Friday, June 18, 2010

Untreated Poor Vision in Elderly Linked to Dementia Study Shows

ScienceDaily (Feb. 20, 2010) — Elderly people with visual disorders that are left untreated are significantly more likely to develop Alzheimer's disease -- the most common form of dementia, according to a University of Michigan Health System study.

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The study used Medicare data and shows that those with poor vision who visited an ophthalmologist at least once for an examination were 64 percent less likely to develop dementia.

The study appears online ahead of print in the American Journal of Epidemiology and may draw a new picture of poor vision as predictor of dementia rather than as a symptom after the diagnosis.

"Visual problems can have serious consequences and are very common among the elderly, but many of them are not seeking treatment," says lead author Mary A.M. Rogers, Ph.D, research assistant professor of internal medicine at the U-M Medical School and research director of the Patient Safety Enhancement Program at the U-M Health System and the Ann Arbor VA Medical Center.

For the study, Rogers and her colleague Kenneth M. Langa, M.D., Ph.D., professor of internal medicine at U-M Medical School, analyzed data from the nationally representative Health and Retirement Study and records from Centers for Medicare and Medicaid Services.

"Our results indicate that it is important for elderly individuals with visual problems to seek medical attention so that the causes of the problems can be identified and treated," Rogers says.

The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders and other eye-related problems.

Proper vision is a requirement for many of the activities that previously have been found to lower the risk of Alzheimer's disease. These include reading, playing board games, other mentally stimulating activities, social networking, as well as physical activity such as walking and routine exercising. A visual disorder may interfere with normal mobility and may also hinder a person's ability to participate in such activities.

"Many elderly Americans do not have adequate health coverage for vision, and Medicare does not cover preventative vision screenings for most beneficiaries," Rogers says. "So it's not unusual that the elderly receive vision treatment only after a problem is severe enough to warrant a visit to the doctor when the problem is more advanced."

According to a survey conducted by the National Eye Health Education Program, less than 11 percent of respondents understood that there are no early warning signs for eye problems such as glaucoma and diabetic retinopathy.

However, vision problems and blindness are among the top 10 disabilities among adults and can result in a greater tendency to experience other health conditions or even to die prematurely.

"While heart disease and cancer death rates are continuing to decline, mortality rates for Alzheimer's disease are on the rise," says Rogers. "So if we can delay the onset of dementia, we can save individuals and their families from the stress, cost and burden that are associated with Alzheimer's disease."

The study was based on the surveys and medical information from 625 people compiled from 1992-2005. Only 10 percent of Medicare beneficiaries who developed dementia had excellent vision at the beginning of the study, while 30 percent of those who maintained normal cognition had excellent vision at the onset of the study.

One in five Americans who are over age 50 report experiencing a visual impairment, according to the U.S. Centers for Disease Control and Prevention. Approximately 5 million Americans have Alzheimer's disease and the number has doubled since 1980. It is expected to be as high as 13 million by 2050.

Funding was provided by the National Institute on Aging

Thursday, June 17, 2010

Elderly and depression: How to understand Depression in the elderly 1/6

Depression in the elderly is very common. It can be triggered by social isolation and the emotional reaction to the loss of loved family members or friends. Depression in the elderly can make them withdraw from all social contact.


‘Depression is perhaps the most frequent cause of emotional suffering in later life’ said Dan G Blazer, Professor of Psychiatry at DukeUniversity. Being socially isolated, particularly after the death of a partner, and co-existing illness may contribute towards depression in elderly. Depression often goes undiagnosed or untreated so it becomes an increasing public health issue in our ageing society. The challenge, then, is more one of managing depression effectively in later life rather than understanding the condition.

How widespread is depression among older people? Recent surveys suggest a prevalence between 1.8% in the over 55s to 15% in those over 85. While depression is actually less prevalent among the old, compared to the young, major depression may be more common. There is also a clear link between chronic disease and depression, with those in nursing homes showing higher rates than those living in the community. But is the link a causal one? We know that illness can cause depression (and vice versa), but we cannot be sure residents of nursing homes are depressed because they are ill or because their care is not sufficiently ‘caring’.

And when it comes to the gender gap, it’s well known that women are more prone to depression in Europe and North America. But a new study from China, covering 2,633 adults, showed that the gender difference is insignificant, save in the 35-49 age group where lifetime prevalence for major depression for men was 3.6% compared to 2.3% for women.

There is also a cultural dimension to elderly depression. A meta-analysis of nine European centres revealed a prevalence of 8.8% in Iceland in the 88-89 age group compared to 23.6% in Munich in the over 85s. And, among the ‘oldest old’ 2% declared ‘life not worth living’ and 3% ‘wish to be dead’ in Iceland, compared to 16% and 25% in Berlin and 30% and 29% in Munich. The researchers wondered if some lingering distress from the Second World War could account for high rates of depression among very elderly Germans.

Causes of depression in the elderly

Pain, functional limitations, visual impairment, stroke, loneliness, lack of social support, negative life events, and perceived inadequacy of care have all been linked to depression in the elderly. Living alone or being socially isolated is also a risk factor for depression. It is certainly possible that, if personal privacy were very important to the resident, a perceived lack of privacy could contribute to feelings of depression. Browse through HealthandAge's Information for Caregivers for tips on choosing nursing homes/care facilities and recognizing depression in the elderly.

