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Older Individuals (older + individual)
Selected AbstractsInformal Caregiving Time and Costs for Urinary Incontinence in Older Individuals in the United StatesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002Kenneth M. Langa MD OBJECTIVES: To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals. DESIGN: Multivariate regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people aged 70 and older (N = 7,443). SETTING: Community-dwelling older people. PARTICIPANTS: National population-based sample of community-dwelling older people. MEASUREMENTS: Weekly hours of informal caregiving, and imputed cost of caregiver time, for community-dwelling older people who reported (1) no unintended urine loss, (2) incontinence that did not require the use of absorbent pads, and (3) incontinence that required the use of absorbent pads. RESULTS: Thirteen percent of men and 24% of women reported incontinence. After adjusting for sociodemographics, living situation, and comorbidities, continent men received 7.4 hours per week of care, incontinent men who did not use pads received 11.3 hours, and incontinent men who used pads received 16.6 hours (P < .001). Women in these groups received 5.9, 7.6, and 10.7 hours (P < .001), respectively. The additional yearly cost of informal care associated with incontinence was $1,700 and $4,000 for incontinent men who did not and did use pads, respectively, whereas, for women in these groups, the additional yearly cost was $700 and $2,000. Overall, this represents a national annual cost of more than $6 billion for incontinence-related informal care. CONCLUSIONS: The quantity of informal caregiving for older people with incontinence and its associated economic cost are substantial. Future analyses of the costs of incontinence, and the cost-effectiveness of interventions to prevent or treat incontinence, should consider the significant informal caregiving costs associated with this condition. [source] Establishing a Case-Finding and Referral System for At-Risk Older Individuals in the Emergency Department Setting: The SIGNET ModelJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2001Lorraine C. Mion PhD Older emergency department (ED) patients have complex medical, social, and physical problems. We established a program at four ED sites to improve case finding of at-risk older adults and provide comprehensive assessment in the ED setting with formal linkage to community agencies. The objectives of the program are to (1) improve case finding of at-risk older ED patients, (2) improve care planning and referral for those returning home, and (3) create a coordinated network of existing medical and community services. The four sites are a 1,000-bed teaching center, a 700-bed county teaching hospital, a 400-bed community hospital, and a health maintenance organization (HMO) ED site. Ten community agencies also participated in the study: four agencies associated with the hospital/HMO sites, two nonprofit private agencies, and four public agencies. Case finding is done using a simple screening assessment completed by the primary or triage nurse. A geriatric clinical nurse specialist (GCNS) further assesses those considered at risk. Patients with unmet medical, social, or health needs are referred to their primary physicians or to outpatient geriatric evaluation and management centers and to community agencies. After 18 months, the program has been successfully implemented at all four sites. Primary nurses screened over 70% (n = 28,437) of all older ED patients, GCNSs conducted 3,757 comprehensive assessments, participating agency referrals increased sixfold, and few patients refused the GCNS assessment or subsequent referral services. Thus, case finding and community linkage programs for at-risk older adults are feasible in the ED setting. [source] Rejection of Conspecific Eggs in Chaffinches: The Effect of Age and Clutch CharacteristicsETHOLOGY, Issue 6 2004Bård G. Stokke Previous experimental studies have found that the majority of chaffinches, Fringilla coelebs, are able to reject both non-mimetic and mimetic cuckoo eggs and also non-mimetic conspecific eggs. However, interestingly the frequency of rejecters of moderately mimetic conspecific eggs has been found to be only approx. 50%. We examined the possibility that acceptors of moderately mimetic conspecific eggs are first time breeders, because these individuals may lack the experience needed to reject eggs that deviate only slightly from their own eggs. Older individuals, with good knowledge of their own egg appearance, should therefore reject such eggs. We also examined the possibility that acceptors of moderately mimetic eggs have a higher intraclutch variation in egg appearance, which makes it more difficult to recognize such eggs when compared with rejecters. We obtained no support for any age-specific pattern in rejection behaviour. Furthermore, there was no relationship between age and intraclutch variation, or intraclutch variation and rejection behaviour. As there is no evidence of intraspecific brood parasitism in this species, the rejection of any foreign eggs is most probably an adaptation to past cuckoo, Cuculus canorus, parasitism. Acceptance of good and moderately mimetic conspecific eggs is probably due to cognitive limitations, because evolution of a more fine-tuned recognition ability is unnecessary in the absence of intraspecific brood parasitism. [source] Personality traits of Russians from the observer's perspectiveEUROPEAN JOURNAL OF PERSONALITY, Issue 7 2009Jüri Allik Abstract Data were collected by the members of the Russian character and personality survey from 39 samples in 33 administrative areas of the Russian Federation. Respondents (N,=,7065) identified an ethnically Russian adult or college-aged man or woman whom they knew well and rated the target using the Russian observer rating version of the Revised NEO Personality Inventory, which measures neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. Factor analyses within samples showed that the factor structure of an international sample combining data from 50 different cultures was well replicated in all 39 Russian samples. Sex differences replicated the known