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Objectives: This study examined a multicommunity alternative transportation program available 24 hours a day, 7 days a week, for any purpose, offering door-through-door service in private automobiles to members who either do not drive or are transitioning away from driving. Specific aims were to describe the characteristics of members by driving status and ride service usage of these members.Methods: Data came from administrative records maintained by a nonprofit ride service program and include 2,661 individuals aged 65+ residing in 14 states who joined the program between April 1, 2010, and November 8, 2013. Latent class analysis was used to group current drivers into 3 classes of driving status of low, medium, and high self-regulation, based on their self-reported avoidance of certain driving situations and weekly driving frequency. Demographics and ride service use rate for rides taken through March 31, 2014, by type of ride (e.g., medical, social, etc.) were calculated for nondrivers and drivers in each driving status class.Results: The majority of ride service users were female (77%) and aged 65-74 years (82%). The primary method of getting around when enrolling for the transportation service was by riding with a friend or family member (60%). Among the 67,883 rides given, nondrivers took the majority (69%) of rides. Medical rides were the most common, accounting for 40% of all rides.Conclusions: Reported ride usage suggests that older adults are willing to use such ride services for a variety of trips when these services are not limited to specific types (e.g., medical). Further research can help tailor strategies to encourage both nondrivers and drivers to make better use of alternative transportation that meets the special needs of older people. [ABSTRACT FROM AUTHOR]

The author suggests best practices in assessing aging physicians for professional competency. Topics covered include statistics on aging physicians in the workforce in both the U.S. and the world, the intellectual advantages that aging clinicians can bring to practice and data regarding physician age and patient outcomes in clinical practice.

Background: In the face of a growing number of older adults in the population, policy-makers in high-income countries are seeking new ways to reduce the expected growth in long-term care expenditure. Research shows that disability is an important determinant of long-term care utilization. In this context, reablement has received increased attention. Reablement is a form of home-based rehabilitation, which focuses on improving independent functioning in daily activities perceived as important by the older adult. Objective: To evaluate the cost-effectiveness of reablement. Methods: The economic evaluation is based on data from a randomized controlled trial in which all participants were assessed at baseline and after 3 and 9 months. The intervention group participated in reablement, while the control group received usual care. The Canadian Occupational Performance Measure (COPM) was used to measure self-perceived activity performance and satisfaction with performance. Cost data were based on daily registrations of usage of home-based care personnel during a period of 9 months. Results: Reablement was found to be more cost-effective than usual care. The assessments of performance and satisfaction regarding daily activities were significantly higher in the reablement group compared with the control group and this was achieved at lower cost. Importantly too, in the post-trial period, the intervention group requested significantly fewer home visits which were, on average, of significantly shorter duration compared with the control group. Expenditure on home visits was significantly lower for the reablement group. Conclusions: Reablement is a more cost-effective intervention compared with usual care. Reablement has a potentially large effect on the demand for compensating home-based care services. Policy-makers should therefore consider implementing reablement on a larger scale. [ABSTRACT FROM AUTHOR]

Purpose: To intra-individually compare discomfort levels and patient satisfaction after arterial access closure using the ExoSeal(®) vascular closure device (VCD) and manual compression (MC) in a prospective study design.Methods: Patients undergoing two planned interventions from 07/2013 to 09/2014 could participate in the study. Access closure was performed with an ExoSeal(®)-VCD in one and MC in the other intervention. Patients were clinically and sonographically examined and were given questionnaires 1 day after intervention [groin- and back-pain during bedrest (100-point visual analog scale; 0: no pain); comfortability of bedrest (10-point Likert scale, 1: comfortable), satisfaction with closure (10-point Likert scale, 1: very satisfied)]. Results were analyzed in a cross-over design.Results: 48 patients (29 male, median age 62.5 (32-88) years) were included. An ExoSeal(®)-VCD was used first in 25 cases. As four of these subsequently refused MC as second intervention, data from 44 patients could be analyzed. All closures were technically successful (successful device deployment) without major complications. Groin- and back-pain after VCD-use/MC was 0 (0-15) vs. 10 (0-80) and 0 (0-75) vs. 25 (0-90), respectively (p < 0.0001). Bedrest after VCD-use was more comfortable than after MC [1 (range 1-7) vs. 6 (2-10); p < 0.0001]. Satisfaction with the closure procedure and with the intervention in general was higher after VCD-use compared to MC [1 (1-3) vs. 5 (2-10) and 1 (1-2) vs. 2 (1-4), respectively; p < 0.0001].Conclusion: Intra-individual comparison showed pain levels and discomfort to be significantly lower after ExoSeal(®) use compared to MC. VCD closure was associated with higher satisfaction both with the closure itself and with the intervention in general. [ABSTRACT FROM AUTHOR]

The article offers information on the summary of the annual plan of the New York City Department local government agency for 2015. It cites the strategic goals of the Bureau of Community Services (BCS) including efforts in distributing Farmers' Market check booklets, sponsoring free bus trips to numerous sites, and offering Automated External Defibrillator (AED), and CPR training to older adults. It explains the purpose and scope of the annual plan summary.

