Current Gerontology and Geriatrics Research The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study Tue, 10 May 2016 06:14:55 +0000 Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed. Seraina Obrist, Slavko Rogan, and Roger Hilfiker Copyright © 2016 Seraina Obrist et al. All rights reserved. Do Aging and Tactile Noise Stimulation Affect Responses to Support Surface Translations in Healthy Adults? Tue, 19 Apr 2016 13:49:15 +0000 Appropriate neuromuscular responses to support surface perturbations are crucial to prevent falls, but aging-related anatomical and physiological changes affect the appropriateness and efficiency of such responses. Low-level noise application to sensory receptors has shown to be effective for postural improvement in a variety of different balance tasks, but it is unknown whether this intervention may have value for improvement of corrective postural responses. Ten healthy younger and ten healthy older adults were exposed to sudden backward translations of the support surface. Low-level noise (mechanical vibration) to the foot soles was added during random trials and temporal (response latency) and spatial characteristics (maximum center-of-pressure excursion and anterior-posterior path length) of postural responses were assessed. Mixed-model ANOVA was applied for analysis of postural response differences based on age and vibration condition. Age affected postural response characteristics, but older adults were well able to maintain balance when exposed to a postural perturbation. Low-level noise application did not affect any postural outcomes. Healthy aging affects some specific measures of postural stability, and in high-functioning older individuals, a low-level noise intervention may not be valuable. More research is needed to investigate if recurring fallers and neuropathy patients could benefit from the intervention in postural perturbation tasks. Marius Dettmer, Amir Pourmoghaddam, Beom-Chan Lee, and Charles S. Layne Copyright © 2016 Marius Dettmer et al. All rights reserved. Associations between Tactile Sensory Threshold and Postural Performance and Effects of Healthy Aging and Subthreshold Vibrotactile Stimulation on Postural Outcomes in a Simple Dual Task Sun, 10 Apr 2016 11:36:12 +0000 Specific activities that require concurrent processing of postural and cognitive tasks may increase the risk for falls in older adults. We investigated whether peripheral receptor sensitivity was associated with postural performance in a dual-task and whether an intervention in form of subthreshold vibration could affect performance. Ten younger (age: 20–35 years) and ten older adults (70–85 years) performed repeated auditory-verbal 1-back tasks while standing quietly on a force platform. Foot sole vibration was randomly added during several trials. Several postural control and performance measures were assessed and statistically analyzed (significance set to -levels of .05). There were moderate correlations between peripheral sensitivity and several postural performance and control measures ( to .59). Several postural performance measures differed significantly between older and younger adults (); addition of vibration did not affect outcome measures. Aging affects healthy older adults’ performance in dual-tasks, and peripheral sensitivity may be a contributor to the observed differences. A vibration intervention may only be useful when there are more severe impairments of the sensorimotor system. Hence, future research regarding the efficacy of sensorimotor interventions in the form of vibrotactile stimulation should focus on older adults whose balance is significantly affected. Marius Dettmer, Amir Pourmoghaddam, Beom-Chan Lee, and Charles S. Layne Copyright © 2016 Marius Dettmer et al. All rights reserved. A Study on Mortality Profile among Fifty Plus- (50+-) Population (FPP) of India: A 5-Year Retrospective Study at New Delhi District Thu, 03 Mar 2016 06:37:36 +0000 Objectives. To find out the mortality profile vis-a-vis different epidemiological factors at the time of autopsy among the 50+-Population. Material and Method. A five-year retrospective evaluation of medicolegal records between 2006 and 2010 was done at Lady Hardinge Medical College, New Delhi. Results. A total of 493 (17.78%) cases belonged to 50+-Population age group out of total 2773 autopsies performed. The proportion of unidentified/unknown persons among this age group was 36.51%. The unnatural and natural causes constituted 44.62% and 55.38% cases, respectively. The unspecified pneumonitis (50.18%) was reported as the commonest cause followed by coronary artery disease and respiratory tuberculosis among natural ones and the transport accident (57.27%) followed by accidental and intentional self-poisoning and exposure to noxious substances and falls among the unnatural ones. Conclusion. The findings reveal that this age group most commonly dies of natural causes rather than the unnatural ones even in autopsy cases. They have definite cure with timely interventions. The study also