Current Gerontology and Geriatrics Research The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta Thu, 12 Oct 2017 09:59:02 +0000 Although self-help group for older people gains the effectiveness, the effect of a nursing intervention using a self-help group model as a guideline for self-monitoring and intervention on the health status and life satisfaction among older people still remains. To determine the effectiveness of this nursing intervention, an experimental design using multistage sampling method was used for this study. The self-help intervention included a single 50–70-minute session once a week for 12 weeks done, using the Life Satisfaction Inventory-A (LSI-A) questionnaire, and SF-36 shows a significant difference. Self-help intervention could be implemented by nurses for older people in the community to improve health and well-being. Junaiti Sahar, Ni Made Riasmini, Dwi Nurviyandari Kusumawati, and Erna Erawati Copyright © 2017 Junaiti Sahar et al. All rights reserved. Identification of Neuroprotective Factors Associated with Successful Ageing and Risk of Cognitive Impairment among Malaysia Older Adults Tue, 03 Oct 2017 08:36:36 +0000 The increase of ageing population has raised public attention on the concept of successful ageing. Studies have shown that vitamin D, telomere length, and brain-derived neurotrophic factor (BDNF) have been associated with cognitive function. Therefore, this study aimed to identify neuroprotective factors for cognitive decline in different ageing groups. A total of 300 older adults aged 60 years and above were recruited in this population based cross-sectional study. Participants were categorized into three groups: mild cognitive impairment (MCI) (), usual ageing (UA) (), and successful ageing (SA) (). Dietary vitamin D intake was assessed through Diet History Questionnaire (DHQ). Out of the 300 participants, only 150 were subjected to fasting blood sample collection. These samples were used for serum vitamin D and plasma BDNF measurements. Whole blood telomere length was measured using RT-PCR method. The results show that the reduction of the risk of MCI was achieved by higher serum vitamin D level (OR: 0.96, 95% CI: 0.92–0.99, ), higher plasma BDNF level (OR: 0.51, 95% CI: 0.30–0.88,  ), and longer telomere (OR: 0.97, 95% CI: 0.95–0.99,  ). In conclusion, participants with higher vitamin D level, higher BDNF level, and longer telomere length were more likely to age successfully. Huijin Lau, Arimi Fitri Mat Ludin, Nor Fadilah Rajab, and Suzana Shahar Copyright © 2017 Huijin Lau et al. All rights reserved. Do Changes in Welfare and Health Policy Affect Life Satisfaction of Older Citizens in Europe? Mon, 25 Sep 2017 07:36:09 +0000 Objectives. Ageing of societies causes serious political concerns on well-being of old citizens and care for the (frail) old. These concerns increased with the economic crisis of 2008. In European countries policy measures were taken to deal with the consequences of this crisis. This study explores the possible effects of these measures on life satisfaction of older citizens. Methods. Life satisfaction was assessed through international surveys in 2007 and 2013 and changes in societal conditions, using eight indicators on demography, welfare, and health, are assessed in 31 European countries in 2006 and in 2014. Data are standardised and based on official, national surveys and statistics. Results. The former found that U-shape relationship between age and life satisfaction disappeared after the crisis. Negative changes in social protection and care arrangements, taken after the economic crisis, are related to low life satisfaction in old citizens. Conclusions. Various societal conditions deteriorated in 2014 as compared to 2006. Policy measures, taken due to the 2008 economic crisis, have changed societal conditions and affected life satisfaction of older citizens negatively. In countries with a rudimentary structure of health and welfare provisions old citizens could not cope with the imposed policy measures. Marinela Olaroiu, Ioana Dana Alexa, and Wim J. A. van den Heuvel Copyright © 2017 Marinela Olaroiu et al. All rights reserved. Burden and Correlates of Falls among Rural Elders of South India: Mobility and Independent Living in Elders Study Tue, 13 Jun 2017 08:42:46 +0000 Aim. Falls are an important contributor to loss of function, morbidity, and mortality in elders. Little is known about falls in Indian populations. The objective of this cross-sectional report was to identify the prevalence and correlates of falls in a cohort of 562 rural southern Indian men and women. Methods. Risk factors included demographics, anthropometrics, self-reported health, medical history, physical function, vision, depression, and lifestyle. Odds ratios were calculated using logistic regression. Results. 