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It's fundamental to understand the reasons for adoption and not adoption, as well as the impact of the use of information and communication technologies by the elderly. To illustrate this need and its importance, I review in this communication a survey conducted with elderly people in Lisbon (Portugal) and describe the preliminary results of a research in Toronto (Canada) with institutionalized elderly people. [ABSTRACT FROM AUTHOR]

Introduction: Obstructive sleep apnea hypopnea syndrome (OSAHS) is caused by an obstruction in the upper airway during sleep. Obesity and advanced age are main risk factors for OSAHS. The classic symptoms of OSAHS include snoring, apneas and choking during sleep. On the other hand, some scientific literature describes that the consumption of benzodiazepines may worsen the snoring and the severity and duration of OSAHS. Case report: A 74-year-old female reported on her appointment to have mood alterations. When asked about other sleep disorders, she said that she snored loudly, with pauses on her breathing. Therefore, a split night polysomnography was performed which revealed a diagnosis of severe OSAHS. Discussion: Old people are frequent consumers of benzodiazepines. The woman of this study had been taking 1.5 mg of clonazepam per day for the last eight years. This may have worsened the OSAHS. Conclusion: The patient presented risk factors that could lead to OSAHS. It is important to study the relationship between benzodiazepines and the severity of OSAHS. [ABSTRACT FROM AUTHOR]

Background: The world is aging with people living longer and fewer children being born; the number of old people is increasing, and thus the aging of populations demands a comprehensive public health response. Objective: The objective of this study was to shed light on the health-care services for old people in age-friendly primary health-care centers (PHCCs) in Baghdad city in respect with its availability, accessibility, and utilization. Methods: This is a descriptive cross-sectional study that was conducted in 22 age-friendly PHCCs in Baghdad. The evaluation was based on the WHO age-friendly PHCCs toolkit. The checklist comprises a list of questions related to clinical services. Results: Wheelchairs were present in 100% of the centers, 85.7% of centers in Al-Karkh and 62.5% of centers in Al-Russafa have clear emergency exits, and all the centers have essential equipment and investigations. Free services for the elderly were not present in any of the centers; the referral system was weak with no feedback. Computerized health information system was present in only quarter of the centers. Conclusion: All the age-friendly PHCCs lack a special unit for the elderly. Most of the centers do not have a suitable source of drinking water. There are some criteria that comply with the WHO instructions, but there are other essential services that should be available to improve the health services and utilization of these services. [ABSTRACT FROM AUTHOR]

Sociological concept of generation should be distinguished from biological and statistical, and they discussed all three of its meaning. In a sociological sense, it is characterized by a common historical experience that has its own internal and external, subjective and objective dimension. In sociology it was introduced by Dilthey, one of the main representatives of historicism, and which is characterized by discontinuous conception of history and emphasizing specificity of cultural epochs. In contemporary sociology, this concept was reaffirmed under the strong influence of Mannheim who argued that the generation is in the range of analytical categories of class and nation. The major historical generations in our society are pointed. Four generations are considered as the main age groups but also as social constructs children, youth, middle aged and old people. Their status in the traditional and contemporary, especially in our society is pointed. In the research of generation and its main forms have formed a special sociological disciplines, except for the middle-aged who are, as a generation, at least sociologically studied.

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Estimates of glomerular filtration rate (eGFR) should provide accurate measure of an individual's kidney function because important clinical decisions such as timing of renal replacement therapy and drug dosing may be dependent on eGFR. Formulae from which eGFR is derived are generally based on serum creatinine measurement, such as Cockcroft-Gault, MDRD and CKD-EPI. More recently, calculation of eGFR using other laboratory biomarkers such as cystatin C has emerged with apparent greater accuracy. In old people, there is age-related physiological change in the kidney, which could lead to reduced GFR. Likewise, physiological changes in body composition that occur with the ageing process impede the use of a single creatinine-based calculation of eGFR across all adult age groups. Studies have shown differences in the prevalence of CKD based on the type of equation used to estimate GFR. This review discusses the evolution of eGFR calculations and the relative accuracy of such equations in older population. [ABSTRACT FROM AUTHOR]

