Number Of Older Adults Research Articles

Enhancing Behavioral Health Competencies for Senior Center Staff: Lessons Learned From Workforce Training Efforts

Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This session will describe a program funded by The Retirement Research Foundation and offered in collaboration with Center for Aging and Disability Education and Research at Boston University and NCOA to increase senior center staff knowledge and skills. Approximately 250 senior center staff in Illinois, Florida, and Wisconsin completed an online certificate in Behavioral Health and Aging. Results show that 100% of respondents felt that the training was useful for their job; 93% felt that they will be a more effective worker as a result of the training; and 97% felt that the information they learned in the training will make a difference with the people they serve. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program. At the organizational level, leaders reported new programming related to behavioral health and revised practices and protocols. This presentation will cover: (1) the extent to which training participants mastered the competencies needed for effective practice; (2) knowledge and skills gained from the training program; (3) Senior Centers’ capacity to identify and refer older adults to mental health services; and (4) organizational changes related to behavioral health programming with older adults.

Local Initiatives to Fund Services for Elders: Increased Community Recognition of the Importance of Social Care

Despite the growing number of older adults in the U.S., federal and state funding for non-medical supportive services remains limited. Recent work reports that states with a more generous supply of supportive services, including home delivered meals and personal care, have fewer low care residents in nursing homes. To boost this supply, some local communities across the nation are exploring alternative funding sources. Our review found 400 local communities across 15 states using voter-approved local revenue streams to fund aging services, such as property tax levies and payroll and sales taxes, and that this strategy has been politically popular. In this paper we provide results from the first national survey of these local communities. Study results found considerable variation by state in number and scope of local initiatives, with Ohio and Michigan each reporting about 70 communities with local property tax levies, while California and Washington had only one community each using this approach. Local programs ranged in size from generating less than $25,000 in annual revenue to more than $35 million. The organizational structure for these programs, and the administrative approaches, such as the use of care managers, varied by state and community. Programs provided an array of services, but typically included traditional social care services such as home delivered meals, homemaker/personal care, transportation, and home emergency response systems. Criteria for program participation also varied, but most were targeted to serve older adults with disability who did not meet Medicaid financial or functional eligibility criteria.

Family Value Matters: Intergenerational Solidarity and Life Satisfaction of Chinese Older Migrants

The number of older adults who migrate due to family reasons has been increasing rapidly in China in the past decade. However, few empirical studies have focused on this group. This study focused on them and explored the association of intergenerational solidarity with older migrants’ life satisfaction when they were adapting to the new environment. We surveyed 340 older adults who migrated to Nanjing with their children either to help care for the grandchildren or enjoy retirement life. Respondents were recruited from the community. Structural equation modeling was adopted to analyze the associations among intergenerational solidarity, loneliness, aging perception, and life satisfaction. Results showed intergenerational solidarity was negatively correlated with loneliness (r=-0.304) but positively correlated with life satisfaction (r=0.386). Loneliness was linked to lower life satisfaction(r=-0.517). Path analyses showed that loneliness played a partial mediation role on the relationship of intergenerational solidarity and life satisfaction. Aging perception negatively moderated the association between intergenerational solidarity and loneliness, and also negatively moderated the mediating effect of loneliness on intergenerational solidarity and life satisfaction. It is concluded family values played important roles in Chinese older migrants’ mental health. When they migrate to a new city, intergenerational solidarity can help ease their loneliness and subsequently improve their life satisfaction, which finally help them adapt to the new environment. Positive perception towards aging also helps improve their well-being after migration. Based on these findings, we suggest practitioners design education program to promote family values among the family with older migrants.

