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Abstract

Conventionally, “elderly” has been defined as a chronological age of 65 years old or older, while those from 65 through 74 years old are referred to as “early elderly” and those over 75 years old as “late elderly.” However, the evidence on which this definition is based is unknown. We have attempted to review the definition of elderly by analyzing data from long-term longitudinal epidemiological studies, and clinical and pathological studies that have been accumulated at the Tokyo Metropolitan Geriatric Hospital and the Tokyo Metropolitan Institute of Gerontology. Our recommendation might be a starting point in developing a strategy for a successful society by reviewing the definition of elderly based on comprehensive evidence in all aspects of social, cultural and medical sciences.
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... Inclusion criteria were male or female, aged 65 years or over, able to walk unassisted (i.e. did not use, or require, any walking aids) for at least 0.5 of a mile and having musculoskeletal pain in two or more joints of more than 12 weeks duration. The inclusion criteria for age follows definitions from Orimo et al. (2006) [68] where 65 years and older constitute "elderly", equivalent to "older people" in this study, 65 through 74 yeas constitute "early elderly" and over 75 years constitute "late elderly". Participants with chronic musculoskeletal pain in two or more joints are at risk of falls [10][11][12]. ...
... Inclusion criteria were male or female, aged 65 years or over, able to walk unassisted (i.e. did not use, or require, any walking aids) for at least 0.5 of a mile and having musculoskeletal pain in two or more joints of more than 12 weeks duration. The inclusion criteria for age follows definitions from Orimo et al. (2006) [68] where 65 years and older constitute "elderly", equivalent to "older people" in this study, 65 through 74 yeas constitute "early elderly" and over 75 years constitute "late elderly". Participants with chronic musculoskeletal pain in two or more joints are at risk of falls [10][11][12]. ...
... Based on a proposed cut-off at 75 years for elderly patients [18], data were grouped accordingly. Differences in CM staging and groupings were found (Chi-square test p = 0.01), namely the patients at stage II were older than stage I and III patients (Mann-Whitney test, p = 0.002 and p = 0.02, respectively). ...
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Simple Summary: Environmental factors such as UVR exposure and altitude of residence can contribute to the development of cutaneous melanoma. We hereby report that altitude of residence significantly associates with the molecular profiling of CM and melanoma specific survival. The fact that different miRNAs and transcriptomic profile vary with different geographical areas and residences altitude could support for possible regulatory mechanisms induced by environmental conditions, such as hypoxic environment and/or higher UVR exposure. Abstract: Cutaneous melanoma (CM) incidence is rising worldwide and is the primary cause of death from skin disease in the Western world. Personal risk factors linked to environmental ultraviolet radiation (UVR) are well-known etiological factors contributing to its development. Nevertheless, UVR can contribute to the development of CM in different patterns and to varying degrees. The present study aimed at investigating whether altitude of residence can contribute to the development of specific types of CM and/or influence its progression. To this aim, 306 formalin-fixed and paraffin-embedded (FFPE) tissues from primary CM diagnosed in different geographical areas were submitted to B-RAF proto-oncogene serine/threonine kinase (BRAF) and N-RAS proto-oncogene GTPase (NRAS) mutational status detection and mRNA and miRNA profiling by qPCR. Genes were chosen for their functions in specific processes, such as immune response (CD2, PDL1, or CD274) and pigmentation (MITF, TYRP1, and TRPM1). Furthermore, four microRNAs, namely miR-150-5p, miR-155-5p, miR-204-5p, and miR-211-5p, were included in the profiling. Our results highlight differences in the gene expression profile of primary CM with respect to the geographical area and the altitude of residence. Melanoma-specific survival was influenced by the gene expression of mRNA and miRNAs and varied with the altitude of patients' residence. In detail, TYRP1 and miR-204-5p were highly expressed in patients living at higher altitudes, unlike miR-150-5p, miR-155-5p, and miR-211-5p. Since miRNAs are highly regulated by reactive oxygen species, it is possible
... Most developed countries set the age of senior citizen at 65 years old, but in other regions such as Africa, the "senior" threshold is much lower at 50 years [4]. Orimo et al. [5] stated that with recent technology in the medical and health science industry, the average lifespan has increased rapidly, thus, such a definition of elderly to simply include all persons over 65 years might be no longer appropriate for this era with a life expectancy of 80 years. WHO [4] agreed that a definition of senior is arbitrary and introduces additional problems of data comparability across nations. ...
