This study investigated physical and financial abuse in an elderly population of age 65 and older, residing in two different settlement regions (rural and urban) of Manisa Province. The population of this cross-sectional study was 3163 elderly individuals who were living at the region of two randomly selected primary medical services (one at rural area, other at urban area) in April 2015. The sample size was calculated using the software of Epi info 7.0; thereby, 480 elderly individuals were enrolled. Each individual was randomly selected from his/her registration at the Manisa Public Health Deparment. All data were collected by faceto-face interview and a standardized questionnaire form, that involved sociodemographic characteristics, health and social status, Katz index was used. The rate of participation was 88.9% (n=427). All data was evaluated using descriptive analysis and chi square test. Logistic regression was used for multivariate analysis. The mean age of the study group was 72.9±6.7. The majority of individuals (86.4%) had a chronic disease for which continuous drug administration was required, 49.6% was women, 35.1% was graduated from elementary school and %23.4 was living alone. More than 79.4 of elderly could have done daily living activities easily, less than 5% were depent in one or more basic activities of their daily life. Elderly abuse was determined 11.3% of study group(urban 13.0%, rural 9.6% , p>0.05). Verbal abuse was most common (10.3%). Physical abuse was 5.4% and financial abuse was 2.7%. The risk factors of elderly abuse were being 85 years of age and over, having worse percieved health status, social isolation, insufficient income and lack of accessibility in health care. In conclusion, low rates of physical and financial abuse were found in Manisa. Preservation of the traditional family structure in this populations seems to be providing protection against elderly abuse.
Ramos M1, Quezada DM1, Ayala R1, Pavón FJG1, Hidalgo JJ1 and Toro R2 1Central Hospital of the Red Cross San José and Santa Adela, Cardiology, Madrid, Spain 2Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, Cadiz, Spain *Corresponding author: Ramos M, Central Hospital of the Red Cross San José and Santa Adela, Cardiology, Madrid, Spain, Tel: + 34914538300; E-mail: monica.ramos81@gmail.com
Coronary Artery Disease (CAD) is the leading cause of morbidity and death in people around the world.In recent years, many studies have shown that cytokine gene polymorphism can change protein expression and protein function, thereby affecting their role in CAD.Interleukin (IL)-1β is a classical inflammatory factor, and the gene mutation of IL-1β plays a very important role in the occurrence and development of CAD.In this paper, the relationship between IL-1β gene polymorphism and CAD reported in the past will be collected and briefly summarized.It is expected that these results can provide a reference for the early diagnosis and treatment of CAD.
ntroduction:Little is known about the oral health of community-dwelling older people, as well as about which oral health care services dentists provide to these older people.It is also unclear to what extent general health issues play a role regarding this group of persons when it comes to maintaining good oral health and regular dental visits.Furthermore, much is unclear about the type and amount of care dentists offer to these people, which treatment strategies they apply, and whether they experience any barriers.These uncertainties have led to a study into the need for care of community-dwelling older people in general dental practices in the Netherlands as well as into the actual care dentists provide to this group of citizens. Materials and methods:This exploratory cross-sectional study will focus on the oral health of older people in the Netherlands who still visit the general dental practice on a regular basis.Additionally, an inventory will be made of their needs for oral health care and the care, which is subsequently provided by dentists based on these needs.This study is based on two groups of older people: persons aged 75 and older and persons between the age of 60 and 64.The study is carried out by conducting a sample survey among general dental practitioners in the Netherlands.They will be asked to prospectively select and describe one older patient and to ask this patient to complete a short questionnaire. Results and Discussion:The insights that will be gained through this study can be used to optimize the organization and quality of oral health care that dental practices provide to community dwelling (frail) older people.It is also expected that this study will identify knowledge gaps with regard to oral health care to older people in general dental practice.
