesis which proposes that neighbourhood inequality is harmful to health and, second, the mixed neighbourhood hypothesis which suggests that socially mixed neighbourhoods are beneficial for health outcomes. Our results are supportive of the mixed neighbourhood hypothesis, we find a significant association between neighbourhood inequality and depression with lower levels of depression amongst older people in neighbourhoods with greater house price inequality after controlling for individual socio-economic and area correlates of depression. The association between area inequality and depression is strongest for the poorest individuals, but also holds among the most affluent. Our results are in line with research that suggests there are social and health benefits associated with economically mixed communities. PMID:24662528

  17. Six-Year Training Improves Everyday Memory in Healthy Older People. Randomized Controlled Trial

    PubMed Central

    Requena, Carmen; Turrero, Agustín; Ortiz, Tomás

    2016-01-01

    Purpose of the study: Everyday memory of older persons does not improve with intensive memory training programs. This study proposes a change in these programs based on a time-extended and massive intervention format. Design and Methods: The sample of 1007 healthy older persons (mean age 71.85; SD = 5.12) was randomized into 2 groups. The experimental group followed an extended 6 years of training (192 sessions over 192 weeks) whereas the control group received an intensive training (3 sessions per week for a total of 32 sessions in 11 weeks). The program included cognitive and emotional content whose effects were assessed with the Rivermead Behavioral Memory Test (RBMT) and with the Mini-Mental State Examination (MMSE). Both groups were evaluated initially, after 32 sessions, and again after 6 years. Results: The relative improvements measured with Blom’s derivative showed that everyday memory and mental status of the experimental group were significantly better both in the short (Δ% 8.31 in RBMT and Δ% 1.51 in MMSE) and in the long term (Δ% 12.54 in RBMT and Δ% 2.56 in MMSE). For everyday memory and mental level, the overall gain estimate representing the mean difference in pre-post change between time-extended and intensive groups was 0.27 (95% CI: 0.13–0.40) and 0.54 (95% CI: 0.40–0.67), respectively. Time-extended programs have significantly improved everyday memory in contrast with the usual intensive programs whose effects decay with time. There are also significant increases in mental level scores while daily life functionality is preserved in all subjects who completed the training. Implications: These results suggest that it is possible to preserve everyday memory in the long term with continuous training and practice. Massive and time-extended formats may contribute in the future to a paradigm shift in memory programs for healthy older people. PMID:27375479

  18. A survey of older Hong Kong people's perceptions of telecommunication technologies and telecare devices.

    PubMed

    Lai, Claudia K Y; Chung, Jenny C C; Leung, Natalie K L; Wong, Jimmy C T; Mak, Diana P S

    2010-01-01

    We investigated how older Hong Kong people perceive the application of telecommunication technologies in products that could enhance their safety at home. The telecare devices in the present study were: (1) the Personal Emergency Link Service (PELS), a 24-hour personal emergency link service; (2) a home-based non-intrusive motion monitoring system; and (3) a wearable vital signs monitoring system. Data were collected from a convenience sample of 368 elderly persons aged 65 years or above from 15 District Elderly Community Centres in Hong Kong, through a structured questionnaire administered during face-to-face interviews by trained interviewers. All three telecare devices were generally perceived as useful by the elderly participants: the PELS by 96% of them, the home-based non-intrusive monitoring system by 91% and the wearable vital signs monitoring system by 84%. However, although many respondents were positive about the function and usefulness of these devices, they stated that they would not personally use them. Technological innovations need to be perceived by the elderly as relevant to their everyday lives.

