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1.
J Stroke Cerebrovasc Dis ; 29(1): 104466, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31734125

RESUMEN

BACKGROUND: Medical mistrust influences patients' treatment seeking, adherence, health behaviors, and minority participation in research studies. However, medical mistrust remains understudied within neurological diseases like stroke despite disproportionately affecting minority populations. OBJECTIVE: This study examines the relationship of medical mistrust with stroke knowledge among Black, Latino, Korean, and Chinese-Americans. METHODS: Subjects greater than 60 years were enrolled from senior centers to test a culturally-tailored educational curriculum around stroke risk reduction in a randomized controlled trial. A Trust Physician Scale and a modified Trust of Medical Researchers Scale measured medical mistrust. The Stroke Action Test instrument measured stroke knowledge, focusing on intent to call 911 appropriately when presented with stroke symptoms. RESULTS: Of 225 subjects, 69.5% were female (n = 157) with an average age of 73.7 years (standard deviation 6.7). Blacks had highest trust scores of physicians relative to Latino/a, Korean or Chinese subjects (P< .05). In multivariable analysis, decreased stroke knowledge was associated with decreased researcher trust at baseline (<.05), but not physician trust, when controlling for covariates. Among Latino/a, Korean, and Chinese groups, mainstream acculturation reduced the association between researcher trust and stroke knowledge. A mediation model showed no evidence of physician trust mediating researcher trust. CONCLUSIONS: Among minority seniors participating in a randomized controlled trial, decreased trust of researchers, not physicians, was associated with low baseline knowledge of stroke symptoms. Those least acculturated to US culture may be a particular focus for trust building intervention. Future studies should examine whether researcher mistrust is disproportionately preventing those with the largest knowledge gaps from participating in trials.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud/etnología , Grupos Minoritarios/psicología , Educación del Paciente como Asunto/métodos , Servicios Preventivos de Salud , Relaciones Profesional-Paciente , Investigadores/psicología , Sujetos de Investigación/psicología , Accidente Cerebrovascular/prevención & control , Confianza , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/etnología , Envejecimiento/psicología , Actitud del Personal de Salud , Estudios Transversales , Características Culturales , Asistencia Sanitaria Culturalmente Competente/etnología , Curriculum , Femenino , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/etnología , Accidente Cerebrovascular/psicología
2.
PLoS One ; 14(12): e0226342, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31851709

RESUMEN

BACKGROUND: Older women perform consistently poorer on physical performance tests compared to men. Risk groups for this "female disadvantage" in physical performance and it's development over successive birth cohorts are unknown. This is important information for preventive strategies aimed to enhance healthy aging in all older women. This study aims to longitudinal investigate whether there are risk groups for a more apparent female disadvantage and study its trend over successive birth cohorts. METHODS: Data of the Longitudinal Aging Study Amsterdam (LASA) were used. All participants were aged 55-65 years at baseline. Longitudinal data of two birth cohorts with baseline measurements in 1992/1993 (n = 966, 24 year follow-up) and 2002/2003 (n = 1002, 12 year follow-up) were included. Follow-up measurements were repeated every three/four years. Cross-sectional data of two additional cohorts were included to compare ethnic groups: a Dutch cohort (2012/2013, n = 1023) and a Migration cohort (2013/2014, n = 478) consisting of migrants with a Turkish/Moroccan ethnicity. RESULTS: Mixed model analysis showed that women aged 55 years and older had a lower age- and height-adjusted gait speed (-0.03 m/s; -0.063-0.001), chair stand speed (-0.05 stand/s; -0.071--0.033), handgrip strength (-14,8 kg; -15.69--13.84) and balance (OR = 0.71; 0.547-0.916) compared to men. The sex difference in handgrip strength diminished with increasing age, but remained stable for gait speed, chair stand speed and balance. In general, results were consistent across different, educational levels and Turkish/Moroccan ethnic groups and birth cohorts. CONCLUSIONS: There is a consistent "female disadvantage" in physical performance among older adults, which remains stable with increasing age (except for handgrip strength) and is consistent across different educational levels, ethnic groups and successive birth cohorts. So, no specific risk groups for the female disadvantage in physical performance were identified. Preventive strategies aimed to enhance healthy aging in older women are needed and should target all older women.


Asunto(s)
Envejecimiento , Escolaridad , Rendimiento Físico Funcional , Caracteres Sexuales , Anciano , Envejecimiento/etnología , Estatura , Estudios de Cohortes , Grupos Étnicos , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Turquia/etnología
3.
Medicine (Baltimore) ; 98(46): e17964, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31725658

RESUMEN

Despite evidence suggesting race and ethnicity are important factors in responses to environmental exposures, drug therapies, and disease risk, few studies focus on the health needs of racially- and ethnically-diverse aging adults.The objective of this study was to determine the burden of 10 health conditions across race and ethnicity for a nationally-representative sample of aging Americans.Data from the 1998 to 2014 waves of the Health and Retirement Study, an ongoing longitudinal-panel study, were analyzed.Those aged over 50 years who identified as Black, Hispanic, or White were included. There were 5510 Blacks, 3423 Hispanics, and 21,168 Whites in the study.At each wave, participants reported if they had cancer, chronic obstructive pulmonary disease, congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Disability-adjusted life years (DALYs) were calculated for each health condition by race and ethnicity. Ranked DALYs determined how race and ethnicity was differentially impacted by the burden of each health condition. Sample weights were utilized to make DALY estimates nationally-representative.Weighted DALY estimates (in thousands) ranged from 1405 to 55,631 for Blacks, 931 to 28,442 for Hispanics, and 15,313 to 295,623 for Whites. Although the health conditions affected each race and ethnicity differently, hypertension had the largest number of DALYs, and hip fractures had the fewest across race and ethnicity. In total, there were an estimated 198,621, 101,462, and 1,187,725 DALYs for older Black, Hispanic, and White aging adults.Our findings indicate that race and ethnicity may be influential on health and disease for aging adults in the United States. Monitoring DALYs may help guide the flow of health-related expenditures, improve the impact of health interventions, advance inclusive health care for diverse aging adult populations, and prepare healthcare providers for serving the health needs of aging adults.


Asunto(s)
Envejecimiento/etnología , Enfermedad Crónica/epidemiología , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Estado de Salud , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Años de Vida Ajustados por Calidad de Vida , Factores Sexuales , Factores Socioeconómicos , Estados Unidos
4.
Dermatol Surg ; 45(12): 1635-1648, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31702594

RESUMEN

BACKGROUND: Racial/ethnic variations in skin structure and function may contribute to differential manifestations of facial aging in various races/ethnicities. OBJECTIVE: To examine self-assessed differences in facial aging in women by race/ethnicity and Fitzpatrick skin phototypes. METHODS: Women aged 18 to 75 years in the United States, Canada, the United Kingdom, and Australia compared their features against photonumeric rating scales depicting degrees of severity for 10 facial aging characteristics. Impact of race/ethnicity (black, Hispanic, Asian, and Caucasian) and skin phototypes on severity was assessed. RESULTS: In total, 3,267 women completed the study. Black women reported the least severe facial aging; Caucasian women reported the most severe facial aging, with Asian and Hispanic women falling between these groups. Similarly, women with a skin phototype V/VI reported lesser aging severity than women with phototypes I through IV. More than 30% of black women did not report the presence of moderate/severe aging of facial areas until 60 to 79 years; most Hispanics and Asians did not report moderate/severe facial aging until 50 to 69 years and Caucasians, 40 to 59 years. CONCLUSION: In this diverse sample, black women reported less severe aging of facial features compared with Hispanic, Asian, and Caucasian women. These results were supported by Fitzpatrick skin phototype analyses.


