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Gallistl V, Kolland F, Kriebernegg U. [Cultural gerontological prolegomena]. Z Gerontol Geriatr 2024; 57:262-265. [PMID: 38922391 DOI: 10.1007/s00391-024-02318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/27/2024]
Affiliation(s)
- Vera Gallistl
- Kompetenzzentrum für Gerontologie und Gesundheitsforschung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Österreich.
| | - Franz Kolland
- Kompetenzzentrum für Gerontologie und Gesundheitsforschung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Österreich.
| | - Ulla Kriebernegg
- Zentrum für Interdisziplinäre Alterns- und Care-Forschung, Schubertstraße 23/I, 8010, Graz, Österreich.
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2
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Zhang X, Wang Z, Zou J, Zhang L, Ning JH, Jiang B, Liang Y, Zhang YZ. Association between physical frailty and cortical structure in middle-aged and elderly people: a Mendelian randomization study. Front Aging Neurosci 2024; 16:1395553. [PMID: 38841102 PMCID: PMC11150765 DOI: 10.3389/fnagi.2024.1395553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Physical weakness is associated with cortical structures, but the exact causes remain to be investigated. Therefore, we utilized Mendelian randomization (MR) analysis to uncover the underlying connection between frailty and cortical structures. Methods The Genome-Wide Association Study (GWAS) on frailty pooled data from publicly available sources such as the UK Biobank and included five indicators of frailty: weakness, walking speed, weight loss, physical activity, and exhaustion. GWAS data on cerebral cortical structure were obtained from the ENIGMA consortium, and we assessed the causal relationship between hereditary frailty and cortical surface area (SA) or cortical thickness (TH). Inverse variance weighting (IVW) was used as the primary estimate, and heterogeneity and multidimensionality were monitored by MR-PRESSO to detect outliers. Additionally, MR-Egger, Cochran's Q test, and weighted median were employed. Results At the aggregate level, there was no causal relationship between frailty and cortical thickness or surface area. At the regional level, frailty was associated with the thickness of the middle temporal lobe, parahippocampus, rostral middle frontal lobe, lower parietal lobe, anterior cingulate gyrus, upper temporal lobe, lateral orbital frontal cortex, pericardial surface area, rostral middle frontal lobe, upper temporal lobe, rostral anterior cingulate gyrus, lower parietal lobe, and upper parietal lobe. These results were nominally significant, and sensitivity analyses did not detect any multidirectionality or heterogeneity, suggesting that the results of our analyses are reliable. Discussion The results of our analyses suggest a potential causal relationship between somatic weakness and multiple regions of cortical structure. However, the specific mechanisms of influence remain to be investigated. Preliminary results from our analysis suggest that the effects of physical frailty on cortical structures are influenced by various factors related to frailty exposure. This relationship has been documented, and it is therefore both feasible and meaningful to build on existing research to explore the clinical significance of the relationship.
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Affiliation(s)
- Xin Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Zhen Wang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Jing Zou
- The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Le Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Jing-Hua Ning
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Bei Jiang
- Yunnan Key Laboratory of Screening and Research on Anti-pathogenic Plant Resources from West Yunnan (Cultivation), Dali, Yunnan, China
| | - Yi Liang
- Princess Margaret Cancer Centre, TMDT-MaRS Centre, University Health Network, Toronto, ON, Canada
| | - Yu-Zhe Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
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3
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Weeks WB, Lavista Ferres JM, Weinstein JN. Health and Wealth in America. Int J Public Health 2024; 69:1607224. [PMID: 38559467 PMCID: PMC10979796 DOI: 10.3389/ijph.2024.1607224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- William B. Weeks
- AI for Good Lab, Microsoft Corporation, Redmond, WA, United States
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4
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Duminy J, Ezeh A, Galea S, Harpham T, Montgomery MR, Salas JMI, Weber D, Weimann A, You D. Demographic change and urban health: Towards a novel agenda for delivering sustainable and healthy cities for all. F1000Res 2023; 12:1017. [PMID: 38434647 PMCID: PMC10905150 DOI: 10.12688/f1000research.139309.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 03/05/2024] Open
Abstract
The focus is on the demographic drivers and demographic implications of urban health and wellbeing in towns and cities across the globe. The aim is to identify key linkages between demographic change and urban health - subjects of two largely disparate fields of research and practice - with a view to informing arguments and advocacy for urban health while identifying research gaps and priorities. The core arguments are threefold. First, urban health advocates should express a globalized perspective on demographic processes, encompassing age-structural shifts in addition to population growth and decrease, and acknowledging their uneven spatial distributions within and between urban settings in different contexts. Second, advocates should recognize the dynamic and transformational effects that demographic forces will exert on economic and political systems in all urban settings. While demographic forces underpin the production of (intra)urban inequities in health, they also present opportunities to address those inequities. Third, a demographic perspective may help to extend urban health thinking and intervention beyond a biomedical model of disease, highlighting the need for a multi-generational view of the changing societal bases for urban health, and enjoining significant advances in how interested parties collect, manage, analyse, and use demographic data. Accordingly, opportunities are identified to increase the availability of granular and accurate data to enable evidence-informed action on the demographic/health nexus.