  19. Evaluating probability of cancer among older people with unexplained, unintentional weight loss.

    PubMed

    Chen, Shih-Ping; Peng, Li-Ning; Lin, Ming-Hsien; Lai, Hsiu-Yun; Hwang, Shinn-Jang; Chen, Liang-Kung

    2010-02-01

    Unexplained, unintentional weight loss (UUWL) in older people is usually multi-factorial and poses a diagnostic challenge, with cancer being the major concern. The main purpose of this study was to evaluate the effectiveness of a cancer scoring system for predicting cancer in elderly UUWL patients. From 2006 to 2007, 50 patients (mean age, 78.8+/-4.7 years, 82% male) who lost > 5% of usual body weight were enrolled. The subjects' mean body weight loss was 14.1%+/-6.6% (8.7+/-4.6 kg). After evaluation, the common diagnoses were non-malignant organic disorder (22/50, 44%), neuropsychiatric disorder (17/50, 34%), unknown (8/50, 16%), and cancer (3/50, 6%). The most rapid weight loss occurred with cancer (6.5% per month), followed by non-malignant organic disorders (5.6% per month), neuropsychiatric disorders (2.8% per month), and unknown causes (2.4% per month); the difference among the groups was significant (p = 0.023). Using a previously proposed scoring system, 42 patients (84%) had a low probability of cancer; all three cancer patients were in this category. In conclusion, the annual incidence of cancer among elderly UUWL patients was 6%, and the previously developed cancer scoring system did not effectively predict cancer occurrence. Further study is needed to develop an effective instrument to predict cancer in elderly UUWL patients.

  20. The experiences of neighbour, volunteer and professional support-givers in supporting community dwelling older people.

    PubMed

    van Dijk, Hanna M; Cramm, Jane M; Nieboer, Anna P

    2013-03-01

    Public policy increasingly emphasises the importance of informal support networks to meet the needs of the ageing population. Evidence for the types of support neighbours provide to older people and how neighbours collaborate with formal support-givers is currently insufficient. Our study therefore explored (i) types of informal neighbour support and (ii) experiences of neighbours, volunteers and professionals providing support. Interviews with nine Dutch neighbour support-givers, five volunteers and 12 professionals were conducted and subjected to latent content analysis. Findings indicate that commitment occurred naturally among neighbours; along with providing instrumental and emotional support, neighbour support seems to be a matter of carefully 'watching over each other'. Neighbour support-givers, however, are often frail themselves and become overburdened; they furthermore lack support from professionals. Neighbour, volunteer and professional support-givers seem to operate in distinct, non-collaborative spheres. Findings suggest that policy-makers should consider the opportunities and limitations of neighbour and volunteer support. Professionals have an indispensable role in providing back-up and accountable, specialised support. They may be trained to adopt a visible and proactive attitude in neighbourhoods to facilitate, cooperate with and mediate between neighbour and volunteer support-givers.

  1. The impact of frailty on oral care behavior of older people: a qualitative study

    PubMed Central

    2013-01-01

    Background Frailty has been demonstrated to negatively influence dental service-use and oral self-care behavior of older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use and oral self-care behavior of frail older people. Methods We conducted a qualitative study through 51 open interviews with elders of varying frailty in the East-Netherlands, and used a thematic analysis to code transcripts, discussions and reviews of the attributes and meaning of the themes to the point of consensus among the researchers. Results Three major themes and five sub-themes emerged from our analyses. The major themes indicate that frail elders: A) favor long-established oral hygiene routines to sustain a sense of self-worth; B) discontinue oral hygiene routines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and C) experience psychological and social barriers to oral health care when institutionalized. The subthemes associated with the discontinuation of oral care suggest that the elders accept more oral pain or discomfort because they: B1) lack belief in the results of dental visits and tooth cleaning; B2) trivialize oral health and oral care in the general context of their impaired health and old age; and B3) consciously use their sparse energy for priorities other than oral healthcare. Institutionalized elderly often discontinue oral care because of C1) disorientation and C2) inconveniencing social supports. Conclusion The level and type of frailty influences people’s perspectives on oral health and related behaviors. Frail elders associate oral hygiene with self-worth, but readily abandon visits to a dentist unless they feel that a dentist can relieve specific problems. When interpreted according to the Motivational Theory of Life Span Development, discontinuation of oral care by frail elderly could be viewed as a manifestation of adaptive development. Simple measures

