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Aging Population (aging + population)
Selected AbstractsGeriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health SystemACADEMIC EMERGENCY MEDICINE, Issue 12 2006Scott T. Wilber MD Abstract Three recently published Institute of Medicine reports, Hospital-Based Emergency Care: At the Breaking Point, Emergency Medical Services: At the Crossroads, and Emergency Care for Children: Growing Pains, examined the current state of emergency care in the United States. They concluded that the emergency medicine system as a whole is overburdened, underfunded, and highly fragmented. These reports did not specifically discuss the effect the aging population has on emergency care now and in the future and did not discuss special needs of older patients. This report focuses on the emergency care of older patients, with the intent to provide information that will help shape discussions on this issue. [source] Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of deathEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010B. JACK phd, bsc (econ), head of research, scholarship JACK B. & O'BRIEN M. (2010) European Journal of Cancer Care19, 636,642 Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death Giving patients with cancer a choice in where they want to die including the choice to die at home if they so wish, underpin the recent UK government policies and is embedded in the End of Life Care Programme. However, this presents increasing challenges for the informal carers particularly with an increasingly aging population. Despite the policy initiatives, there remain a persistent number of patients with cancer who had chosen to die at home being admitted to hospital in the last days and hours of life. A qualitative study using two focus group interviews with community nurses (district nurses and community specialist palliative care nurses) was undertaken across two primary care trusts in the north-west of England. Data were analysed using a thematic analysis approach. The results indicated that informal carer burden was a key reason for prompting hospital admission. Recommendations for the development of a carer assessment tool with appropriate supportive interventions are made. [source] Optimal treatment of hypertension in the elderly: A Korean perspectiveGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2008Kwang-Il Kim With the progression of the aging population, common diseases of the elderly have become the center of attention in most developed countries. Hypertension is one of the most common morbid conditions in the elderly and has a great impact on their health status because it is the main risk factor of cardiovascular and cerebrovascular diseases. However, a considerable amount of uncertainty remains regarding hypertension in the elderly, such as the benefits of hypertension control in oldest-old populations, the optimal level of blood pressure control, and the efficacy of antihypertensive drugs for the prevention of cognitive dysfunction. While there are many controversial issues concerning the optimal management of hypertension in the elderly, the number of elderly hypertensive patients that require treatment is expected to increase due to the aging population. As a result, knowledge regarding the mechanisms of hypertension in the elderly and specific consideration in managing hypertensive elderly patients are needed to improve the clinical outcome. Furthermore, new therapeutic interventions that are aimed at attenuating age-related vascular changes should be investigated, because hypertension in the elderly, especially isolated systolic hypertension has specific characteristics of increased arterial stiffness in most cases. [source] Research use in the care of older people: a survey among healthcare staffINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2006Anne-Marie Boström MSc Background., Sweden has one of the largest proportions of older people in the world. To manage the healthcare needs of an aging population, there has been an alteration from hospital care to community-based care. In these settings, the majority of staff is enrolled nurses (EN) and nurse aides (NA) without university education. Aim and design., The overall aim of this cross-sectional survey was to explore staff perceptions of factors related to research utilization in the care of older people. Method., Questionnaires covering research utilization and demographics were sent to all staff (n = 132) working in seven units in older people care. The response rate was 67% (n = 89). The respondents consisted of ENs/NAs (n = 63), Registered Nurses (RN) and rehabilitation professionals (RP) as physiotherapists and occupational therapists (RN/RP n = 26). Results., Most of staff reported positive attitudes towards research. The RNs/RPs stated more often than the ENs/NAs that they wanted to base their practice on research (81% vs. 25%; P = 0.001). The RNs/RPs also reported a greater extent of research use in daily practice (54% vs. 17%; P = 0.001). Support from colleagues (77% vs. 22%; P < 0.001) and unit managers (73% vs. 10%; P < 0.001) for implementing research findings was also more frequently reported by the RNs/RPs compared with