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Potentially inappropriate medication (PIM) is a primary health concern affecting the quality of life of patients over 65. PIM is associated with adverse drug reactions including falls, increased healthcare costs, health services utilization and hospital admissions. Various strategies, clinical guidelines and tools (explicit and implicit) have been developed to tackle this health concern. Despite these efforts, evidence still indicates a high prevalence of PIM in the older adult population. This systematic review explored the practice of using explicit tools to review PIM in hospitalized patients and examined the outcomes of PIM reduction. A literature search was conducted in several databases from their inception to 2019. Original studies that had an interventional element using explicit criteria detecting PIM in hospitalized patients over 65 were included. Descriptive narrative synthesis was used to analyze the included studies. The literature search yielded 6116 articles; 25 quantitative studies were included in this systematic literature review. Twenty were prospective studies and five were retrospective. Approximately, 15,500 patients were included in the review. Various healthcare professionals were involved in reviewing PIM including physicians and hospital pharmacists. Several tools were used to review PIM for hospitalized patients over 65, most frequently Beer’s criteria and the STOPP/START tool. The reduction of PIM ranged from 3.5% up to 87%. The most common PIM were benzodiazepines and antipsychotics. This systematic review showed promising outcomes in terms of improving patient outcomes. However, the reduction of PIM varied in the studies, raising the question of the variance between hospitals in the explicit tools used for review. Additional studies need to be conducted to further investigate the outcomes of reviewing PIM at different levels, as well as assessing the cost-effectiveness of using explicit tools in reducing PIM.

We examined the influence of prospective memory (PM) cue focality in a sample of preschool children. Prior investigations in older populations indicated that focal targets were associated with enhanced PM performance, perhaps through more automatic retrieval processes. Importantly, this influential variable has not been thoroughly explored in younger samples. Over three test sessions, preschool children completed a memory task where they were shown a series of animals. During retrieval, participants were shown all of the animals except for one, and they had to name the missing animal. While engaged in this task, participants in the focal PM condition were instructed to remove particular animals (e.g., spider) from the game if they saw them. In the nonfocal condition, participants were told to remove any animal that was entirely one color (e.g., black) if they saw them during the game. The results demonstrated no difference in PM remembering between focal and nonfocal conditions. These results suggest that the effects of focality may not be present at the beginning stages of PM development. The implications for PM retrieval processes also are discussed.

Until the 1970s the Asia-born population of Australia remained small due to the racist White Australia Policy which denied entry to non-Europeans. Following its abolition in the early 1970s, Asian immigration progressively intensified, and in 2016 the Asia-born population of the country reached a total of 2.7 million, though the older population aged 65+ remained relatively small. This paper presents new projections of Australia's older Asia-born populations from 2016 to 2056 created with a new birthplace projection model. The results show substantial growth of the older Asia-born population can be expected over coming decades, along with changing composition by country of birth. The Asia-born proportion of Australia's older population overall is projected to rise from just 6 per cent in 2016 to 19 per cent in 2056. These coming demographic changes present challenges and opportunities - in particular relating to the provision of culturally appropriate residential and community aged care.

There has been no research in Pakistan about how to improve quality of life (QOL) of aging populations through intergenerational learning. In this study we aimed to deliver an intervention for inte...

Purpose: This study investigated the impact of sex differences on the relationship of subclinical hypothyroidism (SCH) with the prevalence of metabolic syndrome (MetS) and its components in an olde...

The COVID-19 pandemic has profoundly impacted people’s lives globally; this is especially true for the older population. In this exploratory qualitative study 15 in-depth interviews were held to un...

As older individuals are more vulnerable to the virus and are more likely to vote than younger individuals, a state with a higher share of the older population is expected to impose a more stringen...

