bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Sleeping Medication and Quality of Life among Older Women who Report Sleeping Difficulty
Authors: Hasan Syed , Byles Julie E. , Mishra Gita , Harris Margaret A. 
Published: December 2008

Objective: To estimate the proportion of older women who report sleeping difficulties and/or use sleeping medication; and to identify associated factors. Method: Cross sectional survey of Australian women aged 70–75 years. These women were participants in the Australian Longitudinal Study on Women's Health (ALSWH) randomly selected from the Australian Medicare database.
Results: Of the 12,624 women aged 70–75 years who provided data for this analysis (36% response rate), 50%{n‐6,042) reported sleeping difficulty “never/rarely”, 33% (n=3,979) “sometimes”, and 17% (n=2,011) “often”. Approximately 18% (n=2,287) of women reported using sleeping medication within the previous four weeks. Women reporting sleeping difficulty “sometimes ” were over five times more likely to be taking sleeping medications than women who reported “never/rarely” experiencing difficulties (p≤0.0001); while women reporting difficulty sleeping “often” were over 15 times more likely to be using sleeping medications (p≤0.0001). Mean scores for sub‐scales of the SF‐36 health‐related quality of life measure were significantly lower for women reporting sleeping difficulty and women using sleeping medication (p≤0.001). Similarly, there was an inverse relationship between the SF‐36 physical and mental health summary scores and difficulty sleeping or sleeping medication use. Conclusion: Self‐reported sleeping difficulty is significantly related to reduced quality of life, suggesting sleeping difficulty is not a benign complaint. After adjustment for other explanatory variables there were strong, clinically significant differences between the SF‐36 scores of women reporting sleeping difficulty. However, while this association is statistically and clinically significant, it is not clear whether sleeping difficulty reduces quality of life, or whether quality of life interferes with sleep, or whether both problems are a result of other associated conditions. Further longitudinal exploration of this relationship is necessary. Further, issues need to be explored with older women, with a view to identifying acceptable and effective alternatives to sleeping medication use.
Older People's Perceptions of Their General Practitioner
Authors: Keller Judith , Slee Jo‐Anne 
Published: December 2008

Objective: As part of a larger study into the health and well‐being of older people, their relationships with health and community service providers were explored. This paper focuses on how older people viewed their relationship with their general practitioner (GP).
Method: 49 older people in metropolitan Melbourne were interviewed using qualitative research, via in‐depth interviews.
Results: Most participants described their relationship with their GP as being very important to them. Many described their GP as a friend and key components of the relationship were faith and trust. Good communication skills, on the part of the GP, were important. Consumerist attitudes were generally not apparent and many of the older people interviewed would find the expectation to behave as a consumer very threatening.
Conclusions: Similar to previous studies, most of the older people preferred a very strong trusting relationship with their GP, and it was one of the most important relationships in their lives.
The cost effectiveness of a pharmacist reviewing medication among the elderly in the community
Authors: Harris Anthony , Gospodarevskaya Elena , Callaghan Jennifer , Story Ian 
Published: December 2008

Aims
: The study aims to assess the cost effectiveness of medication review and advice by a consultant pharmacist to elderly people living in the community in Australia.
Method
: The quality of life and cost of health and social services for a cohort of elderly patients seen by an aged care assessment team (ACAT) was measured at initial referral and at one month follow up. Sites in Melbourne and Ballarat were chosen and analysed separately. A second subsequent cohort was assessed by a team, which included a pharmacist who provided advice to the team and the patient's GP. Quality of life was measured using the SF‐36 and the AQoL. Results: Patients seen by an ACAT had a quality of life considerably below full health. Overall there was no significant change in quality of life in either group by either measure. The additional cost of the pharmacist was less than 77 per patient. Compared to no intervention, there was some evidence of an increase in the cost of prescription Pharmaceuticals, and a reduction in home care assistance and medical care costs in Melbourne but not in Ballarat. Cost data were highly skewed however, making statistical tests of cost differences problematic. The addition of a pharmacist may be cost reducing in some settings especially if inpatient episodes for assessment and treatment can be avoided, but the study was not able to demonstrate a statistically significant reduction in overall costs associated with pharmacist review and advice.
Health locus of control, depression and quality of life in people who are elderly
Authors: Bramston Paul , Tomasevic Vilma 
Published: December 2008

