Journal of Aging Research http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Using Structured Observation and Content Analysis to Explore the Presence of Older People in Public Fora in Developing Countries Mon, 08 Dec 2014 00:10:11 +0000 http://www.hindawi.com/journals/jar/2014/860612/ There is a lack of research on the everyday lives of older people in developing countries. This exploratory study used structured observation and content analysis to examine the presence of older people in public fora and considered the methods’ potential for understanding older people’s social integration and inclusion. Structured observation occurred of public social spaces in six cities each located in a different developing country and in one city in the United Kingdom, together with content analysis of the presence of people in newspaper pictures and on television in the selected countries. Results indicated that across all fieldwork sites and data sources, there was a low presence of older people, with women considerably less present than men in developing countries. There was variation across fieldwork sites in older people’s presence by place and time of day and in their accompanied status. The presence of older people in images drawn from newspapers was associated with the news/non-news nature of the source. The utility of the study’s methodological approach is considered, as is the degree to which the presence of older people in public fora might relate to social integration and inclusion in different cultural contexts. Geraldine Nosowska, Kevin McKee, and Lena Dahlberg Copyright © 2014 Geraldine Nosowska et al. All rights reserved. Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study Wed, 22 Oct 2014 11:18:03 +0000 http://www.hindawi.com/journals/jar/2014/198603/ Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insurance coverage and assessed the determinants of frailty with a special focus on socioeconomic status. Participants aged 50 and more from the population-based 2006–2010 Bus Santé study were included ( = 2,930). Four frailty indicators (weakness, shrinking, exhaustion, and low activity) were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. Overall, 63.5%, 28.7%, and 7.8% participants presented no frailty indicators, one frailty indicator, and two or more frailty indicators, respectively. Among middle-aged participants (50–65 years), 75.1%, 22.2%, and 2.7% presented 0, 1, and 2 or more frailty indicators. The number of frailty indicators was positively associated with age, hypertension, and current smoking and negatively associated with male gender, body mass index, waist-to-hip ratio, and serum total cholesterol level. Lower income level but not education was associated with higher number of frailty indicators. Frailty indicators are frequently encountered in both older and middle-aged adults from the Swiss general population. Despite universal health insurance coverage, household income is independently associated with frailty. Idris Guessous, Jean-Christophe Luthi, Christopher Barrett Bowling, Jean-Marc Theler, Fred Paccaud, Jean-Michel Gaspoz, and William McClellan Copyright © 2014 Idris Guessous et al. All rights reserved. Geospatial Relationships between Awareness and Utilization of Community Exercise Resources and Physical Activity Levels in Older Adults Thu, 16 Oct 2014 07:28:44 +0000 http://www.hindawi.com/journals/jar/2014/302690/ Introduction. It is unclear if community-based fitness resources (CBFR) translate to heightened activity levels within neighboring areas. The purpose of this study was to determine whether awareness and utilization of fitness resources and physical activity differed depending on residential distance from CBFR. Methods. Four hundred and seventeen older adults ( years) were randomly recruited from three spatial tiers (≤1.6, >1.6 to ≤3.2, and >3.2 to 8.0 km) surrounding seven senior centers, which housed CBFR. Participants completed questionnaires on health history, CBFR, and physical activity, gathering data on CBFR awareness, utilization, and barriers, overall levels, and predictors to engagement in moderate to vigorous physical activity (MVPA). Results. Across spatial tiers, there were no differences in positive awareness rates of CBFR or CBFR utilization. Engagement in MVPA differed across spatial tiers , with the >3.2 to 8.0 km radius having the highest mean energy expenditure. Across all sites, age and income level were significant predictors of low and high amounts of MVPA, respectively, and current health status and lack of interest represented barriers to CBFR utilization . Conclusion. Closer proximity to CBFR did not impact awareness or utilization rates and had an inverse relationship with physical activity. Christopher J. Dondzila, Ann M. Swartz, Kevin G. Keenan, Amy E. Harley, Razia Azen, and Scott J. Strath Copyright © 2014 Christopher J. Dondzila et al. All rights reserved. Improving Quality of Life in Nursing Homes: The Structured Resident Interview Approach Thu, 09 Oct 2014 09:04:40 +0000 http://www.hindawi.com/journals/jar/2014/892679/ The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged. Howard B. Degenholtz, Abby L. Resnick, Natalie Bulger, and Lichun Chia Copyright © 2014 Howard B. Degenholtz et al. All rights reserved. Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults Thu, 11 Sep 2014 06:27:39 +0000 http://www.hindawi.com/journals/jar/2014/194635/ Health literacy has received increasing attention because of its importance for older individuals’ health, as studies have shown a close relation between older individuals’ health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this finding is variable and may depend on which health literacy test is used. Older individuals assessed with the Test of Functional Health Literacy (TOFHLA) score lower than younger individuals, but a previous study suggested that this may result from age-related differential item functioning (DIF) on the TOFHLA. The study reported here assessed age-related DIF in a sample of community-dwelling volunteers. Twenty-two percent of items were differentially more difficult for older individuals independent of their overall ability, and when these items were eliminated from the total score, age differences were no longer found. Performance on a working memory task predicted older but not younger individuals’ performance on the age-related items. At least part of older individuals’ apparent deficits in health literacy when assessed by the TOFHLA may be related to DIF on its items. The TOFHLA, and any measure that employs the cloze procedure to evaluate reading comprehension, should be used cautiously in older individuals. Raymond L. Ownby, Amarilis Acevedo, Drenna Waldrop-Valverde, and Robin J. Jacobs Copyright © 2014 Raymond L. Ownby et al. All rights reserved. Could Some Geriatric Characteristics Hinder the Prescription of Anticoagulants in Atrial Fibrillation in the Elderly? Wed, 10 Sep 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/693740/ Several studies have reported underprescription of anticoagulants in atrial fibrillation (AF). We conducted an observational study on 142 out of a total of 995 consecutive ≥75 years old patients presenting AF (14%) when admitted in an emergency unit of a general hospital, in search of geriatric characteristics that might be associated with the underprescription of anticoagulation therapy (mostly antivitamin K at the time of the study). The following data was collected from patients presenting AF: medical history including treatment and comorbidities, CHADS2 score, ISAR scale (frailty), Lawton’s scale (ADL), GDS scale (mood status), MUST (nutrition), and blood analysis (INR, kidney function, and albumin). Among those patients for who anticoagulation treatment was recommended (73%), only 61% were treated with it. In the group with anticoagulation therapy, the following characteristics were observed more often than in the group without such therapy: a recent (≤6 months) hospitalization and medical treatment including digoxin or based on >3 different drugs. Neither the value of the CHADS2 score, nor the geriatric characteristics could be correlated with the presence or the absence of an anticoagulation therapy. More research is thus required to identify and clarify the relative importance of patient-, physician-, and health care system-related hurdles for the prescription of oral anticoagulation therapy in older patients with AF. Paule Denoël, Jacques Vanderstraeten, Pierre Mols, and Thierry Pepersack Copyright © 2014 Paule Denoël et al. All rights reserved. Employing a Participatory Research Approach to Explore Physical Activity among Older African American Women Thu, 21 Aug 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/941019/ Introduction. Older African American women are particularly vulnerable to unhealthy lifestyle behaviors such as physical inactivity and the resultant chronic diseases and conditions. This study explored older African American women’s perception of physical activity as well as facilitators of and barriers to being physically active in their local environment. Methods. Using a participatory research approach, a total of 7 women aged 65 years and over had their PA level assessed objectively through accelerometry. In addition, physical activity was discussed through the photo-elicitation procedure, which was supplemented by semistructured interviews. Qualitative thematic analysis was used to identify patterns and themes emerging from participants’ interview. Results. Participants exhibited low levels of physical activity and viewed “physical activity” to be a broadly defined, nonspecific construct. Interviews revealed that many participants lack important knowledge about physical activity. A variety of personal, social, and environmental facilitators and barriers were reported by the participants. Conclusion. Efforts should be made towards clarifying information on physical activity in this population in order to help them incorporate physical activity into their routines, overcome barriers, and make use of opportunities to be active. Emerson Sebastião, Kelechi Ibe-Lamberts, Julie Bobitt, Andiara Schwingel, and Wojtek Chodzko-Zajko Copyright © 2014 Emerson Sebastião et al. All rights reserved. Factors Affecting Mortality in Elderly Patients Hospitalized for Nonmalignant Reasons Sun, 03 Aug 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/584315/ Elderly population is hospitalized more frequently than young people, and they suffer from more severe diseases that are difficult to diagnose and treat. The present study aimed to