Journal Of Gerontology[JOURNAL]
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200 papers
Compliance with social and safety recommendations in an outpatient comprehensive geriatric assessment program.
Devor M, Wang A, Renvall M … +2 more , Feigal D, Ramsdell J
J Gerontol · 1994 Jul · PMID 8014391 · Publisher ↗
BACKGROUND: A unique contribution of a comprehensive outpatient geriatric assessment is its focus on social and safety issues in the frail elderly. The impact of such programs depends on the caregiver and/or patient comp...
BACKGROUND: A unique contribution of a comprehensive outpatient geriatric assessment is its focus on social and safety issues in the frail elderly. The impact of such programs depends on the caregiver and/or patient complying with safety and social recommendations offered by the assessment team. Compliance in this setting has not been previously described. METHODS: A telephone survey was conducted of self-reported compliance in 124 frail geriatric patients with a high prevalence of dementia 3-21 months after completing a comprehensive geriatric assessment program at the University of California, San Diego, Medical Center. RESULTS: The social and safety recommendations constituted 52.8% of all the recommendations offered. The overall compliance rate (total number of safety and social recommendations followed/total number offered x 100) was 50.2% (95% CI: 43.7-56.6). Highest compliance was achieved with recommendations to complete a prior directive for health care (80.6%) and to wear a medic-alert bracelet (57.5%). Patients complied poorly with recommendations to change a living situation (36.2%). Analysis of variance showed compliance to increase with time between the assessment and survey. Stratifying for time, we found higher compliance in patients with greater impairment in functional or cognitive status. Most noncompliance was due to disagreement with the recommendations offered or failure to implement acceptable recommendations. CONCLUSIONS: Compliance with social and safety recommendations offered in a comprehensive geriatric assessment program approximates compliance observed in other clinical settings. In this setting compliance increases over time. When controlled for time, impairment in functional or cognitive status is associated with greater compliance.
Gender differences in the balance of healthy elderly as demonstrated by dynamic posturography.
Wolfson L, Whipple R, Derby CA … +2 more , Amerman P, Nashner L
J Gerontol · 1994 Jul · PMID 8014390 · Publisher ↗
BACKGROUND: Prior studies indicate that older women fall more often than men although there is no evidence of gender-based balance differences. Using a force platform, we measured the effects of restricted sensory input...
BACKGROUND: Prior studies indicate that older women fall more often than men although there is no evidence of gender-based balance differences. Using a force platform, we measured the effects of restricted sensory input and support surface movement to detect gender differences in balance. METHODS: Healthy, elderly community dwellers (N = 234, mean age = 76 +/- 5 years, 52% female) were administered the following perturbations on the balance platform: The platform and/or visual surround were fixed or tilted proportionally to the subject's sway with the eyes open or closed, forward or backward horizontal translations, and toes-up and toes-down rotations. RESULTS: Gender-based balance differences were not present during quiet standing, or when the support surface or visual input were manipulated separately. Women swayed and lost their balance more than men when the surface was sway-referenced while vision was compromised, but by the third trial their sway control was comparable to the men. Women also initially lost their balance more frequently than men during toes-up and -down rotations, and compared to men continued to lose their balance more often during repeated toes-up rotations. Finally, women developed less angular momentum than men in response to forward platform rotations. DISCUSSION: Elderly women show impairments of balance when simultaneously deprived of visual and somatosensory inputs or during a backwards destabilization. Since there is little evidence for a CNS source for such gender differences, biomechanical origins (e.g., dorsiflexion strength and range of motion) are a more likely cause. Limited postural control of women under conditions stressing balance may explain their greater frequency of falling.
Performance-based driving evaluation of the elderly driver: safety, reliability, and validity.
Odenheimer GL, Beaudet M, Jette AM … +3 more , Albert MS, Grande L, Minaker KL
J Gerontol · 1994 Jul · PMID 8014389 · Publisher ↗
BACKGROUND: Our driving population is aging and faces increased risk for injury and death from motor vehicle crashes. Clinicians are often asked to judge the driving safety of their patients without adequate guidelines....
