29 resultados para Old age assistance.


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Several studies have assessed changes in frequency of -174 interleukin (IL)-6 single nucleotide polymorphism (SNP) with age. If IL-6 tracks with disability and age-related diseases, then there should be reduction, in the oldest old, of the frequency of homozgyous GG subjects, who produce higher IL-6 levels. However, discordant results have been obtained. To explore the relationship between this polymorphism and longevity, we analyzed individual data on long-living subjects and controls from eight case-control studies conducted in Europeans, using meta-analysis. There was no significant difference in the IL-6 genotype between the oldest old and controls (Odds Ratio [OR]=0.96; 95% C.I.: 0.77-1.20; p=0.71), but there was significant between-study heterogeneity (I(2)=55.5%). In a subgroup analyses when male centenarians from the three Italian studies were included, the frequency of the IL-6 -174 GG genotype was significantly lower than the other genotypes (OR=0.49; 95% C.I.: 0.31-0.80; p=0.004), with no evidence of heterogeneity (I(2)=0%). Our data supports a negative association between the GG genotype of IL-6 SNP and longevity in Italian centenarians, with males who carry the genotype being two times less likely to reach extreme old age compared with subjects carrying CC or CG genotypes. These findings were not replicated in other European groups suggesting a possible interaction between genetics, sex and environment in reaching longevity.

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Paraoxonase 1 (PON1) has been suggested as a plausible candidate gene for human longevity due to its modulation of cardiovascular disease risk, by preventing oxidation of atherogenic low-density lipoprotein. The role of the PON1 192 Q/R polymorphism has been analyzed for association with survival at old age in several populations, albeit with controversial results. To reconcile the conflicting evidence, we performed a large association study with two samples of 2357 Germans and 1025 French, respectively. We combined our results with those from seven previous studies in the largest and most comprehensive meta-analysis on PON1 192 Q/R and longevity to-date, to include a total of 9580 individuals. No significant association of PON1 192 Q/R with longevity was observed, for either R allele or carriership. This finding relied on very large sample sizes, is supported by different analysis methods and is therefore considered very robust. Moreover, we have investigated a potential interaction of PON1 192 Q/R with APOE epsilon4 using data from four populations. Whereas a significant result was found in the German sample, this could not be confirmed in the other examined groups. Our large-scale meta-analysis provided no evidence that the PON1 192 Q/R polymorphism is associated with longevity, but this does not exclude the possibility of population-specific effects due to the influence of, and interaction between, different genetic and/or environmental factors (e.g. diet).

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While twentieth century Caribbean literature in French (particularly post-Césaire) has generated a large body of criticism, writing from the nineteenth century has been largely neglected. This article begins by contextualising the Creole novel of the early nineteenth century in cultural and historical terms, before proceeding to an analysis of two novels published in 1835 by Martinican authors: Outre-mer by Louis de Maynard, and Les Créoles by Jules Levilloux. In the few studies that exist, these texts have been read in opposition to each other in terms of their portrayal of the (male) mulatto; Levilloux has generally been considered the more progressive writer in this regard. However they are in fact in striking harmony in their depiction of the black mother, a figure (in both senses, as her physiognomy is central in her portrayal) who has until now been overlooked. For both writers, the elderly black mother is an abject and wretched creature. She has necessarily to be shown to be repulsive, filthy and morally hideous in old age in order to counteract the fascination she provokes, and to embody a phantasised repellent to the desires of the white male.

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Aims and objectives. This study explored decision-making experiences of patients with stage 5 chronic kidney disease when opting for conservative management of their renal failure.

Background. Dialysis is an invasive treatment, and for some older patients, there is an associated treatment burden of dialysis-related symptoms. An alternative choice is conservative management, but little is known about those who make this decision and how they are supported through the process.

Design. Qualitative practitioner research study.

Method. Data were generated from nine patients' naturally occurring clinic consultations with a renal clinical nurse specialist between May 2010 - July 2010. Interviews were transcribed verbatim and findings fed back at three multi-disciplinary meetings to check for relevance and resonance. Common themes were identified and codes applied.

Results. Patients reported age and having to travel three times a week to hospital for dialysis as reasons not to opt for treatment. Others felt well without dialysis not wanting to upset the 'status quo' or to burden loved ones. Most felt equipped to make the decision following explanation and discussion with the clinical nurse specialist in the renal clinic.

Conclusions. Patients opting for conservative management give numerous reasons for this including old age, travel limitations, feeling well without dialysis and not wanting to be a burden, but appear content with their decision. One-to-one discussions with the clinical nurse specialist appear helpful during the decision-making process presenting an opportunity for advancing nursing roles in the chronic kidney disease service.

Relevance to clinical practice. Understanding patients' reasons for refusing dialysis assists in supporting until death. There is an opportunity for developing nursing practice to meet the multi-faceted needs of this group.