points out the need to devise the road and home safety measures to reduce mortality among the study population. B. L. Chaudhary, Raghvendra K. Vidua, Arvind Kumar, and Amrita V. Bajaj Copyright © 2016 B. L. Chaudhary et al. All rights reserved. Bone Mineral Density in the Noninstitutionalized Elderly: Influence of Sociodemographic and Anthropometric Factors Wed, 02 Mar 2016 10:16:28 +0000 Objective. Analysis of bone mineral density (BMD) in the elderly and its associated factors according to sex. Methods. A cross-sectional study is presented herein, with a random sample of 132 noninstitutionalized elderly people. Individuals who did not use diuretics were excluded. BMD was obtained from examination of total body densitometry and its association with sociodemographic variables, lifestyle, anthropometric, and body composition was verified. Results. Mean BMD for men was  g/cm2 and for women was  g/cm2. Higher education was associated with higher BMD values ​​in men (). There was a reduction in BMD in the age group 75–79 years of age in women and over 80 years of age in men (). Underweight was associated with significantly low BMD for both sexes (), while normal weight was associated with low BMD in women (). Discussion. The elderly with low schooling and in older age groups are more probable to also present low BMD. Lower levels of body mass index also indicated towards low BMD. Ellen Cristina de Sousa e Silva Araujo, Valéria Pagotto, and Erika Aparecida Silveira Copyright © 2016 Ellen Cristina de Sousa e Silva Araujo et al. All rights reserved. Clinical Screening Tools for Sarcopenia and Its Management Thu, 04 Feb 2016 13:25:01 +0000 Sarcopenia, an age-related decline in muscle mass and function, is affecting the older population worldwide. Sarcopenia is associated with poor health outcomes, such as falls, disability, loss of independence, and mortality; however it is potentially treatable if recognized and intervened early. Over the last two decades, there has been significant expansion of research in this area. Currently there is international recognition of a need to identify the condition early for intervention and prevention of the disastrous consequences of sarcopenia if left untreated. There are currently various screening tools proposed. As yet, there is no consensus on the best tool. Effective interventions of sarcopenia include physical exercise and nutrition supplementation. This review paper examined the screening tools and interventions for sarcopenia. Solomon C. Y. Yu, Kareeann S. F. Khow, Agathe D. Jadczak, and Renuka Visvanathan Copyright © 2016 Solomon C. Y. Yu et al. All rights reserved. Gun Access and Safety Practices among Older Adults Tue, 02 Feb 2016 08:04:26 +0000 Background. Given high rates of gun ownership among older adults, geriatric providers can assess firearm safety practices using a “5 Ls” approach: Locked; Loaded; Little children; feeling Low; and Learned owner. This study describes gun access and the “5 Ls” among US older adults. Methods. Data on the “5 Ls” from the Second Injury Control and Risk Survey (ICARIS-2), a national telephone survey conducted by the Centers for Disease Control and Prevention, were analyzed. Weighted variables were used to generate national estimates regarding prevalence of gun ownership and associated gun safety among older adults (≥55 years). Results. Of 2939 older adults, 39% (95% CI 37%–42%) reported ≥1 gun stored at home. Among those with guns at home, 21% (95% CI 18–24%) stored guns loaded and unlocked; 9.2% (95% CI 6.6–12%) had ≥1 child in household; 5.1% (95% CI 3.5–6.8%) reported past-year suicidal ideation and 3.6% (95% CI 2.1–5.2%) reported history of a suicide attempt; and 55% (95% CI 51–59%) stated that ≥1 adult had attended firearm safety workshop. Conclusion. Some older adults may be at elevated risk of firearm injury because of storage practices, suicidal thoughts, or limited safety training. Future work should assess effective approaches to reduce the risk of gun-related injuries among older adults. Hillary D. Lum, Hanna K. Flaten, and Marian E. Betz Copyright © 2016 Hillary D. Lum et al. All rights reserved. Caregiver Stigma and Burden in Memory Disorders: An Evaluation of the Effects of Caregiver Type and Gender Thu, 28 Jan 2016 12:48:55 +0000 Despite considerable gains in public awareness of dementia, dementia patients and their caregivers continue to be stigmatized. Previous work has explored stigma and burden among adult children of persons with dementia in Israel, but no similar data exist for spousal caregivers or caregivers in general in the United States. This study examines the differences in stigma and burden experienced by spousal and adult child caregivers and male and female caregivers of persons with dementia. Eighty-two caregivers were given the Zarit Burden Inventory Short Form (ZBI) and the Caregiver Section of the Family Stigma in Alzheimer’s Disease Scale (FS-ADS-C). Scores on the FS-ADS-C and ZBI were positively correlated (, ). Female caregivers reported experiencing more stigma on the