Nursing staff has a key role in the multidisciplinary care for patients with combined mental (psychiatric and/or psychogeriatric) and physical problems (DCD-patients). This study explores the experiences and needs of DCDnursing staff in Dutch mental healthcare (MH) and nursing home (NH) settings, to identify factors to provide optimal care for DCD-patients. A qualitative approach was used, consisting of five semi-structured focus group interviews with DCD-staff (n=28) from MH- and NH-settings in the Netherlands. Five levels of factors were identified: Patient-related factors (complexity of combined care needs, and complexity of behavioral problems); Informal care-related factors (misapprehension of DCD-complexity, and involvement of volunteers); Professional carerelated factors (competences and attitudes, well-matched multidisciplinary team, and collaborative care between MH- and NH-settings); Living and work environment-related factors (staff availability and continuity, and facility requirements); and Organization-related factors (clear DCD-care policy, and provision of specific training and coaching). DCD-staff stressed the importance of team-efficacy, depending on commitment, mutual trust, and good communication- and collaboration skills; of experiencing a psychologically and physically safe work-environment; and of empowerment through the acknowledgment of the specificity of DCD-care and the teams’ specific qualities regarding DCD-care. These findings can be used to optimize DCD-care. Many older people su ٴو er from multiple morbidities, with combined mental (psychiatric and/or psychogeriatric) and physical problems Нis so-called double care demanding (DCD) patients require a combination of physical, psychogeriatric and psychiatric care , and usually end up in long-term care (LTC) facilities. Di ٴو erent types of LTC are provided to older people with physical disabilities, advanced dementia or disabling psychiatric illnesses. In the Netherlands, tight networks of regional nursing homes (NHs) and integrated mental healthcare institutions (MHs) exist. Traditionally NHs provide LTC for either physically or cognitively disabled older patients, while MHs provide LTC for patients with chronic mental illness. Earlier studies showed that DCD-patients benefit from a multidisciplinary approach, including a collaborative approach of psychiatric, physical, and nursing interventions . For economic reasons, the number of psychiatric hospital beds has decreased in many Western countries, including the Netherlands Since then, worldwide, a heterogeneous range of LTC-facilities has partly taken over the traditional asylum function for older adults with severe mental illness (SMI). Whether these facilities address the psychiatric care needs adequately has been questioned . A study by the Dutch Trimbos Institute found that, according to NH-personnel, 8.4% of the Dutch NH-residents were DCD-patients who surpassed the capabilities for psychiatric treatment available in their own NHdepartment . Qualified psychiatric nurses are still rarely employed within NHs, and specific psychiatric training for personnel is limited [9]. Despite the knowledge that patients with SMI have a high prevalence of physical disorders and are less competent in interpreting physical symptoms it has been stated that MHs should focus greater attention on the physical needs of DCD-patients and should provide o ٹcial guidelines to help identify and treat physical complications . Based on these challenges encountered in providing appropriate care for DCD-patients, some Dutch NHs and MHs developed specialized care units to allow targeted allocation and care for this specific group of patients. Results from explorative studies on these specialized DCD-units have shown that the group of DCD-patients is quite heterogeneous in both the MH- and the NH-setting Нey tend to be young, more oіen male, and to have low family support. All DCD-patients displayed a high number of neuropsychiatric symptoms, ADL-care dependency, and physical multimorbidity , although, expectedly, psychopathology was more prominent in the MH-DCDgroup Нe high care dependency and the variation in neuropsychiatric patient characteristics present a challenge to the nursing-sta ٴو across both settings, as they must address somatic care needs, as well as psychiatric and psychogeriatric care needs. Research into the impact of caring for DCD- 2 patients on the mental well-being of nursing sta ٴو showed that well-being and performance of nursing sta و
Active ageing is the key word in any debate on ageing of population around the globe.But research on aging have seldom considered the plight of marginalized groups nor tried to quantify the overall wellbeing of aged among tribal community in India.On this perspective this paper tries to explore the data available on tribal elderly population in an attempt to quantify the active ageing process of the tribal elderly population in India.Scheduled tribes in India have a lesser proportion of aged with 6.9% of the population above 60 years compared to 8.6 among the general population in India.Employing McGahan composite index normalization the composite indices is estimated.The health index values indicate that only one in ten elderly have good health.Community participation index depicts a better scenario with more elderly being scored under the 'moderate' and 'good' participation index.Distribution of elderly population by security index shows that 'good' security index values are observed among the medium wealth quintile category of elderly.Overall the Scheduled Tribe population in India shows a moderate level of active ageing.Females are slightly at disadvantage in the overall active ageing index.Welfare of the tribal elderly population demands attention in par with the general population in promoting active ageing among the tribal elderly population in India.A holistic approach encompassing health, social, economic and psychological aspects could be promoted with strong government support for the active and healthy ageing of the tribal population in India.
