Use of geriatric assessment and screening tools of frailty in elderly patients with prostate cancer. Review

The management of prostate cancer in the elderly is a major public health concern in most countries. Currently, most prostate cancers are diagnosed in elderly males. The elderly population is very heterogeneous. Thus, the current challenge is to identify better those individuals for whom specific screening tools and a Comprehensive Geriatric Assessment (CGA) would be beneficial. On the basis of the recommendations of the Prostate Cancer Working Group in the International Society of Geriatric Oncology, older patients with prostate cancer should be managed according to their individual health status and not by their age. CGA is the best tool for determining the health status of an older patient. In this article, we sought to assemble all available evidence on the models of CGA and the prevalence of geriatric conditions in older patients with prostate cancer. We also discuss the feasibility of the most used screening tools in elderly patients, that is, the Vulnerable Elders Survey-13 (VES-13) and G-8 as screening tools in this group of patients.     

Physical activity and patient-reported outcomes: enhancing impact

Physical activity (PA) is beneficial for cancer survivors across the cancer trajectory. Evidence indicates physical and psychosocial benefits, and ultimately, enhanced overall quality of life, for individuals who are more versus less active (Semin Oncol Nurs 23:285–296, 2007; Cancer Epidemiol Biomarkers Prev 14:1672–1680, 2005; J Cancer Surviv 4:87–100, 2010). A number of recent reviews have been conducted that examine different patient or survivor populations and outcomes. In general, the findings across the reviews reveal potential positive associations between exercise (structured activity one engages in for the purposes of enhancing health-related fitness outcomes) and PA (any physical movement, including lifestyle types of activity) with both physical and psychological outcomes. It is important to note, however, that depending on the nature of the review and the types of studies included in the review, the strength of the findings (i.e., effect size) vary. Despite this overwhelmingly positive evidence for the benefits of PA, activity levels are very low among cancer survivors, with one study reporting only 22 % of survivors as active enough to achieve health benefits (Cancer 112(11):2475–2482, 2008). This suggests that we must begin to better understand the factors that impact the uptake and maintenance of PA among cancer survivors. These potential factors are important when considering the patient-reported outcomes to assess and can include timing (i.e., during or after treatment completion), characteristics of the cancer diagnosis and subsequent treatments (i.e., early vs. late stage cancers), and characteristics of the individual (i.e., older vs. younger).     

Anxiety and Depression: Implications for Older Adults

By the year 2030, it is projected that one in every three Americans will be 55-years-old or older. This age group is by far the fastest growing segment of the population. With the growing number of older adults, the importance of understanding aging and common disorders of later life is essential. In particular, anxiety and depression are among the most common problems in older adults. However, differentiating anxiety and depression at the mood, symptom, and syndromal levels has been a long-standing problem in psychopathology research. In addition to a growing need for research, clinicians will also need to take an active role in the development and implementation of treatment as the population of older adults increases. In particular, mental health service providers must become informed about the economic implications for older adults as the structure of health insurance continues to change.     

Anxiety and Depression: Implications for Older Adults

By the year 2030, it is projected that one in every three Americans will be 55-years-old or older. This age group is by far thefastest growing segment of the population. With the growing number of older adults, the importance of understanding aging and common disorders of laterlife is essential. In particular, anxiety anddepression are among the most common problems in older adults. However, differentiating anxiety and depression at the mood, symptom, and syndromal levels has been a long-standing problem in psychopathology research. In addition to a growing need for research, clinicians will also need to take an active role in the development and implementation of treatment as the population of older adults increases. In particular, mental health service providers must become informed about the economic implications for older adults as the structure of health insurance continues to change.     

