Number Of Older Persons Research Articles

THE POLITICS OF AGING IN A DIVERSE SOCIETY

This paper will present a case study of the politics of aging in a diverse society. With much of the world facing aging and growing numbers of older persons, they can expect that the elderly will engage in the political and governmental processes of their country. In addition, however, nations are beginning to also face issues of foreign workers, immigration and migrants and a more diverse society. What happens when aging and diversity come together? What are the policy and political implications of a politics of aging coupled with the pressures of immigration and diversity? This presentation uses the United States of America as a case study of a society becoming older while it becomes majority-minority and faces ongoing immigration pressures. The USA by 2030 will have a doubling of its 65 years and over population but by 2050 will find that Asians, Hispanics, Blacks and Immigrants will constitute a majority of its population; and this while facing the ongoing controversies of immigration and refugee politics. This presentation will present a historical and policy analysis of the nexus of aging, diversity and immigration and provide implications and lessons for others—e.g. Korea, Japan, European Union, Israel, Australia—facing similar pressures. After attending this presentation, participants will have an analytical understanding of demographic forces reshaping society and will be able to apply this case study to their host countries.

Study of Comprehensive Geriatric Care in Sharkia Governorate

Background: In recent years, there has been a sharp increase in the number of older persons all over the world. The number of people aged 60 years and over is expected to increase to 2 billion by the year 2050. One of the greatest challenges in geriatrics is the provision of optimal comprehensive geriatric care for older adults. Family physicians can improve the early identification of specific problems that are common in the elderly and also shift their focus from disease specific intervention to preventive care. Objectives: To improve the health of geriatrics through identifying health problems among the studied geriatric population in Sharkia governorate and determining the level of the family physicians' knowledge and practice of comprehensive geriatric care in Sharkia governorate. Subjects and methods: A cross-sectional study was conducted, it was conducted in 9 accredited family health centers in Sharkia governorate for one year. The family health centers were selected by stratified random sampling technique from health centers of Sharkia governorate. The sample included 630 elderly person and 52 family physicians. Results: The results of this study declared that the most prevalent self-reported morbidities were, diabetes mellitus (36.7%), hypertension (33.5%) and respiratory disease (20.2%). The results also showed that (76.9%) of the studied family physicians have adequate knowledge about physical problems of the elderly population and (25%) of the studied family physicians have adequate performance in taking personal history, abdominal examination and counseling of the elderly population. Conclusion: The more prevalent self-reported morbidities among the studied geriatric population were, diabetes mellitus, hypertension and respiratory diseases. Most of family physicians had inadequate level of performance as regard physicians performance during dealing with geriatric patients. Recommendations: The study highlighted the need to promote geriatric health care services, regular health checkup and social support by people. Continuous training of family physicians specially in comprehensive geriatric care for providing high quality of care for elderly population.

Cognitive Impairment and Quality of Life among Elderly in India

As per the census of India, the Indian population has nearly tripled in last 50 years and the number of older persons has increased more than fourfold. A significant population of the older persons is experiencing cognitive changes which lead to several cognitive health issues and affect their quality of life. Thus, the elderly population in India creates a holistic research base by looking at the dynamics of cognitive impairment and quality of life. This paper aims to examine level of cognitive impairment among the elderly in India and its effect on quality of life. The present paper examines change in the cognitive functioning of the elderly on the basis of score obtained for four cognitive variables (verbal fluency, verbal recall, and digit span (backward & forward). Better score signifies better cognitive health. Data from Study of Global Aging and Adult Health (SAGE) WAVE-I, 2007–10 has been utilised in this study. A sample of 7150 aged 50 and above has been analysed by using principal component analysis (PCA) and structural equation modeling (SEM). The result reveals that cognitive scores for all four variables are very low. Hence with presences of low cognitive scores, the quality of life will reduce by 7% among elderly. Cognitive impairment significantly and directly affected the quality of life of Indian elderly.

Evaluation of Nutritional Status Using Anthropometry and Biochemical Indices of Community Dwelling Older Persons in Nigeria