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Affiliation(s)
- James Duminy
- School of Geographical Sciences, University of Bristol, Bristol, England, UK
- African Centre for Cities, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Alex Ezeh
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, Massachusetts, USA
| | | | - Mark R. Montgomery
- Department of Economics, Stony Brook University, Stony Brook, New York, USA
| | - J. M. Ian Salas
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniela Weber
- International Institute for Applied Systems Analysis, Laxenburg, Lower Austria, Austria
| | - Amy Weimann
- African Centre for Cities, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Danzhen You
- United Nations Children's Fund (UNICEF), New York, New York, USA
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5
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Life Conditions as Mediators of Welfare State Effect on Mental Wellbeing among Oldest Old in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074363. [PMID: 35410040 PMCID: PMC8998964 DOI: 10.3390/ijerph19074363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022]
Abstract
Background: Mental wellbeing is formed by our daily environments, which are, in turn, influenced by public policies, such as the welfare state. This paper looks at how different aspects of life conditions may mediate the welfare state effect on mental wellbeing in oldest old age. Methods: Data were extracted from Round 6 of the European Social Survey (2012). The dataset comprised of 2058 people aged 80 years and older from 24 countries. Mediation analyses determined possible links between the welfare state, including eleven intervening variables representing life conditions and five mental wellbeing dimensions. Results: Our study confirms that the higher the level of welfare state, the better mental wellbeing, irrespective of dimension. Although several life conditions were found to mediate the welfare state effect on mental wellbeing, subjective general health, coping with income and place in society were the most important intervening variables. Conclusions: All three variables centre around supporting autonomy in the oldest old age. By teasing out how the welfare state influences mental wellbeing in the oldest old, we can better understand the many drivers of wellbeing and enable evidence informed age-friendly policy making.
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Savage RD, Hardacre K, Bashi AM, Bronskill SE, Faulkner C, Grieve J, Gruneir A, McCarthy LM, Chamberlain SA, Lam K, Stall NM, Zhu L, Rochon PA. Perspectives on ageing: a qualitative study of the expectations, priorities, needs and values of older people from two Canadian provinces. Age Ageing 2021; 50:1811-1819. [PMID: 34228777 DOI: 10.1093/ageing/afab136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Understanding the needs and values of older people is vital to build responsive policies, services and research agendas in this time of demographic transition. Older peoples' expectations and priorities for ageing, as well as their beliefs regarding challenges facing ageing societies, are multi-faceted and require regular updates as populations' age. OBJECTIVE To develop an understanding of self-perceptions of ageing and societal ageing among Canadian retirees of the education sector to define a meaningful health research agenda. METHODS We conducted four qualitative focus groups among 27 members of a Canadian retired educators' organisation. Data were analysed using an inductive thematic approach. RESULTS We identified four overarching themes: (1) vulnerability to health challenges despite a healthier generation, (2) maintaining health and social connection for optimal ageing, (3) strengthening person-centred healthcare for ageing societies and (4) mobilising a critical mass to enact change. Participants' preconceptions of ageing differed from their personal experiences. They prioritised maintaining health and social connections and felt that current healthcare practices disempowered them to manage and optimise their health. Although the sheer size of their demographic instilled optimism of their potential to garner positive change, participants felt they lacked mechanisms to contribute to developing solutions to address this transition. CONCLUSION Our findings suggest a need for health research that improves perceptions of ageing and supports health system transformations to deliver person-centred care. Opportunities exist to harness their activism to engage older people as partners in shaping solution-oriented research that can support planning for an ageing society.
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Affiliation(s)
- Rachel D Savage
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Kate Hardacre
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Aya Mahder Bashi
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Colin Faulkner
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrea Gruneir
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa M McCarthy
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario
| | | | - Kenneth Lam
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nathan M Stall
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lynn Zhu
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Paula A Rochon
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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7
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Affiliation(s)
- Sharon K Inouye
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
- JAMA Network Open , Chicago, Illinois
| | - Ishani Ganguli
- JAMA Network Open , Chicago, Illinois
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth A Jacobs
- JAMA Network Open , Chicago, Illinois
- MaineHealth and Maine Medical Center Research Institute, Scarborough
- Departments of Medicine and Population Health, The University of Texas, Austin
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8
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Beck AM, Nielsen SB, Bjørnsbo KS. Grandchildren's food workshop: Impact of an intergenerational cooking program on dietary habits, food courage, cooking skills and two-way interaction in Danish children and their grandparents. Nutr Health 2021; 27:413-421. [PMID: 33631082 DOI: 10.1177/0260106021991637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Good nutrition is a key aspect of health. Cooking activities can improve dietary habits, cooking skills and food courage in terms of courage to cook and taste new foods, in individuals of all ages. However, targeting both grandchildren and grandparents at the same time through intergenerational cooking activities, is new. AIM This paper aims to present the impact of intergenerational cooking activities on dietary habits, food courage, cooking skills and two-way interaction between young and old participants in The Grandchildren's Food Workshop. METHODS In this observational pilot study, the Danish Heart Foundation's experimental cooking program for grandchildren and grandparents was developed and tested. The influence of the food workshop on the participants' dietary habits, food courage, cooking skills and two-way interaction was assessed by a before and after questionnaire. McNemar's and chi-squared tests were used to evaluate the effects. RESULTS A total of 180 grandchildren (10 to 12 years) and 183 grandparents participated in The Grandchildren's Food Workshop. A total of 82 (46%) grandchildren (71% of which were girls) and 125 (68%) grandparents (83% of which were women) responded to the baseline and follow-up questionnaires. The impact on dietary habits and food courage was limited, while there was an impact on cooking skills in the grandchildren. The already good two-way interaction was unaltered. CONCLUSIONS The findings indicate an impact on cooking skills among grandchildren participating in The Grandchildren's Food Workshop, while the impact on dietary habits, food courage and two-way interaction between age groups was limited. Further research, including more detailed dietary data, should explore the significance of an intergenerational approach.