the ENs/NAs. The majority of the ENs/NAs stated Do not know on many items concerning attitudes towards research, support for research utilization and actual use of research. Conclusions., Despite overall positive attitudes towards research, the majority of staff did not use research findings in daily practice. This was particularly valid for the EN/NA group. Relevance to clinical practice., There is an urgent need for managers and others in the care of older people to develop strategies for implementing evidence-based practice that involves the EN/NA group. [source] Burden of stroke in SingaporeINTERNATIONAL JOURNAL OF STROKE, Issue 1 2008N. Venketasubramanian Stroke is Singapore's fourth leading cause of death, with a crude death rate of 40·4/100 000 in 2006, a prevalence of 3·65% and an incidence of 1·8/1000, and is among the top 10 causes of hospitalization. Approximately one-quarter of strokes are hemorrhagic. Hospital care for acute stroke costs about US$5000. Subsidized healthcare is widely available for primary level and hospital care, as are rehabilitative services. A national stroke support group has been established. With our rapidly aging population, coupled with the high prevalence of stroke risk factors in the community, the burden of stroke is expected to increase dramatically in the years to come, posing challenges to the healthcare system and society. A national disease management plan incorporating high-quality clinical care coupled with research would be essential. [source] Comparative Effectiveness Research Priorities at Federal Agencies: The View from the Department of Veterans Affairs, National Institute on Aging, and Agency for Healthcare Research and QualityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2010Timothy J. O'Leary MD In the last year, attention has been focused on translating federally sponsored health research into better health for Americans. Since the passage of the American Recovery and Reinvestment Act (ARRA) on February 17, 2009, ARRA funds to support Comparative Effectiveness Research (CER) have increased this focus. A large proportion of topical areas of interest in CER affects the older segment of the population. The Department of Veterans Affairs (VA), the National Institute on Aging (NIA), and the Agency for Healthcare Research and Quality (AHRQ) have supported robust research portfolios focused on aging populations that meet the varying definitions of CER. This short article briefly describes the research missions of the AHRQ, NIA, and VA. The various definitions of CER as the Congressional Budget Office, the Institute of Medicine, and the ARRA-established Federal Coordinating Council have put forward, as well as important topics for which CER is particularly needed, are then reviewed. Finally, approaches in which the three agencies support CER involving the aging population are set forth and opportunities for future CER research outlined. [source] Which Patients Benefit the Most from a Geriatrician's Care?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2008Consensus Among Directors of Geriatrics Academic Programs Given the anticipated limited availability of geriatricians for the foreseeable future, how should the geriatrician's specialized clinical skills be deployed to optimally benefit the health of our aging population? Directors of geriatrics academic programs (DGAPs) at all 145 U.S. allopathic and osteopathic medical schools were asked this question as part of a winter 2007 on-line survey. The DGAPs were to indicate the types of patients who would most benefit from a geriatrician's services in three practice situations: primary care, consultations, and care in the hospital. The survey response rate was 74.5%. There was high consensus among the DGAPs on the benefits of having a geriatrician care for the most complex and vulnerable older adults in primary care and hospital settings. There was slightly less consensus as to when geriatrics consultations are beneficial. The patient subsets that were viewed as benefiting the most from geriatrician care were aged 85 and older, frailty, geriatric syndromes, severe functional impairment, and complexity. The results of this survey suggest that, because of the predicted shortage of geriatricians, the DGAPs would target geriatricians to work with the most vulnerable older adults. These findings offer the beginning of a consensus statement as to the role of geriatricians in the continuum of American medical care. [source] Caring for Older Americans: The Future of Geriatric MedicineJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue S6 2005American Geriatrics Society Core Writing Group of the Task Force on the Future of Geriatric Medicine In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: ,,To ensure that every older person receives high-quality, patient-centered health care ,,To expand the geriatrics knowledge base ,,To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons ,,To recruit physicians and other healthcare professionals into careers in geriatric medicine ,,To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics. [source] Epidemiology of Anemia in the Elderly: Information on Diagnostic EvaluationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3s 