  2. Community service contracting for older people in urban China: a case study in Guangdong Province.

    PubMed

    Lin, Wenyi

    2016-01-01

    Contracting of community services to non-governmental service-providing organisations - mainly social work agencies - is an emerging phenomenon and a social innovation with regard to delivering community services in urban China. Contracting of community services for the older person, which is the focus of this study, is embedded in the macro context of the development of social service contracting in China. Qualitative research techniques, including document analysis, case study, participant observation and in-depth interviews, were adopted for this study. Nine government officials, three staff working in Community Residents' Committees, 15 staff working in social work agencies and 41 older people were interviewed in an effort to understand the impact and challenges of community service contracting in urban China. The findings showed that the involvement of social work agencies in the community service provision system results in integration of community resources, expansion of service coverage and enhancement of older people's access to community services. However, several problems may impede the development of community service provision in the context of contracting in China. These include purchaser-oriented rather than user-oriented service provision, older people's negative attitude towards social work services, inappropriate performance measurement, reliance of non-government organisations on government funding and ambiguous definition of community services.

  3. [Construct and validation of a quality of life's scale for older French people].

    PubMed

    Petit, Sylvie; Bergua, Valérie; Peres, Karine; Bouisson, Jean; Koleck, Michèle

    2014-12-01

    Given changing and subjective aspects of quality of life, the current assessment scales are often encompassing and not very adapted for older people. Thus, the present validation study has several objectives: 1) To elaborate a specific measure of the quality of life of older people, given the characteristics and problems of this population; 2) To propose a simple scale to use for any health care professional and fast passation to encourage the inclusion of such measures in the framework of a comprehensive care of the elderly; 3) To validate this scale in a large cohort of retired older farmers. This scale resulted in 14 items illustrating the various dimensions of quality of life of older people. It was then proposed for validation in a large cohort of retired elderly farmers of 65 years and over, and living at home. After exploratory factor analysis of subjects' responses to the EQVPA, five items were extracted explaining 48.8% of the total variance. Its internal consistency was satisfactory (Cronbach's alpha=0.72). The five items permitted to assess daily and social activities in environment, social and familial relationships, physical and functional health and mental health. The results showed that quality of life is significantly correlated with greater life satisfaction, more social support and social network, higher level of subjective health, lower level of functional impairments, lower level of anxious and depressive symptoms, and lower level of routinization. Validation of the tools such as EQVPA seems important for the prevention and preservation of the quality of life of older people.

  4. Body dissatisfaction among middle-aged and older women.

    PubMed

    Marshall, Catherine; Lengyel, Christina; Utioh, Alphonsus

    2012-01-01

    With the growing pervasiveness of mass media, individuals of all ages and both sexes are bombarded with images that glorify youthfulness, messages that tie self-worth to thinness, and products that promise youth and beauty forever. Aging women are vulnerable to these societal messages and experience strong pressures to maintain their youth and thinness. As the physiological changes that accompany normal aging move these women farther from the "ideal" image, body dissatisfaction may increase. These women are confronted with the impossible task of trying to defy the natural process of aging through a variety of means, including fashion, cosmetics, selective surgeries, and personal food choices. The resulting body image issues, weight preoccupation, and eating disturbances can lead to voluntary food restriction, depression, social withdrawal, lower self-esteem, and disordered eating, all of which can have a negative impact on quality of life and nutritional status. In this review we explore existing research on body dissatisfaction among middle-aged (30 to 60) and older (over 60) women, discuss the prevalence of body dissatisfaction, its predisposing risk factors, and the resulting eating and body maintenance behaviours, and examine implications for dietetic practice.

  5. Cognitive Aging and the Hippocampus in Older Adults

    PubMed Central

    O’Shea, Andrew; Cohen, Ronald A.; Porges, Eric C.; Nissim, Nicole R.; Woods, Adam J.

