Background: In South Africa there data is lacking on the health of the older population. This study aims to report on actions taken by general practitioners on abnormal blood pressure, blood glucose and osteoporosis screen identified by registered nurses, conducting home based visits to older clients. Methods An agency piloted the Comprehensive geriatric assessment (CGA) tool in an urban affluent population. In this cross sectional secondary study analysis, 465 participants aged 60 years and over had a nurse visit in their homes and a subsequent General Practitioner (GP) visit. The prevalence of specific geriatric problems was assessed as well as the frequency of initiated procedures by the GP. This study will focus on initiated actions by the General Practitioners in response to abnormal blood pressures, blood glucose, and osteoporosis screen. Results Frequency tables were utilised to identify prevalence of the abnormal blood pressures, blood glucose and osteoporosis screen. . Abnormal blood pressures were detected (230/465, 49%) of the subjects , the GP initiated actions on only 15/465 (3.2%) of clients. Abnormal blood sugars were detected 106/465 (23%) of the GP initiated actions on 23/465 (5%) of clients. Clinical risk factors for the development of osteoporosis were detected in 252 /465 (54%) subjects GP initiated actions on 11/465 (3%) Conclusion This study explored the relationships between comprehensive geriatric assessment and subsequent GP actions and found using the CGA in this population will be successful in identifying abnormal health findings which will enable intervention. However, due to challenges in the communications and marketing of this service, GP’s were not well informed of their role and did not act on majority of the abnormal findings detected by nurses / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Bibliography: leaves 249-260. / xvii, 260, [35] leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Systematically explores the relationship between medications, dry mouth and dental caries in a longitudinal study of older people. / Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 1999

Made available in DSpace on 2014-06-11T19:32:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-10-18Bitstream added on 2014-06-13T19:02:36Z : No. of bitstreams: 1 000741106.pdf: 794237 bytes, checksum: e87e28cbf8a97fe80c7a35ad7831b962 (MD5) / Em países em desenvolvimento, como o Brasil, idoso é o indivíduo com idade a partir de 60 anos. Esses indivíduos apresentam características próprias da idade devido a mudanças fisiopatológicas, dentre elas destaca-se a anemia e a disfunção renal. Sabe-se que as prevalências dessas alterações aumentam com o envelhecimento, entretanto, poucos estudos avaliaram a relação entre a insuficiência renal e anemia em idosos assintomáticos. Com o objetivo de se avaliar essa associação foram estudados 178 idosos atendidos no CAIMI da zona oeste de Manaus/Am. A presença ou não de anemia foi avaliada pelo nível de hemoglobina arbitrado pela OMS. A função renal foi avaliada pela taxa de filtração glomerular (TFG), estimada pela a fórmula de CKD-epi cistatina. Foi realizada análise univariada para associações entre variáveis demográficas, clínicas e laboratorial com a presença de anemia e a seguir, aplicado o modelo de regressão logística para a presença de associações independentes. A frequência de anemia encontrada no corrente trabalho foi de 14%, sendo a maioria do tipo normocítica e normocrômica. As características socioeconômicas e de comorbidades analisadas (diabetes, hipertensão, fumo, etilismo) nos idosos com anemia foram semelhantes as dos idosos sem anemia, portanto, essas condições não influenciaram no desenvolvimento da anemia, neste estudo. Foram observadas diferenças significativas entre os indivíduos anêmicos e não anêmicos para a pressão arterial diastólica, glicose, creatinina, uréia, albumina, eritropoetina, ferritina, proteina C reativa, citocinas pró-inflamatórias e taxa de filtração glomerular. Dos idosos com anemia quase a metade apresentou taxa de filtração glomerular menor que 60 mL/min/1,73m2, demonstrando uma frequência de 44% de disfunção renal nos idosos com anemia deste estudo. Na análise de regressão logistica a anemia foi significativamente associada com a... / In developing countries such as Brazil, the elderly are every individual from age 60. Such individuals present particular characteristics regarding their age due to pathophysiological alterations, notably including anemia and kidney dysfunction. The prevalence of such alterations are known to increase with the ageing process, nonetheless, only few studies have evaluated the relationship between renal failure and anemia in asymptomatic elderly. Through the objective of assessing such association, 178 elderly patients served at CAIMI in the West of Manaus/Am were studied. The presence or absence of anemia was assessed through the by hemoglobin level standardized by WHO. The renal function was assessed through the glomerular filtration rate (GFR), estimated by the CKD-epi cystatin formulation. A univariate analysis was carried out for associations among demographic, clinical and laboratory variables with the presence of anemia and the applied to the logistic regression model for the presence of independent associations. The anemia frequency found for this study was of 14% mostly of the normocytic and normochromic kinds. The socio-economic and comorbidities characteristics analyzed (diabetes, hypertension, tobacco, alcoholism) in elderly with anemia were similar to what presented in elderly without anemia, therefore, for this study, such conditions do not have influence on the development of anemia. Meaningful differences were found between anemic and non-anemic individuals for diastolic blood pressure, glucose, creatinine, urea, albumin, erythropoietin, ferritin, C-reactive protein, pro-inflammatory cytokine and glomerular filtration rate. Almost half of the elderly with anemia presented glomerular filtration rate lower than 60 mL/min/1.73m2, demonstrating a frequency of 44% of kidney dysfunction for the elderly with anemia in this study. The logistic regression analysis reveals that anemia was meaningfully ...

