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Haak M.,Lund University | Slaug B.,Lund University | Oswald F.,Goethe University Frankfurt | Schmidt S.M.,Lund University | And 6 more authors.
International Journal of Environmental Research and Public Health

To develop an innovative information and communication technology (ICT) tool intended to help older people in their search for optimal housing solutions, a first step in the development process is to gain knowledge from the intended users. Thus the aim of this study was to deepen the knowledge about needs and expectations about housing options as expressed and prioritized by older people, people ageing with disabilities and professionals. A participatory design focus was adopted; 26 people with a range of functional limitations representing the user perspective and 15 professionals with a variety of backgrounds, participated in research circles that were conducted in four European countries. An additional 20 experts were invited as guests to the different research circle meetings. Three themes illustrating cross-national user priorities for housing provision and accessibility were identified: “Information barrier: accessible housing”, “Information barrier: housing adaptation benefits”, and “Cost barrier: housing adaptations”. In conclusion, early user involvement and identification of cross-national differences in priorities and housing options will strengthen the development of a user-friendly ICT tool that can empower older people and people with disabilities to be more active consumers regarding housing provision. © 2015 by the authors; licensee MDPI, Basel, Switzerland. Source

Rose G.,University of Calabria | Crocco P.,University of Calabria | De Rango F.,University of Calabria | Corsonello A.,Italian National Research Center on Ageing | And 3 more authors.
Mechanisms of Ageing and Development

Evidences from model systems and humans have suggested that genetic alterations in cell-ECM interactions and matrix-mediated cellular signaling cascades impact different aspects of metabolism and thereby life span. In this frame, a genetic variant (rs1981429) in the SDC4 gene encoding for syndecan-4, a central mediator of cell adhesion, has been associated with body composition in children and coronary artery disease in middle-age subjects. In order to test the hypothesis that syndecans might affect life span by affecting metabolic endophenotypes, 11 SNPs within the SDC4 gene were tested for association with longevity in a cohort of 64-107 aged individuals. We then determined whether the longevity-associated SNPs were correlated with metabolic parameters in the age group 64-85 years. RobustSNP association tests showed that rs1981429 was negatively associated with longevity (Theop = 0.028), but also with high levels of triglyceride (Theop = 0.028) and low levels of low-density lipoprotein-cholesterol (LDL-C) (Theop = 0.009). On the other hand, rs2251252 was found to be positively correlated with longevity (Theop = 0.018) and high LDL-C (Theop = 0.022). On the whole, our results suggest that SDC4 alleles affect lipid profile in elderly subjects and may in part mediate the link between LDL-C and longevity. © 2015 Elsevier Ireland Ltd. Source

Thordardottir B.,Lund University | Ekstam L.,Lund University | Chiatti C.,Lund University | Chiatti C.,Italian National Research Center on Ageing | Fange A.M.,Lund University
Scandinavian Journal of Occupational Therapy

Background People applying for a housing adaptation (HA) grant are at great risk of participation restrictions due to declining capacity and environmental barriers. Aim To investigate the association of person-, environment-, and activity-related factors with participation frequency and satisfaction among people applying for a housing adaptation grant. Material and methods Baseline cross-sectional data were collected during home visits (n = 128). The association between person-, environment-, and activity-related factors and participation frequency and satisfaction was analysed using logistic regressions. Results The main result is that frequency of participation outside the home is strongly associated with dependence in activities of daily living (ADL) and cognitive impairments, while satisfaction with participation outside the home is strongly associated with self-reported health. Moreover, aspects of usability in the home were associated with frequency of participation outside the home and satisfaction with participation in the home and outside the home alone. Conclusion Dependence in ADL, cognitive impairments, self-rated health, and aspects of usability are important factors contributing to participation frequency and satisfaction among people applying for a housing adaptation grant, particularly outside the home. Significance Our findings indicate that more attention should be directed towards activity-related factors to facilitate participation among HA applicants, inside and outside the home. © 2016 Taylor & Francis Source

Shutes I.,The London School of Economics and Political Science | Chiatti C.,Italian National Research Center on Ageing
Journal of European Social Policy

This article contributes to an understanding of how different institutional contexts produce similar outcomes as regards the employment of migrant workers in care work. It examines how the employment of migrant care workers in both the familial provision of care and the formal provision of care services for older people is shaped, first, by the marketisation of care and, second, by immigration controls. The analysis draws on data on the employment of migrant care workers by families in Italy and by providers of residential and home care services in the UK. It is argued that marketisation processes and immigration controls have contributed to the employment of migrant workers across so-called informal/formal types of care provision, and irregular/regular types of care work and migration. While the institutional contexts in which migrant care labour is located may differ, converging outcomes are evident regarding the structural positioning of migrant workers within the provision of care for older people. © The Author(s) 2012. Source

Santoro A.,University of Bologna | Siviero P.,National Research Council Italy | Minicuci N.,National Research Council Italy | Bellavista E.,University of Bologna | And 23 more authors.
CNS Drugs

Background: Acetylcholinesterase inhibitors (AChEIs) have been used to improve cognitive status and disability in patients with mild to moderate Alzheimer's disease (AD). However, while the efficacy of AChEIs (i.e. how they act in randomized controlled trials) in this setting is widely accepted, their effectiveness (i.e. how they behave in the real world) remains controversial. Objective: To compare the effects of three AChEIs, donepezil (Aricept®), galantamine (Reminyl®) and rivastigmine (Exelon®), in an Italian national, prospective, observational study representative of the 'real world' clinical practice of AChEI treatment for AD. Methods: 938 patients with mild to moderate AD collected within the framework of the Italian National Cronos Project (CP), involving several UVAs (AD Evaluation Units) spread over the entire national territory, who were receiving donepezil, galantamine or rivastigmine were followed for 36 weeks by measuring: (i) function, as determined by the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales; (ii) cognition, as measured by the Mini-Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) [primary outcome measures]; and (iii) behaviour, as measured on the Neuropsychiatric Inventory (NPI) and Clinical Dementia Rating (CDR) scale. Moreover, all patients were genotyped for apolipoprotein E (apoE) genetic variants. Results: No statistically significant improvement in the primary outcome measures (MMSE and ADAS-Cog) was observed with drug therapy at 36 weeks, at which point all groups had lost, on average, 1 point on theMMSE and gained 2-3 points on the ADAS-Cog scale compared with baseline. On the secondary outcome measures at week 36, all treatment groups showed a significant worsening on the ADL and IADL scales compared with baseline, while on the NPI scale there were no significant differences from baseline except for the galantamine-treated group which worsened significantly. Moreover, patients receiving galantamine worsened significantly compared with the donepezil-treated group on the IADL scale. ApoE e4 allele did not influence the effect of drug therapy. Conclusion: Over a 36-week follow-up period, no significant difference in the effects of donepezil, galantamine and rivastigmine on a variety of functional and cognitive parameters was observed in a large number of apoE-genotyped patients with mild to moderate AD recruited within the framework of a national project representative of the scenario usually encountered in actual clinical practice in italy. The limitations (possibility of administration of lower drug doses than are used in clinical trials, relatively short follow-up period and the lack of randomization) and strengths (large number of patients, concomitant observation of the three drugs and the number of parameters assessed, including apoE genotype) of the present study are acknowledged. Our type of naturalistic study should complement clinical trials because 'real world' practice operates in the face of the numerous variables (e.g. health status and co-morbidities) associated with a complex disease such as AD in elderly people. © 2010 Adis Data Information BV. All rights reserved. Source

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