bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Prevention of Cardiovascular Disease in Older People
Authors: Bonita Ruth , Beaglehole Robert
Published: December 2008

Abstract. Cardiovascular disease is the leading cause of death, morbidity and disability in older people. Strategies for cardiovascular disease prevention and intervention in older people are similar to those available for younger ages. The population strategy for primary prevention is broad ranging from food and tobacco policy legislation and media communication to simple and direct advice delivered by all health workers. High risk strategies for reducing elevated levels of the major cardiovascular risk factors such as hypertension and hypercholesterolemia in older populations indicate that gains in life expectancy are greatest where absolute risk is highest and the intervention is the cheapest available. Non‐pharmacological treatment, in particular dietary therapy, is recommended as the first line of treatment for both raised blood pressure and blood cholesterol. Because of the high excess mortality associated with smoking, even a brief advice package associated with modest success is cost effective in older people. Health policy for older people should be directed towards the overall goal of maintenance of autonomy and should include prevention, treatment and rehabilitation of cardiovascular disease as part of a comprehensive program for the prevention and control of all diseases.
The Depression Scale of the Psychogeriatric Assessment Scales
Authors: Stacey Barrie G.
Published: December 2008

Objective: To contribute to the appraisal of the Depression Scale of the Psychogeriatric Assessment Scales (PAS‐D), and its application in community research with older people.

Method: Data obtained from a study of 1,000 community‐residing Melbourne people aged 65–94 years were examined to obtain information about the value of PAS‐D in assessing depression.

Results: Statistical analyses of the data provided information about the psychometric properties and performance of PAS‐D. Its use in the field provided information about its practical utility and possible limitations.

Conclusions: The all‐round functioning of PAS‐D in a community study supported the findings of its originators. More detailed work would be worthwhile on the scale as a potential screening test for possible depressive disorder.
Physical Restraint of Older People: a Study of Australian Practices
Authors: Woodward Michael
Published: December 2008

Objectives: Physical restraint of older people is a controversial issue. The Australian Society for Geriatric Medicine (ASGM) recently published a position paper in this journal. This Australia‐wide audit was undertaken to ascertain the degree of concordance between local policy and practice and the ASGM position.

Methods: An audit package was mailed to each member of the ASGM resident in Australia, with instructions to perform one audit per site.

Results: Thirty five sites providing a range of acute and subacute care completed the audit. All but two had a written policy on physical restraint but a minority stipulated actions included in the ASGM position. A prevalence audit revealed 22.6 per cent of 976 people with a mean age of 78.5 years were physically restrained, and an additional 1.7 per cent had an order for restraint. Most (70 per cent) were restrained with bed rails. There was little documentation of the rationale for, or intended duration of, the restraint. Informed consent for restraint was documented in only 16.2 per cent of cases. There was poor correlation between local written policy and actual practice.

Conclusion: The ASGM position paper is as yet inadequately incorporated into local physical restraint policy and practice.
Gender and Health Issues in Ageing
Authors: Dennerstein Lorraine , Feldman Susan , Murdaugh Carolyn , Rossouw Jacques , Tennstedt Sharon
Published: December 2008

Abstract. There are pronounced gender differences relating to health and ageing reflecting biological and social differences and transitions and adaption to these. The most obvious biological difference is that women have a finite length of reproductive functioning, the termination of which is marked by menopause. The menopausal transition has physical, psychological and sexual concomitants. Postmenopausal life is characterise by increased cardiovascular and osteoporotic risk. Interventions for these disorders have not been adequately evaluated. Men live on average about 7 years less than women in most developed countries. Women form the majority of carers. The most common cost of caring is social, a restriction in personal and leisure time, and is directly related to the amount of care provided. The negative health effects of caring are primarily psychological, not physical. Most of the widowed are women. An Australian study found that women widowed in the last 12 months had lower self‐ related health and were more likely to report they were stressed about their health. Recently widowed women scored lower on all the subscales of the SF‐36 and were also more likely to be taking medication for ‘;nerves’ and ‘;medication to help you sleep’. Women widowed longer than 12 months did not score significantly differently than married women on these parameters. Widowed women reported more difficulty managing on their income than did married women, regardless of the length of widowhood. Widows also reported more stress with children and other family members than did married women.
Multi‐Country Perspectives on Healthy Ageing: a Review
Authors: Hermanova Hana
Published: December 2008