Disability and Long-Term Care in Singapore

Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

Supportive Built Environment for Active Aging in Korea’s Healthy City

Many small and medium-size towns in South Korea experience an increasing number of older adults growing older. This medium-size mountain city has been a member of WHO’s Healthy City Alliances and we investigated the impacts of built environment (BE) in the community on active aging. The purpose of the survey was to identify the BE affecting the residents’ physical activity level and quality of life. The survey data (N=630) were collected from the residents aged 40 years and over in May 2019 from a mountain city near a national park in Northeast part of Korea. The average age of the participants was 67.41 years of age and most wanted to stay in their community. Our descriptive data analysis show that the following items are perceived very important to address in creating more supportive environment: benches in public spaces; safe pathways and public transportation station; well-maintained sidewalks; affordable and accessible housing options. Regression models were also developed to examine the impacts of BE on activity level and quality of life. BE factors included the features related to outdoor spaces and buildings, public transportation, streetscape and housing, and found a significant relation between the participants’ activity level and public transportation in addition to demographic factors such as age and health status. Regarding the quality of life, the participants’ perception on outdoor spaces and buildings and safe public spaces were positively related to quality of life. The study showed the importance of supportive and age-friendly environments for active living.

Provider-Identified Deprescribing Facilitators and Strategies for Older Adults in Primary Care: A Team Alice Study

Potentially inappropriate medications (PIMs) may harm adults over the age of 65, yet PIMs are prescribed at high rates. The process of deprescribing PIMs is challenging in the primary care setting, particularly among older adult patients with multiple chronic conditions. While barriers to deprescribing are well known, less data are available on the facilitators and strategies that primary care providers consider key to successful deprescribing. This study examines providers’ perceptions and attitudes of deprescribing to identify individual and systems-level facilitators and strategies for successful deprescribing. Data were collected through semi-structured interviews with 20 providers recruited from primary care practices located in Western New York. Rapid thematic analysis was used to identify the facilitators and strategies providers perceived as important to successful deprescribing. Facilitators included providers adapting their approach to deprescribing PIMs based on their knowledge of the patient. Providers’ own characteristics were also important, as were those of their organization, including whether a clinical pharmacist was available to consult. Strategies for deprescribing were patient-focused (e.g., adapting to patient’s lifestyle), process-focused (e.g., patient education on polypharmacy), and medication-focused (e.g., tapering). It is clear that many of the primary care providers who treat a larger number of older adults are aware of the importance of deprescribing PIMs. However, deprescribing in a busy primary-care setting is challenging. Findings detailing providers’ perceptions of facilitators and strategies for deprescribing can guide future interventions and target support to reduce the risk of harm from PIMs in older adults.

Effects of Nurse Staffing, Work Environment, Education on Adverse Events in Nursing Homes

This study examined the effect of registered nurse (RN) staffing level, work environment, and education on adverse events experienced by residents in nursing homes. A cross-sectional study was conducted with 216 RNs working in nursing homes who were selected using random stratified sampling by location and bed size. Self-reported questionnaires regarding staffing level, work environment, education level, adverse events, and nurse characteristics were administered. Data from the National Health Insurance Service were used to describe nursing home characteristics. Both multiple and multinomial logistic regressions were used to control for the characteristics of nurses and nursing homes, and investigate the effects of nursing staffing level (number of older adults assigned to a nurse), work environment (Practice Environment Scale of the Nursing Working Index), and level of nursing education on the adverse events experienced by residents. An increase of one resident per RN was significantly associated with a higher incidence of pressure ulcers (OR= 1.019, 95% CI=1.004-1.035). Poor work environment increased the incidence of adverse events such as pressure ulcers (OR= 3.732, 95% CI=1.155-12.056) and sepsis (OR=3.871, 95%CI=1.086-13.800). Compared to RNs with a baccalaureate or higher, RNs with diplomas reported increased incidence rates of pressure ulcers (OR=2.772, 95%CI= 1.173-6.549). RN staffing, work environment, and education level affect the incidence of pressure ulcers, and the work environment affects the incidence of sepsis among residents in nursing homes. Policy-wise, improving the level of nurse staffing, nursing work environment, and nursing education will improve health outcomes of residents.

