Place In Old Age Research Articles

Disorientation in Time and Place in Old Age: Longitudinal Evidence from Three Old Age Cohorts in Germany (AgeDifferent.de Platform).

Only little evidence is available on disorientation, one of the most challenging symptoms of Alzheimer's disease and related dementias. The aim of this study was to investigate the prevalence of disorientation in older age in association with the level of cognitive status, personal characteristics, and life events. Three longitudinal population-based cohort studies on cognitive health of elderly adults were harmonized (LEILA 75 + , AgeCoDe/AgeQualiDe, AgeMooDe). Participants who completed a baseline and at least one follow-up assessment of cognitive functioning and who did not have stroke, Parkinson's disease, atherosclerosis, kidney disease, and/or alcoholism were included in the analysis (n = 2135, 72.6% female, mean age 80.2 years). Data was collected in standardized interviews and questionnaires with the participant, a proxy informant, and the participant's general practitioner. Making three errors in the MMSE other than in the questions on orientation (MMSEwo) came with a probability of 7.8% for disorientation, making ten errors with a probability of 88.9%. A lower MMSEwo score (HR 0.75, CI 95 0.71-0.79, p < 0.001), older age (HR 1.11, CI 95 1.08-1.14, p < 0.001), and living in a nursing home (HR 1.64, CI 95 1.02-2.64, p = 0.042) were associated with incident disorientation. Impairments in walking (OR 2.41, CI 95 1.16-4.99, p = 0.018) were associated with a greater probability for prevalent disorientation. None of the life events were significant. Our findings suggest that disorientation is primarily associated with cognitive status. Regular walking activities might possibly reduce the risk for disorientation but further research is necessary.

Apport de l’attachement dans le travail d’élaboration de la mort d’un sujet âgé en établissement d’hébergement. Le cas de Pierre, 90 ans

ObjectiveFrom a psychological point of view, this article aims to understand the attachment theory's contribution to the psychical elaboration of death for ‘resident elderly’ in nursing homes. Physical, cognitive and social losses make people to be aware of death. A psychical elaboration–the ability to attribute subjective meanings to events - permits to integrate death. Psychical elaboration depends on mentalization, but proximity of death alters mentalization: individuals are no longer able to use appropriate emotional strategies to express a request for social support. These strategies are highlighted by attachment. Social support can help individuals to understand their state of mind. So, social support can ease mentalization and psychical elaboration. We assume that difficulties in finding social support, due to alteration of mentalization and inter relational strategies, complicate psychical elaboration of death. MethodWe report a clinical case of Pierre, 90 years old, who lives in a French nursing home. This case comes from a qualitative study carried out with thirty-three nursing homes’ residents in Switzerland and France. In-depth interview – inspired by Adult Attachment Interview – investigated the participants’ life stories through their relationship experiences, the entry in nursing home, their views on their present and their future, and the meaning of their life. The Relation Scales Questionnaire measured attachment and the Mini Geriatric Depression Scale measured depression. ResultsTo understand the psychical elaboration of death, mentalization and the way how individuals seek social support - underlined by attachment - must be investigated. The proximity of death alters mentalization. The difficulties of mentalization influence attachment: the individuals use emotional regulation strategies which do not allow them to benefit from social support. However, this support could help them to understand their internal state and indirectly support difficulties of mentalization and favour the psychical elaboration. Social support is therefore essential in the psychical elaboration of death. The other's place in old age is also questioned and raises a paradox. Get closer to the other to benefit from social support allows to overcome difficulties of mentalization. But the comparison of oneself with the other as different reinforces the self-esteem. ConclusionFor professionals in nursing homes, providing social support to people who do not seek help and do not appear to need social support is essential. Adopting the therapeutic framework (art therapy, the use of a media) to each person's personality seems to be important.

Challenged but not threatened: Managing health in advanced age

In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health.Twenty community-dwelling people of advanced age (85+) were recruited in 2015–16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines.People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss.People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns.