Purpose The high prevalence of chronic pain and difficulties in pain management in older people are challenging for healthcare providers globally. Patient satisfaction regarding pain management is one of the measures to assess efficacy of pain control as well as healthcare services. Thus, our study aimed to evaluate the older patients' satisfaction with pain management and its associated factors in Vietnam. Patients and methods A cross-sectional study was conducted at National Geriatric Hospital, Hanoi, Vietnam from May to October 2018. Face-to-face interviews were conducted on 495 older patients with chronic pain by using a structured questionnaire. The Pain Treatment Satisfaction Scale (PTSS) was used to assess the level of satisfaction with pain management. A Tobit regression model was used to estimate factors associated with satisfaction toward pain management. Results The mean total satisfaction score was 1.77 (SD= 0.22). Older patients were most satisfied with the aspect of side effects of pain relief medication (mean=0.66, SD=0.56). On the contrary, they were most dissatisfied with information provided about pain and its treatment and efficacy of pain relief medication. Outpatients were less satisfied with information provided, the impact of current medication and pain management in general compared to inpatients. The regression model showed that patients with severe pain tended to be more dissatisfied with pain management than those with no pain. Conclusion This study indicated that the general satisfaction with chronic pain management in older patients was quite good especially in the aspect of pain medication's side effects. However, dissatisfactory factors remained, including information provided about pain and efficacy of current pain medication. Intensive training regarding pain in geriatric care, health education communication for older people, and improved quality of medical services should be performed to ensure the quality of pain management, especially in the older population.

Introduction Recent randomized trials have demonstrated the efficacy of ibrutinib-based therapy in the treatment of patients with CLL. In Alliance A041202, a higher than expected number of unexplained deaths were reported with front-line ibrutinib in a patient population aged at least 65 years compared to ECOG 1912, which included patients up to 70 years of age. Methods Therefore, we conducted a retrospective analysis to investigate whether ibrutinib was associated with a greater mortality in older patients outside of a clinical trial setting. This multicenter analysis was performed by investigators at 20 academic and community practices. Results Amongst the 391 patients included, there was no correlation between age and response rate, PFS, or OS. However, there was a trend to higher rate of deaths in patients >65-years-old (8.7% vs 3.8%, p=0.097), with an increased number of early deaths (13 vs 4, p=0.3). Conclusion These data suggest greater intolerance, and possibly mortality, with ibrutinib in an older population. Patients should be educated regarding the potential complications related to ibrutinib and symptoms of concern to report.

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

Public libraries are critical community facilities through which librarians support their communities before, during, and after natural disasters such as hurricanes. In their disaster responses, pu...

Purpose: To investigate the prevalence of multidimensional frailty in older people with hypertension and to examine a possible relationship of general obesity and abdominal obesity to frailty in older people with hypertension. Patients and Methods: A sample of 995 community-dwelling older people with hypertension, aged 65 years and older and living in Zhengzhou (China), completed the Tilburg Frailty Indicator (TFI), a validated self-report questionnaire for assessing multidimensional frailty. In addition, socio-demographic and lifestyle characteristics were assessed by self-report, and obesity was determined by measuring waist circumference and calculating the body mass index. Results: The prevalence of multidimensional frailty in this older population with hypertension was 46.5%. Using multiple linear regression analysis, body mass index was significantly associated with physical frailty (p = 0.001), and waist circumference was significantly positively associated with multidimensional frailty and all three frailty domains. Older age was positively associated with multidimensional frailty, physical frailty, and psychological frailty, while gender (woman) was positively associated with multidimensional, psychological, and social frailty. Furthermore, comorbid diseases and being without a partner were positively associated with multidimensional, physical, psychological, and social frailty. Of the lifestyle characteristics, drinking alcohol was positively associated with frailty domains. Conclusion: Multidimensional frailty was highly prevalent among Chinese community-dwelling older people with hypertension. Abdominal obesity could be a concern in physical frailty, psychological frailty, and social frailty, while general obesity was concerning in relation to physical frailty.

With its massive older population, China faces challenges related to elderly support and care. One of the proposed solutions is to diversify elderly support systems. Towards this goal, the establis...

While the older population generally and the older workforce in particular has been growing in most countries, scholars have not explored how the work performance of this group is affected by stere...

Aging is one of the most significant social transformations of the twenty-first century. Older populations dramatically shape cities and urbanization, yet remain largely overlooked within geography...

The older population is expected to nearly double across the globe by 2050, and the baby boom cohort is expected to represent at least 20% of the US population by 2030. Geriatric patients will increasingly utilize the health-care system, and therefore surgical and perioperative care must be tailored to this sensitive group given the increased risk for perioperative complications. The literature was reviewed to highlight fundamental components of the preoperative evaluation as well as cardiac, pulmonary, and renal complications. Frailty is a multidimensional process that can lead to the physiologic effects of aging and estimates the risk of perioperative morbidity and mortality better than chronologic age alone. Health-care providers should assess a geriatric patient's cognitive status, decision-making capacity, frailty, advance care planning, medications, and anesthetic approach in a multidisciplinary fashion to ensure optimal care. The risks of postoperative cardiac, pulmonary, and renal complications should be evaluated and optimized preoperatively to reduce the potential for adverse outcomes.