The objective of this study was to perform a systematic review onstudies about social relationsas a predictor factor for cognitive decline and Alzheimer's disease. A search was performed on the PubMed, LILACs, BIREME and SCOPUS databases using the terms "Alzheimer" and "social relations". The final bank included in the analysis of 15 articles, published since 2007. The researchers found indicated that having a good quality in the social relations are considered important to maintain the cognition preserved. In addition, it was that the necessity of an increment of researches that aim to understand how the social support develops and is experience by the elderly in the Brasilin context, suggesting futures directions for the development of studies in this area of the country. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effects of a folk recreation program on the symptoms of people with dementia. The program was tailored to the participants' interest and derived from their traditional culture background.Methods: A quasi-experimental study design was used. A total of 48 participants were assigned to an experimental or a control group. The experimental group received a 40 to 50-min folk recreation intervention, which is mainly about art, music and game, three times a week and for 16 weeks. The control group received routine care without special intervention. The Mini-mental State Examination (MMSE), Barthel Index (BI) and the Chinese version of the neuropsychiatric inventory (CNPI) were used to estimate the cognitive function, ability of daily living and behavioral and psychological symptoms with dementia at baseline and week 16.Results: For the experimental group, the mean scores of MMSE and BI increased significantly from baseline to week 16 (p < 0.01) for cognitive function and activity of daily living, and the mean score of CNPI-symptom decreased significantly (p < 0.01) for behavioral and psychological symptoms. While, for the control group, the mean score of MMSE decreased significantly (p < 0.01), and the mean scores of BI and CNPI-symptom changed non-significantly.Conclusions: The folk recreation program has the potential to improve cognitive function, ability of daily living and behavioral and psychological symptoms of the elders with dementia. The folk leisure activities, which embed in the participants' cultural background, will motivate their positive feelings and memories, can delay the progression of disease and improve the symptoms. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose: To assess whether comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team reduce drug-related hospital readmission rates among people with dementia or cognitive impairment. Methods: This randomized controlled trial was carried out between January 9, 2012, and December 2, 2014. Patients aged ≥65 years with dementia or cognitive impairment admitted to three wards at two hospitals located in Northern Sweden were included. Results: Of the 473 deemed eligible for participation, 230 were randomized to intervention and 230 to control group by block randomization. The primary outcome, risk of drug-related hospital readmissions, was assessed at 180 days of follow-up by intention-to-treat analysis. During the 180 days of follow-up, 18.9% (40/212) of patients in the intervention group and 23.0% (50/217) of those in the control group were readmitted for drug-related reasons (HR = 0.80, 95% CI = 0.53-1.21, p = 0.28, univariable Cox regression). Heart failure was significantly more common in the intervention group. After adjustment for heart failure as a potential confounder and an interaction term, multiple Cox regression analysis indicated that pharmacist participation significantly reduced the risk of drug-related readmissions (HR = 0.49, 95% CI = 0.27-0.90, p = 0.02). A post-hoc analysis showed a significantly reduced risk of 30-day readmissions due to drug-related problems in the total sample (without adjustment for heart failure). Conclusion: Participation of clinical pharmacists in healthcare team conducting comprehensive medication reviews did not significantly reduce the risk of drug-related readmissions in patients with dementia or cognitive impairment; however, post-hoc and subgroup analyses indicated significant effects favoring the intervention. More research is needed. Trial registration: Clinical trials NCT01504672. [ABSTRACT FROM AUTHOR]

Background: Drug-related problems, including medication errors and adverse drug events, are common among old people. Due to, for example, greater susceptibility to side effects, people with dementia are even more at risk of drug-related problems. The objectives of this study were to assess the occurrence and character of drug-related problems found among old people with dementia or cognitive impairment. Methods: Data from a randomized controlled clinical trial exploring the effects of a pharmacist intervention as part of a hospital ward team in patients 65 years and older with dementia or cognitive impairment were used. The study was conducted between 2012 and 2014 in the orthopedic and medicine wards in two hospitals located in Northern Sweden. Drug-related problems identified in this patient group were classified and described, and associations with different factors were investigated. Results: Clinical pharmacists identified at least one DRP in 66% (140/212) of participants in the intervention group, for a total of 310 DRPs. Ineffective drug/inappropriate drug and unnecessary drug therapy were the most common drug-related problems. Discontinuation of drug therapy was the most common action carried out. Drug-related problems were more common among people prescribed a larger number of drugs and among people with an earlier stroke. Conclusions: Drug-related problems are common among people with dementia and cognitive impairment. Comprehensive medication reviews conducted by clinical pharmacists as part of a health care team might be important to prevent, identify and solve these problems. [ABSTRACT FROM AUTHOR]

Background and aim Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007–2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results The measurement model yielded a reasonable fit to the data, χ2 = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037–0.058. The model fit for the conceptual model was acceptable; χ2 = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074–0.093. SES itself was not a direct predictor of HS (β = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (β = 0.31, p < 0.001) or I (β = 0.57, p < 0.001). Conclusion Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. [ABSTRACT FROM AUTHOR]

Along with the aging trend of the world population, the status and determinants of the travel behavior of the elderly have been gaining more attention in planning and research. Most of the existing research has focused on the influence of socio-demographics and built environments, while the impact of socio-cultural backgrounds has attracted less attention. Regarding the influence of built environments, previous studies have mainly focused on general elements such as density, and land use mixture, while specifics about how built environments influence the elderly have largely been ignored. This paper, therefore, attempts to investigate how socio-cultural settings, interacting with built environments, affect the travel behavior of the elderly in urban China. Particularly, we will examine the impacts of a set of built environment attributes on daily activity participation and the travel distance of the elderly in Nanjing. Based on quantitative and qualitative data, we found that special social and cultural contexts make the travel pattern of Chinese elderly and the determinants of that pattern different from those of their western counterparts. Specifically, it was found that public transportation accessibility instead of auto transportation accessibility, vegetable markets instead of supermarkets and convenience stores, open spaces and parks along with chess and card rooms instead of gyms and sports centers are more decisive in affecting the travel behavior of the elderly. These findings offer insights for policy making on distributing appropriate public facilities for the elderly in urban areas, especially in new towns in urban China. [ABSTRACT FROM AUTHOR]

