Illness In Old Age Research Articles

웰에이징 연구경향과 과제

The purpose of this paper is to examine the current trends in research on well-aging and suggest new research directions. This is because Korea's entry into an aging society has raised fundamental questions about the meaning and value of life for individuals, and Koreans are faced with the challenges of solving problems such as poverty, loneliness, and illness in old age. To fulfill the research objectives, this paper reviews the existing wellaging research in academia. The existing well-aging research trends can be categorized into the concept of well-aging, curriculum and training needs, and program effectiveness and satisfaction. Future well-aging research tasks include policy research, interdisciplinary research, educational program development, spreading well-aging discourse in cooperation with civil society organizations, cultural movements, and wellness tourism. The results of this study are expected to provide an academic foundation for the formation of a well-aging culture that fits the Korean reality.

Loneliness, solitude and social desintegration in the elderly and their relationship to health

AbstractLoneliness has become a big issue in the time of the COVID pandemic. The attention to the topic also has to do with the increase in people living alone in Europe, although this also has to do with prosperity. Living alone does not yet mean being lonely. In the scientific discussion and especially in the measures, a differentiation must be made between loneliness, solitude and social disintegration. Poor social integration is easily measurable and has a lot to do with the physical health (mobility, vision and hearing) of the people concerned. However, the extent to which participation in social and cultural opportunities is possible, for example through the expansion of public transport, also plays an important role.Loneliness, on the other hand, is by definition subjective and strongly linked to mental health. It describes the subjective suffering of missing or unsatisfactory social relationships, lack of integration and security. Loneliness is often found in two peaks, among the young and the old. Political and public health campaigns often focus on social integration measures. However, measures to combat loneliness mean first and foremost recognising mental illness in old age, especially depression. But they also mean providing help to people with long-term mental illness in old age.Disclosure of InterestNone Declared

Age images of older patients with psychiatric diseases -The importance of attachment and mentalization

Objectives: The emergence and effects of self-perception of ageing (SPA) are central gerontological research topics. SPA has an influence on numerous psychological, cognitive and physical parameters.The question of its significance for mental illness in old age, which was investigated in the present study, has so far remained in the background. Of particular interest was the connection to attachment and mentalization. Method: A clinical sample (N = 150) was compared with a non-clinical sample (N = 153). Both were divided into three age groups (40-54, 55-69 and over 70 years).The survey instruments used were the Attitude to Own Ageing subscale of the Philadelphia Geriatric Center Moral Scale (PGCMS) and a mentalizing and an attachment questionnaire (MZQ and ECR). Results:The clinical sample showed significantly lower scores in all age groups (more negative SWA), but only the non-clinical sample showed a decrease in age across the three age groups, thus the SPA became more negative. In the regression analytic evaluation, a more negative SPA was associated with an avoidant attachment orientation as well as reduced mentalizing skills. Conclusions: The results highlight the importance of SWA as a clinically and therapeutically significant variable. Finally, therapeutic implications are discussed.

Short-term aerobic exercise for depression in acute geriatric psychiatry: study protocol for a randomized controlled trial

