<p> Baby boomers are a large population rapidly transitioning into older adulthood. As the proportion of older adults will be higher in the coming decade than at any previous point in history, the aging of the population has placed successful aging at the forefront of public health and health care efforts. Baby boomers have disproportionately low rates of successful aging and physical activity, even though physical activity is known to contribute to successful aging. Existing exercise programs are ineffective as evidenced by the widespread access to but poor participation in exercise programs. Archery exercise is a relatively unexplored, yet promising, physical activity intervention for baby boomers. This exploratory and qualitative case study was the first to explore the role of archery exercise in promoting successful aging through physical activity among baby boomers. A purposeful sample of 12 non-institutionalized baby boomers living in a Midwest community were enrolled in a six-week archery exercise program. A total of 8 females and 3 males with varying physical activity levels completed the program. Information from post-program, semi-structured interviews were triangulated with findings from a literature review. Key themes emerging from the interpretive analysis included physical benefits, mental benefits, positive social experience, appropriateness and benefit for older adults, and motivation to continue. Physical benefits included upper body strength, balance, and improvement to individual limitations. Mental benefits included concentration, movement control, confidence, and relief from individual mental challenges. Participants believed archery exercise is appropriate and beneficial for older adults because of the enjoyment, low intensity, rewarding, shareable, individualized, and multiple component aspects. The study demonstrates archery exercise is a promising physical activity intervention for baby boomers in this community. Future research is needed to explore the impact of archery exercise in other communities and among other older adult populations. Awareness about what constitutes physical activity is needed to encourage participation in exercise programs. Collaboration between public health, sporting, and community stakeholders is needed to deliver additional community-based, multiple component exercise programs to baby boomers. Archery exercise may be an effective physical activity intervention to address population aging concerns, although more research is needed to justify this claim.</p>

<p> Alzheimer&rsquo;s disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen&rsquo;s behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged &ge; 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, and negative binomial regressions determined if there was a relationship between independent and dependent variables. Results indicated a statistically significant relationship between age, gender, health insurance type, and presence of comorbidities factors and healthcare utilization patterns among older Puerto Ricans with AD. From the results, opportunities were identified for further research and changes in professional practices in order to initiate discussions and action plans to improve services coordination for older Puerto Ricans with AD. Findings might impact social change by inspiring modifications to the public health infrastructure. These modifications may lead to enhanced disease management support, promoted social justice, and increased resources to improve healthcare access and quality of care, and overall enhancement of health outcomes, for Puerto Ricans living with AD.</p><p>

<p> <b><u>Background</u></b></p><p> Osteoporosis affects an enormous number of people of both sexes, and osteoporosis-related fractures are costly to treat. Yet osteoporosis is poorly managed and managed differently by sex and residential setting. Therefore, this study aimed to assess the difference in medication use, adherence, and outcomes between men and women and among women, between long-term care (LTC) facility and community residents.</p><p> <b><u>Methods</u></b></p><p> Using the 2006-2008 Chronic Condition Data Warehouse 5% national random sample of Medicare beneficiaries, this retrospective study identified elderly 70 years and older with osteoporosis enrolled in Medicare Part A, B, and D stand-alone prescription drug plans from January 1, 2006 through December 31, 2008, or death. Use of bisphosphonates, calcitonin, parathyroid hormone and selective estrogen receptor modulator was tracked over the 3-year period. Treatment effectiveness was measured as hazard of fracture after treatment initiation. Modified Poisson regression was used for analyzing the effect of sex and residential status on osteoporosis medication use. Cox proportional hazard model was used for analyzing the effect of medication use and adherence on fracture risk.</p><p> <b><u>Results</u></b></p><p> The samples included 96,408 females, 8,465 males and 90,956 females, and 2,083 males and 10,262 females enrolled in Medicare Part D for aims 1, 2, 3, respectively. Utilization was lower among LTC residents (RR 0.89, 95% CI [0.87, 0.91]). Bisphosphonates were prescribed less often to LTC residents (RR 0.79, 95% CI [0.75, 0.83]) compared to among community residents. Prevalence of osteoporosis medication use in men was substantially lower than that in women (25.2% vs. 44.3% in 2006). Good adherence decreased the hazard of fracture in both sexes (HR 0.86, 95% CI [0.75, 0.99]). No difference in either treatment or adherence effect on fracture between men and women existed.</p><p> <b><u>Conclusion</u></b></p><p> Prevalence of osteoporosis medication use is low in elderly women enrolled in Part D whether community dwelling or LTC residents. Elderly men are undertreated for osteoporosis compared to elderly women. There is strong confounding by indication in the effect of osteoporosis medications on the risk of fracture; however, good adherence reduces the risk of fracture. There is no evidence for heterogeneity in treatment response among men and women.</p>

