Gerontological Concepts Research Articles

Adherence to a standardized protocol for measuring grip strength and appropriate cut-off values in adults over 65 years with sarcopenia: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The objective of this review is to examine the use of grip strength analysis in well and unwell populations in adults 65 years and over as a tool to establish muscle strength in sarcopenia. More specifically, the main review question is: What protocol, if any, is most commonly used among older adults with sarcopenia and does this match the standardized protocol suggested in 2011 by Roberts et al.? Secondary review questions are: What are the reported cut-off values being used to determine sarcopenia in older adults, with consideration for ethnic and gender variability? Is grip strength, as a tool to measure muscle strength, suitable for people with common comorbidities and geriatric syndromes, such as osteoarthritis, often associated with sarcopenia? INCLUSION CRITERIA Types of participants Participants will be adults, aged 65 years and over living at home or in health or social care settings with sarcopenia as a prevailing pathology. The setting and whether the participants fulfil specific inclusion criteria or form part of an inclusive screening study will be recorded. Notes will be made for sarcopenia status, comorbidities, gender, ethnicity and other geriatric disorders. Studies across varied diseases and disabilities, including stroke, and musculoskeletal, neuromuscular and cognitive disease will be included in the interest of evaluating the suitability of hand grip assessment in these populations, with reference to the ability to complete protocol, free from pain or other relevant noted issues. While no specific exclusion criteria exist for this review, a comment on TRUNCATED AT 250 WORDS

Preparing BSW Students for Competency With Older Adults

As the population of older adults in the United States grows, there is an increasing need for social workers to serve this group. This study examines the effects of a gerontological social work curriculum infusion project for baccalaureate social work students at a southeastern state university that was funded by the John A. Hartford Foundation. Attitudes regarding interest in gerontology and perceived competency in gerontology- related skills were assessed pre- and postintervention. Nonparametric Wilcoxon matched- pairs signed rank tests revealed significant increases in interest in pursuing further gerontology- related experience and related competencies. Open- ended reflection comments were analyzed to further understand the students’ experience with the program. Results indicate that infusion of gerontological concepts into the curriculum increased the number of students interested in pursuing careers in gerontology, increased students’ competency with this population, and enhanced their understanding of the unique needs of older adults.

Epidemiological approaches to frailty - contributions from the ESTHER study.

Frailty is an emerging concept in gerontology. Two popular approaches to quantify frailty include the deficit accumulation approach which quantifies frailty by the proportion of deficits from a list of symptoms, signs, diseases and functional limitations present (the so-called “frailty index” [FI]), and a rules-based approach which defines frailty by the presence of at least 3 of 5 criteria (exhaustion, unintentional weight loss, low grip strength, low gait speed, low physical activity) (Fried frailty criteria). We employed both concepts in the context of ESTHER, a cohort study of older adults in Saarland, Germany. Baseline data from ESTHER (N: 9,886; age: 50-75) were used to create a FI through a deficit accumulation approach. Baseline FI was evaluated by age and sex and related to 10-year survival. Below 60 years of age, men had a higher FI than women. However, mean FI showed a stronger increase with age among women (3.1% per year) than among men (1.7% per year) and was higher among women at older age. Relative mortality (95% confidence interval) was 1.08 (0.84-1.39), 1.32 (1.05-1.66), 1.77 (1.41-2.22), and 2.60 (2.11-3.20) for the 2nd, 3rd, 4th and 5th compared to the 1st quintile of the FI. There was a strong dose-response relationship between the FI and mortality among both men and women and both younger (<65 years) and older subjects. Frailty was operationalized using modified Fried frailty criteria among 3,112 participants aged 58 years or older who underwent extensive geriatric assessment during 8-year follow-up of the study. Frailty criteria were categorised either according to quintiles or using population-independent cut-points, which were derived from the literature. Although frailty prevalence was higher with the latter (8.9%) than with the former (6.5%) approach, agreement and correlation of frailty classification by both approaches was high (Kappa = 0.75, rSpearman = 0.84). Sex differences in frailty prevalence were more pronounced using the population-independent approach. Similarly strong associations with socio-demographic, lifestyle and medical factors such as older age, female sex, smoking, and obesity were seen for both approaches. Both the deficit accumulation approach and the rules-based approach are feasible and highly informative in epidemiological ageing research. The former is applicable and highly predictive of mortality even below 65 years of age. Modification of the Fried index by using population independent cut-points of frailty criteria may enhance comparability across studies.

