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Oldest Old (oldest + old)
Selected AbstractsOPEN MESH-PLUG INGUINAL HERNIA REPAIR IN THE OLDEST OLDJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Theodoros E. Pavlidis MD No abstract is available for this article. [source] THE OLDEST OLD WITH HYPERTENSION: TREAT OR NOT TREAT?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2007Huai Yong Cheng MD No abstract is available for this article. [source] Cardiovascular Disease Is Associated with Greater Incident Dehydroepiandrosterone Sulfate Decline in the Oldest Old: The Cardiovascular Health Study All Stars StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Jason L. Sanders BA OBJECTIVES: To describe cross-sectional and longitudinal associations with dehydroepiandrosterone sulfate (DHEAS) and change in DHEAS with age. DESIGN: Longitudinal cohort study. SETTING: Pittsburgh, Pennsylvania. PARTICIPANTS: Cardiovascular Health Study All Stars study participants assessed in 2005/06 (N=989, mean age 85.2, 63.5% women, 16.5% African American). MEASUREMENTS: Health characteristics were assessed in 2005/06 according to DHEAS level, mean DHEAS and DHEAS change across age categories were tested, and linear and logistic regression was used to identify factors present in 1996/97 associated with continuous and categorical DHEAS change. RESULTS: Mean ± standard deviation DHEAS was 0.555 ± 0.414 ,g/mL in 1996/97 and 0.482 ± 0.449 ,g/mL in 2005/06 for women and 0.845 ± 0.520 ,g/mL in 1996/97 and 0.658 ± 0.516 ,g/mL in 2005/06 for men. In 2005/06, DHEAS was lower in women and subjects with cardiovascular disease (CVD) and chronic pulmonary disease and higher for African Americans and subjects with hypertension and high cholesterol. Mean DHEAS change was greater in men (,0.200 ,g/mL) than in women (,0.078 ,g/mL) (P<.001). Each 1-year increase in age attenuated the effect of male sex by 0.01 ,g/mL (P=.009), abolishing the sex difference in DHEAS change by age 79. Presence of CVD before the study period was associated with greater absolute DHEAS change (,=,0.04 ,g/mL, P=.04) and with the fourth quartile of DHEAS change versus the first to third quartiles (odds ratio=1.46, 95% confidence interval=1.03,2.05). CONCLUSION: DHEAS change continues into very old age, is not homogenous, is affected by sex, and is associated with prevalent CVD. Future studies should investigate factors that might accelerate DHEAS decline. [source] The Tumor Necrosis Factor Alpha ,308G>A Polymorphism Is Associated with Dementia in the Oldest OldJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Helle Bruunsgaard MD Objectives: To test the hypothesis that the tumor necrosis factor (TNF) ,308 G>A promoter gene polymorphism is a risk factor in age-related dementia and longevity. Design: A cross-sectional and a longitudinal study. Setting: A population-based sample of Danish centenarians. Participants: One hundred-year-old Danes (n=122) from "The Longitudinal Study of Danish Centenarians." Octogenarians (n=174) and healthy volunteers aged 18 to 30 (n=47) served as reference groups. Methods: Whether the distribution of TNF ,308 GG/GA/AA genotypes were different in centenarians than in younger age groups was investigated (Fischer exact test). Furthermore, whether the TNF ,308 G>A polymorphism was associated with the prevalence of dementia (logistic regression analysis), the plasma level of TNF-, (analysis of variance), and mortality in the following 5 years (Cox regression analysis) within the cohort of centenarians was tested. Results: The distribution of TNF ,308 genotypes was not different across the three different age groups, but the GA genotype was associated with decreased prevalence of dementia in centenarians. The few centenarians with AA carrier status had higher mortality risk and tended to show higher plasma levels of TNF-,, but the significance was questionable due to a low number of subjects with this genotype. Conclusion: It is possible that the TNF ,308 A allele is maintained during aging because subjects who are heterozygous for this polymorphism possess the optimal inflammatory response with regard to protection against age-related neurodegeneration. [source] Muscle Strength After Resistance Training Is Inversely Correlated with Baseline Levels of Soluble Tumor Necrosis Factor Receptors in the Oldest OldJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Helle Bruunsgaard MD Objectives:, To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. Design:, A 12-week controlled resistance-training study. Setting:, Nursing homes in Copenhagen, Denmark. Participants:, Twenty-one frail nursing home residents aged 86 to 95 completed the study. Intervention:, Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. Measurements:, Muscle strength, plasma levels of TNF-,, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. Results:, The training program improved muscle strength but did not affect plasma levels of TNF-, and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. Conclusion:, Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that theantiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation. [source] Exercise in the Oldest Old: Some New Insights and Unanswered QuestionsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2002FRACP, Maria A. Fiatarone Singh MD No abstract is available for this article. [source] Sociodemographic and Health Profiles of the Oldest Old In ChinaPOPULATION AND DEVELOPMENT REVIEW, Issue 2 2002Zeng Yi Unique data from a 1998 healthy longevity baseline survey provide demographic, socio-economic, and health characteristics of the oldest old, aged 80,105, in China. This subpopu-lation is growing rapidly and is likely to need extensive social and health services. A large majority of Chinese oldest old live with their children and rely mainly on children