Profiles of psychological functioning in the old and oldest old.

Cluster analysis was applied to 12 measures of intellectual, personality, self-related, and social functioning collected in the 1st cross-sectional wave of the Berlin Aging Study (BASE; N?=?516). Central questions concerned the number, profile desirability (functional status), and membership of the subgroups obtained. Of the 9 subgroups extracted, 4 reflected different patterns of desirable functioning (47% of the sample), and 5 reflected less desirable functioning (53%). Relative risk of a less desirable profile was 2.5 times higher for the oldest old (85–103 years) than for people between the ages of 70–84 years and was 1.25 times higher for women compared with men. Relationships with education, health, and mortality suggested underlying systemic differences. Consistent with theoretical propositions about a "4th age" and the incomplete architecture of life span development (P. B. Baltes, 1997), the oldest old appear to have a distinct and less desirable psychological profile. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multilingualism and cognitive state in the oldest old.

In this study, the authors examined whether the number of languages a person speaks predicts performance on 2 cognitive-screening tests. Data were drawn from a representative sample of the oldest Israeli Jewish population (N = 814, M age = 83.0 years; SD = 5.4) that was interviewed first in 1989 and then twice more within the following 12 years. Cognitive state differed significantly among groups of self-reported bilingual, trilingual, and multilingual individuals at each of the 3 interview waves. Regression analyses showed that the number of languages spoken contributed to the prediction of cognitive test scores beyond the effect of other demographic variables, such as age, gender, place of birth, age at immigration, or education. Multilingualism was also found to be a significant predictor of cognitive state in a group of individuals who acquired no formal education at all. Those who reported being most fluent in a language other than their mother tongue scored higher on average than did those whose mother tongue was their best language, but the effect of number of languages on cognitive state was significant in both groups, with no significant interaction. Results are discussed in the context of theories of cognitive reserve. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness among the oldest old, a comparison between residents living in nursing homes and residents living in the community

To ascertain whether membrane signal transduction is induced by bullous pemphigoid (BP) antibody and whether cell lysis is induced by its complement activation, we assessed the intracellular Ca2+ concentration ([Ca2+]i), intracellular pH, membrane potential and morphology of living cells by following the time course of fluorescence intensity of Fluo-3/AM, Snaff-1/AM, Dioc-5 and Luciffer yellow, respectively. A transient increase of Fluo-3 fluorescence intensity in DJM-1 cells (a squamous cell carcinoma line) was revealed when the cells were incubated with 2 of five IgG1 BP antibodies. However, no transient increase of Fluo-3 fluorescence intensity was revealed when the cells were incubated with IgG2 and IgG4 BP antibodies. A transient increase of Fluo-3 fluorescence intensity was revealed in DJM-1 cells incubated with 3 of seven IgG1 and 1 of four IgG2 BP antibodies in an EGTA-containing low-Ca2+ medium. On the other hand, the Dioc-5 fluorescence intensity did not change significantly, though the increase of Fluo-3 fluorescence intensity was observed. The increase of Snarf-1 fluorescence intensity was revealed in DJM-1 cells incubated with 2 of five IgG1 BP antibodies, but was not revealed in the cells incubated with IgG2 or IgG4 of BP antibodies. Study of complement activation by BP IgG1 showed a transient increase of Fluo-3 fluorescence intensity of with 3 of five IgG1 BP antibodies when DJM-1 cells were incubated with complement-supplemented normal-Ca2+ medium. At the same time, however, endocytosis and cell lysis were not observed with 2 IgG1 BP antibodies which did induce an increase of Fluo-3 fluorescence intensity when Lucifer-yellow-loaded DJM-1 cells were incubated with complement-supplemented normal-Ca2+ medium. We examined next whether anti-180 kD BP antigen monoclonal antibodies (mAbs R-223 and 233) induce an increase of Fluo-3 fluorescence intensity. MAb R-223 did not induce any increase of Fluo-3 fluorescence intensity in DJM-1 cells, when incubated with normal- and low-Ca2+ media However, mAb R-223 induced a transient increase of Fluo-3 fluorescence intensity in DJM-1 cells when incubated with complement-supplemented normal-Ca2+ medium. MAb 233 did not induced an increase of Fluo-3 fluorescence intensity in DJM-1 cells when incubated with normal- and low-Ca2+ media. These results suggest that the BP IgG1 induces Ca2+ release from intracellular storage sites, however, the complement activated by BP IgG1 does not induce cell lysis. It could not be confirmed that anti-180 kD BP antigen antibody induced Ca2+ release from intracellular storage sites.     