Introduction and objective: With the world's older population continuing to grow, andropause (male menopause or late-onset hypogonadism) is considered as one of the most important issues of this er...

The aim of this systematic literature review (SLR) was to investigate the effect of companion animals (whether simply as pets or used in more formal intervention approaches) on the physical and mental health of older adults (aged 60+).. The reviewers identified key search terms and conducted a systematic search of the PsycINFO and PubMed databases. The 70 articles reviewed were evaluated through tabular and thematic analysis.. In 52 of the studies examined, companion animals positively contributed to the mental and/or physical health of older adults. With respect to mental health, involvement with a companion animal improved participant quality of life and effectively attenuated symptoms of depression, anxiety, cognitive impairment, and the behavioral and psychiatric symptoms of dementia (BPSD). In relation to physical health, marked increases in physical activity and improvements in blood pressure and heart rate variability were the only consistent physical health improvements observed from companion animal interactions.. Animal companionship can benefit the mental and physical health of older adults, although more and better controlled research on this topic is required.. Use of companion animals has the potential to be an effective treatment or adjunct therapy to improve the health status and quality of life of older individuals.

Purpose Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a "real-world" setting. Methods Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline assessments, participants performed 30 minutes of an SSE-intensity session on an outdoor track and a control session, separated by 7-10 days. Heart rate (HR), rating of perceived exertion (RPE), and affective response were assessed. Ambulatory BP was monitored for 20 hours following both sessions. Paired t-tests and generalized estimation were used for data analysis. Results Participants exercised at 5.1±1.1 km/h, spent ~90% of the exercise time at moderate-vigorous intensity (≥40% of heart rate reserve). SSE-intensity session was reported as light (RPE 11.0±1.5) and pleasant (affect 3.4±1.2). SSE-intensity session elicited reductions in systolic BP in the first 6 hours postexercise (6.0 mmHg, CI 2.7-9.3 mmHg; P 0.05). Conclusion An SSE-intensity session elicited a reduction in ambulatory systolic BP in inactive older women with hypertension during awake and 20-hour periods. Also, the SSE-intensity session was reported as light and pleasant.

Objective: Existing research supports a positive relationship between egg intake and cognitive function in older populations, although the impact of whole egg consumption on multi-domain co...

Objective: To consider the relationships between both peripheral and central hearing impairment and cognition. Design: Narrative review. Study sample: Numerous studies exploring the relationship between hearing impairment and cognitive function, particularly in an older population. Results: In addition to the well-documented relationship between peripheral hearing loss and cognition highlighted in previous comprehensive reviews, there is also some evidence to suggest that there is a relationship between central hearing impairment and cognition. Further research is required to better understand this relationship and its effects on hearing aid benefit in people with both peripheral hearing loss and central hearing impairment. Conclusions: To fully understand the relationship between hearing impairment and cognitive impairment, not only peripheral but central hearing needs to be considered. Such knowledge could be of benefit in the clinical management of people with both peripheral hearing loss and central hearing impairment.

Although the proportion of the older population is growing, the majority of research on technology adoption behaviour, such as the adoption of self-service technologies (SSTs), tends to focus on yo...

Objectives: To explore the feasibility of using the video-conferencing program, Skype, on iPads with older adults living in long-term care (LTC) facilities.Method: Using a mixed-method design, six residents from one LTC facility in Queensland, Australia participated in a one-off interactive intervention session, followed by post-session semi-structured interviews. The intervention session involved a 15-minutes training session in using Skype, and 30-minutes interactive practise in making and receiving a call using Skype. Residents were interviewed after the intervention session to explore their experience and perceptions of using Skype on the iPad. Reflections about the intervention session were written as study notes by the research team. Qualitative data were analysed using an inductive, thematic analytic approach.Results: Four broad themes emerged: (1) Video-conferencing on iPads is inhibited by age-related cognitive decline and physical frailty; (2) Video-conferencing is an unfamiliar technology for many older residents, and practice and staff assistance are required; (3) Video-conferencing is regarded positively, and seen as a good way of communicating with family/friends; and (4) Use of video-conferencing highlights general concerns held about privacy and cyber security issues.Conclusion: Without adequate staff assistance, video-conferencing via iPads may be challenging for an older population in LTC. Alternatives such as telepresence robots may assist with these challenges.

