No / Visual impairment is an important risk factor for falls, but relatively little is known about how it affects stair negotiation. The present study determined how medio-lateral (ML) dynamics of stepping and single limb support stability when stepping up or down to a new level were affected by blurring the vision of healthy elderly subjects. Twelve elderly subjects (72.3±4.2years) were analysed performing single steps up and single steps down to a new level (7.2, 14.4 and 21.6cm). Stepping dynamics were assessed by determining the ML ground reaction force (GRF) impulse, lateral position of the centre of mass (CM) relative to the supporting foot (average horizontal ML distance between CM and CP during single support) and movement time. Stability was determined as the rms fluctuation in ML position of the centre of pressure (CP) during single support. Differences between optimal and blurred visual conditions were analysed using a random effects model. Duration of double and single support, and the ML GRF impulse were significantly greater when vision was blurred, while the average CM¿CP ML distance and ML stability was reduced. ML stability decreased with increasing step height and was further decreased when stepping down than when stepping up. These findings indicate that ML balance during stepping up and down was significantly affected by blurring vision. In particular, single limb support stability was considerably reduced, especially so during stepping down. The findings highlight the importance of accurate visual feedback in the precise control of stepping dynamics when stepping up or down to a new level, and suggest that correcting common visual problems, such as uncorrected refractive errors and cataract may be an important intervention strategy in improving how the elderly negotiate stairs.

No / . Early detection of cognitive decline in the elderly is important because this may precede progression to Alzheimer's disease. The aim of this study was to see whether sensitive neuropsychological tests could identify pre-clinical cognitive deficits and to characterize the cognitive profile of a subgroup with poor memory. Methods. A neuropsychological test battery was administered to a community-dwelling sample of 155 elderly volunteers who were screened with CAMCOG at enrolment (mean age 74·7 years). The battery included tests of episodic memory, semantic and working memory, language and processing speed. Results. Episodic memory test z scores below 1 S.D. from the cohort mean identified 25 subjects with `non-robust¿ memory performance. This group was compared to the remaining `robust memory¿ group with a General Linear Model controlling for age, IQ, education and gender. Test performance was significantly different in all tests for episodic and semantic memory, but not in tests for working memory, processing speed and language. CANTAB paired associates learning and spatial recognition tests identified the highest percentages of those in the `non-robust memory¿ group. Processing speed partialled out the age effect on memory performance for the whole cohort, but the `non-robust memory¿ group's performance was not associated with age or processing speed. Conclusions. Sensitive neuropsychological tests can detect performance below the norm in elderly people whose performance on MMSE and CAMCOG tests is well within the normal range. Age-related decline in memory performance in a cohort of the elderly may be largely due to inclusion within the cohort of individuals with undetected pre-clinical Alzheimer's disease or isolated memory impairment.

No / This paper examines key challenges and strategies for including older people with dementia in an ethnographic study of quality of life in institutional care settings. The methods of interview and observation are described in relation to meeting four research challenges: verbal communication impairment, memory loss, decision-making capacity, and emotional disposition. A range of strategies for privileging the voice of the person with dementia is recommended which include: using different methods bespoke to each person with dementia; greater flexibility and time; preliminary meetings with the person with dementia; discussions with formal and informal carers; and research training. The researchers also conclude that the use of observation and interview are 'meaning-making occasions' which are qualitatively different but equally valuable for understanding quality of life in care settings.

No / This study utilises a rarely examined biomechanical parameter – the free vertical moment to determine age-related differences in rotational kinetics of the body about the vertical-axis when stepping down from a stationary position. Ten older and 10 young adults completed step-downs from three heights. Free vertical moment impulse and peak during step-initiation double-support and the subsequent step-execution phase, and vertical-axis pelvis angular displacement and velocity at instant of landing were compared. The free vertical moment during double-support was directed away from the intended leadlimb side, producing a change in vertical-axis rotational momentum that moved the lead-limb in a forwards- medial direction about the stationary support/trailing limb during the subsequent step-execution phase. The free vertical moment during step-execution was directed towards the lead-limb side and acted to slow/halt the body’s vertical-axis rotation away from lead-limb side. Free vertical moment impulse and peak during double-support were similar between groups (P > 0.05), but during step-execution were significantly reduced in older adults (P = 0.002). As a result older adults had greater verticalaxis pelvis angular displacement and velocity at instant of landing (directed away from lead-limb side), with significant (P < 0.001) group-by-step height interactions indicating that differences between groups became more pronounced with increasing step-height. These findings highlight that older adults were unable to exert the same vertical-axis control during single-support as young subjects did. Findings also highlight that the analysis of free vertical moment data can be a useful biomechanical tool to highlight age-related differences in how steps/stairs are negotiated.

