Plant response to water stress of native and non-native Oenothera drummondii populations.

Invasive plants can spread over climatically diverse areas. We explore the effects of drought on gas exchange and water relations on the invasive dune species Oenothera drummondii, using plants from four populations with different rainfall and temperatures regimes. Plant material was obtained germinating plants from one native and three non-native populations in a greenhouse. Drought stress was induced by withholding water. Responses to drought stressed plants were then compared to well-watered controls. Measurements of gas exchange, chlorophyll fluorescence and leaf traits were taken initially and every 10 days after water was withheld, until day 36 when plants were re-watered and recover capacity was measured. The effect of water stress was more evident in Fv/Fm and gas exchange variables. The results suggest that this species possess a mechanism of thermal dissipation of energy. Leaf relative water content was significant lower in drought stressed than control plants. At the end of withholding water period, stressed plants are separated from control plants along the axis I of the ordination analysis evidencing differences in functional traits. All plants recovered well after re-watering. Our results provide evidence for permanent differences in morphological traits and functional responses to drought stress among native and invasive populations of O. drummondii. Although we have only studied four populations, these results may provide evidence for the role of plasticity in contributing to the invasion success of this species.

Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage III colon or stage II/III rectal cancer.

BACKGROUND: Many older patients don't receive appropriate oncological treatment. Our aim was to analyse whether there are age differences in the use of adjuvant chemotherapy and preoperative radiotherapy in patients with colorectal cancer. METHODS: A prospective cohort study was conducted in 22 hospitals including 1157 patients with stage III colon or stage II/III rectal cancer who underwent surgery. Primary outcomes were the use of adjuvant chemotherapy for stage III colon cancer and preoperative radiotherapy for stage II/III rectal cancer. Generalised estimating equations were used to adjust for education, living arrangements, area deprivation, comorbidity and clinical tumour characteristics. RESULTS: In colon cancer 92% of patients aged under 65 years, 77% of those aged 65 to 80 years and 27% of those aged over 80 years received adjuvant chemotherapy (χ2trends < 0.001). In rectal cancer preoperative radiotherapy was used in 68% of patients aged under 65 years, 60% of those aged 65 to 80 years, and 42% of those aged over 80 years (χ2trends < 0.001). Adjusting by comorbidity level, tumour characteristics and socioeconomic level, the odds ratio of use of chemotherapy compared with those under age 65, was 0.3 (0.1-0.6) and 0.04 (0.02-0.09) for those aged 65 to 80 and those aged over 80, respectively; similarly, the odds ratio of use of preoperative radiotherapy was 0.9 (0.6-1.4) and 0.5 (0.3-0.8) compared with those under 65 years of age. CONCLUSIONS: The probability of older patients with colorectal cancer receiving adjuvant chemotherapy and preoperative radiotherapy is lower than that of younger patients; many of them are not receiving the treatments recommended by clinical practice guidelines. Differences in comorbidity, tumour characteristics, curative resection, and socioeconomic factors do not explain this lower probability of treatment. Research is needed to identify the role of physical and cognitive functional status, doctors' attitudes, and preferences of patients and their relatives, in the use of adjuvant therapies.

Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up the International Mobility in Aging Study.

BACKGROUND: Abdominal obesity is related to the disability process in older adults, however, little is known about this relationship when adjusted for important confounders such as depression and physical performance measures in a diverse international aged population. OBJECTIVES: To explore the longitudinal relationship between abdominal obesity and mobility disability controlling for physical performance and depression. DESIGN AND SETTING: Longitudinal observational study using data from the International Mobility in Aging Study (IMIAS) Study. PARTICIPANTS: 1104 out of 2002 older adults aged 64-74 years old free of mobility disability at baseline (2012) and then reassessed in 2016. MEASUREMENTS: Mobility disability was defined as reporting difficulty in walking 400 m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. Abdominal obesity was defined as waist circumference ≥ 88cm for women or ≥ 102 cm for men. Four meters gait speed, handgrip strength and depressive symptoms (CES-D) were assessed. Generalized Estimating Equations (GEE) and multinomial regressions were used to estimate associations between disability and abdominal obesity. RESULTS: 1104 free of disability participants were followed over 4 years, the mean age was 68.9 (±2.9) years among men and 68.7 (±2.6) years among women. Prevalence and incidence rates of mobility disability varied widely across research site and sex. The longitudinal associations between mobility disability and abdominal obesity remained significant even when adjusted by depressive symptoms, handgrip strength, gait speed, age, sex, education and research site. Participants with abdominal obesity had higher mobility disability (OR=1.68, 95% CI 1.23-1.76, p-value=0.01) and also increased risk for ADL disability (OR: 1.47, 95% CI 1.23-1.76, p-value=0.01). Abdominal obesity in baseline was also predictor of mobility disability in 2016 (OR: 1.93, 95% CI 1.17-3.17, p-value <0.01) but not for ADL disability (OR: 1.59, 95% CI 0.93-2.71, p-value =0.09) with accounting mortality. CONCLUSION: Abdominal obesity is associated longitudinally and predicts mobility disability, even over a short period (4 years) in community-dwelling older adults from different epidemiological contexts.

