Study Of Older Persons Research Articles

Metric properties of nurses' ratings of parkinsonian signs with a modified Unified Parkinson's Disease Rating Scale.

We evaluated the ability of nurse clinicians to assess parkinsonian signs in older persons with a modified version of the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). After completing a structured training protocol, three nurse clinicians and a neurologist with expertise in movement disorders administered a modified UPDRS to 75 older persons. The nurses repeated the assessment about 3 weeks later. Inter-rater agreement and short-term temporal stability were estimated for each item, the total modified UPDRS score, and for summary measures of bradykinesia, postural reflex impairment, rigidity, and tremor, and a global parkinsonian sign score. We performed our assessment in Catholic religious communities in the Chicago area, using consecutive subjects at four communities participating in the Religious Orders Study, a longitudinal, clinical-pathologic study of older persons. Our results showed that nurses were not a significant source of variability, with intraclass correlations exceeding 0.97 for all items, and they showed good to excellent agreement with the neurologist for most modified UPDRS items. Correlations between nurses and neurologist exceeded 0.90 for the total modified UPDRS, ranged from 0.76 to 0.95 for the four parkinsonian domain scores, and exceeded 0.90 for the global parkinsonian sign score. Nurses showed fair to good agreement with themselves over the 3-week interval for most modified UPDRS items. Correlations over the 3-week interval exceeded 0.90 for the total modified UPDRS score, ranged from 0.70 to 0.95 for the four domain scores, and exceeded 0.90 for the global parkinsonian sign score. Ratings of parkinsonian signs by nurse clinicians corresponded closely to those of a neurologist with expertise in movement disorders and showed good inter-rater agreement and temporal stability. With appropriate training, nurse clinicians can reliably administer the modified UPDRS.

Lipoprotein alterations and atherosclerosis in the elderly.

Lipoproteins play a key role in the pathogenesis of atherosclerotic diseases. With increasing age, modifications in the metabolism, distribution and correlates of lipoprotein lipids have been described. Age associated changes in lipoproteins are determined by several genetic and environmental factors, but in elderly populations, an important role is also played by the presence of comorbid diseases and poor health. In older populations, the ability of lipoprotein levels to predict cardiovascular risk is controversial. When lipoprotein levels are measured at old age, secondary changes in total and high density lipoprotein-cholesterol levels may lead to misclassification and to underestimation of associations. When analyzing associations in older populations, it is therefore important to consider measures of disease burden and comorbidity. When these caveats are taken into account, evidence from observational studies in older persons confirms the association between lipoprotein lipids, cardiovascular and cerebrovascular disease. Among older patients with cardiovascular disease, intervention trials have demonstrated that lipid lowering drugs can significantly reduce total and coronary heart disease mortality. Unequivocal evidence that lipid-lowering drugs are beneficial in old and very old persons without pre-existing cardiovascular disease is still lacking. Results from primary and secondary intervention trials in older men and women are needed to provide conclusive guidelines.

Usefulness of M-mode, 2-dimensional, and Doppler echocardiography in the diagnosis, prognosis, and management of valvular aortic stenosis, aortic regurgitation, and mitral annular calcium in older patients.

To review the diagnosis, prognosis, and management of valvular aortic stenosis, aortic regurgitation, and mitral annular calcium (MAC) with emphasis on older persons. A computer-assisted search of the English-language literature (MEDLINE database) followed by a manual search of the bibliographies of pertinent articles. Studies on the diagnosis, prognosis, and management of valvular aortic stenosis, aortic regurgitation, and MAC were screened for review. Studies in older persons and recent studies were emphasized. Pertinent data were extracted from the reviewed articles. Emphasis was on studies involving older persons. Relevant articles were reviewed in depth. Available data about the diagnosis, prognosis, and management of valvular aortic stenosis, aortic regurgitation, and MAC with emphasis on studies involving older persons were summarized. Valvular aortic stenosis, aortic regurgitation, and MAC are degenerative cardiac disorders which are common in older people. The presence and severity of these cardiac disorders are diagnosed by M-mode, 2-dimensional, and Doppler echocardiography. M-mode, 2-dimensional, and Doppler echocardiographic techniques are also very useful in the prognosis and management of these cardiac disorders in older persons.

Neuropathological indexes of Alzheimer's disease in demented and nondemented persons aged 80 years and older.

Subjects with clinically diagnosed senile dementia of the Alzheimer type (n = 37) and healthy controls (n = 5) were assessed clinically until death. Postmortem examination of the brain was performed at age 80 years or older. The brains of all of the group with dementia (except one that was found to have a non-Alzheimer dementia) had substantial densities of neocortical senile plaques regardless of dementia severity; the control brains had very few senile plaques. In those subjects with Alzheimer's disease, moderate correlations were found between dementia duration and severity (cognitive portion of the Blessed Dementia Scale and the Sum of Boxes from the Clinical Dementia Rating) and certain neuropathological lesions, both gross and microscopic. Densities of neocortical neurofibrillary tangles were related to degree of dementia; densities of neocortical senile plaques were unrelated. We conclude that (1) neocortical senile plaque densities differentiate very old subjects with Alzheimer's disease from nondemented controls, but there is a need for more postmortem studies of older persons who are free of dementia; and (2) among the microscopic lesions studied, densities of neocortical neurofibrillary tangles were most closely related to the degree and duration of dementia.

