Senior Citizen Centers Research Articles

The Effect of Lumbar Muscle Strengthening Exercise Types on Balance and Walking Ability of Elderly

The purpose of this study is to examine the effect of stabilization, resistance exercise, and combined exercise for lumbar on balance and walking ability of elderly. This study selected 22 subjects of over 65 years old elderly women who satisfy the study condition from A, B and C Senior Citizen's Center, in Daegu. The subjects were divided into groups; 7 for resistance exercise group, 8 for stabilization exercise group, and 7 for combined exercise group(resistance and stabilization exercise). The exercises were conducted for 60min a day, three times a week for 12 weeks. Balance and walking ability were checked before the exercise, 6 weeks later, and 12 weeks later. First, all lumbar muscle strengthening exercises were effective for static balance which changed according to exercising period. In dynamic balance, the resistance exercise group showed significant improvement in sit to stand. Stabilization exercise group showed significant improvement in all factors. The combined exercise group showed significant improvement in sit to stand and timed up and go. There was no difference between the exercise types. Second, the resistance exercise group showed significant change in Cadence which changed according to exercising period. The combined exercise group showed significant improvement in all factors. Between the exercise types, combined exercise was a bit more effective than resistance exercise. According to the result of 12 weeks of lumbar muscle exercise, combined exercise is considered to be the most effective exercise to prevent fall as it helps balance and walking ability slightly more than other exercises. Therefore, this study can understand the risk factors for fall accidents that frequently occur among elderly and adopt the combined exercise to prevent fall which in turn will prevent secondary problems occur from fall accidents and improve quality of life of elderly.

Atividade física e acidentes por quedas em idosos que frequentam centro de convivência

Abstract de Tese de Doutorado Physical activity and accidental falls in senior center users Priscila Carneiro Valim-Rogatto UNIFESP - Universidade Federal de Sao Paulo, Escola Paulista de Medicina. Depto. de Enfermagem, Sao Paulo, SP, Brasil The aims of this observational, cross-sectional study were: i) investigate the prevalence of accidental falls in Senior Citizen Centers (SCC) users and the influence of factors associated with these falls such as age group, sex, civil status, level of education, family/person income, retirement, labor market participation, cognitive status, registration period and activities carried out at SCC, and level of physical activity; ii) estimate the level of physical activity in this elderly population relating to the variables described above as well as the possible association with accidental falls; and iii) analyze the association among level of physical activity and related-factors and/or consequences on the most recent fall (number, daytime and fall location, fracture or injury occurrence, search for medical services and fear of falling). The sample included 350 Senior Citizens from three different SCC from Cuiaba City (Mato Grosso State, Brazil) that answered the Mini-mental State Examination–MMSE and the International Physical Activity Questionnaire-IPAQ short version. The Characterization of Falls Questionnaire was answered only by those elderly who had fallen. Descriptive Statistic, Binary Logistic Regression and Ordinal Logistic Regression by Proportional Odds Model (POM) were used for data analyses (p<0.05) from a 291 elderly sub-sample. About 40% of the elderly suffered falls in the last year. From this group, 45.3% declared to have fallen two or more times in the same period. The predictive model of falls was comprised by the following variables: female gender (OR= 5.12; IC= 2.48–10.56), 75-79 years old age group (OR=3.0; IC= 1.20–7.47), divorced marital status (OR=4.09; IC= 1.27–13.22), and to be pensioner (OR=2.82; IC= 1.20–6.64). Analyzing the level of physical activity (LPA), 38.1% of voluntaries were classified as high level, 49.8% as moderate level and 12.1% as low level. The results of POM indicated that the oldest group showed lower chance to be classified as high LPA (OR=0.78: IC=0.96-2.92) than elderly younger groups. Seniors that do not have a job (OR=0.38: IC=0.22–0.67) and those with low cognitive status (OR=0.31; IC=0.31-0.38) had little possibility to be in high LPA in opposition to the other levels. Regarding to the last fall reported, it was verified that 46.2% occurred in the afternoon, 9.4% resulted in fractures, 70.9% resulted in some sort of injury and 23.9% did not result in any impairments. It was also verified that 54.7% of the elderly suffered outdoor falls, 61.5% did not seek any medical

Avaliação do nível de fragilidade em idosos participantes de um grupo de convivência

