scholarly journals Trauma and Adversity: Factors Impacting Vulnerability and Resilience Among Older Disaster Survivors

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 591-591
Author(s):  
Molly Davis ◽  
Nikki Bellamy
Keyword(s):  
Older Adults ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Age Related ◽  
Increased Risk ◽  
Disaster Survivors ◽  
Trauma Informed ◽  
Disaster Trauma ◽  
The Impact

Abstract Most would agree that older adults represent a highly vulnerable group prior to, during and post disaster. Age-related vulnerabilities often lead into an increased risk for traumatic experiences and post-traumatic stress symptoms after a disaster. Trauma informed principles offer a possible way to reduce the vulnerability of older adults after a disaster. For example, utilizing the trauma informed question “what has happened to you” shifts the focus from a deficit approach and allows for a deeper understanding of the impact of traumatic life experiences on current functioning and reaction to the disaster. It is this understanding of trauma’s impact that may have a role in how older adult disaster survivors view, respond, and recover after a natural disaster (Seery et.al. 2010; Iacoviello & Charney, 2014). In addition, understanding the role of lifetime adversity provides critical insights for disaster planning, reducing vulnerability and promoting resilience among older disaster survivors.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

scholarly journals LONG-TERM EFFECTS OF CHILDHOOD SEXUAL ASSAULT AMONG OLDER PEOPLE WITH HIV

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S549-S549
Author(s):  
Mark Brennan-Ing ◽  
Liz Seidel ◽  
Rebecca Erenrich ◽  
Stephen E Karpiak
Keyword(s):  
Older Adults ◽  
Sexual Assault ◽  
San Francisco ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Transgender People ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Living With Hiv ◽  
The Impact

Abstract Research finds high rates of childhood sexual assault (CSA) among people with HIV (PWH). CSA is related to depression, post-traumatic stress disorder, substance abuse, and poor health. PWH age 50 and older account for the majority of this population in the U.S., but we have little information on the impact of CSA on these older adults. Data were obtained from the San Francisco arm of the Research on Older Adults with HIV 2.0 study (n=197). Fifty percent reported CSA. Cisgender women and transgender people were more likely to report CSA compared to other groups. PWH reporting CSA were more likely to meet the diagnostic criteria for PTSD (42% vs. 27%), and had higher mean PHQ-9 depression scores (9.3 vs. 6.8). Those reporting CSA had significantly more comorbid health conditions compared to their peers. Implications for using a trauma-informed care model with older adults living with HIV will be discussed.

scholarly journals P047 Sleep and diet in older adults: what do we know and what do we need to find out?

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A36-A37
Author(s):  
C Gupta ◽  
C Irwin ◽  
G Vincent ◽  
S Khaleesi
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Adverse Outcomes ◽  
Dietary Factors ◽  
Current Evidence ◽  
Age Related ◽  
Increased Risk ◽  
Current Evidence Base ◽  
Population Demographic ◽  
The Impact

Abstract Older adults experience reduced sleep quality and quantity more frequently than younger adults. Inadequate sleep in older adults has been linked to several adverse outcomes such as poor psychological and physical health, cognitive impairments, increased risk of falls, lower quality of life, and greater risk of all-cause and cardiovascular mortality. Diet is one modifiable lifestyle factor that may influence sleep outcomes. The purpose of this review was to synthesise the current literature investigating the impact of diet, including foods and nutrients, on sleep quality and quantity in older adults (defined as >50 years based on age-related changes in sleep quality and quantity that begin age 50). A systematic search of four databases identified 17 articles for inclusion (observational (n=8) and interventional (n=9) studies). Overall, findings suggest that following a Mediterranean diet, consuming milk, fish, bean and egg products, cherries, vitamin D and vitamin E have demonstrated some efficacy in improving sleep outcomes in this population demographic. Given the heterogeneity of the included studies (i.e. aims, methodologies, outcomes assessed), it is difficult to consolidate the available evidence to make specific recommendations. However, this review describes dietary factors that show promise for improving sleep outcomes in older adults. More targeted research exploring the relationship between dietary factors and sleep outcomes in older adults is needed to strengthen the current evidence base. This presentation will provide a much-needed research agenda that includes a need for more randomised control trials that employ rigorous dietary assessments and objective measures of sleep.

