Journal of Aging Research The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. An Online Platform to Support the Network of Caregivers of People with Dementia Tue, 15 Aug 2017 00:00:00 +0000 Increasing numbers of persons with dementia (PWD) augment the pressure on dementia care, especially informal care. Care technology can support the network of PWD. We tested the usability and perceived value of an online platform that aims to support the communication and collaboration between family and professional caregivers of PWD. A mixed methods design was used for this pilot study, including semistructured interviews, a postal questionnaire, and monitoring of log data. Seven family and thirty-two professional caregivers involved with four PWD participated during a 10-week period. Overall, the results indicate that the platform is easy to use and valuable for both family and professional caregivers. They felt better informed and prepared regarding the situation of the PWD and felt supported by the more direct lines of communication within the network. Also, a broadening and deepening of the relationship between family and professional caregivers was experienced. Although connecting care organizations’ record systems with the platform and an active contribution of all care professionals involved (e.g., general practitioners and those working at day care units) were suggested for optimal use of the platform, family and professional caregivers positively valued the platform for improving the efficiency and ease of communication and collaboration. April B. C. G. Boessen, Renée Verwey, Saskia Duymelinck, and Erik van Rossum Copyright © 2017 April B. C. G. Boessen et al. All rights reserved. Gender, Success, and Drop-Out during a Resistance Exercise Program in Community Dwelling Old Adults Mon, 14 Aug 2017 06:14:11 +0000 Background. Resistance exercise training can be effective against sarcopenia. We identified predictors of drop-out and compared physical outcomes between men and women after such training. Methods. Subjects (, years) participated in a 12-week resistance exercise program. Outcome variables were measured at baseline and endpoint. Results. Drop-out was 11.9% and not significantly different between genders. Drop-outs were significantly older and had poorer strength and physical function in comparison to completers. Anthropometrics, QoL, and cognitive function were not related to drop-out. According to multivariate analysis, gait speed and physical activity were the strongest predictors of drop-out. After the training, gains in lean mass or appendicular muscle were significantly higher in men than women; however relative gains in appendicular muscle as well as absolute improvements in strength and function were similar in men and women, respectively. Conclusions. Participants who drop out are older, have poorer physical function, and are less physically active. Old women do not drop out more frequently than men and show meaningful improvements in relevant outcomes similar to men after such a training program. The trial is registered at the US National Library of Medicine (NCT01074879). O. G. Geirsdottir, M. Chang, K. Briem, P. V. Jonsson, I. Thorsdottir, and A. Ramel Copyright © 2017 O. G. Geirsdottir et al. All rights reserved. Everyday Health among Older People: A Comparison between Two Countries with Variant Life Conditions Thu, 10 Aug 2017 06:00:52 +0000 This study described health factors of importance for everyday health, such as pain, tiredness, and sleeping problems, in a cross-national context. Data for persons 60+ years were obtained from the Poverty and Health in Aging study, Bangladesh, and the Swedish National Study on Aging and Care-Blekinge. The strongest associations with everyday health in Sweden were found for pain and tiredness, while in Bangladesh they were financial status, tiredness, and sleeping problems. As similarities were found regarding the associations of tiredness on everyday health, tiredness may be a universal predictor of everyday health in older adults irrespective of country context. Cecilia Fagerström, Lena Sandin Wranker, Zarina Nahar Kabir, and Ola Sternäng Copyright © 2017 Cecilia Fagerström et al. All rights reserved. Validity of the German Version of the Continuous-Scale Physical Functional Performance 10 Test Sun, 09 Jul 2017 08:58:55 +0000 Background. The Continuous-Scale Physical Functional Performance 10 Test (CS-PFP 10) quantitatively assesses physical functional performance in older adults who have a broad range of physical functional ability. This study assessed the validity and reliability of the CS-PFP 10 German version. Methods. Forward-translations and backtranslations as well as cultural adaptions of the test were conducted. Participants were German-speaking Swiss community-dwelling adults aged 64 and older. Concurrent validity was assessed using Pearson correlation coefficients between CS-PFP 10 and gait velocity, Timed Up and Go Test, hand grip strength, SF-36 physical function domain, and Freiburger Physical Activity Questionnaire. Internal consistency was calculated by Cronbach’s alpha. Results. Backtranslation and cultural adaptions were accepted by the CS-PFP 10 developer. CS-PFP 10 total score and subscores (upper