Life Expectancy In Older People Research Articles

3D built virtual arctic environment increase vigor through connectedness in older people.

While the life expectancy of older people has increased significantly, this is often related to more long-term care in healthcare residences and nursing homes. Staying in these facilities can lead to a reduction in the sense of connection with others and the world around, as well as in vigor, with significant psychophysical repercussions in the long term. Although previous studies have shown that the virtual nature can benefit both, there are no significant studies that have tested its effect in generating these positive outcomes in the older population. Therefore, our study sought to investigate, in a sample of 53 older people in care at a nursing home or healthcare residence, the indirect effect of a 3D built virtual arctic environment (vs. a 3D built virtual urban environment) exposure in virtual reality on vigor through connectedness. Both the virtual scenarios were designed with a first-person view, with no translation around the environment and only in-situ rotation. Results highlighted that exposure to the 3D built virtual arctic environment leads to higher connectedness than the 3D built virtual urban environment, and this, in turn, leads to an increase in vigor. Findings were discussed based on the potential of adopting virtual nature in facilities to improve older people's sense of connectedness and, in turn, improve their well-being.

Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study

ObjectivesTo estimate the burden, trends, and inequalities of type 1 diabetes mellitus (T1DM) among older adults at global, regional, and national level from 1990 to 2019.DesignPopulation based study.PopulationAdults aged ≥65...

Smoking, respiratory symptoms, lung function and life expectancy: A longitudinal study of ageing.

Prognostic indices have been developed to predict various outcomes, including mortality. These indices and hazard ratios may be difficult for patients to understand. We investigated the association between smoking, respiratory symptoms and lung function with remaining life expectancy (LE) in older adults. Data were from the 2004/05 English Longitudinal Study of Ageing (ELSA) (n = 8930), participants aged ≥50-years, with mortality data until 2012. Respiratory symptoms included were chronic phlegm and shortness of breath (SOB). The association between smoking, respiratory symptoms and FEV1/FVC, and remaining LE was estimated using a parametric survival function and adjusted for covariates including age at baseline and sex. The extent to which symptoms and FEV1/FVC predicted differences in remaining LE varied by smoking. Compared to asymptomatic never smokers with normal lung function (the reference group), in never smokers, only those with SOB had a significant reduction in remaining LE. In former and current smokers, those with respiratory symptoms had significantly lower remaining LE compared to the reference group if they had FEV1/FVC <0.70 compared to those with FEV1/FVC ≥0.70. Males aged 50-years, current smokers with SOB and FEV1/FVC <0.70, had a remaining LE of 19.2 (95%CI: 16.5-22.2) years, a decrease of 8.1 (5.3-10.8) years, compared to the reference group. Smoking, respiratory symptoms and FEV1/FVC are strongly associated with remaining LE in older people. The use of remaining LE to communicate mortality risk to patients needs further investigation.

Geriatric symptoms associated with healthy life expectancy in older people in Japan.

We investigated the relationship between characteristic geriatric symptoms and healthy life expectancy in older adults in Japan. Additionally, we determined relationship predictors that would help formulate effective approaches toward promoting healthy life expectancy. The Kihon Checklist was used to identify older people at high risk of requiring nursing care in the near future. We evaluated the association of geriatric symptoms with healthy life expectancy while considering risk factors (frailty, poor motor function, poor nutrition, poor oral function, confinement, poor cognitive function, and depression). Data from the 2013 and 2019 Japan Gerontological Evaluation Studies were used. Healthy life expectancy was assessed using the multistate life table method. Overall, 8,956 individuals were included. For both men and women, healthy life expectancy was shorter in the symptomatic group than in the asymptomatic group for several domains of the Kihon Checklist. For men, the difference between individuals with risk factors and those with no risk factors was the maximum for confinement (3.83 years) and the minimum for cognitive function (1.51 years). For women, the difference between individuals with risk factors and those with no risk factors was the maximum for frailty (4.21 years) and the minimum for cognitive function (1.67 years). Healthy life expectancy tended to be shorter when the number of risk factors was higher. Specifically, the difference between individuals with ≥3 risk factors and those with no risk factors was 4.46 years for men and 5.68 years for women. Healthy life expectancy was negatively associated with characteristic geriatric symptoms, with strong associations with frailty, physical functional decline, and depression. Therefore, comprehensive assessment and prevention of geriatric symptoms may increase healthy life expectancy.