BACKGROUND: Our driving population is aging and faces increased risk for injury and death from motor vehicle crashes. Clinicians are often asked to judge the driving safety of their patients without adequate guidelines. This article describes the development of a systematic performance-based road test for measuring driving skills of elderly drivers and its correlation with cognitive measures. METHODS: This was a prospective, masked, observational study in which a driving instructor's global scores ("criterion standard") and cognitive test scores were correlated with research driving scores created by two independent research raters sitting in the back seat of the care during each driving test. A convenience sample of 30 licensed drivers with a broad range of cognitive skills, over age 60, were studied on a closed course and in traffic. RESULTS: Statistically significant correlations were observed between the "criterion standard" and closed course scores (r = .35, p < .05) and between the "criterion standard" and in-traffic scores (r = .64, p < .01). Significant correlations were obtained between in-traffic and cognitive test scores, e.g., Mini-Mental State Exam (r = .72, p < .01). Inter-rater reliability on the closed course was .84 and on the in-traffic component was .74. Internal consistency for the closed course was .78 and for in-traffic was .89. CONCLUSION: This study documented the safety, reliability, and validity of a systematic road test for elderly drivers with a range of cognitive skills. Larger studies are needed to determine the cognitive factors that independently predict driving performance.
Time-varying covariates in models of human mortality and aging: multidimensional generalizations of the Gompertz.
Manton KG, Stallard E, Woodbury MA … +1 more , Dowd JE
J Gerontol · 1994 Jul · PMID 8014388 · Publisher ↗
Models of mortality and aging depend on assumptions about physiological change even if they are not made explicit. Standard models, like the Gompertz, often fail to describe mortality at extreme ages, suggesting a need f...
Models of mortality and aging depend on assumptions about physiological change even if they are not made explicit. Standard models, like the Gompertz, often fail to describe mortality at extreme ages, suggesting a need for biologically more detailed and flexible models. One solution is to model the interaction of time-varying covariates with mortality to better describe the age dependence of mortality, test hypotheses about the relation of physiological change and mortality, and use longitudinal data to generalize assumptions about physiological change. This model is applied to (a) a 34-year follow-up of risk factors and mortality and (b) a 9.5-year follow-up of function and mortality from longitudinal surveys of the U.S. elderly population.
Effect of clenbuterol on recovery of muscle mass and carcass protein content following dietary protein depletion in young and old rats.
Carter WJ, Lynch ME
J Gerontol · 1994 Jul · PMID 8014387 · Publisher ↗
There is a need for new therapeutic agents designed to prevent or restore skeletal muscle loss in frail, elderly subjects resulting from injury or disease and associated catabolic stresses such as malnutrition. Since the...
There is a need for new therapeutic agents designed to prevent or restore skeletal muscle loss in frail, elderly subjects resulting from injury or disease and associated catabolic stresses such as malnutrition. Since the beta 2-adrenergic agonist clenbuterol increases skeletal muscle mass in rats, the effect of this agent on recovery of muscle mass and carcass protein content following protein malnutrition was studied in young and old rats. The 3-week period of severe dietary protein restriction reduced body weight 21%, hind-limb muscle weight 24 and 15%, and carcass protein content 31 and 19%, respectively, in 3- and 24-month-old rats. During the 3-week recovery period induced by feeding a complete diet, 10 mg clenbuterol per kg diet increased hind-limb muscle weight 34 and 30% and carcass protein content 27 and 25%, respectively, in 3- and 24-month-old rats. Restoration was complete in animals of both ages fed clenbuterol and incomplete in animals fed the control diet. These observations suggest that clenbuterol or similar beta 2-adrenergic agonists may be useful in hastening the recovery of muscle mass and body protein stores lost because of malnutrition in frail, elderly humans.
L-arginine-nitric oxide pathway and chronic nephropathy in aged rats.
Sonaka I, Futami Y, Maki T
J Gerontol · 1994 Jul · PMID 8014386 · Publisher ↗
Effects of aging and dietary protein on the L-arginine-nitric oxide (Arg-NO) pathway and the progress of chronic nephropathy were examined. At 6-7 months of age, 10 male Fischer 344 rats were fed a 23% protein diet until...
