Nutrition through the life course: part 8 - the elderly

Aging is an inevitable natural process. It results in changes to several organs which function less efficiently leading to the development of disease. Research has shown that the risk of chronic disorders increases significantly with age.

Autoinforme de salud general en adultos mayores de America Latina y el Caribe: su utilidad como indicador / Self-reported general health in older adults in Latin America and the Caribbean: usefulness of the indicator

OBJECTIVES. To evaluate self-reported general health (SRGH) as a health indicator and to analyze its covariates in people 60 years old or older living in private homes in seven cities of Latin American and the Caribbean.METHODS. This cross-sectional descriptive study was based on data from the Health, Well-Being, and Aging survey (Salud, Bienestar y Envejecimiento, or "SABE survey"), which was carried out in 1999 and 2000 in Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and Sao Paulo, Brazil. The survey looked at the demographic and socioeconomic characteristics of the participants, several health indicators (self-reported chronic diseases, depression, and cognitivefeatures), the social and family suport network, the use of health services, reported and observed functionality, the respondent's income, and the durable consumer goods in the household. In probit regression models, self-reported fair or poor health was used as the dependent variable. The marginal effect of each categorical explanatory variable was used to indicate the difference between the probability of reporting poor health by persons who did or did not have a given characteristic. RESULTS. In all the cities studied the self-reporting of "excellent" health was very low (6 percent or less). The results of the multivariate analysis of the relationships between SRGH and covariates showed: (1) the relative importance of several health indicators as covariates of SRGH, (2) the association between sociodemographic characteristics and SRGH, and (3) the differences or similarities found among the seven cities with respect to the relationships studied. The level of self-rated good health was highest in Buenos Aires and Montevideo (60 percent), followed by Bridgetown and Sao Paulo (around 50 percent) and Havana, Santiago, and Mexico City (between 30 percent and 40 percent). The respondents evaluation of their memory was the factor that was most strongly related to SRGH, followed by satisfaction with nutritional status and satisfaction with life.CONCLUSIONS. The SRGH captured multiple facets of the health of the older adults, such as suffering from chronic diseases, the degree of satisfaction with the level of nutrition and with life, perception of memory, and any functional problems .... (AU)

More need for the "old" in new public health research in the Americas

Research on the health of older adults in Latin America and the Caribbean has been neglected in epidemiology and public health. This is of grave concern since dramatic changes in fertility and mortality rates in recent decades ensure a rapid aging of the population in the Western Hemisphere. Persons 60 and older in Latin America and the Caribbean now make up 8 percent of the total population; by the middle of this century that figure will grow to 22 percent. In absolute numbers, the population of older persons will total over 180 million by 2050. In the coming decades we expect to find poorer health status and grater disability in the cohorts of persons who survived childhood and adult diseases. That higher survival rate is due to more public health interventions and less to an improvement in their socioeconomic status. Therefore, policy-makers in Latin America and the Caribbean need to understand the correlation among different gradients of poverty, access to health care, social networks, and health in old age (AU)

National policy on ageing for Trinidad and Tobago.

The needs of older persons must be assessed against the rapid demographic changes society is undergoing. Such changes may impact differently on the situation of older persons, unless effective countervailing measures are instituted. If mechanisms for treating with ageing issues in Trinidad and Tobago are to be effective, they must be located within a comprehensive policy framework. It is on this basis that the Government of Trinidad and Tobago has sought to develop a national policy on ageing. The overall goal of this policy is to promote the well being of older persons in a sustainable manner and provide older persons with the opportunity to be integrated into the mainstream of society.

Falls in the elderly: an underestimated hazard - abstract

Accidents constitute the sixth leading cause of death in the elderly American population, and falls account for two-thirds of these accidental deaths. Although most falls in the elderly do not cause injury, some result in severe consequences. Hip fractures alone occur in approximatley 200,000 older Americans each year leading to significant morbidity and mortality, and resulting in a staggering cost to society. A fall is a marker of homeostatic dysfunction which is due to interaction of intrinsic and extrinsic factors. Intrinsic factors include age-related physiological changes, various disease processes, psychological problems and medication usage. Extrinsic factors are environmental hazards such as slippery floors, inadequate lighting and loose rugs. The majority of falls are multifactorial origin. A "premonitory fall" may be the presenting event of an impending illness such as a myocardial infarction, major infection, gastro-intestinal haemorrhage or stroke. Medication usage is an important contributor to falls. Centrally acting drugs such as tranquilizers, hypnotics and antidepressants are associated with increased risk of injury from falling. Other classes of implicated drugs include diuretics, antiarrhythmics, antihypertensives and hypoglycaemic agents. Fall prevention requires a multifaceted approach aimed at identification and amelioration of modifiable risk factors, improvement of balance, gait and muscle strength, use of assistive devices, exercise of adaptive behaviours and elimination of environmental hazards. Iatrogenic causes may be minimized by reduction of polypharmacy, awareness of the modified pharmacokinetics and pharmacodynamics of drugs in the elderly and careful consideration of benefit versus risk of medication usage (AU)