bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships Between Sleep and Body Temperature in Middle‐Aged and Older Subjects
Authors: Campbell Scott S. , Murphy Patricia J. 
Published: April 2015

OBJECTIVES: Although changes in the circadian timing system are thought to be a major factor in the decline of sleep quality that often accompanies aging, few reports have actually examined this relationship in detail. Because some treatments for age‐related insomnia are based on putative circadian changes, it is important to expand the limited database that specifically addresses this issue. This study examined age‐related changes in sleep, and relationships between those sleep changes and alterations in the circadian timing system, in a group of middle‐aged and older subjects.DESIGN: Sixty healthy men and women between the ages of 40 and 84 were studied. A subset of older subjects (< 65 years) had reported sleep disturbance for at least 1 year before participation. Polysomnography was obtained, and body core temperature was recorded continuously for 24 hours. All recordings took place in the Laboratory of Human Chronobiology, Department of Psychiatry, Cornell University Medical College.RESULTS: There were no differences in sleep quality between middle‐aged and non‐sleep‐disturbed older subjects. However, timing of the minimum body temperature was earlier in the older non‐sleep‐disturbed subjects than in the middle‐aged group. In contrast, sleep‐disturbed older people had shorter total sleep times, reduced sleep efficiency, more waking time after sleep onset, and a reduced proportion of REM sleep compared with non‐sleep‐disturbed older subjects. Yet, there were no differences between the two older groups in the rhythm of body temperature. For the entire group, age was correlated negatively with total sleep time, sleep efficiency, percentage of stage 2 sleep, and the timing of the temperature minimum.CONCLUSION: The results support the widely held notion that sleep and circadian rhythm changes occur with aging. However, the hypothesis that age‐related changes in sleep may be associated with aging of the circadian system was supported only to a limited degree, suggesting that age‐related sleep disturbance is likely to have multiple causes. Thus, treatment strategies that incorporate a combination of interventions may be the most effective.
Age Dependence of Choroidal Blood Flow
Authors: Dallinger Susanne , Findl Oliver , Strenn Karin , Eichler Hans‐Georg , Wolzt Michael , Schmetterer Leopold 
Published: April 2015

OBJECTIVE: To investigate the age dependence of choroidal blood flow.DESIGN: A cross‐sectional study.SETTING: Department of Clinical Pharmacology, Vienna University.PARTICIPANTS: A total of 130 healthy volunteers between the ages of 19 and 83 years.MEASUREMENTS: Fundus pulsation amplitude (FPA) with a recently developed laser interferometric method, mean arterial pressure (MAP) with an automated oscillometric device, intraocular pressure (IOP) with an applanation tonometer, and ocular perfusion pressure (OPP) as calculated from MAP and IOP.RESULTS: There was a significant correlation of FPA with age r = −0.242 (P = .005). MAP, IOP, and OPP showed a significant positive correlation with age. Multiple regression analysis showed that FPA is associated with age but not with MAP, IOP, or OPP.CONCLUSION: Choroidal blood flow is reduced in older subjects, which argues in favor of an increase in ocular vascular resistance with age. This may be a risk factor in the development of common ocular diseases such as age‐related macular degeneration or glaucoma
A Census‐Based Comparison of Centenarians in New Zealand with Those in the United States
Authors: Wilkinson Tim J. , Sainsbury Richard 
Published: April 2015

OBJECTIVE:To describe the characteristics of New Zealand's centenarians, as given in the 1991 census, and to compare these characteristics with those of centenarians from the United States.DESIGN:A census‐based descriptive study.SETTING:The complete national population as defined by the 1991 New Zealand census.RESULTS:In 1991, there were 246 female and 51 male centenarians in New Zealand. Fifty‐one percent of the men and 29% of the women lived at home; 16% lived at home with someone else (55% with children). People who were widowed were more likely to be living in a residential institution (69%) than people who were married (40%). Forty‐three percent of men and 39% of women earned less than NZ$10,000 per year. Most had no formal educational qualification. Fourteen percent of men and 35% of women living at home did housework in the previous week. Compared with the United States, there are fewer New Zealand centenarians per number of population. People of European race were overrepresented in the New Zealand centenarian population, whereas African Americans were overrepresented in the United States centenarian population.CONCLUSIONS:Our data have shown the heterogeneity associated with extreme ageing and can be used as a basis for comparison with other countries.
Cross‐Cultural Adaptation of the Hearing Handicap Inventory for the Elderly‐Screening Version (HHIE‐S) for Use with Spanish‐Speaking Mexican Americans
Authors: Lichtenstein Michael J. , Hazuda Helen P. 
Published: April 2015