Aim Slow gait speed has been associated with mortality, poor physical function and disability in older people. Our aim was to evaluate the association between slow gait speed and rapid cognitive decline among oldest-old men in Taiwan. Methods We carried out a longitudinal cohort study in a veterans' retirement community, and enrolled 249 male residents aged 80 years and older. Slow gait speed was defined as <1 m/s, and rapid cognitive decline was defined as a Mini-Mental State Examination (MMSE) decline of ≥3 points over 1 year. Body mass index, Charlson's Comorbidity Index, handgrip strength, gait speed and Mini-Mental State Examination datasets were collected, and a logistic regression model was built to evaluate the association between fast cognitive decline and slow gait speed. Results In all, 249 residents (mean age 86.4 ± 4.01 years) were recruited, including 58 (23.3%) with rapid cognitive decline. Univariate analysis showed that slow gait speed could predict rapid cognitive decline (OR 4.10, 95% CI 1.20-14.00, P = 0.024). After adjusting for age, Charlson's Comorbidity Index, polypharmacy, psychiatric drug usage, cigarette smoking experience, baseline cognitive function, depressive mood, handgrip strength, nutritional status and history of fall, slow gait speed was still independently associated with rapid cognitive decline (adjusted OR 4.58, 95% CI 1.22-17.2, P = 0.024). Conclusions Slow gait speed was thus an independent predictor of rapid cognitive decline in oldest-old men in a veterans' retirement community in Taiwan. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 14-19. [ABSTRACT FROM AUTHOR]

Inner strength is reported as an important resource associated with aging, health, and disease management. The aim was to explore inner strength in people (n=12) aged 65 years and older, who had experienced a crisis in life associated with a disease. The participants had self-rated their inner strength as high. We found that sources of inner strength were mutual love and support, and the fact that tough times have been managed before. Expressions of inner strength comprised focusing on possibilities instead of brooding, facing and take an active part in care and treatment, and being able to confront reality and pick yourself up again. Inner strength is a complex phenomenon. Increased knowledge of inner strength can serve as an aid in efforts to identify the need to promote inner strength. [ABSTRACT FROM AUTHOR]

Background. Osteoporosis is a debilitating condition characterized by fractures, pain and premature death. Risk factors for osteoporosis predict the risk of fragility fractures. Aim. To describe the occurrence of risk factors for osteoporosis among populations in Nuuk, the capital of Greenland. Methods. A random sample of women born in 1934–42, 1945–47, 1956, and men born in 1956 were selected from the national civil registry. A questionnaire was sent out in Greenlandic and Danish on risk factors for osteoporosis: family history, smoking habits, alcohol intake, presence of disease, sun exposure, intake of dairy products, age at menopause (women) and number of falls. Additional questions included the frequency of back pain, previous fractures, intake of vitamin D and calcium supplements, use of anti-osteoporotic drugs, steroids and other drugs. Results. The questionnaire was sent to 317 subjects confirmed to be living at an address in Nuuk and 181 (57.1%) responded. More young women than older women were smokers (60.6% vs. 35.0%; p=0.022) while limited sun exposure was reported by more of the old women (37.2% vs. 5.6%; p=0.003). Family history of osteoporosis was reported by 15.0%, without difference between groups. Alcohol and milk intake did not differ between groups. Premature menopause was reported by 17.9% of the women. Falls within the last year were reported by 42.4% with fewer falls in the oldest age group (21.9% vs. 50.0%; p=0.005). Frequency of fragility fractures increased with age (5.7% vs. 24.3% vs. 30.4%; p=0.02) and the risk of a fragility fracture increased with age (p=0.004; OR, 95% CI: 4.5, 1.6–12.2, reference: below 70 years), when adjusted for smoking, gender and falls. The use of anti-osteoporotic drugs was low (3.4%) while 28.8% took calcium and vitamin D supplements. Conclusions. Age is a dominating risk factor for fragility fractures in Greenland. The use of anti-osteoporotic drugs is low in Greenland, even if osteoporotic fractures are common in old age.

