Traumatic Stress in Older Adults

2012 ◽  
pp. 118-127
Author(s):  
Joan M. Cook ◽  
Tatyana Biyanova ◽  
Diane L. Elmore
Keyword(s):  
Older Adults ◽  
World War Ii ◽  
Functional Impairment ◽  
Stress Disorder ◽  
Acute Stress ◽  
Age Groups ◽  
Care Utilization ◽  
Older Individuals ◽  
Delayed Recognition ◽  
The Impact

This chapter focuses on older adult trauma survivors. Information is presented on prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD); course, functional impairment, suicide risk, and health care utilization in older adults with PTSD; and the impact of demographic factors such as gender, ethnicity, and race on PTSD in older individuals. In general, rates of ASD and PTSD are lower in older adults compared to other age groups. PTSD in older adults has been linked to suicidal ideation and attempts, functional impairment, physical health, and increased healthcare utilization. Although delayed onset of PTSD has been empirically verified in some military samples with World War II veterans and younger adult civilians, it is rare in the absence of any prior symptoms and might more accurately be labeled “delayed recognition.” More information on trauma and PTSD in diverse populations of older adults is needed, such as racial and ethnic minorities, those with severe physical or mental impairment, noncommunity-residing groups, and those from nonindustrialized countries.

Traumatic Stress in Older Adults

2020 ◽  
Author(s):  
Joan M. Cook ◽  
Vanessa Simiola
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Healthcare Utilization ◽  
Functional Impairment ◽  
Stress Disorder ◽  
Acute Stress ◽  
Age Groups ◽  
Accelerated Aging ◽  
Older Individuals ◽  
The Impact

This chapter focuses on older adult trauma survivors. Information is presented on prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD); course, functional impairment, suicide risk, cognitive impairment, accelerated aging, healthcare utilization in older adults with PTSD, and the impact of demographic factors such as gender, ethnicity, and race on PTSD in older individuals. In general, rates of ASD and PTSD are lower in older adults compared to other age groups. PTSD in older adults has been linked to suicidal ideation and attempts, functional impairment, physical health, cognitive impairment, accelerated aging, and increased healthcare utilization. Although delayed onset of PTSD has been empirically verified in some military samples with veterans and younger adult civilians, it is rare in the absence of any prior symptoms and might more accurately be labeled “delayed recognition.” More information on trauma and PTSD in diverse populations of older adults is needed, such as racial/ethnic as well as sexual and gender minorities, those with severe physical or mental impairment, non–community-residing groups, and those from non-industrialized countries.

scholarly journals Social and Behavioral Factors, Oral Health, and Dental Care Utilization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Oral Health ◽  
Health Outcomes ◽  
Dental Care ◽  
Care Utilization ◽  
Behavioral Factors ◽  
Dental Care Utilization ◽  
The Impact ◽  
The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

scholarly journals Automated Speech Recognition Systems and Older Adults: A Literature Review and Synthesis

2019 ◽  
Vol 63 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Lauren Werner ◽  
Gaojian Huang ◽  
Brandon J. Pitts
Keyword(s):  
Older Adults ◽  
Speech Recognition ◽  
Current Knowledge ◽  
Age Groups ◽  
Older Individuals ◽  
Age Related ◽  
Wide Range ◽  
Automated Speech Recognition ◽  
Technological Developments ◽  
Physical Changes

The number of older adults is growing significantly worldwide. At the same time, technological developments are rapidly evolving, and older populations are expected to interact more frequently with such sophisticated systems. Automated speech recognition (ASR) systems is an example of one technology that is increasingly present in daily life. However, age-related physical changes may alter speech production and limit the effectiveness of ASR systems for older individuals. The goal of this paper was to summarize the current knowledge on ASR systems and older adults. The PRISMA method was employed and 17 studies were compared on the basis of word error rate (WER). Overall, WER was found to be influenced by age, gender, and the number of speech samples used to train ASR systems. This work has implications for the development of future human-machine technologies that will be used by a wide range of age groups.