OBJECTIVE: To cross‐culturally adapt the Hearing Handicap Inventory for the Elderly‐Screening Version (HHIE‐S) for use with older Spanish‐speaking Mexican Americans.SUBJECTS AND SETTING: Two different samples were used. First, a convenience sample of 100 older community‐dwelling Mexican American men and women in San Antonio, Texas, was used to test technical equivalence of the Spanish and English language versions of the HHIE‐S. Second, a neighborhood‐based sample of older Mexican Americans was used to establish conceptual (n = 433) and criterion equivalence (n = 381) of the two HHIE‐S language versions.METHODS: Independent forward and back translations were done to create a Spanish language version of the HHIE‐S. In the convenience sample, subjects were administered the English and Spanish HHIE‐S in random order on separate days. In the neighborhood sample, the HHIE‐S was given on one occasion in the language of the subject's preference. Depressive symptoms were assessed using the Geriatric Depression scale to see if the two language versions of the HHIE‐S were similarly associated with depression (conceptual equivalence). Hearing impairment was assessed using the Welch‐Allyn AudioscopeTM to see if the two language versions were similarly associated with an audiometric measure for hearing loss (criterion equivalence).RESULTS: In the convenience sample, the overall mean (SD) Spanish and English HHIE‐S scores were 6.2 (8.7) and 6.2 (9.3), respectively (P = 1.00). Total scores of the English and Spanish versions were highly correlated (r = .89), and regression analysis indicated that the two language versions gave nearly identical results.In the neighborhood‐based sample, men had higher HHIE‐S scores than women (OR 2.0, 95% CI = 1.3–3.5). Having depressive symptoms (OR 3.2, 95% CI = 1.9–5.5) or hearing impairment (OR 6.1, 95% CI = 3.5–10.5) was associated with higher HHIE‐S scores. After adjustment for gender, depressive symptoms, and/or hearing impairment, the language of interview was not associated with HHIE‐S score.CONCLUSION: We have developed and tested a Spanish translation of the HHIE‐S that yields equivalent results to those obtained with the English version in bilingual Mexican Americans. The Spanish HHIE‐S presented here is suitable for clinical use and research studies involving older Mexican Americans.
Getting Meaningful Informed Consent from Older Adults: A Structured Literature Review of Empirical Research
Authors: Sugarman Jeremy , McCrory Douglas C. , Hubal Robert C. 
Published: April 2015

OBJECTIVES: To perform a structured literature review of the published empirical research on informed consent with older adults in order to make recommendations to improve the informed consent process and to highlight areas needing further examination.DESIGN: Relevant literature was identified by searching electronic databases (AGELINE, BIOETHICSLINE, Cancer‐Lit, Ethics Index, Health, LegalTrac, MEDLINE, PAIS International, PsycInfo, and Sociofile). Studies were included if they were reports of primary research data about informed consent and, if patients or other subjects were used, older subjects were included in the sample. Data related to the aspect of informed consent under study (recruitment, decision‐making capacity, voluntariness, disclosure of information, understanding of information, consent forms, authorization, and policies and procedures) were abstracted and entered into a specially designed database.MEASUREMENTS: Characterization of the population, age of subjects, setting, whether informed consent was being studied in the context of research or treatment, study design, the nature of outcome or dependent variables, independent variables (e.g., experimental conditions in a randomized controlled trial or patient/subject characteristics in a nonrandomized comparison), and results according to the aspect of informed consent under study.RESULTS: A total of 99 articles met all the inclusion criteria and posed 289 unique research questions covering a wide range of aspects of informed consent: recruitment (60); decision making capacity (21); voluntariness (6); disclosure (30); understanding (139); consent forms (7); authorization (11); policies (13); and other (2). In the secondary analyses of numerous studies, diminished understanding of informed consent information was associated with older age and fewer years of education. Older age was also sometimes associated with decreased participation in research. Studies of disclosure of informed consent information suggest strategies to improve understanding and include a variety of novel formats (e.g., simplified, storybook, video) and procedures (e.g., use of health educators, quizzing subjects, multiple disclosure sessions).CONCLUSIONS: A systematic review of the published literature on informed consent reveals evidence for impaired understanding of informed consent information in older subjects and those with less formal education. Effective strategies to improve the understanding of informed consent information should be considered when designing materials, forms, policies, and procedures for obtaining informed consent. Other than empirical research that has investigated disclosure and understanding of informed consent information, little systematic research has examined other aspects of the informed consent process. This deficit should be rectified to ensure that the rights and interests of patients and of human subjects who participate in research are adequately protected.
Aerobic Exercise and Lumbar Spine Bone Mineral Density in Postmenopausal Women: A Meta‐Analysis
Authors: Kelley George 
Published: April 2015