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Affiliation(s)
- Anne Marie Beck
- 87011University College Copenhagen, Institute of Nursing and Nutrition, Denmark.,Dietetic and Nutritional Research Unit, Herlev-Gentofte University Hospital, Denmark
| | | | - Kirsten S Bjørnsbo
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Denmark
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9
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Affiliation(s)
- Linda P Fried
- From the Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York
| | - John W Rowe
- From the Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York
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10
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Calvo E, Medina JT, Ornstein KA, Staudinger UM, Fried LP, Keyes KM. Cross-country and historical variation in alcohol consumption among older men and women: Leveraging recently harmonized survey data in 21 countries. Drug Alcohol Depend 2020; 215:108219. [PMID: 32795884 PMCID: PMC7585691 DOI: 10.1016/j.drugalcdep.2020.108219] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol consumption causes greater harm in older than younger adults. As the population ages, understanding cross-country and time-varying drinking patterns of older adults is of critical importance. Available evidence relies primarily on ecological data. METHODS We harmonized survey data for 179,881 adults age 50+ observed repeatedly between 1998 and 2016 in 21 countries. Next, we estimated historical variation in consumption across countries (overall and stratified by gender and age group 50-64/65+). RESULTS On average, 51.95 % of older adults consumed any alcohol over the observed period. For 13 countries, the proportion of older adults who drink increased (mean annual increase: 0.76 percent points). Heavy drinking (men drinks/day>3 or binge>5, women drinks/day>2 or binge>4) peaked at 23.54 % for England in 2010 and lifetime abstainers at 69.65 % for China in 2011. Across countries and among drinkers, consumption frequency was 2.57 days/week, the number of standard drink units when drinking was 2.57, and the average number of drinks/day over a week was 1.12. Consumption patterns varied substantially across countries and historical time. Overall probability and frequency of consumption were higher in men than women, with the largest gaps observed in 2011 for China, but gender gaps decreased (even reversed) in the young old and varied across country and time. CONCLUSIONS Wide variation in older adults' alcohol consumption across countries and time suggests that broad scale prevention and intervention efforts can be harnessed for potential population-level health benefits. Further variation by gender and age reflect physiological and social factors simultaneously shaping alcohol consumption.
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Affiliation(s)
- Esteban Calvo
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, United States; Society and Health Research Center and Laboratory on Aging and Social Epidemiology, School of Public Health and Facultad de Humanidades, Universidad Mayor, Santiago, Chile.
| | - José T Medina
- Laboratory on Aging and Social Epidemiology, Universidad Mayor, Santiago, Chile
| | - Katherine A Ornstein
- Geriatrics and Palliative Medicine and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center and Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Linda P Fried
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America. Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
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11
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Fulmer T, Patel P, Levy N, Mate K, Berman A, Pelton L, Beard J, Kalache A, Auerbach J. Moving Toward a Global Age-Friendly Ecosystem. J Am Geriatr Soc 2020; 68:1936-1940. [PMID: 32700767 DOI: 10.1111/jgs.16675] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Abstract
The designation of "age friendly" has clearly engaged the attention of scholars and leading experts in the field of aging. A search of PubMed references citing the term produced 15 results in the 5-year period from 2006 to 2011; that number increased to 572 in the period from 2015 to 2019. The work, notably led by the World Health Organization with the initiation of age-friendly cities and age-friendly communities, has now sparked a movement for the creation of age-friendly health systems and age-friendly public health systems. Now more than ever, in an era of pandemics, it seems wise to create an ecosystem where each of the age-friendly initiatives can create synergies and additional momentum as the population continues to age. Work of a global nature is especially important given the array of international programs and scientific groups focused on improving the lives of older adults along with their care and support system and our interconnectedness as a world community. In this article, we review the historical evolution of age-friendly programs and describe a vision for an age-friendly ecosystem that can encompass the lived environment, social determinants of health, the healthcare system, and our prevention-focused public health system.