Asunto(s)
Envejecimiento/psicología , Autoevaluación , Envejecimiento de la Piel , Adolescente , Adulto , Grupo de Ascendencia Continental Africana/psicología , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Anciano , Envejecimiento/etnología , Grupo de Ascendencia Continental Asiática/psicología , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Australia , Canadá , Estudios Transversales , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Cara , Femenino , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Reino Unido , Estados Unidos , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-31569371

RESUMEN

The purpose of this study is to investigate the direct and indirect relationships among death anxiety, religious doubt, and depressive symptoms in older adults. This study also investigates race as a moderator for these relationships. This study used data from the Religion, Aging, and Health Survey. Participants identified as Christian, identified as Black or White, lived in a non-institutionalized household within the U.S., were retired, and spoke English. Using PROCESS, results revealed that religious doubt partially mediated the relationship between death anxiety and depressive symptoms. Furthermore, moderated mediation models revealed that race moderated the relationship between religious doubt and depressive symptoms. Specifically, there was significant, positive relationship between religious doubt and depressive symptoms for participants who identified as Black but not White. Results highlight how religious doubt can influence depressive outcomes among the geriatric communities of color. Limitations and future directions are also discussed.


Asunto(s)
Envejecimiento/etnología , Ansiedad/etnología , Grupos de Población Continentales , Depresión/etnología , Religión , Anciano , Anciano de 80 o más Años , Emociones , Femenino , Humanos , Masculino
7.
Z Gerontol Geriatr ; 52(Suppl 3): 180-187, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31363837

RESUMEN

BACKGROUND: As population ageing takes place around the world, research on attitudes toward ageing and older people increases in relevance. With migration of people from the Arab world into countries with high percentages of older adults, attitudes toward ageing and older adults held in Arab culture are of particular interest. OBJECTIVE: The article provides a review of the empirical literature on attitudes toward ageing and older adults held in the Arab world and discusses the findings on the basis of the general literature on age stereotypes, attitudes toward ageing, and ageism as well as their link to culture. METHOD: A literature search was performed to find empirical studies on attitudes toward ageing and older adults that include Arab samples. Studies published in Arabic or English were included. RESULTS: Studies on attitudes toward ageing with Arab samples are scarce and do not show cohesive patterns of results. None of the hypotheses that have been brought forward to explain cross-cultural differences regarding attitudes toward ageing (i.e., the culture, modernization, and speed of population ageing hypotheses) can fully account for the results. Possible reasons for conflicting results include sociodemographic variables, regional differences, lack of differentiation between meta-perceptions and personal attitudes, heterogeneity of measurement instruments and definitions of "older people" and possible confounds due to the usage of subjective Likert scales in cross-cultural studies. CONCLUSION: Further research on attitudes toward ageing in Arab samples are needed and should consider heterogeneity within Arab culture as well as variables other than culture.


Asunto(s)
Ageísmo/etnología , Envejecimiento/etnología , Árabes , Estereotipo , Anciano , Anciano de 80 o más Años , Ageísmo/psicología , Envejecimiento/psicología , Actitud , Comparación Transcultural , Femenino , Humanos , Masculino
8.
Neuropsychology ; 33(8): 1078-1088, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31343235

RESUMEN

OBJECTIVE: Valid neuropsychological assessment is critical to the accurate diagnosis and effective treatment of diverse populations. American Indians and Alaska Natives experience substantial health disparities relative to the general U.S. POPULATION: Given the dearth of studies on neuropsychological health in this population, we aimed to characterize neuropsychological performance among older American Indians with respect to age, sex, education, income, and language use. METHOD: From 2010 to 2014, we recruited 818 American Indians aged 60 and older from the Cerebrovascular Disease and Its Consequences in American Indians Study, who comprised all of the surviving members of a cardiovascular study (Strong Heart Study). This cohort from 11 tribes resided on or near their home reservations in three geographic regions (Northern Plains, Southern Plains, and Southwest). Using a cross-sectional design investigating potential vascular brain injury, we administered a brief, targeted neuropsychological and motor function assessments. RESULTS: Higher scores on neuropsychological tests were associated with younger age, female sex, more education, higher income, and less Native American language use. Similar associations were found for the motor tests, although men had higher scores on both motor function tests. After accounting for other sociocultural and health factors, age, sex, education, income, and Native American language use all had significant associations to the test scores. CONCLUSIONS: Our findings may be used to guide research and inform clinical practice. The development of future normative studies for older American Indians will be more culturally appropriate when sociocultural factors are included. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Envejecimiento/etnología , Nativos de Alaska/etnología , Indios Norteamericanos/etnología , Pruebas Neuropsicológicas/estadística & datos numéricos , Anciano , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/etnología
9.
Geriatr Gerontol Int ; 19(9): 930-937, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31309695