Issues concerning older adults are recognized as a research priority in developed countries, evidenced by a growing body of research in the area of psychological, social and health needs of the aged. Despite attracting less attention, there is also great need for research in the different aspects of elderly people in developing as well as the least developed countries so that it may help to know the well being of elderly which is not examined in depth [1] and these types of research supports for the appropriate policy formulation. The issue of elderly is critical for poor elders in the developing world, where formal welfare systems are less extensive. Although co-residence benefits the younger as well as the older generation, in many societies living together with adult children has been ‘a fundamental means of ensuring that the day-to-day needs of the older population would be met’ [2]. In Nepali culture, elderly generally prefer to stay with their children and living in old age home is not very common [3].
authors asked whether the criteria currently used to define anemia in older adults should be reevaluated.The current examination explored whether hemoglobin concentrations are related with physical function in the group of older adults.The original IceProQualita study was conducted as a randomized, controlled trial, which is designed to test the effects of post exercise protein ingestion on the efficacy of 12-week strength training in old adults [9].The intention of the current analysis was to examine: •Whether baseline hemoglobin predicts physical function,• Whether baseline hemoglobin predicts response to 12-week resistance exercise training, and
Human life is based on three important stage of life. The first stage of life is child stage, the second stage is an adult stage and third stage is old age stage. In every stage, people faced the different type of challenges, but old age stage is the unique stage in an individual’s life. It is the closing period of the life span. In this stage, a person becomes weaker on Physical perspective as well as more sensitive and emotional on Psychological perspective. This unwanted process of becoming older makes it more important in human life.
Background: Although several systematic reviews have shown the effects of exercise interventions on frailty, no exercise intervention studies based on cardiopulmonary exercise testing (CPET) have been conducted, and no studies investigated whether robust, pre-frailty and frailty has specificity of effectiveness on frailty related indices with same exercise training (ET). Objectives: The aim of this study is examine the effect of ET based on CPET on physical, cognitive and psychological frailty including with health-related quality of life (HRQOL), and verified whether there are specificity of exercise effectiveness on frailty related indices with same ET among community-dwelling robust, pre-frailty and frailty older adult. Methods: Seventy-three older adult completed ET twice per week over a 6-month period in this cohort study. Frailty-related physical indices included body mass index (BMI), skeletal muscle mass index (SMI), handgrip strength (HGS), Timed Up and Go test (TUG), usual walking speed (UWS), and exercise tolerance (Peak and Anaerobic threshold (AT)). Cognitive and psychological status and HRQOL were also measured. Participants were divided into robust, pre-frailty, and frailty groups according to the Japanese version of the Cardiovascular Health Study criteria. Results: Twenty-four (32.9%) participants were classified as robust, 39 (53.4%) as pre-frailty, and 10 (13.7%) as frailty. Analysis of variance for split-plot factorial design showed improvement in HGS, TUG, UWS, exercise tolerance, cognitive and psychological as main effects of this ET. The interaction (intervention × group) analyses showed significant differences in UWS and AT watts. Post hoc analyses showed improvement of frailty in UWS and pre-frailty and frailty in AT watts, as specificity of ET effectiveness. We found that 89% of robust, pre-frailty, and frailty participants improved or maintained their status with this ET. Conclusion: This study showed exercise training based on CPET is effective for frailty and showed the specificity of exercise effectiveness in pre-frailty and frailty.
Social gerontology is the branch of geriatrics. Growing age is inevitable. Every stage of age has its own importance. The senior years are often viewed as a period of poor health, yet many older adults are capable of remaining active and busy well into their 80s and 90s. After 60, a person feels, he has completed his work, responsibilities or duties. But the important aspect at this point is social interaction. At old age, the neurotransmitters and hormones disturbance cause dementia, osteoporosis, diabetes, hyper tension and common knee pain, low back ache, ankle pain, tremors, anxiety and depression are the common ailments they suffer with. Increased health concerns mark this period of development, and some individuals may experience mental declines related to dementia and Alzheimer's disease. Erikson also viewed the elder years as a time of reflection back on life. A gerontologist who studies the biological, psychological, and sociological phenomena of old age and aging will take care of old people by engaging them in social rehabilitation, sports, walking etc.
BACKGROUND:Hypertension is a major problem among the geriatric population, presenting the risk of multiple associated co-morbidities and organ system damage. Data related to the epidemiology of controlled and uncontrolled hypertension among the oldest old population is sparse, more so from developing countries. The objectives of the present paper were to identify the prevalence and correlates of hypertension according to gender among the urban community-dwelling healthy oldest old population. METHODS:200 healthy people aged 80 years and above were recruited by random selection from Hyderabad city of South India in 2017. A trained investigator collected data on background history, history of hypertension and other co-morbidities, medications and sleep. Participants were tested for muscle strength, gait speed, and SPPB and cognitive impairment. RESULTS:The prevalence of hypertension was 83.5%; 81.6% among men and 84.7% among women. 64.5% was self-reported. Hypertension was controlled with treatment among only 46.2%. In 74.6%, it was controlled even without treatment. The independent correlates were BMI per SD increase (OR: 1.92, 95% CI: 1.17-3.16), diabetes (OR: 6.02, 95% CI: 1.24-29.11) and asthma (OR: 3.59, 95% CI: 1.05-12.29). Among men, BMI per SD increase was significantly associated while hemoglobin per SD increase, height per SD decrease, and arthritis were positively associated among women. Increasing heart rate among total subjects (OR: 0.44, 95% CI: 0.27-0.71), and among women (OR: 0.47, 95% CI: 0.24-0.92) showed a negative association. CONCLUSION:The prevalence of hypertension was high. The correlates were different for men and women. Subjects were unaware of their control status which posed an increased risk for organ damage, and development of co-morbidities. Policies aimed at improving quality of life of the oldest old should place due stress on appropriate hypertension management in developing countries.