FS-ADS-C ( = −4.37, ) and more burden on the ZBI ( = −2.68, ) compared to male caregivers, and adult child caregivers reported experiencing more stigma on the FS-ADS-C ( = −2.22, ) and more burden on the ZBI ( = −2.65, ) than spousal caregivers. These results reinforce the importance of support for caregivers, particularly adult child and female caregivers who may experience higher levels of stigma and burden. Phoebe V. Kahn, Heather A. Wishart, Jennifer S. Randolph, and Robert B. Santulli Copyright © 2016 Phoebe V. Kahn et al. All rights reserved. Subjective Memory Complaint and Depressive Symptoms among Older Adults in Portugal Thu, 31 Dec 2015 07:16:05 +0000 Background. Older adults report subjective memory complaints (SMCs) but whether these are related to depression remains controversial. In this study we investigated the relationship between the SMCs and depression and their predictors in a sample of old adults. Methods. This cross-sectional study enrolled 620 participants aged 55 to 96 years (74.04 ± 10.41). Outcome measures included a sociodemographic and clinical questionnaire, a SMC scale (QSM), a Geriatric Depression Scale (GDS), a Mini-Mental Status Examination (MMSE), and a Montreal Cognitive Assessment (MoCA). Results. The QSM mean total score for the main results suggests that SMCs are higher in old adults with depressed symptoms, comparatively to nondepressed old adults. The GDS scores were positively associated with QSM but negatively associated with education, MMSE, and MoCA. GDS scores predicted almost 63.4% of variance. Scores on QSM and MoCA are significantly predicted by depression symptomatology. Conclusion. Depression symptoms, lower education level, and older age may be crucial to the comprehension of SMCs. The present study suggested that depression might play a role in the SMCs of the older adults and its treatment should be considered. Mónica Sousa, Anabela Pereira, and Rui Costa Copyright © 2015 Mónica Sousa et al. All rights reserved. A Cross-Sectional Study of Self-Rated Health among Older Adults: Association with Drinking Profiles and Other Determinants of Health Wed, 30 Dec 2015 11:52:03 +0000 This study compares the relationship between drinking profiles and self-rated health with and without adjusting for other determinants of health among a sample of older adults from the general population. Respondents were 1,494 men and 2,176 women aged between 55 and 74 from the GENACIS Canadian survey. The dependent variable was self-rated health, an individual’s perception of his or her own general health, a measure used as a proxy for health status. The independent variables were drinking profiles (types of drinkers and nondrinkers) as well as other demographic, psychosocial, and health-related variables (control variables). After adjustment for other determinants of health, regression analyses showed that (1) frequent/moderate drinkers were more likely to have a better self-rated health compared with nondrinkers (lifetime abstainers and former drinkers) and (2) self-rated health did not differ significantly between frequent/moderate drinkers and other types of drinkers (frequent/nonmoderate and infrequent drinkers). Our results suggest that drinking is related to a better self-rated health compared with nondrinking regardless of the drinking profile. Drinking and healthy lifestyle guidelines specific to older adults should be studied, discussed, and integrated into public health practices. Pascale Audrey Moriconi and Louise Nadeau Copyright © 2015 Pascale Audrey Moriconi and Louise Nadeau. All rights reserved. Indirect Fist Percussion of the Liver Is a More Sensitive Technique for Detecting Hepatobiliary Infections than Murphy’s Sign Tue, 15 Dec 2015 09:52:28 +0000 Background. Murphy’s sign and Charcot’s triad are established clinical findings of acute cholecystitis and cholangitis, respectively, but both show low sensitivity and limited clinical application. We evaluated if indirect fist percussion of the liver improves the efficiency of diagnosing cholecystitis and cholangitis when used as a diagnostic adjunct. Methods. The presence/absence of right upper quadrant (RUQ) tenderness, Murphy’s sign, and pain induced by indirect fist percussion of the liver was assessed, and the results were compared with the definite diagnosis based on ultrasound and additional examinations in patients aged over 18 who visited our outpatient clinic with suspected hepatobiliary diseases. Results. Four hundred and eight patients were investigated, and 40 had hepatobiliary infection (acute cholecystitis: 10, acute cholangitis: 28, liver abscess: 1, and hepatic cyst infection: 1). The sensitivity of indirect fist percussion of the liver for diagnosing hepatobiliary infection was 60%, being significantly higher than that of RUQ tenderness (33%) and Murphy’s sign (30%), and its specificity was 85%. There was no significant improvement in sensitivity or diagnostic accuracy when Murphy’s sign was combined with indirect fist percussion of the liver. Conclusion. Indirect fist percussion-induced liver pain is a useful clinical finding to diagnose hepatobiliary infection, with high-level sensitivity. Takeshi Ueda and Eri Ishida Copyright © 2015 Takeshi Ueda and Eri Ishida. All rights reserved. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey Thu, 10 Sep 2015 14:15:54 +0000 Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents’ physical and emotional capacities. Deborah M. Whitley, Esme Fuller-Thomson, and Sarah Brennenstuhl Copyright © 2015 Deborah M. Whitley et al. All rights reserved. Provider Perspectives on the Influence of Family on Nursing Home Resident Transfers to the Emergency Department: Crises at the End of Life Mon, 24 Aug 2015 10:38:03 +0000 Background. Nursing home (NH) residents often experience burdensome and unnecessary care transitions, especially towards the end of life. This paper explores provider perspectives on the role that families play in the decision to transfer NH residents to the emergency department (ED). Methods. Multiple stakeholder focus groups ( participants) were conducted with NH nurses, NH physicians, nurse practitioners, physician assistants, NH administrators, ED nurses, ED physicians, and a hospitalist. Stakeholders described experiences and challenges with NH resident transfers to the ED. Focus group interviews were recorded and transcribed verbatim. Transcripts and field notes were analyzed using a Grounded Theory approach. Findings. Providers perceive that families often play a significant role in ED transfer decisions as they frequently react to a resident change of condition as a crisis. This sense of crisis is driven by 4 main influences: insecurities with NH care; families being unprepared for end of life; absent/inadequate advance care planning; and lack of communication and agreement within families regarding goals of care. Conclusions. Suboptimal communication and lack of access to appropriate and timely palliative care support and expertise in the NH setting may contribute to frequent ED transfers. Caroline Stephens, Elizabeth Halifax, Nhat Bui, Sei J. Lee, Charlene Harrington, Janet Shim, and Christine Ritchie Copyright © 2015 Caroline Stephens et al. All rights reserved. The Contribution of a “Supportive Community” Program for Older Persons in Israel to Their Offspring Who Are Primary Caregivers Sun, 09 Aug 2015 13:35:46 +0000 The “supportive community” programs in Israel provide a basket of services for older persons living in their own homes. This study examined the differences between caregiver burden and quality of life of 55 offspring who were the primary caregivers of their older parents who were members of a supportive community, compared to 64 offspring whose parents were nonmembers. The findings showed that the role stress factor of caregiving burden was lower, and the psychological health domain of quality of life was higher among offspring whose parents were members of supportive communities. Some of the predictor variables of burden were income status of caregiver, sharing with others in caregiving, and membership of the parent in a supportive community. The primary predictor variable of the quality of life was caregiving burden. The practical conclusion of this study is to further develop and market supportive community programs in various communities. Ahuva Even-Zohar Copyright © 2015 Ahuva Even-Zohar. All rights reserved. ICT Learning by Older Adults and Their Attitudes toward Computer Use Wed, 05 Aug 2015 13:20:55 +0000 Information and communication technologies have proven to be an effective way of helping older adults improve independence outcomes, but such technologies are yet not widely used by this segment of the population. This paper aims to study computer use and senior citizens’ attitudes toward computer technology in the context of a 20-hour course in basic skills. A questionnaire was used to conduct pre- and postcourse analyses with a sample of 191 adults over the age of 60. The findings show that direct contact with computers generates more positive attitudes toward computer use and also positive relationships with attitudes, user behavior, training expectations, and self-confidence. Results are discussed in the light of need-to-know attitudes toward computer use and training in new technologies as an opportunity for life-long learning and for improving quality of life in old age. Antonio González, María Paz Ramírez, and Vicente Viadel Copyright © 2015 Antonio González et al. All rights reserved. Menopausal Symptoms and Its Correlates: A Study on Tribe and Caste Population of East India Thu, 30 Jul 2015 13:48:53 +0000 Present study aimed to compare the incidence of menopausal problems and concomitants between tribe and caste population. This cross section study was conducted in five villages of West Bengal, a state in the eastern part of India. This study was conducted between two different ethnic groups—one of the “Particularly Vulnerable Tribal Groups (PTG)” of India named as “Lodha” and the other was a Bengali speaking caste population. A total number of 313 participants