Introducción: el envejecimiento poblacional es un desafío para las sociedades y es necesario que los recursos humanos dedicados a la atención del anciano se nutran de conocimientos que dinamicen un adecuado manejo farmacoterapéutico a este grupo poblacional muy vulnerable por su comorbilidad y por una respuesta peculiar a los medicamentos. Objetivo: determinar la interrelación entre comorbilidad, estado funcional y consumo de medicamentos. Métodos: investigación descriptiva, de tipo transversal, cuyo universo estuvo conformado por todos los ancianos de 60 años y más que ingresaron en el Hospital "Calixto García" durante el año 2007. Se acopió información de una muestra aleatoria de 267 pacientes. Se consideraron variables de respuesta la comorbilidad, el deterioro funcional y la polifarmacia. Se creó una base de datos validada automáticamente para la confirmación de su congruencia. Resultados: el mayor consumo de medicamentos correspondió a las edades comprendidas entre 80 y 89 años; 263 (98,5 %) ancianos presentaban comorbilidad y de ellos 211 (79 %) tenían polifarmacia asociada a un promedio de 5 fármacos por paciente. Los adultos mayores que clasificaron en la categoría más afectada de la evaluación funcional fueron los de mayor edad, los que también se relacionaron con mayor comorbilidad y consumo de medicamentos. Conclusiones: la comorbilidad y el deterioro funcional en ancianos se relacionan estrechamente con el consumo elevado de medicamentos, lo que repercute negativamente en su estado de salud, de ahí que es imprescindible que los profesionales de la atención primaria pongan especial atención en el manejo fármacoterapéutico en sus adultos mayores.Introduction: population aging represents a challenge for all the societies, hence it is necessary that the human resources devoted to take care of aged persons be well documented for the adequate drug and therapeutic management of this particular population, which is highly vulnerable due to its comorbidity and its particular drug response. Objective: to determine the interrelation between comorbidity, functional state and drug consumption. Method: a cross-sectional and descriptive study was carried out, which included all 60 and over years-old patients, admitted to "Calixto García" hospital in 2007. The response variables were comorbidity, functional deterioration and multiple drug consumption. Data was collected on a random sample of 267 patients. An automatically-validated database was created to confirm congruency. Results: the greatest use of drugs was found in the 80 to 89 years old age group. It was found that 263 older people (98.5 %) suffered comorbidity and 211 of them (79 %) took 5 drugs as an average. The oldest persons accounted for the worst functional state evaluation, the highest index of comorbidity and the greatest use of drugs. Conclusions: both comorbidity and functional deterioration are closely related to drug consumption in the older people, all of which has a negative impact on their health state. It is indispensable that the primary health professionals pay special attention to the drug and therapeutic management of the older adults under their care.

Se realizó una investigación epidemiológica explicativa, analítica y transversal con el objetivo de determinar el comportamiento de los factores de riesgo vascular en los ancianos diabéticos ingresados en el Centro de Atención al Diabético de Pinar del Río, en el período comprendido entre enero y junio de 2010. Utilizando un muestreo intencional, el universo y muestra, quedó conformado por todos los pacientes diabéticos de ambos sexos y en las edades de 60 y más años (n=108). En la historia clínica se registraron los resultados del examen físico y los complementarios necesarios para determinar los factores de riesgo vasculares así como dos cuestionarios. Con los datos obtenidos se elaboró una base de datos utilizando el paquete estadístico SPSS para Windows en versión 11.5. Se aplicaron las pruebas estadísticas de 2 y K proporciones de grupos independientes y la paramétrica Ji cuadrado. Los datos para su análisis fueron reflejados en los cuadros de distribución de frecuencia y gráfico. El grupo de edad que predominó fue de 60-69 años, y el sexo femenino. La dislipidemia y el hábito de fumar fueron los factores de riesgo de mayor frecuencia; se observaron proporciones significativas de pacientes con la presencia de 3 a 6 factores de riesgo. La polineuropatía y la insuficiencia arterial periférica fueron las complicaciones más frecuentes. Se concluye que se debe realizar un proyecto de mayor magnitud que permita una mejor valoración de la situación de riesgo vascular en ancianos diabéticos tipo 2.An epidemiological, explanatory, analytical and cross sectional research was conducted aimed at determining the behavior of vascular risk factors in diabetic old patients admitted to the Diabetes Care Center in Pinar del Rio, from January to June 2010. An intentional sampling, the target group and sample were comprised of all diabetic patients of both sexes, 60 years old and older (n=108). The results of physical examination and complementary check-up to determine vascular risk factors, the results of two questionnaires applied as well were written in the individual clinical history. Through the data obtained a database was created using Windows SPSS statistical package in version 11.5. Statistical tests of 2 and K proportions for independent groups and chi square parametric test were used, showing the results in pictures for the distribution of frequency and graphics in order to carry out the analysis of the data. Ages from 60 to 69 years old and female sex prevailed. Dislipidemia and smoking were the most frequent risk factors; examined significant proportions of patients presenting from 3 to 6 risks factors. The most frequent complications were polyneuropathy and peripheral arterial deficiency. A full-reaching project must be carried out to assess vascular risk status in old diabetic type-2 patients.

