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This study examined predictors of driving among oldest-old Australian women in their late 80s in accordance with the World Health Organization's healthy aging framework. The study used data from the 1921–26 cohort of the Australian Longitudinal Study on Women's Health, wave-6 (n = 4025). The result of the multivariable logistic regression showed providing care, living alone, volunteering, living in rural/outer regional Australia, having higher educational attainment, and social interactions were associated with driving. The findings indicate driving should not be dismissed based on age alone. Policymakers need to also consider social roles, driving environment and context with the goals of healthy aging. [ABSTRACT FROM AUTHOR]

Background: Older population with dementia use huge range of medications. In this study, we aimed to determine the prevalence of commonly used medications a year before and after first recorded dementia diagnosis among older Australian women. Methods: The study utilized Australian Longitudinal Study on Women's Health (ALSWH) data from 2090 women with known dementia, linked with administrative health datasets. The Pharmaceutical Benefits Scheme (PBS) data provided detailed information about prescribed medications. We applied latent class analysis (LCA) to the post-dementia data to identify patterns of medication use. Logistic regression model was used to explore the impact of potential predictors for medication utilization. Results: Antipsychotic use increased from 5% before dementia to 19% after dementia, while antidementia medication use increased from < 1 to 28%. There was a modest increase in benzodiazepines and antidepressants. Post-dementia, four distinct groups were identified using LCA (names based on probabilities of medications use) as: "High Psychotropic–Low Cardiovascular" (16% of the sample); "Moderate Psychotropic–High Cardiovascular" (12%); "Low Psychotropic–High Cardiovascular" (27%); and "Low Psychotropic–Low Cardiovascular" (45%). Living in Residential Aged Care (RAC) and frailty were associated with increased odds of being in the higher psychotropic use groups. Conclusions: Substantial utilization of psychotropic medications by older people with dementia indicates a need for a careful review of the use of these medications. Appropriate alternative approaches to the management of dementia should be practiced with a special focus on RAC residents with frailty. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the circumstances and characteristics of falls with fractured femur reported in nursing homes. Method: Mixed methods were used. There were reports on 401 eligible falls from 88 residential care facilities in the Hunter region of Australia. A falls report form was developed for the study and was completed by nursing staff. Information was collected about the circumstances of falls with fractured femur and resident data. Descriptive and qualitative analyses were used. Results: Falls with fractured neck of femur were associated with being ambulant, having dementia, increasing age, and a high falls risk assessment. Themes from the falls report data were resident-related factors, organizational or environmental issues, and activities at the time of the fall. Discussion: Falls in residential care settings are very complex and difficult to prevent. Attention should be given to the needs of recently admitted residents and management of the facility environment. [ABSTRACT FROM AUTHOR]

Aim: To determine differences in food and nutrient intakes between Australian‐ and Asian‐born women living in Australia. Methods: Data were obtained from the Australian Longitudinal Study on Women's Health, including 6461 women born in Australia or Asia who completed food frequency questionnaires in 2001 and 2013. Diet was assessed using the Dietary Questionnaire for Epidemiological Studies version 2. Longitudinal generalised estimating‐equation modelling was performed to determine the effect of country of birth and survey year on fruit and vegetable intake. Results: Asian‐born women ate more cereals, soybeans and fish but less vegetables, legumes, dairy, meat and meat products than Australian‐born women both in 2001 and in 2013. Asian‐born women ate less cereals, rice and noodles, meat and its products (P < 0.05) in 2013 than in 2001. The earlier people came to Australia, the less their rice and noodle intake per day. However, the reverse was demonstrated regarding vegetable intake. Asian‐born women had a lower daily intake of fat, calcium, zinc, thiamin, riboflavin, folate and retinol compared with those born in Australia. Conclusions: Asian‐born women living in Australia show different food and nutrient intakes from Australian‐born women, although their diets tend to deviate from typical Asian characteristics and approach a Western diet. [ABSTRACT FROM AUTHOR]

In 1999, the Australian Federal Government introduced Medicare items for Health Assessments for people aged 75 years and older (75+ health assessments). This research examined uptake of these assessments and identified predictors of use by women from the Australian Longitudinal Study on Women's Health (ALSWH). Assessments were identified for each year from 1999 to 2013 using linked Medicare data. Time to first assessment was examined, as well as social and health factors associated with having an assessment. From 1999 to 2013, 61.8% of women had at least one assessment. Almost one-third had an assessment within 2 years of their introduction, 25% of women died before having an assessment and 13% survived but did not have an assessment. Factors associated with assessment included being widowed, private health insurance, marital status, education, having arthritis and urinary incontinence, and less difficulty managing on income. Many women never received an assessment, and many only received one. Promotion of the 75+ health assessments is necessary among older women to increase uptake. [ABSTRACT FROM AUTHOR]