body strength, upper body flexibility, lower body strength, balance and coordination, and endurance) correlated significantly with all measures of physical function tested. Internal consistency was high (Cronbach’s alpha 0.95–0.98). Conclusion. The CS-PFP 10 German version is valid and reliable for measuring physical functional performance in German-speaking Swiss community-dwelling older adults. Quantifying physical function is essential for clinical practice and research and provides meaningful insight into physical functional performance of older adults. This trial is registered with NCT01539200. Irene Härdi, Stephanie A. Bridenbaugh, M. Elaine Cress, and Reto W. Kressig Copyright © 2017 Irene Härdi et al. All rights reserved. The Cooccurrence of Obesity, Osteoporosis, and Sarcopenia in the Ovariectomized Rat: A Study for Modeling Osteosarcopenic Obesity in Rodents Thu, 01 Jun 2017 10:10:06 +0000 Background. Obesity, osteoporosis, and sarcopenia may individually occur due to age-related gradual alterations in body composition. This study investigates the cooccurrence of these age-related diseases in female animals with low levels of ovarian hormone in the absence of complex multifactorial process of chronological aging. Methods. Thirty-six 5- and 10-month-old female rats were chosen to model pre- and postmenopausal women, respectively. Rats were divided into three treatment groups in each age category—sham, ovariectomized (ovx), and ovx + E2 (17β-estradiol, 10 μg/kg)—and were pair-fed. Volunteer wheel running activity, body composition, bone microstructure, serum C-telopeptides of type I collagen, bone specific alkaline phosphatase, E2, and gastrocnemius and soleus muscles were analyzed. Results. The cooccurrence of osteoporosis, sarcopenia, and obesity was observed in the older ovx rats associated with a significant () increased fat mass (30%), bone loss (9.6%), decreased normalized muscle mass-to-body-weight ratio (10.5%), and a significant decrease in physical activity (57%). The ratio of tibial bone mineral density to combined muscle mass was significantly decreased in both ovx age categories. Conclusion. Ovariectomized rat could be used as an experimental model to examine the effect of loss of ovarian hormones, while controlling for energy intake and expenditure, to conduct obesity and body composition translational research in females without the confounding effect of genetic background. Zahra Ezzat-Zadeh, Jeong-Su Kim, P. Bryant Chase, and Bahram H. Arjmandi Copyright © 2017 Zahra Ezzat-Zadeh et al. All rights reserved. Home Features and Assistive Technology for the Home-Bound Elderly in a Thai Suburban Community by Applying the International Classification of Functioning, Disability, and Health Thu, 01 Jun 2017 09:39:39 +0000 The ageing population is having an impact worldwide and has created a serious challenge in Thailand’s healthcare systems, whereby healthcare practitioners play a major role in promoting independent interaction of their client’s abilities, as well as environmental factors. The purpose of this study was to survey features of the home and assistive technology (AT) for the home-bound elderly in the community of Chiang Mai, Thailand. Home evaluation included features inside and outside the home, and AT was based on the International Classification of Functioning, Disability, and Health (ICF) concept. Methods included observation and an interview that were used by the researcher for evaluation. The study found that every home had at least one hazardous home feature such as inappropriate width of the door, high door threshold, tall stair steps, no bedside rail, and inappropriate height of the toilet pan. AT was found in houses as general products and technology for personal use in daily living and for personal indoor and outdoor mobility as well as transportation. Therefore, home features and AT can afford the home-bound elderly independent living within the community. Perspective AT according to the ICF concept could provide a common language for ageing in place benefits. Supawadee Putthinoi, Suchitporn Lersilp, and Nopasit Chakpitak Copyright © 2017 Supawadee Putthinoi et al. All rights reserved. Decline in Memory, Visuospatial Ability, and Crystalized Cognitive Abilities in Older Adults: Normative Aging or Terminal Decline? Mon, 29 May 2017 09:29:34 +0000 The aim of this study is to explore the pattern of change in multiple measures of cognitive abilities in a sample of oldest-old adults, comparing two different time metrics (chronological age and time to death) and therefore examining both underlying conceptual assumptions (age-related change and terminal decline). Moreover, the association with individual characteristics as sex, education, and dementia diagnosis was also examined. Measures of cognitive status (Mini-Mental State Examination and the Swedish Clock Test) and tests of crystallized (knowledge and synonyms), memory (verbal memory, nonverbal long-term memory, recognition and correspondence, and short-term memory), and visuospatial ability were included. The sample consisted of 671 older Swedish adult participants of the OCTO Twin Study. Linear mixed models with random coefficients were used to analyse change patterns and BIC indexes were