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An examination of the impact of gender and veteran status on falls among community-dwelling seniors: implications for targeting falls prevention activities.

https://arctichealth.org/en/permalink/ahliterature164363
Source
Fam Community Health. 2007 Apr-Jun;30(2):121-8
Publication Type
Article
Author
Lori E Weeks
Author Affiliation
Department of Family and Nutritional Sciences, University of Prince Edward Island, Prince Edward Island, Canada. lweeks@upei.ca
Source
Fam Community Health. 2007 Apr-Jun;30(2):121-8
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Female
Frail Elderly
Geriatric Assessment
Health Services for the Aged - utilization
Health Surveys
Humans
Male
Psychometrics
Public Health Administration
Residence Characteristics
Risk assessment
Risk factors
Sex Factors
Social Work
Veterans - statistics & numerical data
Wounds and injuries - epidemiology - prevention & control
Abstract
The objective of this study was to broaden our understanding of the specific characteristics of community-dwelling seniors who are at increased risk of falling and becoming injured, by paying particular attention to gender and veteran status. The 137 respondents included 69 senior male veterans and 68 seniors in the general population. Results indicated that the veterans were at higher risk of falling than the general senior population, and were at higher risk of becoming injured after falling. Senior women were at less risk of falling and becoming injured than the veterans, but were at higher risk than the senior nonveteran men. It is imperative to target screening and falls prevention activities at these and other specific subgroups in the senior population that are at high risk of falling and becoming injured.
PubMed ID
19241648 View in PubMed
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An unsuitable old age: the paradoxes of elder care.

https://arctichealth.org/en/permalink/ahliterature171685
Source
CMAJ. 2005 Dec 6;173(12):1500-1
Publication Type
Article
Date
Dec-6-2005
Author
Kenneth Rockwood
Author Affiliation
Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
CMAJ. 2005 Dec 6;173(12):1500-1
Date
Dec-6-2005
Language
English
Publication Type
Article
Keywords
Aged
Canada
Frail Elderly
Health Care Costs
Health Services for the Aged
Humans
National Health Programs
Notes
Cites: Can J Cardiol. 2004 May;20 Suppl A:7A-16A15190403
PubMed ID
16330653 View in PubMed
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An urgent need to improve life conditions of seniors.

https://arctichealth.org/en/permalink/ahliterature140269
Source
J Nutr Health Aging. 2010 Oct;14(8):711-4
Publication Type
Article
Date
Oct-2010
Author
R. Hebert
Author Affiliation
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada.
Source
J Nutr Health Aging. 2010 Oct;14(8):711-4
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Caregivers
Consumer Participation
Disabled Persons
Female
Frail Elderly
Geriatrics - education
Health Priorities
Health Promotion - methods - organization & administration
Health Services for the Aged - organization & administration
Home Care Services - organization & administration
Housing for the Elderly
Humans
Male
Needs Assessment
Poverty - prevention & control
Public Policy - trends
Quebec
Vulnerable Populations
Abstract
In the fall of 2007, the Government of Quebec set up a Public Consultation on Living Conditions of Seniors. Fifty sessions were held in 26 cities across all 17 regions of the province. More than 4000 seniors attended the sessions and 275 briefs were received from scientists and associations. Three themes were identified in the report published in 2008: supporting seniors and their caregivers, reinforcing the place of seniors in society, and preventing problems associated with aging (suicide, abuse, addictions). The main actions that I recommended included: Increasing the Guaranteed Income Supplement to prevent poverty; Modifying pension plans and working conditions to allow for progressive retirement; Making a major investment in home care to provide access to services regardless of place of residence; Introducing an Autonomy Support Benefit and autonomy insurance program for financing services to support people with disabilities; Generalizing an Integrated Service Delivery Network providing services to frail older people; Better training for professionals in gerontology. I also recommended setting up a National Policy on Seniors to align all government departments and agencies, municipalities and the private sector around a vision, objectives and a set of actions for improving the integration of seniors in an aging society. This would contribute to a more equitable, interdependent and wiser society. Unfortunately, the Government did not support these recommendations. It is now time for scientists to get involved in leading policy on seniors and in the political arena.
PubMed ID
20922350 View in PubMed
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Apathy: prevalence, associated factors, and prognostic value among frail, older inpatients.