2003Lodovico Balducci MD A rise in the aging population has been predicted, and, as a result, it is expected that the incidence of age-related health conditions will also increase. Although common in the elderly, anemia is often mild and asymptomatic and rarely requires hospitalization. However, untreated anemia can be detrimental, because it is associated with increased mortality, poor health, fatigue, and functional dependence and can lead to cardiovascular and neurological complications. Several factors have been suggested to cause anemia in this population, for example, blood loss or chronic disease. In some cases, the cause is unknown. It has been suggested that this is a result of the presence of comorbid conditions that can mask the symptoms of anemia. Therefore, appropriate diagnosis and management strategies of anemia in the elderly need to be identified, particularly because anemia may indicate the presence of other serious diseases. [source] Development of Geriatric Competencies for Emergency Medicine Residents Using an Expert Consensus ProcessACADEMIC EMERGENCY MEDICINE, Issue 3 2010Teresita M. Hogan MD Abstract Background:, The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes. Objectives:, The objective was to develop a consensus document, "Geriatric Competencies for Emergency Medicine Residents," by identified experts. This is a minimum set of behaviorally based performance standards that all residents should be able to demonstrate by completion of their residency training. Methods:, This consensus-based process utilized an inductive, qualitative, multiphase method to determine the minimum geriatric competencies needed by emergency medicine (EM) residents. Assessments of face validity and reliability were used throughout the project. Results:, In Phase I, participants (n = 363) identified 12 domains and 300 potential competencies. In Phase II, an expert panel (n = 24) clustered the Phase I responses, resulting in eight domains and 72 competencies. In Phase III, the expert panel reduced the competencies to 26. In Phase IV, analysis of face validity and reliability yielded a 100% consensus for eight domains and 26 competencies. The domains identified were atypical presentation of disease; trauma, including falls; cognitive and behavioral disorders; emergent intervention modifications; medication management; transitions of care; pain management and palliative care; and effect of comorbid conditions. Conclusions:, The Geriatric Competencies for EM Residents is a consensus document that can form the basis for EM residency curricula and assessment to meet the demands of our aging population. ACADEMIC EMERGENCY MEDICINE 2010; 17:316,324 © 2010 by the Society for Academic Emergency Medicine [source] Oxysterol-induced osteogenic differentiation of marrow stromal cells is regulated by Dkk-1 inhibitable and PI3-kinase mediated signalingJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 2 2008Christopher M. Amantea Abstract Osteoporosis and its complications cause morbidity and mortality in the aging population, and result from increased bone resorption by osteoclasts in parallel with decreased bone formation by osteoblasts. A widely accepted strategy for improving bone health is targeting osteoprogenitor cells in order to stimulate their osteogenic differentiation and bone forming properties through the use of osteoinductive/anabolic factors. We previously reported that specific naturally occurring oxysterols have potent osteoinductive properties, mediated in part through activation of hedgehog signaling in osteoprogenitor cells. In the present report, we further demonstrate the molecular mechanism(s) by which oxysterols induce osteogenesis. In addition to activating the hedgehog signaling pathway, oxysterol-induced osteogenic differentiation is mediated through a Wnt signaling-related, Dkk-1-inhibitable mechanism. Bone marrow stromal cells (MSC) treated with oxysterols demonstrated increased expression of osteogenic differentiation markers, along with selective induced expression of Wnt target genes. These oxysterol effects, which occurred in the absence of ,-catenin accumulation or TCF/Lef activation, were inhibited by the hedgehog pathway inhibitor, cyclopamine, and/or by the Wnt pathway inhibitor, Dkk-1. Furthermore, the inhibitors of PI3-Kinase signaling, LY 294002 and wortmanin, inhibited oxysterol-induced osteogenic differentiation and induction of Wnt signaling target genes. Finally, activators of canonical Wnt signaling, Wnt3a and Wnt1, inhibited spontaneous, oxysterol-, and Shh-induced osteogenic differentiation of bone marrow stromal cells, suggesting the involvement of a non-canonical Wnt pathway in pro-osteogenic differentiation events. Osteogenic oxysterols are, therefore, important small molecule modulators of critical signaling pathways in pluripotent mesenchymal cells that regulate numerous developmental and post-developmental processes. J. Cell. Biochem. 