used to compare models. Results showed that the time to death model was the best option in analyses of change in all the cognitive measures considered (except for the Information Test). A significant cognitive decline over time was found for all variables. Individuals diagnosed with dementia had lower scores at the study entrance and a faster decline. More educated individuals performed better in all the measures of cognition at study entry than those with poorer education, but no differences were found in the rate of change. Differences were found in age, sex, or time to death at baseline across the different measures. These results support the terminal decline hypothesis when compared to models assuming that cognitive changes are driven by normative aging processes. R. Bendayan, A. M. Piccinin, S. M. Hofer, D. Cadar, B. Johansson, and G. Muniz-Terrera Copyright © 2017 R. Bendayan et al. All rights reserved. Polypharmacy among Underserved Older African American Adults Tue, 23 May 2017 00:00:00 +0000 The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants’ characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively. Thirty-eight percent of participants received prescription medications from at least three providers. Inappropriate drug use occurred among seventy percent of the participants. Multivariate analysis showed that number of providers was the strongest correlate of polypharmacy. Moreover, data show that gender, comorbidity, and potentially inappropriate medication use are other major correlates of polypharmacy. Conclusions. This study shows a high rate of polypharmacy and potentially inappropriate medication use among underserved older African American adults. We documented strong associations between polypharmacy and use of potentially inappropriate medications, comorbidities, and having multiple providers. Polypharmacy and potentially inappropriate medications may be attributed to poor coordination and management of medications among providers and pharmacists. There is an urgent need to develop innovative and effective strategies to reduce inappropriate polypharmacy and potentially inappropriate medication in underserved elderly minority populations. Mohsen Bazargan, James Smith, Masoud Movassaghi, David Martins, Hamed Yazdanshenas, Seyede Salehe Mortazavi, and Gail Orum Copyright © 2017 Mohsen Bazargan et al. All rights reserved. Effects of Medicare Coverage of a “Welcome-to-Medicare” Visit on Use of Preventive Services among New Medicare Enrollees Thu, 04 May 2017 08:09:10 +0000 In January 2005, Medicare began covering a one-time initial preventive physical examination (IPPE), also called a “Welcome-to-Medicare” visit, during a beneficiary’s first 6 months under Part B. This paper examines the effects of offering Medicare IPPE coverage on the use of mammograms, breast self-exams, Pap smears, prostate cancer screenings, cholesterol screenings, and flu vaccines among beneficiaries new to Part B. We adopt a difference-in-difference estimator and estimate a set of multivariate logit models to quantify the effects of introducing Medicare IPPE coverage on the use of preventive services. Models are estimated separately for men and women. Data for the analysis come from the 1996–2008 Health and Retirement Study. Among both men and women, having coverage for a one-time IPPE under Medicare had no effects on the utilization of any of the preventive services listed above. In this study, we find that offering coverage for a one-time IPPE under Medicare was insufficient to spur greater use of preventive services among new Medicare beneficiaries. These findings are important and suggest that policy-makers may need to consider other approaches to increase the use of recommended preventive services. Boon Peng Ng, Gail A. Jensen, and Heather Fritz Copyright © 2017 Boon Peng Ng et al. All rights reserved. Patient Perspectives on Engagement in Recovery after Hip Fracture: A Qualitative Study Mon, 20 Mar 2017 09:38:32 +0000 Purpose. To understand older adults’ engagement in their recovery experience and rehabilitation after a fall-related hip fracture. Method. 50 community-dwelling older adults recovering from a recent (3–12 months) hip fracture (32 women, 18 men) participated in telephone interviews using a semistructured format at 6 and 12 months after recruitment into the study. Interviews were conducted as part of a mixed-methods study designed to test the effect of a postoperative hip fracture management program (B4 Clinic). Results. Three substantive themes were identified in the qualitative data: (1) managing expectations; (2) engaging in physical activity; and (3) there is life after fracture. Participants shared valuable insight into how their expectations for their recovery period compared to their lived experience and the role of physical activity in their ability to return to their prefracture activities. Conclusions. Our findings reflect older adults’ expectations for recovery from hip fracture. Encouraging engagement in rehabilitative exercises and addressing expectations prior to hospital discharge may improve patients’ adherence to rehabilitation programs, functional outcomes, and postoperative quality of life. Implications for rehabilitation include the necessity for early and ongoing engagement of rehabilitation professionals. Joanie Sims-Gould, Sarah Stott-Eveneshen, Lena Fleig, Megan McAllister, and Maureen C. Ashe Copyright © 2017 Joanie Sims-Gould et al. All rights reserved. Effects of Multicomponent Exercise on Functional and Cognitive Parameters of Hypertensive Patients: A Quasi-Experimental Study Sun, 19 Mar 2017 00:00:00 +0000 Purpose. The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP) on physical function and cognitive parameters of normotensive (NTS) and hypertensive (HTS) older patients and verify if age can influence the adaptations in response to the exercise. Methods. A total of 218 subjects, 101 NTS and 117 HTS, were recruited and underwent functional and cognitive evaluations before and after six months of a MCEP. The program of exercise was performed twice a week, for 26 weeks. The physical exercises were thought to mimic the activities of daily living and, therefore, aggregated functional and walking exercises. Exercise sessions were performed at moderate intensity. Results. Data indicated that HTS and NST patients showed a similar increase in the performance of walking speed test and one-leg stand test after the MCEP. Regarding age, results did not show differences in the magnitude of adaptations between old and young HTS and NTS patients. Conclusions. Data of the present study indicated that a 6-month MCEP was able to increase equally balance and mobility in NTS and HTS patients. Moreover, data demonstrated that aging did not seem to impair the capacity to adapt in response to exercise in both groups. Hélio José Coelho Junior, Bruno Rodrigues, Daniele Jardim Feriani, Ivan de Oliveira Gonçalves, Ricardo Yukio Asano, Samuel da Silva Aguiar, and Marco Carlos Uchida Copyright © 2017 Hélio José Coelho Junior et al. All rights reserved. Knockout of Vasohibin-1 Gene in Mice Results in Healthy Longevity with Reduced Expression of Insulin Receptor, Insulin Receptor Substrate 1, and Insulin Receptor Substrate 2 in Their White Adipose Tissue Mon, 06 Mar 2017 07:34:24 +0000 Vasohibin-1 (Vash1), originally isolated as an endothelium-derived angiogenesis inhibitor, has a characteristic of promoting stress tolerance in endothelial cells (ECs). We therefore speculated that the lack of the vash1 gene would result in a short lifespan. However, to our surprise, vash1−/− mice lived significantly longer with a milder senescence phenotype than wild-type (WT) mice. We sought the cause of this healthy longevity and found that vash1−/− mice exhibited mild insulin resistance along with reduced expression of the insulin receptor (insr), insulin receptor substrate 1 (irs-1), and insulin receptor substrate 2 (irs-2) in their white adipose tissue (WAT) but not in their liver or skeletal muscle. The expression of vash1 dominated in the WAT among those 3 organs. Importantly, vash1−/− mice did not develop diabetes even when fed a high-fat diet. These results indicate that the expression of vash1 was required for the normal insulin sensitivity of the WAT and that the target molecules for this activity were insr, irs1, and irs2. The lack of vash1 caused mild insulin resistance without the outbreak of overt diabetes and might contribute to healthy longevity. Eichi Takeda, Yasuhiro Suzuki, Tetsuya Yamada, Hideki Katagiri, and Yasufumi Sato Copyright © 2017 Eichi Takeda et al. All rights reserved. Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial Sun, 05 Feb 2017 11:47:19 +0000 Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p < 0.001) after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with Identifier NCT02190045. Kalpana P. Padala, Prasad R. Padala, Shelly Y. Lensing, Richard A. Dennis, Melinda M. Bopp, Christopher M. Parkes, Mark K. Garrison, Patricia M. Dubbert, Paula K. Roberson, and Dennis H. Sullivan Copyright © 2017 Kalpana P. Padala et al. All rights reserved. Measuring Fluid Intelligence in Healthy Older Adults Mon, 30 Jan 2017 10:05:48 +0000 The present study evaluated subjective and objective cognitive measures as predictors of fluid intelligence in healthy older adults. We hypothesized that objective cognitive measures would predict fluid intelligence to a greater degree than self-reported cognitive functioning. Ninety-three healthy older (>65 years old) community-dwelling adults participated. Raven’s Advanced Progressive Matrices (RAPM) were used to measure fluid intelligence, Digit Span Sequencing (DSS) was used to measure working memory, Trail Making Test (TMT) was used to measure cognitive flexibility, Design Fluency Test (DFT) was used to measure creativity, and Tower Test (TT) was used to measure planning. The Cognitive Failures Questionnaire (CFQ) was used to measure subjective perceptions of cognitive functioning. RAPM was correlated with DSS, TT, and DFT. When CFQ was the only predictor, the regression model predicting fluid intelligence was not significant. When DSS, TMT, DFT, and TT were included in the model, there was a significant change in the model and the final model was also significant, with DFT as the only significant predictor. The model accounted for approximately 20% of the variability in fluid intelligence. Our findings suggest that the most reliable means of assessing fluid intelligence is to assess it directly. Mohammed K. Shakeel and Vina M. Goghari Copyright © 2017 Mohammed K. Shakeel and Vina M. Goghari. All rights reserved. Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward Tue, 29 Nov 2016 09:27:35 +0000 Background. A risk factor associated with stroke onset is chronic kidney disease (CKD). To prevent stroke reoccurrence, it is necessary to strictly manage blood pressure, lipids, and plasma glucose. Therefore, some cases are forced to polypharmacy, elderly patients in particular. Polypharmacy often leads to adverse drug reactions and has the potential to negatively affect the rehabilitation of stroke patients. The aim of the present study was to investigate the effects of polypharmacy using a functional independence measure (FIM). Methods. A total of 144 stroke patients with CKD were included in the present analysis. We divided stroke patients into those taking six or more drugs (polypharmacy group) and those taking less than six drugs (nonpolypharmacy group) upon admission. Patient background features, laboratory data, and FIM scores were compared. Results. FIM-Motor (FIM-M) efficiency, age, and diabetes mellitus were positively associated with polypharmacy. FIM-M efficiency in the polypharmacy group was significantly lower than in the nonpolypharmacy group. Conclusion. Polypharmacy interferes with the effect of rehabilitation in stroke patients with CKD. Pharmacists and doctors should make efforts to optimize medications to be able to respond to the outcome of each patient. Eiji Kose, Riku Maruyama, Susumu Okazoe, and Hiroyuki Hayashi Copyright © 2016 Eiji Kose et al. All rights reserved. Robotic Seals as Therapeutic Tools in an Aged Care Facility: A Qualitative Study Sun, 20 Nov 2016 13:55:34 +0000 Robots, including robotic seals, have been used as an alternative to therapies such as animal assisted therapy in the promotion of health and social wellbeing of older people in aged care facilities. There is limited research available that evaluates the effectiveness of robot therapies in these settings. The aim of this study was to identify, explore, and describe the impact of the use of Paro robotic seals in an aged care facility in a regional Australian city. A qualitative, descriptive, exploratory design was employed. Data were gathered through interviews with the three recreational therapists employed at the facility who were also asked to maintain logs of their interactions with the Paro and residents. Data were transcribed and thematically analysed. Three major themes were identified from the analyses of these data: “a therapeutic tool that’s not for everybody,” “every interaction is powerful,” and “keeping the momentum.” Findings support the use of Paro as a therapeutic tool, revealing improvement in emotional state, reduction of challenging behaviours, and improvement in social interactions of residents. The potential benefits justify the investment in Paro, with clear evidence that these tools can have a positive impact that warrants further exploration. Melanie Birks, Marie Bodak, Joanna Barlas, June Harwood, and Mary Pether Copyright © 2016 Melanie Birks et al. All rights reserved. Living on the Edge: Social Exclusion and the Receipt of Informal Care in Older People Tue, 01 Nov 2016 09:55:53 +0000 Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care is provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion. A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people () living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care-receiver; assurance-receiver; nonreceiver with no need; and nonreceiver with need. Compared to being a nonreceiver with no need, participants were more likely to be care-receivers or assurance-receivers if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in nonreceivers with need. Despite a lack of informal care and support, formal practical support and personal care were also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of nonreceivers with need. Lena Dahlberg and Kevin J. McKee Copyright © 2016 Lena Dahlberg and Kevin J. McKee. All rights reserved. Death Anxiety, Reliability, Validity, and Factorial Structure of the Farsi Form of the Arabic Scale of Death Anxiety in Iranian Old-Aged Persons Thu, 27 Oct 2016 13:47:08 +0000 The present study is aimed at examining the level of death anxiety and the sex-related differences among old-aged Iranian individuals sample to compare the old-aged persons with young college students and to explore the psychometric properties of the Arabic Scale of Death Anxiety (ASDA) factors in old-aged sample. A sample of 146 volunteer Iranian individuals took part in the study. The mean ages were 68.58 (SD = 7.10), men 68.81 (SD = 7.44) and women 68.28 (SD = 6.76), respectively. The mean score of the ASDA was 51.09 (SD = 20.19). Cronbach’s alpha of the ASDA was found to be high (0.94); and Spearman-Brown coefficient was 0.92. Women had a significantly higher mean total score on the ASDA. Old-aged individuals had a significantly higher mean ASDA total score than younger college students (M age = 25.77). The factor analysis of the ASDA items yielded three factors accounting for 67.88% of the total variance labeled (F1) fear of dead people and tombs; (F2) fear of