Objectives
: This study examines the relationship between quality of life, depression and three aspects of health locus of control for people living in retirement villages.
Method
: A total of 101 people who are elderly living in a south Queensland city completed self‐report scales of life quality, depression, and health locus of control. Results and Conclusion: The results revealed that attributing control over one's health to powerful others can be linked with greater helplessness and depression which in turn is linked with lower perceptions of aspects of life quality. Depression was found to be a mediator between locus of health control and quality of life.
A checklist for comprehensive health assessment for the over 70's
Authors: Byles Julie E. , Tavener Meredith A. , Fitzgerald Patrick E B. , Hair Balakrishnan R. , Higginbotham Nick , Jackson Claire L. , Heller Richard F. , Newbury Jonathan W. 
Published: December 2008

Objectives: To describe the development and performance of an instrument for health assessment of older Australian veterans and war widows, including: (a) the underlying dimensions of the assessment instrument, (b) problems identified and (c) associations with health related quality of life. Method: Participants were randomly selected veterans and war widows aged 70 years and over, living independently in 10 regions of NSW and QLD. The intervention consisted of a series of preventive care home visit health assessments by health professionals using a specially developed 113‐item screening checklist, together with targeted health education materials, telephone follow‐up and computer generated reports to the veteran's local medical officer. Main outcome measures were underlying facets of the checklist, and associations with self reported quality of life. Results: 904 home visit assessments were conducted using the checklist. Problems identified included having no recent hearing check, poor rate of vaccination against pneumonia and tetanus vaccination, and problems with feet. Exploratory factor analysis of the checklist reported four main factors, explaining 31% of the variance. Three out of four checklist scales were significantly associated with both physical and mental component scores of the SF‐36 quality of life measure.Conclusions: The preventive care checklist proved easy to administer, acceptable to participants, and contained valid items for use with an older veteran population.
Impotence in older men: do geriatricians have a role?
Authors: Granger Andrew S. , Wilkinson Tim J. 
Published: December 2008

Background: Impotence, or erectile dysfunction, is the commonest health disorder affecting older men. However, this may be a topic not well addressed by geriatricians focussing on the health care of this group Objectives: To determine how often older male patients presenting to a single geriatric outpatient clinic were questioned about erectile dysfunction. Also to explore the attitudes of the physicians and patients with regard to whether such an assessment should be taking place in this setting.Method: 121 men aged ≥ 65 years of age, assessed as ‘new outpatients' (1 hour appointments) during the period 1 June ‐ 4 December 1998, were sent written questionnaires enquiring about whether the subject of erectile dysfunction had been discussed at the appointment, and whether the patient felt that this was appropriate. A second questionnaire was sent to the physicians involved in the clinics, asking about their individual practice and opinions relating to the assessment of erectile dysfunction in this setting. Results: Anonymous replies were received from 60 (49.6%) of the 121 patients and 11 (78.6%) of the 14 doctors. Only 5/60 (8.3%) of the respondents recalled having discussed the subject of erectile dysfunction at the appointment, and in all cases the discussion was initiated by the doctor. None of the 5 reported feeling embarrassed or uncomfortable at the question. 44/60 (73.3%) replied that they would have liked the opportunity to discuss this issue, and the same number stated that this should be a routine part of a geriatrician's assessment. 59/60 (98.3%) responded that they would not feel uncomfortable with such a discussion. In contrast, only 1/11 (9.1%) of the doctors routinely asked all new male patients about erectile dysfunction. Furthermore, only 3/11 (27.3%) felt this to be a topic which should be a routine part of a geriatrician's full assessment. This was significantly different (p < 0.01) from the proportion of patients who considered that it should be routine. Conclusion: Erectile dysfunction was a health problem poorly addressed in this outpatient geriatrics clinic. Patients and physicians held divergent opinions on the role of the geriatrician in assessing this common problem. The patients' view, and our recommendation, is that enquiring about erectile dysfunction should become a routine part of a geriatrician's clinical practice.
Quality in aged care: a question of relational ethics?
Authors: Marquis Ruth 
Published: December 2008

Objectives: This paper reports on findings from interviews with residents and aged care workers in seven aged care facilities in Western Australia to explore the relational context of aged care environments and how daily relational experiences with staff influenced residents' views on service quality. Method: Twenty‐four residents and eleven aged care workers, who were identified by residents as providing a quality service, were engaged in recurrent in‐depth interviews over a two year period. Data collection and inductive analysis took place simultaneously. Member checks validated findingsFindings: From the analysis of interview data two opposing relational cultures in aged care are discussed and five relational categories commonly experienced by participants described. Findings highlighted the importance of resident/staff relationships in residents' perceptions of receiving a ‘quality’ service and the positive and negative influences these had on their daily lives.Conclusion: Aged care facilities need to adopt relational ethics as a guiding principle in creating quality services. Relationships with aged care workers may be central in the lives of people living in aged care facilities and their only opportunity for personal validation. Evaluating quality in aged care services needs also to address the daily relational experiences of residents. Recruitment and training of aged care workers need to consider relational competencies as an integral characteristic of quality care. Relational deprivation and abuse is not addressed by current evaluation procedures.
Determinants of service use among the elderly: the Sydney Older Persons Study
Authors: Broe G.A. , Grayson DA , Waite L.M. , Creasey H. , Edelbrock D. , Bennett H.P. , Brooks W.S. 
Published: December 2008