D.Litt. et Phil. / Hypertension amongst older adults is one of the highest indices of prevalence in the general population, both in the United States and in South Africa. Due to this high 'indices in South Africa, it has. a tendency to develop into malignant hypertension, resulting in high indices of morbidity and mortality. Seniors South Africans, mainly Black South Africans (more than elsewhere in the world), face severe indices of morbidity and mortality as a result of uncontrolled, untreated or poorly treated hypertension. For this reason, the HELPS Project (Hypertension, Exercise and Lifestyle Program for Seniors) at San Diego State University was replicated in the South African context to determine wbetherit would show similar differential effects. The initial findings of this study suggest that exercise and physical activity has a significant effect on blood pressure in elderly hypertensives. There was a lowering of blood pressure, as well as reduction in some of the antihypertensive medication. The results indicated that all forms of exercise tend to lower blood pressure in older hypertensives. Very little difference was noted between groups who did only stretching and calisthenics exercise, slow walking, or brisk aerobic walking. This was attributed to a so-called "threshold effect" by the projectleader Dr J. Martin. The results of this study was in keeping with the findings of the HELPS (San Diego) Project. The study proved that both aerobic and anaerobic exercise alike provide elderly people with benefits in both physiological and psychological aspects of functioning. More specifically, where drug therapy may cause health risks and negative side effects, exerciseoften leads to overall benefits and enhances quality of life in the elderly. The overall results of the study was generally upheld and in keeping with the proposed hypotheses

Aging has long been associated with a (i) systematic bias in both attention and in memory towards positive stimuli compared with negative, and (ii) a gradual increase in self-reported positive affect and decrease in negative affect in daily life. The findings are considered to be paradoxical, because as people get older, the neural mechanisms responsible for cognitive functioning undergo gradual decline in structure and function. This dissertation aims to break down the mechanisms of aging that allow for the age-related changes in emotion to prevail in the midst of other ongoing aging processes. Here, I present three papers that address age-related changes in emotional experience. Study 1 showed that age predicted feeling more positive and less negative when faced with a pandemic that disproportionality impacted older adults. Study 2 showed that while younger adults are better than older adults at regulating negative images, all participants rely on similar brain regions for accomplishing the same regulatory goals. Study 3 showed that when given the explicit goal to up or down-regulate positivity, older adults do not have an advantage over younger adults. One way to explain these results is that there are age-related distinctions between the way participants behave in lab-based studies and when they are observed in daily life, which account for inconsistencies between my three studies.

B. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Background: In a group of the elderlies (older person) in Sharpeville, Gauteng, South Africa, the majority live in poverty with a poor nutritional status. This makes them susceptible to develop infectious diseases as well as the risk of Chronic Diseases of the Lifestyle (CDL) such as cancer, diabetes, heart attack, obesity and hypertension. One of the most constant features of aging is the progressively elevated levels of coagulation factors such as FVII, fibrinogen, and impairment of fibrinolysis might play a role in the ageing process. These are associated with increased susceptibility to Cardiovascular diseases (CVD) commonly found. An association between elevated levels of FVII and R353Q polymorphism has been established as a risk factor for CVD. This genetic polymorphism R353Q characterizes the substitution in the exon 8 of the FVII gene of guanine-to-adenine, which results in the replacement of arginine (R) by glutamine (Q) in codon 353 of the F7gene. Objectives: The aim of this study was to evaluate the prevalence of R353Q polymorphism in correlation with haemostatic markers within an urban elderly community in South Africa. Method: This study was ethically approved, and it is an experimental research design on the prevalence of R353Q polymorphism in correlation with homeostatic status (Factor VII, Fibrinogen and PAI-1). The study was done in a black elderly population living in the Vaal triangle region of Sharpeville, attending a day care center, who gave consent to participate in the study. A purposely selected sample of 102 subjects, who met the inclusion criteria were used. The homeostatic status was measured by factor VII and fibrinogen measuring coagulation and PAI-1 measuring fibrinolysis. Results: The prevalence of R353Q genetic polymorphism was established in 14.5% of the sampled population. The prevalence of the RQ (AG) genotype was determined in the sample population with 6.5 % of elevated factor VII levels, 7.8% of increased fibrinogen levels (coagulation) and 10.5 % of decreased levels of PAI-1. The R(A) allele, was detected in 1.3% of the sampled population of normal levels of FVII, fibrinogen and PAI-1. The dominant allele G(Q) was present in 76.3% of the sampled population. An imbalance haemostatic marker was established in the sampled population with 61% of elevated levels of factor VII, 70% of elevated levels of fibrinogen and 88% had a decreased level of PAI-1. Conclusion: The prevalence of R353Q polymorphism was established in this sample population, having an imbalanced haemostatic status of hypercoagulation (factor VII and fibrinogen) and imbalance fibrinolysis (PAI-1), which are strongly associated to CVDs.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Made available in DSpace on 2014-08-13T14:50:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-08-19Bitstream added on 2014-08-13T18:00:23Z : No. of bitstreams: 1 000760134.pdf: 1725206 bytes, checksum: 222454d9746b364842305efbfe5f9a10 (MD5) / A Organização Mundial de Saúde (OMS) define como idoso todo indivíduo com mais de 60 anos de idade. Atualmente no Brasil os idosos são aproximadamente 15 milhões de pessoas e apesar de viverem mais, apresentam maiores condições crônicas devido ao declínio da maioria das funções orgânicas, inclusive do sistema imunológico, aumentando a susceptibilidade e a maior incidência de doenças infecciosas. As hepatites virais tem distribuição mundial e são doenças infecciosas que apresentam características epidemiológicas, clínicas e laboratoriais distintas. Há uma estimativa de que 350 milhões de pessoas sejam portadores crônicos do vírus da hepatite B (VHB) ao redor do mundo e, embora menos prevalente que a hepatite B, o vírus da hepatite C (VHC) é a causa mais comum de hepatite crônica com cerca de 180 milhões de indivíduos infectados. Embora os conhecimentos a respeito da patogênese, curso e tratamento das hepatites virais crônicas tenham avançado nos últimos anos, há ainda pouco conhecimento sobre seu curso e tratamento na população idosa, especialmente no Brasil, justificando a relevância deste estudo, cujo objetivo geral é avaliar a prevalência de hepatites virais crônicas B e C na população idosa residente no município de Botucatu-SP. Foi realizado com 1029 idosos cadastrados na UNIMED, nas Unidades Básicas de Saúde, Unidades de Saúde da Família, participantes de Centros de Convivência de Terceira Idade e residentes em instituições de longa permanência. Os voluntários, após assinarem o Termo de Consentimento Livre e Esclarecido (TCLE), foram submetidas a testes sorológicos para detecção do Anti-HBs, AgHbs e Anti HBc IgG, onde foram coletados 5ml de sangue através de punção venosa com seringa e agulha descartáveis. Para detecção do anti-VHC foram realizados testes sorológicos digitais (HCV Rapid Test Bioeasy®). A mediana de idade encontrada foi de 71 anos (65:78). A prevalência de ... / The World Health Organization (WHO) defines as elderly any person aged over 60 years old. Currently in Brazil the elderly are approximately 15 million people and although they live longer have more chronic conditions due to decline in most physiological functions, including immune system, increasing susceptibility and a higher incidence of infectious diseases. Viral hepatitis has a worldwide distribution and are infectious diseases that present epidemiological, clinical and laboratory differences. It is estimated that 350 million people are chronic carriers of hepatitis B virus (HBV) worldwide and, although less prevalent than hepatitis B, hepatitis C virus (HCV) is the most common cause of chronic hepatitis with about 180 million infected individuals. While the knowledge about the pathogenesis, course and treatment of chronic viral hepatitis have advanced in recent years, there is still little knowledge about their course and treatment in the elderly population, especially in Brazil, justifying the relevance of this study, whose general objective is to evaluate the prevalence of chronic viral hepatitis B and C in the elderly population living in Botucatu-SP. Was held with 1029 elderly enrolled in Basic Health Units, the Family Health Units, participants of Social Centers for Seniors and residents of long-term institutions. The volunteers, after having signed an informed consent (IC), were submitted for serological tests for the detection of anti-HBs, HBsAg and Anti HBc IgG, where 5 ml of blood were collected by venipuncture with syringe and disposable needle. For detection of anti-HCV digital serological tests were done (HCV Rapid Test Bioeasy®). Mean age was 72.01 years (± 8.19 years). The prevalence of HBsAg positive with elderly was 0,58% and of these, all showed results for HBeAg negative characterizing inactive chronic disease. For the Anti-HCV, prevalence was 1,94%, data in agreement with ...