A Síndrome da Fragilidade é uma condição frequente em idosos e pode ser precursora de incapacidade e quedas. Os objetivos deste estudo foram avaliar o nível de fragilidade em idosos de um Grupo de Convivência (GC) e a relação entre fragilidade, incapacidade e quedas. Participaram do estudo 64 idosos, avaliados de acordo com o Fenótipo de Fragilidade, que é composto pelos indicadores: perda de peso não intencional, auto-relato de fadiga, diminuição da força de preensão, baixo nível de atividade física e redução da velocidade da marcha. Foi considerado frágil o idoso que apresentasse três ou mais critérios, pré-frágil quem apresentasse um ou dois e não-frágil nenhum. Foram utilizadas a escala de Atividades Instrumentais de Vida Diária (AIVD), a escala de Atividades Básicas de Vida Diária (ABVD) e questões sobre história de quedas e medo de cair. O teste Mann-Whitney U e o coeficiente de Spearman foram utilizados (a=0,05). Em relação ao nível de fragilidade, foram encontrados 21 idosos não-frágeis, 42 pré-frágeis e um frágil. Os idosos pré-frágeis apresentaram maior necessidade de assistência em ABVD (p=0,046) e AIVD (p=0,011), maior ocorrência de quedas (p=0,004) e medo de cair (p=0,007) que os não-frágeis. Foram encontradas associações significativas e fracas entre estas variáveis e o nível de fragilidade. Os resultados demonstram a importância de intervenções preventivas em idosos pré-frágeis e sugere que fragilidade e incapacidade são entidades distintas em idosos deste GC.

Nível de atividade física e sua relação com quedas acidentais e fatores psicossociais em idosos de centro de convivência

Este estudo seccional teve por objetivo estimar o nível de atividade física (NAF) de idosos que frequentam centros de convivência (CCI), analisando a possível associação com quedas acidentais e outras variáveis relacionadas. Uma amostra de 291 idosos de três CCI da cidade de Cuiabá (MT, Brasil) respondeu ao Mini-Exame do Estado Mental (MEEM) e ao Questionário Internacional de Atividades Físicas (IPAQ). Foram utilizadas para a análise de dados, estatística descritiva e a regressão logística ordinal pelo Modelo de Odds Proporcional (MOP) (p&lt;0,05). Cerca de 40% dos idosos disseram ter caído no ano anterior ao inquérito. Quanto ao NAF, 38,1% dos voluntários foram classificados no NAF "alto", 49,8% no "moderado" e 12,1% no "baixo". Os resultados do MOP para NAF indicaram que idosos mais velhos têm menos chance de estar no NAF alto (OR=0,78: IC=0,96-2,92) do que idosos nas faixas etárias mais jovens. O mesmo foi observado em idosos que não trabalham (OR=0,38: IC=0,22-0,67) e aqueles com baixo índice cognitivo (OR=0,31; IC=0,31-0,38). A ocorrência de quedas não mostrou associação com o NAF.

High Prevalence of Depression and Anxiety Symptoms among Hospitalized Geriatric Medical Inpatients: A study from a Tertiary Level Hospital in Nepal

ABSTRACT Introduction: Depression and Anxiety symptoms are widely prevalent in the geriatric population and the prevalence is higher in those suffering from any kind of medical illness. Although the prevalence of anxiety and depression among elderly medical patients have been evaluated in a few studies from developed countries in Europe and the Americas, data from a developing country like Nepal is lacking. The main aim of our study was to estimate the burden of these psychiatric morbidities in our setting. Materials and methods: A cross sectional analytical study where 42 geriatric inpatients admitted to the Department of Internal Medicine of Tribhuvan University Teaching Hospital during the period from April 1st to May 20th 2009 were studied for the prevalence of depressive and anxiety symptoms using the Beck Depression Inventory and Beck Anxiety Inventory respectively. 23 healthy geriatric community dwellers from a senior citizen centre in Kathmandu were taken as the control group. Data was analyzed using SPSS 14.0. Results: Significant anxiety symptoms were present in 76.1% (N=32) of the hospitalized geriatric patients and significant depressive symptoms in 57.1% (n=24) as compared to 21.7% (n=5) and 17.3% (n=4) of healthy community dwellers respectively. Between the hospitalized geriatric medical inpatients and elderly healthy community dwellers, there was statistically significant differences in anxiety scores (F=26.06, p<0.01) and depression scores (F=22.97, p<0.01) as measured by one way analysis of variance (ANOVA). Conclusion: There is a very high prevalence of depressive and anxiety symptoms among hospitalized geriatric medical inpatients as compared to healthy community dwellers in Nepal. Presence of these psychiatric morbidities can further exacerbate the physical illness slowing down recovery and adversely affecting a wide range of outcomes. Such a high amount of psychiatric morbidity in this population needs to be addressed by appropriate mental health interventions.