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Affiliation(s)
- Terry Fulmer
- The John A. Hartford Foundation, New York, New York, USA
| | - Pinkey Patel
- Institute for Healthcare Improvement, Boston, Massachusetts, USA
| | | | - Kedar Mate
- New York Academy of Medicine, New York, New York, USA
| | - Amy Berman
- Trust for America's Health, Washington, DC, USA
| | - Leslie Pelton
- Institute for Healthcare Improvement, Boston, MA, USA
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12
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Dzau VJ, Jenkins JAC. Creating a Global Roadmap for Healthy Longevity. J Gerontol A Biol Sci Med Sci 2020; 74:S4-S6. [PMID: 31690929 DOI: 10.1093/gerona/glz226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Victor J Dzau
- National Academy of Medicine, Washington, District of Columbia
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13
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Farrell TW, Francis L, Brown T, Ferrante LE, Widera E, Rhodes R, Rosen T, Hwang U, Witt LJ, Thothala N, Liu SW, Vitale CA, Braun UK, Stephens C, Saliba D. Rationing Limited Healthcare Resources in the COVID-19 Era and Beyond: Ethical Considerations Regarding Older Adults. J Am Geriatr Soc 2020; 68:1143-1149. [PMID: 32374466 PMCID: PMC7267288 DOI: 10.1111/jgs.16539] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Coronavirus disease 2019 (COVID‐19) continues to impact older adults disproportionately with respect to serious consequences ranging from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these issues have focused attention on how these resources are ultimately allocated and used. Some strategies, for example, misguidedly use age as an arbitrary criterion that disfavors older adults in resource allocation decisions. This is a companion article to the American Geriatrics Society (AGS) position statement, “Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond.” It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations that should be considered when developing strategies for allocation of scarce resources during an emergency involving older adults. This review presents the legal and ethical background for the position statement and discusses these issues that informed the development of the AGS positions: (1) age as a determining factor, (2) age as a tiebreaker, (3) criteria with a differential impact on older adults, (4) individual choices and advance directives, (5) racial/ethnic disparities and resource allocation, and (6) scoring systems and their impact on older adults. It also considers the role of advance directives as expressions of individual preferences in pandemics. J Am Geriatr Soc 68:1143–1149, 2020. See related paper by Farrell et al.
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Affiliation(s)
- Timothy W Farrell
- Division of Geriatrics, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.,VA SLC Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah, USA.,University of Utah Health Interprofessional Education Program, Salt Lake City, Utah, USA
| | - Leslie Francis
- University of Utah S.J. Quinney College of Law, Salt Lake City, Utah, USA.,Department of Philosophy, University of Utah, Salt Lake City, Utah, USA
| | - Teneille Brown
- Center for Law and the Biomedical Sciences, University of Utah S.J. Quinney College of Law, Salt Lake City, Utah, USA.,Program in Medical Ethics and Humanities, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Lauren E Ferrante
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Eric Widera
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
| | - Ramona Rhodes
- Division of Geriatric Medicine, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.,Central Arkansas Veterans Healthcare System, Geriatric Research, Education, and Clinical Center, Little Rock, Arkansas, USA
| | - Tony Rosen
- Department of Emergency Medicine, Division of Geriatric Emergency Medicine, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York, USA
| | - Ula Hwang
- Department of Emergency Medicine & Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, New York, USA
| | - Leah J Witt
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.,Division of UCSF Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Niranjan Thothala
- Hospitalist Division, Department of Medicine, Good Samaritan Hospital, Vincennes, Indiana, USA.,Hospitalist Division, Department of Medicine, Union Hospital, Terre Haute, Indiana, USA
| | - Shan W Liu
- Department of Emergency Medicine, Division of Geriatric Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Caroline A Vitale
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,VA Ann Arbor Geriatric Research, Education, and Clinical Center (GRECC), Ann Arbor, Michigan, USA
| | - Ursula K Braun
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.,Rehabilitation and Extended Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | | | - Debra Saliba
- UCLA Borun Center for Gerontological Research, Los Angeles, California, USA.,VA Los Angeles Geriatric Research Education and Clinical Center, Los Angeles, California, USA.,RAND Corporation, Santa Monica, California, USA
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14
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Roche AM, Harrison NJ, Chapman J, Kostadinov V, Woodman RJ. Ageing and Alcohol: Drinking Typologies among Older Adults. J Aging Health 2020; 32:1486-1497. [PMID: 32583701 DOI: 10.1177/0898264320936953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: Alcohol consumption and harms among older people are increasing. We examined different demographic characteristics and drinking patterns among an older population. Methods: Secondary analyses of nationally representative Australian data; subjects aged 50+ years (N = 10,856). Two-step cluster analysis was performed to identify demographic groups and alcohol consumption behaviours. Results: Three groups were identified: Group 1 (older, unmarried, and lived alone): >65 years, moderate drinkers, poorest health, psychological distress, social disadvantage, smokers, illicit drug users, and more frequent previous alcohol treatment. Group 3 (older married): >65 years, good health, low psychological distress, less likely to drink at risky levels, and one in five drank daily. Group 2 (younger married): 50-64 years, mostly employed, highest proportion of risky drinkers and of 5+ standard drinks per session, and liberal drinking attitudes with most concern from others about their drinking. Discussion: These demographic typologies can inform targeted prevention efforts for an estimated 1.3 million adults older than 50 years drinking at risky levels.
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Affiliation(s)
- Ann M Roche
- 1065Flinders University, Adelaide, Australia
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15
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Dzau VJ, Inouye SK, Rowe JW, Finkelman E, Yamada T. Enabling Healthful Aging for All - The National Academy of Medicine Grand Challenge in Healthy Longevity. N Engl J Med 2019; 381:1699-1701. [PMID: 31633895 DOI: 10.1056/nejmp1912298] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Victor J Dzau
- From the National Academy of Medicine, Washington, DC (V.J.D., E.F.); Harvard Medical School, Boston (S.K.I.); Columbia University Mailman School of Public Health, New York (J.W.R.); and Frazier Healthcare Partners, Seattle (T.Y.)
| | - Sharon K Inouye
- From the National Academy of Medicine, Washington, DC (V.J.D., E.F.); Harvard Medical School, Boston (S.K.I.); Columbia University Mailman School of Public Health, New York (J.W.R.); and Frazier Healthcare Partners, Seattle (T.Y.)
