Group Of Elderly Adults Research Articles

The Effect of Age on Decision Making According to the Iowa Gambling Task

Aging has been associated with several brain changes that often affect the cognitive functioning of adults, but changes in executive functions, particularly in the field of decision making, have not been fully investigated. The Iowa Gambling Task (IGT) is a widely used tool to evaluate decision making, but little is known about the effect of age on its results. This study used the IGT and compared healthy young (n = 40) and elderly (n = 40) adults to evaluate their decision making processes. There were significant differences in the learning curve of the two age groups, but no difference in overall IGT performance. The results for the first IGT block were different from those of the rest of the task, and the group of elderly adults had a better performance in this block. Elderly adults also showed a preference for deck A, the one that resulted in greater losses. Findings confirmed the results of other studies, which reported that the IGT block score is the variable with the greatest sensitivity to age in this instrument.

Age-related diffusion patterns in human lumbar intervertebral discs: a pilot study in asymptomatic subjects

Diffusion tensor imaging (DTI) may provide an accurate noninvasive method of detecting degenerative matrix alterations in human lumbar intervertebral discs (IVDs). This study aimed to investigate age-related degenerative changes in human lumbar IVDs using DTI. Thirty asymptomatic volunteers ranging in age from 25 to 67 years underwent single-shot diffusion weighted echo-planar imaging on a 3 T scanner. DTI-derived metrics including fractional anisotropy (FA) and mean diffusivity (MD) were analyzed by a histogram analysis method. A Mann–Whitney test was used to compare subject groups (young and elderly) with respect to the diffusion measures, and piecewise linear regression was used to characterize the change in each metric as a function of age. We found significant age-related changes in the elderly adult group, with decrease of MD (11%, P<.001) and increase of FA (20%, P<.001). Our results demonstrate that the degenerative-related changes taking place in the IVDs through aging can be quantitatively accessed by DTI-derived metrics, while the morphologic changes are difficult to be identified in conventional T 2-weighted images. Our initial findings suggest that it would be worthwhile to validate the relationship between DTI metrics and the actual degenerative status of IVDs using extracted disc samples and to extend it to studies on patients with degenerative discs in order to further explore the clinical usefulness and relevance of DTI.

Estimation of minimum ground clearance (MGC) using body-worn inertial sensors

Objective assessment of balance and mobility in elderly populations using body-worn sensors has recently become a prevalent theme in falls-related research. Recent research by the authors identified mean absolute-valued vertical angular velocity measured using shank mounted inertial sensors during a timed-up-and-go test as having a strong association with falls history in a group of elderly adults. This study aimed to investigate the clinical relevance of this parameter by exploring the relationship between it and minimum ground clearance (MGC) measured with an optical motion capture system. MGC is an important variable when considering trip-related falls risk. This paper also presents a method of estimating properties of MGC during walking, across a range of speeds and gait patterns, using body-worn inertial sensors. We found that mean MGC and coefficient of variation (CV) MGC are correlated with mean absolute-valued vertical angular velocity and acceleration as measured by shank or foot mounted inertial sensors. Regression models generated using inertial sensor derived variables were used to robustly estimate the mean MGC and CV MGC measured by an optical marker-tracking system. Foot-mounted sensors were found to yield slightly better results than sensors on the shank. Different walking speeds and gait patterns were not found to influence the accuracy of the models. We conclude that these findings have the potential to evaluate a walking trial using body-worn inertial sensors, which could then be used to identify individuals with increased risk of unprovoked collisions with the ground during locomotion.

Validity and reliability of a Self-Implementable method to evaluate masticatory performance: Use of color-changeable chewing gum and a color scale

The objective of this study was to confirm the validity of a Self-Implementable method to evaluate masticatory performance using a newly developed color scale and color-changeable chewing gum. We developed a dedicated color scale that enables anyone to easily check the color of the chewing gum instead of using specialist equipment. To examine the reliability of evaluating the masticatory performance by the subjects themselves, three groups of six subjects were recruited: a group of dentists, a group of adults and a group of elderly adults were asked to check the colors of the chewed samples using the color scale. The correlation between the use of the color scale and the use of a colorimeter to determine the color of the chewing gum was studied to confirm the validity of the color scale. To assess the reliability, intraclass correlation coefficients (ICCs) were determined. A strong correlation was found between the a* value measured by the colorimeter and the mean scores from the color scale. The ICCs for intra-examiner and inter-examiner consistency were more than 0.88 for all three groups. This research confirmed the validity and reliability of colorimetric analysis of color-changeable chewing gum using a color scale as a Self-Implementable method of evaluating masticatory performance.