investigate the factors affecting mortality in elderly patients hospitalized for nonmalignant reasons. Demographic data, reason for hospitalization, comorbidities, duration of hospital stay, and results of routine blood testing at the time of first hospitalization were obtained from the hospital records of the patients, who were over 65 years of age and hospitalized primarily for nonmalignant reasons. The mean age of 1012 patients included in the study was 77.8 ± 7.6. The most common reason for hospitalization was diabetes mellitus (18.3%). Of the patients, 90.3% had at least a single comorbidity. Whilst 927 (91.6%) of the hospitalized patients were discharged, 85 (8.4%) died. Comparison of the characteristics of the discharged and dead groups revealed that the dead group was older and had higher rates of poor general status and comorbidity. Differences were observed between the discharged and dead groups in most of the laboratory parameters. Hypoalbuminemia, hypertriglyceridemia, hypopotassemia, hypernatremia, hyperuricemia, and high TSH level were the predictors of mortality. In order to meet the health necessities of the elderly population, it is necessary to well define the patient profiles and to identify the risk factors. Teslime Ayaz, Serap Baydur Sahin, Osman Zikrullah Sahin, Ozlem Bilir, and Halil Rakıcı Copyright © 2014 Teslime Ayaz et al. All rights reserved. Psychological Impacts among Older and Younger People Living with HIV/AIDS in Nanning, China Mon, 14 Jul 2014 10:03:53 +0000 http://www.hindawi.com/journals/jar/2014/576592/ Objectives. The HIV epidemic has drastically increased among older adults in China, yet little research has examined the psychological impacts among older and younger people living with HIV/AIDS (PLWHAs). This study examined and compared self-efficacy, depression, well-being, and quality of life among older and younger PLWHAs in China. Method. A two-stage sampling procedure was used to recruit a final sample of 148 participants. Older adults were defined as age 50 and older. Result. Compared to younger PLWHAs aged 18–49 years old, older PLWHAs reported lower levels of well-being (7.6 versus 11.4), higher levels of depression (18.6 versus 15.8), and poorer quality of life. Self-efficacy was similar among older (23.9) and younger (24.6) PLWHAs. A higher level of depression among older PLWHAs was associated with much lower levels of subjective well-being and quality of life (physical health and psychological health). Conclusion. The findings suggest that older PLWHAs face psychological problems and mental health challenges beyond those experienced by younger PLWHAs. Intervention programs dedicated to improving mental health and quality of life are greatly needed for HIV infected older adults. Hongjie Liu, Xin He, Judith A. Levy, Yongfang Xu, Chunpeng Zang, and Xinqin Lin Copyright © 2014 Hongjie Liu et al. All rights reserved. The Relationship between Health and Community across Aging Cohorts Tue, 10 Jun 2014 06:51:42 +0000 http://www.hindawi.com/journals/jar/2014/626097/ Research is needed to examine the connection between older adults and their community as they age. This is important as increasing numbers of older adults wish to age in place. Regression models were examined across 3 cohorts testing relationships among social capital indicators (neighborhood trust, neighborhood support, neighborhood cohesion, neighborhood participation, and telephone interaction) with health outcomes (self-rated health, activities of daily living (ADL), and instrumental activities of daily living (IADL)). Results showed that most social capital indicators remained significant for all health outcomes into very old age. Development of tools for individual and community interventions to ensure optimal fit between the aging individual and their environment is discussed, along with recommendations for enhancing social work theory and practice. Julie Norstrand and Keith T. Chan Copyright © 2014 Julie Norstrand and Keith T. Chan. All rights reserved. A Brief Report on the Factor Structure of the Cognitive Measures in the HRS/AHEAD Studies Wed, 28 May 2014 11:33:11 +0000 http://www.hindawi.com/journals/jar/2014/798514/ Using cognitive data from the Health and Retirement Study and Asset Health Dynamics Among the Oldest Old studies that were collected between 1992 and 2004, McArdle and colleagues (2007) found that a two-factor model (episodic memory and mental status) fit better than a one-factor model. The question that was addressed in the present study was whether these results would replicate in newer cohorts of data, collected between 2006 and 2010. We also tested age, education, and gender as predictors of the identified factors. Results confirm that a two-factor structure fits better than the single-factor model in the newer cohorts. Differential predictors were also observed. A. Nayena Blankson and John J. McArdle Copyright © 2014 A. Nayena Blankson and John J. McArdle. All rights reserved. Accelerometer Derived Activity Counts and Oxygen Consumption between Young and Older Individuals Mon, 26 May 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/184693/ The purpose of this investigation was to compare accelerometer activity counts and oxygen consumption between young and elderly individuals. Sixteen young ( yrs) and