How students evaluate university programmes for older people: A comparison between two models in Spain

This study examines how older students evaluate the University Programme for Older People (UPOP) they participate in, and how such evaluation might vary depending on the type of UPOP. The sample was made up of 257 older students (mean age = 67.6 years) and was gathered from two UPOP models, one structured as Older People Classrooms (134 participants) and the second one as University of Experience (123 participants). Participants completed a questionnaire evaluating different dimensions of the programme and two incomplete sentences to identify its weak and strong points. Overall, results suggest that older students are very satisfied with the educational experience. Apart from attracting a different profile of student (younger and more involved), University of Experience students seem to give more importance to methodological issues when compared to Older People Classroom counterparts. These results are discussed in the context of new strategies to improve university courses aimed at older people.     

Caring for older adults with bipolar disorder

Bipolar disorder is a recurrent, chronic mental illness that has a profound impact on the lives of patients and their families and may require extensive use of mental health services. Although bipolar disorder is often considered an illness of young people, the disorder is being recognized as more common in older adults than previously thought. Much more research needs to be done to understand the impact of aging on the course and treatment of bipolar disorder. Evidence-based interventions for treatment of this disorder in older adults must be developed. Mental health nurses can play a key role in enhancing medication adherence, implementing structured psychosocial interventions, and carrying out research to enhance diagnosis and treatment of older adults with bipolar disorder.     

THE PATRIARCHAL BARGAIN AND INTERGENERATIONAL CORESIDENCE IN EGYPT

This article examines variation in intergenerational coresidence among older women and men in Egypt using data from the WHO Collaborative Study on the Social and Health Aspects of Aging . Residence with sons and daughters-in-law is preferred, although residence with daughters and sons-in-law occurs because patrilocal endogamy is common. Whereas residence with sons and daughters declines with age among men, it declines then increases with age among women. Residence with sons-in-law is uncommon among older men and becomes more frequent with age among older women. Findings support the idea that women's exchange of kin-keeping tasks for protection from kin gives older women greater access to normative and alternative forms of intergenerational coresidence, even after accounting for differences in need.     

Subjective distress from trauma in older clients with severe mental illness

There is little research on older persons with severe mental illness (SMI) who have experienced trauma. We conducted an exploratory study with 174 community mental health clients with SMI who were 50 years of age or older (range 50–87; mean age 58) to examine the relationship between subjective distress related to six common traumas and post-traumatic stress symptoms while controlling for gender and other key psychiatric symptoms. With regression analysis, we found that of the six common traumas, only distress from unexpected loss of a loved one was significant. That factor accounted for the most variance in post-traumatic stress symptoms than all other factors in the model including gender, psychiatric symptoms of SMI, and other trauma. Gender and symptoms of psychosis were also significant in the model. Unexpected losses, particularly in older persons with SMI, can cause considerable emotional distress and could be related to post-traumatic stress symptoms. Practitioners should be vigilant in regularly screening older people with SMI for recent loss of loved ones and be prepared to address their distress with grief/bereavement counseling.     

The cooperative “family”

Health staus is of primary importance in determining the lifestyle of older persons, in contrast to other periods of life, in which socio-economic status is of major significance. Research is presented on an alternative living arrangement in Florida for the slightly dependent elderly, in which older persons share living facilities and other aspects of a common lifestyle. This comprises one set of realistic alternatives which can be workable, economical, energy-conserving, and fulfilling in terms of the quality of life.     

Dating Relationships in Older Adulthood: A National Portrait

Dating in later life is likely common, especially as the proportion of older adults who are single continues to rise. Yet there are no recent national estimates of either the prevalence or factors associated with dating during older adulthood. Using data from the 2005–2006 National Social Life, Health, and Aging Project, a nationally representative sample of 3,005 individuals ages 57–85, the authors constructed a national portrait of older adult daters. Roughly 14% of singles were in a dating relationship. Dating was more common among men than women and declined with age. Compared to non‐daters, daters were more socially advantaged. Daters were more likely to be college educated and had more assets, were in better health, and reported more social connectedness. This study underscores the importance of new research on partnering in later life, particularly with the aging of the U.S. population and the swelling ranks of older singles.     