Objectives: With over one-fifth of the world’s older population, shrinking family size and increasing number of women in the workforce, elder care is a growing challenge for families in mainland Ch...

As America’s older population continues to grow, more individuals are experiencing cognitive decline in the United States. At the same time, we live in an age where technology has increasingly beco...

COVID-19 pandemic has devastated large urban areas across the country. Most rural areas have so far been able to avoid the initial surge in cases due to the low population density. However, as the pandemic advances, rural areas are at an increased risk for the second wave of the epidemic. Rural areas are especially vulnerable due to the older population, higher comorbidities, and lack of access to healthcare. This field report discusses the experiences and issues faced by the rural Appalachian community during the ongoing COVID-19 pandemic.

Objective: This study was designed with the purpose of determining the relationship between social capital and lifestyle and their sub-variables among older adults. Methods: This is a cross-sectional study using interviews that was conducted in 2017. This study was performed with randomly selected older people over 60 years of age in an urban area of Iran. Data were collected using a questionnaire in 3-month duration. The relationship between the study variables (lifestyle and social capital) was assessed through correlation analysis (in the case of non control of the underlying variables) and general linear modeling (in the case of control of the underlying variables). Data were analyzed using SPSS v.24 software at a 0.05 significant level. Results: A total of 512 questionnaires were filed out. According to the Pearson correlation test, all social capital variables were associated with lifestyle components. However, in the general linear model test, feeling of trust and safety (p < 0.001), value of life (p = 0.030), and social participation (p = 0.004) had a significant relationship with the lifestyle. Conclusions: The results indicated that social capital and lifestyle in the older adults were interconnected. Therefore, there is a need to improve social capital factors, especially social participation, feeling of trust and safety, and value of life, which is in-line with the strategies of achieving healthy older population. The results can be used to learn how to increase lifestyle in older adults.

Background: Older individuals are at high risk for morbidity and mortality due to influenza, and the most effective way to prevent influenza is yearly vaccination. In China, the influenza vaccine is not covered by the national Expanded Program on Immunization, and more evidence is needed about influenza vaccine usage among older individuals. Objective: To determine the influenza vaccination coverage and its influencing factors, and understand barriers to older adults receiving influenza vaccinations in Shanghai, China. Methods: A cross-sectional survey was conducted with residents aged 60 and older. Vaccination status in the 2016–17 influenza season and reasons for or against vaccination were surveyed. The vaccination coverage rates were adjusted by gender, age and community distribution, and potential factors influencing vaccination uptake were determined by bivariate logistic regression. Results: In total, 253 of the 4417 respondents received an influenza vaccine during the 2016–17 season, yielding an adjusted coverage rate of 5.2% (95% CI, 4.5-5.8). The frequency of receiving the vaccine was higher for older individuals living with family/friends than that for those living alone (p < 0.05), and lower among individuals with chronic respiratory diseases (p < 0.05). Among unvaccinated respondents, lack of influenza vaccine awareness was the most common reason for being unvaccinated (48.3%, 2012/4164). Conclusion: Influenza vaccination coverage is extremely low among older people in Shanghai, and lack of awareness of the influenza vaccine might be a potential barrier to vaccination. Our study highlights the need for an appropriate influenza vaccination strategy and program targeting the older population.

Objective: Increasing evidence suggests a reverse J-shaped association between body mass index (BMI) and all-cause mortality among the older population. However, findings from non-Western s...

Online dating has become increasingly popular among older adults following broader social media adoption patterns. The current study examined the visual representations of people on 39 dating sites intended for the older population, with a particular focus on the visualization of the intersection between age and gender. All 39 dating sites for older adults were located through the Google search engine. Visual thematic analysis was performed with reference to general, non-age-related signs (e.g., facial expression, skin color), signs of aging (e.g., perceived age, wrinkles), relational features (e.g., proximity between individuals), and additional features such as number of people presented. The visual analysis in the present study revealed a clear intersection between ageism and sexism in the presentation of older adults. The majority of men and women were smiling and had a fair complexion, with light eye color and perceived age of younger than 60. Older women were presented as younger and wore more cosmetics as compared with older men. The present study stresses the social regulation of sexuality, as only heterosexual couples were presented. The narrow representation of older adults and the anti-aging messages portrayed in the pictures convey that love, intimacy, and sexual activity are for older adults who are "forever young."

