Make the first move!

This leaflet was developed in conjunction with Age Concern as part of the Actively Ageing Well initiative and provides information on physical activity aimed at retired people.

Sunbeds campaign poster

The Sunbeds campaign communicates the long term health effects of sunbeds, including skin cancer and pre-mature ageing, to sunbed users and the wider public. Particularly those under the age of 35 who are at an increased risk of developing melanoma skin cancer from sunbed use. For moreinformation on this issuevisit www.careinthesun.orgThe sunbeds campaign poster highlights that using a sunbed before the age of 35 increases your risk of skin cancer by up to 75%.

The Role and Future Development of the Meals-on-Wheels Service for Older People in Ireland

This report provides, for the first time, a snapshot of the meals-on-wheels service in Ireland and gives a unique insight into client and provider perceptions of the service. The research findings underline the dual importance of the service for clients, who noted that it is a vital source of both nutritious meals and social contact and connectivity to the wider community. From a supply side perspective, the research findings point to the wide organisational diversity that exists within the service and the critical role that volunteers play, as well as highlighting difficulties that many services currently experience.

A Cluster Randomised Controlled Trial to Evaluate a Policy of Making Hip Protectors Available to Residents of Nursing Homes

Objectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes. Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation. Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland. Participants: 40 homes in the intervention group (representing 1,366 occupied beds) and 87 homes in the control group (representing 2,751 occupied beds). Interventions: a policy of making hip protectors available free of charge to residents of nursing homes and supporting the implementation process by employing a nurse facilitator to encourage staff in the homes to promote their use, over a 72-week period. Main outcome measures: the rate of hip fractures in intervention and control homes, and the level of adherence to use of hip protectors. Results: there were 85 hip fractures in the intervention homes and 163 in the control homes. The mean fracture rate per 100 residents was 6.22 in the intervention homes and 5.92 in the control homes, giving an adjusted rate ratio for the intervention group compared to the control group of 1.05 (95% CI 0.77, 1.43, P = 0.76). Initial acceptance of the hip protectors was 37.2% (508/1,366) with adherence falling to 19.9% (272/1,366) at 72 weeks.Conclusions: making hip protectors available to residents of nursing and residential homes did not reduce the rate of hip fracture. This research does not support the introduction of a policy of providing hip protectors to residents of nursing homes.

Executive Summary: Healthy Diet v Dietary Supplementation: improving physical fitness and quality of life in older people

Older people have the greatest barriers (mostly in terms of ability/opportunity) to participating in exercise, and thus have the highest incidence of decreased ease in carrying out tasks of daily living. In an ageing society, the negative effects of age on skeletal muscle performance would be reduced if compliance to exercise regimens could be encouraged through simple advice on timing, duration, frequency, intensity, as well as appropriate nutritional interventions. Research into the impact of optimal nutrition/diet supplementation in young and/or athletic populations is extensive. Such data are scarce when considering healthy, older populations. We therefore propose to investigate the impact of healthy eating habits with or without supplementation, on exercise responsiveness. This protocol seeks to maximise training benefits on the neural muscular and tendinous complexes.

Acute coronary syndrome in the elderly

This editorial refers to the Management and 6-month outcomes in elderly and very elderly patients with high-risk non-ST-elevation acute coronary syndromes: In the well developed countries of the world, ischaemic heart disease is the prevailing cause of death among patients aged >65 years. In Europe, more than in other countries in the world, we will witness during the next few decades a dramatic surge of patients with ischaemic heart disease due to the progressive ageing of our population.

Age does not hamper the response to pulmonary rehabilitation of COPD patients

Pulmonary rehabilitation (PR) improves health status and exercise tolerance, but not respiratory function in patients with chronic obstructive pulmonary disease (COPD). The objective of the study was to identify predictors of improvement in the 6-min walked distance (6'WD) in elderly COPD patients after PR. Methods: this was a prospective observational study performed in an ambulatory rehabilitation setting. The authors enrolled 74 patients aged 65-83 years (mean: 74.2, SD: 4.4) with stable COPD in GOLD stage 3-4. About half (45.6%) of them had a basal O2 saturation of 90% or less. After a baseline multi-dimensional assessment, patients underwent a 20-session rehabilitation cycle including training of the upper and lower extremities, and respiratory exercises, along with education sessions.