Effects of aging and dietary protein on the L-arginine-nitric oxide (Arg-NO) pathway and the progress of chronic nephropathy were examined. At 6-7 months of age, 10 male Fischer 344 rats were fed a 23% protein diet until 24 or 25 months of age, and another 10 were fed a 12% protein diet until that age. Twenty male Fischer 344 rats that were fed the 23% protein diet from 6 to 8 months of age were used as a control. Urinary excretion of nitrite/nitrate (NOx) at the age of 24 months in the 23% protein group was remarkably decreased, whereas in the 12% protein group, urinary NOx remained comparable to that of the control. Histological examination revealed that chronic nephropathy was highly progressive in the 23% protein group, accompanied by lowered renal function, but these changes were obviously suppressed in the 12% protein group. These results suggest that an age-related decrease in the synthesis of NO could be associated with the progress of chronic nephropathy.
Catecholamine-sensitive lipolysis in the rat: different loci for effect of age on the lipolytic cascade in epididymal vs perirenal fat cells.
Carraro R, Li ZH, Gregerman RI
J Gerontol · 1994 Jul · PMID 8014385 · Publisher ↗
The biochemical locus of the decrease of lipolytic responsiveness to catecholamines in the aging rat has not heretofore been completely identified. Although increased sensitivity to the inhibitory action of adenosine is...
The biochemical locus of the decrease of lipolytic responsiveness to catecholamines in the aging rat has not heretofore been completely identified. Although increased sensitivity to the inhibitory action of adenosine is the likely explanation for the decrease during maturation, the nature of the age effect during senescence has been unclear. In order to determine whether the proximal or distal portion of the lipolytic pathway is involved, we have studied the lipolytic effect of the distally acting cyclic AMP analogue, 8-(4-chlorophenylthioadenosine)3'5'-monophosphate (cyclic) (Cl-cAMP) on rat fat cells from both the epididymal and perirenal fat pads of mature (6 mo) and senescent (24 mo) Fischer 344 rats. Using an adenosine (N6-1-2-phenylisopropyl-adenosine; PIA) regulated system, the lipolytic response to epinephrine (glycerol release) was measured simultaneously with that to Cl-cAMP. The effects of age on lipolysis are greatly influenced by the anatomic site of origin of the fat cells. The epididymal cells of the old rats showed no decreased responsiveness to either epinephrine or Cl-cAMP. However, the perirenal cells of the old rats showed a grossly impaired maximal response to both epinephrine (60% decrease relative to young; p < .005) and Cl-cAMP (42% and 58% decrease in 2 sets of experiments; p < .05 and .04, respectively). Although decreased lipolytic response to epinephrine in epididymal cells was not seen in these studies, this has been clearly shown in earlier work, suggesting that diminished response to epinephrine is demonstrable only when the system is not already maximally inhibited by PIA.(ABSTRACT TRUNCATED AT 250 WORDS)
Aging and hormone-sensitive lipolysis: reconciling the literature.
Gregerman RI
J Gerontol · 1994 Jul · PMID 8014384 · Publisher ↗
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Production of age-synchronous mass cultures of Caenorhabditis elegans.
Fabian TJ, Johnson TE
J Gerontol · 1994 Jul · PMID 7516947 · Publisher ↗
Methods are described for culturing large populations of age-synchronous Caenorhabditis elegans throughout the adult life span. Contamination of adult populations by progeny was prevented by constructing double-mutant st...
Methods are described for culturing large populations of age-synchronous Caenorhabditis elegans throughout the adult life span. Contamination of adult populations by progeny was prevented by constructing double-mutant strains that produce progeny at a frequency of less than .005 per adult at the nonpermissive temperature (25.5 degrees C). Of four double-mutant strains that we have characterized, three have wild-type life spans at 25.5 degrees. The other strain contains a mutant allele, age-1(hx542), that results in an increase in life span of 60% over wild type. All four strains produced sufficient numbers of progeny at the permissive temperature (20 degrees C) to generate populations containing 1-5 x 10(6) nematodes within two weeks. Age-synchronous young adult populations were produced using these strains and have been maintained as adults both in liquid culture and on agar medium. Procedures that reduce E. coli contamination by 30-fold in harvested samples of adults are also described.