Drawing on quantitative data from a large study, we explored service providers' perceptions of the care and support provided to older women from Black and minority ethnic backgrounds living in the UK. Analyzing 102 responses to a questionnaire, we found that the care needs of this group of older women were not adequately addressed, with ineffective communication being frequently reported. A number of information pathways and barriers to service provision were identified. More work is needed to explore not only how best to acknowledge diversity in care needs within older populations, but also to design and deliver responsive services accordingly.

The ethical, logistical, and biological complications of working with an older population of people inherently limits clinical studies of frailty. The recent development of animal models of frailty, and tools for assessing frailty in animal models provides an invaluable opportunity for frailty research. This review summarizes currently published animal models of frailty including the interleukin-10 knock-out mouse, the mouse frailty phenotype assessment tool, and the mouse clinical frailty index. It discusses both current and potential roles of these models in research into mechanisms of frailty, interventions to prevent/delay frailty, and the effect of frailty on outcomes. Finally, this review discusses some of the challenges and opportunities of translating research findings from animals to humans.

Social work curriculum that offers an optimistic perspective on aging has the potential to help social work students go on to practice in a nondiscriminatory way with older adults. This study intro...

Asthma in older populations is characterized by frequent comorbid conditions, which increase the risk of side effects and of detrimental interactions between respiratory and non-respiratory drugs. These observations lead to the need to manage asthma in older populations by applying a multidimensional assessment and a multidisciplinary treatment; therefore, we favor the use of the ‘geriatric’ term to define asthma in the elderly. Geriatric asthma is a complex disease, which may not necessarily imply that it is also complicated, although the two conditions may often coexist. On this basis, the switch from an organ-driven management to the holistic approach may be the key factor to attain optimal control of the disease in this age range. The current review discusses the age-related factors affecting asthma treatment in the oldest individuals, such as the comorbid conditions, and age-related changes of metabolism and excretion that can impair the efficacy and safety of drugs.

It is generally accepted that preadolescents have a limited capacity to develop muscle hypertrophy in response to exercise compared with older populations; however, studies are scarce and conflicting. The main aim of the present study was to assess if playing tennis is associated with the hypertrophy of dominant pectoralis muscles (PM) in professional (PRO) and in prepubescent tennis players (PRE). A secondary aim was to assess if the degree of asymmetry of PM is greater in PRO than PRE. The volume of PM of both sides was determined using magnetic resonance imaging in 8 male PRO (21.9 years), 6 male PRE (11 years, Tanner 1-2) and 12 male non-active controls (6 adults: 23.5 years; and 6 prepubescents: 10.7 years, Tanner 1-2). PRO and PRE had 15 and 30% greater volume, respectively, in the dominant than in the contralateral PM (P

In this study, we analyze the price and time-on-market effects related to the location of the master bedroom within single-family houses. As the “graying” of the U.S. population continues, it seems reasonable to investigate how those demographic changes might impact residential real estate markets. Toward that goal, we analyze sold property data obtained from the multiple listing services of two different markets: one with a relatively younger population and one with a relatively older population. The results indicate that houses with the master bedroom located upstairs exhibit a significant discount in both markets, with a larger discount observed in the market with the older population. The results also indicate that houses with upstairs master bedrooms exhibit reduced marketing time in the market with an older population, but that marketing time is unrelated to master bedroom location in the market with a younger population.

Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

Previous research on senior center attendance has focused mainly on the differences between senior center users and nonusers. However, this study explored the predictors distinguishing 3 categories of senior center users: users, nonusers, and former users. The data for this study were drawn from the 2004 National Survey on Living Status and Social Needs of the Korean Older Population, conducted jointly by the Korea Ministry of Health and Welfare and the Korea Institute for Health and Social Affairs. A total of 3,009 elderly persons aged 65 years and older living in the community were analyzed. Results showed there are significant predictors distinguishing both nonusers from users and nonusers from former users. However, no significant differences were found between former users and users. Overall, this study moderately supports the findings of previous studies and revealed contradictory results for gender, education, and location of residence variables. Older Koreans who are male, educated, social...