RESUMEN

AIM: To quantify variations in health-related behaviors (HRB) clustering of older adults in Western and Eastern countries. METHODS: Using six aging cohorts from the USA, England, Europe, Japan, Korea and China, latent class analysis was applied to access the clustering of smoking, alcohol consumption, physical activity and social activity. RESULTS: A total of 104 552 participants (55% women) aged ≥50 years in 2010 were included. Despite a different number of clusters identified, three consistent cluster profiles emerged: "Multiple-HRB" (ex-/never smoking, moderate drinking, frequent physical and social activity); "Inactives" (socially and physically inactive without other risk behaviors); and "(ex-)Smokers with Risk Behaviors". Sex and cohort variations were shown. For men in Western cohorts, "Multiple-HRB" was the predominant cluster, whereas their Asian counterparts were more likely to be members of the "Smokers with risk behavior" and "Inactives" clusters. Most women, particularly those in Asian cohorts, were never smokers and non-drinkers, and most of them belonged to the socially "Inactives" cluster. CONCLUSIONS: We provide a person-centered understanding of HRB clustering of older adults over selected countries by sex, informing tailored health promotion for the target population. Geriatr Gerontol Int 2019; 19: 930-937.


Asunto(s)
Envejecimiento , Consumo de Bebidas Alcohólicas , Ejercicio Físico/psicología , Conductas Relacionadas con la Salud/etnología , Promoción de la Salud/métodos , Estilo de Vida/etnología , Conducta Sedentaria/etnología , Fumar , Anciano , Envejecimiento/etnología , Envejecimiento/psicología , Consumo de Bebidas Alcohólicas/etnología , Consumo de Bebidas Alcohólicas/psicología , Análisis por Conglomerados , Comparación Transcultural , Europa (Continente)/epidemiología , Lejano Oriente/epidemiología , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Fumar/etnología , Fumar/psicología , Estados Unidos/epidemiología
10.
Nutrients ; 11(7)2019 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-31262080

RESUMEN

In vitro and in vivo experimental studies have shown garlic has protective effects on the aging process; however, there is no evidence that garlic consumption is associated with all-cause mortality among oldest-old individuals (≥80 years). From 1998 to 2011, 27,437 oldest-old participants (mean age: 92.9 years) were recruited from 23 provinces in China. The frequencies of garlic consumption at baseline and at age 60 were collected. Cox proportional hazards models adjusted for potential covariates were constructed to estimate hazard ratios (HRs) relating garlic consumption to all-cause mortality. Among 92,505 person-years of follow-up from baseline to September 1, 2014, 22,321 participants died. Participants who often (≥5 times/week) or occasionally (1-4 times/week) consumed garlic survived longer than those who rarely (less than once/week) consumed it (p < 0.001). Participants who consumed garlic occasionally or often had a lower risk for mortality than those who rarely consumed garlic at baseline; the adjusted HRs for mortality were 0.92(0.89-0.94) and 0.89(0.85-0.92), respectively. The inverse associations between garlic consumption and all-cause mortality were robust in sensitivity analyses and subgroup analyses. In this study, habitual consumption of garlic was associated with a lower all-cause mortality risk; this advocates further investigation into garlic consumption for promoting longevity.


Asunto(s)
Envejecimiento/etnología , Grupo de Ascendencia Continental Asiática , Ajo , Raíces de Plantas , Factores de Edad , Anciano de 80 o más Años , Causas de Muerte , China/epidemiología , Femenino , Estado de Salud , Humanos , Longevidad , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Nutritivo , Factores Protectores , Factores de Riesgo , Factores de Tiempo
11.
Australas J Ageing ; 38(3): e98-e102, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31250971

RESUMEN

OBJECTIVE: The aim of the study was to improve the measurement of ageing in Oceania taking into account characteristics of populations and, in particular, changes in life expectancy. METHOD: Using past and projected life tables, we calculated prospective old age dependency ratios (POADRs) to 2060, placing the boundary to old age at a moving point with a fixed remaining life expectancy (RLE) for thirteen territories of Oceania. RESULTS: In some territories, POADRs grow less rapidly than old age dependency ratios (OADRs). For example, in Australia and Guam, the OADR is forecast to increase from 0.20 and 0.07 in 1980, respectively, to 0.45 and 0.39 in 2050-55, while the POADR is forecast to increase from 0.17 and 0.07 to 0.19 and 0.19, respectively, over the same period. CONCLUSION: Policymakers may consider this more rational approach to measurement when considering holistic policy responses to both current issues relating to ageing and mitigating against future challenges.