The validity of survey data on utilization of health and social services among the very old.
Carsjö K, Thorslund M, Wärneryd B
J Gerontol · 1994 May · PMID 8169350 · Publisher ↗
Survey responses to questions regarding utilization of health and social services among very old persons were compared to independently registered utilization records. Survey data came from in-person interviews with a sa...
Survey responses to questions regarding utilization of health and social services among very old persons were compared to independently registered utilization records. Survey data came from in-person interviews with a sample of noninstitutionalized 75-84-year-olds and all noninstitutionalized individuals over the age of 84 in a Swedish community. Agreement regarding utilization vs no utilization during the past three months was found to be very high for hospitalizations and home help, somewhat lower for home visits by nurses, and lower yet for visits to physicians and to nurses. Except for visits to nurses, aggregate survey estimates of proportion with utilization were not significantly different from those based on records. Reporting patterns were generally in agreement with predictions made on the basis of frequency and saliency of service utilization. Reasons for over- and underreporting were investigated on the basis of register data, and some evidence for telescoping was observed.
The influence of a diagnosed mental impairment on family caregiver strain.
Bass DM, McClendon MJ, Deimling GT … +1 more , Mukherjee S
J Gerontol · 1994 May · PMID 8169349 · Publisher ↗
This study examines whether a diagnosis of mental impairment of a care recipient influences the strain of family caregiving. Two competing hypotheses, derived from labeling theory, provide alternative views. One posits t...
This study examines whether a diagnosis of mental impairment of a care recipient influences the strain of family caregiving. Two competing hypotheses, derived from labeling theory, provide alternative views. One posits that a diagnosis reduces strain by linking problematic characteristics of care recipients' impairment to an illness. The competing hypothesis suggests that a diagnosis increases strain by reifying the existence of a progressive chronic condition. LISREL analysis with data from a sample of 576 primary caregivers shows that the diagnosis has an important effect, but this influence varies for different types of strain. Relationship strain and restrictions in social activities are increased for caregivers of diagnosed care recipients. Functional impairment also causes a greater restriction of social activities when a diagnosis has been made. A different pattern emerges for depression, with caregivers in the diagnosed group being less depressed and less negatively affected by care recipients' impaired ability for social interaction, but more depressed by disruptive behavior and functional impairment.
Race and gender differences in religiosity among older adults: findings from four national surveys.
Levin JS, Taylor RJ, Chatters LM
J Gerontol · 1994 May · PMID 8169348 · Publisher ↗
Using data from four national surveys, this article presents findings on racial and gender differences in religiosity among older adults. Surveys include the second Quality of American Life study, the Myth and Reality of...
Using data from four national surveys, this article presents findings on racial and gender differences in religiosity among older adults. Surveys include the second Quality of American Life study, the Myth and Reality of Aging study, wave one of Americans' Changing Lives, and the 1987 sample of the General Social Survey. These four data sources collectively include a broad range of items which tap the constructs of organizational, nonorganizational, and subjective religiosity. In all four studies, and for most indicators, results revealed significant racial and gender differences which consistently withstood controlling for sociodemographic effects, including age, education, marital status, family income, region, urbanicity, and subjective health.
Couples' employment/retirement status and the division of household tasks.
Szinovacz M, Harpster P
J Gerontol · 1994 May · PMID 8169347 · Publisher ↗
This study investigates how the employment/retirement status of both spouses impinges on each spouse's contributions to traditionally male and female household chores as well as on the couple's division of household labo...
This study investigates how the employment/retirement status of both spouses impinges on each spouse's contributions to traditionally male and female household chores as well as on the couple's division of household labor. Results based on a subsample of the National Survey of Families and Households (N = 672) indicate more complex patterns than those suggested by previous research. Specifically, employment/retirement status effects on housework vary by gender and domain, as well as by wife's work history. Compared to dual-earner couples, retired wives spend more and their husbands less time on "female" chores. Husbands' contributions to "male" tasks are highest if they are retired and their wives employed, and lowest if the husband is employed and the wife retired. Retired husbands of housewives spend more time with both male and female chores than employed husbands of housewives, whereas housewives whose husbands are retired contribute less to female chores than housewives whose husbands are employed.