BackgroundMajor depression is one of the main mental illnesses in old age, with acute exacerbated episodes requiring treatment in geriatric psychiatry. A meta-analysis showed that aerobic exercise in moderate intensity has large effects in older adults with major depression, but there is no evidence of aerobic exercise in geriatric psychiatry. Therefore, this study aims to analyze the feasibility and effects of an ergometer-based aerobic exercise on depressive symptoms.MethodsA single-center randomized controlled trial will be conducted in an acute geriatric psychiatric hospital. Inpatients allocated to the intervention group will receive a 2-week aerobic ergometer program. The control group will receive seated flexibility exercise in addition to usual care. The overall effects on the patients’ depressive symptoms will be measured by clinical global impression of change (CGI) as the primary outcome. Changes in depressive symptom domains, physical (in)activity, and aerobic performance as well as the dosage of applied antidepressants will be examined as secondary outcomes.DiscussionThis short-term aerobic exercise program is expected to decrease depressive symptoms in acute exacerbated periods in older adults. The results may increase the evidence for implementing physical activity interventions in acute hospital settings. The disease-related motivation for exercise in acute exacerbated depressive periods will be the most challenging aspect. The treatment of depression requires new cost-effective approaches, especially in acute geriatric psychiatry with potential benefits for patients, family members, and clinicians.Trial registrationGerman Clinical Trial Register ID: DRKS00026117Trial statusProtocol Version 1.2 dated February 23, 2022. By February 23, 2022, the trial had recruited a total of 15 participants in two wards at the Department of Geriatric Psychiatry at the LVR-Hospital Cologne. Recruitment started on November 12, 2021. The recruitment is expected to continue for at least 12 months.

How can assisted technology support family caregivers in everyday care? Results of afeasibility study for the Liv app

HintergrundAufgrund der älter werdenden Bevölkerung und der Zunahme von Menschen mit chronischen Erkrankungen im Alter, steigt die Zahl der pflegenden Angehörigen sowie deren Wert für die Versorgung. Dabei agieren sie meist ohne Vorerfahrungen im Bereich der Versorgung, haben begrenztes Verständnis für das Gesundheitssystem und erfüllen die Aufgabe neben der Bewältigung des eigenen Alltags. Daher gewinnen technische Unterstützungsmöglichkeiten wie die App Liv (entwickelt im Projekt münster.land.leben) an Bedeutung. Ziel der App Liv ist die Verbesserung der digitalen Gesundheitskompetenz der vulnerablen Gruppe der pflegenden Angehörigen in Deutschland.Ziel der Arbeit (Fragestellung)Ziel dieser Studie war, einen Prototyp der App Liv partizipativ mit pflegenden Angehörigen zu testen und das Konzept der App weiterzuentwickeln.Material und MethodenMit 10 pflegenden Angehörigen wurden unter Zuhilfenahme eines Prototyps der App qualitative online Interviews geführt, mittels qualitativer Inhaltsanalyse ausgewertet.ErgebnisseDie pflegenden Angehörigen bewerteten das Layout und die Einfachheit der Funktionen insgesamt positiv. Als Voraussetzung für die Nutzung betonten die Interviewten die Einfachheit der Anwendung und eine Vielfalt an Dokumentationsmöglichkeiten. Erweiterungsvorschläge erfolgten in den Bereichen Spezifizierung der Aktivitäten, Hinzufügung von weiteren Kommunikationsformen, Reminder oder Bestätigungen für erledigte oder zu erledigende Aufgaben, Verweis auf weiterführende Informationen, Verknüpfung mit anderen digitalen Systemen und Hinterlegung wichtiger Dokumente.DiskussionAus Sicht der Betroffenen stößt die App auf eine Versorgungslücke. Auf Grundlage der Vorschläge der Interviewteilnehmerinnen werden 6 Erweiterungen für die App diskutiert. Um die App nicht zu überfrachten, müssen diese in einer weiteren Studie auf ihre Nützlichkeit getestet werden.

Symposium

Protective factors are characteristics associated with a lower likelihood of negative outcomes. Protective factors may be seen as positive countering events. These are characteristics within the individual or conditions in the family, school or community that help someone cope successfully with life challenges. Protective factors are instrumental in healthy development; they build resiliency, skills and connections. Individual-level protective factors might include positive self-image, self- control, or social competence. Risk and protective factors can affect individuals at different stages of their lives. At each stage, risks occur that can be changed through prevention intervention. Early childhood risks, such as aggressive behaviour, can be changed or prevented with family, school, and community interventions that focus on helping children develop appropriate, positive behaviours. If not addressed, negative behaviours can lead to more risks, such as academic failure and social difficulties, which put children at further risk for later drug abuse. Loneliness, neglect, abuse and illness in old age are risks for developing dependence on benzodiazepine or other substances. Staying with family members, getting proper care are some of the protective factors in old age. Certain highly stressful work conditions poses risks of substance use for the personnel working in such situations. Cohesiveness, conducive work culture, promotional avenues are considered as protective factors at work place. In the seminar role of the protective factors will be discussed in relation of prevention and management of substance use disorders

Tailoring First Aid Courses to Older Adults Participants.