Higher Rates of Untreated Distress in Older Versus Younger Adults With Indolent Lymphoma

Indolent lymphomas are incurable but slow-growing cancers, resulting in a large number of older adults living with these diseases. Patients typically live with their illness for years with the knowledge that disease progression is likely. Yet, little is known about psychological distress in this population. This study examined rates of and the relationship between distress and mental health service use in older and younger adults with indolent lymphomas. Adult patients diagnosed with an indolent lymphoma (e.g., follicular lymphoma, marginal zone lymphoma) within the past six months completed self-report surveys of distress (Hospital Anxiety and Depression Scale; HADS) and mental health service use since the cancer diagnosis (yes/no). Descriptive statistics, t-tests, and chi-square analyses were used to examine study questions. The sample (n=84) included 35 patients 65 years or older. Across the entire sample, 21.4% screened positive for distress on the HADS; 58.8% of these patients did not receive mental health services. Older adults reported lower distress levels than younger adults (17.1% v. 24.5%; p=.038). Among younger adults, 50% of distressed patients received mental health services; only 20% of distressed older adults received mental health services. Distress was associated with mental health service use in younger adults (p=.004) but not in older adults (p=.17). Older adults with indolent lymphomas have higher levels of untreated distress than younger adults. Research on the mechanisms underlying these age differences (e.g., stigma toward mental health services, ageism) would inform interventions to increase rates of mental health service use and reduce care disparities due to age.

A Systematic Review of Interventions That Reduce Family and Friend Caregiving Time

The decreasing number of family/friend caregivers available to help the rising number of older adults is creating a critical family care gap. For this reason, there is a growing need for interventions that reduce family/friend caregiving time. We systematically reviewed five electronic databases to identify randomized trials, case control, quasi-experimental, and cross-sectional studies that evaluated a modifiable element that could be targeted for interventions with care recipients 65+ and/or their family/friend caregivers and reported on an outcome of time spent caregiving. We excluded studies without a comparison, broadly defined. The initial search included 1,812 unique records. Following abstract and title screening 311 full-texts were reviewed. Fifty-five studies published between the years of 1990 and 2019 met inclusion criteria. Studies predominantly focused on care recipients with dementia (58%) and were largely conducted in western countries (91%). The categories of interventions reviewed included pharmaceuticals (25%), public long-term care financing (7%), case management (7%), care setting (16%), technology (7%), multi-component interventions (9%), skills building (15%), additional formal expertise/care (9%), and other (5%), with one study falling into multiple categories. Pharmaceuticals, case management, care setting, and multi-component interventions demonstrated promising evidence to reduce family/friend caregiving time. Methodologically, studies were inconsistent in measurement and ascertainment of caregiving time. Given the public health concerns of reduced availability of family/friend caregivers for older persons in the upcoming decades, caregiving interventions should consider measurements of caregiving time as key outcomes.

Family Solidarity, Social Support, Loneliness, and Well-Being Among Older Adults in Rural China

China is experiencing a large increase in elderly population. In 2019, China’s population aged 60 and above had reached 253 million, accounting for 18.1% of the total population (National Bureau of Statistics of China, 2020). By 2050, the number of adults aged 60+ would be up to 430 million, reaching one third of the total population (Du, Zhai & Chen, 2005). Considering such a rapid aging process and the existing large number of older adults in China, it becomes imperative to investigate how psychosocial factors affect this group’s subjective well-being. This study proposed that, among older adults, higher support received from each of the three relational sources (adult children, family and friends) were associated with reduced loneliness and improved well-being. Structural equation modeling was conducted using a sample of rural adults aged 60 and older (N= 1142) from the 2018 wave of data from the Longitudinal Study of Older Adults in Anhui Province, China. Findings indicated that support from adult children directly and indirectly decreased older adults’ depression and improved their life satisfaction through loneliness; while support from family members directly decreased depression but did not directly improve life satisfaction or indirectly improve well-being through loneliness. Although support from friends did not have a significant impact on older adults’ well-being, it indirectly improved well-being through reduced loneliness. Findings have implications for programs or interventions targeting both parent -adult-child support and friends support and reducing rural older adults’ loneliness.

