International Journal of Aging Research <p>ISSN:2637-3742<br>DOI:10.28933/IJOAR</p> eSciPub LLC en-US International Journal of Aging Research 2637-3742 THE IMPACT OF COVID-19 ON INFORMAL CAREGIVERS IN THE US <p>Background: Caregiver burden has negative effects on mental and physical health along with quality of life. Meanwhile, social and physical distancing protocols during the COVID-19 pandemic have created additional impacts on informal caregiving in a rapidly changing environment. Early research over the past year suggests that the pandemic has caused increased caregiver burden as well as caregiving intensity among these individuals.</p> <p>Purpose: Our primary purpose in this informational literature review is to describe the impacts of the pandemic on informal caregiver burden and the sudden shift in roles and responsibilities as a result of pandemic-related changes in caregiving. This review will describe emerging effects on various aspects of health among informal caregivers and explore the growing need to support unpaid caregiving during this time.</p> <p>Methods: A streamlined search was conducted to fit the scope of this review, with key terms determined to identify relevant publications. Common research databases and up-to-date mainstream resources were utilized. Notably, we focused on research published or released since March 2020, primarily rapidly reviewed studies, to align with the timing of the COVID-19 pandemic in the US.</p> <p>Results: Early research suggests that the pandemic has worsened caregiver burden and increased caregiving intensity and hours of care among unpaid, informal family caregivers. Reported health impacts include higher stress, pain, and depression, along with decreased social connectedness and quality of life. Notably, however, COVID-related research generally does not focus on the positive aspects of caregiving, such as its role as a source of purpose in life, creating an opportunity to explore ways to boost certain valuable personal resources among caregivers.</p> <p>Conclusions: Informal family caregivers face their own negative health outcomes and distress as a result of greater caregiver burden, intensity, and the changing landscape of caregiving during the ongoing COVID-19 pandemic. Immediate policy and support recommendations should be considered to alleviate informal caregiver burden and provide ongoing resources over the longer term. In addition, future work should explore the potential of boosting positive resources such as resilience and purpose to ease caregiver burden.</p> Stephanie MacLeod, Rifky Tkatch, Sandra Kraemer, Annette Fellows, Michael McGinn, James Schaeffer, Charlotte S. Yeh Copyright (c) 2021 Stephanie MacLeod, Rifky Tkatch, Sandra Kraemer, Annette Fellows, Michael McGinn, James Schaeffer, Charlotte S. Yeh 2021-08-06 2021-08-06 4 3 87 87 10.28933/ijoar-2021-07-0705 THE EFFECTS OF A COGNITIVE TRAINING PROGRAM FOR OLDER ADULTS: A BRIEF PRELIMINARY REPORT <p>As one ages, some degree of cognitive decline is expected. Despite this, declines in cognitive abilities and the possibility of dementia is a common concern among older adults. In response to these concerns, a variety of cognitive training programs have been developed that aim to improve or maintain cognitive functioning. Prior literature has shown mixed or limited findings on cognitive changes after implementation of cognitive training. This study evaluated the effectiveness of a cognitive training program designed for older adults with no to minimal cognitive decline. The current study included 17 participants who engaged in two one-hour cognitive training sessions each week for 12 weeks. Each session required participants to complete activities that targeted the following cognitive domains: attention, visual and verbal memory, visual spatial skills, processing speed and executive functioning, and language. These cognitive domains, along with depression and memory self-efficacy, were assessed prior to and immediately after completion of the program. Small to large effect sizes on the majority of cognitive outcome measures were observed following participation in the program. Small reductions in depressive symptoms were also found. These findings provide preliminary support for the use of a comprehensive cognitive training program for cognitively-intact older adults.</p> Nathan Jensen, Caroline Kinskey, Jeffrey Buchanan Copyright (c) 2021 Nathan Jensen, Caroline Kinskey, Jeffrey Buchanan 2021-08-06 2021-08-06 4 3 86 86 10.28933/ijoar-2021-07-0706 NURSE ROLE AS NA EDUCATOR IN HIV PREVENTION IN THE ELDERLY: A NEW PERSPECTIVE FOR THE HEALTH CARE OF THE ELDERLY <p>Objective: Reflect the nurse role as an educator in HIV prevention in the elderly.</p> <p>Methods: This is a qualitative, descriptive and exploratory study. An online bibliographic survey was carried out in the databases of the Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Scientific Electronic Library Online (SciELO). The descriptors were used: “Assistance to the Elderly”; “Nursing”; “HIV” and “Public Health”. The inclusion criteria defined for the selection of articles were: articles published in Portuguese, articles in full that portrayed the theme and articles published in the referred databases in the last ten years.</p> <p>Results: When reading the eleven selected articles, it was possible to observe the high rate of elderly people with HIV. The profile of sexual behavior is commonly described only in people up to 59 years of age, abstaining from the population above 60 years, which favors forgetting this age group. From the perspective of HIV in the health of the elderly, the multidisciplinary team has an importance, especially the nurse, as its role is directed to the maintenance and restoration of health, leading them to self-care with a focus on health education practices.</p> <p>Conclusion: In the studies that were analyzed, the relevance of the nurse’s role as an educator was explicit, because unfortunately there is still a “taboo” when sexuality is explained in the elderly, and the nurse exercising his / her health education function may be adding knowledge of prevention and treatment for this population that is neglected by society.</p> Sebastiana Nobre da Silva1, Katia Monteiro Maia da Costa2, Gabriele da Silva Botelho3, Luana Márcia Batista Alves4, Rana Schacila Araújo Ávila5, Francisco Ariclene Oliveira6 Copyright (c) 2021 Sebastiana Nobre da Silva1, Katia Monteiro Maia da Costa2, Gabriele da Silva Botelho3, Luana Márcia Batista Alves4, Rana Schacila Araújo Ávila5, Francisco Ariclene Oliveira6 2021-06-18 2021-06-18 4 3 84 84 10.28933/ijoar-2021-06-1507 CORRELATION OF BODY MASS INDEX WITH THE HAND GRIP STRENGTH AND ADDUCTOR POLLICIS MUSCLE THICKNESS IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERITEMATOSUS IN A BRAZIL NORTHEAST REFERENCE CENTER <p>Introduction: Rheumatoid arthritis and systemic lupus erythematosus are autoimmune, chronic and progressive diseases, which can be get worst in the presence of muscle mass loss due to physical inactivity and continuous inflammatory. Therefore, estimate body composition can assist in the treatment of these diseases.</p> <p>Objective: To evaluate the correlation of body mass index with handgrip strength and adductor pollicis muscle thickness in elderly patients with rheumatoid arthritis and systemic lupus erythematosus followed in a reference center in Brazil.</p> <p>Material and Methods: Cross-sectional study carried out in a rheumatology outpatient clinic in a reference center in Northeastern Brazil (Recife / PE). Elderly patients with rheumatoid arthritis and systemic lupus erythematosus. Anthropometric measurements of weight, height and Body Mass Index (BMI) were taken, in addition to the measurement of body composition: calf circumference (CC), arm circumference (MUAC), adductor pollicis muscle thickness (APMT) and strength of hand grip (HGS). The data were treated using the SPSS version 17.0 for Windows and Excel 2010. Pearson correlation and the Chi-square test were used for analysis. The level of significance was set at 5%. The IMIP Research Bioethics Committee approved the present study under No. 19163619.1.0000.5201 the participants’ guardians signed the Free and Informed Consent Form (ICF).</p> <p>Results: The study included 19 patients aged 60 to 85 years and a mean age of 70.05 years +/- 8.47 SD, 94.74% of whom were female. The BMI, MUAC, CC, APMT and HGS mean of (26.93g / m2 ± 5.75DP), (28.85 ± 4.06DP), (34.79 ± 3.62DP), (11.52 ± 4.437DP) and (10.81 ± 6.77DP) respectively. The BMI showed that 31.26 were overweight, while HGS showed that 66.7% had a deficit in handgrip strength justified by the high prevalence of depletion of the adductor pollicis muscle, which identified that 97.4% showed signs of depletion of this musculature. There was a moderate correlation between BMI, MUAC and CC (r = 0.453) and (r = 0.426), respectively, while for BMI and APMT the correlation was weak (r = 0.348), as well as the correlation between BMI and HGS was r = 0.005.</p> <p>Conclusions: There was a prevalence of eutrophic and overweight elderly people, however with loss of muscle mass and decreased hand grip strength. This may suggest a greater risk for the development of senile sarcopenia.</p> <p>&nbsp;</p> Flávia de Seabra Trevisan1, Marianny de Siqueira Vasconcelos1, Elda Silva Augusto de Andrade2, Samanta Siqueira de Almeida2; Maria Josemere de Oliveira Borba2 Copyright (c) 2021 Flávia de Seabra Trevisan1, Marianny de Siqueira Vasconcelos1, Elda Silva Augusto de Andrade2, Samanta Siqueira de Almeida2; Maria Josemere de Oliveira Borba2 2021-06-18 2021-06-18 4 3 85 85 10.28933/ijoar-2021-06-1508 Potentially Inappropriate Medications for Older Adults in Dental Practice <p>Objective: The present study aimed to review the medications frequently prescribed in dental practice that are potentially inappropriate for the elderly population due to the risks presented.</p> <p>Methods: An integrative literature review was carried out, based on the Guidance Manual: Prescription and Dispensing of Medicines Used in Dentistry, which reports the main drugs prescribed in dental practice (2017). From this, medications described in the Beers list of the American Society of Geriatrics (2019) were extracted, in order to identify medications that are potentially inappropriate in the elderly, what are the main consequences of use and appropriate management in view of the need for prescription.</p> <p>Results: The prescription and dispensing guidance manual for medicines used in dentistry has a list of 142 medicines, containing anti-inflammatories, antibacterials, opioids, benzodiazepines and other types of drugs. Of the drugs listed, 27 are considered inadequate and the most common therapeutic class among the drugs was anti-inflammatory drugs, being equivalent to 44.5% of the inadequacies found.</p> <p>Conclusion: Despite the risks associated with medications, it appears that they are widely prescribed in dental practice, making these groups worthy of special attention due to their potential for serious adverse events and negative impacts on the elderly and the health system, in addition to to emphasize the importance of the professional regarding the best indications and pharmacotherapeutic follow-up by the clinical pharmacist in caring for the elderly.</p> Anna Carolinne Santana Neves, Aurylanne Mikaelle Brandão Silva, José Monteiro dos Santos, Lara Rebelo de Almeida Copyright (c) 2021 Anna Carolinne Santana Neves, Aurylanne Mikaelle Brandão Silva, José Monteiro dos Santos, Lara Rebelo de Almeida 2021-06-18 2021-06-18 4 3 83 83 10.28933/ijoar-2021-06-1805 Older Adults’ Engagement in Mindfulness Practices <p>There is substantial evidence to suggest that mindfulness practices positively affect older adults’ physical, emotional, and cognitive wellbeing. However, there is still little information available about the interest and inclination among older adults for performing mindfulness-related exercises. We conducted a survey study aimed at exploring the prevalence of older adults engaged in such activities. Data were collected from 174 older adults (Males: 48; Females:126) who responded using a self-constructed survey, and analyzed using SPSS. Results indicate that almost two-thirds of older adult respondents engage in at least one mindfulness practice and almost a third engage in more than one, with meditation, deep breathing, and yoga being the most prevalent.</p> Neha Shivhare1, David Kaufman2 Copyright (c) 2021 Neha Shivhare1, David Kaufman2 2021-06-18 2021-06-18 4 3 82 82 10.28933/ijoar-2021-05-0705 Epithelial tissue response to pathological effects in various age groups. Participation of morphofunctional zones and Src-kinase in this process <p>The response of human organism tissues to various pathological effects depends to a large extent on the presence of the total amount of key protein in the organism – Src-kinase and the ratio of its active part to inactive. With a sharp preponderance of an inactive portion of this protein over the active, the proliferative activity of cells is suppressed, and with a significant preponderance of the active part, proliferation is inadequately increased. The amount of this protein is embedded in embryogenesis and individually in each person. In the age aspect, a decrease in the Src-kinase content in the human organism is observed. The epithelial tissue of two age groups: 20-40 and 75 years and older responds most acutely to pathological effects, including the entering of viruses, since in 20-40 years the number of Src-kinase is the greatest in relation to other age groups, and in 75 years and older – the least, which causes a decrease in the reactivity of organism tissues or, conversely, hyperactivity.</p> Tatiana Yavisheva, Sergey Shcherbakov Copyright (c) 2021 Tatiana Yavisheva, Sergey Shcherbakov 2021-06-18 2021-06-18 4 3 81 81 10.28933/ijoar-2021-05-2605 The Usefulness of Short Physical Performance Battery Score for Predicting the Ability of Toilet Activity in Hospitalized Older Patients <p>Background: It has been still unclear whether the cut-off value of the short physical performance battery for predicting the ability of the toilet activity in the hospitalized older patients. The aim of this study was to reveal the relationship between the short physical performance battery and the ability of toilet activity, and also to determine the cut-off value of the short physical performance battery score for the ability of toilet activity in the hospitalized older patients.</p> <p>Methods: In this cross-sectional study, 71 hospitalized older patients were recruited. The short physical performance battery and the ability of toilet activity using the Barthel index (BI) were measured. The patients were split into two groups, according to the ability of toilet activity (Group 1: 10 point; Group 2: 5 point or less in BI score). A multiple logistic regression analysis was used to assess the relationship between the two groups. Moreover, the cut-off value for dividing into two groups, (Group 1 and Group 2) using the short physical performance battery score, which was calculated by a receiver operating characteristic curve.</p> <p>Results: The short physical performance battery score was an independent explanator for the ability of toilet activity using multiple logistic regression analysis. Besides, the cut-off value of the short physical performance battery for the ability of toilet activity was set in this study.</p> <p>Conclusion: The findings of this study suggest that the cut-off value of the short physical performance battery score could be a useful index to predict the ability of toilet activity in the hospitalized older patients.</p> <p>&nbsp;</p> Daisuke Takagi, PhD1*, Masatoshi Kageyama2,3, Kenta Yamamoto4, Hiroshi Matsumoto, MD5 Copyright (c) 2021 Daisuke Takagi, PhD1*, Masatoshi Kageyama2,3, Kenta Yamamoto4, Hiroshi Matsumoto, MD5 2021-05-22 2021-05-22 4 3 80 80 10.28933/ijoar-2021-04-0205 Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study <p>Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended.<br>Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit.<br>We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge.<br>DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased.<br>In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients.</p> Massimiliano Massaia1, Maria Garro1, Valeria Quaranta1, Elisa Calvi1, Francesca Santagata1, Patrizia D’Amelio1,2* Copyright (c) 2021 Massimiliano Massaia1, Maria Garro1, Valeria Quaranta1, Elisa Calvi1, Francesca Santagata1, Patrizia D’Amelio1,2* 2021-05-03 2021-05-03 4 3 79 79 10.28933/ijoar-2021-02-1905 Mitochondrial Metabolism, Dysfunctions in Senescence Cell and the Possible Interventions through Herbal Medicines <p>The mitochondria are the cell`s powerhouse. They are considered ubiquitous organelles of all eukaryotic cells, being responsible for the cell’s life and death cycle. Through stimuli in the environment in which they live, mitochondria can modulate their own biogenesis as well as signal retrograde to the nucleus to modify the structure of their proteins. Since the mitochondrial genome contains only 37 genes, much of the encoding of its proteins depends on the nuclear genome. Thus, the communication between mitochondria and the nucleus seems to be a target of science in understanding the pathologies associated with this organelle. Some medicinal herbs have been shown to influence mitochondrial biogenesis, such as Gynostemma pentaphyllun (GP) and berberine, which increase the phosphorylation of proteins AMPactivated protein kinase (AMPK). Just as GP and berberine phosphorylate AMPK in signaling for mitochondrial biogenesis, the sesquiterpene beta-caryophyllene (BCP) demonstrated positive results in reorganizing mitochondrial transcription factors, being an agonist of the peroxisome proliferatoractivated alpha receptor (PPAR-?). Another plant derivative, the non-psychoactive cannabinoid known as cannabidiol (CBD), has been showing control in the metabolism of calcium in the mitochondrial matrix. In this review, we seek to get a closer look at the biochemical mechanisms of action of some of these plants, as well as their synergies in the results of different treatments. In the view of oriental medicines, the use of associated medicinal herbs has always been part of their treatment protocols. However, the effectiveness of these treatments in relation to plant synergy can be observed in future clinical trials for better understanding.</p> Ferro M.*, Graubard A., Escalante P., Ledezma R., Channan G., Mia N., Dotres V., Bencomo Y., Datri P. Copyright (c) 2021 Ferro M.*, Graubard A., Escalante P., Ledezma R., Channan G., Mia N., Dotres V., Bencomo Y., Datri P. 2021-03-08 2021-03-08 4 3 78 78 10.28933/ijoar-2021-02-1206 Predictors of in-hospital mortality in critically ill Geriatric patients <p>Objective: To determine the predictors of in-hospital mortality in critically ill older patients.</p> <p>Participants and Methods: A prospective cohort study including 305 critically ill older adults (age ?60 years) who were admitted to High Dependency Units (HDUs) in a tertiary care university hospital from March 22, 2019 to January 4, 2020. Demographic, clinical and laboratory data of participants were collected thought a review of medical records and clinical observation at HDUs till either death or discharge alive. Statistical analysis included univariate analysis of selected potential predictors such as various comorbidities, C- reactive protein / Albumin ratio (CAR), Neutrophil-lymphocyte ratio (NLR), Red cell distribution width (RDW), Po2/Fio2 ratio (PFR), Simplified acute physiology score II (SAPS II), Charlson comorbidity index (CCI) and multidrug-resistant Gram-negative bacterial (MDR-GNB) infection to ascertain their association with mortality, followed by multivariable logistic regression to derive the final prediction model. The discriminative ability of the model was evaluated by using the receiver operating characteristic (ROC) curve.