The article offers information on the summary of the annual plan of the New York City Department local government agency for 2015. It cites the strategic goals of the DFTA including efforts in educating the public about aging issues, serving as a catalyst increased resources to enhance and expand programs and services for older New Yorkers and ensuring the provision of quality services fairly to those people. It explains the purpose and scope of the annual plan summary.

Objectives To better understand how centenarians use the healthcare system as an important step toward improving their service delivery. Design Population-based retrospective cohort study using linked health administrative data. Setting Ontario-Canada's largest province. Participants All individuals living in Ontario aged 65 and older on April 1 of each year between 1995 and 2010 were identified and divided into three age groups (65-84, 85-99, ≥100). A detailed description was obtained on 1,842 centenarians who were alive on April 1, 2010. Measurements Sociodemographic characteristics and use of health services. Results The number of centenarians increased from 1,069 in 1995 to 1,842 in 2010 (72.3%); 6.7% were aged 105 and older. Over the same period, the number of individuals aged 85 to 99 grew from 119,955 to 227,703 (89.8%). Women represented 85.3% of all centenarians and 89.4% of those aged 105 and older. Almost half of centenarians lived in the community (20.0% independently, 25.3% with publicly funded home care). Preventive drug therapies (bisphosphonates and statins) were frequently dispensed. In the preceding year, 18.2% were hospitalized and 26.6% were seen in an emergency department. More than 95% saw a primary care provider, and 5.3% saw a geriatrician. Conclusion The number of centenarians in Ontario increased by more than 70% over the last 15 years, with even greater growth among older people who could soon become centenarians. Almost half of centenarians live in the community, most are women, and almost all receive care from a primary care physician. [ABSTRACT FROM AUTHOR]

The article discusses the influence of the aging process on the health and well-being of elderly individuals. Aging may manifests in physiological degenerations of the neurological, cardiovascular, respiratory, renal, gastrointestinal and immune system, and sensory organs. An assessment of these manifestations and the amount of clinical support are the main keys to addressing the needs of older people.

An essay is presented on international patterns in population change among persons over the age of 65. Particular focus is given to the relationship between these patterns and the larger demographic transition from high to low birth and death rates. The authors also compare patterns among more developed countries (MDCs) and less developed countries (LDCs).

In the coming years the United States will experience a burgeoning number of senior residents, including those with disabilities. A review of these developments and the dental and medical concerns in the delivery of dental services is presented. [ABSTRACT FROM AUTHOR]

This article explores the intersection between discourses with multiple meanings that relate to the cultural construction of elder identities in South Korea. The authors explore the experiences of elder patients at a free clinic to consider how government policy, attitudes among biomedical professionals, and elders themselves come into contact and influence the experiences of older Koreans within the national health care system. The study is ethnographic, using interview data to examine how the identities of elder Koreans are being shifted from "weak and in need of care" to "potentially problematic consumer" and how governmental policies both stimulate and respond to that shift. By focusing on the situational status of the elderly, this article is intended to represent the voices of some elderly, voices that can be submerged within the process of decision making related to public policy. [ABSTRACT FROM AUTHOR]

Objectives: To compare the oldest old (85 years and above) in pain with those with no pain across gender, regarding demographic data, living conditions, social network/support, walking/mobility problems, fatigue, sleeping problems, depressed mood and quality of life (QoL). The aim was also to test how these variables were related to QoL among the oldest old in pain.Methods: The study comprised 1622 people aged 85-105 years, of whom 47% reported pain. SF-12 and the LGC questionnaire were used to measure QoL. Multiple linear regression analysis was used to identify factors associated with QoL.Results: Functional limitations, fatigue, sleeping problem and depressed mood were significantly more prevalent and QoL was significantly lower among those in pain than those not in pain, and among women compared to men. These complaints, along with financial problems, living in sheltered housing and living alone, were associated with low QoL among those in pain.Conclusion: Pain is common among the oldest old and coexists with several other complaints that together negatively affect QoL. By identifying those in pain and coexisting factors, actions can be taken to contribute to QoL, also in late life. [ABSTRACT FROM AUTHOR]