Objectives: To examine the determinants of service use in a community dwelling sample aged 75 or over.Methods: Subjects (n = 537) were interviewed about use of community and medical services and the provision of unpaid support from their social network. Measures of disease and disability, detailed network support data and factors that may either enable or predispose subjects to service use were obtained and their prediction of service use examined.Results: Unpaid support and community service use were predicted predominantly by disability, with disease providing little additional prediction. Medical service use was predicted by both disease and disability. With disease and disability controlled for, other variables did not significantly predict medical service use or unpaid support; but did predict small additional variation in some community service use.Conclusions: Disability and disease are the major determinants of service use with other factors contributing to the use of some community services.
Smoking, alcohol use and engagement in exercise and cognitive performance among older adults
Authors: Bryan Janet , Ward Lynn 
Published: December 2008

Objectives: To examine cross‐sectional and longitudinal effects of history of smoking, alcohol use and engagement in exercise on cognitive performance. Method: Health habits and cognitive performance of a large community sample of older adults were assessed at measurement points two years apart.Results: Past smokers performed more poorly on tests of recall and speed of information processing at times 1 and 2 than those who had never smoked. Past smokers and moderate users of alcohol performed better on confrontation naming and working memory, than those who had never smoked or drank alcohol. Engagement in exercise was related to immediate recall and speed of processing before, but not after, controlling for covariates. Health habits were not related to longitudinal change in cognition.Conclusions: The results suggest a negative effect of history of smoking on effortful cognitive tasks and a protective effect of alcohol use on more automatic cognitive tasks among older adults.
Predictors of the decision to yield care of a person with dementia
Authors: Bond Malcolm J. , Clark Michael S. 
Published: December 2008

Objective: The aim of this study is to determine the relative contributions of caregiver and patient characteristics to the subsequent decision to yield care of a person with dementia.Method: The sample comprised 158 people with dementia and their spouse caregivers. The inclusion criteria were that the patient had a diagnosis of Alzheimer's disease, the patient and caregiver were both at least 65 years of age, were co‐resident, that the caregiver was the spouse of the patient, and was actively providing care. Caregiver measures were the Geriatric Depression Scale, SF36, Adelaide Activities Profile, self‐rated health, use of respite services and time as a caregiver. Patient measures were the Functional Dementia Scale, Adelaide Activities Profile, and time since diagnosis. Age and sex were also recorded. Data were obtained by personal interview with caregivers. Two years later, all caregivers were re‐contacted by telephone. At this time 60 (38%) were still providing care; the remaining 98 (62%) had yielded their role to formal institutional care, on average 11.2 months previously.Results: Caregiver characteristics significantly associated with yielding care included greater age, greater use of respite services, less social activities, poorer mental health and greater depression. Patient characteristics significantly associated with yielding care included greater dementia severity, lower activity level, and more frequent incontinence.Conclusion: Dementia severity was the key predictor of the decision to relinquish care. However, it is important to recognise the full range of factors that might indicate that a caregiver is in need of assistance and might be close to yielding the role.
Fear of crime and protective behaviours in older and younger adults: results of a community survey
Authors: Ranzijn Rob , Howells Kevin , Wagstaff Vicki 
Published: December 2008

Objectives: The aim of the present survey was to evaluate the extent of fear of crime and the use of protective behaviours in a community sample.Method: A total of 287 people aged between 16 and over 90 years in the local government area of Tea Tree Gully, South Australia, were surveyed by means of a short questionnaire.Results: The level of self‐reported fear of crime was moderately high but there were no differences between older and younger age‐groups. Women felt significantly less safe than men, at all ages. There was no apparent relationship between protective behaviours and fear of crime.Conclusions: Crime prevention programs may have reduced the incidence of crime but do not appear to have reduced the level of fear. Theoretical issues a*e also discussed.
The utility of the revised elderly persons disability scale (REPDS) in an Asian psychogeriatric patient group
Authors: Sim K. , Ng L.L. 
Published: December 2008