Natural disasters disproportionately affect older adults, resulting in worse outcomes compared to younger age groups. This highlights the need for effective interventions to reduce mortality rates among the elderly population during natural disasters. This literature review explores the various strategies aimed at protecting and supporting the elderly population by searching through the databases PubMed and Google Scholar. The search strategy included key terms related to the elderly population, strategies, and natural disasters. Articles meeting the inclusion criteria are reviewed to identify common strategies utilized in reducing elderly mortality during disasters. The findings highlight various categories of strategies, including education and awareness programs, community-based initiatives, infrastructure improvements, and technological advancements. These interventions demonstrate potential for enhancing outcomes among older adults during disasters. The implications of these findings for policy development, disaster preparedness, and future research are also discussed.

BACKGROUND: Hearing loss is the third most prevalent chronic condition faced by older adults and has been linked to difficulties in speech perception, activities of daily living, and social interaction. Recent studies have suggested a correlation between severity of hearing loss and an individual's cognitive function; however, a causative link has yet to be established. One intervention option for management of the most severe to profound hearing loss in older adults is cochlear implantation. We performed a review to determine the status of the literature on the potential influence of cochlear implantation on cognition in the older adult population. METHODS: Over 3800 articles related to cochlear implants, cognition, and older adults were reviewed. Inclusion criteria were as follows: (1) study population including adults > 65 years, (2) intervention with cochlear implantation, and (3) cognition as the primary outcome measure of implantation. RESULTS: Out of 3,886 studies selected, 3 met inclusion criteria for the review. CONCLUSIONS: While many publications have shown that cochlear implants improve speech perception, social functioning, and overall quality of life, we found no studies in the English literature that have prospectively evaluated changes in cognitive function after implantation with modern cochlear implants in older adults. The state of the current literature reveals a need for further clinical research on the impact of cochlear implantation on cognition in older adults.

<p> </p><p>We are aware of the fact that elderly people suffering from alcoholism doesn’t stop their be-haviour the day they turn 65. But when they do turn 65, they might become a case for social workers who only handle cases regarding people over 65, and we wanted to find out if they have any experience of working with elderly who have problems related to alcohol. We de-cided that a group interview, a focus group, would be the best method when our purpose was to try discovering their own experiences, so we interviewed seven social workers in the Stockholm area. The interview was based on four main questions: the social workers experi-ences, difficulties in the cases, how to handle the difficulties and how the social workers talk about these cases among themselves. These questions were analysed with the theory of social construction, Bourdieu´s theory of doxa and Goffman´s theory of stigma. The analyse showed that the social workers had experience but that they didn’t want more recourses, they wanted a cooperation with social workers who specializes on clients with alcohol related problems. They currently focus on the individual, not the alcohol issue which we believe might be a problem in the future.</p>

Much of the developed world is experiencing an aging population. This requires society to adapt to take care of a growing elderly population and improve their quality of life. Today, mobile systems are available that makes it possible to monitor and improve health (m-health). Even though these systems could be immensely helpful for the elderly population, this has not been the primary demographic for the current m-health systems. This case study aimed at examining how persuasive technology (technology for changing behavior and/or attitude) can be used to promote usage of m-health applications by the elderly. For this purpose, a theoretical framework for supporting m-health systems is proposed. This framework consist of persuasive technology (for motivation and support for fulfillment of human needs), knowledge of elderly issues in interacting with mobile interfaces, smartphone usability heuristics and the Plan-Do-Study-Act (PDSA) cycle (to support goalsetting and incremental progress). To determine how persuasive technology can be used to motivate elderly and find effective strategies for this purpose, the case study examined health behavior, motivations for healthy behavior, attitude to health, general goal setting behavior, needs, preferences, technological experience and self-efficacy, as well as usage of m-health systems using qualitative and participatory methods. Methods used included semi-structured interviews, future workshop, revolutionary rapid prototyping and usability evaluation. The findings of the interviews and the future workshop suggested the primary motivation for healthy behavior was derived from social aspects. Thus, the most effective persuasive strategies for the elderly likely target their need for social belonging and socialization. Based on the findings, an interactive prototype was developed. The prototype proposed an m-health application with self-monitoring that implemented an elderly community around healthy behavior, with opportunities to earn digital rewards and challenge other users to competition. The interactive prototype was then used in a usability evaluation to gauge its usability by the elderly and revised in higher fidelity according to their feedback.