105: 424,436, 2008. © 2008 Wiley-Liss, Inc. [source] Novel EGF pathway regulators modulate C. elegans healthspan and lifespan via EGF receptor, PLC-,, and IP3R activationAGING CELL, Issue 4 2010Hiroaki Iwasa Summary Improving health of the rapidly growing aging population is a critical medical, social, and economic goal. Identification of genes that modulate healthspan, the period of mid-life vigor that precedes significant functional decline, will be an essential part of the effort to design anti-aging therapies. Because locomotory decline in humans is a major contributor to frailty and loss of independence and because slowing of movement is a conserved feature of aging across phyla, we screened for genetic interventions that extend locomotory healthspan of Caenorhabditis elegans. From a group of 54 genes previously noted to encode secreted proteins similar in sequence to extracellular domains of insulin receptor, we identified two genes for which RNAi knockdown delayed age-associated locomotory decline, conferring a high performance in advanced age phenotype (Hpa). Unexpectedly, we found that hpa-1 and hpa-2 act through the EGF pathway, rather than the insulin signaling pathway, to control systemic healthspan benefits without detectable developmental consequences. Further analysis revealed a potent role of EGF signaling, acting via downstream phospholipase C-,plc-3 and inositol-3-phosphate receptor itr-1, to promote healthy aging associated with low lipofuscin levels, enhanced physical performance, and extended lifespan. This study identifies HPA-1 and HPA-2 as novel negative regulators of EGF signaling and constitutes the first report of EGF signaling as a major pathway for healthy aging. Our data raise the possibility that EGF family members should be investigated for similar activities in higher organisms. [source] First-trimester Down syndrome screening in women younger than 35 years old and cost-effectiveness analysis in Taiwan populationJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2009Ching-Yu Chou MD Summary Objectives, Outcome of the first-trimester Down syndrome screening in younger population was less reported before. We present the outcome of this screening in Taiwanese women younger than 35 years old. We also test whether or not the first-trimester Down syndrome screening of women <35 years of age and women >35 years old routinely receiving amniocentesis is cost-effective compared with all pregnant women screened with this test in the setting of increased maternal age. Methods, From 1999 to 2007, the first-trimester Down syndrome screening including nuchal thickness, pregnancy-associated plasma protein A and free ,-hCG are provided to 10 811 singleton women <35 years of age with the cut-off of 1/270. A cost-effectiveness analysis of young women receiving this screening and older women undergo amniocentesis versus all women undergo this screening was performed in Taiwan population from 1987 to 2006, in which advanced age pregnancies increased from 2.8% to 11.6% of total pregnancies. Results, Detection rates of trisomy 21, trisomy 18, Turner syndrome and other chromosome anormalies in women <35 years of age are 87.5% (14/16), 50% (2/4), 80% (8/10) and 63% (12/19), respectively, with a false-positive rate of 5.5% (590/10 811). As advanced age pregnancies reached 11.6%, the average cost per one case averted for all women screened ranged from $77 204 to $98 421, while the cost ranged from $99 647 to $116 433 for only women <35 years of age receiving this screening. Conclusions, In an aging population, the first-trimester Down syndrome screening should be implemented for all pregnant women when it is available. [source] Food consumption and demographics in Japan: Implications for an aging populationAGRIBUSINESS : AN INTERNATIONAL JOURNAL, Issue 4 2007Mauricio V.L. Bittencourt This study estimates a cross-sectional model based on the Almost Ideal Demand System (AIDS) to examine the determinants of food consumption patterns in Japan over life-cycle periods. The test of structural changes, the analysis of the effects of demographic characteristics, and the estimation of expenditure and price elasticities are conducted from a random sample of 1,281 households from a Japanese household survey in 1997. Results show that each economic or noneconomic factor has a different impact on food consumption over a lifetime. Changes in consumption of some food groups can be explained by price and income effects where others can be explained by demographic characteristics. Financial constraint is not binding and residential location is likely to have little or no impact on predicting consumers' food choices at different periods of their lives. Other key factors that affect consumption pattern include family size, number of children, lifestyle, and health concern. [EconLit citations: C310, D120, D910.] © 2007 Wiley Periodicals, Inc. Agribusiness 23: 529,551, 2007. [source] Demographic change and the demand for environmental regulationJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 1 2002Matthew E. Kahn Environmental regulation in the United States has increased pollution abatement expenditure as a percentage of gross national product from 1.7 percent in 1972 to an estimated 2.6 percent in the year 2000. This rise in regulation has coincided with demographic and economic changes that include rising educational levels, a growing minority population, an aging population, and decreasing employment in polluting industries. This paper examines