sixteen elderly ( yrs) participants completed 30 minutes of resting oxygen consumption to determine resting metabolic rate and four 6 min walking intensities ranging from 27 to 94 mmin−1. Resting oxygen uptake was significantly lower for the older participants. Exercise oxygen consumption was significantly higher for the elderly group. There were no significant differences in activity counts between groups at each of the exercise intensities. When using measured resting metabolic rate, activity counts of 824 and 2207 countsmin−1 were associated with moderate (3 METs) physical activity intensity for the older and young participants, respectively. However, using standard resting metabolic rate (3.5 mLkg−1min−1), activity counts of 784 and 2009 countsmin−1 were associated with moderate physical activity intensity for the elderly and young participants, respectively. These findings indicate that activity counts are similar across age groups even though the oxygen consumption of exercise is greater among elderly individuals. Lucas Whitcher and Charilaos Papadopoulos Copyright © 2014 Lucas Whitcher and Charilaos Papadopoulos. All rights reserved. Redundant Vasodilator Pathways Underlying Radial Artery Flow-Mediated Dilation Are Preserved in Healthy Aging Wed, 21 May 2014 06:41:49 +0000 http://www.hindawi.com/journals/jar/2014/876125/ Background. Blocking nitric oxide (NO) and vasodilator prostanoids (PN) does not consistently reduce flow-mediated dilation (FMD) in young adults. The impact of aging on the contribution of NO and PG to FMD is unknown. Methods. FMD was measured in older adults (,  y) after arterial infusion of saline, N(G)-monomethyl-L-arginine (L-NMMA), and ketorolac + L-NMMA. Data were compared to published data in young adults. Results. L-NMMA reduced FMD in older adults ( to ) although this was not statistically significant () and did not differ () from the reduction observed in young adults ( to ; ). Blocking PN did not affect FMD in young or older adults. In older adults, L-NMMA reduced (; range = 36–123% decrease), augmented (; 10–122% increase), or did not change FMD (; 0.4% increase). After PN blockade, FMD responses were reduced (), augmented (), or unaffected (). Conclusions. NO or PN blockade did not consistently reduce FMD in healthy older adults, suggesting the existence of redundant vasodilator phenotypes as observed previously in young adults. Kevin D. Ballard, Michael E. Tschakovsky, Amanda L. Zaleski, Donna M. Polk, Paul D. Thompson, Francis J. Kiernan, and Beth A. Parker Copyright © 2014 Kevin D. Ballard et al. All rights reserved. Interactions between Identity and Emotional Expression in Face Processing across the Lifespan: Evidence from Redundancy Gains Tue, 15 Apr 2014 12:18:22 +0000 http://www.hindawi.com/journals/jar/2014/136073/ We tested how aging affects the integration of visual information from faces. Three groups of participants aged 20–30, 40–50, and 60–70 performed a divided attention task in which they had to detect the presence of a target facial identity or a target facial expression. Three target stimuli were used: (1) with the target identity but not the target expression, (2) with the target expression but not the target identity, and (3) with both the target identity and target expression (the redundant target condition). On nontarget trials the faces contained neither the target identity nor expression. All groups were faster in responding to a face containing both the target identity and emotion compared to faces containing either single target. Furthermore the redundancy gains for combined targets exceeded performance limits predicted by the independent processing of facial identity and emotion. These results are held across the age range. The results suggest that there is interactive processing of facial identity and emotion which is independent of the effects of cognitive aging. Older participants demonstrated reliably larger size of the redundancy gains compared to the young group that reflect a greater experience with faces. Alternative explanations are discussed. Alla Yankouskaya, Pia Rotshtein, and Glyn W. Humphreys Copyright © 2014 Alla Yankouskaya et al. All rights reserved. Erratum to “Sarcopenia, A Neurogenic Syndrome?” Tue, 15 Apr 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/751469/ Ping Kwan Copyright © 2014 Ping Kwan. All rights reserved. The Use of Session RPE to Monitor the Intensity of Weight Training in Older Women: Acute Responses to Eccentric, Concentric, and Dynamic Exercises Sun, 13 Apr 2014 13:23:40 +0000 http://www.hindawi.com/journals/jar/2014/749317/ The rating of perceived exertion (RPE) is ability to detect and interpret organic sensations while performing exercises. This method has been used to measure the level of effort that is felt during weight-training at a given intensity. The purpose of this investigation was to compare session RPE values with those of traditional RPE measurements for different weight-training muscle actions, performed together or separately. Fourteen women with no former weight-training experience were recruited for the investigation. All participants completed five sessions of exercise: familiarization, maximum force, concentric-only (CONC-only), eccentric-only (ECC-only), and dynamic (DYN = CONC + ECC). The traditional