for financial support and care. Most Chinese oldest old had no or very little education. Ability to function independently in daily living declines rapidly and self-rated health declines moderately across the oldest old ages. As compared to their urban counterparts, the rural oldest old have far less pension support, are significantly less educated, and are more likely to be widowed and to rely on children for support. Apart from higher rates of survival, the female oldest old in China are far more disadvantaged than the male oldest old. [source] Oral satisfaction , or getting to the root of the problem of the oldest old?GERODONTOLOGY, Issue 4 2004James P Newton Editor No abstract is available for this article. [source] Suicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988,2003INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2008Kaisa Karvonen Abstract Objective Elderly people commit suicide more often than people under the age of 65. An elevated risk is also attached to depression and other axis I psychiatric disorders. However, little is known about the preferred suicide method, effect of primary psychiatric diagnosis, and length of time between discharge from psychiatric hospitalization and suicide. The lack of information is most apparent in the oldest old (individuals over 75 years). Methods On the basis of forensic examinations, data on suicide rates were separately examined for the 50,64, 65,74 and over 75 year-olds (Total n,=,564) with regard to suicide method, history of psychiatric hospitalization and primary diagnoses gathered from the Finnish Hospital Discharge Register. Study population consisted of all suicides committed between 1988 and 2003 in the province of Oulu in Northern Finland. Results Of the oldest old, females had more frequent hospitalizations than males in connection with psychiatric disorders (61% vs 23%), of which depression was the most common (39% vs 14%). In this age group, 42% committed suicide within 3 months after being discharged from hospital and 83% used a violent method. Both elderly males and females were less often under the influence of alcohol, but used more often violent methods than middle-aged persons. Conclusions Suicide rates within the first 3 months following discharge from hospital in the 65,74 and the over 75 year olds were substantial and should influence post-hospitalization treatment strategies. To reduce the risk of suicides in elderly patients discharged from hospital, close post-hospitalization supervision combined with proper psychoactive medication and psychotherapy, are possible interventions. Copyright © 2007 John Wiley & Sons, Ltd. [source] The Oldest Old in the Last Year of Life: Population-Based Findings from Cambridge City over-75s Cohort Study Participants Aged 85 and Older at DeathJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010Jun Zhao MSc OBJECTIVES: To characterize people of advanced old age in their last year of life and compare those dying in their late 80s with those dying aged 90 and older to inform policy and planning. DESIGN: Retrospective analysis of prospectively collected population-based data from the Cambridge City over-75s Cohort (CC75C) Study, United Kingdom. PARTICIPANTS: Men and women aged 85 and older at death who died less than 1 year after taking part in any CC75C survey (N=321). MEASUREMENTS: Physical health, functional disability, self-rated health, cognitive status. RESULTS: Functional and cognitive impairments were markedly higher for those who died aged 90 and older, predominantly women,than for those who died aged 85 to 89. At least half (49.4,93.6%) of subjects aged 90 and older needed maximum assistance in virtually every daily activity; those aged 85 to 89 needed this only for shopping and laundry. Disability in basic and instrumental activities rose from 59.1% before to 85.4% after the age of 90 and cognitive impairment (Mini-Mental State Examination score ,21) from 41.7% to 69.4%. Despite this and proximity to death, 60.5% and 67.0%, respectively, rated their health positively. Only one in five reported needing more help. CONCLUSION: This study provides new data identifying high levels of physical and cognitive disability in very old people in the year before death. As the very old population rises, so will support needs for people dying in extreme old age. The mismatch between health perceptions and functional limitations suggests that these vulnerable older adults may not seek help from which they could benefit. These findings have major policy and planning implications for end-of-life care for the oldest old. [source] Ten Dimensions of Health and Their Relationships with Overall Self-Reported Health and Survival in a Predominately Religiously Active Elderly Population: The Cache County Memory StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2006Truls Østbye MD OBJECTIVES: To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. DESIGN: A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. SETTING: Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. PARTICIPANTS: Inhabitants of Cache County aged 65 and older (January 1, 1995). MEASUREMENTS: Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. RESULTS: This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. CONCLUSION: This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts. [source] Muscle Strength After Resistance Training Is Inversely Correlated with Baseline Levels of Soluble Tumor Necrosis Factor Receptors in the Oldest OldJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Helle Bruunsgaard MD Objectives:, To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. Design:, A 12-week controlled resistance-training study. Setting:, Nursing homes in Copenhagen, Denmark. Participants:, Twenty-one frail nursing home residents aged 86 to 95 completed the