An Exploratory Study of Resistance Training and Functional Ability in Older Adults

This pilot study examined the effects of resistance training on functional task performance by older adults. Two groups of elderly adults participated in two 8-week resistance training programs, one using weight machines (n = 8) and the other calisthenics (n= 9). Paired t tests revealed the subjects in both groups significantly improved in their ability to perform six tasks: lifting five pounds overhead, getting down to and up from the floor, climbing and descending stairs, carrying groceries, getting out of the bathtub, and walking speed. In addition, the subjects' self-efficacy increased while RPE, or effort sense during the task, decreased. This study demonstrates that resistance training is a viable method for improving functional ability in older adults.

Age‐related non‐Gaussian diffusion patterns in the prefrontal brain

To characterize age-related MR diffusion patterns of the prefrontal brain cortex microstructure using a new method for investigating the non-Gaussian behavior of water diffusion called diffusional kurtosis imaging (DKI). Measures of mean diffusivity (MD), fractional anisotropy (FA) and mean kurtosis (MK) were compared in the prefrontal brain cortex of 24 healthy volunteers (adolescents, young adults, and elderly) ranging from age 13 to 85 years. A Mann-Whitney test was used to compare subject groups with respect to the diffusion measures, and linear regression was used to characterize the change in each diffusion measure as a function of age. We found significant age-related changes in the elderly adult group, with increase of MD and decrease of FA. The current study demonstrates distinct mean kurtosis patterns for different age-ranges, with significant age-related correlation for mean kurtosis (MK) and MK peak position, showing that diffusional kurtosis is able to characterize and measure age-related diffusion changes for both grey and white matter, in the developing and aging brain.

The potential applications of a virtual moving environment for assessing falls in elderly adults

The purpose of this study was to investigate whether the moving room paradigm could be used to assess fall risk in older people. A group of young adults (18–29 years) and two groups of elderly adults (60–79 years) with and without a history of falls were placed into a simulated moving room. Participants stood still facing an oscillating three dimensional virtual room moving in the antero-posterior plane with three types of room movement conditions, continuous oscillatory, discrete anterior and discrete posterior. The young adults performed with less postural motion and coherence with the virtual motion than the older age groups. The group of elderly fallers exhibited more postural motion [center of pressure (COP) length, p < 0.05], a trend towards higher coherence with the object motion ( p = 0.07), and the greatest amount of time-to-stability ( p < 0.05). A virtual moving room incorporating measures of time-to-stability and egomotion appears useful in predicting risk for falls.

Changes in Dual-task Voice Reaction Time Among Elders Who Use Assistive Devices

Assistive devices are prescribed for a variety of reasons and have the obvious benefit of enhancing gait performance for some individuals. However, the use of an assistive device may make walking a more complex and cognitively challenging task. The purpose of this study was to use a dual-task voice reaction time (VRT) paradigm to examine the attentional demands of walking with an assistive device in a group of elderly adults. Standing and walking VRTs were measured in a sample of 105 elderly adults who ambulated independently with either a rolling walker (RW; mean age = 87.8 +/- 5.5 yrs), a straight cane (SC; mean age = 84.1 +/- 5.6 yrs), or used no device (ND; mean age = 79. 9 +/- 4.5 yrs). A 3 (group) by 2 (task condition) ANOVA with repeated measures on the last factor was used to examine between and within group differences in VRTs. The main effects of group (p = 0.004) and task (P < 0.001) and the interaction of group with task (P = 0.025) were all statistically significant. There were no statistically significant between group differences in standing VRT. Between group differences appeared during the walking task, VRT for the RW group was significantly longer than for the ND group. When examining within group difference, walking VRT was significantly longer than standing VRT for the SC and RW groups. The results demonstrated that there is an increase in the attentional demands of walking for elderly adults who are experienced assistive device users. The increased attention required to walk with an assistive device may be a factor leading to increased fall risk.