The number of older persons is on the increase and nutrition and health risks tend to increase with age.The study evaluated the nutritional status of community dwelling older persons using anthropometric and biochemical indices.The study was a cross sectional one carried out in semi-urban and rural communities comprising 600 older community dwellers aged ≥ 65years selected using multi-stage random sampling. Anthropometric status was assessed by body mass index (BMI), mid upper arm circumference (MUAC), waist-hip ratio (WHR), waist circumference (WC) and calf circumference (CC). Biochemical indices of serum haemoglobin (Hb), albumin, ferritin, total cholesterol (TC), low density lipoprotein (LDL), C - reactive protein (CRP) were assessed for 25% of the subjects using standard procedure/methods and compared with recommended cut-off. Most (62.7%) had normal BMI, while 21.33% were overweight. Majority (74%) were at risk of heart disease with WHR. About 75.6% had normal MUAC and 24.33% were malnourished. Some (69.5%) had normal WC and 30.5% had increased risk of abdominal fat adiposity. About 56.2% had normal CC, 43.8% were at risk of malnutrition. There was high prevalence of anaemia as 78% had low Hb. Majority (81%) had serum ferritin levels below normal range. About 43.3% had normal albumin level, 56.7% were within abnormal range of either < 35 or > 50g/l. Most (82.7%) were in lower risk category (< 1mg/l) of CRP. Majority (82%) had desirable total cholesterol, 53.3% had optimal LDL levels. Significant relationship (p<0.01) existed between Hb and ferritin for males (r = 0.794) and females (r = 0.839). Negative relationship was noted for Hb and CRP. There was positive association (p< 0.01) between BMI and CC, MUAC, WC; as well as between TC and LDL. Most of the subjects had normal BMI; many were at risk of heart disease with WHR and there was high prevalence of anaemia.

The geriatric management of frailty as paradigm of “The end of the disease era”

The sustainability of healthcare systems worldwide is threatened by the absolute and relative increase in the number of older persons. The traditional models of care (largely based on a disease-centered approach) are inadequate for a clinical world dominated by older individuals with multiple (chronic) comorbidities and mutually interacting syndromes. There is the need to shift the center of the medical intervention from the disease to the biological age of the individual. Thus, multiple medical specialties have started looking with some interest at concepts of geriatric medicine in order to better face the increased complexity (due to age-related conditions) of their average patient. In this scenario, special interest has been given to frailty, a condition characterized by the reduction of the individual's homeostatic reserves and increased vulnerability to stressors. Frailty may indeed represent the fulcrum to lever for reshaping the healthcare systems in order to make them more responsive to new clinical needs. However, the dissemination of the frailty concept across medical specialties requires a parallel and careful consideration around the currently undervalued role of geriatricians in our daily practice.

Using Reality Therapy to Facilitate Successful Aging in Clinical Practice

Within the next 15 years, the population of older persons in the United States is expected to reach 20% of the population by 2030. Undoubtedly, there will be an increase in the number of older persons with mental health issues as well as issues simply related to aging. The purpose of this article is twofold. It will briefly examine how the counseling profession has addressed the needs of the aging population. Second, it will provide an introduction to reality therapy as a flexible theoretical approach that can be tailored to individuals throughout the life span. This approach can help older persons in making choices that are need fulfilling and tailored to match their dreams and identified wants.

Frailty: An Emerging Public Health Priority

The absolute and relative increases in the number of older persons are evident worldwide, from the most developed countries to the lowest-income regions. Multimorbidity and need for social support increase with age. Age-related conditions and, in particular, disabilities are a significant burden for the person, his or her family, and public health care systems. To guarantee the sustainability of public health systems and improve the quality of care provided, it is becoming urgent to act to prevent and delay the disabling cascade. Current evidence shows that too large a proportion of community-dwelling older people present risk factors for major health-related events and unmet clinical needs. In this scenario, the “frailty syndrome” is a condition of special interest. Frailty is a status of extreme vulnerability to endogenous and exogenous stressors exposing the individual to a higher risk of negative health-related outcomes. Frailty may represent a transition phase between successful aging and disability, and a condition to target for restoring robustness in the individual at risk. Given its syndromic nature, targeting frailty requires a comprehensive approach. The identification of frailty as a target for implementing preventive interventions against age-related conditions is pivotal. Every effort should be made by health care authorities to maximize efforts in this field, balancing priorities, needs, and resources. Raising awareness about frailty and age-related conditions in the population is important for effective prevention, and should lead to the promotion of lifelong healthy behaviors and lifestyle.

Living Arrangements and Conditions of Older Persons in Namibia

In Africa, ageing is a phenomenon that is just beginning to reveal its shape. Most governments, including the Namibian government, recognize the fact that the number of older persons is on the increase, however, discussing it is still a distant phenomenon and family matter. This paper examines the living arrangements of older adults in Namibia, identifying the existing structure of living arrangements and the nature of family relationships of older people, as well as provides some basic descriptive information on the housing conditions in which older persons live and how they are associated with their socioeconomic and demographic factors. The analysis is based on 1991, 2001 and 2011 Namibia Population and Housing Censuses. The study concluded that living arrangements is constantly changing from extended family pattern to western nuclear family, mainly due to urbanization and decreased fertility rate. Housing conditions had notably improved in rural areas while in urban areas the conditions are affected by the mushrooming of informal settlements. There is need to encourage or conduct focused research on ageing to help coin policies based on evidence and make communities sensitive towards ageing. The study further recommends Government to encourage old people to form organizations that would in turn focus on sensitizing and help championing issues of ageing and aged persons.

