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2128 results in Geriatrics

Page 24 of 107

  • 13 - Nutrition, Muscle Function, and Mobility in Older People

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 203-220

  • Summary

    Aging is associated with diminishing reserves and significant changes in body composition. In this context, the nutritional status of older persons deserves special consideration as the preservation of functionality is linked closely to it. The basic requirements of energy and protein intake, which should be calculated on an individual basis, have to be met. Otherwise the resulting nutritional deficits will accelerate the development of sarcopenia and frailty. In recent years, it could be shown that the anabolic effects of protein and branched-chain amino acids could stabilize or even improve strength and functionality in older persons. Vitamin D and other micronutrients may only be of benefit in this regard if a deficit is present. Most recently the effect of polyunsaturated fatty acids has received wider attention.

  • 15 - Optimization of Drug Use in Older People

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 237-262

  • Summary

    Older people use more drugs than any other age group. The prescription strategy constitutes a major challenge. Polypharmacy, inappropriate prescribing and drug-related problems in older people are important problem of public health as a link exists with significant morbidity and mortality and with a large waste of health resources. The main target is the balance between an unsustainable number of different prescription drugs to treat various chronic diseases and the failure to take preventive measures in these older patients. In this review, the difficulties in prescribing in the older population and the identification, prevention and optimization of inappropriate prescribing and drug related problems in older people are respectively discussed. Medication reconciliation, medication review, tools for detection of potentially inappropriate prescribing, use of health information technology, adherence optimization, patient-tailored pharmacotherapy en judicious drug cessation are highlighted as a part of collaborative and integrative approaches.

  • 23 - Coping Mechanisms through Successful Aging

  • from Part II - Psychosocial Factors
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 401-425

  • Summary

    Aging brings along many changes in many areas of human functioning, some of them involving important losses and life transitions. According to the main gerontological theoretical models, the ability to effectively cope with life changes and demands is a cornerstone of psychological health and adaptation in old age. This chapter analyzes the construct of coping in old age, its relation with other variables such as self-efficacy or resilience, and its central role for older adults´ adaptation and health. Interventions aimed at improving older adults´ ability to cope effectively are described. Main findings of research on the stress and coping process in older adults, including empirical studies analyzing specific coping strategies in older adults facing diverse stressful situations, such as health problems, retirement, interpersonal stressors or bereavement, are reviewed. Finally, future lines of research in the field are highlighted.

  • 17 - The Adaptation Process of Aging

  • from Part II - Psychosocial Factors
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 281-298

  • Summary

    Aging is characterized by decreasing resource gains and increasing resource losses in many life domains. However, most older adults successfully adapt to the shifting balance of resource gains and losses. In this chapter, we focus on motivational factors as a key for understanding the adaptation process in older adulthood. Based on an action-theoretical perspective that acknowledges individuals as producers of their development, the motivational approach focuses on the role of goals for successful aging. We discuss different motivational models of adaptation (the model of selection, optimization, and compensation, the theory of primary and secondary control, and the model of assimilative and accommodative coping) and summarize some of the empirical evidence for each model as illustrations of research in this area. We also address age-related changes in the cognitive representation of goals (i.e., gain and loss orientation, outcome and process focus) and their role for successful aging. In the second part of the chapter, we place the motivational changes into the context of the transition to retirement, leisure, and social relationships. Finally, we outline ideas on adaptation processes to newer socio-demographic developments such as the increasing life expectancy or the increasing proportion of older adults in the society.

  • 4 - The Connection between Cellular Senescence and Age-Related Diseases

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 41-52

  • Summary

    Age is associated with a progressive decline in the functional reserve of multiple organ systems and, at the molecular and cellular level, with the accumulation of mutations. Cumulative evidence has demonstrated that senescence contributes both to tissue exhaustion as well as diseases associated with aging. This article seeks at answering to the simple following questions, on the basis on current knowledge and recent findings coming from basic and translational research: (i) why do somatic cells have to senesce?; (ii) how to define cell senescence(s)?; (iii) how senescence is activated?; (iv) what are the phenotypic changes are induced by senescence?; (v) what are the relationships between senescence and the longevity pathways? and (vi) what are the relationships between senescence and age-related diseases? In this last section, a special attention is paid to the more frequent age-related diseases: osteoporosis, neurodegenerative diseases, atherosclerosis, type 2 diabetes, cataract, respiratory diseases and cancer.