Relevant organizations emphasize the importance of first aid (FA) for older adults due to the increased risk of injuries and sudden illnesses in old age. Even though FA training guidelines have been developed, no program for an FA course adapted for the older adults has been formally adopted in Europe. This study’s objective is to identify older adults’ needs, beliefs, desires, advantages, and possible limitations in connection with FA. This qualitative study used semistructured interviews with 22 laypersons and retired health professionals older than 60 years old. The qualitative content analysis indicated that the major themes elicited by the older adults are motivation to participate in the FA training, older adults’ specific features as a resource or obstacle for participating in FA training, general suggestions, and content suggestions for FA training. Older adults are very differently motivated to participate in FA training due to the heterogeneity of their psychophysical abilities. They need and want to obtain additional knowledge from the field of FA and health protection for which any psychophysical limitations are not as relevant as when learning cardiopulmonary resuscitation. They want to learn how to recognize emergency situations and more about calling emergency services with the use of modern technology. In addition to cardiopulmonary resuscitation without rescue breaths, they also want to learn about topics related to the treatment of injuries. Those who had practiced FA in their work–life think that they can be a good source to transfer their knowledge to persons from their generation. While planning an FA training course, it has to be taken into consideration that older adults want a short course, adjusted to their varied psychophysical abilities. Due to the wide array of contents they want to learn, it would be reasonable to prepare a selection of different programs for short training courses.

The Research Protocol of SENIOR Project-Psychiatric Services and Support System for Serious Mental Illness in Old Age, Kerala, India.

Background:India has the second-largest population of elderly in the world. Serious mental illness (SMI) is a subset of the mental disorders that result in significant functional impairment and is usually long term. Persons with SMI face several challenges in their old age that are different from the issues faced by younger people with SMI. Understanding the problems faced by elderly individuals suffering from SMI is fundamental for planning programs to address them. The SENIOR (Support Systems Evaluation of Neuropsychiatric Illness in Old age) project is a study aimed at evaluating the problems faced in obtaining mental health care by elderly persons having SMI in the Kerala state of India.Aim:To describe the scientific methodology of the SENIOR project.Methods:This study employs mixed-methods cross-sectional design among a minimum sample of 768 SMI patients identified through cluster sampling from three districts, and Focus Group Discussion among mental health program officials.Discussion:This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life.

Role of social integration in the protection against depression in the Chilean elderly population