Abstract. The invited symposium Multi‐Country Perspectives in Healthy Ageing had two parts: Part I. Epidemiological Evidence of Healthy Ageing, presented in Honolulu; Part II. Epidemiological Implications for Healthy Ageing Policies, presented in Adelaide. The presentations in Honolulu highlighted the fact that routinely collected data are of greatest value (census data; demographics; health and social statistics) in comparing younger and older adult groups, contribute with data on selected mortality and enable international comparisons. Epidemiological data on health and function, lifestyles, living arrangements and use of services provide important sources of complementary information. These data help in designing and justifying special medicosocial services for older persons (eg. comprehensive geriatric assessments, hypertension clinics), and confirm the importance of environmental factors in the ageing process and the pay‐off of preventive approaches later in life.
International Trends in Health Expectancies: a Review
Authors: Mathers C.D. , Robine J.M.
Published: December 2008

Abstract. Are we living longer but in worse health? Are the increases in life expectancy at older ages in developed countries occurring because we are keeping sick or disabled people alive longer or because we are saving people from death but leaving them in states of disability and handicap? This question was addressed in a symposium entitled International Trends in Health Expectancies. This review paper summarises the international evidence presented at that symposium on trends in health expectancies in developed countries. Health expectancies provide a powerful tool for monitoring the health of older populations, testing hypotheses about the evolution of health, and developing public policy. The available international evidence of time series of health expectancies for older people suggests that increases in disability prevalence began in the late 1960s and 1970s at the time when mortality rates at older ages began to decline significantly, but that these increases were confined to the less severe end of the disability spectrum. There is no evidence of expansion of morbidity based on more severe measures of disability prevalence. Recently emerging evidence from Europe and North America suggests that disability prevalence rates among older people may be starting to decline and we may actually be starting to see compression of morbidity in low mortality populations.
In‐Home Programs of Prevention and Comprehensive Geriatric Assessment: International Perspectives
Authors: Rubenstein L.Z. , Stewart S. , Schroll M. , Bernabei R. , Büla C. , Jones D. , Wieland D.
Published: December 2008

Abstract. Innovative geriatric care programs have developed worldwide in the past two decades to better address the special problems and care needs of the growing elderly population. Many of these have been based in the home setting and involved basic concepts of prevention and comprehensive geriatric assessment (CGA). Some have focused on periodic screening of relatively healthy and independent elderly persons in their homes and provision of prevention‐oriented services, others have targeted more frail and disabled individuals (eg. post‐hospitalisation), still others involve entire population groups of elderly persons and provide both prevention and treatment. A common thread has been the use of CGA to evaluate patient problems, understand needs for care, help arrange for services and plan follow‐up. Benefits have included more complete diagnosis, discovery of important treatable problems, improvement in drug regimens, reductions in use of hospitals and nursing homes, improved function and satisfaction and reduced mortality. Meta‐analysis has confirmed some of the most important of these benefits: improved functional status, reduced mortality and reduced use of institutional services. In this symposium, reports on in‐home prevention and geriatric assessment programs were presented from six countries: Australia, Denmark, Italy, Switzerland, the UK and the US.
Free Radicals and Glycoxidative Stress in Ageing and Age‐Related Diseases
Authors: Staehelin Hannes B.
Published: December 2008

Abstract. Free radicals and glycoxidative reactions are known to be associated with ageing on the level of the cell and whole organism. Free radicals are ubiquitous in living things and they lead to irreversible reactions in cell organelles and cell metabolism. One important source of free radicals is advanced glycation end products (AGEs) resulting from non‐enzymatic glycation and oxidation of proteins and lipids. Ageing, and thus life span, correlate with free radical generation and antioxidative defense as well as with advanced glycation end products. Most chronic diseases are also associated with free radicals and AGEs. Overproduction of free radicals accelerates cell ageing and is counteracted by antioxidants. Antioxidant status is in part amendable through nutritional and pharmacological interventions. AGE interaction with its receptor contributes also to accelerated ageing in many pathological conditions. Particularly vulnerable are long‐lived proteins, eg. in lens crystallin and skin collagen. The analysis of the mechanism generating free radicals and of the reaction of AGEs with cellular metabolism opens new avenues for the delaying of the development of chronic diseases such as atherosclerosis and neurodegenerative disease. On the other hand, the impact of free radicals on carcinogenesis may differ according to the cancer stage and hence the preventive potential of antioxidants is proposed to be different in early and late stages of cancer development. Free radicals and AGE products are important mediators of age‐related diseases and ageing per se. Intake of antioxidants over the life‐time determines, among other factors, the rate of ageing and the development of degenerative diseases. Interventive strategies such as soluble receptors for AGEs and effective antioxidants might become important therapeutic strategies in the near future.
Challenges and Directions for Gerontological Research Beyond 2000
Authors: Wetle Terrie
Published: December 2008