Asunto(s)
Envejecimiento/etnología , Esperanza de Vida/etnología , Modelos Teóricos , Grupo de Ascendencia Oceánica , Dinámica Poblacional , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oceanía , Factores de Tiempo , Adulto Joven
12.
J Frailty Aging ; 8(3): 131-137, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31237313

RESUMEN

BACKGROUND: Prospective studies examining the potential association of vitamin D with age-related muscle loss have shown inconsistent results. OBJECTIVE: To examine the association between baseline serum 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), and prospective change in lean mass with aging in African ancestry population. We also determined if associations were modulated by age and diabetes mellitus (DM). DESIGN: Prospective observational cohort study. SETTING: Data were collected from a random sub-sample of 574 men, participants of the Tobago Bone Health Study (TBHS). PARTICIPANTS: 574 Afro-Caribbean men, aged 43+ years (mean age: 59.1 ± 10.5), who were randomly selected as the participants in both the baseline and the follow-up visits. MEASUREMENTS: Baseline fasting serum 25(OH)D was measured using liquid chromatography mass spectrometry (LC-MS/MS), and and 1,25(OH)2D was measured using radioimmunosassay (RIA). Changes in dual-energy X-ray absorptiometry (DXA)-measured appendicular lean mass (ALM), and total body lean mass (TBLM) were measured over an average of 6.0 ± 0.5 years. The associations of 25(OH)D and 1,25(OH)2D with ALM and TBLM were assessed by multiple linear regression model after adjusting for potential confounders. RESULTS: When stratifying all men into two groups by age, greater baseline 25(OH)D and 1,25(OH)2D levels were associated with smaller losses of ALM and TBLM in older (age 60+ years) but not in younger (age 43 - 59 years) men. When stratifying by DM status, the associations of 25(OH)D and 1,25(OH)2D with declines in ALM and TBLM were statistically significant only in prediabetic, but not among normal glycemic or diabetic men. CONCLUSION: Higher endogenous vitamin D concentrations are associated with less lean mass loss with aging among older and prediabetic Afro-Caribbean men independent of potential confounders. Our findings raise a possibility that maintaining high serum vitamin D level might be important for musculoskeletal health in elderly and prediabetic African ancestry men.


Asunto(s)
Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Envejecimiento/etnología , Atrofia Muscular/etnología , Vitamina D/sangre , Adulto , Distribución por Edad , Anciano , Envejecimiento/patología , Diabetes Mellitus/etnología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
13.
Womens Health (Lond) ; 15: 1745506519846747, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31084282

RESUMEN

OBJECTIVES: Attitudes to aging have been linked with important health outcomes. It is unclear whether interventions to improve attitudes to aging are effective across cultural contexts. This study investigated the efficacy of an intervention among women of either Australian or Chinese backgrounds. METHODS: Among 96 women who provided baseline measures, 86 attended a single, 90-min group session on either healthy aging or healthy diet. Measures of three domains of attitudes to aging were collected at baseline, then immediately and 8 weeks after the intervention. RESULTS: The intervention improved attitudes in the psychological growth domain, but not the physical change or psychosocial loss domains. Cultural identification did not moderate intervention efficacy. DISCUSSION: The findings suggest that brief, culturally inclusive interventions may be partially effective at improving attitudes to aging. Furthermore, research is needed to investigate if the intervention would be more effective when baseline attitudes to aging are less positive.