Factors associated with self‐assessed oral health in the Japanese independent elderly

The purpose of this research was to analyse the relationship between oral health status, oral motor function, daily life situations and self-assessed oral health. A cross-sectional survey was conducted on 190 independent elderly volunteers aged 62-99 years from senior citizen centres in Tokyo, Japan. A questionnaire survey and oral examination were conducted on each participant. For the descriptive analyses, Independent t-test and the chi-squared test were used. Following that, using four latent variables, (oral health, oral function, daily life situations and chronic health condition), a structural equation modelling analysis (SEMA) was undertaken. In the descriptive analyses, there were no significant differences between self-assessed oral health and oral health status. However, there were significant differences between self-assessed oral health and oral function and daily life situations. Findings from SEMA revealed that daily life situations and oral function have independent effects on self-assessed oral health and that the relationship between self-assessed oral health and oral health status was weak. Many factors affect self-assessed oral health status. Dental clinicians and researchers should attempt to understand these factors and incorporate them into effective personal and population-based oral health education and oral health promotion programmes.

Rates of depression and participation in senior centre activities in community-dwelling older persons

The purpose of this study was to determine the role that senior citizen centres play in decreasing depression in community-dwelling older persons. A quantitative cross-sectional design was utilized. A questionnaire was used to determine demographic and lifestyle data. The dependent variable, depression symptoms, was measured using the 15-point Geriatric Depression Scale. Eighty-eight per cent stated that they attend for the friends and social support. Second, the study demonstrated that community-dwelling older persons can have those needs fulfilled at the senior centres. Ninety-four per cent of them have made close friends at their centres. Ninety-four per cent stated that their lives had improved since attending the senior centre. Eighty-six per cent felt they had made friends on whom they could rely when needed.

Fecal Incontinence in Elderly Koreans

To estimate the prevalence and correlates of fecal incontinence (FI) and its effect on quality of life in ambulatory elderly people in Korea. Cross-sectional, convenience sample-based survey. Twenty-seven senior citizen centers and two health clinics in two cities of Korea. Nine hundred eighty-one relatively healthy and ambulatory community-dwelling people aged 60 and older. Data were collected through in-person interviews with a structured questionnaire. Multivariate logistic regression analysis was used to determine independent risk factors for FI. The prevalence of FI was 15.5%. FI was significantly associated with lower quality of life (Medical Outcomes Study 36-item Short-Form Survey) for physical and mental health. In men, FI was significantly associated with urinary incontinence (odds ratio (OR)=4.89, 95% confidence interval (CI)=2.45-9.77), hemorrhoids (OR=4.66, 95% CI=1.67-12.97), and poor self-perceived health status (P for trend=.02). In women, FI was associated with urinary incontinence (OR=2.91, 95% CI=1.76-4.81), diabetes mellitus (OR=2.04, 95% CI=1.24-3.37), hemorrhoids (OR=2.99, 95% CI=1.31-6.83), and infrequent dietary fiber intake (P for trend=.02). FI is prevalent in elderly Koreans and has a profound effect on quality of life. Physicians should closely screen for FI in elderly patients with certain risk factors and evaluate to control these potentially preventable or modifiable factors.