Abstract. There is a world‐wide demographic revolution taking place. The population is ageing, causing us to rethink health, disease and ageing globally. New strategies must be developed to provide medical and social services for the increasing numbers of older people. In addition we are challenged to expand our knowledge of causes of morbidity and mortality and to explore new strategies to prevent excess disability and promote the health span of older people world‐wide. Increased effort in three promising areas of research will help us to reach this goal. These include research into reducing disability, increasing healthy life span, and conquering Alzheimer's disease. Although major scientific advances have been made, there is still much to be done to understand the major causes of disability and to develop and implement preventive strategies to decrease the incidence of excess disability. Promoting healthy life styles as well as understanding the biological bases of ageing and age‐related diseases hold the key to increasing healthy life span. Alzheimer's disease is a major cause of disability, and while our understanding of Alzheimer's disease is expanding, continued efforts are necessary to conquer this devastating disease. The demographic revolution has caused us to rethink health, disease and ageing globally. World‐wide, epidemiologists are predicting a shift in the disease burden from infectious diseases prevalent in the developing world (eg. respiratory and diarrheal diseases) to the chronic diseases of more developed societies (eg. ischaemic heart disease, depression and cerebrovascular disease). The ageing of the population world‐wide and the shift in the global burden of disease pose many challenges to research scientists, clinicians and policy makers. Not only will we need to develop new strategies to provide medical and social services for the increased numbers of older people, but we are also challenged to expand knowledge of the causes of morbidity and mortality among the old and to explore new strategies to prevent excess disability and promote the health span of people world‐wide.
Sensory Loss and Communication Difficulties in the Elderly
Authors: Erber Norman P. , Scherer Samuel C.
Published: December 2008

Abstract. Many older people with hearing and vision loss experience reduced communicative capacity. Medical treatments (eg. cerumen removal, lens replacement), and ‘;instant’ therapies (eg. slowed speech, close proximity) may improve communication in the short term. In serious cases, specialist therapists may need to implement longer‐term intervention (eg. environmental control, perceptual aids, communication training). Recurrent communication breakdown can have devastating consequences for interpersonal relationships and psychosocial well‐being. Some older people with severe sensory impairment are able to interact only with skilled communication partners. This condition of age‐related communicative dependence on others has major implications for health care and professional education.
Alzheimer's Disease and Brain Reserve
Authors: Schofield Peter
Published: December 2008

Abstract. Alzheimer's disease has a long early phase in which limited pathological changes accumulate without apparent functional consequences. Once pathology exceeds a certain threshold, clinical features arise, but this threshold seems to differ from patient to patient, reflecting individual differences in ‘;brain reserve’. This review discusses the concept and possible determinants of brain reserve, and their implications for the diagnosis of Alzheimer's disease.
Low Level Disability in Activities of Daily Living in Elderly People Living Independently: Risk Factors and Implications
Authors: Collison Shari , Cicuttini Flavia , Mead Valerie , Savio Fiona
Published: December 2008

Objectives: To determine the prevalence and risk factors for low level disability in activities of daily living in elderly people living independently, and the association with quality of life and accidents.

Design: Cross sectional survey of 334 individuals aged ≥ 80 years randomly selected from the electoral roll.

Results: 15.9% of participants had significant disability in at least one of the activities of daily living assessed. Risk of disability was associated with taking 4 or more medications, female gender, arthritis and a previous cerebrovascular event. Those with disabilities had more recent accidents (67.9% vs. 43.8%, p=0.0001) and poorer quality of life as measured by the SF 36. Self reporting was a poor method for identifying disabilities (sensitivity = 68.5%).

Conclusions: Low level disabilities in activities of daily living are common in elderly people living independently and are associated with lowered quality of life and increased accidents. This highlights the need for a targeted screening program to identify such disabilities and examine interventions to minimise them.
Undernourished Patients With Hip Fracture: Poor Outcome is Not Due to Excess Infections
Authors: Bruce David , Laurance Isabel , Ng Lisa , Goldswain Peter , Perth Royal
Published: December 2008

Background: Undernourished hip fracture patients have poorer outcomes for undetermined reasons. We postulated that an immune deficit from malnutrition could lead to excess infections in these patients.

Objective: To document the nutritional status (body mass index, BMI), infection rates and outcome in a group of patients with hip fracture.

Subjects: One hundred consecutive cases, after excluding nursing home residents and those with end‐stage or malignant disease.

Results: Low BMI was common and was associated with greater age, presence of dementia and falling indoors. Patients with low BMI had significantly poorer functional outcomes, greater mortality and nursing home admission rates. Infections were not more common in those with low BMI. An apparent association between poor outcome and the presence of infection in those with low BMI was not confirmed by multiple logistic regression analysis.