Shunning retirement: work experience of men in their seventies and early eighties.
Parnes HS, Sommers DG
J Gerontol · 1994 May · PMID 8169346 · Publisher ↗
Using data from the National Longitudinal Surveys (NLS) of Older Men, this study examined the extent and character of the work experience of men who opt to continue labor force participation well beyond conventional reti...
Using data from the National Longitudinal Surveys (NLS) of Older Men, this study examined the extent and character of the work experience of men who opt to continue labor force participation well beyond conventional retirement age. Logistic regression results showed that good health, a strong psychological commitment to work, and a corresponding distaste for retirement are among the most important characteristics related to continued employment into old age. The probability of employment was also found to be positively related to educational attainment and being married to a working wife; it was negatively related to age and level of income in the absence of work. Of the men in the sample who were not working, very few gave evidence of a desire to do so. Policy implications of the findings are explored.
Middle generation roles and the well-being of men and women.
Spitze G, Logan JR, Joseph G … +1 more , Lee E
J Gerontol · 1994 May · PMID 8169345 · Publisher ↗
Sociological literature on gender, work, and families has focused on both conflict and benefits created by combining the spouse, parent, and paid worker roles, whereas research by family gerontologists has focused on str...
Sociological literature on gender, work, and families has focused on both conflict and benefits created by combining the spouse, parent, and paid worker roles, whereas research by family gerontologists has focused on stress experienced by those who provide care to frail elderly parents as well as other roles associated with being in the "middle generation." We examine consequences of adding middle generation roles to other major life roles during the middle years. We find that giving help to parents increases men's distress, while giving help to adult children enhances women's well-being. When help to biological parents is examined separately, it is found to increase both men's and women's distress. Women are unaffected by the multiplicity of roles while, for men, there is evidence of both role buffering and strain from conflicting demands. We discuss further directions for research on consequences of roles for well-being.
Sensory perception and pleasantness of food flavors in elderly subjects.
de Graaf C, Polet P, van Staveren WA
J Gerontol · 1994 May · PMID 8169344 · Publisher ↗
This study was designed to determine the perceived intensity and pleasantness of different food flavors. A group of 32 young subjects (mean age: 22, range 20-25) and 23 elderly subjects (mean age: 76, range 72-82) judged...
This study was designed to determine the perceived intensity and pleasantness of different food flavors. A group of 32 young subjects (mean age: 22, range 20-25) and 23 elderly subjects (mean age: 76, range 72-82) judged the intensity and the pleasantness of five series of food flavors, each with five geometrically spaced concentration levels: (a) bouillon flavor in water, (b) tomato juice flavor in water, (c) orange juice flavor in water, (d) strawberry flavor in yogurt, and (e) sugar in unsweetened yogurt. On average, the elderly subjects had lower perceived intensities for the highest concentrations of the series of bouillon, tomato juice, strawberry flavor in yogurt, and sugar in yogurt, whereas the average responses to the lowest concentrations were almost equal. The slope of the psychophysical function for the orange juice flavor was equal for the group of young and elderly subjects. Optimal preferred concentrations were higher for the elderly than for the young subjects in the cases of bouillon, tomato juice and orange flavor. Optimal concentrations for strawberry flavor and sugar in yogurt were about equal. It was found that there are considerable differences between young and elderly subjects in the sensory perception and pleasantness of food flavors. Changes with age in functions relating (a) concentration with perceived intensity (psychophysical), (b) concentration with pleasantness, and (c) perceived intensity with pleasantness were specific for the different flavor qualities.
Stressors in salient social roles and well-being in later life.
Krause N
J Gerontol · 1994 May · PMID 8169343 · Publisher ↗
This study is designed to evaluate two main hypotheses. The first hypothesis specifies that stressors that arise in roles that are highly important to older adults exert a more deleterious effects on feelings of life sat...
