Age-related mortality in 61,993 confirmed COVID-19 cases over three epidemic waves in Aragon, Spain. Implications for vaccination programmes

Background Risk for severe COVID-19 increases with age. Different vaccination strategies are currently being considered, including those aimed at slowing down transmission and those aimed at providing direct protection to those most at risk. Methods The objectives of the current study were i) to assess age-related incidence and survival between PCR-diagnosed COVID-19 cases (n = 61,993) in the Autonomous Community of Aragon from March to November 2020, and ii) to characterize age differences regarding the course of the disease in hospitalized patients in a tertiary university hospital. Results We found a similar incidence of COVID-19 in individuals between 10 and 79 years. Incidence increased in those over 80 years possibly because of the elevated transmission within the nursing homes. We observed a profound disparity among age groups; case fatality rates (CFRs) were near 0 in cases younger than 39 years throughout different waves. In contrast, there was an age-dependent and progressive increase in the CFRs, especially during the first pandemic wave. SARS-CoV-2 infection caused a more severe and rapid progression in older patients. The elderly required faster hospitalization, presented more serious symptoms on admission, and had a worse clinical course. Hospitalized older individuals, even without comorbidities, had an increased mortality risk directly associated with their age. Lastly, the existence of comorbidities dramatically increased the CFRs in the elderly, especially in males. Conclusion The elevated incidence of COVID-19 and the vulnerability of the elderly call for their prioritization in vaccination and targeted prevention measures specifically focused on this aged population.

Download Full-text

Optimizing Antiepileptic Drug Therapy in the Elderly

Annals of Pharmacotherapy ◽

10.1345/aph.1e683 ◽

2005 ◽

Vol 39 (11) ◽

pp. 1852-1860 ◽

Cited By ~ 9

Author(s):

William R Garnett

Keyword(s):

Drug Therapy ◽

Elderly Patients ◽

Antiepileptic Drug ◽

Age Groups ◽

The Elderly ◽

Complex Partial Seizures ◽

Medline Search ◽

Age Related ◽

Epilepsy In The Elderly ◽

Clonic Seizures

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

Download Full-text

Decline in rates of clearance of IgG-sensitized erythrocytes with increasing age

Blood ◽

10.1182/blood.v71.6.1726.bloodjournal7161726 ◽

1988 ◽

Vol 71 (6) ◽

pp. 1726-1730

Author(s):

KA Melez ◽

LF Fries ◽

BS Bender ◽

T Quinn ◽

MM Frank

Keyword(s):

Aging Process ◽

Elderly Population ◽

The Elderly ◽

Older Individuals ◽

Immune Functions ◽

Macrophage Function ◽

Normal Volunteers ◽

Age Related ◽

Male Subjects

Decreased immune functions have been suggested as a cause for the increased incidence of autoimmunity, malignancy, and infection in the elderly population. To assess the possible role of changes in macrophage function in the aging process we studied the Fc receptor- mediated clearance of IgG-coated erythrocytes in 56 healthy normal volunteers by following the removal of radiolabeled autologous erythrocytes. An age-related decrease in Fc-mediated clearance rates in both female and male subjects was found, which suggests a physiological decline of this macrophage function in older individuals.

Download Full-text

Age-related Utilization of Advanced Life Support Services

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00028004 ◽

1991 ◽

Vol 6 (1) ◽

pp. 9-14 ◽

Cited By ~ 5

Author(s):

Steven A. Meador

Keyword(s):