Guidelines to facilitate self-care among older persons in South Africa

Background: The number of older persons is growing at an alarming rate, yet the South African healthcare sector is not giving this issue the required attention. Moreover, the healthcare sector serves four-fifths of the country's population and primary healthcare (PHC) facilities are overcrowded, and thus professional nurses are prevented from providing sufficient self-care health education to older persons.Aim: To develop guidelines for the three role players — the public health sector, professional nurse and older person — to facilitate self-care among older persons in South Africa.Design: Quantitative, descriptive, explorative and contextual research design.Methods: A literature review followed by a self-care assessment of a sample of older persons using the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires which led to the identification of conclusions and self-care deficits.Results: Based on Menon's psychological health empowerment model, and from the conclusions and self-care deficits, nine self-care guidelines were developed for the public health sector, professional nurses and older persons.Conclusion: This is the first systematic development of guidelines to facilitate self-care among older persons in South Africa.Implications for practice: The implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop.

New understandings of patients and carers as people - an ethical imperative

As the numbers of older persons (and with managed chronic diseases) increases rapidly, so will the number of people involved in caring, as the case of Mary illustrates. This is both a threat and a challenge to understanding and upholding the generally accepted ethical principle of respect for autonomy of patients. I will argue that we need to broaden the traditional ethical framework in addressing the connectivity between patients and their carers. We first need a new understanding of what it means to be elderly and dependent. Vulnerability is often understood as an inescapable dimension of life, but its meaning in healthcare is unclear. In gerontology, the concept of frailty is used. The degree of frailty reflects overall functional capacity, which is dependent on many factors, including social and psychological functioning and thus ‘self-management capabilities'. We will discuss the meaning of autonomy in the context of frailty, vulnerability and care dependency in elderly persons. In what way is Mary frail, vulnerable, dependent? Secondly, we need to understand the position of informal carers (Mary's stepson, niece, neigbours) who are partners in the (virtual) support team. These carers can be described as ‘dependency workers' (Kittay 1999) - they support someone who is dependent upon them, but this dependency in turn makes them vulnerable, and thus in need of ‘care for the carer'. Formal agencies, and related records, need to develop ways of identifying the needs of these ‘dependency workers' for respect and support. We need to remedy for the fact that informal carers are not only a resource and a team member but also persons with consequent needs and rights in their own respect. We will need to assess the accumulation of responsibilities many informal carers face (Mary's neighbours keeping an eye on her and at the same time caring for their own partner). Kittay EF (1999) Love's Labor - Essays on Women, Equality, and Dependency. New York, Routledge.

The “Rising Tide” of dementia in Canada

Dementia is an umbrella term for a large class of brain disorders. The prevalence of dementia was estimated at 44.4 million people worldwide in 2013, and in the absence of any significant new scientific discovery, prevalence rates are estimated to increase to 75.6 million in 2030 and 135.5 million in 2050.1 Alzheimer’s disease is the most common irreversible form of dementia. It is a fatal, progressive and degenerative disease that destroys brain cells.2 The syndrome consists of a number of symptoms that include changes in memory, judgment, reasoning, mood, behaviour, communication abilities and the ability to function on a day-to-day basis. Rising Tide: The Impact of Dementia on Canadian Society3 is a report released by the Alzheimer Society in 2010 following 2 years of intensive study. It is the first study to estimate the health and economic burden of dementia in Canada over the next 30 years. It also reviews and makes recommendations on policy options to address this issue. The 5 main pillars are as follows: Provide support for family caregivers (family includes anyone in the supportive network of the individual). Emphasize risk reduction and early intervention. Build an integrated system of care. Strengthen and supplement Canada’s dementia workforce. Increase investment in dementia research. Approximately 747,000 Canadians are living with cognitive impairment including dementia.4 Additional statistics from Rising Tide are similarly compelling. Despite advancing age being the biggest risk factor for Alzheimer’s disease, more than 70,000 of those living with dementia are under the age of 65. Women make up 72% of those living with Alzheimer’s disease. Within a generation, incidences of new cases will increase from 1 every 5 minutes to 1 every 2 minutes. The total cost of care for persons with dementia was about $15 billion in 2008 in Canada; this is expected to rise to $153 billion in 2038.3 Moreover, long-term care beds are projected to have a shortfall of 157,000 in Canada by the year 2038. The number of older persons with dementia living at home is expected to steadily rise from 55% to 62%.3 All of these trends will require community or home-based care to become more responsive to the needs of those living with dementia. Pharmacists play a vital role in the health and overall well-being of all Canadians. Pharmacists are highly visible and regularly accessed by members of the community, forming long-standing relationships with their patients. They are trained to understand pharmacotherapy that can benefit or impair cognitive function, and they can monitor for progression and related issues such as medication adherence. However, like many health care professionals, pharmacists may feel ill-equipped to support the unique needs of people living with dementia and their families or caregivers. Simply put, many pharmacists are uncomfortable dealing with patients with dementia. This article is the first in a series that aims to identify roles, strategies and resources pharmacists can apply in daily practice in service of people with dementia.

