Mortality In Elderly Research Articles

Air pollution and mortality in Barcelona.

Studies conducted in Barcelona reported a short term relation between daily air pollutant values and emergency department admissions for exacerbation of chronic obstructive pulmonary diseases and asthma. Air pollution in Barcelona is mainly generated by vehicle exhaust and is below the World Health Organization air quality guidelines. The acute relation between air pollution and mortality was assessed. Daily variations in total mortality, mortality in subjects older than 70 years, and cardiovascular and respiratory mortality were related with daily variations in air pollutants for the period 1985-91, using autoregressive Poisson regression models that allow to control for temperature, relative humidity and variables handling temporal and autoregressive patterns. Black smoke and sulphur dioxide (SO2) were related to total mortality (relative risks (RR) for 100 micrograms/m3 = 1.07 and 1.13 respectively), elderly mortality (RR = 1.06 and 1.13), cardiovascular mortality (RR = 1.09 and 1.14), and respiratory mortality (RR = 1.10 and 1.13); all the associations being statistically significant, except for respiratory mortality (p = 0.07). The association between SO2 and respiratory mortality was stronger in summer (1.24, p < 0.01) than in winter (1.08, p > 0.1). Oxidant pollutants (nitrogen dioxide and ozone) were positively related with elderly mortality (RR = 1.05 and 1.09, respectively) and cardiovascular mortality (RR = 1.07 and 1.09) during the summer (p < 0.05), but not during the winter. Current air pollutant levels were related to mortality in Barcelona. These results were consistent with similar studies in other cities and coherent with previous studies with emergency room admissions in Barcelona.

Association of antidepressants and other medications with mortality in the residential-care elderly.

To explore the extent to which treatment of depression affects survival, we evaluated the association between use of antidepressant medications and death rates among the residents of a large residential-care facility for the elderly using a retrospective record-review study (N = 624). One year survival, among those taking antidepressants (10.9%), was 11.8% compared to 11.1% among the remainder of the population. A second study followed a group of 32 patients in the same institution who had participated in a therapeutic trial of nortriptyline treatment for major depression. Patients who experienced adverse medical events during treatment exhibited significantly increased mortality; among treatment completers, there was no significant relationship between mortality and therapeutic response. These findings suggest that the inability to tolerate treatment with an antidepressant can be considered a manifestation of physiologic frailty and increased vulnerability to mortality from disease. The previously reported decrease in survival among residential-care patients with major depression is not paralleled by a similar effect in those taking antidepressants. This may reflect selection factors with respect to the ability to tolerate antidepressants, rather an effect of treatment.

Self-Rated Health and Mortality in the High-Functioning Elderly - a Closer Look at Healthy Individuals: MacArthur Field Study of Successful Aging

This study tested the predictive value of self-rated health on 3-year mortality, with attention focused on healthy, high-functioning elders. Data from the MacArthur Field Study of Successful Aging were utilized. Subjects were 70-79-year-old (at baseline) residents of the communities of East Boston, MA, New Haven, CT, and a five-county area in and around Durham County, NC (N = 1192) which comprise three sites of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). In-home interviews were conducted in 1988 and 1991. Logistic regression was performed to create odds ratios adjusted for age, sex, race, marital status, education, alcohol consumption, cigarette smoking, chronic diseases, past hospitalizations, and cognitive function. The sample was then divided into healthy and less healthy cohorts based on number of chronic diseases, and the analyses were repeated. The adjusted odds ratios for self-rated health (poor/bad ratings compared to excellent ratings) in relation to mortality were 19.56 in the general sample, 93.51 in the healthy cohort, and 2.75 in the less healthy cohort. Self-rated health is predictive of mortality in controlled analyses, with the greatest impact seen in healthy individuals. Health care professionals should be sensitive to the significance of poor self-rated health in apparently healthy patients.

MEDICATIONS AND NUTRITION IN THE ELDERLY

Single drug and drug combinations taken by elderly individuals may impose nutritional risk. Nutritional risk induced by drug intake include anorexia, excessive increase in appetite, drug-induced nutritional deficiencies, and toxic reactions. Drug side effects, such as postural hypotension, may interfere with food shopping or cooking ability. Prescribed diets may also impose a risk of drug-induced side effects or diminished drug efficacy. Unwanted outcomes of drug-food and drug-nutrient interactions can be minimized by instructing elderly men and women and their caregivers to avoid timing errors in drug-taking behavior and toxic reactions due to food incompatibility. In addition, drug-induced nutritional deficiencies can be avoided by advising drug-taking elderly on the appropriate levels of nutrient intake.