This article compares residential mobility at the middle of the retirement period with mobility observed at the beginning of retirement. The survey covers four specific sites in order to characterize the impact on the retirement mobility of rural versus urban settings, and of tourist places versus others. We examine the reasons given by 286 persons who moved between ages 55 and 84 and we then focus our discussion on retirees who moved between ages 70 and 84 to explore strategies at play in various settings. We also show that some mobility patterns are related to characteristics of the new living environment of retirees, both in terms of housing and of ‘living space’. However, mobility patterns are not only influenced by the spatial context, but are also related to local social relations (family, friends, neighbourhood, etc.)

The advance of health conditions is propitiating the progressive increase of longevity and life expectancy. Studies have identified the existence of a connection between Diabetes Mellitus and (DM) and dementia. The hyperglycemia can be a significant factor for the incidence of Alzheimer, which could be a secondary cause for dementia. Type 2 Diabetes Mellitus (DM2) is associated to cognitive and functional deficits and, one of the tools, which can be used to assess executive functions, is the WCST. The objetive was the assessment of the cognitive prejudice in older people with DM2 through the WCST. Two hundred and fifty four (254) old people of both genders, with 60 years of age or older, divided into 44 persons with a DM2 diagnosis and 210 old people of the control group from the general population. The design was that of a quantitative and transversal study. The instruments used were: sociodemographic filing cards, WCST, MMSE, BDI, BAI, GDS. The Vocabulary, Coding, Digit Span, Block Design and WAIS – III sub-tests. The results showed there were a significant difference in the performance of old people with DM2, when compared to old people of the control group in four describers of the WCST, cognitive prejudice. The old people with DM2 showed intensity of depressive and anxiety symptoms of statistically larger regarding the group control.

Resumen El envejecimiento produce una involución de las capacidades físicas que origina un deterioro del estado físico y una reducción de la funcionalidad personal. Conforme avanza la edad se produce una pérdida de fuerza, un descenso de la capacidad aeróbica y una reducción progresiva no lineal y específica por articulación y movimiento articular de la flexibilidad. Además, los desórdenes de equilibrio son frecuentes en las personas mayores, por lo que el trabajo de flexibilidad y equilibrio, secundario en personas adultas, cobra especial protagonismo en las personas mayores. Asociada a la edad se producen modificaciones sustanciales de la composición corporal, con una disminución de la masa libre de grasa, que condiciona un descenso del gasto metabólico basal y un incremento de la masa grasa. La práctica de actividad física ha demostrado ser una herramienta eficaz para atenuar o retardar el envejecimiento, pero sólo si dicho ejercicio es practicado de forma regular y con la intensidad adecuada, contribuirá a mejorar la capacidad funcional global del organismo. Las diferentes recomendaciones de actividad física para personas mayores publicadas hasta la fecha, determinan dichos criterios mínimos de volumen e intensidad, por lo que se deben tener presentes a la hora de realizar una prescripción de ejercicio físico a una persona mayor.AbstractAging process is associated with progressive declines in physical fitness and functionality. Across age, there is a lost of strength, aerobic capacity (Vo2max) and a progressive but not linear decreasing of specific joint mobility. Furthermore, balance disorders are common in older people. In addition, the flexibility and balance training, which is secondary in adult people, it is of special relevance in old people. Age-related changes occur in body composition: fat free mass decreases and it determines lower energy expenditure and consequent increase in fat mass. Physical activity has showed to be an useful tool for decelerating the aging process; however, benefits only occur when the physical activity is practiced at the appropriate volume and intensity. Different recommendations for frequency, intensity and duration of physical exercise have been published. The current recommendations for elderly people, determine the minimal criteria for volume and intensity, and they must be taken into consideration when prescribing physical exercise in old people.

Los mayores están sujetos a riesgos acrecentados por el poco compromiso con la vida, el aislamiento, la precariedad de recursos y la enfermedad, entre otros. Hoy, la depresión es considerada la perturbación mental con mayor crecimiento, repercutiendo en los cambios en el estilo de vida y en la salud. Nos cuestionamos sobre el estado de humor deprimido de los mayores que viven en la comunidad. El objetivo es evaluar la depresión e identificar los factores relacionados con ella. Estudio descriptivo correlacional. Conclusión: Hay un número elevado de personas con humor deprimido. Ser mujer y estar enferma revela relaciones con la depresión, así como tener limitaciones para ejecutar las actividades.Old people are submit to risk factors that increase from life disengagement; loneliness, decrease in income and in resources and also from diseases, among others. Today depression is considered a mental disturb in a growing process which affects life style and health. That's why we questioned old people living in community, about depressed humor. The aim of this study is to evaluate depression's level nd associate factors. It's a descriptive, correlate study. Conclusions: There are a great number of people with depressed humor and, be woman, have diseabilities are factors relate to depression.