were finally recruited for this study. Study participants were married, had at least one child, had no major gynaecological problems, and had stopped menstrual bleeding spontaneously for at least 1 year. Additionally, data on sociodemographic status and menstrual and reproductive history were collected using a pretested questionnaire/schedule. Bivariate analyses (chi square test) revealed that significantly more number of caste participants suffered from urinary problems than their tribe counterpart. The reverse trend has been noticed for the frequency of vaginal problems. Multivariate analyses (binary logistic regression) show that sociodemographic variables and menstrual and reproductive history of the present study participants seem to be the concomitants of menopausal symptoms. Tribe and caste study population significantly differed with respect to the estrogen deficient menopausal problems and the concomitants to these problems. Doyel Dasgupta, Priyanka Karar, Subha Ray, and Nandini Ganguly Copyright © 2015 Doyel Dasgupta et al. All rights reserved. Physical Activity during Winter in Old-Old Women Associated with Physical Performance after One Year: A Prospective Study Mon, 22 Jun 2015 11:02:31 +0000 Background. The aim of this study was to evaluate whether the decline of physical activity during winter influences physical performances (after 1 year) in old-old women. Methods. Fifty-three Japanese women (mean age: 78.4 ± 3.2 years) participated in this study. Data of physical activity was collected by using an accelerometer at baseline and 3-month follow-up, and participants who decreased step counts in this period were defined as declining groups. We measured grip strength, knee extensor strength, total length of the center of gravity, hip walking distance, and maximum walking speed to evaluate physical performances at baseline and 1-year follow-up. Repeated-measures analysis of variance determined the difference in physical performance between declining groups and maintenance group with maintained or improved step counts. Results. Daily step counts for 22 older women (41.5%) decreased during winter. A statistically significant interaction effect between group and time was found for maximum walking speed (, ). Post hoc comparisons revealed that walking speed in the maintenance group significantly increased compared with baseline (); the declining group showed no significant change (). Conclusion. Change of physical activity during winter influences the physical performance level after 1 year in community-dwelling old-old women, particularly its effect on maximum walking speed. Atsushi Mizumoto, Hikaru Ihira, Keitaro Makino, Shigeyuki Saitoh, Hirofumi Ohnishi, and Taketo Furuna Copyright © 2015 Atsushi Mizumoto et al. All rights reserved. Factors Associated with Insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria Mon, 22 Dec 2014 00:10:00 +0000 Background. Insomnia is a form of chronic sleep problem of public health importance which impacts the life of elderly people negatively. Methods. Cross-sectional study of 843 elderly patients aged 60 years and above who presented consecutively at Geriatric Centre, University College Hospital, Ibadan, Nigeria. The World Health Organization Composite International Diagnostic Interview was used to diagnose insomnia. We assessed the following candidate variables which may be associated with insomnia such as socidemographic characteristics, morbidities, and lifestyle habits. Statistical analysis was done with SPSS 17. Results. The point prevalence of insomnia was 27.5%. Insomnia was significantly associated with being female, not being currently married, having formal education, living below the poverty line, and not being physically active. Health complaints of abdominal pain, generalized body pain, and persistent headaches were significantly associated with insomnia. Conclusion. The high prevalence of insomnia among elderly patients in this setting calls for concerted effort by healthcare workers to educate the elderly on lifestyle modification. Adetola M. Ogunbode, Lawrence A. Adebusoye, Olufemi O. Olowookere, Mayowa Owolabi, and Adesola Ogunniyi Copyright © 2014 Adetola M. Ogunbode et al. All rights reserved. The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals Sun, 16 Nov 2014 08:36:47 +0000 Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals. E. Paul Cherniack and Ariella R. Cherniack Copyright © 2014 E. Paul Cherniack and Ariella R. Cherniack. All rights reserved. A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan Thu, 06 Nov 2014 09:25:49 +0000 Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC) services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (), (), and (), respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses. Abdullah Alkhawaldeh, Margo B. Holm, Jamal Qaddumi, Wasileh Petro, Madi Jaghbir, and Omar Al Omari Copyright © 2014 Abdullah Alkhawaldeh et al. All rights reserved. Prevalence and Determinants of Fall-Related Injuries among Older Adults in Ecuador Thu, 02 Oct 2014 07:06:09 +0000 Objectives. To estimate the prevalence and determinants of fall-related injuries in the previous year among adults aged 60 years or older in Ecuador. Methods. The prevalence of fall-related injuries was estimated using cross-sectional data from the first national survey of Health, Wellbeing, and Aging study. Logistic regression models were used to examine the associations between participants’ demographic characteristics and fall-related injuries. Results. Of 5,227 participants with a mean age of 72.6 years, 11.4% (95% CI, 10.3%–12.7%) reported a fall-related injury in Ecuador, representing an estimated 136,000 adults aged 60 years or older. Fall-related injuries were more frequently reported among older adults residing in the most urbanized and populated provinces of the country. After controlling for potential confounders, self-reported race as Indigenous (OR 2.2; 95% CI, 2.11–2.31), drinking alcohol regularly (OR 2.54; 95% CI, 2.46–2.63), subjects with greater number of comorbid conditions (OR 2.03; 95% CI, 1.97–2.08), and urinary incontinence (OR 1.83; 95% CI, 1.79–1.87) were factors independently associated with increased odds of sustaining fall-related injuries. Conclusions. Fall-related injuries represent a considerable burden for older adults in Ecuador. The present findings may assist public health authorities to implement fall prevention programs among subjects at higher risk for this type of injury. Carlos H. Orces Copyright © 2014 Carlos H. Orces. All rights reserved. Role of Sociocultural Factors in Depression among Elderly of Twin Cities (Rawalpindi and Islamabad) of Pakistan Sun, 21 Sep 2014 06:41:17 +0000 This research was conducted to examine the role of sociocultural factors on depression among elderly of twin cities (Rawalpindi and Islamabad) of Pakistan. 310 older adults participated in the present study. Through convenient sampling technique, face to face interview was carried out for data collection. Urdu translated Geriatric Depression Scale Short Form and demographic sheet were used to test hypotheses. Descriptive statistics and -test were used for data analysis. Results showed significant mean differences among gender, marital status, family system, and status of employment on depression. Financial crisis, feeling of dejection because of isolation, and trend of nuclear family system have been observed as strong predictors of depression in older adults. Saira Javed Copyright © 2014 Saira Javed. All rights reserved. Aging and Others’ Pain Processing: Implications for Hospitalization Sun, 31 Aug 2014 06:43:27 +0000 Objectives. While self-pain perception has been widely investigated in aging, the perception as well as memory of pain in others has received little attention. Methods. The study was designed as a cross-sectional behavioral study in which a group of 41 younger and a group of 41 older adults evaluated a series of valenced and pain-related pictures and were later required to recall them. Results. We found that older adults judge the stimuli as being less intense compared to their younger counterparts. However, older adults remembered a larger number of pictures with individuals expressing pain compared to pictures with individuals who have neutral or positive facial expressions. Conclusions. Older adults may underestimate emotional intensity in others, but they seem to remember painful information in others as well as younger adults. These data are discussed in terms of theories of pain perception and implications for hospitalization. Alberto Di Domenico, Beth Fairfield, and Nicola Mammarella Copyright © 2014 Alberto Di Domenico et al. All rights reserved. Physical Activity, Physical Performance, and Biological Markers of Health among Sedentary Older Latinos Thu, 12 Jun 2014 08:39:16 +0000 Background. Physical activity is associated with better physical health, possibly by changing biological markers of health such as waist circumference and inflammation, but these relationships are unclear and even less understood among older Latinos—a group with high rates of sedentary lifestyle. Methods. Participants were 120 sedentary older Latino adults from senior centers. Community-partnered research methods were used to recruit participants. Inflammatory (C-reactive protein) and metabolic markers of health (waist circumference, HDL-cholesterol, triglycerides, insulin, and glucose), physical activity (Yale physical activity survey), and physical performance (short physical performance NIA battery) were measured at baseline and 6-month followup. Results. Eighty percent of the sample was female. In final adjusted cross-sectional models, better physical activity indices were associated with faster gait speed (). In adjusted longitudinal analyses, change in self-reported physical activity level correlated inversely with change in CRP (; ) and change in waist circumference (; ). Biological markers of health did not mediate the relationship between physical activity and physical performance. Conclusion. In this community-partnered study, higher physical