| | - John W Rowe
- From the National Academy of Medicine, Washington, DC (V.J.D., E.F.); Harvard Medical School, Boston (S.K.I.); Columbia University Mailman School of Public Health, New York (J.W.R.); and Frazier Healthcare Partners, Seattle (T.Y.)
| | - Elizabeth Finkelman
- From the National Academy of Medicine, Washington, DC (V.J.D., E.F.); Harvard Medical School, Boston (S.K.I.); Columbia University Mailman School of Public Health, New York (J.W.R.); and Frazier Healthcare Partners, Seattle (T.Y.)
| | - Tadataka Yamada
- From the National Academy of Medicine, Washington, DC (V.J.D., E.F.); Harvard Medical School, Boston (S.K.I.); Columbia University Mailman School of Public Health, New York (J.W.R.); and Frazier Healthcare Partners, Seattle (T.Y.)
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Gebremariam KM, Sadana R. On the ethics of healthy ageing: setting impermissible trade-offs relating to the health and well-being of older adults on the path to universal health coverage. Int J Equity Health 2019; 18:140. [PMID: 31488220 PMCID: PMC6727389 DOI: 10.1186/s12939-019-0997-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022] Open
Abstract
This article aims to clarify the moral underpinning of the policy framework of Healthy Ageing. It is a policy adopted by the World Health Organization designed to operate in alignment with the United Nations (UN) framework of the Sustainable Development Goals (SDGs) and the urgency given for the achievement of Universal Health Coverage (UHC). It particularly reflects on what, if anything, justifies protecting the most basic rights to health and well-being of older adults from possible policy trade-offs on the path to UHC.It argues that the dignity of older adults-under which are nested more specific ideas of self-respect, respect for autonomy, as well as the ethical priority for living well-underpins a categorical moral injunction against imposing the familiar utilitarian calculus as the default criterion for policy trade-offs across age groups. Respect for the dignity of older persons marks the moral threshold that every society ought to uphold even under conditions of relative resource scarcity.The moral constraint on permissible policy trade-offs relating to the health of older adults must reflect an understanding of older persons as active agents in the social structure of (their) well-being, not merely as passive vessels through which a good healthy life may or may not occur. We argue that there are three main domains where trade-offs are unacceptable from the moral point of view: it is impermissible (1) to prioritise key service(s) across different (vulnerable) age groups on the basis of actual or future contribution to society, (2) to prioritise across different age groups when co-prioritisation is warranted by the ethical theory, and (3), to always prioritise (by default) services that improve well-being over those that foster respect for dignity and autonomy.
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Affiliation(s)
| | - Ritu Sadana
- Ageing and Life Course, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
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Carr DC, Kail BL, Rowe JW. The Relation of Volunteering and Subsequent Changes in Physical Disability in Older Adults. J Gerontol B Psychol Sci Soc Sci 2019; 73:511-521. [PMID: 28958062 DOI: 10.1093/geronb/gbx102] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/27/2017] [Indexed: 02/06/2023] Open
Abstract
Objectives To describe the association between initiating volunteering and changes in physical disability in older adults, and whether intensity and gender modify this relationship. Methods Employing propensity score weighted regression adjustment, we calculate changes in disability using a sample of U.S. adults (n = 7,135) in the Health and Retirement Study (1996-2012) not volunteering at baseline but later initiating volunteering (1-99 hr/year or 100+ hours per year) or remaining a nonvolunteer. Results Relative to continuous nonvolunteers, low-intensity volunteering is related to 34% lower disability in the low-intensity group (average treatment effect [ATE] = -0.12) and 63% lower in the higher-intensity group (ATE = -0.23). For men, progression was lower only in the highest intensity group (ATE = +0.02), but women experienced similarly less progression of disability (38%-39%) at either level of new engagement (ATE = -0.17 and -0.18). Discussion Initiating a new volunteer role in later life is related to decreased progression of disability, at low or high levels for women and only at higher levels for men. This study suggests that volunteer intervention programs may represent a major public health strategy to delay the progression of physical disability for older adults.
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Affiliation(s)
- Dawn C Carr
- Department of Sociology, Florida State University, Tallahassee
| | | | - John W Rowe
- Mailman School of Public Health, Columbia University, New York, New York
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Binotto MA, Lenardt MH, Carneiro NHK, Lourenço TM, Cechinel C, Rodríguez-Martínez MDC. Gait speed associated factors in elderly subjects undergoing exams to obtain the driver's license. Rev Lat Am Enfermagem 2019; 27:e3138. [PMID: 31038632 PMCID: PMC6528639 DOI: 10.1590/1518-8345.2667-3138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022] Open
Abstract
Objective to analyze the factors associated with gait speed in elderly subjects
undergoing physical and mental fitness tests to obtain a driver’s
license. Method a cross-sectional quantitative study conducted in transit agencies. The
probabilistic sample included 421 elderly (≥ 60 years old). The study was
developed through application of questionnaires and tests that assess the
frailty phenotype. For evaluating gait speed, the time spent by each
participant to walk a 4.6 meter distance at normal pace on a flat surface
was timed. Data were analyzed by using multiple linear regression and the
stepwise method. The R statistical program version 3.4.0 was adopted. Results there was a significant association between gait speed and paid work
(<0.0000), body mass index (<0.0000), Mini-Mental State Examination
(=0.0366), physical frailty (pre-frail =0.0063 and non-frail <0.0000),
age (<0.0000), sex (=0.0255), and manual grip strength (<0.0000). Conclusion elderly drivers who do not work, women of advanced age, high body mass
index, low score in the Mini-Mental State Examination, low hand grip
strength, and frail tend to decrease gait speed and should be a priority of
interventions.