pattern in all samples, demonstrating that women scored higher than men on most of the neuroticism, openness, agreeableness and conscientiousness facet scales. Cross-sectional analyses demonstrated consistent age differences for four factors: Older individuals compared to younger ones were less extraverted and open but more agreeable and conscientious. The mean levels of traits were similar in all 39 samples. Although in general personality traits in Russians closely followed the universal pattern, some reliable culture-specific effects were also found that future studies can help interpret. Copyright © 2009 John Wiley & Sons, Ltd. [source] A forward application of age associated gray and white matter networks,HUMAN BRAIN MAPPING, Issue 10 2008Adam M. Brickman Abstract To capture patterns of normal age-associated atrophy, we previously used a multivariate statistical approach applied to voxel based morphometry that identified age-associated gray and white matter covariance networks (Brickman et al. [2007]: Neurobiol Aging 28:284,295). The current study sought to examine the stability of these patterns by forward applying the identified networks to an independent sample of neurologically healthy younger and older adults. Forty-two younger and 35 older adults were imaged with standard high-resolution structural magnetic resonance imaging. Individual images were spatially normalized and segmented into gray and white matter. Covariance patterns that were previously identified with scaled subprofile model analyses were prospectively applied to the current sample to identify to what degree the age-associated patterns were manifested. Older individuals were also assessed with a modified version of the Mini Mental State Examination (mMMSE). Gray matter covariance pattern expression discriminated between younger and older participants with high optimal sensitivity (100%) and specificity (90.5%). While the two groups differed in the degree of white matter pattern expression (t (75) = 5.26, P < 0.001), classification based on white matter expression was relatively low (sensitivity = 80% and specificity = 61.9%). Among older adults, chronological age was significantly associated with increased gray matter pattern expression (r (32) = 0.591, P < 0.001) but not with performance on the mMMSE (r (31) = ,0.314, P = 0.085). However, gray matter pattern expression was significantly associated with performance on the mMMSE (r (31) = ,0.405, P = 0.024). The findings suggest that the previously derived age-associated covariance pattern for gray matter is reliable and may provide information that is more functionally meaningful than chronological age. Hum Brain Mapp 2008. © 2007 Wiley-Liss, Inc. [source] Design and Implementation of a Multicenter Trial of Vitamin E in Aging Individuals with Down SyndromeJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2005Paul S. Aisen Abstract, Older individuals with Down syndrome have an extremely high risk of Alzheimer's disease (AD). Advances in understanding the pathophysiology of AD, and the development of effective therapies for individuals with sporadic AD, have raised the possibility that aging Down syndrome individuals may benefit from therapy directed against AD. As no prior large clinical trials had been conducted with this population, the authors launched "A Multicenter Trial of Vitamin E in Aging Individuals with Down Syndrome." The authors describe how they assembled an international group of investigators to develop the infrastructure and methodology for studying the efficacy of therapeutic interventions aimed at slowing the process of AD in Down syndrome. The process of designing and implementing the trial drew together clinical scientists and clinicians from two distinct but overlapping areas: researchers in the areas of Down syndrome and AD therapeutics. The authors review the issues considered and decisions made regarding various aspects of the trial design. [source] Anemia and its impact on function in nursing home residents: What do we know?JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2010CRNP Assistant Professor, Valerie K. Sabol PhD Purpose: To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes. Data Sources: Literature review of current peer-reviewed research articles. Conclusions: In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community-dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes. Implications for Practice: Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence-based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence. [source] Age- and gender-related changes in the temporal-spatial characteristics of forwards and backwards gaitsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2003Dr Yocheved Laufer Head Abstract Background and Purpose Backward walking is used increasingly as a rehabilitation technique for individuals with neurological and orthopaedic impairments. The purpose of the present study was to examine changes in the temporal-spatial characteristics of gait resulting from walking backwards as opposed to forwards, and to determine age and gender effects on these changes. Method Thirty young and 40 aged, independently functioning, subjects were asked to walk forwards and backwards across a computer-based walkway system, providing data on gait velocity, stride length, cadence, swing phase and double support phase. Subjects were divided into groups based on age (young and old) and gender, and each subject was tested under two walking conditions (forwards and backwards). Five temporal-spatial gait parameters were evaluated separately as a function of the three independent variables, with the walking condition repeated for each subject. Results Backwards ambulation is characterized by a slower velocity, shorter stride length and an increased double support phase in both young and older adults. These changes were significantly greater in the older subjects, among whom the swing phase was also decreased. Cadence, however, was not affected by direction of ambulation in either group. The female subjects had a shorter stride length in both movement directions, associated with reduced speed only in backwards ambulation. Conclusions Older individuals are capable of walking backwards for short