A longevidade é um processo inevitável, irreversível e de extrema importância para a civilização. A população de idosos de 80 anos ou mais tem aumentado, demandando atenção e compromisso por parte dos profissionais de saúde. Conhecer o processo de envelhecimento envolve o estudo de vários fatores, dentre eles, o estilo de vida que pode estar relacionado a maior longevidade desses idosos muito velhos. Portanto, o objetivo geral deste estudo foi avaliar o estilo de vida e sua associação com a longevidade de idosos muito velhos do município de Aracaju-SE. Metodologia: estudo descritivo-exploratório, transversal, com abordagem quantitativa. O cenário de estudo foi o município de Aracaju, uma das capitais do nordeste que apresentou crescimento acelerado do número de idosos nos últimos 40 anos. Os critérios de inclusão para a população foram: idosos cadastrados nas Unidades de Saúde da Família, de ambos os sexos, com 80 anos ou mais, que deveriam atingir o mínimo de 19 pontos no Mini-Exame do Estado Mental (MEEM). Foram realizadas entrevistas estruturadas por meio de três formulários: um com dados do MEEM; outro com dados socioeconômico e demográfico, de saúde, de nutrição e de longevidade e o terceiro com dados do Perfil do Estilo de Vida Individual (PEVI)-Pentáculo do Bem-Estar. Para a análise dos dados, foi aplicada a estatística descritiva. Para a análise da associação entre PEVI e perfil socioeconômico e demográfico, de saúde, de nutrição e de longevidade, bem como para o conhecimento da consistência interna do formulário PEVI, foram utilizados testes estatísticos. Resultados: Foram entrevistados 524 idosos muito velhos, a faixa etária variou de 80 a 108 anos, com prevalência de idosos entre 80 a 85 anos, predominância do sexo feminino, baixa escolaridade, mais da metade eram viúvos, aposentados, católicos, residentes em casa própria. Com relação ao PEVI Pentáculo do Bem-estar - a maioria obteve referência para um bem-estar positivo para os determinantes nutrição, comportamento preventivo, relacionamento sociale controle do stress. Somente o determinante atividade física apresentou predominância de índice negativo para o bem-estar. Houve associação estatisticamente significativa com a longevidade para as variáveis: idade, escolaridade, consumo diário de verduras e legumes, de feijão, de hortaliças, ingestão de água, de leite integral ou semi-desnatado, de suco natural, chá e de café, a condição de saúde e ter plano de saúde. Quanto aos fatores de longevidade que tiveram associação significativa temos: avós/bisavós que viveram mais de 80 anos, contato pessoal familiar e atividade social. Os resultados do PEVI apresentaram adequada consistência interna, com medidas psicométricas confiáveis para avaliar o estilo de vida de idosos nesta faixa etária. Conclusões: A aplicação do instrumento PEVI em uma faixa etáriaaté então pouco explorada mostrou a possibilidade de identificar e diagnosticar o perfil do estilo de vida dos idosos muito velhos, permitindo estabelecer uma associação entre os componentes do pentáculo com a longevidade. Dessa forma, os resultados proporcionaram o perfil do estilo de vida desses idosos que podem constituir uma base de informações para que os profissionais de saúde realizem intervenções de saúde, seja no cuidado, orientação e planejamento, buscando proporcionar um envelhecimento saudável e de qualidade. / Longevity is an unavoidable process, irreversible and of extreme importance to civilization. The population of over-80 elderly has increased, demanding attention and commitment of health professionals. Learning about the aging process involves the study of several factors, among them, lifestyle which can be related to greater longevity of these very aged elderly. Therefore, the general objective of this study was to evaluate lifestyle and its association to longevity or very old elderly of Aracaju-SE (Brazil). Methodology: descriptive-exploratory study, cross-sectional, quantitative approach. Study setting was the City of Aracaju, one of the capitals of Brazilian Northeast which showed a rapid growth in the number of elderly in the last 40 years. Inclusion criteria to population were: elderly registered in Family Health Unities, from both sexes, over-80, 19 or more points in Mini-Mental State Examination (MMSE). Structured interviews were performed by means of three forms: one with MMSE data; another with socioeconomic, demographic, health, nutrition and longevity data and a third one with Individual Lifestyle Profile data, Welfare Pentacle (PEVI). To data analysis, descriptive statistics was applied. To analysis of association between PEVI and socioeconomic, demographic, nutrition and longevity profile, as well as knowledge about internal consistence of the PEVI form, statistical tests were used. Results: 524 very old elderly were interviewed, their age group between 80 and 108 years-old, with 80-85 elderly prevalence, female predominance, low schooling, most of them widowers, retired, catholic, living in own home. On what concerns PEVI Welfare Pentacle most of them obtained reference of a positive welfare for the determiners of nutrition, preventive behavior, social relationship and stress controlling. Only determiner physical activity presented predominance of negative index to welfare. There was statistically significant association to longevity to the variable: age, schooling, daily consumption of vegetables, beans and greenery, water, whole or semi-skimmed milk, natural juice, tea and coffee intake, the healthy condition and having health insurance. On what concerns longevity factors which had significant association, we have: great-grandparents and grandparents which lived 80 years or more, personal family contact and social activity. PEVI results showed appropriate internal consistency, with reliable psychometric measures to assess elderly lifestyle in this age group. Final thoughts: PEVI instrument application to an age group until then underexplored showed the possibility of identifying and diagnosing very old elderly lifestyle, allowing the establishment of an association between the pentacle components and longevity. This way, results provided the lifestyle profile of these elderly which can constitute a basis of information for health professionals to perform health interventions in care, orientation or planning, targeting to provide a healthy and quality aging.