Conclusions: Significant undernutrition was common and was associated with poorer outcomes in patients with hip fracture. This did not appear to be due to either an excess of infections or an adverse response to infection.
The Effect of Sensory Impairment on the Lifestyle Activities of Older People
Authors: Clark Michael S. , Bond Malcolm J. , Sanchez Linnett
Published: December 2008

Objective: To evaluate the relative effects of hearing and vision impairments on the lifestyle activities of older people.

Method: The sample was drawn from the Australian Longitudinal Study of Ageing, and consisted of 1,052 participants aged 70 years and over. Lifestyle activities were assessed using the Adelaide Activities Profile. Hearing and vision impairments were determined on the basis of clinical assessments using pure tone audiometry and a Snellen chart respectively. Self‐report measures of the effect of sensory impairment on activities were recorded.

Results: Respondents with either a hearing or vision impairment were likely to report that their hearing or vision affected their activities. Indeed, vision impairment was associated with an objective reduction in lifestyle activities in domestic chores and household maintenance. Among males vision impairment was also associated with reduced social activities. Hearing impairment had no direct effect on lifestyle activities, nor was there any significant joint effect of hearing and vision impairment.

Conclusions: Vision impairments are more likely to lead to reductions in activities than hearing impairments, particularly when the activities are physically demanding or optional. However, age may be a more important determinant of reduced activities than sensory impairment.
The Effects of Physical Health upon the Outcome of Admission to an Acute Psychogeriatrics Ward
Authors: Draper Brian , Luscombe Georgina
Published: December 2008

Objectives: To quantify the physical health of admissions to an acute psychogeriatric unit (PGU) and to determine whether measures of physical health predict psychiatric outcome at discharge and mortality at 12 months.

Method: Prospective audit of PGU admissions over 12 months using the Physical Health Schema (PHS) to quantify physical health.

Results: There were 88 admissions categorised into four principal psychiatric diagnostic groups: major depression (46), dementia (20), delirium (7) and ‘;other’ diagnoses (15). The mean number of organ systems affected by physical illness was 3.9 per admission (sd 1.5, range 1–8), which did not differ between psychiatric diagnostic groups. On the PHS, neurological disorders were the most severe and disabling conditions, with gastrointestinal and musculoskeletal disorders the other main acute conditions, and cardiovascular and sensory disorders the other main chronic conditions. Ratings of global outcome as recovered/improved were associated with significantly fewer chronic organ systems affected by physical illness than unchanged/worse outcomes (Model x2= 8.01, df = 1, P = 0.005) and ADL score (Model x2= 6.33, df = 1, P = 0.012). Mortality 12 months after discharge was predicted by PHS acute illness scores (Model x2= 7.94, df = 1, P < 0.005) and ADL score (Model x2= 6.43, df = 1, P < 0.05).

Conclusion: Acute PGUs are best co‐located near geriatric medical wards in general hospitals due to high rates of physical illness.
A Falls Intervention Database: Describing and Evaluating Falls Prevention Programs Nationally
Authors: Gilsenan Belinda , D. Keith , Kerse Ngaire
Published: December 2008

Abstract. Falls affect one in three people over the age of 65 at least once every year. They can result in death, fracture, other major and minor injuries and a loss of confidence in mobility. One of the responses to this public health concern has been a proliferation of falls prevention programs. A comprehensive national database of community based falls prevention programs has been developed which aims to facilitate the exchange of information concerning falls interventions. Falls prevention programs have been identified and critically appraised by an interdisciplinary team using evaluation guidelines based on published findings and reviewed by a reference group. It is envisaged that the Falls Intervention Database will be a valuable resource for those planning and developing future falls prevention programs.
Transportation Needs of Community‐living Older People in Sydney
Authors: Dent O.F. , Broe G.A. , Creasey H. , Waite L.M. , Cullen J.S. , Grayson D.A.
Published: December 2008

Objectives: To assess difficulty of access to both private and public transport experienced by older people living in the community in Sydney, to identify demographic and disability‐related risk factors for poor access to transport, and to gauge the extent to which transport needs were met by assistance from relatives and friends.

Method: An interview survey of a random sample of 620 people aged 75 years and older living in the community was conducted in the inner western suburbs of Sydney between August 1991 and September 1993. Questions covered demographic background, self‐perceived disability, difficulty of access to transport, and assistance given by relatives and friends.

Results: Slightly over half of the respondents said that access to private transport was difficult or impossible for them; one‐third said that using public transport was difficult; 29% had difficulty with both forms of transport; yet only a quarter received help from relatives or friends. Fifteen per cent of all respondents were transport deprived in that they found access to both forms of transport difficult but did not receive any assistance. In general, the severely disabled were not significantly at risk of transport deprivation.

