Benefits of Sustained Physical Activity From Middle-Age To Early Old Age On Quality Of Life In Early Old Age

This secondary data analysis study aimed to examine the changes in physical activities (PAs) over time (2009-2017) in the same participants and to determine an association between changes in PA and health-related quality of life (HRQoL) in early older adults (n=994) using data from the Korea Health Panel Survey. The HRQoL was measured using the EuroQol quality-of-life system and the amount of PA were grouped to 4 activity levels (remained inactive, became inactive, became active, and remained active). The association of changes in PA over 8 years with HRQoL was examined using logistic regression analysis while controlling for socioeconomic and behavioral factors. The total PA decreased from 1,859.72±1,760.01 MET-minutes in 2009 to 1,264.80 ±1,251.14 MET-minutes in 2017 (P < 0.001). In 2017, 142 (14.3%) remained inactive, whereas 419 (42.2%) remained active. The participants who remained inactive at early old age were more likely to be at the lowest 10% HRQoL of the sample (odds ratio = 1.95, 95% confidence interval = 1.09–3.48). This indicates that educating middle-aged adults who are relatively inactive must be a priority in order to maintain and improve PA, enhance HRQoL, and maximize the benefits of PA in old age.

Age-associated features of the development of fibrosis and inflamaging in patients with arterial hypertension and ischemic stroke

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.

Morphological differences of the fallopian tube ampoule in young and old age

Работа основана на морфологическом исследовании ампул маточных труб 130 рожавших женщин молодого и старческого возраста. Применены макрометрический, гистологический, иммуногистохимический и микрометрический методы исследования. Выявлены закономерности возрастной морфологической изменчивости ампулы маточной трубы, проявляющиеся в уменьшении параметров их длины, а также наружных диаметров в середине ампулы и в местах перехода перешейка в ампулу и ампулы в воронку от молодого возраста к старческому возрасту. Гистоархитектоника ампул маточных труб у женщин в старческом возрасте характеризуется уплощением эпителия слизистой оболочки, образующей обилие близлежащих утолщенных складок, формирующих неравномерное сужение просвета ампулы. Определяется истончение мышечной оболочки с разрастанием вместо нее соединительной ткани и скоплением адипоцитов в подсерозной основе. В старческом возрасте отмечается более выраженная экспрессия виментина, прослеживающаяся не только в эндотелии и субэндотелиальном слое кровеносных сосудов, включая капилляры, но и в отдельных фибробластах. Установлено, что особенности микрометрических характеристик ампул маточных труб заключаются в уменьшении внутреннего периметра эпителиальной выстилки и площади просвета, наряду с увеличением площади их стенки при срединном сечении, в старческом возрасте в сравнении с молодым. The work is based on a morphological study of ampoules of the fallopian tubes of 130 young and senile women who gave birth. Macrometric, histological, immunohistochemical and micrometric methods of investigation were applied. The regularities of age-related morphological variability of the fallopian tube ampoule are revealed, which are manifested in a decrease in the parameters of their length, as well as external diameters in the middle of the ampoule and at the places of transition of the isthmus into the ampoule and ampoule into the funnel from young age to old age. Histoarchitectonics of ampoules of the fallopian tubes in women in old age is characterized by flattening of the epithelium of the mucous membrane, which forms an abundance of nearby thickened folds that form an uneven narrowing of the lumen of the ampoule. The thinning of the muscle membrane is determined with the growth of connective tissue instead of it and the accumulation of adipocytes in the subserose base. In old age, there is a more pronounced expression of vimentin, which can be traced not only in the endothelium and subendothelial layer of blood vessels, including capillaries, but also in individual fibroblasts. It was found that the features of the micrometric characteristics of the fallopian tube ampoules consist in a decrease in the inner perimeter of the epithelial lining and the lumen area, along with an increase in the area of their wall at the median cross-section in old age compared with young age.

Dignity and the Provision of Care and Support in ‘Old Age Homes’ in Tamil Nadu, India: A Qualitative Study

Background: In 2016, Tamil Nadu was the first state in India to develop a set of Minimum Standards for old age homes. The Minimum Standards stipulate that that residents’ dignity and privacy should be respected. However, the concept of dignity is undefined in the Minimum Standards. To date, there has been very little research within aged care facilities exploring the dignity of residents. This study draws on the concepts of (i) status dignity and (ii) central human functional capabilities, to explore whether long term care facilities uphold the dignity of residents. Objectives: The study was designed to obtain insights into human rights issues and experiences of residents, and the article addresses the research question, “to what extent do old age homes in Tamil Nadu support the central human functional capabilities of life, bodily health, bodily integrity and play, and secure dignity for older residents?”Method: A cross-sectional qualitative exploratory study design was utilised. Between January and May 2018 face-to-face interviews were conducted using a semi-structured topic guide with 30 older residents and 11 staff from ten care homes located three southern districts in Tamil Nadu, India. Framework analysis of data was structured around four central human functional capabilities. Results. There was considerable variation in the extent to which the four central human functional capabilities life, bodily integrity, bodily health and play were met,. There was evidence that Articles 3, 13, 25 and 24 of the Universal Declaration of Human Rights were contravened in both registered and unregistered facilities. Juxtaposing violations of human rights with good practice demonstrated that old age homes have the potential to protect the dignity of residents.Conclusion: The Government of India needs to strengthen care home policies to protect older residents. A new legislative framework is required to ensure that all old age homes are accountable to the State. Minimum Standards should include expectations for quality of care and dignity in care that meet the basic needs of residents and provide health care, personal support, and opportunities for leisure, and socializing. Standards should include staff-to-resident ratios and staff training requirements.