Social networks, social support, and mortality among older people in Japan.

This study examined the effects of social networks and social support on the mortality of a national probability sample of 2,200 elderly Japanese persons during a three-year period. The direct and indirect effects of social relationships were assessed by using hazard rate models in conjunction with ordinary least squares regressions. Among the five measures of social relationships, social participation is shown to have a strong impact on mortality, and this effect remains statistically significant when other factors are considered. Social participation, social support, and feelings of loneliness are found to have indirect effects on the mortality of the Japanese elders through their linkages with chronic diseases, functional status, and self-rated health. On the other hand, marital status and social contacts are not shown to have statistically significant effects on the risk of dying, either directly or indirectly.

Geographical inequalities in mortality in Latin America

This paper is an attempt to synthesize several models of health and levels of affluence in Latin America. An analysis is accomplished wherein various countries and regions of Latin America are classified for health purposes as either products of a poverty model or a wealth model. Variables utilized include: mortality rates in preschool children and infants; elderly mortality; life expectancy; and overall causes of death. All three of the general models can be found in different parts of Latin America. More developed countries and regions tend to approximate the wealth model where chronic and degenerative diseases dominate. Still, while life expectations are shorter in countries and regions with lower levels of development, some elderly are afflicted by chronic and degenerative diseases.

Morbidity and mortality in rural community-dwelling elderly with low total serum cholesterol.

Low serum cholesterol has been associated with morbidity and mortality in the elderly. This study compared the health, functional status, and two-year mortality rates of community-dwelling rural elderly with serum cholesterol < 150 mg/dl to age- and sex-matched controls with serum cholesterol 200-240 mg/dl. Self-reported disease history, disability, health habits, and cognitive function data were collected at a health risk appraisal interview. A single blood sample was also collected and analyzed for total serum cholesterol at a central lab. Of the 3,874 participants, 109 (2.8%) had total cholesterol levels < 150 mg/dl. Seventy-five percent of the low cholesterol group were male compared to 44% in the main study population. The low cholesterol group had significantly greater smoking history, current cigarettes smoked, diabetes history, angina and COPD symptoms, and assistance needed for heavy and light work. Men in the low cholesterol group had significantly lower blood pressure. After two years, 14 (12.8%) of the low cholesterol group had died vs 16 (7.3%) in the control group. There was no relationship to specific causes of death and cholesterol level. A very low cholesterol level in older individuals should be evaluated carefully to determine whether it is due to genetic or life-style factors such as diet or, more likely, is a marker of disease.

Trauma in the Elderly

Severity of injury, patient age and preexisting medical conditions, time from injury to treatment, and quality of care rendered are generally recognized as major determinants of outcome after trauma. In a retrospective review, we compared 456 elderly patients (age greater than or equal to 65 years) with traumatic injuries to 985 younger patients (age less than 65). We compared cause of injury, injury severity score (ISS), seven risk factors indicating preexisting disease, complications, length of stay, and mortality. Overall mortality was 6.0% for patients aged less than 65 years and 8.6% for those older than 65. The injury severity score at which the probability of death was 10% was 17.3 in the older group and 24.9 in the younger group. Factors associated with outcome included cause of trauma (P less than .001), ISS (P less than .001), and number of complication factors (P less than .01). Preexisting risk factors were not significantly associated with outcome. We conclude that trauma in the elderly causes higher mortality with less severe injury, and that the mortality is related to the cause and severity of the trauma and the number of complications, and not to pre-existing disease. Length of stay increases with the severity of injury, except in the severely injured, who die.