</p> <p>RESULTS: Overall mortality was 53.1%. Multivariate regression analysis revealed independent predictors of mortality including dementia in clinical history with an odds ratio (OR) of 4.86 (95% CI: 1.28-18.34), total protein with an OR of .53 (95% CI: .30-.95) and the use of mechanical ventilation (MV) and/or intravenous cardiovascular support with an OR of 148.34 (95% CI: 34.28-641.77), formulating a novel prognostic model with an area under the ROC curve of .93 (95% CI: .89-.96, P.000).</p> <p>CONCLUSION: History of dementia, total protein and the use of MV and/or intravenous cardiovascular support are predictors of mortality in critically ill geriatric patients. It provides a novel prognostic model which needs validation in other multicenter prospective studies.</p> Khalid E. Elsorady Copyright (c) 2021 Khalid E. Elsorady 2021-02-02 2021-02-02 4 3 77 77 10.28933/ijoar-2020-12-3005 Development of Estimate Formulas for Waist Circumference Using Body Mass Index and Limb Circumferences in Hospitalized Older Adults <p>Background: Little research has been conducted on the estimate formulas for waist circumference using body mass index and limb circumferences in hospitalized older adults. Thus, we conducted the present study to develop estimate formulas of waist circumference using body mass index and limb circumferences in hospitalized older adults.</p> <p>Methods: Forty hospitalized older patients were recruited in this cross-sectional study. We measured waist circumference, body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference. The estimate formulas for waist circumference were developed using simple and multiple regression analysis.</p> <p>Results: Simple regression analysis indicated that body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference were independent explanators for waist circumference (p &lt; 0.05 for all). In addition, body mass index, upper arm circumference, and forearm circumference but not thigh circumference and calf circumference were extracted as independent explanators for waist circumference in multiple regression analysis (p &lt; 0.05). We were able to develop the estimate formulas using body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference.</p> <p>Conclusion: The results suggest that the estimate formulas for waist circumference may provide an opportunity to easily evaluate waist circumference, even in hospitalized older adults with kyphosis posture. However, future studies should be conducted to develop the estimate formulas for waist circumference with a lower error value.</p> Daisuke Takagi1, Masatoshi Kageyama2,3, Kenta Yamamoto4, Hiroshi Matsumoto,5 Copyright (c) 2021 Daisuke Takagi1, Masatoshi Kageyama2,3, Kenta Yamamoto4, Hiroshi Matsumoto,5 2021-01-20 2021-01-20 4 3 76 76 10.28933/ijoar-2020-12-2505 Social prescription for those living with dementia; does MedTech have a role to play? <p>Ageing is the major risk factor for dementia and nearly every country has seen its life expectancy rise from the beginning of the 21st century. Remaining socially connected has positive health and social implications and may be even more significant for marginalized group of people like those living with dementia. If appropriately used, social prescriptions can help deliver value-based social engagement and primary care by maximising the utilisation of resources and addressing social determinants of health, decreasing dependency on the biomedical model and thus providing a way for health care systems to deal with social determinants of health. More frequently, however, those seeking access to these programmes do not tend to do so simply due to lack of understanding and knowledge of the availability of such services. So, provision of social activities involves more than developing a program and hoping people will attend, and considering the particular situations of those living with dementia as marginalised group of people, and taking into account that there is no treatment for dementia, societies need to move toward social prescription, integrating appropriate MedTech support- targeting on those living with dementia- into such programs.</p> Azam Bazooband1*, Saba Kaviani2 Copyright (c) 2020 Azam Bazooband1*, Saba Kaviani2 2020-12-30 2020-12-30 4 3 75 75 10.28933/ijoar-2020-11-1005 Exergaming improves functional fitness in MCI patients. Does the APOE genotype moderate the outcome? <p>Objectives: Mild cognitive impairment could be defined as the condition between healthy aging and dementia. MCI patients seem to retain the neuroplasticity to benefit from Physical Exercise (PE) interventions delaying the progression to dementia. The present study investigates the impact of PE via “Exergaming” on the functional fitness of MCI adults, depending on the presence of the APOE?4 allele.</p> <p>Methods: 159 MCI participants were recruited. They were separated to two groups (performing PE or not). The Fullerton Functional Test was used as a primary outcome measure in two-time points (prior to and after PE).</p> <p>Results: The Active group showed more considerable improvement compared to the Passive group in all Fullerton components despite the presence of APOE?4.</p> <p>Discussion: ?? via exergaming has a beneficial functional effect in MCI patients, whether carrying the APOE?4 allele or not.</p> Anthoula C. Tsolaki1,2*, Magda Tsolaki2, Niki Pandria1, Eftychia Lazarou2, Olympia Gkatzima3, Vasiliki Zilidou1, Maria Karagianni1, Zafiroura Iakovidou- Kritsi4, Vasilios K. Kimiskidis2, Panagiotis D. Bamidis1 Copyright (c) 2020 Anthoula C. Tsolaki1,2*, Magda Tsolaki2, Niki Pandria1, Eftychia Lazarou2, Olympia Gkatzima3, Vasiliki Zilidou1, Maria Karagianni1, Zafiroura Iakovidou- Kritsi4, Vasilios K. Kimiskidis2, Panagiotis D. Bamidis1 2020-12-21 2020-12-21 4 3 74 74 10.28933/ijoar-2020-11-2105 Human Rights Violation of the Elderly People in Bangladesh: Do They Enjoy Basic Needs? <p>Basic needs are the fundamental human rights recognized by national and international law. This study is an attempt to reveal the picture of human rights violations of the elderly people in Bangladesh focusing particularly on the deprivation of the basic needs of the aged people. In this study, data have been collected from both primary and secondary sources. It reviews the right to basic needs, such as adequate food, clothes, shelter, healthcare, and education. As a human being, everybody deserves these basic needs as fundamental human rights and it is a fundamental responsibility of the state to secure these rights according to the constitution of Bangladesh, Article 15(a). But the study found that these basic rights are not implemented properly in the case of elderly people of the study area. Lacks of moral education and humanity have been identified as mainly responsible hindrances in this sphere. Corruption and poverty are also strong impediments in this regard. The paper proposes some workable suggestions. The government, responsible institutions, and concerned families should come forward to ensure proper education, to ensure proper and sound socialization with native culture, and to raise far-reaching consciousness regarding the welfare of elderly people.</p> Md. Zahid Hossain1, A.K.M. Mahmudul Haque2*, S. M. Akram Ullah3 Copyright (c) 2020 Md. Zahid Hossain1, A.K.M. Mahmudul Haque2*, S. M. Akram Ullah3 2020-12-01 2020-12-01 4 3 73 73 10.28933/ijoar-2020-10-2505 Older Adult Perspectives towards Health Literacy and Knowledge of Chronic Diseases in Nepal: A case study <p>Background: The individual level of health literacy directly affects the health outcomes of any people. Older adult people are more vulnerable to chronic diseases than other groups of people. Also they have low health literacy and poor understanding of diseases than any other age group of people. Aim: This study aim is to explore older adult perspectives towards health literacy and knowledge of chronic diseases. Methods: The study was taken during December 2019 in the Budhanilkantha Municipality of Kathmandu district of Nepal. Semi-structured interview was conducted in four older adult participants with chronic diseases. It included health knowledge, level of understanding of chronic disease conditions, and the use of health services. Inductive analysis was followed for the patterns, themes, and categories of analysis to emerge. Results: Health literacy and knowledge of chronic diseases, health belief system, and experience of health problems were the emerging themes included here. The study results finds that lack of disease knowledge, low health literacy, health belief system, socio-economic, and cultural factors were influencing factors to chronic diseases among older adults. Participants had a minor knowledge of chronic diseases; they had lack in knowledge regarding their own chronic diseases. Conclusion: Health literacy is an important factor of understanding, accessing and utilizing health knowledge and health services. It is most important that the health literacy of the people is necessary to improve for positive health and gaining the knowledge of chronic diseases. To overcome the chronic health problems it is most important to improve the health knowledge, understanding of chronic diseases, and literacy level to the older adult people.</p> Binod Kumar Karki, Krishna Prasad Pathak Copyright (c) 2020 Binod Kumar Karki, Krishna Prasad Pathak 2020-10-15 2020-10-15 4 3 72 72 10.28933/ijoar-2020-09-0605 Psychosocial support for families of persons with dementia through home based care programme from a developing country: Process of intervention development and pilot testing <p>In India, person with dementia continue to live with their families all through their illness period. It is common in India that because of the family relationships and cultural values the caregiving process is a joint effort made by the adult members in the family. Thus understanding the psychosocial issues of the caregivers of persons with dementia in the Indian context and providing appropriate psychosocial support for the caregivers is essential in the holistic approach for the care for persons with dementia.The current paper shares the process of development of psychosocial intervention for the families of persons with dementia and findings from the pilot study in urban Bangalore. The findings were helpful in systematically developing the content for the proposed homebased care programme for caregivers of persons with dementia. The pilot results show that the psychosocial support through home based programme for the family caregivers of persons with dementia is feasible and effective.</p> Sherin Yohannan, Aravind Raj.E, A.Tirumoorthy Copyright (c) 2020 Sherin Yohannan, Aravind Raj.E, A.Tirumoorthy 2020-10-15 2020-10-15 4 3 71 71 10.28933/ijoar-2020-02-1105 Alzheimer’s Disease & Dementia-From Pathophysiology To Clinic <p>Dementia is a syndrome that occurs due to the difficulty of a patient in doing his cognitive and instrumental activities of daily life with the same performance as before, bringing him losses. This syndrome is caused by numerous primary and secondary etiologies. The most common primary cause of dementia is Alzheimer’s disease (AD), which reaches almost 50% of dementia cases. The DA it consists of biological fragments of the amyloid precursor protein that are deposited in the brain 10 years or more, before the first symptoms appear. The period before the onset of symptoms is called the preclinical stage. The transition between the silence of symptoms and their appearance, usually due to memory loss for recent events, is known as the prodromal phase. Continuing the pathophysiological process, the stage of mild dementia takes place, when the patient has one more cognitive component associated with memory loss; follows the moderate, severe, profound and terminal phase of dementia.</p> Paulo Roberto de Brito Marques Copyright (c) 2020 Paulo Roberto de Brito Marques 2020-09-26 2020-09-26 4 3 70 70 10.28933/ijoar-2020-08-1005 Sharing Stories as Legacy: What Matters to Older Adults? <p>Objectives: Legacy allows individuals to make meaning of their lives by passing on their experiences and beliefs to younger people and influencing their perspectives, perceptions, and actions. This mixed-methods study investigated: (1) What is important for older adults to share as legacy with families, friends and others, based on the types and features of their digital stories ? and (2) How do older adults’ digital stories affect story viewers?</p> <p>Methods: One hundred adults aged between 55 and 95 years participated in ten-week Elder’s Digital Storytelling courses and created short digital stories. Using the content analysis approach, the story transcripts were thematically analyzed and iteratively coded by three researchers and the results were quantified. A diverse group of 60 viewers at a public event provided their reactions to the digital stories.</p> <p>Results: The findings revealed that character, place, and family were chosen as the primary types by the older adults for their legacy digital stories. Accomplishment and career/school were the next most prominent story types. Moreover, these digital stories appeared to have a powerful impact on the viewers.</p> <p>Discussion: A digital story is a powerful artifact to communicate an older person’s legacy because it is based on familiar forms of communication, such as speech and photographs. The major legacy themes chosen by the older adults align with the findings of the research literature. The feedback from the viewers of the digital stories reflects these as a source of life wisdom and legacy for younger generations.</p> <p>Funding details: This work was supported by the AGE-WELL National Centre of Excellence (AW CRP 2015-WP4.3).</p> Neha Shivhare, Ph.D.1, Luciane Maria Fadel, Ph.D.2, David Kaufman, Ed.D.3 Copyright (c) 2020 Neha Shivhare, Ph.D.1, Luciane Maria Fadel, Ph.D.2, David Kaufman, Ed.D.3 2020-09-15 2020-09-15 4 3 69 69 10.28933/ijoar-2020-08-2806 Smokeless Tobacco dependence and cessation measures in India <p>India being the largest smokeless tobacco (SLT) producer and consumer in the South East Asia Region (SEAR) entitled with a range of products. SLT consumption is very common because it is associated with socio-economic and cultural perspectives in the India. After the implementation of the first treaty of the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), public health standards were reaffirmed and improvised through successful implementation of articles since 2007 as reported in the global progress factsheet. Many measures have been implemented for achieving the success of WHO-FCTC in India and to control the huge disease burden induced by tobacco use. The objective of the present study was to understand and explore the factors involved in the SLT demand reduction by revealing the dependence and cessation implementation in India in the context of strategies and policies. For this study, we searched for SLT dependence and SLT cessation literature survey in PubMed and obtained 102 literatures consisting of studies and reviews, which were further scrutinized by excluding the reviews, studies conducted abroad and studies conducted within the last 5 years (after 2015). No statistical significance was observed in comparison of National to International SLT dependence and an attempt to quit SLT following the tenure of a year. This is in-line with GATS-2 and international data. We have also discussed a diverse approach in the control of SLT at different levels-such as SLT users, healthcare professional, policy advocates supplier, labeling, legal policies, and educating at various platforms. Effective strategies for the cessation of SLT is mandatory with proper guidance for the manufacturer, users and sellers in controlling SLT products.</p> Ramu Venkatesan*1, Reena C. Jhamtani1, Shilpa Gupta1, Samir Vinchurkar1,2, Nilesh Jain1 Copyright (c) 2020 Ramu Venkatesan*1, Reena C. Jhamtani1, Shilpa Gupta1, Samir Vinchurkar1,2, Nilesh Jain1 2020-07-15 2020-07-15 4 3 68 68 10.28933/ijoar-2020-06-1305 Dementia syndromes and health psychology <p>The aging process is considered a worldwide phenomenon, and it is observed that the population has aged, where there is an inversion in the age pyramid resulting from the increase in life expectancy. This phenomenon has been investigated by several national and international studies. As results, there are some justifications that are being cited. Among these, are the presence of some demographic factors such as a reduction in fertilit, fecundity and mortality rate over the years, in addition, we highlight the technological advances in health and improvement in the quality of life of individuals1,2. Consequently, with the presence of these influencing factors, some studies highlight an epidemiological transition, where infectious diseases are being replaced by chronic-degenerative, as the main cause of morbidity and mortality, giving emphasis on dementia syndromes .</p> <p>In addition of aging, are expected physical, psychological and social changes that lead to changes in the life of each elderly. At this stage of life, in addition to chronic conditions, the decline in cognitive functions, such as changes in memory, speed of reasoning, and attention seem to take on a broader dimension. Thus, with the decline of these and other functions, several difficulties can be observed in the execution of activities of daily living of the elderly, implying difficulties in their “coming and going”, that is, in their autonomy and self-care.</p> Eduardo Falcão Felisberto1, Leopoldo Barbosa2, Paulo César Gomes1, Mônica Cristina Batista de Melo3 Copyright (c) 2020 Eduardo Falcão Felisberto1, Leopoldo Barbosa2, Paulo César Gomes1, Mônica Cristina Batista de Melo3 4 3 10.28933/ijoar-2020-05-1205 The Elderly, Carriers of Dementia Syndromes and Dental Care <p>The demographic and epidemiological transition resulting from declining birth rates, increased economically active population, decreased infectious diseases and increased chronic degenerative diseases produce a population scenario with a high number of elderly individuals, prone to developing dementia, whose prevalence is directly related to increasing age. Dementia is progressive and characterized by the loss of self-care ability and ability to perform activities of daily living, including the difficulty to perform oral hygiene and accept dental treatment, thus resulting in decreased oral health. Thus, it is necessary to know and think about oral care to increase the quality of life of this population through actions of health promotion, prevention and recovery with the accomplishment of home and hospital dental procedures, besides the traditional service, at a dental office.</p> Berta Luíza Gabriela Moreno¹, Cinthia Natali Pontes dos Santos2, Andreza de Oliveira Melo2, Maria Tereza Nascimento Filgueiras Andrade2, Nathalia Patrícia Almeida Santos3, Aurora Karla de Lacerda Vidal4 Copyright (c) 2020 Berta Luíza Gabriela Moreno¹, Cinthia Natali Pontes dos Santos2, Andreza de Oliveira Melo2, Maria Tereza Nascimento Filgueiras Andrade2, Nathalia Patrícia Almeida Santos3, Aurora Karla de Lacerda Vidal4 2020-05-28 2020-05-28 4 3 66 66 10.28933/ijoar-2020-05-1005 Position of the Rural Elderly in Familial Decision Making: A Sociological Study <p>Previously the elderly had authoritarian role in familial decision making process. Now it depends on many associated factors. This study explored the position of the rural elderly in familial decision making process. Mixed approach has been given priority. Data have been collected from primary and secondary sources. The study found that position of elderly in familial decision making process is unsatisfactory. That is, position as head of the family, involvement in buying and selling something, dependency on their sons in receiving treatment, invitation of relatives in different socio-religious occasions, taking part in rural arbitration, taking part in resolving familial disputes, influencing in election, compelling members to do work according to wishes etc. are not satisfactory. This study may help the academicians to conduct more empirical studies to understand this crucial reality and help the policy makers to take appropriate policy for the welfare of the elderly.</p> Md. Aminul Islam Copyright (c) 2020 Md. Aminul Islam 2020-05-01 2020-05-01 4 3 65 65 10.28933/ijoar-2020-04-0505 The Wellbeing of the Heterogeneous Older Persons: The Analysis of ‘Going in Style’ Gereontological Comedy Film and Real-life Malaysian Elderly <p>While ageing has become a global phenomenon and received prominent attention due to the rapid increase in the older population, including Malaysia; There has also been an increase in comedy films focusing on old people. Therefore, this study aims to analyse how older persons represented in a gerontological comedy film ‘Going in Style’. This study also aims to relate how older persons represented in this comedy film with real-life situations of Malaysian older people. In meeting these aims, a qualitative research approach through thematic analysis has been adopted. The findings of this study shows how the older person represented in ‘Going in Style’ is similar to real-life situations experienced by some of Malaysian older people. The comedy highlights that ageing is not a single dimensional concept concentrated on physical aspects but is multidimensional, consisting of social,psychological, spiritual and economic and environmental aspects.</p> Rajeswary S. Rajaratnam Copyright (c) 2020 Rajeswary S. Rajaratnam 2020-04-15 2020-04-15 4 3 64 64 10.28933/ijoar-2020-03-2505 Prevalence of Non-Communicable Diseases among Geriatric population in Block Hazratbal, District Srinagar <p>Elderly population aged 60 years and above in the world will reach 1.2 billion by the year 2025, the majority of whom will be in developing countries.Major health problems which are faced in this age group are hypertension, coronary artery disease, strokes, diabetes mellitus, obesity, cancers, cataracts, osteoarthritis, osteoporosis, chronic obstructive airway disease, benign hyperplasia of prostate, Alzheimer’s disease, Parkinson’s disease, senile Dementia and depression. Globally, the burden of non-communicable diseases, which also bear the greatest morbidity and mortality, is rising in developing countries. Demographic and epidemiological transitions taking place in the developing countries of Asia is shifting the disease burden from communicable towards non-communicable disease. India’s poor are at heightened risk of acquiring NCDs owing to high rate of smoking, tobacco use and high salt intake. So this paper analyses the links between sociodemographic correlates and non-communicable diseases in block Hazratbal, district Srinagar. Objectives:1.To estimate the prevalence of NCDs among study population.2.To find out the socio-demographic correlates of NCDs in the study population. Study design: A Community Based, Cross sectional study. Study population: Elderly (?60 years) persons residing in selected geographical area. Results:In this study, majority of the elderly study population were suffering from Hypertension/Ischemic/Other heart diseases (52.2%) followed by COPD (11.4%), Arthritis/other Musculoskeletal problems (10.6%), Diabetes mellitus (10.4%). Gastritis (9.8%), Hypothyroidism (9.6%), Benign prostrate hypertrophy (9.4%). The main reason for high prevalence of Hypertension/Ischemic heart disease could be that we take lots of salty products in our daily diet. Other causes could be living in a conflict area or genetic susceptibility. Most of elderly study subjects 446(89.9%) were on drugs for their chronic diseases.</p> Umar Nazir1, Rouf Hussain Rather1, Shazia Benazir2, S Mohammad Salim Khan3 Copyright (c) 2020 Umar Nazir1, Rouf Hussain Rather1, Shazia Benazir2, S Mohammad Salim Khan3 2020-04-08 2020-04-08 4 3 63 63 10.28933/ijoar-2020-03-1005 Study of Variables Involved in Male Infertility Identified in the Spermograms Assessed in Assisted Human Reproduction <p>Introduction: According to the World Health Organization, about 8 to 10% of couples worldwide have infertility problems and male internal aspects are the main reasons for half of occurrences of human sterility. Through the spermogram, it is possible to qualitatively and quantitatively analyze semen, contributing to the diagnosis of male fertile state.</p> <p>Objective: To study the relationship among sperm viscosity, concentration, motility and volume parameters and male infertility factors and to show the influence of the subject age on these seminal parameters.</p> <p>Methodology: A survey was conducted in the male infertility database of the Nascer Clinic (Recife / Pernambuco) of men aged 27 to 61 years, with a history of marital infertility, from 2018 to 2019. The subjects studied were grouped into categories according to the classification of the seminal parameters analyzed (volume, concentration, motility and viscosity) in their sperm. Student’s t-test was used for normal distribution and Mann-Whitney test for non-normal using the GraphPad Prism 8 program.</p> <p>Results: Among the studied individuals, there was a significant difference (p &lt;0.05) between the populations with obstructive azoospermia and nonobstructive azoospermia and among the percentages of oligozoospermic individuals with obstructive azoospermia. The azoospermia group had a significantly higher average age than the normozoospermia group.</p> <p>Conclusions: This suggests that azoospermia is present in older men, compromising male fertility. Sperm testing should be performed by all men of childbearing age to investigate possible changes in the genesis of gametic cells.</p> Bárbara Stefany da Silva Souza1*, Evandro Valentim da Silva2, Sérgio Antônio Santos da Costa e Silva1, Ana Maria Medeiros de Ataídes3, Fálba Bernadete Ramos dos Anjos1, Adriana Fracasso4 Copyright (c) 2020 Bárbara Stefany da Silva Souza1*, Evandro Valentim da Silva2, Sérgio Antônio Santos da Costa e Silva1, Ana Maria Medeiros de Ataídes3, Fálba Bernadete Ramos dos Anjos1, Adriana Fracasso4 2020-04-01 2020-04-01 4 3 62 62 10.28933/ijoar-2020-03-1105 The Analysis of the Prevalence of Diabetes in the Third Age in a Northeast State Between the Years From 2002 To 2013 <p>Diabetes potentiates when the body can not control the amount of glucose (sugar) in the blood. This disease develops when the body does not produce enough amounts of the hormone called insulin. The elderly are more fragile in not producing adequate insulin for their proper functioning, since the prevalence is related to aging, sedentary lifestyle and obesity, and these last two factors, in turn, intensify with the advancing age. The decompensated glycemia accentuates frequent difficulties in this phase of life. It can incapacitate the elderly because it increases the risk of dementias such as Alzheimer’s, in addition to diabetic neuropathy, which causes the elderly to lose firmness on the floor, the use of many medications and other problems that impact the quality of life and increase the risk of death.</p> Silva Júnior, M.P.¹ *, Gusmão, J.P.O¹, Silva, M.K.¹, Ferro, R.V.C¹, Silva, F.M.L², Mota, L.M² Copyright (c) 2020 Silva Júnior, M.P.¹ *, Gusmão, J.P.O¹, Silva, M.K.¹, Ferro, R.V.C¹, Silva, F.M.L², Mota, L.M² 2020-04-01 2020-04-01 4 3 61 61 10.28933/ijoar-2020-03-1106 Determinants of a Digital Divide Among Able-Bodied Older Adults: Does “Feeling Too Old” Play a Role?” <p>While younger adults have embraced internet technology, older adults have lagged behind in internet adoption. An age-based digital divide has developed globally. This is a concern because digital literacy is becoming an essential, rather than an optional, skill. This paper investigates the reasons why some able-bodied older adults with access to the internet choose not to use the internet. Previous studies of the age-based digital divide have identified income and education, and perceived need, as factors that influence internet use. This paper adds to knowledge on the age-based digital divide by studying the internet behavior of able-bodied older adults with internet access (rather than all older adults) and by investigating the association between “feeling too old to use the internet” and the internet use decision. This paper offers suggestions for bridging the age-based digital divide and discusses whether this divide will continue as younger adults, who are digital natives, become older adults.</p> Carol C. McDonough Copyright (c) 2020 Carol C. McDonough 2020-03-28 2020-03-28 4 3 60 60 10.28933/ijoar-2020-02-2305 PSYCHIC DIAGNOSIS OF THE FAMILY CAREGIVER OF THE ALZHEIMER: CASE STUDY OF A BASIC HEALTH UNIT <p>Introduction: Alzheimer’s disease (AD) is a chronic degenerative disease that compromises the physical, mental and social integrity of the elderly, and therefore leads to an increasing dependence on care, and almost always linked to family dynamics and performed at home. Objectives: The main objective of this research is to analyze the daily lives of family caregivers of patients with AD. Methodology: The qualitative approach was used. Data were collected in the municipality of Tamandaré/PE, through semi-structured interviews with ten family caregivers of patients with Alzheimer’s disease. In addition to the interview, a structured questionnaire with closed-ended questions was applied, referring to the general and personal characteristics of each interviewee. For data analysis, the verbatim reports were fully transcribed, where relevant aspects were observed and organized into two categories: impact of diagnosis and challenges in caring. Results: The results showed that all coexistence and adaptation to this new reality modify the style and quality of life of those involved. The changes are significant and need to be understood and incorporated into the family routine. Negative emotional reactions involving impotence, fear and anger are common, besides a deep feeling of injustice. Conclusion: The study showed the need for assistance that includes all affected family members. The nurse should support and contribute to overcoming the difficulties faced from the moment of diagnosis to the most advanced stages of the disease.</p> Milena Pereira da Silva¹ *, Jhonata Willian Amaral Sousa², Isabella Francilayne de Jesus Lima³, Débora Aline de Souza Ribeiro⁴, João Murilo dos Santos⁵. Copyright (c) 2020 Milena Pereira da Silva¹ *, Jhonata Willian Amaral Sousa², Isabella Francilayne de Jesus Lima³, Débora Aline de Souza Ribeiro?, João Murilo dos Santos?. 2020-02-19 2020-02-19 4 3 59 59 10.28933/ijoar-2020-01-1808 INTEGRATIVE REVIEW STUDY: FACTORS RELATED TO METABOLIC SYNDROME IN THE ELDERLY <p>Introduction: Metabolic Syndrome (MS) is a set of pathological and physiological changes, defined by pre-established parameters, such as dyslipidemia, central adiposity, arterial hypertension and diabetes. Objective: To identify the scientific production of associated cardiovascular risk factors in elderly patients with MS. Methodology: This is an integrative review of the literature obtained by searching scientific articles in the LILACS, MEDLINE, SCIELO and BDENF databases, by crossing the descriptors Metabolic X Syndrome, Aged and Risk Factors. Inclusion criteria were articles that had a summary available online, published in the period from 2013 to 2017, focusing on the proposed theme. Review articles, books, book chapters, opinion articles, editorials, dissertations, theses, programs and government reports were excluded, and 8 articles were selected. Results: The findings showed that the regular practice of physical activity associated with a diet rich in fruits, vegetables and whole grains contributes to the metabolic syndrome control. In addition to other important factors such as the diagnostic criteria that may vary according to the severity of MS. The criteria were established from some associations that work with the theme such as: National Cholesterol Education Program/Adults Treatment Panel – NCEP – ATP III (ATPIII) and International Diabetes Federtion (IDF), the first most used because it is not necessary to evaluate insulin resistance, thus making it more viable for the development of research. Conclusion: The study showed that there is a lack of knowledge regarding MS, since there are few organs that treat and study this problem, thus reflecting on the search for research on this topic, because the subject is little discussed, especially in the elderly.</p> Ana Cláudia Cavalcante da Silva1*, Analucia de Lucena Torres2, Luana Bertoldo Freitas de Andrade3, Mariana Carolini Oliveira Faustino4, Mariana Isabel Alexandre Moura5, Thayse Andressa Nascimento Silva6 Copyright (c) 2020 Ana Cláudia Cavalcante da Silva1*, Analucia de Lucena Torres2, Luana Bertoldo Freitas de Andrade3, Mariana Carolini Oliveira Faustino4, Mariana Isabel Alexandre Moura5, Thayse Andressa Nascimento Silva6 2020-02-19 2020-02-19 4 3 58 58 10.28933/ijoar-2020-01-1807 SYSTEMATIZATION OF NURSING ASSISTANCE TO PATIENTS WITH DIABETES MELLITUS TYPE 2: EXPERIENCE REPORT <p>Introduction Type 2 Diabetes Mellitus (DM2) is the form found in 90 to 95% of diabetes cases characterized by defects in the action and secretion of insulin and in the regulation of hepatic glucose production. Insulin resistance and functional defect of beta cells appear early in the preclinical phase of the disease. Obesity is the main risk factor for triggering this pathology, considering that, in these cases, insulin resistance is usually the consequence. From this perspective, Systematization of Nursing Assistance (SNA) is essential for the care of patients with a diagnosis of DM2, as it ensures the promotion of systematic and continuous assistance, thus constituting a basis for selection for care interventions. Objective To analyze the importance of Systematization of Nursing Assistance in health promotion for patients with Diabetes Mellitus Type 2. Methodology Descriptive study of the experience report type, conducted from the academic experience in supervised curricular internship, from the Adult and Elderly Health discipline in Primary Care, with home visits together with the Family Health Strategy Team in municipality of Recife – PE, in June 2019. Results With the practice of care planning from SNA, in DM2, it was possible to reach the following Nursing Process implementations: NANDA: Impaired skin integrity related to injury in the left lower limb evidenced by pain and loss of skin continuity after debridement. Nursing Outcomes Classification (NOC): Will have wound healing in a timely manner without complications. Nursing Interventions Classification (NIC): Check for general weakness associated with chronic disease. NANDA – Risk of falls related to visual impairment and difficulty walking. NOC – Verbalizes that understands the personal risk factors that contribute to the risk of falling. NIC – Assess the general health status of the individual, paying attention to factors that may compromise safety, including chronic disorders. Conclusions/Considerations: In this context, the importance of Nursing Systematization is noteworthy, since it can be applied in various areas of nursing practice, concretizing nursing care through scientific bases, granting greater credibility and autonomy to the professional. It also provides the patient with holistic care through various pathological contexts.</p> Ana Cláudia Cavalcante da Silva1*, Analucia de Lucena Torres2; Luana Bertoldo Freitas de Andrade3; Mariana Carolini Oliveira Faustino5; Mariana Isabel Alexandre Moura 4; Thayse Andressa Nascimento Silva6 Copyright (c) 2020 Ana Cláudia Cavalcante da Silva1*, Analucia de Lucena Torres2; Luana Bertoldo Freitas de Andrade3; Mariana Carolini Oliveira Faustino5; Mariana Isabel Alexandre Moura 4; Thayse Andressa Nascimento Silva6 2020-02-19 2020-02-19 4 3 57 57 10.28933/ijoar-2020-01-1806 VULNERABILITY FOR SELF-ADVOCATED VIOLENCE IN THIRD AGE: RISK FACTORS AGAINST LACK OF PROSPECTION <p>Introduction: Population aging is a phenomenon that occurs on a global scale in developed countries. This process is characterized by a constant increase in life expectancy ².</p> <p>Objectives: To analyze in the current literature aspects related to vulnerability to self-harm in the elderly, based on the sociodemographic profile and the relationship of psychic factors in order to point out effective means of prevention and prevention.</p> <p>Methodology: This is an integrative literature review through the materials indexed in the Virtual Health Library Databases: LILACS, MEDLINE and BDENF, and the descriptors: Suicide, Elderly, Population aging. Finding 52 articles, of which only selected 10. Being LILACS (07), MEDLINE (02) and BDENF (01), respective percentages: 70%, 20%, 10%. Considering inclusion criteria: full text, publications from 2014 to 2019, Portuguese language and meeting the research theme. Results: Regarding the profile of the victims; most of them are male, aged between 60 – 70 years old, brown in color, poorly educated and economically inactive, retirees or pensioners ³.</p> <p>Conclusion: The mobilization of people on the subject, including actions in education and health, prevention of reductions through harm reduction, along with approaches through social media that has had a positive impact on the decline of suicide cases in Brazil. It is important to break the taboos that permeate this theme. However, the result is the need for actions aimed at reaching the population in question aiming to outline intervention plans in crisis, including</p> Isabele Caroline Santos Clemente 1*; Vivia Conceição da Silva 2; Priscila Ione Nunes dos Santos1; Vitória Alexandra da Silva Gregório1; Larissa Stephanie Mendonça Costa1; Aliny Laboher Cavalcante de Sales1 Copyright (c) 2020 Isabele Caroline Santos Clemente 1*; Vivia Conceição da Silva 2; Priscila Ione Nunes dos Santos1; Vitória Alexandra da Silva Gregório1; Larissa Stephanie Mendonça Costa1; Aliny Laboher Cavalcante de Sales1 2020-02-19 2020-02-19 4 3 56 56 10.28933/ijoar-2020-01-1805 Studying the Relation between lipid profile and HbA1c in elderly patients with Type 2 Diabetes <p>Introduction: Diabetes mellitus is characterized by chronic hyperglycemia with disturbances in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Glucose and lipid metabolism are linked to each other. It is well known that dyslipidemia is considered a major risk factor for macrovascular complications in patients with type-2 diabetes mellitus. Recently, obesity-related metabolic syndrome has received widespread attention. The aim of the current study was to find out the correlation between HbA1c, lipid profile and BMI of elderly patients with type 2 Diabetes mellitus.<br>Methods: A cross-sectional observational study was conducted in a sample consists of one hundred and sixty elderly patients with type 2 diabetes. Glycemic control, lipid profile, body mass index (BMI) were assessed.<br>Results: There was a significant positive correlation between HbA1c and FBS with total cholesterol, LDL and triglycerides and a significant negative correlation with HDL. Also, there was a significant positive correlation between HbA1c and FBS with BMI.