Abstrats: The superficial mycoses frequency was evaluated in a population of 71 old people between 62 and 98 years old, males and females, residents of a geriatrical unit, during the October 2005-February 2006 period, of which 49 presented a suggestive diagnosis. A direct exam with KOH at 10% was done to the obtained samples, which were cultivated in fungobiotic agar and incubated during 15 days at room temperature. The colonies of filamentous bacteria were identified by macro and microscopic characteristics, while leavenings of Candida genus by the API 20 C AUX® identification system. The obtained results were analyzed trough method of percentage analysis (%) and test of Chi-square (x2). 40 (81.63%) cases resulted positive, of which 82.50% were cutaneous candidosis, being ungual candidosis the most frequent, followed by la tinea unguium (12.50%) and onychomycosis due to non-dermatophytic fungi (5.00%). No case of pityriasis versicolor was detected. C. albicans was the fungus most frequently isolated (64.81%), generally in nails of feet, followed by C. parapsilosis (12.96%) and Trichophyton mentagrophytes (5.56%). A high incidence of cutaneous candidosis was observed at old people, which was favoured by the physical conditions common in them, concomitant disease, deficiency in cellular immunity and certain predisponent factors, such as life style, the use of closed shoes, warm weather and the humidity in the region where they live. Resumen; Se evaluó la frecuencia de micosis superficiales en una población de 71 adultos mayores entre 62 y 98 años, de sexo masculino y femenino, residentes de la Unidad Geriátrica, durante el periodo octubre 2005-Febrero 2006, de los cuales 49 presentaron diagnóstico sugestivo. A las muestras obtenidas, se les practicó examen directo con KOH al 10%, se cultivaron en agar Fungobiotic y se incubaron durante 15 días a temperatura ambiente. Las colonias filamentosas se identificaron a través de las características macro y microscópicas, mientras que las levaduras del género Candida por el sistema de identificación API 20 C AUX®. Los resultados obtenidos fueron analizados a través del método de análisis porcentual (%) y la prueba de Chi-cuadrado (x²). Resultaron positivos 40 (81,63%) casos, de los cuales el 82,50% fueron para candidosis cutáneas, siendo la candidosis ungueal la más frecuente, seguido de la tinea unguium (12,50%) y las onicomicosis por hongos no dermatofitos (5,00%). No se detectó ningún caso de pitiriasis versicolor. C. albicans fue el hongo más frecuentemente aislado (64,81%), sobre todo en uñas de pies, seguido de C. parapsilosis (12,96%) y Trichophyton mentagrophytes (5,56%). En la vejez, se observa una alta incidencia de candidosis cutáneas, la cual es favorecida por las condiciones físicas propias del adulto mayor, enfermedades concomitantes, déficit en la inmunidad celular y ciertos factores predisponentes como el ritmo de vida, el uso de calzados cerrados, el clima cálido y la humedad de la región donde se reside.

In the face of limited resources and an ageing population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalisation, hospitalisation and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care. We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community (RISC) to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (Severe). The mean age of the 4499 people assessed was 76.3 years (sd=7.3) and 2645 (58.8%) were female. According to the primary care team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR=2.22, 95% CI 1.83-2.69 for institutionalisation; OR=1.66, 95% CI 1.41-1.94 for hospitalisation; OR=1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

Intergenerational social support between adult children and elderly parents is a phenomenon that is becoming a challenge for Malaysian families, particularly with an increase in the elderly population. The purpose of this article is to assess the intergenerational social support received by the elderly living in public care institutions. The sample consisted of ten elderly respondents recruited through purposive sampling from one of the Rumah Seri Kenangan that provides shelter and basic care for the elderly. Thematic analysis was used to arrive at pragmatic findings. Results revealed that the elderly in this care institution received less intergenerational social support from the children or next of kin. The majority reports their relationship with children and next of kin to be more distant and even lost contact with them after moving into institutions. This article proposes that the items in the family dimension in Lubben scale were appropriate to be used for measuring quantitatively the receipt of intergenerational social support among elderly living in a care institution. The quantitative measurements using family sub-scale allows researchers to do research on a larger sample sizes. At the same time inferential analysis can be carried out and the results can be generalized to all members of the population. [ABSTRACT FROM AUTHOR]

The media literacy in the Spanish old people is an issue rarely discussed in the academic studies, but of increasing interest. This work provides a review of recent studies on the old people and their relationship with the media. Furthermore, we define the concept of media and the objectives of this research: to describe competency levels of old people in a representative sample and to determine how sociodemographic variables are linked with levels of media literacy in this group of population. We conclude that participants are distributed equally among the three levels of media literacy. Some variables that are related to higher levels of competition are the highest level of education (master, PhD), marital status, incomes, gender and level of audiovisual training. [ABSTRACT FROM AUTHOR]

The excess mortality related to the August 2003 heat-wave occurred with different intensity according to places: it was more important in Île-de-France and in the Centre region that in other areas of France. Its impact was more massive in urban environment than in the rural communes. In Paris, the expression of the excess mortality was clearly exacerbated with an increase of almost 190% of mortality between 1st and August 20th 2003 compared to the previous years. However, this extra-mortality did not occur in a homogeneous way in the city. The analysis of the space disparities of mortality in the city was led on the deaths domiciled according to two levels of aggregation, the districts (20) and the quarters (80). It rests, in other, on the cartography of simple indicators of mortality (standardized ratio of mortality) and of excess mortality. The determination of the factors of social risks (socio-demographic and socio-economic characteristics of the population) and contextual (temperature, pollution) is based on the construction of a Poisson regression model. In 2003 a space structure of mortality very different from that of the previous years review was highlighted: it is characterized by a pole of excess mortality in the south of the city. This shift of mortality is the result of a narrow intrication between socio-economic factors and other factors, such as the levels of pollution or the intra-urban variations of temperature. Beyond the dramatic dimension of this without precedent event, the study puts forward the social and economic precariousness of a part of the old population in the capital. This study thus stresses in a strong way the importance of the links between various dimensions (medical, social and contextual) of a health phenomenon.