Background: Identifying biological measures that are predictive of mortality for elderly people aged over 65 years has not been fully elucidated in oriental studies.Objective: The associations between these biological measures and long-term mortality were therefore investigated, and classifications for risk of death were developed among Taiwanese elderly peopleMethods: Data used in this study were derived from a total of 597 apparently healthy subjects aged over 65 years identified from a nationwide survey that was conducted between 1989 and 1991 in Taiwan. Each participant received a physical examination and a wide range of biological measures. These 597 apparently healthy subjects were followed to 31 December 1999 to determine the cause of death. The grouping technique using factor analysis was first used to aggregate similar characteristics of biological measures into reduced components. Risk of death for each subject was classified into four groups: good (A), fair (B), modest (C) and poor (D). Hazard ratios for groups B, C, D against A were calculated.Results: The overall 10-year survival rate was 72% [95% confidence interval (CI) 68-76%]. The adjusted hazard ratios for all-cause death in high and mid-level categories of haematological components versus the lowest group were 0.51 (95% CI 0.33-0.80) and 0.56 (95% CI 0.37-0.85), respectively. Group D had a 6-fold risk of death as compared with group A (relative risk = 6.34, 95% CI 3.85-10.52). The corresponding figures were 2.48 (95% CI 1.43-4.29) and 1.60 (95% CI 2.88-6.89) for groups B and C, respectively.Conclusions: The relationships of biological measures to long-term mortality were elucidated. Information on classification for risk of death may be helpful for elderly people to pay attention to their health status after receiving a health check-up. [ABSTRACT FROM AUTHOR]

Background: Several countries have reported an increase in life expectancy at advanced ages. This paper analyses recent changes in life expectancy at age 60 and 85 in The Netherlands, a low mortality country with reliable mortality data.Methods: We used data on the population and the number of deaths by age, sex and underlying cause of death for 1970-1994. Life expectancy at age 60 and 85 was estimated using standard life-table techniques. The contribution of different ages and causes of death to the change in life expectancy during the 1970s (1970/74-1980/84) and the 1980s (1980/84-1990/94) were estimated with a decomposition technique developed by Arriaga.Results: Life expectancy at age 60 increased in the 1970s and 1980s, whereas life expectancy at age 85 decreased (men) and stagnated (women) in the 1980s, and has decreased in both sexes since 1985/89. The decomposition by age showed that constant mortality rates in women aged 85-89, and increasing mortality rates at ages 85+ (men) and 90+ (women) have caused this lack of increase in life expectancy. The decomposition by cause of death showed that smaller mortality reductions from other cardiovascular and cerebrovascular diseases, which contributed most to the increase in life expectancy at age 85 in the 1970s, and mortality increases from, amongst others, chronic obstructive pulmonary disease (COPD), mental disorders and diabetes mellitus produced the decrease (men) and plateau (women) in life expectancy at age 85.Conclusions: Life expectancy at advanced ages stopped increasing during the 1980s in The Netherlands due to mortality increases at ages 85+ (men) and 90+ (women). Cause-specific trends suggest that, in addition to (past) smoking behaviour in men, changes in the distribution of morbidity and frailty in the population might have contributed to this stagnation. [ABSTRACT FROM AUTHOR]

Statistics are given regarding ageing in the 21st century, including the projected increase in number of people aged 60 or over by the year 2050, the percentage of Americans aged 60 or over who use the Internet, and the number of people who celebrate their 60th birthday every second.

The author discusses the national statistical data regarding the aged population in Turkey which has been provided by the Turkish Statistical Institute.

Several charts and statistics regarding long-term care for seniors as of August 28, 2013 are presented, including total long-term care spending in 2011, Medicaid spending on long-term care and the number of U.S. citizens aged 65 years and above in the U.S.

The article presents the U.S. Census Bureau Report, "90+ in the United States: 2006-2008" which discussed the characteristics of the 90-plus population. It reported that most 90-plus population completed high school, have Social Security income as personal income and their living arrangements vary by race and Hispanic origin. Key issues discussed are their health and disability status including difficulties on instrumental activities of daily living (IADL) and activities of daily living (ADL).

This section offers news briefs in Asia in 2012. Bangladesh officials are considering land in Ukraine, Cambodia and sub-Saharan African in which to grow food to meet the demand of Bangladeshi. Indonesian males are starting their smoking habit at age seven. The number of elderly people are increasing in China.