Health Behaviors and Chronic Conditions Mediate the Protective Effects of Masculinity for Physical Performance in Older Adults.

OBJECTIVE: We estimated the 2-year incidence of poor physical performance according to gender roles and examined mediating pathways related to health behaviors and chronic conditions. METHOD: Data are from the International Mobility in Aging Study ( n = 1,676). The Bem Sex Role Inventory was used to classify participants into four gender roles as "masculine," "feminine," "androgynous," and "undifferentiated." RESULTS: We found a higher incidence of poor physical performance among participants endorsing the feminine (adjusted incidence rate ratio [IRR] = 2.36, 95% confidence interval (CI) = [1.55, 3.60]) or the undifferentiated role (adjusted IRR = 2.19, 95% CI = [1.45, 3.30]) compared with the androgynous role. Smoking, physical activity, the number of chronic conditions, high body mass index, and depression were mediators of this association but not alcohol consumption. DISCUSSION: This study provides evidence that gender roles are independently associated with physical performance. Health behaviors and chronic conditions are mediators of the relationship between gender roles and lower extremity physical function.

How do Mediterranean shrub species cope with shade? Ecophysiological response to different light intensities.

Under natural conditions, light exposure for Mediterranean shrubs can be highly variable, especially during cloudy days or under a canopy, and can interfere with other environmental factors such as temperature and water availability. With the aim of decoupling the effect of radiation and temperature from water availability, we conducted an experiment where two perennial and three summer semi-deciduous shrub species were subjected to different levels of irradiation. In order to follow plant responses to light exposure, we measured gas exchange, photosystem II photochemical efficiency, photosynthetic pigments and leaf mass area in spring and summer. Results showed that all study species presented a plastic response to different light conditions, and that light-related traits varied in a coordinated manner. Summer semi-deciduous species exhibited a more opportunistic response, with higher photosynthesis rates in full sun, but under shade conditions, the two strategies presented similar assimilation rates. Stomatal conductance did not show such a drastic response as photosynthetsis, being related to changes in WUE. Daily cycles of Fv /Fm revealed a slight photoinhibitory response during summer, mainly in perennial species. In all cases photosynthetic pigments adjusted to the radiation level; leaves had lower chlorophyll content, higher pool of xanthophylls and higher proportion of the de-epoxydaded state of xanthophylls under sun conditions. Lutein content increased in relation to the xanthophyll pool under shade conditions. Our results evidenced that radiation is an important driving factor controlling morphological and physiological status of Mediterranean shrub species, independently of water availability. Summer semi-deciduous species exhibit a set of traits with higher response variability, maximising their photosynthetic assimilation under different sun conditions.

Reliance on deep soil water in the tree species Argania spinosa.

In South-western Morocco, water scarcity and high temperature are the main factors determining species survival. Argania spinosa (L.) Skeels is a tree species, endemic to Morocco, which is suffering from ongoing habitat shrinkage. Argan trees play essential local ecological and economic roles: protecting soils from erosion, shading different types of crops, helping maintain soil fertility and, even more importantly, its seeds are used by the local population for oil production, with valuable nutritional, medicinal and cosmetic purposes. The main objective of this study was to identify the sources of water used by this species and to assess the effect of water availability on the photosynthetic rate and stem water potential in two populations: one growing on the coast and a second one 10 km inland. Stem water potential, photosynthetic rate and xylem water isotopic composition (δ18O) were seasonally monitored during 2 years. Trees from both populations showed a similar strategy in the use of the available water sources, which was strongly dependent on deep soil water throughout the year. Nevertheless, during the wet season or under low precipitation a more complex water uptake pattern was found with a mixture of water sources, including precipitation and soil at different depths. No evidence was found of the use of either groundwater or atmospheric water in this species. Despite the similar water-use strategy, the results indicate that Argania trees from the inland population explored deeper layers than coastal ones as suggested by more depleted δ18O values recorded in the inland trees and better photosynthetic performance, hence suggesting that the coastal population of A. spinosa could be subjected to higher stress.