Starting an Older Adult Lecture for First Semester Nursing Students With a Truth or Myth Game

False ideas about the physical and psychosocial characteristics of older adults exist in America. It is especially important that nurses are not susceptible to myths and stereotypes as these myths can affect the quality of patient care. For example, some people stereotype older adults as forgetful, disabled, ill, and unable to understand new information. Misconceptions and negative stereotypes are also present in first year nursing students. It is vital that students assess their own attitudes about older adults to form positive attitudes and gain knowledge about aging and health care needs. To achieve this goal, the older adult lecture in a first semester theory and fundamental course begins with a PowerPoint slide presentation asking students to distinguish truths and myths. The truth or myth topics include a) developmental tasks; b) common physiological changes; c) a comparison of delirium, dementia, and depression; and d) addressing health concerns of older adults. Active discussion follows the activity. Seventy to ninety percent of students correctly answered nine of ten questions related to older adult content on the final exam. Considering the increasing number of older adults in the health care setting, nurse educators must dismantle negative stereotypes with creative teaching strategies.

Late- and Typical-Onset Heroin Use Among Older Adults Seeking Treatment for Opioid Use Disorder

Analyze 10-year trends in opioid use disorder with heroin (OUD-H) among older persons and to compare those with typical-onset (age <30 years) to those with late (age 30+) onset. Naturalistic observation using the most recent (2008-2017) Treatment Episode Data Set-Admissions (TEDS-A). Admission records in TEDS-A come from all public and private U.S. programs for substance use disorder treatment receiving public funding. U.S. adults aged 55 years and older entering treatment for the first time between 2008 and 2017 to treat OUD-H. Admission trends, demographics, substance use history. The number of older adults who entered treatment for OUD-H nearly tripled between 2007 and 2017. Compared to those with typical-onset (before age 30), those with late-onset heroin use were more likely to be white, female, more highly educated, and rural. Older adults with late-onset were more likely to be referred to treatment by an employer and less likely to be referred by the criminal justice system. Those with late-onset were more likely to use heroin more frequently but less likely to inject heroin than those with typical-onset. Those with typical onset were more likely to receive medication for addiction treatment than those with late-onset. Late-onset heroin use is increasing among older U.S. adults. Research is needed to understand the unique needs of this population better. As this population grows, geriatric psychiatrists may be increasingly called upon to provide specialized care to people with late-onset OUD-H.

Does Identifying Frailty from ICD-10 Coded Data on Hospital Admission Improve Prediction of Adverse Outcomes in Older Surgical Patients

IntroductionAs the population ages, increasing numbers of older adults are undergoing surgery. Outcomes for older people are known to be worse than younger people following surgical procedures, and identifying which patients stand to benefit from surgery can be challenging.&#x0D; Frailty is recognised as a major contributor to poor outcomes, however assessing frailty clinically is time-consuming and not routinely undertaken. Using data available from electronic medical records can potentially provide the opportunity to routinely screen for frailty electronically at time of admission.&#x0D; Objectives and ApproachThis population-based external validation study aimed to: 1. assess the performance of the Hospital Frailty Risk Score (HFRS) in the prediction of adverse outcomes (mortality, prolonged length of stay (LOS) and 28-day readmission), 2. to determine optimal age-groups and lookback periods and 3. compare HFRS performance against the Charlson Comorbidity Index (CCI).&#x0D; Hospital and death data for individuals (n=487,197) aged &gt;50 years admitted under a surgical specialty to all public/private hospitals in NSW, Australia, 2013-2017 were linked. Logistic regression models were tested for each outcome of interest. Area under receiving operator curve (AUC) and Akaike information criterion (AIC) were assessed for each model.&#x0D; ResultsFor prediction of 30-day, all models performed better than age and sex alone; however adjusting for CCI (AUC 0.76) provided marginally better prediction than adjusting for HFRS (AUC 0.75). Models consistently performed better in the younger age-group (50-65), providing excellent discrimination (AUC 0.82). In contrast, all models had poor ability to predict prolonged-LOS (AUC range 0.62- 0.63) or readmission (AUC range 0.62-0.65). Using a 5-year lookback period did not improve model discrimination over using a 2-year period.&#x0D; Conclusion / ImplicationsAdjusting for frailty using the HFRS did not improve prediction of 30-mortality over that achieved by the CCI. Neither HFRS nor CCI were useful for predicting prolonged-LOS r 28-day unplanned readmission.