Article
The purpose of this study was to evaluate the impact of airport road access wayfinding and signage preferences on senior driver. Wayfinding complexity varied due to differing levels of airport road-side furniture such as traffic signs and bollards. Experienced car drivers were asked to drive self- designed simulated routes. Forty drivers in the age ranges: 50 to over 60 were selected to perform the study. Questionnaire then were distributed after driving simulation test was performed. The driver performance was analysed by Mean and Standard Deviation (SD), and discussed with reference to the use of the driving simulator and drivers’ general experience. The results confirmed that there is a correlation between airport road access wayfinding design and senior driving performance.
... In accordance with the previous study, we divided patients into the following two groups: older patients (age ≥65 years old; n = 26) and younger patients (age 16-64 years old; n = 211). 18 We performed statistical analyses to compare the characteristics of these two groups. All statistical analyses were performed using Stata/IC software (version 15.1; Stata Corp., College Station, TX, USA). ...
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Aim: Although various neutrophilic immunosenescence mechanisms have been shown, there are few clinical studies on age-related differences in leukocytosis against acute bacterial infections, including acute colonic diverticulitis. Methods: We performed a retrospective study of 26 patients ≥65 years old and 211 patients 16-64 years old who were hospitalized for acute colonic diverticulitis at Toho University Medical Center Omori Hospital between 2010 and 2016. We compared patients' characteristics, including sex, immunocompromised status, diverticulitis site, complications, severity, previous diverticulitis, vital signs, leukocyte counts, neutrophil-to-lymphocyte ratio and serum C-reactive protein on admission. To adjust for confounding factors, we performed a logistic regression analysis. Results: Univariate comparisons showed that leukocyte count (older: 10 850 [interquartile range, 9400-12 000]/mm3 vs. younger: 12 600 [interquartile range, 10 500-15 000]/mm3 , P = 0.004) and prevalence of leukocytosis (leukocytes >11 000/mm3 ) were lower in older compared with younger patients. There were significantly more female, left-sided diverticulitis and immunocompromised patients in the older compared with the younger group. Logistic regression showed that leukocyte count, prevalence of female patients, and left-sided diverticulitis were independent predictors for the older patients: Their odds ratios were 0.866 (95% confidence interval [95% CI] 0.753-0.996), 2.631 (95% CI, 1.032-6.707) and 5.810 (95% CI, 2.328-14.497), respectively. Conclusion: Caution should be taken when managing older patients with colonic diverticulitis because reactive leukocytosis might be poor, possibly reflecting immunosenescence. Geriatr Gerontol Int 2020; ••: ••-••.
... Furthermore, the relationship between low protein-energy intake and also deficiency of micronutrients with an increase in impaired immunity and, consequently, increased risk of serious disorders has been reported. "Elderly" is regarded as a chronological age of 65 years old or older (Orimo et al., 2006). The elderly population is at higher risk of food insecurity not only as a result of economic limitation but also because of cognitive or functional impairment and health problems which result in the inability of intake food (Vargas Puello et al., 2013). ...
