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Parkville, Australia

Biggs S.,University of Melbourne | Haapala I.,University of Eastern Finland | Haapala I.,National Ageing Research Institute
International Psychogeriatrics | Year: 2013

Background: Elder mistreatment, social ageism, and human rights are increasingly powerful discourses in positioning older people in society, ye. The relationship between them has rarely been subjected to critical investigation. This perceived relationship will have implications for how mistreatment is understood and responded to. Method: Critical gerontological approach based on narrative and textual analysis. Results: Reports of public attitudes toward mistreatment suggest that it is thought to be more common than scientific evidence would suggest; however, reporting is much lower than prevalence. Whil. The discourse over mistreatment has tended to focus on interpersonal relationships, ageism has emphasized social attitudes, and human rights have concentrated on relations betwee. The state an. The individual. Conclusions: In this paper, a series of models have been examined which mark a tendency to restrict and then attempt to reintegrate individual, interpersonal, and social levels of analysis. It is concluded that a focus o. The processes of transaction across boundaries rather than contents would facilitate both integrative modeling and deeper understanding o. The qualities of abusive situations. © 2013 International Psychogeriatric Association.

Brodaty H.,University of New South Wales | Connors M.H.,University of New South Wales | Xu J.,University of New South Wales | Woodward M.,University of Melbourne | And 2 more authors.
Journal of Alzheimer's Disease | Year: 2014

Patients with dementia often require institutionalization when they can no longer care for themselves. The study examined demographic and clinical variables that predict the time until institutionalization in patients with dementia attending memory clinics. Of 970 patients recruited from nine memory clinics around Australia, 779 patients had dementia at baseline. Measures of dementia severity, cognition, functional ability, neuropsychiatric symptoms, caregiver burden, and medication use were completed for all patients. Patients were followed for three years. Overall, 197 (25.3%) of the patients with dementia were institutionalized within three years. Lower cognitive ability, lower functional ability, and more neuropsychiatric symptoms at baseline predicted a shorter time until institutionalization, as did use of antipsychotic medication. In addition, greater deterioration in cognitive ability, functional ability, and neuropsychiatric symptoms over the initial three months predicted a shorter time to institutionalization. The findings confirm that clinical features of dementia at baseline predict the time to institutionalization, as do greater changes in symptoms over three months independent of baseline levels. © 2014 - IOS Press and the authors. All rights reserved.

Lautenschlager N.T.,University of Melbourne | Lautenschlager N.T.,University of Western Australia | Cox K.,University of Western Australia | Cyarto E.V.,National Ageing Research Institute
Biochimica et Biophysica Acta - Molecular Basis of Disease | Year: 2012

Physical activity has been recognized as an important protective factor reducing disability and mortality and therefore it is focus of many health promotion activities at all ages. More recently a growing body of literature is focusing whether physical activity could also have a positive impact on brain aging with exploring healthy brain aging as well as on cognitive impairment and dementia. An increasing number of prospective studies and randomized controlled trials involving humans take place both with older adults with normal cognition as well as with mild cognitive impairment or dementia. However, the body of evidence is still sparse and many methodological issues make comparisons across studies challenging. Increasingly research into underlying mechanisms in relation to physical activity and brain aging identify biomarker candidates with especially neuroimaging measurements being more used in trials with humans. Whilst the evidence base is slowly growing more detailed research is needed to address methodological issues to finally achieve clinical relevance. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease. © 2011.

You E.C.,University of Melbourne | Dunt D.R.,University of Melbourne | Doyle C.,National Ageing Research Institute | Doyle C.,Australian Catholic University
Journal of Aging and Health | Year: 2013

Objective: To evaluate the effects of case management in community aged care (CMCAC) interventions on service use and costs. Method: Five databases were searched from inception to 2011 July to include randomized control trials and comparative observational English studies. Results were summarized by using the best-evidence synthesis approach. Results: Twenty-one studies were included. Available studies supported improvements in clients' use of case management services (all of the four studies), some community services (8 of the 10) and nursing home admission and stay (around one half), delay of nursing home placement (all of the two studies), and achieving cost neutrality (8 of the 11). The effects on medical care utilization were varying. Discussion: In general, these positive effects justify the further development and refinement of CMCAC programs. Result applicability is limited by only including English studies. Cost studies applying a societal perspective, and full economic appraisals where appropriate are warranted. © 2013 The Author(s).

Anpalahan M.,Western Hospital | Gibson S.,National Ageing Research Institute
European Journal of Internal Medicine | Year: 2012

Aims: To determine the prevalence and clinical significance of carotid sinus syndrome (CSS) and vasovagal syncope (VVS), the two common types of Neurally Mediated Syncope (NMS), in a cohort of older patients with unexplained falls. Methods: Patients presenting with unexplained and accidental falls were identified from 200 consecutive admissions of falls in patients aged 65 years and older admitted to the Rapid Assessment Medical Unit (RAMU) in a teaching hospital. A sample of unexplained and accidental fallers underwent carotid sinus massage (CSM) and tilt table testing (TTT) as per a standardised protocol. Baseline characteristics, clinical variables and the prevalence of NMS were compared between the two groups. Results: Falls were unexplained in 26% of patients. The prevalence of NMS was 24% (5/21) among patients with unexplained falls who underwent assessment for NMS, whereas it was nil (0/17) in patients with accidental falls (P = 0.050). The prevalence of previous falls was significantly higher in patients with unexplained falls (P = 0.0025), but all other baseline characteristics were similar between the two groups. Conclusion: Falls are unexplained in a significant number of older patients presenting to acute hospitals. The assessment of unexplained fallers for NMS is clinically important as this may be aetiologically related in nearly a quarter of these patients. © 2011 European Federation of Internal Medicine.

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