Non-institutionalized Elderly People Research Articles

Factors Predicting Medicine Use in Institutionalized and Non-institutionalized Elderly

RÉSUMÉPour cette étude, une quantité de données démographiques sur la santé et la personnalité ont été recueillies à partir d'échantillons de persones âgées institutionnalisées et non-institutionnalisées à Terre-Neuve. Puis ces données ont été reportées au nombre de médicaments utilisés. Dans les deux échantillons, l'analyse a démontré que l'usage de médicaments peut être prédit d'abord et avant tout en tenant compte de la gravité de la maladie (Disease Severity), une combinaison du nombre de différentes maladies ou désordres et leur gravité. Ce facteur représente entre 28 et 33 pour cent de la variance. Aucun autre facteur n'a prédit l'usage de médicaments chez les personnes âgées institutionnalisées. Cependant, chez les gens âgés non-institutionnalisés, le baromètre de la santé (Health Rating), c'est-à-dire la façon dont la personne perçoit son état de santé, représente un autre 5 à 7 pour cent de la variance. Il n'y a aucun effet de réciprocité entre la gravité de la maladie (Disease Severity) et le baromètre de la santé (Health Rating), mais ces deux facteurs contribuent indépendamment et de façon complémentaire à prédire l'usage de médicaments. Ces deux facteurs servent également à prédire l'usage total de médicaments et les changements de médications durant une période de 12 à 18 mois. Le sexe et l'âge ne représentent pas des éléments qui aident à prédire l'usage de médicaments lorsqu'on tient compte de la variance causée par la gravité de la maladie (Disease Severity) et le baromètre de la santé (Health Rating).

Dietary survey of a large random sample of elderly people: Energy and nutrient intakes

The average daily intakes of energy and nutrients were estimated in a randomlyselected group of 2195 people aged 65 years and over residing in Adelaide, South Australia, by means of a semi-quantitative food frequency questionnaire. Mean intakes for most nutrients were equal to or above the recommended intakes. The proportion of people with intakes below two-thirds of the RDA, however, was highest for folate, calcium, magnesium, copper, and zinc, and varied from approximately 10 to 35 per cent of the total group. Comparisons with the results of other large surveys of noninstitutionalized elderly people in Boston and Gothenburg, Sweden, showed some variation in total intakes, but many similarities in patterns of nutrient density and those nutrients least adequately supplied.

Vitamin C status and nutrient interactions in a healthy elderly population.

Vitamin C status and interactions with other nutrients were studied in 677 healthy, noninstitutionalized elderly people aged 60-98 y. Although 6% of the males and 3% of the females showed marginal vitamin C status (plasma ascorbic acid 11 to less than 23 mumol/L), only one person had a plasma ascorbic acid (AA) level less than 11 mumol/L. At all levels of total vitamin C intake, mean plasma AA levels were higher in females than males. Vitamin C supplement use was associated with generally higher blood levels of vitamins B-6, B-12, and E and folate in both sexes and with higher levels of retinol in females. However, after both age and the total dietary intake of the specific nutrient being examined were controlled for, plasma AA levels were significantly correlated only with plasma levels of vitamin E and folate in females.

Alveolar bone levels in a geriatric Swedish population.

A random sample of non-institutionalized elderly people in Orebro County, Sweden, has been examined. The present report studies marginal bone levels in this population. Measurements were made on intra-oral radiographs. The marginal bone levels of the teeth were measured in fifths between the apex and a point 1 mm apical to the cemento-enamel junction. More than 87% of the teeth received a bone score 1 or 2, which indicates that more than 60% of the original bone level was remaining. About half of the teeth were given the bone score of 1, i.e., having more than 80% of the original bone level intact. For those subjects receiving regular dental treatment, the average bone level index (mean bone score for the subject) was lower than for the others. The general bone level of a subject is described by a classification which takes into consideration only the best 70% of the teeth. Using these bone level classes, people aged 65-74 years positively differ from older groups. The % of subjects belonging to the better bone level classes increases with increasing number of remaining teeth. In a multiple stepwise regression analysis, the number of teeth is the only predictor having significant correlation to bone level index. A variable such as regular treatment in itself seems to have little influence.