노인여가시설 이용자의 서비스질 만족요인

The purpose of this study is to help establish policy for senior citizens` leisure activities by analyzing determinants of service qualities and factors affecting their satisfaction when they use leisure facilities such as senior citizen center, senior citizen class, and senior citizen welfare hall. To examine the determinants of service quality, a structured questionnaire made up of 15 items was composed. Using SPSS/PC+Version 12.0 program, 184copies of valid samples were statistically arranged. Multiple regression analysis and lower variables affect the senior citizens` satisfaction. Results showed that facility on senior citizen center, program on senior citizen class and service on senior citizen welfare hall respectively had the highest correlation with users` satisfaction. Concerning service quality factors of senior citizen center users` satisfaction, correspondence on facility factor, sympathy on service factor was the most significant variables. Concerning the satisfaction of senior citizen welfare hall users, facility, service and program in descending order showed to affect the satisfaction of the elderly. Regarding service quality factors, type on program and service factor, and correspondence on facility was the most significant variables.

The effects of measurement site and ambient temperature on body temperature values in healthy older adults: A cross-sectional comparative study

Background Accurate baseline body temperature measurement is essential for assessment. Tympanic membrane temperature (TMT) measurement is popular, but there is no consensus on whether it is as accurate as oral temperature (OT) for use with the elderly at varying ambient temperature levels. Objectives To test agreement between TMT and OT measurement of body temperature among an elderly population; and to explore whether agreement between the two sites depends on ambient temperature. Design A cross-sectional comparison study. Methods Two samples of older community-dwelling adults were recruited from 17 community senior citizen centers in Taipei, Taiwan in winter ( n = 262) and summer ( n = 257) of 2007. TMT and OT were simultaneously measured by electronic infrared ear thermometer and electronic digital thermometer. Ambient temperatures measured by digital thermo-hygrometer of the data collection setting were recorded when body temperature was taken. Results In winter mean TMT was 36.64 °C (S.D. 0.37), and mean OT was 36.74 °C (S.D. 0.18). In summer, the mean TMT was 37.05 °C (S.D. 0.30) and mean OT was 36.85 °C (S.D. 0.22). The relationship between TMT and OT were r = 0.42 ( p < 0.001) in winter and r = 0.57 ( p < 0.001) in summer. The values of OT were used as standard to assess the accuracy of the measurement. The bias between TMT and OT was −0.10 °C (S.D. 0.34) and 95% limits of agreement were 0.57 and −0.77 °C in winter; and bias was 0.20 °C (S.D. 0.25) and 95% limits of agreement were 0.69 and −0.29 °C in summer. The findings of this study demonstrate that the TMT has high variability that may under or over estimate body temperatures. Conclusions There is a lack of agreement in body temperatures values between TMT and OT in community-dwelling elderly in both winter and summer. OT was more stable than TMT regardless of ambient temperature influences. Therefore, the oral cavity is preferable to the TM site for temperature measurement in alert elderly. The limitation of this study is that hospitalized patients who are most likely to need temperature measurement are not included in this study.

New Recreational Facilities for the Young and the Old in Los Angeles: Policy and Programming Implications

It is assumed that higher quality recreation facilities promote physical activity and serve communities better. We tested this assumption by comparing changes in the use of an expanded and renovated skate park (a facility for skateboarding) and a modernized senior citizen's center to two similar facilities that were not refurbished. The skate park was nearly tripled in size, and the senior center was remodeled and received new exercise equipment, a courtyard garden, and modern architectural features. We assessed use of these facilities through direct observation and surveyed both facility users and residents living within 2 miles of each facility. We found that making improvements to facilities alone will not always guarantee increased use. Although there was a 510% increase in use of the expanded skate park compared to a 77% increase in the comparison skate park, the senior center had substantially fewer users and provided fewer hours of exercise classes and other programmed activities after the facility was renovated. The implication of our study is that use results from a complex equation that includes not only higher quality recreation facilities but also progamming, staffing, fees, hours of operation, marketing, outreach, and perhaps a host of other human factors.

Development, situation and perspective of self-help support in Germany

Self-help groups and self-help associations are an important part of the social security system. In Germany, self-help contact points, senior citizen centers, volunteer agencies, citizen centers and multi-generation houses combine citizen participation with innovative professional services. Unfortunately, there is no guarantee of continuous financial support for these important, locally administered institutions. There are about 280 self-help contact points and more than 400 federal self-help associations that support and promote self-help in Germany. Healthy communities, healthy workplaces and healthy people need a decentralized system of self-help programs operated at local and regional levels, in districts and towns. Thereby, professional support systems that operate self-help programs and promote citizen participation in the self-help programs must be managed in a similar regional format. New forms of cooperation from the regional and local governments, private companies, and citizen engagement already exist. Additionally, regional projects of integrated maintenance systems with the regional health maintenance institutions have been established. Currently, the central challenges of the self-help programs are quality development, inclusion of people with social disadvantages and of people with migrational background. The essential prerequisites for this work are continuous financial support and a politically supported infrastructure, which is in fact an important health investment.