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Affiliation(s)
- Maria Angélica Binotto
- Universidade Estadual do Centro-Oeste, Departamento de Educação Física, Irati, PR, Brasil
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19
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Determinants of multidimensional mental wellbeing in the oldest old: a rapid review. Soc Psychiatry Psychiatr Epidemiol 2019; 54:135-144. [PMID: 30498846 DOI: 10.1007/s00127-018-1633-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Improved life expectancy imposes new challenges for policy-makers. The growing oldest-old age group (defined as 80 and over) is often characterised by increased support needs. Greater attention to wellbeing in this population group is necessary, and may well require a shift in social policy focus. The current review seeks to explore current research on determinants of mental wellbeing for the oldest old. METHODS An iterative rapid review approach was used to review existing literature in line with four dimensions of mental wellbeing defined by the European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY) study; functional, social, personal and environmental. A specific focus on articles employing multidimensional definitions of mental wellbeing was adopted. RESULTS Multidimensional indicators reflect the multifaceted and multidirectional dynamics of wellbeing in very old age. Considerable variety in both measures and terminology was found within the literature making precise comparison difficult. The current review takes steps towards comparability by focusing on studies implementing multiple measures of mental wellbeing including evaluative, hedonistic and eudaimonic factors. Clearly defined and multifaceted measures of mental wellbeing are needed to sharpen evidence used in policy development, appraisal and evaluation in light of the considerable diversity of health and functional states experienced in later life. CONCLUSIONS Previous studies appear to line up the four main dimensions of mental wellbeing identified in the EMMY study. Actively improving opportunities for older adults to produce benefits to society can be done via a stronger focus on resources such as mental wellbeing.
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Spoelstra SL, Sikorskii A, Gitlin LN, Schueller M, Kline M, Szanton SL. Dissemination of the CAPABLE Model of Care in a Medicaid Waiver Program to Improve Physical Function. J Am Geriatr Soc 2018; 67:363-370. [DOI: 10.1111/jgs.15713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sandra L. Spoelstra
- Kirkhof College of NursingGrand Valley State University Grand Rapids Michigan
| | - Alla Sikorskii
- Department of Psychiatry and Department of Statistics and ProbabilityMichigan State University East Lansing Michigan
| | - Laura N. Gitlin
- College of Nursing and Health ProfessionsDrexel University Philadelphia Pennsylvania
| | - Monica Schueller
- Kirkhof College of NursingGrand Valley State University Grand Rapids Michigan
| | - Margaret Kline
- Kirkhof College of NursingGrand Valley State University Grand Rapids Michigan
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21
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Binotto MA, Lenardt MH, Rodríguez-Martínez MDC. Physical frailty and gait speed in community elderly: a systematic review. Rev Esc Enferm USP 2018; 52:e03392. [PMID: 30570081 DOI: 10.1590/s1980-220x2017028703392] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 06/04/2018] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To identify the outcomes of studies on gait speed and its use as a marker of physical frailty in community elderly. METHOD Systematic review of the literature performed in the following databases: LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus and ProQuest. The studies were evaluated by STROBE statement, and the PRISMA recommendations were adopted. RESULTS There were 6,303 studies, and 49 of them met the inclusion criteria. Of the total number of studies, 91.8% described the way of measuring gait speed. Of these, 28.6% used the distance of 4.6 meters, and 34.7% adopted values below 20% as cutoff points for reduced gait speed, procedures in accordance with the frailty phenotype. Regarding the outcomes, in 30.6% of studies, there was an association between gait speed and variables of disability, frailty, sedentary lifestyle, falls, muscular weakness, diseases, body fat, cognitive impairment, mortality, stress, lower life satisfaction, lower quality of life, napping duration, and poor performance in quantitative parameters of gait in community elderly. CONCLUSION The results reinforce the association between gait speed, physical frailty and health indicator variables in community elderly.
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Affiliation(s)
- Maria Angélica Binotto
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brasil.,Universidade Estadual do Centro-Oeste, Departamento de Educação Física, Guarapuava, PR, Brasil
| | - Maria Helena Lenardt
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brasil
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Fahim SM, Bhuayan TA, Hassan MZ, Abid Zafr AH, Begum F, Rahman MM, Alam S. Financing health care in Bangladesh: Policy responses and challenges towards achieving universal health coverage. Int J Health Plann Manage 2018; 34:e11-e20. [PMID: 30238490 DOI: 10.1002/hpm.2666] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 11/08/2022] Open
Abstract
Bangladesh has attained notable progress in most of the health indicators, but still, health system of the country is suffering badly from poor funding. Issues like burden of out-of-pocket expenditure, low per capita share in health, inadequate service facilities, and financial barriers in reducing malnutrition are being overlooked due to inadequacy and inappropriate utilization of allocated funds. We aimed to review the current status of health care spending in Bangladesh in response to national health policy (NHP) and determine the future challenges towards achieving universal health coverage (UHC). National health policy suggested a substantial increase in budgetary allocation for health care, although government health care expenditures in proportion to total public spending plummeted down from 6.2% to 4.04% in the past 8 years. Overall, 67% of the health care cost is being paid by people, whereas global standard is below 32%. Only one hospital bed is allocated per 1667 people, and 34% of total posts in health sector are vacant due to scarcity of funds. The country is experiencing demographic dividend with a concurrent rise of aged people, but there seems no financial protection schemes for the aged and working age populations. Such situation results in multiple obstacles in achieving financial risk protection as well as UHC. Policy makers must think effectively to develop and adapt systems in order to achieve UHC and ensure health for all.