Sociodemographic differences in the prevalence of self-reported stomach pain in school children

The study considered the prevalence of experienced stomach pain in a nationwide random sample of 2161 Icelandic 11-12 and 15-16-year-old school children. It found an 18.4% prevalence of "at least weekly" stomach pain and a 53.4% overall prevalence. The prevalence of stomach pain was significantly higher among younger children (P < or = 0.001). Higher prevalence (P < or = 0.001) of stomach pain was seen in girls in the overall sample and the gender difference was significant in both age groups. No overall class or residential differences were detected. However, the findings suggest some age-related links between social status and the experience of stomach pain. The frequency of stomach pain was moderately and significantly associated with medication use. The theoretical and clinical implications of the results are briefly discussed. CONCLUSION: The high prevalence of frequent stomach pain found in this study calls for future research documenting further the epidemiology of stomach pain and various bio-psycho-social factors related to the experience and extent of this pain in school children.     

The oldest old, ADL, social network, and loneliness

This study examined the influence of activities of daily living (ADL) and frequency of social contacts on the loneliness and social relationships in a sample of very elderly individuals. Associations between functional ability, social contacts, and emotional loneliness and social loneliness were also assessed. The sample was composed of 221 participants, age 80 to 105 years, residing in the greater Bergen area in Norway. Results demonstrated that dependence on the environment in ADL is related to low levels of emotional loneliness, whereas only dependence in activities of toileting and transferring corresponded with low levels of social loneliness. High frequency of social contacts with family, friends, or neighbors was negatively related to both emotional and social loneliness. Results show that frequency of such contacts appeared to buffer the effect of continence on emotional loneliness and the effect of toileting and transferring on social loneliness.     

Flavonoid intake and coronary mortality in Finland: a cohort study

OBJECTIVE: To study the association between dietary intake of flavonoids and subsequent coronary mortality. DESIGN: A cohort study based on data collected at the Finnish mobile clinic health examination survey from 1967-72 and followed up until 1992. SETTINGS: 30 communities from different parts of Finland. SUBJECTS: 5133 Finnish men and women aged 30-69 years and free from heart disease at baseline. MAIN OUTCOME MEASURE: Dietary intake of flavonoids, total mortality, and coronary mortality. RESULTS: In women a significant inverse gradient was observed between dietary intake of flavonoids and total and coronary mortality. The relative risks between highest and lowest quarters of flavonoid intake adjusted for age, smoking, serum cholesterol concentration, blood pressure, and body mass index were 0.69 (95% confidence interval 0.53 to 0.90) and 0.54 (0.33 to 0.87) for total and coronary mortality, respectively. The corresponding values for men were 0.76 (0.63 to 0.93) and 0.78 (0.56 to 1.08), respectively. Adjustment for intake of antioxidant vitamins and fatty acids weakened the associations for women; the relative risks for coronary heart disease were 0.73 (0.41 to 1.32) and 0.67 (0.44 to 1.00) in women and men, respectively. Intakes of onions and apples, the main dietary sources of flavonoids, presented similar associations. The relative risks for coronary mortality between highest and lowest quarters of apple intake were 0.57 (0.36 to 0.91) and 0.81 (0.61 to 1.09) for women and men, respectively. The corresponding values for onions were 0.50 (0.30 to 0.82) and 0.74 (0.53 to 1.02), respectively. CONCLUSIONS: The results suggest that people with very low intakes of flavonoids have higher risks of coronary disease.     

The nature and cross-domain correlates of subjective age in the oldest old: Evidence from the OCTO Study.

Self-reflections of age and aging are predictors for key outcomes such as mortality, but little is known about the nature and potential antecedents of subjective age in very old age. We used cross-sectional data from the Swedish OCTO study (N = 267; B. Johansson & S. H. Zarit, 1995) and found that almost two thirds of the 84- to 90-year-olds reported not feeling old. Multinomial logistic regression analyses indicated that younger age and better physical functioning as well as higher well-being and mastery beliefs were all related to not feeling old. In multivariate analyses, however, mastery beliefs emerged as the most consistent and robust predictor of subjective age. Our findings suggest that adaptive capacities may be preserved into advanced age and highlight the pivotal role of perceived control for successful aging. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased socioeconomic differences in mortality in eight Spanish provinces

In Spain, the study of socioeconomic differences in mortality has been limited by the fact that death certificates often do not include complete information on occupation. In this study, we chose those geographic areas with the highest quality information on occupation of the deceased in order to study socioeconomic differences in mortality from various causes of death. We used information from the death certificates of males who died between 30 and 64 years of age in eight Spanish provinces to compare mortality from the leading causes of death in professionals and managers (group I) and in manual laborers (group II) in 1980-82 and 1988-90. In each period the standardized mortality ratios (SMRs) were higher in group II, except for ischaemic heart disease during the first period, and cancer of the colon and rectum in both, although in the latter case the differences were not statistically significant. The ratio between the SMR from all causes in group II and group I was 1.27 in 1980-82, and 1.72 in 1988-90; for cancer of the colon and rectum the ratio went from 0.98 to 0.84, and for ischaemic heart disease, from 0.80 to 1.31. Except for cancer of the colon and rectum, which resulted in higher mortality in occupational group I, the excess mortality in occupational group II increased between the first and second period. The relation between socioeconomic level and mortality for ischaemic heart disease was reversed, a phenomenon similar to that which took place in the 1960s and 1970s in the developed countries.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of cognition in predicting activities of daily living and ambulation functioning in the oldest old rehabilitation patients.

Examined what demographic, medical, cognitive, and affective measures predicted activities of daily living (ADL) and ambulation for 60 geriatric rehabilitation inpatients (aged 85 yrs or older) at discharge. Ss completed the Geriatric Depression Scale, Dementia Rating Scale (DRS), and Functional Independence Measure. Cognition, as measured by the DRS, was the only significant predictor of both ADL and ambulation scores. Gender was correlated with ADL skills, indicating that women attained higher ADL scores, while men did better on ambulation skills. DRS scores accounted for 8% of ADL variance and 16% of ambulation variance, above and beyond demographic and medical variables. Depression was a poor predictor of functional skills among this sample, few of whom were depressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religion and mortality among the community-dwelling elderly

OBJECTIVES: This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state. METHODS: The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect. RESULTS: Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support. CONCLUSIONS: Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.     

Increase in incidence of insulin-dependent diabetes mellitus among children in Finland

It has been proposed that NO may function as an endogenous cardioprotectant. We have investigated whether modulation of NO levels (detected in coronary effluent by chemiluminescence) by a blocker of its synthesis, by supplementation of its precursor, and by administration of an NO donor can influence reperfusion arrhythmias in the isolated rat heart. Rat hearts were perfused with modified Krebs' solution and subjected to 5, 35, or 60 minutes of left regional ischemia followed by 10 minutes of reperfusion. NG-Nitro-L-arginine methyl ester (L-NAME), which blocks NO synthase, increased the incidence of reperfusion-induced ventricular fibrillation (VF) from 5% in the control condition to 35% after 60 minutes of ischemia (n = 20, P < .05). The profibrillatory effect of L-NAME was prevented in hearts coperfused with 1 or 10 mmol/L L-arginine (an NO precursor) but persisted in hearts coperfused with D-arginine (1 mmol/L). L-NAME did not increase VF susceptibility in hearts reperfused after 5 or 35 minutes of ischemia. L-NAME caused sinus bradycardia (264 +/- 10 versus 309 +/- 5 bpm in control groups, P < .05) and reduced coronary flow before ischemia (6.2 +/- 0.6 versus 9.2 +/- 0.6 mL.min-1.g-1 tissue in controls, P < .05). L-NAME reduced coronary effluent NO levels after 60 minutes of ischemia; during the first minute of reperfusion, values were reduced from 1457 +/- 422 to 812 +/- 228 pmol.min-1.g-1 (P < .05). This effect was prevented by coperfusion with L-arginine (10,344 +/- 1730 pmol.min-1.g-1, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Socioeconomic differences in 'avoidable' mortality in Sweden 1986-1990