PURPOSE: To use the meta‐analytic approach to examine the effects of aerobic exercise on lumbar spine bone mineral density in postmenopausal women.DATA SOURCES: Studies were retrieved from computer searches (MEDLINE, Current Contents) as well as cross‐referencing from the bibliographies of retrieved studies and review articles.STUDY SELECTION: A total of 17 effect sizes consisting of 330 subjects (192 exercise, 138 nonexercise) were included from the 10 studies that met the criteria for inclusion: (1) aerobic activity as the only exercise intervention, (2) postmenopausal women as subjects, (3) comparative nonexercise group included, (4) changes in lumbar spine bone mineral density reported, (5) studies published in English‐language journals between January 1975 and December 1994.DATA EXTRACTION: The primary outcome measure of interest was the treatment effect Δ3, defined as the percent change in lumbar spine bone mineral density, calculated by subtracting the percent change in the exercise group from the percent change in the nonexercise group.RESULTS: Using a fixed effects model, bootstrap analysis (10,000 replications) showed that significant changes in lumbar spine bone mineral density occurred (X̄ ± SD = 2.83 ± 0.77%, 95% confidence interval (CI) = 1.33 to 4.35%). This overall average increase was caused primarily by the loss of lumbar spine bone mineral density in the nonexercise group relative to the exercise group (X̄ ± SD, exercise = .32 ± 2.46%, 95% CI = −0.94 to 1.58; nonexercise = −2.51 ± 2.69%, 95% CI = −4.60 to −0.96).CONCLUSION: The results of this meta‐analysis suggest that aerobic exercise helps to maintain lumbar spine bone mineral density in postmenopausal women.
Effects of Home‐Based Intervention on Unplanned Readmissions and Out‐of‐Hospital Deaths
Authors: Stewart Simon , Pearson Sue , Luke Colin G. , Horowitz John D. 
Published: April 2015

OBJECTIVE: To determine the effect of a home‐based intervention (HBI) on the frequency of unplanned readmission and out‐of‐hospital death among patients discharged home from acute hospital care.DESIGN: A randomized controlled trial comparing HBI with usual care (UC).SETTING: A tertiary referral hospital servicing the northwestern region of Adelaide, South Australia.PARTICIPANTS: Medical and surgical patients (n = 762) discharged home after hospitalization.INTERVENTION: Home‐based intervention (n = 381) consisted of counseling of all patients before discharge followed by a single home visit (by a nurse and pharmacist) to those patients considered to be at high risk of readmission (n = 314) in order to optimize compliance with and knowledge of the treatment regimen, identify early clinical deterioration, and intensify follow‐up of such patients where appropriate.MEASUREMENTS: The primary endpoint was the number of unplanned readmissions plus out‐of‐hospital deaths over a 6‐month follow‐up period.RESULTS: During the study follow‐up, the major endpoint occurred most commonly in the UC group (217 vs 155 episodes: P < .001). Overall, the HBI group demonstrated fewer unplanned readmissions (154 vs 197: P = .022), out‐of‐hospital deaths (1 vs. 20: P < .001), total deaths (12 vs. 29: P = .006), emergency department attendances (236 vs 314: P < .001), and total days of hospitalization (1452 vs 1766: P < .001). There was a disproportionate reduction in multiple events among HBI patients (P = .035). Hospital‐based costs of health care during study follow‐up tended to be lower in the HBI group ($A2190 vs $A2680 per patient: P = .102). Mean cost of HBI was $A190 per patient visited, whereas other community‐based health care costs were similar for both groups.CONCLUSIONS: Among high‐risk patients discharged from acute hospital care, HBI is beneficial in limiting unplanned readmissions and reducing risk of out‐of‐hospital death. It may be particularly cost‐effective if applied selectively to patients with a history of frequent unplanned hospital admission.
Use of Antipsychotic Drugs in Nursing Homes: Current Compliance with OBRA Regulations
Authors: Llorente Maria D. , Olsen Edwin J. , Leyva Oscar , Silverman Michael A. , Lewis John E. , Rivero Jesus 
Published: April 2015