Screening for memory disorders, dementia and Alzheimer's disease

Dementia and its most common cause, Alzheimer’s disease, affect memory and occur predominantly in the elderly. Dementia has become increasingly prevalent in the world as health has improved and life expectancy has increased. However, the fields of clinical care have not responded adequately to develop diagnostic tools and treatments for this rapidly increasing group of conditions. While scientists search for cures for the numerous causes of dementia, improvement of diagnostic measures are needed now and should begin with screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations.

Poverty, inequality and policy since 1997

This study examines the impact of policy on poverty and inequality in Britain since 1997This research shows what effect policies introduced since 1997 have had on reducing poverty and inequality. It offers a considered assessment of impacts over a decade:How did policies change, before 1997 and since then?What evidence is there of impacts on key outcomes?What gaps or problems remain or emerged?The study covers a range of subjects, including public attitudes to poverty and inequality, children and early years, education, health, employment, pensions, and migrants. It measures the extent of progress and also considers future direction and pressures, particularly in the light of recession and an ageing society.The research draws on extensive analysis of policy documents, analysis by government departments and research bodies, published statistics and evaluations, analysis of large-scale datasets, micro-simulation modelling and a long-running qualitative study with residents of low-income neighbourhoods.��

In-depth assessment delivers the verdict on the Government�۪s promise of a more equal society

An independent and detailed expert analysis of a decade of reforms (published 25 February) takes up the challenge made by Peter Mandelson in 1997 to “judge us after ten years of success in office. For one of the fruits of that success will be that Britain has become a more equal society.����”Commissioned by the Joseph Rowntree Foundation, the study, by a team led by LSE’s Centre for Analysis of Social Exclusion, shows sharp contrasts between different policy areas. Notable success stories include reductions in child and pensioner poverty, improved education outcomes for the poorest children and schools, and narrowing economic and other divides between deprived and other areas.But health inequalities continued to widen, gaps in incomes between the very top and very bottom grew, and poverty increased for working-age people without children.����In several policy areas there was a marked contrast between the first half of the New Labour period and the second half, when progress has slowed or even stalled.John Hills, one of the leaders of study, said, “Whether Britain has moved towards becoming a ‘more equal society’ depends on what you look at, and when. Where clear initiatives were taken, results followed. But as the growth of living standards slowed, even well before the recession, and public finances tightened, momentum seems to have been lost in several key areas.”Kitty Stewart added, “The government can take heart from achievements such as the reduction in child poverty up to 2004.����Recent data show that by then, child well-being in the UK had begun to move up the European league table from its dismal showing at the start of the decade that formed the basis of UNICEF’s damning 2007 report. But even with improved figures, Britain was still left with one of the highest rates of child poverty out of the 15 original EU members, and the latest figures show it had increased again by 2006/7.”����The study concludes that the decade from 1997 was favourable to an egalitarian agenda in several ways: the economy grew continuously; the government had large majorities and aspired to create more equality; and public attitudes surveys suggested pent-up demand for more public expenditure. But that environment now looks very uncertain, not just in the near future, but also in the longer term.����Fiscal pressures from an ageing society could further constrain resources available for redistribution, and public attitudes towards the benefit system have hardened while support for redistribution has declined.Hills added, “The 1980s and 1990s showed that hoping that rapid growth in living standards at the top would ‘trickle down’ to those at the bottom did not work.����The period since 1997 has shown that gains are possible through determined interventions, but they require intensive and continuous effort to be sustained.”JRF Chief Executive Julia Unwin added, “We know the potential impact the deepening recession will have on those already living in poverty. This book provides an important, timely and comprehensive assessment of where we are and what remains to be done.”

Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment

Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function.��Eleven studies of aerobic physical activity programmes for healthy people over the age of 55 years have been included in this review. Eight of these 11 studies reported that aerobic exercise interventions resulted in increased fitness of the trained group and an improvement in at least one aspect of cognitive function. The largest effects were on cognitive speed, auditory and visual attention. However, the cognitive functions which improved were not the same in each study and the majority of comparisons yielded no significant results.��The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness.