lethal disease and postmortem events; and (F3) death fear. These factors were highly replicable with previous factors extracted from a middle-aged Kuwaiti sample. On the basis of the present results, there are the following three general conclusions: death anxiety is not significantly correlated with age; the sex-related differences on death anxiety are striking in the Iranian samples; and the ASDA has a highly replicable factor structure among two Iranian and Arab countries. Mahboubeh Dadfar, David Lester, and Fazel Bahrami Copyright © 2016 Mahboubeh Dadfar et al. All rights reserved. Active and Healthy Ageing and Independent Living 2016 Wed, 12 Oct 2016 06:06:50 +0000 Maddalena Illario, Miriam M. R. Vollenbroek-Hutten, D. William Molloy, Enrica Menditto, Guido Iaccarino, and Patrik Eklund Copyright © 2016 Maddalena Illario et al. All rights reserved. Implementation of an Evidence-Based Exercise Program for Older Adults in South Florida Wed, 05 Oct 2016 09:51:17 +0000 Introduction. This study aimed to examine how well an evidence-based physical activity program could be translated for wide scale dissemination and adoption to increase physical activity among community-dwelling older adults. Methods. Between October 2009 and December 2012, reach, fidelity, dosage, ease of implementation, and barriers to translation of EnhanceFitness (EF) were assessed. To assess effectiveness, a pretest-posttest design was used to measure increases in functional fitness (chair stands, arm curls, and the up-and-go test). Results. Fourteen community-based agencies offered 126 EF classes in 83 different locations and reached 4,490 older adults. Most participants were female (72%). Thirty-eight percent of participants did not complete the initial 16-week EF program. The 25% who received the recommended dose experienced an increase in upper and lower body strength and mobility. Further, participants reported high satisfaction with the program. Conclusion. EF was successfully implemented in a variety of settings throughout South Florida and reached a large number of older adults. However, challenges were encountered in ensuring that those who participated received a program dose that would lead to beneficial gains in functional fitness. Richard C. Palmer, Anamica Batra, Chelsie Anderson, Timothy Page, Edgar Vieira, and Laura Seff Copyright © 2016 Richard C. Palmer et al. All rights reserved. Does Sensory Function Decline Independently or Concomitantly with Age? Data from the Baltimore Longitudinal Study of Aging Tue, 27 Sep 2016 11:49:42 +0000 Objectives. To investigate whether sensory function declines independently or in parallel with age within a single individual. Methods. Cross-sectional analysis of Baltimore Longitudinal Study of Aging (BLSA) participants who underwent vision (visual acuity threshold), proprioception (ankle joint proprioceptive threshold), vestibular function (cervical vestibular-evoked myogenic potential), hearing (pure-tone average audiometric threshold), and Health ABC physical performance battery testing. Results. A total of 276 participants (mean age 70 years, range 26–93) underwent all four sensory tests. The function of all four systems declined with age. After age adjustment, there were no significant associations between sensory systems. Among 70–79-year-olds, dual or triple sensory impairment was associated with poorer physical performance. Discussion. Our findings suggest that beyond the common mechanism of aging, other distinct (nonshared) etiologic mechanisms may contribute to decline in each sensory system. Multiple sensory impairments influence physical performance among individuals in middle old-age (age 70–79). Shekhar K. Gadkaree, Daniel Q. Sun, Carol Li, Frank R. Lin, Luigi Ferrucci, Eleanor M. Simonsick, and Yuri Agrawal Copyright © 2016 Shekhar K. Gadkaree et al. All rights reserved. Personality Traits in College Students and Caregiving for a Relative with a Chronic Health Condition Tue, 06 Sep 2016 13:59:14 +0000 The purpose of this study was to investigate among college students the relationship between personality traits and willingness to care for a relative with a chronic health condition. 329 undergraduate students completed an online questionnaire. Hierarchical multiple regressions found that after controlling for demographics personality traits explained 10% of the variance in willingness to provide emotional care, 7% in instrumental care, and 7% in nursing care. Within these models, greater empathy was uniquely associated with willingness to provide emotional, instrumental, and nursing care for a family member in the future. Similarly, participants with high agreeableness were more willing to provide emotional care, and participant older age was a unique predictor of instrumental care. The results can help shape research on interventions that incorporate perspective taking, motivational interviewing, and training in life skills as a means of boosting college students’ willingness to provide care for a relative with a chronic health condition. Michael A. Trujillo, Paul B. Perrin, Aaliah Elnasseh, Bradford S. Pierce, and Melody Mickens Copyright © 2016 Michael A. Trujillo et al. All rights reserved. Perspectives on the Role and Synergies of Architecture