Conclusions: There was a sizeable group of older people living in the community for whom access to transport posed considerable difficulties and who received no transport assistance from relatives or friends. Further research is needed on the impact of transport deprivation and the extent to which this is ameliorated by formal services.
Family Environment of Older Indians with Chronic Illness
Authors: Soneja Shubha , Dey A.B. , Singh Rajvir
Published: December 2008

Background: Disparity in perception of old age and illness, between older people and their family, has been noticed in Indian society.

Objectives: To assess perception of the family environment by older patients with chronic obstructive airway disease and their primary caregiver.

Methodology: Family environment was assessed using a standard family environment scale.

Results: Significant agreement was noticed between perceptions of older people and their caregiver in all aspects of family environment.

Conclusion: Family environment of this group of older Indians is supportive and caring during health and illness.
Older People In Hospital
Authors: Davis Michael W. , Trim Geoffrey , Buchanan June , Le Couteur David G. , Rubenach Sally , McLean Allan J.
Published: December 2008

Abstract. We describe the evolution of an Aged Care Unit (ACU) in a S00 bed teaching hospital in the Australian Capital Territory (ACT). Demographic data on overall hospital usage by older patients in the ACT is presented to give a perspective on the role of the ACU, showing ACU patients to be older, sicker and more complex. A survey of patients' expectations of hospitalisation showed that regaining independence and returning home were their main priorities. Achieving these goals is an important indicator of quality care.
Old Age is Not Downhill: the Satisfactions and Well‐Being of Older Australians
Authors: Headey Bruce
Published: December 2008

Abstract. It is widely believed that old age is a period of psychological and emotional decline. This paper reviews sample survey evidence for the 1980s and the 1990s which appears to show that Australians aged over 60 have about the same levels of life satisfaction and lower levels of anxiety and depression than adults under 60. Fewer major life events, whether favourable or adverse, happen to older people compared to younger. Life becomes less turbulent; there are fewer emotional highs and lows. It is argued that these results cannot be explained away as due to either resignation in old age or selective survival. The survey sources are the Victorian Quality of Life Panel Survey 1981–89 (n=942) and the International Social Science Surveys/Australia 1996–97 (n=2033).
Not Just Surviving But Living: Policy and Income for Retirement and Old Age
Authors: Rosenman Linda
Published: December 2008

Abstract. In this paper, data on the income of older people is analysed to develop a profile of the economic position of the aged population. This is supplemented by data from a recent survey of financial planning by women. The major policy issues and options in relationship to income security for current and future older populations are raised and discussed.
Social Policy and Research for Older Citizens
Authors: Russell Cherry , Kendig Hal L.
Published: December 2008

Abstract. It is particularly appropriate in the International Year of Older Persons for researchers and policy makers to reflect on their contributions to improving the lives of elderly citizens. In this essay we draw on our two decades of experience as researchers with a focus on understanding the social dimensions of ageing and an interest in the role of research in informing public policy. One of the most significant changes we see over this period is the shift from an essentially paternalistic view that older people need ‘;experts' to identify their needs and make decisions on their behalf to widespread acceptance of older people's rights to have a say ‐ including a right to be active participants in the policy making process. We look in particular at how the voices of elderly people themselves have come to be heard (or not) in the policy process. We begin by considering the context in which policy‐relevant research is generally conducted and note some of the key research directions in this field over the past two decades. Next we examine some of the processes through which elderly people have been engaged as participants in the policy process. These include formal consultation with government and direct political action. We point out the particular value of focused qualitative research in giving a voice to those who are otherwise likely to be excluded from the public domain because of poverty, sickness or disability.
An Evaluation of Healthy Ageing Programs
Authors: O'Connor‐Fleming MaryLouise
Published: December 2008

Abstract. The fundamental principle of prevention for older people is to increase quality of life and to promote optimal functioning, ideally at an independent level. This paper examines the nature of health promotion from an older person's perspective, it provides a brief overview of current health promotion efforts, it examines a selection of programs and it looks at the implications for healthy ageing programs. Finally, it draws a series of conclusions about the future of health promotion initiatives for older people.
Prevalence of Analgesic and Psychotropic Medication Use by Older People with Chronic Pain
Authors: Kung Francis , Gibson Stephen J. , Helme Robert D.
Published: December 2008

Objective: The aim of the study was to examine the profile of analgesic and psychotropic medication use in community dwelling older people with chronic pain of non‐malignant origin.

Method: Two groups of older people with chronic pain were compared. The first group comprised 193 from a random sample of 1,000 community dwelling older people. The second group comprised 150 consecutive patients from a pain management centre for older people.