Treatment of hypertension in the elderly with a new calcium channel blocking drug, nitrendipine

purpose: Treatment of hypertension in the elderly decreases cardiovascular morbidity and mortality. We hypothesized that nitrendipine would be efficacious in the treatment of hypertension in the elderly. We evaluated potential differences between nitrendipine and the commonly used drug hydrochlorothiazide (HCTZ). patients and methods: The study was conducted as a double-blind randomized clinical trial of nitrendipine or HCTZ. Thirty hypertensive subjects over age 60 with a median sitting blood pressure greater than or equal to 95 mm of Hg were recruited into the study. A diastolic blood pressure with treatment of less than 95 mm Hg with a 5 mm Hg or greater decrease from baseline was considered a successful response. results: Nitrendipine decreased mean (±SEM) blood pressure from 163 ± 3 102 ± 1 to 142 ± 2 89 ± 2 mm Hg , and HCTZ decreased it from 164 ± 4 102 ± 1 to 143 ± 5 91 ± 2 mm Hg . A greater proportion of patients had a successful response with nitrendipine (81 percent) than with HCTZ (64 percent). The antihypertensive effect of nitrendipine twice daily appeared to be sustained for 24 hours. Blood pressure response to exercise was attenuated with both drugs. HCTZ caused gout, leg pains, muscle aches, hypokalemia, increased uric acid levels, and increased total cholesterol and triglyceride levels. Nitrendipine caused edema and tachycardia. conclusion: Nitrendipine significantly reduces blood pressure with few side effects and no adverse metabolic effects, and offers a reasonable alternative for treating hypertension in the elderly.

Neurological disorders in Nigerian Africans: a community-based study.

In a Nigerian town with a stable population of 20,000, a door-to-door survey was conducted, using a questionnaire involving a complete census and a simple neurological evaluation which had previously showed a 95% sensitivity and an 80% specificity for detecting neurological disease. Positive responders were evaluated and categorised, using agreed criteria for diagnoses. Nearly 100% cooperation was obtained. Life prevalence ratio for at least one episode of headache was 51/1000. Crude point prevalence ratio for migrainous headache was 5.3/100, and peak age-specific ratio was in the first decade. Prevalence ratio for epilepsy was 533/100,000 and peak age-specific prevalence ratio occurred in the 5-14 years age groups. The prevalence ratio for peripheral nerve disorders was 268/100,000, and age-specific prevalence ratio for tropical neuropathy increased with age. Prevalence ratio for stroke was rather low at 58/100,000, but was probably due to the people's attitude to the disabled elderly and high mortality of stroke which showed annual mortality rate of 70/100,000 which increased with age to 1519/100,000 per year in the eighth decade. Crude prevalence ratios (cases per 100,000) for others are 112 for neurological complications (including sciatica) of spondylosis, 15 each for poliomyelitis, motor neurone disease, development speech disorders, 10 each for syncope, hereditary neuropathies. Parkinson's disease, benign essential tremor, primary cerebellar degeneration, cerebral palsy, mental retardation, organic psychosis (probable intracranial tumor) and 5 each for muscular dystrophy, pyomyositis, spina bifida occulta, alcohol dependence and cerebral malaria. The implications of the findings are important for development of community neurological services in the developing countries.

Neurological disorders in Nigerian Africans: a community-based study

In a Nigerian town with a stable population of 20,000, a door-to-door survey was conducted, using a questionnaire involving a complete census and a simple neurological evaluation which had previously showed a 95% sensitivity and an 80% specificity for detecting neurological disease. Positive responders were evaluated and categorised, using agreed criteria for diagnoses. Nearly 100% cooperation was obtained. Life prevalence ratio for at least one episode of headache was 51/1000. Crude point prevalence ratio for migrainous headache was 5.3/100, and peak age-specific ratio was in the first decade. Prevalence ratio for epilepsy was 533/100,000 and peak age-specific prevalence ratio occurred in the 5-14 years age groups. The prevalence ratio for peripheral nerve disorders was 268/100,000, and age-specific prevalence ratio for tropical neuropathy increased with age. Prevalence ratio for stroke was rather low at 58/100,000, but was probably due to the people's attitude to the disabled elderly and high mortality of stroke which showed annual mortality rate of 70/100,000 which increased with age to 1519/100,000 per year in the eighth decade. Crude prevalence ratios (cases per 100,000) for others are 112 for neurological complications (including sciatica) of spondylosis, 15 each for poliomyelitis, motor neurone disease, development speech disorders, 10 each for syncope, hereditary neuropathies. Parkinson's disease, benign essential tremor, primary cerebellar degeneration, cerebral palsy, mental retardation, organic psychosis (probable intracranial tumor) and 5 each for muscular dystrophy, pyomyositis, spina bifida occulta, alcohol dependence and cerebral malaria. The implications of the findings are important for development of community neurological services in the developing countries.