whether these trends have contributed to increasing aggregate demand for environmental regulation. New evidence on voting on environmental ballots in California, local government environmental expenditures across the United States, and 25 years of congressional voting on environmental issues is examined to document the demographic correlates of environmental support. Minorities and the more educated are more pro-green, whereas manufacturing workers oppose environmental regulation. While demographics help explain observed differences in environmental support and thus can help predict long trends in the "average voter's" environmentalism, environmentalism varies substantially year to year unrelated to population demographics. © 2002 by the Association for Public Policy Analysis and Management. [source] The Aging Dilemma: Is Increasing Longevity Among People With Intellectual Disabilities Creating a New Population Challenge in the Asia-Pacific Region?JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2009Matthew P. Janicki Abstract The Macau Declaration on Ageing for Asia and the Pacific and the Plan of Action on Ageing for Asia and the Pacific provide a framework for defining the needs of the aging population in the Asia-Pacific region. It also served as a stimulus for planning and public commitment to addressing the needs of the region's elderly population, including the needs of each of the nation's adult and aging populations of persons with intellectual disabilities. Within the Asia-Pacific region, the diversity of cultural and economic interests often combines to define how services are provided to their aging populations and both how disabilities are perceived and how national policies reflect these interests in serving people with disabilities. Reports issued by the World Health Organization on improving longevity and promoting healthy aging among people with intellectual and developmental disabilities and the Tampa Scientific Conference on Aging and Intellectual Disabilities on defining health factors help provide the structure for both the consideration of the impact of aging on people with intellectual and developmental disabilities and how national social and public welfare policies can be framed to respond to aging and lifelong disability. [source] Dental care coverage and retirementJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2010Richard J. Manski DDS Abstract Objectives: To examine the convergence of an aging population and a decreased availability of dental care coverage using data from the Health and Retirement Study (HRS). Methods: We calculate national estimates of the number and characteristics of those persons age 51 years and above covered by dental insurance by labor force, retirement status, and source of coverage. We also estimate a multivariate model controlling for potentially confounding variables. Results: We show that being in the labor force is a strong predictor of having dental coverage. For older retired adults not in the labor force, the only source for dental coverage is either a postretirement health benefit or spousal coverage. Conclusions: Dental care, generally not covered in Medicare, is an important factor in the decision to seek dental care. It is important to understand the relationship between retirement and dental coverage in order to identify the best ways of improving oral health and access to care among older Americans. [source] Incidence-based estimates of life expectancy of the healthy for the UK: coherence between transition probabilities and aggregate life-tablesJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2008Ehsan Khoman Summary., Will the UK's aging population be fit and independent, or suffer from greater chronic ill health? Life expectancy of healthy people represents the expected number of years of healthy well-being that a life-table cohort would experience if age-specific rates of mortality and disability prevailed throughout the cohort's lifetime. Robust estimation of this life expectancy is thus essential for examining whether additional years of life are spent in good health and whether life expectancy is increasing faster than the decline of rates of disability. The paper examines a means of generating estimates of life expectancy for people who are healthy and unhealthy for the UK that are consistent with exogenous population mortality data. The method takes population transition matrices and adjusts these in a statistically coherent way so as to render them consistent with aggregate life-tables. [source] Prospective real-time correction for arbitrary head motion using active markersMAGNETIC RESONANCE IN MEDICINE, Issue 4 2009Melvyn B. Ooi Abstract Patient motion during an MRI exam can result in major degradation of image quality, and is of increasing concern due to the aging population and its associated diseases. This work presents a general strategy for real-time, intraimage compensation of rigid-body motion that is compatible with multiple imaging sequences. Image quality improvements are established for structural brain MRI acquired during volunteer motion. A headband integrated with three active markers is secured to the forehead. Prospective correction is achieved by interleaving