Asunto(s)
Envejecimiento/etnología , Envejecimiento/psicología , Actitud , Competencia Cultural , Promoción de la Salud/organización & administración , Australia , China , /psicología , Femenino , Promoción de la Salud/normas , Envejecimiento Saludable/etnología , Envejecimiento Saludable/psicología , Humanos , Salud Mental , Persona de Mediana Edad , Factores Socioeconómicos , Salud de la Mujer
14.
J Cross Cult Gerontol ; 34(2): 149-170, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30903551

RESUMEN

This study examined the association between widowhood and depressive symptoms and the extent to which the association is contingent upon risk and resiliency, including immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. The sample included 344 parent-child pairs reported by 83 respondents. Clustered regression analysis showed that widowhood elevated risks for depressive symptoms. We found that having some functional limitations, having more children and living in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. We also found that living in the same city with children increased the detrimental effects of widowhood on the depressive symptoms in men, whereas we did not find this pattern in women. The findings highlight the heterogeneity within the widowed Mexican American older adults. Implications for future research and practice are discussed.


Asunto(s)
Envejecimiento/etnología , Depresión/etnología , Matrimonio/etnología , Americanos Mexicanos/psicología , Resiliencia Psicológica , Viudez/etnología , Anciano , Envejecimiento/psicología , Depresión/psicología , Femenino , Humanos , Relaciones Intergeneracionales , Masculino , Matrimonio/psicología , Persona de Mediana Edad , República de Corea/etnología , Apoyo Social , Estados Unidos , Viudez/economía , Viudez/psicología
15.
Eur Radiol ; 29(10): 5549-5558, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30887200

RESUMEN

OBJECTIVES: Cerebral blood flow (CBF) estimates from arterial spin labelling (ASL) show unexplained variability in older populations. We studied the impact of variation of haematocrit (Hct) on CBF estimates in a tri-ethnic elderly population. MATERIALS AND METHODS: Approval for the study was obtained from the Fulham Research Ethics Committee and participants gave written informed consent. Pseudo-continuous arterial spin labelling was performed on 493 subjects (age 55-90) from a tri-ethnic community-based cohort recruited in London. CBF was estimated using a simplified Buxton equation, with and without correction for Hct measured from blood samples. Differences in perfusion were compared, stratified by sex, ethnicity and diabetes. Results of Student's t tests were reported with effect size. RESULTS: Hct adjustment decreased CBF estimates in all categories except white European men. The decrease for women was 2.7 (3.0, 2.4) mL/100 g/min) (mean (95% confidence interval (CI)), p < 0.001 d = 0.38. The effect size differed by ethnicity with estimated mean perfusion in South Asian and African Caribbean women found to be lower by 3.0 (3.6, 2.5) mL/100 g/min, p < 0.001 d = 0.56 and 3.1 (3.6, 2.5) mL/100 g/min), p < 0.001 d = 0.48, respectively. Estimates of perfusion in subjects with diabetes decreased by 1.8 (2.3, 1.4) mL/100 g/min, p < 0.001 d = 0.23) following Hct correction. Correction for individual Hct altered sample frequency distributions of CBF values, especially in women of non-European ethnicity. CONCLUSION: ASL-derived CBF values in women, non-European ethnicities and individuals with diabetes are overestimated if calculations are not appropriately adjusted for individual Hct. KEY POINTS: • CBF quantification from ASL using a fixed Hct of 43.5%, as recommended in the ISMRM white paper, may lead to erroneous CBF estimations particularly in non-European and female subjects. • Individually measured Hct values improve the accuracy of CBF estimation and, if these are not available, an adjusted value according to gender, ethnicity or diabetes status should be considered. • Hct-corrected ASL could be potentially important for CBF threshold decision making in the fields of neurodegenerative disease and neuro-oncology.


Asunto(s)
Envejecimiento/fisiología , Circulación Cerebrovascular/fisiología , Diabetes Mellitus Tipo 2/fisiopatología , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Envejecimiento/sangre , Envejecimiento/etnología , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Diabetes Mellitus Tipo 2/etnología , Femenino , Hematócrito , Humanos , Angiografía por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Enfermedades Neurodegenerativas , Reproducibilidad de los Resultados , Caracteres Sexuales
16.
Psychogeriatrics ; 19(5): 419-425, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30723992