Abstract Chile has improved survival however this process occurs under a framework of socioeconomic and gender inequalities, which results in an impact of mental health, especially in vulnerable groups. The objective was to determine the association between depression and social integration in Chilean older adults. Cross-sectional study from the National Study of Dependence in Old Person 2010. The risk of depression was amount with Geriatric Depression Scale (>5). The social integration were quantity as frequency of meeting with close relatives (child, partner, daughter/ son-in-law, grandchildren); with other relatives (brother, brothers-in-law, nephews or other relatives) and with friends and neighbors in the last 12 months in 5 categories (never visit; less frequently; 1-2 times a month; 1-2 times a week; every day or almost). Logistic regression models considered the sampling design of the survey to identify association with odd ratio (OR) (never as reference category), adjustment for sex, age, ethnicity, household income, education, housing arrangement and chronic diseases (p ≤ 0,5). Total of 4179 older adults 25,3% reported risk of depression, the significative association with close relatives was in daily or almost frequency OR:0.42 (95%CI 0.27-0.67), 1-2 times a week OR: 0,57 (95%CI 0,33-0,99), 1-2 times/month OR: 0,56 (95%CI 0,99); other relatives were lower frequency OR: 0.54 (95%CI 0.38-0.78); 1-2 times/month OR; 0.50 (95%CI 0.31-0.81); 1-2 times/week OR:0.35 (95%CI 0.22-0.55); daily or almost OR:0.27 (95%CI 0.18-0.42). And meeting with friends and neighbors in the same frequency order were OR: 0.66 (95%CI 0.44-0.99); OR:0.43 (95%CI 0.26-0.73); OR:0.4 (95%CI 0.25-0.62); OR: 0.32 (95%CI 0.21-0.47). There is a negative gradient between depression and the frequency of meeting with friends, neighbors and family, independent of sociodemographic and health characteristics. Social integration must be promoted as a protective factor of mental health in elderly. Key messages Depression is one of the most common mental illnesses in old age and we found a negative gradient between the frequency of meeting friends, neighbors and family and the possibility of depression. It seems essential for public health to have strategies that address social life in old age to strengthen quality of live and mental health.

Epidemiology and mental illness in old age

SUMMARYThis is an overview of epidemiology relevant to mental health problems in old age. We start by reviewing some basic terminology: the definitions of prevalence and incidence; the difference between descriptive and analytical epidemiology; the differences between study designs, including cross-sectional, case–control and cohort studies. We then cover the main epidemiological features of the major psychiatric diseases that affect older people (dementia and its different types, depression, late-onset schizophrenia, bipolar affective disorder, delirium, anxiety-related disorders, eating disorders, alcohol and substance misuse, personality disorders) and suicide.We end with some descriptive statistics regarding quality of life in older people.

New horizons in frailty: the contingent, the existential and the clinical.

In the past decade, frailty research has focused on refinement of biomedical tools and operationalisations, potentially introducing a reductionist approach. This article suggests that a new horizon in frailty lies in a more holistic approach to health and illness in old age. This would build on approaches that view healthy ageing in terms of functionality, in the sense of intrinsic capacity in interplay with social environment, whilst also emphasising positive attributes. Within this framework, frailty is conceptualised as originating as much in the social as in the biological domain; as co-existing with positive attributes and resilience, and as situated on a continuum with health and illness. Relatedly, social science-based studies involving interviews with, and observations of, frail, older people indicate that the social and biographical context in which frailty arises might be more impactful on the subsequent frailty trajectory than the health crisis which precipitates it. For these reasons, the article suggests that interpretive methodologies, derived from the social sciences and humanities, will be of particular use to the geriatrician in understanding health, illness and frailty from the perspective of the older person. These may be included in a toolkit with the purpose of identifying how biological and social factors jointly underpin the fluctuations of frailty and in designing interventions accordingly. Such an approach will bring clinical approaches closer to the views and experiences of older people who live with frailty, as well as to the holistic traditions of geriatric medicine itself.

Novel Approaches for the Treatment of Alzheimer's and Parkinson's Disease.

Neurodegenerative disorders affect around one billion people worldwide. They can arise from a combination of genomic, epigenomic, metabolic, and environmental factors. Aging is the leading risk factor for most chronic illnesses of old age, including Alzheimer’s and Parkinson’s diseases. A progressive neurodegenerative process and neuroinflammation occur, and no current therapies can prevent, slow, or halt disease progression. To date, no novel disease-modifying therapies have been shown to provide significant benefit for patients who suffer from these devastating disorders. Therefore, early diagnosis and the discovery of new targets and novel therapies are of upmost importance. Neurodegenerative diseases, like in other age-related disorders, the progression of pathology begins many years before the onset of symptoms. Many efforts in this field have led to the conclusion that exits some similar events among these diseases that can explain why the aging brain is so vulnerable to suffer neurodegenerative diseases. This article reviews the current knowledge about these diseases by summarizing the most common features of major neurodegenerative disorders, their causes and consequences, and the proposed novel therapeutic approaches.

