(Press-News.org) A study by Yale School of Medicine researchers reveals that the illnesses and injuries that can restrict the activity of older adults or land them in the hospital are linked to worsening functional ability, especially among those who are physically frail. The report appears in JAMA's November 3 theme issue on aging.
Thomas M. Gill, M.D., the Humana Foundation Professor of internal medicine (geriatrics), investigative medicine and epidemiology and public health at Yale, will present the findings at a JAMA media briefing at the National Press Club November 2 at 10 a.m.
"We now have a much better understanding of the complex and highly dynamic disabling process," said Gill, who is also an attending physician at Yale-New Haven Hospital.
Among older adults, disability in essential activities of daily living, such as bathing, and dressing, is common and associated with an increased rate of death, institutionalization, and greater use of formal and informal home services. But many older adults also recover from disabilities. Gill points to high rates of recovery and frequent transitions between states of disability, but he said the role of intervening illnesses and injuries on these transitions was little understood until this study shed some light on it.
Gill and his co-authors followed 754 adults age 70 and older living in the Greater New Haven area, with monthly phone interviews for over 10 years starting in 1998. The team assessed disability and ascertained exposure to intervening illnesses and injuries. Physical frailty—slow walking speed—was assessed every 18 months for nine years. The team evaluated the relationship between two types of intervening events—hospitalization and restricted activity, and transitions between no disability, mild disability, severe disability and death.
The team found that among the 637 participants, who had at least one functional transition, 90.7 percent had at least one hospital admission and 94.3 percent had at least one month of restricted activity. Hospitalization was associated with disability for eight of the nine transitions.
Among the possible reasons for hospitalization or restricted activity, fall-related injury led to the highest likelihood of developing new or worsening disability.
Gill notes that despite the reductions observed in the prevalence of disability over the past two decades, the number of disabled older Americans could increase substantially in the coming years with the aging of the baby boom generation. "To address this increase, more aggressive efforts will be needed to prevent and manage intervening illnesses and injuries, given their apparent role in precipitating and perpetuating the disabling process," said Gill.
###
Co-authors on the study include Heather G. Allore, Evelyne A. Gahbauer, M.D. and Terrence E. Murphy.
The study was supported by the National Institute on Aging and was conducted at the Yale Claude D. Pepper Older Americans Independence Center.
Citation: JAMA Vol. 304 No. 17 (November 3, 2010)
END
Researchers at the University of California, San Diego School of Medicine have discovered that a multi-tasking protein called FoxO1 has another important but previously unknown function: It directly interacts with macrophages, promoting an inflammatory response that can lead to insulin resistance and diabetes. Contrarily, it also generates a negative feedback loop that can limit damage from excessive inflammation.
The findings by Jerrold M. Olefsky, MD, Associate Dean for Scientific Affairs and professor of Medicine, and colleagues are published in the November 2 issue ...
Brain damage continues to develop and evolve for months after a traumatic brain injury (TBI), revealing a potential target for treatments to improve brain trauma, new research led by the University of Melbourne, Australia has found.
The study funded by the Victorian Neurotrauma Initiative is published in the latest issue of The Journal of Nuclear Medicine (JNM).
Around 400,000 Australians have a disability related to traumatic brain injury with cognitive, psychiatric and epileptic problems the most common symptoms. The major cause of TBI is motor vehicle accidents. ...
While the risk remains low the authors are surprised at the results and say "a critical evaluation of the obstetrical care system in the Netherlands is urgently required."
Despite the high level of medical care in the Netherlands, the perinatal mortality rate (death of fetus or new born baby) is one of the highest in Europe, says the study.
The management of childbirth delivery in the Netherlands is divided into two independent systems – midwife-led care for low risk pregnancies and obstetrician-led care for high-risk pregnancies. This differs to all other obstetric ...
The mysterious origins of Australia's bizarre and secretive marsupial moles have been cast in a whole new and unexpected light with the first discovery in the fossil record of one of their ancestors.
The find reveals a remarkable journey through time, place and lifestyle: living marsupial moles are blind, earless and live underground in the deserts of the Northern Territory, Western Australia and South Australia, yet their ancestors lived in lush rainforest far away in north Queensland.
In the journal Proceedings of the Royal Society B, a team led by Professor Mike ...
Researchers at the Swedish medical university Karolinska Institutet have shown that they may be able to monitor the aging process in the brain, by using MRI technique to measure the brain lactic acid levels. Their findings suggest that the lactate levels increase in advance of other aging symptoms, and therefore could be used as an indicator of aging and age-related diseases of the CNS.
"It's exciting to think that we are one step closer to understanding what happens as the brain ages, and how a change of brain metabolism may be important during the onset of age-related ...
A new breakthrough by scientists at the University of Sheffield has shed light on how the Earth's first plants began to colonise the land over 470 million years ago by forming a partnership with soil fungi.
The research, which was published today (2 November 2010) in Nature Communications, has provided essential missing evidence showing that an ancient plant group worked together with soil-dwelling fungi to 'green' the Earth in the early Palaeozoic era, nearly half a billion years ago.
The research, which also involved experts from the Royal Botanic Gardens, Kew, Imperial ...
A new study from North Carolina State University finds that anti-immigrant practices – such as anti-immigrant legislation or protests – are likely to backfire, and spur increased political action from immigrant communities. The study examined political activity in 52 metropolitan areas across the United States.
"U.S. Census data indicate that 60 percent of the foreign-born in the U.S. are not citizens," says Dr. Kim Ebert, an assistant professor of sociology and co-author of a paper describing the research. "Non-citizens can't vote, so we wanted to determine how they ...
SAN DIEGO -- A third of breast cancer survivors who received the breast-conserving treatments lumpectomy and radiation rate the appearance of their post-treatment breast as only "fair" or "poor" in comparison to their untreated breast, according to a new University of Pennsylvania School of Medicine study that will be presented today at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Diego. In addition, one fifth of patients report complications including chronic pain in their breast or arm and loss of arm or shoulder flexibility following ...
A pre-school language intervention programme can significantly improve the educational lives of children with poorly developed speech and language skills, according to new research by psychologists at the University of York.
In the Language 4 Reading project, a team from the University's Department of Psychology at the University of York have evaluated the benefits of a pre-school language intervention programme for children who enter school with poorly developed speech and language skills.
The project, which involved 15 schools and feeder-nurseries across Yorkshire, ...
The report by Jeanne Lenzer, a medical investigative journalist in New York, and Shannon Brownlee from the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire, looks at the FDA's approval of a device to prevent or reduce seizures in patients with epilepsy who do not respond to drug treatment.
The device, manufactured by Cyberonics, is implanted under the skin and sends electrical impulses to stimulate the vagus nerve in the neck. It was approved by the FDA in 1997 on the condition that Cyberonics carried out a post-approval study to examine the ...