Finally, a number of risk factors for elderly depression have been identified, including medical burden, bereavement, chronic insomnia, cerebrovascular disease, Alzheimer’s disease and Parkinson’s disease. In the next article in this series, we will explore differences between depression in elderly and young persons.


Source: adapted from ‘Elderly depression. 1. Its prevalence, causes and implications for society’ Heinz Redwood, August 2009. Visit website http://www.healthandage.com/elderly-and-depression-how-to-understand-depression-in-the-elderly-14

Addressing an age old issue of the elderly

Addressing an age old issue of the elderly

The outcome of a case study by Birla Institute of Technology and Science and Swinburne, Ageing: Social Issues could do much to solve the daily challenges faced by India's ageing population problems, giving them independence in their own homes.

DAILY CHALLENGES facing India’s ageing population are confronted in a new book co-authored by Swinburne University of Technology, Australia academic Rashmi Kapoor.

The outcome of a case study by Birla Institute of Technology and Science (BITS) and Swinburne, Ageing: Social Issues, could do much to solve these problems, giving elderly people independence in their own homes.

According to Kapoor, by identifying these issues, Swinburne and BITS can begin to engineer products that best suit the needs of India’s elderly population.

“For example, one of the most common problems reported by the elderly was difficulty lifting and moving. These issues can be solved quite easily by installing railings along walls and bars at an angle in the bathroom so people can grab them at any height,” Kapoor said.

“Another problem we identified was difficulty gripping and holding on to objects. In this case, round door handles or taps, that older people can’t grip properly, can be replaced with bar-like handles that can be easily opened.”

According to Kapoor, age-related weakening is a growing problem in India and other developing countries as the elderly population are not used to living on their own.

“Unlike Western society where it is expected that elderly people will live by themselves, problems associated with ageing are relatively new for India’s elderly - this is where the collaboration between BITS and Swinburne is very important,” Kapoor said.

“Many of these engineering solutions have already been found successful in Australia, so now we can develop similar products for India’s ageing population.”

Kapoor believes that this book will also be a useful resource for other designers.

“By making this research available in a book, designers can adapt and create products that meet the specific needs of the elderly. So in the future if they are making a knife, for example, they know it has to have a chunky handle so it doesn’t slip out of someone’s hand.”

(Source: http://www.merinews.com/article/addressing-an-age-old-issue-of-the-elderly/15799820.shtml)

Sunday, June 6, 2010

Rush in your applications for the Diploma Programmes in Gerontology and Counselling!

A good news for all those who are interested in the Diploma programmes (Counselling and Gerontology). The dates for receiving applications have been extended for the Diploma Programme in Counselling and Diploma Programme in Gerontology for the academic year 2010 - 2011. So please make use of this opportunity.

Hurry up and send in your application for these two courses as soon as possible.

Tuesday, June 1, 2010

Elder abuse on the rise

Elder abuse on the rise

Posted On Saturday, May 08, 2010 at 04:08:15 PM

With changing demographical equations, the elderly are being marginalised globally. International visitors at TISS discuss elder abuse
Vrunda Moghe Dev Deonar

This aspect was discussed at length at the Tata Institute of Social Sciences (TISS) by Susan B Somers, General Secretary, International Network for the Prevention of Elder Abuse (INPEA) on Monday. She was accompanied by Sailesh Mishra, founder president, Silver Innings, a Bandra-based NGO and Reese Woollen, a geriatric nurse working on a module for the care of the elderly in India. Somers was in India to explore the possibility of networking with groups working in this field.

INPEA, an international NGO is a legal entity in the US and was started around 14 years ago by Welsley Wolf, considered to be a pioneer in the field of elder abuse and the organization works in an international framework coordinating with the already existing care-givers and holding orientation programmes for such workers.

Somers, a practising lawyer in the field in the USA, says, “The implications of ageing in India and South Asia with regard to frailty, dementia or Alzheimer’s need to be studied and what we could do to support the family structure can be explored. Even if cultures are different the issues are similar.”

Referring to her visit to Nepal, she says that already there were a few individuals and groups working in the field and adds, “We have just tried to develop a curriculum for their training for updating of knowledge.” Dr Nusreen Rustomfram of the TISS feels that it is important to look into the possibility of how the elderly can stand up against abuse. In India, she feels the situation is complex as the elderly do not bring the injustice done to them in the open.


“There are always the defences, rationalizations and denials like saying that the son or daughter must have done it in anger, it may not recur, etc,” she says.Dr S Parasuraman, director of TISS states, “Considering the breakdown of the family system and migration, the number of caregivers in this category is small and training poor.

There is a great need across the country for proper training of these groups.” The situation he feels is complex considering the various socio-economic strata in the country: these need to be identified and some sort of universality could be worked out but he admits that it is a huge agenda. The challenge is even greater as 70 percent of the elderly in India are poor and vulnerable.


There is a staggering population of 90 million elders in India and the government has given no proper guidelines on the issue of care or abuse of the elderly.


Besides physical and mental abuse, Sommers has come across even sexual abuse of the elderly which is horrifying. “In the US,” she explains, “the elders have a right to a lawyer, right not to be discriminated against on grounds of age and the right to choose health and medical care.

Elders need to know that they are valuable. In the American legal system the penal aspect of crime against the elders is taken care of as there is an enhancement of a sentence for a crime against an elder as it sends a strong message to the perpetrator of the crime.”