Results: The overall use prevalence of analgesic and psychotropic medications was similar in the two study groups. However, significant differences in use prevalence of sub categories of analgesic and psychotropic medications were found between the two study groups. The referred patients with neurological and non‐musculoskeletal conditions as the main causes of pain were more likely to use narcotics and anti‐depressants, while the community sample with the majority having musculoskeletal pain was more likely to use non‐steroidal anti‐inflammatory drugs.

Conclusion: The differences regarding the use of analgesic and psychotropic medications between the two study groups appear to be associated with different causes of pain.
End‐of‐Life Decision Making: Practical and Ethical Issues for Health Professionals
Authors: Cartwright Colleen
Published: December 2008

Abstract. Life‐extending changes in medical technology and an ageing population pose practical and ethical problems relating to end‐of‐life decision making. Health professionals need to understand the fears and concerns of their patients, their preferred place to die, and to respect patient autonomy. Such wishes may be expressed verbally by a competent patient or through an advance directive (living will) or proxy by an incompetent patient. There is an urgent need for increased and improved training of health professionals in pain management and palliative care, and for the development of practical, ethical policies and guidelines with respect to withdrawing/withholding life‐sustaining treatment. In addition, physician‐assisted suicide and euthanasia, two of the important moral issues of the 90s, will continue to require open community debate as we move into the new millennium. Australia, in company with most other countries, has many challenges ahead in relation to end‐of‐life decision making.
Pet Ownership is Not Associated with Future Health: a Nine Year Prospective Study in Older Australians
Authors: Simons Leon A. , Simons Judith , McCallum John , Friedlander Yechiel
Published: December 2008

Objective: To examine the relationship between pet ownership and future health in older Australians.

Method: A longitudinal study was conducted over 110 months in Dubbo, New South Wales, in a community‐based sample of subjects 60 years and over (1,235 men and 1,570 women). There was a baseline survey of demographic, psychosocial and cardiovascular risk factors in 1988–89, with follow‐up of all‐causes mortality and hospitalisation. Results were modeled using multiple logistic regression.

Results: At baseline, 52% of men and 42% of women owned a pet. In comparison with non‐owners, older people who owned pets were younger and more likely to be married, yet they were less likely to live alone or use blood pressure medication. Among women only, pet owners had a greater peak expiratory flow volume than non‐owners and were less likely to have physical disability. After controlling for the confounding effects of age and other factors likely to influence mortality, there was no significant relationship between pet ownership and all‐causes mortality in either sex (odds ratio [95% confidence interval] in men 1.02 [0.75–137], in women 1.27 [0.93–1.75]). Pet ownership was associated with reduced risk of a hospitalisation in women (odds ratio 0.72 [0.54–0.96]).

Conclusions: Pet ownership in older subjects is not associated with all‐causes mortality. Female owners have a slightly reduced risk of hospitalisation.
A Longitudinal Study of Alcohol Consumption and Functional Disability in a Community Sample of Older People
Authors: Dent Owen F. , Grayson David A. , Waite Louise M. , Cullen John S. , Creasey Helen , Bennett Hayley P. , Casey Barney J. , Broe G. Anthony
Published: December 2008

Objective: To examine the association between alcohol consumption and incident functional disability in community‐living older people after adjustment for other risk factors.

Method: Randomly sampled community‐living people aged 75 years and older from the inner western suburbs of Sydney underwent a clinical interview and medical examination by a physician experienced in geriatric medicine. This was repeated three years later. The examination included an assessment of functional disability and chronic systemic and neurodegenerative illnesses and impairments. Self‐reported alcohol consumption was recorded. The relationship between alcohol consumption and incident disability was examined by logistic regression analysis.

Results: Cross‐sectional analysis at the first wave showed that those who did not drink were more likely to be disabled than drinkers (39.3% and 30.4% respectively, p = 0.032). Although 11.3% were drinking at hazardous or harmful levels there was no concurrent association between disability and hazardous/harmful drinking. Incident disability between waves did not differ between non‐drinkers at the first wave and those who drank at non‐hazardous/harmful levels (35.3% and 29.3% disabled respectively, p=0.306). However 80% of those who drank at hazardous/harmful levels experienced incident disability as compared with 32.5% among non‐drinkers and non‐hazardous/harmful drinkers combined (p<0.001). Logistic regression showed that, among the risk factors examined, hazardous/harmful consumption had by far the strongest effect with an adjusted odds ratio of 12.9 (95% CI 3.1–53.9).