Adrenal insufficiency, also known as Addison’s disease, can occur due to both primary and secondary means [1-3]. In primary adrenal insufficiency, the damage to the adrenal glands results in the inadequate production of adrenocortical hormones [1,4-7]. In secondary adrenal insufficiency, the pituitary gland diseases decrease the production of adrenocorticotropic hormone which signals the adrenal cortex to begin hormonal production [8-10]. The symptoms of adrenal insufficiency, whether primary or secondary, include fatigue, weight loss, reduced appetite, hyperpigmentation, hypoglycemia, salt cravings, nausea, muscle and joint pain, depression and irritability; if untreated, adrenal insufficiency leads to death [1-14].
BACKGROUND:Cognitive impairment among elderly is increasing owing to increases in life expectancy globally. The problem is multifactorial. The objective of the present paper was to study the correlates of cognitive impairment in an urban elderly population in India.METHODS:A cross sectional study was conducted among 100 randomly selected urban elderly population. Data was collected upon household visits using a predesigned pretested questionnaire administered by a trained investigator. Measurements included cognitive function assessment using Mini Mental State Examination, depression assessment using Geriatric Depression Scale, blood pressure measurement and anthropometry. Cognitive impairment was defined at MMSE score <24. Logistic regression was done to identify independently associated factors with cognitive impairment.RESULTS:Prevalence of cognitive impairment among elderly was 10%. Women had a higher prevalence than men. Higher age, no schooling, living single, lower weight, lower waist and hip ratios, difficulty in activities of daily living, poor self-reported health, bedridden and depression significantly associated with cognitive impairment. The independently associated factors upon logistic regression were increasing age, no schooling and bedridden status for past six months.CONCLUSION:Although the current prevalence of cognitive impairment among Indian urban elderly is low, several associated factors exist in this population that may increase the burden in future. Geriatric health policy should address the modifiable risk factors to manage the problem of cognitive impairment and its consequent outcomes.
Purpose of the study: One to two million elderly Americans are injured, exploited, or otherwise mistreated by someone on whom they depend on for care or protection. Elder abuse (EA) is detrimental to the individual and has significant societal and health cost implications. Despite these profound consequences, research suggests that elder abuse is often underreported. We conducted a retrospective review of reported EA cases over a 7 year period at 2 large VA Medical Centers (VAMC) to assess the types of EA cases reported, the characteristics of those patients who were reported and the 1 year outcome. Design and methods: A retrospective review of all cases of elder abuse reported to Adult Protective Services at two large VA Medical Centers between 2006 and 2012 was conducted as part of an educational initiative to improve health care provider identification and triage of elder abuse. Results: Thirty cases of EA were reported at the Providence VAMC and 25 were reported at the Durham VAMC during the study period. A dementia diagnosis was common among EA cases, present in 50% of cases in Providence and 72% in Durham. The majority (41/55) of referrals were made by the medical team but cases were also reported by caregivers and patients themselves. In over half of the cases, the Veteran was able to remain in the home environment with support from additional community based services, such as home health aides, physical and occupational therapy. Implications: Based on the published prevalence of elder abuse in elderly populations, EA was likely underreported in the two large VAMCs. More research is necessary to help determine the prevalence of elder abuse among Veterans, to identify risk factors that might aid diagnosis, and to develop interventions that target this important problem.
Falling is a common problem in the older adults, which can lead to serious injuries and deaths. This study was conducted to determine the validity and reliability of the Turkish version of the Modified Falls Efficacy Scale (MFES) developed to diagnose the fear of falling of older adult individuals. This methodological study was conducted with 141 older adults who are 65-years-old and above who are independent in their activities of daily living. The internal consistency coefficient of the Turkish Form of MFES is 0.98, the split half test consistency coefficient is 0.97 and, test-retest stability coefficient of the items is between 0.73-0.99. The Turkish Form of MFES was found to correlate positively with the Barthell Index and the rivermead mobility index, while it negatively correlated with the falls behavioral scale for the Older Person. The MFES Turkish form is a valid and reliable instrument that can be used to determine the potential fears of falling, and practice regarding the fear of falling in older adults.