Life Support ◽

Age Groups ◽

Rank Correlation ◽

Advanced Life Support ◽

The Elderly ◽

Population Projections ◽

Patient Treatment ◽

Related Case ◽

Spearman’S Rank Correlation ◽

Age Related

AbstractPurpose:To investigate the relationship between age and Advanced Life Support (ALS) utilization.Population:All patients from 1 January 1987 to 31 December 1988 transported by ALS ambulances within Lebanon County, a rural/urban county of 112,000.Methods:All runs resulting in patient treatment by ALS personnel were tallied at five-year age intervals and sub-grouped by trauma- and non-trauma-related calls. Utilization rates for each age group were obtained by dividing the calls by the population of each group. Correlation with age was tested by Spearman's rank correlation. Treatment rates for age groups were calculated for the six most frequent medical etiologies. To illustrate the effect of age distributions, age rates were applied to projected state and national population distributions.Results:There was a significant correlation with age for all transports (p < .01; r=.93) and for those not related to trauma (p<.01; r=.98). Correlation was not detected for trauma-related responses (p>.10; r=.19). Non-trauma-related case incidence varied among age groups, ranging from 1.1/1,000 for age five through nine years to 89/1,000 for age 80–84 years. Congestive heart failure, cardiac ischemia, syncope, myocardial infarction, and cardiac arrest evidenced increased incidence with age. Seizure did not. Older populations had a higher projected utilization of ALS services than did the younger age groups.Conclusion:Non-trauma ALS utilization is highly dependent on the age of the patient. Due to projected aging of the population and increased utilization of ALS by the elderly, projected utilization will increase at a rate faster than will the population. Age:rate data can be combined with population projections to estimate future need.

Download Full-text

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

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181319631121 ◽

2019 ◽

Vol 63 (1) ◽

pp. 42-46 ◽

Cited By ~ 1

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.

Download Full-text

Aging and immune response to exercise

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y98-043 ◽

1998 ◽

Vol 76 (5) ◽

pp. 562-572 ◽

Cited By ~ 22

Author(s):

Shoji Shinkai ◽

Masamitsu Konishi ◽

Roy J Shephard

Keyword(s):

Cellular Immunity ◽

Acute Exercise ◽

Cell Function ◽

Nk Cell ◽

Cell Activity ◽

The Elderly ◽

Strenuous Exercise ◽

Elderly Subjects ◽

Older Individuals ◽

Age Related

Human immune function undergoes adverse changes with aging. The T cells, which have a central role in cellular immunity, show the largest age-related differences in distribution and function, with thymus involution as the apparent underlying cause. The immune responses to acute exercise and training have not been studied extensively in the elderly. The natural killer (NK) cell response to a single exercise challenge is normal in older individuals, but immediately after exercise the elderly subjects manifest less suppression of phytohemagglutinin (PHA)-induced lymphocyte proliferation than younger individuals. In contrast, a strenuous exercise seems to induce a more sustained postexercise suppression of cellular immunity in older individuals than in their young peers. A few cross-sectional comparisons of immune status between physically fit elderly individuals and young sedentary controls suggest that habitual physical activity may enhance NK cell activity, checking certain aspects of the age-related decline in T cell function, such as reduced mitogenesis in response to plant lectins and decreases in the production of certain types of cytokine. The clinical implications, however, remain to be clarified by future study.Key words: immune senescence, innate immunity, adaptive immunity.

Download Full-text

Conclusion

10.1093/med/9780199392063.003.0012 ◽

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.

Download Full-text

Age-Related Changes in the 25-Hydroxyvitamin D Versus Parathyroid Hormone Relationship Suggest a Different Reason Why Older Adults Require More Vitamin D

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2002-021064 ◽

2003 ◽

Vol 88 (1) ◽

pp. 185-191 ◽

Cited By ~ 298

Author(s):

Reinhold Vieth ◽

Yasmin Ladak ◽

Paul G. Walfish

Keyword(s):

Older Adults ◽

Vitamin D ◽

Secondary Hyperparathyroidism ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Hydroxyvitamin D ◽