Inequalities in Old Age: The impact of the recession on older people in Ireland, North and South CARDI Grants

Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthAbout the research:This research, led by Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast, was carried out with funding from CARDI’s Grants Programme Call 2. The purpose of the study was to analyse the impact of the recession on older people in Northern Ireland (NI) and the Republic of Ireland (ROI) and the extent to which inequalities within the older population have been affected by the economic crisis.Research Brief:This brief, authored by CARDI staff, is based on the findings of the research project and also contains additional information of interest.Research Team:Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast - lead researcher;Dr Francesca Lundstr̦m, Research Consultant;Dr Demi Patsios, Policy Research Consultant;Sarah Machniewski, Researcher;David Taylor, Chartered Accountant and Management Consultant;Dr Maureen Lyons, Research Manager, School of Social Justice, UCD.Methodology and availability of data:Several methods were used in the research, including:�� a review of relevant literature;����a detailed analysis of many databases relevant to older people’s incomes and lives;��building a model to assess the impact of the recession on older people;surveys of financial advisers in voluntary, private and public sectors;��six focus groups, three each in NI and RoI.Availability of data:Despite the huge amount of information which is officially collected and published in NI and RoI, very little is directly comparable. ��The development of a mechanism to encourage the production of more comparable data North and South would be very beneficial.��For example, this study identified a basket of 25 factors that can be used to compare the living standards of older people in NI and RoI and to monitor changes in future yearsTo access the full report please click on the following link:Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthPlease find the presentation from the launch below:Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.��������

Inequalities in old age - old news or new debate: Presentations

On October 20th, 2010, CARDI hosted an event entitled��'Inequalities in old age - old news or new debate?’. The event marked the launch of a CARDI funded research report Inequalities in Old Age: the impact of the recession on older people in Ireland, North and South��and the launch of a discussion paper prepared for CARDI by Dr. Maria Pierce and Dr.��Virpi Timonen, Trinity College Dublin��Theories of Ageing and Approaches to Welfare in Ireland, North and South [summary]. The event also featured a number of other presentations. Please find a selection of the presentations from the day below:Theories of Ageing: Lenses for Understanding, Signposts for Reforming Social Protection in Old Age by Dr Virpi Timonen, Director of SPARC and Dr Maria Pierce, Research Fellow, Trinity College Dublin.Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.Pensions and Older Women by Dr Aine N�_ L̩ime, Programme Co-ordinator, ICSG (Irish Centre for Social Gerontology), NUI Galway.����

Dementia, lesbians and gay men: Alzheimer's Australia

This paper was commissioned by Alzheimer's Australia to promote an informed discussion about the issues affecting lesbians or gay men with dementia or caring for someone with dementia. It addresses the issues associated with the interaction between service providers and lesbian and gay men with dementia and their family carers, including the complexity of family relationships and barriers that may affect care provision and quality of life.The focus of this paper is on lesbian and gay seniors, including their same-sex partners. Not all people with dementia are seniors; however younger lesbians and gay men living with dementia may have a number of similar concerns and needs to those of lesbian and gay seniors. This paper also includes information about the needs of younger lesbians and gay men who are supporting a heterosexual family member living with dementia.Some issues and concerns identified in this paper are shared by transgender people, as well as additional specific issues such as the impact of medical interventions on ageing, including surgical changes and hormone treatments over a long period of time. This paper encompasses the needs of those members of the transgender community to the extent to which they identify themselves as gay or lesbian, but does not address the specific needs of transgender people.This paper seeks to contextualise the issues involved and inform readers by way of discussion and case examples.Full paper available at: http://www.apo.org.au/node/23373

Interventions to achieve long-term weight loss in obese older people

Purpose: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group. Design: systematic review and meta-analysis. Data sources: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE. Study selection: we included studies with participants�۪ mean age 60 years and mean body mass index 30 kg/m2, with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus. Data extraction: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis. Results: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1���0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: ���0.36 mmol/l (95% CI ���0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50���0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study. Conclusions: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people. ��Keywords: obesity, older, weight loss, meta-analysis, elderly, systematic review��