activity was associated with better physical performance in cross-sectional analyses. In longitudinal analysis, increased physical activity was associated with improvements in some metabolic and inflammatory markers of health. Gerardo Moreno, Carol M. Mangione, Pin-Chieh Wang, Laura Trejo, Anthony Butch, Chi-Hong Tseng, and Catherine A. Sarkisian Copyright © 2014 Gerardo Moreno et al. All rights reserved. Predictors of Inpatient Utilization among Veterans with Dementia Thu, 29 May 2014 08:47:28 +0000 Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia () and their caregivers found marital status to predict hospitalization in the multivariate logistic model (, ) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (, , , and , resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with NCT00291161. Kyler M. Godwin, Robert O. Morgan, Annette Walder, David M. Bass, Katherine S. Judge, Nancy Wilson, A. Lynn Snow, and Mark E. Kunik Copyright © 2014 Kyler M. Godwin et al. All rights reserved. Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score Wed, 30 Apr 2014 08:29:35 +0000 Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients’ ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient’s ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient’s preoperative physical status. Rachel V. Thakore, Young M. Lee, Vasanth Sathiyakumar, William T. Obremskey, and Manish K. Sethi Copyright © 2014 Rachel V. Thakore et al. All rights reserved. Prevalence of Dementia, Emotional State and Physical Performance among Older Adults in the Metropolitan Area of Guadalajara, Jalisco, Mexico Thu, 27 Mar 2014 11:40:44 +0000 Background. Dementia affects memory, thinking, language, judgment, and behavior. Depression, is common in older adults with dementia. The concomitance of dementia and depression increases disability with impaired activities of daily living (ADL), increasing the chances of institutionalization and mortality. Methods. Cross-sectional study of a population 60 years and older who live in the State of Jalisco, Mexico. A total of 1142 persons were assessed regarding their cognitive function, emotional state, and physical performance. Door-to-door interview technique was assigned in condition with multistage probability random sampling. Cognitive function, depression and functional disability were assessed by applying standardized Minimental State Examination (Folstein), Geriatric Depression Scale, and the Katz index, respectively. Diagnosis of dementia was performed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, the Fourth Edition. Data were analyzed using SPSS software. Results. Prevalence of demency was 9.5% (63.35% women, and 36.7% men). Demency was associated with being woman, being older than 70 years, low level of education, not having the economic benefit of retirement, being single or living without a partner, low level of education, suffering from depression and have functional disability in ADL. Conclusion. Dementia is more common in women and is related to depression and disability. Irma E. Velázquez-Brizuela, Genaro G. Ortiz, Lucia Ventura-Castro, Elva D. Árias-Merino, Fermín P. Pacheco-Moisés, and Miguel A. Macías-Islas Copyright © 2014 Irma E. Velázquez-Brizuela et al. All rights reserved. The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands Mon, 24 Mar 2014 16:37:41 +0000 Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability. Robbert J. J. Gobbens and Marcel A. L. M. van Assen Copyright © 2014 Robbert J. J. Gobbens and Marcel A. L. M. van Assen. All rights reserved. Senescent Remodeling of the Innate and Adaptive Immune System in the Elderly Men with Prostate Cancer Wed, 19 Mar 2014 06:52:15 +0000 Despite years of intensive investigation that has been made in understanding prostate cancer, it remains a major cause of death in men worldwide. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer in the elderly men is becoming a disease of increasing significance. Aging is a progressive degenerative process strictly integrated with inflammation. Several theories have been proposed that attempt to define the role of chronic inflammation in aging including redox stress, mitochondrial damage, immunosenescence, and epigenetic modifications. Here, we review the innate and adaptive immune systems and their senescent remodeling in elderly men with prostate cancer. Gianluigi Taverna, Mauro Seveso, Guido Giusti, Rodolfo Hurle, Pierpaolo Graziotti, Sanja Štifter, Maurizio Chiriva-Internati, and Fabio Grizzi Copyright © 2014 Gianluigi Taverna et al. All rights reserved. The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the “Oldest Old” Mon, 17 Feb 2014 10:06:55 +0000 Elderly patients in the USA account for 26–50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the “Oldest Old” is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student’s t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the “Oldest Old” population. Aftab Haq, Sachin Patil, Alexis Lanteri Parcells, and Ronald S. Chamberlain Copyright © 2014 Aftab Haq et al. All rights reserved.