<p>Functional Status in Hospitalized Senior Patients: Measurement, Prediction Models, and Cost-Saving Opportunities By Margaret A. Kornuszko-Story Abstract Seniors have declining functional ability which is made worse from immobility during hospitalization. Accountable providers have underestimated how addressing patient function can reduce costs and improve quality by reducing length of stay, readmissions, and discharges to skilled nursing facilities (SNF). This study conducted a budget impact analysis to determine potential cost savings associated with an early patient function assessment and mobility intervention. Binary logistic regression was employed to explore whether prediction models for discharge disposition and 30-day all-cause hospital readmissions can be improved with the addition of Ambulatory Measure Post-Acute Care (AM-PAC) predictors. Semi-structured interviews were conducted with process stakeholders to understand how function measurement and patient mobility can be supported in acute care facilities. Results indicated that acute care facilities in this Network would save a net of $6.4 million; and the Accountable Care Organization by reducing discharges to SNFs and readmissions would generate $4.6 million and $4.5 million respectively. AM-PAC Mobility and Self-Care scores are good predictors of discharge destination (C = 0.890), and while not significant predictors of readmission, improved the C-statistic from 0.792 to 0.811. All interviewees (n=13) stated that a culture of mobility is an important aspect for an early patient assessment and mobility intervention.

<p> Health literacy among the elderly Hispanics is a problem for 44% who read at the lowest level due to issues with recognition, cognition, or vision. The purpose of this study was to determine the extent that elderly Hispanics have problems with medication adherence due to health literacy. The social cognitive theory was the framework for this study. Inclusion criteria consisted of being 65-75 years of age, and speaking and/or reading English and/or Spanish. Questionnaires from 156 individuals were completed in Cobb County/Atlanta GA and analyzed using multiple regression to determine the relationship between health literacy and medication usage. Medication adherence was the dependent variable and independent variables were gender, age, Hispanic origin, education, income, income means, health insurance, health literacy, and medication usage. Statistical significance was noted in medication adherence, health literacy, and working full-time. Results were based on the correct answers from health literacy questions, which showed an association between medication adherence and health literacy and a reduction in medication adherence problems among elderly Hispanics who worked full-time. These findings showed a significant association between medication adherence and health literacy level among elderly Hispanics. No medication adherence problems were noted among participants who had good health literacy, unlike participants with poor health literacy. A larger ethnic group may show a variation of problems in future studies. Implications for social change could include recommendations for the use of Spanish language hotlines and reading materials to provide care, knowledge, and medication information assistance.</p>

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 152-170).

No description available.

Thesis (M.P.H.)--University of Michigan, 1947. / Also issued in print.

Thesis (M.P.H.)--University of Michigan, 1947. / eContent provider-neutral record in process. Description based on print version record.

<p> Humans as far back as ancient history have been leveraging the physiological and psychological benefits of drumming to enhance health, access higher states of consciousness, and cultivate shared optimal experiences. It is understandable that the applied practice of drumming is now starting to permeate into mental fitness training research as a healthy alternative toward cross training the brain. Extensive surveys conducted in the United States show that 60% of individuals who are in middle age and older complain about their memory. This translates to approximately 80 million Baby Boomers reaching the age of memory decline. Furthermore, according to the UCLA research, the main factors necessary for a healthy brain lifestyle and to combat memory decline are physical activity, social engagement, mental challenges, and unfamiliar stimuli. Neurodrumming has incorporated these findings into a therapeutic intervention that targets brain health, emotional health, stress management, and social engagement, all of which help to prevent cognitive decline, and promotes mental performance. This study offers a meta-theoretical exploration to determine the comprehensiveness of Neurodrumming as a therapeutic mental fitness intervention for healthy aging, by applying Integral Theory as an epistemological framework.</p><p>