Gerontology
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Multicenter Study
Caregiver fear of falling and functional ability among seniors residing in long-term care facilities.
Consistent with fear-avoidance models of falling and pain, past research has demonstrated that, among adults living in the community, excessive fear of falling and fear of pain result in activity restriction and predict functional outcomes including falls (possibly because self-imposed activity restriction, due to fear of pain or falling, can lead to muscular decline and deconditioning). Among seniors with dementia, who rely on others for their care, decisions concerning activity restrictions are made by caregivers. As such, caregivers' fear about the possibility of care recipient falls and pain is important to examine. ⋯ This is the first study to apply a modified fear-avoidance model of falls and pain to seniors with dementia who reside in LTC facilities. Our results demonstrate the importance of considering caregiver fears concerning falls and pain, when developing programs designed to optimize the use of physical restrictions (to prevent falls and minimize functional decline) in LTC facilities.
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Both age and dementia have been shown to have an effect on nociception and pain processing. The question arises whether mild cognitive impairment (MCI), which is thought to be a transitional stage between normal ageing and dementia, is also associated with alterations in pain processing. ⋯ The pain response system appeared to be quite unaltered in MCI patients compared to cognitively unimpaired individuals of the same age. Only the sympathetic responsiveness qualified as an indicator of early aging effects as well as of pathophysiology associated with MCI, which both seemed to affect the pain system independently from each other.
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Older people often experience unusual sleeping patterns and a poor quality of night-time sleep. Insufficient sleep has potential effects on cognition and physical functioning and therefore may increase the incidence of falls in older people. ⋯ Sleep disturbances were common and associated with a variety of psychological, physiological, health and lifestyle factors. Long daytime naps and short night-time sleep periods were associated with an increased risk of falls.
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To describe total and yearly demographic trends relative to aging, dysphagia referral rates and oral feeding status in hospitalized patients from 2000 through 2007. ⋯ From 2000 to 2007, dysphagia referrals across all ages increased by 20% each year, with more referrals for older (70.4%) than younger patients (29.6%). Referrals almost doubled for 80 to 89-year-old patients and more than tripled for patients over 90 years. This increase will necessitate additional trained dysphagia specialists at least through 2050 and probably longer.
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The older Hispanic population of the United States is growing rapidly. Hispanic older adults have relatively high-risk profiles for increased morbidity and disability, yet little is known about how the construct of frailty is related to health trajectories in this population. ⋯ The 5-item frailty index differentiated odds of 10-year mortality in older community-dwelling Mexican Americans. This clinical index has the potential to identify older minorities at risk for poor health outcomes and mortality.