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Affiliation(s)
| | | | | | | | - Farhana Begum
- Directorate of Secondary and Higher Education, Ministry of Education, Dhaka, Bangladesh
| | - Md Mizanur Rahman
- Department of Global Health Policy, School of International Health, University of Tokyo, Japan
| | - Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Calvo E, Berho M, Roqué M, Amaro JS, Morales-Martinez F, Rivera-Meza E, Gutiérrez Robledo LMF, López EC, Canals B, Kornfeld R. Comparative analysis of aging policy reforms in Argentina, Chile, Costa Rica, and Mexico. J Aging Soc Policy 2018; 31:211-233. [DOI: 10.1080/08959420.2018.1465797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Esteban Calvo
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, USA
- Society and Health Research Center, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Santiago, Chile
| | - Maureen Berho
- Laboratory on Aging and Social Epidemiology, Santiago, Chile
| | - Mónica Roqué
- Asociación Latinoamericana de Gerontología Comunitaria, Buenos Aires, Argentina
| | | | | | | | | | | | - Bernardita Canals
- Center of Health and Wellbeing, Princeton University, Princeton, New Jersey, USA
| | - Rosa Kornfeld
- Centro UC Estudios de Vejez y Envejecimiento, Facultad de Ciencias Sociales, Universidad Católica de Chile, Santiago, Chile
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Shea JL. Dominant Chinese National Policies on Aging and Their Degree of Attention to Eldercare by Seniors. AGEING INTERNATIONAL 2018. [DOI: 10.1007/s12126-017-9318-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kenawy S, Hegazy R, Hassan A, El-Shenawy S, Gomaa N, Zaki H, Attia A. Involvement of insulin resistance in D-galactose-induced age-related dementia in rats: Protective role of metformin and saxagliptin. PLoS One 2017; 12:e0183565. [PMID: 28832656 PMCID: PMC5568415 DOI: 10.1371/journal.pone.0183565] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/07/2017] [Indexed: 01/05/2023] Open
Abstract
Age-related dementia is one of the most devastating disorders affecting the elderly. Recently, emerging data suggest that impaired insulin signaling is the major contributor in the development of Alzheimer's dementia (AD), which is the most common type of senile dementia. In the present study, we investigated the potential therapeutic effects of metformin (Met) and saxagliptin (Saxa), as insulin sensitizing agents, in a rat model of brain aging and AD using D-galactose (D-gal, 150 mg/kg/day, s.c. for 90 successive days). Six groups of adult male Wistar rats were used: normal, D-gal, Met (500 mg/kg/day, p.o), and Saxa (1 mg/kg/day, p.o) control groups, as well as D-gal/Met and D-gal/Sax treated groups. Impaired learning and memory function was observed in rats treated with D-gal using Morris water maze test. Biochemical and histopathological findings also revealed some characteristic changes of AD in the brain that include the increased content of acetylcholine, glutamate, and phosphorelated tau, as well as deposition of amyloid plaques and neurofibrillary tangles. Induction of insulin resistance in experimentally aged rats was evidenced by increased blood glycated hemoglobin, brain contents of insulin and receptors for advanced glycated end-products, as well as decreased brain insulin receptor level. Elevation of oxidative stress markers and TNF-α brain content was also demonstrated. Met and Saxa, with a preference to Met, restored the normal memory and learning functions in rats, improved D-gal-induced state of insulin resistance, oxidative stress and inflammation, and ameliorated the AD biochemical and histopathological alterations in brain tissues. Our findings suggest that D-gal model of aging results in a diminishing of learning and memory function by producing a state of impaired insulin signaling that causes a cascade of deleterious events like oxidative stress, inflammation, and tau hyper-phosphorylation. Reversing of these harmful effects by the use of insulin-sensitizing drugs like Met and Saxa suggests their involvement in alleviation insulin resistance as the underlying pathology of AD and hence their potential use as anti-dementia drugs.