Revisiting Gerontology's Scrapbook: From Metchnikoff to the Spectrum Model of Aging

The historical roots of gerontology date to a time when old age was characterized as physical and mental decline. Nonetheless, Metchnikoff questioned the inevitability of this decline, believing that quality of life could be improved by broadening our understanding of the science of aging, a multifaceted concept that extends well beyond the biological science interpretation so prevalent in gerontology's history. This article examines foundational gerontological theories in an effort to unravel complex interactions that constitute physiological aging processes, the psychological manifestations of individual adaptation, and the importance of social and spiritual relationships in aging successfully. Evaluating these theories through an interdisciplinary lens will benefit scholars, researchers, and aging services professionals because it offers opportunities to extend gerontological concepts from theory to development of models that can ultimately be applied in common practice to promote successful aging, regardless of one's physical or cognitive health status. To that end, we propose the Spectrum Model of Aging. Utilizing components of game theory, we believe it offers a synergistic approach to improving quality of later life and thus promises to move the field of gerontology beyond disciplinary boundaries.

The Active Ageing–concept translated to the residential long-term care

Active Ageing (AA), as described by the WHO (Active Ageing: a policy framework. World Health Organisation, Geneva 5), is an important concept in gerontology. Since the AA-concept has not been examined in the context of residential long-term care facilities, our study addresses this gap by describing the determinants of AA within this setting. A qualitative study with semi-structured focus groups, followed by a thematic analysis, was conducted. Through purposive sampling, four focus groups of either residents of long-term care facilities (n = 8), children of residents (n = 8), community-dwelling older people (n = 8) and gerontologists (n = 6) were formed. The thematic analysis yielded nine determinants of AA. Seven correspond to those identified by the WHO: Culture, Behaviour, Psychological Factors, Physical Environment, Social Environment, Economic Characteristics and Health and Social Care. Two new determinants were identified: Meaningful Leisure and Participation. The determinant Participation is seen as crucial to AA in residential care. This study points to a more extensive set of determinants of AA than those identified by the WHO (Active Ageing: a policy framework. World Health Organisation, Geneva 5). Staff of long-term care facilities can make use of these determinants to promote AA in their residents.

(Re)considering the Life Course as a Key Concept in Social Gerontology

(Re)considering the Life Course as a Key Concept in Social Gerontology

The Role of the Social Environment on Physical and Mental Health of Older Adults

Understanding the complex relationship between the environmental context and the well-being of older adults is paramount as aging in place is increasingly acknowledged as a policy goal. This study investigated how the social environment (measured by social capital) was related to both physical and mental health. A sample of 3,219 older adults (60 years and older) from Philadelphia, Pennsylvania, and 4 surrounding counties were obtained from the Philadelphia Health Management Corporation survey collected in 2006. Binary and ordinal logistic regressions of self-rated health and depression symptoms were regressed on sociodemographic and six social capital items. Participation in groups, sense of belonging, and neighbors willing to help were associated with self-rated health, whereas trust in neighbors and sense of belonging and neighbors willing to help were associated with depressive symptoms even when sociodemographic indicators were controlled. This study furthers our understanding of how social capital may relate to the physical and mental health of the elderly and illustrates the usefulness of this important concept in environmental gerontology.

Predictors and Prevalence of Successful Aging among Older Malaysians

Background: Successful aging is an important and worldwide concept in gerontology. However, until recently, there has been very little known about successful aging in Malaysia. This study was designed to describe the prevalence and correlates of successful aging among older Malaysians. Methods: Data for this study were obtained from the national survey ‘The Mental Health and Quality of Life of Older Malaysians’. For this study, successful aging was defined based on a multidimensional model, encompassing the avoidance of chronic disease and physical functioning difficulty, and maintenance of good psychocognitive functioning. Results: The prevalence of successful aging among older Malaysians was calculated at 13.8% (CI: 12.6–15.1). Results of multiple logistic regression analysis showed that age, educational attainment, household income, and ethnicity were significantly associated with successful aging. Conclusion: Results of this study show that successful agers were more likely to be among the younger age, ethnic Chinese, and those with a higher education level and household income, after adjusting for all other variables in the model.

Gender Relations and Applied Research on Aging

As a concept in gerontology, gender appears as lists of traits learned through socialization when theorized at all. I argue for a framework that theorizes the intersections of relations of gender inequality with those of age. This framework holds that men and women gain resources and bear responsibilities, in relation to one another, by virtue of mundane categorization into naturalized stratified groups. Current research shows that this approach allows explanation of gender differences, which appear in many reports but which usually go untheorized, as responses to social inequality. I illustrate applications to research and practice in relation to three areas of old age experiences: financial security, spousal care work, and health. Throughout, I discuss implications of focusing on inequality to enhance our abilities to engage in effective research, practice, and policy for older people, women and men alike. For instance, an understanding of the gender division of labor and workplace discrimination makes clear that financial status in later life cannot be reduced to individual choices concerning paid labor or retirement planning. And understanding that people orient their behaviors to gender ideals allows us to see that men and women perform spousal care in similar and different ways that require varied responses from practitioners; it also reveals contexts in which men engage in positive health behaviors. Finally, I argue that gerontologists interested in facilitating favorable outcomes for old people should consider research and practice that would disrupt, not reinforce, the bases of gender inequalities in later life.