Implication of Exercise for Healthy Longevity in Older People

As the aging population is increasing substantially worldwide, extending the healthy life expectancy of older people has become a challenging issue. The structure and function of skeletal muscle decline with age, and this change has been shown to be involved in the development of various adverse health outcomes. In recent years, sarcopenia, a disease that is associated with age-related skeletal muscle mass loss and muscle weakness, has been attracting attention, and disuse muscle atrophy is also an important condition. For these diseases, it is recommended to increase exercise and physical activity, especially resistance exercise. In addition to conducting further research, it is necessary to widely disseminate information regarding the significance of exercise and physical activity as cost-effective interventions to the general public as well as health care professionals.

A Dichotomous Relationship of Intergenerational Caregiving within Elderly Care: Disruption/Disharmony and Connection/ Harmony Across the Generations

In Taiwan, caregiving for older person is an intergenerational responsibility. Modern Taiwanese society faces changing family structures and increased life expectancy of older people which prolongs caregiving responsibilities, however the family relationships of intergenerational caregiving experience are not fully known. This study explored how intergenerational caregiving reconstruct relationships between offspring caregivers and their frail older people to understand how health care services can better meet family needs. We conducted a genogram and eco-map to map individual support networks and relationships. We recruited 32 family members within 12 families across three generations to participate in an individual interview, including 11 frail older people, 3 spousal caregivers, 10 adult child caregivers and 8 grandchildren. The findings demonstrated that the intergenerational caregiving experience was a dichotomous relationship between disruption/disharmony and connection/harmony. For the caregiving experiences, individuals’ cultural values, beliefs, and family relationships should be considered in the context of shifting tradition, in Taiwan.

Life expectancy of older people living in aged care facilities after a hip fracture

To the authors’ knowledge, no study has been conducted on life expectancy for aged care facility residents with hip fracture. We assessed life expectancy of 240 residents of aged care facilities in Australia who experienced recent hip fracture treated with surgery. 149 deaths occurred over a mean follow-up of 1.2 years. Being female and having better cognition were associated with longer life expectancy. Increased age was associated with shorter life expectancy. The cumulative mortality rate within three months after hip fracture was 25.0% while the cumulative mortality rate for the whole study period was 62.1%. Life expectancy was 8.2 years, 4.8 years and 2.8 years for 70, 80 and 90-years old female patients. Life expectancy was 3.8 years, 2.2 years and 1.3 years for 70, 80 and 90 years old male patients, respectively. In conclusion, age, gender and cognition level were associated with life expectancy of hip fracture patients living in aged care facilities and their life expectancy was much shorter than that of the general Australian population.

Characteristics of the nutritional status of the elderly and senile age with alimentary-dependent diseases

Aging is not a disease, it is a physiological process of vital activity of the body as a result of which changes in functional and adaptation balance occur, that is, deviations in terms of health and are mainly the result of changes in cell structure and changes in biochemical and metabolic functions, as well as the prevalence of chronic diseases. One of the significant environmental factors that have a direct impact on the health and life expectancy of older people is rational and complete nutrition. Rational and balanced nutrition in the elderly and senile age affects the development of aging and the characteristic functional abnormalities in the organs and systems of the body. Nutrition in the elderly and senile is expressed by an imbalance of nutrients in the diet, such as protein, vitamins and minerals, which, in turn, can cause alimentary-related diseases. Preventing diseases and increasing life expectancy should be for every individual a credo in life — that is, common rules in life, such as playing sports, defeating stress, eating quality food and drinking water, preventing the appearance and development of diseases.

