Journal of Aging Research https://www.hindawi.com The latest articles from Hindawi © 2018 , Hindawi Limited . All rights reserved. Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study Wed, 17 Jan 2018 07:07:02 +0000 http://www.hindawi.com/journals/jar/2018/4180565/ Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions. Pattaraporn Khongboon and Sathirakorn Pongpanich Copyright © 2018 Pattaraporn Khongboon and Sathirakorn Pongpanich. All rights reserved. Conceptions of Healthy Aging Held by Relatives of Older Persons in Isan-Thai Culture: A Phenomenographic Study Sun, 14 Jan 2018 00:00:00 +0000 http://www.hindawi.com/journals/jar/2018/3734645/ In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons’ family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative’s perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging. Pornpun Manasatchakun, Åsa Roxberg, and Margareta Asp Copyright © 2018 Pornpun Manasatchakun et al. All rights reserved. Self-Rated Health Trajectories among Married Americans: Do Disparities Persist over 20 Years? Thu, 11 Jan 2018 10:46:20 +0000 http://www.hindawi.com/journals/jar/2018/1208598/ The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. We estimate multilevel models of SRH using six observations from 1980 to 2000 from a nationally representative panel of married individuals initially aged 25–55 (Marital Instability Over the Life Course Study). Results indicate that gender, race/ethnicity, and social class are associated with initial SRH disparities. Women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women’s health declined slower than men’s but did not differ by race/ethnicity or education. Results from complex intersectional models show that white men with any college had the highest initial SRH. Only women with any college had significantly slower declines in SRH compared to white men with any college. For married individuals of all ages, most initial SRH disparities persist over twenty years. Intersecting statuses show that education provides uneven health benefits across racial/ethnic and gender subgroups. Terceira A. Berdahl and Julia McQuillan Copyright © 2018 Terceira A. Berdahl and Julia McQuillan. All rights reserved. Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly Thu, 11 Jan 2018 10:42:12 +0000 http://www.hindawi.com/journals/jar/2018/7218102/ With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted. Cristiane Batisti Ferreira, Pâmela dos Santos Teixeira, Geiane Alves dos Santos, Athila Teles Dantas Maya, Paula Americano do Brasil, Vinícius Carolino Souza, Cláudio Córdova, Aparecido Pimentel Ferreira, Ricardo Moreno Lima, and Otávio de Toledo Nóbrega Copyright © 2018 Cristiane Batisti Ferreira et al. All rights reserved. Health Indicators of US Older Adults Who Received or Did Not Receive Meals Funded by the Older Americans Act Sun, 22 Oct 2017 07:36:13 +0000 http://www.hindawi.com/journals/jar/2017/2160819/ Background. The Older Americans Act (OAA) requires that nutrition programs provide meals and related nutrition services that promote health and help manage chronic diseases. The purpose of this study was to compare health status, food security, functional limitations, and chronic diseases of older adults who received or did not receive OAA meals using data from a representative sample of US adults. Methods. Data were from the National Health and Nutrition Surveys 2011–2014 for 2,392 older adults ≥ 65 years of age, including 187 Mexican Americans, 212 other Hispanics, 521 non-Hispanic Blacks, 219 non-Hispanic Asians, and 1253 non-Hispanic Whites. Results. Those receiving OAA meals had higher percent of food insecurity and functional disabilities. Adjusting for potential confounders, adults who received OAA meals had higher odds of emphysema (OR = 2.02; 1.05, 3.89) and lower odds of good-to-excellent health (OR = 0.52; 0.36, 0.77). Women and minorities had poorer health status compared to non-Hispanic Whites. Conclusion. A higher proportion of older adults who received nutritional services reported poorer health as compared to older adults who do not participate in these services. Future studies should assess nutritional adequacy for older adults who participate in nutritional programs comparing sex and race/ethnicity. Edgar R. Vieira, Joan A. Vaccaro, Gustavo G. Zarini, and Fatma G. Huffman Copyright © 2017 Edgar R. Vieira et al. All rights reserved. Effects of Long-Term Cultivation on Medium with Alpha-Ketoglutarate Supplementation on Metabolic Processes of Saccharomyces cerevisiae Tue, 17 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/jar/2017/8754879/ During last years, alpha-ketoglutarate (AKG), an important intermediate in the Krebs cycle, has been intensively studied as a dietary supplement with stress-protective and potential antiaging effects. Here, we examined the effects of exogenous AKG on metabolic processes and survival of yeast Saccharomyces cerevisiae during long-term cultivation. Growth on AKG had no effect on the total cell number but increased the number of reproductively active cells at the late days of cultivation (from day 7 to day 15). A gradual increase in levels of total protein, glycogen, and trehalose was found over 7-day cultivation with more pronounced effects in AKG-grown cells. In control cells, metabolic activity and the activities of superoxide dismutase and catalase decreased, whereas levels of carbonyl proteins and low-molecular-mass thiols increased during 7-day cultivation. This suggests development of oxidative stress in stationary phase cells. Meanwhile, stationary phase cells cultured on AKG possessed higher levels of low-molecular-mass thiols and lower levels of carbonyl proteins and α-dicarbonyl compounds when compared to control ones. Collectively, higher levels of storage carbohydrates and an activation of antioxidant defense with diminishing oxidative protein damage can prevent a loss of reproductive ability in yeast cells during long-term cultivation on AKG-supplemented medium. Nadia Burdyliuk and Maria Bayliak Copyright © 2017 Nadia Burdyliuk and Maria Bayliak. All rights reserved. Frail Patient in Hemodialysis: A New Challenge in Nephrology—Incidence in Our Area, Barcelonès Nord and Maresme Thu, 28 Sep 2017 12:42:12 +0000 http://www.hindawi.com/journals/jar/2017/7624139/ Introduction. Labeling a patient as “frail” may be useful in assessing the prognosis and therapeutic approach. Objective. The aim of the study is to define a pattern of frailty among our dialysis population, to analyse the incidence and clinical evolution of these patients. Materials and Methods. We analysed a total of 320 patients with stage V chronic kidney disease (CKD) who were on hemodialysis between September 2014 and September 2015. To define a patient as frail we used the Fried phenotype model, and we added a new criteria-dialysis session length longer than 12 hours/week. Results. 