RPE method was measured after each series of exercises, and the session RPE was measured 30 min after the end of the training session. The statistical analyses used were the paired t-test, one-way analysis of variance, and repeated measures analysis of variance. Significant differences between traditional RPE and session RPE for DYN, CONC, and ECC exercises were not found. This investigation demonstrated that session RPE is similar to traditional RPE in terms of weight-training involving concentric, eccentric, or dynamic muscle exercises, and that it can be used to prescribe and monitor weight-training sessions in older subjects. Sandro S. Ferreira, Kleverton Krinski, Ragami C. Alves, Mariana L. Benites, Paulo E. Redkva, Hassan M. Elsangedy, Cosme F. Buzzachera, Tácito P. Souza-Junior, and Sergio G. da Silva Copyright © 2014 Sandro S. Ferreira et al. All rights reserved. Blood Transfusion Reactions in Elderly Patients Hospitalized in a Multilevel Geriatric Hospital Thu, 03 Apr 2014 08:52:54 +0000 http://www.hindawi.com/journals/jar/2014/178298/ Background/Objectives. Blood transfusion is a critical issue for patients with chronic diseases such as heart failure, chronic kidney disease, and malignancy. However, side effects are not rare. The purpose of the study is to evaluate the frequency of adverse blood transfusion reactions in hospitalized elderly patients during a one-year period. Design/Setting/Participants. Blood transfusion reactions such as fever, chills, dyspnea, and others following blood transfusions in hospitalized geriatric patients during one-year period were examined. Results. 382 blood units (242 patients) were administered during the study period. In 40 (11%) cases, blood transfusion reactions occurred. Fever was the most common reaction in 29 cases (72%), four (10%) had shortness of breath, and 3 (8%) had vomiting and chills each. There were no lethal cases in the 24-hour period following blood transfusions. Conclusion. A relatively low rate of adverse blood transfusion reactions occurred in our geriatric patients. We may speculate that this is related to underreporting of minor symptoms due to the high percentage of demented patients in this population. E. Lubart, R. Segal, N. Tryhub, E. Sigler, and A. Leibovitz Copyright © 2014 E. Lubart et al. All rights reserved. Sources of Life Strengths Appraisal Scale: A Multidimensional Approach to Assessing Older Adults’ Perceived Sources of Life Strengths Sun, 09 Mar 2014 07:46:44 +0000 http://www.hindawi.com/journals/jar/2014/783637/ Both cognitive and psychosocial theories of adult development stress the fundamental role of older adults’ appraisals of the diverse sources of cognitive and social-emotional strengths. This study reports the development of a new self-appraisal measure that incorporates key theoretical dimensions of internal and external sources of life strengths, as identified in the gerontological literature. Using a pilot study sample and three other independent samples to examine older adults’ appraisals of their sources of life strengths which helped them in their daily functioning and to combat life challenges, adversity, and losses, a psychometric instrument having appropriate reliability and validity properties was developed. A 24-month followup of a randomly selected sample confirmed that the nine-scale appraisal measure (SLSAS) is a promising instrument for appraising older adults’ sources of life strengths in dealing with stresses of daily life’s functioning and also a robust measure for predicting outcomes of resilience, autonomy, and well-being for this age group. A unique strength of the appraisal instrument is its critically relevant features of brevity, simplicity of language, and ease of administration to frail older adults. Prem S. Fry and Dominique L. Debats Copyright © 2014 Prem S. Fry and Dominique L. Debats. All rights reserved. Gray and Green Revisited: A Multidisciplinary Perspective of Gardens, Gardening, and the Aging Process Thu, 06 Mar 2014 11:37:41 +0000 http://www.hindawi.com/journals/jar/2014/283682/ Over fourteen years ago, the concept of “gray and green” was first introduced by Wright and Lund (2000) to represent a new awareness and a call for increased scholarship at the intersection of environmental issues and the aging process. This review paper revisits that concept with a fresh perspective on the specific role of gardens and gardening in the aging experience. As example, gardening is one of the most popular home-based leisure activities in the US and represents an important activity in the lives of older adults in a variety of residential settings. Yet, there has been a lack of any comprehensive and multidisciplinary (science and humanities) examination of the nexus between gardening and the aging experience, and in particular with research connections to stewardship and caring. In this paper, we review contemporary articles demonstrating the multidisciplinarity of gardening and the aging process. First, we will focus on the beneficial psychological effects resulting from the cultivation of caring, including personal contentment and artistic expression. Second, we will focus on stewardship and how gardening increases health, community awareness, and a connection to future generations. On the surface, this may demonstrate