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Inflammation is thought to play an important role in the development of cognitive decline and dementia in old age. The interleukin-1 signalling pathway may play a prominent role in this process. The gene encoding for interleukin-1 beta-converting enzyme (ICE) is likely to influence IL-1 beta levels. Inhibition of ICE decreases the age-related increase in IL-1 beta levels and may therefore improve memory function. We assessed whether genetic variation in the ICE gene associates with cognitive function in an elderly population. All 5804 participants of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) were genotyped for the 10643GC, 9323GA, 8996AG and 5352GA polymorphisms in the ICE gene. Cross-sectional associations between the polymorphisms and cognitive function were assessed with linear regression. Longitudinal associations between polymorphisms, haplotypes and cognitive function were assessed with linear mixed models. All associations were adjusted for sex, age, education, country, treatment with pravastatin and version of test where appropriate. Subjects carrying the variants 10643C and 5352A allele had significantly lower IL-1 beta production levels (P

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Several studies have assessed changes in frequency of -174 interleukin (IL)-6 single nucleotide polymorphism (SNP) with age. If IL-6 tracks with disability and age-related diseases, then there should be reduction, in the oldest old, of the frequency of homozygous GG subjects, who produce higher IL-6 levels. However, discordant results have been obtained. To explore the relationship between this polymorphism and longevity, we analyzed individual data on long-living subjects and controls from eight case-control studies conducted in Europeans, using meta-analysis. There was no significant difference in the IL-6 genotype between the oldest old and controls (Odds Ratio [OR]=0.96; 95% C.I.: 0.77-1.20; p=0.71), but there was significant between-study heterogeneity (I2=55.5%). In a subgroup analyses when male centenarians from the three Italian studies were included, the frequency of the IL-6 -174 GG genotype was significantly lower than the other genotypes (OR=0.49; 95% C.I.: 0.31-0.80; p=0.004), with no evidence of heterogeneity (I2=0%). Our data supports a negative association between the GG genotype of IL-6 SNP and longevity in Italian centenarians, with males who carry the genotype being two times less likely to reach extreme old age compared with subjects carrying CC or CG genotypes. These findings were not replicated in other European groups suggesting a possible interaction between genetics, sex and environment in reaching longevity.

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Introduction.– Sibling relationships have been described as intimate,
congenial, loyal, apathetic or hostile but little is known about
sibling relationships in very old age.Weasked nonagenarian brothers
and sisters from the EU-funded Genetics of Healthy Ageing
(GeHA) project whether they had felt supported by having a living
sibling to have better coping abilities.
Methods and results.– Nonagenarian siblings were a convenience
sample from four countries from the GeHA study–Italy, Poland,
N Ireland, Finland. All were consented willing participants. Most
male/female dyads demonstrated healthy respect for each other’s
opinion and their sibling relationship fits the “loyal” type, though
with a clear sense of independence.Noneof the eight female/female
nor the one male/male dyad seemed to fit the “intimate” description;
two might be described as “apathetic”, while the other two
seemed to show aspects of family “loyalty”, alongside other traits
perhaps best described as “congenial”. There were apparent different
cultural influences across Europe with siblings in Italy and
Poland more likely to report supportive siblinghood, compared to
sibling pairs/trios in Finland or N Ireland where self-resilience and
independence seemed more common. Polish and Italian nonagenarians
often felt supported by their religious faith and church.
Conclusions.– In general, nonagenarian siblings most often demonstrated
loyal family relationships, which may have helped each
other’s coping and survival mechanisms. However, there was
widespread evidence of tolerance for individual decision-making.
Perhaps rather, these 90-year-olds survive because they are
resilient and independent and don’t need to depend on each other!

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The area of mortality modelling has received significant attention over the last 20 years owing to the need to quantify and forecast improving mortality rates. This need is driven primarily by the concern of governments, professionals, insurance and actuarial professionals and individuals to be able to fund their old age. In particular, to quantify the costs of increasing longevity we need suitable model of mortality rates that capture the dynamics of the data and forecast them with sufficient accuracy to make them useful. In this paper we test several of those models by considering the fitting quality and in particular, testing the residuals of those models for normality properties. In a wide ranging study considering 30 countries we find that almost exclusively the residuals do not demonstrate normality. Further, in Hurst tests of the residuals we find evidence that structure remains that is not captured by the models.

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OBJECTIVES: To determine the proportion of Republic of Ireland 35-44 and 65+ year-olds currently satisfying the criteria for a classic shortened dental arch (SDA) of 20 anterior teeth.

RESEARCH DESIGN: Secondary analysis of data collected in the 2000/02 epidemiological survey of the oral health of Irish adults.

CLINICAL SETTING: Participants underwent a clinical oral examination in health board dental clinics and completed a detailed interview pertaining to dental and general health.