Factors associated with hypertension prevalence, awareness, treatment and control among participants in the International Mobility in Aging Study (IMIAS).

The aim of this study is to assess the factors associated with hypertension prevalence, awareness, treatment, and control, in the elderly populations of the International Mobility in Aging Study (IMIAS). Approximately 200 men and 200 women aged 65-74 years were recruited at each site (n=1995) during IMIAS' 2012 baseline survey at five cities: Kingston (Canada), Saint-Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia) and Natal (Brazil). Blood pressure and anthropometric measurements were taken at participants' homes. Hypertension prevalence ranged from 53.4% in Saint-Hyacinthe to 83.5% in Tirana. Diabetes and obesity were identified as risk factors in all cities. More than two-thirds of hypertensive participants were aware of their condition (from 67.3% in Saint-Hyacinthe to 85.4% in Tirana); women were more aware than men. Awareness was positively associated with diabetes in Kingston, Manizales and Natal. Though most of those aware of their hypertensive condition were being treated pharmacologically, associations between awareness and physical activity and refraining from smoking were weak. Control among treated hypertensive participants was low, especially in Tirana and Natal. Diabetes and physical inactivity were associated with poor hypertension control. Hypertension is common in the older populations of IMIAS. Diabetes is strongly associated with hypertension prevalence, awareness and lack of control of hypertension. The fact that awareness is not strongly associated with healthy behaviours suggests that antihypertensive medication is not accompanied by non-pharmacological therapies. Improved health behaviours could strengthen hypertension control. Efforts should be made to increase men's awareness of hypertension. Hypertension control in diabetic patients is a challenge.

The mobility gap between older men and women: the embodiment of gender.

OBJECTIVES: To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. METHODS: Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. RESULTS: Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. DISCUSSION: Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age.

Socio-demographic correlates of late treatment initiation in a cohort of patients starting antiretroviral treatment in Mali, West Africa.

The objective of this study was to investigate factors correlated with late treatment initiation in a cohort of patients starting treatment in Mali, West Africa, while focusing on the role of sex/gender. This study consisted of a cross-sectional analysis of baseline data from a prospective, observational cohort of patients initiating antiretroviral treatment in Mali. Patient data were analyzed with a gender perspective to examine factors correlated with late treatment initiation, defined as having a CD4 count below 100 cells/µl. Aday and Andersen's conceptual framework of access to medical care was used to classify baseline participant characteristics associated with late treatment initiation. Logistic regression was used to evaluate the modifying effect of sex/gender. Results show that 39% of patients initiated treatment late; significantly more of these were men than women. Sex/gender, marital status, and education were associated with late treatment initiation. Unmarried men and uneducated women were significantly more likely to initiate treatment late. Programs need to target unmarried men while being cognizant that uneducated women are arriving late as well.

Gender, social relationships and depressive disorders in adults aged 65 and over in Quebec.

The objective of this study was to examine if social relationships have a differential association with the presence of depression in men and women aged 65 and over. Data came from a survey of a representative sample of 2670 community-dwelling older adults in Quebec. Depressive disorders were measured using DSM-IV criteria. The prevalence of depression was 17.8% for women and 7.6% for men. Men reported a greater diversity of ties but less support than women. Having a confidant and/or being engaged in a good marital relationship was negatively associated with depression in both men and women. Compared with married people in general, widowhood was associated with a considerably higher risk of depression in men than in women. Compared with non-volunteers in general, men who volunteer were at considerably lower risk of depression than women who volunteer. This exploratory study could serve as a basis for future longitudinal studies on the impact of community activities and volunteering on the incidence and remission of depression in older men and women in Canada.