<br>Conclusion: Increased levels of HbA1c, is associated with dyslipidemia and increased BMI</p> Marwa Abdel azim Abdel Gawad and Hend F Mahmoud Copyright (c) 2020 Marwa Abdel azim Abdel Gawad and Hend F Mahmoud 2020-01-21 2020-01-21 4 3 55 55 10.28933/ijoar-2020-01-1605 INFLUENCE OF TAE BO EXERCISE ON BONE MARKERS AND FRAX SCORE <p>In recent times, osteoporosis has taken epidemic proportions. It is a disorder that in time of industrialization and application of new technologies is starting to impact even the younger population. The use of modern devices in everyday life is resulting in a reduce level of human physical activity, consequently leading to inactive way of life and increase in number of people suffering from osteoporosis. Going beyond its educational character, this dissertation also has an aim to point out potential positive aspects of Tae Bo exercises on people with osteoporosis and potential positive effect on bone mass, lowering of FRAX score and better quality of life.<br>The study included 92 patients with osteoporosis diagnosis, who at the beginning and at the end of the study carried out laboratory blood, urine, densitometry tests and filled out questionnaires of the ten-year risk of fracture (FRAX) and Quality Questionnaire QUALEFFO 31. The study was prospective, randomized controlled study conducted on a group of women between 55 and 65 years age during the period from 01.07.2018. to 01.07.2019. Research has shown that programs Tae Bo exercise can positively impact the greater bone mass and quality of life of people with osteoporosis. Considering the social and economic magnitude and the breath of osteoporosis as a global and widespread problem, the main contribution of this study was to find new ways in mitigating the effects.</p> Slavica Janković1, Mirsad Muftić2, Amra Macić Džanković3, Majda Zonić Imamović4 Copyright (c) 2020 Slavica Jankovi?1, Mirsad Mufti?2, Amra Maci? Džankovi?3, Majda Zoni? Imamovi?4 2020-01-15 2020-01-15 4 3 10.28933/ijoar-2019-11-2805 Use and preventive value of metformin in geriatric women with polycystic ovary syndrome <p><strong>Objective</strong>: To establish the effects of long-term use and preventive value of metformin in geriatric women with PCOS.</p> <p><strong>Methods</strong>: A search of published review articles was carried out in sites such as NCBI, ScienceDirect, Elsevier, Springer, Wolters Kluwer, among others, using the key words: “polycystic ovary syndrome”, “PCOS”, “Polycystic ovary syndrome and metformin”, “effects of metformin and PCOS“,” insulin resistance and metformin “and” long-term sequelae of polycystic ovarian syndrome“.</p> <p><strong>Results</strong>: We retrospectively analyzed data specific to the randomized clinical trial of Pedersen et al. 2017, to determine the impact that treatment had for twelve months with metformin in three specific variables: weight, total cholesterol and HDL. The study was conducted in 40 Caucasian women from 18 to 39 years of age, with a fixed dose of metformin (2 g / day for 12 months), who met the Rotterdam criteria for PCOS in their genetic variant MATE1 with SOP7.</p> <p><strong>Conclusions</strong>: It was confirmed that the establishment of twelve-month treatment with metformin in the randomized clinical trial of Pedersen et al. 2017 had a significant effect on the three specific variables: weight, total cholesterol and HDL.</p> Jazmín Abril Pérez Aguilar, Alejandra Niño Herrera, Guillermo Muñoz Zurita Copyright (c) 2019 Jazmín Abril Pérez Aguilar, Alejandra Niño Herrera, Guillermo Muñoz Zurita 2019-12-18 2019-12-18 4 3 10.28933/ijoar-2019-11-2605 Myocardial Revascularization Surgery <p><strong>Introduction</strong>: Acute myocardial infarction (AMI) is characterized as the cellular death of the muscle that involves the heart, causing ischemia, which is associated with the clinical presentation, presenting electrocardiographic compatibility and / or electrocardiographic changes typical of the reduction or interruption of blood flow to the myocardium. Myocardial revascularization (MRI) is a surgical procedure that connects mammary arteries, radial arteries, or saphenous veins. These “bridges” allow the blood to return to the coronary arteries preserving them, in any part of their follow-up.&nbsp;<strong>Objectives</strong>: To describe the casuistry of the patient with a diagnosis of acute myocardial infarction (AMI), developing for a post-surgical picture of chronic renal failure (CRI), including therapeutic management, specific care, criticism and referential confrontations.&nbsp;<strong>Methodology</strong>: This is a descriptive and casuistic study. The study was based on a review of recent and recent publications regarding the proposed theme, electronic search of articles and journals in the following databases: in the portal of CAPES and BIREME, LILACS, SCIELO, MEDLINE, conducting authors’ confrontation and exposition of a case carrying out the specific considerations. The data collection instrument consists of data collection and has as study period from May 2016 to September 2016.&nbsp;<strong>Results</strong>: Description and analysis of the clinical picture of the patient JJFG, male, 77 years old, hospitalized in a hospital of the private network , where he was hospitalized in this hospital for more than a hundred days. After the therapeutic interventions the patient presented decay in his clinical picture. With several associated complications that culminated in the death of the patient. Conclusion: The infection table and the old age were determining factors for the clinical decline of this patient.</p> Limacedo Firmino da Silva1, Sonia Silva dos Santos1, Isabel Cristina Pinheiro da Fonseca1, Georgia Cybelle dos Santos Silva1, Veronica Emile Santos de Araujo2, Cristie Aline Santos de Araujo3 Copyright (c) 2019 Limacedo Firmino da Silva1, Sonia Silva dos Santos1, Isabel Cristina Pinheiro da Fonseca1, Georgia Cybelle dos Santos Silva1, Veronica Emile Santos de Araujo2, Cristie Aline Santos de Araujo3 2019-11-29 2019-11-29 4 3 10.28933/ijoar-2019-11-1805 Chronic disease profile, health utilization and self-reported financial situation of older people in rural South Africa <p><strong>Background</strong>: Chronic diseases are more prevalent among older people. These illnesses require seeking continuous medical services which oftentimes have spill-over effects on the financial situation of individuals and households. Objective: To describe the chronic disease profile, health utilization and self-reported financial situation of older people in a rural population.&nbsp;<strong>Methods</strong>: Cross-sectional data from South Africa Wellbeing and Older People Study (WOPS)-wave 2 was utilized for this study. The survey included 519 respondents and was carried out between April 2013 and August 2013. Descriptive statistics was used to report respondents’ socio-economic characteristics, chronic disease profile, health utilization patterns, hospitalizations and access to medical and non-medical financial aid. Chi square test was conducted to examine the factors associated with chronic diseases and self-reported financial situation at 5% level of confidence.&nbsp;<strong>Results</strong>: The mean age of respondents was 62 years. Of the respondents, 259 (50%) had hypertension and 122 (24%) had arthritis, twenty-two (4%) had stroke, 43 (8%) had diabetes, 25 (5%) hade asthma, 10 (2%) had heart disease and 6 (1%) had cancer. Following the experience of a health problem, 119 (46.67%) adopted self-medication and 36 (14.12%) consulted traditional healer. Four hundred and fifty-four (97.63%) respondents received no financial aid for buying drugs and paid out-of-pocket. Also, 452 (97.41%) had no access to financial aid to pay for hospital bills. Risk factors like tobacco use (?2 =6.77, p=0.009) and alcohol consumption (?2 = 8.90, p= 0.003) were also associated with hypertension. Also, being hospitalized in the last 1 year (?2 = 8.15, p=0.017) was associated with whether households’ financial condition got better, remained the same or got worse. Having chronic disease (?2 = 7.68, p= 0.022) was similarly significantly associated with self-reported financial situation.&nbsp;<strong>Conclusions</strong>: The burden of chronic disease was high among older persons in this study. The study provided evidence that suggests that unearned income such as government grants and transfers as well financial supports from individuals’ families and acquaintances can provide some form of insurance against worsening financial condition among older people.</p> Folashayo Adeniji Copyright (c) 2019 Folashayo Adeniji 2019-11-13 2019-11-13 4 3 Better satisfaction with life is associated with normal immune profile (CD4/CD8 ratio) – and dependent on the successful aging status – in older Brazilian individuals <p><strong>Introduction</strong>: The immune system is an important determinant of longevity and has also contributed to the way individuals feel as they reach older ages. The inverted CD4/CD8 ratio is a parameter of the immune risk phenotype, and its prevalence increases with age. Association between immunological function, cognition and mood has been supported by studies with clinical and aging populations.&nbsp;<strong>Objective</strong>: We explored the relationship between the CD4/CD8 ratio and life satisfaction in a small sample of elderly people from Southern Brazil with good general health.&nbsp;<strong>Method</strong>: The sample consisted of 44 elderly individuals, who participated in an aging study in Southern Brazil (the PALA Study), and accepted to continue in the investigation collecting additional blood sample for the CD4/CD8 analysis. From this sample, 52% (N = 23) presented successful aging according to Rowe and Kahn’s criteria. No participant was HIV positive or presented any autoimmune diseases. A questionnaire was applied for sociodemographic and clinical data, lifestyle, and occupational activity. Cognitive function, basic and instrumental activities of daily living, and depressive symptoms were evaluated with specific instruments. Life satisfaction was evaluated with the Life Satisfaction Scale from Diener et al. (1985).&nbsp;<strong>Results</strong>: Forty-two individuals (95%) showed CD4/CD8 ratio&gt;1. CD4/CD8 ratio correlated significantly with life satisfaction (rho = -0.35) and with age (rho = -0.42) for the whole sample and among the successful aging sub-group only.&nbsp;<strong>Conclusion</strong>: This is an exploratory analysis with a small sample of elderly participants from a cohort started in 1996 in Southern Brazil (the PALA study). Their level of satisfaction with life was high, and correlated significantly, and inversely, with the CD4/CD8 ratio. It was also dependent on the successful aging status.</p> Juciclara Rinaldi1; Gabrielle do Canto1; Márcia Lorena Fagundes Chaves1,2 Copyright (c) 2019 Juciclara Rinaldi1; Gabrielle do Canto1; Márcia Lorena Fagundes Chaves1,2 2019-10-23 2019-10-23 4 3 10.28933/ijoar-2019-09-1205 THE PRACTICE OF LADDIC ACTIVITIES AS NURSING CARE FOR ELDERLY RESIDENTS IN A LONG-STAY INSTITUTION <p>Introduction: Aging is increasing in the world population and this phase of life requires special care, but there are a number of elements that interfere in the elderly’s stay with their relatives. With this, these elderly people are inserted in institutions of long stay. And in many moments, far from their family members, the elderly people who live there present pictures of solitude. In this scenario, practices of play activities are an excellent strategy to promote change in the lifestyle of the institutionalized elderly, as they are related to the viability of moments of physical, mental and interpersonal well-being, significantly improving the quality of life of these subjects, in addition to strengthening autonomy and self-esteem. Objective: To report the experience of nursing students in nursing care and to practice playful activities with them. Methodology: This is an experience report that emerged from practical classes held at the Maria Julia Miranda Long-Term Institution, located in the Gruta neighborhood of Maceió, Alagoas, during September 2017, by nursing Faculty Estácio de Alagoas. Results: The care provided was understood based on the individual needs of each elderly woman, divided into two moments. In the first one, the nursing history was performed, which enabled us to identify diseases and risks of injuries. the construction of the care plan. The second moment was composed of playful moments where the old women sang, danced, told their stories, besides solving puzzles, hunting words and painting booklets. Studies show that these activities can contribute in a promising way to an effective work with institutionalized elders, play, simply for the pleasure of play, without commitment or formal rules, gives the elderly a new look about their moment, awakening spontaneity and creativity, improving their quality of life. life. It was also noticed a greater interaction between the elderly residents and their caregivers, from the intensification of the moments of dance and group singing. Conclusion: It was verified that health care of the elderly requires a comprehensive, holistic, continuous care, where the singularities are observed. We believe that the practice of play activities significantly favors learning, social interaction and autonomy, as well as fostering the maintenance of cognitive and functional status, improving the quality of life of the institutionalized elderly. We also emphasize that the leisure activities are low cost and can be incorporated into the daily schedules of long-stay institutions maintaining the feelings of pleasure and joy in these women. It was a very rewarding and very constructive experience for the training of professionals committed to the profile of social aging, seeing in old age ethical values of respect for life.</p> Itamara Barbosa Souza1*; Everaldo de Lima Gomes Junior2; Hulda Alves de Araújo Tenório3; Luciana da Silva Viana4; Raíssa Fernanda Evangelista Pires dos Santos5. Copyright (c) 2019 Itamara Barbosa Souza1*; Everaldo de Lima Gomes Junior2; Hulda Alves de Araújo Tenório3; Luciana da Silva Viana4; Raíssa Fernanda Evangelista Pires dos Santos5. 2019-10-01 2019-10-01 4 3 10.28933/ijoar-2019-09-1005 COGNITIVE PROFILE IN ELDERLY WITH MEMORY CHANGE COMPLAINTS <p>Introduction: Population aging has increased over the years and directly affecting the health system. Latin America is considered to be a region where good information about dementia is lacking. Objective: The objective of this study was to evaluate the cognitive profile of the elderly with complaints of memory impairment. Method: The study was performed with patients who were being followed up at a public hospital in Recife – PE. Data were collected through the CERAD neuropsychological battery. Results and Discussion: 42 elderly people were evaluated in the first half of 2018, of which 13 were men and 29 were women with a mean age of 74.12 years. The majority, 74.36%, did not present scores compatible with GDS depression and MMSE was normal in 69.05% of the elderly; 66.67% presented alterations in the design of the clock and the majority presented alterations in the evocations of immediate and late words and also in the recognition of words. The CDR scores for 34.15% were compatible with mild dementia and moderate dementia classified 24.39% by CDR. Conclusions: Measures to diagnose the cognitive profile in the elderly are fundamental for the elderly to have a good quality of life and qualified treatment from health professionals.</p> João Carlos Alchieri1, Leopoldo Nelson Fernandes Barbosa2, Mônica Cristina Batista de Melo3, Maria Athina Kotzias-Bandeira4* Copyright (c) 2019 João Carlos Alchieri1, Leopoldo Nelson Fernandes Barbosa2, Mônica Cristina Batista de Melo3, Maria Athina Kotzias-Bandeira4* 2019-09-25 2019-09-25 4 3 10.28933/ijoar-2019-09-1006 A Study of the Attitudes of Nigerian Civil Servants towards Ageing <p>The human population is continuously ageing and previous studies suggest that one’s attitude towards ageing predicts ageing outcome. While several factors have been shown to influence attitude towards ageing, the current study investigated the influence of self-esteem and gender on attitude towards ageing. The study adopted a cross sectional design and a total of two hundred and five (205) civil servants were randomly selected from state Civil Service Secretariats and Local Government headquarters in Enugu, Anambra and Ebonyi states respectively. Self-report measures including the Rosenberg Self-Esteem Scale and a Self-Developed Attitude towards Ageing Scale were used for data collection. A Two-Way Analysis of Variance was used for the data analysis. The findings revealed that our first proposition that self-esteem as a psychological mechanism will significantly predict attitude towards ageing was not supported meaning that self-esteem whether high or low does not matter in how individuals respond to ageing consciousness. Whereas, the second proposition that gender will greatly influence attitude towards ageing was confirmed. In other word, the result further confirmed that female show more positive attitude about ageing than the male. The findings are discussed.</p> Grace M. Nwasogwa1, Kelechi T. Ugwu2 Copyright (c) 2019 Grace M. Nwasogwa1, Kelechi T. Ugwu2 2019-09-16 2019-09-16 4 3 10.28933/ijoar-2019-07-2905 Anthropometric Parameters for Height Estimation in Egyptian Elderly Males <p><strong>Background</strong>: Aging as a natural physiological process is accompanied with nutritional and metabolic changes that is reflected by the anthropometric indices furthermore loss of muscular and fat masses rises. elderly individuals it is complex, and sometimes impossible, to measure standing height precisely because of standing straight difficulties arising from underlying mobility issues Anthropometric indices and measuring formulas are greatly trustworthy when compared with more sophisticated methodologies such as hydro densitometry, electronic bio impedance.</p> <p><strong>Aim</strong>: To assess which one of the three anthropometric measures (demi-span, ulna length and knee height) is the most accurate for height estimation in Egyptian elderly males, and to provide a nationally representative regression equation for stature prediction that could be applied to Egyptian elderly males.</p> <p><strong>Methodology</strong>: A cross sectional research study was conducted to estimate height in community dwelling Egyptian ambulant elderly males. The study sample consisted of 226 community dwelling elderly males.</p> <p><strong>Results</strong>: The model for using knee height to estimate standing height of Egyptian elderly males [Height = 57.345 + 2.131 (Knee height in cm)], was found to be statistically significant reflecting 63.3% of standing height changes. [Table (5)] Besides there was strong statistically significant positive correlation between measured standing heights and study predicted standing heights (P value &lt; 0.001). [Table (6)] Finally it was revealed and displayed that by using the study equation, there is no statistically significant difference between measured and predicted heights.</p> <p><strong>Conclusions</strong>: In the current research study, knee height was found to be more accurate than demi-span and ulna length for estimating height of Egyptian elderly males.</p> Hala Samir Sweed1, Maram Maher Monier1, Nahla Fawzi Abu-ElEzz2, Ahmed A Abdelgaleel1 Copyright (c) 2019 Hala Samir Sweed1, Maram Maher Monier1, Nahla Fawzi Abu-ElEzz2, Ahmed A Abdelgaleel1 2018-09-01 2018-09-01 4 3 10.28933/ijoar-2019-08-1605 Benefits of Digital Gameplay for Older Adults: Does Game Type Make a Difference? <p>Digital games can help older adults to entertain themselves, socialize with others, engage their cognitive functions, and enhance emotional states. This study surveyed 463 older Canadian adults to identify the digital games they had played and investigate whether playing them was associated with perceived socioemotional and cognitive benefits. The most widely reported socioemotional benefits were developing self-confidence, dealing with loneliness, and connecting with family. The most widely reported cognitive benefits were focusing, memory improvement, improved reaction speed, and problem solving. In the socioemotional category, connecting with current friends and connecting with family were both associated with strategy games, while connecting with current friends was also associated with sport games. In the cognitive category, both problem solving and speed in reacting/responding were associated with arcade games. Results show that playing digital games has the potential to be an intervention tool to improve older adults’ wellbeing.