PARTICIPANTS: The analysis is based on a random sample of adults, aged 35 to 44 years (n = 978), and 65 years and older (n = 714).

MAIN OUTCOME MEASURES: The SDA was measured as 20 teeth in the mouth in the positions normally described as from the left second premolar to the right second premolar in each arch.

RESULTS: Only one of the 35-44 year-olds and none of the 65+ year-olds had teeth in their mouths in positions normally described as a classic SDA. However, of the 35-44 year old age group only five patients who had at least a premolar dentition of 20 contiguous teeth had been provided with a removable denture compared to one patient from the 65+ years group.

CONCLUSIONS: Very few older patients in the Republic of Ireland have a SDA based on the measure used. However, very few have been provided with removable dentures where they already possess at least a premolar dentition of 20 contiguous teeth. Suggested reasons for this may include limitations of the data recorded, patient preferences and economic factors.

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Toothwear is commonly observed in dentate older patients and may be physiological or pathological in nature. Toothwear can be caused by abrasion, attrition, erosion or a combination of aetiologies. Where treatment is required, a number of options exist, including the use of adhesive materials and fixed and removable prosthodontics.

CLINICAL RELEVANCE: With patients retaining natural teeth into old age, physiological and pathological toothwear amongst dentate older patients is an increasingly common presentation.

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The proportion of adults over the age of 60 years is expanding rapidly across European Union countries, including the Republic of Ireland. As the older population has grown faster than the total population, the proportion of older persons relative to the rest of the population has increased considerably (Figure 1). This trend mirrors the arrival of the “baby boomer� generation into early old age and will have wide ranging effects on social, political and economic spheres as well as presenting significant challenges for healthcare delivery and public healthcare policy.

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This article uses feminist scholarship to investigate ‘the elderly mystique’ – which contends that the potential of old age is masked by a set of false beliefs about ageing (i.e. ageism) which permeate social, economic and political life (Cohen, 1988).
The article presents a theoretical model which explores the extent to which institutionalised ageism shapes the trajectory of life after 60. The hypothesis under-pinning the model is simple: The challenge for ageing societies is not the average age of a given population but, rather, how age is used to structure economic, social and political life. An inter-disciplinary framework is used to examine how biological facts about ageing are used to segregate older from younger people, giving older people the status of “other”; economically through retirement, politically through assumptions about ‘the grey vote’ and socially through ageist stereotyping in the media and through denial and ridicule of the sexuality of older people. Each domain is informed by the achievements of feminist theory and research on sexism and how its successes and failures can inform critical investigations of ageism.
The paper recognises the role of ageism in de-politicising the lived experience of ageing. The paper concludes that feminist scholarship, particularly work by feminists in their seventies, eighties and nineties has much to offer in terms of re-framing gerontology as an emancipatory project for current and future cohorts of older people.

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Due to population ageing, Japan and Germany have to extend individuals´ working lives. However, disability increases with old-age. Workplace accommodation is a means to enable disabled individuals to remain productively employed. Drawing on qualitative interview data, this paper explores how School Authorities in these countries use workplace accommodation to support ill teachers, a white-collar profession strongly affected by (mental) ill-health. It furthermore explores how such measures influence older teachers´ career expectations and outcomes. It finds that even though the institutional contexts are similar, career options and expectations vary, though with similar (negative) outcomes for national strategies to extend working lives.

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How much should an individual invest in immunity as it grows older? Immunity is costly and its value is likely to change across an organism's lifespan. A limited number of studies have focused on how personal immune investment changes with age in insects, but we do not know how social immunity, immune responses that protect kin, changes across lifespan, or how resources are divided between these two arms of the immune response. In this study, both personal and social immune functions are considered in the burying beetle, Nicrophorus vespilloides. We show that personal immune function declines (phenoloxidase levels) or is maintained (defensin expression) across lifespan in nonbreeding beetles but is maintained (phenoloxidase levels) or even upregulated (defensin expression) in breeding individuals. In contrast, social immunity increases in breeding burying beetles up to middle age, before decreasing in old age. Social immunity is not affected by a wounding challenge across lifespan, whereas personal immunity, through PO, is upregulated following wounding to a similar extent across lifespan. Personal immune function may be prioritized in younger individuals in order to ensure survival until reproductive maturity. If not breeding, this may then drop off in later life as state declines. As burying beetles are ephemeral breeders, breeding opportunities in later life may be rare. When allowed to breed, beetles may therefore invest heavily in "staying alive" in order to complete what could potentially be their final reproductive opportunity. As parental care is important for the survival and growth of offspring in this genus, staying alive to provide care behaviors will clearly have fitness payoffs. This study shows that all immune traits do not senesce at the same rate. In fact, the patterns observed depend upon the immune traits measured and the breeding status of the individual.