Functional status among community‐dwelling older adults is determined by cognitive status

AbstractBackgroundSince 2008, the number of older adults has increased by 34% and is expected to nearly double by 2060. Among US older adults over 70 years of age, 22‐30% report difficulty performing at least one activity of daily living (ADL). ADL performance is associated with functional fitness parameters. Negative longitudinal changes in functional performance among older adults are associated with cognitive decline and may be able to predict future cognitive impairment. Thus, it is imperative to understand the influence of cognition on functional fitness among older adults.Method84 older adults (80.9+5.4 years) consented to have their functional fitness and cognition assessed. Functional fitness parameters included the following assessments: Short Physical Performance Battery (SPPB), 10‐meter walk (habitual and fast), dual‐task (habitual and fast), power chair stand assessment (average and peak power and velocity). Cognition was assessed using the Montreal Cognitive Assessment (MoCA) and a digital Visual Paired Comparison (VPC) task. Categories of low and high cognitive function were determined using the VPC results. A one‐way ANOVA was conducted to determine differences between cognitive groups.ResultParticipants with high cognitive performance scored significantly better on the SPPB, 10‐meter fast walk, dual‐task fast condition, and average velocity during the power chair stand assessment. SPPB scores were 10.2% lower among older adults with low cognitive performance (p = .04). The high cognition group walked 16.5% (0.16 m/s) faster when compared to the low cognitive group (p = .04). Dual‐task (fast) performance was 13.2% slower among the low cognition group (p = .03). Additionally, low cognitive older adults moved 16.7% slower when rising from a seated position during the power chair stand task (p = .01). MoCA was 2.76 points lower among the low cognition group (p &lt; .001).ConclusionBased on the current results, a relationship exists between functional fitness and cognitive performance in older adults. However, it remains unknown whether functional fitness can influence cognition or vice versa and how these impact ADL performance. Future research is warranted to determine if and how the relationship between cognitive function and functional fitness changes over time in older adults.

Decision-making capacity evaluations: the role of neuropsychological assessment from a multidisciplinary perspective

Decision-making capacity (DMC) in aging adults has become increasingly salient as the number of older adults, life expectancy, and the amount of wealth to be transferred from older generations have all increased. The accurate and reliable determination of older adults’ DMC is a particularly important topic given its implication in legal, financial, and health decisions. Based upon the four-ability DMC model promulgated by Appelbaum and Grisso in the 1980’s, a number of MacArthur Competence Assessment Tools have been developed and widely utilized. However, these tools do not include cognitive testing or other sources of objective data and have limited validity in a medico-legal setting, necessitating additional options for the evaluation of DMC. This is significant from the perspective of the patient because they have a vested interest in accurate and objective assessment of their DMC across domains.Given the disparities in the assessment of DMC, the authors propose, through this debate article, that the evaluation of DMC in the aging adult population utilize a combination of traditional interview and domain specific instruments and neuropsychological testing. To achieve a consensus on the issue, medical experts in a number of fields related to capacity evaluation, including psychiatry, neurology, neuropsychology, and general medicine were consulted and recruited as authors. Experts in Swiss law and ethics were also consulted and provided input.A tendency to focus on a single capacity, and in particular, the ability to consent to medical treatment, arose in the literature. Similarly, there are many instruments purporting to evaluate a single capacity (e.g., consenting to medical treatment, managing finances), while other areas important to the evaluation of DMC received little attention (e.g., activities of daily living, the ability to live independently, to marry, to resist undue influence, and to make a will or advanced care directive). Medical and legal experts in the multidisciplinary group agreed that there is a clear need for more consistency across evaluation of DMC domains and that a combined approach of traditional methods and neuropsychological testing provides a more thorough evaluation and better serves the patient.