BACKGROUND: 'Avoidable' mortality is commonly studied as an indicator of the outcome of health care. In this study socioeconomic differences in avoidable mortality in Sweden from 1986 to 1990 are analysed and related methodological issues discussed. METHODS: The 1985 Swedish Population and Housing Census was linked to the National Cause of Death Register 1986-1990. Mortality from potentially 'avoidable' causes of death was analysed for the age group 21-64 years. Analyses were performed for different socioeconomic groups, blue-collar workers, white-collar workers and the self-employed as well as for individuals outside the labour market. Standardized Mortality Ratios were calculated using standardization by age and sex. RESULTS: For all indicators studied, the death rates for those not in work were higher than for people at work. The largest differences were found for chronic bronchitis, diabetes, bacterial meningitis, ulcer of the stomach and duodenum, chronic rheumatic heart disease, asthma and hypertensive and cerebrovascular disease. For these causes of death the risk of dying was between 3.1 and 7.5 times greater in the non-working population than in the work-force. The differences in avoidable mortality between blue-collar workers and white-collar workers and the self-employed were, however, much smaller. For most of the indicators no significant differences were found. For ulcers of the stomach and duodenum, however the death rate for blue-collar workers was 2.8 times higher than those for other categories in work. CONCLUSIONS: The small difference in mortality outcome for different socioeconomic groups within the work-force indicates an equal quality of care for these groups. The greatly increased risk among the non-working population, however, is a warning sign. These results may be due to a 'healthy worker' effect. The measurement of socioeconomic differences in mortality may be dependent on the time-period chosen between occupational exposure and mortality outcome.     

Avoidable mortality among psychiatric patients

Avoidable mortality is a selection of causes of death considered to be amenable to health care and thereby used as an indicator of the quality of health care. In this study avoidable mortality for more than 30,000 psychiatric patients discharged from any hospital of Stockholm County between 1981 and 1985 has been followed up in the Cause of Death Register for the period 1986-1990. Standardised rate ratios were calculated for different groups of psychiatric disorders compared to the general population of Stockholm County for indicators of avoidable mortality, suicide, other mortality ("unavoidable") and causes possibly related to treatment with psychotrophic drugs. As expected, the psychiatric patients had the most pronounced elevated risk for suicide. i.e. 6- to 24-fold compared to the general population, and noticeably more elevated for women. It is also noteworthy that the relative mortality risks for diagnoses amenable to medical interventions and potential side-effects of psychotrophic drugs are higher than for other causes of death ("unavoidable"). The relative risks for avoidable mortality were 4.7 for men and 3.8 for women and for diagnoses possibly related to side-effects of psychotrophic drugs, 7.2. The relative risks for "unavoidable" mortality were 3.4 for men and 3.2 for women. The excess avoidable mortality rates for psychiatric patients and the elevated suicide risk, especially for female patients, are warning signals of shortcomings in psychiatric care that warrants further investigation.     

Sociodemographic associations with mental health and residential care utilization among juvenile delinquents.

Research has supported the notion that ethnoracial minorities in the juvenile justice system use fewer mental health services than Caucasians do. The authors' aim was to examine potential sociodemographic (including racial background) associations with the use of mental health and residential care among juvenile delinquents adjudicated through court services. The authors extracted demographic, mental health, and residential care data from archival records of 149 juveniles consecutively adjudicated from a midwestern city's juvenile court services facility (from 1999 to 2002). The authors found no significant associations with mental health treatment or residential care utilization based on ethnoracial background, age, gender, and educational level, neither in bivariate nor multivariate analyses. Implications for policy in the juvenile justice system are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)