Aim China faces a 'time-bomb' of the aging population. Successful aging has long been a goal in the field of gerontology. The present study aimed to evaluate successful aging among Chinese older adults. Methods Data on a total of 7102 people in the China Health and Retirement Study aged ≥60 years were analyzed in the present study. Successful aging is defined by the model of Rowe and Kahn including the following five indicators: 'no major diseases,' 'no disability,' 'high cognitive functioning,' 'high physical functioning' and 'active engagement with life.' Using logistic regression analysis, crude and adjusted odds ratios with 95% confidence intervals were calculated to evaluate the relationship between sociodemographic parameters and successful aging. Results The prevalence of successful aging was 13.2% among Chinese older people. The percentage of older people with the five indicators, 'no major diseases,' 'no disability,' 'high cognitive functioning,' 'high physical functioning,' and 'active engagement with life' was 41.7%, 92.1%, 54.2%, 70.2% and 46.0%, respectively. Multiple logistic regression showed people who had received education of high/vocational school or above had significantly greater odds of successful aging compared with those with less than primary school education ( P < 0.05). The effect of education to college level or above on cognitive functioning was 2.51-fold higher in women than men ( P = 0.006). Older people from a non-agricultural Hukou had 1.85-fold higher odds of successful aging than those from an agricultural Hukou. Older people living in the central, northeast or western regions had lower odds of successful aging relative to those living in the east coast region (0.72, 0.72 and 0.56, respectively). Conclusions The prevalence of successful aging is low among Chinese older people, and is affected by sociodemographic factors, such as education, Hukou and regions. Geriatr Gerontol Int 2017; 17: 1183-1190. [ABSTRACT FROM AUTHOR]

We examined women's access to health insurance in Indonesia. We analyzed IFLS-4 data of 1,400 adult women residing in four major cities. Among this population, the health insurance coverage was 24%. Women who were older, involved in paid work, and with higher education had greater access to health insurance (p < .05). We also found there were disparities in the probability of having health insurance across community levels (Median Odds Ratios = 3.40). Given the importance of health insurance for women's health, strategies should be developed to expand health insurance coverage among women in Indonesia, including the disparities across community levels. Such problems might also be encountered in other developing countries with low health insurance coverage. [ABSTRACT FROM AUTHOR]

Aim To explore the implementation of poslansia, a community-based integrated health service implemented across Indonesia to improve the health status of older people through health promotion and disease prevention. Methods Data analysis of 307 poslansia surveyed in the 4th wave of Indonesia Family Life Survey ( IFLS-4). We examined the services provided in the programme, resources and perceived problems. Results The services provided by poslansia focused mostly on risk factor screening and treatment for minor illness, and less on health promotion activities. Lack of support from community health centres, no permanent place for holding poslansia and lack of participant interest in joining the programme were associated with fewer services provided in the programme ( P < 0.05). Conclusion The findings indicate existing support from the community, community health centres and related institutions for poslansia is not adequate for optimal service function. Health awareness among the older population should also be increased for programme sustainability. [ABSTRACT FROM AUTHOR]

Objectives To investigate the relationship between urinary incontinence ( UI) and subsequent development of social dysfunction, using longitudinal data collected over 15 years from women aged 70 and older. Design Longitudinal data from the Australian Longitudinal Study on Women's Health. Setting Australia. Participants Women born between 1921 and 1926 (aged 70-75 in 1996, 85-90 in 2011) (N = 12,432). Measurements UI, social dysfunction, other health and demographic factors. Results Generalized estimating equations were used to examine the association between social dysfunction and UI over time, adjusted for time, health, and social covariates. Social dysfunction and UI increased over time in older women. UI was associated with 30% greater odds of social dysfunction ( P < .001), adjusted for time, health, and social covariates in the model with no time lag. UI was also associated with social dysfunction measured one survey period later (forward time lag) (odds ratio ( OR) = 1.23, 95% confidence interval ( CI) = 1.13-1.34) and one survey period earlier (reverse time lag) ( OR = 1.30, 95% CI = 1.19-1.43), indicating an absence of causality. Social dysfunction was associated with living in urban areas, more health conditions, poor mental health, providing care for other people, and poor physical function. Conclusion UI was associated with social dysfunction in older women, although the association did not appear to be causal but reflective of the women's overall level of function and general health. UI is not necessarily socially debilitating, unless a woman has other health problems. [ABSTRACT FROM AUTHOR]

