Is there more to subjective cognitive impairment than meets the eye? A perspective.

Multi-disciplinary research has revealed evidence of significant abnormality in a much wider range and level of information processing than that currently definitive for amnestic mild cognitive impairment (MCI). This raises the possibility that the contemporary approach to MCI is inappropriately delimited, and the true nature and extent of brain dysfunction and thus disease burden, underestimated. It follows therefore that the closely related concept of subjective cognitive impairment (SCI) may be similarly constrained. Although research into the wider range of potential brain dysfunction in MCI and SCI is in its infancy, as yet precluding systematic reviews, we present here findings to prompt debate about SCI with respect to its clinical assessment and its personal and societal burden.

Characteristics of outdoor falls among older people: a qualitative study.

BACKGROUND: Falls are a major threat to older people's health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people's experiences of outdoor falls to develop understanding of how they may be prevented. METHODS: We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. RESULTS: Forty-four adults aged 65 - 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. CONCLUSIONS: This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people.

Age-Friendly Rural Communities: Conceptualizing 'Best-Fit'.

The literature on age-friendly communities is predominantly focused on a model of urban aging, thereby failing to reflect the diversity of rural communities. In this article, we address that gap by focusing on the concept of community in a rural context and asking what makes a good fi t between older people and their environment. We do this through (a) autobiographical and biographical accounts of two very different geographical living environments: bucolic and bypassed communities; and through (b) analysis of the different needs and resources of two groups of people: marginalized and community-active older adults, who live in those two different rural communities. We argue that the original 2007 Health Organization definition of age friendly should be reconceptualized to explicitly accommodate different community needs and resources, to be more inclusive as well as more interactive and dynamic, incorporating changes that have occurred over time in people and place.

Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic.

BACKGROUND: The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among patients presenting to a head and neck oncology clinic prior to a diagnosis. METHODS: The study was conducted by administering questionnaires to 102 patients after being seen in the Head and Neck Oncology clinic for their initial consultation. The questionnaire assessed the extent of CAM use, types of CAMs used, and their reasons for use. RESULTS: A total of 132 CAMs were currently being used among 56 patients. The most common CAMs in use were multivitamins (26/132) and vitamin D (21/132). Meditation and yoga were associated with the greatest perceived benefit. The majority of patients obtained their information from family and friends. Most patients were using CAMs for physical health and well-being. CONCLUSION: As CAM use among the population is widespread, it is important for clinicians to specifically address their use on initial presentation.