Effects of socio-economic factors on old-age mortality in Russia

Исследование смертности занимает важное место в демографии в целом и в особенности в демографии старения. России свойственна неоднородность демографического развития, в частности региональная дифференциация показателей смертности населения. Работа посвящена анализу зависимости смертности в регионах России в старших возрастных группах от социально-экономических показателей. Исследование проводили с использованием методов регрессионного анализа, где в качестве единиц наблюдения выступали субъекты РФ, в качестве объясняемой переменной - смертность мужского (женского) населения старшего (60+) возраста, представленная в виде стандартизованных по структуре населения коэффициентов. В результате работы выявлены значимые социально-экономические факторы, позволяющие объяснить различия уровней смертности в субъектах РФ. Studies of old-age mortality are an important part of demography, especially the demography of ageing. Demographic development of Russia is characterized by heterogeneity including regional differences in mortality. The aim of the paper is to analyze the dependence of mortality at old-age groups on socio-economic indicators. The study is conducted using methods of regression analysis; the units of observation are the regions of the Russian Federation, the explained variable is the mortality rate of male (female) population at older (60+) ages standardized by the population-age structure. As a result, the significant socio-economic factors, explaining the differences of mortality rates in the regions of the Russian Federation, were identified.

Planning for mental wellbeing in an old age home during the Covid-19 pandemic by homoeopathic institution: Structuring the intervention

Objectives: During the on-going COVID-19 pandemic, the risk to the mental well-being of the elderly living in an old age home (OAH) has increased considerably. Dealing with this issue requires special measures. The current literature has very few examples of such programmes. We aimed to promote emotional balance and an independent living with positive outlook on life among the residents of the OAH facility during the pandemic based on action learning principles. This programme was conducted in an OAH that our institute has been associated with for several years. HelpAge India, a non-governmental organisation working in India to assist disadvantaged senior citizens, provided a programme that covered 12 themes. This article deals with the structuring process of the programme. Materials and Methods: The team comprised homoeopathic consultants and the faculty and students of a postgraduate homoeopathic institute. An extensive literature search and consultation with experts from various fields enabled the team to plan and build the final programme were evolved. Results: Broad themes gave rise to distinct modules and objectives were derived for each of these. Detailed action plans were worked out and a plan of evaluation for each of these modules was worked out. Conclusion: Planning a programme to ensure well-being needs a close and accurate identification of the needs of the residents of a particular OAH. A multidisciplinary approach can help in evolving effective strategies to formulate models for geriatric mental well-being.

Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland

Background Mild cognitive impairment (MCI) is a condition that exists between normal healthy ageing and dementia with an uncertain aetiology and prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual responds to the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics. Method As part of a larger longitudinal study looking at patients’ adjustment to MCI disclosure, we interviewed Old Age Psychiatrists at the five participating sites across Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi-structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of progression to dementia. The interviews were voice recorded and were analysed using reflective thematic analysis. Results Initial results show that most clinicians interviewed (Total N = 19) considered MCI to have significant limitations as a diagnostic term. Nevertheless, most clinicians reported using the term MCI (n = 15/19). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke’s Cognitive Examination-III as a primary assessment tool. Neuroimaging was frequently found to have minimal usefulness due to the neuroradiological reports being non-specific. Conclusion Our study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its uncertain prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying the aetiology of MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact the management of individuals with MCI.

“The Internal Police Officer Has Not Retired but Has Slowed Down”: Israeli Women Reframe Their Aging Experiences in the Second Half of Life

Compared with gains, losses have received a substantial amount of research and public attention. The present study aims to shed light on the positive gains associated with older age from the perspective of older women. Five focus groups with 19 Israeli women over the age of 54 were conducted. Trailers of three different films were used to stimulate discussion about old age and aging and allow for reflections on societal norms in light of personal experiences. Focus group interviews were analyzed thematically. Respondents identified four contexts, characterized by reframing their experiences against societal norms. These included gender stereotypes, physical appearance, interpersonal relations, and employment. This study represents an opening to a different discourse around old age, which is characterized by gains and possibilities brought about by changes in reframing one’s experiences, while distancing oneself and exerting free will vis à vis social norms.