71 (13%) subjects reported at least 1 fall in the past year. Prevalence was higher among women (17%) than men (8%), . Sex and age showed significant interaction () whereby falls prevalence increased with age among women but decreased among men. Correlates of falls among men included a history of osteoarthritis (OA) (odds ratio (OR): 6.91; 95% CI: 1.4–33.1), depression (OR:9.6; 3.1–30.1), and greater height (OR per 1 standard deviation increase: 2.33; 1.1–5.1). Among women, poor physical performance (OR: 3.33; 1.13–9.86) and history of cardiovascular disease (CVD) (OR: 2.42; 1.01–5.80) were independently associated with falls. Implications. Prevalence of falls in elderly South Indians was lower than published reports from western countries and likely reflects low exposure to fall risks. Patterns with age differed in men and women and may reflect sex differences in the accuracy of age recall. Presence of comorbidities specifically OA, CVD, and depression was independent correlate of falling. Pawan Kumar Sharma, Clareann H. Bunker, Tushar Singh, Enakshi Ganguly, P. Sudhakar Reddy, Anne B. Newman, and Jane A. Cauley Copyright © 2017 Pawan Kumar Sharma et al. All rights reserved. Associations of Pet Ownership with Older Adults Eating Patterns and Health Mon, 29 May 2017 00:00:00 +0000 Pet ownership has been shown to improve quality of life for older adults. The objective of this cross-sectional study was to compare older pet owners and older non-pet owners and assess differences between groups. This study was conducted on adults over 50 years of age, who owned either one cat or one dog versus nonowners based on age, race, gender, and education. Matched older pet owners (OPO) versus non-pet owners (NPO) pairs (), older cat owners (OCO) versus non-cat owners (NCO) (), and older dog owners (ODO) versus non-dog owners (NDO) pairs () were analyzed. No differences were found between OPO and NPO for dietary, activity, or lifestyle, except OPO had fewer health conditions []. Total OCO had greater body mass indices [BMI] () than ODO () [], less activity [], and shorter duration of activity [] and took fewer supplements []. OCO and NCO differed on health conditions ( versus , []) and ODO versus NDO differed on BMI ( versus , []). Although there are limitations to this study, data may be useful for targeting marketing and health messages to older persons. Roschelle Heuberger Copyright © 2017 Roschelle Heuberger. All rights reserved. The Relationship between Locomotive Syndrome and Depression in Community-Dwelling Elderly People Wed, 05 Apr 2017 08:20:29 +0000 Locomotive syndrome (LS) is a concept that refers to the condition of people requiring healthcare services because of problems associated with locomotion. Depression is a major psychiatric disease among the elderly, in addition to dementia. The purpose of this study was to determine the association between LS and depression. The study participants were 224 healthy elderly volunteers living in a rural area in Japan. LS was defined as scores ≥ 16 on the 25-question Geriatric Locomotive Function Scale (GLFS-25). Depression was defined as scores ≥ 5 on the 15-item Geriatric Depression Scale (GDS-15). Height and body weight were measured. The prevalence of LS and depression was 13.9% and 24.2%, respectively. Compared with the non-LS group, the LS group was older, was shorter, had a higher BMI, and had higher GDS-15 scores. Logistic regression analysis showed that participants with GDS-15 scores ≥ 6 had higher odds for LS than those with GDS-15 scores < 6 (odds ratio [OR] = 4.22). Conversely, the depression group had higher GLFS-25 scores than the nondepression group. Participants with GLFS-25 scores ≥ 5 had higher odds for depression than those with GLFS-25 scores < 5 (OR = 4.53). These findings suggest that there is a close relationship between LS and depression. Misa Nakamura, Hiroshi Hashizume, Sachiko Nomura, Ryohei Kono, and Hirotoshi Utsunomiya Copyright © 2017 Misa Nakamura et al. All rights reserved. Age-Friendliness and Life Satisfaction of Young-Old and Old-Old in Hong Kong Fri, 24 Feb 2017 00:00:00 +0000 Age-friendliness, promoted by the World Health Organization (WHO), aims to enable and support individuals in different aspects of life for fostering life satisfaction and personal well-being as they age. We identified specific aspect(s) of age-friendliness associated with life satisfaction and examined similarities and differences in age-friendliness and life satisfaction in young-old and old-old adults. Six hundred and eighty-two ageing adults were asked to complete a survey questionnaire consisting of the Age-friendly City Scale, Satisfaction with Life Scale, and sociodemographic variables. Multiple linear regression analysis was used to examine the effects of various domains of age-friendliness on life satisfaction among the young-old adults (aged 65 to 74, ) and the old-old adults (aged 75 to 97, ). Common domains associated with life satisfaction in both young-old and old-old groups were transportation and social participation. Community and health services were associated with life satisfaction for the young-old group only. On the other hand, civic participation and employment was significantly associated with the old-old group only. Social participation is important for the young-old and the old-old. Ageing older adults can be a resource to the society. Implications for promoting and implementing age-friendliness were discussed in the context of successful and productive ageing and the need for a more refined taxonomy of social activities. Alma M. L. Au, Stephen C. Y. Chan, H. M. Yip, Jackie Y. C. Kwok, K. Y. Lai, K. M. Leung, Anita L. F. Lee, Daniel W. L. Lai, Teresa Tsien, and Simon M. K. Lai Copyright © 2017 Alma M. L. Au et al. All rights reserved. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey Tue, 21 Feb 2017 07:55:49 +0000 Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants’ smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (<12 g/dL in women and <13 g/dL in men). Gender-specific logistic regression models were used to examine the association between demographic and health characteristics and anemia. Results. A total of 2,372 subjects with a mean age of 71.8 (SD 8.2) years had their hemoglobin measured, representing an estimated 1.1 million older adults. The crude prevalence of anemia was 20.0% in women and 25.2% in men. However, higher anemia prevalence rates were seen with advancing age among black women and subjects residing in the urban coast. Likewise, certain health conditions such as hypoalbuminemia, cancer in men, chronic kidney disease, iron deficiency, and low grade inflammation were associated with increased odds of having anemia. Conclusions. Anemia is a prevalent condition among older adults in Ecuador. Moreover, further research is needed to examine the association between anemia and adverse health-related outcomes among older Ecuadorians. Carlos H. Orces Copyright © 2017 Carlos H. Orces. All rights reserved. Pancreatic Surgery in the Older Population: A Single Institution’s Experience over Two Decades Sun, 27 Nov 2016 09:01:41 +0000 Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups. Results. Even though patients aged 75 years or older had significantly more postoperative morbidities compared with the younger patient group, the age group was not associated with increased risk of 90-day mortality after pancreatic resection. Discussion. The study suggests that age alone should not preclude patients from undergoing curative pancreatic resection. Bhaumik Brahmbhatt, Abhishek Bhurwal, Frank J. Lukens, Mauricia A. Buchanan, John A. Stauffer, and Horacio J. Asbun Copyright © 2016 Bhaumik Brahmbhatt et al. All rights reserved. SABE Colombia: Survey on Health, Well-Being, and Aging in Colombia—Study Design and Protocol Sun, 13 Nov 2016 14:31:17 +0000 Objective. To describe the design of the SABE Colombia study. The major health study of the old people in Latin America and the Caribbean (LAC) is the Survey on Health, Well-Being, and Aging in LAC, SABE (from initials in Spanish: SAlud, Bienestar & Envejecimiento). Methods. The SABE Colombia is a population-based cross-sectional study on health, aging, and well-being of elderly individuals aged at least 60 years focusing attention on social determinants of health inequities. Methods and design were similar to original LAC SABE. The total sample size of the study at the urban and rural research sites (244 municipalities) was 23.694 elderly Colombians representative of the total population. The study had three components: (1) a questionnaire covering active aging determinants including anthropometry, blood pressure measurement, physical function, and biochemical and hematological measures; (2) a subsample survey among family caregivers; (3) a qualitative study with gender and cultural perspectives of quality of life to understand different dimensions of people meanings. Conclusions. The SABE Colombia is a comprehensive, multidisciplinary study of the elderly with respect to active aging determinants. The results of this study are intended to inform public policies aimed at tackling health inequalities for the aging society in Colombia. Fernando Gomez, Jairo Corchuelo, Carmen-Lucia Curcio, Maria-Teresa Calzada, and Fabian Mendez Copyright © 2016 Fernando Gomez et al. All rights reserved. Muscle Functions and Functional Performance among Older Persons with and without Low Back Pain Mon, 31 Oct 2016 14:51:48 +0000 This study aims to compare muscle functions and functional performances between older persons with and without low back pain (LBP) and to determine the association between muscle functions and functional performances. This is a cross-sectional study, involving 95 older persons (age = years). Anthropometric characteristics, muscle functions, and functional performances were measured. Data were analyzed using ANOVA, Pearson’s correlation, and multiple linear regression. The functional performances showed no significant differences (females LBP versus non-LBP, males LBP versus non-LBP) (). For muscle functions, significant differences were found (females LBP versus non-LBP) for abdominal muscle strength () and back muscle strength (). In the LBP group, significant correlations were found between back and abdominal muscle strength and hand grip strength ( and , resp.), multifidus control and lower limb function () in females, and back muscle strength and lower limb function () in males (all ). Regression analysis showed that abdominal and back muscle strengths were significant predictors of hand grip strength ( and , resp.), and multifidus control was a significant predictor of lower limb function in females (). This study demonstrates that older women with LBP exhibit poorer muscle functions compared to older women without LBP. Nor Azizah Ishak, Zarina Zahari, and Maria Justine Copyright © 2016 Nor Azizah Ishak et al. All rights reserved. Elder Orphans Hiding in Plain Sight: A Growing Vulnerable Population Sun, 23 Oct 2016 13:05:38 +0000 Adults are increasingly aging alone with multiple chronic diseases and are geographically distant from family or friends. It is challenging for clinicians to identify these individuals, often struggling with managing