Gerokomie - Gerontologie - Geriatrie. Geschichte der Altersheilkunde im Spiegel ihrer Benennungen

300 years ago, the lawyer Theodosius Schöpffer coined the notion gerontology. On this occasion, this paper offers terms and corresponding concepts of gerontology which arose in the western tradition: 1. From the Graeco-Roman antiquity until 1750, gerocomy (the care for the elderly) was defined as a branch of medicine, but in practice almost did not exist. Basically, it provided instructions for a way of life in conformity with the physiological circumstances of elderly people. Its implementation was left to the patient. Furthermore, in the early modern times medical treatises dealt more frequently with diseases of the elderly and their therapy. The gerokomia succeeded in evolving a specific technical literature. Yet it failed to get institutionalized. 2. At the beginning of the 20th century, Ignaz Nascher interpreted geriatrics as a counterpart to pediatrics and opposed it to a clinical-pathological consideration of old age before 1900. He aimed at the exploration and treatment of old age as an autonomous physiological entity. Under the influence of the demographic transformation the institutionalization of geriatrics as a interdisciplinary branch within medicine could be realized relatively soon. 3. Around 1930, we experience the recreation of the notion gerontology, initially restricted to medical gerontology. However, with the integration of the non-medical sciences of old age the spectrum and the objectives changed. Today gerontology signifies on a international level a generic term or independent scientific discipline beside medicine. This evolution corresponds with the intentions pursued 300 years ago.

The portrayal of older people in prime time television series: the match with gerontological evidence

Empirical studies in several disciplines including sociology, psychology and communications science have investigated images of older people in the mass media, but analyses to date have failed systematically to apply gerontological concepts and to compare the portrayal of old age with ‘real-world’ evidence. A model of older people's internal and external resources was used to assess the portrayal of older people in prime-time television drama series. Three hours of programmes broadcast over six weeks in 2001 of 32 prime-time television series on the four German networks with the largest market shares were examined. The age of 355 portrayed characters were estimated, and the socio-economic, health-related and psychological resources of the 30 characters rated as 60 years or older were assessed. Observational categories and rating dimensions were developed on the basis of the resource model. Older people were heavily under-represented, especially women and those of advanced old age. Furthermore, the representation of older people's social participation and financial resources was overly positive. Finally, older women and men were portrayed in traditional gender roles. The antecedents and consequences of the biased portrayals (of old and young people) are discussed from a psychological perspective.

Social Support and Quality of Life Among Older People in Spain

Social support is a key concept in social gerontology; there is empirical evidence of its relationships with health, well–being and quality of life in old age. The density of an individual’s social relationships, the degree to which he/she interacts with others and how much he/she receives and gives affect, instrumental support, and/or services are all associated with health indicators, subjective well–being, and quality of life measures. This article deals with social support in old age in Spain, its relationships with health indicators, and its role in quality of life. Several descriptive studies dealing with social integration, frequency of social interactions, satisfaction with social relationships, and formal and informal social support are reviewed. Finally, the role attributed by elders to social relationships is an important conditioning factor of quality of life.

The new trends in survival improvement require a revision of traditional gerontological concepts

In 1960, Strehler and Mildvan (SM) theoretically predicted that the parameters of the Gompertz approximation to a mortality curve are negatively correlated. This means that the changes in the human mortality rate resulting from improvement in living standards, progress in health care or the influence of other factors must follow certain regularities prescribed by dependence between the Gompertz parameters. Such dependence, called SM correlation, was then confirmed in a number of empirical studies using period data on human mortality. Since the SM theory was based on the cohort model of mortality, it was tacitly assumed that period and cohort SM correlation patterns are similar. The remarkable stability of the SM correlation pattern revealed in these studies was often regarded as manifestation of a universal demographic law regulating changes in the age pattern of mortality rates. In this paper, we investigated trends in mortality decline in France, Japan, Sweden and the United States. In contrast with traditional expectations, we found that the SM correlation pattern was relatively stable only in certain periods of a population's survival history. Recently, several new correlation patterns emerged and, despite some differences in the timing of the changes, the new patterns are remarkably similar in all four countries. Contrary to traditional expectations, the patterns are not the same for cohort and period mortality data when SM correlations are calculated for France, Sweden and the United States. We show that some changes in the patterns of SM correlation admit interpretation in terms of a biological mechanism of individual adaptation (survival trade off). Some other patterns, however, contradict basic postulates of the SM theory. This indicates the need for revision of traditional concepts establishing the relationship between physiological and demographic patterns of aging.