Elderly mortality in Denmark: past, present and future

An analysis of mortality trends among the growing elderly population in Denmark is presented. Death rates and the relative distribution of deaths according to age sex and cause are examined using official data on causes of death for 1960 and 1981. Comparisons are also made with other Scandinavian countries alternative projections of the elderly population to the year 2000 are provided and the implications of demographic aging are briefly discussed. (ANNOTATION)

Aging in Society: Selected Reviews of Recent Research.

This book consists of a selection of papers that were prepared by various authors as background papers for the 1981 White House Conference on Aging. The papers provide an overview of current knowledge on various aspects of aging in the United States. Topics covered include aging and the family economic aspects of an aging population recent trends in the geographical distribution of the elderly population and mortality and health differentials by sex. (ANNOTATION)

Excess mortality and influenza surveillance in Taiwan.

Excess mortality has proven to be a useful epidemiologic tool for influenza surveillance in the temperate zone. A retrospective analysis of the epidemiology of influenza in Taiwan was undertaken to explore the usefulness of this technique in the tropical--subtropical zone. Excess mortality similar to that observed during influenza epidemics in the temperate zone was noted during periods of previously recognized influenza epidemics in Taiwan. For the very young and the elderly excess mortality was observed to be even higher than in the temperate zone. Virus isolations, increased school absenteeism, and high clinical attack rates were also noted during influenza epidemics. Use of these epidemiologic techniques in Taiwan proved to be a useful approach to describe the impact of influenza.

Reflux esophagitis in the elderly, with special reference to antacid therapy.

ABSTRACT:The incidence of hiatal hernia increases with aging. When esophagitis occurs in the susceptible esophageal mucosa, it is probably the result of degenerative changes in the supporting tissues (collagen‐elastin) and a diminution in cellular replication. The authors' concepts of the etiology of reflux esophagitis are described. Severe complications are not uncommon. In most patients, there is a good response to postural, dietary and antacid therapy, not only during the initial episode but during recurrence and in complicated cases. No surgical procedure has general acceptance. In the elderly patient, morbidity and mortality are of such significance that the benefits must be measured carefully against the disadvantages. Most operations are designed to correct a hiatal hernia and to enhance sphincteric competency. The complication, esophagitis, is a medical problem unless a concomitant disorder refractory to medical management requires operative intervention. The presence of hiatal hernia usually is a coincidence. The authors have found an antacid combination (Gaviscon) to be an effective factor in the medical treatment of reflux esophagitis.

Mortality in elderly patients after anesthesia and operation.

Journal of the American Geriatrics SocietyVolume 5, Issue 5 p. 537-540 Article MORTALITY IN ELDERLY PATIENTS AFTER ANESTHESIA AND OPERATION Gerard R. F. Landry M.D., Gerard R. F. Landry M.D. The Department of Surgery (Anesthesiology), University of Nebraska Hospital, Omaha, NebraskaSearch for more papers by this authorJohn L. Barmore M.D., John L. Barmore M.D. The Department of Surgery (Anesthesiology), University of Nebraska Hospital, Omaha, NebraskaSearch for more papers by this author Gerard R. F. Landry M.D., Gerard R. F. Landry M.D. The Department of Surgery (Anesthesiology), University of Nebraska Hospital, Omaha, NebraskaSearch for more papers by this authorJohn L. Barmore M.D., John L. Barmore M.D. The Department of Surgery (Anesthesiology), University of Nebraska Hospital, Omaha, NebraskaSearch for more papers by this author First published: May 1957 https://doi.org/10.1111/j.1532-5415.1957.tb00078.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume5, Issue5May 1957Pages 537-540 RelatedInformation

Characteristics of State Plans for Old-Age Assistance, Aid to the Blind, and Aid to Dependent Children, April I , 1946.

Previous articleNext article No AccessReviews of Government Reports and Public DocumentsCharacteristics of State Plans for Old-Age Assistance, Aid to the Blind, and Aid to Dependent Children, April I , 1946.PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Social Service Review Volume 21, Number 2Jun., 1947 Article DOIhttps://doi.org/10.1086/636385 Views: 1Total views on this site Citations: 1Citations are reported from Crossref PDF download Crossref reports the following articles citing this article:Andreea Balan-Cohen Healthy, Wealthy, and Wise? The Impact of the Old Age Assistance Program on Elderly Mortality in the United States, SSRN Electronic Journal (Jan 2007).https://doi.org/10.2139/ssrn.1115333