distances. However, changes in gait characteristics typical to the reversal of movement direction are accentuated with age. These effects must be considered when planning to use backwards ambulation as a rehabilitation technique for older individuals. Copyright © 2003 Whurr Publishers Ltd. [source] Mars and Venus at Twilight: A Critical Investigation of Moralism, Age Effects, and Sex DifferencesPOLITICAL PSYCHOLOGY, Issue 1 2003Daniel Aldrich Analysts have long sought to understand whether women and men have different ethical orientations. Some researchers have argued that women and men consistently make fundamentally different ethical judgments, especially of corruption; others have found no such disparities. This study considered whether an individual's age may also play a role in determining his or her moral judgment. A statistical investigation of interactive effects between gender and age in a nationally representative data set from Japan shows that this interaction functions better as a predictor of moralism than do education or gender alone. Older individuals of both sexes were found to have similar strict moral perceptions; as women and men age, their ethical judgments converge. [source] Recipient Outcomes for Expanded Criteria Living Kidney Donors: The Disconnect Between Current Evidence and PracticeAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009Y. Iordanous Older individuals or those with medical complexities are undergoing living donor nephrectomy more than ever before. Transplant outcomes for recipients of kidneys from these living expanded criteria donors are largely uncertain. We systematically reviewed studies from 1980 to June 2008 that described transplant outcomes for recipients of kidneys from expanded criteria living donors. Results were organized by the following criteria: older age, obesity, hypertension, reduced glomerular filtration rate (GFR), proteinuria and hematuria. Pairs of reviewers independently evaluated each citation and abstracted data on study and donor characteristics, recipient survival, graft survival, serum creatinine and GFR. Transplant outcomes for recipients of kidneys from older donors (,60 years) were described in 31 studies. Recipients of kidneys from older donors had poorer 5-year patient and graft survival than recipients of kidneys from younger donors [meta-analysis of 12 studies, 72% vs. 80%, unadjusted relative risk (RR) of survival 0.89, 95% confidence interval (CI) 0.83,0.95]. In meta-regression, this association diminished over time (1980s RR 0.79, 95% CI 0.65,0.96 vs. 1990s RR 0.91, 95% CI 0.85,0.99). Few transplant outcomes were described for other expanded criteria. This disconnect between donor selection and a lack of knowledge of recipient outcomes should give transplant decision-makers pause and sets an agenda for future research. [source] Use of the first rib for adult age estimation: a test of one methodINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2005H. Kurki Abstract The human first rib is relatively easy to identify and is often preserved, in comparison with elements such as the fourth rib and pubic symphysis. Therefore it is potentially a valuable skeletal element for estimating age in forensic and archaeological contexts. A method of adult age estimation using the first rib (Kunos et al., 1999) is tested on a sample of known age skeletons from the J.C.B. Grant Collection (n,=,29, mean age,=,55.7 years). The high correlation coefficient (r,=,0.69) and moderate coefficient of determination (r2,=,0.47) demonstrate agreement between the known and estimated ages, suggesting that the first rib demonstates morphological changes with age. The inaccuracy and bias are high (all ages inaccuracy,=,10.4 years, bias,=,4.7 years) but comparable to several other age estimation methods in common use. Although the results are not as good for younger age categories (<,50 years: inaccuracy and bias rank ninth of nine age estimation methods), the inaccuracy and bias for the older age categories are relatively low (60,+ years inaccuracy,=,8.9 years, ranks third out of nine; bias,=,,,5.8 years, ranks first out of nine) compared with other age estimation methods. The first rib method is reasonably precise (93% of individuals fall within the limits of agreement of the mean difference between two trials). The first rib method is therefore a useful addition to the methods available for biological profile reconstructions from skeletal remains, especially if it is suspected that the remains represent an older individual. Copyright © 2005 John Wiley & Sons, Ltd. [source] Reassessing the value of nursery areas to shark conservation and managementCONSERVATION LETTERS, Issue 2 2009Michael John Kinney Abstract Concern over declining shark populations has led to an intense interest in their conservation and management. Due to the difficulties involved in managing adult sharks, focus has been placed on young juvenile and neonate age classes that inhabit discrete inshore nursery areas. However, past confusion over what qualifies as a nursery habitat has led to the identification of vast coastal areas as nurseries, making conservation unfeasible. With the establishment of more discerning criteria for nursery area identification such concerns have been somewhat alleviated, but while effort has been put into defining, identifying, mapping, and in some cases protecting nursery areas, little attention has been paid to the practical value of nurseries for the recovery of exploited shark populations. Often neonate and young juveniles are considered the most critical age classes in terms of population stability/recovery, but evidence is mounting that suggests life stages outside the nursery may be more important in this regard. While nursery area protection should remain a component in shark management strategies it will be critical to link early life stage conservation with management strategies that encompass older individuals residing outside nurseries if effective management is to be achieved. [source] Flow cytometric measurement of circulating endothelial cells: The effect of age and peripheral arterial disease on baseline levels of mature and progenitor populationsCYTOMETRY, Issue 2 2006Rebecca Gusic Shaffer Abstract