and Social and Built Environment in Enabling Active Healthy Aging Tue, 30 Aug 2016 09:29:09 +0000 Research has demonstrated that enabling societal and physical infrastructure and personal accommodations enhance healthy and active aging throughout the lifespan. Yet, there is a paucity of research on how to bring together the various disciplines involved in a multidomain synergistic collaboration to create new living environments for aging. This paper aims to explore the key domains of skills and knowledge that need to be considered for a conceptual prototype of an enabling educational process and environments where healthcare professionals, architects, planners, and entrepreneurs may establish a shared theoretical and experiential knowledge base, vocabulary, and implementation strategies, for the creation of the next generation of living communities of active healthy adults, for persons with disabilities and chronic disease conditions. We focus on synergistic, paradigmatic, simple, and practical issues that can be easily upscaled through market mechanisms. This practical and physically concrete approach may also become linked with more elaborate neuroscientific and technologically sophisticated interventions. We examine the domains of knowledge to be included in establishing a learning model that focuses on the still-understudied impact of the benefits toward active and healthy aging, where architects, urban planners, clinicians, and healthcare facility managers are educated toward a synergistic approach at the operational level. Evangelia Chrysikou, Richard Rabnett, and Chariklia Tziraki Copyright © 2016 Evangelia Chrysikou et al. All rights reserved. Risk Factors for Six Types of Disability among the Older People in Thailand in 2002, 2007, and 2011 Wed, 24 Aug 2016 13:16:23 +0000 Background. There is an important need to characterize risk factors for disability in Thailand, in order to inform effective prevention and control strategies. This study investigated factors associated with risk of 6 types of disability in Thailand’s ageing population in 2002, 2007, and 2011. Methods. Data came from the Cross-Sectional National Surveys of Older Persons in Thailand conducted by the National Statistical Office (NSO) in 2002, 2007, and 2011. Stratified two-stage sampling was employed. Interviews of 24,835, 30,427, and 34,173 elderly people aged 60 and above were conducted in the respective study years. Prevalence of disabilities was measured, and factors associated with disability risk were assessed with probability-weighted multiple logistic regression. Results. Disability prevalence decreased slightly over the study period. The characteristics with greatest positive impact on disability prevalence were not working over the past week (average impact: 61.2%), age (53.7% per decade), and suffering from one or more chronic illnesses (46.3%). Conclusions. The strong observed positive impact of not working on disability prevalence suggests that raising the mandatory retirement age might result in some reduction of disability risk. Also, the observed positive impact of living with others (versus alone) on disability risk was somewhat unexpected. Pattaraporn Khongboon, Sathirakorn Pongpanich, and Robert S. Chapman Copyright © 2016 Pattaraporn Khongboon et al. All rights reserved. The Emerging Roles of the Calcineurin-Nuclear Factor of Activated T-Lymphocytes Pathway in Nervous System Functions and Diseases Mon, 15 Aug 2016 09:31:24 +0000 The ongoing epidemics of metabolic diseases and increase in the older population have increased the incidences of neurodegenerative diseases. Evidence from murine and cell line models has implicated calcineurin-nuclear factor of activated T-lymphocytes (NFAT) signaling pathway, a Ca2+/calmodulin-dependent major proinflammatory pathway, in the pathogenesis of these diseases. Neurotoxins such as amyloid-β, tau protein, and α-synuclein trigger abnormal calcineurin/NFAT signaling activities. Additionally increased activities of endogenous regulators of calcineurin like plasma membrane Ca2+-ATPase (PMCA) and regulator of calcineurin 1 (RCAN1) also cause neuronal and glial loss and related functional alterations, in neurodegenerative diseases, psychotic disorders, epilepsy, and traumatic brain and spinal cord injuries. Treatment with calcineurin/NFAT inhibitors induces some degree of neuroprotection and decreased reactive gliosis in the central and peripheral nervous system. In this paper, we summarize and discuss the current understanding of the roles of calcineurin/NFAT signaling in physiology and pathologies of the adult and developing nervous system, with an emphasis on recent reports and cutting-edge findings. Calcineurin/NFAT signaling is known for its critical roles in the developing and adult nervous system. Its role in physiological and pathological processes is still controversial. However, available data suggest that its beneficial and detrimental effects are context-dependent. In view of recent reports calcineurin/NFAT signaling is likely to serve as a potential therapeutic target for neurodegenerative diseases and conditions. This review further highlights the need to characterize better all factors determining the outcome of calcineurin/NFAT