M. Tech (Department of Biotechnology, Faculty of Applied and Computer Sciences) Vaal University of Technology. / Background: Cardiovascular diseases are one of the most common causes of death worldwide. This is not only a problem in developed countries, it is of major concern for public health in developing countries as well. Increased homocysteine is an independent risk factor for cardiovascular diseases. Nutritional deficiencies of folate, vitamin B6 and vitamin B12 are associated with hyperhomocysteinemia. MTHFR A1298C, a single nucleotide polymorphism, is similarly linked with higher concentrations of homocysteine. The aim of this study was to determine the prevalence of MTHFR A1298C in a black elderly population, along with folate, vitamin B6 and vitamin B12 and to evaluate the effect on homocysteine levels. Methodology: The research design was an observational cross-sectional study and was ethically approved. A total of 84 elderly who attend a day-care centre (also met inclusion criteria) were purposively selected. DNA was extracted and frozen on the day of blood collection. The MTHFR A1298C genotype was determined with real time PCR. Homocysteine, folate, vitamin B6 and vitamin B12 serum levels were detected with commercial assay kits. Results: Homocysteine was found to be elevated with a median of 17.78 µmol/L (interquartile range 13.98-21.03 µmol/L). Serum folate, vitamin B6 and vitamin B12 medians were in the normal range. Although, 5.95% and 22.62% of the population were deficient and possibly deficient for vitamin B12, respectively. MTHFR A1298C frequency was as follow: 89.29% (AA), 9.52% (AC) and 1.19% (CC), with no significant correlation (p>0.05) with homocysteine. Vitamin B12 correlated significantly with homocysteine levels. Conclusion: Vitamin B12 deficiency had an effect on homocysteine levels. Overall, nutritional deficiencies are not responsible for the hyperhomocysteinemia in this population. In conclusion from this study showed MTHFR A1298C frequency in black South Africans does not contribute to homocysteine as a risk factor for cardiovascular disease. Keywords: Cardiovascular disease, elderly, folate, homocysteine, MTHFR A1298C, vitamin B6, vitamin B12.

The proportion of HIV-positive people over the age of 50 is increasing rapidly in New York City. An estimated half of those living with HIV are over 50. While many are long-term survivors, reflecting the transformation of HIV from a life-threatening illness to a chronic disease—due to the advent of highly active antiretroviral therapy (HAART) in 1996—others are newly diagnosed or newly infected. However, relatively few studies have examined how older adults with HIV/AIDS are aging well, and whether these strategies are associated with a reduction in risk behaviors. To address these gaps, paper one, using a basic qualitative research methodology and constructivist grounded theory analysis approach, had two related objectives: (1) to explore the lived experience of men over 50 with HIV/AIDS in New York City; (2) to examine the ways in which individuals have aged successfully. Based on the findings of the aforementioned paper, paper two and paper three, using the Research on Older Adults with HIV/AIDS (ROAH) data set, determined if loneliness predicted condomless sex in the past three months and chemsex (paper 2) and if loneliness predicted a reduced CD4 count and substance use in the past three months. Using the three-paper model, the following dissertation sheds new insight into how older adults age well with HIV/AIDS but finds that loneliness does not predict negative health and risk behaviors in this group. The dissertation does, however, highlight other avenues for research, policy and practice based on the results.