Background: Age and cardiovascular disease status appear to alter numbers and function of circulating endothelial progenitor cells (EPCs). Despite no universal phenotypic definition, numerous studies have implicated progenitors with apparent endothelial potential in local responses to vascular injury and with cardiovascular disease in general. To further define the role of this lineage in peripheral artery disease (PAD), we developed a multiparameter flow cytometry assay to analyze multiple phenotypic definitions of progenitor cells (PCs), EPCs, and mature endothelial cells (ECs) and evaluate effects of age and PAD on baseline levels of each subset. Methods: Blood was collected from young healthy subjects (N = 9, mean age 33 ± 8 years), older healthy subjects (N = 13, mean age 66 ± 8 years), and older subjects with PAD (N = 15, mean age 69 ± 8 years). After ammonium chloride lysis, cells were stained and analyzed on a Becton-Dickinson LSR II with a 5-color antibody panel: FITC-anti-CD31, PE-anti-CD146, PE-anti-CD133, PerCP-Cy5.5-anti-CD3,-CD19,-CD33 (lineage panel), PE-Cy7-anti-CD34, and APC-anti-VEGF-R2. Viability was assessed by propidium iodide exclusion, and only viable, low to medium side scatter lineage-negative singlets were analyzed. In some studies, cells were sorted for morphological studies. Subsets were defined as indicated later. Results: Our results, using a comprehensive flow cytometric panel, indicate that CD133+, CD34+, and CD133+/CD34+ PCs are elevated in younger healthy individuals compared to older individuals, both healthy and with PAD. However, the number of EPCs and mature ECs did not significantly differ among the three groups. Assessment of endothelial colony forming units and dual acLDL-lectin staining supported the flow cytometric findings. Conclusions: We describe a comprehensive flow cytometric method to detect circulating mature and progenitor endothelial populations confirmed by conventional morphological and functional assays. Our findings suggest that aging may influence circulating levels of PCs, but not EPCs or ECs; PAD had no effect on baseline levels of any populations investigated. This study provides the basis for evaluating the potential effects of acute stress and therapeutic intervention on circulating progenitor and endothelial populations as a biomarker for cardiovascular status. © 2005 International Society for Analytical Cytology [source] Beliefs about worry in community-dwelling older adults,DEPRESSION AND ANXIETY, Issue 8 2006Ignacio Montorio Ph.D. Abstract This study examines the association between several kinds of beliefs about worry and generalized anxiety disorder (GAD) severity in a sample of older individuals recruited from a community setting (N=142, mean age=71.0 years, SD=6.0, range=55,88). Beliefs about worry were assessed with a 17-item scale designed for older adults, including three dimensions: Positive Beliefs, Negative Beliefs, and Responsibility. All three dimensions distinguished between people endorsing GAD symptoms and those without GAD symptoms, and only Negative Beliefs had a significant independent weight when regressed on GAD severity, even after controlling for level of trait worry. Results of this study suggest that negative beliefs appear to be strongly related to pathological worry in older adults. These results are consistent with empirical findings in younger adults and potentially support the use of particular interventions in clinical work with older adults with GAD. Depression and Anxiety 23:466,473, 2006. Published 2006 Wiley-Liss, Inc. [source] Recent time trends in levels of self-reported anxiety, mental health service use and suicidal behaviour in StockholmACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010K. Kosidou Kosidou K, Magnusson C, Mittendorfer-Rutz E, Hallqvist J, Gumpert CH, Idrizbegovic S, Dal H, Dalman C. Recent time trends in levels of self-reported anxiety, mental health service use and suicidal behaviour in Stockholm. Objective:, To investigate recent time trends in several indicators of mental ill-health and the patterning of these indicators between genders and younger vs. older individuals in Stockholm County. Method:, Several indicators were used; self-reported anxiety from the Swedish Survey of Living Conditions, information on psychiatric in-patient and out-patient care, attempted and completed suicides from national and regional registers. Gender- and age-specific trends were compared for the time period of 1997,2006. Results:, Self-reported anxiety and psychiatric service use increased among young individuals of both genders, while attempted suicides increased only among young women. By contrast, these indicators decreased or remained stable in the older age group from year 2001 and onwards. Conclusion:, Our data indicate a rising, and highly prevalent, mental ill-health among the young in Stockholm County, a region representative of urbanized, secular Western societies. [source] Prevalence of undiagnosed Type 2 diabetes and impaired fasting glucose in older B ritish men and womenDIABETIC MEDICINE, Issue 6 2005M. C. Thomas Abstract Aim To estimate the prevalence of undiagnosed diabetes and impaired fasting glucose in older British men and women, using the 1999 World Health Organization (WHO) thresholds based on fasting glucose measurements. Methods Participants in the British Regional Heart Study and the British Women's Heart and Health Study were selected from one socially representative general practice in 24 British towns. Included in this analysis were 3736 men and 3642 women aged 60,79 years (predominantly white), who provided a single fasting blood sample at a clinical examination between 1998 and 2001, and who had no previous diagnosis of diabetes. Results Two hundred and eleven men (5.7%) and 190 women (5.2%) had a fasting blood glucose level consistent with the WHO threshold for a diagnosis of diabetes (, 7.0 mmol/l), whilst a further 667 men (17.9%) and 642 women (17.6%) had impaired fasting glucose levels (6.1 , 7 mmol/l). When analyses were restricted to subjects who had fasted for at least 8 h, and whose blood sample was taken before 12.00 h, the predicted prevalence of undiagnosed diabetes (based on two separate measurements) was 6.7% in men and 