https://arctichealth.org/en/permalink/ahliterature124530
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Publication Type
Article
Date
Jul-2012
Author
Eeva H Hölttä
Marja-Liisa Laakkonen
Jouko V Laurila
Timo E Strandberg
Reijo S Tilvis
Kaisu H Pitkälä
Author Affiliation
Helsinki University Central Hospital, Unit of General Practice and City of Helsinki, Health Center, Helsinki, Finland. eeva.holtta@hel.fi
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Apathy
Delirium - mortality - psychology
Dementia - mortality - psychology
Female
Finland - epidemiology
Frail Elderly - psychology
Humans
Inpatients - psychology
Male
Prevalence
Prognosis
Proportional Hazards Models
Risk factors
Sex Factors
Statistics, nonparametric
Abstract
The association of apathy with Alzheimer disease and other dementias and caregiver burden has been examined in a number of studies; however, less is known about its relationship with delirium and mortality. We aimed to investigate the prevalence, relationship with delirium and dementia, and prognostic value of apathy in an elderly and frail inpatient population.
The cohort included 425 patients in acute geriatric wards and in 7 nursing homes in Helsinki (1999-2000). Demographic factors, physical functioning, diagnoses, and drugs were assessed with special reference for dementia, delirium, and apathy. Mortality was registered from central registers.
Of the patients, 98 (23.1%) suffered from apathy, and it was more frequent among men (32% versus 21% women, P = .037 ). There was no difference in mean age, number of comorbidities, or in the mean number of medications between those with and without apathy; however, those with apathy had lower mean MMSE points (9.2 versus 14.0 without apathy, P
PubMed ID
22572553 View in PubMed
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Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke.

https://arctichealth.org/en/permalink/ahliterature46149
Source
Cerebrovasc Dis. 2000 Nov-Dec;10(6):455-61
Publication Type
Article
Author
M L Kauhanen
J T Korpelainen
P. Hiltunen
R. Määttä
H. Mononen
E. Brusin
K A Sotaniemi
V V Myllylä
Author Affiliation
Department of Neurology, University of Oulu, Finland. marja-liisa.kauhanen@fimnet.fi
Source
Cerebrovasc Dis. 2000 Nov-Dec;10(6):455-61
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aphasia - epidemiology - psychology
Brain Ischemia - epidemiology - psychology
Cerebrovascular Accident - epidemiology - psychology
Cognition Disorders - epidemiology - psychology
Depression - epidemiology
Depressive Disorder, Major - epidemiology
Female
Frail Elderly
Humans
Male
Middle Aged
Neuropsychological Tests
Prevalence
Prospective Studies
Research Support, Non-U.S. Gov't
Abstract
Aphasia, depression, and cognitive dysfunction are common consequences of stroke, but knowledge of their interrelationship is limited. This 1-year prospective study was designed to evaluate prevalence and course of post-stroke aphasia and to study its psychiatric, neurological, and cognitive correlates. We studied a series of 106 consecutive patients (46 women and 60 men, mean age 65. 8 years) with first-ever ischaemic brain infarction. The patients were clinically examined, and presence and type of aphasia were evaluated during the 1st week after stroke and 3 and 12 months later. Psychiatric and neuropsychological evaluations were performed 3 and 12 months after stroke. Aphasia was diagnosed in 34% of the patients during the acute phase, and two thirds of them remained so 12 months later. Seventy percent of the aphasic patients fulfilled the DSM-III-R criteria of depression 3 months and 62% 12 months after stroke. The prevalence of major depression increased from 11 to 33% during the 12-month follow-up period. The non-verbal neuropsychological test performance in the aphasic patients was significantly inferior to that of the patients with dominant hemisphere lesion without aphasia. One third of the patients with ischaemic stroke suffer from communicative disorders which seem to increase the risk of depression and non-verbal cognitive deficits. Although the prevalence of depression in aphasic patients decreases in the long term, the proportion of patients suffering from major depression seems to increase. We emphasize the importance of the multidimensional evaluation of aphasic stroke patients.
PubMed ID
11070376 View in PubMed
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Apolipoprotein E-polymorphism, frailty and mortality in older adults.