Evaluation of the Chronic Disease Self-Management Program With Low-Income, Urban, African American Older Adults

A 1-group pretest–posttest design to assess for changes in outcomes at 10 weeks and 6 months was the method used to evaluate the standardized 6-session Chronic Disease Self Management Program (CDSMP) with low income, urban African American older adults. Participants included 153 older adults (primarily African American) with 1 or more chronic health conditions. Classes were provided in the community at senior citizen centers, senior housing, and churches. Significant improvements were noted in selected areas at 10 weeks and 6 months after the program completion. The CDSMP was feasible and well-received with the older adults who participated in the study. This study was funded by The Barra Foundation, Inc., Wyndmoor, Pennsylvania.

End‐of‐Life Decision‐Making, Decisional Conflict, and Enhanced Information: Race Effects

To examine the effect of enhanced information regarding the risks, benefits, and life-sustaining treatment alternatives on hypothetical medical decisions and decisional conflict in older, community-dwelling Caucasian and African-American adults. Two-group (enhanced information; no information) between-subjects design. Community-based dwellings, two assisted living facilities, and one senior citizen center. Seventy-eight adults (aged 74.5+/-7.18) with a mean Telephone Interview for Cognitive Status--Modified (TICS-m) score of 31.5+/-4.7 were recruited through personal contacts and informational talks held at the recruitment sites. Measures included the Life Support Preferences/Predictions Questionnaire--modified (LSPQ-m); the Decisional Conflict Scale; and enhanced information, including detailed descriptions of life-sustaining treatment options for each LSPQ-m illness scenario, risks of the treatment, benefits of the treatment, and alternatives for each treatment (called medical information stimuli). Enhanced information (e.g., medical information stimuli) reduced decisional conflict (P=.049, d=0.47) for hypothetical life-sustaining treatment decisions. A mixed analysis of variance with group and race as between-subjects variables and illness and treatment as within-subjects variables revealed significant main effects of race, illness, and treatment, as well as a significant race-by-illness-by-group interaction (Wilk's lambda=0.923, F(2, 73)=3.05, P=.05, partial eta(2)=0.08). Enhanced information produced different patterns of desire for life-sustaining treatments in African Americans and Caucasians. Physicians and other healthcare professionals can reduce decisional conflict in patients by providing enhanced information regarding treatment risks, benefits, and alternatives. Such decision aids may provide new information or knowledge and thus reduce desire for treatment in African Americans.

A creative-bonding intervention and a friendly visit approach to promote nursing students’ self-transcendence and positive attitudes toward elders: A pilot study

Nursing students' disinterest in caring for elders presents health care challenges. As the aged population increases, nursing faculty are challenged to improve students' attitudes toward elder care. Reed's self-transcendence theory guided this pilot study with nursing students (n=22) who implemented either a Creative-Bonding Intervention (CBI) or a Friendly Visit (FV) at senior citizen centers to test the effect of creative approaches on student self-transcendence and attitudes toward elders. Demographic data, a revised Kogan's Attitudes toward Old People statements, and Reed's Self-transcendence Scale were analyzed with descriptive, paired t test, ANCOVA, and Pearson correlation statistics. Results demonstrated significant differences in attitudes in the FV and changes in the expected directions in the CBI group. Self-transcendence had no significant changes. Valuable information was provided by students' comments about the interventions. Reed's belief that self-transcendence is present regardless of age was supported. Future studies are suggested with an increased sample size, a combined CBI/FV intervention, and supportive help during students' intervention delivery.