6.0% in women. The predicted prevalence of impaired fasting glucose (based on two separate measurements) was approximately 20% in both sexes. Conclusions More than one-fifth of older white British men and women have either undiagnosed diabetes or impaired fasting glucose according to new WHO criteria. Strategies for the primary and secondary prevention of Type 2 diabetes among older individuals are urgently needed. [source] Opioid agonist pharmacotherapy in New South Wales from 1985 to 2006: patient characteristics and patterns and predictors of treatment retentionADDICTION, Issue 8 2009Lucy Burns ABSTRACT Aims The aims of this study were to: examine the number and characteristics of patients entering and re-entering opioid replacement treatment between 1985 and 2006, to examine select demographic and treatment correlates of leaving treatment between 1985 and 2000, and to compare retention rates in methadone and buprenorphine maintenance treatment from 2001 to 2006. Design A retrospective cohort study using register data from the Pharmaceutical Drugs of Addiction System. Setting Opioid substitution treatment in New South Wales (NSW), Australia. Participants A total of n = 42 690 individuals prescribed opioid replacement treatment between 1985 and 2006 in NSW. Measurements Client characteristics over time, retention in days in first treatment episode, number of episodes of treatment and proportion switching medication. Findings Overall, younger individuals were significantly more likely to leave their first treatment episode than older individuals. In 2001,06, after controlling for age, sex and first administration point, the hazard of leaving treatment was 1.9 times for those on buprenorphine relative to those on methadone. Retention in treatment varied somewhat across historical time, with those entering during 1995,2000 more likely to leave at an earlier stage than those who entered before that time. Conclusions Retention in treatment appears to fluctuate in inverse proportion to the availability of heroin. Individuals in contemporary treatment are older users with a lengthy treatment history. This study has provided population-level evidence to suggest that retention in methadone and buprenorphine differ in routine clinical practice. Future work might investigate ways in which patient adherence and retention may be improved. [source] Influence of developmental stage on sensitivity to ammonium nitrate of aquatic stages of amphibiansENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 1 2006Manuel E. Ortiz-Santaliestra Abstract In static renewal experiments, we studied how developmental stage influences the effect of ammonium nitrate on embryonic and larval stages of anuran amphibians. The observed lethal effects caused by ammonium nitrate increased with both concentration and duration of exposure. Significant differences were observed in sensitivity to ammonium nitrate as a function of developmental stage in Discoglossus galganoi, Pelobates cultripes, and Bufo calamita. In D. galganoi and P. cultripes, younger individuals displayed greater acute effects from the chemical fertilizer compared with older individuals. For example, 100% of P. cultripes hatchlings died after 4 d of exposure to a nominal concentration of 225.8 mg N-NO3NH4/L, whereas less than 40% of individuals from older larval stages died when exposed to this concentration. A delay of 4 d in the beginning of the exposure to the chemical was enough to cause significant differences in sensitivity. Bufo calamita showed a higher sensitivity in later larval stages after 12 d of exposure. Hyla meridionalis and B. calamita were less sensitive than the other two species. Peak ammonium nitrate concentrations usually occur when amphibians are breeding and, thus, when the most sensitive aquatic stage is in the water. The developmental stage of the test animals should be considered when evaluating the risk of ammonium nitrate to amphibians. [source] Influence of Age and Prior Experience on Territorial Behavior and the Costs of Defense in Male Collared LizardsETHOLOGY, Issue 1 2007Andrew M. Schwartz In polygynous species where males maintain strong interseasonal philopatry to the same breeding territories, older individuals have prior experience defending their areas, whereas younger individuals are defending a territory for the first time. Theoretical and empirical studies predict that under such conditions the cumulative costs of defense may be lower for older experienced males as a consequence of familiarity with environmental and/or social conditions in their particular local habitats. We used quantitative data from focal observational studies and introduction experiments to test the hypothesis that older collared lizard males (Crotaphytus collaris) with prior territorial experience (3 yr+ males) acquire larger territories allowing them to court more, different females, with greater frequency without incurring higher defense costs. Consistent with this hypothesis, 3 yr+ males controlled significantly larger territories and courted more females, without having significantly higher rates of territory patrol, frequencies of advertisement display, or aggressive interactions with same-sex competitors. Moreover, the intensity of responses to size- and age/experience-matched tethered intruders by 3 yr+ males was lower than that by 2 yr males in their first season of territory defense. Our results support the hypothesis that age/prior occupancy of territories lowers defense costs allowing males to defend larger areas and increase opportunities to court females, perhaps increasing mating opportunities. By contrast, 2 yr males may need to respond more aggressively to intruders because their ownership of territories is tenuous as a consequence of shorter territory occupancy. [source] New insights into the pathology of Parkinson's disease: does the peripheral autonomic system become central?EUROPEAN JOURNAL OF NEUROLOGY, Issue 2008A. Probst Recent studies in aged, neurologically unimpaired subjects have pointed to a specific induction site of the pathological process of Parkinson's disease (PD) in the region of the dorsal glossopharyngeus,vagus complex as well as in the anterior olfactory nucleus. From the lower brainstem, the