Journal of Aging and Health

Objectives: Hearing impairment, which affects both peripheral and central structures of the auditory system, is highly prevalent among older adults and has serious consequences both for the people with hearing impairment and for those around them. This article provides an updated overview of the rehabilitation of this population. Methods: This article critically reviews the rehabilitation interventions available to older adults with hearing impairment: hearing aids, hearing assistance technology, and communication programs. Results: Current evidence suggests positive outcomes of similar magnitude for the three rehabilitation interventions, however their availability/uptake and adherence are suboptimal. Discussion: To improve the current situation, two changes to practice are warranted. First, availability of the range of rehabilitation interventions should be improved. Second, in accordance with the self-management of other chronic health conditions, older adults with hearing impairment should be invited to be actively involved in their rehabilitation.

Objective: To determine the prevalence of olfactory impairment and its associations with neurodegenerative and other conditions in older adults. Method: 1,636 participants (≥60 years) enrolled in the Blue Mountains Eye Study (2002-2004) were analyzed. Olfaction was assessed by the San Diego Odor Identification Test and used to classify mild impairment (4 or 5), moderate impairment (≤3), or any impairment (<6). Results: Prevalent olfactory impairment was 27.0%. After multivariate adjustment, the likelihood increased twofold with each decade of life after 60 years and was higher in men than women. Olfactory impairment and body mass index (BMI) were inversely associated. Persons with Parkinson’s disease and cognitive impairment had an increased likelihood of mild and moderate olfactory impairment. Discussion: Over one in four older persons had olfactory impairment. The prevalence was higher in men, increased with age and decreasing BMI, and was higher among persons with Parkinson’s disease and cognitive impairment.

Objectives: To compare the perception of the determinants of preventable hospitalization among nursing home residents by surveying medical directors (MDs) and directors of nursing (DONs). Methods: A survey (N = 52) was completed in January 2008. Data included resource availability, determinants of hospitalization, and nursing home practice. Multivariate linear regression examined the associations between potential determinants and preventable hospitalization. Results: Four significant determinants perceived by MDs to influence preventable hospitalization: MD/nurse practitioner (NP) access by pager, family preferences, access to medical history and lab/ electrocardiograph (EKG) reports, and physicians better paid to manage acutely ill residents (R ² = .58). None of these factors were echoed by DONs (R ² = .15). Whereas DONs perceived stat lab results on weekends were associated with increased hospitalization (p = .03), MDs did not (p = .28). Conclusions: Our analysis showed that communication and consensus are important factors in the hospital transfer decision and that the discord in perceptions among MDs and DONs may complicate interventions to reduce preventable hospitalization.

Objectives: To examine factors associated with change in grip strength. Method: Grip strength was measured at baseline and 3 years later. Change was divided into “decreased ≥5 kg,” “increased ≥5 kg,” and “no change” and analyzed using multinomial multivariable logistic regression. Results: Decline in grip strength was more likely for men, those reporting having cardiovascular disease, and those with instrumental activities of daily living, lower body functional limitations, high diastolic blood pressure, higher physical activity, and greater body mass. Decline was less likely among those ever having Medicaid, those with basic activities of daily living disabilities, and those unable to see a doctor in past year due to cost. Gain in grip strength was more likely for men and those with instrumental activities of daily living disabilities, lower body functional limitations, high diastolic blood pressure, and higher physical activity; it was less likely for older participants. Discussion: Results can be used to design interventions to improve strength outcomes.

Objective: To examine the contextual effects of urban neighborhood characteristics on mortality among older adults. Method: Data are from the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD). Death is assessed between the baseline assessment (1993) and the first follow-up interview (1995). Neighborhood data are from the 1990 Census. Results: The log odds of dying between the two time points are higher in high proportion Hispanic neighborhoods, net of individual-level sociodemographic variables, but this effect is partly mediated by individual-level health. The log odds of dying are significantly (p < .05) lower in affluent neighborhoods, controlling for all individual-level variables and neighborhood proportion Hispanic. Discussion: There are survival-related benefits of living in an affluent urban neighborhood, which we posit may be manifested through the diffusion of innovations in health care and health-promotion activities.

Objective: Guided by a life-course approach to chronic disease, this study examined the ways in which childhood deprivation (low parental education and father’s manual occupation) may be associated with coronary heart disease (CHD). Method: Multilevel modeling techniques and a nationally representative sample of Americans above age 50 from the Health and Retirement Study (HRS; N = 18,465) were used to examine childhood and CHD relationships over the course of 6 years (1998-2004). Results: Having a father with ≤8 years of education was associated with 11% higher odds of CHD, accounting for demographic characteristics, adult socioeconomic status (SES; education, income, and wealth), CHD risks (diabetes, hypertension, cigarette smoking, and obesity), and other factors (childhood health, exercise, stroke, and marital status). Discussion: Policies and programs aimed at improving the conditions of poor children and their families may effectively reduce the prevalence of CHD in later life.

Objective: Determine basic anthropometry for elderly participants in a Venezuelan community and compare results for subgroups with different health status. Method: Standardized anthropometric, nutritional, neurological, neuropsychiatric, and cardiovascular assessments generated data on weight, height, and body mass index (BMI) by sex and age for the total sample, for normative groups without health problems that might impact anthropometry, and for reference groups with no major health problems. Centile curves of anthropometric measurements versus age are determined for women and men in the normative group. Results : Mean weight and height are significantly different between sexes, but not BMI. All three parameters show gradual declines with age. The mean 90% central interval for BMI in the normative and reference groups is 20-29 kg/m². Conclusion: The anthropometric data for healthy elderly Venezuelans can be used in monitoring anthropometric changes and disease risk analysis for this population and possibly for other Latin American populations.