Objective. To estimate the prevalence and examine the associations of neuropathic-like pain in a community-based sample of older Australian women with arthritis. Design. Population based cross-sectional survey. Setting. Participants were recruited from the 1946-1951 cohort of the Australian Longitudinal Study of Women's Health. Subjects. Women with self-reported arthritis (n = 147). Methods. Primary outcome measure was self-reported neuropathic-like pain, defined as scores ≥12 via the pain DETECT screening tool. Descriptive statistics summarized health and socio-demographic characteristics, and comparisons made using student's t-test or Wilcoxon Rank Sum test, and Chi-square tests. Independent health and demographic variables were examined by univariable logistic regression, and significant variables included in multiple variable logistic regression modelling. Results. Thirty-nine women (26.5%) were screened as having neuropathic-like pain. Women with neuropathic-like pain were more likely to have poorer health, worse pain, higher pain catastrophizing, more fatigue, and more depression than women with nociceptive pain. Neuropathic-like pain was significantly associated with higher scores on the SF-MPQ sensory scale and pain catastrophizing scale, and with more medication use. Conclusions. Neuropathic-like pain in women with arthritis was common and is associated with greater disability and poorer quality of life. [ABSTRACT FROM AUTHOR]

Dietary intake during pregnancy influences maternal health. Poor dietary practices during pregnancy have been linked to maternal complications. The objective was to determine the effect of dietary intervention before or during pregnancy on pregnancy outcomes. A systematic review was conducted without date restrictions. Randomised controlled trials (RCTs) evaluating whole diet or dietary components and pregnancy outcomes were included. Two authors independently identified papers for inclusion and assessed methodological quality. Meta‐analysis was conducted separately for each outcome using random effects models. Results were reported by type of dietary intervention: (1) counselling; (2) food and fortified food products; or (3) combination (counselling + food); and collectively for all dietary interventions. Results were further grouped by trimester when the intervention commenced, nutrient of interest, country income and body mass index. Of 2326 screened abstracts, a total of 28 RCTs were included in this review. Dietary counselling during pregnancy was effective in reducing systolic [standardised mean difference (SMD) −0.26, 95% confidence interval (CI) −0.45 to −0.07; P < 0.001] and diastolic blood pressure (SMD −0.57, 95% CI −0.75 to −0.38; P < 0.001). Macronutrient dietary interventions were effective in reducing the incidence of preterm delivery (SMD −0.19, 95% CI −0.34 to −0.04; P = 0.01). No effects were seen for other outcomes. Dietary interventions showed some small, but significant differences in pregnancy outcomes including a reduction in the incidence of preterm birth. Further high‐quality RCTs, investigating micronutrient provision from food, and combination dietary intervention, are required to identify maternal diet intakes that optimise pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objectives:To examine the relationships of retirement and reasons for retirement with psychological distress in men and women at the age of 45–79 years. Method:Data from 202,584 Australians participating in the large-scale 45 and Up Study was used. Psychological distress was measured by the Kessler psychological distress scale. Associations between different work status and reasons for retirement with psychological distress were assessed for men and women at different ages using logistic regression. Results:Being fully retired or unemployed was associated with the high levels of psychological distress compared to being in paid work for men and women aged 45–64 (p< 0.0001), and for men aged 65–74 years (p≤ 0.0014). At the age of 75–79 years, there was no difference in psychological distress between different work statuses. Among retirees, retirement due to ill health, being made redundant or caring duty was associated with the high level of psychological distress. Conclusion:The association between work and mental health underscores the importance of policies and strategies to encourage and enable people to continue in the workforce after age 55, particularly for men. Important reasons for retirement with worse mental health outcomes include redundancy, ill health and needing to care for family or a friend. These circumstances will affect whether a person can continue working and their risk of poor mental health, and both considerations should be addressed in developing approaches for maintaining older workers or assisting them with their retirement transition. [ABSTRACT FROM AUTHOR]

Objectives:The ability of older people to mobilise within and outside their community is dependent on a number of factors. This study explored the relationship between spatial mobility and psychological health among older adults living in Australia.Methods:The survey sample consisted of 260 community-dwelling men and women aged 75–80 years, who returned a postal survey measuring spatial mobility (using the Life Space Questionnaire) and psychological health (using the SF36 Health Related Quality of Life Profile). From the Life Space Questionnaire, participants were given a life-space score and multinomial regression was used to explore the potential effect of mental health on life-space score.Results:The study found a significant association between mental health and life space. However, gender, physical functioning, and ability to drive were most strongly associated with the extent of life space and spatial mobility. Compared to men, older women are more likely to experience less spatial mobility and restricted life space, and hence are more vulnerable to social isolation.Conclusion:Mental health and life space were associated for the older people in this study. These findings have important implications for health policy and highlight the need to support older persons to maintain independence and social networks, and to successfully age in place within their community. This study also highlights the utility of the Life Space Questionnaire in terms of identifying older persons at risk of poorer mental health. [ABSTRACT FROM PUBLISHER]