O envelhecimento populacional é, hoje, fenômeno mundial consequente a um crescimento mais elevado da população idosa com relação aos demais grupos etários. O declínio da habilidade física e mental freqüentemente associado ao envelhecimento tem implicações sociais, econômicas e com a saúde pública. O presente estudo realizado com idosos residentes no município de Batatais-SP, objetivou estudar algumas características dos idosos, a prática de exercício físico e a cognição. Pesquisou-se 400 idosos de ambos os sexos, com idade igual ou superior a 60 anos, utilizando-se um questionário estruturado;o Questionário de Atividade Física Internacional (IPAQ)-versão curta e para a avaliação cognitiva o mini-exame do estado mental (MEEM). Os dados receberam tratamento estatístico para observações de associações de variáveis através de regressão logística utilizando o procedimento PROC SURVEYLOGISTIC do programa SAS versão 9. Os resultados mostraram que 161 (40,2%) eram do sexo masculino e 239 (59,8%) do feminino. A idade média encontrada foi de 72 anos (DP= 8,3). A maioria, 62,7% dos idosos possuía baixa escolaridade com até 4 anos de estudo. Dos idosos 224(56%) morava com companheiros, sendo maior este percentual entre os homens (72,7%). Entre os que moravam com parentes verificou-se uma associação com déficit cognitivo (OR = 2,13 [1,27; 3,58]). Eram sedentários 86,7% dos idosos, sendo que as mulheres (15,5%) praticavam mais exercícios do que os homens (9,9%).Apenas 4,7% dos idosos foram classificados como ativos e 8,5% como irregularmente ativos. O uso de medicamentos foi mais freqüente entre as mulheres (89,2%). Dos idosos 40,5% de ambos os sexos não faziam nenhuma atividade intelectual. As mulheres tiveram maior participação nas atividades em grupo (58,7%). Nas atividades individuais 86,7% dos idosos realizavam de 1 a 2 atividades. A maior freqüência de déficit cognitivo foi encontrada nas mulheres (45,6%) (OR = 1,64 [1,10; 2,45]) e nos idosos com idade de 80 anos e mais 61,9% (OR = 3,26 [1,92; 5,51]). Os resultados indicam a importância da adoção de um estilo de vida saudável, com prática de exercício físico e em outras atividades de integração, que podem melhorar a qualidade de vida promovendo a autonomia dos idosos para a realização das atividades do cotidiano. / The population aging is a present worldwide phenomenon, consequence of a higher growth on the old age population compared to the other age groups. The decrease of mental and physical ability usually linked to aging has social and economical implications and with public health. The current study made with the elderly who live in Batatais-São Paulo, aims at studying some characteristics of the elderly, the practice of physical exercise and cognition. A group of 400 elderly of both genders with the age of 60 or over was researched, by using a structured questionnaire; the international physical activity questionnaire (IPAQ) short version and for the cognitive evaluation the mini exam of the mental state (MEEM) was applied. The data were statistically analyzed for observations of associations of variables through logistic regression using the procedure PROC SURVEYLOGISTIC of the SAS program version 9. The results obtained showed that 161 (40,2 %) were male and 239 (59,8%) were female. The average age was 72 years old (DP= 8,3). Most of them, 62,7% of the elderly had low academic level up to 4 years of study. Most of the elderly lived with partners, 224 (56%), and the highest percentage was among men (72,7). Among the ones who lived with relatives, an association with cognition deficit was checked (OR= 2,13[ 1,27;3,58]). It was also observed that 86,7% of the elderly belong to the sedentary group and that the women (15,5%) practice more exercise than men (9,9%). Only 4,7% of the elderly were classified as active and 8,5% as irregularly active. The women are the ones who most use medicine (89,2%). From the elderly, 40,5% of male and female elderly dont have any kind of intellectual activity. The women have a greater participation in group activities (58,7%). Concerning to individual activities 86,7% of the elderly practice 1 or 2 activities. The most incidence of cognitive deficit is found among the women (45,6%) (OR= 1,64] 1,10;2,45]) and from the 80-year-old elderly on, 61,9%(OR=3,26]1,92;5,51]). The outcomes show that both the habit of a healthy way of living through the practice of physical exercises and in other group activities can enhance the life quality, this way promoting the old people more self confidence to the fulfillment of the everyday activities.