OBJECTIVE: To examine the degree and patterns of compliance with the Omnibus Budget Reconciliation Act (OBRA) regulations regarding the use of antipsychotic drugs in nursing homes.DESIGN: Retrospective chart review of all resident records.PARTICIPANTS: Eight nursing homes: five community, two county‐owned, and one university‐affiliated Veterans Administration facility.MEASUREMENTS: A structured assessment instrument to track compliance with each aspect of the OBRA regulations regarding antipsychotic drug use.RESULTS: A total of 1573 nursing home residents' pharmacy records were reviewed between August 1994 and March 1996. Two hundred seventy‐nine residents were actively taking antipsychotic medications (prevalence = 17.7%). Mean compliance greater than 70% was found for (1) appropriate diagnostic indication (X̄ = 70.9%), (2) dosage within recommended limits (X̄ = 90.1%), and 3) documented appropriate target symptoms (X̄ = 90.4%). Dosages were more likely to exceed limits in those patients with histories of major mental illness, particularly schizophrenia.CONCLUSIONS: Nursing homes were better able to comply with those guidelines that are most specific. Educational interventions now need to focus on behavioral interventions, monitoring of adverse effects, and efficacy. These data are useful in establishing threshold levels of performance and can be used by nursing homes for continuous quality improvement. OBRA continues to impact neuroleptic drug prescribing practices in nursing homes significantly.
Osteoarthritis in Older Adults
Authors: Ling Shari Miura , Bathon Joan M. 
Published: April 2015

OBJECTIVE: This review highlights the clinical and pathophysiologic features of osteoarthritis (OA) of the peripheral joints and discusses the current and future management options for this common but potentially disabling disease. This article also addresses the contribution of osteoarthritis to falls and functional impairment in older people.DESIGN: A critical assessment of current data regarding the pathogenesis of osteoarthritis, current and future therapies, and the potential role of OA in falls and functional impairment in older people.CONCLUSIONS: Osteoarthritis is the most prevalent articular disease in older adults. Disease markers that will detect early disease and allow early intervention with pharmacologic agents that modify, if not halt, disease progression are much needed, but they are presently unavailable. Current management should include safe and adequate pain relief using systemic and local therapies and should also include medical and rehabilitative interventions to prevent, or at least compensate for, functional deficits. Although OA can result in impaired mobility and lower extremity function, its contribution as a cause of recurrent falls or impaired self‐care, relative to other comorbid conditions, remains ill‐defined. Further analysis of the determinants of disability, loss of mobility and falls in older patients with OA is needed.
Serum Estrogen Levels, Cognitive Performance, and Risk of Cognitive Decline in Older Community Women
Authors: Yaffe Kristine , Grady Deborah , Pressman Alice , Cummings Steve 
Published: April 2015