DEPRESSION IN MATURE MARRIAGES: IMPACT AND IMPLICATIONS FOR MARITAL THERAPY

Recent reviews of MFT literature have shown a failure to address mental health issues of the aging. Chief among these issues is depression, one of the most common psychological disorders found in older people. Although the relationship between depression and aging is a well-researched topic, few studies approach this common problem from a systemic perspective. Using data from a national survey of preretirement- and retirement-aged couples, this paper discusses the association between depression and marital quality in mature marriages as well the possibility of mediating variables such as the personality construct hardiness. Implications for marital therapy with older couples experiencing depression and future research are discussed.     

Good personal finances or a strong social capital—on different life conditions of importance for an active life when becoming alone in old age

Becoming alone in old age can be a decisive life event that brings major changes depending on various causes as health status, financial resources, family situation, and available welfare services. This article discusses the situation of older people in Sweden who have transitioned from a two-person to single-person household in recent years and what impact this might have on their everyday lives. Through in-depth interviews with 18 older people, age 67–90, their experiences about life conditions and opportunities were examined. Findings showed large differences between the men and women. They all tried to live as they always had done and they used the same personal life strategies that they always had. But the men could live as before on their own financial merits, while the women needed assistance from children, grandchildren and the welfare system. Transportation options were central and clearly related to both private economy and social services available. Shortcomings in the welfare state's way of caring for the elderly were clearly uncovered. The gap between social policy promises of opportunities for autonomy and independence to live an active life in old age and the everyday reality for older people still seems to be wide.     

Parents of adults with developmental disabilities: Age and reasons for reluctance to use another caregiver

Parents of individuals with developmental disabilities differ in their expressed reluctance to use another caregiver depending on their age. Older parents, more than younger parents, reported a reluctance to use another caregiver because of financial reasons and the unavailability of qualified caregivers. The results suggest that elderly parents may be willing to leave their developmentally disabled child with someone else but they require financial assistance and education regarding program quality and availability.Jean L. Engelhardt is a Research Associate of the Family and Child Studies Center, Department of Home Economics and Consumer Sciences, at Miami University in Oxford, Ohio. Her current research is in the area of older parents of developmentally disabled children. Dr. Engelhardt received her Ph.D. in Psychology from Notre Dame.Dr. Lutzer is Assistant Professor of Educational Psychology and an Associate of the Family and Child Studies Center at Miami University in Oxford, Ohio. She is currently involved in research on the older parents of developmentally disabled children.Timothy H. Brubaker is Professor and Director of the Family and Child Studies Center, Department of Home Economics and Consumer Sciences, at Miami University in Oxford, Ohio. Dr. Brubaker holds a Ph.D. from Iowa State University and is currently conducting research on the older parents of developmentally disabled children.We express our gratitude to the Family Resource Services Program of the Butler County (Ohio) Board of Mental Retardation and Developmental Disabilities for their help, and to the Jacob G. Schmidlapp Trust of Cincinnati for financial support during the writing of this article.     

The Elderly's Perceptions of Nursing Home Sponsorship of Retirement Communities

A research study involving 350 healthy, middle-income seniors indicated that people of retirement age have very different expectations about a housing community depending upon the nature of the sponsoring organization - be it a specific well-known hotel chain, a respected local builder, or a local, not-for-profit nursing home. A nursing home sponsored community is seen, for example, as very friendly, very sensitive to the needs of older people, but only average in quality and average in price. Further, there are differences in perceptions among demographic sub-groups of this population.     