signaling in diseases and the downstream targets mediating the beneficial and detrimental effects. Maulilio John Kipanyula, Wahabu Hamisi Kimaro, and Paul F. Seke Etet Copyright © 2016 Maulilio John Kipanyula et al. All rights reserved. HIV Infection in the Elderly: Arising Challenges Tue, 09 Aug 2016 13:24:30 +0000 Globally there is an increase in the number of people living with HIV at an advanced age (50 years and above). This is mainly due to prolonged survival following the use of highly active antiretroviral therapy. Living with HIV at an advanced age has been shown to be associated with a number of challenges, both clinical and immunological. This minireview aims at discussing the challenges encountered by elderly HIV-infected patients. Bonaventura C. T. Mpondo Copyright © 2016 Bonaventura C. T. Mpondo. All rights reserved. The Effects of Exercise on the Physical Fitness of High and Moderate-Low Functioning Older Adult Women Tue, 12 Jul 2016 14:35:52 +0000 Introduction. Understanding how exercise affects individuals with varying levels of functional ability will provide further insight into the role of exercise during the aging process. It will also aid in the development of exercise programs that are appropriate for a wider spectrum of older adults. Specifically it was the primary aim of this study to determine and compare the effects of 10 weeks of community-based exercise on the cardiovascular endurance, muscular strength, flexibility, and balance fitness components of older adult women with high and moderate-low levels of physical function. Methods. Participants were placed in either the high functioning () or moderate/low functioning () groups based on their level of physical functioning. Fitness components were measured by the Senior Fitness Test and physical function was determined by the Composite Physical Function scale. Results. The results of the 3 × 2 mixed ANOVA statistical analysis showed no significant interaction effect for time ⁎ group for any of the six subtests (chair stand, arm curls, 2-minute step, chair sit-and-reach, back scratch, and 6-foot up-and-go) of the SFT. However, the main effect of time was significant for all fitness components and the main effect of group was significant for all fitness components except lower extremity flexibility. Discussion. Community-based exercise programs offering a variety of exercise types to people with varying levels of functional ability can be useful in maintaining or improving fitness and independence. These programs may also be capable of improving the self-efficacy of lower functioning older adults toward performing daily tasks. R. Christopher Mason, Michael Horvat, and Joe Nocera Copyright © 2016 R. Christopher Mason et al. All rights reserved. The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010 Tue, 12 Jul 2016 09:46:05 +0000 Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. Yaena Min, Pramit A. Nadpara, and Patricia W. Slattum Copyright © 2016 Yaena Min et al. All rights reserved. Health Status and Social Networks as Predictors of Resilience in Older Adults Residing in Rural and Remote Environments Sun, 10 Jul 2016 10:00:43 +0000 Purpose. Health status and social networks are associated with resilience among older adults. Each of these factors may be important to the ability of adults to remain in rural and remote communities as they age. We examined the association of health status and social networks and resilience among older adults dwelling in a rural and remote county in the Western United States. Methods. We selected a random sample of 198 registered voters aged 65 years or older from a frontier Wyoming county. Hierarchical linear regression was used to examine the association of health status as well as social networks and resilience. We also examined health status as a moderator of the relationship between social networks and resilience. Results. Family networks () and mental health status () significantly predicted resilience. Mental health status moderated the relationship of family () and friend () networks with resilience. Smaller family and friend networks were associated with greater resilience when mental health status was low, but not when it was high. Conclusion. Efforts to increase mental health status may improve resilience among older adults in rural environments, particularly for those with smaller family and friends networks. Christine McKibbin, Aaron Lee, Bernard A. Steinman, Catherine Carrico, Katelynn Bourassa, and Andrea Slosser Copyright © 2016 Christine McKibbin et al. All rights reserved. Active Ageing Level of Older Persons: Regional Comparison in Thailand Tue, 07 Jun 2016 10:59:25 +0000 Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different ()). Mean AAI in Central region is lower than North, Northeast, and South regions but there is no significant difference in the latter three regions of Thailand. Special emphasis should be given to Central region and policy should be undertaken for increasing active ageing level. Implementation of an Integrated Active Ageing Package (IAAP), containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons’ active ageing level in Thailand. Md. Nuruzzaman Haque Copyright © 2016 Md. Nuruzzaman Haque. All rights reserved.