5.6% of the 320 patients were frail. We found statistically significant differences regarding body mass index (BMI), hemoglobin (Hgb), and serum albumin, as well as the ability to perform the basic activities of daily living (), ability to ambulate () and perform transfers (). We found statistically significant differences between the two groups in terms of hospital admissions () and mortality (). Conclusion. 5.6% of the study population were frail, with lower BMI, serum albumin and hemoglobin, lower capacity for basic activities of daily living, ambulation, and transference, as well as higher morbidity and mortality. Ioana Bancu, Fredzzia Graterol, Jorge Bonal, Pilar Fernández-Crespo, Jessica Garcia, Susana Aguerrevere, Domingo Del Castillo, and Josep Bonet Copyright © 2017 Ioana Bancu et al. All rights reserved. Novel Combined Training Approach Improves Sleep Quality but Does Not Change Body Composition in Healthy Elderly Women: A Preliminary Study Thu, 14 Sep 2017 06:11:59 +0000 http://www.hindawi.com/journals/jar/2017/8984725/ The aim of this study was to investigate the effects of a novel combined training protocol on sleep quality and body composition of healthy elderly women. The study sample consisted of 8 sedentary elderly individuals with mean (±SD) of 67 (±8) years of age, 96.0 (±7.8) mg/dL fasting blood glucose, 94.4 (±36.1) mg/dL triglycerides, 179.1 (±22.4) mg/dL total cholesterol, 57.2 (±15.7) mg/dL high-density lipoprotein (HDL), 103.1 (±25.2) mg/dL low-density lipoprotein (LDL), 125.3 (±8.4) mmHg systolic blood pressure, and 72.6 (±10.1) mmHg diastolic blood pressure. The training protocol consisted of resistance training exercises (approximately 18-minute duration) combined with aerobic exercises (approximately 26-minute duration), performed interspersed in the same session, for 8 weeks (3 times a week), with a 24-hour interval rest between each session. Continuous variables were expressed as the mean (±standard deviation) and the paired sample -test compares baseline with final measurement. The results showed a significant improvement in quality of sleep (4.9 ± 1.5 versus 3.8 ± 1.8 for total PSQI index) without body significant improvements in the fat-free mass (59.9 ± 4.0 versus 60.5 ± 4.4; ) and fat mass (40.1 ± 4.0 versus 39.5 ± 4.4; ) in healthy elderly women. In this sense, the novel combined training proposed may be an effective alternative or adjunct to present therapies aimed at improving the sleep quality in this population. Thiago Matheus da Silva Sousa, Bruno Rodrigues, Marco Carlos Uchida, Olivia de Moraes Ruberti, Paulo Adriano Schwingel, Tânia Maria Gaspar Novais, Paula de Lourdes Lauande Oliveira, Fabiano de Jesus Furtado Almeida, Janaína Oliveira Bentivi Pulcherio, and Bruno Bavaresco Gambassi Copyright © 2017 Thiago Matheus da Silva Sousa et al. All rights reserved. An Online Platform to Support the Network of Caregivers of People with Dementia Tue, 15 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/jar/2017/3076859/ 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 http://www.hindawi.com/journals/jar/2017/5841083/ 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 http://www.hindawi.com/journals/jar/2017/2720942/ 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 http://www.hindawi.com/journals/jar/2017/9575214/ 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 ClinicalTrials.gov 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 http://www.hindawi.com/journals/jar/2017/1454103/ 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 http://www.hindawi.com/journals/jar/2017/2865960/ 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 http://www.hindawi.com/journals/jar/2017/6210105/ 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 http://www.hindawi.com/journals/jar/2017/6026358/ 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 http://www.hindawi.com/journals/jar/2017/2074810/ 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 http://www.hindawi.com/journals/jar/2017/2171865/ 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 http://www.hindawi.com/journals/jar/2017/1978670/ 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 http://www.hindawi.com/journals/jar/2017/9851380/ 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 http://www.hindawi.com/journals/jar/2017/4653635/ 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 ClinicalTrials.gov 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 http://www.hindawi.com/journals/jar/2017/8514582/ 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 http://www.hindawi.com/journals/jar/2016/7957825/ 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 http://www.hindawi.com/journals/jar/2016/8569602/ 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 http://www.hindawi.com/journals/jar/2016/6373101/ 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 http://www.hindawi.com/journals/jar/2016/2906857/ 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 http://www.hindawi.com/journals/jar/2016/8062079/ 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 http://www.hindawi.com/journals/jar/2016/9630241/ 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 http://www.hindawi.com/journals/jar/2016/1865038/ 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 http://www.hindawi.com/journals/jar/2016/3650927/ 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.