Detection of Root Caries Using Laser-Based Detection Device - DIAGNOdent

Introduction: Dental care for older population is becoming a matter of concern within the National health services (NHS) United Kingdom (UK) due to increasing life expectancy of older people and retention of their natural teeth. The aim of study was to relate the International Caries Detection and Assessment System (ICDAS) scores with severity index in order to detect root caries and DIAGNOdent readings, at an early stage, to manage these lesions non-invasively. Methods: Fresh 95 extracted teeth were collected from Oral Surgery and Dental Emergency Department at Barts and the London, Queen Mary University of London. In this in vitro study, 19 out of 95 teeth had root caries. Prior to recording the readings, extracted teeth were cleaned and polished. Each lesion underwent clinical examination. To detect root caries DIAGNOdent readings (ICDAS), severity index were obtained. Pearson’s correlation coefficients tests were applied. Results: The correlation between cavitation and ICDAS scores shows the significant value of 0.01. The DIAGNOdent reading with momentum and peak values was 45.37 with standard deviation of 32.16 and for peak with the mean value of 49.79 and 31.72 of standard deviation. Regarding, readings of DIAGNOdent and severity index establishment of correlation was difficult to establish. The reason was score of severity index regarding specimen no.1 is 3.3 was illustrative of lesion that is leathery. Conclusion: The DIAGNOdent readings system did not support the detection of root caries. However, the severity index scoring system is in need of greater categories regarding caries of the root.

Self-assessed life expectancy among older adults in C\xf4te d\u2019Ivoire

BackgroundThe purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d’Ivoire.MethodsPaper-based questionnaires were administered to a sample (n = 267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals’ life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants.A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants.ResultsThe mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02, and 77.79 years in the first, second, third, and fourth component of the subjects’ overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component.ConclusionsWe extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.

Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study

BackgroundWe examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States.MethodsWe used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability.ResultsSocioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50.ConclusionsInequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.

Development of an education integrated design framework for the physical space of nursing homes in relation to life expectancy of the older people.

The purpose of this research is to find design variables effective on education integration with physical spaces of nursing homes in association with life expectancy of older people. Delphi technique was used to obtain the design variables by which the education integration with physical spaces of nursing homes can be achieved. Subsequently, in order to investigate the modifying effect of education integrated physical space on life expectancy of the elderly, questionnaires were sent to 50 local researchers and experts in the field of ageing. Results showed a significant and positive correlation between education integrated physical space and life expectancy indicators (p<.05). The results suggest that as per expert opinions, designing a physical space integrated with education could increase the life expectancy of older people.

Predicting life expectancy of older people using respiratory symptoms and smoking status: Data from the Australian Longitudinal Study of Ageing.

Respiratory symptoms are recognizable to patients and may be markers of chronic disease and mortality risk. This risk may be easier to conceptualize if presented as remaining life expectancy (LE) rather than hazard ratios. We aimed to predict the remaining LE of older people with respiratory symptoms using data from the Australian Longitudinal Study of Ageing (ALSA). The ALSA is a prospective longitudinal cohort of older Australians (n = 2087) with 22 years of follow-up. The symptoms analysed were cough, shortness of breath (SOB) and wheeze. The implied impact on LE was estimated using a parametric survival function. SOB predicted shorter LE irrespective of smoking status. Cough predicted shorter LE in former smokers and wheeze predicted shorter LE in current smokers. The estimated remaining LE of a 70-year-old male never smoker with no symptoms was 16.6 (95% CI: 14.8-17.7) years. The years of life lost for a 70-year-old male current smoker with cough, SOB and wheeze compared to a never smoker with no symptoms was 4.93 (95% CI: 2.87-7.36) years with only 2.99 (95% CI: 1.35-4.97) years being attributed to their current smoking and the remainder to their respiratory symptoms. Respiratory symptoms predict mortality in older people. Cough in former smokers, wheeze in current smokers and all those with SOB require further investigations and disease-specific management.

PRM105 - Self-Assessed Life Expectancy Among the Elderly in Developing Countries: Evidence From Côte D’ivoire

The purpose of this study was to propose an approach to estimate individuals’ expected longevity based on self-assessed survival probabilities and elicit the determinants such subjective life expectancy in a representative sample of elderly people in Côte d’Ivoire. Paper-based questionnaires were administered to a sample (n=267) of older adults residing in the city of Dabou, Côte d’Ivoire, in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. The subjective expectations were related to sociodemographic, health and lifestyle indicators. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression model was used to account for the heterogeneous nature of the distribution of the estimated subjective life expectancy of the study participants and therefore identify components of such distribution. Mean subjective life expectancy in older people varied according to four components. The average subjective life expectancy among elderly people was 79.51, 78.89, 80.02 and 77.79 years in the first (24.73% of the sample), second (20.97%), third (33.33%) and fourth (20.97%) component of the elders’ overall subjective life expectancy respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. As an example, a U-shape relationship between household per capita income and subjective life expectancy has been established for individuals belonging to the third component while an inverse U-shape relationship was found for individuals belonging the fourth component. We extended the concept of subjective life expectancy by accounting for the heterogeneity in the distribution of the estimated subjective life expectancy. This approach may provide more insights into elderly people’s perceptions regarding aging, which could be used to forecast the demand for health services and long-term care needs.

