A case-only approach for assessing gene-sex interaction in human longevity

As one aspect of the complex feature of longevity, gene-sex interaction plays an important role in influencing human life span. With advances in molecular genetics, more studies aimed at assessing gene-sex interaction are expected. New and valid statistical methods are needed. In this paper, we introduce a nontraditional approach, the case-only design, which was originally proposed for assessing gene and disease associations, to detect gene-sex interaction in human longevity. Applications of this method to data collected from centenarian studies show that it can produce consistent results as compared with results obtained from case-control and other approaches. Important features of the application in human longevity studies are highlighted and discussed. Since centenarians constitute a special population representing successful ageing, the easily applicable case-only approach will be an important tool for screening potential major genes that contribute to human longevity. (AUTHORS)

Pårørende til demente. En spørgeskemaundersøgelse om deres helbred og behov

Demens er en alvorlig sygdom, der fører til svigtende hukommelse og ændret adfærd. Personer med demens har derfor behov for støtte til den daglige omsorg og pleje (1) - en omsorg og pleje, der ofte varetages både af familien og den kommunale ældrepleje. En undersøgelse har vist, at ca. 85% af de demente bor i eget hjem, hvoraf ca. 55% modtager hjemmepleje (2). Mange pårørende til demente (ægtefæller, børn/svigerbørn, børnebørn, fjernere slægtninge eller nærtstående venner) påtager sig ofte en meget stor plejemæssig opgave ved enten at være samboende eller ved at have en regelmæssig og tæt kontakt til den demente. I de kommende årtier, hvor de yngre generationer bliver mindre, samtidig med, at ældrebefolkningen vokser, må det formodes at der bliver en øget andel af ældre med demenssygdom samt et øget behov for offentlig finansieret ældrepleje. Pårørende til demente er ofte en vigtig ressource i pleje- og omsorgsindsatsen for hjemmeboende demente. Udenlandske undersøgelser af pårørende, som er omsorgsgivere til demente, har vist, at såvel den dementes sygdom som den pårørendes rolle som omsorgsgiver, påvirker den pårørende negativt: De pårørende giver oftere udtryk for dårligt fysisk helbred, manglende overskud, stress og isolation, ligesom de oftere udviser symptomer på angst og depression end personer på samme alderstrin i den generelle befolkning (3-5). Pårørende, som er samboende med og omsorgsgivere til demente (ex. ægtefæller og samlever), udviser højere grad af depression og angst end ikke-samboende (ex. børn og børnebørn) i forbindelse med plejeog omsorgsgivning (6-8). Kvindelige ægtefæller til demente klager hyppigere over depressive symptomer, mens mandlige ægtefæller hyppigere klager over angst (9). Et godt socialt netværk hos den pårørende, uanset relation til den demente, synes at mindske belastningen (10). Undersøgelsen Undersøgelsen er en tværsnitsundersøgelse gennemført blandt pårørende til demente personer, som var hjemmeboende eller indflyttet på plejehjem maks. 6 måneder før undersøgelsestidspunktet. Pårørende blev defineret som nuværende eller tidligere ægtefælle/samlever, søskende, børn, børnebørn, svigerbørn eller nære venner til den demente. Da der ikke findes registeroplysninger på pårørende til demente, er deltagerne rekrutteret fra 3 forskellige rekrutteringssteder.Center for Anvendt Sundhedstjenesteforskning og Teknologivurdering (CAST), SD