a rapid track-and-update module into the imaging sequence. For every repetition of this module, a short tracking pulse-sequence remeasures the marker positions; during head motion, the rigid-body transformation that realigns the markers to their initial positions is fed back to adaptively update the image-plane,maintaining it at a fixed orientation relative to the head,before the next imaging segment of k -space is acquired. In cases of extreme motion, corrupted lines of k -space are rejected and reacquired with the updated geometry. High-precision tracking measurements (0.01 mm) and corrections are accomplished in a temporal resolution (37 ms) suitable for real-time application. The correction package requires minimal additional hardware and is fully integrated into the standard user interface, promoting transferability to clinical practice. Magn Reson Med, 2009. © 2009 Wiley-Liss, Inc. [source] IPOS Sutherland Memorial Lecture: psycho-oncology and health care researchPSYCHO-ONCOLOGY, Issue 6 2008Uwe KochArticle first published online: 2 MAY 200 Abstract Remarkable changes of health-care systems, increasing costs of health care and of social inequality in modern societies, an aging population and the increase of chronic illnesses such as cancer implicate various future challenges for the provision of health care. Health-care research aims to improve the effectiveness and efficiency of patient-oriented services involving the evaluation of innovative treatment approaches and settings. It deals with the patients' path through different areas of health-care systems in order to identify significant factors for the provision of quality assurance of structures and resources concerning treatments, processes and health outcomes. Health-care research focusses on three main topics that play an important role for quality management: (1) the admission to health-care services and assessment strategies including indication, utilization and specificity of settings and target groups; (2) the treatment process including the implementation, standardization and flexibility of services and dose-effect relationship of interventions; (3) health-care outcome including effectiveness and efficiency of interventions and services, the cost-benefit relationship and the transfer from research to health-care practice. Given the objectives of health-care research, the topics of health-care research in psychosocial care for cancer patients include the study of structural conditions of psycho-oncological services, the epidemiology of distress and mental disorders and the subjective need of psycho-oncological support in cancer patients, the improvement of psycho-oncological measures and assessment strategies in daily treatment, the study of psycho-oncological interventions under routine conditions, and quality assurance. Requirements of future health-care research and developments of psycho-oncology including aspects of orientation, strategies, health-care equity, and resources are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [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] Demographic Change and Asian Dynamics: Social and Political ImplicationsASIAN ECONOMIC POLICY REVIEW, Issue 1 2009Takashi INOGUCHI J11; D63; F2; H55; H56 This article describes the demographic change and its social and political implications in East and South-East Asia with a trajectory up to 2050. It selectively touches on inequalities, migration, social policy, and international security. In the course of this exercise, I present two hypotheses: one relating to the formation of the new middle class, and the other relating to the geriatric peace argument. The first hypothesis posits that when the growing inequalities in terms of per capita income aggravate the sense of happiness among the low- and middle-income strata as contrasted to high-income strata, the formation of a new middle class becomes more difficult. The second hypothesis posits that when the aging population carries a large demographic weight, it tends to be transformed into strong political voice, which is, in turn, translated into larger government spending on social policy items often accompanied by a likely decline in the defense expenditure budget. These hypotheses paint a provocative picture of East and South-East Asia in the next four decades, especially in the wake of the deepening economic difficulties prevailing over the entire globe. I present these hypotheses for further conceptual elaboration and empirical analysis. [source] The Coming of an Aged Society in Taiwan: Issues and PoliciesASIAN SOCIAL WORK AND POLICY REVIEW, Issue 3 2010Wan-I Lin For most advanced industrialized countries, an aging society has been a national issue since the 1970s. However, Taiwan was not aware of this issue until 1993, the year when the old-age population reached 7.0%. As an aging nation under the definition of the United Nations, the Taiwanese government began to pay more attention to the aging population, and executed several policies in response to this demographic transition. First, this article examines Taiwan's demographic transition from an aging society to an aged society, and its impacts. Second, it demonstrates the responses of Taiwan to the coming of