    2016-01-01

    The hippocampus is one of the most well studied structures in the human brain. While age-related decline in hippocampal volume is well documented, most of our knowledge about hippocampal structure-function relationships was discovered in the context of neurological and neurodegenerative diseases. The relationship between cognitive aging and hippocampal structure in the absence of disease remains relatively understudied. Furthermore, the few studies that have investigated the role of the hippocampus in cognitive aging have produced contradictory results. To address these issues, we assessed 93 older adults from the general community (mean age = 71.9 ± 9.3 years) on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening measure for dementia, and the NIH Toolbox-Cognitive Battery (NIHTB-CB), a computerized neurocognitive battery. High-resolution structural magnetic resonance imaging (MRI) was used to estimate hippocampal volume. Lower MoCA Total (p = 0.01) and NIHTB-CB Fluid Cognition (p < 0.001) scores were associated with decreased hippocampal volume, even while controlling for sex and years of education. Decreased hippocampal volume was significantly associated with decline in multiple NIHTB-CB subdomains, including episodic memory, working memory, processing speed and executive function. This study provides important insight into the multifaceted role of the hippocampus in cognitive aging. PMID:28008314

  6. Overlooked potential: older-age parents in the era of ART.

    PubMed

    Williams, Nathalie; Knodel, John; Kiry Kim, Sovan; Puch, Sina; Saengtienchai, Chanpen

    2008-11-01

    The advent of widespread ART provision in low- and middle-income countries requires not just medical attention, but also social and psychological support to encourage and monitor strict adherence to drug regimens. Developing innovative approaches to providing this broad support is a major challenge, especially within the financial constraints of resource-limited countries hardest hit by the epidemic. In this study, we examine the role of older-age parents in monitoring ART treatment and caring for their HIV-infected children and grandchildren in Cambodia. Our results are based on 25 open-ended interviews with older-age parents of people with AIDS (PWHA). A high level of co-residence when PWHA become ill and a sense of parental responsibility and emotional attachment facilitate high parental involvement in their children's and grandchildren's illness, care and treatment. Our interviews indicate that parents play an important role in encouraging their children to get tested and to access treatment if they test positive. They consistently monitor antiretroviral therapy (ART) adherence and opportunistic infections and remind PWHA to attend medical appointments and support-group meetings. Parents also provide for the nutrition and hygiene of PWHA essential to the success of ART treatments. We find that despite low levels of education, older parents were able to express clear, correct and detailed knowledge of complicated ART treatment regimens, nutrition and hygiene. Overall, our findings show that older parents play a pivotal role in care and treatment if they are provided with proper resources and training and have the ability to understand the necessity and details of ensuring strict adherence to medications. Based on these results, we suggest that explicitly including older parents in policy and programs for care and treatment would allow Cambodia and other countries to take advantage of this unique and effective but overlooked asset in AIDS care and treatment.

  7. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes.

    PubMed

    Sinclair, Alan; Morley, John E; Rodriguez-Mañas, Leo; Paolisso, Giuseppe; Bayer, Tony; Zeyfang, Andrej; Bourdel-Marchasson, Isabelle; Vischer, Ulrich; Woo, Jean; Chapman, Ian; Dunning, Trisha; Meneilly, Graydon; Rodriguez-Saldana, Joel; Gutierrez Robledo, Luis Miguel; Cukierman-Yaffe, Tali; Gadsby, Roger; Schernthaner, Guntram; Lorig, Kate

    2012-07-01

    Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.