  • 30 - The Promise of Active Aging

  • from Part III - Socio-Demographic Issues
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 557-569

  • Summary

    This chapter considers the major global concept of active ageing, which represents the widely agreed optimum response to population ageing among international governmental organisations such as the European Community, UN, WHO and OECD. Despite its pre-eminence however there is often confusion about precisely what it means in practice. This chapter argues that this lack of clarity is restricting the potential of the idea of active ageing to provide an effective strategy aimed at ensuring that the effects, both societal and individual, of ageing are as beneficial as possible. In the course of examining why active ageing is so important in the era of population ageing, the promise it embodies, the concept is contrasted with its sister concept of successful ageing. The chapter then focuses on the barriers in the way of realising the full potential of active ageing and, finally, there is a sketch of the principles upon which it can be advanced in an effective and equitable way.

  • 18 - Behavioral Health

  • from Part II - Psychosocial Factors
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 299-320

  • Summary

    The present chapter explores the effect of behavior on reaching a successful aging. The chapter begins exploring the main protective factors that determine  a healthy life style. Then, main models of behavioral change are outlined with special emphasis to the empirical support obtained by each of them and detailing a specific example of a behavioural change program carried out in older people. The chapter continues analysing the relationship between personality (i.e. conscientiousness) and behavioural change, giving a special dedication to the role played by conscientiousness. Finally the chapter explores the role of education as an important determinant for successful aging.

  • 32 - The Active Aging Index

  • from Part III - Socio-Demographic Issues
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 594-609

  • Summary

    The Active Ageing Index (AAI) has been developed as a tool to monitor the contribution and untapped potential of older people with a purpose to provide evidence for public policy actions. This chapter discusses the conceptual basis of the AAI (first outlined in Zaidi et al. 2013). In the 1990s, the concept of active ageing started to develop, underlining the active role of elderly in society. However, differently from the concept of successful aging, it emphasised also the need to account for optimization of opportunity structures and enabling environment. The active ageing strategy is predicated on the insight that, in tackling issues associated with population aging, successful measures are those which empower older people in increasing their participation not just in the labour market but also in social and family engagement, and recognise that independent, self-reliant, secure and healthy living is an important prerequisite for active aging. This chapter’s contribution lies in highlighting the operationalisation of these concepts using the micro-data of different EU wide surveys, and analysing the trends across Europe. Furthermore, gender and educational inequalities are also outlined and discussed to reveal the differences in active ageing experiences across subgroups.

  • 2 - The Biomedical Bases of Successful Aging

  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 23-26

  • Summary

    Life expectancy at birth increased by more than 30 years during the last century. However, maximal life span increased little during the last centuries indicating that there is a limit in the maximal life expectancy of the human species. The respective roles of and interactions between genes, environment and stochastic factors determine the pace of the aging process. The important progress in the biomedical domain contributes in the development of strategies for the prevention of the functional decline and the frailty process, thereby increasing the probability of successful aging. However, it is rather illusory that these actions may alter the limits of human maximum longevity and stop the ageing process.

  • 7 - Gene–Lifestyle Interactions in Longevity

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 91-109

  • Summary

    Individuals exposed to the same environmental factor show variation in responses and health outcomes. Such observations could be caused by chance or by gene-environment interactions – where gene variants modulate the effect of environmental factors on morbidity, aging and mortality or vice-versa. Twin and family studies have shown that lifespan is moderately heritable and that the chance of survival at the highest ages might be increasingly influenced by genetic factors. However, only for two genes, common variants have consistently been associated with longevity: the Apolipoprotein E gene and, to a lesser extent, FOXO. In this chapter, we review current knowledge on the association between Apolipoprotein E variants and mortality and summarize current evidence for interactions between lifestyle and Apolipoprotein E gene variants in morbidity, aging and longevity.

  • 9 - Arterial Stiffness and Blood Pressure during the Aging Process

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 131-152

  • Summary

    The progressive increase of aortic stiffness with age contributes to the development of systolic hypertension, and several cardiovascular alterations often leading to the heart failure, which is one of the most common causes of not only death, but also loss of autonomy, poor quality of life and repeated hospitalization in older adults. In addition, age-related vascular changes play an important role in the development of kidney and brain abnormalities as observed in chronic kidney disease, vascular dementia and also Alzheimer’s disease. Using methods that can measure non-invasively arterial stiffness is has been shown that this parameter is an independent strong determinant of cardiovascular complications, cognitive decline, and other age-related diseases. Clinical trials should determine and predict to what extent non-drug and drug therapeutic strategies might attenuate the increase of aortic stiffness with age. Non-pharmacological prevention, including dietary interventions and increased physical activity may have some effects on this process. Drug therapy requires further research on the mechanisms of systolic hypertension and the possible role of vascular smooth muscle and extracellular matrix. All treatments require investigations on the potential new goal of reducing the age-related increase in aortic stiffness.