Conclusion

2016 ◽  
Author(s):  
Maria A. Sullivan
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
The Elderly ◽  
Social Consequences ◽  
Individual Therapy ◽  
Older Individuals ◽  
Prescribing Practices ◽  
Elderly Age ◽  
Age Related ◽  
The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

scholarly journals The Impact of Expanded National Health Insurance Coverage of Dentures and Dental Implants on Dental Care Utilization among Older Adults in South Korea: A Study Based on the Korean Health Panel Survey

2020 ◽  
Vol 17 (17) ◽  
pp. 6417 ◽  
Author(s):  
Jin-Sun Choi ◽  
Se-Hwan Jung
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Dental Implants ◽  
National Health Insurance ◽  
Dental Care ◽  
Insurance Coverage ◽  
Care Utilization ◽  
Sociodemographic Characteristics ◽  
Panel Survey ◽  
The Impact

In South Korea, the National Health Insurance Service (NHIS) began its coverage of dentures and dental implants for older people in 2012 and 2014, respectively. This study aimed to investigate the impact of these policies on dental care utilization among people aged 65 years or older according to their sociodemographic characteristics. Data were collected from the Korea Health Panel Survey (KHP; years 2012 and 2015). The statistical significance of the relationships between sociodemographic characteristics and the use of outpatient dental care, denture, and dental implant were analyzed. Results showed an increase of 5.7%, 1.4%, and 2.8% in the use of outpatient dental care, denture, and dental implant, respectively, over the course of three years. Including dentures increased its use by 2.5–3.7 times among people aged 70 years or older. Including dental implants alleviated the disparities among older adults based on age groups and duration of education, except those among uneducated people; however, it caused inequity according to household income. Some Korean older adults remain neglected from the benefits of the expanded NHIS. Therefore, older adults’ access to dental care should be enhanced by the implementation of policies to promote oral health care utilization, dental prosthetic services, and older adults’ insurance coverage.

scholarly journals Comparison of epidemiology, treatments, and outcomes in pediatric versus adult ependymoma

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Aladine A Elsamadicy ◽  
Andrew B Koo ◽  
Wyatt B David ◽  
Victor Lee ◽  
Cheryl K Zogg ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Radiation Treatment ◽  
Age Groups ◽  
Anatomical Location ◽  
Seer Database ◽  
Coding System ◽  
Significant Difference ◽  
All Cause Mortality ◽  
The Impact

Abstract Background Mounting evidence supports the presence of heterogeneity in the presentation of ependymoma patients with respect to location, histopathology, and behavior between pediatric and adult patients. However, the influence of age on treatment outcomes in ependymoma remains obscure. Methods The SEER database years 1975–2016 were queried. Patients with a diagnosis of ependymoma were identified using the International Classification of Diseases for Oncology, Third Edition, coding system. Patients were classified into one of 4 age groups: children (age 0–12 years), adolescents (age 13–21 years), young adults (age 22–45 years), and older adults (age >45 years). The weighed multivariate analysis assessed the impact of age on survival outcomes following surgical treatment. Results There were a total of 6076 patients identified with ependymoma, of which 1111 (18%) were children, 529 (9%) were adolescents, 2039 (34%) were young adults, and 2397 (40%) were older adults. There were statistically significant differences between cohorts with respect to race (P < .001), anatomical location (P < .001), extent of resection (P < .001), radiation use (P < .001), tumor grade (P < .001), histological classification (P < .001), and all-cause mortality (P < .001). There was no significant difference between cohorts with respect to gender (P = .103). On multivariate logistic regression, factors associated with all-cause mortality rates included males (vs females), supratentorial location (vs spinal cord tumors), and radiation treatment (vs no radiation). Conclusions Our study using the SEER database demonstrates the various demographic and treatment risk factors that are associated with increased rates of all-cause mortality between the pediatric and adult populations following a diagnosis of ependymoma.

Acute Stress Symptoms, Dissociation, and Depression Among Rescue Personnel 24 Hours after the Bet-Yehoshua Train Crash: The Effects of Exposure to Dead Bodies

2008 ◽  
Vol 23 (5) ◽  
pp. 461-465 ◽  
Author(s):  
Menachem Ben-Ezra ◽  
Yuval Palgi ◽  
Nir Essar ◽  
Hilik Sofer ◽  
Yeela Haber
Keyword(s):  
Depressive Symptoms ◽  
Stress Disorder ◽  
Acute Stress ◽  
Previous Exposure ◽  
Stress Symptoms ◽  
Dead Bodies ◽  
The Impact ◽  
Threat To Life ◽  
Rescue Personnel ◽  
Acute Stress Symptoms

AbstractIntroduction:The immediate impact of exposure to severe wounds, dead bodies, and immediate threat to life has been understudied. Most studies focus on the acute stress disorder and/or post-traumatic stress disorder phases in order to assess rescue personnel's symptomatology, and tend to neglect the immediate exposure to elements of the disaster.Hypothesis:Rescue personnel who had a history of previous exposure to dead bodies would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms within the 24 hours following a traumatic event.Methods:Twenty-three rescue personnel participated in the search and excavation of dead and mutilated bodies following the Bet-Yehoshua train crash in Israel.The rescue personnel group was divided based on previous exposure to dead bodies. Each participant completed a demographic questionnaire, which included a question on perceived threat to life, the impact of event scale revised, the dissociative experience scale, and the center of epidemiologic studies depression questionnaire. Student's t-tests, along with multivariate analysis of covariance (MANCOVA) were conducted in order to learn which factors are related to psychiatric symptomatology following the immediate exposure to such stressors.Results:Among rescue personnel, those with previous exposure to dead bodies did not differ in their levels of acute stress symptoms, dissociation, and depressive symptoms from those who were not previously exposed to dead bodies.Conclusions:These results may suggest the possibility that the impact of exposure to dead bodies does not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later when people have time to process the trauma. Another possibility is that the rescue coping mechanisms of detachment may serve as a buffer for the horrific sights encountered during the ASR period.

Successful Aging from the Viewpoint of Older Adults: Development of a Brief Successful Aging Inventory (SAI)

Gerontology ◽  
2017 ◽  
Vol 63 (4) ◽  
pp. 359-371 ◽  
Author(s):  
Jeong Eun Lee ◽  
Boaz Kahana ◽  
Eva Kahana
Keyword(s):  
Older Adults ◽  
Measurement Invariance ◽  
Successful Aging ◽  
Panel Study ◽  
Age Groups ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Community Dwelling ◽  
Retirement Community ◽  
Older Individuals

Objective: Researcher-defined criteria for successful aging (SA) have been criticized for their limited perspective and failure to acknowledge subjective perceptions of older individuals. We assessed the extent to which older individuals consider specific factors, which they had suggested, to be important in defining SA. The present study had 2 objectives: (a) to develop a brief multidimensional questionnaire for assessing SA and to evaluate its psychometric properties; and (b) to examine age associations with each dimension of SA. Methods: A survey was conducted with 550 participants in a panel study of older adult residents of an elderly retirement community and with community-dwelling older adults, regarding factors that they considered to be important for SA. The psychometric evaluation involved exploratory and confirmatory factor analyses, reliability and validity analyses, and measurement invariance testing. Partial correlations were used to examine the association of age with SA. Results: The 4-factor solution provided a satisfactory fit to the data: proactive engagement, wellness resources, positive spirit, and valued relationships. Metric measurement invariance for this factor structure was confirmed across 2 age groups. The findings also suggest that the Successful Aging Inventory (SAI) scale might be a useful predictor of SA. Discussion: Our findings highlight the value of considering more comprehensive models of SA that include social relationships and proactive engagement.

scholarly journals A simulation study on the relative role of age groups under differing pertussis transmission scenarios

2018 ◽  
Author(s):  
Ana I. Bento ◽  
Aaron A. King ◽  
Pejman Rohani
Keyword(s):  
Herd Immunity ◽  
Age Groups ◽  
Transmission Model ◽  
Relative Role ◽  
Older Individuals ◽  
Age Cohorts ◽  
Relative Risks ◽  
Transmission Mechanisms ◽  
Acellular Vaccines ◽  
The Impact

AbstractPertussis has resurged in many countries where it was once regarded as under control, with the recent outbreaks showing a shift in incidence towards teens and older individuals. Here, using an age-stratified transmission model, we tested two potential causes for underlying changes in pertussis transmission dynamics. We did so assuming hypothesized mechanisms supporting present-day pertussis epidemiology: (I) improved diagnostics, (II) acellular vaccines leading to asymptomatic transmission (III) both. We used the relative risks and odds ratio methods to examine the impact of these differing assumptions on signatures of relative roles of key age groups through time, allowing us to explore those age cohorts that disproportionately account for transmission. Our findings show that for epidemics after the vaccine switch, a scenario with increased adult reporting and no asymptomatic transmission reflect a loss of signal, where no age group appears to be key. While scenarios with asymptomatic transmission, reflect a population where children (1-10 years old) are still disproportionally at risk. These results demonstrate that understanding the underlying transmission mechanisms in a population are paramount for vaccination policies in attaining herd immunity and eventually eradication.

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