the growing difficulties and the complexities involved in delivering care to this population. Clinicians often may not recognize or know how to address the needs that these patients have in managing their own health. While many such patients function well at baseline, the slightest insult can initiate a cascade of avoidable negative events. We have resurrected the term elder orphan to describe individuals living alone with little to no support system. Using public data sets, including the US Census and University of Michigan’s Health and Retirement Study, we estimated the prevalence of adults 65 years and older to be around 22%. Thus, in this paper, we strive to describe and quantify this growing vulnerable population and offer practical approaches to identify and develop care plans that are consistent with each person’s goals of care. The complex medical and psychosocial issues for elder orphans significantly impact the individual person, communities, and health-care expenditures. We hope to encourage professionals across disciplines to work cooperatively to screen elders and implement policies to prevent elder orphans from hiding in plain sight. Maria T. Carney, Janice Fujiwara, Brian E. Emmert Jr., Tara A. Liberman, and Barbara Paris Copyright © 2016 Maria T. Carney et al. All rights reserved. Osteosarcopenic Obesity Syndrome: What Is It and How Can It Be Identified and Diagnosed? Wed, 07 Sep 2016 13:25:56 +0000 Conditions related to body composition and aging, such as osteopenic obesity, sarcopenia/sarcopenic obesity, and the newly termed osteosarcopenic obesity (triad of bone muscle and adipose tissue impairment), are beginning to gain recognition. However there is still a lack of definitive diagnostic criteria for these conditions. Little is known about the long-term impact of these combined conditions of osteoporosis, sarcopenia, and obesity in older adults. Many may go undiagnosed and progress untreated. Therefore, the objective of this research is to create diagnostic criteria for osteosarcopenic obesity in older women. The proposed diagnostic criteria are based on two types of assessments: physical, via body composition measurements, and functional, via physical performance measures. Body composition measurements such as -scores for bone mineral density, appendicular lean mass for sarcopenia, and percent body fat could all be obtained via dual energy X-ray absorptiometry. Physical performance tests: handgrip strength, one-leg stance, walking speed, and sit-to-stand could be assessed with minimal equipment. A score could then be obtained to measure functional decline in the older adult. For diagnosing osteosarcopenic obesity and other conditions related to bone loss and muscle loss combined with obesity, a combination of measures may more adequately improve the assessment process. Jasminka Z. Ilich, Owen J. Kelly, and Julia E. Inglis Copyright © 2016 Jasminka Z. Ilich et al. All rights reserved. The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years Tue, 19 Jul 2016 09:39:10 +0000 Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons. Methods. Community-dwelling persons aged 65–70 years (). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards). Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: −.040, 95% CI: −.0.78 to −.002, ). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories. Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status. Laurence Seematter-Bagnoud, Christophe Büla, and Brigitte Santos-Eggimann Copyright © 2016 Laurence Seematter-Bagnoud et al. All rights reserved. Does Frailty Predict Health Care Utilization in Community-Living Older Romanians? Sun, 17 Jul 2016 08:46:24 +0000 Background. The predictive value of frailty assessment is still debated. We analyzed the predictive value of frailty of independent living elderly. The outcomes variables were visits to the general practitioner, hospital admission, and occurrence of new health problems. Methods. A one-year follow-up study was executed among 215 community-living old Romanians. General practitioners reported the outcome variables of patients, whose frailty was assessed one year before, using the Groningen Frailty Indicator. The predictive validity is analyzed by descriptive and regression analysis. Results. Three-quarters of all participants visited their general practitioner three times more last year and one-third were at least once admitted to a hospital. Patients who scored frail one year before were more often admitted to a hospital. Visits to the general practitioner and occurrence of new health problems were not statistically significant related to frailty scores. The frailty items polypharmacy, social support, and activities in daily living were associated with adverse outcomes. Conclusions. The predictive value of frailty instruments as the Groningen Frailty Indicator is still limited. More research is needed to predict health outcomes, health care utilization, and quality of life of frailty self-assessment instruments. Validation research on frailty in different “environments” is recommended to answer the question to what extent contextual characteristics influence the predictive value. Marinela Olaroiu, Minerva Ghinescu, Viorica Naumov, Ileana Brinza, and Wim van den Heuvel Copyright © 2016 Marinela Olaroiu et al. 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.