Oral health and functional capacity of centenarians

The number of very old individuals, namely centenarians, is growing fast. In dentistry, the increasing number of older adults retaining natural teeth present new challenges for preventive and restorative dental care. However, there is a considerable lack of knowledge on the oral health status and needs in this exceptional age group. The aim of this population-based study was to identify the prevalence of oral diseases, therapeutic needs and functional capacity (evaluating centenarians’ autonomy and their capabilities regarding treatment and oral hygiene) in centenarians. Subjects born before 1920 were recruited from population registries in South-Western Germany, providing information on dental health experiences, oral health behaviors and undergoing dental examination. 55 centenarians participated in the study (mean age ± SD = 101.2 ± 1.6, 83.6% females). Results were compared to epidemiological data on adults aged 75–100 years examined in the Fifth German Oral Health Study. Adherence to recommended dental behaviors and dental check-ups was lower in the centenarian population. Moreover, with the exception of a lower Root Caries Index, centenarians showed a higher caries experience, and presented with a mean DMFT of 25.2 ± 3.9, a DMFS of 111.0 ± 21.8, a root caries prevalence of 34.5% and a Restorative Index of 54.0%. Centenarians’ functional capacity was also considerably lower. Non-existent or greatly reduced treatment capabilities and oral hygiene capabilities were registered in 63.7% and 43.6% of cases, respectively. Centenarians with a lower educational level (p = 0.018), in a care facility (p = 0.045) or in need of nursing care (p = 0.001) were more likely to have a low functional capacity. 98.2% of centenarians received help in their daily activities but only 12.7% in their oral hygiene. In conclusion, although most still have natural teeth, a decline of oral health can be perceived. As compliance with recommended behaviors is limited and most centenarians can no longer undergo dental treatment, the lack of assistance in daily oral health care is problematic.

Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes.

BackgroundThe number of older adults with insulin-treated diabetes mellitus (DM) is steadily increasing worldwide. Errors in the insulin injection technique can lead to skin lipohypertrophy (LH), which is the accumulation of fat cells and fibrin in the subcutaneous tissue. While lipohypertrophic lesions/nodules (LHs) due to incorrect insulin injection techniques are very common, they are often flat and hardly visible and thus require thorough deep palpation examination and ultrasonography (US) for detection. Detection is crucial because such lesions may eventually result in poor diabetes control due to their association with unpredictable insulin release patterns. Skin undergoes fundamental structural changes with aging, possibly increasing the risk for LH. We have therefore investigated the effect of age on the prevalence of LHs and on factors potentially associated with such lesions.MethodsA total of 1227 insulin-treated outpatients with type 2 DM (T2DM) referred to our diabetes centers were consecutively enrolled in the study. These patients underwent a thorough clinical and US evaluation of the skin at injection sites, as previously described, with up to 95% concordance betweenthe clinical and US screening techniques. Of these 1227 patients, 718 (59%) had LH (LH+) and 509 (41%) were LH-free (LH−). These patients were then assigned to two age class groups (≤ 65 years and > 65 years), and several clinical features, diabetes complication rates, and injection habits were investigated.ResultsComparison of the two age subgroups revealed that 396 (48%) and 322 (79%) patients in the younger and older groups, respectively, had LHs (p < 0.001). Compared to the younger subgroup, the older subgroup displayed a higher LH rate in the abdomen (52.9 vs. 38.3%; p < 0.01) and a lower rate in the arms (25.4 vs. 35.8%; p < 0.05), thighs (26.7 vs. 33.4%; p < 0.05), and buttocks (4.9 vs. 26.2%; p < 0.01). In older subjects, the most relevant parameters were: habit of injecting insulin into LH nodules (56 vs. 47% [younger subjects]; p < 0.01), rate of post-injection leakage of insulin from injection site (drop-leaking rate; 47 vs. 39% [younger subjects]; p < 0.05), and rate of painful injections (5 vs. 16% [younger subjects]; p < 0.001). Multivariate analysis showed a stronger association between LH and poor habits, as well as between several clinical parameters, among which the most relevant were hypoglycemic events and glycemic variability.DiscussionThe higher rate of post-injection drop-leaking and pain-free injections might find an explanation in skin changes typically observed in older adults, including lower thickness, vascularity and elasticity, and a more prominent fibrous texture, all of which negatively affect tissue distensibility. Consequently, in addition to the well-known association between aging skin impaired drug absorption rate, aging skin displays a progressively decreasing ability to accommodate large volumes of insulin-containing fluid.ConclusionsThe strong association between LH rate and hypoglycemic events plus glycemic variability suggests the need (1) to take specific actions to prevent and control the high risk of acute cardiovascular events expected to occur in older subjects in the case of hypoglycemic events, and (2) to identify suitable strategies to fulfill the difficult task of performing effective educational programs specifically targeted to the elderly.Trial RegistrationTrial registration number 172–11:12.2019, Scientific and Ethical Committee of Campania University “Luigi Vanvitelli”, Naples, Italy).