  • 14 - Gerontechnologies and Successful Aging

  • from Part I - Biomedical Aspects
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 221-236

  • Summary

    Successful ageing is a multidisciplinary and complex concept. How to distinguish it from similar terms as healthy aging, active aging, well aging, and aging in place? To provide good quality of life, the development of a preventive, organized, multidisciplinary, early and evaluated policy to prevent loss of autonomy is essential. Gerontechnology is a discipline dedicated to the use of new technologies in the field of aging to maintain physical fitness, cognitive health, social links and emotional balance of the users. Assistive technologies, by replacing or compensating for diminished functionality, can restore some autonomy while relieving caregivers. Radical changes in society will deeply influence the practice of medicine. Tomorrow all the recorded health data will be transferred to mobile phone from capture on the skin (miniature epidermal captures or ‘‘electronic skin’’) and could be constantly updated the person on his/her medical situation from the cloud computer. The devices must help the persons and the care givers if necessary, in an accepted, efficient and ethical way. The participation and acceptance of the person is essential. But it is not already the time, that in the care system, human will be completely replaced by ‘‘companion’’ robots.

  • 1 - The Concept of Successful Aging and Related Terms

  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 6-22

  • Summary

    There are two traditions in the study of aging or, perhaps better, two sides of aging in the sense that aging is a natural life-long process, associated with illness, which unavoidably terminates with dying and death, but also that the process of aging is determined not only genetically but by environmental and behavioural circumstances. The conclusion is that a lifelong process can be optimized by extrinsic factors and even by those personal conditions determined by the transaction between intrinsic biological and extrinsic environmental factors, mediated always by behavioural conditions. In fact, during the last four decades, demographic and epidemiological data as well longitudinal, cohort, cross-sectional and experimental studies have yielded a new paradigm, variously called healthy, positive, optimal, productive, active or successful aging, which is considered a key issue at individual and population level from a scientific and socio-political perspective. After a review of several definitions of this view of aging and the description of the most important empirical studies of successful aging and related terms, as well as of the outcomes and determinants implied, problematic issues will be reviewed and we will finish by trying to disentangle the various factors specific to successful aging and other commonly considered equivalents by emphasizing that at the heart of this vision lies a focus on improvements in preventive medicine and the untapped potential of health promotion and illness prevention.

  • 22 - Personal Control and Successful Aging

  • from Part II - Psychosocial Factors
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 384-400

  • Summary

    A broad range of studies conducted over the past 50 years suggests that the perception of personal control is an important construct to successful aging. When people feel that they can exert control, they tend to experience better psychological and physical health. For example, those who experience perceived control demonstrate better immune responses, cardiovascular functioning, physical strength, increased life satisfaction, and decreased anxiety and depressive symptoms. We will describe the literature surrounding the relationship between perceived control and successful aging. We will also survey the literature on self-efficacy, mastery, attributional style, and locus of control, which have all often been used interchangeably with the notion of perceived control. We will also discuss how perceived control can be maximized through the lens of mindfulness without meditation (Langerian mindfulness). In this framework, mindfulness is defined as the simple process of noticing new things, a process that promotes flexible responding to the demands of the environment and perception of control. Both lack of perceived control and mindlessness are rooted in rigidity and a view of the world as unchangeable. We will present suggestions about how the simple act of noticing new things improves the perception of control and facilitates successful aging.

  • 33 - Aging and Capabilities

  • from Part III - Socio-Demographic Issues
  • Edited by Rocío Fernández-Ballesteros, Universidad Autónoma de Madrid, Athanase Benetos, Jean-Marie Robine
  • Book:
    The Cambridge Handbook of Successful Aging
    Published online:
    10 January 2019
    Print publication:
    24 January 2019, pp 610-626

  • Summary

    This chapter describes the concept of successful aging and summarizes criticisms made of the Rowe and Khan’s model. Then, the capability approach initially developed by Amartya Sen and its key concepts are introduced. The value of this approach in the domain of (successful) aging is illustrated using examples of published or on-going empirical research. The first shows how the approach can help develop a methodological framework that enriches the definition and the operational implementation of the successful aging model while remaining within the spirit of the initial model. The following examples illustrate the advantage of using the capability approach as a theoretical framework. The works presented in this chapter were selected to show how the approach can provide a methodological framework to enrich the multi-dimensionality of the concept, go beyond the dichotomy (Successful/usual aging) of aging trajectories used in the Rowe and Khan's model, identify the determinants of these trajectories, evaluate courses of action taken and guide policy decisions. The capability approach thus transcends the reductionism and individualism criticized in the initial successful aging model.

Page 24 of 107