Ageism has a negative influence on older peoples’ self-identity and behaviour, forming stereotyped attitudes toward the older population that further aggravate ageism. Volunteerism may reduce ageism by improving older adults’ self-identification. This study examined the association between community volunteering and self-identity, and further explored the relationship between participation level and self-identity among Chinese older adults in Beijing. Logistic regression modelling was applied. After controlling for demographic characteristics, financial security and self-rated health, volunteerism was significantly associated with youthful self-identity. Older people who volunteer at least once a week for no more than two hours at a time are the least likely to identify themselves as being of old age.

Nutrition interventions are important as the older population, most of whom live in the community, increases in size and diversity. They are key to leading a healthy, functional life and mitigating chronic health conditions. The Older Americans Act Nutrition Program served 86.3 million congregate and 137.4 million home-delivered meals to 1.6 million and 850,000 older adults, respectively (2012). Congregate and home-delivered participants were older, poorer, sicker, more functionally impaired, and at a greater risk of institutionalization than the general U.S. older population. The Nutrition Program is publically and privately funded. About 44% of congregate and 30% of home-delivered expenditures are from federal sources, which dropped from $25 per older adult in 1990 to $12 in 2013. Despite multiple funding sources, funding is insufficient for the expanding older population. Health, nutrition, and social service professionals need to coordinate their community-based services to truly help older adults remain in their homes.

The expanding older population is increasingly diverse with regard to, for example, age, income, location, and health. Within transport research, this diversity has recently been addressed in studies that segment the older population into homogeneous groups based on combinations of various demographic, health-related, or transport-related factors. This paper reviews these studies and compares the segments of older people that different studies have identified. First, as a result of a systematic comparison, we identified four generic segments: (1) an active car-oriented segment; (2) a car-dependent segment, restricted in mobility; (3) a mobile multimodal segment; (4) and a segment depending on public transport and other services. Second, we examined the single factors used in the reviewed segmentation studies, with focus on whether there is evidence in the literature for the factors’ effect on older people’s travel behaviour. Based on this, we proposed a theoretical model on how the different determinants work together to form the four mobility patterns related to the identified segments. Finally, based on current trends and expectations, we assessed which segments are likely to increase or decrease in future generations of older people and what should be done to support the multi-optional and independent mobility of older people.

Clinical guidelines may change with time, as more information from topline studies emerges. Calcium plus vitamin D supplementation became routine decades ago, especially in the older population, based on the assumption that it may promote bone health and prevent fractures, and perhaps induce additional favorable health outcomes. During the past years, an ongoing debate defies this paradigm, mainly because of a potential cardiovascular risk on the one hand, and uncertainty in regard to the extent of the beneficial bone effects on the other hand. The following article summarizes the main recent developments, trying to put some order into the controversial information and opinions which have been published in the medical literature. We conclude that the best current evidence supports a primary strategy of obtaining recommended intakes of calcium and vitamin D from dietary sources. But, since most western diets are inadequate in that regard, and since there is no clear evidence of harm from modest supplementation (up to 1000 mg of elemental calcium and 400 IU of vitamin D3), supplementation is appropriate when dietary intake is inadequate.

Indoor air quality (IAQ) affects health particularly in susceptible individuals such as the elderly. It has been estimated that the older population spends approximately 19–20 h/d indoors, and the majority of the elderly spend all of their time indoors in elderly care centers (ECC). Older individuals may be particularly at risk of exposure to detrimental effects from pollutants, even at low concentrations, due to common and multiple underlying chronic diseases that increase susceptibility. This study, aimed to assess the impact of indoor biological agents in 22 ECC located in Porto, was conducted during summer and winter from November 2011 to August 2013 at a total of 141 areas within dining rooms, drawing rooms, medical offices, and bedrooms (including the bedridden). Air sampling was carried out with a microbiological air sampler (Merck MAS-100) and using tryptic soy agar for bacteria and malt extract agar for fungi. The results obtained were compared with the recently revised Portuguese standards. In winter, mean fungi concentration exceeded reference values, while bacteria concentrations were within the new standards in both seasons. The main fungi species found indoors were Cladosporium (73%) in summer and Penicillium (67%) in winter. Aspergillus fumigatus, Aspergillus niger, and Aspergillus flavus, known potential pathogenic/toxigenic species, were also identified. Although the overall rate and mean values of bacteria and fungi found in ECC indoor air met Portuguese legislation, some concern is raised by the presence of pathogenic microorganisms. Simple measures, like opening windows and doors to promote air exchange and renewal, may improve effectiveness in enhancing IAQ. Our current research is supported by the GERIA Project (www.geria.webnode.com), PTDC/SAU-SAP/116563/2010, and a PhD grant (SFRH/BD/72399/2010) from the Foundation for Science and Technology (Fundação para a Ciência e Tecnologia–FCT).