The Effect of Walking Speed on Lower-Extremity Joint Powers Among Elderly Adults Who Exhibit Low Physical Performance

Graf A, Judge JO, Õunpuu S, Thelen DG. The effect of walking speed on lower-extremity joint powers among elderly adults who exhibit low physical performance. Objectives To compare peak joint powers and joint angles between comfortable and fast walking speeds among a group of elderly adults who exhibit low physical performance, and to test the primary hypothesis that peak ankle powers would not change when walking speed was increased, but that peak hip power output would increase significantly with speed. Design Three-dimensional analysis of joint kinematics and kinetics during comfortable and fast walking by both healthy and low-performing elderly adults (age, >70y). Setting Gait laboratory. Participants Twenty-four healthy elderly adults and 27 elders who exhibited low performance on a standard battery of walking, standing balance, and chair-rise tasks that places them at risk of mobility-related disability. Interventions Not applicable. Main Outcome Measures Peak lower-extremity joint powers and joint angles. Results Low-performing elders increased both ankle and hip power outputs to increase walking speed. However, peak ankle power remained significantly below that of the healthy elderly adults even when the low-performing elders walked at a faster gait speed. Joint-power changes in the low-performing elderly were accompanied by a reduction in hip extension and ankle dorsiflexion, and an increase in transverse pelvic rotation. Conclusions Compared with healthy elderly, the low-performing elderly adults showed speed-independent differences in ankle and hip mechanics that may reflect underlying neuromuscular impairments. In particular, an understanding of the interdependent contributions of hip flexibility and ankle power limitations seem important to inform interventions to maintain gait into advanced age.

Diagnostic tools for general practitioners and specialists

Diagnostic tools for general practitioners and specialists

Horticulture Therapy Activities for Preschool Children, Elderly Adults, and Intergenerational Groups

Ten different horticulture therapy (HT) activities that can be adapted for preschool children, elderly adults, and intergenerational groups are outlined here. The goals for these activities included participation, self-motivation, and fun. The children's activities were designed for freedom to explore and learn and to ensure completion of the activity. The elderly adult activities were designed for flexibility to adapt to the different ability levels of the participants. The intergenerational activities were designed for group interaction. While these activities produced variable results for the children's group, the elderly adult group, or the intergenerational group, they were all successful. Guidelines are given for increasing effectiveness and success of activities when working with these populations.

Diabetes is associated independently of body composition with BMD and bone volume in older white and black men and women: The Health, Aging, and Body Composition Study.

The association between type 2 diabetes, BMD, and bone volume was examined to determine the effect of lean and fat mass and fasting insulin in the Health, Aging, and Body Composition Study, which included white and black well-functioning men and women 70-79 years of age (N = 2979). Diabetes predicted higher hip, whole body, and volumetric spine BMD, and lower spine bone volume, independent of body composition and fasting insulin. The purpose of this study was to determine if the association between type 2 diabetes and higher BMD observed in older white women is seen in elderly white men and blacks and to evaluate if higher BMD in diabetic individuals is accounted for by lean mass, fat mass, or fasting insulin differences. In the Health, Aging, and Body Composition Study, which included white and black well-functioning men and women 70-79 years of age (N = 2979), 19% of participants had diabetes at baseline. Of those with diabetes, 57% were men, and 62% were black. Multivariate linear regression models examined independent effects of diabetes, lean mass, fat mass, visceral fat, and fasting insulin on BMD and bone volume while adjusting for relevant covariates. Fasting insulin, visceral fat, and volumetric spine BMD, assessed by CT, and lean mass, fat mass, and total hip and whole body BMD, assessed by DXA, were higher (p < or = 0.05 for all) for those with diabetes. Hip BMD was higher in white men (0.99 +/- 0.14 versus 0.93 +/- 0.14 g/cm2, p < 0.001), black men (1.06 +/- 0.17 versus 1.00 +/- 0.15 g/cm2, p < 0.001), white women (0.83 +/- 0.13 versus 0.76 +/- 0.13 g/cm2, p < 0.001), and black women (0.90 +/- 0.15 versus 0.85 +/- 0.15 g/cm2, p < 0.001) with diabetes compared with those without diabetes, although the relationship was attenuated by body composition. In multiple regression models, diabetes was an independent predictor of higher hip, whole body, and volumetric spine BMD in all participants (p < or = 0.001), but lower spine volume (p = 0.01) and higher hip BMD for each race-gender group (p < or = 0.01). Type 2 diabetes was associated with a 4-5% higher total hip BMD in all race-gender groups of elderly adults, independent of body composition and fasting insulin levels.