Cancer incidence increasing globally: The role of relaxed natural selection.

Cancer incidence increase has multiple aetiologies. Mutant alleles accumulation in populations may be one of them due to strong heritability of many cancers. The opportunity for the operation of natural selection has decreased in the past ~150 years because of reduction in mortality and fertility. Mutation‐selection balance may have been disturbed in this process and genes providing background for some cancers may have been accumulating in human gene pools. Worldwide, based on the WHO statistics for 173 countries the index of the opportunity for selection is strongly inversely correlated with cancer incidence in peoples aged 0–49 years and in people of all ages. This relationship remains significant when gross domestic product per capita (GDP), life expectancy of older people (e 50), obesity, physical inactivity, smoking and urbanization are kept statistically constant for fifteen (15) of twenty‐seven (27) individual cancers incidence rates. Twelve (12) cancers which are not correlated with relaxed natural selection after considering the six potential confounders are largely attributable to external causes like viruses and toxins. Ratios of the average cancer incidence rates of the 10 countries with lowest opportunities for selection to the average cancer incidence rates of the 10 countries with highest opportunities for selection are 2.3 (all cancers at all ages), 2.4 (all cancers in 0–49 years age group), 5.7 (average ratios of strongly genetically based cancers) and 2.1 (average ratios of cancers with less genetic background).

Insulin resistance: a risk marker for disease and disability in the older person

Clinical metabolic studies have demonstrated that insulin action declines progressively with age in humans. In addition to its close association with Type 2 diabetes, which reduces life expectancy in older people, age-related insulin resistance is implicated in pathogenesis of several highly prevalent disorders for which ageing is a major risk factor. These include atherosclerotic cardiovascular disease, dementia, frailty and cancer. Accordingly, insulin resistance may be viewed as biomarker of age-related ill health and reduced lifespan. The rapidly rising number of older people, coupled with a high prevalence of insulin resistance resulting from obesity and sedentary lifestyles, presents unprecedented public health and societal challenges. Studies of centenarians have shown that preserved whole-body sensitivity to insulin is associated with longevity. The mechanisms through which insulin action is associated with age-related diseases remain unclear. Changes in body composition, i.e. sarcopenia and excess adiposity, may be more potent than age per se. Moreover, the impact of insulin resistance has been difficult to disentangle from the clustering of vascular risk factors that co-segregate with the insulin resistance-hyperinsulinaemia complex. Potentially modifiable mediators of age-related changes in insulin sensitivity include alterations in adipocytokines, impaired skeletal myocyte mitochondrial function and brown fat activity. The hypothesis that improving or maintaining insulin sensitivity preserves health and extends lifespan merits further evaluation. Practical non-pharmacological interventions directed against age-related insulin resistance remain underdeveloped. Novel metabolically active pharmacological agents with theoretical implications for some age-related disorders are entering clinical trials. However, recent adverse experiences with the thiazolidinediones suggest the need for a cautious approach to the use of insulin sensitizing drugs in older people. This could be particularly important in the absence of diabetes where the risk to benefit analysis may be less favourable.