</p> David Kaufman1, Mengxin Ma2, Louise Sauvé3, Lise Renaud4, Emmanuel Dupláa5 Copyright (c) 2019 David Kaufman1, Mengxin Ma2, Louise Sauvé3, Lise Renaud4, Emmanuel Dupláa5 2019-09-01 2019-09-01 4 3 10.28933/ijoar-2019-07-2805 Pharmacists in Home/Hospice/Palliative Care Settings <p>Medication-related problems are common among home care patients who take many medications and have complex medical histories and health problems. The goals of home health care services are to help individuals to improve function and live with greater independence; to promote the client’s optimal level of well-being; and to assist the patient to remain at home, avoiding hospitalization or admission to long-term care institutions. Home care is an arrangement of care given by gifted experts to patients in their homes under the heading of a doctor. Home medicinal services administrations incorporate nursing care; physical, word related, and discourse dialect treatment; and therapeutic social administrations. Doctors may allude patients for home social insurance administrations, or the administrations might be asked for by relatives or patients. The scope of home social insurance benefits a patient can get at home is boundless. Contingent upon the individual patient’s circumstance, care can extend from nursing care to specific therapeutic administrations, for example, research facility workups. Normal analyses among home social insurance patients incorporate circulatory infection, coronary illness, damage and harming, musculoskeletal and connective tissue sickness and respiratory malady.</p> Abdul Kader Mohiuddin Copyright (c) 2019 Abdul Kader Mohiuddin 2019-09-01 2019-09-01 4 3 10.28933/ijoar-2019-08-1006 Incidence of Cognitive Decline and Association with Changes in Sociodemographic, Lifestyle, and Health Indicators in Individuals aged 50 years and older: Prospective Cohort <p><strong>Objectives</strong>: To identify the incidence of cognitive decline (CD) in an urban community-dwelling population aged 50 years and older in a 4-year follow-up period and its prospective association with sociodemographic factors, lifestyle and health conditions as well as with changes in these factors.</p> <p><strong>Methods</strong>: This is a prospective cohort with a representative sample of people aged 50 years and older (n = 206) from Cambé, PR, where baseline data collection occurred in the year 2011 and the follow-up occurred in 2015. The incidence of CD was the outcome of this study, and its evaluation occurred through the Mini-Mental State Examination.</p> <p><strong>Results</strong>: The incidence of CD was 13.1% over the 4 years of follow-up, and adjusted Poisson regression models (sex, age and age range) showed that this condition was prospectively associated with depression (adjusted relative risk (RR) = 3, 50, 95% CI = 1.65-7.43). When analyzing the effect of sociodemographic factor changes on CD, it was verified that the risk of CD was 2.86 times higher among the group that stopped having a companion in the 4 years of follow-up when compared to the group that maintained a companion in that same period, independent of confounding factors.</p> <p><strong>Conclusion</strong>: The data suggest that the CD process begins before the age of 60 y and that aggravation is associated with potentially modifiable factors that can be approached by health services from the perspective of promotion, prevention and care.</p> Maria Cristina Umpierrez Vieira1, 2, Douglas Fernando Dias1, Maira Sayuri Sakay Bortoletto1, Ana Maria Rigo Silva1, Marcos Aparecido Sarria Cabrera*3 Copyright (c) 2019 Maria Cristina Umpierrez Vieira1, 2, Douglas Fernando Dias1, Maira Sayuri Sakay Bortoletto1, Ana Maria Rigo Silva1, Marcos Aparecido Sarria Cabrera*3 2019-07-18 2019-07-18 4 3 39 39 10.28933/ijoar-2019-06-2105 The Neuro Engraftment and Neuroregenerative effects of Hydrogen Sulphide Donor, Intracerebral MSCs, Ginko Biloba and Kefir in Attenuating Neuropathological hallmarks of Lipopolysaccharide induced Alzheimer’s disease Rat models <p>Background: Memory disorders have been characterized by being a devastating long term incurable diseases with a huge social impact in addition to a diminished efficient available medical treatments. Deep Brain stimulation via using neuroprotective inducers for treatment of brain structure degenerative diseases such as Alzheimer’s disease (AD) can be considered as being a promising successful therapy due to its various targets and underlying mechanisms for improving brain dysfunction. Objectives: The main aim of this study is to suggest therapeutic protocol having the potentials for restoring normal neurons diverse population and modifying neuropathological deposited hallmarks including both positive and negative lesions. Materials and Methods: Rats were divided into nine groups: (G1) control ;(G2) rats received LPS as a method of inducing nongenetically manipulated AD;(G3)AD rats received NaHS;(G4) AD rats received MSCs intracerebrally;(G5) AD rats received MSCs+NaHS;(G6)AD rats received kefir+GB;(G7)AD rats received MSCs+kefir+GB;(G8)AD rats received NaHS+kefir+GB; (G9) AD rats received MSCs+NaHS+kefir+GB. Results: AD induction resulted in down-regulation of CBS expression and GSH brain tissue level accompanied with overexpression in amyloid-? protein, MAPK, tau protein, ACAT expression and MDA brain tissue level in addition to elevated caspase-3 serum level. Conclusion: The implantation of amyloid reliving therapy that do have a wide clinical impact if initiated at benign plaques stage before irreversible brain damage occurs. The following effects have been observed following the administration of suggested medical protocol where a decrease in AD pathological deposited hallmarks has been observed with maintaining inflammatory brain factors by functioning as a potent neuroregenerative.</p> Mai M.Anwar1, Ola S.M.Ali2, Laila A. Rashed.3, Badawi A.M.1, Nadia A.Eltablawy1 Copyright (c) 2019 Mai M.Anwar1, Ola S.M.Ali2, Laila A. Rashed.3, Badawi A.M.1, Nadia A.Eltablawy1 2019-07-18 2019-07-18 4 3 38 38 10.28933/ijoar-2019-06-2005 Alzheimer´s Disease and Age-related Macular Degeneration could simultaneously be treated or prevented with a single therapeutic intervention <p>Alzheimer ´s diseases becomes the most common type of dementia in the world. There is more of 5.4 million AD patients in America, more than 6 million patients in China, and 35.6 million patients worldwide. AD and other dementias worldwide will increase to 67.5 million by 2030 and 115.4 million by 2050. In the aging population, two of the most common neurodegenerative diseases, AD and AMD, could simultaneously treated or prevented with single therapeutic intervention.</p> Arturo Solís Herrera, MD, PhD. Copyright (c) 2019 Arturo Solís Herrera, MD, PhD. 2019-07-18 2019-07-18 4 3 37 37 10.28933/ijoar-2019-04-0805 Depression and suicidal ideation in institutionalized elderly in Recife <p>This study aimed to analyze the disorders of depression and suicidal ideation in a population of institutionalized elderly in the city of Recife – PE. To measure the phenomena under study two standardized scales were adopted, the BECK SCALE FOR Suicide Ideation (BSI) and the Geriatric Depression Scale (GDS / GDS). The collected data were entered into a database, and statistical procedures performed using the Statistical Package for Social Sciences (SPSS) version 13.0 for Windows. After analysis of the data was possible to show that with the EDG, 48% of the interviewed elderly population is with some degree of depression. It was observed higher scores on the BSI scale for women. Among the elderly depression affects more the age less than 80 years, suicidal ideation was little evident in the population studied, being more related to female.</p> Evandro Valentim da Silva; Carla Andrea de Moura; Carolina Silva de Aleluia; José Marcio Nogueira da Silva; Fálba Bernadete Ramos dos Anjos; Eliane Helena Alvim de Sousa Copyright (c) 2019 Evandro Valentim da Silva; Carla Andrea de Moura; Carolina Silva de Aleluia; José Marcio Nogueira da Silva; Fálba Bernadete Ramos dos Anjos; Eliane Helena Alvim de Sousa 2019-07-18 2019-07-18 4 3 36 36 10.28933/ijoar-2019-05-2005 Prevalence of Polypharmacy and Association to Pharmacotherapy Complexity in Older HIV-Positive Patients. The Sevihlla Study <p><strong>Background</strong>: Increased life expectancy of older HIV-positive patients has been associated to a parallel increase in age-related comorbidities.<br><strong>Objectives</strong>: To ascertain the prevalence of polypharmacy and its association to pharmacotherapy complexity, as measured by the Medication Regimen Complexity Index, in older HIV-positive patients; to calculate the median value of pharmacotherapy complexity; to identify polypharmacy and multimorbidity patterns; and to address adherence to antiretroviral and concomitant drugs.<br><strong>Methods</strong>: A cross-sectional, observational study was conducted in patients over 50 years of age receiving active antiretroviral drugs during 2014 at outpatient pharmacy services of a tertiary hospital in Spain. Data collected from the electronic medical record included demographic, clinical and comorbidity related endpoints.<br>The primary endpoint was the proportion of patients with polypharmacy and major polypharmacy. Polypharmacy was defined as treatment with six or more drugs (including antiretroviral). Major polypharmacy (more than 11 drugs) was also considered.<br>Patients was categorized according to their polypharmacy pattern. Three patterns were applied based on age of participants: cardiovascular, depression-anxiety, and chronic obstructive pulmonary (COPD) disease patterns. A patient was classified into a pattern when at least three drugs of the treatment were in the same pattern.<br>Antiretroviral treatment adherence was measured using the SMAQ questionnaire and hospital dispensing records. Adherence to concomitant medication was measured using the Morisky-Green questionnaire and electronic pharmacy dispensing records.<br>Pharmacotherapy complexity index, as assessed by MRCI, was also considered. Patients were classified as low MRCI (less than 14 points) or high MRCI (more than 14 points).<br><strong>Results</strong>: The study sample consisted of 223 patients (86.5% men), with a median age of 53.0 years. More than 80.0% of the patients were viro-inmunological controlled. Prevalence of polypharmacy was 56.1%. The median value of pharmacotherapy complexity was 11.0. The main contribution to this value was from the concomitant medication.<br>The polypharmacy pattern mainly calculated was cardiovascular (60.0%) and the multimorbidity pattern was cardiometabolic (73.8%).<br>Presence of polypharmacy was associated to greater pharmacotherapy complexity (p&lt;0,001). Adequate adherence to the antiretroviral and to concomitant medication was found in 83.6% and 37.9% of patients respectively.<br><strong>Conclusions</strong>: More than a half of the older HIV-positive patients received six or more different drugs with a significant pharmacotherapy complexity showing adequate adherence to antiretroviral but not to concomitant drugs. Cardiovascular conditions were most common in terms of prescriptions and comorbidities.</p> 1Ramón Morillo-Verdugo. PharmD, 1Mª de las Aguas Robustillo-Cortés*. PharmD., 2Laila Abdel-Kader Martín. PharmD., 3María Álvarez de Sotomayor Paz. PhD., 4Fernando Lozano de León Naranjo. MD, 5Carmen Victoria Almeida-González. MS Copyright (c) 2019 1Ramón Morillo-Verdugo. PharmD, 1Mª de las Aguas Robustillo-Cortés*. PharmD., 2Laila Abdel-Kader Martín. PharmD., 3María Álvarez de Sotomayor Paz. PhD., 4Fernando Lozano de León Naranjo. MD, 5Carmen Victoria Almeida-González. MS 2019-07-18 2019-07-18 4 3 35 35 10.28933/ijoar-2019-2606 Whey Protein Supplementation as a Strategy to Preserve Muscle Mass and Increase Protein Synthesis in the Elderly: a Review of Literature <p><strong>INTRODUCTION</strong>: Aging often coincides with loss of muscle mass, strength and function, known as sarcopenia. Sarcopenia, a geriatric syndrome closely linked to physical frailty, has a substantial impact on the quality of life. Inadequate dietary intake, especially protein intake, has been associated with decreased lean body mass. Dietary protein affects muscle mass by the stimulation of muscle protein synthesis after absorption of amino acids into muscle cells&nbsp;<strong>AIMS</strong>: Verify the effectiveness of whey protein supplementation in increasing protein synthesis and muscle mass in elderly.&nbsp;<strong>METHODS</strong>: This is a systematic review conduced in the pubmed database, which sought clinical trials published between 2012 and 2016, with the combination of descriptors: Whey protein, muscle mass, protein synthesis, sarcopenia.&nbsp;<strong>RESULTS</strong>: We found 30 articles and after exclusion of non-relevant issues and duplicate articles were included 11 articles in this study. Of the selected material, 3 studies did not find positive effects with supplementation, this null response could have occurred because of dose and/or timing of supplementation, 1 study found the same effect with leucine supplementation and 7 studies found positive effects with whey protein supplementation for the protein synthesis and the increase of lean body mass in the elderly.&nbsp;<strong>CONCLUSIONS</strong>: Therefore, we can conclude that supplementation of whey protein shows positive results for increased protein synthesis and muscle mass in the elderly. However, the results differ between the sexes, quantity and timing of consumption, which after the need of new studies for the best understanding of the subject. It seems that the elderly respond best to higher amounts of supplement and the periods more distant from the practice of resistive exercise. In addition, after reviewing the articles it appears that men present better results than women do. The results give us another option to maintain the independence and quality of the elderly.</p> Celine de Carvalho Furtado1; Império Lombardi Jr2 Copyright (c) 2019 Celine de Carvalho Furtado1; Império Lombardi Jr2 2019-04-18 2019-04-18 4 3 34 34 10.28933/ijoar-2019-03-1805 Investigation of Feedback Schedules on Speech Motor Learning in Older Adults <p><strong>Background</strong>: The principles of motor learning (PML) emerged from studies of limb motor skills in healthy, young adults. The applicability of these principles to speech motor learning, and to older adults, is uncertain.&nbsp;<strong>Aims</strong>: The purpose of this study was to examine one PML, feedback frequency, and its effect on retention and generalization of a novel speech and comparable tracing task.&nbsp;<strong>Methods</strong>: Sixty older adults completed a speech motor learning task requiring the production of a novel phrase at speaking rates 2 times and 3 times slower than habitual rate. Participants also completed a limb motor learning task requiring the tracing of a sine wave 2x and 3x slower than habitual rate. Participants were randomly assigned to receive feedback every trial, every 5th trial, or every 10th trial. Mean absolute error was measured to examine immediate generalization, delayed generalization, and 2-day retention.&nbsp;<strong>Findings</strong>: Results suggested that feedback frequency did not have an effect on the retention and generalization of the speech or manual task, supporting the small but growing literature highlighting the constraints of generalizing the PML to other modalities and populations.</p> <p><em><strong>Funding:&nbsp;</strong>This research was supported by the National Institute on Deafness and Other Communication Disorders Grants T32 DC000033, P30DC04661, and the University of Washington Royalty Research Fund (A70442) awarded to Dr. Kristie Spencer. The authors gratefully acknowledge Sara Savaglio, Christopher Woollcott, and all participants for their contributions to this study. The content is solely the responsibility of the authors and only represents their views.&nbsp;</em></p> Phil Weir-Mayta, Ph.D.1; Kristie A. Spencer, Ph.D.2; Steven M. Bierer, Ph.D.3; Ayoub Daliri, Ph.D.4; Peter Ondish, Ph.C.5; Ashley France, M.S.2; Erika Hutchison, M.S.2; Caitlin Sears, M.S.2 Copyright (c) 2019 Phil Weir-Mayta, Ph.D.1; Kristie A. Spencer, Ph.D.2; Steven M. Bierer, Ph.D.3; Ayoub Daliri, Ph.D.4; Peter Ondish, Ph.C.5; Ashley France, M.S.2; Erika Hutchison, M.S.2; Caitlin Sears, M.S.2 2019-04-18 2019-04-18 4 3 33 33 10.28933/ijoar-2019-03-2006 Nutrition Care for Residents with Dementia in Long-Term Care Homes: Umbrella Review of Care Aide and Registered Dietitian Services <p>Recent attention has highlighted the distinct food and nutrition needs of residents with dementia living in long-term care (nursing homes). Nutrition care involves assessment of nutritional need, along with providing safe and appropriate food that fulfills nutritional requirements. Within long-term care, much of the direct care responsibilities lies with care aides who provide the day-to-day assistance including at mealtimes; however, it is the registered dietitian (RD) who provides specialized nutrition care. We sought to examine how roles and responsibilities of care aides and dietitians were described in long-term care settings. As many systematic reviews addressing nutrition care in dementia have appeared in the past two decades, we examined these using an Umbrella Review protocol. Ten papers were retrieved which examined nutrition services for dementia residents. These were diverse in nature. While all addressed some aspect of nutrition and the need for appropriate staffing, only three noted and discussed care aides and only three either noted or made recommendations for involvement of dietitians. Thus, the lack of attention to RDs and care aides represents a true gap that must be addressed in order for recommendations to enhance nutrition care for residents with dementia to be effective.</p> <p><em>Funding statement: This work was supported by scholarship awards to A.C. from Alzheimer Society of Canada Quality of Life Doctoral Fellowship, a Public Health and the Rural Agricultural Ecosystem (PHARE) graduate trainee fellowship, CIHR-STIHR, University of Saskatchewan.</em></p> Allison Cammer1, Debra Morgan2 and Susan J Whiting1 Copyright (c) 2019 Allison Cammer1, Debra Morgan2 and Susan J Whiting1 2019-04-18 2019-04-18 4 3 32 32 10.28933/ijoar-2019-03-1005 An evaluation of a walking and socialization program in long-term care: Impact on injurious falls <p>The effects of a walking program in long-term care (LTC) are affected by multiple comorbidities and the LTC milieu. We randomly assigned residents 60 years and older into three groups (walking, socializing and control). Interventions were delivered five days weekly up to 30 minutes daily. Measurements were performed at baseline, 8, 16, 24 and 32 weeks, and included falls, grip strength, Berg Balance Scale, Senior Fitness Test, and Geriatric Depression Scale Short Form. Survival analysis with 168 participants for time to first injurious fall showed a significant (p=0.001) interaction between age and sex, with fall risk increasing with age in females, but lowest in the oldest age group in males. The hazard ratio for first injurious fall was more than doubled by the use of an antidepressant (HR=2.198, p=0.005), decreased by the score on the Berg Balance high fall risk rating (HR=0.471, p=0.010), but not affected by the activity-socialization intervention. The increased hazard of injurious falls related to antidepressants, but not depressive symptoms, suggests that the high prevalence of antidepressants in LTC needs re-evaluation. Further research efforts will need to control for alternate physical activities.