The Relationship between Quadriceps Strength and Balance to Fall of Elderly Admitted to a Nursing Home

This study was undertaken to determine the relationship between quadriceps strength and balance to falls of institutionalized elderly people. The subjects comprised 25 elderly women aged 75.3 ± 3.4 years. The values of the postural sway in two standing positions, functional reach test, and quadriceps strength were compared between two groups of elderly adults, those with or without a history of fall. Quadriceps strength was measured using isometric contraction of the knee extension. There were no significant differences between the two groups in the postural sway in the two standing positions and the functional reach test. Quadriceps strength in the non-fall group was, however, significantly higher than that in the fall group (1.48 Nm/kg vs. 1.08 Nm/kg, p<0.01). The discriminating criterion for muscle strength between the two groups was 1.28 Nm/kg, with an apparent error rate of 24.8%. These findings suggest that (1) the degree of quadriceps strength may be a useful indicator for the prospect of fall in institutionalized elderly people, and (2) quadriceps strength should be maintained at least more than 1.28 Nm/kg to prevent fall.

Cognitive distinctions between depression and early Alzheimer's disease in the elderly

Background : Currently, there is a diagnostic dilemma in terms of discriminating the reversible cognitive problems associated with depression from the irreversible dementia associated with early or mild Alzheimer's disease (AD) in the elderly. Previous research has focused on contrasting memory functions in depression versus AD, and methodological limitations undermine the results of the few empirical studies that have compared the linguistic and attentional abilities of these two patient populations. Aims : The objective of the current study was to determine whether depression is associated with any unique form of deficit in language or attention, and consequently whether more comprehensive assessment of these cognitive abilities may help to distinguish depression from early AD in elderly populations. Methods & Procedures : Age-matched groups of elderly adults with depression, early AD, or no psychiatric or neurological problems completed a comprehensive battery of basic and complex attention, language, and memory tests. Outcomes & Results : Results indicated that of the various cognitive abilities examined, the attention abilities of the depressed group, in particular their attention performance latencies, were most compromised compared to the control group. Tests of complex attention functions, working and episodic memory, and high-level language comprehension and production were most useful at distinguishing the depressed and early AD groups. Conclusions : These findings suggest that use of a small subset of high-level cognitive tests may allow accurate discrimination of elderly patients with depression from those in the early stages of AD.

Museums: Using keyworkers to deliver lifelong learning

The article describes a major study of the activities of keyworkers (mediators between museums and their public) within the context of museums' contribution to lifelong learning and to overcoming cultural exclusion. Field studies were undertaken in the UK, Ireland and Sweden based upon live projects with keyworkers who were subsequently interviewed about their roles, professional development needs and attitudes. In the UK, the Victoria & Albert Museum's keyworkers comprised youth workers, in Sweden they were traffic wardens and taxi drivers, and the Irish Museum of Modern Art worked with a group of elderly adults. From these studies, the research was able to articulate key recommendations for developing museum policy on keyworkers to enhance adult learning in and through museums.

Statistical and clinical evaluation of the Mattis Dementia Rating Scale-Spanish adaptation: an initial investigation.

The usefulness of the Mattis Dementia Rating Scale (MDRS) for Spanish dominant elderly adults has seen little empirical documentation, though there is considerable reason to hypothesize its value with this diverse and growing population. A Spanish adaptation of the MDRS (MDRS-SA) was developed for the present study in a manner to facilitate linguistic equivalence. Reliability for the MDRS-SA showed high split half internal consistency across all scales and Total Score. Two groups of elderly adults, one neurologically impaired and one not, both with low Mexican American acculturation level, Spanish dominance, and little formal education were participants. Results of a MANCOVA analysis, controlling for age, education, acculturation, and gender, showed the MDRS-SA to be effective at discriminating between groups across all scales (p < .001) and Total Score (p < .05). After determining significant differences between original norms and normative data on the present Spanish group, clinical utility of these statistical findings was investigated by generating specificity, sensitivity, and accuracy rates for the MDRS-SA Total Score, using Spanish normative data. Results of this preliminary study supported the MDRS-SA for use within the Mexican American, Spanish dominant elderly population, though additional larger validation studies are needed, particularly with well-documented clinical samples.