disease process would then pursue an ascending course and involve more rostral brainstem areas, limbic structures, and eventually the cerebral cortex. One barrier to the acceptance of the caudal medullary structures as the induction site of PD pathology is that not all parts of the nervous system have been investigated for the presence of PD-associated lesions in cases of early asymptomatic PD. Using alpha-synuclein immunostaining, we investigated the brain, the sacral, and thoracic autonomic nuclei of the spinal cord as well as several components of the peripheral autonomic nervous system in a autopsy cohort of 98 neurologically unimpaired subjects aged 64 or more. Our data indicate that the autonomic nuclei of the spinal cord and the peripheral autonomic nervous system belong to the most constantly and earliest affected regions next to medullary structures and the olfactory nerves in neurologically unimpaired older individuals, thus providing a pathological basis for early premotor autonomic dysfunctions at a prodromal stage of PD. [source] Is self-reported alcohol consumption associated with osteoporotic mandibular bone loss in women?EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2009Olivia Nackaerts The aim of this study was to determine whether alcohol consumption would predict mandibular bone quality and quantity in a large European female population. In total, 672 middle-aged and elderly women (45,70 yr of age; standard deviation = 6) were recruited in the study. Alcohol consumption was recorded through a self-reported questionnaire. Mandibular cortical width was measured, by five observers, in the mental foramen region on panoramic radiographs. Mandibular bone density, expressed as aluminium thickness, was recorded on intra-oral radiographs. Alcohol consumption was associated with a reduction of mandibular bone density and cortical width. This association was higher in subjects with excessive alcohol consumption, defined in the present study as > 14 units consumed per week. This study showed reduced jaw-bone quality in older individuals and in those with increased alcohol consumption. [source] Late-life insomnia: A reviewGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2009Arne Fetveit Aging is associated with substantial changes in sleep patterns, which are almost always negative in nature. Typical findings in the elderly include a reduction in the deeper stages of sleep and a profound increase in the fragmentation of nighttime sleep by periods of wakefulness. The prevalence of specific sleep disorders increases with age, such as a phase advance in the normal circadian sleep cycle, restless legs syndrome, and obstructive sleep apnea, which is increasingly seen among older individuals and is significantly associated with cardio- and cerebrovascular disease as well as cognitive impairment. Elderly patients with sleep disturbances are often considered difficult to treat; yet, they are among the groups with the greatest need of treatment. Management of sleep disturbances begins with recognition and adequate assessment. Hypnotic drugs have clearly been shown to improve subjective and objective sleep measures in short-term situations, but their role in chronic insomnia still remains to be further defined by research evidence. Non-pharmacological treatments, particularly stimulus control and sleep restriction, are effective for conditioned aspects of insomnia and are associated with a stable, long-term improvement in sleep. This review delineates the common causes of disordered sleep in older individuals, and effective diagnostic approaches and treatments for these conditions. [source] An update on the neuropathology of HIV in the HAART eraHISTOPATHOLOGY, Issue 6 2004J E Bell This review compares the neuropathology of highly active antiretroviral therapy (HAART)-treated HIV+ individuals with the reported central nervous system (CNS) findings from the pre-HAART era. HAART has had considerable success in combating HIV-related immune collapse and has prevented many of the former end-stage complications of AIDS. However, with increased survival times the prevalence of minor HIV-associated cognitive impairment appears to be rising among treated patients and this may be a particular risk for older individuals. HIV encephalitis (HIVE) is still prevalent in treated patients although attenuated forms of HIVE and CNS opportunistic disorders are also observed. Some subjects show very significant CNS lymphocytic infiltrates in the context of HAART-induced immune reconstitution. HIV-associated cognitive impairment correlates best with the increased presence of activated, though not necessarily infected, microglia and CNS macrophages. This suggests that indirect mechanisms of neuronal injury and loss occur in HIV/AIDS as a basis for dementia since neurones are not themselves productively infected. Research to elucidate the mechanisms of neuronal injury in HIV/AIDS may contribute to the understanding of CNS function not only in HAART-treated subjects but also in other neurodegenerative disorders. [source] Depression status as a reliable predictor of functional decline among Japanese community-dwelling older adults: a 12-year population-based prospective cohort studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2009Hajime Iwasa Abstract Objective This study aimed to examine a longitudinal relationship between depression status and functional decline among Japanese community-dwelling older adults, using a 12-year population-based, prospective cohort study design. Method A total of 710 men and women, aged 65 years and over, participated in the study. Katz's Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence were used to measure the functional capacities of basic activities of daily living (BADL) and higher-level competence, respectively. For the purpose of analysis, a decline in each subscale of functional capacity during the follow-up period were used as outcome variables; depression status assessed by the Japanese version of the 30-item Geriatric Depression Scale (GDS), with a cut-off of 11, was used as an independent variable; and age, gender, education level, history of chronic disease, hospitalization, smoking, physical activity, living alone, hearing