https://arctichealth.org/en/permalink/ahliterature158869
Source
J Cell Mol Med. 2008 Dec;12(6B):2754-61
Publication Type
Article
Date
Dec-2008
Author
Kenneth Rockwood
Bassam Nassar
Arnold Mitnitski
Author Affiliation
Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Kenneth.Rockwood@Dal.Ca
Source
J Cell Mol Med. 2008 Dec;12(6B):2754-61
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged, 80 and over
Alleles
Apolipoproteins E - genetics
Canada - epidemiology
Cognition
Female
Frail Elderly
Genotype
Humans
Male
Mortality
Polymorphism, Genetic
Survival Analysis
Abstract
Although apolipoprotein E (ApoE) polymorphism is associated with variable risks of several illnesses, and with mortality, no persuasive relationship has been demonstrated with frailty. Here, the clinical examination cohort (n=1452 older adults, aged 70+ years at baseline) of the Canadian Study of Health and Aging was evaluated, with 5-year follow-up data. Frailty was defined using both the phenotypic definition from the Cardiovascular Health Study (Frailty-CHS) and the 'Frailty Index', from which age-specific trajectories of deficit accumulation can be estimated. In age-sex adjusted analyses, people with ApoE 4 allele had a higher risk of death (hazard ratio [HR]=1.20; 95% confidence interval: 1.01-1.45), but this relationship was not significant when adjusted for cognitive impairment (1.06; 95% confidence interval: 0.88-1.27). There was no association between frailty and ApoE polymorphism, defined in age-sex adjusted models either as Frailty-CHS (ApoE4 HR 1.17; 95% confidence interval: 0.98-1.40, frailty HR 1.37; 95% confidence interval: 1.28-1.46) or by the Frailty Index (ApoE4 HR 1.07; 95% confidence interval: 0.90-1.29, frailty HR 35.3; 95% confidence interval: 20.4-61.1). The data do not support an association between ApoE polymorphism and frailty. This result did not depend on how frailty was defined.
PubMed ID
18266965 View in PubMed
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Are physicians meeting the needs of family caregivers of the frail elderly?