  8. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic

    PubMed Central

    Vance, David E; Brennan, Mark; Enah, Comfort; Smith, Glenda L; Kaur, Jaspreet

    2011-01-01

    By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided. PMID:21753865

  9. Functional Diversity of Cytomegalovirus–Specific T Cells Is Maintained in Older People and Significantly Associated With Protein Specificity and Response Size

    PubMed Central

    Bajwa, Martha; Vita, Serena; Vescovini, Rosanna; Larsen, Martin; Sansoni, Paolo; Terrazzini, Nadia; Caserta, Stefano; Thomas, David; Davies, Kevin A.; Smith, Helen; Kern, Florian

    2016-01-01

    Background. Parallel upregulation of several T-cell effector functions (ie, polyfunctionality) is believed to be critical for the protection against viruses but thought to decrease in large T-cell expansions, in particular at older ages. The factors determining T-cell polyfunctionality are incompletely understood. Here we revisit the question of cytomegalovirus (CMV)–specific T-cell polyfunctionality, including a wide range of T-cell target proteins, response sizes, and participant ages. Methods. Polychromatic flow cytometry was used to analyze the functional diversity (ie, CD107, CD154, interleukin 2, tumor necrosis factor, and interferon γ expression) of CD4+ and CD8+ T-cell responses to 19 CMV proteins in a large group of young and older United Kingdom participants. A group of oldest old people (age >85 years) was included to explore these parameters in exceptional survivors. Polyfunctionality was assessed for each protein-specific response subset, by subset and in aggregate, across all proteins by using the novel polyfunctionality index. Results. Polyfunctionality was not reduced in healthy older people as compared to young people. However, it was significantly related to target protein specificity. For each protein, it increased with response size. In the oldest old group, overall T-cell polyfunctionality was significantly lower. Discussion. Our results give a new perspective on T-cell polyfunctionality and raise the question of whether maintaining polyfunctionality of CMV-specific T cells at older ages is necessarily beneficial. PMID:27521364

  10. "The Wisdom of Age": Perspectives on Aging and Growth among Lesbian Older Adults.

    PubMed

    Putney, Jennifer M; Leafmeeker, Rebecca R; Hebert, Nicholas

    2016-04-01

    Older lesbian-identified women are a health disparate yet resilient population about whom knowledge is limited and emerging. Among the areas in need of research are older lesbians' experiences of later life and stress-related growth. This article presents the findings from a qualitative study that investigated older lesbians' experiences of adversity and adaptation as they age. In-depth, exploratory interviews were conducted with 12 lesbian-identified women who were between the ages of 65-80. This study applied grounded theory methodology to identify respondents sources of stress and fear, their strengths and coping strategies and how those relate to each other and to their growth in later life. We advance a model of adaptive change that shows how spirituality, social support, and resistance to cultural norms help older lesbian adults cope with loss, illness, and discrimination and develop wisdom in later life. Knowledgeable practitioners can help older lesbian women identify and maintain sources of social support, explore spirituality, and facilitate continuous growth through the end of life. Social workers can advocate for services that are welcoming and affirmative so as to reduce fears of isolation and dependence associated with health decline.

  11. Usual walking speed and all-cause mortality risk in older people: A systematic review and meta-analysis.

    PubMed

    Liu, Bing; Hu, Xinhua; Zhang, Qiang; Fan, Yichuan; Li, Jun; Zou, Rui; Zhang, Ming; Wang, Xiuqi; Wang, Junpeng

    2016-02-01

    The purpose of this study was to investigate the relationship between slow usual walking speed and all-cause mortality risk in older people by conducting a meta-analysis. We searched through the Pubmed, Embase and Cochrane Library database up to March 2015. Only prospective observational studies that investigating the usual walking speed and all-cause mortality risk in older adulthood approaching age 65 years or more were included. Walking speed should be specifically assessed as a single-item tool over a short distance. Pooled adjusted risk ratio (RR) and 95% confidence interval (CI) were computed for the lowest versus the highest usual walking speed category. A total of 9 studies involving 12,901 participants were included. Meta-analysis with random effect model showed that the pooled adjusted RR of all-cause mortality was 1.89 (95% CI 1.46-2.46) comparing the lowest to the highest usual walk speed. Subgroup analyses indicated that risk of all-cause mortality for slow usual walking speed appeared to be not significant among women (RR 1.45; 95% CI 0.95-2.20). Slow usual walking speed is an independent predictor of all-cause mortality in men but not in women among older adulthood approaching age 65 years or more.