Activity

This article presents a selected review of literature concerning environmental influences on activity participation by the elderly person, the relationship between activity engagement and satisfaction in the environment, and the ways in which activity participation influences environmental experiences. The studies reviewed examine such factors as the amount and quality of activities offered, the types of roles available to elderly people in institutional settings, and how elderly people themselves experience and perceive their current living environments. The literature underscores the need for an awareness of how environmental variables can affect the individual's involvement in activity, as well as an understanding of how activity engagement may relate to the individual's evaluation of the environment and of oneself. The article concludes with some general implications for clinical intervention with institutionalized and non-institutionalized elderly people.

Life stress as a correlate of depression among older adults

Although there is some evidence that stressful life events are related to depression in the general population, there has been less research on this relationship with random community samples of older adults. The purpose of this study was to examine whether life stress (both stressful life events and chronic life strains) is correlated with depressive symptoms among a representative sample of noninstitutionalized elderly people. The findings indicate that chronic life strains (strains associated with financial and physical health problems) as well as bereavement are highly significant correlates of depression. Issues in the statistical estimation of these effects are also addressed.

Serum concentrations of 25-hydroxyvitamin D and vitamin D-binding protein in elderly people. Effects of institutionalization, protein-energy malnutrition and inflammation.

Serum concentrations of 25-hydroxyvitamin D (25-OH-D) and vitamin D-binding protein (DBP) were measured in institutionalized and non-institutionalized elderly people. The institutionalized subjects were found to have low serum 25-OH-D in confirmation of other studies, but their serum DBP levels were similar to those found in non-institutionalized elderly subjects. Serum DBP concentrations were slightly higher in elderly females than in males, while no age dependence was found for DBP. Elderly people with protein-energy malnutrition who lived in their own homes had slightly reduced serum DBP and 25-OH-D levels. Elderly subjects with infections or other diseases causing acute inflammation, as indicated by an elevated serum haptoglobin and C-reactive protein, had normal levels of DBP.

Active life expectancy.

This study was designed to demonstrate the feasibility of forecasting functional health for the elderly. Using life-table techniques, we analyzed the expected remaining years of functional well-being, in terms of the activities of daily living, for noninstitutionalized elderly people living in Massachusetts in 1974. The expected years, or active life expectancy, showed a decrease, from 10 years for those aged 65 to 70 years to 2.9 for those 85 or older. Active life expectancy was shorter for the poor than for others, and women had a longer average duration of expected dependence than men. The measure of active life expectancy provides important information about health at a given population level, in terms other than death. This information can be used for actuarial purposes in planning and policy making. It is also useful in identifying high-risk populations for which preventive health care and medical care can compress morbidity during the last years of life.

Factors Affecting the Use of Social and Health Services Among the Elderly

ABSTRACTThis study has systematically examined the use of health and social services among non-institutionalized elderly people according to the Andersen model which groups factors influencing use into predisposing, enabling and need variables. Need for service as evidenced by physical and psychological functioning was the most important predictor of use of physician services and hospitalization. Predisposing factors had the most effect on use of dental services. On the other hand, knowledge of services, an enabling factor, was most relevant to use of social services. Since this factor is manipulable to planned change, several program strategies were suggested for increasing awareness of social services particularly among the impaired elderly.

The effects of instructions on recall and recognition of categorized lists by the elderly

Sixty noninstitutionalized elderly people were tested for recall of both taxonomic and thematically related lists. On Trial 1, subjects were instructed either to look at, categorize, or remember the pictures; on Trial 2, they were all required only to look at the items. Subjects instructed to remember or categorize recalled and clustered more than subjects required only to look. Although there were no differences due to category type on the first trial, when freed from the restriction to organize or memorize on Trial 2, subjects performed better on the thematic lists. The results are discussed in terms of the possible effects of institutionalization and age-related shifts in the logical basis for classification.