https://arctichealth.org/en/permalink/ahliterature218411
Source
Can Fam Physician. 1994 Apr;40:679-85
Publication Type
Article
Date
Apr-1994
Author
S L Brotman
M J Yaffe
Author Affiliation
McGill University School of Social Work Consortium for Ethnicity and Stategic Social Planning.
Source
Can Fam Physician. 1994 Apr;40:679-85
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Attitude to Health
Caregivers - psychology
Counseling
Family - psychology
Female
Frail Elderly
Geriatric Assessment
Health Services Accessibility
Health services needs and demand
Health Services Research
Home Care Services - utilization
Humans
Jews
Male
Middle Aged
Patient satisfaction
Physician's Role
Quebec
Questionnaires
Abstract
To explore expressed needs, both formal and informal, of family caregivers of frail elderly. To evaluate roles of physicians.
Questionnaire survey of members of the Montreal Jewish community providing care for frail elderly family members.
Jewish community of Montreal.
Volunteer caregivers who were caring for a family member or friend 60 years or older, who had greatest responsibility for providing physical or emotional support to an elderly person, who saw themselves as caregivers, and who could speak English or French were studied. Of 118 volunteers, 32 were excluded because they withdrew for personal reasons or because they did not meet study criteria.
Demographic variables, functional status of the care receiver, use of home care services, and needs assessment to identify additional services.
An average of 75.4% respondents did not use formal support services. Just under half of caregivers were dissatisfied with the attention they received from the health care system, and more than one third expressed feelings of stress, depression, guilt, and isolation.
Hypotheses for this discontent are presented. Physicians may be uninterested in helping caregivers; even if they were receptive to counseling caregivers, they could be poorly remunerated for the types of counseling sessions that are usual for caregivers; and being a professional caregiver to family caregivers is demanding in itself.
Notes
Cites: Br J Psychiatry. 1968 Mar;114(508):265-784295821
Cites: Gerontologist. 1993 Jun;33(3):315-238325518
Cites: J Gerontol. 1977 Jul;32(4):420-7864206
Cites: Health Soc Work. 1980 Nov;5(4):39-467203256
Cites: J Am Geriatr Soc. 1981 Dec;29(12):568-717310040
Cites: Gerontologist. 1983 Dec;23(6):597-6046662373
Cites: Psychosomatics. 1984 May;25(5):369-71, 374-56739692
Cites: Gerontologist. 1979 Apr;19(2):175-83162534
Cites: Soc Work Health Care. 1985 Spring;10(3):1-143158088
Cites: Annu Rev Gerontol Geriatr. 1985;5:249-823936516
Cites: Gerontologist. 1987 Apr;27(2):209-143583013
Cites: CMAJ. 1988 Feb 1;138(3):231-53337990
Cites: Nurs Res. 1988 Jul-Aug;37(4):217-223393428
Comment In: Can Fam Physician. 1994 Sep;40:15097920040
Erratum In: Can Fam Physician 1994 Jun;40:1093
PubMed ID
8199520 View in PubMed
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ASIM: a system for monitoring and evaluating the long-term care of the elderly and disabled.

https://arctichealth.org/en/permalink/ahliterature221356
Source
Health Serv Res. 1993 Apr;28(1):27-44
Publication Type
Article
Date
Apr-1993
Author
M. Lagergren
Author Affiliation
Ministry of Health and Social Affairs, Stockholm, Sweden.
Source
Health Serv Res. 1993 Apr;28(1):27-44
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Databases, Factual - standards
Disabled Persons
Frail Elderly
Geriatric Assessment
Health Services Needs and Demand - standards - statistics & numerical data
Health Services Research
Humans
Institutionalization - statistics & numerical data
Long-Term Care - classification - organization & administration - standards
Medical Record Linkage
Outcome and Process Assessment (Health Care)
Quality Assurance, Health Care
Registries
Regression Analysis
Reproducibility of Results
Social Environment
Sweden
Urban Population
Abstract
A system for monitoring and evaluating the long-term care of the elderly and disabled is presented, and its problems of completeness, reliability, and validity are discussed.
Half-yearly (before 1987) and yearly (after 1987) surveys were taken from 1984 to 1990 of all persons living in the city of Solna, Sweden, who at May 1 and November 1, or November 1, were receiving long-term care services from the municipality or county council, or both.
Completeness of observations was studied by linking survey and admission/discharge observations and checking for breaks in the chain of care. Reliability was estimated by comparing involuntary double registrations. Validity of the chosen measures of need was tested by comparing them with the actual provision of care services.
Registrations concerning actually provided services, assessed need, social environment, and disability were collected on a regular basis by the staff responsible for the care services.
Completeness was estimated to be more than 99 percent after a special procedure was carried out for filling in gaps in the "care chain." Reliability testing of the disability measures showed between .69 and .76 Kappa coefficient of agreement. Disability variables were shown to explain 56 percent of variance in the need measure "appropriate level of care."
Tests of completeness, reliability, and validity showed satisfactory results with regard to the purpose of the monitoring system and the limitations inherent in a system intended for routine application.
Notes
Cites: Health Serv Res. 1980 Fall;15(3):281-3066782043
Cites: Int J Nurs Stud. 1985;22(3):183-2003850075
Cites: Scand J Soc Med. 1977;5(2):67-72302983
Cites: J Chronic Dis. 1987;40(6):481-93597653
Cites: Soc Sci Med. 1991;32(4):455-642024161
Cites: Milbank Q. 1987;65(4):614-383452018
Cites: Health Serv Res. 1990 Jun;25(2):349-602113045
Cites: Scand J Soc Med. 1978;6(1):25-9635497
Cites: Med Care. 1982 May;20(5):468-886808257
Cites: Soc Sci Med. 1987;24(10):867-732956687
Cites: JAMA. 1963 Sep 21;185:914-914044222
PubMed ID
8463108 View in PubMed
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Assessment of individual risk of death using self-report data: an artificial neural network compared with a frailty index.

