Role In Older People Research Articles

Understanding Older People's Readiness for Receiving Telehealth: Mixed-Method Study.

BackgroundThe Dutch Ministry of Health has formulated ambitious goals concerning the use of telehealth, leading to subsequent changes compared with the current health care situation, in which 93% of care is delivered face-to-face. Since most care is delivered to older people, the prospect of telehealth raises the question of whether this population is ready for this new way of receiving care. To study this, we created a theoretical framework consisting of 6 factors associated with older people’s intention to use technology.ObjectiveThe objective of this study was to understand community-dwelling older people’s readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators.MethodsA mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people’s intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people’s actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2).ResultsIn phase 1, a total of 256 people aged 65 years or older participated in the survey study (50.0% male; median age, 70 years; Q1-Q3: 67-76). Using a significance level of .05, we found seven significant associations regarding older people’s perception of videoconferencing. Older people’s (1) intention to use videoconferencing was predicted by their performance expectancy (odds ratio [OR] 1.26, 95% CI 1.13-1.39), effort expectancy (OR 1.23, 95% CI 1.07-1.39), and perceived privacy and security (OR 1.30, 95% CI 1.17-1.43); (2) their performance expectancy was predicted by their effort expectancy (OR 1.38, 95% CI 1.24-1.52); and (3) their effort expectancy was predicted by their self-efficacy (OR 1.55, 95% CI 1.42-1.68). In phase 2, a total of 6 men and 9 women aged between 65 and 87 years participated in the qualitative observation study. Of the primary themes, 5 themes were identified that could provide greater understanding of older people’s capacities and incapacities in using digital technology: (1) “self-efficacy and digital literacy,” (2) “obstacles to using technology,” (3) “prior experience and frequency of use,” (4) “sources of support and facilitating conditions,” and (5) “performance expectancy.” These 5 themes recurred in all 15 observations.ConclusionsPerformance expectancy, effort expectancy, and perceived privacy and security are direct predictors of older people’s intention to use videoconferencing. Self-efficacy appeared to play a role in both older people’s intention to use, as well as their actual use of technology. The path analysis revealed that self-efficacy was significantly associated with older people’s effort expectancy. Furthermore, self-efficacy and digital literacy appeared to play a major role in older people’s capacities to make use of digital technology.

New Roles for Older People

New Roles for Older People

Hip muscle and hand-grip strength to differentiate between older fallers and non-fallers: a cross-sectional validity study.

BackgroundHip muscle weakness in older people seems to be an influencing factor of falls. Currently, it is unclear which muscles out of the hip muscle group play an important role in older people. A validating process in the measurement regarding muscle strength related to falls is necessary before answering that question.ObjectiveFirstly, we aimed to investigate which hip muscle group strength shows an acceptable level of distinction between older adult fallers and non-fallers compared to a predefined external criterion regarding falling. Secondly, we aimed to compare the same outcomes and questions for hand-grip strength in relation to the same external criterion.DesignThis study was a cross-sectional validity study.MethodsThe maximum voluntary isometric strength (MVIS) and the rate of force generation of hip abductors (ABD), adductors, internal and external rotators, extensors, and flexors were measured with a dynamometer fixed to a custom-made frame as well as hand-grip strength with a Martin Vigorimeter in 60 older people aged over 65 years (38 females and 22 males).ResultsThe area under the curve (AUC) and the results of the mean decrease in Gini index assessed by random forest approach show that of all the assessed parameters, hip ABD MVIS showed the highest discriminative value regarding the chosen external criterion in older people (AUC ABD MVIS 0.825, 95% confidence interval: 0.712–0.938).ConclusionResults indicate that ABD MVIS is a useful measure to distinguish between older adult fallers and non-fallers regarding the chosen external criterion.

Elderly fall risk prediction based on a physiological profile approach using artificial neural networks.

Falls play a critical role in older people's life as it is an important source of morbidity and mortality in elders. In this article, elders fall risk is predicted based on a physiological profile approach using a multilayer neural network with back-propagation learning algorithm. The personal physiological profile of 200 elders was collected through a questionnaire and used as the experimental data for learning and testing the neural network. The profile contains a series of simple factors putting elders at risk for falls such as vision abilities, muscle forces, and some other daily activities and grouped into two sets: psychological factors and public factors. The experimental data were investigated to select factors with high impact using principal component analysis. The experimental results show an accuracy of ≈90 percent and ≈87.5 percent for fall prediction among the psychological and public factors, respectively. Furthermore, combining these two datasets yield an accuracy of ≈91 percent that is better than the accuracy of single datasets. The proposed method suggests a set of valid and reliable measurements that can be employed in a range of health care systems and physical therapy to distinguish people who are at risk for falls.