Masculinity beyond repair

This article explores representations of male aging in Jonathan Franzen’s The Corrections (2001) by looking at theories of aging, pathology, and hegemonic masculinity. While, in general, academic discourses about aging tend to link old age to pathology, the focus on gender stereotypes adds another layer to the perception of aging in Franzen’s novel. The Corrections is constructed around an aged patriarch who is not only struck by the illnesses of old age but, more importantly, he keeps clinging to an idealized masculine identity he is no longer able to maintain as an old man. Drawing on the difficulties of identity construction concerning Aging Studies and the lack of what Gabriela Spector-Mersel defines as “masculinity scripts,” my article illustrates how literary representations can construct male losses as symptoms of a silent virus that appears to break out in the aged body. The article will show that these (lived) hegemonic concepts of masculinity establish the male as a dominant collective but simultaneously constitute the inevitable failure of the individual. Hegemonic masculinities then have a disabling impact on the old man as is mirrored in Franzen’s doomed protagonist who becomes the victim of his own concepts of masculinity.

Translating the biology of aging into novel therapeutics for Alzheimer disease.

Aging is the leading risk factor for most chronic illnesses of old age, including Alzheimer disease (AD), a progressive neurodegenerative disease with currently no therapies that prevent, slow, or halt disease progression. Like other chronic diseases of old age, the progressive pathology of AD begins decades before the onset of symptoms. Many decades of research in biological gerontology have revealed common processes that are relevant to understanding why the aging brain is vulnerable to AD. In this review, we frame the development of novel therapeutics for AD in the context of biological gerontology. The many therapies currently in development based on biological gerontology principles provide promise for the development of a new generation of therapeutics to prevent and treat AD.

Health, illness and frailty in old age: a phenomenological exploration

The aim of this paper is to subject the clinical classification of frailty to scrutiny through exploring, via a phenomenological lens, the lived experiences of older people who meet the objective, or clinical, criteria of frailty. Drawing on a range of published research that explores the heterogeneous experiences of embodied ageing, the paper highlights the continuity of phenomenological structures of experience across successful ageing, normal ageing and frailty, suggesting the permeability and contestability of the boundaries between them and highlighting the complexity of health and illness in old age. Such data suggests a need to question the perception of frailty as something both apart from ‘normal’ ageing, and constitutive of frailed or failed ageing, and challenges the construction of the third age/fourth age polarity that underpins much of the meaning accorded to old age today.

Taking a Systems Approach to Chronic Illness in Old Age.

We are living through a demographic transition from a world in which there were lots of young people and very few older adults to one in which the numbers in these age groups are becoming more evenly balanced. One reason for this is that more of us are living into our seventies, eighties, nineties, and beyond. That is the good news. Unfortunately, the chance of developing chronic illnesses (including diabetes, arthritis, and dementia) is typically higher for people in these older age groups than for those who are younger. Because we do not know how to cure these illnesses, many of us will spend at least some of this extra time with one or more chronic illness. While we are more likely than in the past to live into older age, we are likely to be living with illness when we get there. That raises a challenge: how should we respond to this change?