生态养老:养老服务中场所性的健康促进策略

老年人口占总人口比例以及提供健康服务成本的财政需求增加,正日益威胁着全球的稳定性。同时,这样的人口发展趋势也给传统的老年人健康服务供给带来挑战。本文以澳大利亚的案例为背景,论证在养老服务中运用场所性的健康促进能够给老年人创造更大的福利,缩短通常与年龄增长有关的慢性病患病率时间。提倡生态养老意味着无需像以前那样对老年人实行隔离管理,而是将他们视为整个社会生活、工作和娱乐不可缺少的一部分。文章比对了健康促进学校与养老产业等场所性的健康促进的特征,认为涵盖各种养老服务的场所是建立一个新的健康促进场所的最佳选择。场所性的健康促进策略的核心就在于为老年人的生活创造有利的环境。更广义地说,生态养老指导我们将环境与健康联系在一起,减少这一日益庞大的人口群体对环境的影响。因此,在老龄事业中应用场所性的健康促进策略有助于降低待赡养的老年人口对全球稳定性的威胁。     

Epidemiological aspects of diabetes in the aging male

Type 2 diabetes mellitus is a common chronic disease of older men, affecting an estimated 40% of American men over age 60¹. This paper reviews epidemiological aspects of diabetes mellitus in the aging male, with emphasis on the impact of diabetes in older American men. The first part of the report provides an overview of diabetes in relation to health-care costs, key demographic factors and population dynamics. The second part uses data examples from the Health, Aging and Body Composition Study to illustrate several areas of interest to researchers who study diabetes in older men.     

Naturally Occurring Retirement Communities

Naturally occurring retirement communities (NORCs) are defined as housing developments that are not planned or designed for older people, but which over time come to house largely older people. NORCs are of interest because they differ from the stereotypical retirement community (RC) and yet are probably the most common form of RC in the U.S. An analysis of NORCs is presented by examining their evolution and comparing them to planned RCs and community-based housing. A supportive neighborhood emerges as the common denominator in each living arrangement.     

Accelerometry analysis of physical activity and sedentary behavior in older adults: a systematic review and data analysis

Accelerometers objectively monitor physical activity and sedentary patterns and are increasingly used in the research setting. It is important to maintain consistency in data analysis and reporting, therefore, we: (1) systematically identified studies using accelerometry (ActiGraph, Pensacola, FL, USA) to measure moderate-to-vigorous physical activity (MVPA) and sedentary time in older adults, and (2) based on the review findings, we used different cut-points obtained to analyze accelerometry data from a sample of community-dwelling older women. We identified 59 articles with cut-points ranging between 574 and 3,250 counts/min for MVPA and 50 and 500 counts/min for sedentary time. Using these cut-points and data from women (mean age, 70 years), the median MVPA minutes per day ranged between 4 and 80 min while percentage of sedentary time per day ranged between 62 % and 86 %. These data highlight (1) the importance of reporting detailed information on the analysis assumptions and (2) that results can differ greatly depending on analysis parameters.     

Sexuality in Older Adults (65+)—An Overview of the Literature,Part 1: Sexual Function and its Difficulties

Objectives: The aim of the current article was to provide an overview of literature on sexual function and sexual difficulties in older adults. Method: The authors conducted a narrative review of papers published in English between January 2005 and July 2015 based on an extensive search in PsycINFO. Results: The review showed that although common biological changes may adversely affect sexual function in old age, sexual experience seems to also be affected by psychological and interpersonal factors. Conclusions: Greater life expectancy and better medical care will result in older individuals with chronic diseases living longer. The need for help to cope with changes in sexual health is likely to increase in older adults, as sexuality may be negatively affected through several pathways.     

Post-Stroke Depression Among African-American Elders

ABSTRACT

In the United States, the expanding 65 and older population comprises 13% of the total population (U.S. Census, 2000, population estimates; projections). African-Americans will be the largest segment of Non-Caucasians 65 and older (Administration on Aging, [AoA], statistics, 2005). Post-stroke depression (PSD), is a common post-stroke consequence (May et al., 2002; American Stroke Association [ASA], 2005, behavior changes). Existent research on PSD focuses predominantly on Caucasian Americans. To my knowledge, no singular study examines the effects of PSD among African-American older persons. This article provides information that reveals the need to examine African-American elders in relation to PSD.