Reflexiones sobre la pertinencia de la educación en el campo de la gerontología en Colombia y en el mundo

<p>Este artículo tiene como propósito presentar un cúmulo de reflexiones sobre la pertinencia de la gerontología como carrera profesional, las cuales se sustentan en un conjunto de necesidades y aspectos que tienen resonancia a diferente escala (mundial y nacional) tales como: el envejecimiento demográfico y sus consecuencias; la transición epidemiológica; el perfil social de la población vieja; el reto de la dependencia; el rol de las personas mayores en la socialización de generaciones más jóvenes y, en la normatividad en temas relacionados con el envejecimiento y la vejez. Se concluye, con preocupación, que ante el panorama que justifica plenamente la necesidad de formar profesionales en gerontología, hoy exista una muy baja oferta de formación en pregrado en este campo en Colombia, lo cual demuestra la poca visibilización de las profundas transformaciones y consecuencias que, a mediano y largo plazo, trae el proceso de envejecimiento que actualmente vive el mundo y nuestro país.</p><p> </p>

THU-417 - Ischemia/Reperfusion Injury in the Aged Liver: The Importance of the Sinusoidal Endothelium in Developing Therapeutic Strategies for the Elderly

The liver endothelium plays a key role in the progression and resolution of liver diseases in young and adult individuals. However, its role in older people remains unknown. We have herein evaluated the importance of the sinusoidal endothelium in the pathophysiology of acute liver injury, and investigated the applicability of simvastatin, in aged animals.18 months old male Wistar rats underwent 60 min of partial warm ischemia followed by 2h of reperfusion (WIR). A group of aged rats received simvastatin for 3 days before WIR. Endothelial phenotype, parenchymal injury, oxidative and nitrosative stress, and fenestrae dynamics were analysed. The effects of WIR and simvastatin were investigated in primary LSEC from aged animals.The results of this study demonstrated that WIR significantly damages the liver endothelium and its effects are markedly worse in old animals. WIR-aged livers exhibited reduced vasodilation and sinusoidal capillarization, associated with liver damage and cellular stress. Simvastatin prevented the detrimental effects of WIR in aged livers.In conclusion, the liver sinusoidal endothelium of old animals is highly vulnerable to acute insult, thus targeted protection is especially relevant in preventing liver damage. Simvastatin represents a useful therapeutic strategy in aging.

Older people as grandparents: how public policy needs to broaden its view of older people and the role they play within families

PurposeThe purpose of this paper is to provide a new perspective on the importance of grandparenting relationships and to highlight the continuing importance of intergenerational exchange across the life course.Design/methodology/approachThe paper draws on research from diverse fields including child welfare, gerontology and demography and journalistic sources, presenting an evidenced argument of the importance of grandparenting in contemporary families.FindingsThe paper argues that the role of grandparents in family life is becoming more important as a result of demographic changes, and that grandparents offer a huge resource to families. Older people generally find their role as grandparents rewarding and that this contributes to wellbeing and reduced risk of loneliness.Originality/valueThe paper provides a new perspective on the role of older people as grandparents.

The Role of Older People as Consumers - the Comparative Analysis of Old and New Member States of European Union

The aim of this paper is to investigate differences between the role of older people as consumers of goods and services in Old and New Member States of European Union. An ageing of society process causes changes in the structure of consumers of goods and services, in size and age respectively and therefore should be comprehensively considered. The consequences of an ageing process have been illustrated with an example of the tourism market. To reach the goal of this paper statistical analysis has been carried out, particularly in order to examine the differences between EU New and Old Member States2 with respect to dynamics of population ageing and characteristics of older customers. Most of the recent scientific literature considering the specific influence of demographic processes on customers behaviour has been reviewed. The key findings prove that an ageing of societies process is significant for each European country. However EU-12 societies are generally younger in comparison to EU-15. On the other hand EU-12 societies are exposed to higher risk of rising dynamics of demographic changes. In a consequence, the increasing role of older people as customers brings also essential changes in relation between supply and demand on each markets. What is highly important, older customers needs are evolving due to their increasing purchasing power, higher education level and better consumers awareness. For instance, these relationships can be observed on tourism services markets where older people are becoming a significant and more attractive group of consumers, due to the level of their tourism expenditures. Moreover, the study described clearly considerable differences between older customers behaviour in EU Old and New Member States: in the purchase frequency of tourism services, in the length of holiday trips and in the level of expenditures. In the subsequent years, a higher homogenisation of purchasing habits of older people in European countries is expected. This paper contributes to the most current European scientific discussions on an importance of older people for a development of economies from the perspective of their impact on goods and services markets. Furthermore, especially in a context of insufficient optimization of companies strategies, which are still directed to a shrinking group of young buyers and the lack of knowledge about changing needs of older customers need to be highlighted and analyzed to bring new solutions for producers, retailers and whole markets.