Background Little is known about change in physical activity (PA) and its relationship to all-cause mortality among old people. There is even less information about the association between PA, fitness, and all-cause mortality among people aged 80 years and above. The objective is to investigate persistence and change in PA over 5 years as a predictor of all-cause mortality, and fitness as a mediator of this association, among people aged 80 and 85 years at the beginning of an 18-year mortality follow-up period. Methods Using Evergreen Project data (started in 1989), 4 study groups were formed according to self-reported changes in PA level, over a 5-year period (starting in 1989–1990 and ending in 1994–1995): remained active (RA, control group), changed to inactive (CI), remained inactive (RI), and changed to active (CA). Mortality was followed up over the 18-year period (1994–2012). Cox models with different covariates such as age, sex, use of alcohol, smoking, chronic diseases, and a 10 m walking test were used to analyze the association between change in PA level and mortality. Results Compared to RA, those who decreased their PA level (CI) between baseline and follow-up had higher all-cause mortality (hazard ratio (HR = 2.09; 95%CI: 1.63–2.69) when adjusted for age, gender, and chronic diseases. RI showed the highest all-cause mortality (HR = 2.16; 95%CI: 1.59–2.93). In CA, when compared against RA, the risk of all-cause mortality was not statistically significant (HR = 1.51; 95%CI: 0.95–2.38). In comparison with RA, when walking speed over 10 m was added as a covariate, all-cause mortality risk was almost statistically significant only in CI (HR = 1.37; 95%CI: 1.00–1.87). Conclusion Persistence and change in PA level was associated with mortality. This association was largely explained by fitness status. Randomized controlled studies are needed to test whether maintaining or increasing PA level could lengthen the life of old people. [ABSTRACT FROM AUTHOR]

Introduction The prevalence of malnutrition increases with age. The aim of the study was to compare the usefulness of the Controlling Nutritional Status (CONUT) score with that of the Mini Nutritional Assessment (MNA) score, for detecting risk of malnutrition and predicting mortality in a very old community-dwelling population. Material and methods Cross-sectional community-based survey of 328 inhabitants aged 85 at baseline (Octabaix Study cohort). Geriatric assessment, socio-demographic variables, and co-morbidity were collected in all participants. Nutritional status and its correlation with 4-year mortality rates were assessed by using both the CONUT and the MNA indexes. Results Of the total of 328 subjects, 322 (98%) were finally included in the study. Prevalence of abnormal nutritional status was 16.5% when using the CONUT score and 34.2% when the MNA index at baseline. There was no correlation between the CONUT and the MNA score values ( r = −0.37; P = 0.51). Cumulative mortality rates throughout the 4-year period of follow-up were, respectively: 4.6%, 10.5%, 17.7, and 28.8%. While the CONUT score showed correlation with mortality rates only during the second year of follow-up ( P = 0.02), the MNA score showed a statistically significant association in each of the 4 years of follow-up (first year P = 0.01, second year P = 0.006, third year P = 0.001, and fourth year P = 0.002). Conclusions When compared, the MNA score detected a higher proportion of individuals at risk for malnutrition than that detected by the CONUT. Furthermore, MNA was more effective for predicting 4-year mortality rates than the CONUT. [ABSTRACT FROM AUTHOR]

Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Universal Excellence (JUE) / Revija za Univerzalno Odličnost (RUO) is the property of Fakulteta za Organizacijske Studije v Novem mestu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Haematology reference values are needed to interpret haematology results and make clinical decisions, but these have not been established for old people in sub-Saharan Africa. The objective of this study was to establish haematology reference values for people aged 50 years and above in Uganda, to compare the haematology reference values for those aged 65 years and over with those less than 65 years and to compare these haematology reference values with established haematology reference values for old people from high income countries. Methods: A total of 1449 people aged 50 years and above were recruited from the Medical Research Council/Uganda Virus Research Institute general population cohort between January 2012 and January 2013 (response rate 72.3 %). From the blood samples collected, we did haematology, HIV testing and malaria tests. We also obtained stool samples and tested them for hookworm infection. Questionnaire data were obtained through interviews. In the analysis, we excluded those with HIV infection, malaria infection, hookworm infection and those not feeling well at the time of recruitment. Medians and reference ranges for 12 haematology parameters were determined, based on the Clinical Laboratory and Standards institute's guidelines. Results: In total, 903 people aged 50 years and above were included in the analysis with the majority 545 (60.3 %) being female. Men had significant difference in median haemoglobin, haematocrit, erythrocytes counts and white blood cells counts, which were higher than those of women. Women had significant difference in mean platelet counts and neutrophil percentages which were higher than those of men. Comparing those aged 65+ and those aged less than 65 years, the following parameters were significantly lower in those aged above 65 years: haemoglobin, haematocrit, erythrocytes counts, platelets and mean corpuscular volume. Compared to the reference intervals from old people in high income countries, all the haematology parameters from our study population were low. Conclusion: The differences between haematology reference ranges in old people compared to adults and the very old (65+) compared to those between 50 and 65 call for more population based studies using nationwide surveys to be carried out among old people in other study settings in Uganda and the rest of Africa to explore the differences in haematology reference ranges between these different age groups with a view of establishing whether there is need to have separate reference range for these different categories of old people. [ABSTRACT FROM AUTHOR]