  12. Perceptions of Speed and Risk: Experimental Studies of Road Crossing by Older People.

    PubMed

    Butler, Annie A; Lord, Stephen R; Fitzpatrick, Richard C

    2016-01-01

    Crossing a road safely is a complex task requiring good sensorimotor function and integration of information about traffic speed, distances and one's own speed. Poor judgement through age-related sensorimotor or cognitive impairment or a predisposition to take risks could lead to errors with serious consequences. On a simulated road, 85 participants (age ≥70 years) were asked to cross in front of an approaching car with a clearance as small as considered safe in two conditions; (1) with nothing else to attend to (free crossing) and (2) with an additional ball-gathering task while waiting to cross (task crossing). Participants were categorised according to their crossing outcome (failed to cross, 'hit', exact, safe, cautious). Participants also performed two sub-studies; (1) the perception of the time-to-arrival of moving objects and (2) the perception of own gait speed. Physical and cognitive function and everyday risk-taking behaviour were also assessed. In free crossing, clearances varied but no participants were "hit" by the car. In task crossing, participants allowed smaller clearances and 10% of participants would have been hit while 13% missed the opportunity to cross altogether. Across a wide range of physical and cognitive measures, including perceived and actual gait speed, a consistent pattern was observed in the task crossing condition. The exact group performed best, the 'hit', safe and cautious groups performed less well while those who missed the opportunity (fail) performed worst. The exact group reported taking the greatest risks in everyday life whereas the remaining groups reported being cautious. In conclusion, we found older people with poorer perceptual, physical and cognitive function made inappropriate and risky decisions in a divided attention road-crossing task despite self-reports of cautious behaviour in everyday life.

  13. Perceptions of Speed and Risk: Experimental Studies of Road Crossing by Older People

    PubMed Central

    Butler, Annie A.

    2016-01-01

    Crossing a road safely is a complex task requiring good sensorimotor function and integration of information about traffic speed, distances and one’s own speed. Poor judgement through age-related sensorimotor or cognitive impairment or a predisposition to take risks could lead to errors with serious consequences. On a simulated road, 85 participants (age ≥70 years) were asked to cross in front of an approaching car with a clearance as small as considered safe in two conditions; (1) with nothing else to attend to (free crossing) and (2) with an additional ball-gathering task while waiting to cross (task crossing). Participants were categorised according to their crossing outcome (failed to cross, ‘hit’, exact, safe, cautious). Participants also performed two sub-studies; (1) the perception of the time-to-arrival of moving objects and (2) the perception of own gait speed. Physical and cognitive function and everyday risk-taking behaviour were also assessed. In free crossing, clearances varied but no participants were “hit” by the car. In task crossing, participants allowed smaller clearances and 10% of participants would have been hit while 13% missed the opportunity to cross altogether. Across a wide range of physical and cognitive measures, including perceived and actual gait speed, a consistent pattern was observed in the task crossing condition. The exact group performed best, the ‘hit’, safe and cautious groups performed less well while those who missed the opportunity (fail) performed worst. The exact group reported taking the greatest risks in everyday life whereas the remaining groups reported being cautious. In conclusion, we found older people with poorer perceptual, physical and cognitive function made inappropriate and risky decisions in a divided attention road-crossing task despite self-reports of cautious behaviour in everyday life. PMID:27054918

  14. Internet use as a predictor of sense of community in older people.

    PubMed

    Sum, Shima; Mathews, R Mark; Pourghasem, Mohsen; Hughes, Ian

    2009-04-01

    The Internet opens new options for communication and may change the extent to which older people use other modes of communication. The importance of older adults' participation in cyberspace has increased as Internet use for commerce and communication has increased. The present study explores how older adults' Internet use affects their sense of community. An online survey was conducted at the University of Sydney to determine the associations between Internet use and seniors' sense of community and well-being. Participants were recruited online. There was a positive association between a sense of belonging to an online community, sense of community, and well-being. Seniors' use of the Internet for communication and information, and the frequency and history of their Internet use, were consistently related to a greater sense of community.