</p> <p><em>This work was supported by the Saskatchewan Health Research Foundation Health Research (SHRF) Team Grant.&nbsp;</em><em>Trial registration: NCT01277809</em></p> Lilian U Thorpe MD, PhD1, Susan J. Whiting PhD2*, Vanina PM Dal Bello-Haas PhD3, Thomas Hadjistavropoulos PhD4. Copyright (c) 2019 Lilian U Thorpe MD, PhD1, Susan J. Whiting PhD2*, Vanina PM Dal Bello-Haas PhD3, Thomas Hadjistavropoulos PhD4. 2019-04-18 2019-04-18 4 3 31 31 10.28933/ijoar-2019-03-0405 The Effects of Cognitive Training Program for Cognitively Impaired Older Adults: A Pilot Randomized Control Trial <p><strong>Objective:</strong>&nbsp;This pilot investigation evaluated the effectiveness of a cognitive training program for older adults with cognitive impairment.<br><strong>Methods:</strong>&nbsp;A sample of 23 individuals were randomly assigned to either a 24-session cognitive training program or a wait-list control group. Cognitive training sessions required participants to complete activities that targeted the following cognitive domains: attention, visual and verbal memory, visual spatial skills, processing speed, executive functioning, and language. A battery of cognitive tests were administered prior to and immediately after completion of the program. Depression, quality of life, agitated behavior, and daily functioning were also assessed.<br><strong>Results:</strong>&nbsp;Small to large effect sizes on half of the cognitive outcome measures were observed following participation in the program. No positive effects were found with regard to non-cognitive outcomes.<br><strong>Discussion:</strong>&nbsp;These results warrant further investigation into the benefits of this cognitive training program in larger randomized control trials.<br>Clinical Implications: The cognitive training program may provide activity staff in assisted living or memory care settings a highly structured, manualized, and user-friendly intervention for older adults experiencing cognitive decline.</p> Jeffrey A. Buchanan, Erica Johnson, Joseph Kennedy, Katherine Stypulkowski, and Nathan Jensen Copyright (c) 2019 Jeffrey A. Buchanan, Erica Johnson, Joseph Kennedy, Katherine Stypulkowski, and Nathan Jensen 2019-04-18 2019-04-18 4 3 30 30 10.28933/ijoar-2019-03-0705 Risks factors for significant injury after geriatric falls <p>Elderly falls are a healthcare epidemic. We aimed to identify risk factors of serious falls by linking data on functional status from the Global Longitudinal Study of Osteoporosis in Women (GLOW) and our institutional trauma registry. 124 of 5,091 local women enrolled in GLOW were evaluated by our trauma team for injuries related to a fall during the study period. Median injury severity score was 9. The most common injuries were intertrochanteric femur fracture (n = 25, 9.8%) and skin contusion/hematoma to face (n = 12, 4.7%). Injured women were older than the uninjured cohort (median 80 versus 68 years), more likely to have cardiovascular disease and osteoarthritis, and less likely to have high cholesterol. Prospectively collected Short Form 36 (SF-36) baseline activity status revealed greater limitation in all assessed activities in women evaluated for fall-related injuries in our trauma center. In multivariable analysis, age (per 10 year increase) and two or more self-reported falls in the baseline survey were the strongest predictors of falling (both HR 2.4, p &lt;0.0001 and p&lt;0.001 respectively), followed by history of osteoarthritis (HR 1.6, p= 0.01). Functional status was no longer associated with risk of fall when adjusting for these factors.<br>Functional status appears to be a surrogate marker for frailty. With the aging of the US population and long lifespan of American women, this finding has important implications for both fall prevention strategies and research intended to better understand why aging women fall as burdensome validated metrics may not be the best indicators of fall risk.</p> <p><em>The authors have no conflict of interests to declare. Funding statement: This work was partially supported by grants from NIH (8KL2TR000160-03), AHRQ (R01HS22694), and PCORI (ME-1310-07682) to HS.</em></p> Jon D. Dorfman MD1, Allison Wyman MS2, Gordon FitzGerald PhD2, Timothy A. Emhoff MD1, Fred A. Anderson PhD2, Heena P. Santry MD MS3 Copyright (c) 2019 Jon D. Dorfman MD1, Allison Wyman MS2, Gordon FitzGerald PhD2, Timothy A. Emhoff MD1, Fred A. Anderson PhD2, Heena P. Santry MD MS3 2019-02-04 2019-02-04 4 3 30 30 10.28933/ijoar-2018-12-2305 The mask we wear: Chronological age versus subjective ‘age inside’ <p><strong>Objectives:&nbsp;</strong><em>Age inside</em>&nbsp;is a type of self-reported, subjective age, that is unconstrained by years lived or physical health.&nbsp; The goal of this study was to explore: 1. How age inside is described and whether there is a relationship between age inside and chronological age; 2. Whether gender, income adequacy and education level associated with age inside or age inside perception; 3. Whether the associated variables be used to predict age inside and age inside perception as the dependent variables, in separate regression models.<br><strong>Method:&nbsp;</strong>Using a cross-sectional design, the data was collected via an online or in person questionnaire.&nbsp; Recruitment was done through doctor’s offices and seniors centres, as well as word-of-mouth utilizing a non-probability, purposive, sampling method along with snowball sampling.<br><strong>Results:</strong>&nbsp;Participants were 66 adults aged 65–90 years, (<em>m</em><sub>age&nbsp;</sub>= 73 years, SD = 6.5) all of whom reported at least one illness.&nbsp; The majority of participants identified an&nbsp;<em>age inside</em>&nbsp;of 20 to 40 years less than their chronological age (<em>m</em><sub>AI&nbsp;</sub>= 51 years, SD = 14.9). Gender (not sex) and self-reported health were associated with&nbsp;<em>age inside</em>.<br><strong>Conclusion:&nbsp;</strong><em>Age inside</em>&nbsp;may explain mid and later life purchases such as sailboats, and sports cars, new hobbies and new loves.&nbsp; With a youthful&nbsp;<em>age inside,</em>&nbsp;the older adult may be more interested in risk taking and radical changes than fitting into stereotypical elder roles and as such, may cause confusion and frustration for loved ones and health practitioners.&nbsp;<em>Age inside</em>&nbsp;has clinical value and could help explain some older adults’ lack of compliance with medical directives due to the attitude ‘they are for old people, I’m not old’. &nbsp;By acknowledging that the chronological age may not be reflective of the age of the person inside, policy makers and/or service providers might take a step back from programs for ‘seniors’ and create instead, programs that appeal to the young&nbsp;<em>inside</em>.</p> L. F. Carver M.A., PhD. Copyright (c) 2019 L. F. Carver M.A., PhD. 2019-02-04 2019-02-04 4 3 29 29 10.28933/ijoar-2019-02-2606 “Beyond shame and sorrow”: Abandoned elderly women in India speak out <p>I heard the story of Lakshamma from a couple of my friends who met her at the bus stop in Bangalore, South India. ‘You know, she did not look comfortable when she approached us asking for money’, my friend told me. ‘She quickly added that she was not a beggar and she felt bad doing that.’ Lakshamma told my friends that she had no choice because of her current situation. They gave her some money and asked if they could do anything else for her. First, she seemed both startled and grateful at this question. Then she told them her story. “My name is Lakshamma. I am 62 years old. I live in Shivajinagar, one of the neighborhoods in Bangalore, with my son and daughter-in-law. My son is a sales manager in one of the city malls and works long hours six days a week. A couple of months ago, my daughter-in-law who does not work and stays at home, started making every excuse to not have me at home as much as possible. She used to ask me to go to the neighbors or to the shop to get something and when I got back I found the door of the house locked. After unsuccessfully calling to my daughter-in-law to open the door, I had to sit and wait until the door was unlocked if my daughter-in-law was inside or until my son came home in the evening. I did not complain to my son because he came home tired and sleepy most of the evenings and went to bed right after the quick supper. Pretty soon the daughter-in-law told me not to stay near the house during the day but to go somewhere else, so the neighbors do not start talking. She never gave me any money or any food besides meager meal in the morning and that’s how I ended up at this bus stop asking people for money to survive until I have to go home in the evening.”<br>After hearing this story, I had a lot of unanswered questions at the time about this elderly woman whom I never met. What were the societal triggers that made it possible for Lakshamma to end up in this situation? Did Lakshamma’s son know about his mother’s situation? Did he pretend not to know and sided with his wife? What were the reasons for Lakshamma to be subjected to this treatment? Where else could she turn for help instead of just trying to get some money from the total strangers at a bus stop? How was she treated by the rest of the society? Those were among the questions that I hoped to answer some day doing this research work. During my previous work in Bangalore, I encountered an alarming number of women, especially elderly women, who were finding themselves even in worse daily situations than Lakshamma. They had been abandoned by their family members due to the economic instability of the family, the breakdown of the extended family system, and other reasons. They are thrown out of their homes, subsist on handouts, are exploited, and often are victims of street violence.<br>Traditionally, old age and women in India have been identified with the image of the multigenerational family, with the expectation that adult children will care for their aging parents. The family has been the most important social institution for the care of the elderly and has been expected to serve the role of primary care-giver, the principal source of support and security in old age. In stereotypical images, older adults in India are supposed to be perceived as wise, spiritually focused, and economically and socially stable (Nandan, 2007). However, as I came to increasingly appreciate during the course of this work, the capacity of the family to care for the elderly, as well as the availability and quality of support services, is dependent on the economic and social circumstances of the family, the overall political-economic environment, and changing economic conditions resulting from globalization and urbanization. During the last two decades, the decreasing family size, immigration and other changes in society have started posing challenges for care in India. The elderly can no longer solely depend on family to take care of them. Old age homes are filling the gap to a certain extent. But as of now, it is not a popular and affordable choice for most. Traditionally, old age homes were meant for the poor and destitute and hence mostly managed by charitable organizations, but in recent years, paid facilities have also emerged to cater to the needs of middle and upper middle-class older persons, who can pay for care in old age (Dutta, 2017).<br>The abandonment of elderly people in India and other places is not a new phenomenon. However, Salerno (2012) asserts that abandonment is central to modern times. He argues that while forms of abandonment and reactions to it vary from society to society, it appears to have taken on enormous social and cultural importance in modern life and characterizes not only our superficial relationships, but also many of our most intimate ones. As people’s life experiences are structured by wider societal relations, it is important to set the issue of abandonment of elderly within the larger historical, social and politico-economic contexts. In examining the issue of abandoned elderly women in India, my research focuses on identifying the linkages between the individual families and the wider structures and processes of society. As class and caste positions constitute the key social contexts essential to understanding the lives of women in all stages of life, I also examine what significance class and caste of abandoned elderly women have in shaping, sustaining and changing these women’s lives and experiences.<br>In this article I wish to focus on the abandonment-related experiences lived and told by the elderly women abandoned by their family members in Bangalore, South India. These experiences present alternate realities of powerlessness of the beggared and displaced faced by abandoned elderly in the society. They contrast with the official versions focused on the power that elderly females gradually acquire within their families as they get older.</p> Olya Clark, PhD Copyright (c) 2019 Olya Clark, PhD 2019-02-04 2019-02-04 4 3 28 28 10.28933/ijoar-2019-02-2605 Mandatory training in aged care- issues for Australian organisations and workers <p>There are significant issues related to the implementation of Mandatory Compliance Training in Not For Profit Aged Care provision in Australia. This paper provides an overview of those issues through an autoethnographic approach based on my 4 decades as an educator. It critiques the application of Mandatory Compliance Training using contemporary understandings of adult learning.</p> Graham Blaxell B.A. Dip. Ed. Copyright (c) 2019 Graham Blaxell B.A. Dip. Ed. 2019-02-04 2019-02-04 4 3 27 27 10.28933/ijoar-2018-12-0205 Neuroprotective Effect of Flavonoids: A Systematic Review <p>Neurodegenerative disorders such as Parkinson’s and Alzheimer’s disease are underpinned by neuronal damage corollary to the cascade of events pitched in by neuron inflammatory processes. Increase in cases of neurodegenerative diseases and ageing population indicates the need for developing new strategies to prevent or treat brain dysfunction and associated cognitive decline. Flavonoids have been documented for various health promoting effects. They exert multiple neuroprotective actions within the brain, such as protection of neurons from neurotoxins, suppression of neuron-inflammation and thus improve memory, learning and cognitive function. Two processes appear to be the basis of these effects. Firstly, they promote neuronal survival and synaptic plasticity by inhibition of apopotosis triggered by neurotoxic species due to interaction with critical protein and lipid kinase signaling cascades. Secondly they induce beneficial effects on the vascular system leading to changes in cerebrovascular blood flow capable of causing angiogenesis, neurogenesis and neuronal morphology. Limiting neurodegeneration and prevention or reversal of age-dependent loss in cognitive performance is possible by consumption of flavonoids-rich food throughout life. Thus flavonoids are strong candidates of being an important precursor molecule in the development of new generation of brain enhancing drugs. The present review accentuates current information on neuroprotective effects of flavonoids.</p> Divya Singh1 and Sukanya Hembrom2 Copyright (c) 2019 Divya Singh1 and Sukanya Hembrom2 2019-02-04 2019-02-04 4 3 26 26 10.28933/ijoar-2018-11-0906 Age-related circadian disturbances in melatonin causing changes in thymus hormones and glucocorticoids rhythmicity in healthy animals and humans <p>Circadian rhythms of the organism functions cause its adaptation to changes in environmental lighting. The pineal gland is a key regulator of the circadian rhythms of the immune system. The thymus, its central organ, is the source of some hormones, in particular, the highly active thymic serum factor / thymulin. Therefore, the issues of age-related changes in the circadian intra-immune relationships with thymus involvement and the possibility of melatonin influence not only on the above links but also on the glucocorticoids hormones with adaptive effect require an in-depth analysis.<br>Discussed are the literature data and our own findings how age-related changes in the circadian rhythms of thymus endocrine and adrenal gland glucocorticoid functions are linked with the melatonin-forming function of the pineal gland in healthy animals of different species (mice, rats, rabbits) and humans. The similar manifestations of the above interactions in healthy animals and humans demonstrate the biological significance of the pineal gland for the supporting circadian rhythms of the thymus and adrenal gland functions in the adult organism. The correlation of age-related changes in circadian rhythmicity of pineal gland in healthy animals and human, on the one hand, with the thymus and adrenal glands, on the other hand, has been demonstrated. In addition, the decrease of age-related disorders in the thymulin and glucocorticoid blood levels under the influence of pineal gland factors (melatonin and peptides) was shown. Thus, (a) the thymus endocrine function does not completely disappear in the old organisms and it responds to the effects of melatonin and peptide factors of the pineal gland and (b) age-related pineal gland desynchronosis has pathogenic significance for the formation of circadian disturbances in the thymus hormones and glucocorticoids.</p> Labunets Irina F. Copyright (c) 2018 Labunets Irina F. 2018-09-04 2018-09-04 4 3 25 25 10.28933/ijoar-2018-12-0101 Are self-consciousness and mindfulness altered by aging? <p>It is well known that aging is the process of becoming older. It is also associated normally with a progressive loss of biological functions – both physical and mental –, underlied by naturally-occurring changes at the molecular level that may lead to the development of so-called aging-related health problems – e.g., Parkinson’s Disease, dementia, memory loss, cerebrovascular problems and Alzheimer’s Disease. Along this idea, a fundamental question remains – are self-consciousness and mindfulness also affected by these physiological or pathophysiological changes? This short article summarizes briefly some of the key sementic, conceptual, methodological and physiological issues that shall be addressed prior to tentatively providing answers to comparable questions.</p> Pierre A. Guertin Copyright (c) 2018 Pierre A. Guertin 2018-09-04 2018-09-04 4 3 24 24 10.28933/ijoar-2018-11-1507 Is Propanediol a safer molecule than some other glycols in personal care and anti-aging biocosmeceutical products? <p>Propanediol (1,3-propanediol) is an ingredient increasingly used by the industry for electronic cigarettes, personal care creams and anti-aging serums among many other products. For some skin care purposes, it is used to enhance the transdermal absorption of other ingredients (e.g., the actives) enabling moisturizing effects and skin smoothness to be improved. Propanediol may be derived from corn although synthetic forms also exist. It is a chemical similar to other glycols such as propylene glycol (1,2-propanediol) but generally believed to be safer. This short communication reveals in fact that only limited scientific evidence of safety is available. Preliminary signs of toxicity have been found following administration of propanediol in humans although its dose-dependent toxicity and long-term side effects on health have not been significantly explored. Consequently, as of today, skin care and anti-aging products for elderly, a vulnerable population, should not automatically be considered as safe. Those comprising 1,3-propanediol should probably be used with caution until scientifically-proven safety data for the intended purposes are obtained by independent scientists.