Purpose: Drug treatment associated problems are common and are the cause of a large proportion of hospitalizations in old people. People with dementia are especially at risk of drug-related problems. The objectives of this study were to assess the occurrence and character of drug-related problems that lead to acute hospital admissions among old people (≥65 years) with dementia or cognitive impairment. Methods: This study was conducted in orthopedic and internal medicine wards in two hospitals in Northern Sweden. Information about acute admissions was collected from the medical records. A total of 458 people aged 65 years or older with dementia or cognitive impairment were included in the study. The contribution of drug-related problems to each hospitalization was assessed. Results: Of 458 acute hospital admissions, 189 (41.3 %) were determined to be drug-related. The most common drug-related problem (86/189; 45.5 %) was an adverse drug reaction. In total, 264 drugs were judged to be involved in 189 drug-related admissions, of which cardiovascular (29.5 %) and psychotropic (26.9 %) drugs were the most commonly involved drug classes. The relationship between the drug-related problem and the admission was judged certain in 25 cases, probable in 78 cases, and possible in 86 cases. Drug-related admissions were more common among people taking more drugs ( p = 0.035) and among younger patients ( p = 0.031). Conclusion: Drug-related problems appear to be responsible for a major proportion of hospitalizations among old people with dementia or cognitive impairment. Targeted interventions such as education and medication reviews may be warranted to reduce drug-related problems. [ABSTRACT FROM AUTHOR]

SUMMARY Background Chronic kidney disease (CKD) is a global problem. With an ageing population the burden on the health services has increased due to the growing number of older people with CKD. This group of individuals is far different to the younger CKD population and their risk of cardiovascular death is far greater than the risk of progressing to end stage kidney disease (ESKD). Objective In this review we explore the role of certain biomarkers and medications in predicting the risk of progression to ESKD and death in old people with CKD. Methods An electronic literature search of EMBASE and MEDLINE databases was performed using Healthcare Databases Advanced Search (HDAS) in December 2014. Results Albuminuria is a key biomarker in predicting the risk of death and progression to ESKD. Cystatin C appears to be superior in predicting the risk of cardiovascular and non-cardiovascular death compared to GFR or creatinine. Several inflammatory biomarkers can be used to predict the risk of death and progression to CKD but measuring and monitoring them in routine clinical practice will be expensive and impractical. The effects of long-term RAAS inhibition in older people are not well established. Older people especially those with CKD receive suboptimal secondary preventive measures. Due to multiple comorbidities older people with CKD are usually receiving a number of medications. This can potentially lead to significant adverse drug events (ADE) due to drug interactions. Conclusion Novel non-traditional risk factors like albuminuria, Cystatin C and inflammatory biomarkers play an important role in predicting their risk of death and progression to ESKD. The efficacy and safety of medications in older people with CKD is not well established and requires more extensive, focused study. [ABSTRACT FROM AUTHOR]

Variations across Finland in the use of six different long-term care ( LTC) services among old people in their last 2 years of life, and the effects of characteristics of municipalities on the variations were studied. We studied variations in the use of residential home, sheltered housing, regular home care and inpatient care in health centre wards by using national registers. We studied how the use of LTC was associated with characteristics of the individuals and in particular characteristics of the municipalities in which they lived. Analyses were conducted with multilevel binary logistic regression. Data included all individuals (34,753) who died in the year 2008 at the age of 70 or over. Of those, 58.3% used some kind of LTC during their last 2 years of life. We found considerable variations between municipalities in the use of different kinds of LTC. A portion of the variation was explained by municipality characteristics. The size and location of the municipality had the strongest association with the use of different kinds of LTC. The economic status of the municipality and morbidity at the population level were poorly associated with LTC use, whereas old-age dependency showed no association. When individual-level characteristics were added to the models, these associations did not alter. Results indicated that the delivery system characteristics had an important effect on the use of LTC services. The considerable variation in LTC services also poses questions with respect to equity in access and to quality of LTC across the country. [ABSTRACT FROM AUTHOR]