Conclusion: Alcohol consumption at defined hazardous/harmful levels is a major independent risk factor for incident functional disability in older people.
Pre‐clinical Dementia: Does it Exist?
Authors: Waite Louise M.
Published: December 2008

Abstract. Identification of syndromes that will progress to dementia carries immense importance for the management of these diseases when therapies are available and for future research into effective early prevention. Evidence supporting the presence of a preclinical phase for dementia has arisen from a range of different areas. Clinical and epidemiological studies have identified both cognitive and neurological abnormalities which predict the future development of dementia. Similarly, various neuroimaging techniques have identified abnormalities in asymptomatic subjects with significant risk for developing Alzheimer's disease and subjects who show mild cognitive deficits. Neuropathological series are hampered by non‐representative study populations and poor antemortem data but in studies where informants have been utilised to provide details of subjects' antemortem cognitive function, evidence indicates that the presence of brain pathology is associated with cognitive deficits. This paper reviews the current literature exploring the presence of a pre‐clinical phase for dementia, identifies the weaknesses in this research and provides suggestions for future research.
An ageing society issues and challenges
Authors: Bevan Celia
Published: December 2008

I acknowledge standing on Darbalung Nyumgar land for the presentation of this discussion. Moore (1998) reminds us of the importance of our own particular positions. In my case, this is the position of an academic gerontologist and activist who lives and works in Australia. I am also a partner, mother and grandmother.
Knowledge, stereotyping and attitudes towards self ageing
Authors: Getting Lindsay , Fethney Judith , McKee Kevin , Churchward Margaret , Goff Marilyn , Matthews Siade
Published: December 2008

Objectives: The Reactions to Ageing Questionnaire (RAQ) was developed in Australia in order to measure attitudes to personal or self ageing. A two‐country project assessed the relationships between attitudes to self ageing and measures of misconceptions and stereotyping of older people. Method: Researchers in Australia and the United Kingdom administered to nursing samples the Reactions to Ageing Questionnaire, Facts about Aging Quiz and Aging Semantic Differential, along with a page of demographic questions.

Results: Results indicated patterns of stereotyping and misconception about older people that were similar across two countries. In the main, views were negative and devalued older people in their personal attributes and capabilities. Significant correlations extended across two countries, indicating that attitudes to self ageing as measured by the RAQ were significantly associated with measures of misconception and stereotyping of older people.

Conclusion: It was concluded that urgent attention is required to address negative attitudes and to develop strategies for addressing ageism among nurses.
The involvement of adult children in their parent's decision to move to a retirement village
Authors: Knight Steve C. , Buys Laurie R.
Published: December 2008

Objective: For a variety of reasons, some older people seek alternative accommodation, with retirement villages being one option. However, deciding to move is a significant decision, and one that often involves family members. The purpose of this research was to investigate the involvement of adult children in the decision to relocate to a retirement village by independent older adults.

Method: Thirty older adults, aged 65 years of age and over, living in retirement villages in South East Queensland, were interviewed, as were thirty nominated adult children.

Results: The results suggest that whilst adult children play a significant role in the relocation to a retirement village, the decision to move is most likely made independently by the parent.

Discussion: The decision to move seems to have been made quite independently by the older parents. However, the results indicate that adult children do have some level of involvement probably in providing support to the older adult.
‘Stops walking to talk’: a simple measure of predicting falls in the frail elderly
Authors: Nitz Jennifer C. , Thompson Karen J.
Published: December 2008

Objective: To discover if the measure ‘stops walking to talk’ is a useful indicator of falls risk in the frail elderly in residential care.

Method: Twelve frail elderly residents of care facilities were assessed for falls likelihood with the Timed Up‐and‐Go (TUG) and the Berg Balance Scale (BBS) tests, and then observed in walking to determine if they needed to stop walking to talk. These results were compared with the number of falls subjects had experienced in the previous six months.

Results: Eight subjects were deemed at risk of falling by the TUG and seven by the BBS. Four of these subjects had fallen in the previous six months. Three subjects needed to stop walking to talk on at least one occasion and were deemed at risk of falling by the TUG and BBS. One of these had fallen in the previous six months.

Conclusion: This study demonstrated in this group of frail older people that falling in the previous six months was associated with high TUG and low scores on the BBS. Only three observations of ‘stops walking to talk’ were made; this limited the comparisons as only one of these subjects had fallen but all were predicted as falters by the TUG and BBS. A future study with a larger sample size and incorporating memory recall in the conversation should confirm these results.
Vision screening for older people: the barriers and the solutions
Authors: Camicelli Anthony , Keeffe Jill , Martin Kern , Carbone Joe , Balding Cathy , Taylor Hugh
Published: December 2008

The need for detection of vision impairment in older people has been well established To help achieve such a goal, vision screening should be integrated into the provision of aged care services, health and Community organisations.