Age differences in the perception of social presence in the use of 3D virtual world for social interaction

3D virtual worlds are becoming increasingly popular as tool for social interaction, with the potential of augmenting the user’s perception of physical and social presence. Thus, this technology could be of great benefit to older people, providing home-bound older users with access to social, educational and recreational resources. However, so far there have been few studies looking into how older people engage with virtual worlds, as most research in this area focuses on younger users. In this study, an online experiment was conducted with 30 older and 30 younger users to investigate age differences in the perception of presence in the use of virtual worlds for social interaction. Overall, we found that factors such as navigation and prior experience with text messaging tools played a key role in older people’s perception of presence. Both physical and social presence was found to be linked to the quality of social interaction for users of both age groups. In addition, older people displayed proxemic behavior which was more similar to proxemic behavior in the physical world when compared to younger users.

Lebensqualität älterer Frauen bei Abhängigkeit und Gewalt

Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing demand for specific measures of health promotion and prevention activities addressing vulnerable older people.

Honouring the elders: a transition model of inclusion for older people

This paper is the result of a workshop delivered by the authors at the National Development Team for Inclusion's 2009 conference. It examines the role of older people within the transition towns movement and suggests that the skills and knowledge that many older people possess are vital to the changes that must be made as we seek more sustainable lifestyles.The paper presents a variety of current projects where older people have been integral to teaching skills to younger generations. It outlines the suggestions that delegates at the workshop put forward and invites practitioners working with older people to consider the potential for their further involvement in transition initiatives.

Adiponectin Isoforms in Elderly Patients with or without Coronary Artery Disease

To study the distribution of adiponectin isoforms in a group of very old patients. Cross-sectional. Geriatric ambulatory clinic of the Department of Medicine at Policlinico "Tor Vergata." One hundred eight elderly adults (mean age 85.0+/-3.2) with or without a history of a previous myocardial infarction as proof of established coronary artery disease (CAD) at least 3 months before entry into the study. Accordingly, subjects were divided into CAD positive (CAD+, n=50) and CAD negative (CAD-, n=58). Assessment of adiponectin isoforms along with metabolic, lipid, and inflammatory profiles. CAD+ subjects had significantly higher levels of total adiponectin (Tot-Ad) and low-molecular-weight adiponectin (LMW-Ad) than CAD- subjects (P=.008 for both). LMW-Ad and high-sensitivity C-reactive protein were positively correlated, even after adjustment for waist circumference, sex, glomerular filtration rate, and presence of diabetes mellitus (correlation coefficient (r)=0.25, P=.05). This association was not confirmed when CAD+ subjects were analyzed alone. A positive association was found in CAD+ subjects between brain natriuretic peptide (BNP), high-molecular-weight adiponectin (HMW-Ad), and Tot-Ad (r=0.798 and r=0.795, P<.001 for all) but not LMW-Ad. Distribution of adiponectin isoforms differed in populations of elderly subjects according to the presence of coronary atherosclerosis. The data support the hypothesis for a protective role of LMW-Ad during aging, although additional studies are needed to definitively clarify whether LMW-Ad plays a protective role in older people with a history of CAD.

Caregiving and Volunteering Among Older People in Sweden—Prevalence and Profiles

This study examines the role of older people in Swedish society by exploring the prevalence of their informal caregiving and volunteering and by analyzing the profiles of these contributors of unpaid work. Data were collected by means of telephone interviews in a Swedish representative survey conducted in 2005. Our analysis reveals three distinct profiles of people involved in unpaid activities. One of these consists of those involved both in informal helpgiving and volunteering, a group that has been labeled “super helpers” or “doers” in earlier research. It is important for social policy planners to recognize these groups of older people and better understand the dynamics of their unpaid work in order to ascertain whether they might need support as providers and to enhance their well-being. There does not seem to be any simple contradiction between the parallel existence of a universal welfare model of the Swedish kind and an extensive civil society in which older people play important roles as active citizens.

Daily Activity and Life Satisfaction in Older People Living in Rural Contexts

This study is aimed at exploring daily and desired activity patterns in a sample of older people living in a rural context, as well as at examining the effect of some influential factors and their relationships with life satisfaction. Our sample was made of 216 retired people and was recruited from 12 villages from Catalonia and Valencia with populations of less than 1000 inhabitants. Data were gathered by means of an interview that included daily and ideal activities and life satisfaction (by applying the Life Satisfaction Index). Our results show that yesterday's pattern of activities is similar to an ideal pattern, although in the ideal day, our sample allocated more time to social activities and less time to passive activities such as watching TV or resting. In both cases, leisure activities and time spent working seem to play an important role in older people's life. Gender has a remarkable influence on patterns of activity, as women devoted more time to instrumental activities and less time to leisure. In general, differences between yesterday's and ideal activities were not related to life satisfaction.