Psychometric properties of self-care management and life-quality amongst elderly

The cost of health care and welfare for the elderly continues to increase as the numberof elderly persons is increasing and they live longer. To help the elderly assess the right type and amount of resources needed, the self-care capabilities of the elderly should be assessed. Lorensen's Self-care Capability Scale (LSCS), developed in Denmark in 1986, was designed to assess the capabilities for self-care in the elderly throughout their remaining lifespan on an ongoing basis either at home or in institutions. The purpose of this study was to further test the validity and reliability of the LSCS. The scale (56 items rated on a 4 point rating scale (4 3 2 1) within 13 dimensions of self-care with scores ranging from 56 to 224) was tested on a convenient group of elderly adults, who were living in a retirement community that included both independent and assisted living. Various statistical methods were used. Test-retest reliability completed with 40 subjects 2 weeks apart was r=0.97. Inter-observer reliability was r=0.95. The factor analysis identified the three types of enabling conditions. In conclusion, LSCS was stable when used across two different observation time points and had good interobserver agreement. When used on two different populations of older adults, scores varied for independent living and assisted living. The sample, however, was small and there is a need for future testing with larger samples. This instrument provides a means for nurses to accurately and reliably assess self-care capabilities of older adults to help them decide the level of health and welfare resources needed.

Memory improvement tapes: How effective for elderly adults?

The effectiveness of two commercially available audiocassette memory improvement programs was evaluated in a sample of 32 healthy, community-living elderly adults. Participants were given a set of either Syber Vision's Neuropsychology of Memory Power tapes (Bornstein, 1989) or Nightingale-Conant's Mega Memory tapes (Trudeau, 1992), and a portable cassette player, and instructed to complete the programs within 10 weeks. All participants received a comprehensive battery of memory tests prior to and immediately following the memory improvement programs. Participants completing the memory improvement programs showed no greater gains in memory test performance than no-treatment control participants, but did report greater confidence in their memory abilities. Participants completing the Mega Memory program thought they were less likely to develop Alzheimer's disease after having completed it compared with participants in the other two conditions. Participants reported finding both tape programs acceptable and potentially useful for improving memory; those who completed the Memory Power program reported somewhat greater satisfaction than those completing the Mega Memory program. the claims about rapid, dramatic memory improvement with use of these products were not substantiated in this group of elderly adults and appear to be grossly exaggerated.

An Evaluation of the Length-Tension Relationship in Elderly Human Plantarflexor Muscles

The purpose of this study was to determine the effect of aging on the muscle length-tension relationship in the plantarflexor muscles of 10 subjects aged 20-30 yr (Mean = 23; 5 males, 5 females), 10 subjects aged 60-80 yr (Mean = 72.3; 5 males, 5 females), and 10 subjects over 80 yr (Mean = 84.1, 5 males, 5 females). Isometric twitch properties, maximum voluntary strength, passive tension, and range of motion were measured at five different joint angles [20 degrees dorsiflexion (DF), 10 degrees DF, 0 degree, 10 degrees plantarflexion (PF), and 20 degrees PF]. Active (evoked and voluntary) and passive torque production were maximal when the ankle was rotated into the DF positions for all three age groups, whereas the lowest values were recorded when the ankle was rotated into 20 degrees PF. Males were stronger than females at all joint angles (p < .01). Also, young adults were stronger than both elderly adult groups (p < .01). These results illustrate that despite the considerable age-associated loss in both voluntary and evoked strength in the plantarflexors, the optimal angle for torque production remains the same for younger and older adults.

The Effect of Color on Perceived Flavor Intensity and Acceptance of Foods by Young Adults and Elderly Adults

The Effect of Color on Perceived Flavor Intensity and Acceptance of Foods by Young Adults and Elderly Adults