  15. Naturalistic speeding data: Drivers aged 75 years and older.

    PubMed

    Chevalier, Anna; Chevalier, Aran John; Clarke, Elizabeth; Wall, John; Coxon, Kristy; Brown, Julie; Ivers, Rebecca; Keay, Lisa

    2016-09-01

    The data presented in this article are related to the research article entitled "A longitudinal investigation of the predictors of older drivers׳ speeding behavior" (Chevalier et al., 2016) [1], wherein these speed events were used to investigate older drivers speeding behavior and the influence of cognition, vision, functional decline, and self-reported citations and crashes on speeding behavior over a year of driving. Naturalistic speeding behavior data were collected for up to 52 weeks from volunteer drivers aged 75-94 years (median 80 years, 52% male) living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Global Positioning System (GPS) data were recorded at each second and determined driving speed through triangulation of satellite collected location data. Driving speed data were linked with mapped speed zone data based on a service-provider database. To measure speeding behavior, speed events were defined as driving 1 km/h or more, with a 3% tolerance, above a single speed limit, averaged over 30 s. The data contains a row per 124,374 speed events. This article contains information about data processing and quality control.

  16. Alcohol use in women 65 years of age and older.

    PubMed

    Sedlak, C A; Doheny, M O; Estok, P J; Zeller, R A

    2000-01-01

    The purpose of this study was to examine the relationships between depression, codependency, self-coherence, and alcohol use and health outcomes in women 65 years of age and older. The framework is Erikson's ego-development theory. A convenience sample of 238 women was obtained from women attending flu shot clinics. This cross-sectional field study used survey methodology. Measures included the Beck Depression Inventory, Codependency Assessment Tool, Self-Coherence Survey Form C, Alcohol Use Disorders Identification Test, Alcohol Use Questionnaire, Self-Rated Health Tool, Quality of Life Visual Analogue Scale, Functional Ability Scale, Illness Prevention Screening Behaviors Checklist, and Sociodemographic Data. Results indicate a low consumption and little variation in use of alcohol. There were no significant associations between alcohol consumption and the dependent variables. Depression was significantly related to all the health outcomes; codependency was significantly related to all health outcomes except perceived quality of life; and self-coherence was significantly related to all health outcomes except illness prevention behavior. These findings have important implications for those providing care for older women.

  17. Naturalistic rapid deceleration data: Drivers aged 75 years and older.

    PubMed

    Chevalier, Anna; Chevalier, Aran John; Clarke, Elizabeth; Coxon, Kristy; Brown, Julie; Rogers, Kris; Boufous, Soufiane; Ivers, Rebecca; Keay, Lisa

    2016-12-01

    The data presented in this article are related to the research manuscript "Predictors of older drivers' involvement in rapid deceleration events", which investigates potential predictors of older drivers' involvement in rapid deceleration events including measures of vision, cognitive function and driving confidence (A. Chevalier et al., 2016) [1]. In naturalistic driving studies such as this, when sample size is not large enough to allow crashes to be used to investigate driver safety, rapid deceleration events may be used as a surrogate safety measure. Naturalistic driving data were collected for up to 52 weeks from 182 volunteer drivers aged 75-94 years (median 80 years, 52% male) living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Accelerometer data were recorded 32 times per second and Global Positioning System (GPS) data each second. To measure rapid deceleration behavior, rapid deceleration events (RDEs) were defined as having at least one data point at or above the deceleration threshold of 750 milli-g (7.35 m/s(2)). All events were constrained to a maximum 5 s duration. The dataset provided with this article contains 473 events, with a row per RDE. This article also contains information about data processing, treatment and quality control. The methods and data presented here may assist with planning and analysis of future studies into rapid deceleration behaviour using in-vehicle monitoring.