Factors influencing duration of exposure with symptoms and costs of occupational asthma.

The most important factor for the prognosis of occupational asthma is the length of exposure with symptoms prior to removal from exposure. We wanted to identify factors, including socioeconomic status, that can influence the delay in submitting a claim to a medicolegal agency after the onset of asthmatic symptoms, and to confirm that this delay is associated with worse respiratory prognosis and higher direct costs. This is a cross-sectional study of subjects who claimed compensation for occupational asthma at the Workers' Compensation Board of Quebec, Canada. Data were collected at re-evaluation ∼2.5 yrs after diagnosis. Information on the number of years with symptoms and removal from exposure was obtained from the medicolegal file. 60 subjects were included in the study. Being older, having a revenue of >30,000 Canadian dollars and having occupational asthma due to high molecular weight agents were all positively associated with the number of years of exposure with symptoms before removal from exposure. Subjects with persistent airway hyperresponsiveness at follow-up had a higher number of years with symptoms. Experiencing symptoms in the workplace for <1 yr generated lower direct costs. These findings might help in surveillance programmes that could be preferentially targeted for these subgroups of workers.

Discrimination and mental health in Ecuadorian immigrants in Spain.

BACKGROUND: The aim of this study was to examine the effects of ethnic discrimination on the mental health of Ecuadorian immigrants in Spain and to assess the roles of material and social resources. METHODS: Data were taken from the "Neighbourhood characteristics, immigration and mental health" survey conducted in 2006 in Spain. Psychological distress measured as "Possible Psychiatric Case" (PPC) was measured by the GHQ-28. A logistic regression was fitted to assess the association between PPC and discrimination. Interactions of discrimination with social and material resources were tested using product terms. RESULTS: Some 28% of the participants met our definition of PPC. About 20% of those who reported no discrimination were PPCs, rising to 30% of those who sometimes felt discriminated against and 41% of those who continually perceived discrimination. The OR for continuous discrimination was 12 (95% CI 3.5 to 40.3) among those with high financial strain, and 10 (2.4 to 41.7) when there was lack of economic support. Emotional support had an independent effect on PPC (OR 1.8, 95% CI 1.0 to 3.6, for those who reported having no friends). Social integration through a community group or association was positively related to the probability of being a PPC (OR 1.7, 95% CI 1.0 to 2.9). CONCLUSION: Ethnic discrimination is associated with psychological distress in these Ecuadorian immigrants in Spain. Discrimination effects may be exacerbated among those facing economic stress and those without economic support. These particularly vulnerable immigrants should be the subject of social and health interventions.

Duration of lack of money for basic needs and growth delay in the Quebec Longitudinal Study of Child Development birth cohort.

OBJECTIVE: To examine the relationship between duration of lack of money for basic needs and growth delay in a birth cohort. METHODOLOGY: Mothers of children (n = 1929) from the Quebec Longitudinal Study of Child Development (QLSCD) participating when the children were ages 2(1/2) and 4 years were interviewed at home and data were extracted from birth records. Children's height at 4 years old was transformed into an age- and sex-adjusted z-score. A z-score under the 10th percentile of the Centers for Disease Control and Prevention population growth curve was equated with growth delay. Lack of money for basic needs (paying for rent, electricity and/or heating, clothing, medications or other needs) when the children were ages 2(1/2) and 4 years was reported by the mother. RESULTS: Only 2.5% of children experienced two episodes of lack of money for basic needs. Logistic regression analyses showed that, after adjusting for confounding variables, the probability of growth delay at 4 years among children whose families experienced two episodes of lack of money was higher than for their peers who had not lacked money (OR 3.43; 95% CI 1.54 to 7.66). Experiencing lack of money only at 2(1/2) years showed higher but not significant odds of growth delay at 4 years (OR 1.51; 95% CI 0.84 to 2.72), whereas the likelihood of growth delay was similar for children who experienced lack of money only at 4 years and for their counterparts who never lacked money (OR 0.74; 95% CI 0.26 to 2.11). CONCLUSION: In an industrialised country toddlers whose families experienced persistent lack of money for basic needs are more likely to have growth delay even after controlling for neonatal conditions and their mothers' characteristics.

Gender-related factors influencing HIV serostatus disclosure in patients receiving HAART in West Africa.