study. Intervention:, Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. Measurements:, Muscle strength, plasma levels of TNF-,, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. Results:, The training program improved muscle strength but did not affect plasma levels of TNF-, and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. Conclusion:, Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that theantiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation. [source] Walking and Talking as Predictors of Falls in the General Population: The Leiden 85-Plus StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2003Annetje Bootsma-van der Wiel MD Objectives: To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy-to-administer single tasks. Design: Prospective population-based follow-up study. Setting: Municipality of Leiden, the Netherlands. Participants: Representative cohort of 380 individuals, all aged 85 at baseline. Measurements: During enrollment, walking time over a 12-meter distance was measured, as well as the verbal fluency to recite names of animals or professions during a 30-second period. In the dual task, performance was assessed when participants combined walking with reciting names. Incidence of falls and fractures was assessed by interviewing participants and checking their medical histories. Results: After 1 year of follow-up, 42% of the participants reported one or more falls, and 4% suffered a fracture. Total walking time, number of steps, and verbal fluency were all strongly related to incident falls (P for trend for all <.01), but dual-task performance was not a better predictor for incident falls than single-task performance. Conclusion: The dual-task test in this study had no predictive value above that of a single-task test to predict falling. Dual tasks with more-sensitive measures of impaired dual-task execution might have better test characteristics. In this study, history of falls and performance on an easy-to-administer single walking task identified old persons at higher risk for falling who could benefit from fall preventive strategies. [source] Cognitive and Functional Decline in Adults Aged 75 and OlderJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2002Sandra A. Black PhD OBJECTIVES: To simultaneously examine the influence of functional disability on the development of cognitive impairment and the influence of cognitive status on the development of functional disability over time and compare findings across ethnic groups. DESIGN: A population-based longitudinal study. SETTING: Galveston County, Texas. PARTICIPANTS: Three hundred sixty-five community-dwelling Hispanic Americans, African Americans, and non-Hispanic whites, aged 75 and older. MEASUREMENTS: Baseline measures included demographics, self-reported chronic medical conditions, functional disability, and cognitive status. Longitudinal measures included functional decline and cognitive decline. RESULTS: Substantial functional decline was associated with each additional error on the mental status measure; substantial cognitive decline was associated with each additional antecedent disability. These findings were evident across all three ethnic groups, even when taking into account the effects of demographic factors and chronic health conditions, although the specific chronic health conditions that influenced cognitive and functional decline were found to vary across the three ethnic groups. CONCLUSION: Our findings suggest that, rather than simply being correlated markers of increasing frailty, cognitive and functional decline appear to influence the development of one another. Clinicians need to be aware of these associations, which may affect the direction of preventive care and rehabilitation in the oldest old. Appropriate intervention may result in the prevention or delay of functional disability and cognitive decline. Awareness of the specific chronic health conditions that increase the risk for cognitive or functional decline in various ethnic groups, and the effect of comorbid disease, may also help efforts to prevent decline in older adults. [source] Telomere length in white blood cells is not associated with morbidity or mortality in the oldest old: a population-based studyAGING CELL, Issue 6 2005Carmen M. Martin-Ruiz Summary Cross-sectional studies have repeatedly suggested peripheral blood monocyte telomere length as a biomarker of aging. To test this suggestion in a large population-based follow-up study of the oldest old, we measured telomere length at baseline in 598 participants of the Leiden 85-plus Study (mean age at baseline 89.8 years). We also obtained second telomere measurements from 81 participants after an average time span of between 3.9 and 12.9 years. Telomere length at baseline was not predictive for mortality (P > 0.40 for all-cause, cardiovascular causes, cancer or infectious diseases, Cox regression for gender-adjusted tertiles of telomere length) or for the incidence of dementia (P = 0.78). Longitudinally, telomere length was highly unstable in a large fraction of participants. We conclude that blood monocyte telomere length is not a predictive indicator for age-related morbidity and mortality at ages over 85 years, possibly because of a high degree of telomere length instability in this group. [source] Successful Aging: Implications for Oral HealthJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2000H. Asuman Kiyak PhD ABSTRACT The past few years have seen a growing emphasis in gerontology on the concept of "successful" or "robust" aging. This represents a major paradigm shift in the field from a focus on declines in physical and social functioning, assumptions of the aging process as a downward spiral, and studies on how to manage these declines. Leading the way toward this new perspective on aging, the MacArthur Studies of Successful