Sarcopenia and diabetes: Hyperglycemia is a risk factor for age-associated muscle mass and functional reduction.

Sarcopenia and diabetes: Hyperglycemia is a risk factor for age-associated muscle mass and functional reduction.

Quality of Life of Older Persons in Indonesia: Sex Differences

East Java province is one of the most populated provinces of older persons in Indonesia, and Kota Batu District occupied most of the older persons in the province. Most of older persons in Indonesia, including those who are residing in Kota Batu District, are poor. Kota Batu District is one of the districts that have a large number of older persons in Indonesia. Thus far not many research related to older persons has been conducted in the area. Although in recent years quality of life of the population has become a popular topic of discussion among academicians in Indonesia, quality of life of older persons has been a neglected area of study. Research on demography in Indonesia is still concentrated on younger population. Therefore, this paper is aimed at examining the level of quality of life of older persons aged 60 years and older. In particular, this study is aimed at exploring whether the level of quality of life is difference in terms of sex differences of older persons. Using a simple random sampling technique, a total of 300 older persons aged 60 years and older was selected. Data were gathered through face-to-face interviews using a questionnaire form, and analyzed descriptively. Result of the study show the majority of older persons in study area has a moderate level of quality of life, and there was no significant difference exist in the level of quality of life of old persons in terms of sex differences. DOI: 10.5901/mjss.2015.v6n3s2p313

Introduction: Mental Health of Older Adults in Asia

Population aging is taking place in nearly all the countries of the world. The number of older persons (aged 60 years or over) is expected to more than double, from 841 million people in 2013 to mo...

Developing a comprehensive cancer specific geriatric assessment tool.

Population aging is one of the most distinctive demographic events of this century. United Nations projections suggest that the number of older persons is expected to increase by more than double from 841 million in 2013 to >2 billion by 2050. It is estimated that 60% of the elderly patients may be affected by cancer and may present in the advanced stage. The aim of this paper was to develop a brief cancer-specific comprehensive geriatric assessment tool for use in a geriatric population with advanced cancer that would identify the various medical, psychosocial, and functional issues in the older person. Literature on assessment of geriatric needs in an oncology setting was reviewed such that validated tools on specific domains were identified and utilized. The domains addressed were socioeconomic, physical symptoms, comorbidity, functional status, psychological status, social support, cognition, nutritional status and spiritual issues. Validated tools identified were Kuppuswamy scale (socioeconomic), Edmonton Symptom Assessment Scale (Physical symptoms) and SAKK cancer-specific geriatric assessment tool, which included six standard geriatric measures covering five geriatric domains (comorbidity, functional status, psychological status, social support, cognition, nutritional status). The individual measures were brief, reliable, and valid and could be administered by the interviewer. The tool was developed for use under the geriatric palliative care project of the department of palliative medicine at Tata Memorial Hospital, Mumbai. We plan to test the feasibility of the tool in our palliative care set-up, conduct a needs assessment study and based on the needs assessment outcome institute a comprehensive geriatric palliative care project and reassess outcomes.

Assisting Older Persons With Adjusting to Hearing Aids.

This intervention study tested the feasibility and initial effect of Hearing Aid Reintroduction (HEAR) to assist persons aged 70 to 85 years adjust to hearing aids. Following this 30-day intervention, hearing aid use increased between 1 and 8 hr per day with 50% of participants able to wear them for at least 4 hr. Hearing aid satisfaction improved from not satisfied to satisfied overall. The study demonstrated that HEAR is feasible and could improve hearing aid use of a substantial number of older persons who had previously failed to adjust to their hearing aids and had given up. However, further testing among a larger and more diverse population is needed to better understand the effectiveness and sustainability of the intervention.