problems, physical pain, dietary habits, and usual walking speed at baseline were used as covariates. Results Use of the multivariate Cox proportional hazards model adjusted for potential confounders showed that depression status was significantly and independently associated with BADL decline (risk ratio (RR),=,1.46, 95% confidence interval (CI): 1.13,1.89) and with higher-level competence decline (RR,=,1.56, 95% CI: 1.18,2.04). Conclusion Our study found an independent relationship between depression status and longitudinal change in functional capacity among community-dwelling older individuals, suggesting that depression status is a reliable predictor of functional decline (both of BADL decline and higher-level competence decline) in older adults. Copyright © 2009 John Wiley & Sons, Ltd. [source] The diagnostic value of tau protein, ,-amyloid (1,42) and their ratio for the discrimination of alcohol-related cognitive disorders from Alzheimer's disease in the early stagesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2005Elisabeth Kapaki Abstract Background Chronic and heavy alcohol abuse or dependence may result in impaired cognition and dementia. The increased risk of Alzheimer's disease (AD) in older individuals interferes with the differential diagnosis, especially when dealing with elderly patients with a long history of alcohol abuse. The aim of the present study was to evaluate the diagnostic value of the putative cerebrospinal fluid (CSF) biomarkers tau, ,-amyloid 1,42 (A,42) and their ratio in differentiating alcohol related cognitive disorder (ARCD) from AD. Methods Double-sandwich ELISA (Innotest htau antigen and ,-Amyloid (1,42), Innogenetics) were used to quantify the above markers in a total of 20 patients with ARCD, 33 AD patients with mild to moderate dementia and 50 mentally intact subjects. Results Tau protein successfully differentiated AD from normal ageing with 96% specificity and 93.9% sensitivity and from ARCD with 95% specificity, and 87.9% sensitivity. A,42 alone had a specificity of 88% and a sensitivity of 69.7% in differentiating AD from normal ageing, while the corresponding values for differentiating AD from ARCD were 80% and 84.8% respectively. The tau/A,42 ratio was better than tau alone for differentiating AD from normal ageing (specificity 94%, sensitivity 97%) and better than any of the candidate markers alone, for differentiating AD from ARCD (specificity 100%, sensitivity 97%). Conclusions The combined use of CSF tau and A,42 may be a useful tool in the differential diagnosis of ARCD from AD, especially in the early stages, where diagnostic uncertainty is greater. Copyright © 2005 John Wiley & Sons, Ltd. [source] Hyperostosis Frontalis Interna and sex identification of two skeletons from the Early Middle Ages necropolis of Vicenne-Campochiaro (Molise, Italy)INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 6 2006M. G. Belcastro Abstract Lesions attributable to Hyperostosis Frontalis Interna (HFI) were examined in two skulls (from graves 100 and 113) from the Early Middle Ages necropolis of Vicenne-Campochiaro (Molise, Italy). Both skeletons were of older individuals and it was difficult to sex them using standard anthropological methods. We discuss the sex identification of the skeletons in relation to the presence of HFI, as well as the usefulness of this pathological condition as a sex marker, underlining the importance of the relationship between palaeopathological and clinical-forensic studies. Our study is a further contribution to the case history of HFI in osteoarchaeological material. Copyright © 2006 John Wiley & Sons, Ltd. [source] Established ways to keep donor's interest aliveISBT SCIENCE SERIES: THE INTERNATIONAL JOURNAL OF INTRACELLULAR TRANSPORT, Issue n1 2010J. Ringwald Background, The future demographic changes will be associated with an enhancement of the worldwide shortage of blood. The ageing of the population in developed countries is associated with a decrease in young individuals being potentially eligible to donate blood and an increase in older individuals who might be in the need of blood transfusion. Therefore, the retention of active blood donors (BD) is becoming more important. A substantial increase in blood donations could be achieved by a relatively small increase in BD return. It is the task of blood donation services (BDSs) to elaborate specific and adequate measures to increase the BD's likelihood to return. Successful BD retention programmes are viable to ensure a sufficient supply with blood and blood components at present and the upcoming years. Aims, To give recommendations for BD retention strategies based on a survey of potential and established measures how BD's interest could be kept alive. Methods, With focus on the last decade, literature about internal and external influences on BD's intention to regular blood donation and their actual return behaviour was reviewed. Furthermore, a special aspect was drawn on published articles about established or potential measures to increase BD's return-rate. Based on this information, different ways how BD's interest could be kept alive were suggested. Results, Overall, individuals of younger age (< 30,40 years), women, those with a lower education level are less likely to return to blood donation. External influences of friends, family or co-workers are import for starting a BD career. To become a committed BD, however, a high level of intrinsic motivation is needed. To keep BD's interest alive for a long time, BDSs should focus on the following to increase the satisfaction of the BD: Make blood donation a good experience and as convenient as possible, reduce adverse events and anxiety, and train and motivate your staff. This could be further supported by an intensive and active communication with the BDs right from the start, the application of loyalty builders to establish BD identity, and the appropriate use of incentives. Finally, temporarily deferred BDs should ask to return personally and advertisement programmes for repeat BDs should appeal on personal motivation and moral norms. However, BDS should always try to adapt their measures on their target population considering that people are different all around the world. Moreover, some