Valoració qualitativa de la salut oral d'una població institucionalitzada de la tercera edat

La construcció cultural i social de la salut/malaltia oral i del dolor associat en residents de la tercera edat. Què entenen i què significa per a ells la salut oral?

Who Cares? A comparison of informal and formal care provision in Spain, England and the USA

This paper investigates the prevalence of incapacity in performing daily activities and the associations between household composition and availability of family members and receipt of care among older adults with functioning problems in Spain, England and the United States of America (USA). We examine how living arrangements, marital status, child availability, limitations in functioning ability, age and gender affect the probability of receiving formal care and informal care from household members and from others in three countries with different family structures, living arrangements and policies supporting care of the incapacitated. Data sources include the 2006 Survey of Health, Ageing and Retirement in Europe for Spain, the third wave of the English Longitudinal Study of Ageing (2006), and the eighth wave of the USA Health and Retirement Study (2006). Logistic and multinomial logistic regressions are used to estimate the probability of receiving care and the sources of care among persons age 50 and older. The percentage of people with functional limitations receiving care is higher in Spain. More care comes from outside the household in the USA and England than in Spain. The use of formal care among the incapacitated is lowest in the USA and highest in Spain.

Onnistunut vanheneminen ja vanhuuden muuttuvat mielikuvat

Kirjoitus on käännetty ja muokattu versio professori Marja Jylhän Successful Ageing -symposiumissa pitämästä englanninkielisestä esitelmästä "Rethinking successful aging : the changing images of old age"

El significado de las ocupaciones en las personas mayores-jóvenes: algunas tendencias

Con la llegada del nuevo paradigma del “envejecimiento activo” planteado por la Organización Mundial de la Salud (OMS, 2002), estamos asistiendo a una nueva manera de enfocar el progresivo envejecimiento de la población. Este enfoque trata de fomentar la consecución de una esperanza de vida saludable y libre de discapacidad, gracias a la promoción de políticas y programas cuyos objetivos principales se centran en la independencia y en la autonomía a lo largo del proceso de envejecimiento. Acorde con este enfoque pensamos que las ocupaciones significativas son una buena herramienta para mantener la autonomía de estas personas al fomentar la prevención y la promoción de su salud, motivo por el cual desarrollamos este estudio. Los objetivos principales del presente estudio son conocer y comprender que ocupaciones adquieren un significado y satisfacción personal en las personas mayores-jóvenes, que han concluido su etapa laboral, que cuentan con buena salud y condiciones psicofísicas favorables y que viven de manera autónoma en la comunidad, así como explorar también si se establece en estas personas alguna vinculación entre las actividades que eligen desarrollar en la actualidad con su perfil e historia ocupacional previa. Por último, este estudio pretende conocer el tipo de gestión que cada persona prefiere para llevar a cabo las actividades cotidianas que les son más significativas, a partir de los contextos en los que se inscribe. El marco teórico se desarrolla a partir de la conceptualización aportada por diversos autores sobre el envejecimiento activo y la ciencia de la ocupación. La metodología utilizada es de carácter cualitativo, enfocado desde un paradigma constructivista. Los resultados del estudio muestran que se inicia tímidamente un cambio de tendencias en la elección y el significado que las personas mayores-jóvenes atribuyen a sus ocupaciones. Muestran también que las ocupaciones elegidas como más significativas por estas personas mantienen una vinculación con las que ya realizaban con anterioridad a la jubilación, con su historia o perfil 6 ocupacional previo. Y finalmente demuestran que el tipo de gestión que eligen para efectuarlas influye en la elección del entorno donde las llevan a término.

Rakkautta, kumppanuutta, hoivaa vai vaivaa? : leskien uudelleenavioituminen keski-iässä ja vanhuudessa

Abstract: Love, companionship, care or trouble? Remarriage of widows and widowers in middle-age and in old age

Dietary restriction affects lifespan but not cognitive aging in Drosophila melanogaster.

Summary Dietary restriction extends lifespan in a wide variety of animals, including Drosophila, but its relationship to functional and cognitive aging is unclear. Here, we study the effects of dietary yeast content on fly performance in an aversive learning task (association between odor and mechanical shock). Learning performance declined at old age, but 50-day-old dietary-restricted flies learned as poorly as equal-aged flies maintained on yeast-rich diet, even though the former lived on average 9 days (14%) longer. Furthermore, at the middle age of 21 days, flies on low-yeast diets showed poorer short-term (5 min) memory than flies on rich diet. In contrast, dietary restriction enhanced 60-min memory of young (5 days old) flies. Thus, while dietary restriction had complex effects on learning performance in young to middle-aged flies, it did not attenuate aging-related decline of aversive learning performance. These results are consistent with the hypothesis that, in Drosophila, dietary restriction reduces mortality and thus leads to lifespan extension, but does not affect the rate with which somatic damage relevant for cognitive performance accumulates with age.