Article
Purpose-Elderly people are at higher risk of food insecurity because of limited or uncertain inaccessibility to adequate food supply. This is not only as a result of economic limitation but also as the outcome of the inability to intake food because of cognitive or functional impairment and health problems. Because of the lack of data about food insecurity and depression among the elderly population in Iran, this study was conducted to examine the relationship between socioeconomic factors and depression with food insecurity among the elderly population. Design/methodology/approach-This cross-sectional study was performed in 2016 on 720 elderly people of Qarchak city that were selected by the proportional stratified sampling method. Food insecurity was evaluated using the FaCPS-FSSM food security questionnaire; Geriatric Depression Scale questionnaire to measure the score of depression and the socioeconomic questionnaire filled out during interviews. All statistical analyses were performed using the SPSS version 22 software. Findings-Food insecurity was found in 396 (56.1%) of the elderly population. Food insecure elderly population had lower education (P < 0.001). While the percentage of educated individuals who were in food security was 53.2%, the percentage for not educated participants was 28.7%. Household economic status (P < 0.001). Data showed 64.6% of individuals with the normal economic condition were in food security, and the percent for the poor economic condition was 37.2%. Food insecurity was highly associated with depression in the elderly population (odds ratio: 4.76, 8.92 and 3.32 for mild, moderate and severe hunger, respectively, P < 0.001).
... Patients were grouped according to their chronological age, a younger group (≤65 years), and an elderly group (>65 years). It is the classical, conventional threshold, that we adopted, even if it is subject to changes based on comprehensive evidence in various aspects of social, cultural, and medical sciences [35]. ...
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Ultrasonographic risk-stratification systems (RSS), including various Thyroid Imaging Reporting and Data Systems (TIRADS), were proposed to improve reporting and reduce the number of fine-needle aspiration biopsies. However, age might be a confounder since some suspicious ultrasonographic features lack specificity in elderly patients. We aimed to investigate whether the diagnostic performance of the RSS varied between age groups. All patients consecutively referred for thyroid biopsy between November 1, 2015, and March 10, 2020, were included. The malignancy risk of each nodule was estimated according to five RSS: the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi guidelines, the American College of Radiology (ACR) TIRADS, the American Thyroid Association guidelines, the European TIRADS, and the Korean TIRADS. Overall, 818 nodules (57 malignant) were evaluated. The malignancy rate was higher in patients ≤ 65 years (8.1%) than in patients > 65 years (3.8%; p = 0.02). All RSS confirmed a significant discriminative performance in both age groups, with a negative predictive value of 100% in patients > 65 years, although specificity was lower in older patients. The ACR TIRADS was the best performing in both age groups. RSS could avoid a sizable number of biopsies when applied as rule-out tests in elderly patients.
... The understanding of ageing people's initial trust formation in new technology is one subject of major interest to both scientists and practitioners; and critical to this understanding is to formulate a definition of ageing people. While 'elderly' is generally defined as a chronological age of 65 years and over, this definition might no longer be appropriate for the present era of improved health and increased life expectancy (Orimo et al. 2006). Alternatively, Hawthorn (2000) defined an 'older adult' as a person over 45, claiming that the effects of ageing start to become visible as we reach our mid-40s. ...
... The understanding of ageing people's initial trust formation in new technology is one subject of major interest to both scientists and practitioners; and critical to this understanding is to formulate a definition of ageing people. While 'elderly' is generally defined as a chronological age of 65 years and over, this definition might no longer be appropriate for the present era of improved health and increased life expectancy (Orimo et al. 2006). Alternatively, Hawthorn (2000) defined an 'older adult' as a person over 45, claiming that the effects of ageing start to become visible as we reach our mid-40s. ...
Conference Paper
Governments across the world are facing the challenge of meeting the needs of growing ageing populations. In Finland, the response to this challenge has been to focus on integrating digital assistive technology with public social and healthcare services as well as developing new types of living environment and care services that enable ageing people to maintain a good quality of life while living at home longer and independently. This paper presents the findings of a study aiming to contribute to the understanding of how initial trust formation can be supported before the older person's interaction with new technology takes place. It was carried out as an empirical investigation in three Finnish cities using a qualitative approach with focus group interviews. The bases of trust (personality base, cognitive base, calculative base and institutional base) underpin the theoretical framework of initial trust development in this study. Preliminary findings demonstrate (using rich qualitative data) a complex process of initial trust formation that shows convincing interaction between the identified determinants of each base of trust. Communication among all stakeholders underlying the assistive system is confirmed to be of critical importance for ageing people's initial trust formation.