promotion programmes should be even tailored for distinct subgroups of BDs to have a successful outcome. Conclusions, There is quite a number of ways to keep BDs interest alive and to start a career as a regular and committed BD. In this context, the self-identification as a BD is definitely of major importance. BDSs are challenged to support this developmental process. They have to make sure that blood donation is associated with a good experience for the BD, making him or her feeling good and happy. [source] Effect of Fish Oil Supplementation on Quality of Life in a General Population of Older Dutch Subjects: A Randomized, Double-Blind, Placebo-Controlled TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Ondine Van De Rest MSc OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS: Three hundred two individuals aged 65 and older without depression or dementia. INTERVENTION: 1,800 mg/d EPA-DHA (n=96), 400 mg/d EPA-DHA (n=100), or placebo capsules (n=106) for 26 weeks. MEASUREMENTS: QOL was assessed using the short version of the World Health Organization QOL questionnaire (WHOQOL-BREF). The WHOQOL-BREF covers four domains: physical health, psychological health, social relationships, and satisfaction with environment. The total score range is 26 to 130, with higher scores indicating a more favorable condition. RESULTS: Mean age of the participants was 70, and 55% were male. Plasma concentrations of EPA-DHA increased 238% in the high-dose and 51% in the low-dose EPA-DHA group, reflecting excellent adherence. Median baseline total WHOQOL scores ranged from 107 to 110 in the three groups and were not significantly different from each other. After 26 weeks, the mean difference from placebo was ,1.42 (95% confidence interval (CI)=,3.40,0.57) for the high-dose and 0.02 (95% CI=,1.95,1.99) for the low-dose fish oil group. Treatment with 1,800 mg or 400 mg EPA-DHA did not affect total QOL or any of the separate domains after 13 or 26 weeks of intervention. CONCLUSION: Supplementation with high or low doses of fish oil for 26 weeks did not influence the QOL of healthy older individuals. [source] Increasing Dietary Protein Requirements in Elderly People for Optimal Muscle and Bone HealthJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2009Erin Gaffney-Stomberg MS Osteoporosis and sarcopenia are degenerative diseases frequently associated with aging. The loss of bone and muscle results in significant morbidity, so preventing or attenuating osteoporosis and sarcopenia is an important public health goal. Dietary protein is crucial for development of bone and muscle, and recent evidence suggests that increasing dietary protein above the current Recommended Dietary Allowance (RDA) may help maintain bone and muscle mass in older individuals. Several epidemiological and clinical studies point to a salutary effect of protein intakes above the current RDA (0.8 g/kg per day) for adults aged 19 and older. There is evidence that the anabolic response of muscle to dietary protein is attenuated in elderly people, and as a result, the amount of protein needed to achieve anabolism is greater. Dietary protein also increases circulating insulin-like growth factor, which has anabolic effects on muscle and bone. Furthermore, increasing dietary protein increases calcium absorption, which could be anabolic for bone. Available evidence supports a beneficial effect of short-term protein intakes up to 1.6 to 1.8 g/kg per day, although long-term studies are needed to show safety and efficacy. Future studies should employ functional measures indicative of protein adequacy, as well as measures of muscle protein synthesis and maintenance of muscle and bone tissue, to determine the optimal level of dietary protein. Given the available data, increasing the RDA for older individuals to 1.0 to 1.2 g/kg per day would maintain normal calcium metabolism and nitrogen balance without affecting renal function and may represent a compromise while longer-term protein supplement trials are pending. J Am Geriatr Soc 57:1073,1079, 2009. [source] Agreement Between Nosologist and Cardiovascular Health Study Review of Deaths: Implications of Coding DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2009Diane G. Ives MPH OBJECTIVES: To compare nosologist coding of underlying cause of death according to the death certificate with adjudicated cause of death for subjects aged 65 and older in the Cardiovascular Health Study (CHS). DESIGN: Observational. SETTING: Four communities: Forsyth County, North Carolina (Wake Forest University); Sacramento County, California (University of California at Davis); Washington County, Maryland (Johns Hopkins University); and Pittsburgh, Pennsylvania (University of Pittsburgh). PARTICIPANTS: Men and women aged 65 and older participating in CHS, a longitudinal study of coronary heart disease and stroke, who died through June 2004. MEASUREMENTS: The CHS centrally adjudicated underlying cause of death for 3,194 fatal events from June 1989 to June 2004 using medical records, death certificates, proxy interviews, and autopsies, and results were compared with underlying cause of death assigned by a trained nosologist based on death certificate only. RESULTS: Comparison of 3,194 CHS versus nosologist underlying cause of death revealed moderate agreement except for cancer (kappa=0.91, 95% confidence interval (CI)=0.89,0.93). kappas varied according to category (coronary heart disease, kappa=0.61, 95% CI=0.58,0.64; stroke, kappa=0.59, 95% CI=0.54,0.64; chronic obstructive pulmonary disease, kappa=0.58, 95% CI=0.51,0.65; dementia, kappa=0.40, 95% CI=0.34,0.45; and pneumonia, kappa=0.35, 95% CI=0.29,0.42). Differences between CHS and nosologist coding of dementia were found especially in older ages in the sex and race categories. CHS attributed 340 (10.6%) deaths due to dementia, whereas nosologist coding attributed only 113 (3.5%) to dementia as the underlying cause. CONCLUSION: Studies that use only death certificates to determine cause of death may result in misclassification and potential bias. Changing trends in cause-specific mortality in older individuals may be a function of classification process rather than incidence and case fatality. [source] | |||||||||||||||||||||||||||||||||||||||||||