Fear of Crime Among the Elderly: Foresight, Not fright

The seemingly paradoxical result that despite their much lower objective risk of criminal victimization older persons show significantly higher fear of crime than younger ones has become a commonplace within criminology in the last two decades. It is argued that this so-called ‘victimization-fear-paradox’ can be resolved by theoretically and empirically differentiating cognitive, affective, and behavioral aspects of fear. Additionally, gerontological concepts partially explain the linkage between objective risk of victimization and fear on the one hand and age and fear on the other. In particular, arguments from a gerontopsychological perspective reveal that older people are by no means irrational but, on the contrary, behave in an adequately cautious way because they know about their higher physical vulnerability. It is due to their carefulness that older people are in fact less often victims of crime than younger ones. Results from a nationwide representative victim-survey in Germany are presented in order to support and illustrate these arguments. It is concluded that a closer look at the concept of ‘fear of crime’, as well as at the victimological data, explains a finding which seems to be unexpected from the ‘paradox's’ point of view: fear of crime is not a major problem of the elderly's daily life.

Gerontology Review Guide for Nurses

This series addresses issues and clinical information for nurses in their work with the elderly, including long-term care, acute care, psychological considerations, and health promotions.This book distills key concepts of gerontology and caring for older adults into a readily accessible outline format. The 23 chapters span a wide range of topics from the most prominent theories in aging to physical changes and psychosocial considerations in aging. It may serve with equal benefit continuing education, basic nursing education, curriculum development, as well as a review for the ANA certification exams.

The Absent Body – A Social Gerontological Paradox

AbstractThis contribution, which is mainly theoretical, focuses on the paradox that, to a considerable extent, the body has been absent from social gerontology, despite the fact that in our culture, ageing is presented both in terms of surface and body and is experienced via the body. This paradox is brought into the open and clarified using as a starting point the ontological dualism of the Platonic-Christian tradition in which body and soul are seen as hierarchical opposites. The article shows how this dualism penetrates society and science and is carried on into the construction of gerontological concepts and theories, e.g. the ‘ageless self’ concept. The article also illustrates what consequences this dualism has for the everyday understanding of ageing based on biographical interviews with elderly Finnish people.

Continuing Education in Gerontological Nursing Makes a Difference

As a result of the Department of Nursing at Saint Anselm College receiving a federal grant to increase their faculty members' knowledge in gerontological nursing and to integrate gerontological nursing within the baccalaureate curriculum, the Continuing Nursing Education program changed its focus to emphasize more gerontological concepts. By shifting its paradigm to an across the lifespan approach to curriculum development, a program that was already successful was further enhanced by offering a gerontological nursing certification review course and a certificate program in gerontological nursing.

Curriculum Development in Gerontological Nursing Education

Many departments of nursing across the country are making concerted efforts to integrate gerontological nursing concepts into their curriculum. In general, many of these faculty members do not have advanced education in gerontology and, therefore, are unclear as to which concepts are vital in educating the generalist nurse. This, couple with the question of how to teach these concepts, leaves faculty wanting advice and direction. With the benefit of five years of federal funding, the authors share their experience of integrating content relative to the older adult into the nursing curriculum.

Aging in Art: Beyond Stereotypes

The human experience of aging has always been compelling for artists. This article examines what artists have expressed about demeaning stereotypes related to physical and psychological deprivations, social influence and power, and sexuality in old age. Artistic representations transcend demeaning stereotypes and unveil the truth behind misconceptions. They balance negative experiences of growing old with the forces of inner and social development and growth and reconcile the negative and positive in visions of old age as a valuable, constructive stage of life. The examination of 424 works of art representing old age suggests that art can be successfully discussed in terms of gerontological concepts. Artistic representations of old age can play a heuristic role as a resource for research.

TRENDS IN EDUCATION AND GERONTOLOGY

Educational gerontology, as defined by Peterson, is demonstrated to have two distinctly different knowledge bases predicted to subdivide with the progress of time. Although prediction is a problematic undertaking, this is the same process as other subjects/disciplines have undergone. After presentation of a theoretical baseline, the concepts of educational gerontology and gerontological education are discussed.