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Objective The COVID-19 pandemic imposed a psychological burden on people worldwide, including fear and anxiety. Older adults are considered more vulnerable during public health emergency crises. Therefore, the aim of the present study was to investigate the psychological response of older adults during the acute phase of the pandemic in Greece.Method This cross-sectional study was part of a larger three-day online survey. A total of 103 participants over the age of 60 fulfilled inclusion criteria. The survey included sociodemographic questions and six psychometric scales: the Fear of COVID-19 Scale (FCV-19S), the Brief Patient Health Questionnaire (PHQ-9) depression scale, the Generalized Anxiety Disorder scale (GAD-7), the Athens Insomnia Scale (AIS), the Intolerance of Uncertainty Scale (IUS-12), and the De Jong Gierveld Loneliness Scale (JGLS).ResultsA significant proportion of the participants reported moderate to severe depressive symptoms (81.6%), moderate to severe anxiety symptoms (84.5%), as well as disrupted sleep (37.9%). Women reported significantly higher levels of COVID-19–related fear, more severe depressive symptoms and sleep disturbances, as well as higher levels of intolerance of uncertainty. Participants living alone showed higher levels of loneliness. Intolerance of uncertainty was shown to modulate levels of loneliness.Conclusions During the quarantine, attention was promptly drawn upon the risks related with older people’s loneliness. Studies identifying factors that may contribute to loneliness during a public health emergency facilitate the implementation of supportive interventions. Preparedness to address and manage older people’s loneliness may limit this deleterious emotional response during the pandemic, as well as at the post-COVID-19 phase.
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Health literacy (HL) is recognised as an important, modifiable factor in the self-management and health performance of elderly people. The aim of this preliminary study was to identify and analyse the level of health literacy among the elderly living in one of the eastern regions in Poland. The cross-sectional study was conducted among a convenience sample of 200 seniors aged 65+ after cognitive pre-screening with the use of the Montreal Cognitive Assessment (MoCA) scale. To collect data, the Polish version of the HLS-EU-Q47 was used. More than half of the elderly surveyed presented problematic levels of general HL (GEN-HL), and also problematic levels of other dimensions: health care health literacy (HC-HL), disease prevention health literacy (DP-HL), and health promotion health literacy (HP-HL). The level of seniors' HL is dependent on the level of their education, place of living, participation in activities run by Daily Center for the Elderly, and their self-assessment of health condition (p < 0.05). These results imply the important message that there is a need to create initiatives and programs improving health literacy targeted at seniors living in rural areas, those with lower levels of education, and those with poor access to activities organised by institutions supporting seniors.
  • N Ogawa
  • Kurashi
  • Mainichi Shimbun
Ogawa N. Kurashi. Mainichi Shimbun. 2005. 5 Policy Review Committee. Report by the Policy Review Committee Related to the Care Insurance System Review. Tokyo: Policy Review Committee, 2005.
Report from the Council for Creation of a Spiritually Rich and Vigorous Long-living Society
Health and Welfare Bureau for the Elderly. Report from the Council for Creation of a Spiritually Rich and Vigorous Long-living Society. Health and Welfare Bureau for the Elderly: Japan, 1997.
Report by the Policy Review Committee Related to the Care Insurance System Review
Policy Review Committee. Report by the Policy Review Committee Related to the Care Insurance System Review. Tokyo: Policy Review Committee, 2005.