RESUMEN

BACKGROUND: The increase in proportion of elderly implies that their problems demand more attention of the administrators. The current study was carried out to assess the functional status of the elderly and to explore the extent and pattern of routine daily life problems faced by them. METHODS: An integrated qualitative and quantitative research design was employed. A stratified multistage random sampling technique was used to select the respondents from various areas of Chandigarh. The houses were selected randomly from where elderly persons (> 60 years) were identified. Katz Index of Independence in activities of daily living (ADL) was used to evaluate functional ability of the respondents. Instrumental ADLs (IADLs) were assessed using Lawton and Brody scale. Focus group discussions and in-depth interviews were conducted among the elderly to explore their problems using an interview guide. RESULTS: One thousand and eighty elderly were enrolled in the study. Their mean age was 67.22 ± 7.54 years. (range 60-102 years). The majority (70%) were independent in carrying out their daily life activities. Financially, around one-third were completely dependent and around half were partially dependent. Major dependence was in food preparation, housekeeping and laundry. From the qualitative data, four main themes were formulated, that is general personal problems of elderly; family problems; problems faced by elderly in hospitals and at public places. A feeling of purposelessness, financial insecurity, physical dependency, problems in hospitals and so on, emerged as the main problems. CONCLUSIONS: Majority of the elderly considered their lives as problematic because they were dependent physically as well as financially. The main domains of dependency were problems related to bowel continence, food preparation, housekeeping and laundry.


Asunto(s)
Actividades Cotidianas , Envejecimiento , Evaluación Geriátrica , Anciano , Anciano de 80 o más Años , Envejecimiento/etnología , Envejecimiento/fisiología , Envejecimiento/psicología , Femenino , Evaluación Geriátrica/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa
17.
Rev Bras Epidemiol ; 21Suppl 02(Suppl 02): e180004, 2019 Feb 04.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-30726349

RESUMEN

INTRODUCTION: Understanding racial disparities in Brazil has been very complex and poorly investigated in some population segments, such as the elderly individuals. OBJECTIVE: This study aimed to present descriptively a comparative analysis in a racial perspective of sociodemographic profile, health conditions, and health service use by older people in the city of São Paulo. METHODS: This is a cross-sectional analysis of the Health, Welfare and Aging Study (SABE). For this study, 1,345 elderly individuals were considered in the cohort of 2010. Data about the black, brown, and white elders were selected. The data were addressed in three major axes: sociodemographic, health conditions, and health service use. The chosen epidemiological measure of association was the prevalence ratio (PR), as well as the percentage values for expressing differences among the groups. RESULTS AND CONCLUSION: The results showed a more favorable scenario for the aging of the white elderly compared to those of brown or black color, considering sociodemographic indicators, health conditions or use and access to health services.


Asunto(s)
Envejecimiento/etnología , Servicios de Salud para Ancianos/estadística & datos numéricos , Disparidades en el Estado de Salud , Grupo de Ascendencia Continental Africana , Distribución por Edad , Anciano , Anciano de 80 o más Años , Brasil/etnología , Estudios Transversales , Femenino , Evaluación Geriátrica , Conductas Relacionadas con la Salud/etnología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Religión , Distribución por Sexo , Factores Socioeconómicos
18.
Rev Bras Epidemiol ; 21Suppl 02(Suppl 02): e180005, 2019 Feb 04.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-30726350

RESUMEN

INTRODUCTION: The city of São Paulo has the largest community of Japanese descendants outside of Japan. OBJECTIVES: To compare the demographic, economic, functional, and health conditions of non-Japanese, Japanese, and their descendants; and to analyze comparatively the functional and health conditions of older adults born in Japan and their descendants born in Brazil. METHODS: A cross-sectional study was carried out in the city of São Paulo, in 2010, with 1,345 older adults (≥ 60 years) participants in the SABE Study (Health, Welfare and Aging). The participants were classified as non-Japanese (not born in Japan), Japanese (born in Japan) or have reported being a direct descendant of Japanese. For the data analysis, χ2 test with Rao-Scott correction was used. RESULTS: Of the 1,345 older adults, 3.3% were Japanese or descendants. These differed from non-Japanese in terms of higher education and reported income sufficiency. Among older adults born in Japan, there was a higher proportion of oldest old (38.8%), cardiovascular diseases (48.9%) and cognitive decline (26.7%). CONCLUSION: It is noted that Japanese and descendants older adults presented better functionality when compared to non-Japanese. Among Japanese and descendants, differences in the profile of diseases were observed. It is believed that such results may be due to cultural influences.