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Affiliation(s)
- Sara Kenawy
- Pharmacology Department, Medical division, National Research Centre, Giza, Egypt
| | - Rehab Hegazy
- Pharmacology Department, Medical division, National Research Centre, Giza, Egypt
- * E-mail:
| | - Azza Hassan
- Pathology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Siham El-Shenawy
- Pharmacology Department, Medical division, National Research Centre, Giza, Egypt
| | - Nawal Gomaa
- Pharmacology Department, Medical division, National Research Centre, Giza, Egypt
| | - Hala Zaki
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Amina Attia
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Chalyk NE, Bandaletova TY, Kyle NH, Petyaev IM. Morphological Characteristics of Residual Skin Surface Components Collected from the Surface of Facial Skin in Women of Different Age. Ann Dermatol 2017; 29:454-461. [PMID: 28761294 PMCID: PMC5500711 DOI: 10.5021/ad.2017.29.4.454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/08/2016] [Accepted: 10/12/2016] [Indexed: 11/23/2022] Open
Abstract
Background Problems of skin aging and its prevention currently attract increasing attention with the growth of human life expectancy. The morphology of the stratum corneum (SC) is well known, but investigation of age-related changes of its structure is difficult in the absence of non-invasive sampling methods. The residual skin surface components (RSSC) that overlay the SC can be easily collected non-invasively. Objective The aim of this study was to examine morphology of RSSC samples collected from the surface of facial skin of healthy female volunteers of different age. Methods RSSC samples were non-invasively collected from 53 adult female volunteers (22 aged in the range 18∼25 years and 31 aged in the range 50∼73 years). The samples were analysed microscopically. Results Distinct age-related changes were determined for lipid droplet size, corneocyte desquamation level and lipid crystal count. There was a significant (p=0.0006) decrease in lipid droplet size among older women. Similarly, significantly (p=0.0401) lower lipid crystal numbers were present in the older group. Conversely, corneocyte desquamation was significantly higher (p=0.0007) in older women. No age-related difference in microbial presence in the RSSC could be detected. Result patterns were generally similar to those previously found in male volunteers; however gender-related differences in the absolute values were revealed. Conclusion Non-invasively collected RSSC samples allow identifying age-related changes on facial skin surface. The results of this study highlight gender-dependence of distinct elements of age-associated impairment of epidermal barrier and can be employed for developing new approaches to prevent changes associated with skin aging.
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Affiliation(s)
- Natalya E Chalyk
- Lycotec Ltd., Cambridge, United Kingdom.,Saratov State Medical University named after V. I. Razumovsky, Institute of Cardiology of the Ministry of Health of the Russian Federation, Saratov, Russian Federation
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27
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28
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Cozzi B, Ballarin C, Mantovani R, Rota A. Aging and Veterinary Care of Cats, Dogs, and Horses through the Records of Three University Veterinary Hospitals. Front Vet Sci 2017; 4:14. [PMID: 28261586 PMCID: PMC5306394 DOI: 10.3389/fvets.2017.00014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/27/2017] [Indexed: 12/27/2022] Open
Abstract
The present article examines over 63,000 medical records belonging to the Veterinary Hospitals of the Universities of Bologna, Torino, and Padova, all in Northern Italy, and relative to dogs (approximately 50,000), cats (approximately 12,000), and companion horses (slightly less than 1,000). The animals of the three species were divided into age classes and categorized per sex into males, females, and neutered individuals. The mean age at visit and the effects of age classes and category (analyzed via ANOVA) are presented and discussed. The data indicate that many animals are presented to the hospitals either in the early phases of their life (presumably for vaccination and, in cats and dogs, gonadectomy) or in the advanced age (over 10 years in dogs, over 15 years in cats, and over 17 years in horses). The records of very old individuals of the three species are also reported. On the whole, the results suggest that a growing population of mature to old domestic carnivores or companion horses reaches ages that were considered exceptional only a few years ago. The data also testify an evolution in the animal–owner relationship and a renewed respect for the value of life in companion domestic mammals.
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Affiliation(s)
- Bruno Cozzi
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy; Department of Agronomy, Food, Natural resources, Animals and Environment, University of Padova, Padova, Italy
| | - Cristina Ballarin
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy; Department of Agronomy, Food, Natural resources, Animals and Environment, University of Padova, Padova, Italy
| | - Roberto Mantovani
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy; Department of Agronomy, Food, Natural resources, Animals and Environment, University of Padova, Padova, Italy
| | - Ada Rota
- Department of Agronomy, Food, Natural resources, Animals and Environment, University of Padova, Padova, Italy; Department of Veterinary Sciences, University of Turin, Turin, Italy
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Beard JR, Officer AM, Cassels AK. The World Report on Ageing and Health. THE GERONTOLOGIST 2017; 56 Suppl 2:S163-6. [PMID: 26994257 DOI: 10.1093/geront/gnw037] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- John R Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | - Alana M Officer
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland.
| | - Andrew K Cassels
- Global Health Programme, The Graduate Institute of International and Development Studies, Geneva, Switzerland
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30
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Fried LP. Confronting Global Chronic Disease: The Role for Schools of Public Health. Glob Heart 2016; 11:409-412. [PMID: 27938827 DOI: 10.1016/j.gheart.2016.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Linda P Fried
- Mailman School of Public Health, Columbia University, New York, NY, USA; and the College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
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31
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Chalyk NE, Bandaletova TY, Kyle NH, Petyaev IM. Age-related differences in morphological characteristics of residual skin surface components collected from the surface of facial skin of healthy male volunteers. Skin Res Technol 2016; 23:212-220. [DOI: 10.1111/srt.12321] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/29/2022]
Affiliation(s)
- N. E. Chalyk
- Lycotec Ltd; Cambridge UK
- Institute of Cardiology; Saratov Russia
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Carr DC, Gunderson JA. The Third Age of Life: Leveraging the Mutual Benefits of Intergenerational Engagement. ACTA ACUST UNITED AC 2016. [DOI: 10.1093/ppar/prw013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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