Age Related ◽

25 Hydroxyvitamin D ◽

The Relationship

Vitamin D requirements are thought to vary with age, but there is little comparative evidence for this. One goal in establishing a vitamin D requirement is to avoid secondary hyperparathyroidism. We studied 1741 euthyroid, thyroid clinic outpatients without evidence of calcium abnormalities, ranging in age from 19 to 97 yr, whose serum and urine had been analyzed for calcium, vitamin D, and parathyroid status. We found no effect of age on the 25-hydroxyvitamin D [25(OH)D] concentration associated with specific vitamin D intakes, and there was no relationship between 25(OH)D and 1,25hydroxyvitamin D [1,25(OH)2D]. In every age group, serum 1,25(OH)2D declined with increasing creatinine (P < 0.001). What changed with age included creatinine, which correlated with 25(OH)D (r = 0.146, P < 0.001) only in the youngest age group (19–50 yr) but not in the older age groups (P > 0.1). Creatinine did not correlate with PTH in the youngest age group, but the relationship became significant as age increased (e.g. for the elderly, r = 0.365, P < 0.001). Linear regression of log PTH vs. log 25(OH)D agreed with the natural shape of the relationship observed with scatterplot smoothing, and this showed no plateau in PTH as 25(OH)D increased. We compared PTH concentrations among age groups, based on 20 nmol/liter increments in 25(OH)D. Mean PTH in adults older than 70 yr was consistently higher than in adults younger than 50 yr (P < 0.05 by ANOVA and Dunnett’s t test). PTH levels of the elderly who had 25(OH)D concentrations greater than 100 nmol/liter matched PTH of younger adults having 25(OH)D concentrations near 70 nmol/liter. This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function.

Download Full-text

Consumer preferences for banking technologies by age groups

International Journal of Bank Marketing ◽

10.1108/ijbm-04-2015-0056 ◽

2016 ◽

Vol 34 (4) ◽

pp. 587-602 ◽

Cited By ~ 17

Author(s):

Michael Harris ◽

K. Chris Cox ◽

Carolyn Findley Musgrove ◽

Kathryn W Ernstberger

Keyword(s):

New Technologies ◽

Consumer Preferences ◽

Age Groups ◽

The Elderly ◽

Analysis Of Covariance ◽

Content Type ◽

Cohort Differences ◽

Use Of Technology ◽

Age Related ◽

Concepts Of Technology

Purpose – The prevailing mindset is that younger people value and more readily adopt technology. The purpose of this paper is to determine if this is true with respect to banking practices. Design/methodology/approach – A survey was conducted to evaluate the importance of mobile, online, and physical-based banking across multiple age groups. Factor analysis and analysis of covariance were used to evaluate the responses. Findings – The results show that older consumers see more value in traditional, physical-based banking, all ages are equally interested in currently emerging technologies (online), and younger users are more interested in the newest technologies. Research limitations/implications – The stereotype of technology-adverse elderly may be too limiting. Age influences are not absolute barriers enacted by time, but are potentially learned behaviors. Practical implications – Practitioners interested in introducing new technologies to the elderly might consider making their innovations more compatible with existing technologies already in use. Originality/value – This study builds on the concepts of technology adoption and previous work on aging as it relates to adoption. However, it is shown that cognitive declines are not the only factor that can explain age-related differences in technology usage. Cohort differences in experience and resources may also be important. This is of value not only to the banks, but to all businesses that rely on consumer use of technology to maintain the business relationship.

Download Full-text

Age-Related Differences in Experiences With Social Distancing at the Onset of the COVID-19 Pandemic: A Computational and Content Analytic Investigation of Natural Language From a Social Media Survey (Preprint)

10.2196/preprints.26043 ◽

2020 ◽

Author(s):

Ryan C Moore ◽

Angela Y Lee ◽

Jeffrey T Hancock ◽

Meghan C Halley ◽

Eleni Linos

Keyword(s):