Cataract surgery utilization after acute stroke: A nationwide cohort study

BackgroundCataract is a common and correctable ophthalmological condition that is associated with a poor quality of life and shortened life expectancy in older people. However, little is known regarding the use of cataract surgery in stroke patients after the incident event. MethodsA national cohort of 5462 patients who had experienced an acute stroke event without severe physical disability between 2000 and 2003, and 26,434 randomly selected age- and sex-matched controls were obtained from a random population-based sample of the National Health Insurance database in Taiwan. Multivariate Cox proportional hazard regression analysis was used to assess the association between stroke events and cataract surgery. ResultsAfter a 5-year follow-up, 482 stroke patients (8.8%) and 1897 controls (7.2%) had received cataract surgery after the index dates of their stroke. The incidence of subsequent cataract surgery following acute stroke was 27% higher than that in the comparison group (crude hazard ratio 1.27; p < 0.001). Adjusted for age, sex, co-morbid medical diseases, use of systemic steroids, exposure to radiation during computed tomography, and socioeconomic status, the incidence of cataract surgery in the stroke patients was 30% higher than that in the comparison group (adjusted hazard ratio 1.30; p < 0.001). ConclusionA 30% increase in the use of cataract surgery was noted among the survivors of acute stroke with mild-to-moderate disabilities, which may result from the increased need for better vision after stroke.

Health Care Professionals Underestimate the Mean Life Expectancy of Older People

Background: The estimated life expectancy of older persons is an important component of medical decision-making. To date, no data are available on the accuracy of health care professionals in estimating the remaining life expectancy of older subjects. Methods: A survey estimating the mean remaining life expectancy of Germans of both sexes at the ages of 0, 70, 80 and 90 years was performed from September to November 2010. Results: Two hundred and six health care professionals underestimated the mean remaining life expectancy of older persons by 10%, on average, and with great variance (SD = 34%). Medical doctors, especially those not specialized in geriatrics, estimated worst. Conclusions: Underestimation of the remaining life expectancy of older people is prevalent in health care professionals and may lead to patients being managed inappropriately. This underscores the need for further studies and better training on this issue in health care education.

Active life expectancy of older people in Mexico

Background: Social and economic development together with demographic changes and health interventions have resulted in an increase in life expectancy and a rapidly ageing population in Mexico. Whether people will live longer active and independent lives is still, however, unknown. We will address this question, providing the first estimates of active life expectancy by age, sex and local regional area in Mexico.Methods: Active life expectancy was calculated using the Sullivan method with abridged life tables. Information on the older Mexican population covered by the Mexican Institute of Social Security (IMSS) and the number of deaths for the same group in the year 2000 was obtained from the Office for Health Statistics and Information at IMSS in Mexico. Information on ability to perform basic activities of daily living was obtained from the National Survey on Ageing carried out in IMSS during 1998 – 99.Results: For males and females combined, active life expectancy decreased from 26.9 years at 60 years to 5.7 years at 85 years. Women's life expectancy exceeded that of men but women lived more years dependent. Similarly, older people in geographical areas with longer life expectancy spent a lower proportion of remaining life active.Conclusion: The success in increasing life expectancy above average in some groups of older people covered by IMSS has been accompanied by increments in the proportion of remaining years dependent upon others for help in basic self-care activities.

The role of sensory and cognitive function in the onset of activity restriction in older people

Background: Extending healthy active life expectancy is a priority if we are to achieve gains in both the quality and quantity of life lived at older ages. We investigated the role of sensory (vision and hearing) and cognitive function on the onset of activity restriction in older people.Methods: A survey of a total population (N = 1579) of people aged 75 years and older, registered with a large general population in Melton Mowbray, Leicestershire, England, was undertaken in 1988 and linked with subsequent routine health assessments (up to a maximum of five) over 10 years. Activity restriction was defined as having difficulty performing on their own, requiring help or aids or not doing any one of seven Activities of Daily Living (ADLs). The study population comprised the 643 persons who were not restricted at baseline. Cox proportional hazard regression models were fitted to time of onset of activity restriction with those dying before activity restriction was reported being censored at time of death.Results: After adjustment for confounding factors (socio-demographic and psychosocial factors, physical health and physical functional limitations), difficulty with both vision and hearing conferred a doubling of risk of activity restriction (RR = 2.36, 95% CI 1.31 to 4.28). A unit decrease in the Information/Orientation subtest was associated with a 10% increase in risk (RR = 1.10, 95% CI 1.02 to 1.19), even after adjustment for vision and hearing as well as other confounding factors, though baseline Mini-Mental State Examination score was not indicative of increased risk (RR = 1.02, 95% CI 0.98 to 1.06).Conclusion: Differentiating whether disability is a result of physical, sensory or cognitive functional limitations, is necessary to identify need and the direction in which efforts should be targeted to improve active life expectancy in older people.