Development of a diet history questionnaire for studies of older persons

This paper describes the criteria of a simplified diet history method and the procedures for developing a dietary questionnaire for studies of older persons. Suggestions are included on selecting food items representative of the population's dietary patterns, designing objective methods to estimate quantitative and frequency intakes of food items, and collecting information on other dietary practices. Potential problems in dietary surveys among older persons are discussed, along with their prevention or alleviation.

An Examination of Testing Effects in a Panel Study of Older Persons

Testing effects have been obtained on attitudinal and cognitive variables in studies typically conducted on college students in which the pretest-posttest interval usually was several days or weeks. In an effort to expand our knowledge of testing effects, an assessment of testing was incorporated into a panel study of the mental health, social and psychological resources, and stressful life events of older persons. Conceivably, prior assessment of life events might produce greater subsequent recollection of events in the pretest-posttest interval. Also, the rapport established in the initial interview together with previous discussion of possible physical and mental health symptoms might yield greater disclosures of illness in a subsequent interview. In a multistage sample survey, seven out of eight dwellings in the selected segments were randomly assigned to be in the panel group; the eighth dwelling was assigned to the control group. A total of 2,042 persons 55 years and older living in the panel dwellings were interviewed on Wave 1 and reinterviewed with the same instruments six months later on Wave 2; 248 persons in the control group were interviewed only on Wave 2. Comparisons between the two groups on six measures of mental health, several measures of physical health, self-esteem and social support scales, and five measures of life events found no evidence for testing effects.

Religion, Age, Life Satisfaction, and Perceived Sources of Religiousness: A Study of Older Persons

Eighty-five persons aged 65 to 88 years participated in this interview study of three issues. The present study supported previous findings of a tendency toward increased religiosity in older age. This was tempered, however, by the finding that, although highly religious older persons tended to report an increase in religiousness over the course of their lives, respondents who were low in religiosity tended to report a decrease. These two groups reported that before the age of 20 a relatively small difference in religiosity existed but by old age this difference had become substantial. Second, there was evidence of a low to moderate positive relationship between religiosity and life satisfaction. Finally, mothers were reported to have had the strongest proreligious influence, although both parents were generally perceived to be important influences in religious development.

Aging and voluntary association participation.

This longitudinal analysis examines changes in voluntary association participation levels over a 4-year period using data from the middle age of the Duke Adaptation Study (N=374) and over a 2 1/2-year period using data from a study of older persons in Oberlin, Ohio (N=104). The findings showed; the extent of participation was high in both samples; mean levels of participation remained essentially unchanged; persons with stable or increasing participation levels outnumbered those with declining levels; and persons not participating at the time of the initial interview were unlikely to be participating later, while those who were participating initially were likely to have continued their participation. Contrary to predictions of declining activity based on disengagement theory, aging appears to be accompanied by stability and continuity in levels of voluntary association participation.

Attrition in a longitudinal study of an aged population.

This report focuses upon attrition in longitudinal studies of older persons using a Florida survey as an illustration. In 1959 interviews were completed with a probability sample (N = 2544) of older noninstutionalized residents (age 65+) of a retirement community. Data were collected on health status, health practices, social factors, and activities. Nine years later a follow-up study of the same sample was undertaken. In this report 1959 data for 2497 of these persons are analyzed by results of the 1968 effort (reinterviewed, lost to follow-up, or deceased). About one third of this highly migratory sample could not be located in 1968; death certificates were located for another one third; and the remaining one third was reinterviewed. Social characteristics, housing arrangements, activities, and chronic conditions of the three subpopulations are compared. Persons reinterviewed were found to differ from dropouts in age, sex, type of dwelling unit, activity patterns, and prevalence of chronic conditions. No significant differences were found in educational level, household composition, usual occupation, and retirement status (when controlled for sex).

Inverse relationship between serum IgG concentrations and measures of intelligence in elderly persons.

WE have found a negative correlation between intelligence test scores and serum immunoglobulin concentrations in healthy subjects aged 45 yr and older. This finding adds a potentially important dimension in studies of older persons who exhibit declining intellectual function.

BED REST, SLEEP, AND SYMPTOMS. STUDY OF OLDER PERSONS.

Excerpt It is commonly stated that people sleep less as they grow older and that they sleep less because they need less sleep. This is apparently confirmed by many elderly persons who report sleepi...