Disclosure of HIV serostatus remains an important tool for the prevention of new infections and early initiation of treatment for HIV-positive individuals' regular sexual partners. Our aim is to identify factors associated with disclosure to partner in patients taking antiretroviral treatment, with a gender- and sex-based approach. In this study conducted in Mali and Burkina Faso, men (154) and women (164) who reported being in a marital or cohabitating relationship were included. Sex-specific bivariate analyses and multivariate logistic regression were performed to identify determinants of disclosure. Disclosure to partner was 72.1% in men and 79.9% in women. Results of bivariate and multivariate analyses indicated that cohabiting with partner was strongly associated with disclosure in both men and women. In men only, older age, literacy and having good communication with the treating doctor were significantly associated with disclosure. Among women, disclosure was associated with having children and high self-reported importance of religion. Future research and interventions promoting disclosure should take into account these differences reflecting the social construction of gender roles in these settings.

Le Test Du Sénégal: Un Instrument Valide Et Fiable Pour Le Dépistage De La Démence Dans Une Population De Personnes Âgées Sénégalaises

"Description. Face au vieillissement de la population et au developpement de la demence; il est necessaire de disposer d'outil de depistage valide et fiable qui soit adapte au contexte socio-culturel. Objectif.Valider le Test du Senegal; un instrument de depistage de la demence aupres de la population agee senegalaise. Methode .Le Test du Senegal est un instrument de depistage de la demence incluant des items en rapport avec l'orientation; la memoire; l'attention/calcul; la praxie et le langage avec un score de 0-39 points. Sa validation s'est deroulee en deux phases aupres de personnes agees de 55 ans et plus frequentant le Centre Medicosocial et Universitaire de l'IPRES (Institut de Prevoyance Retraite du Senegal) pour des soins : 1) etude transversale aupres de 872 patients interviewes avec le questionnaire ""Vieillir au Senegal"" pour identifier les cas selon les criteres DSM IV-R; 2) une etude cas-temoins avec 116 patients (58 sujets dements et 58 temoins apparies par le sexe) pour la validation proprement dite. Le Test du Senegal a ete administre lors de la premiere phase; re-administre une semaine puis deux semaines apres lors de la deuxieme phase. La validite de critere; la validite de construit et la fidelite du test ont ete estimees. L'effet de l'age et de l'instruction sur la performance du test pour depister la demence a ete etudie avec des analyses de regression logistique. Resultat. Le Test du Senegal identifiait les cas de demence avec les caracteristiques suivantes au point de coupure de 28/29 : sensibilite : 93;1; specificite : 89;6; valeur predictive positive : 93;1; valeur predictive negative : 92;8; surface sous la courbe caracteristique de performance: 0;967; kappa : 0;82; coefficient de correlation intraclasse variant entre 0;67 et 0;87. L'age et l'education n'avaient aucune influence sur la performance au Test du Senegal. Conclusion Le Test du Senegal est un instrument valide et fiable pour le depistage de la demence dans la population agee senegalaise. Il pourra etre utilise comme outil de depistage de la demence dans les services de sante."

Inadequate adherence to antiretroviral treatment and prevention in hospital and community sites in Burkina Faso and Mali: a study by the ATARAO group.

Our objective was to determine the prevalence and identify the factors that influence antiretroviral therapy (ART) adherence among patients in Bamako and Ouagadougou. A cross-sectional study was conducted among 94 men and 176 women receiving ART. Data were collected through questionnaires and chart reviews. Logistic regressions were performed to isolate determinants of adherence. Overall, 58% of the patients were adherent, but there were differences in the levels of adherence according to country and treatment site. Sociodemographic factors were not associated with adherence. However, social characteristics such as having children, in Ouagadougou, or being a housewife and not planning to have a child in the next year, in Bamako were associated with adherence. Time on ART was negatively associated with adherence in both countries with decline occurring later in Bamako. Levels of adherence are inadequate particularly among more experienced patients. Further adherence research and monitoring using longitudinal designs are warranted to assess the extent to which adherence is declining with time on treatment.

[Prevalence of vascular risk factors among Spanish populations aged 70 years and over, as reported in door-to-door studies on neurological diseases]. / Prevalencia de factores de riesgo vascular en poblaciones españolas de 70 años y más en estudios puerta a puerta de enfermedades neurológicas.