a separation between the humanities and science, but we will clarify a symbiotic relationship between the two disciplines in our conclusion. Scott D. Wright and Amy Maida Wadsworth Copyright © 2014 Scott D. Wright and Amy Maida Wadsworth. All rights reserved. Effect of Posture Training with Weighted Kypho-Orthosis (WKO) on Improving Balance in Women with Osteoporosis Thu, 06 Mar 2014 07:30:53 +0000 http://www.hindawi.com/journals/jar/2014/427903/ Objectives. To determine the effect of weighted kypho-orthosis (WKO) on improving balance in women with osteoporosis. In this nonrandomized controlled clinical trial, 31 patients with osteoporosis were included. The patients were assigned to two groups: (1) control group who received 4-week home-based daily exercise program including weight bearing, back strengthening, and balance exercises and (2) intervention group (WKO) who performed aforementioned exercises and wore WKO for one hour twice a day. Patients were assessed using clinical balance tests (timed up and go test, functional reach test, and unilateral balance test) before and 4 weeks after start of treatment. Results. Functional reach and timed up and go test were improved significantly in both groups compared to baseline. The improvement in intervention group was more significant in comparison to control group (). Discussion. Posture training with WKO together with exercise program improved two clinical balance tests in women with osteoporosis. Conclusion. Posture training support (PTS) applied as WKO together with back extension exercises can be prescribed as an intervention in elderly women in order to reduce the risk of falling. Seyed Ahmad Raeissadat, Leyla Sedighipour, Safura Pournajaf, Reza Vahab Kashani, and Shahram Sadeghi Copyright © 2014 Seyed Ahmad Raeissadat et al. All rights reserved. The Propensity for Inducing Atrial Fibrillation: A Comparative Study on Old versus Young Rabbits Sun, 02 Mar 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/684918/ It is well established that atrial fibrillation (AF) is far more common in elderly humans. Autonomic activation is thought to be an operative mechanism for AF propensity. The aim of the study was to investigate the impact of age on atrial tachyarrhythmia induction in a rabbit model. Six old (aged 4–6 years) and 9 young (aged 3-4 months) New Zealand white rabbits were subjected to a catheter-based electrophysiological study. Atrial tachyarrhythmia susceptibility was tested by burst pacing before and after infusion of increasing concentrations of acetylcholine. Both young and old rabbits were in normal sinus rhythm at the beginning of the infusion/burst pacing protocol. The old rabbits had faster heart rates and a marked increase in atrial tachyarrhythmias compared to the young rabbits. Nonsustained and sustained AF events were more frequent in the old rabbits. No significant fibrosis was observed in the atria of either young or old rabbits. In conclusion, the old rabbits have a greater propensity for induction of AF. The significantly faster heart rates in the old rabbits suggest that dominant sympathetic activity may play an important role in the propensity for AF in this group. Hongliang Li, Benjamin J. Scherlag, David C. Kem, Caitlin Zillner, Shailesh Male, Sorkko Thirunavukkarasu, Xiaohua Shen, Alexandria Benbrook, Jan V. Pitha, Ralph Lazzara, and Xichun Yu Copyright © 2014 Hongliang Li et al. All rights reserved. Effect of Dementia on the Use of Drugs for Secondary Prevention of Ischemic Heart Disease Tue, 25 Feb 2014 09:53:21 +0000 http://www.hindawi.com/journals/jar/2014/897671/ Background. Dementia and cardiovascular disease (CVD) are frequently comorbid. The presence of dementia may have an effect on how CVD is treated. Objective. To examine the effect of dementia on the use of four medications recommended for secondary prevention of ischemic heart disease (IHD): angiotensin-converting enzyme inhibitors, beta-blockers, lipid-lowering medications, and antiplatelet medications. Design. Retrospective analysis of data from the Cardiovascular Health Study: Cognition Study. Setting and Subjects. 1,087 older adults in four US states who had or developed IHD between 1989 and 1998. Methods. Generalized estimating equations to explore the association between dementia and the use of guideline-recommended medications for the secondary prevention of IHD. Results. The length of follow-up for the cohort was 8.7 years and 265 (24%) had or developed dementia during the study. Use of medications for the secondary prevention of IHD for patients with and without dementia increased during the study period. In models, subjects with dementia were not less likely to use any one particular class of medication but were less likely to use two or more classes of medications as a group (OR, 0.60; 95% CI, 0.36–0.99). Conclusions. Subjects with dementia used fewer guideline-recommended medications for the secondary prevention of IHD than those without dementia. Nicole R. Fowler, Amber E. Barnato, Howard B. Degenholtz, Angela M. Curcio, James T. Becker, Lewis H. Kuller, and Oscar L. Lopez Copyright © 2014 Nicole R. Fowler et al. All rights reserved. Dementia Care: Intersecting Informal Family Care and Formal Care Systems Thu, 20 Feb 2014 12:11:05 +0000 