A Clinical Trials Recruitment Education Program for Immigrant Chinese Americans

This study was designed to develop and evaluate a community-based education program to facilitate enrollment of immigrant Chinese into clinical cancer screening trials. The program included workshops with culturally tailored health education materials. It was piloted to recruit persons into an ongoing lung cancer screening trial from a senior citizen center in Manhattan's Chinatown and compared with a control program at a second senior center. Survey results from a convenience sample of seniors showed that the workshop raised awareness about cancer screening and clinical trials. However, it did not change attitudes towards cancer screening. The results highlighted prior focus group findings in which factors influencing participation in cancer screening and clinical trials are similar. Important facilitative factors include doctor recommendation, friend/family recommendation, the belief that early detection could “save lives,” no cost, and having an-interpreter.

Quality of lay person CPR performance with compression:ventilation ratios 15:2, 30:2 or continuous chest compressions without ventilations on manikins

The new CPR guidelines emphasise chest compression depth and have increased the compression:ventilation ratio to cause less time intervals without chest compressions. How this change may influence the quality of chest compressions is not documented. Sixty-eight volunteers among travellers at Oslo international airport and a senior citizen centre performed 5 min of CPR on a manikin with compression:ventilation ratios 15:2, 30:2 or continuous chest compressions. Median age was 37.5 years (range 15-87), 59% were men, and 71% reported CPR training median 8 years (3-15) previously. Three of 22, 4 of 23 and 3 of 23 subjects in the 15:2, 30:2 and continuous compressions groups respectively stopped before 5 min had passed. Mean compression depth was 41 +/- 11, 45 +/- 8 and 30 +/- 8 mm, respectively. Depth was reduced as a function of time in the continuous compression group. Number of compressions per minute was 40 +/- 9, 43 +/- 14 and 73 +/- 24 and percent no flow time 49 +/- 13%, 38 +/- 20% and 1 +/- 2%, respectively. In conclusion, continuous chest compressions without ventilations gave significantly more chest compressions per minute, but with decreased compression quality. No flow time for 30:2 was significantly less than for 15:2.

A Senior Care Clerkship for Pharmacy Students

This paper describes a 200-hour senior care clerkship for pharmacy students over a five-year period from 1998-2003. This clerkship used community long-term resources of a 160+ bed skilled nursing facility, adult day care, and senior citizen centers involving medicine, pharmacy, and nursing preceptors. The facility consultant pharmacist was the primary preceptor of students. He conducted pharmacy rounds and daily patient case reviews three times per week. He provided monthly drug regimen review (DRR) and quarterly drug utilization review (DUR) to the skilled nursing facility and, as needed, consultation and therapeutic recommendations to the adult day care center and the senior citizen center. A 200-hour clerkship was developed with multidisciplinary preceptor experiences to orient internal and external PharmD students to long-term care adult consultation with the attending physicians and nurses in the three sites. Each student prepared for physician rounds by performing an intensive DRR process for selected nursing facility patients. This included a preliminary discussion with the charge nurse on the unit and the consultant pharmacist. As directed, each rotation group proposed and completed one DUR project and written report. The overall goal was to enable the student to serve as a consultant pharmacist and, upon graduation, become a certified geriatric pharmacist. Rotation-specific objectives, evaluation instruments, and DRR and DUR processes are described. Documentation of contact time, completion of DRR and DUR activities, and interprofessional communication activities. There were 96 students who completed a 200-hour clerkship over five, 40-hour weeks during a five-year period from 1998 to 2003. Students evaluated some 10,000 patient-months of skilled nursing facility drug therapy and completed 20 DUR projects. All former students who have provided verbal feedback on their clinical training in this rotation have indicated that the rounds and conference contact with the medical director and med passes with the nurse were the key components in that they contributed most to effective interprofessional communication beyond what the consultant pharmacist preceptor offered. A senior care clerkship can be enhanced with medical director preceptorship in conjunction with the facility consultant pharmacist and nursing staff. This clerkship offered an experiential training that enabled pharmacy students to more effectively communicate with attending physicians and nurses, provide senior pharmacy care, and orient students to the opportunity for geriatric pharmacist certification.