Indeterminate test results of T-SPOT.TB performed under routine field conditions

Interferon-gamma release assays for the diagnosis of tuberculosis (TB) can give indeterminate results. The prevalence of indeterminate test results (ITRs) among T-SPOT.TB tests was assessed. A retrospective analysis of samples processed in 2005 was performed. ITRs were assessed by age, sex, immunosuppression, distance to the laboratory and season. A subgroup of tests performed for specific indications (contact tracing, migrants with positive tuberculin skin test, TB suspects and immunosuppression) were analysed separately. Of a total of 1,429 tests, 49 (3.4%) were indeterminate. ITRs were significantly associated with old age (>75 versus 5-75 yrs; odds ratio (OR) 7.97, 95% confidence interval (CI) 3.968-15.438) and the season during which samples were transported (autumn and winter versus spring and summer; OR 3.47, 95% CI 1.753-7.514). The incidence of ITR was 302 (2.0%) among TB contacts, 75 (1.6%) among immigrants, 156 (3.0%) in TB suspects and 32 (3.0%) among immunosuppressed patients. Sex, young age and distance to the laboratory were not associated with the rate of ITR. Of the 13 tests with ITR that were repeated, 10 gave a clear positive or negative result. Indeterminate test results with T-SPOT.TB under routine conditions were infrequent and more common in individuals aged >75 yrs than in children and younger adults. The incidence of indeterminate test results was low and similar among healthy tuberculosis contacts, immigrants with a positive tuberculin skin test, tuberculosis suspects and the immunosuppressed. The conditions of transportation may influence the incidence of indeterminate test results.

Vocally disruptive behavior (VDB) in the institutionalized elderly: A naturalistic multiple case report.

Employing a naturalistic multiple case study approach, we investigated the current clinical practice in the treatment and care of VDB among a convenience sample of 85 patients cared for in specialized old age psychiatric clinics and nursing homes in French and German-speaking Switzerland. We wished to clinically characterize VDB patients, to identify common approaches used to treat VDB in everyday practice, and to explore how the efficiency of the interventions employed was judged by the responsible carers. Data were collected by means of a questionnaire. Most patients with VDB in this study had dementia, of whom 75% had at least one current or premorbid psychiatric disorder and 25% had premorbid personality disorder. A majority of patients received multiple psychosocial care interventions that were often judged to be effective, but the potential of psychosocial interventions is underused. Many patients did not receive psychotropic medication specifically targeted at VDB, but about 70% of all prescriptions were judged to have positive effects. Premorbid psychiatric and personality disorders or traits are likely candidates to be entered into the etiopathogenic equation of VDB and set a new frame for approaches used to treat these underlying disorders.

Residència de la tercera edat al carrer Almogàvars, Santa Coloma de Gramanet

Award-winning

Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.

BACKGROUND: Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. METHODS: Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. RESULTS: The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. CONCLUSIONS: A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.

Turvapuhelin vanhuutta rakentamassa

Summary: Safety telephone as an element of constructing old age

Asociaciones entre la red social y la discapacidad al comienzo de la vejez en las ciudades de Madrid y Barcelona en 2005

La pérdida de autonomía a edades avanzadas no se asocia únicamente con el envejecimiento sino también con características del entorno físico y social. Investigaciones recientes han demostrado que la red social, la integración social y la participación, actúan como predictores de la discapacidad en la vejez. El objetivo de este trabajo es nalizar el efecto de la red social sobre el nivel de autonomía(en términos de discapacidad instrumental y básica) en etapas iniciales de la vejez.

Protective effects of social networks on disability among older adults in Spain

The loss of autonomy at advanced ages is not only associated with ageing, but also with the characteristics of the physical and social environment. Recent investigations have shown that social networks, social engagement and participation act like predictors of disability among the elderly. The aim of this study is to determine whether social networks are related to the development and progression of disability in the early years of old age. The source of data is the first wave of the survey "Processes of Vulnerability among Spanish Elderly", carried out in 2005 to a sample of 1 244 individuals. The population object of study is the cohort aged 70 to 74 years in metropolitan areas (Madrid and Barcelona) and not institutionalized. Disability is measured by the development of basic activities of daily life (ADL), and instrumental activities of daily life (IADL). The structural aspects of the social relationships are measured through the diversity of social networks and participation. We used the social network index (SNI). For each point over the SNI, the risk of developing any type of disability decreased by 49% (HR = 0.51, 95%CI = 0.31-0.82). The SNI was a decisive factor in all forecasting models constructed with some hazard ratios (HR) that ranged from 0.29 (95%CI = 0.14-0.59) in the first model to 0.43 (95%CI 0.20-0.90) in the full model. The results of the present study showed a strong association between an active social life, emotional support provided by friends and confidents and disability. These findings suggest a protective effect of social networks on disability. Also, these results indicate that some family and emotional ties have a significant effect on both the prevalence and the incidence of disability.

The ‘Dys-Appearing’ Body in Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough?

If the old body is usually read as a synonym of fragility and upcoming illness, even though not the case for most elderly citizens, the reality is that the longer we live, the increased probability of being affected by different illnesses cannot be eluded or denied. In Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough? the reader is invited to participate in the day-to-day routines of two aged female protagonists, as well as to empathize with their inner feelings as they go through their last life stage. In fact, their ‘dys-appearing’ bodies, marked by their respective terminal illnesses, force these characters to grow closer to those around them and to accept the help of their families and friends, despite their desire to keep their free will and independence until the very end. The analysis of the two novels within the framework of ageing studies aims to show the contradictions existing between a growing ageing society and the negative cultural connotations of old age in Western society and the need to revise them.