Background: Nutrition plays a fundamental role in fetal growth and birth outcomes. Objective: We synthesized effects of dietary interventions before or during pregnancy on neonatal and infant outcomes. Design: Randomized controlled trials that assessed the whole diet or dietary components and neonatal or infant outcomes were included. Two authors independently identified articles to be included and assessed the methodologic quality. A meta-analysis was conducted separately for each outcome by using a random-effects model. Results were reported by dietary intervention as follows: 1) counseling, 2) food and fortified food products, or 3) a combination (counseling plus food) intervention, and 4) collectively for all dietary interventions. Results were subanalyzed by the nutrient of interest, country income, and BMI. Results: Of 2326 abstracts screened, a total of 29 randomized controlled trials (31 publications) were included in this review. Food and fortified food products were effective in increasing birth weight [standardized mean difference (SMD): 0.27; 95% CI: 0.14, 0.40; P < 0.01] and reducing the incidence of low birth weight (SMD: -0.22; 95% CI: -0.37, -0.06; P < 0.01). All dietary interventions and those focused on macronutrient intake also increased birth weight (P < 0.01) and length (P < 0.05) and reduced the incidence of low birth weight (P < 0.01). Dietary interventions in low-income countries and underweight or nutritionally at-risk populations increased birth weight (P < 0.05) and reduced the incidence of low birth weight (P = 0.01). No effects were seen for the following other outcomes: placental weight, head circumference, macrosomia, Apgar score, small for gestational age, large for gestational age, and perinatal mortality. Conclusion: Additional high-quality randomized controlled trials that test different dietary interventions are required to identify maternal diet intakes that optimize neonatal and infant outcomes. [ABSTRACT FROM AUTHOR]

Aim To identify the extent to which homes and neighbourhoods of older community-dwelling people are 'supportive'. Method Cross-sectional survey, in-home observation and interviews involving 202 participants (75-79 years). Measures included SF-36 health-related quality of life and Late Life Function and Disability Instrument ( LLFDI) scores, and self-reported home usability, access, safety and neighbourhood. Associations between home and neighbourhood characteristics were assessed using χ2-tests, t-tests and Pearson correlations. Results Older people rated neighbourhood satisfaction highly (3.0 men, 3.2 women; 4 being the highest score). Many homes failed objective adaptability and safety ratings, particularly bathrooms (80% did not have a shower grab rail, 77% did not have non-slip floors); 27% of homes scored ≥8 of 25 possible hazards. There were significant correlations between perceptions of housing and neighbourhood and SF-36 and disability scores. Conclusion Many homes and neighbourhoods may not accommodate increased frailty or disability of older people into the future. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with research which investigated the utility and acceptability of the modified telephone interview for cognitive status in a longitudinal study of Australian women between the ages of 85 and 90.

Objectives. The aim of this study was to examine age differences in high- and low-arousal positive and negative affect, and associations of physical functioning with affect over the latter half of the life course. Method. Participants consisted of 39,958 midlife and older adults contributing to DYNOPTA; a large-scale collaborative project concerned with pooling data from Australian studies of aging. Items assessing the experience of discrete emotions were selected to represent different combinations of high- and low-arousal affect, and positive and negative valence affect. Results. Older adults were more likely to endorse low-arousal positive affect, and less likely to endorse negative affect (both high and low arousal) relative to those in midlife. Better self-reported physical functioning was associated with younger age, higher positive, and lower negative affect, with physical functioning emerging as a suppressor of associations of age with affect in regression analyses. Conclusions. The results, based on a very large sample of older adults, are consistent with those of other studies demonstrating lower levels of negative emotion among older, relative to midlife adults. The findings also highlight the relevance of physical functioning to emotional well-being over the latter part of the life course. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented discussing a study on how factors predicting attrition change across groups in a longitudinal study of older women.

The article presents a study to explore work status and other activities of fully or partially retired men and women during their retirement. The study findings include involvement of fully retired participants in unpaid or voluntary work, involvement of women retirees in care of sick or disabled family members or friends and looking after home and family, and need for encouraging economically and socially productive activities of retirees.