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Background: The objective of this study is to examine the important factors associated with functional disabilities in elderly patients with diabetes mellitus. Methods: This was a multicenter cross-sectional study. A total of 1135 elderly diabetic outpatients aged over 65 years in 10 hospitals participated in our study. Functional disabilities were assessed with questionnaires on the instrumental activity of daily livings (IADL), intellectual activity and social role using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Cognitive function and well-being were assessed by the mini-mental state examination and morale scale, respectively. Results: The patients were divided into three age groups. The oldest (≥ 80 years) group reported significant high prevalence of functional disabilities (10% to 36%) compared to the youngest (65–69 years) group (4% to 20%). The number of vascular complications (≥ 4) was associated with a 5.5–8.8 fold increased risk of disabilities relating to the tasks on IADL (using public transportation, shopping, preparing meals and paying bills). Using multiple logistic regression analyses, low scores of morale scales (≤ 7) and mini-mental state examination (≤ 23) were significantly associated with disabilities on the IADL, intellectual activity and social role after adjustment for age, gender, BMI, duration of diabetes, HbA1c, insulin treatment, microangiopathy and macroangiopathy. Insulin treatment and low visual acuity were also associated with the IADL after adjustment for the other variables. Conclusions: Older age, insulin treatment, low well-being, cognitive impairment, and visual impairment were independently associated with the functional disabilities of elderly patients with diabetes mellitus.
Article
Background: The purpose of the present paper was to elucidate the influence of an elevated serum lipoprotein (a) (Lp(a)) concentration on the incidence of ischemic heart disease (IHD) and perforating artery occlusion-type cerebral infarction (CI) in elderly patients with type-2 diabetes. Methods: The serum Lp(a) levels in type-2 diabetic subjects aged ≥60 years (n = 158; 81 male, 77 female) were measured. At the commencement of the study, subjects were allocated on the basis of past history of CI to a CI– or CI+ group, and on the basis of past history of angina pectoris or myocardial infarction to an IHD– or IHD+ group. They were followed up prospectively for 4 years and the incidences of IHD and CI were monitored. Diagnoses of CI were confirmed by computed tomography (CT), and of myocardial infarction by electrocardiography and blood chemistry. Serum Lp(a) levels of ≥ 20 mg/dL were considered elevated, and < 20 mg/dL as normal. Kaplan–Meier survival analysis (log–rank test) was used to assess the time to event rate stratified by an Lp(a) cut-off of 20 mg/dL. The predictive value for CI or IHD events was assessed by multiple logistic regression analysis. Results: The probability of IHD events was significantly higher in the elevated Lp(a) group than in the normal Lp(a) group without a history of IHD (P < 0.001; log–rank test), but was similar in the two subgroups of subjects with a history of IHD. No significant difference was seen between the elevated Lp(a) and normal Lp(a) groups in the probability of CI events, with or without a history of CI. On multiple logistic regression analysis, Lp(a), hyperlipidemia and a history of IHD were significant predictors of IHD, whereas hypertension, hyperlipidemia and a history of CI were significant predictors of CI. Conclusion: These results indicate that an elevated serum Lp(a) concentration is an independent risk factor for IHD, but not for perforating artery occlusion-type CI, in elderly patients with type-2 diabetes.
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We conducted comparative studies on intracranial atherosclerosis and coronary artery stenosis over the past 28 years. Two-year consecutive autopsy case studies from an urban geriatric hospital between 1974-1975 (Group I. 484 cases). 1986-1987 (Group II, 504 cases) and 2000-2001 (Group III, 273 cases) were employed. Atherosclerotic changes of the bilateral middle cerebral arteries and basilar artery were semiquantitatively evaluated as none (0), mild (1), moderate (2) and severe (3) and values of the 3 arteries were totalled to give a value of 0-9 which was taken as the intracranial atherosclerotic index (ICAI). The coronary stenotic index was calculated as previously reported (Sugiura et al 1969). ICAI and CSI were directly compared with each other, together with risk factors for each, including mean blood pressure (BP), serum level of total cholesterol (Tch) and the history of diabetes mellitus (DM+). Chronologically ICAI decreased dramatically but CSI did not change at all. There was continuous lowering of BP, elevation of Tch and increased incidence of DM+. There was a significant positive correlation in BP in relation to both ICAI and CSI (p < 0.01). DM+ vs. CSI (p < 0.01) and ICAI (p < 0.05), and Tch vs. CSI (p < 0.01) but not ICAI. Regression analysis highlighted age and BP as major risk factors for ICAI. Our study provides the first morphological confirmation of marked decrease of the intracranial atherosclerosis in the recent 28 years, in contrast with unchanged coronary stenosis in Japanese elderly subjects.