Asunto(s)
Envejecimiento/etnología , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Evaluación Geriátrica/estadística & datos numéricos , Actividades Cotidianas , Distribución por Edad , Anciano , Anciano de 80 o más Años , Brasil/etnología , Estudios Transversales , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Distribución por Sexo , Factores Socioeconómicos , Encuestas y Cuestionarios
19.
Australas J Ageing ; 38(1): 39-46, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30632245

RESUMEN

OBJECTIVE: To examine the prevalence and context of racism self-reported by older Aboriginal and Torres Strait Islander people. METHODS: The 2015 National Aboriginal and Torres Strait Islander Survey was used to measure the prevalence, contexts and demographic differences in reports of racism. Multivariable logistic regression was used to examine the association of age with racism in later life. RESULTS: A sizeable minority of older Aboriginal people reported experiences of unfair treatment (31%) and avoidance (15%), oftentimes occurring in contexts critical to human capital investments. Specific demographic groups, including those with higher levels of education, were more likely to report experiences of unfair treatment. The prevalence of unfair treatment and avoidance remains relatively high in later life (albeit lower than younger ages), with a significant reduction from age 65. CONCLUSION: Addressing racism, particularly in contexts crucial to human capital, is important for the health and well-being of older Aboriginal people.


Asunto(s)
Envejecimiento/psicología , Reacción de Prevención , Grupo de Ascendencia Oceánica/psicología , Racismo/psicología , Adolescente , Adulto , Factores de Edad , Anciano , Envejecimiento/etnología , Actitud del Personal de Salud/etnología , Australia , Asistencia Sanitaria Culturalmente Competente/etnología , Prestación de Atención de Salud/etnología , Escolaridad , Femenino , Empleados de Gobierno/psicología , Humanos , Masculino , Persona de Mediana Edad , Opinión Pública , Racismo/etnología , Factores de Riesgo , Autoinforme , Factores de Tiempo , Adulto Joven
20.
Lung ; 197(1): 73-80, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30637476

RESUMEN

OBJECTIVE: To determine and explain the effect of age on exhaled nitric oxide values in North African healthy subjects aged from 5 to 83 years. DESIGN: Prospective cross-sectional study. METHODS: Volunteer children adults and elderly healthy subjects were included. A medical questionnaire was used to assess several subject characteristics. The levels of exhaled fraction of nitric oxide (FeNO) were measured by Medisoft HypAir FeNO method. Spirometry function test was done after the FeNO measurement. The following parameters were measured: forced vital capacity (FVC, L); 1st second forced expiratory volume (FEV1, L); FEV1/FVC ratio (absolute value); maximal mid expiratory flow (MMEF, L/s); Mid expiratory flow from 25 to 75% (MEF25%, MEF50%, and MEF75%). Statistical analyses were carried out using Statistica software with a significance set at the 0.05 level. RESULTS: A significant increase in FeNO is noted between groups with respective age ranges of (5, 17) and (17, 25) years with a breakpoint at 1,397,034 years. A significant decrease of FeNO is noted between groups with respective age ranges of (45, 55) and (55, 65) years with a breakpoint at 6,366,052 years. No statistical significant difference was found between females' and males' means FeNO data. Finally, SEL, obesity status, and hypertension contribute significantly in the variations of FeNO values. CONCLUSION: The development and aging of the lung touched non-respiratory functions and so modified FeNO values in healthy North African subjects.


Asunto(s)
Envejecimiento/metabolismo , Espiración , Pulmón/metabolismo , Óxido Nítrico/metabolismo , Adolescente , Desarrollo del Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/etnología , Biomarcadores/metabolismo , Niño , Desarrollo Infantil , Preescolar , Estudios Transversales , Femenino , Volumen Espiratorio Forzado , Humanos , Hipertensión/etnología , Hipertensión/metabolismo , Hipertensión/fisiopatología , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Obesidad/etnología , Obesidad/metabolismo , Obesidad/fisiopatología , Túnez , Capacidad Vital , Adulto Joven
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