http://www.hindawi.com/journals/jar/2014/486521/ Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions related to ageing. This paper is based on a qualitative study undertaken in the Australian state of Queensland and explores issues of access to and use of formal services in dementia care from the perspective of the informal family carers. It identifies three critical points at which changes in policy and practice in the formal care system could improve the capability of informal carers to continue to care for their family member with dementia: when symptoms first become apparent and a diagnosis is sought; when the condition of the person with dementia changes resulting in a change to their support needs; and when the burden of informal care being experienced by the carer is so great that some form of transition appears to be immanent in the care arrangement. Prabhjot Singh, Rafat Hussain, Adeel Khan, Lyn Irwin, and Roslyn Foskey Copyright © 2014 Prabhjot Singh et al. All rights reserved. Association of Leukocyte Telomere Length with Fatigue in Nondisabled Older Adults Sun, 16 Feb 2014 09:30:14 +0000 http://www.hindawi.com/journals/jar/2014/403253/ Introduction. Fatigue is often present in older adults with no identified underlying cause. The accruing burden of oxidative stress and inflammation might be underlying factors of fatigue. We therefore hypothesized that leukocyte telomere length (LTL) is relatively short in older adults who experience fatigue. Materials and Methods. We assessed 439 older nondisabled Danish twins. LTL was measured using Southern blots of terminal restriction fragments. Fatigue was measured by the Mob-T Scale based on questions on whether the respondents felt fatigued after performing six mobility items. Results. LTL was significantly associated with fatigue (), showing an increase of 0.038 kb/fatigue score unit. Aging-related diseases and mental health did not explain the association, while lifestyle factors slightly attenuated the estimates. Conclusion. Our results support an association between LTL and fatigue. Further studies are required to confirm this finding and the link of LTL with oxidative stress/inflammation over the life course. Laila Bendix, Mikael Thinggaard, Masayuki Kimura, Abraham Aviv, Kaare Christensen, Merete Osler, and Kirsten Avlund Copyright © 2014 Laila Bendix et al. All rights reserved. Following Up on Clinical Recommendations in Transitions from Hospital to Nursing Home Sun, 09 Feb 2014 11:18:14 +0000 http://www.hindawi.com/journals/jar/2014/873043/ Following up on recommendations made at the time of a hospital discharge is important to patient safety. While data is lacking, specifically around the transition of patient to nursing home, it has been postulated that missed items such as laboratory tests may result in adverse patient outcomes. To determine the extent of this problem, a retrospective cohort study of subjects discharged from an academic medical center and admitted to nursing homes (NH) was followed to determine the type of discharge recommendations and the rate of completion. In addition, for the purpose of generalizability, the 30-day hospital readmission rate was calculated. 152 recommendations were made on 51 subjects. Almost a quarter of the recommendations made by the hospital discharging team were not acted upon. Furthermore, for the majority of those recommendations that were not acted upon, a reason could not be determined. In concert with national data, 20% of the subjects returned to the hospital within 30 days. Further investigation is warranted to determine if an association exists between missed recommendations and hospital readmission from the nursing home setting. Lisa B. Caruso, Soe Soe Thwin, and Gary H. Brandeis Copyright © 2014 Lisa B. Caruso et al. All rights reserved. Effect of Caloric Restriction on Hepatic Sinusoidal System and Stellate Cells in Mice Tue, 04 Feb 2014 13:21:38 +0000 http://www.hindawi.com/journals/jar/2014/670890/ Aging associated changes in liver include reduced hepatic blood flow, increased number of stellate cells, and collagen deposits in perisinusoidal space. We tested the possibility of mitigating these changes with caloric restriction. Two-month-old mice were subjected to 30 percent caloric restriction for 12 months and then examined for the effect of caloric restriction on the sinusoidal network, collagen deposition, and the number of stellate cells. Using intravital fluorescence microscopy, assessments were made on sinusoidal diameter, density, volumetric flow, perfusion index, and autofluorescence of vitamin A that was primarily stored with lipid droplets in stellate cells. A significant effect was observed in the vitamin A autofluorescence of stellate cells; stellate cell associated fluorescence was diminished in terms of number and size of fluorescent spots. Caloric restriction reduced collagen deposits in liver sections and lowered the gene expression of α1-(I) collagen but not α-smooth muscle actin. No differences were detected in sinusoidal dimension measurements. Our results showed that caloric restriction was effective in ameliorating the increase in stellate cells and the mild fibrosis in old mice. However, caloric restriction had no impact on stellate cell activity level as indicated by the unaffected α-smooth muscle actin expression. Jian