Geriatric medicine: services and training in Africa

the population is ageing globally and developing countries are experiencing the most rapid increase in the number of older persons. By 2045 the United Nations estimate that for the first time in history more people will be over 65, than under 15, years of age. The World Health Organization predicts that deaths from non-communicable diseases will rise by 24% in Africa in the next decade. The aim of this survey was to determine the specialist medical services available for older persons and the undergraduate and postgraduate training systems in place for geriatrics in each African country. a short survey was developed and sent to representatives from every country. Where appropriate, French and Portuguese translations were available. responses were received from 40/54 countries (74%). Data were obtained via an internet search for a further three countries. Out of 43, 25 countries had no geriatricians. Out of 40, 35 countries had no formal undergraduate training for medical students on geriatrics and 33 of 40 countries reported no national postgraduate training scheme for geriatrics. Having at least one geriatrician in the country was associated with a World Bank upper middle-income status (P = 0.04), but there was no significant association with the population size (P = 0.395). despite increasing numbers of older people and the increasing burden of chronic disease there are few geriatricians in Africa. Without undergraduate training, even general medical physicians will have limited knowledge of specialist geriatric needs. This is an area that will require development and investment in the future.

Gender, Elder Care and Care Workers in Thai Governmental Home for the Aged

Thai government discouraged formal care. Research on care workers and care work in Thai governmental homes for the aged was limited and unvoiced. This research aimed to investigate gender, elder care and care workers in Thai governmental home for the aged by exploring (1.) gender and care workers, (2.) how elder care was performed, (3.) care workers’ work condition and (4.) care workers’ work satisfaction. Qualitative research was employed to understand care workers’ perspectives. Research techniques were observation, focus group interview and in-depth interview with all care workers in one Thai governmental home for the aged and interview with key informants. Identifying themes and content analysis was applied. The results showed that there were more female than male care workers. Care work was socially constructed to women’s roles. There was an awareness to include both genders in care work, especially demanding for same sex of care workers and older persons for personal care. Since there were high numbers of older persons, care work demanded work that is more physical. Care work was not a professional work and attracted more women who were unemployed or had low level of education. Care work was linked to unpaid or low paid work. Since Thai government discouraged formal care, more care workers experienced poor work condition and dissatisfaction due to double disadvantages of under valuation of care work and formal care. There were more dissatisfied care workers who expressed poor working condition as no advancement, inadequate salary and benefits, poor coordination among departments, conflicts among coworkers, which affected personal goals, family life and health of care workers. However, satisfied care workers expressed mental and spiritual fulfillment as love, care, attachment, life meaning and morality that could overcome negative aspects of care work. Research, policy, practical implications and recommendations were to create more awareness of gender and care work that links to care workers’ work condition and satisfaction in formal care in Thailand.

Correlation between balance and the level of functional independence among elderly people

As the overall number of elderly people increases there is a corresponding rise in the number of older persons with disabilities. In order to examine whether there is any relationship between balance and activities of daily living, we evaluated balance and daily activities among elderly people living in the community. Cross-sectional study at Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil. The study included 70 community-dwelling elderly people aged 65 and over. Balance was evaluated using the Berg Balance Scale (BBS) and physical independence in daily activities was evaluated using the Barthel Index (BI). The Spearman correlation coefficient was used to examine the relationship between the parameters evaluated. Significance was set at the level of 5% (P < 0.05). The population's mean age was 70.5 ± 5 years. The mean BBS score was 50.9 ± 4.1, whereas the mean BI score was 98.1 ± 2.8. Statistically significant relationships were found between the BBS and BI (r = 0.41; P = 0.0004); between age and BI (r = -0.24; P = 0.04); and between age and BBS (r = -0.57; P = 0.0001). The results showed that among elderly people, there are correlations between age, balance and independence level.

Geropsychology in Spain

Spain, like other developed countries, has witnessed exponential growth in the number of older persons, and it has made great efforts to address this new social situation, gradually developing an extensive network for supporting not only dependent persons, but also healthy retired people with new demands. In order to better understand the situation with respect to aging, this chapter provides some demographic indicators illustrating the current structure of Spain’s aging population. The second and third sections outline the main research areas in Spain and the resources available for older adults. With regard to research on aging, there has been a considerable increase in the number of both research projects and publications in the Spanish context, particularly from the 1980s to the present. Most of the studies are aimed at assessing the different characteristics and conditions of senior citizens. This is a good first step with a view toward identifying their demands, though more research is necessary for making crucial changes. On the subject of resources and services, Spain has developed a wide variety of resources designed to meet the needs of both independent and dependent older adults. Finally, it should always be borne in mind that social needs change over time, so that they must be continuously studied and reappraised – and our respective responses updated – in order to maintain standards of excellence.