  18. Assessing Age Differences in the Relationship Between Emotional Support and Health Among Older Mexican Americans.

    PubMed

    Krause, Neal

    2016-02-01

    Research reveals that people tend to place greater value on emotional support as they move through the life course. Older people are likely to do so because emotional support benefits them in some way. The purpose of this study was to see whether there are age differences in the relationship between emotional support and the number of chronic health conditions. In the process, an effort is made to contribute to the literature in three ways. First, an emphasis placed on assessing the relationship between emotional support and health within late life. Second, variations in the source of support are taken into account by contrasting support within religious institutions with support that is received outside church. Third, these issues are examined with data provided by a nationally representative sample of older Mexican Americans (N = 663). The findings suggest that age differences in the relationship between emotional support and health are present within late life. Moreover, the data indicate that this relationship holds for church-based social support but not support that is received outside the church.

  19. Is There a Paradox of Aging: When the Negative Aging Stereotype Meets the Positivity Effect in Older Adults.

    PubMed

    Zhou, Liqing; Lu, Jia; Chen, Guopeng; Dong, Li; Yao, Yujia

    2017-01-01

    Background/Study Context: Socioemotional selectivity theory (SST) states that the positivity effect is a result of older adults' emotion regulation and that older adults derive more emotional satisfaction from prioritizing positive information processing. The authors explored whether the positivity effect appeared when the negative aging stereotype was activated in older adults and also whether the effect differed between mixed and unmixed valence conditions.

  20. Patient Choice for Older People in English NHS Primary Care: Theory and Practice

    PubMed Central

    Harding, Andrew J. E.; Sanders, Frances; Lara, Antonieta Medina; van Teijlingen, Edwin R.; Wood, Cate; Galpin, Di; Baron, Sue; Crowe, Sam; Sharma, Sheetal

    2014-01-01

    In the English National Health Service (NHS), patients are now expected to choose the time and place of treatment and even choose the actual treatment. However, the theory on which patient choice is based and the implementation of patient choice are controversial. There is evidence to indicate that attitudes and abilities to make choices are relatively sophisticated and not as straightforward as policy developments suggest. In addition, and surprisingly, there is little research on whether making individual choices about care is regarded as a priority by the largest NHS patient group and the single largest group for most GPs—older people. This conceptual paper examines the theory of patient choice concerning accessing and engaging with healthcare provision and reviews existing evidence on older people and patient choice in primary care. PMID:24967329

  1. Assessing the skills of home care workers in helping older people take their prescribed medications.

    PubMed

    Smyth, Elizabeth E J

    2015-08-01

    The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity.

  2. From hope to hope: the experience of older Chinese people with advanced cancer.

    PubMed

    Chen, Hong; Komaromy, Carol; Valentine, Christine

    2015-03-01

    In our study that explored the current end-of-life care provision for Chinese older people with advanced/terminal cancer, hope emerged as a significant aspect of coping with their condition. Drawing on data from in-depth interviews with a group of older people, their family carers and health professionals, this article explores participants' constructions of hope in terms of what they were hoping for, how their hopes helped them cope with their illness and what sociocultural resources they drew on to build and sustain these hopes. While acknowledging similarities to Western studies of hope in terminal illness, this article identifies significant divergences in terms of the impact of different sociocultural values and their implications for clinical practice in light of an unfavourable health care environment for patients with advanced cancer and a social support system sustained mainly by Chinese families. It argues that hope represents an important resource for coping with terminal illness among these patients.

  3. Self-perceived Age and Attitudes Toward Marketing of Older Consumers in China

    PubMed Central

    Ying, Bin

    2010-01-01

    Understanding consumer psychological characteristics and their impact on consumer behavior is an important foundation for business marketing strategies. Self-perceived age has a great impact on older consumers’ behavior. This article defines the gray market in China, investigates the factors that affect the differences between older