This study is designed to evaluate two main hypotheses. The first hypothesis specifies that stressors that arise in roles that are highly important to older adults exert a more deleterious effects on feelings of life satisfaction than stressors that arise in roles that are less salient. The second hypothesis aims to contribute to the literature by evaluating whether stressors in salient social roles affect well-being by eroding feelings of personal control over the same roles in which the stressors emerged. Support for both hypotheses is provided by a recent nationwide survey of older adults. When coupled with a carefully devised theoretical rationale, these findings point to the insights that can be gained by utilizing role-specific measures of stress and personal control.
Cognitive performance in older and middle-aged depressed outpatients and controls.
Lyness SA, Eaton EM, Schneider LS
J Gerontol · 1994 May · PMID 8169342 · Publisher ↗
Cognitive performance was assessed in older (60-75 years) and middle-aged (40-59 years) unmedicated outpatients with major depression and in healthy controls to examine potential interactive effects of age and depression...
Cognitive performance was assessed in older (60-75 years) and middle-aged (40-59 years) unmedicated outpatients with major depression and in healthy controls to examine potential interactive effects of age and depression. Cognitive performance was assessed from three categories of tasks: verbal, visual-spatial, and visuo-motor scanning tasks. Depressed subjects did not perform as well as controls on visuo-motor scanning tasks that included the Trail Making Tests A and B, and the Symbol Digit Modalities Test. Likewise, the older compared to the middle-aged group was slower on the visuo-motor scanning tasks. In addition, the older group showed poorer performance on visual-spatial tasks. Neither depression nor age group effects were observed for the primarily verbal tasks. Age and depression combined in an additive (noninteractive) fashion such that the older depressed subjects performed worse than the middle-aged depressed subjects, and older and middle-aged controls, on visuo-motor scanning tasks.
Older readers' processing of medical information that contradicts their beliefs.
Rice GE, Okun MA
J Gerontol · 1994 May · PMID 8169341 · Publisher ↗
Older adults' memory for accurate information which either contradicted their previously held false beliefs or affirmed their previously held true beliefs about osteoarthritis was studied. Independent variables included...
Older adults' memory for accurate information which either contradicted their previously held false beliefs or affirmed their previously held true beliefs about osteoarthritis was studied. Independent variables included information type (text affirms or disconfirms the reader's initial belief), explicitness of statement (explicit vs implicit statement of the target belief), filler tasks (repetition vs filter tasks), passage order, and time. Participants were 125 adults (65-80 years old) with average vocabularies who self-reported having osteoarthritis for at least two years. In support of a schema-copy plus tag model, we found (a) false alarm rates were higher for schema-related than for topic-related recognition distractors; (b) updating of erroneous opinions from pretest to immediate posttest was positively correlated with maintenance of accurate recognition from immediate to delayed posttest; and (c) disconfirming information was less accurately recognized and recalled than affirming information. Explicit text presentation and repetition of recognition and opinion tasks enhanced accurate recognition of disconfirming information. Findings suggest that older readers often have difficulty distinguishing between their erroneous prior knowledge and accurate information presented in text.
Perceived intellectual performance change over seven years.
Schaie KW, Willis SL, O'Hanlon AM
J Gerontol · 1994 May · PMID 8169340 · Publisher ↗
Actual and perceived change in intellectual performance over seven years was examined in a sample of 837 participants in the Seattle Longitudinal Study who took five subtests of Thurstone's Primary Mental Abilities (PMA)...
Actual and perceived change in intellectual performance over seven years was examined in a sample of 837 participants in the Seattle Longitudinal Study who took five subtests of Thurstone's Primary Mental Abilities (PMA) test in 1977 and 1984. In 1984 participants rated perceived change in intellectual performance from 1977 to 1984. Participants were categorized, based on their actual performance, into those who maintained earlier performance level, significantly increased their performance, or declined in performance. A typology linking actual and perceived change in performance was created: Realists (those who accurately estimated change in their performance); Optimists (those who oveestimated positive change); and Pessimists (those who overestimated negative change). Classification of participants varied across abilities. Women were more likely to be pessimists on Spatial Orientation than men. Older individuals were more likely to be pessimists on Verbal Meaning and Inductive Reasoning Abilities and to be realists on Number ability compared to younger participants.
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