Singapore and the Experience of Place in Old Age

Since the 1970s, humanistic geography has gained adherents among geographers who emphasize the centrality of and their condition (Tuan 1976, 266). Humanistic research has focused on human relationships with place, notably the development, characterization, and outcome of such relationships. Except in relation to homes (Perkins 1988), neighborhoods (Rivlin 1982), or places of worship (Kong 1992), few authors except Graham Rowles (1978, 1980, 1983a, 1983b) have investigated in detail how elderly people relate to the places with which they interact. We address this deficiency in the context of Singapore, in view of the growing proportion and number of the aged and the necessity for understanding their experiences and considering their future needs. Specifically, we use two case studies, Tiong Bahru and Chinatown, to explore how the elderly in rapidly modernizing Singapore relate to their places. Environments are especially important to aging residents, affecting their adaptation to change, the sustenance of their personal identities, and their continued participation in life, particularly given their diminishing physical ability, reduced economic means, and changing surroundings. Tiong Bahru and Chinatown represent two areas with larger-than-average concentrations of elderly residents. The census divisions Tiong Bahru and Kreta Ayer, which correspond closely to our study areas, are two of only seventeen census divisions (out of a total of eighty-one) in which the age category with the highest proportion of residents is sixty and above (Lau 1992, 22-24). Tiong Bahru can be divided into two areas [ILLUSTRATION FOR FIGURE 1 OMITTED]. The first comprises primarily three-to-five-story walk-up apartments, built between the 1930s and 1950s by the Singapore Improvement Trust (SIT), the housing authority prior to the current Housing and Development Board (HDB). The second comprises the high-rise HDB apartments in the Kim Tian estate. Physically, Tiong Bahru has not undergone many changes in the past few decades. The SIT apartments still look much the way they did when they were newly constructed. Likewise, Seng Poh Road Market / Food Center has been in existence since 1950, although the stalls were already operating in an unauthorized open-air market in the immediate prewar years (SIT n.d.). Only in the past five years have some changes been apparent: a Mass Rapid Transit station is now in operation on Tiong Bahru Road, and two developments on either side of the same road (one residential and one commercial retail, office, and entertainment) were recently completed. Even so, these changes have not drastically altered the essentially Old World environment of the SIT heartland. In demographic terms, however, the area has changed. The distinctively aged community has resulted because, over the years, many younger people have moved out to newer HDB housing developments that offer bigger and better facilities. Chinatown, in contrast, has seen many physical changes over the years. The shophouses (two- or three-story units in which the ground floor functions as shop space and the upper floors as residential quarters) were threatened by the bulldozer in the early 1980s; some were in fact demolished [ILLUSTRATION FOR FIGURE 2 OMITTED]. However, with a change in thinking toward a proconservationist stance, the Urban Redevelopment Authority has begun government conservation works and has initiated such works in the private sector since the late 1980s. Many of the elderly residents who lived in squalid conditions in these shophouses have since been moved to HDB apartments elsewhere, primarily in the adjacent Sago Street-Kreta Ayer Road vicinity. Focusing on these as our study areas, we conducted in-depth interviews with residents in 1993 and 1994, tape recording them when we were permitted to and translating them from Mandarin and other Chinese dialects when we had to. Part of our analysis was based on the observations we made as we walked through Tiong Bahru and Chinatown, noting in particular where the elderly congregated and what they did in their meeting places. …

Effects of denervation on enzyme‐histochemical and morphometrical properties of the rat soleus muscle in relation to age

The soleus muscle of young adult (5 months), adult (10-11 months) and old (23 months) male Wistar rats was unilaterally denervated for a period of 3 weeks and studied with regard to enzyme-histochemical and morphometrical properties. Denervation caused a marked atrophy of all fibres, irrespective of age and enzyme-histochemical type. Fibres having myofibrillar ATPase staining characteristics intermediate to type I and type IIA fibres increased in number in all age groups and a reduction in the number/proportion of type I fibres was found in adult and old animals. These results indicate that a slow-to-fast shift in myofibrillar properties as a consequence of denervation, shown to occur in the soleus muscle of young animals, also takes place in old age. This supports the view that atrophic fibres with intermediate myofibrillar ATPase staining characteristics, and possibly also atrophic IIA fibres, seen in old soleus muscle could be type I fibres which have undergone a transformation in response to the age-related denervation process.

Place and personal identity in old age: Observations from Appalachia

This paper explores the phenomenon of attachment to place in old age. Three complementary dimensions of attachment—physical, social and autobiographical insideness—are identified from a three year in-depth study of elderly residents of an Appalachian community. It is argued that autobiographical insideness may be particularly important to old people in sustaining a sense of personal identity and may be adaptive in old age. The paper develops the hypothesis that the increasing mobility of current elderly generations is resulting in changing manifestations of attachment to place. Whereas the old-old (persons over 75 years of age) remain strongly attached to their proximate physical environment, the young-old (those under 75 years of age) appear to be developing identifications with places that involve greater emphasis upon vicarious involvement in displaced settings.

The Breakdown of Hereditary Immunity to a Transplantable Tumor by the Introduction of an Irritating Agent

The experiments reported in this paper were undertaken to test the effect of an external irritating agent in the production of susceptibility to an inoculable tumor in non-susceptible strains of mice. The role played by irritation in the production of malignant growths de novo has been considered of great importance by clinicians and experimentalists alike. Thus Carrel (1) has stated … “it is certain that tumors practically always occur at the site of a chronic irritation, sarcoma appearing during youth, and carcinoma during old age. These simple observations indicate that two factors are necessary for the production of cancer—local irritation, and a certain condition of the tissues and the humors, such as takes place in old age and youth.” The factor of chronic irritation in experiments with inoculable tumors has not been particularly stressed up to the present time. Such work has been primarily concerned with the problems connected with Carrel9s second factor, “the certain conditions of the tissues.” These problems have been attacked from various angles, for instance, by means of tissue culture experiments, work on cell physiology, transplantation of normal and of malignant tissues. It is this last line of investigation which has led to the conception of an hereditary mechanism determining the ability or failure of an individual to grow a certain bit of transplanted tissue—or, in the usual terminology, the susceptibility or non-susceptibility of an individual.