</p> Pierre A. Guertin Copyright (c) 2018 Pierre A. Guertin 2018-09-04 2018-09-04 4 3 23 23 10.28933/ijoar-2018-11-1508 Entropy production as a physical pacemaker of lifespan in mole-rats <p>This work discusses the relationship of the biological aging between mole-rats and rats through a unified approach from the perspective of thermodynamics. Taking calorimetric data from some published studies of the metabolism on mole-rats and rats, it is calculated the entropy production rate. It is observed that the entropy production rate in rats decays with chronological age, and develops a kind of first order phase transition. However, the mole-rats, showed that entropy production rate did not change significantly with age and exhibits a slightly higher value as an average compared to the rats analyzed. This result can be interpreted in terms of a mole-rats exhibit a more robustness, i.e. greater plasticity than rats. Furthermore, it is shown that the entropy production rate could be consider as a physical marker of biological age and a predictor of Lifespan.</p> L. Triana1, G. Cocho2, R. Mansilla3, & J.M. Nieto-Villar4* Copyright (c) 2018 L. Triana1, G. Cocho2, R. Mansilla3, & J.M. Nieto-Villar4* 2018-09-04 2018-09-04 4 3 22 22 10.28933/ijoar-2018-11-0601 Diagnosis and monitoring of Alzheimer Disease with saliva biomarker BACE1 <p>Alzheimer’s disease (AD) is characterized by the slow decline of cognition and functional abilities over time. The diagnosis for probable and possible AD relies principally on clinical criteria. The confirmation of the disease is made post-mortem by identifying extracellular senile plaques and intraneuronal fibrillary tangles in the brains of subjects with clinically defined dementia. However, the field critically lacks validated AD specific peripheral biomarkers to support the diagnosis in living patients or for early detection of patients at risk before symptoms appear. BACE1 (Beta site amyloid precursor protein cleaving enzyme 1) cleaves Amyloid Precursor Protein (APP) at two beta sites and represents a key target enzyme in the monitoring and possible treatment of AD. In our preliminary study, we evaluated the usefulness of salivary BACE1 to determine risk to develop AD in clinically normal patients. A preliminary in house laboratory grading system for BACE1 content in saliva was established with high levels of salivary BACE1 present in older patients and putatively at risk to develop AD. BACE1 seems to be a useful biomarker to help diagnose AD and to monitor disease progression, and remarkably regression, when treated with stem cell secretome.</p> Dr SJ Kellner and Prof M Ferchichi Copyright (c) 2018 Dr SJ Kellner and Prof M Ferchichi 2018-09-04 2018-09-04 4 3 21 21 10.28933/ijoar-2018-10-0909 Geriatrics & e-Technology: a personalized follow-up of elderly residents in nursing homes to anticipate the decompensation of geriatric syndromes. Rationale for a first prospective study Ger-e-Tech <p>The objective of the GER-e-TEC project is to provide recorded personalized medical monitoring of residents in nursing homes using an intelligent telemedicine platform. It will assist healthcare staff by automatically processing the information from sensors and questionnaires to provide early detection and escalate alerts to enable health professionals, operating in retirement homes, to optimize patient care.</p> A.A. Zulfiqar1,2, A. Hajjam3, B. Gény2, S. Talha2,4, M. Hajjam5, J. Hajjam6, S. Ervé6, E. Andrès 2,7 Copyright (c) 2018 A.A. Zulfiqar1,2, A. Hajjam3, B. Gény2, S. Talha2,4, M. Hajjam5, J. Hajjam6, S. Ervé6, E. Andrès 2,7 2018-09-04 2018-09-04 4 3 20 20 10.28933/ijoar-2018-10-1602 Telemedicine and Dermatology in the elderly in France: inventory of experiments <p>Telemedicine is now in vogue, allowing thanks to the computer and communication tools to be deployed in the field of health, such as Dermatology, areas in which it has shown interest. As the population is aging, Geriatrics is more and more concerned by this innovative practice and nursing homes are more and more concerned. We take a look at telemedicine projects in France deployed in the field of dermatology in the elderly.</p> A.A. Zulfiqar1,2, A. Hajjam3, S. Talha2,4, Geny B2, M. Hajjam5, J. Hajjam6, S. Ervé6, E. Andrès 2,7 Copyright (c) 2018 A.A. Zulfiqar1,2, A. Hajjam3, S. Talha2,4, Geny B2, M. Hajjam5, J. Hajjam6, S. Ervé6, E. Andrès 2,7 2018-09-04 2018-09-04 4 3 19 19 10.28933/ijoar-2018-10-0810 Emotional Intelligence in Older Adults: Psychometric Properties of Trait Meta Mood Scale <p>Nowadays, ageing in a healthy way is one of the greatest challenges of our era. The management of emotions is a powerful predictor of psychological well-being and health during all periods of life. However, to date, such evidence cannot be extended accurately to the older adult population since young adults have been the primary target of valid and reliable measures. Therefore the aim of this article is to analyse the validity and reliability of the Trait Meta Mood Scale (TMMS) in a sample of middle-aged and older adults, and its relation to personality traits and subjective well-being. Findings show that the TMMS represents a useful tool in examining social and psychological adjustment of older adults. The TMMS-22 will allow the analysis of emotional regulation development, explaining differences in psychosocial adaptation and perceived emotional competence. Finally, a TMMS for the older adult population is a complementary resource to the ability measures of EI and encourages increasing awareness of emotional abilities and self-evaluation in an individual.</p> Nerea Galdona1, Aitor Aritzeta2, Cristina Martínez-Taboada2, Erkuden Aldaz1, Elena Urdaneta3 Copyright (c) 2018 Nerea Galdona1, Aitor Aritzeta2, Cristina Martínez-Taboada2, Erkuden Aldaz1, Elena Urdaneta3 2018-09-04 2018-09-04 4 3 18 18 10.28933/ijoar-2018-09-1001 Changing Roles of Care Team Members within New Models of Care Delivery in Residential Care Facilities: Implications for the Delivery of Quality of Care <p>Providing quality of care (QoC) to older adults in residential care settings is an ongoing challenge given the increasingly complex needs of this population and the escalating economic constraints within which health authorities operate. While the implementation of the residential care delivery model in a Western Canadian health authority has contributed to some improvements in QoC, it has also highlighted key challenges that are both interpersonal and organizational in nature; specifically, gaps in leadership, teamwork, mentorship, and communication, as well as staffing mix, staffing consistency, resident complexity, and competing policy and program initiatives and directives. The implementation of a major change in care delivery impacts residents, families, and staff and may, in turn, impact their perceptions of change in QoC. When evaluating a model, therefore, it is important to examine both qualitative and quantitative outcomes: stories from those most affected in their everyday lives and trends in QoC indicator data.</p> Karen M. Kobayashi1*, Ruth Kampen2, Amy Cox3, Denise Cloutier4, Heather Cook5, Deanne Taylor6, Gina Gaspard7, Mushira Mohsin Khan8 Copyright (c) 2018 Karen M. Kobayashi1*, Ruth Kampen2, Amy Cox3, Denise Cloutier4, Heather Cook5, Deanne Taylor6, Gina Gaspard7, Mushira Mohsin Khan8 2018-09-04 2018-09-04 4 3 17 17 10.28933/ijoar-2018-08-0601 The Genetic and environmental risk Factors of Alzheimer’s disease <p>Alzheimer is one of the most common neurodegenerative disease generally found in the form of dementia in old age population. Advanced age is still considered as most influencing risk factors for this disease. WHO reported that dementia is the seventh leading cause of death in 2018 and affecting about fifty million people worldwide. Aging led to impair protein metabolism in the Alzheimer’s disease. A number of molecular events has been implicated behind this disease. As AD is a chronic neurodegenerative disease and etiology is still unclear, familial AD accounts only 5% of the disease. Then it is important to know about some other hidden risk factors that may play crucial role in the onset of the disease. Thus, this paper focused on the role of genetics, different environmental, oxidative stress factors and its association with the pathogenesis of Alzheimer’s disease.</p> Jyoti Yadav and Prof. Anoop Kumar Verma Copyright (c) 2018 Jyoti Yadav and Prof. Anoop Kumar Verma 2018-09-04 2018-09-04 4 3 16 16 10.28933/ijoar-2018-07-2401 Prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients <p>Vitamin D deficiency is highly prevalent worldwide and certain groups as elderly persons women and institutionalized persons are particularly prone to severe deficiency. Objective: To identify the prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients. Method: A cross sectional study conducted from the first of October 2014 to the end of March, 2016, where 163 elderly diabetic females who attended Ain shams university hospital at that time were included. They underwent careful history taking, body mass index calculation, blood pressure measurement and Serum 25(OH) D measurement, assessment of insulin secretion including fasting serum C-peptide and CPI measurement in addition to assessment of glycemic control by fasting blood sugar estimation. The level of 25 hydroxy vitamin D (25OHD) was measured. Results: The prevalence of vitamin D deficiency (25OHD level &lt;20 ng/mL ) and insufficiency (25OHD concentration of 20–29 ng/mL) among elderly Egyptian diabetic female patients are 71.2% and 28.2% resp. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index. The 3 independent predictor of the presence of vitamin D deficiency were types of diabetic medications, low C-peptide and CPI values and upon logistic regression analysis for these 3 variables, lower CP level was an independent predictor of the presence of vitamin D deficiency. Results showed a weak negative correlation between serum 25(OH)D, systolic BP, BMI and HOMA IR in studied subjects. Conclusion: Prevalence of vitamin D deficiency among elderly Egyptian diabetic female patients is 71.2%. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index.</p> Walaa W. Aly1, Hend M. Taha1, Khalid E. Elsorady1, Wessam E. Saad2, Ahmed K. Mortagy1 Copyright (c) 2018 Walaa W. Aly1, Hend M. Taha1, Khalid E. Elsorady1, Wessam E. Saad2, Ahmed K. Mortagy1 2018-09-04 2018-09-04 4 3 15 15 10.28933/ijoar-2018-07-2801 Effectiveness of the “Kwido-Mementia” computerized cognitive stimulation programme in older adults <p>Despite the importance of cognitive stimulation to counteract the cognitive decline associated with age, there is contradictory evidence about the benefits of cognitive training programs that are carried out through new technologies, and little evidence about those programs conducted at home. This research examines the effectiveness of a computerized cognitive stimulation program in adults 65 years old and over who are users of a home care service. The sample consisted of 43 participants (88% women) and an average age of 81.4 years. A quasi-experimental research design with a control group was carried out, where the experimental group completed a 15-session training (Kwido-Mementia). The results showed that the training program improves cognitive functions; both visuospatial memory capacity and perceptual reasoning skills. The computerized cognitive training proves to be an effective tool, not only to prevent deterioration, but also to improve the cognitive abilities of people 65 years old and over. The work contributes to clarify, in part, the existing controversy in the literature regarding the usefulness of cognitive training programs based on new technologies and provides positive evidence, contrary to what other studies indicate regarding the programs carried out at home.</p> 1Álvarez-Lombardía, I., 2Migueles, M., 2Aritzeta, A., 1Acedo-Gil, K. Copyright (c) 2018 1Álvarez-Lombardía, I., 2Migueles, M., 2Aritzeta, A., 1Acedo-Gil, K. 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-08-0301 Deciphering the longevity of the mole-rats <p>A theoretical model of a nonlinear network that outlines the general aspects of mole-rat resistance to age-related diseases, such as cancer and the action of ROS was elaborated. According to our conjecture, it was shown that the protection is established because hyaluronic acid of high molecular mass forms a non-linear network of interactions. That network leads to self-organization away from the thermodynamical equilibrium, which appears through a “first order” phase transition as a supercritical bifurcation of Andronov-Hopf type. Finally, it is shown how the rate of entropy production is a Lyapunov function of the dynamics of the process.</p> L. Triana1, G. Cocho2, R. Mansilla3 and J.M. Nieto-Villar4* Copyright (c) 2018 L. Triana1, G. Cocho2, R. Mansilla3 and J.M. Nieto-Villar4* 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-07-3101 Life quality in hypertensive elderly people in Olinda – PE <p>Introduction: Hypertension is among the first places in the problems of public health in worldwide. Being the most common chronic disease in the elderly. Objective: To identify the hypertensive elderly community so that we can verify the functional ability, mental health, general health, pain, vitality, social functioning, limitations due to emotional and physical aspects of that population. Methodology: The study was conducted in the Community Center and welfare of the Town of COHAB 7 ° RO, whose sample consisted of 53 elderly hypertensive patients, aged 60 years, of both genders. Later we used the SF-36. Result and Discussion: The final sample comprised 44 volunteers with mean age of 72.5 years. A comparison between scores in different domains of the SF-36 in individuals who engage in activities to entertain and physical activities, observing significantly higher in the SM domain, the group of individuals who practice physical activity (85.1 ± 16 , 0 vs 70.0 ± 18.6, p = 0.02). Conclusion: Given the results run in this study, to denote the deleterious effects of hypertension, thus demonstrating the damage that interfere with the general health of the elderly. Making clear the importance of applying a questionnaire to assess quality of life in this population.</p> Ribeiro, G.O1; Silva, K.C.L2; Souza, F.S3³; Melo, T.A4; Fernandes, M.G5; Lima, A.K.P6 Copyright (c) 2018 Ribeiro, G.O1; Silva, K.C.L2; Souza, F.S3³; Melo, T.A4; Fernandes, M.G5; Lima, A.K.P6 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-05-0809 To correlate levels of knee osteoarthrosis with alteration of balance and quality of life in the elderly <p>Introduction: In aging there are several physiological and biochemical changes, being recurrent pathologies, such as osteoarthrosis (OA). Objective: This study aimed to correlate levels of knee osteoarthrosis with alteration of balance and quality of life in the elderly. Methodology: It is a study observational, cross-sectional descriptive study performed at a Clinical School. The socio-demographic questionnaire, Visual Analogue Scale (EVA), Berg Balance Scale, Tinetti Test, Time Up Go Test (TUGT), Scale Somewhat functional of Lequesne, SF-36 and WHOQOL-Bref. The data were analyzed Statistically, using software R version 3.2.4, with values of significance (p &lt;0.05). Results: The sample consisted of 19 elderly individuals, 88.88% female, with a mean age of 66.78 years. In VAS, the mean score was 5.11; already in Tinetti was 19. The mean in the BERG scale was 40.95 and the time during the TUG Test was 22.56s. In Lequesne we obtained as a result 12.53. The lowest score of SF-36 was in the Pain domain (46,17); already in WHOQOL-Bref, was Environment (12,53). Conclusion: It is concluded that the found findings give indications that OA knee is a condition that interferes with the quality of life, as well as in the compromising the balance.</p> Gomes, V. M. S. A. ¹, Silva, G. Â. B. ², Uchôa, E. P. B. L ³ Copyright (c) 2018 Gomes, V. M. S. A. ¹, Silva, G. Â. B. ², Uchôa, E. P. B. L ³ 2018-11-04 2018-11-04 4 3 10.28933/ijoar-2018-05-0808 To evaluate the quality of life of family caregivers of patients with knee osteoarthritis <p>Introduction: The demographic situation in Brazil has changed with the elderly, increasing the need for caregivers to help with their daily activities. The tasks assigned to the caregiver can lead to physical and emotional exhaustion. Objective: To evaluate the quality of life of family caregivers of patients with knee osteoarthritis. Method: This is an observational, descriptive and cross-sectional study conducted at a school clinic and at the hospital outpatient clinic in Recife. Caregivers of both sexes, aged between 18 and 70 years, were included, and those with cognitive deficits were excluded. Participants signed the informed consent form. Questionnaires were then applied: Socio-clinical, SF-36 and WHOQOL-BREF. Results: Nine caregivers were evaluated, the majority female (66.7%), mean age 51.44 ± 9.88 years, 66.7% did not practice physical activity and BMI of 25.39 ± 5.79. Of these, 66.7% are children, with associated diseases and similar to high school. No SF-36 questionnaire, as well as no WHOQOL-BREF, a moderate to good quality of life. In the linear correlation of Pessoa, there was a positive association between WHOQOL-BREF and SF-36. Conclusion: it was verified that the caregivers presented moderate to very good quality of life, such as the good relationship between the couple.</p> Gomes, V. M. S. A. ¹, Araujo, A. E. L. ², Uchôa, E. P. B. L. ³ Copyright (c) 2018 Gomes, V. M. S. A. ¹, Araujo, A. E. L. ², Uchôa, E. P. B. L. ³ 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-05-0807 Study on Mental Pension and Its Influence Factors of Rural Empty-nest Old Men <p>With the continuous development of urbanization and aging, the rate of empty-nest old man in rural areas in China continues to rise. Due to the “Healthy China” strategy proposed by the 19th CPC National Congress and the changing family structure in rural areas, the vulnerable elders in rural vulnerable population have been placed in a prominent place. It is urgent to solve mental pension for the elderly in the countryside. On the basis of comprehensively understanding the connotation of mental support, we analyzed the data from the 2012 Renmin University of China. The factors influencing the mental pension of rural empty-nest old men were divided into three categories and 19 types. We deeply summarized the impact of different factors on the mental pension of rural empty-nest old men.</p> He Xihui and He Yixuan Copyright (c) 2018 He Xihui and He Yixuan 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-06-1401 Turning Performance and Factors Related to Turning in Mild And Moderate Phase Parkinson’s Disease Patients <p>Background/aim: The purpose of study is to determine the turning performance and other factors related to turning in mild and moderate phase Parkinson’s disease patients (PD).<br>Methods: Ninety two patients were followed up for observation. After passing neurological examinations, the Unified Parkinson Disease Rating Scale (UPDRS), Hoehn / Yahr Scale (H&amp;Y), Mini Mental State Examination (MMSE), Tinetti test, Berg Balance test, 6 m walking test, step count, 360° turning duration, and Functional Independence Measure (FIM) were applied. All cases were evaluated according to the “on” period.