an aged society and explores crucial issues that Taiwanese society is facing. [source] Mandatory retirement and older worker employmentCANADIAN JOURNAL OF ECONOMICS, Issue 3 2004M. Shannon The results suggest that making mandatory retirement illegal would have little effect on the size of the older workforce, and therefore such a policy alone would do little to alleviate problems associated with an aging population and the consequent decline in the share of the population employed. JEL Classification: J26, J88 Retraite obligatoire et emploi des travailleurs plus âgés., Ce mémoire tire profit du fait que les règles de la retraite obligatoire ont varié au Canada dans le temps, et d'une juridiction à l'autre, pour étudier l'impact de ces règles sur la proportion des personnes plus âgées qui travaillent. Les résultats suggèrent que rendre la retraite obligatoire illégale aurait peu d'effet sur la taille de main d',uvre plus âgée, et donc qu'une telle politique en soi ferait peu pour atténuer les problèmes associés au vieillissement de la population et au déclin qui s'ensuit dans la proportion de cette population au travail. [source] Age differences in dual information-processing modes,,§CANCER, Issue S12 2008Implications for cancer decision making Abstract Age differences in affective/experiential and deliberative processes have important theoretical implications for cancer decision making, as cancer is often a disease of older adulthood. The authors examined evidence for adult age differences in affective and deliberative information processes, reviewed the sparse evidence about age differences in decision making, and introduced how dual process theories and their findings might be applied to cancer decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age, particularly when decisions are unfamiliar and the information is numeric. However, age-related adaptive processes, including an increased focus on emotional goals and greater experience, can influence decision making and potentially offset age-related declines. A better understanding of the mechanisms that underlie cancer decision processes in our aging population should ultimately allow us to help older adults to better help themselves. Cancer 2008;113(12 suppl):3556,67. © 2008 American Cancer Society. [source] Comparative Effectiveness Research Priorities at Federal Agencies: The View from the Department of Veterans Affairs, National Institute on Aging, and Agency for Healthcare Research and QualityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2010Timothy J. O'Leary MD In the last year, attention has been focused on translating federally sponsored health research into better health for Americans. Since the passage of the American Recovery and Reinvestment Act (ARRA) on February 17, 2009, ARRA funds to support Comparative Effectiveness Research (CER) have increased this focus. A large proportion of topical areas of interest in CER affects the older segment of the population. The Department of Veterans Affairs (VA), the National Institute on Aging (NIA), and the Agency for Healthcare Research and Quality (AHRQ) have supported robust research portfolios focused on aging populations that meet the varying definitions of CER. This short article briefly describes the research missions of the AHRQ, NIA, and VA. The various definitions of CER as the Congressional Budget Office, the Institute of Medicine, and the ARRA-established Federal Coordinating Council have put forward, as well as important topics for which CER is particularly needed, are then reviewed. Finally, approaches in which the three agencies support CER involving the aging population are set forth and opportunities for future CER research outlined. [source] The Aging Dilemma: Is Increasing Longevity Among People With Intellectual Disabilities Creating a New Population Challenge in the Asia-Pacific Region?JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2009Matthew P. Janicki Abstract The Macau Declaration on Ageing for Asia and the Pacific and the Plan of Action on Ageing for Asia and the Pacific provide a framework for defining the needs of the aging population in the Asia-Pacific region. It also served as a stimulus for planning and public commitment to addressing the needs of the region's elderly population, including the needs of each of the nation's adult and aging populations of persons with intellectual disabilities. Within the Asia-Pacific region, the diversity of cultural and economic interests often combines to define how services are provided to their aging populations and both how disabilities are perceived and how national policies reflect these interests in serving people with disabilities. Reports issued by the World Health Organization on improving longevity and promoting healthy aging among people with intellectual and developmental disabilities and the Tampa Scientific Conference on Aging and Intellectual Disabilities on defining health factors help provide the structure for both the consideration of the impact of aging on people with intellectual and developmental disabilities and how national social and public welfare policies can be framed to respond to aging and lifelong disability. [source] | |||||||||||||||||||||||||||||||