Objective: The Revised Elderly Persons Disability Scale (REPDS) was developed in Australia as a measure of disability in psychogeriatric patients. We sought to test its utility in an Asian psychiatric hospital.Method: The study involved 33 patients, 65 years or older, and admitted for the first time to an acute psychogeriatric ward at Woodbridge Hospital, SingaporeResults: The total REPDS score was significantly higher in male patients and in patients with dementia, due to there being more male patients with dementia and with dementia generating high disability Itvels. There was no significant difference in the total disability score between those referred from nursing homes and other sources. REPDS scores decreased during hospital stay, with decreases significant on several scales.Conclusions: The REPDS appeared to have utility in an Asian psychogeriatric unit in allowing disability components to be profiled, while scale score differences and changes over time indicated that the measure was sensitive to change. The measure identified the core problem areas in the disability profile of a psychogeriatric population and of sub‐groups with and without dementia, results which can assist clinical service delivery and staff training activities.
The probability of using an aged care home over a lifetime (1999–00)
Authors: Rowland Frieda , Liu Zhibin , Braun Peter 
Published: December 2008

Objective: This paper aims to project the probability of using an aged care home over a lifetime for Australian men and women at various ages.Method: This paper applies life table models [1] to 1999–00 residential aged care data to estimate the probability of using an aged care home over a lifetime. Results: Women are more likely than men to enter an aged care home for permanent care over their lifetime. Based on current patterns of use of aged care homes, a woman at age 65 faces a probability as high as 0.46 of using an aged care home for permanent care before her death compared with 0.28 for a man at the same age.Conclusion: A much larger proportion of older people than has often been recognised are likely to be admitted to an aged care home at some point in their lives.
The health and social needs of recently widowed older women in Australia
Authors: Feldman Susan , Byles Julie , Mishra Gita , Powers Jenny 
Published: December 2008

Objective: To identify women's health and social needs immediately following the death of their husband.Method: A cross‐sectional survey of 430 widowed women participating in the Australian Longitudinal Study on Women's Health was undertaken.Results: Surveys were returned by 340 women (79%) and 231 of these women had been widowed three years or less. While 82 % of the 231 women still lived in their own homes, 19% had moved house since being widowed for financial or social reasons. There were needs for legal services (44%), and home maintenance (55%). Assistance from medical practitioners included understanding (64%), support (38%) and information (23%). Thirty percent said they had received medication to assist their bereavement, and 30% had taken medication to help them sleep or “for their nerves” within the four weeks prior to survey. Most women (85%) felt they had maintained or increased their level of social contact since becoming widowed.Conclusion: Widowed women have broad needs for practical help and advice. Appropriate services for widowed women need to encompass the social context in which widowed women are attempting to reconstruct their lives.
Hearing and vision loss within residential care facilities ‐the need for improved service delivery
Authors: Flynn Mark C. , Kennedy Esther J. , Johns Julianne , Stanbridge Rachael 
Published: December 2008

Objective: To assess the level of hearing impairment within residential care facilities and to determine the efficacy of providing aural rehabilitation services within the facility.Method: 178 elderly residents participated in this project. The procedures included case history, pure‐tone screening, otoscopic examination, vision screening, hearing aid assessment and sentence identification.Results: Despite 87.1% of participants having a significant hearing impairment only 43.3% currently wore hearing aids. Linked to poor hearing aid use was the fact that 43.9% of hearing aids required some degree of maintenance. Otoscopic examination revealed 42.1% of ear canals to be occluded with cerumen to a degree that medical intervention was required. Sentence identification revealed the importance of aiding and access to contextual and visual cues (lip‐reading) for this population.Conclusions: This study confirms the high prevalence of hearing impairment amongst the elderly and makes a case for increased rehabilitation services being directed towards this population particularly in the areas of hearing aid maintenance, cerumen removal and delivery of communication skills training to residential care workers.
Ageing and the economy: costs and benefits
Authors: Ranzijn Rob , Harford Jane , Andrews Gary 
Published: December 2008

Objectives: The purpose of this study was to estimate the financial value of the productive contributions that older adults make to South Australian society and to compare this to the cost of maintaining them in good health and well‐being.Method: 391 participants aged between 65 and 101 years were interviewed over the telephone about the number of hours per week engaged in a comprehensive list of activities in the previous week, and half of the sample also completed a week‐long inventory of goods and services which they produced. The goods and services were converted into financial values using current market rates. The costs of health and aged care were obtained from official sources like the Australian Bureau of Statistics.Results: The total value of productive activities was estimated to be between A4.9 and A8.1 billion, and the value of work performed for other people was estimated at between 0.82 and 1.38bn (the South Australian older population is about 200,000). The cost of health and aged care was calculated to be about 1.8bn.Conclusions: It was concluded that older South Australians make essential contributions to society, contributions which have a very large economic value.