INTRODUCTION: The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. METHODS: The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. RESULTS: The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. CONCLUSIONS: There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention.

A harmonized measure of activities of daily living was a reliable and valid instrument for comparing disability in older people across countries.

BACKGROUND AND OBJECTIVES: Our aim was to construct a harmonized measure of activities of daily living (ADL) across six countries, and to evaluate the reliability and validity of this measure. METHODS: A population of 9,297 persons, aged 65-89 years, was drawn from the Comparison of Longitudinal European Studies on Aging (CLESA) study, which includes data from five European countries and Israel. Because the number, type, and response format of the ADL items differed across the six studies, a four-item scale was constructed to harmonize the data, using items common to most countries. A procedure was devised to substitute or construct items that were not available in two of the countries. RESULTS: Cronbach's alpha for the four-item ADL measure varied from 0.81 in Spain to 0.92 in Finland, and was similar to the alpha of scales including five or six items. Kappa scores between substituted or constructed items and the actual items varied from 0.50 to 0.78. In all countries, the percentage of persons with ADL disability differed significantly across age and was associated with chronic diseases, poor self-rated health, global disability, and home help utilization. CONCLUSION: The harmonized four-item ADL measure seems a reliable and valid instrument for comparing ADL disability in older people across countries.

Disability and social ties: comparative findings of the CLESA study.

The associations between prevalence, incidence and recovery from activities of daily living (ADL) disability and social ties among community-dwelling persons over 65 in Finland, The Netherlands and Spain are examined. Data were harmonized in the CLESA study. The baseline sample was composed of 3,648 subjects between 65 and 85 years old, living in Finland, The Netherlands and Spain. Disability in four activities of daily living was determined at baseline and at follow-up. Social participation, number of family ties and presence of friends were added to obtain a social ties index. Logistic regressions were fitted to the prevalence, incidence and recovery data to estimate the associations between disability and social ties, adjusting for education, co-morbidity and self-rated health. The modifying effects of country, age and sex were tested in all models. For every country, the social ties index, having friends and social participation were negatively associated with ADL disability prevalence. ADL incidence was negatively related to the number of family ties, with a stronger relationship in Spain than in The Netherlands or Finland. ADL recovery was associated with the social ties index. No age or gender differences in these associations were found. Social ties appear to generate a beneficial effect on the maintenance and restoration of ADL function. While social ties play an important role in maintaining and restoring function in all three countries, family ties appear to generate a stronger effect on protection from disability incidence than does social participation, and the strength of this effect varies by culture.

[Spanish version of the 7 Minute screening neurocognitive battery. Normative data of an elderly population sample over 70]. / Versión española del Test de los 7 Minutos. Datos normativos de una muestra poblacional de ancianos de más de 70 años.

INTRODUCTION: To standardize the Spanish version of the 7 Minute screening neurocognitive battery (7MS) in a population sample of elderly over 70 years. METHODS: We examined 416 persons, living at home, participating in elderly the longitudinal study "Aging in Leganes", aged 71 to 99 years old (mean age: 79 +- 9.2 years; 51.7 % women; 10.6 illiterate, 25 % without formal education). In order to do so, we used an extensive clinical survey, general and neurological exam and extensive neuropsychological battery with several cognitive scales, attention, language, memory, visuomotor skill and reasoning tests, Jorm's IQCODE questionnaire, CES-D depression questionnaire and the 7MS including the Benton Orientation Test, Clock Drawing Test, Free and Cued Learning Test and Categorial Verbal Fluency. Dementia was diagnosed according to DSM-IV criteria but independently of the 7MS scores. Several methods to obtain the total score of the 7MS were analyzed and the normative parameters of the test were obtained in the subgroup of non-demented subjects. RESULTS: The easiest and most efficient method to obtain the total score of the 7MS was the sum of the z-scores of the four subtests. We present the mean values, -1 and -1.5 standard deviations, range and percentiles of the partial and total scores of the 7MS stratified by age (71-75, 76-80, 81-85 and > or = 86 years) and education (less than primary education and primary education or greater) in the subgroup of non-demented subjects. CONCLUSIONS: The normative data of the 7MS obtained in a representative sample of the general elderly population support its rigorous use in the Spanish clinical setting.