https://arctichealth.org/en/permalink/ahliterature179540
Source
J Am Geriatr Soc. 2004 Jul;52(7):1180-4
Publication Type
Article
Date
Jul-2004
Author
Xiaowei Song
Arnold Mitnitski
Chris MacKnight
Kenneth Rockwood
Author Affiliation
Geriatric Medicine Research Unit, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada.
Source
J Am Geriatr Soc. 2004 Jul;52(7):1180-4
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada - epidemiology
Female
Frail Elderly
Geriatric Assessment
Humans
Male
Mortality - trends
Neural Networks (Computer)
Predictive value of tests
ROC Curve
Risk assessment
Self-Assessment
Abstract
To evaluate the potential of an artificial neural network (ANN) in predicting survival in elderly Canadians, using self-report data.
Cohort study with up to 72 months follow-up.
Forty self-reported characteristics were obtained from the community sample of the Canadian Study of Health and Aging. An individual frailty index score was calculated as the proportion of deficits experienced. For the ANN, randomly selected participants formed the training sample to derive relationships between the variables and survival and the validation sample to control overfitting. An ANN output was generated for each subject. A separate testing sample was used to evaluate the accuracy of prediction.
A total of 8,547 Canadians aged 65 to 99, of whom 1,865 died during 72 months of follow-up.
The output of an ANN model was compared with an unweighted frailty index in predicting survival patterns using receiver operating characteristic (ROC) curves.
The area under the ROC curve was 86% for the ANN and 62% for the frailty index. At the optimal ROC value, the accuracy of the frailty index was 70.0%. The ANN accuracy rate over 10 simulations in predicting the probability of individual survival mean+/-standard deviation was 79.2+/-0.8%.
An ANN provided more accurate survival classification than an unweighted frailty index. The data suggest that the concept of biological redundancy might be operationalized from health survey data.
PubMed ID
15209659 View in PubMed
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Assistive devices among very old people in five European countries.

https://arctichealth.org/en/permalink/ahliterature82816
Source
Scand J Occup Ther. 2005 Dec;12(4):181-92
Publication Type
Article
Date
Dec-2005
Author
Löfqvist Charlotte
Nygren Carita
Széman Zsuzsa
Iwarsson Susanne
Author Affiliation
Department of Health Sciences, Lund University, Sweden. Charlotte.lofqvist@med.lu.se
Source
Scand J Occup Ther. 2005 Dec;12(4):181-92
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Europe
Frail Elderly
Health status
Humans
Self-Help Devices - statistics & numerical data - utilization
Abstract
The aim of this study was to investigate the use and need of assistive devices (ADs) in a cross-national European sample of very old persons, focusing on national similarities and differences as well as similarities and differences according to age and level of health status. Data from the ENABLE-AGE research project were utilized involving very old persons in Sweden, Germany, Latvia, Hungary, and the United Kingdom (UK). Personal interviews with single-living old persons were conducted (n = 1918). Of the total sample 65% reported that they had and used one or more ADs, and 24% reported unfilled need. The most commonly used ADs were devices for communication, followed by devices for mobility. Participants in Hungary and Latvia used a lower total number of ADs. Comparisons among sub-groups according to age between the Western and the Eastern European national samples showed significant differences. The result can to some extent be explained by different welfare systems and presumably differences in knowledge and awareness of ADs, and further research is called for. However, the result can serve as input for future planning and development of information, services, and community-based occupational therapy, to improve healthcare and social services for older people.
PubMed ID
16457091 View in PubMed
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462 records – page 2 of 47.