This study aimed to facilitate access to vision screening for people aged 65 and over in the City of Whitehorse (Melbourne) through aged care, health and community services. In total 147 people within these organisations were trained to use a vision screening kit. However, it was estimated that only 20% of participants used the kit, citing a number of barriers: the major ones being time restraints, conflict with other duties, and wanting an outside organisation to perform resting. Overall out of 510 people, 442 (87%) could be tested and 169 (38%) wre detected with vision impairment. Of these, 40 (24%) were under care and 129 (76%) were referred for further examination.

As a result of this study we recommended that vision screening be integrated into a services provision of care to older people and patients as part of a holistic approach to heath.
Women of the baby boom generation and unpaid work ‐What are the indications for the future?
Authors: Merkes Monika , Wells Yvonne
Published: December 2008

Objectives:Most unpaid work is performed by women. Will Australian women of the baby boom generation continue to provide such work for the benefit of their families and communities? This article examines the indications for changes in the provision of unpaid work in the future, in particular, the potential future contribution of unpaid work performed by women of the baby boom generation.

Method:Data from the Healthy Retirement Project were used to assess the views of a large group of women from the baby boom generation (n= 1359) regarding voluntary work in retirement. Focus groups explored in more depth the views of women of the baby boom generation regarding paid and unpaid work after the age of 65.

Results:A large proportion of female baby boomers intend to provide unpaid caring and community work after their retirement. Women in the baby boom generation were equally as likely as their predecessors to be volunteers and to be looking forward to having more time for voluntary work in retirement. Women were more likely to anticipate having more time for voluntary work in retirement if they were already involved in voluntary work and in good health.

Conclusions:The provision of unpaid work in Australia is likely to increase, as the proportion of older people in the population increases.
The experiences of staff concerning the introduction and impact of a fall prevention intervention in aged care facilities: a qualitative study
Authors: Butler Meg , Kerse Ngaire , Coggan Carolyn
Published: December 2008

Objective: Falls in aged care facilities are a major public health concern. A pilot study tested the acceptability of a falls risk management intervention.

Method: Focus group discussions with care giving staff and falls coordinators and individual interviews with principal nurse managers were taped and transcribed and thematic analysis identified main issues for staff in utilising the intervention.

Results: Acceptance of the intervention was high for principal nurse managers and falls coordinators, although the paper work was found to be time consuming. While most caregivers found undertaking fall prevention strategies worthwhile, others found such strategies were irrelevant to them as they “knew” their residents.

Conclusions: Among all levels of staff, falls among residents were regarded as stressful events. While the general acceptunce of the intervention programme was high, resistance to changing practices of care by some staff could limit the wider implementation of such a programme. Further research is needed to examine appropriate delivery of educational messages for caregivers, which include multiple cultural understandings.
Challenging patient populations in breast cancer: Taxane resistance and triple‐negative receptor subtype
Authors: OHNO Shinji , FORNIER Monica N
Published: December 2008

Over the last decade the introduction of the taxanes and several targeted therapies have led to an improvement in breast cancer morbidity and mortality. However, several groups of patients, including patients with taxane‐resistant, multidrug resistant, and estrogen‐negative, progesterone‐negative, and HER2/neu receptor‐negative tumors, have now emerged that present challenges to clinicians as they strive to improve the outcomes for patients with breast cancer. This review examines the state of knowledge at the time of writing regarding the mechanisms of taxane resistance and the natural history of triple‐negative disease. Strategies for overcoming taxane resistance and the improving clinical outcomes for these groups of patient are discussed.
Apparent Digestibility of Gross Nutrients from Feedstuffs in Extruded Feeds for Rainbow Trout, Oncorhynchus mykiss
Authors: Gaylord T. Gibson , Barrows Frederic T. , Rawles Steven D.
Published: December 2008

Abstract.— The current experiment was performed to determine apparent protein and energy digestibility coefficients of feed ingredients by the fecal stripping technique using extruded diets. The ingredients tested included five fish meals, three terrestrial animal by‐products, five plant protein concentrates, four plant meals, and seven low‐protein plant ingredients. Protein digestibility differed among fish meals and ranged from 90% for fair and average quality menhaden meal to 97% for anchovy meal. Protein apparent digestibility coefficients (ADCs) in plant concentrates ranged from a low of 89% for rice protein concentrate to a high of 100% for wheat gluten meal. Apparent protein digestibility was lower in plant meals than fish meals with a low of 70% for flaxseed meal to a high of 89% for soybean meal. Low‐protein plant meals had generally lower protein ADC from 64% for rice bran to 85% for whole wheat. A similar pattern for energy ADCs was observed; ADCs ranged from 106% for anchovy meal to 32% for whole wheat. In the current trial, divergent protein and energy ADC values were obtained most notably in ingredients known to be high in fiber or have very high starch content. The comparability of ingredients/diets processed by cold pelleting or extrusion thus appears questionable at this juncture.