Use of mobility devices and changes over 12 months among very old people in five European countries

Mobility devices (MDs) such as walking sticks, rollators and wheelchairs, often play an important role for older people living at home, striving to remain independent in everyday activities. The aim of this study was to explore how the use of MDs changes over time among very old people in five European countries. Empirical data from the ENABLE-AGE Survey Study, part of a major interdisciplinary research project carried out in Sweden (n=314), Germany (n=322), the United Kingdom (n=316), Hungary (n=179), and Latvia (n=225), were used. The use of MDs in the Swedish, German and UK samples showed a significant increase between the first occasion of data collection (T1) and the second (T2), 12 months later. A walking stick was the most common MD on both occasions, with the exception that the number of users of rollators outdoors exceeded the number of users of walking sticks in the Swedish sample at T2. Among non-users of MDs at T1, 12-21% became new users at T2. Continued use was seen between T1 and T2 (80-94%) in the various samples, but the type of MD used changed. In the Swedish, German and UK samples, significant changes were seen in the use of MDs with greater assistive potential over the year. This study shows that the pattern of MD use changes over a short period of time. More research is needed to determine outcomes of MD use in very old age, focusing on the extent to which MDs decrease disability during the aging process, not least in a European perspective.

Environmental Support for Outdoor Activities and Older People's Quality of Life

The outdoor environment provides older people with opportunities to be active, have contact with nature and meet friends and neighbours. Research has shown that such outdoor activities have substantial benefits for older people's well-being. However, going outdoors is often difficult for them due to increasing frailty and environmental barriers. This study argues that a neighbourhood environment facilitating older people's outdoor activities has a positive effect on their well-being. Small-scale studies were conducted to explore the concept of “environmental support” for outdoor activities and its effect on people's Quality of Life (QOL). Two methods were employed to identify the degree of environmental support. One was based on the assessment of neighbourhood environments and the other focused on outdoor activities people undertake. Analysis found highly significant correlations between environmental support and participants' QOL in both measurements even after controlling for participants' functional capability. The results suggest that outdoor environments adjacent to where one resides play a significant role in older people's QOL.

Extending Quality Life: Policy Prescriptions from the Growing Older Programme

This article provides a policy-oriented overview of the five-year ESRC Growing Older Programme of research on quality of life in old age: the largest UK social sciences research endeavour to date in the field of ageing. By way of an introduction to the Growing Older Programme, its main objectives are stated and some of its unique contributions to knowledge and research methods are summarised. Then the bulk of the article focuses on the relationship between research and policy: first in general terms and then specifically with regard to the operation of and outputs from the Programme. The particular methods used by the Programme to engage with the policy process are described, within a broad enlightenment framework. This is followed by an outline of the key elements of a multi-dimensional approach to extending the quality of later life. The five priority elements of this skeletal strategy – inequalities in old age, environments of ageing, economic and family roles, participation and involvement, and frailty and identity – are derived from the Growing Older Programme's comprehensive evidence base. In each case the policy implications of the research evidence are illustrated. Finally, the role of older people in living their own lives of quality is discussed, and the results of the Programme are used to show how aspects of both structure and agency combine to determine the quality of later life.

The relationship between oral health and nutrition in older people

The oral health of older people is changing with reducing numbers of people relying on complete dentures for function, and retaining some natural teeth. Despite this there are substantial numbers of older people whose ability to chew foods is compromised by their oral health status, either because they have few or no natural teeth. This alteration results in individuals selecting a diet that they can chew in comfort. Such diets are low in fruits and vegetables intake with associated reduction in both non-starch polysaccharide and micronutrient intakes. There is also a trend for reduced dietary intake overall. Salivary flow and function may have an impact in relation to the ability to chew and swallow. Whilst there are few differences in salivary function in fit healthy unmedicated subjects, disease resulting in reduced salivary flow and particularly polypharmacy, with xerostomia as a side effect, are likely to have a role in older people. This paper explores the relationships between oral health status and food's choice and discusses the potential consequences for the individual of such dietary change.

Champion start

A new role for older people's champions was first described in the National Service Framework for Older People (NSF) ( Department of Health 2001 ). Older people's champions have a crucial role to play in helping to implement the NSF, particularly in rooting out age discrimination. There is much interest in how the roles and responsibilities are being developed in different areas.

The role of older people in our communities.

The proportion of older people in the total population is increasing in most countries because of advances in medical technology and resulting longer life expectancy. The role that older people play in our communities does not reflect this. Sometimes they are reduced to mere statistics and stereotypes in economic and political discussions on the financial burdens of care for older people. I argue that we need to rebuild inclusive munities in which older people are respected as valuable members. I suggest that this can be done by studying the characteristics of past communities and by learning from the work of environmental ethicists who advocate the preservation of our heritage. Nurses share with them a holistic perspective on complex issues such as ageing. They are therefore in a position to empower older people to play a role in our communities as unique individuals with integrity and wisdom.