Globally, the need for development of a competent workforce to serve the burgeoning older population is well documented. Persons with degrees in gerontology are prepared to fill positions in this labor market, yet they are not in demand. This research explores the path of professionalization of gerontologists in Canada as a means of increasing their contribution to the aging services workforce. A cross-sectional online survey of aging-service administrators (n = 66) was conducted in Ontario, Canada, to ascertain their perceptions of gerontologists as professionals in the service delivery to older persons. Aging-service administrators show low rates of hiring gerontologists and low knowledge of gerontological competencies. There was a significant (p

Social connections provided through religious participation are associated with subjective well-being in older populations. This study investigated how much of this association can be explained by other social connections, and whether these associations vary by age. A cross-sectional random-sample telephone survey was completed by 1,025 individuals over 55 years of age. The contribution of religious participation was examined using hierarchical multiple regression and ANCOVA analyses for the entire sample and for four age-specific groups: (1) 55–64, (2) 65–74, (3) 75–84, and (4) 85+. Religious participation was found to be a significant predictor of subjective well-being for the oldest and youngest groups.

The acceptable noise level (ANL), a measure of noise tolerance, has been proposed as a predictor for successful hearing aid use. The aims of this study were to obtain normative data, and to evaluate the clinical feasibility and predictive value of an Australian version of the ANL test in an older population.Repeated ANL measurements were presented diotically using earphones. All participants provided demographic information and hearing aid owners were asked about their aid use.A total of 290 older adults were assessed; 166 participants had a hearing impairment and 96 owned a hearing aid.The mean ANL was lower than previously reported. While age and gender had no effect on ANL, a significant, but weak, correlation was found between ANL and hearing loss. The test-retest reliability showed the results were clinically unreliable. In addition, the ANL did not predict hours or pattern of hearing aid use.While the Australian ANL test showed several similar characteristics to previous versions of the test, low test-retest reliability raised questions about its clinical value as a predictor for long-term hearing aid use.

A critical examination of the literature suggests that older African Americans are more likely to be diagnosed with depression, anxiety, and dementia. Assessment is complicated by potential differences in symptom presentation or reporting and a lack of assessment instruments validated for use with ethnically diverse older populations. Disparities in treatment are exacerbated for several reasons, including failure to access formal treatment, differences in symptomatology response to treatment, lack of available mental health resources, and stigma. Results indicate an enhanced awareness and training of the cultural context of mental health should be considered in clinical practice and research.

There is growing interest in the development of ambient assisted living services to increase the quality of life of the increasing proportion of the older population. We report on the Night Optimised Care Technology for UseRs Needing Assisted Lifestyles project, which provides specialised night time support to people at early stages of dementia. This article explains the technical infrastructure, the intelligent software behind the decision-making driving the system, the software development process followed, the interfaces used to interact with the user, and the findings and lessons of our user-centred approach.

The demographic shift towards an older population combined with the increasing demand for self-reliance and community-based care for the elderly calls for a thorough examination of continuing education programs in local communities as a viable means of promoting successful and active aging. This study examined patterns of older adults’ motivations for, and perceived benefits from, participating in a publicly funded local continuing education program in relationship with their gender, income, and self-perceived general health. Six hundred ninety-nine learners over 60 years old were surveyed. The study found both commonalities as well as distinct patterns of difference due to the influence of gender, income, and health. The results of the study provide validation and additional knowledge to buttress previous studies, while underscoring the necessity for further research on older adults’ participation, motivations, and benefits in the intersection with sociodemographic and health factors. The findings of thi...

The important role which older people play in rural community development through their various activities has become a substantive area of interest across social science disciplines, including gerontology, sociology, psychology and human geography. Reflecting the demographic shift of an ageing countryside within many parts of the global north, the future of rural social policy initiatives will increasingly depend on a nuanced appreciation of the social and voluntary activities undertaken by the growing older population. We seek to expand this focus to consider the social value of these practices for both the individual and the particular communities of which they are a part, and make a case for ‘serious leisure theory’ (Stebbins 1982) as a potentially rich seam for exploring these relations. This is put into practice through a case study involving the over 60s residents of a village in rural Wales, and through in-depth interviews we draw attention to their role in securing socio-economic sustainability i...