Aging asked the fundamental question: "What genetic, biomedical, behavioral, and social factors are crucial to maintaining health and functional capacities in the later years?" These studies examined longitudinally a large cohort of independent elders on several physical, cognitive, emotional, and social parameters. Other researchers have focused on the theme of robust aging; however, common predictors have emerged, such as remaining active physically and cognitively, maintaining social contacts, and avoiding disease. This research is timely, given the expanding population of the oldest old, and with successive cohorts demonstrating the "compression of morbidity" phenomenon. Such a paradigm shift is critical in geriatric dentistry as well, where successful aging is evident in the growing number of older adults who have retained their natural dentition into advanced old age. This presentation draws parallels between successful aging at the systemic and oral health levels, with illustrations from epidemiologic studies that demonstrate trends in improved health and quality of life among newer cohorts of older adults. [source] The Aging Experience of Well Elderly Women: Initial ResultsNURSING & HEALTH SCIENCES, Issue 3 2002Wendy Duggleby In aging research, the concentration of the majority of studies on the effects of disease and other problems has resulted in a view of aging that focuses on losses (Agen, 1998). However, little is actually understood about the aging experience in well elderly women and how they adapt to changes in aging. The purpose of this study was to explore the aging experience among well community-living older women participating in activities at a seniors' center. The specific aims were: (i) describe the experience of aging; and (ii) describe how participants deal with aging. A descriptive qualitative focus group design was used. Fourteen women who attend a seniors' center in a large urban multi-purpose recreation center in north central Texas participated in focus groups based on their age: young,old (65,74); old,old (75,84) and oldest old (85 years of age and older). The focus group interviews were audiotaped, transcribed and analyzed using content analysis methodology. One member from each focus group confirmed the results. All three age groups described changes in interests, loss of friends, loss of spouse, and retirement. The ,old,old' and ,oldest old' groups described physical changes that interfered with ,doing what they did before'. All three groups said the best part about growing older was a sense of freedom and the most difficult was loss of spouse. They all dealt with the changes by maintaining relationships with family and friends, faith, staying physically and mentally active and staying involved. The participants identified seniors' programs as helping them with changes. However, transportation was an issue. They also described how they needed others to be patient with them as they dealt with their changes. [source] Sociodemographic and Health Profiles of the Oldest Old In ChinaPOPULATION AND DEVELOPMENT REVIEW, Issue 2 2002Zeng Yi Unique data from a 1998 healthy longevity baseline survey provide demographic, socio-economic, and health characteristics of the oldest old, aged 80,105, in China. This subpopu-lation is growing rapidly and is likely to need extensive social and health services. A large majority of Chinese oldest old live with their children and rely mainly on children for financial support and care. Most Chinese oldest old had no or very little education. Ability to function independently in daily living declines rapidly and self-rated health declines moderately across the oldest old ages. As compared to their urban counterparts, the rural oldest old have far less pension support, are significantly less educated, and are more likely to be widowed and to rely on children for support. Apart from higher rates of survival, the female oldest old in China are far more disadvantaged than the male oldest old. [source] Dementia incidence continues to increase with age in the oldest old: The 90+ studyANNALS OF NEUROLOGY, Issue 1 2010María M. Corrada ScD Objective The oldest old are the fastest growing segment of the US population, and accurate estimates of dementia incidence in this group are crucial for healthcare planning. Although dementia incidence doubles every 5 years from ages 65 to 90 years, it is unknown if this exponential increase continues past age 90 years. Here, we estimate age- and sex-specific incidence rates of all-cause dementia in people aged 90 years and older, including estimates for centenarians. Methods Participants are from The 90+ Study, a population-based longitudinal study of aging and dementia. Three hundred thirty nondemented participants aged 90 years and older at baseline were followed between January 2003 and December 2007. Age- and sex-specific incidence rates of all-cause dementia were estimated by person-years analysis. Results The overall incidence rate of all-cause dementia was 18.2% (95% confidence interval [CI], 15.3,21.5) per year and was similar for men and women (risk ratio, 0.94; 95% CI, 0.65,1.37). Rates increased exponentially with age from 12.7% per year in the 90,94-year age group, to 21.2% per year in the 95,99-year age group, to 40.7% per year in the 100+-year age group. The doubling time based on a Poisson regression was 5.5 years. Interpretation Incidence of all-cause dementia is very high in people aged 90 years and older and continues to increase exponentially with age in both men and women. Projections of the number of people with dementia should incorporate this continuing increase of dementia incidence after age 90 years. Our results foretell the growing public health burden of dementia in an increasingly aging population. ANN NEUROL 2010;67:114,121 [source] | ||||||||||