Does organizational participation affect farmers' behavior in adopting the joint mechanism of pest and disease control? A study of Meixian County, Shaanxi Province.

In China, there are a lack of well-established relationships regarding farmers' behavior and participation in farmer organizations. The main objective of this study was to explore the effects and mechanisms of organizational participation in the joint control of pest and disease among kiwifruit growers (within the members of organizations). To fulfill this objective, the present study utilized survey data from 577 kiwifruit growers collected from Meixian County, Shaanxi Province, China. A combined method utilizing the instrumental variable (IV) ordered probit and bootstrap multiple mediation effect models were employed to determine the effects of participation by farmers' organizations in the joint control of pest and disease among kiwifruit growers. A positive relationship was found between organizational participation and the joint control of pests and diseases. The empirical analysis of this study found that organizational support, organizational learning and organizational norms have mediating effects in the process of farmers' participation in the joint control of pests and disease. It is essential to go beyond individual behavior and tackle group decision-making at the farm level. This study found a positive effect of organizational participation in joint pest and disease control mechanisms. Moreover, whether the farm is situated in the demonstration zone for kiwifruit cultivation, planting experience, planting area, whether there are people in the family who are village cadres, and the number of older adults in the family significantly positively affect the degree of pest and disease control. © 2020 Society of Chemical Industry.

AGE-RELATED CHANGES OF GLYCOLYTIC ACTIVITY AND ANTIOXIDANT CAPACITY IN THE BLOOD OF ALLOXAN DIABETIC RATS

The increasing incidence of type 1 diabetes coupled with advances in treatment of type 1 diabetes has resulted in an unprecedented number of older adults living with and controllable type 1 diabetes. The objective of this experimental study was to assess the impact of aging on the level of basal glycaemia and activities of glucose-6-phosphate dehydrogenase [EC1.1.1.49], pyruvate kinase [EC 2.7.1.40] and glutathione reductase [EC1.6.4.2] in erythrocytes of alloxan-diabetic rats. Methods: We used 100 male Wistar rats, divided into two age groups: I group included- 2-month (adult) animals, and II group was made up of 4-month (old) animals. Diabetes was modelled by injecting the rats with 5% solution of alloxan monohydrate intraperitoneally in a dose of 170 mg/kg. Blood was taken from the tail vein to evaluate the basal glycaemia on 5-th and 47-th day after the alloxan injection. Rats were sacrificed on the 47-th day of the experiment in accordance with the regulations on ethical treatment of vertebrates. The assessment of the activity of the enzymes was carried out by standard methods. Statistical analysis was performed by using Statistica 10 StatSoft Inc. Results. The level of basal glycaemia on the fifth day of the experiment in the animals of both groups went up on average by 115% from baseline values. We founded that on 47-th day this index was higher in group of old rats by 20% than in adult rats. Pyruvate kinase activity in erythrocytes of adult and old animals with diabetes decreased by 35% and 50% respectively compared with the control. Glucose-6-phosphate dehydrogenase activity in erythrocytes of adult and old animals with diabetes decreased by 27% and 45% respectively compared with the control on 47-th day. The changes may be considered as the result of age-related disorders of glucose metabolism due to disturbances in free radical mechanisms. Glutathione reductase activity in erythrocytes of adult and old animals with diabetes decreased by 29% and 35% respectively compared with the control on 47-th day. Conclusion. We have determined when getting aged, the alloxan-diabetic rats demonstrate changes in the sensitivity of pyruvate kinase, glucose-6-phosphate dehydrogenase and glutathione reductase activities in erythrocytes resulted from the effect of diabetes mellitus factors (hyperglycaemia). We can suggest that glycaemic control is key purpose for older patients with type 1 diabetes in order to prevent of complication, which can be aggravated with age.

Voluntary work for the physical and mental health of older volunteers: A systematic review.

Voluntary work for the physical and mental health of older volunteers: A systematic review.