The process of aging is under genetic control. The traditional view derived from evolutionary biology is that aging is a polygenic trait, controlled by a large number of genes, each with a small additive effect. An alternative point of view is presented here, which suggests that there may be only a few master genes that control aging. These could include protective genes that ensure accuracy of protein synthesis and protect against free radical damage, as well as genetic control switches that initiate or delay the aging process. As genetic technology advances and the human genome is mapped, our understanding of genes that control aging and age-related diseases may advance to the point that gene therapy becomes possible.

Human diploid fibroblasts undergo a limited number of population doublings in vitro and are used widely as a model of cellular aging. Despite growing evidence that cellular aging occurs as a result of altered gene expression, little is known about the activity of transcription factors in aging cells. Here we report that the dramatic reduction in the expression of the transcription factor FOS during cellular aging appears to be due to the inability of another transcription factor, serum response factor (SRF), to bind to its cognate site termed the serum response element (SRE) that is found upstream of several genes including the human c-fos gene. In contrast, the activities of proteins binding to the RNA polymerase “core” element TATA and to the cAMP response element (CRE) were maintained in senescing human fibroblasts. We present evidence that hyperphosphorylation of SRF is responsible for the decreased binding activity seen in late passage cells, as proposed previously for the FOS protein.

According to the free radical theory, aging is caused by the damaging effects of oxygen radicals. These agents are produced continuously and they become toxic when their intra-cellular levels become elevated. Although well-known for the damage they cause, recent studies indicate that free radicals may also have a beneficial side regulating some of the processes within a cell. With aging, however, it seems that the ability to control endogenous concentrations declines, and rising levels become progressively more harmful. In addition to the primary changes, the effects of free radical damage should also be examined at the secondary level. Because of its importance in regulating homeostatic mechanisms, it is possible that in this regard the hypothalamus may play a crucial role in the aging process. Progressive loss of function in this centre may lead to systemic changes which cause widespread disruption throughout the organism.

Considerable research on osteoporosis has recently focused on the prevention of bone loss in the later years. Researchers and clinicians are now able to accurately measure the effects of therapies and preventive strategies on the skeleton. It has been suggested that regular physical activity will be one of the valuable strategies in maintaining bone density and preventing osteoporosis. This paper will review the quantitative techniques available for bone density assessment and provide an overview of the recent cross-sectional and longitudinal studies related to the potential benefits of physical activity on the aging skeleton.

One thousand, four hundred and six seniors were asked about their consumer spending preferences. While some could name a product spending preference, others could not. This study examines the characteristics that best distinguish those elders who are uninterested in spending on consumer products from those who choose product specific preferences. Discriminant function analyses show that age best distinguishes the non-interested group from the others, supporting a previous report by Walker and Schwenk (1991). Income and health status most reliably separate those whose most important spending priority is a recreational product from those most interested in basic needs or housing products. Those whose spending priority is a housing item tend to be home-owners who have lived in their residences for long periods of time. The results confirm that the heterogeneity among seniors documented in other areas (such as health and social characteristics) extends to their consumption preferences. The diversity in spending preferences can be understood in terms of a desire to enhance quality of life.

The Fit (Falls Intervention Trials) Project was a randomized clinical trial of a program designed to reduce falls and their sequela among older people. The sample consisted of 100 persons who were age 60 and over, who lived in the Capital Region District (Victoria, B.C.) and who had experienced a fall in the preceding three months. The intervention consisted of a comprehensive risk assessment, individualized feedback about identified risks and a motivational video and booklet entitled “Head Over Heels”. Outcome measures included fall incidence, falls self-efficacy, fear of falling, social functioning, health service utilization and quality of life. While there were no statistically significant differences between the intervention and control groups on the key study variables, there were improvements in both groups between the beginning of the study and the six-month follow-up assessment. The paper discusses possible reasons for these findings and their implications for further research.

The pattern of transfers of clients between different levels of care in an area-based system of long-term care for elderly and disabled people is described and analysed using data collected through a monitoring system, called ASIM, from 1985–1991 in the Municipality of Solna, Sweden. Transfers between levels of care occurred in both directions but the frequency of downward transfers was small compared to the number of upward transfers – especially for sheltered housing and residential homes. For all levels of care there were great variations in disability among the entering clients, suggesting non-systematic assessment procedures in connection with admission. An analysis of changes over time in the pattern of transfers illustrated the interdependence of the different levels of care. Reduced resources in long-term hospital care resulted in a near blocking of transfers from the residential homes and increased average disability for the admitted patients in general.

The General Well-Being Schedule (GWB) is a questionnaire that is frequently used in large-scale epidemiological surveys to evaluate the psychological health of a given population. In spite of its popularity, it appears that no validation study has been done on a French version of the instrument. The present study proposes a French version of the GWB and establishes its psychometric qualities based on a sample of 369 subjects, 179 of whom are bilingual. The subjects were recruited through notices placed in the different francophone and anglophone media. The questionnaires were mailed to the subjects. First, the results show a very strong correlation between the translated version and the original version of the questionnaire (r = 0.88, p < 0.0001). The internal consistency of the French version is estimated at 0.92 and its test-retest reliability at 0.82 (95% CI: 0.71–0.89). Correlations between the total score on the general well-being scale and measures of depression and anxiety are over 0.70. Principal component analysis applied to the French and English versions of the questionnaire suggests the presence of a main factor which accounts for 50 per cent of the variance. This study provides a French version of the GWB that may justifiably be considered reliable and valid. Validation of the questionnaire should be pursued by establishing normative values for the elderly francophone population and by studying its responsiveness.

This paper reports on a project aimed at creating support groups for caregivers of the frail elderly and assessing their impact on participants. The effect evaluation was based on a quasi-experimental design with repeated measures (n = 120). The results show that participation in support groups did not lower the caregivers' subjective burden, and indeed contributed to its increase. Conversely, such participation appears to have had a stabilizing effect on their level of depressive symptoms. Both these effects, reported at the end of the support group experience, persisted three months later. Various possible explanations of these contradictory results are discussed.

Despite its publication year (1991), this volume deserves the attention of facilitators and researchers in the field of gerontology interested in the issue of housing for the elderly in loss of independence. The authors discuss from different viewpoints the concept of congregate housing, a form of living which offers a minimum of support services to older adults with disabilities. The book consists of ten papers of debates, analyses and experiences which sensitize the reader to this alternate form of institutional housing. Without question, this volume is of great interest, and the quality of work from the researchers who contributed to the various articles noteworthy.