Public Health ◽

Age Groups ◽

Prevention Measures ◽

Middle Aged ◽

Social Distancing ◽

Aged People ◽

Age Related ◽

Health Related ◽

The Impact ◽

Health Guidance

BACKGROUND As COVID-19 poses different levels of threat to people of different ages, health communication regarding prevention measures such as social distancing and isolation may be strengthened by understanding the unique experiences of various age groups. OBJECTIVE The aim of this study was to examine how people of different ages (1) experienced the impact of the COVID-19 pandemic and (2) their respective rates and reasons for compliance or noncompliance with social distancing and isolation health guidance. METHODS We fielded a survey on social media early in the pandemic to examine the emotional impact of COVID-19 and individuals’ rates and reasons for noncompliance with public health guidance, using computational and content analytic methods of linguistic analysis. RESULTS A total of 17,287 participants were surveyed. The majority (n=13,183, 76.3%) were from the United States. Younger (18-31 years), middle-aged (32-44 years and 45-64 years), and older (≥65 years) individuals significantly varied in how they described the impact of COVID-19 on their lives, including their emotional experience, self-focused attention, and topical concerns. Younger individuals were more emotionally negative and self-focused, while middle-aged people were other-focused and concerned with family. The oldest and most at-risk group was most concerned with health-related terms but were lower in anxiety (use of fewer anxiety-related terms) and higher in the use of emotionally positive terms than the other less at-risk age groups. While all groups discussed topics such as acquiring essential supplies, they differentially experienced the impact of school closures and limited social interactions. We also found relatively high rates of noncompliance with COVID-19 prevention measures, such as social distancing and self-isolation, with younger people being more likely to be noncompliant than older people (<i>P</i><.001). Among the 43.1% (n=7456) of respondents who did not fully comply with health orders, people differed substantially in the reasons they gave for noncompliance. The most common reason for noncompliance was not being able to afford to miss work (n=4273, 57.3%). While work obligations proved challenging for participants across ages, younger people struggled more to find adequate space to self-isolate and manage their mental and physical health; middle-aged people had more concerns regarding childcare; and older people perceived themselves as being able to take sufficient precautions. CONCLUSIONS Analysis of natural language can provide insight into rapidly developing public health challenges like the COVID-19 pandemic, uncovering individual differences in emotional experiences and health-related behaviors. In this case, our analyses revealed significant differences between different age groups in feelings about and responses to public health orders aimed to mitigate the spread of COVID-19. To improve public compliance with health orders as the pandemic continues, health communication strategies could be made more effective by being tailored to these age-related differences.

Download Full-text

Age and Lateral Sleep Position: A Pilot Study

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2009.1232 ◽

2009 ◽

Author(s):

Susan Gordon ◽

Petra Buettner

Keyword(s):

Pilot Study ◽

Research University ◽

Age Groups ◽

Elderly Person ◽

South Australia ◽

The Elderly ◽

Total Sample ◽

Lateral Position ◽

Sleep Position ◽

Age Related

Purpose: Previous research, undertaken using a Super 8 camera and non-continuous data, has reported that with increasing age, people are more likely to sleep in the right lateral position. It has been postulated that this is due to age related alterations in cardiovascular function. This pilot study was undertaken to determine if collection and analysis of continuous sleep data was a feasible method for further investigation of this topic and to determine the sample size required for an adequately powered study. Increased understanding of age related changes in sleep position may provide valuable information to improve sleep quality and nursing care of the elderly person. Method: Research at the Centre for Sleep Research, University of South Australia, investigated the association between age and sleep position. Infra-red illumination and video cameras recorded the sleep patterns of 12 subjects for two nights. Videos were examined and the amount of time spent in each sleep position was calculated in seconds. Results: In a one-way analysis of variance, sample sizes of 19, 19, and, 19 are necessary from the three age groups whose means are to be compared. The expected means are 20, 25 and 45 for the three age groups respectively. The total sample of 57 subjects achieves 82% power to detect differences among the means versus the alternative of equal means using an F test with a 0.05 significance level.Conclusions: The results of this pilot study support further investigation of the relationship between age and lateral sleep position preference, and particularly the physiological parameters which may underpin the adoption of different sleep positions with increasing age. The described method is appropriate and modifications are suggested to further improve future studies.

Download Full-text