<br>Results: Forty one females and 51 males participated in the study. The duration of time it took to turn right was 8.22 ± 6.26 seconds, and the time it took to turn from left was 8.51 ± 6.63 sec. There appeared to be no statistical difference in the turn times of patients either in terms of the socio-economic factors of gender, education level, or employment status. But, statistically significant relationships were found when it came to in both directions, age, duration of illness, UPDRS, FIM, Tinetti, the Berg Test, the walking test, and the number of steps taken.<br>Conclusion: Our results suggest that 360 degree turning performance in mild and moderate stage PD is strongly associated with patient’s age, disease duration and disease severity.</p> Ferhan Soyuer1 Prof Dr, Murat Gültekin2 MD, Ass Prof, Feyzan Cankurtaran1 Ass Prof Copyright (c) 2018 Ferhan Soyuer1 Prof Dr, Murat Gültekin2 MD, Ass Prof, Feyzan Cankurtaran1 Ass Prof 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-06-0702 The Relat?on Between Qual?tat?ve And Qant?tat?ve Parameters Of Freez?ng And Walk?ng In Id?opath?c Park?nson’s D?sease <p>Purpose: Our study is planned for determining the relation of some qualitative and quantitative parameters of freezing phenomenon and walking in patients with Idiopathic Parkinson’s Disease (IPD). Methods: 87 patients (37 -%42.5 female, 50-%57.5 male) in ErciyesUniversity Faculty of Medicine Neurology Department involved in this study. Patients were evaluated by demographic data, Mini Mental State Examination (MMSE), Hoehn- Yahr Scale, the Unified Parkinson’s Disease Rating Scale (UPDRS), freezing, 6 meter walking time, step count, rotation and related to step parameters. Results: Hoehn- Yahr Scale for the involved patients between 1-3, 14 out of their was 1(%16.1) and 17 out of their was 3 (%19.5). Freezing phenomenon was determined in 34 (%39.1) of the patients. There were no statistically difference between freezing and non-freezing patients about age, gender, education, profession, marital status and MMSE (p&gt;0.05). Statistically difference were obsorved between freezing and non-freezing groups about UPDRS, rotation time 360 degrees from right, rotation time 360 degrees from left, balance defect at 360 degrees right rotation, 6m walking time, step count, hesitating gait, arrhythmic stepping, opening arms outside while walking (p&lt;0.05). Discussion: Our study showed freezing phenomenon effects some walking parameters for IPD. Effect of freezing phenomenon on postural instability and It’s effection balance should be investigated. Also exercise programmes in IPD with freezing phenomenon should focus on walking education.</p> Assistant Prof Feyzan CANKURTARAN1, Assistant Prof Murat GÜLTEKİN2, Prof Dr Ferhan SOYUER1, Prof Dr Meral MİRZA2, Assistant Prof Gözde ERTÜRK3 Copyright (c) 2018 Assistant Prof Feyzan CANKURTARAN1, Assistant Prof Murat GÜLTEK?N2, Prof Dr Ferhan SOYUER1, Prof Dr Meral M?RZA2, Assistant Prof Gözde ERTÜRK3 2018-09-04 2018-09-04 4 3 10.28933/ijoar-2018-06-0701 Anti-Aging Gene linked to Appetite Regulation Determines Longevity in Humans and Animals <p>The process of aging is determined by various genetic and environmental factors. Aging is associated with increased oxidative stress that alters cellular chromatin structure, DNA methylation with histone modifications. These epigenetic alterations lead to nuclear changes associated with mitochondrial apoptosis that is a major defect in the global chronic disease epidemic (1). The variability in longevity between individuals in different communities implicate various nutritional and environmental factors involved in transcriptional dysregulation that lead to cell damage that accumulates with age and contributes to mitophagy, insulin resistance and programmed cell death. The absence or malfunction of a gene (2) necessary for transcriptional regulation of gene expression, DNA repair and telomere maintenance in neurons has become essential with relevance to neurodegeneration that determines aging and lifespan.</p> Ian James Martins Copyright (c) 2018 Ian James Martins 2018-09-04 2018-09-04 4 3 10.28933/IJOAR-2018-05-1101 Alzheimer’s Disease and Overload of Informal Caregivers <p>Introduction: Alzheimer’s disease is one of the most common chronic diseases of aging and caring for an elderly with this pathology causes a great deal of overload in the family. Objective: To analyze the overload of informal caregivers of elderly with Alzheimer’s disease. Methodology: Cross-sectional study approved by the Research Ethics Committee with Human Subjects (CAAE: 0178.0.236.000-11) and carried out at the Brazilian Alzheimer’s Association, in the section Pernambuco with 33 caregivers. The instruments used were: semi-structured sociodemographic questionnaire (caregiver and senior citizen ages, gender, degree of dependence of the elderly and degree of kinship among the participants) and Zarit Burden Interview Scale. These caregivers were divided into 4 groups, according to the degree of caregiver overload: mild, moderate, moderate to severe and severe. The Spearman correlation was used, considering p?0.05. Results: Caregivers presented a mean age of 57.9 ± 12.2 years, while the elderly had 79.0 ± 8.1 years. 90.9% of the informal caregivers and 66.7% of the elderly were female. Regarding the degree of dependency of the elderly, 54.5% were considered totally dependent and, in relation to the classification by kinship, 63.6% were children. The moderate overload achieved a higher percentage, 39.4%, along with the moderate to severe overload level, 36.4%. When analyzing the degrees of overload with the age of the caregiver and the elderly, there was a positive correlation in the degrees of moderate to severe overload (rho = 0.734, p = 0.007). Discussion: The literature points out the predominance of the female gender in the elderly care and has been analyzing the caregiver’s overload by relating it to numerous factors. Conclusion: The present study demonstrates that the majority of informal caregivers are the daughters of the elderly with Alzheimer’s Disease. And the overload of care is directly related to the increase in the ages of the caregiver and the person receiving the care.</p> Oliveira, R.C.S1, Lima Neto, J.S2, Hemmlepp, L.K.F.S3, Bezerra, M.A.B4, Eufrásio, J.C5, Fittipaldi, E.O.S6 Copyright (c) 2018 Oliveira, R.C.S1, Lima Neto, J.S2, Hemmlepp, L.K.F.S3, Bezerra, M.A.B4, Eufrásio, J.C5, Fittipaldi, E.O.S6 2018-07-04 2018-07-04 4 3 10.28933/ijoar-2018-05-0805 The Efficacy of Vestibular Rehabilitation in the Treatment of the Elderly With Vestibular Symptomatologies <p>Introduction: Changes in structures and systems of the human body through the process of senescence are responsible for frequent complaints in the elderly population, among which are those of dizziness, vertigo and imbalance. The aging of the vestibular, visual, somatosensory, musculoskeletal and central nervous systems mainly affects the postural control, being this of fundamental importance for the autonomy of these individuals. Vestibular rehabilitation aims to improve the overall balance, quality of life and spatial orientation of patients with dizziness. Objective: To verify the efficacy of vestibular rehabilitation in the treatment of elderly patients with symptoms of vestibular alterations. Methods: We conducted extensive research and selected articles published between 2012 and 2016, indexed in the databases SciELO, PubMed, MEDLINE and LILACS. The following keywords were selected in Portuguese: Speech Therapy, Elderly and Vestibular Rehabilitation. Results and discussion: Currently vestibular rehabilitation is increasingly being indicated in the treatment of vestibular dysfunction, as it is also being prescribed for individuals who present alterations related to balance and spatial orientation. The main peripheral vestibular disorders prevalent in the elderly are: Benign Paroxysmal Positional Vertigo; Menière’s syndrome; Vestibular neuritis and persistent perceptual postural dizziness (subjective chronic dizziness). The treatment of coexisting pathologies is also fundamentally important for the success of the therapy. Conclusion: Vestibular rehabilitation was shown to be an effective and viable alternative for vestibular symptomatology in the elderly. It is a satisfactory strategy to treat or minimize vestibular alterations, as well as improvement in anxiety, depression, static and dynamic balance and reduction of the quality of life and social interaction of this population. However, the practice of vestibular rehabilitation has not yet become routine in many speech-language rehabilitation services.</p> Souza Neta, H.H1; Veras, A.R.A.L2; Aguiar, I.P1; Franco e Santos, S.N.S1; Costa, S.M.S1; Silva, V.R1. Copyright (c) 2018 Souza Neta, H.H1; Veras, A.R.A.L2; Aguiar, I.P1; Franco e Santos, S.N.S1; Costa, S.M.S1; Silva, V.R1. 2018-07-04 2018-07-04 4 3 10.28933/ijoar-2018-05-0804 Fonoaudiology and Nutrition: a Multidisciplinary Look on the Elderly Dysphagic <p>Introduction: In view of the inversion of the growth of the age pyramid in Brazil, where the increase in the elderly population has been highlighting, studies on this growing population and its specifications, such as incoordination in the act of swallowing food or saliva, are relevant. Functional, anatomical and physiological alterations resulting from senescence and associated pathologies directly interfere in swallowing, causing a damage. The swallowing deficit can lead to dysphagia, leading to malnutrition and dehydration in the elderly, due to a low caloric intake, food intake and even death. Since these aspects are impaired, it is necessary nutritional care and speech-language interventions on difficulties encountered at meals. Objective: To carry out a literature review through selected scientific articles about the importance of speech and hearing intervention in the elderly dysphagic. Methods: We conducted extensive research and selected articles published between 2013 and 2016, indexed in the SciELO, PubMed, MEDLINE and LILACS databases. The following keywords were selected in English: Dysphagia, Speech-Language Pathology, Elderly and Nutrition. Results: The elderly is prone to nutritional problems due to physiological and social factors, the occurrence of chronic disease, the use of various medications, feeding problems, chewing and swallowing, as well as changes in mobility with functional dependence. The swallowing impairment can result in dysphagia, since it is not alerted, the risk of aspiration is immense causing pneumonia and if untreated leading to death. The implantation of nutritional risk screening and risk of dysphagia specific for the elderly patient is extremely important aiming at the early diagnosis of nutritional status and deglutition so that there is adequate speech-language intervention. Conclusion: In this way, it is known the importance of the multiprofessional performance to result in the best quality of life for such population, giving nutritional support, as well as the speech-language rehabilitation in the elderly dysphagic, aiming at it holistically.</p> Souza Neta, H.H1; Paulo, A.M.F1; Veras, A.R.A.L2; Honorato, C.D.P3; Araújo, N.T.A1; Franco e Santos, S.N.S1. Copyright (c) 2018 Souza Neta, H.H1; Paulo, A.M.F1; Veras, A.R.A.L2; Honorato, C.D.P3; Araújo, N.T.A1; Franco e Santos, S.N.S1. 2018-05-04 2018-05-04 4 3 10.28933/ijoar-2018-05-0803 Diabetic Elderly: Correlation Between Falls and Risk Factors <p>Introduction: The fall event, when associated with Diabetes Mellitus in the elderly, is multifactorial, however, it can be triggered by the reduction of functional capacity, mainly of the lower limbs. Objective: To correlate the fall event and risk factors in diabetic elderly. Methodology: Cross-sectional and correlational study, approved by the Ethics Committee in Research with Human Subjects (CAAE: 0127.0.106.000-09) and composed of elderly diabetic patients accompanied by medical professionals in a nucleus of attention to the elderly of a Brazilian public university. The instruments used were: semi-structured questionnaire with clinical data (age, gender, body mass index (BMI) and number of falls), Timed Up &amp; Go test (TUG) and Short Physical Performance Battery (SPPB). Statistical analysis used the Spearman correlation. Results: Diabetic elderly (70.37 ± 6.65 years) were matched according to gender and age (1: 1 ratio), two groups were selected for correlation analysis, one with 28 men and the other with 28 women. In the correlation between genders, of the variables age and BMI with number of falls, TUG and SPPB, only women presented correlations between age and number of falls (rho = 0.382, p = 0.045), TUG (rho = 0.529, p = 0.004 ) and SPPB (rho = -0.547, p = 0.003), as well as between BMI and TUG (rho = 0.532, p = 0.004). Discussion: These findings corroborate the current literature, demonstrating that the reduction of functional capacity during aging, when associated with the presence of chronic diseases, increases the risk of falls. Conclusion: As the age advances, the elderly diabetic women become more susceptible to falls than men, possibly due to reduced functional capacity of the lower limbs and gait speed. And overweight seems to influence the reduction of the pace of walking.</p> Oliveira, R.C.S1, Lima Neto, J.S2, Torres, A.L.N.P.G3, Queiroz, S.S4, Souza, J.F.S5, Fittipaldi, E.O.S6 Copyright (c) 2018 Oliveira, R.C.S1, Lima Neto, J.S2, Torres, A.L.N.P.G3, Queiroz, S.S4, Souza, J.F.S5, Fittipaldi, E.O.S6 2018-05-04 2018-05-04 4 3 10.28933/ijoar-2018-05-0802 Alternative Supplementary Communication (ASC) as a Field for the Development of Communication in Elderly Afasics <p>Introduction: Aphasia is a pathology that causes a compromise in speech and / or writing, caused by an acquired lesion on the left side of the brain. It can cause language confusion and can impair access to vocabulary, syntactic organization, coding, and decoding of messages. We can classify as a severe aphasic patient, the one who does not speak or write, but there is production of unintelligible sounds, in other words, doesn’t have an articulate speech. Supplementary and / or alternative communication (SAC) is a form of contribution to benefit the language of patients with impairment in verbal communication, in this case aphasic. It is composed of verbal and nonverbal signs that stimulate dialogue favoring the adequacy of language. Objective: To carry out a bibliographic survey about supplementary and alternative communication (SAC) in aphasic elderly. Methods: This study was carried out with publication inclusion criteria between 2014 and 2017, indexed in the SciELO, PubMed, MEDLINE and LILACS databases. The following keywords were selected in English: Aphasia; Supplementary and Alternative Communication; Speech therapy; Elderly; Language. Results and discussion: Most of the studies analyzed reported that CSA contributed to the more active interaction during communication and influenced the development of linguistic and social quality. Pictogram Ideogram Communication (PIC), Picture Communication Symbols (PCS), Bliss system and use of communicators and softwares are technological resources that can be used for aphasics in speech and language practice. Conclusion: The use of alternative supplementary communication allows a perspective of non-verbal language and its dimensions, being effective for the manifestations of aphasia, since it provides a better quality in communication becoming more effective mainly for the family environment and generating benefits before the development of various other skills.</p> Franco e Santos, S.N.S1; Paulo, A.M.F1; Veras, A.R.A.L2; Souza Neta, H.H1; Andrade, M.A.F1; Costa, S.M.S1 Copyright (c) 2018 Franco e Santos, S.N.S1; Paulo, A.M.F1; Veras, A.R.A.L2; Souza Neta, H.H1; Andrade, M.A.F1; Costa, S.M.S1 2018-05-04 2018-05-04 4 3 10.28933/ijoar-2018-05-0801 Primary Prevention of Alzheimer’s Disease in Indonesia <p>Indonesia is the fourth most populous country in the world. An increase number in the proportion of elders is accompanied by an increase of degenerative diseases and disabilities, including Alzheimer’s disease (AD). Prevalence of dementia in Indonesia is 1.2 million cases in 2015 and will keep increasing up to 3,980,000 in 2050. This study discusses data on the prevalence of dementia’s risk factors in Indonesia, calculates population-attributable risks (PAR) to identify the number of dementia cases that could be prevented, and determines which intervention strategies will have the most significant effect in reducing Alzheimer’s Disease (AD) cases. Prevalence of potentially modifiable risk factors for AD such as low education, hypertension, diabetes, obesity, and mental disorders are still high. Moreover, the prevalences keep increasing for the last five years. Low education has the highest estimated PAR, which could significantly lower new AD cases if it is being improved. Ten and thirty percent of risk factor reduction can decrease AD cases by 18,000 and 66,000 cases. In addition, reducing physical inactivity by 10% and 30% can reduce 19,000 and 55,000 cases of AD respectively; lowering 10% prevalence of midlife hypertension and diabetes can reduce 2400 and 1600 cases of AD. Decreasing 10% of all risk factors is estimated to reduce 22,000 of new AD cases. By reducing these modifiable risk factors, especially by improving access to education, the incidence of AD could be greatly reduced. This review is expected to give suggestion to the government in determining the priority scale of controlling risk factors for reducing the social and economic burden caused by AD.</p> Yuda Turana1, Jeslyn Tengkawan1, Ika Suswanti1, DY Suharya2, Woro Riyadina3, Julianti Pradono3 Copyright (c) 2019 Yuda Turana1, Jeslyn Tengkawan1, Ika Suswanti1, DY Suharya2, Woro Riyadina3, Julianti Pradono3 2019-07-10 2019-07-10 4 3 40 40 10.28933/IJOAR-2019-06-2506 Pharmacists in Aged Care Facilities <p>The expression “Home-based care” or basically home care might be characterized as a wide exhibit of various kinds of care gave in the home by a wide scope of gatherings. The continuum of various sorts of home-based care conveyed in the home shifts as far as various measurements, including sharpness, kind of care gave, and level of physician contribution. Home-based care incorporates both formal and casual individual care services, Medicare gifted home health, physician house calls, and even “emergency clinic at-home” services. Prescription related issues are essential among home care patients who take various drugs and have complex medical annals and medical issues. The destinations of home social protection organizations are to help individuals with improving limit and live with progressively noticeable opportunity; to propel the client’s optimal element of thriving; and to assist the patient with staying at home, keeping up a vital good way from hospitalization or admission to long haul care establishments. Home care is a game plan of care given by capable specialists to patients in their homes under the heading of a doctor. Home restorative services organizations join nursing care; physical, word related, and talk language treatment; and medical social organizations. Doctors may suggest patients for home therapeutic services organizations, or the organizations may be requested by relatives or patients. The extent of home human services benefits a patient can get at home is endless. Contingent upon the individual patient’s condition, care can reach out from nursing care to explicit medical organizations, for instance, research center workups. Essential investigations among home therapeutic services patients consolidate circulatory disease, coronary ailment, harm and hurting, musculoskeletal and connective tissue disease and respiratory disease.</p> Abdul Kader Mohiuddin Copyright (c) 2019 Abdul Kader Mohiuddin 2019-07-31 2019-07-31 4 3 41 41 10.28933/ijoar-2019-07-1805