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- Electrocardiographic Findings in 888 Patients 90 and Older
- Indicators for Healthy Aging Need to Improve
- Older Women Lose Muscle Strength
- New Report on Instruments Used to Evaluate Assisted Living Facilities
- Ethnic and Educational Differences in Cognitive Test Performance on Mini-Mental State Examination in Asians
- Cognitive Predictors of Mortality in Elderly Retirees: Results From the Freedom House Study
- Want to Age Without Aching?
Electrocardiographic Findings in 888 Patients 90 and Older
The electrocardiograms (ECGs) of 888 subjects aged ≥90 years presenting for any reason were retrospectively analyzed using standard criteria for 128 separate ECG findings. Left ventricular enlargement (28%), first-degree atrioventricular block (16%), and atrial fibrillation (15%) were the most common abnormalities found in the population as a whole. Sinus rhythm was observed in 79% of the population. More Caucasians than African Americans had atrial fibrillation (19% vs. 12%, P = .004). Women had more normal ECG results than men (6% vs. 2%, P = .02), and more women demonstrated complete right bundle branch block (13% vs. 7%, P = .002). In conclusion, few patients aged ≥90 years who have their ECGs recorded at hospitals have completely normal ECG results. The frequencies of some ECG findings in the target population vary by gender and race.
Source: Am J Cardiol 2006;98:1512-4.
Indicators for Healthy Aging Need to Improve
According to the State of Aging and Health in America 2007 report, 80% of Americans ages 65 and older have at least 1 chronic disease that could lead to premature death and disability, and nearly 95% of health care expenditures are spent on treating older adults’ chronic conditions.
Using current national- and state-level data from multiples sources, the report includes data on 15 older adult health indicators in 4 areas: health status, health behaviors, preventive care and screening, and injury. These indicators were chosen because these areas can be modified, and as a group they present a comprehensive picture of older adult health.
According to the report, older adults have met national targets for 4 indicators measured by Healthy People 2010 objectives: current smoking, mammogram within the past 2 years, colorectal cancer screening, and cholesterol checked within the past 5 years. Missed targets included levels of physical activity and vegetable and fruit intake.
Although physical activity supports healthy aging, 28% of those ages 65 to 74 and 36% of those aged 75+ report no leisure-time physical activity (Healthy People 2010 target is no more than 20% of adults reporting no leisure-time activity). Only about 30% of those 65+ met the 5-a-day recommendation for consuming at least 2 servings of fruit and 3 servings of vegetables every day.
Source: Centers for Disease Control and Prevention, www.cdc.gov/aging/saha.htm.
Older Women Lose Muscle Strength
To identify the risk factors for muscle loss, researchers measured the hand-grip strength of women aged 65 to 91 years at 10-year intervals. During the 10 years, grip strength declined an average of 2.4% per year, with women over 80 years demonstrating the greatest loss. Muscle strength loss was correlated with older age, higher weight, greater height loss from age 25, lower protein intake, difficulties with functional tasks, and less physical activity.
Source: Gerontology 2007;531-40.
New Report on Instruments Used to Evaluate Assisted Living Facilities
A new report, Environmental Scan of Instruments to Inform Consumer Choice in Assisted Living Facilities, is now available on the AHRQ Web site at www.ahrq.gov/. The report presents an overview of assisted living, describes the ways that assisted living facilities are evaluated, and reviews the tools currently available to evaluate assisted living facilities and services, including consumer-reported instruments, expert observational instruments, and provider-reported tools. The instruments reviewed for this report were used in an array of assisted living settings and other long-term care facilities, such as nursing homes and residential settings. The instruments are being used to evaluate services offered in a particular facility, the physical and cultural environment, staff issues, activities, social support, and contractual issues. Lastly, the report describes the gaps in the instruments currently available—that is, important aspects of facility performance from the perspective of consumers and other stakeholders that are not being addressed.
Ethnic and Educational Differences in Cognitive Test Performance on Mini-Mental State Examination in Asians
Objective: The objective of this study is to examine ethnic differences in Mini-Mental State Examination (MMSE) test performance in discriminating between demented and nondemented elderly Asians.
Methods: A nationally representative population sample (N = 1,092) of community-living elderly, comprising Chinese, Malays, and Indians in Singapore, was interviewed using MMSE, Geriatric Mental State, and demographic and health questionnaires.
Results: There were significant ethnic differences in mean MMSE scores among Chinese (26.2), Indians (25.0), and Malays (23.6), but only in noneducated subjects. No ethnic differences in MMSE were observed in higher-educated subjects. The sample proportion of subjects with dementia was 4.2% in Chinese, 9.4% in Malays, and 8.8% in Indians. Overall, MMSE discriminated well between subjects with and without dementia (cutoff: 23/24, area under the curve: 95%, sensitivity: 97.5%, specificity: 75.6%). MMSE test performance was much better in higher-educated subjects (higher specificity: 85.2%). Lower specificities were shown in less-educated subjects (57.3%), and in Malays (62.8%), and especially in less-educated Malays (35.3%) and Indians (50.0%). Significant differences in MMSE scores in less-educated subjects persisted after adjusting for differences in sociodemographic, health, and behavioral variables.
Conclusion: Ethnic nonequivalence in MMSE test performance should be taken into account in dementia screening in Asians in less-educated subjects. Known correlates of cognitive functioning did not sufficiently explain these differences.
Source: Am J Geriatr Psychiatry 2007;15:130-9.
Cognitive Predictors of Mortality in Elderly Retirees: Results From the Freedom House Study
Objective: The objective of this longitudinal cohort study was to study the cognitive domains associated with five-year longitudinal survival among healthy, well-educated, noninstitutionalized elderly.
Methods: Survival curves were generated as a function of cross-sectional baseline cognitive test performance.
Results: Nonverbal tests were significantly associated with survival. This finding was markedly consistent. Several nonverbal tasks were each significantly associated with survival independently of age, gender, baseline level of care, and healthcare utilization. In a multivariate model, copying a clock made the strongest, independent contribution to survival.
Conclusions: Right hemisphere integrity in general and nonverbal drawing tasks in particular have been associated with survival in conditions as diverse as Alzheimer disease, stroke, and epilepsy. This study extends this association to “normal” aging. The mechanism by which nonverbal cognitive function is related to mortality remains unclear but may be mediated by changes in right hemisphere cortical control of autonomic function. Nondemented older persons may be at risk. Clock drawing may provide a simple means of identifying them.
Source: Am J Geriatr Psychiatry 2007;15:243-51.
Want to Age Without Aching?
Researchers reporting in the journal Arthritis & Rheumatism found that for every pound of weight lost, there is a 4-pound reduction in the load placed on the knee joint with each step. The accumulated reduction in knee load for a one-pound loss in weight would be more than 4800 pounds per mile walked. Lose 10 pounds and your knees would be subjected to 48,000 less pounds of pressure per mile. Less pressure, less knee pain.
Source: UCLA Medical Center’s Healthy Years, March 2007.
PII: S0197-4572(07)00112-7
doi:10.1016/j.gerinurse.2007.04.011