OBJECTIVE: To determine the association between serum estrogen levels, cognitive performance, and risk of cognitive decline in older women.DESIGN: Prospective cohort study with an average follow‐up of 5 years.SETTING: Clinical centers in Baltimore, MD, Minneapolis, MN, Portland, OR, and the Monongahela Valley in Pennsylvania.PARTICIPANTS: 532 women aged 65 years or older who were the controls from two nested case‐control studies in the ongoing Study of Osteoporotic Fractures.OUTCOME MEASURES: Three cognitive tests – a modified Mini‐Mental Status Exam, Digit Symbol, and Trails B – were administered at study initiation and were then repeated approximately 5 years later. Estrone and estradiol levels were determined by radioimmunoassay at two laboratories from baseline stored serum.RESULTS: The characteristics of the women in the four serum estrogen quartiles did not differ except that body weight and change in weight since age 50 increased directly with higher quartile of serum estrogen (P <.001, for both estrone and estradiol). Initial cognitive performance on all three tests did not differ consistently by quartile of estradiol or by the estradiol to estrone ratio. Women in the higher estrone quartiles had 15% lower (worse) scores on Digit Symbol compared with the lower quartiles (P =.004) but there was no difference by quartile on the modified MMSE or on Trails B. Cognitive function test scores declined over the 5 years of follow‐up. There was no difference in amount of change by quartile of estradiol, but women in the higher estrone quartiles had greater reduction of scores on Trails B compared with those in the lower quartiles (P =.012), even after adjusting for age, education, depression, stroke history, weight, and change in weight since age 50. The age‐adjusted odds of cognitive decline (defined as tenth percentile of women with the largest decline in cognitive performance) did not vary across quartile of estrone or estradiol.CONCLUSIONS: Endogenous estrogens are not associated consistently with cognitive performance or risk of cognitive decline on a selected battery of cognitive tests in older community‐dwelling women. Worse performance on two cognitive tests among women with higher estrone levels was surprising and warrants further investigation.
Oxidative Stress and Advancing Age: Results in Healthy Centenarians
Authors: Paolisso Giuseppe , Tagliamonte Maria Rosaria , Rizzo Maria Rosaria , Manzella Daniela , Gambardella Antonio , Varricchio Michele 
Published: April 2015

OBJECTIVE: Our study aims at investigating the degree of oxidative stress in centenariansDESIGN: Indices of oxidative stress (reaction products of malondialdehyde with thiobarbituric acid (TBARS) and lipid hydroperoxides (LPO)), and plasma concentrations of antioxidant defenses (plasma vitamin E and C concentrations and reduced/oxidized glutathione ratio (GSH/GSSG)) were determined.SUBJECTS: Eighty‐two subjects volunteered for the study. They were divided into three groups: (1) adults (< 50 years of age, n = 30); (2) aged subjects (70–99 years, n = 30); (3) centenarians (age ≥ 100 years, n = 22).MEASUREMENTS: TBARS and LPO, plasma vitamin E and C concentrations, and plasma GSH/GSSG ratio were determined. Insulin action was assessed by euglycemic hyperinsulinemic glucose clamp.MAIN RESULTS: TBARS (0.44±0.07 vs 0.31 ±.05 nmol malondialdehyde/mL plasma, P =.020) and LPO (0.36 ± 0.05 vs 0.31 ±.04 μmol/L, P =.050) were lower in centenarians than in aged subjects. In contrast, plasma GSH/GSSG ratio (0.82 ± 0.09 vs 1.17 ±.06, P =.010), vitamin C (72.3 ± 4.6 vs 59.4 ± 3.8 μmol/L P =.010), and vitamin E (29.1 ± 2.2 vs 24.4 ± 2.3 μmol/L P =.050) concentrations were more elevated in centenarians than in aged subjects. Differences in daily vegetable intake, in fasting plasma glucose and free fatty acid (FFA) concentrations, and in insulin action are significant determinants of degree of oxidative stress. A specific genetic background in centenarians might also provide a possible explanation.CONCLUSIONS: The degree of oxidative stress is lower in healthy centenarians than in aged subjects.
Elder Abuse in the Community: Prevalence and Consequences
Authors: Comijs Hannie C. , Pot Anne Margriet , Smit Johannes H. , Bouter Lex M. , Jonker Cees 
Published: April 2015

OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community‐based sample; (2) to investigate the circumstances that led to the abuse and the ways in which the victims handled the problem.DESIGN: Prevalence was assessed in a population‐based sample of 1797 older people living independently in Amsterdam, the Netherlands. In a follow‐up study 1 year later, the victims were questioned again about the background and consequences of the abuse.RESULTS: The 1‐year prevalence of elder abuse was 5.6%. The prevalence of the various types of elder abuse was: verbal aggression 3.2%, physical aggression 1.2%, financial mistreatment 1.4%, and neglect 0.2%. Most victims reported emotional reactions immediately after the abuse. Seven of 36 victims experienced physical or financial damage as a consequence of the abuse. More than 70% of the victims were able to stop the abuse, either by themselves or with the help of others.CONCLUSION: The rate of occurrence and the consequences of elder abuse in the Netherlands was established. Elder abuse is more widely spread if not only close relatives or people with whom the older person lives are considered as possible perpetrators but other familiar and trusted people are considered as well. Intervention should be focused on the roughly 40% of victims who were not able to stop the abuse.