Natural antibodies – facts known and unknown

In contrast to adaptive antibodies, natural antibodies are present in a non-immunised organism from birth, and they do not include anti-Gal antibodies and/or anti-Gal natural antibodies, which are developed as a result of the effect of the α-Gal epitope and physiological flora. Natural antibodies are the first line of the organism’s defence before the formation of the immunity created via the stimulation of elements that determine specific and non-specific immunity. This is especially important in the case of infants. Despite the fact that natural antibodies differ in their function from adaptive antibodies, they are polyreactive and they detect autoantigens and new antigenic determinants. Natural antibodies are formed from the subpopulation of B lymphocytes, mainly B1 lymphocytes and B lymphocytes of the marginal zone. This phenomenon is supported by the fact that when the quantity of these cells in the organism decreases, which happens with age, the level of natural antibodies also decreases and the risk of illnesses of old age becomes higher. During ontogenesis, these antibodies participate in many physiological processes, including the “support” of the immune system and homeostasis, the prevention of inflammation, infections and other pathological states, such as autoimmune and cardiovascular diseases, or the process of carcinogenesis. The best known natural antibody is IgM, but the role of IgGs and IgAs is also considered important. Nowadays, many researchers also mention intravenous immunoglobulins, which are used in the treatment of numerous illnesses, and there are discussions on the possibility of increasing their potential if they were based on natural antibodies.

Humour Based Intervention Program (HBIP):A Pilot Study

Depression is a common problem among older adults. It affects primarily those with medical illnesses in old age. Depression not only makes a person feel physically ill, but also deteriorates psychological wellness and upsurges mortality. Elderly depression averts a person from enjoying things he or she used to find pleasure in and affects his/her memory and concentration. The depressive condition of the person leads to neurological imbalances and obstructs normal functioning of the human brain and the nervous system. Hence, this research sought to assist the elderly to alleviate depression and enhance happiness through 'Humor Based Intervention Program' that is developed by the researchers and to pilot test its practicability and usability in the clinical practice. Making use of a 'Mixed-methods' research design for the development of the program. Geriatric Depression Scale and Oxford Happiness Questionnaire (OHQ) were administrated to measure the level of depression and happiness among the older adults. In order to have a better understanding of the current scenario and prevalence of depression among the older adults, the researchers carried out need-assessment survey, semi-structured interviews and focused-group discussions. Basing on these, researchers developed a twelve-modular intervention program, Humor Based Intervention Program (HBIP), incorporating the Humor Theory and PERMA model happiness theory. The program was subjected to expert validation by seven inter-disciplinary experts and pilot tested with ten older adults. The intervention was positively received by the participants and the results of the pilot test showed a decreased level of depression and increased level of happiness.

Supportive ConSenT-Therapie im Krankenhaus – selbstreferenzielle Unterstützung zum Wohlbefinden bei Schwererkrankung

Summary Supportive ConSenT-Therapie in hospital – self-referential support for well-being in case of severe illness Chronic illness and severe illness are a turning point in men’s life. They are associated with an impairment of quality of life. These perspectives already emerge in first days of hospitalization. Therefore increasingly medical treatment is supplemented by psychosocial interventions, supporting coping with illness. As a special supportive therapeutical method, the supportive CliC-Therapie has proved successful in various deseases. It aims to extend the «compliance» of patients within the inpatient setting as well as their individual scope of manageability for a well-being despite illness. This results by reactivating individual skills und resources and acquiring willingness and confidence in such potentials, which had been impaired by illness. With accentuation of severe illness in old age, the supportive CliC-Therapie is presented in this paper as a self-referential support for psychosocial...

Old and new reasons for specialization

Mental illness is one of the largest areas of activity in the health service, with mental disorders of the elderly an important part of it. This substantial ageing of the population is a new phenomenon, occurring over the last century. It has given prominence to mental illness in old age. There is a growing interest in making decisions about how many and which services to provide to the older community.The expertise of old age psychiatry services lies in the care and treatment of people with complex mixtures of psychological, cognitive, functional, behavioral, physical and social problems usually relating to ageing. Current evidence suggests specialist old age services are best equipped to diagnose and treat mental illness in our ageing population. However, the specialists should be integrated optimally into a service system to the benefit of the elderly. It will be crucial to improve access of older patients to the services. The service system and the partners in the system differ to those for younger adult psychiatric patients. Thus, not only knowledge and skills underline the necessity of specialization but also the increasingly complex health service structures of modern societies.Disclosure of interestThe author has not supplied his declaration of competing interest.