Factors Influencing Food Intake in Patients With Heart Failure

Promoting adequate nutritional intake of patients with heart failure (HF) is an essential component of comprehensive management. This goal can be hampered by decreased appetite, as well as psychological, social, and HF-related factors that can affect food intake. Factors related to aging may also affect food intake in older patients. The purpose of this study was to compare patients with HF to healthy elders regarding the extent to which they perceived how appetite and hunger, emotional and social, and illness factors affected the amount of food they ate in the previous week. Sixty-seven patients with HF were recruited from 3 Midwestern HF clinics. As part of a larger study examining nutrition in HF, patients filled out the Food Eating Experiences and Diet (FEED) questionnaire, an instrument designed to assess factors affecting appetite and hunger. Patients were asked to rate their hunger and appetite on a visual analog scale. On Likert-type scales, they rated the extent to which appetite/hunger, emotional/social, and illness factors affected the amount of food intake. Sixty-eight healthy elders were recruited from 2 Midwestern senior citizen centers. As part of a study collecting a large data set for comparison with HF patients, healthy elders provided demographic and health information and filled out the FEED questionnaire. Factors rated as affecting food intake most often by patients with HF were decreased hunger sensations, diet restrictions, fatigue, shortness of breath, nausea, anxiety, and sadness. Factors rated most often by healthy elders as affecting food intake were diminished hunger sensations, early satiety, eating alone, and decreased senses of taste and smell. Among patients with HF, many factors unique from those present due to age were reported to affect food intake.

Depression in Older Adults

The purpose of this article is to address selected aspects of depression in older adults. Specifically, symptoms, risk factors, diagnosis, and interventions for depression in older adults are reviewed. ********** Ageism can influence the diagnosis of depression in older adults because of a tendency of society to dismiss the person as just being grumpy. However, some older adults do experience depression that needs to be diagnosed and treated (Boyd & Bee, 2006). One needs only to review the cases in nursing and convalescent homes, hospitals, and senior citizen centers to recognize that crises arise for older adults as frequently and are experienced as intensely for these individuals as for people at any other age. The nature of the crises of older adults is similar to that of crises of individuals at other ages, but there is a special quality that derives from age itself. Most often this lies in the combined impacts of loneliness from losses of family members and friends, the need to adapt to deteriorating physical capacities, and the lack of treatment and diagnosis of depression in older persons (Serby & Yu, 2003). Among other factors, the high rate of suicide among older people in the United States urges mental health professionals and families to take depression and related symptoms among older adults seriously (Erber, 2005). In fact, the National Institute of Mental Health (NIMH; 2003) reported that compared with 13% of the total U.S. population, 18% of individuals 65 years and older commit suicide. Furthermore, White men who are 85 years old or older are among the individuals with the highest suicide rates. Despite these alarming rates, Duberstein and Conwell (2000) suggested that with proper and more vigilant attention to the signs and symptoms of depression, some of these suicides could be prevented. Persons who are 65 years and older tend to be vulnerable to chronic or episodic depression (Boyd & Bee, 2006). Depression among older adults can be the consequence of many factors including stress and impairment, medical conditions, relational problems, and loss of family and friends (Kraaij & Garnefski, 2002; Lynch, Compton, Mendelson, Robins, & Krishnan, 2000). Depression among older persons can also occur in response to chronic physical impairments. LaRue (1992) reported that about 80% of older persons have at least one chronic condition. These chronic conditions can consequently add to one's emotional distress or depression. For example, Serby and Yu (2003) noted in their study that 40% of adults with Parkinson's disease, 20%-25% of those who have had a stroke, 15%-20% of those who have Alzheimer's disease, and 50% of patients with dementia have significant levels of depression. Other comorbid medical conditions include cancer, neurological disorders, various metabolic disturbances, arthritis, cardiovascular disease, and sensory loss (NIMH, 2003). The overlapping of such negative symptoms with depression makes assessing and, thus, treating depression a challenging task. Descriptions of older adults as anxious, sad, disabled and frail represent a common misconception within society (Knight, 2004). Associated with these notions is the belief that aging and frailty are associated with multiple physical and emotional problems. Also, it is expected that older adults should be happy and stay active. These societal attitudes may affect the way older adults feel about themselves and express their emotions and thoughts, and they may even influence the disturbing rates of depression and suicide among this demographic. These stereotypes about aging do not necessarily represent the reality of the aging process. Being constantly depressed and mentally debilitated is not normal or natural at any age. Hence, it is crucial for all helping professionals to understand and possibly reconstruct their own perceptions about the mental health of older adults. In addition, helping professionals need to consider and have a deeper knowledge about the symptoms, risks, diagnosis, treatment, and interventions of depression in older adults. …