The Role of Vascular Aging in Atherosclerotic Plaque Development and Vulnerability

2019 ◽  
Vol 25 (29) ◽  
pp. 3098-3111 ◽  
Author(s):  
Luca Liberale ◽  
Giovanni G. Camici
Keyword(s):  
Atherosclerotic Plaque ◽  
Molecular Mechanisms ◽  
Driving Forces ◽  
Plaque Burden ◽  
Vascular Aging ◽  
Age Related ◽  
Plaque Development ◽  
Increased Risk ◽  
The Impact ◽  
Over Time

Background: The ongoing demographical shift is leading to an unprecedented aging of the population. As a consequence, the prevalence of age-related diseases, such as atherosclerosis and its thrombotic complications is set to increase in the near future. Endothelial dysfunction and vascular stiffening characterize arterial aging and set the stage for the development of cardiovascular diseases. Atherosclerotic plaques evolve over time, the extent to which these changes might affect their stability and predispose to sudden complications remains to be determined. Recent advances in imaging technology will allow for longitudinal prospective studies following the progression of plaque burden aimed at better characterizing changes over time associated with plaque stability or rupture. Oxidative stress and inflammation, firmly established driving forces of age-related CV dysfunction, also play an important role in atherosclerotic plaque destabilization and rupture. Several genes involved in lifespan determination are known regulator of redox cellular balance and pre-clinical evidence underlines their pathophysiological roles in age-related cardiovascular dysfunction and atherosclerosis. Objective: The aim of this narrative review is to examine the impact of aging on arterial function and atherosclerotic plaque development. Furthermore, we report how molecular mechanisms of vascular aging might regulate age-related plaque modifications and how this may help to identify novel therapeutic targets to attenuate the increased risk of CV disease in elderly people.

scholarly journals Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties

2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
Mental Health Difficulties ◽  
Post Traumatic ◽  
The Impact

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

HIV is associated with an increased risk of age-related clonal hematopoiesis among older adults

2021 ◽  
Author(s):  
Nila J. Dharan ◽  
Paul Yeh ◽  
Mark Bloch ◽  
Miriam M. Yeung ◽  
David Baker ◽  
...  
Keyword(s):  
Older Adults ◽  
Clonal Hematopoiesis ◽  
Age Related ◽  
Increased Risk

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

Trauma Focused Psychodynamic Psychotherapy

2021 ◽  
Author(s):  
Frederic Busch ◽  
Barbara Milrod ◽  
Cory Chen ◽  
Meriamne Singer
Keyword(s):  
Traumatic Stress ◽  
Psychodynamic Psychotherapy ◽  
Symptomatic Relief ◽  
Traumatic Experiences ◽  
Veterans Administration ◽  
Post Traumatic Stress ◽  
Interpersonal Engagement ◽  
Post Traumatic ◽  
The Impact ◽  
Insight Into

This book, which operationalizes and articulates in detail a unique, brief, tested psychodynamic psychotherapy for Post-Traumatic Stress Disorder, Trauma Focused Psychodynamic Psychotherapy [TFPP], describes how to perform this helpful treatment. The book provides tailored psychodynamic background that underpins these approaches, and explains the different phases of treatment. Additionally, it articulates common underlying dynamics of PTSD that the treatment commonly addresses in patients to bring about symptomatic relief. TFPP is being tested in two diverse populations: military Veterans with PTSD who are receiving care at three Veterans Administration Hospitals, and also among LGBTQ patients with PTSD. The book is focused on the authors’ experiences treating Veterans and many clinical examples are provided demonstrating how to work with these principles and approaches. In general, patients and therapists have found the treatment to be an extremely useful tool. Veterans have gained insight into the impact of traumatic experiences on various aspects of their lives and had improvements in dissociation, interpersonal engagement, anxiety, and anger/hostility. TFPP appears to be particularly effective for patients with prominent avoidance symptoms and those who are unwilling or unable to recount the details of their trauma directly. Patients have been found to be more affectively engaged and better connected to others (including the therapist) following treatment.

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