Chen, Kara King, and Jian X. Zhang Copyright © 2014 Jian Chen et al. All rights reserved. White Blood Cell Count in Elderly Is Clinically Useful in Predicting Long-Term Survival Wed, 29 Jan 2014 08:48:31 +0000 http://www.hindawi.com/journals/jar/2014/475093/ Introduction. White blood cell (WBC) count is often included in routine clinical checkups. We determined the prognostic impact of WBC count on all-cause, cardiovascular, and noncardiovascular mortality during an 11-year followup in a general population of 75-year-olds. Study Population. The study included 207 men and 220 women comprising 69% of the invited 75-year-olds in a defined geographical area. Main Results. The median WBC count (in 109/L) was 6.3 (interquartile range 5.4–7.2) for men and 5.7 (4.9–6.8) for women, for sex difference. The hazard ratio (HR) for all-cause mortality per 109/L increase in WBCs was 1.16 (95% confidence interval, 1.03–1.32; ) in men and 1.28 (1.10–1.50; ) in women. These HRs were essentially unchanged by adjustment for established risk factors (current smoking, known hypertension, prior myocardial infarction, known diabetes, total cholesterol, high-density lipoprotein cholesterol, and body mass index). Furthermore, increased WBC count was significantly associated with cardiovascular mortality in both sexes and with noncardiovascular mortality in women. Conclusions. The WBC count deserves attention as a potentially clinical useful predictor of survival in the 75-year-olds, especially among women. Göran Nilsson, Pär Hedberg, and John Öhrvik Copyright © 2014 Göran Nilsson et al. All rights reserved. Effects of Periodic Task-Specific Test Feedback on Physical Performance in Older Adults Undertaking Band-Based Resistance Exercise Wed, 29 Jan 2014 00:00:00 +0000 http://www.hindawi.com/journals/jar/2014/171694/ The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG, ) or a functional mobility feedback group (FMG, ). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant () interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities. Ryuichi Hasegawa, Mohammod Monirul Islam, Ryuji Watanabe, Naoki Tomiyama, and Dennis R. Taaffe Copyright © 2014 Ryuichi Hasegawa et al. All rights reserved. Clinical Correlates of Awareness for Balance, Function, and Memory: Evidence for the Modality Specificity of Awareness Thu, 16 Jan 2014 13:46:26 +0000 http://www.hindawi.com/journals/jar/2014/674716/ Awareness in dementia is increasingly recognized not only as multifactorial, but also as domain specific. We demonstrate differential clinical correlates for awareness of daily function, awareness of memory, and the novel exploration of awareness of balance. Awareness of function was higher for participants with mild cognitive impairment (aMCI and non-aMCI) than for those with dementia (due to Alzheimer disease; AD and non-AD), whereas awareness of memory was higher for both non-aMCI and non-AD dementia patients than for those with aMCI or AD. Balance awareness did not differ based on diagnostic subgroup. Awareness of function was associated with instrumental activities of daily living and caregiver burden. In contrast, awareness of balance was associated with fall history, balance confidence, and instrumental activities of daily living. Clinical correlates of awareness of memory depended on diagnostic group: associations held with neuropsychological variables for non-AD dementia, but for patients with AD dementia, depression and instrumental activities of daily living were clinical correlates of memory awareness. Together, these data provide support for the hypothesis that awareness and dementia are not unitary and are, instead, modality specific. Megan E. O'Connell, Vanina Dal Bello-Haas, Margaret Crossley, and Debra Morgan Copyright © 2014 Megan E. O'Connell et al. All rights reserved. Older Adults Making End of Life Decisions: An Application of Roy's Adaptation Model Thu, 26 Dec 2013 14:20:13 +0000 http://www.hindawi.com/journals/jar/2013/470812/ Purpose. The purpose of this study was to identify variables that influenced completion of advanced directives in the context of adaptation from national data in older adults. Knowledge gained from this study would help us identify factors that might influence end of life discussions and shed light on strategies on effective communication on advance care planning. Design and Method. A model-testing design and path analysis were used to examine secondary data from 938 participants. Items were extracted from the data set to correspond to variables for this study. Scales were constructed and reliabilities were tested. Results. The final path model showed that physical impairment, self-rated health, continuing to work, and family structure had direct and indirect effects on completion of advanced directives. Five percent of the variance was accounted for by the path analysis. Conclusion. The variance accounted for by the model was small. This could have been due to the use of secondary data and limitations imposed for measurement. However, health care providers and families should explore patient’s perception of self-health as well as their family and work situation in order to strategize a motivational discussion on advance directive or end of life care planning. Weihua Zhang Copyright © 2013 Weihua Zhang. All rights reserved.