Pårørende til demente. En spørgeskemaundersøgelse om deres helbred og behov

Demens er en alvorlig sygdom, der fører til svigtende hukommelse og ændret adfærd. Personer med demens har derfor behov for støtte til den daglige omsorg og pleje (1) - en omsorg og pleje, der ofte varetages både af familien og den kommunale ældrepleje. En undersøgelse har vist, at ca. 85% af de demente bor i eget hjem, hvoraf ca. 55% modtager hjemmepleje (2). Mange pårørende til demente (ægtefæller, børn/svigerbørn, børnebørn, fjernere slægtninge eller nærtstående venner) påtager sig ofte en meget stor plejemæssig opgave ved enten at være samboende eller ved at have en regelmæssig og tæt kontakt til den demente. I de kommende årtier, hvor de yngre generationer bliver mindre, samtidig med, at ældrebefolkningen vokser, må det formodes at der bliver en øget andel af ældre med demenssygdom samt et øget behov for offentlig finansieret ældrepleje. Pårørende til demente er ofte en vigtig ressource i pleje- og omsorgsindsatsen for hjemmeboende demente. Udenlandske undersøgelser af pårørende, som er omsorgsgivere til demente, har vist, at såvel den dementes sygdom som den pårørendes rolle som omsorgsgiver, påvirker den pårørende negativt: De pårørende giver oftere udtryk for dårligt fysisk helbred, manglende overskud, stress og isolation, ligesom de oftere udviser symptomer på angst og depression end personer på samme alderstrin i den generelle befolkning (3-5). Pårørende, som er samboende med og omsorgsgivere til demente (ex. ægtefæller og samlever), udviser højere grad af depression og angst end ikke-samboende (ex. børn og børnebørn) i forbindelse med plejeog omsorgsgivning (6-8). Kvindelige ægtefæller til demente klager hyppigere over depressive symptomer, mens mandlige ægtefæller hyppigere klager over angst (9). Et godt socialt netværk hos den pårørende, uanset relation til den demente, synes at mindske belastningen (10). Undersøgelsen Undersøgelsen er en tværsnitsundersøgelse gennemført blandt pårørende til demente personer, som var hjemmeboende eller indflyttet på plejehjem maks. 6 måneder før undersøgelsestidspunktet. Pårørende blev defineret som nuværende eller tidligere ægtefælle/samlever, søskende, børn, børnebørn, svigerbørn eller nære venner til den demente. Da der ikke findes registeroplysninger på pårørende til demente, er deltagerne rekrutteret fra 3 forskellige rekrutteringssteder.Center for Anvendt Sundhedstjenesteforskning og Teknologivurdering (CAST), SD

Distributed Computing and Monitoring Technologies for Older Patients

This book summarizes various approaches for the automatic detection of health threats to older patients at home living alone. The text begins by briefly describing those who would most benefit from healthcare supervision. The book then summarizes possible scenarios for monitoring an older patient at home, deriving the common functional requirements for monitoring technology. Next, the work identifies the state of the art of technological monitoring approaches that are practically applicable to geriatric patients. A survey is presented on a range of such interdisciplinary fields as smart homes, telemonitoring, ambient intelligence, ambient assisted living, gerontechnology, and aging-in-place technology. The book discusses relevant experimental studies, highlighting the application of sensor fusion, signal processing and machine learning techniques. Finally, the text discusses future challenges, offering a number of suggestions for further research directions

In the footstep of the old patient from hospital to home: A qualitative field observation study

BACKGROUND: Older people often have multiple health conditions and therefore extended care needs. The transition from the hospital back to their home requires careful planning. The fragmented healthcare system and rapid discharge from the hospital can result in limited involvement of the older patient in the discharge planning process. We aimed to explore how older hospitalised patients experienced the transition from hospital to home and how possibilities and constraints in interactions with relevant parties in the transition affected their everyday lives. METHOD: An ethnographic participant observation study including interviews was conducted with 10 older hospitalised patients. The theoretical perspective in the study is critical psychology and data were analysed using the condition-, meaning- and reasoning analysis. RESULTS: Three themes were identified: (1) Lost in transition - the person's ability to act is limited, (2) In transition - the relatives become important, (3) At home - the home transforms into a workplace. CONCLUSION: Lack of involvement becomes a condition for older patients as some struggle to create meaning in their transition, affecting their everyday lives. The patients experienced their relatives as important as they ensured that the HCPs got to know their values and wishes. This knowledge is important for HCPs working closely with older people both at the hospital and at home ensuring active involvement of the older person with respect and acknowledgement of the older person's wishes, needs, resources and vulnerability

Subjective vision and hearing impairment and falls among community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE)

Purpose: To investigate the association between vision and hearing impairment and falls in community-dwelling adults aged ≥ 50 years.Methods: This is a prospective study on 50,986 participants assessed in Waves 6 and 7 of the Survey of Health, Ageing and Retirement in Europe. At baseline, we recorded socio-demographic data, clinical factors and self-reported vision and hearing impairment. We classified participants as having good vision and hearing, impaired vision, impaired hearing or impaired vision and hearing. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The cross-sectional and longitudinal associations between vision and hearing impairment categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors.Results: Mean age was 67.1 years (range 50–102). At baseline, participants with impaired vision, impaired hearing, and impaired vision and hearing had an increased falls risk (OR (95% CI)) of 1.34 (1.22–1.49), 1.34 (1.20–1.50) and 1.67 (1.50–1.87), respectively, compared to those with good vision and hearing (all p

Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international5-COOP study.

To measure the use of healthcare services and assistive devices by centenarians in five countries. Cross-sectional study using a survey questionnaire. Community-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark. 1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions. Recent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries. There was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark. Our findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences