ID: 36 Theme: Behavioural and psychological sciences

Transcription

ID: 36
Theme: Behavioural and psychological sciences
EXPERIENCES OF OLD AGE IN DEVELOPING WORLD SLUMS: EVIDENCE AND FUTURE AGENDAS
Hans-Joachim Von Kondratowitz (German Centre of Gerontology, , Germany)
Dr. Isabella Aboderin, United Kingdom (1) Dr. Ousmane Faye, Kenya (2) Dr. Machado Laura, Brazil (3) Dr. Vera-Sanso Penny, United Kingdom (4)
(1) Oxford Institute of Ageing (2) African Population and Health Research Centre (3) Candido Mendes University (4) Birkbeck Institute for Social Research
The unprecedented rate of urbanization in the developing world, specifically in Africa and Asia, is one of the most important demographic trends in the
world today. A critical concern is the rapid growth of city slums, which feature the worst in urban poverty and inequality, wreaking extreme challenges
on the well-being of their residents - due to lack of basic services, unemployment, overcrowding and insecurity of tenure. 62% of sub-Saharan Africa’s,
40% of Asia’s, and 30% of Latin America’s urban population live in slums. While mainstream development debates have given wide attention to the
detrimental effects of slums on children and younger aged adults, the experiences of older persons under these conditions have been neglected. A
focus on the experiences of older people in slums is similarly lacking in the emergent gerontological debate on ageing in the developing world.
The symposium sets out to demarcate this important but hitherto neglected research area. Scholars in the social sciences and civil society
representatives will present the state of the art evidence on old age in developing world slums, and delineate key areas and perspectives for future
inquiry. In doing so, the presentations will emphasise questions of social exclusion, capability and the life course, and focus on older persons in the
context of intergenerational family and community networks.
Presentation title(s) proposal
DR. LAURA MACHADO
EXPERIENCES OF OLD AGE IN URBAN SLUMS IN LATIN AMERICA: EVIDENCE FROM SAO PAULO, BRAZIL
DR. OUSMANE FAYE
EXPERIENCES OF OLD AGE IN SLUMS: SOCIAL EXCLUSION AND OPPORTUNITY: EVIDENCE FROM NAIROBI, KENYA
DR. ISABELLA ABODERIN
URBANIZATION, SLUMS, AGEING AND DEVELOPMENT: CHARTING AND CONNECTING RESEARCH AGENDAS AND DEBATES
DR. PENNY VERA SANSO
EXPERIENCES OF OLDER PERSONS IN URBAN SLUMS IN ASIA: EVIDENCE FROM CHENNAI, INDIA
Chair(s)
Hans-Joachim Von Kondratowitz DZA 12101 Berlin [email protected] +49-30-26074072
Aboderin Isabella 0IA Oxford [email protected] 44-01865 286193
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ID: 40
MANAGING SENIOR MOBILITY ACROSS THE WESTERN CONTINENTS
Anne Dickerson (East Carolina University, Occupational Therapy, United States)
Anne Dickerson, United States of America (1) Lisa Molnar, United States of America (2) Jim Langford, Australia (3) Michelle Porter, Canada (4)
(1) East Carolina University (2) University of Michigan (3) Monash University (4) University of Manitoba
The purpose of this symposium is to provide an overview of senior mobility research in the United States, Canada, and Australia, including what we
currently know and what we still need to find out. The research highlighted will focus largely on driving automobiles because none of these countries
have extensive public transportation and people are dependent on and prefer automobiles for their transportation needs.
The presenters are
researchers in the area of senior mobility, participate in funded research in their respective countries, and will present the most recent evidence based
data to discuss their perspective on how to best address senior mobility in their countries. In addition, each presenter will describe results of their
individual research that adds to the knowledge base of this topic. Jim Langford is a senior research fellow at the Monash University Accident
Research Center in Australia. In addition to providing a perspective on older driver safety in Australia, he will describe how Safe System Principles
can be used as an effective strategy to increase both safety and mobility specifically for senior drivers and for the public generally. Lisa Molnar, Lead
Research Associate at the University of Michigan Transportation Research Institute will discuss the feasibility of using instrumented vehicle technology
to monitor the driving performance of older adults under naturalistic driving conditions (i.e., in normal everyday driving over long periods of time). Most
driving evaluations are a single hour assessment and do not consider variability in performance over days and weeks. Dr. Michelle Porter, Professor
at the University of Manitoba, will describe senior mobility in Canada and discuss technology to assess older drivers as well as assist older drivers
drive more safely. Dr. Anne Dickerson, Director of the Research on Older Adult Drivers Initiative at East Carolina University will describe the CarFit
and DriveWell programs to improve safe senior mobility in the United States and tie the three presentations together to suggest components of an
optimal program of senior mobility for any country. The aims of this symposium will be to 1) describe the state of senior mobility in three countries that
have increasing numbers of senior drivers who are dependent on automobiles for transportation and 2) offer evidence-based information about how to
keep seniors safely on the road to maintain their independence.
Although other countries may have different issues, the panel will present
ideas/issues that are universal to older drivers.
USING SAFE SYSTEM PRINCIPLES TO ENHANCE OLDER DRIVER SAFETY AND MOBILITY
TECHNOLOGY FOR ASSESSING OLDER DRIVERS AND ASSISTING THEM TO DRIVE SAFELY
USING INSTRUMENTED VEHICLE TECHNOLOGY TO MONITOR THE DRIVING PERFORMANCE OF OLDER ADULTS
IMPLEMENTATION OF SAFETY PROGRAMS FOR OLDER DRIVERS
Chair(s)
Anne Dickerson 3305 Health Sciences Building [email protected] 252-744-6190
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ID: 83
HOME CARE TO OLDER ADULTS: CHALLENGES AND PROMISE
Liat Ayalon (Bar Ilan University, School of Social Work, Israel)
Graziano Onder, Italy (1) Daniela Fialova, Czech Republic (2) Liat Ayalon, Israel (3) Patricia Arean, United States of America (4)
(1) Catholic University of the Sacred Heart (2) Charles University (3) Bar Ilan University (4) University of California, San Francisco
The increase in life span, decrease in child birth, and the changes in the family system including the entrance of women into the work force, the
increase in divorce rate, and the popularity of the nuclear family have resulted in a shortage of available family members to provide unpaid care to the
sick. To fill this shortage of unpaid caregivers to older adults, home care, provided by paid caregivers, has become a preferred alternative by many
family members and older adults. This is because home care allows older adults to stay in their natural environment and is often cheaper than
institutional care.
Despite the popularity of home care worldwide, there is little systematic knowledge about its characteristics, benefits, and
challenges.
This symposium aims to address the shortage of knowledge about home care by bringing together researchers from different countries and disciplines
that have investigated different aspects of home care services to older adults around the world. First, Dr. Graziano Onder of Catholic University of
Sacred Heart, Italy, will be presenting results from a large-scale research project that defines the characteristics of home care patients and services in
11 European countries, the ADHOC Aged in Home Care Project. Dr. Daniela Fialova of Charles University, Czech Republic, will be discussing the
management and appropriateness of medication treatment in home care elderly patients in Europe as well as risks of pharmacological treatments.
Taking a somewhat different look at the problem, Dr. Liat Ayalon of Bar Ilan University, Israel, will be presenting results from qualitative research that
explored the division of roles within the family system as a result of the entrance of an around the clock home care worker into the home. Finally, Dr.
Patricia Arean of the University of California, San Francisco, U.S.A will be presenting results from three clinical trials of depression treatment in the
home of older adults. Hence, this symposium addresses not only the characteristics of home care and some of the challenges associated with this
popular caregiving arrangement, but also the promises associated with home care and potential interventions that have shown promise with home
care older adults.
HOME CARE IN EUROPE: THE EXPERIENCE OF THE ADHOC STUDY
DRUG USE AND COMPLIANCE IN HOME CARE ELDERLY IN EUROPE- EXPERIENCES FROM THE ADHOC (AGED IN HOME CARE) PROJECT
FAMILY AND FAMILY-LIKE TRANSFERS WITHIN AROUND THE CLOCK FOREIGN HOME CARE SYSTEM
PROVIDING PSYCHOTHERAPY IN THE HOME: THE RESULTS OF THREE CLINICAL TRIALS
Chair(s)
Liat Ayalon Bar Ilan University, Israel [email protected] 972775253609
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ID: 112
GLOBAL ISSUES IN SOCIAL INCLUSION OF OLDER ADULTS
Norah Keating (University of Alberta, Research on Aging, Policies and Practice, Canada)
Adele Hayutin, United States of America (1) Chris Phillipson, United Kingdom (2) Isabella Aboderin, United Kingdom (3) Kevin Cheng, Hong Kong (4)
(1) Global Aging Project, Stanford Center on Longevity, Stanford University (2) Centre for Social Gerontology, Keele University (3) Oxford Institute of Ageing, Oxford
University (4) Asia-Pacific Institute of Ageing Studies (APIAS) and Dept. of Politics and Sociology, Lingnan University
Evidence of widening inequalities in later life suggests increased likelihood of social exclusion among some groups of older adults. Across time and
place differences exist in expectations of individual and societal responsibility, while regional differences in social, geographic and economic context
ameliorate or exacerbate exclusion. This symposium draws on experts from four continents who will address key issues concerning older adults’ social
inclusion/exclusion. Professor Hayutin is an acknowledged expert on global demographic trends and aging. Her analysis shows how dramatic
differences in age structures across countries and regions may result in some areas being unable to adapt their social, economic, and political
infrastructures to population ageing. Her broad comparative perspective on patterns of aging across countries highlights trends that exacerbate
exclusion, including demographic and economic factors such as dependency ratios, labor force participation, gender, migration patterns, and living
arrangements. Professor Phillipson is an international expert on influences of globalization on social aspects of ageing. He will discuss the increasing
power of global finance and private transnational bodies in transforming later life. Although ageing is constructed as a global problem and issue, risks
are increasingly transferred to individual older people and their families, creating distinctive forms of inequality, though these may be counterbalanced
by the influence of transnational governance and organisations representing older people. He examines emerging inclusion/exclusion debates in light
of such global trends. Dr. Aboderin has expertise on ageing issues in sub-Saharan Africa. She will undertake a critical analysis of why questions of
inequalities in later life and the social exclusion of particular groups of older people have received little attention in sub-Saharan Africa. She analyses
how global forces and agendas combine to exclude older persons from basic public services, exploring the possible increase in late-life inequalities in
access to basic services, linked to older persons’ differential material resource capacity and family support conditions. Professor Phillips is an
international expert on social policy in the Asia-Pacific area. He will address regional, global, social and demographic trends in many Asia-Pacific
countries, including smaller families and feminization of ageing, which may shape future inclusion/exclusion of older people. Evolution in "traditional
Asian values", including respect for old age, filial piety and lessening emphasis on tradition and religion, is likely to affect family solidarity and support,
although some older people are becoming discerning and canny consumers and using modern communications methods to maintain contacts.
DEMOGRAPHIC PERSPECTIVES ON SOCIAL EXCLUSION (HAYUTIN)
GLOBALISATION AND AGEING: NEW PATTERNS OF SOCIAL INCLUSION AND EXCLUSION (PHILLIPSON)
SOCIAL INCLUSION/EXCLUSION OF OLDER ADULTS: PERSPECTIVES FROM SUB-SAHARAN AFRICA (ABODERIN)
SOCIAL INCLUSION/EXCLUSION: AN ASIA-PACIFIC PERSPECTIVE (CHENG)
Chair(s)
Norah Keating University of Alberta, Canada [email protected] +780 492-4191
Thomas Scharf Keele University, UK [email protected] +44 (0)1782 584066
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ID: 121
SPECIAL SESSION ON FORGIVENESS IN AGING
AMERICAN/ISRAELI COLLABORATION
ROBERTA GREENE, PHD. UNIVERSITY OF AUSTIN, TEXAS, USA
SHIRA HANTMAN, PHD, TEL HAI ACADEMIC COLLEGE, ISRAEL
Shira Hantman (Tel Hai Academic College, Social Work, Israel)
Shira Hantman, Israel (1) Roberta Greene, United States of America (2)
(1) Tel Hai Academic College (2) University of Texas
I.A Holocaust Survivorship Model*
Roberta R. Greene, Sandra Graham, Marilyn Armour,
The Holocaust Survivorship Model (HSM) is designed to examine the factors that contributed to people’s ability to survive the horrific event of the
Holocaust, to rebuild their lives, and to maintain a coherent life story. It provides a systematic way of looking at and clarifying survivorship as involving
a number of interacting variables. The model consists of the following elements: 1) The Resilience-Enhancing Model; 2) The Healthy Personality; 3) A
Family Typology; 4) Forgiveness.
II.The Role of Performed Meaning in Survivorship: Application to Holocaust Survivors*
Marilyn Armour,
The Holocaust literature gives meaning making a central role. Although sense-making and finding-benefit are well documented examples of the
meaning making processes, studies suggest that these mechanisms may not be useful for survivors of severe trauma. This paper will examine
meaning making by older Holocaust survivors. Attention will also be given to the role of context, including those conditions that facilitate or constrain
meaning making, the relationship between emotion and meaning making, and the significance of meaning making responses to survivors.
III. Erikson’s Healthy Personality and Survivorship: Life Stage Meets Life Course*
Sandra Graham, Roberta Greene, Carmen Morano,
The application of Erikson's approach is a means of collecting a psychosocial history to determine how a person has negotiated the developmental
tasks or milestones associated with life transitions. In this sense, Erikson’s framework was a precursor to the life course approach, with each stage
understood within the context of social influences including economic, historical, and ethnic factors. This paper will present the results of an analysis of
Holocaust survivors’ life stage and life course transitions.
IV. Can we forgive or forget? Forgiveness in old age
Shira Hantman, Department of Social Work, Orna Cohen, Lichtentritt Ronit,
This paper presents the results of a study about the willingness to forgive among 224 older adults in Israel. It examines the contribution of life events,
meaning of life and forgiveness-related variables. Findings indicate that among respondents who cited an event related to a person who was no longer
alive, the more time had elapsed since the event, the less likely they were to forgive, family members were more likely to be forgiven than
non-members.
* Papers funded by the John Templeton Foundation grant #12082
I.A HOLOCAUST SURVIVORSHIP MODEL
II.THE ROLE OF PERFORMED MEANING IN SURVIVORSHIP: APPLICATION TO HOLOCAUST SURVIVORS
III. ERIKSON’S HEALTHY PERSONALITY AND SURVIVORSHIP: LIFE STAGE MEETS LIFE COURSE
IV. CAN WE FORGIVE OR FORGET? FORGIVENESS IN OLD AGE
Chair(s)
shira Hantman Tel Hai Academic College [email protected] 972-3-5351639
Greene Roberta U of Texas [email protected] 5122324168
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ID: 125
LATE-LIFE DEPRESSION AND PSYCHOTHERAPY
Karen Munk (University of Aarhus, Institute of Philosophy and History of Ideas, Denmark)
Ken Laidlaw, United Kingdom (1) Esben Hougaard, Denmark (2) Hanne Jensen, Denmark (3) MIke Bird, Australia (4)
(1) Section of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh (2) Institute of Psychology, University of Aarhus (3) Copenhagen
University Hospital (4) Southern Area Health Service
Generally pscyhotherapy against late-life depression has been ignored in clinical practice and in research. Due to demographic change with new
generations of elderly probably demanding psychotherapy against mental sufferings and due to the uncertain effect of anti-depressants on mild and
moderate depression a reorientation on how to treat depression in old age is needed.
DEMOGRAPHIC CHANGE AND PSYCHOTHERAPY BY DR. KEN LAIDLAW
DEPRESSION AS A PLACEBO SENSIBLE ILLNESS BY PROFESSOR ESBEN HOUGAARD
ELDERLY MEN WITH LATE-LIFE DEPRESSION. IMPLICATIONS FOR PSYCHOTHERAPY BY DR. HANNE JENSEN
PSYCHOTHERAPY AND COMPLEX PRESENTATIONS OF DEPRESSION IN OLD AGE BY DR. MIKE BIRD
Chair(s)
Karen Munk University of Aarhus [email protected] +45 - 20127996
Johansson Boo University of Göteborg [email protected]
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ID: 142
DETERMINANTS AND CONSEQUENCES OF FEAR OF FALLING FROM CROSS-NATIONAL PERSPECTIVE
Gertrudis Kempen (Maastricht University, School for Public Health and Primary Care (CAPHRI), The Netherlands)
Kim Delbaere, Australia (1) Kevin McKee, United Kingdom (2) Gertrudis Kempen, The Netherlands (3)
(1) Prince of Wales Medical Research Institute (2) Sheffield Institute for Studies on Ageing (3) School for Public Health and Primary Care, Maastricht University
Previous studies indicated that fear of falling and fear-related avoidance of activities can play an important role in the transition to physical frailty and
increased risk of falls in older people. However, the complex nature and limited background information on fear of falling still hampers its integration in
falls prevention programs. In this symposium, we present data from three recent studies carried out in different countries. Each study highlights an
aspect of fear of falling that will help our understanding.
Fear of falling has been shown to be more prevalent than falls themselves in community-dwelling older people, with estimates ranging between 20 to
60%. In the first contribution, we will discuss prevalence data and associated factors of inappropriate fear of falling, i.e. an excessive or insufficient fear
not based on actual risk, from an Australian longitudinal study in 500 community-dwelling older people. At baseline, each participant undertook an
extensive assessment of physiological and psychological risk factors of falls. During 12 months, falls, injuries and fear of falling were monitored using
monthly calendars, after which the same procedure as at baseline was repeated. Results are expected end 2008.
For many older people a fall is an ever-present threat, which embodies a potential obstruction to independent living and functioning. In a second
presentation, we will discuss fear of falling from a Posttraumatic Stress Disorder (PTSD) perspective. A prospective British study was conducted
among 196 older people hospitalised after a fall, with follow-up data collected at 12 and 24 weeks. Full or partial chronic PTSD was found in 26.1% of
the participants at first follow-up, and in 27.4% of the participants at second follow-up. Older age, pre-fall activity problems, fear of falling, and anxiety
assessed in hospital, were also associated with follow-up PTSD diagnosis.
A variety of adverse consequences can be expected as a result of fear of falling, particularly when fear of falling results in unnecessary avoidance of
activities. In our third presentation, we will consider a range of socio-demographic, health-related and psychosocial correlates of fear of falling among
540 Dutch older people with at least some fear of falling and related avoidance of activity. Old age, female sex, limitations in ADLs, impaired vision,
poor perceived health, chronic morbidity, falls, low general self-efficacy, low mastery, loneliness, feelings of anxiety and symptoms of depression were
identified as significant.
UNDERSTANDING FEAR OF FALLING AND RISK-TAKING BEHAVIOUR IN OLDER PEOPLE
POSTTRAUMATIC STRESS DISORDER (PTSD)IN OLDER PEOPLE AFTER A FALL
SOCIO-DEMOGRAPHIC, HEALTH-RELATED AND PSYCHOSOCIAL CORRELATES OF FEAR OF FALLING AND AVOIDANCE OF ACTIVITY IN
COMMUNITY-LIVING OLDER PERSONS WHO AVOID ACTIVITY DUE TO FEAR OF FALLING
Chair(s)
Gertrudis I.J.M. Kempen School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
[email protected] +31 43 3882292
Zijlstra G.A. Rixt School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
[email protected] +31 43 3882289
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ID: 165
SLEEP, HEALTH AND AGING:ADDRESSING THE SPECIAL NEEDS OF A GROWING GERIATRIC POPULATION
S-Hakki Onen (Hospices Civils de Lyon, Hopital Geriatrique Antoine Charial, France)
S-Hakki Onen, France (1) Harrison Bloom, United States of America (2) Fannie Onen, France (3) Markku Partinen, Finland (4)
(1) Hopital Geriatrique A. Charial, HCL (2) International Clinical Education and Consultation Service, ILC-USA (3) Hopital Bichat, APHP, Service de Geriatrie (4)
Department of Neurology
Sleep is fundamental but often ignored component of healthy aging. While we do not fully understand its myriad functions, we know that sleep is both
restorative and protective. With the increase in the older population, sleep-related problems increase in importance. The goal is to shed more light on
this frequently misunderstood and overlooked topic.
Circadian sleep rhythms change as we age, but age itself, does not predict sleep problems. It is a major issue to understand normal sleep before
considering sleep disorders.
Quality of sleep is tied to quality of life and, indeed, to the genesis of disease. Sleep may play a salient role in increasing vulnerability to illness and
disability. For example, sleep deprivation produces a prediabetic state, decrease pain tolerance and evidence suggests that sleep is important in the
maintenance of immune function.
Assessing sleep in aged care must be a priority and deserves more attention. Clinical assessment tools for gerontologists are now available. Some of
these tools are specifically developed for the elderly with dementia, polypathology and physical dependency. Familiarity with these tools helps the
health care providers prevent
unnecessary iatrogenesis and promote optimal function of the aging patient.
While the prevalence of sleep apnea increases with age, it is still underdiagnosed and undertreated in the elderly. When unrecognized and untreated,
sleep apnea is associated with cardiac disease, cognitive and behavioral disorders, and impaired quality of life.
Speakers from USA, France and Finland accepted to participate and have financial support. Dr. Harrison Bloom is Senior Associate and Director of
the International Geriatrics Clinical Education and Consultation Service at the ILC-USA. He has published several articles on longevity.
Dr Hakki Onen is Geriatrician at Lyon University and Director of Geriatric Sleep Medicine Center. His research focuses on the interface between sleep
and cognition and development of patient education strategies in sleep apnea. Dr Markku Partinen is Professor of Neurology at University of Helsinki
and Director of the Sleep Disorders Laboratory. His famous works include epidemiology and treatment of sleep apnea. Dr Fannie Onen is a
Geriatrician and Sleep Medicine Expert at University of Paris-7, Bichat Hospital. His current research include development of clinical tools to asses
sleep apnea in the elderly.
Since IAG Congress was founded, research on sleep was given low priority. But because sleep problems are so common among older persons and
the topic so neglected, this symposium on health, aging and sleep
AGING AND CIRCADIAN SLEEP CHANGES
(HAKKI ONEN, CHU DE LYON, FRANCE)
THE ROLE OF SLEEP IN HEALTHY AGING AND LONGEVITY
(HARRISON BLOOM, INTERNATIONAL LONGEVITY CENTER, NY, USA)
SLEEP ASSESSMENT TOOLS FOR GERONTOLOGIST
(FANNIE ONEN, CHU BICHAT, PARIS, FRANCE)
COST AND QUALITY OF LIFE IN UNTREATED SLEEP APNEA
(MARKKU PARTINEN, HELSINKI UNIVERSITY, HELSINKI FINLAND)
Chair(s)
Fannie Onen Centre Hospitalo-Universitaire Bichat, Service de Gériatrie, 46 rue Henri Huchard, 75018 Paris, France [email protected] +33
1 40 25 73 74
Bloom Harrison International Clinical Education and
Consultation Service, ILC-USA,
60 East 86th St. NewYork, N.Y. 10028, USA
[email protected] +1 (212) 517-1308
____________________________________________________________________________________________________________
ID: 191
LONELINESS IN VARIOUS SOCIETIES
Theo Van Tilburg (VU University Amsterdam, Dept. of Sociology, The Netherlands)
Jenny De Jong Gierveld, The Netherlands (1) Linda J. Waite, United States of America (2) Vanda Zammuner, Italy (3) Theo Van Tilburg, The Netherlands (4)
(1) Netherlands Interdisciplinary Demografic Institute (2) University of Chicago, Department of Sociology (3) Università di Padova, Facoltà di Psicologia (4) VU University
Amsterdam, Department of Sociology
Lonely people feel a disagreeable or unacceptable lack of meaningful social relationships. Loneliness refers to a situation of social isolation and results
in elevated risk for morbidity and mortality. Data from various Western countries reveal that about one third of the older population suffers from mild or
severe loneliness. However, across societies differences in prevalence of loneliness have been observed which so far have not been well understood.
Furthermore, data from non-Western countries are scarce and not studied from a comparative perspective. The symposium brings together scholars
from three countries who will present evidence from various societies. The first presentation by Jenny de Jong Gierveld is based on analyses of
international comparative data from the Generations and Gender Surveys. Scales for emotional and social loneliness are reliable and valid instruments
in each of the countries. Based on these scales, differences in prevalence of loneliness among older adults have been observed, with sharp variations
between West and East Europe. The presentation discusses whether current theoretical perspectives are useful in understanding these differences.
The second presentation by Waite is based on one of the validated shortened measures of loneliness for administration to large numbers of people in
large, nationally-representative surveys. Findings on the predictors of loneliness among older adults are discussed, using the Health and Retirement
Study and the National Social Life Health and Aging Study. It also discusses findings on the consequences of loneliness for the health of older adults.
The third presentation by Zammuner reports from studies conducted in Italy. The reliability of subscales for social, emotional, and ‘general’ loneliness
is confirmed. Loneliness was significantly predicted by sex, age, education, sad mood, social contact, depression and social network quality. Results
are discussed as regards their implications for life quality in older people across cultures. The fourth presentation discusses whether prevalence of
loneliness has increased due to societal developments such as urbanization and individualization after WW2. Van Tilburg presents an overview of
previous studies conducted in Germany, Britain and Belgium, and presents data from the Longitudinal Aging Study Amsterdam, The Netherlands
(1992-2006). Adopting two types of measurement instruments, the study shows that the assessment of whether loneliness increased depends on
which instrument is applied, and that the likelihood of reporting being lonely has increased. Together the symposium presentations will enhance our
understanding of the societal impact on older people’s loneliness.
INTERPRETING DIFFERENCES IN EMOTIONAL AND SOCIAL LONELINESS IN OLDER PERSONS IN THREE EASTERN AND THREE WESTERN
EUROPEAN COUNTRIES
LONELINESS IN THE OLDER US POPULATION: PREDICTORS AND CONSEQUENCES
SOCIAL AND EMOTIONAL LONELINESS IN YOUNG, MATURE AND OLDER ITALIAN ADULTS
TODAY’S OLDER PERSONS: INCREASINGLY LONELY OR INCREASINGLY LIKELY TO REPORT SO?
Chair(s)
Theo van Tilburg VU University Amsterdam, De Boelelaan 1081, 1081HV Amsterdam, The Netherlands [email protected] +31-20-5986870
de Jong Gierveld Jenny NIDI, PO Box 11650, 2502 AR The Hague, Netherlands [email protected] +31-70-3565200
____________________________________________________________________________________________________________
ID: 198
PREDICTORS OF LONGEVITY: 20 YEARS OF DATA FROM THE GEORGIA CENTENARIAN STUDY
Leonard Poon (University of Georgia, Institute of Gerontology, United States)
Leonard Poon, United States of America (1) Jonathan Arnold, United States of America (1) Peter Martin, United States of America (2) John Woodard, (3)
(1) The University of Georgia (2) Iowa State University (3) Wayne State University
The Georgia Centenarian Study is a series of studies supported by the National Institute of Mental Health and the National Institute on Aging, USA,
from 1988 to 2008. Phase 1 examined adaptational characteristics of community-dwelling and cognitively-intact centenarians, octogenarians, and
sexagenarians. Phase 2 examined longitudinal changes of these three groups. Phase 3 is a population-based study of genetics, neuropathology,
health, blood chemistry, nutrition, neuropsychology, functional capacity, adaptation and resources of centenarians compared to younger controls. This
symposium presents three major predictors of longevity. The first paper examines how the biological clock in Neurospora crassa controls two major
longevity genes, ras-1 and lag-1. We focused on the effects of the human homologs of LAG1 and RAS1 in Saccharomyces cerevisiae, on aging. We
have shown that lag-1 gene in N. crassa is under transcriptional control of the clock in N. crassa. We have measured replicative life-span of both wild
type (WT), ras-1, and lag-1 and found that ras-1 prolongs replicative life-span relative to WT and that the double mutant, shortens replicative life-span
relative to WT. The second paper outlines results in four development outcome domains: 1. functional capacity and subjective health, 2. cognitive
impairment, 3. mental health problems, and 4. economic-financial independency. We tested the following hypotheses: The current stressful life events
significantly predicts lower functioning. Social support and economic assets predict higher functioning. Personality traits also serve as important
determinants of developmental outcomes.
The third paper investigates models accounting for neuropsychological trajectories associated with
longevity. Significant age related declines in global cognitive functioning and increases in depressive symptoms were observed between the ages of
98 and 108.5 years. Significant declines in executive functioning and gross motor speed accounted for additional unique, age-related variance over
and above global cognition and mood. However, unique age-related memory changes were not observed. Preserved executive functioning skills and
motor speed were predictive of ability to retain instrumental activity of daily living skills with increasing age. Investigators from the Tokyo Centenarian
Study and Okinawa Centenarian Study will compare and contrast findings from the three studies.
LEONARD W. POON, PETER MARTIN, & MARY ANN JOHNSON. INTRODUCTION OF THE GEORGIA CENTENARIAN STUDY.
JONATHAN ARNOLD & MICHAL JAZWINSKI. BIOLOGICAL CLOCK & LONGEVITY.
PETER MARTIN, MAURICE MACDONALD, JENNIFER MARGRETT. RESOURCES AND ADAPTATION PREDICTORS.
JOHN WOODARD, L. STEPHEN MILLER, & LEONARD POON. NEUROPSYCHOLOGICAL PREDICTORS.
Chair(s)
Leonard Poon Institute of Gerontology, 255 E. Hancock, Athens, GA 30602 [email protected] (706) 425-3222
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ID: 207
TAKING A "BIOPSYCHOSOCIAL" VIEW OF COGNITIVE AGING
Teresa Seeman (UCLA, Geriatrics & Epidemiology, United States of America)
Teresa Seeman, United States of America (1) David Alemeida, United States of America (2) Stefan Agrigoroaei, United States of America (3) Arun Karlamangla, United
States of America (4)
(1) UCLA (2) Pennsylvania State University (3) Brandeis University (4) UCLA
This symposium will be comprised of a series of integrated presentations focused on evaluation of hypothesized links between social, psychological,
physical, and cognitive engagement on the one hand and adult cognition on the other. The rich and multi-disciplinary data from the national Mid-life in
the US (MIDUS) study provide a unique opportunity to examine these relationships across different phases of adulthood (early, middle and late) and,
importantly, simultaneously allow for assessment of multiple hypothesized biological pathways (e.g., inflammation, hypothalamic-pituitary-adrenal axis
and autonomic system activity) that may mediate such associations. Begun in 1994/95 as a national survey, MIDUS I (M1) includes extensive
behavioral, psychological and social data along with health data for over 7,000 adults, aged 25-75. MIDUS II (M2) was initiated in 2005 as the first
follow-up of the original M1 participants.
Over and above measures included in M1, M2 data collection encompasses: (a) an innovative
telephone-based cognitive battery developed to assess key dimensions of cognitive function that are believed by current theorists to be especially
vulnerable to the effects of aging and central to everyday functioning in adulthood, including episodic memory, working memory capacity and executive
function, reasoning, and speed of processing; (b) collection of diurnal salivary cortisol data in the context of a diary study of daily stressors for a subset
of some 2,000 participants; and (c) collection of data on major biological systems, including assessment of resting states as well as patterns of
response to challenge for approximately 1,300 of the M2 participants.
Presentations examine: (1) relationships between patterns of adult social
engagement from M1 and M2, and adult cognition at M2, (2) relationships between M1 & M2 control beliefs and cognitive and physical activity and
cognition at M2, (3) relationships between reports of daily social interactions and psychological status at M1 and M2, and cognition at M2, and (4) the
role of major biological regulatory systems in mediating these relationships. All analyses also include a focus on age-related differences in patterns of
association.
LIFE HISTORIES OF SOCIAL ENGAGEMENT AND ADULT COGNITION.
HISTORIES OF "DAILY DIARY REPORTS" ON SOCIAL EXPERIENCE AND PSYCHOLOGICAL STATUS AND ADULT COGNITION
PSYCHOSOCIAL AND BEHAVIORAL PROTECTIVE FACTORS FOR COGNITIVE AND PHYSICAL HEALTH
TESTING THE ROLE OF MAJOR BIOLOGICAL REGULATORY SYSTEMS AS MEDIATIONAL PATHWAYS LINKING PSYCHOSOCIAL
EXPERIENCE TO ADULT COGNITION
Chair(s)
Teresa Seeman 10945 LeConte Ave, Suite 2339 [email protected] 310-825-8253
____________________________________________________________________________________________________________
ID: 219
DISABILITY AND AGEING - A PROBLEM OF 3RD AGE
Saumitra Basu (The Asiatic Society, Research Wing, India)
Saumitra Basu, India (1) Prabir Das, India (2) Indrani Chakravarty, India (3)
(1) The Asiatic Society (2) Calcutta Metropolitan Institute of Gerontology (3) Calcutta Metropolitan Institute of Gerontology
Disability in any form in the life span of a human being is a debilitating factor. To cope with this it is a challenge that requires both mental and physical
strength.For the aged it creates problems both socially and culturally.With the progression of chronological age these problems tend tocreate
depression, ostracism and exclusiveness that percolates even in the daily lives of the gerons.The present research is an attempt to understand
disability and its effects on the elderly population of both rural and urban sector. The aim of the present study is to find out the impact of disability and
how far that is impairing the process of adjustment of the aged to th conditions of ageing.
Keeping it in mind the present study has been conducted both in Calcutta (one of the major metropolis of eastern India) as urban venue and in
Chakdha in the district of Nadia,West Bengal,India as rural venue.Following Stratified Random Sampling Method 200 disabled aged male and female
were selected for the present study. Apart from canvassing a semi-structured questionnaire,participant observation, cas study, focus group discussion
and direct observation were used for data collection.
The analyses reveal that in spite of disability a sizeable section of the aged population cope with the problems with much resilence.The results also
show that much of these coping mechanisms can be supported within the family as well as externally by the state and the society at large.
In brief, the present study is to examine emerging situations of the disabled aged people of both genders living in rural and urban set ups. In doing so,
the attempt is primarily to remain within a micro level and subsequent conclusions may be drawn thereafter in the macro level.
FAMILY LIFE AND HEALTH CONDITION OF THE DISABLED AGED - DR.SAUMITRA BASU
BEHAVIOURAL PATTERN OF THE DISABLED AGED - DR.PRABIR KUMAR DAS
DISABILITY AND AGEING - PROBLEM OF 3RD AGE - DR.INDRANI CHAKRAVARTY
Chair(s)
Indrani Chakravarty 53 B Dr.S.C. Banerjee Road,Kolkata-700010,West Bengal,India [email protected] +919830398184/913323596464
Basu Saumitra AVISHIKTA Phase-I,369/1 Purbachal Kalitala Road,Kolkata-700078,West Bengal,India [email protected] +919830828876/
913324843357
____________________________________________________________________________________________________________
ID: 250
THE PREDICTIVE VALUE OF MEMORY TESTS IN « QUESTIONABLE » DEMENTIA
Eric Salmon (University of Liège, Neurology/ Memory Centre, Belgium)
Françoise Lekeu, Belgium (1) Bruno Dubois, France (2) Stéphane Adam, (1)
(1) Memory Clinic, CHU Liège (2) Neurology Department, La Salpétrière, Paris
The symposium will provide the audience with recent data showing the interest of specific memory tests in predicting the evolution of “mild cognitive
impairment” to Alzheimer type dementia.
The scientific purpose is to discuss “in depth” the characteristic of the memory tests that seem suitable to allow predicting an evolution to AD. Three
different tests will be discussed during the symposium.
The participants are members of the neuropsychological task force of the European Alzheimer’s Disease Consortium.
Stéphane Adam and Françoise Lekeu are Doctors in Neuropsychology, working in the Memory Center/ Day Geriatric Hospital of the CHU Liège
Bruno Dubois is Professor of Neurology at the Salpétrière Hospital, Paris
The chairmen will be Jean Petermans, Professor of Geriatrics, and Eric Salmon, Professor in the Department of Neurology, CHU Liège.
Most data will be relatively novel, concerning memory tests available for most Memory Clinics.
THE CALIFORNIA VERBAL LEARNING TEST IN QUESTIONABLE AD
FRANCOISE LEKEU, MEMORY CLINIC AND GERIATRIC DAY HOSPITAL, CHU LIèGE
FREE AND CUED RECALL IN VERY EARLY AD
BRUNO DUBOIS, LA SALPETRIèRE HOSPITAL, PARIS
RI48 IN VERY EARLY AD
STéPHANE ADAM, MEMORY CLINIC, CHU LIèGE
Chair(s)
Eric SALMON Memory Centre, CHU de Liège, 4020 Liège, Belgique [email protected] 32-4-2703042
PETERMANS Jean Service de Geriatrie, CHU de Liège, 4020 Liège, Belgique [email protected] 32-4-2703019
____________________________________________________________________________________________________________
ID: 259
FEAR OF FALLING IN OLDER PEOPLE: RESULTS FROM DIFFERENT POPULATIONS
Fernando Gomez (University of Caldas, Clinical Geriatrics, Colombia)
Helene Corriveau, Canada (1) Johanne Filiatrault, Canada (2) Carmen-Lucia Curcio , Colombia (3) G.A. Rixt Zijlstra, The Netherlands (4)
(1) Université de Sherbrooke (2) University of Montreal (3) University of Caldas (4) Maastricht University
About 20% to 85% of older people living in the community report a fear of falling. Fear of falling itself may not be a problem as long as it is not
excessive and does not interfere with daily life. However, if fear of falling results in unnecessary avoidance of activities, it may lead to a loss of balance
confidence, reduced physical activity and fitness, social isolation, future (recurrent) falls and associated mortality, disability, and premature nursing
home admissions. Overall, a fear of falls can have a considerable impact on the health and quality of life of older people. This underscores the
importance of research on fear of falling and related avoidance of activities.
In this symposium four presenters from 3 parts of the world, i.e. South America, North America and Europe, will share their results with respect to
research on fear of falling in older people. The different studies on fear of falling will present the broad spectrum of research possible, for example the
assessment of fear of falling, factors associated with fear of falling and the feasibility of an intervention. The first presenter will discuss fear of falling in
different populations, i.e. in older people in good and poor health. The second presenter will present evidence on the psychometric qualities of a
simplified version of a fear of questionnaire assessing balance confidence. The third presenter will address which factors are more important, i.e.
functional or psychosocial factors, with regard to activity restriction due to fear of falling in older people living in the Andes Mountains. The last
presenter will show results of the feasibility of a cognitive behavioral group intervention aimed at managing fear of falling and related avoidance of
activity in community-living older people.
After the presentations the audience is invited to participate in a discussion with respect to the outcomes presented.
FEAR OF FALLING IN DIFFERENT POPULATIONS: HEALTHY AND ILLNESS ELDERLY.
EVIDENCE OF THE PSYCHOMETRIC QUALITIES OF A SIMPLIFIED VERSION OF THE ACTIVITIES-SPECIFIC BALANCE CONFIDENCE SCALE.
CORRELATES OF ACTIVITY RESTRICTION ASSOCIATED WITH FEAR OF FALLING IN ANDES MOUNTAINS. ARE FUNCTIONAL OR
PSYCHOSOCIAL FACTORS MORE IMPORTANT?
FEASIBILITY OF A COGNITIVE INTERVENTION TO MANAGE FEAR OF FALLING AND ASSOCIATED AVOIDANCE OF ACTIVITY IN
COMMUNITY-LIVING OLDER PEOPLE.
Chair(s)
Fernando Gomez Carrera 24 Calle 48 [email protected] (5768) 851981
____________________________________________________________________________________________________________
ID: 274
NEW ASSESSMENT TOOLS FOR RESEARCHERS AND CLINICIANS: INTERNATIONAL DATA AND PERSPECTIVES
Ken Laidlaw (University of Edinburgh, Section of Clinical and Health Psychology, United Kingdom)
Ken Laidlaw, United Kingdom (1) Nancy Pachana, Australia (2) Andres Losada, Spain (3) Bob Knight, United States of America (4)
(1) University of Edinburgh (2) University of Queensland (3) Universidad Rey Juan Carlos. (4) University of Southern California (USC)
This symposium introduces and describes three major new assessment measures specifically designed for use with older people in clinical and
healthcare settings, as well as focussing on measurement issues in clinical gerontology. These instruments cover contemporary issues in gerontology
such as late-life anxiety, caregiver guilt and attitudes to ageing and quality of life. Designed for use across cultures, these scales have been
systematically developed using modern and traditional psychometric approaches.
The Attitudes to Ageing Questionnaire (AAQ) is the first specific and comprehensive assessment tool designed to facilitate cross-cultural research on
attitudes towards ageing from a broad meta-theoretical perspective. It was developed following a coherent process taking account of relevant
gerontological knowledge and modern and classical psychometric analytical methods. Pilot testing on 1356 participants from 15 centres worldwide
refined the scale and further testing with a field trial of 5566 participants from 20 centres confirmed the structure as well as the cross-cultural utility of
this measure.
The Geriatric Anxiety Inventory (GAI) is the only systematically derived assessment tool for use with anxious older adults, and successfully navigates
the differentiation of physical and psychological symptoms of anxiety in later life. A brief self-report measure of dimensional anxiety, it was developed
and validated in a variety of patient populations, including outpatient psychiatric, residential care and neurologic cohorts. Reliability, concurrent validity,
and sensitivity and specificity were robust. Evidence of good pre-post utility of the measure in treatment studies on clinical populations has been found.
The Caregivers Guilt Questionnaire (CGQ), a brief self-report instrument developed to measure an often neglected issue in the caregiving domain.
The CGQ was validated on a large caregiving cohort, and has demonstrated good reliability and validity. Five factors have been obtained through
exploratory factor analysis, explaining 47% of the variance. Significant associations (p < .01) have been found between the CGQ and its subscales as
well as measures of depression and frequency and appraisal of behavioural problems.
Measurement invariance issues and their relevance for clinical and research work with older populations, particularly in the caregiving domain and with
reference to cultural factors, will be discussed. Each presentation will provide a succinct review of the potential uses of these scales in research, policy
formation and clinical work.
THE ATTITUDES TO AGEING QUESTIONNAIRE
THE GERIATRIC ANXIETY INVENTORY
THE CAREGIVERS GUILT QUESTIONNAIRE
CROSS CULTURAL MEASUREMENT INVARIANCE, AND LACK OF SAME, IN CAREGIVER ASSESSMENT MEASURES
Chair(s)
Ken Laidlaw University of Edinburgh [email protected] 44 651 3947
____________________________________________________________________________________________________________
ID: 335
APATHY AND NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER
Philippe Robert (Centre Memoire de Ressources et de Recherche, Hopital Pasteur, France)
Philippe Robert, France (1) Constantine Lyketsos , United States of America (2) Serge Gauthier, Canada (3) Jerome Yesavage, United States of America (4)
(1) Memory center CM2R (2) Johns Hopkins University (3) McGill Centre for Studies in Aging (4) Stanford Department of Psychiatry and Behavioral Sciences
There is wide acknowledgement that apathy and neuropsychiatric symptoms are a major problem in Alzheimer’s Disease and related disorders.
Apathy is common particularly in neurodegenerative disease, approaching the 70% prevalence in some series of patients with Alzheimer’s disease
(AD). In light of recent research and the renewed interest in the correlates and impacts of apathy, and in its treatments, it is important to develop
criteria for apathy that will be widely accepted, have clear operational steps, and that will be easily applied in practice and research settings. Meeting
these needs was the focus of the task force developed in 2008. The task force includes members of the Association Française de Psychiatrie
Biologique, the European Psychiatric Association, the European Alzheimer’s Disease Consortium and experts from Europe, Australia and North
America.
An advanced draft of the criteria was discussed at the consensus meeting, in April 7th 2008 and a final agreement reached concerning operational
definitions and hierarchy of the criteria. Apathy is defined as a disorder of motivation that persists over time and should meet the following
requirements. Firstly, the core feature of apathy, diminished motivation, must be present for at least four weeks; secondly two of the three dimensions
of apathy (reduced goal-directed behaviour, goal-directed cognitive activity, and emotions) must also be present; thirdly there should be identifiable
functional impairments attributable to the apathy. Finally, exclusion criteria are specified to exclude symptoms and states that mimic apathy.
The aim of the symposium including some of the task force members is to present the criteria and updated results concerning, the measurement and
the treatment of apathy and neuropsychiatric symptoms in Alzheimer’s Disease.
P Robert from Nice university, chairman of the EADC behavioural disturbances sub group and coordinator of the task force will focus on the apathy
criteria
C Lyketsos from the Johns Hopkins University (Baltimore) and coordinator of the new version of the Neuropsychiatic Inventory (NPI) will present
develop the importance of NPS assessment in real life and clinical trials
S Gauthier from the McGill Centre for Studies in Aging, Quebec will review the therapeutic stratégies for apathy and NPS
J Yesavage from the Stanford Department of Psychiatry and Behavioral Sciences will chair the session and discuss the 3 presentations
CLINICAL, CONCEPT AND CRITERIA OF APATHY IN ALZHEIMER
MEASUREMENT OF APATHY AND NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER DISEASE
TREATMENT OF APATHY AND NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER DISEASE
DISCUSSANT AND CHAIR
Chair(s)
Philippe Robert Memory Center Nice [email protected] 33 4 92 03 47 70
Yessavage Jerome Stanford [email protected]
____________________________________________________________________________________________________________
ID: 337
ORGANIZATION AND
Anthony L. Kupferschmidt (Simon Fraser University, Department of Gerontology, Canada)
Anthony L. Kupferschmidt, Canada (1) Lidyane Gomide, Brazil (2) Sarah Ruiz Ramon, United States of America (3) Helen Feist, Australia (4)
(1) Simon Fraser University - Vancouver Campus (2) Universidade Federal de Goiás (3) RAND Labor & Population (4) University of Adelaide
Purpose:
- To increase understanding and provide examples of existing national and regional representation of gerontology and geriatrics students to facilitate
the creation and growth of student organizations within the IAGG; and
- To raise awareness and explore the history, future, and current status, membership and framework of the International Council of Gerontology
Student Organizations (ICGSO) of IAGG.
This symposium will focus on engagement of future researchers and scholars in gerontology and geriatrics at national, regional and international levels
within the IAGG. Student representatives from four national gerontology and/or geriatrics organizations across multiple IAGG regions will address the
level of local student representation and the development and growth of each national student association. The speakers will also review the state of
student engagement and representation within their IAGG region. Each speaker will briefly contribute information on both similarities between the
represented countries and regions and distinguishing local factors and circumstances (e.g. national only vs. divisional and national student
representation; one vs. multiple national gerontology and/or geriatrics organizations per country). Barriers to the formalization of a recognized student
entity or position within national organizations and regions will be addressed and suggestions and potential solutions will be offered. Techniques and
strategies for promoting and enabling the establishment and evolution of student organizations within the member organizations and regions of the
IAGG will be provided. National, regional and international initiatives and efforts to foster the development and advancement of gerontological/geriatric
student bodies will also be examined.
Presentations will address the implications of increased organization of and communication between
recognized student groups at all levels.
This symposium will progress from a focus on the national and regional levels to a summary of the
development of the International Council of Gerontology Student Organizations (ICGSO), a standing committee of the IAGG since 2002. This
discussion will explore the past and present of ICGSO and address the challenges and opportunities related to the role of students and student
organizations within the IAGG. Future directions for ICGSO, both internally and within the IAGG, will be addressed. The symposium will conclude
with a critical analysis of international experiences and a summary of how national student sections and regional councils can further the objectives of
ICGSO and advance the role of students within the disciplines of gerontology and geriatrics.
INCREASING VISIBILITY AND ESTABLISHING A UNIQUE IDENTITY IN A LARGER PROFESSIONAL ORGANIZATION: EXPERIENCES FROM
THE EMERGING SCHOLAR & PROFESSIONAL ORGANIZATION (ESPO) IN THE U.S.
STUDENT ENGAGEMENT: EARLY RESPONSIBILITY FOR A RESPONSIBLE FUTURE
ENABLING THE ESTABLISHMENT AND EVOLUTION OF STUDENT ORGANISATIONS - FACILITATORS, BARRIERS, TECHNIQUES AND
STRATEGIES: EXPERIENCES OF THE AUSTRALIAN ASSOCIATION OF GERONTOLOGY
THE PAST, PRESENT AND FUTURE OF IAGG’S INTERNATIONAL COUNCIL OF GERONTOLOGY STUDENT ORGANIZATIONS
Chair(s)
____________________________________________________________________________________________________________
ID: 442
CROSS-NATIONAL EVIDENCE ON HEALTH CHANGE WITH AGEING
Dorly Deeg (VU University Medical Centre, LASA, The Netherlands)
Jean-Marie Robine, France (1) Yasuhiko Saito, Japan (2) Coen Van Gool, The Netherlands (3) Howard Bergman, Canada (4)
(1) INSERM, Equipe démographie et santé (2) Nihon University, Center for Information Networking (3) National Institute for Public Health, Center for Public Health
Forecasting (4) McGill University, Division of Geriatric Medicine
Motivation: There is growing evidence that life expectancy and levels of health of the older population differ across countries. In Europe, for example,
the rate of increase in life expectancy differs greatly, with sharp increases in Mediterranean countries and less increase in some countries in
North-West Europe. In levels of health both a North-South gradient and an East-West gradient can be distinguished. For more than a decade, Japan
has the longest life expectancy of the world. In North-America, the levels of health of the older population have been improving, but life expectancy is
lagging behind. Many of these cross-national differences depend on the health measure considered. Much less evidence exists on potential
cross-national differences in the rate of change in health with ageing in various health measures. Such evidence is badly needed because of the
ageing of populations worldwide, and the consequences this will have for health care and well-being.
This symposium will address the question how health measures change with ageing in various countries, including life expectancy, disability and
frailty. The latter is a relatively unexplored concept which will gain in importance with the ageing of populations. In addition, trends in changes in these
health measures over time are presented and cross-national differences in these trends are discussed. Evidence is presented from longitudinal studies
in Japan (Saito), the Netherlands (Van Gool and Deeg), and Canada (Bergman), and from a worldwide overview of changes in mortality and disability
(Robine and Cambois).
‘IS THERE A RELATIONSHIP BETWEEN MORTALITY (LIFE EXPECTANCY) AND OLD AGE DISABILITY TRENDS WORLDWIDE?’
‘ARE WE REALLY LIVING LONGER HEALTHIER YEARS? A CASE OF JAPANESE ELDERLY’
RATES OF CHANGE IN OLD AGE DISABILITY ACROSS FIVE STUDIES IN THE NETHERLANDS
‘FRAILTY: SEARCHING FOR A RELEVANT CLINICAL AND RESEARCH CONCEPT’
Chair(s)
Dorly Deeg VU University Medical Centre / Longitudinal Aging Study Amsterdam, the Netherlands [email protected] +31204446767
____________________________________________________________________________________________________________
ID: 364
“NEW LOOK AT FILIAL PIETY IN EAST ASIA:
CHANGING FAMILY SUPPORT FOR THE ELDERLY”
KYU-TAIK (Ph.D., Univ. of Michigan, 1974) SUNG (South Korean) (Univ. of Michigan; Exc. Director, Elder-Respect, Inc., School of Social
Work (Visiting Professor), United States of America)
Peng Du, China (1) Nelson Chow, Hong Kong (2) Wataru Koyano, DHSc., Japan (3) Kyu-taik Sung, Ph.D., United States of America (4)
(1) Renmin University of China (2) University of Hong Kong (3) Seigakuin University (4) University of Michigan
[Purpose, Scientific Interest & Internatl Research]
The nations of East Asia--China, Japan, and Korea--have a notable tradition of filial piety (the East Asian ideal and practice of family-centered support
for the elderly). In the process of social changes in recent decades, however, this age-old value is believed to be on the decline. The purported
decline of the value has emerged as one of the most vexing problems for the East Asian nations because of the significant impact it has on the
well-being of the elderly as well as on the morality of the young and the overburdened social welfare system.
Concern over eldercare has been rapidly growing. The growing concern necessitates a critical review of the practice of filial piety, i.e., family support
for the aged.
Information on the practice of filial piety based on empirical data has been scarce. Cross-cultural research on the issue is even more scarce. At the
symposium, the extent to which family support or filial piety is practiced in the three nations will be reviewed, and country specifics as well as
universals regarding family support will be explored in order to set the future direction of in-country as well as cross-national and cross-cultural
research. Taking into account these needs and challenges, the proposed symposium will focus on the following topics:
1) Assessing the state of the practice of filial piety
2) Exploring the impact of the decline of filial piety
3) Modifying the practice of filial piety to suit to the changing world
4) Exploring possibilities of cross-national and cross-cultural--The East verus the West--research
[Choice of Participants]
The proposed symposium will invite prominent gerontologists from the three nations--China, Japan, and South Korea--who are highly recognized for
their gerontological studies. They conducted qualitative and quantitative research and wrote extensively on aging population, family relations, family
support, and filial piety in and outside of their respective countries. Dr. Du Peng (Vice President of Gerontological Society of China; President, Beijing
Gerontological Society), Chow (Endowed Chair Prof.), Koyano (Distinguished Prof.), and Sung (Former Endowed Chair Prof. Univ. of Southern
California) are internationally known for research and publications. [Please, refer to their works introduced on the web: Yahoo of Japan for Wataru
Koyano, Yahoo of Hong Kong for Nelson Chow, Yahoo of U.S. for Kyu-taik Sung, and Yahoo of China for Du Peng.]
PENG DU (VICE PRES., GERONTOLOGICAL SOCIETY OF CHINA): “NEW LOOK AT FAMILY SUPPORT IN CHINA: CHANGING WAY OF
PRACTICING FILIAL PIETY" (ACCEPTED BY DR. DU ON JUNE 30, 2008)
NELSON CHOW (ENDOWED CHAIR PROF., UNIV. OF HONG KONG): “NEW LOOK AT FAMILY SUPPORT FOR THE ELDERLY IN GREATER
CHINESE COMMUNITIES IN EAST ASIA" (ACCEPTED BY DR. CHOW ON JUNE 23, 2008)
WATARU KOYANO: “NEW LOOK AT FAMILY RELATIONS OF SENIORS IN JAPAN: CHANGING PRACTICE OF FILIAL PIETY"
(ACCEPTED BY DR. KOYANO ON JUNE 21, 2008)
KYU-TAIK SUNG (FORMER ENDOWED CHAIR PROF., UNIV. OF SOUTHERN CALIFORNIA): “NEW LOOK AT FILIAL PIETY IN SOUTH KOREA:
CHANGING WAY OF TREATING THE ELDERLY”
(ACCPTED BY DR. SUNG ON JUNE 12, 2008)
Chair(s)
kyu-taik Sung Director, Center for Filial Piety Studies, F-2 Pyung Hwan Bldg., 1579-6 Seocho-Dong, Seocho-Gu, Seoul 137-070 South Korea
[email protected] 82-010-5595-7928
____________________________________________________________________________________________________________
ID: 380
TEACHING GERONTOLOGY ACROSS BORDERS: THE GREAT PLAINS INTERACTIVE DISTANCE EDUCATION ALLIANCE (GREAT PLAINS
IDEA) AND THE EUROPEAN MASTER’S IN GERONTOLOGY (EUMAG)
Peter Martin (Iowa State University, Gerontology Program, United States)
Greg Sanders, United States of America (1) Marja Aartsen, The Netherlands (2) Martha Meyer, Germany (3) Peter Martin, United States of America (4) Ed Rosenberg,
United States of America (0)
(1) North Dakota State University (2) VU-University Amsterdam (3) University of Applied Sciences Saarland (4) Iowa State University (5) Appalachian State University
Gerontology programs around the world are collaborating with other programs to form educational alliances that have become effective teaching
teams. This symposium will highlight two such consortia: The Great Plains Interactive Distance Education Alliance (Great Plains IDEA,
http://www.gpidea.org)is a consortium of six universities in the United States that collaborates on a master’s program in gerontology. The European
Master’s in Gerontology (EuMaG, www.eumag.org)is a joint master’s program delivered and supported by more than 20 European universities. The
symposium will provide an overview of the goals for each program, their students, the curricula, assessment, and respective teaching experiences.
Faculty members from both consortia will highlight interinstitutional experiences with their programs focusing on collaboration and communication
across institutions. A secondary purpose is to highlight and compare some of the unique topics that have come up during the first years of the
program.
TITLE: THE GREAT PLAINS INTERACTIVE DISTANCE EDUCATION ALLIANCE: GOALS, CURRICULUM, AND STUDENTS
THE EUROPEAN MASTER’S IN GERONTOLOGY: GOALS, CURRICULUM, AND STUDENTS
CHALLENGES OF GERONTOLOGY EDUCATION IN A SHRINKING WORLD
TEACHING EXPERIENCES IN A COLLABORATIVE ENVIRONMENT
Chair(s)
Peter Martin Ames, U.S.A. [email protected] 515-294-5186
Aartsen Marja Amsterdam [email protected]
____________________________________________________________________________________________________________
ID: 403
SLEEP DISORDERS IN OLDER PERSONS
Christophe Arbus (CHU Toulouse, Psychiatry, France)
Valérie Cochen, France (1) Christophe Arbus, United States of America (1) Sonia Ancoli-Israel, United States of America (2) Jerome Yesavage, (3)
(1) CHU Toulouse (2) University of California (3) Stanford University School of Medicine
Sleep changes substantially and continuously with age across adulthood. Sleep architecture is altered with aging. Inability to phase-shift readily, the
occurrence of daytime napping, and larklike tendencies all characterize the sleep-wake rhythms of older adults. Inability to sustain long bouts of
waking and uninterrupted sleep may reflect a fundamental age-dependent change in the homeostatic regulation of sleep. Waking not rested, waking
too early, trouble falling asleep, daytime napping, nocturnal waking, and difficulty initiating or maintaining sleep are among the chief sleep complaints
of older adults. The aim of this symposium is to describe the sleep disorders observed in healthy but also in dependant older people. Sleep disorders
are prevalent in these 2 categories of elderly persons; however, their causes, consequences and treatment are different and need specific
approaches. Actually, non pharmacologic management of sleep disorders are developed. Sleep disorders are frequent in Alzheimer’s disease (AD)
and increase with the severity of the cognitive impairment. They are significant source of caregiver psychological and physical stress and can lead to
institutionalisation as much as other behavioural or psychological symptoms of dementia. The sleep patterns observed in AD patients are often similar
to those observed in non-demented elderly but alterations are more severe and occur more frequently. Conversely, some changes in sleep
architecture do not suggest only aging evolution but show specific pattern of alteration like some REM sleep modifications. Sleep disturbances have
behavioural correlates in dementia and this association is not well understood.
AGITATION DURING SLEEP IN OLDER PERSONS
SLEEP DISORDERS IN DEMENTIA
EPIDEMIOLOGY OF SLEEP DISORDERS IN NURSING HOME
NON-PHARMACOLOGIC MANAGEMENT OF SLEEP DISORDERS IN OLDER ADULTS
Chair(s)
Jerome Yesavage Palo Alto, US [email protected] 858 643-4398
Ancoli-Israel Sonia San Diego, US [email protected] 858 642-3828
____________________________________________________________________________________________________________
ID: 404
PAIN IN OLDER PEOPLE WITH DEMENTIA, NEW APPROACHES IN A PROGRESSING RESEARCH AREA
Sandra Zwakhalen (Maastricht University, Health Medicine and Life Sciences, The Netherlands)
Sandra Zwakhalen, The Netherlands (1) Erik Scherder, The Netherlands (2) Ann Horgas, United States of America (3) Thomas Fischer, Germany (4)
(1) Maastricht University (2) Vrije Universiteit (3) University of Florida (4) Charité - Universitätsmedizin Berlin
Pain assessment and its management in nursing home residents with dementia is a complex challenge. Study findings demonstrate that pain is
undertreated among dementia patients. Key questions therefore to resolve are: how to recognize pain in dementia patients? How patients with
dementia perceive pain and does pain differ between patients with different subtypes? Last decade there has been an increase of studies on pain in
elderly people with dementia to resolve these questions. Insight is essential to improve care of the demented elderly and contribute to optimal
treatment.
This symposium presents findings from four recent studies. Latest findings in the field of pain and dementia will be presented from different
perspectives. Experts in the field of care for the elderly from different universities with different backgrounds (e.g. nursing, mental health and
neuropsychology) will participate in this symposium. The findings that will be presented on recent developments in pain and pain assessment will gain
insight in: - what we have achieved and what will be the focus for the near future; -how to improve the assessment of pain; and what should be the
future research agenda in this field.
In the first presentation, results from a study performed in the Netherlands are presented by Dr. S. Zwakhalen regarding the use of a different
approach to the reduction of the items in a clinically useful observational pain scale. In contrast to previous pain studies, this study made use of
confirmatory robust maximum likelihood factor analysis and item response theory to investigate the psychometric properties of pain cues.
The second presenter, Prof. Dr. Horgas will focus on pain assessment and its management. Thirdly, another study performed in the Netherlands will
be presented by Prof. dr. Scherder, addressing differences in pain experience between subtypes of dementia and the complexities/ consequences of
this for addressing research. Finally, findings from a German study on an observational pain tool are addressed by Dr. Fischer. The presentation will
focus on facial expression as a pain indicator in clinical, non - experimental settings. Fundamental issues on validity of this indicator in patients with
severe dementia will be discussed.
USING MOST VALID ITEMS TO MEASURE PAIN IN OLDER PEOPLE WITH DEMENTIA: A NEW APPROACH TO THE ITEM SELECTION OF A
OBSERVATIONAL PAIN ASSESSMENT
INFLUENCE OF DEMENTIA ON THE PERCEPTION OF PAIN
PAIN IN PERSONS WITH DEMENTIA
PAIN ASSESSMENT IN PERSONS WITH SEVERE DEMENTIA: THE CASE OF FACIAL EXPRESSION IN THE CLINICAL SETTING
Chair(s)
Sandra Zwakhalen PO BOX 616 6200 MD Maastricht The Netherlands [email protected] 0031433884083
____________________________________________________________________________________________________________
ID: 407
COGNITIVE TRAINING IN LATER ADULTHOOD: FINDINGS FROM FOUR INTERVENTION PROGRAMS
Willis Sherry (University of Washington, Psychiatry and Behavioral Sciences, United States)
Sherry Willis, United States of America (1) Yee Lee Shingl, Germany (2) Sylvie Belleville, Canada (3) Denise Park, United States of America (4)
(1) University of Washington (2) Max Planck Institute for Human Development (3) University of Montreal (4) University of Texas - Dallas
There is increasing evidence for considerable cognitive plasticity in old age from both brain and behavioral research. Much of the evidence has come
from cognitive intervention programs. However, there remains serious debate regarding issues, such as the magnitude and breadth of intervention
effects, neural and behavioral mechanisms associated with performance enhancement, and the characteristics of interventions that would provide
maximal outcomes.
In this symposium, findings will be presented from four major intervention programs that represent diverse approaches to
addressing these key questions regarding cognitive training outcomes; symposium presenters are from Germany, Canada, and the U.S.
The
Advanced Cognitive Training in Vital Elders (ACTIVE) randomized controlled trial represents the largest behavioral cognitive intervention trial in the
U.S., funded by the National Institutes of Health, with nondemented elders (S. Willis, presenter). Significant training effects on memory, speed of
processing, and executive reasoning abilities were maintained at five-years after training. Some transfer to activities of daily living was demonstrated
at fifth annual follow-up with trained subjects reporting less difficulty with tasks of daily living than controls; those in the booster condition trained on
speed of processing performed speeded tasks more quickly than controls. Transfer to self-reported driving behaviors was shown for reasoning and
speed training. The COGITO Study involved young and older adults participating in 100 sessions with daily practice of 12 tasks representing
perceptual speed, episodic and working memory (Shingl, presenter). Time-accuracy functions examining speed and accuracy at the individual level
were studied to differentiate mechanisms underlying within and between group differences in plasticity for working versus episodic memory. The
efficacy of memory training was examined for elders with mild cognitive impairment (MCI; S. Belleville, presenter). Training studies with MCI subjects
is critical to understanding plasticity in a transitional phase between normal aging and dementia. Relatively short multifactorial training produced
marked memory performance improvement; in addition, memory improvement was accompanied by neural changes in brain areas typically involved in
memory processes. The fourth presenter (D. Park) reports on an experimental study of social and cognitive engagement as a means of facilitating
neurocognitive function in late adulthood and maximizing the breadth of cognitive training effects. This intervention is based on the premise by Park
and Reuter-lorenz that the ability to create neurocognitive “scaffolding” is a critical aspect of maintaining cognitive function in old age.
THE ACTIVE RANDOMIZED CONTROL TRIAL: MEMORY, PROCESSING SPEED AND REASONING EXECUTIVE TRAINING WITH
NON-DEMENTED ELDERS
PLASTICITY OF WORKING MEMORY AND EPISODIC MEMORY IN THE COGITO STUDY: FINDINGS FROM TIME-ACCURACY FUNCTIONS
MEMORY TRAINING OF ELDERS WITH MILD COGNITIVE IMPAIRMENT: MEMORY, FMRI AND ERP FINDINGS
INTELLECTUAL AND SOCIAL ENGAGEMENT AS A FORM OF COGNITIVE INTERVENTION
Chair(s)
Sherry Willis 180 Nickerson Suite 206, Seattle WA 98109 USA [email protected] 206-281-4050
Belleville Sylvie Department of Psychology and CERNEC, University of Montreal, Montreal, Canada [email protected]
____________________________________________________________________________________________________________
ID: 451
SUPPORTIVE TECHNOLOGIES IN LATER LIFE
(F. OSWALD & H.-W. WAHL)
Frank Oswald (University of Heidelberg, Dept. of Psychological Ageing Research, Germany)
Sara Czaja, United States of America (1) Frank Oswald, Germany (2) Andrew Sixsmith, Canada (3) Katrin Classen, (2)
(1) University of Miami Miller School of Medicine, Dept. of Psychiatry and Behavioral Sciences Centre on Aging (2) University of Heidelberg, Institute of Psychology, Dept. of
Psychological Ageing Research (3) Simon Fraser University, Gerontology Research Centre
Over the last years there has been an intensive discussion on the use of technology in order to keep older people with physical, sensory or cognitive
impairments independent as long as possible. It was shown that technology can facilitate access to health-related online information, ageing in place
as well as communication and mobility in later life. Moreover, technologies can serve to manage chronic illness as well as to support and enhance
efficiency of daily routines in care settings. The aim of this symposium is to provide recent empirical evidence on a selected range of
technology-related topics on healthy and impaired ageing among community-dwelling elders and old people in institutional settings. As a starting point,
Czaja et al. will present data from a study examining the ability of older adults to find and interpret Internet-based health information. Findings, e.g., on
obtained accuracy, reported problems with usability and the feeling of getting “lost” are discussed in terms of the implications for training and Interface
design. Next, Oswald et al. will focus on measuring outdoor mobility by taking advantage of tracking technology among urban living demented, mildly
cognitively impaired persons, and unimpaired controls in Israel and Germany. Findings are based on interview data and tracking protocols striving to
explain differences in outdoor mobility patterns over a period of four weeks. In a third presentation Sixsmith et al. will address the need for pervasive
healthcare and lifestyle monitoring systems to manage people with chronic illnesses. Thus, telecare networks with miniaturised wireless sensors worn
either on the body or embedded in the environment are used to provide intelligent, unobtrusive and continuous healthcare monitoring. Finally Claßen
et al. will focus on a project to evaluate consequences of the implementation and use of new technologies on the life of vulnerable residents in an
institutional setting. The main focus is on expected positive (well-being, quality of life) as well as negative (insecurity, handling problems) effects of the
technology on residents and staff of a nursing home. Finally Rick Scheidt (Kansas State University, USA) will discuss all presentations in the light of
the role of technologies in order to support and enhance quality of life in old age.
OLDER ADULTS AND THE USE OF E-HEALTH INFORMATION
(S. J. CZAJA, C. C. LEE, S. N. NAIR, & J. SHARIT)
ANALYZING OUTDOOR MOBILITY OF COMMUNITY DWELLING ELDERS WITH COGNITIVE IMPAIRMENT BY MEANS OF TRACKING
TECHNOLOGIES IN ISRAEL AND GERMANY: DATA FROM THE PROJECT SENTRA
(F. OSWALD, H.-W. WAHL, O. SCHILLING, E. VOSS, N. SHOVAL, T. FREYTAG, G. AUSLANDER, J. HEINIK, & R. LANDAU)
USING TECHNOLOGY TO MANAGE PEOPLE WITH CHRONIC ILLNESSES: RESULTS OF THE SAPHE PROJECT
(A. SIXSMITH, N. BARNES, A. BHACHU, R. CURRY, & B. EGAN)
EVALUATION OF NEW TECHNOLOGIES BY RESIDENTS AND STAFF IN THE INSTITUTIONAL CONTEXT: DATA FROM THE PROJECT
BETAGT
(K. CLAßEN, H.-W. WAHL, F. OSWALD, C. BECKER, & C. HEUSEL)
Chair(s)
Frank Oswald Bergheimer Str. 20, 69115 Heidelberg, Germany [email protected] +49-6221-548114
Wahl Hans-Werner Bergheimer Str. 20, 69115 Heidelberg, Germany [email protected] +49-6221-548110
____________________________________________________________________________________________________________
ID: 512
THE CHALLENGES OF SCREENING FOR DEMENTIA IN MULTICULTURAL SOCIETIES.
Bilkish Cassim (University of KwaZulu-Natal, Geriatrics, South Africa)
Tricia Woo, Canada (1) Belinda Park, Canada (2) Kathleen Cruttenden, Canada (3) Bilkish Cassim, South Africa (4) Suvira Ramlall, Canada (5) Serela Ramklass, Canada
(6) Thirusha Naidu, Canada (7)
(1) McMaster University, St Peters Hospital, Hamilton (2) Camosun College, University of Victoria (3) University of New Brunswick (4) University of KwaZulu-Natal (5)
McMaster University (6) University of New Brunswick (7) University of Victoria
The increasing proportion of older persons in developing countries brings with it unique challenges for the screening and diagnosis of age-related
diseases. Screening instruments and tools, developed and validated in developed countries, are not sensitive to the differences in culture, language,
educational level and literacy in developing countries.
At the same time developed countries are also faced with similar challenges due to an
increasingly migrant and multicultural society.
In the International Collaboration for the Care of the Elderly, the international arm of the Canada-based National Initiative for the Care of the Elderly
(NICE), partners from South Africa, Australia and Canada have been collaborating on the development of appropriate screening tools for dementia
and the effective transfer of this knowledge to primary care physicians.
In SA, there is little data on dementia and screening is complicated by the multicultural society, 11 official languages, high level of illiteracy and the
constraints of the health system. Approximately 80% of the population is reliant on the public health system in which the first contact is with a nurse in
a busy general clinic where there is little time and training for the administration of screening questionnaires while 20% of the population have access
to a family physician. Further, the disease profile is different and HIV/AIDS is an emerging cause of dementia.
In Canada the challenges of screening for dementia are linked to the role of the family physician, the vague and often non-specific early signs and
symptoms, the role of family, and the social implications of a diagnosis. Conventional wisdom using a strict medical model approach has limitations
that required an integrated approach to the process of identifying an appropriate dementia screening tool.
These presentations will explain the approach taken by the Dementia working groups to select the DECO (Deterioration Cognitive
Observee)1 Screening Tool, the corresponding pocket card and investigation algorithm as a knowledge translation (KT) approach.
This
will include a literature review, the challenges of screening tool selection, and the KT strategy in each country.
These presentations will provide attendees with practical strategies for integrating dementia screening taking into account multiple factors. Further,
the applicability these approaches to other geriatric syndromes will be explained.
1. Ritchie, K. & Fuhrer, R. (1996). The validation of an informant screening test for irreversible cognitive decline in the elderly: Performance
characteristics within a general population sample. International Journal of Geriatric Psychiatry,
DEVELOPMENT OF A POCKET TOOL FOR FAMILY AND INTERDISCIPLINARY SCREENING OF AN OLDER PERSON WITH COGNITIVE
SYMPTOMS IN CANADA
CHALLENGES OF SCREENING FOR DEMENTIA IN A MULTICULTURAL SOCIETY
THE FACE VALIDITY OF THE DECO IN A SOUTH AFRICAN POPULATION
DEVELOPMENT OF AN ALGORITHM FOR THE ASSESSMENT OF DEMENTIA IN A SOUTH AFRICAN POPULATION
Chair(s)
Bilkish Cassim Univeristy of KwaZulu-Natal. Private Bag 7. PO Congella. 4013. South Africa [email protected] +27312604246
Woo Tricia McMaster University, St Peters Hospital, Hamilton. Ontario. Canada [email protected] 9057773837 extension 12506
____________________________________________________________________________________________________________
ID: 523
CHANGING FAMILIES / EMERGING ISSUES AND NEEDS
Rosemary Blieszner (Virginia Polytechnic Institute and State University, Center for Gerontology, United States)
Karen Hooker, United States of America (1) Pearl Dykstra, The Netherlands (2) Karen A. Roberto, United States of America (3) Keiko Takahashi, Japan (4)
(1) Oregon State University (2) Netherlands Interdisciplinary Demographic Institute (NIDI) (3) Virginia Polytechnic Institute and State University (4) University of the Sacred
Heart
Older adults and their families are experiencing a vast array of changes in economic, political, social, medical, and technological arenas. These and
other aspects of contemporary society, occurring in conjunction with aging processes, have an impact on physical and psychological well being of
older adults and their family members. The scientific purpose of this symposium is to analyze contemporary changes and contexts affecting the family
dynamics and relational ties of older adults. Participants were chosen to represent multiple facets of changing families as well as multiple disciplines
and geographic regions. The first presentation, by scholars from Human Development and Family Studies in the U.S., examines the effects that the
lengthening time span for young adults’ life course transitions (marriage, job, parenthood) have on their parents’ perceptions of their retirement and
elder care plans. Ambivalence occurs in family ties as the sandwich generation balances changing needs of their young adult offspring, parent care,
and their own retirement. The second presentation, by a sociologist from The Netherlands, investigates associations between norms of family
obligations and the actual provision of support. The paper explores the extent to which men and women respond differently to increasing parental
needs and whether people in countries with different welfare regimes respond differently to increasing parental needs. Ultimately, it addresses the
question, How well do norms predict actual behavior? In the third paper, by gerontologists from the U.S., the authors analyze the effects on family
members of having a relative diagnosed with a fairly new, ambiguous cognitive deficit - mild cognitive impairment (MCI). Lack of information about
prognosis and treatment options creates stress as care partners negotiate unfamiliar behaviors and interaction dynamics with the person having MCI.
This paper demonstrates both frustrations and resilience among older adults with MCI and their family members as they cope with challenging new
circumstances. The fourth paper, by a psychologist from Japan, illustrates the adaptability of older adults who become involved in new
technology-related pursuits in retirement. The findings illustrate the applicability of the Selection, Optimization, and Compensation model of successful
aging in this context. Taken together, these papers provide novel insights into emerging issues associated with changing family patterns.
HOW CHANGING NEEDS OF FAMILIES ARE CREATING AMBIVALENCE IN FAMILY TIES
NORMATIVE BELIEFS AND RESPONSIVENESS TO INCREASING PARENTAL NEEDS
FAMILY EXPERIENCES WITH THE MILD COGNITIVE IMPAIRMENT TRAJECTORY
SUCCESSFUL AGING THROUGH PARTICIPATION IN SOCIAL ACTIVITIES: EXAMINING THE SELECTION, OPTIMIZATION AND
COMPENSATION MODEL WITH JAPANESE SENIOR CITIZENS
Chair(s)
Rosemary Blieszner Virginia Polytechnic Institute and State University [email protected] 001-540-231-5437
____________________________________________________________________________________________________________
ID: 532
PSYCHOSOCIAL PREDICTORS OF LATER LIFE DISPARITIES
Toni Antonucci (University of Michigan, Institute for Social Research, United States)
Cleopatra Caldwell, United States of America (1) Kira Birditt, Japan (1) Hiroko Akiyama, Germany (2) Clemens Tesch-Roemer, United States of America (3) Lisa Berkman,
(4) Toni Antonucci, (1)
(1) University of Michigan (2) University of Tokyo (3) German centre of gerontology (4) Harvard University
This symposium takes a lifespan and life course perspective on the development of disparities in later life. While, for example, it has long been
recognized that people of lower socioeconomic status have worse health, the degree to which earlier life experiences influence later life outcomes has
not been well documented. We, therefore, propose to use both longitudinal and cross-sectional data to examine these associations across different
countries, ethnic and age groups. Caldwell, Jackson, and Zhang explore the role of ethnic differences in early life experiences as they predict
depressive symptoms. In particular they utilize a cross-sectional nationally representative sample from the U.S. to examine retrospective family
background data, place of birth and childhood health status as predictors of depression among African American and Caribbean Blacks. Birditt and
Brown utilize unique longitudinal data from Black and White marital couples over 16 years of marriage in the U.S. They assess associations between
tension, conflict strategies and depressive symptoms over time. Destructive and avoidant strategies were associated with greater negative affect and
lower conflict resolution whereas constructive strategies were associated with lower negative affect and greater conflict resolution. Gender and race
differences are also considered. Akiyama and Antonucci use parallel datasets from Yokohama, Japan and Detroit, Michigan (in the U.S.) to explore
the role of reciprocity over twelve years. Reciprocity has been shown to be related to depression cross-sectionally and to vary by country but little
research has explored these associations both longitudinally and across nations. And finally, Herbrich, Huxhold, and Tesch-Roemer use the German
Ageing Survey to examine the SES-Health link. In particular, they explore the degree to which this association is age-specific. Benefitting from three
waves of longitudinal data, they demonstrate that psychosocial resources mediate the SES-Health relationship in adulthood and old age. In sum, this
symposium explores later life health disparities by examining earlier life experiences among groups that vary by age, gender, race, nationality, and
ethnicity. As we enter a period of rapidly increasing numbers of older people, with fewer social, economic and health resources available to them,
understanding those factors which predict disparities and those most likely to ameliorate them represents an important contribution to the health and
well-being of older people.
ETHNIC DIFFERENCES IN EARLY LIFE EXPERIENCES AND DEPRESSIVE SYMPTOMS ACROSS THE LIFE COURSE
KEEPING QUIET, TALKING IT OVER, OR FIGHTING IT OUT: A LONGITUDINAL STUDY OF MARITAL CONFLICT AND WELL-BEING
THE IMPLICATIONS OF RECIPROCITY FOR DEPRESSIVE SYMPTOMS: A LONGITUDINAL STUDY OF SOCIAL RELATIONSHIPS IN JAPAN
AND THE U.S.
PSYCHOLOGICAL RESOURCES AND THE LINK BETWEEN SOCIAL INEQUALITY AND HEALTH IN ADULTHOOD AND OLD AGE – FINDINGS
FROM THE GERMAN AGEING SURVEY
Chair(s)
Toni Antonucci University of Michigan [email protected] 7347635846
Berkman Lisa Harvard University Lisa Berkman 7347635846
____________________________________________________________________________________________________________
ID: 546
LONGITUDINAL PERSPECTIVES ON HEALTH DISPARITIES WITH AGING: COMPARATIVE STUDIES OF HEALTH AND RETIREMENT
David Weir (University of Michigan, Institute for Social Research, United States)
James Banks, United Kingdom (1) Zhao Yaohui, China (2) Axel Borsch-Supran, Germany (3) Jacqui Smith, United States of America (4)
(1) The Institute for Fiscal Studies (2) Beijing University (3) University of Mannheim (4) University of Michigan
Health disparities in old age are well-documented in many countries. Cross-nation comparisons of the social and behavioral factors associated with
disparities in health provide some insight into the underlying causes and inform policy. Beginning with the Health and Retirement Study (HRS) in the
US, many countries have initiated longitudinal studies of aging based on similar designs, including the English Longitudinal Study of Ageing (ELSA)
and the multi-country EU-based Study of Health Aging and Retirement in Europe (SHARE). These studies combine the large sample sizes and
national representation of population surveys with extensive multi-disciplinary measurement more common to small localized studies. China is
embarking on a similar effort with the China Health Aging and Retirement Longitudinal Study (CHARLS). This symposium brings together the senior
investigators from each of these studies to address issues of social and economic disparities in health and the psychosocial dimensions of them.
Banks and James Smith drew attention to the health gap in late middle age between England and the United States in a recent JAMA paper (Banks,
Marmot, Oldfield & Smith, 2007).
In this symposium,
they will explore further possible explanations for the lagging performance of the US,
emphasizing the demands and stressors of work and family using comparative data from ELSA and HRS.
Strauss and Zhao are principal investigators of the new China Health Aging and Retirement Longitudinal Study. They will present results from the first
baseline interviews--the first to shed light on health disparities in Chinas aging population.
Boersch-Supran is a senior investigator in the multi-country SHARE network. He describes large variations between European countries in health,
well-being, and socio-economic status, potentially caused by different welfare policies.
Jacqui Smith and Weir discuss the moderating and unique role of psychosocial factors in health disparities beyond socioeconomic and demographic
influences. They link data on personality, social relationships, and lifestyle collected in the Health and Retirement Study (HRS) to health outcomes.
The four studies represented in this symposium provide a unique context for examining nation- and region-specific variations in socioeconomic factors,
social policy, and social contexts and their role in health disparities in old age.
DISADVANTAGE IN COMPARATIVE PERSPECTIVE: THE ENGLISH LONGITUDINAL STUDY OF AGING AND THE US HEALTH AND
RETIREMENT STUDY
IS THERE A HEALTH GRADIENT IN CHINA?: NEW EVIDENCE FROM THE CHINA HEALTH, AGING, AND RETIREMENT STUDY
THE SES-HEALTH GRADIENT IN EUROPE: THE STUDY OF HEALTH, AGING, AND RETIREMENT IN EUROPE
PSYCHOLOGICAL DIMENSIONS OF HEALTH DISPARITIES IN THE US: THE HEALTH AND RETIREMENT STUDY
Chair(s)
David Weir 426 Thompson St., Ann Arbor, MI, 48104 [email protected] 734-615-4694
____________________________________________________________________________________________________________
ID: 569
IMMIGRATION AMONG OLDER MIGRANTS OF COLOR
James Jackson (University of Michigan, Institute foir Social Research, United States)
James Jackson, United States of America (1) Claudine Attias-Donfut, France (2) James Nazroo, United Kingdom (3) Sam Noh, Canada (4)
(1) University of Michigan (2) Department CNAV (3) University of Manxhester (4) University of Toronto
The growth of aging populations worldwide is contributing to growing migration among people of all ages. Reduced fertility and the need for younger
workers in Western nations, and political and economic difficulties in less developed countries are producing circumstances resulting in large
movements of people from less to more developed countries. Migrant pressures are especially significant among advanced industrial Western nations
(AIN). Citizens of advanced industrialized nations, such as those in Western Europe and North America, may become increasingly intolerant of
increased immigration; especially as population aging takes place in these countries placing heightened strains on economic, social security, and
retirement systems; recent violent disruptions in South Africa provide a striking example.
Additional research is needed to examine the interrelationships among public sentiments, immigrant attitudes and beliefs, public policies, and the
adjustment of immigrant populations in receiving countries. Similarly, additional attention is needed from researchers to examine the increased
pressure for family and kin reunification which may lead older people to immigrate in order to reunite with their children and other relatives in these
countries. This movement is most likely to be from less to more economically and socially resourceful countries. Thus, the potential for negative
attitudes and lack of receptivity in these host countries may have enormous negative influences on immigrant individuals and families, as well as
broader societal disruptions.
Finally, individuals who immigrate late in life, perhaps to join their children, or who have themselves immigrated years earlier with their children, will
age as immigrants. As noted earlier, increased life expectancy and reduced numbers of children among native members of advanced industrial
countries may result in both more immigrating to age, as well as more ageing in place as immigrants, among immigrant groups. Additional research
on the intersection of immigration and aging related processes is necessary to develop programs that may maximize the positive, and minimize the
negative, life-course experiences of both immigrants of color and native members of their host countries.
CARIBBEAN BLACK MIGRATION TO THE UNITED STATES
AFRICAN MIGRATION TO FRANCE, UK AND SOUTH AFRICA: A COMPARATIVE STUDY
SOUTH ASIAN AND CARIBBEAN MIGRATION TO ENGLAND
ASIAN, AFRICAN AND CARIBBEAN MIGRATION TO CANADA
Chair(s)
James Jackson 5010 ISR University of Michigan, 426 Thompson Street, Ann Arbor, MI 48106-1248 USA [email protected] 1-734-763-2491
____________________________________________________________________________________________________________
ID: 603
RESEARCH DIRECTIONS OF THE MACARTHUR FOUNDATION AGING SOCIETY NETWORK
John Rowe (Columbia University, Department of Health Policy and Management, United States)
James Jackson, United States of America (1) Lisa Berkman, United States of America (2) Martin Kohli, Italy (3) Jay Olshansky, United States of America (4)
(1) University of Michigan (2) Harvard University (3) European University Institute (4) University of Illinois at Chicago
The aging society, in the U.S. and globally, will be shaped by two critical forces: 1. the remarkable increase in disability-free life expectancy; and, 2.
the enormous ‘baby boom’ generation reaching retirement age. Taken together, these forces will create societies populated by previously unimagined
numbers and shares of older people. We know very little about how the major institutions, e.g. education, families, housing and labor markets,
churches, political parties and governments will adjust to address these major societal changes.
The MacArthur Foundation Research Network on an Aging Society is an interdisciplinary group of scholars who are conducting a society-wide,
broad-based analysis of the modifications required in the major societal institutions to facilitate emergence of a productive and equitable aging society
in the United States and elsewhere. We are focused on a number of important areas that provide special opportunities or that are relatively neglected.
These include new supplemental population projections for the U.S. for 2030 and 2050, which are currently being developed, and a robust
interdisciplinary evaluation of the following three closely related themes: 1) intergenerational relationships and responsibilities, including both the
positive and adverse effects of interactions and transfers between generations at the level of family and society; 2) the development of meaningful
roles and clarification of the responsibilities of individuals and cohorts over an extended life course, including the workforce and engagement in civic
activities; and 3) the impact of diversity and inequalities on the aging society, including the possible social consequences of late-life diversity and the
implications of a widening resource gap.
In addition to the three main themes, a number of important cross-cutting issues have been identified. These include the potential benefits of
remodeling the distribution of key life-activities, including education, work, and leisure, across the life course; the impact of health-related and
non-health-related technology, especially the likely future of the generational “digital divide”; the ethical considerations that emerge from the types of
policy decisions facing aging societies; and international comparisons, especially with the experiences in Western Europe,. This symposium will offer
preliminary thoughts and findings on the role of the intergenerational family (Jackson), the potential for positive interventions (Berkman), life course
implications of the aging society (Kohli), and an overview of demographic transitions defining an aging society (Olshansky).
AGING SOCIETY AND THE ROLE OF THE INTERGENERATIONAL FAMILY
INTERVENTIONS TO IMPROVE HEALTH AND WELL-BEING FOR OLDER PEOPLE IN AN AGING SOCIETY
LIFE-COURSE IMPLICATIONS OF THE AGING SOCIETY
U.S. POPULATION SIZE AND AGE STRUCTURE IN 2030 AND
2050: FORECASTS FROM THE MACARTHUR FOUNDATION AGING SOCIETY NETWORK
Chair(s)
John Rowe Mailman School of Public Health, Columbia University, 600 West 168 th Street, New York, NY 10032, USA [email protected]
212-305-3505
____________________________________________________________________________________________________________
ID: 607
OLDER PERSONS IN DISASTERS
Cheng Sheung-Tak (City University of Hong Kong, Applied Social Studies, Hong Kong)
Patricia Brownell, United States of America (1) Buxin Han, China (2) Li-xin Chen, China (3) Sheung-Tak Cheng, Hong Kong (4)
(1) Fordham University (2) Institute of Psychology, Chinese Academy of Sciences (3) Beijing Geriatric Hospital (4) City University of Hong Kong
The heat wave in Europe (2003), the Asian Tsunami (2004), hurricane Katrina (2005), cyclone Nargis in Myanmar (2008), and the Sichuan (China)
earthquake (2008) are just some of the major disasters in recent years. Due to weather change, droughts, floods and heat waves of a massive scale
periodically hit many parts of the world. What most of these disasters share in common is that they hit older people and children hardest, though most
of the attention goes to child victims, leaving older victims very much in neglect.
Despite the burgeoning literature on disaster psychology, little is known about the vulnerabilities of older people in disasters and how older survivors
adjust to the aftermath. This symposium will provide an integrative perspective of how disasters impact older persons, and report some findings
coming out from post-disaster work in Sichuan, China. Attempts will be made, where possible, to highlight the differential impact of the different kinds
of disaster (e.g., flood, heat, earthquake) and the sociocultural conditions that facilitate the survivors’ adaptation.
While the impact of floods, volcanoes, and drought have been studied in developed countries like the U.S., Japan, Scotland, and Italy, few studies
have been undertaken in developing countries. According to United Nations, the Asia-Pacific and Africa together account for 85% of the world’s death
toll due to disasters in 2006. Because of the lack of infrastructure and the tight competition for resources in the developing countries, older survivors
are often most at risk for lack of medical treatment and basic necessities (such as food and water) following disasters. Existing studies on disasters
highlight the importance of quick emergency response systems, communitarian relief efforts, and aftercare programs, all of which are generally lacking
in developing countries. Sadly, when resources are insufficient, older survivors are often seen as burden by their communities.
Besides getting the resources to older people, older victims face additional difficulties in adjusting to disasters, most notably disruption of their support
systems due to the deaths of family members, friends, and neighbors, and sometimes relocation to an unfamiliar environment. Some found
themselves as lone caregivers for their grandchildren when their children died in disasters. These drastic changes tax the older persons’ coping
abilities; many suffer from mental health problems, as longitudinal data from Sichuan, China show. Having said this, studies also document the
remarkable emotional resilience of older persons in the face of disasters.
NATURAL DISASTERS: A MISSING TOPIC IN THE GERONTOLOGICAL LITERATURE - BY SHEUNG-TAK CHENG
THE PSYCHOLOGICAL CONSEQUENCES OF EARTHQUAKE: A FOCUS ON OLDER PEOPLE - BY LI-XIN CHEN, ZHENG CHEN, XUE-LI CHEN,
RONG-HUAN JIANG
MENTAL HEALTH STATUS OF THE ELDERLY IN SICHUAN EARTHQUAKE AREA - BY BUXIN HAN, JUAN LI
OLDER PEOPLE AND NATURAL DISASTERS - BY PATRICIA BROWNELL
Chair(s)
Sheung-Tak Cheng Dept of Applied Social Studies, City University of Hong Kong, 83 Tat Chee Ave, Hong Kong [email protected] +852 2788
8745
____________________________________________________________________________________________________________
ID: 52
Theme: Biological Sciences
GENETIC, EPIGENETIC AND POST-TRANSLATIONAL MECHANISMS OF AGING
Ladislas ROBERT (Hötel Dieu Hospital, Univ. Paris 5, Ophthalmol Res Lab, France)
Ladislas Robert, France (1) Jay Olshansky, United States of America (2) Sylvie Ricard-Blum, France (3) Jacqueline Labat-Robert, France (4)
(1) Hôtel Dieu Hosp, Univ Paris 5 (2) School of Public Health, University of Illinois, Division of Epidemiology and Biostatistics (3) Institut de Biologie et Chimie des Protéines,
UMR 5086 CNRS - Université Lyon 1 (4) Laboratoire de Recherche Ophtalmologique, Hôpital de l’Hôtel Dieu
During the early years of the eclosion of the molecular genetics most scientists (and Insurance companies) believed that longevity is genetically
determined. With the refinement of our knowledge of gene functions, its control by epigenetic and extra genetic processes this belief in "all genetic"
determination of longevity started to decline. Still a few decades ago, direct genetic determinism of longevity was set at 25 % of all causes of aging.
More recently, and essentially as the result of the study of identical twins raised separately, this percentage declined well below 10 %. As a matter of
fact, some of these twins died young with diseases which never affected the other twin who lived a healthy long life. This does not mean however that
genes do not play an important role in the functional decline of the aging organism. The identification of genes involved in the control of longevity as for
instance the Sirtuins(controlling increased longevity by calorie restriction) is one example. These genes act however at the epigenetic level controlling
chromatin structure and gene availability. Another example is the identification of the genes responsible for Werner syndrome and progeria. Another
well-known example are the genes accelerating age-asssociated pathologies, cardiovascular in particular. Another recent and important example
which will be presented is the identification of a genetic switch controlling the exit of cells from the mitotic pool to enter senescence. This switch is
under the control of some anti-oncogens(p53, pRB and others) and acts also as a protecting device against malignant transformation. Post
translational mechanisms such as calcification of elastic fibers, followed by lipid accumulation, accelerating cardiovascular and respiratory insufficiency
is another exemple. Proteolytic fragmentation of some matrix macromolecules such as fibronectin, with the production of harmful peptides which
accelerate cell and tissue aging is another example.The above-selected lectures could summarize this important field which is in the front line of
modern basic gerontology.
L. ROBERT: INTRODUCTION, 5 MINUTES
SJ. OLSHANSKY: A BIODEMOGRAPHIC VIEW OF AGING, DISEASE, AND THE DURATION OF LIFE. 30 MINUTES WITH DISCUSSION
S. RICARD-BLUM: INVESTIGATION OF AGING MECHANISMS AND REGULATION USING INTERACTION NETWORKS. 30 MINUTES WITH
DISCUSSION
L. ROBERT & J. LABAT-ROBERT: EPIGENETIC AND POST-TRANSLATIONAL MECHANISMS OF AGING. 20 MINUTES + 5 MINUTES
DISCUSSION
Chair(s)
Ladislas ROBERT Hotel Dieu Hospital, Univ Paris 5 [email protected] 01 43 86 02 40
Olshansky Jay Chicago, Univ Illinois [email protected] 1-312-355-4668
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ID: 89
AGING AND ANTI-AGING NON INFLAMMATORY PROTEINS
ERIC BOULANGER (AGING BIOLOGY, LILLE MEDICAL SCHOOL, France)
Maria ERIKSSON, Sweden (1) Luc BUEE, France (2) Eric BOULANGER, France (3) Makoto KURO-O, United States of America (4)
(1) Department of Biosciences and Nutrition, Karolinska Institutet, Karolinska University Hospital (2) INSERM U 837 (3) Vascular Aging Biology, Lille Medical School (4)
Department of Pathology, The University of Texas Southwestern Medical Center
Dr Maria ERIKSSON (PhD) Maria Eriksson's doctorate at the Karolinska Institute was in the field of neurogenetics and she has completed her
post-doc training at the National Human Genome Research Institute in Maryland, USA. She was offered the chance to try and find out which mutation
causes the premature aging disease called progeria, or Hutchinson-Gilford Progeria Syndrome (HGPS). Maria Eriksson found the mutation behind
progeria. HGPS is caused by a dominant-negative mutation in LMNA, a gene that encodes two major proteins of the inner nuclear lamina: lamin A and
lamin C. Dr ERIKSSON will present the more recent fundamental data of this accelerated aging disease.
Dr Luc BUEE (PhD) is head of the Team2 in the Unity 815 of INSERM, Lille, France. He has made his PhD in the laboratory of NeuroImmunology,
Department of Geriatrics, in the Mount Sinai Hospital, NY, USA. Dr BUEE has published many works in Alzheimer’s dementia research especially
concerning implication of Tau protein in neurofibrillary degeneration. Microtubule-associated Tau proteins belong to a family of factors that polymerize
tubulin dimers and stabilize microtubules. Dr BUEE will present latest understanding concerning TAU implication in neurofibrillary degeneration.
Dr Eric BOULANGER (MD, PhD) is a head of the Vascular Aging Biology team in Lille Medical School. His work is focused in the field of the protein
modification called protein glycation which lead to Advanced Glycation End-product (AGE) formation. He made his PhD in Paris7 university and his
post-doc at Columbia University, NY, USA in the team where the RAGE (Receptor for AGE) was identified. AGEs accumulate in aging tissues and
organs, and could interact with RAGE. AGE are aging toxins especially involved in accelerated aging during diabetes mellitus (glycotoxin) and renal
failure (uremic toxin). Dr BOULANGER will present the AGE deleterious effect on aging. He will insist on the more recent preventive and therapeutic
aspects.
Pr Makoto KURO-O (MD, PhD) is working in the Pathology Department of the University of Texas Southwestern Medical Center in Dallas, USA. Pr
KURO-O identified a new gene, termed Klotho, that is involved in the suppression of various aging symptoms. A defect in Klotho in the mouse leads to
a syndrome resembling human aging, including a short life-span, infertility, arteriosclerosis, skin atrophy, osteoporosis and pulmonary emphysema.
The Klotho gene encodes a membrane or secreted Klotho protein that shares sequence homology with glucosidase enzymes
Lamin A/C, progeria, and possible implications in aging
Dr Maria ERIKSSON, Karolinska University Hospital, Stockholm, Sweden
Implication of Tau in neurofibrillary degeneration during aging and Alzheimer's disease
Dr Luc BUEE, INSERM U815, Lille, France
Protein glycation in aging: role and control
Dr Eric BOULANGER, Medical School, Lille, France
The anti-aging mechanism mediated by Klotho
Pr Makoto KURO-O, University of Texas Southwestern, Dallas, USA
Chair(s)
Eric Boulanger Medical School, Lille, France [email protected] 33 6 62 70 05 67
Makoto Kuro-o University of Texas Southwestern, Dallas, USA [email protected] -- Confirm Not yet confirmed 1 214-648-4018
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ID: 128
TELOMERE DYNAMICS AND CARDIOVASCULAR AGING
Athanase Benetos (University of Nancy, , France)
Abraham AVIV, United States of America (1) Athanase BENETOS, France (2) Rosine NZIETCHUENG, (3) Isabelle GORENNE, United Kingdom (4)
(1) UMDNJ, NJ Medical School (2) University Hospital of Nancy (3) INSERM U684 (4) Division of Cardiovascular Medicine, University of Cambridge
Cardiovascular risks, including aortic stiffness and atherosclerotic disease, increase with age, perhaps because of progressive cardiovascular tissue
degeneration resulting from chronic mechanical stress and hormonal factors, and also from inflammation and oxidative stress. Age-related
cardiovascular alterations show large inter-individual variations, suggesting that in individuals with the propensity for cardiovascular diseases the
biological age of the arteries may be older than their chronological age would indicate. Telomeres, the TTAGGG tandem repeats at the ends of
mammalian chromosomes, undergo attrition with each division of somatic cells in culture. Hence, their length is an indicator of replicative history and
replicative potential of these cells. This feature of telomere biology is at the core of the concept that at the cellular level telomeres serve as a mitotic
clock. Clinical studies have shown that telomere length is shorter in subjects with pronounced aortic stiffness and in patients with coronary heart
disease. Telomere length at a given age depends on telomere length at birth, which is believed to be strongly determined by genetic factors. Telomere
attrition rates depend on both genetic and environmental factors. Although telomere lengths in different tissues are closely correlated, attrition in
telomere length may be more or less pronounced from one tissue to another according to the local tissues effects of oxidative stress. Attrition in
telomere length may be a major determinant of human aging not only at the cellular level, but also at the organ and perhaps the systemic levels. It is
reasonable to propose, therefore, that attrition in telomere length may explain, in addition to chronological age, interindividual variation in the
predilection to cardiovascular risks associated with aging.
The aim of this symposium is to present the clinical and experimental data showing the possible interest of telomere length in the evaluation of arterial
aging and cardiovascular risk.
TELOMERE DYNAMICS AND EVALUATION OF CARDIAVASCULAR AGING : CLINICAL IMPLICATIONS
CLINICAL EVIDENCE FOR THE IMPLICATION OF TELOMERE LENGTH IN THE CARDIOVASCULAR AGING
TELOMERE LENGTH IN ATHEROGENIC AND NON ATHEROGENIC TISSUS
ENDOTHELIAL CELL SENESCENCE AND TELOMERE ATTRITION
Chair(s)
Athanase Benetos CHU de Nancy [email protected] 03.83.15.33.22
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ID: 133
IMMUNOSENESCENCE: STATE OF THE ART
Tamas Fulop (Université de Sherbrooke, De Médecine, Canada)
Tamas Fulop, Canada (1) Graham Pawelec, Germany (2) Michael P. Cancro, United States of America (3) Claudio Franceschi, Italy (4)
(1) Université de Sherbrooke, Research center on Aging (2) University of Tubingen (3) University of Pennsylvania School of Medicine (4) University of Bologna
The number of people with age-related diseases is increasing. One of the leading causes of morbidity and mortality in the very elderly is infection, with
cardio-vascular diseases and cancer less prevalent than in younger elderly. All three major pathologies are to some extent related to immune system
dysfunction. A large amount of data accumulated over the past decade or more has allowed a better but still incomplete understanding of all the
complex alterations affecting the immune system with aging. Many established ideas have changed during the last decade, such as those related to
the effect of aging on the innate immune system, antigen presentation, cytokine imbalance and low grade inflammation. A critical evaluation and
update of the current state-of-the-art in these different areas is essential.
We therefore propose four presentations by internationally-recognised researchers in the field of immunosenescence. The presentation by Tamas
Fulop will deal with the changes of the innate immune system with aging. The innate immune system is the first to encounter any aggressor and strive
to neutralise it, at the same time modulating the adaptive immune response. The discovery of TLRs has greatly changed our comprehension of the
interaction between the innate and adaptive immune responses. The next presentation will be by Graham Pawelec on the role of persistent antigenic
challenge, exemplified in the elderly by chronic viral infections, especially with CMV, as a driving force for the changes occurring in the adaptive
immune response. Progress in this field will help to design better interventions to restore appropriate immune function. The next presentation made by
Michael Cancro will deal with another important aspect of immunosenescence, namely B lymphocyte function changes which were considered for a
long time as little changed with aging. However, new data are emerging to show that alterations to B cells also contribute to the process of
immunosenescence. Finally, the last presentation made by Claudio Franceschi will focus on “Inflammaging” and how both benefits and deficits arise
from this state. This theory postulates that a low grade inflammation exists with aging and this has deleterious effects on the appearance of
age-related chronic diseases, such as Alzheimer disease, cardiovascular diseases and cancer, but may also protect against infection.
At the end of this symposium participants will have been able to learn about new developments in research on immunosenescence, as well as to make
the connection between immunosenescence, longevity
T. FULOP: THE INNATE IMMUNE RESPONSE AND AGING
G. PAWELEC: CHRONIC VIRAL INFECTION AS A DRIVING FORCE FOR T CELLS IMMUNOSENESCENCE
M. CANCRO: B CELL CONTRIBUTION TO IMMUNOSENESCENCE
C. FRANCESCHI: INFLAMAGING: A UNIFYING THEORY FOR IMMUNOSENESCENCE
Chair(s)
Tamas Fulop Centre de Recherche sur le vieillissement [email protected] +1 819 829 7131
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ID: 146
NONCODING RNA AND EPIGENETIC CONTROL OF AGING: FROM WORM TO MAN
Eugenia Wang (University of Louisville, Gheens Center on Aging, United States of America)
Monica Driscoll, United States of America (1) Hyman Schipper, Canada (2) Weixiong Zhang, United States of America (3) Anna McCormick, United States of America (4)
(1) Rutger, The State University of New Jersey, (2) McGill University (3) Washington University (4) National Institute on Aging, NIH
This symposium, co-organized by Drs. Eugenia Wang and Anna McCormick, focuses on how the aging process and age-dependent diseases are
affected by noncoding RNAs, small RNA molecules which do not code any genetic products, but exhibit potent regulatory functions to control the
expression of many genes post-transcriptionally. Among many species of small RNA molecules, microRNAs are the best characterized, functioning as
“genetic dimmer switches” fine-tuning the expression of hundreds of genes by binding to either the coding region or the 3’-untranslated region (UTR) of
their target genes’ messages, resulting in either messenger RNA degradation or inhibited translation. This regulatory role is recently recognized as an
epigenomic factor, pivotal to orchestrating the signal transduction pathways essential to cellular functions such as oxidative defense, intermediate
metabolism, DNA repair, and regulation of genomic stability. Thus, microRNAs are considered as “hubs” embedded within signaling networks; their
aberrant expression may contribute to significant changes in the outcome of cellular functionality, leading to major disease manifestations. A noted
example is the down-regulation of microRNA 34a, linked to the up-regulation of a host of oncogenes in cancer. Obviously, dysregulation of specific
microRNA expression may be the underlying hub contributing to the physiological decline seen during aging.
In this symposium, Dr. Driscoll will discuss the role of microRNAs in controlling C. elegans life span; Dr. Wang will discuss mid-life dysregulation of
microRNA expression as a route to late-life decline and disease manifestation; Dr. Schipper will discuss biomarkers related to neurodegenerative
diseases such as Alzheimer’s disease; and Dr. Zhang will discuss the general regulation of microRNA activation, and possible “cis” elements
regulating en bloc expression of several microRNAs together in replicatively senescent fibroblasts. Since microRNAs have attracted significant
interest in the field of biomedical research, beside these four speakers we would like to invite an outstanding young scientist from an EU laboratory,
selected from “hot papers” published between now and Spring, 2009, to present in this symposium. In addition, we would like to have a panel
discussion with one-slide presentations from the scientists who attend and participate in this symposium, to allow ample time for discussion and
scientific exchange for future collaboration among biogerontologists. These collaborations should promote future exciting advances and generate new
knowledge and discoveries, thus opening new windows to explore the biology of aging in the post-genomic age.
MONICA DRISCOLL: microRNA modulation of C. elegans Healthspan and Lifespan
EUGENIA WANG: Programmed microRNA Shift during Mid-Life: Prediction for Age-dependent fraility and diseases
HYMAN SCHIPPER: microRNA Profiling in Alzheimer disease
WEIXIONG ZHANG: Transcriptional Regulation of microRNA in Aging Brain and Senescent Fibroblasts
Chair(s)
Eugenia Wang 580 South Preston St., Louisville, Kentucky, USA 40202 [email protected] 502-852-2556
McCormick Anna National Institute on Aging, 7201 Wisconsin Ave. Bethesda, Maryland, USA 20892 [email protected] 301-496-6402
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ID: 155
MELATONIN, BIORHYTHMES AND AGING
Vladimir Anisimov (N.N.Petrov Research Institute of Oncology, Carcinogenesis and Oncogerontology, Russian Federation)
Vladimir Anisimov, Russian Federation (1) Yvan Touitou, France (0) Ettore Ferrari, Italy (0)
(1) N.N.Petrov Research Institute of Oncology (2) Faculty of Medicine Pierre and Maria Curie (3) University of Pavia
The current data on age-related changes in melatonin secretion and rhythmicity in human and animals as well as the role of environmental factors
affecting biorhythms (shift work, constant illumination, electromagnetic fields, etc.) in acceleration of aging and age-associated pathology will be
discussed in reports. Data on effect of expogenous melatonin administration on life span and age-associated pathology will be critically reviewed as
well.
All 3 speakers are leaders in the topic.
MELATONIN AS GEROPRTECTOR AND ANTICARCINOGEN
MELATONIN AND BIORHYRHMS IN NORMAL AND ACCELERATED AGING
MELATONIN SECRETION IN PHYSIOLOGICAL AGING, IN SENILE DEMENTIA AND IN CLINICALLY HEALTHY CENTENARIANS.
Chair(s)
Vladimir Anisimov N.N.Petrov Research Institute of Oncology, Pesochny-2, St.Petersburg 197758, Russia [email protected] +7-812-596-65-39
Touitou Yvan Department of Biochemistry and Molecular Biology; Faculty of Medicine Pierre et Marie Curie, 91 boulevard de l"Hopital, 75634 Paris
Cedex 13, France [email protected] +33 1 40 77 96 63
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ID: 173
MOLECULAR MECHANISMS OF BRAIN AGING AND AGE-RELATED NEURODEGENERATION: GENETICS, SIGNALING, CYTOSKELETAL
ABNORMALITY, AND PROTEIN TOXICITY
Nozomu Mori (Nagasaki University School of Medicine, Anatomy and Neurobiology, Japan)
Nozomu Mori, Japan (1) Frederic Saudou, France (2) Yong-Sun Kim, Korea, Republic of (3) Mahendra Thakur, India (4)
(1) Nagasaki University School of Medicine (2) Institut Curie (3) Hallym University Insong Institute for Life Science (4) Banaras Hindu University
Aging affects various cellular and tissue functions, most of which could be attributed to dysregulation of the efficacy and/or specificity of various cellular
signal transduction pathways. During the last several decades, genes and pathways involving the cause and processes of neurodegeneration, have
been elucidated, particularly for Alzheimerﾕs, Parkinsonﾕs, and Huntington diseases. The mechanisms of neurodegeneration seem
distinct; however, many of those degenerative neurons represent gene expression changes and cytoskeletal, e.g., microtubule, abnormalities. Recent
studies on longevity-related genes indicate that SIRT1-related members (also called Sirtuins) of NAD-dependent histone deacetylase are crucial for
neuronal survival and neuroprotection against various environmental stresses. Interestingly, some members of Sirtuins and histone deacetylases
(HDACs) reside only in cytoplasm, and function as tubulin deacetylases, i.e. TDACs. Thus, there is an increasing possibility that those HDACs and
TDACs play some roles in the chromatin and microtubule abnormalities in degenerative neurons. In this symposium, we aim to discuss latest findings
on the molecular mechanisms of various types of neurodegeneration such as Alzheimerﾕs, Huntington, and Prion disease, especially focusing
on neuronal signal transduction, microtubule abnormality, and protein toxicity.
MAHENDRA THAKURNEUROPROTECTIVE SIGNALING IN BRAIN AGING
YONG-SUN KIMMolecular Etiologies Underlying Prion Disease in Drosophila Model
FREDERIC SAUDOUHuntington disease: Huntingtin and the control of axonal transport
NOZOMU MORITUBULIN DEACETYLASES IN NEURONAL AGING IN VITRO AND IN VIVO
Chair(s)
Nozomu Mori Nagasaki University School of Medicine, [email protected] +81-95-819-7017
Thakur Mahendra Biochemistry and Molecular Biology Lab [email protected] 0542 2313958
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ID: 210
ESSENTIAL TRACE ELEMENT (ZN, CR, SE)
DEFICIENCIES IN ELDERLY: WHICH POLICY OF SUPPLEMENTATION?? SYMPOSIUM
ORGANISED BY SFERETE(FRENCH SOCIETY FOR TRACE ELEMENT RESEARCH) AND TEU(TRACE ELEMENT INSTITUTE FOR
UNESCO/LYON
Anne-Marie Roussel (Universite Joseph Fourier, LBFA/INSERM 884, France)
Anne-Marie Roussel, France (1) Margaret Rayman, United Kingdom (2) Richard Anderson, United States of America (3) Monique Ferry, France (4) Guy Chazot, France (5)
(1) INSERM/UJF (2) Faculty of Health and Medical sciences (3) Human Nutrition research center USDA (4) INSERM (5) Trace Element Institute For Unesco
Several epidemiological studies have reported poor trace element status in Elderly, due to low intakes, decreased bioavailability, and increased
needs.Zinc, Selenium and Chromium deficiencies are mostly reported and involved in several biological and clinical aspects of aging such as
infections,inflammation,
oxidative pathologies,cognitive decline and decreased insulin sensitivity.However, the importance of an adequate trace
element status in prevention of age-related pathologies is still poorly known despite the increasing number of interventional studies published in this
field . Therefore, we aim to work out a symposium devoted (i) to present recent data on the incidence of trace element deficiencies in elderly and their
consequences, (ii)to debate about the potential interest of supplemental intakes of these trace elements, combined or not with vitamins in healthy
aging ,(iii)to define a policy of efficient and adapted supplementation (forms, doses, duration).
Pr Margaret Rayman (UK) will present a lecture on Selenium needs in Elderly and forms of supplementation.Selenium intakes are very low in Europe
and selenium status decreases with aging. Several recent papers have reported an adequate selenium status as a longevity factor. Pr Rayman is one
of the most wellknown scientist in the field of human selenium research and selenium forms of supplementation.
Chromium is crucial in aging since it acts as insulin potentiating factor and could therefore prevent from insulin resistance and increased risk of
diabetes.Dr Richard Anderson(USA)is recognized for his expertise and he has accepted to participate to the symposium to debate about the
controversal needs of chromium (Cr III)supplementation in aging. Finally,Pr Roussel(Fr) will rise the problems linked to zinc supplementation following
the data of the European study ZENITH(Zinc supplementation in older and middle aged subjects)in which her french team was mainly involved.
Dr Ferry(France) will chair the symposium and present a synthesis of the recommendations for trace element intakes in elderly taking into account the
age-segment and the environmental conditions(free living, house bound, still healthy, pathologies).
Finally, we would undeline that this symposium is supported by the SFERETE(French Society for Trace Element Research) and the Trace element
institute for Unesco (Lyon).
IS SELENIUM SUPPLEMENTATION NEEDED FOR AN HEALTHY AGING? (BY PR MARGARET RAYMAN)
CHROMIUM AND INSULIN SENSITIVITY IN ELDERLY (BY DR RICHARD A ANDERSON)
ZINC AND AGING:LESSONS FROM RECENT EUROPEAN STUDIES (BY PR ANNE-MARIE ROUSSEL°
CONCLUSIONS/POLICY FOR TRACE ELEMENT SUPPLEMENTATION FOR AN HEALTHY AGING (BY PR FERRY AND CHAZOT)
DR FERRY AND PR CHAZOT
Chair(s)
Monique Ferry 7 rue de Mulhouse 26000Valence France [email protected] 33 (0)607453917
Chazot Guy Trace Element Institute For Unesco, 1 place de l'école, BP7021 Lyon Cedex 07, 69342 France [email protected] 33(0)472808290
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ID: 237
AGEING BONE AND GENETICS
Serge FERRARI (Service des maladies osseuses, De réhabilitation et gériatrie, Switzerland)
Douglas P. Kiel, United States of America (1) Serge Ferrari, Switzerland (2) Luigi Gennari, Italy (3)
(1) Division on Aging, Hebrew Rehabilitation Center (2) Service des maladies osseuses - Département de réhabilitation et gériatrie (3) University of Siena
Genetic factors account for 60 to 80 % of the variance of peak bone mass. Using candidate genes or genome wide scanning, complex models are
being developed to predict low bone mass, altered microstructure and/or fracture risk.
In this symposium, the state of the art in terms of genetics and fracture will be discussed, together with the interaction with environmental factors such
as nutrition in the elderly.
D KIEL: GENE-ENVIRONMENT INTERACTIONS ON THE AGEING SKELETON
S FERRARI: PLEIOTROPIC EFFECTS OF OSTEOPOROSIS GENES ON AGE-RELATED
DISORDERS
L GENNARI: GENETICS OF MALE OSTEOPOROSIS
Chair(s)
SERGE FERRARI Hôpitaux Universitaires de Genève [email protected] +41223829952
RIZZOLI RENE Hôpitaux Universitaires de Genève [email protected] +41223829972
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ID: 277
AGEING IS NO LONGER AN UNSOLVED BIOLOGICAL PROBLEM
Leonard Hayflick (University of California, San Francisco, Anatomy, United States)
Leonard Hayflick, United States of America (1) Robin Holliday, Australia (2) Thomas Kirkwood, United Kingdom (3) Steven Austad, United States of America (4)
(1) University of California, San Francisco (2) The Australian Academy of Science (3) University of Newcastle (4) University of Texas
At the end of the 20th century a remarkable scientific discovery emerged. It was not a discovery in the usual sense, because it was based on a series
of important insights by a number of scientists over a long period of time. These insights made it possible for the first time to understand the biological
reasons for the ageing of animals and man.
For centuries people have been puzzled by the inevitability of human ageing. It has often been referred to as a mystery, or an unsolved biological
problem. There have been many studies of ageing in the 20th century, using a variety of experimental systems. Much of this work could be called
descriptive. For example, many comparisons were made between young and old animals. Innumerable differences were documented, but these were
often hard to interpret. Also, there were many theories of aging that seemed to compete with each other. One of the most puzzling features of the
ageing of mammals was the fact that their lifespans vary by 30-fold, but the changes seen during senescence are very similar. Thus, age changes
occur at very different rates in different species.
For most of the 20th century this was not understood. Thousands of scientific papers were published with many long reviews and several books. Yet
they came to no firm conclusion about the biological reasons for aging, and why animals age at different rates. Then, towards the end of the century
the situation changed, and many new insights were published
in the following books: How and why we age by Leonard Hayflick (1994);
Understanding ageing by Robin Holliday (1995); Why we age by Steve Austad (1997), and Time of our lives by Tom Kirkwood (1999) . The authors
were working quite independently, and the books are by no means the same, but they come to a similar conclusion, namely, that ageing is no longer
an unsolved problem of biology.
Some scientific discoveries are accepted quickly, but others may be ignored. It is likely that the discovery of the biological reasons for ageing will
not become established knowledge for some time. We think it is very important to promote the new understanding of ageing to the wide audience
provided by the Congress. This understanding will advance future research to uncover in much more detail the reasons for the breakdown of
molecular fidelity and maintenance.
THE CAUSES OF BIOLOGICAL AGEING ARE KNOWN (LEONARD HAYFLICK, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, USA)
UNDERSTANDING THE BIOLOGICAL REASONS FOR AGEING (ROBIN HOLLIDAY, THE AUSTRALIAN ACADEMY OF SCIENCE, CANBERRA,
AUSTRALIA)
AGEING IS SOLVED BUT ITS SOLUTION ALSO HIGHLIGHTS ITS COMPLEXITY - GEARING UP FOR THE CHALLENGES AHEAD (TOM
KIRKWOOD, NEWCASTLE UNIVERSITY, NEWCASTLE UPON TYNE, UK)
MAKING SENSE (AND MAKING USE) OF PATTERNS OF MAMMALIAN LONGEVITY (STEVEN N. AUSTAD, UNIVERSITY OF TEXAS HEALTH
SCIENCE CENTER SAN ANTONIO, SAN ANTONIO, TEXAS, USA)
Chair(s)
Leonard Hayflick University of California,San Francisco, USA [email protected] 707 785 3181
Holliday Robin The Australian Academy of Science. Canberra, Australia [email protected] Fax 61 2 9886 4818
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ID: 291
NUTRITION AND BRAIN AGING: PRIMING THE BRAIN AGAINST THE RAVAGES OF TIME
James Joseph (USDA Human Nutrition Research Center on Aging at Tufts University, Neuroscience, United States)
James Joseph, United States of America (1) Charles Ramassamy, Canada (2) Elizabeth Head, United States of America (3) Donald Ingram, United States of America (4)
(1) USDA Human Nutrition Research Center at Tufts University (2) INRS-Institut Armand-Frappier (3) University of California, Irvine Brain Research Center (4) Pennington
Biomedical Research Center
The evidence is becoming increasing clear that diet plays an important role in increasing “health span”. However, questions of which foods might be
the most beneficial in preventing cognitive and motor behavioral deficits in aging remain. It has been shown that the inclusion of fruits (e.g.,
blueberries, strawberries, blackberries etc. and beverages (red wine) that contain high amounts of polyphenolic compounds with
antioxidant/anti-inflammatory properties are likely to promote healthy brain aging. In fact, recent evidence suggest that the polyphenolic compounds
such as resveratrol (one of several pterostilbenes) which are found in red wine, grapes and berries and other dietary antioxidants may be especially
important in this regard. In this symposium we will discuss the mechanisms involved in the beneficial effects of these polyphenols and show how they
may prevent or forestall age-related behavioral and neuronal deficits. The presentations in this symposium will revolve around 4 specific, interrelated
discussions: 1. Showing how fruit walnut polyphenols can prevent and reverse the deleterious effects of aging on motor and cognitive behavior and
describe the molecular mechanisms (e.g., antagonism of stress signalning)involved in these beneficial effects 2. Describing the role of some specific
polyphenols derived from fruits, vegetables, and beverages in providing neuroprotection during aging and in neruodegenerative diseases such as
Alzheimer’s disease. 3. Elaborating upon the synergistic effects among behavioral enrichment, exercise and an antioxidant diet in enhancing cognitive
behavior in an aged dog model and showing how the antioxidant diet may shift beta-amyloid precursor protein processing in favor of
nonamyloidogenic pathways leading to a redused amyloid beta accumulation of plaques. 4. Showing that although caloric restriction is “gold standard”
in extending longevity in many animal models, it may be difficult to implement in human populations. Therefore, it may be necessary to utilize and
develop caloric restriction mimetics such as reseveratrol to and prevent or reverse cognitive and neuronal deficits in aging. In summary the speakers in
this symposium will attempt to show that increasing the intake of dietary antioxidants, especially fruit- vegetable- or nut-derived polyphenols may have
a plethora of effects that could increase healthy brain aging by decreasing oxidative and inflammatory stressors, especially when incorporated into a
lifestyle which involves exercise and environmental cognitive enrichment.
QUENCHING THE "FIRES" OF BRAIN AGING VIA NUTRITIONAL SUPPLEMENTATION WITH FRUITS AND WALNUTS
BENEFICIAL EFFECTS OF POLYPHENOLS FROM FOODS DURING AGEING AND IN ALZHEIMER’S DISEASE.
THE ROLE OF ANTIOXIDANT DIETS IN COGNITION IN THE AGED BEAGLE
DIET RESTRICTION VS CALORIC RESTRICTION MIMETICS IN BRAIN AGING AND DISEASES ASSOCIATED WITH BRAIN AGING
Chair(s)
James Joseph USDA Human Nutrition Research Center on Aging at Tufts University [email protected] 617 556-3178
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ID: 298
WHY WE AGE: THE MODERN SYNTHESIS
Robin Holliday (The Australian Academy of Science, , Australia)
Robin Holliday, Australia (1) Jorge Barja, Spain (2) Bruce Carnes, United States of America (3) Jay Olshansky, United States of America (4)
(1) Australian Academy of Science (2) University of Madrid (3) University of Oklahoma (4) University of Illinois at Chicago
Ageing is seen in animals that live in protected environments, such as zoos or under domestication. In natural environments they rarely reach old age,
because there is high mortality from predators, disease, starvation and drought. It is therefore advantageous for an animal to develop to an adult,
reproduce, but not to invest resources into long term survival after reproduction. The resources saved can instead be channeled into reproduction. The
strategies for survival vary amongst mammalian species. Rapid development to adulthood and reproduction are associated with short lifespans,
whereas slow development and slow reproduction are associated with long lifespans. The adult body, or soma, depends on many repair and
maintenance mechanisms, and ageing is brought about by the eventual failure of these mechansims. Many comparative studies have now shown
that maintenance mechanisms are more efficient in long lived species, than in short lived ones.
Ageing can be regarded as a manifestation of the eventual loss of molecular fidelity, which has wide-ranging effects on cell, tissue and organ
functions. In mammals at least twelve maintenance mechanisms can be identified, the more important ones being DNA repair, protein turnover, the
immune system, the defence against free radical damage, the detoxification of toxic chemicals in food. The study of each of these - and several others
- comprises a scientific discipline in its own right. Taken together, this is a substantial proportion of all biological research. Therefore the study of
ageing should be of great interest and significance to a very wide spectrum of biologists.
Also, maintenance mechanisms depend on the activities of many different genes. With the sequencing of the human genome, more and more genes
will be identified that have relevance to the study and understanding of human ageing. That is not to say that individual genes will be discovered that
determine longevity. Instead, the study of the many genes that influence aging in one way or another is of particular importance, because there are
many human age-associated diseases which are the subject of intense ongoing biomedical research. These include cardiovascular disease,
dementias, late onset diabetes, kidney failure, osteoporosis and osteoarthritis, and many cancers. By comparison the resources invested in
fundamental research on ageing are miniscule by comparison. Although the biological reasons for ageing are now well understood, much more
information is needed to reveal the underlying causes of age-associated disease.
(Olshansky) Why we age: a biodemographic perspective
(Carnes) Ageing: why, how and when
(Barja) Ageing and the rate of production of free radicals
Chair(s)
Robin Holliday The Australian Academy of Science. Canberra, Australia [email protected] 61 2 9873 3476
Hayflick Leonard University of California, San Francisco [email protected] 7077853181
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ID: 615
ROLE OF CELLULAR SENESCENCE AND OXIDATIVE STRESS IN TISSUE AGEING. A LINK-AGE SPONSORED SYMPOSIUM
Olivier Toussaint (University of Namur, URBC, Belgium)
Florence Debacq-Chainiaux, Belgium (1) Alain Meybeck, France (2) Tilman Grune, Germany (3) Bertrand Friguet, France (4)
(1) University of Namur (2) AM Phytoconseil (3) University of Hohenheim (4) University of Paris VI
The aim of this session would be to present the latest work on the role of cellular senescence in tissue ageing, considering the interplay with oxidative
stress. It is now recognized that premature senescence takes place after exposure of replicative cells to sublethal oxidative stresses. As example Dr
Debacq-Chainiaux will present her elegant work on UVB-induced premature senscence, with new data strengthenin her seminal 1995 paper in J. Cell
Sci. Exposure to oxidative stress not only damages DNA, leading to senescence, but also proteins. As for DNA damage, it is acknowledged since a
little number of years, that proteins can be repaired namely through the MSR (methione sulfoxide reductase) system, as shown by Dr. Bertrand
Friguet. Proteasome also intervenes as well as other proteins for the degradation of oxidized proteins, as will be shown by Dr. Tilman Grune. In
addition to oxidative stress alone, cross-talks with other processes can also achieve fine tuning of the response to oxidative stress, as shown by Dr.
Alain Meybeck, for vitaminD pathway and Dr. Debacq-Chainiaux as for Insulin-like Growth Factor Binding Proteins.
All together these different talks will illustrate the role of oxidative damage to DNA and proteins in cellular senescence.
All proposed speakers have already been invited to many scientific congress, from broad meetings (ex IUBMB) to specialized congresses such as this
one. Their recognition in the field suffers no doubt as these are well established scientists with an excellent publication record.
ROLE OF THE PROTEASOME IN PROTEOLYSIS OF OXIDATED PROTEINS IN AGEING
ROLE OF THE METHIONINE SULFOXIDE REDUCTASE SYSTEM IN PROTEIN REPAIR DURING AGEING
ROLE OF INSULIN-LIKE GROWTH FACTOR BINDING PROTEINS AND DNA DAMAGE IN UVB-INDUCED PREMATURE SENESCENCE
ROLE OF VITAMIN D-DEPENDENT PATHWAYS AND P53 IN CELLULAR SENESCENCE
Chair(s)
Florence Debacq-Chainiaux Univ of Namur, rue de Bruxelles, 61 B-5000 Namur Belgium [email protected] +3281724132
____________________________________________________________________________________________________________
ID: 356
THE GENETIC COMPONENT OF AGING AND LONGEVITY: A REAPPRAISAL.
Giuseppe Passarino (University of Calabria, Department of Cell Biology, Italy)
Gerald E. McClearn, United States of America (1) Caleb E. Finch, United States of America (2) Valter D. Longo, United States of America (3)
(1) Department of Biobehavioral Health The Pennsylvania State University (2) Andrus Gerontology Center and Department of Biological Sciences, University of
Southern California (3) Andrus Gerontology Center and Department of Biological Sciences, University of Southern California
For many years the existence of a genetic control on aging and longevity has been neglected. This was mainly due to the idea that there is no
opportunity, or need, for natural selection to act on a phenotype that is expressed during this late period of life. This view is largely changed after the
discovery (from 1980ties onward) of different genes that may significantly elongate life span in model organism. In addition, many studies on human
populations have indicated that the interindividual variability in lifespan is partly due to a genetic component. Many estimates have shown that
heritability of life span is about 25%, but new estimates suggest that genetic influence on lifespan further increases at advanced ages. In addition, it
has recently emerged that also the quality of aging can be due to a genetic component. In fact, children of centenarians show better performances with
respesct to the general population for many physical tests. Finally, the advancement of high throughput technology is allowing to accumulate a great
amount of data on the variability of many human genes. This has led to identify many loci which are involved in determining the individual proneness to
longevity and to healthy aging.
However, as in many fields of the molecular research, the huge advancement of the knowledge and of the interest on the genetic factors of aging and
longevity, is not always paralleled by a thoughtful consideration of the basic principles of population and evolutionary genetics.
For these reasons we think it is useful to organize a symposium in the frame of IAGG for reviewing the advancement of the genetic research on aging
and longevity but also to point out the importance of a deep knowledge of population and evolutionary genetics for coping with the study of complex
traits such as the quality of aging and longevity.
CAUSAL COMPLEXITY IN AGING:GENES AND THE COMPANY THEY KEEP
EVOLUTION OF THE HUMAN LIFESPAN
CONSERVED MOLECULAR STRATEGIES TO REGULATE LONGEVITY: FROM BACTERIA TO HUMANS?
Chair(s)
Giovanna De Benedictis Ponte Pietro Bucci, Department of Cell Biology, University of Calabria, 87036 Rende-Italy [email protected]
+390984492932
Passarino Giuseppe Ponte Pietro Bucci, Department of Cell Biology, University of Calabria, 87036 Rende-Italy [email protected]
+390984492930
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ID: 369
IMPLICATION OF BUTYRYLCHOLINESTERASE IN DEMENTIA: PRECLINICAL AND CLINICAL EVIDENCES
THIERRY DANTOINE (Hospital University of Limoges, DEPARTMENT OF GERONTOLOGY, France)
NIGEL GREIG, United States of America (1) ROGER BULLOCK, United Kingdom (2) GUSTAVO ARBO, Paraguay (3) THIERRY DANTOINE, France (4)
(1) National Institute on Aging (2) Department of Old Age and Kingshill Research Centre PsychiatryVictoria Hospital, (3) Exploracion funcional de la memori (4) University
Hospital CHU
•Background: Butyrylcholinesterase (BuChe) is known to be the second brain anticholinergic enzyme and has recently been implicated in Alzheimer’s
disease (AD) and other related diseases such as Body Lewy Disease (BLD) or Parkinson’s Disease (PD) Cognitive impairment. BuChE inhibition is
highly suspected to be a second potential key treatment of cognitive decline in these diseases. Evidence is now growing about BuChE participation in
subcortical and psychotic symptoms and studies of the relationship between Genetic polymorphism of BuChe and cognitive decline in AD are so far
contradictory.
•Purpose: The aim of the symposium is to expose the physiopathological basis of BuChE implication in dementias, the preclinical and pharmacological
knowledges on BuChE action and conclusions of the latest studies of serum BuChe activity and / or genetic polymorphism in dementias and specially
studies of its relationship with the rate of cognitive decline in mild to moderate AD. Identifying prognosis factors of AD such as suspected BuChe could
modify follow-up, treatment and may improve functional decline of patients suffering from AD. All of this aspects will be discussed in this symposium
•Expertise of different specialists who are working on BuChE and / or dementia will feed high quality discussion and debate:
-Pr Greig is recognised as a great American research PhD in the field of pharmacological and enzymological knowledge of BuChE. He will present his
works in pharmacology and preclinical studies results updates.
-Pr Bullock is worldwide known for his works in Alzheimer’s diseases as a psychiatrist and conducted recent very interesting international studies
about cognitive decline where implication of BuChE gene appeared to be a potential marker of rapid cognitive decline. He will develop clinical studies
results on that point
-Dr Arbo is a Paraguayan geriatrician and psychogeriatrician who worked in France for his post-doctoral studies. He will review the relationship
between BuChE inhibition and behavorial / subcortical extrapyramidal symptoms in AD, BLD and PD.
-Pr Dantoine is a geriatrician MD/PhD who is working on BuChE activity. He created in 2006 the first Rapid Cognitive Decline Observatory, a French
regional longitudinal study on factors and BuChE markers of the cognitive impairment in dementias. He will present results of this 3-years follow-up.
UPDATE ON BUTYRYLCHOLINESTERASE ENZYMOLOGICAL PROPERTIES AND ON REVERSIBLE SELECTIVE BUTYRYLCHOLINESTERASE
INHIBITORS IN PRECLINICAL STUDIES(PR GREIG)
LAST DATAS FROM CLINICAL STUDIES OF BUTYRYLCHOLINESTERASE IMPLICATION IN ALZHEIMER’S DISEASE AND COGNITIVE
DECLINE (PR BULLOCK)
BUTYRYLCHOLINESTERASE IN PARKINSON’S AND LEWY BODY DISEASES AND IN SUBCORTICAL SYMPTOMS OF DEMENTIAS (DR ARBO)
RAPID COGNITIVE DECLINE OBSERVATORY OF LIMOUSIN: UPDATE ON BUTYRYLCHOLINESTERASE AS A RISK MARKER
Chair(s)
Thierry Dantoine CHU Limoges, 2 avenue ML King 87042 Limoges Cedex 42 France [email protected] +33555058626
Bullock Roger Kingshill Research Centre, Victoria Hospital Okus Road Swindon SN4 9PU United Kingdom [email protected] +44
1793 437501
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ID: 470
COPING WITH ELASTIC TISSUES AGEING
Pascal Sommer (CNRS, IBCP, France)
Marie-paule Jacob, France (1) Julia Bujan, Spain (2) Ulrich Stock, Germany (3) Daniela Quaglino, Italy (4)
(1) INSERM (2) University Madrid (3) University Tubingen (4) University Modena
One of the most remarkable manifestations of ageing is the evolution of the “body frame”, with the loss of tissue elasticity together with a decrease on
skeleton and muscle mass density and an increase of osteoporosis fractures. The prevention of this frailty and loss of body elasticity is a major
challenge for the aged persons. Interestingly, the elastic tissues are mainly made during development and early adult growth, with a low replacement
rate during adulthood.
Ageing is accompanied by several "age-associated' diseases, most of them involving a tissue disorganization associated with manifestation of hard
and soft connective tissue ageing.
The degeneracy of elastic tissues, which are built during development and, has consequences for breathing, regulation of pulse pressure (and,
consequently, cardiac function), atherosclerosis, aneurysms, hypertension, emphysema, skin wrinkles, degeneration of inter-vertebral ligaments, and
the degeneration of the Bruch's macula membrane. Dysfunctions of elastic tissue are due to the lack of elastic fibre components (more than 30
proteins are involved in functional elastogenesis) and/or to modifications of elastic fibres (calcification, lipidation, oxidation or glycation). Degradation of
elastic fibers is considered, as a whole, as a factor amplifying the inflammation process and the degradation-dependent ageing processes. It is notable
that normal ageing and ageing of elastic tissues display common features among the major parameters affecting the maximal lifespan potential (such
as the beneficial influence of dietary restriction or the post-translational modification). Therefore, elastic tissues can be considered as relevant
biomarkers of ageing.
The main challenges are to protect, repair or reinduce those soft elastic tissues, which requires the collaborative efforts of different domains of
research: development of relevant animal models for long standing ageing studies, role of stress (neurological, mechanical, chemical, hormonal,
psychological) and survey mechanisms (immuno-senescence, inflammation), comparison between development and ageing, development of
dedicated tissue engineering (including stem cell research), importance of nutrition and behaviour (stretching, exercising).
REMODELLING OF ARTERIAL AND VENOUS ELASTIC TISSUES WITH AGEING: THE ANEURISMS RISK MARIE PAULE JACOB (FRANCE) AND
TAMAS FULOP (HUNGARY)
STRESS OXIDANT, HYPOXIA AND ACCELERATED ELASTIC TISSUE AGEING: FROM VARICOSIS VEINS TO BEDSORE. DANIELA
QUAGLINO(ITALY)AND JULIA BUJAN (MADRID)
HOW TO REPAIR OR REPLACE THE VALVES OR VASCULAR ELASTIC FUNCTION IN ELDERLY: ULRICH STOCK (GERMANY)
AGED AND GENETICALLY RELATED AGEING: PASCAL SOMMER (FRANCE)
Chair(s)
marie-paule Jacob INSERM U460 IFR Medecine Bichat 46 rue Henri Huchard 75877 Paris cedex 18 [email protected] (01) 40 25 86 17
Sommer Pascal IBCP CNRS Université Lyon 1, 7 passage du vercors, 69367 Lyon cedex 07 [email protected] 0472722666
____________________________________________________________________________________________________________
ID: 497
GH/IGF-1 AND INSULIN SIGNALING IN MAMMALS AND ITS RELEVANCE TO HUMAN LONGEVITY
Pierrette Gaudreau (University of Montreal, Medicine, Canada)
Nir Barzilai , United States of America (1) Laurent Kappeler, France (2) Jacques Epelbaum, France (3) Pierrette Gaudreau, Canada (4) , (3)
(1) Department of Medicine, Albert Einstein College of Medicine (2) UMR 893 INSERM, Hôpital Saint-Antoine (3) UMR 894 INSERM, Faculté de Médecine, Université Paris
Descartes (4) Department of Medicine, University of Montreal
Lower species have been the source for most of our current knowledge on the role of the insulin/IGF-1 signaling in modulating lifespan. These
hormonal systems are likely to have originated from a common ancestor and are involved in metabolism, growth, and fertility in animal models such as
flies, nematodes and rodents. Disruption of the insulin/IGF-1 receptor in nematodes, flies and mice increases lifespan significantly. Abnormalities in the
insulin signaling pathway generate age-related diseases and increased mortality, whereas the GH/IGF-1 axis could potentially modulate longevity in
many species. The aim of this symposium is to describe the regulatory role of the GH/IGF-1 and insulin signaling on lifespan in rodent models and
compare it with the human species.
FUNCTIONAL GENOTYPES IN THE GH/IGF-1 IN HUMANS WITH EXCEPTIONAL LONGEVITY
BRAIN IGF-1 RECEPTOR PROGRAMS MAMMALIAN LIFESPAN
THE HYPOTHALAMIC COMPONENT OF THE SOMATOPAUSE
THE PITUITARY GROWTH HORMONE-RELEASING HORMONE RECEPTOR CONTRIBUTION TO HEALTHY AGING
Chair(s)
Pierrette
Gaudreau Centre de psychiatrie et Neuroscience, Faculté de Médecine, Université Paris Descartes, Paris, France
[email protected] (514) 890-8000 ext. 23613
Epelbaum Jacques Laboratory of Neuroendocrinology of aging, Centre Hospitalier de l'U niversité de Montréal Research Center, Faculty of Medicine,
University of Montreal, Montreal Canada [email protected] 331 4078 9282
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ID: 580
PLEIOTROPIC ANTAGONISM: AGE-DEPENDENT DISEASES AS THE PRICE FOR THE VIGOUR OF YOUTH
Georg Wick (Innsbruck Medical University , Division of Experimental Pathology and Immunology, Laboratory of Autoimmunity, Austria)
S. Jay Olshansky, United States of America (0) Georg Wick, Austria (0) Beatrix Grubeck-Loebenstein, Austria (0) Gillian Butler-Browne, France (0)
(1) School of Public Health (2) Div. of Experimental Pathology and Immunology, Laboratory of Autoimmunity (3) Institut für Biomedizinische Alternsforschung (4) Faculte de
Medicine Pitie-Salpetriere
An attractive concept to explain the development of age-related diseases is that of Pleiotropic Antagonism. In principle, this theory states that genes
the effect of which is beneficial in youth, i.e. before cessation of reproduction, may have deleterious (antagonistic) effects in older age when they
become active at other areas (pleiotropic) of the body than their original site of expression. In other words, according to this concept age-related
diseases may be “the price we pay for the vigour of youth”.
In this symposium S. Jay Olshansky will introduce the concept of Pleiotropic Antagnosm in general and with respect to its potential role for the
emergence of age-dependent diseases in particular. Georg Wick will introduce arteriosclerosis as an example of an important age-related disease. In
the earlier stages of arteriosclerosis preexisting protective immunity against microbial heat shock protein 60 (HSP60) leads to cross reactivity with
autologous HSP60 expressed by arterial endothelial cells when they are stressed by classical arteriosclerosis risk factors such as high blood pressure,
smoking, etc. Beatrix Grubeck-Loebenstein will address the age-related decline of adaptive immunity versus the increase of innate immunity resulting
in a general pro-inflammatory state (“Inflammage”) in the elderly. This proinflammatory state is insufficient to protect from infections and necessitates
the development of new strategies for vaccinations of the elderly. It also has deleterious side effects, e.g. the stimulation of the production of â-amyloid
in neuronal cells promoting the development of Alzheimer’s disease. Gillian Butler –Browne will exemplify the concept of Pleiotropic Antagonism by the
altered regulation of the expression of muscular genes entailing age-dependent sarcopenia.
Finally, the importance of this concept for the discovery of new biomarkers for an earlier diagnosis of age-dependent diseases and potential new
therapeutic approaches will be discussed. An example for the latter are the endeavors to develop a HSP60 based vaccine against arteriosclerosis.
S. JAY OLSHANSKY, CHICAGO, ILL, USA
THE CONCEPT OF PLEIOTROPIC ANTAGONISM
GEORG WICK, INNSBRUCK, AUSTRIA
ATHEROSCLEROSIS - AN AGE ASSOCIATED AUTOIMMUNE DISEASE
BEATRIX GRUBECK-LOEBENSTEIN, INNSBRUCK, AUSTRIA
AGING OF INNATE AND ADAPTIVE IMMUNITY
GILLIAN BUTLER-BROWNE, PARIS, FRANCE
MOLECULAR BASIS OF SARCOPENIA IN THE ELDERLY
Chair(s)
Georg Wick Division for Experimental Pathology and Immunology Laboratory of Autoimmunity Biocenter Innsbruck Medical University
Peter-Mayr-Straße 4a 6020 Innsbruck [email protected] 0043(0)512900370960
Butler-Browne Gillian CNRS UMR 7000 Faculte de Medicine Pitie-Salpetriere 105 boulevard de l'Hopital F-75634 Paris cedex 13
[email protected] 0033/140/77 9636
____________________________________________________________________________________________________________
ID: 593
VASCULAR AGING, CAUSES AND CONSEQUENCES
Francesco Mattace-Raso (Erasmus university medical center, Geriatric medicine, The Netherlands)
Francesco Mattace-Raso, The Netherlands (1) Stephane Laurent, France (2) Charalambos Vlachopoulos, Greece (3)
(1) Department of geriatric medicine (2) Department of Pharmacology and INSERM U652 (3) Athens Medical School, Athens
Increased arterial stiffness is a hallmark of the aging process and a predictor of cardiovascular events. After age also hypertension and diabetes
mellitus are important determinants of arterial stiffness, causing structural changes and impairment of the vascular elastic properties.
The predictive value of conventional cardiovascular risk factors decreases with age because of selective survival and the influence of comorbidities on
risk factor levels. In contrast, vascular stiffness increases steadily with age and can be considered a cumulative measure of previous exposures.
Arterial stiffness can be measured directly by noninvasive assessment of the velocity of the arterial wave propagation between 2 arterial points or by
assessment of the vascular distensibility at a given site of the arterial tree. The study of the functional properties of the arterial wall may offer new
insights in understanding the process of ageing and give new information in the pathogenesis of disease in the elderly.
MATTACE-RASO: VASCULAR STIFFNESS AND BLOOD PRESSURE CHANGES WITH AGEING.
LAURENT: STRUCTURAL AND GENETIC BASES OF ARTERIAL STIFFNESS
VLACHOPOULOS: INFLAMMATION AND VASCULAR PROPERTIES
Chair(s)
franceso mattace raso 'sgavendijkswal [email protected] 0031107035979
____________________________________________________________________________________________________________
ID: 16
Theme: Health Sciences / Geriatric Medecine
MULTI-SYSTEM GERIATRIC TRAUMA: AN INTERNATIONAL PERSPECTIVE
WM. CAMERON CHUMLEA (Lifespan health research center, , United States)
Larry LAWHORNE, United States of America (1) Dror SOFFER, Israel (2) Paul GERDHEM, Sweden (3) Therese RICHMOND, United States of America (4)
(1) Boonshoft School of Medicine (2) Tel - Aviv Sourasky Medical Center (3) Karolinska University Hospital, Karolinska Institute (4) University of Pennsylvania
This symposium will address the prevalence and characteristics of non-hip fracture multi-system trauma in the elderly emphasizing risk factors for
injury occurrence and predictors of functional outcomes, morbidity and mortality. A better understanding of the determinants of geriatric trauma and its
outcomes is needed to guide future efforts in prevention and acute and long-term care.
THE GLOBAL PERSPECTIVE ON GERIATRIC TRAUMA AND ITS PREVALENCE
NON-HIP FRACTURE ASSOCIATED TRAUMA IN THE ELDERLY
PHYSICAL FUNCTION AND TRAUMA
POPULATION-BASED APPROACHES IN THE STUDY OF GERIATRIC TRAUMA
Chair(s)
Larry Lawhorne One Elizabeth Place Dayton OH 45408 [email protected] 937.331.9167
Chumlea William 3171 Research Blvd, Kettering OH 45420 [email protected] 937.775.1428
____________________________________________________________________________________________________________
ID: 28
TECHNOLOGY, ETHICS AND DEMENTIA CARE: FROM TRUE NEEDS TO THOROUGHLY ASSESSED RESPONSES
Vincent Rialle ( University Joseph Fourier & University Hospital of Grenoble, Laboratoire TIMC-IMAG UMR UJF/CNRS 5525, France)
Van Berlo Ad, The Netherlands (1) Gowans Gary M., United Kingdom (2) Rialle Vincent, France (3)
(1) Smart Homes Association (2) University of Dundee (3) University Hospital of Grenoble
Alzheimer’s disease (AD) and other dementias demand considerable care efforts for patients and frequently lead to severe physical and psychological
exhaustion on the part of family caregivers. On the other hand numerous innovative technologies are more and more available for the patient’s safety,
healthcare and lifestyle improvement, and a longer stay at home. Furthermore, the technologies that are making the concept of ‘aging in place’
possible, both medically and socially, have arrived at a time when there are more and more elderly people all over the world, when health expenditure
is a growing concern in every country, and when there is an increasing scarcity of caregivers and healthcare professionals. Given this worrying
situation there is a risk to develop a technological society governed only by time saving and profitability, and consequently a demotion of humaneness
owed to people with loss of autonomy, and especially demented patients. Now, despite markedly available useful products and services, distribution
and up taking of these tools is so poorly developed that personalized care plans and coping aids often do not even mention them. For instance, family
caregivers of demented patient (more than 60% of whom live at home) remain physically and psychologically overstrained by the heavy care burden,
whilst several international R&D projects have designed and assessed useful technologies for them for at least fifteen years. Such a matter of fact
clearly pinpoints our society’s difficulty of to achieve a convergence of technological innovation, cutting-edge research, and human compassion.
Besides, the rapid evolution of innovative technologies and services by far outpaces the necessary public debate that must accompany their use with
regard to both their positive action regarding handicap and isolation, and their potential threats regarding privacy disruption, intrusiveness, control or
solvability based discrimination. As a consequence, the legal and ethical issues they raise have to be carefully studied and solved in order to help
assigning them their right place in medicine and society. The symposium will provide a panel of visionary research and developments focused on true
needs to thoroughly assessed responses to dementia care needs and ethics.
ETHICAL AND PRIVACY ISSUES IN AMBIENT ASSISTED LIVING
SERIOUS GAMES: A ROLE FOR COMPUTER-BASED INTERVENTION IN DEMENTIA CARE AND A SUPPORT TO ETHICS OF THE CARE
TOWARDS AN ETHICAL AIM OF TECHNOLOGICAL PROGRESS IN DEMENTIA CARE: A CONTRIBUTION TO THE FRENCH THIRD
ALZHEIMER’S PLAN
Chair(s)
Vincent RIALLE Laboratoire TIMC-IMAG, Faculté de Médecine de Grenoble, 38700 La Tronche, FRANCE [email protected] +33 6 73 68 76 19
RIGAUD Anne-Sophie Hôpital Broca, 54-56 rue Pascal, 75013 Paris, FRANCE [email protected] +33 1 44 08 30 00
____________________________________________________________________________________________________________
ID: 32
MILD COGNITIVE IMPAIRMENT - DISCUSSED AND LESS DISCUSSED ISSUES
Perla Werner (University of Haifa, Gerontology, Israel)
Karen Ritchie, France (1) Amos Korczyn, Israel (2) Perla Werner, Israel (3) Serge Gauthier, Canada (4)
(1) French National Institute of Medical Research (2) Tel Aviv University (3) University of Haifa (4) McGuill University
Mild cognitive impairment (MCI) is defined as a condition characterized by newly acquired cognitive decline to an extent that is beyond that expected
for age or educational background, yet not causing significant functional impairment.
MCI has received considerable attention in the literature over the past few years, but many aspects are still controversial.
The present symposium will synthesize the implications of the current status of research in this area on conceptual, methodological, and particularly on
assessment and ethical aspects of MCI which attracted less attention.
The presenters in the symposium are nationally and internationally recognized experts in the area of MCI. The areas to be presented include:
The epidemiology of MCI
Is MCI really a single nosological entity? - Difficulties with the definition
Novel computerized methods to diagnose MCI
Ethical considerations
THE EPIDEMIOLOGY OF MCI
IS MCI REALLY A SINGLE NOSOLOGICAL ENTITY? - DIFFICULTIES WITH THE DEFINITION
NOVEL COMPUTERIZED METHODS TO DIAGNOSE MCI - questions and dilemmas
ETHICAL CONSIDERATIONS
Chair(s)
Perla Werner University of Haifa, Israel [email protected] 972-4-8249950
Korczyn Amos University of Tel Aviv, Israel [email protected]
____________________________________________________________________________________________________________
ID: 58
REDUCED FUNCTIONAL STATUS IN ELDERLY PEOPLE: CONSEQUENCES AND PHYSIOLOGICAL DETERMINANTS
William Evans (University of Arkansas for Medical Sciences, Geriatrics, United States)
William Evans, United States of America (1) Jack Guralnik, United States of America (2) Luigi Ferrucci, United States of America (3) Bret Goodpaster, United States of
America (4)
(1) University of Arkansas for Medical Sciences (2) National Institute on Aging (3) Baltimore Longitudinal Study on Aging, NIA (4) University of Pittsburgh Medical Center
Although poor functional capacity in elderly people is associated with increased morbidity and mortality, the potential causes are not well understood.
Slow walking speed, for example, is highly predictive of poor outcomes, but the reason why elderly people slow their walking speed is not clear. This
symposium will discuss a number of factors that are associated with poor functional status. Dr. Guralnik will present information on how functional
capacity and changes in function influence outcomes such as mortality, risk of dementia, nursing home admissions and hip fracture will be presented.
Dr. Ferrucci will present data from the Baltimore Longitudinal Study on Aging and the IN CHIANTI study to discuss the influence of factors such as
inflammation, reduced muscle mass and physical activity on frailty and poor function will. Dr. Evans will discuss the influence of increased physical
activity as well as the effects of reduced activity and bed rest on muscle metabolism, mass ,and function in the elderly will be discussed. New data
show that elderly people adapt to reduced activity with an accelerated loss of muscle and strength. Dr. Goodpaster will present information from the
Health and Body Composition Study on the effects of body fat and skeletal muscle lipid content on muscle function and metabolism.
presentations will provide new and important information on the etiology and consequences of poor functional capacity in elderly people.
GURALNIK: FUNCTIONAL STATUS: PREDICTOR OF OUTCOMES
FERRUCCI: PHYSIOLOGICAL AND METABOLIC DETERMINANT OF FRAILTY
EVANS: BED REST AS A CAUSE OF REDUCED FUNCTIONAL STATUS: LOSS OF MUSCLE AND FUNCTION
GOODPASTER: FAT AND MUSCLE: WHICH HAS THE MORE POWERFUL EFFECT ON FUNCTION?
Chair(s)
William Evans UAMS, 46301 W. Markham #806, Little Rock, AR, 72205 USA [email protected] 501 526-5701
____________________________________________________________________________________________________________
These
ID: 66
CANADIAN GERIATRICS SOCIETY SYMPOSIUM: DEVELOPING AND ASSESSING GERIATRICS CURRICULUM – TRAINING TO MEET THE
NEEDS OF AN AGING SOCIETY
Christopher Frank (Canadian Geriatrics Society, Family Medicine, Queen’s University , Canada)
Janet Gordon, Canada (1) Christopher Frank, Canada (2) John Kirk, Canada (3) Janet Kushner Kow, Canada (4)
(1) Dalhousie University (2) Queen's University (3) McGill University (4) University of British Columbia
Objectives
To review the geriatrics content of Canadian undergraduate curricula.
To discuss the features of integrated curricula for postgraduate geriatric medicine and family medicine care of the elderly trainees.
To describe web based instruments for evaluation of geriatrics curricula.
To describe the rationale and development of Standardized Assessments of Clinical Evaluation Report (STACERs) in postgraduate geriatric medicine
certification.
Selection of participants
Dr. Janet Gordon is the past Chair of the Education Committee of the Canadian Geriatrics Society (CGS) and is actively involved in undergraduate
geriatrics education. She has extensive experience in the development of core competencies in geriatrics for medical students.
Dr. Christopher Frank is the President of the CGS and Program Director of the care of the elderly residency program at Queen’s University. He is
actively involved in postgraduate geriatrics education.
Dr. John Kirk is the Program Director of the Care of the Elderly fellowship program at McGill University. He has been responsible for curriculum
development for both undergraduate and postgraduate geriatrics education.
Dr. Janet Kushner Kow is the Chair of the Continuing Professional Development Committee of the CGS and Program Director of the geriatric medicine
residency program at the University of British Columbia. She is also the Vice Chair of the Royal College of Physicians and Surgeons of Canada
geriatric medicine examination board. She has experience in the development of standardized assessment tools in geriatrics.
Novelty and scientific interest
Although many geriatrics curricula exist for undergraduate and postgraduate medical trainees, uptake has been suboptimal in many educational
institutions. This is further compounded by a paucity of specific assessment instruments for geriatrics teaching. In this symposium, we will talk about
the current state of geriatrics education and the innovations involved, including development of integrated and collaborative curricula across
specialties. We will also discuss web based assessments as they apply to geriatrics education, and a novel use of real-life standardized clinical
evaluation as part of the summative evaluation process for specialty certification.
HOW MUCH GERIATRICS ARE CANADIAN MEDICAL TRAINEES TAUGHT? (DR. JANET GORDON)
FAMILY MEDICINE CARE OF THE ELDERLY TRAINING: DEVELOPING CURRICULA FOR A VARIETY OF ROLES. (DR. CHRIS FRANK)
WEB BASED INSTRUMENTS FOR EVALUATION OF GERIATRICS CURRICULA. (DR. JOHN KIRK)
STANDARDIZED ASSESSMENTS OF CLINICAL EVALUATION REPORT (STACERS) FOR SUMMATIVE EVALUATION IN GERIATRIC MEDICINE
FELLOWSHIP. (DR. JANET KUSHNER KOW)
Chair(s)
Chris Frank 101 Lower Union St., KIngston, Ontario, Canada K7L 2N3 [email protected] 613 548 7222 (2208)
____________________________________________________________________________________________________________
ID: 69
APPROACHES TO FRAILTY IN THE AMERICAS
Rafael Samper-Ternent (University of Texas Medical Branch, Sealy Center on Aging, United States)
Kenneth Ottenbacher, United States of America (1) Howard Bergman, Canada (2) Luis Miguel Gutierrez, Mexico (3) Carlos Cano, Colombia (4)
(1) University of Texas Medical Branch (2) McGill University (3) Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (4) Fundación Santa Fe De Bogotá
Frailty is a fairly new concept that has tried to define a condition that has been observed by clinicians for several decades. In the last years several
different models, constructs and tools have been published that attempt to make the concept more comprehensive and applicable to a variety of
patients. Despite the conceptual difficulties that these publications have brought to the attention of health care professionals, Frailty has highlighted the
importance of early detection and intervention of some conditions that affect older adults and that increase their risk of mortality and the likelihood of
adverse outcomes. In the Americas, several groups are currently conducting research related to Frailty. Groups in different countries are trying to
apply the available knowledge to help with local needs. Each group has a different approach and uses different criteria to both define and use the
concept. We have organized an International symposium that includes 4 speakers that have studied the condition thoroughly and that through their
work have increased awareness of the importance of Frailty as a tool to identify possible interventions that can improve the quality of life of frail older
adults and reduce the risk of adverse outcomes. The idea of making the symposium International is to explore how different groups, in different
countries, with varying needs, are looking at Frailty and identify useful ideas that other groups might use to improve our understanding on the subject.
The symposium will first go over the various definitions, constructs and models that have been proposed in an attempt to clarify the concept of Frailty
and set a scientific base to support the need of continuing research in the subject. We will then cover how ethnicity affects Frailty and what
interventions have shown promising results. Then a review of biomarkers that have been shown to be related to Frailty and how an interdisciplinary
approach can further benefit the Frailty concept will be presented. We will finally review the existing discussion on the relationship between cognitive
problems and Frailty and what interventions and theories might help clarify concepts and benefit older adults. This comprehensive symposium will
cover Frailty from 4 complementary perspectives that illustrate how Frailty research is showing promising results in Canada, the United States, Mexico
and Colombia.
FRAILTY INTERVENTIONS AND ETHNIC DIFFERENCES
THE CONCEPT OF FRAILTY: IMPORTANCE, RELEVANCE AND USEFULNESS
FRAILTY, BIOMARKERS AND INTERDISCIPLINARY IMPLICATIONS
COGNITIVE FRAILTY: TRANSLATING MEMORY PROBLEMS TO USEFUL INTERVENTIONS
Chair(s)
Kenneth Ottenbacher 301 University Blvd. Galveston, TX, 77555-0460 [email protected] 409 772 0008
____________________________________________________________________________________________________________
ID: 78
THE PREVENTION OF IATROGENIC DISEASE WHEN PRESCRIBING DRUGS AND PROCEDURES
Knight Steel (Hackensack University Medical Center, Geriatric Medicine, United States)
Nigel Millar, New Zealand (1) Daniela Fialová, Czech Republic (2) Vince Mor, United States of America (3) Giovanni Gambassi, Italy (4)
(1) Canterbury District Health Board (2) Charles University (3) Brown University School of Medicine (4) Università Cattolica del Sacro Cuore
Background: The changes in medical care over the past fifty years are merely prologue to the changes to be witnessed in the twenty-first century. New
drugs as well as novel surgical and non-interventional procedures are defining the practice of medicine in ways unimagined even a decade ago. The
population to be served is changing as well, as the elderly account for an ever larger percentage of heath care services and costs and chronic disease
replaces acute disease as the focus of care. The benefits and risks of both medications and procedures must be viewed in light of the population they
would be prescribed for. Only then can iatrogenic disease be minimized and the benefits of a medical intervention of any kind maximized.
A decision to use any pharmaceutical agent must be made with an appreciation of the pharmacokinetics of the drug as well its pharmacodynamic
properties. This is especially important when prescribing for an elder who likely is taking multiple medications, both prescribed and "over the counter".
In addition the use of any drug for a particular condition might well produce undesirable side effects because of the presence of one or more other
diseases. So too an intervention of any kind, including many diagnostic studies, must be carried out with a vision of the whole person.
Using data from interRAI, an international research corporation, and other sources we will provide an overview of the use of medications in elders. A
discussion of the inappropriate use of drugs in the older age group will highlight not only the direct undesirable side effects of a particular drug but the
negative indirect consequences as well. For example, the use of sleeping medications in the hospital setting, especially when prescribed with other
psychoactive drugs, may well contribute to the risk of falling.
As cure is less frequent in this population, maximizing function and quality of life for the longest period of time become the objectives of medical care.
Procedures, such as PEG tubes used for feeding, must be viewed as having negative consequences. Even diagnostic studies that are unlikely to
promote the two objectives named above carry a risk, not only directly but indirectly, as further tests and procedures which may have serious
consequences may follow from an abnormal finding.
THE PHARMACOEPIDEMIOLOGY OF DRUG USE IN THE ELDERLY
PRESENTER: DANIELA FIALOVA,PHD. CZECH REPUBLIC
THE USE OF PROCEDURES AND DRUGS IN LONG TERM CARE SETTINGS
PRESENTER: VINCE MOR,PH.D USA
THE VALUE OF INTERRAI-BASED RESEARCH ON DRUG USE AND POLICY
PRESENTER: GIOVANNI GAMBASSI, M.D. ITALY
IDEAS TO MINIMIZE IATROGENIC ILLNESS IN ELDERS
PRESENTER: NIGEL MILLAR, M.B. B.S.FRACP NEW ZEALAND
Chair(s)
Knight Steel, MD Hackensack Universtiy Medical Center, Division of Geriatrics 30 Prospect Avenue, Hackensack, NJ 07601 [email protected]
201-996-2503
____________________________________________________________________________________________________________
ID: 80
PAQUID : ALREADY TWENTY YEARS !
Jean François Dartigues (INSERM U 897, Epidemiology and Biostatistics, France)
Jean François Dartigues, France (1) Catherine Helmer, (1) Hélène Amieva, (1) Karine Péres, (1)
(1) INSERM U 897
We will propose in this symposium an overview and three communications on the PAQUID cohort study. The Paquid cohort is an ongoing study
conducted in the South West of France, around Bordeaux. This population-based cohort was designed to study brain aging, cognition, dementia,
depression and disabilities in elderly people. This cohort aws constituted in 1988-1989 and was followed-up every two years to three years for 20
years. We will present recent results on epidemiology of dementia, cognitive decline before dementia, and relationships between dementia, depression
and disabilities.
OVERVIEW OF THE PAQUID COHORT STUDY
EPIDEMIOLOGY OF DEMENTIA : THE PAQUID EXPERIENCE
COGNITION, AGING OF THE BRAIN AND DEMENTIA : AN EPIDEMIOLOGICAL PERSPECTIVE
DISABILITIES, DEMENTIA AND DEPRESSION : THE PAQUID CONNECTIONS
Chair(s)
Barberger-Gateau Pascale INSERM U 897, Université de Bordeaux II [email protected] 0557571191
Jean François Dartigues INSERM U 897, Université de Bordaeux II [email protected] 0557571596
____________________________________________________________________________________________________________
ID: 82
IMAGING DEMENTIA IN ELDERLY
Pierre Krolak-Salmon (Centre Mémoire Ressources Recherche de Lyon, Médecine Gériatrique, France)
Pierre Krolak-Salmon, France (1) Stéphane Léhéricy, France (2) Serge Goldman, Belgium (3) Agneta Nordberg, Sweden (4)
(1) Centre Hospitalier Lyon Sud (2) GH Pitié-Salpêtrière (3) ULB-Hôpital Erasme (4) Karolinska University Hospital Huddinge
This symposium aims at presenting how neuroimaging can help the diagnosis of Alzheimer's disease and related disorders in elderly. Current
knowledge on structural and metabolic neuroimaging will be discussed in terms of daily clinical practice in 2009 and perspective application in older
people. In particular, we will insist on the justification of such biomarkers in aging, on the place of volumetric MRI; on the role of metabolic imaging and
on the future of amyloid imaging.
Swedish scientist and professor, Pr. Agneta Nordberg, MD, PhD, of Karolinska University in Stockholm (Sweden) has performed an outstanding in
Alzheimer’s dementia research. Agneta Nordberg’s research work has made significant contributions to the improved understanding of the disease, its
early diagnosis and consequently also the further development of therapeutic approaches to Alzheimer’s dementia. She is one of the leaders working
on amyloid imaging in Alzheimer disease, using in particular positon emission tomography with PIB.
Pr. Stéphane Léhéricy, MD, PhD works in the Department of Neuroradiology at the Pitie-Salpetriere Hospital. He is also the director of the functional
neuroimaging centre in the Salpetriere hospital. He is research active with ANR programme grants. His scientific interest is in structural brain mapping
in the normal and pathological brain. His focus is on on neurodegenerative dementias including Alzheimer’s disease. He will present current
knowledge on the role of structural imaging in elderly.
Pr Serge Goldman, MD, PhD, is the head of the PET/Biomedical Cyclotron Unit of the ULB-Hôpital Erasme (Brussels, Belgium), and a leader of the
Belgian Society for Nuclear Medicine. He works especially in the field of SPECT and PET in dementia. He will present recent data concerning
neuronal and functional imaging in dementing conditions.
Dr. Pierre Krolak-Salmon, MD, PhD, head of the research committee of the Memory Centre of Lyon, works in the field of the multidisciplinary diagnosis
of Alzheimer's disease and related disorders. He has recently supervised neuroimaging studies using positon emission tomography using an original
ligand. He will present shortly why neuroimaging is crucial for dementia diagnosis in elderly and he will present the speakers.
WHY USING NEUROIMAGING TO DIAGNOSE DEMENTIA IN THE ELDERLY?
PIERRE KROLAK-SALMON
MRI IN THE DIAGNOSIS OF ALZHEIMER
STEPHANE LEHERICY
IMAGING NEURONES AT WORK IN DEMENTIA
SERGE GOLDMAN
AMYLOID IMAGING IN THE EARLY DIAGNOSIS OF ALZHEIMER ´S DISEASE AND EVALUATION OF ANTI-AMYLOID THERAPY
AGNETA NORDBERG
Chair(s)
Pierre Krolak-Salmon Hospice civils de Lyon [email protected] 33 6 61 21 86 32
Verny Marc Hôpital de la Pïtié-Salpêtrière [email protected] 33 1 42 16 41 12
____________________________________________________________________________________________________________
ID: 84
NUTRITION AND AGE-RELATED DISEASES OF THE BRAIN AND EYE
Pascale Barberger-Gateau (INSERM U897, university of Bordeaux, Nutritional epidemiology, France)
Stephen Cunnane, Canada (1) Pascale Barberger-Gateau, France (2) Claudine Berr, France (3) Astrid Fletcher, United Kingdom (4)
(1) Research Center on Aging, Université de Sherbrooke (2) INSERM U897, université de Bordeaux (3) INSERM U888 (4) London School of Hygiene & Tropical Medicine
In the absence of curative treatment, there is a need for identifying environmental risk factors on which we could act to slow down pathological aging of
the brain and eye, which both severely disable older persons. The role of nutrition in dementia and Alzheimer’s disease raises increasing interest, with
particular hypotheses on the joint role of anti-oxidants and fatty acids. The same mechanisms are evoked in the pathogenesis of Age-related Macular
Degeneration (AMD). This symposium will successively review these two hypotheses through the results of biological and epidemiological studies and
will suggest new directions for research and intervention studies in older persons.
The participants represent a panel of highly acknowledged researchers in the field in France, UK and Canada. They belong to the few research teams
in the world that have collected data on dietary behaviour, biological parameters, and objective markers of brain or eye aging. Stephen Cunnane is
professor at the Department of Medicine of the Université de Sherbrooke and Director of the Research Center on Aging, where he is particularly
involved in research on Omega 3 fatty acids, brain glucose uptake and cognition in the elderly. Pascale Barberger-Gateau is head of the “Nutritional
epidemiology” team at INSERM U897 where the PAQUID and 3C epidemiological studies on brain aging are carried out. She is coordinator of the
COGINUT (COGnItion and NUTrition) research program. Cecile Delcourt belongs to the same team and she is coordinator of the ALIENOR
(Anti-oxidants, Lipids, Nutrition and Eye disease) cohort study. Claudine Berr is co-investigator of the 3C and COGINUT studies but she also
developed an original research in the EVA (Etude du Vieillissement Arteriel) epidemiological study. Astrid Fletcher is professor of epidemiology of
aging at the London School of Hygiene and Tropical Medicine, where she is particularly involved in research on eye diseases. She is the Principal
Investigator of two large studies on risk factors for eye diseases, including nutritional factors: the seven country EUREYE study and the INDEYE, a two
centre study in India.
DO PROBLEMS OF ENERGY SUBSTRATE SUPPLY CONTRIBUTE TO AGE-RELATED BRAIN DISEASES?
FATTY ACIDS AND BRAIN AGING
THE ROLE OF OXIDATIVE STRESS IN BRAIN AGING
NUTRITION AND AGE-RELATED EYE DISEASE: FROM OBSERVATION TO INTERVENTION STUDIES
Chair(s)
Pascale Barberger-Gateau INSERM U897, university of Bordeaux, France [email protected] +33 5 57 57 15 96
Delcourt Cecile INSERM U897, university of Bordeaux, France [email protected] +33 5 57 57 15 96
____________________________________________________________________________________________________________
ID: 107
PAIN ASSESSMENT AND PAIN TREATMENT APPROACHES IN OLDER PERSONS
Gisèle PICKERING (Clinical Pharmacology Department, INSERM U766 and CIC501, , France)
Steven Gibson, Australia (1) Henry McQuay, United Kingdom (2) Debra Weiner, United States of America (3)
(1) National Aging Institute (2) Pain Relief Unit, (3) Department of Medicine, University of Pittsburgh,
Pain is a major healthcare problem worldwide and adults of advanced age represent an expanding proportion of the population with pain complaints,
exceeding 50% of community-dwelling older persons and up to 80% of nursing home residents. Pain evaluation in elderly persons is particularly
difficult especially when communication disorders are present. Pain treatment faces the problem of polypatholologies and polymedication associated
with aging and the increased risk of side-effects and drug interactions. The symposium we propose aims at presenting the most recent data on pain in
the elderly with highly-renowned academics and clinicians.
Steven Gibson is Professor and Director of Clinical Research at the world-leading National Aging Research Institute, Melbourne, Australia. He is
President of the Special Interest Group on Pain in the elderly in the International Association for the Study of Pain. His main research interest is the
under-estimation of pain in elderly persons. He will present the available tools for pain evaluation, and the recent interdisciplinary expert consensus
statement on assessment of pain in older persons.
Henry McQuay is Professor of Pain Relief at the Oxford Pain Relief Unit, Nuffield Department of Anaesthetics, University of Oxford. and a Professorial
Fellow at Balliol College. His clinical expertise is in the management of chronic pain and his research interests have included bench studies of
analgesics, primary clinical trials of analgesic interventions and latterly using systematic review techniques to work out the relative efficacy and safety
of analgesics. He will present the specificities of pain treatment in elderly persons.
Debra Weiner is Professor of Medicine, Psychiatry and Anesthesiology in the division of Geriatrics at the University of Pittsburgh School of Medicine
and is a physician in the University of Pittsburgh Institute on Aging. Her research interests include the effectiveness of complementary and alternative
medicine in the management of persistent pain conditions in older adults, evaluation of pain and pain behaviours in cognitively impaired older adults
and development of educational programs on older adult pain management for health care providers.
In the context of international research, pain assessment and pain treatment strategies have been the focus of attention of many researchers in the
last decade, and the three speakers are leaders in that field. They have a very strong international reputation in the domain of pain and geriatrics,
have presented numerous lectures, published extensively in international journals, are authors and editors of books on pain.
ASSESSMENT OF PAIN IN OLDER PERSONS
ANALGESICS FOR THE ELDERLY
NON-PHARMACOLOGICAL APPROACHES TO PAIN IN ELDERLY PERSONS
Chair(s)
Gisèle Pickering Clinical Pharmacology Centre, University Hospital, Clermont-Ferrand, France [email protected] 33 4073017084016
____________________________________________________________________________________________________________
ID: 115
NUTRITIONAL EVIDENCE FOR SLOWING DOWN AGEING PATHOLOGIES
Lisette CPGM De Groot (Wageningen University, Human Nutrition, The Netherlands)
Paul Lips, The Netherlands (1) Patrick Ritz, France (2) Martha Claire Morris, United States of America (3) John Morley, United States of America (4)
(1) VU Medical Center (2) Centre Hospitalier Unviersitaire de Toulouse (3) Rush Institute for Healthy Aging (4) Saint Louis University Health Sciences Center, and Geriatric
Research, Education, and Clinical Center, VA Medical Center
Poor health and loss of independence are not inevitable consequences of ageing. Ensuring a healthy, independent and active ageing population
requires the effective exploitation of the great potential of modifiable risk factors - including diet.
Around midlife the signs and symptoms of ageing become clinically evident. Later in life ageing-related pathologies - such as osteoporosis, dementia,
sarcopenia and the anorexia of ageing – may become major disabling conditions. Manifestations of the ageing process and malnutrition are likely to
intermingle, given the overlap between the multiple mechanisms that drive these processes, involving diet, lifestyle, genes and the environment.
Elderly people are disproportionately affected by combinations of the disabling conditions, creating an urgent need for ways into the alleviation of
ageing related pathologies and their functional consequences.
With diet and nutrition playing a role in osteoporosis, dementia, sarcopenia and the anorexia of ageing, scientific evidence is expanding in support of a
new paradigm of preventative or optimal diets, in which ageing related pathologies, and their functional consequences, can be prevented or
postponed. Thus nutritional ways into facilitating independence and improving functional health and quality of life in old age (WHO, Active Ageing,
2002) are becoming increasingly important.
The present symposium aims to review the current knowledge in this field, hereby focussing on the role of nutrition in the prevention of osteoporosis,
dementia, sarcopenia and the anorexia of ageing.
NUTRITION AND OSTEOPOROSIS (P. LIPS - CONFIRMED)
NUTRITION AND SARCOPENIA (P. RITZ - CONFIRMED)
NUTRITION AND COGNITION (MC MORRIS - CONFIRMED)
NUTRITION AND THE ANOREXIA OF AGEING (J. MORLEY) - CONFIRMED)
Chair(s)
Lisette de Groot Bomenweg 2,6703 HD Wageningen, NL [email protected] 00 31 317 48 2577
Vellas Bruno Toulouse University Hospital, 31300 Toulouse, France [email protected]
____________________________________________________________________________________________________________
ID: 118
FOR A NEW DIAGNOSTIC APPROACH OF ALZHEIMER’S DISEASE
Bruno DUBOIS (Salpetriere University Hospital, Department of Neurology, France)
Giovani Frisoni, Italy (1) Harald Hampel, Germany (2) Bruno Dubois, France (3)
(1) The National Centre for Alzheimer's and Mental Diseases (2) Department of Psychiatry, Ludwig-Maximilian University (3) Department of Neurology, Salpetrire Hospital
Speaker 1: Neuro-imaging and Alzheimer’s disease: Giovanni Frisoni (Brescia, Italy)
Speaker 2: Biomarkers and Alzheimer’s disease: Harald Hampel (Munchen, Germany)
Speaker 3: New criteria for Alzheimer’s disease: Bruno Dubois (Paris, France)
Chair(s)
Bruno DUBOIS GHPS - Federation of Neurology - 47 bd de l'hopital - 75013 PAIRS France [email protected] 33 1 42 16 17 61
____________________________________________________________________________________________________________
ID: 124
STUDIES OF TELEHEALTH AND TELECARE SERVICES FOR OLDER ADULTS WITH CHRONIC ILLNESSES AND THEIR FAMILY CAREGIVERS:
AN INTERNATIONAL PERSPECTIVE
Elizabeth Hanson (University of Kalmar, E-Health Institute, Department of Human Sciences, Sweden)
Elizabeth Hanson, Sweden (1) Josep Roca, Spain (2) Elsa Marziali, Canada (3) Peter Cudd, United Kingdom (4)
(1) eHealth Institute University of Kalmar (2) Hospital Clinic Barcelona (3) University of Toronto (4) University of Sheffield
The purpose of this symposium is to bring together current innovative examples of best practice with regards to research based telehealth and
telecare services for older people with chronic illnesses and their family caregivers from Sweden, England, Spain and Canada. An overview will be
given of the ‘state of the art’ in the field including a description of the current situation with regards to the implementation of such services within health
and social care in the countries concerned. Each participant will give a succinct presentation of their work in the field including a demonstration of their
IT based service/s followed by key research results. The chairs (Prof Nolan & Dr Magnusson) will then draw together the common critical success
factors across the four international examples and will invite active discussion and debate with the audience. The session will conclude with delegates
reaching consensus on a set of key recommendations for future research initiatives in the field.
The participants are established researchers in the field with known track records for research grants and publications. Examples are drawn from four
countries making an international comparison feasible and there is also a multi-disciplinary perspective as participants come from different disciplines.
Dr. Josep Roca, Medical Professor, University of Barcelona and Medical Director Barcelona Hospital. Leader of the Chronic Advisory Group reporting
to the Catalan Ministry of Health on the implementation of new technology-based models of care for chronically-ill patients.
Dr. Mike Nolan, Professor Gerontological Nursing, Sheffield Institute for Studies on Ageing, University of Sheffield, co-director of the EU-funded ACT
(Advanced Care Technologies) Programme. Dr. Peter Cudd, Senior project researcher, School of Health and related research, University of Sheffield.
UK
Dr.Elsa Marziali, Professor of Social Work, Research Scientist, Baycrest, University of Toronto, Canada, principal investigator for several major
nationally funded projects to design and evaluate e-health home-based services for patients with chronic disease and their caregivers.
Dr Elizabeth Hanson, Dr Lennart Magnusson Senior Lecturers Human Sciences, eHealth Institute University of Kalmar, Scientific Leader & Director
respectively of the Swedish Family Care Competence Centre
Telehealth and telecare solutions within care for older people is highly topical and a recognised priority area within policy, research and practice.
Diverse ‘state of the art’ examples from four countries are presented with a focus on chronically ill older people and family caregivers.
THE MAINSTREAMING OF AN ICT BASED SERVICE (ACTION) FOR OLDER PEOPLE WITH CHRONIC ILLNESS LIVING AT HOME, FAMILY
CAREGIVERS AND PRACTITIONERS IN SWEDEN.
AN INTEGRATED CARE MODEL FOR CHRONIC HEALTH CONDITIONS IN OLD AGE BY THE USE OF IT IN BARCELONA, SPAIN.
WEB-BASED VIDEO-CONFERENCING SUPPORT PROGRAMS FOR DEMENTIA CAREGIVERS AND OLDER ADULTS WITH CHRONIC ILLNESS
IN TORONTO, CANADA
EASY ACCESSIBLE AND USER FRIENDLY TECHNOLOGY BASED PRODUCTS AND SERVICES FOR OLDER PEOPLE AND CARERS IN
SHEFFIELD, ENGLAND.
Chair(s)
Mike Nolan Sheffield Institute for Studies on Ageing, University of Sheffield, Northern General Hospital, Herries Road, Sheffield S5 7AU, England
[email protected] 00441142266851
Magnusson Lennart eHealth Institute, University of Kalmar, Kalmar Science Park, Bredbandet 1, Varvsholmen [email protected]
0046706302321
____________________________________________________________________________________________________________
ID: 131
E-SERVICES FOR A DIETARY APPROACH IN AGEING PROCESS AND ELDERLY MALNUTRITION
Lorenzo Maria Donini (University of Rome - Sapienza, Medical Phisiopathology - Food Science, Italy)
Domenico Cucinotta, Italy (1) Isabelle Bourdel-Marchasson, France (2) Herbert Lochs, Germany (3) Fabio Buccolini, Italy (4)
(1) University of Bologna (2) Arnozan Hospital Gerontology Clinic (3) Charite Hospital Univesity of Berlin (4) Vox Net
In literature some of main factors defining quality of ageing process are related to inflammation status, oxidative stress and gut microbiota alteration.
These factors may increase prevalence of age related anorexia that is a physiologic effect of healthy aging and reveals itself with a loss of eating need
and pleasure. This reduction intake may predispose to the harmful anorexic effect of psychological, social and physical problems that become
increasingly frequent with ageing.
Age-related anorexia may represents a sign of a failure to preserve steady state levels of body weight and energy stores.
Further studies are necessary to better understand factors contributing to
poor nutrition in the elderly and to develop preventive and treatment strategies that could benefit from improvement in food science and technology
such as innovations in agriculture and food technologies putting on the market new foodstuffs as functional foods.
This is an opportunity to realize a more personalized diets adaptable to different state of physiology, fit to preserve health and successful ageing.
Nevertheless, it’s quite manifest that the effectiveness of functional foods is subordinated to the whole adequacy of the diet to specific individual
needs, and to the consumer acceptance and compliance in the long run. For these reasons, it’s more rightly to talk of a functional diet than a specific
functional food, and the perfect integration of the functional foods in the traditional eating habits is necessary. The whole healthy diet approach is, also,
necessary for ascribe nutritional or functional claim to a potential functional foods, before it’s put on the market.
In this prospective the E-Health Dietary Services concept is the valorization and exploitation of functional foods in preventing and contrasting the
inflammation, oxidative stress and gut microbiota alteration in elderly people by developing an innovative ICT system, which integrates nutritional and
epidemiological data for a remote E-health service.
On the whole, the main challenges targeted are :
1.development of new E-Health dietary services for elderly people as suitable tools for a preventive telemedicine approach;
2.definition of an integrated solution to better manage the diet and nutritional needs of elderly people to contrast inflammation, oxidative stress and gut
microbiota alteration.
The E-Health Dietary Services approach will be based on the recognition and management of the food intake as a crucial step to control, balance
nutritional substances and environmental stress in order to increase the quality of life.
SENILE ANOREXIA
EATING PATTERNS IN THE ELDERLY
MALNUTRITION:THE ROLE OF FUNCTIONAL FOODS IN ELDERLY
E-HEALTH DIETARY SERVICES IN ELDERLY
Chair(s)
Lorenzo M DONINI Sapienza University of Rome- Medical Physiopathology Department [email protected] +393385926464
FRANCESCHI Claudio Alma Mater University of Bologna [email protected] +390512094743
____________________________________________________________________________________________________________
ID: 321
HOW TO IMPROVE THE CARE OF ELDERLY PEOPLE WITH DIABETES?
THE ALFEDIAM/SFGG FRENCH-SPEAKING GROUP FOR THE STUDY OF DIABETES IN THE ELDERLY.
CHAIRMAN: PR ALAN J SINCLAIR
Isabelle Bourdel-Marchasson (CHU Bordeaux; university Bordeaux2, Pole de gérontologie clinique, France)
Ulrich Visher, Switzerland (1) Jean-Frederic Blickle, France (2) Anne Fagot-Campagna , France (3) Isabelle Bourdel-Marchasson, France (4)
(1) Geneva University Hospital, Department of rehabilitation and geriatric (2) CHRU de Strasbourg, Hopital Central (3) Institut de Veille Sanitaire - Département des
Maladies Chroniques et Traumatismes (4) CHU de Bordeaux, Pole de gérontologie Clinique; Université Bordeaux 2
Quality of care in elderly people with diabetes requires several major improvements. The number of elderly people with diabetes will keep increasing in
the coming decades. Their medical needs are heterogeneous, and care should be tailored individually according to their health status, taking into
account their cognitive and functional autonomy, existing diabetic complications and other associated diseases. We propose to present practitioners’
guidelines for the care of diabetes in the elderly, written by French-speaking a multidisciplinary group, addressing assessment of frailty in elderly
people with diabetes, and proposing practical targets for blood glucose control and for monitoring and providing care regarding diabetes-related
conditions and complications.
A large population-based study is being conducted on a sample of 9000 people representative of community-living people with diabetes receiving
anti-diabetic medications in France (ENTRED 2007-2008 study). We propose to report data on the large sub-group of elderly patients, in particular
regarding current patterns of care and estimation of the future burden of diabetes in this population. Quality of life and functional limitations of elderly
people with diabetes will also be presented.
The speakers belong to the French-speaking group for the study of diabetes in the elderly and took a large and active part in the guide composition
and writing.
The chairman for this symposium is Pr Alan Sinclair who organized and composed the european guidelines for diabetes in the elderly in 2004.
INDIVIDUALIZED TARGETS FOR GLYCEMIC CONTROL IN ELDERLY DIABETIC PEOPLE
PREVENTION AND SCREENING OF DIABETES RELATED COMPLICATIONS; TARGETS FOR ASSOCIATED CARDIO-VASCULAR RISK
FACTORS IN ELDERLY PEOPLE WITH DIABETES
AGING AND DIABETES IN THE FRENCH POPULATION: EPIDEMIOLOGY, QUALITY OF CARE AND PERSPECTIVES FOR IMPROVEMENTS:
ENTRED 2001 THROUGH ENTRED 2007
QUALITY OF LIFE IN FRENCH ELDERLY DIABETIC SUBJECTS: ENTRED 2007-2008
Chair(s)
Alan Sinclair Bedfordshire and Hertfordshire Postgraduate Medical School [email protected] 01582 743285
____________________________________________________________________________________________________________
ID: 157
GERIATRIC PALLIATIVE MEDICINE
Sophie Pautex (Coordinator EUGMS interest group PC, Rehabilitation and Geriatrics, Switzerland)
Trevor Smith, Canada (1) Cees Hertogh, Netherlands Antilles (2) Miel Ribbe, Netherlands Antilles (3) Sophie Pautex, Switzerland (4)
(1) Department of Health Studies, University of Waterloo (2) Vrije Universiteit Medical Center (3) Free University medical center VUMC (4) University Hospital Geneva
Optimal palliative care for older adults involves treating the primary disease process (advanced heart failure), managing their multiple chronic medical
conditions and co morbidities (diabetes mellitus, arthritis) and geriatric syndromes (cognitive impairment, frailty), assessing and treating the physical
and psychological symptom distress associated and treatment plans in the setting of an unpredictable prognosis. Older adults often make multiple
transitions across care settings (home, hospital, rehabilitation, long-term care), especially in the last months of life. Care plans and patient goals must
be maintained from one setting to another. Older adults die in acute care hospital, nursing home, hospices and at home.
Different studies have demonstrated some deficiencies in the care of elderly dying, in particular the high rates of uncontrolled symptoms, poor
communication, inadequate use of advance directives and unwanted medical interventions, like life support or artificial nutrition.
Providing high quality geriatric and palliative care for older adults requires time, effort, regular communication and discussions about goals of care
across all the different settings or health care systems.
The aims of our symposium are, after a short introduction about the definition of geriatric palliative medicine, to emphasize the importance of
comprehensive assessment of elderly patients with the experience of the RAI-PC, to underlie the dilemmas in communication and decision making in
elderly patients with cognitive impairment and to give two examples of good practice of palliative care : one in nursing homes in the Netherlands and
one in an acute-subacute geriatric hospital in Switzerland.
COMPREHENSIVE ASSESSMENT – RAI-PC
DILEMMAS IN COMMUNICATION AND DECISION MAKING
BEST PRACTICE IN NURSING HOMES
GERIATRIC PALLIATIVE MEDICINE: CONSULTATION IN ACUTE CARE GERIATRIC HOSPITAL
Chair(s)
Nele Van Den Noortgate Universitair ziekenhuis Gent (1K2)– De Pintelaan 185- 9000 Gent – [email protected] ++32/9/24029
Curiale Vito Via Cesare Rossi 6, 16146 Genova, Italy [email protected] +39 3473834885
____________________________________________________________________________________________________________
ID: 160
RECENT ADVANCES IN NURSING HOME CARE: THE AMDA SYMPOSIUM
John Morley (Saint Louis University School of Medicine, Division of Geriatric Medicine, United States)
Steven Levenson, United States of America (1) Charles Crecelius, United States of America (2) John Morley, United States of America (3)
(1) AMDA (2) AMDA (3) Saint Louis University
This symposium will develop the latest information from the Journal of the American Medical Directors Association (JAMDA) on care in elders living in
the nursing home. The problems of relying on evidence from non-nursing home residents to develop approaches to nursing home residents will be
stressed. Approaches to treating common problems in the nursing home will be given. We will stress differences between USA and other countries.
The first two speakers are the past president and president of AMDA and Dr. Morley is the Editor-in-Chief of JAMDA.
This symposium will stress the state of the art of nursing home care in the United States.
STEVEN A. LEVENSON: EVIDENCE BASED CARE IN THE NURSING HOME
CHARLES CRECELIUS: TREATING PAIN IN THE NURSING HOME
JOHN E. MORLEY: FALLS AND WEIGHT LOSS IN THE NURSING HOME
Chair(s)
Steven Levenson 7801 Ruxwood Rd, Baltimore, MD 21204 [email protected] 410-258-4161
Crecelius Charles 675 Old Ballas Rd., Suite 101, St. Louis, MO 63141 [email protected] 314-567-7090
____________________________________________________________________________________________________________
ID: 619
GERONTECHNOLOGY FOR OPTIMAL HEALTH IN A MULTIDISCIPLINARY CONTEXT
Herman Bouma (International Society for Gerontechnology, , The Netherlands)
Herman Bouma, The Netherlands (0) Oppenauer Claudia, Austria (0) Bronswijk Johanna E.M.H. van, The Netherlands (0) Franchimon Francesco, The Netherlands (0)
(1) International Society for Gerontechnology (2) Fac.of Psychology University Vienna (3) Technische Universiteit Eindhoven (4) Technische Universiteit Eindhoven
Moderator: Alain Franco, president of the International Society for Gerontechnology, France
Gerontechnology is a scientific response to the simultaneous occurrence of demographic ageing and massive technological innovation. It concerns the
study of technology and ageing (gerontology) for ensuring an optimal technological environment for all ageing and aged people. Gerontechnology is
multidisciplinary between disciplines of human ageing (physiology, psychology, sociology, medicine) on the one hand and disciplines of technology
(physics and chemistry, building, mechatronics, communication, ergonomics, marketing) on the other. This set-up has enormous potential for societal
benefits, but also faces significant methodological challenges especially concerning reproducibility and validity of results. Different disciplinary points of
view result in different approaches and methodologies and might lead to invalid conclusions unless interdisciplinary collaboration is practiced in which
responsibility for the whole is fully shared.
Goals of gerontechnology are directed at realising specific ambitions and needs within the main domains of daily life. Following the encompassing
definition of the WHO of health as a basic condition for independence and for following one’s ambitions in later life, the selection to be covered
concentrates on aspects of health and rehabilitation.
The aim of this symposium is to show how in present-day society technology innovation has become all-important for the health of all ageing citizens,
including prevention, compensation of restrictions, rehabilitation, and care support. For gerontechnology research the challenge will be elucidated.to
combine monodisciplinary approaches and methodologies in a multidisciplinary framework.
GERONTECHNOLOGY AS A FIELD OF ENDEAVOUR
HOW DO PSYCHOLOGICAL MODELS FIT INTO GERONTECHNOLOGICAL RESEARCH
A MULTIDISCIPLINARY CHALLENGE OF BENEFITS AND RISKS: PREVENTIVE HEALTH ENGINEERING IN EARLIER AND LATER LIFE
HOME AUTOMATION, ROBOTICS, ASSISTIVE TECHNOLOGY, GERIATRIC TELECARE AND TELEMEDICINE:DO THESE TECHNOLOGIES
MATCH?
Chair(s)
Herman Bouma Lantie 2A, 5512NG Vessem NL [email protected] +31620407351
Franco Alain CHU-Grenoble, Fr [email protected]
____________________________________________________________________________________________________________
ID: 181
TARGETED GERIATRIC ASSESSMENT IN PRIMARY CARE - AN INTERNATIONAL RESEARCH COLLABORATION.
Ian Philp (University of Sheffield, School of Medicine, United Kingdom)
Ian Philp, United Kingdom (1) Jack Watters, United States of America (2) Marcel Olde-Rikkert, The Netherlands (3) Mario Barbagallo, Italy (4)
(1) University of Sheffield (2) Pfizer PLC (3) Raboud University Nijmegen (4) University of Palermo
An international advisory board and research network has been established to develop, evaluate and disseminate best practice in assessing and
responding to older people’s health and care needs in primary and community settings using the Easy-Care system of assessment instruments,
guidance and training programmes.
Ian Philp will describe the development of the system through international collaboration and results of studies in the USA, Russia, and the European
Union, and of emerging studies in South East Asia, the Middle-East and South America.
Jack Watters will describe the potential of using aggregated population data obtained from Easy-Care assessments to inform policy and planning to
meet the needs of older people, drawing from previous population studies using Easy-Care in Portugal, Poland and Northern Ireland.
Marcel Olde-Rikkert will present the results of the Dutch Easy-Care Trial for evidence of costs and benefits of using Easy-Care as part of a targeted
system of assessing and responding to the needs of at-risk older people in primary care.
Mario Barbagello will present plans for the work of the Easy-Care International Research Network under three themes:•Development and evaluation of use in routine practice.
•Statistical and economic modelling leading to trials of effectiveness.
•Development and use of population data.
Members of the Easy-Care International Advisory Board, chaired by Jean-Pierre Baeyens (President of IAGG Europe) will act as panel discussants.
This research and development project is at a key point where there is a solid foundation of published work and strong interest with high-level support
for a major programme of collaborative international work to realise the benefits of the project for improving the lives of older people.
Members of the Easy-Care International Research Collaboration have been encouraged to submit work to the Conference for poster and platform
presentations, to complement this proposal for a Symposium.
We firmly believe that this Symposium will be of great interest and value to colleagues involved in research, policy and practice in improving health and
care services for older people.
DEVELOPMENT OF THE EASY-CARE SYSTEM FOR TARGETED GERIATRIC ASSESSMENT IN PRIMARY CARE.
POPULATION NEEDS ASSESSMENT USING EASY-CARE DATA.
COSTS AND BENEFITS; RESULTS OF THE DUTCH EASY-CARE TRIAL.
FUTURE PLANS FOR COLLABORATION THROUGH THE EASY-CARE INTERNATIONAL RESEARCH NETWORK.
Chair(s)
Jean-Pierre Baeyens Gen.Jungbluthlaan, 11 B-8400 Oostend - Belgium [email protected] +32475266820
____________________________________________________________________________________________________________
ID: 183
THE CENTRAL CONTROL OF MOBILITY IN OLDER ADULTS
Joe Verghese (Albert Einstein College of Medicine, Neurology, United States)
Joe Verghese, United States of America (1) Roee Holtzer, United States of America (1) Caterina Rosano, Israel (2) Jeffery Hausdorff, (3)
(1) Albert einstein College of Medicine (2) University of Pittsburgh (3) Tel Aviv Sourasky Medical Center
The objective of this symposium is to address the relationships between the central nervous system and mobility in the context of aging and pathology
using neuroimaging, cognitive neuroscience, motor assessment, biological and genetic methodologies.Recent studies indicate that older adults
experiencing mobility impairment are more likely to have underlying structural and functional impairments in the central nervous system. Emerging
evidence indicates that changes in brain networks that are important for executive control function and memory are also associated with slower gait,
poor balance, and increased gait variability. This symposium will increase our knowledge of the specific impairments in the neural substrates and
brain networks that contribute to mobility impairment in community dwelling older adults. The discussants will utilize cognitive neuroscience, motor
assessment, neuroimaging and genetic methodologies to address these relationships both in the context of aging and pathology. Understanding the
relationship between the central nervous system and mobility may help identifying new targets for intervention and preventive strategies aimed at
reducing the burden of mobility limitations in older adults.
COGNITIVE AND GENETIC DETERMINANTS OF GAIT PERFORMANCE AND ADAPTABILITY. DR ROEE HOLTZER
WHEN IS GAIT AUTOMATIC? INSIGHTS FROM DUAL TASKING AND PHARMACOLOGIC STUDIES. DR JEFFERY HAUSDORFF
MOBILITY SIGNATURES OF BRAIN DYSFUNCTION. DR JOE VERGHESE
BRAIN NETWORK ANALYSIS OF GAIT CHARACTERISTICS IN OLDER ADULTS.
Chair(s)
Joe Verghese New York, USA [email protected] 0117184303877
Rosano Caterina Pittsburgh, USA [email protected] 011412 3831294
____________________________________________________________________________________________________________
ID: 190
LONELINESS IN OLD AGE
Kaisu Pitkala (University of Helsinki, General Practice and Primary Health Care, Finland)
Kaisu Pitkala, Finland (1) Pirkko Routasalo, Finland (2) Niina Savikko, Finland (3) Marja Jylhä, Finland (4)
(1) University of Helsinki (2) University of Turku (3) The Central Union for the Welfare of the Aged (4) University of Tampere
Loneliness is one of the ‘geriatric giants’ leading to an impaired quality of life, cognitive decline, the need for institutional care and increased mortality.
For the past 20 years, a number of descriptive studies have focused on loneliness. The prevalence of loneliness has varied greatly across cultures. In
Nordic countries about one third of older people suffer from loneliness. Loneliness has been defined as an individual’s subjective experience of a lack
of satisfying human relationships. A person may feel lonely even if surrounded by other people. Although the terms loneliness, social isolation, and
living alone are often used interchangeably, they are distinct - albeit interrelated – concepts. Social isolation refers to the number of one’s social
contacts, and has been studied extensively, showing a prognostic significance on mortality. Depression and global feeling of insecurity are also
intertwined with the concept of loneliness. Further studies are thus needed to understand the causal relationships between life-events and loneliness
or prognostic significance of loneliness. Besides that loneliness has been vaguely defined, the research is hampared by the fact that loneliness is a
shameful feeling to admit for older people.Thus, the way of inquiring older people has effect on their responses.
However, there is a consensus that loneliness has negative associations and effects on quality-of-life as well as health. Very little is known about
whether or not its negative consequences may be alleviated by interventions. Some randomized studies have shown that older people may be socially
activated, and their loneliness can be alleviated. However, these prior studies have not been able to show effects on health, cognition or mortality. In
this symposium we will discuss the concept of loneliness in realionship to its close concepts such as social isolation, depression, global feeling of
insecurity and show some results form our large epidemiological follow-up studies on how these concepts affect the prognosis. In addition, the concept
of loneliness will be discussed in depth. We will also present results of our randomized intervention study which shows that by conscious use of peer
support, empowering older people and supporting their mastery in groups, loneliness and itse harmful health consequences may be relieved and there
are even effects on cognition.
EFFECTIVENESS OF PSYCHOSOCIAL GROUP REHABILITATION ON LONELY OLDER PEOPLE- A RANDOMIZED CONTROLLED TRIAL
PROGNOSTIC VALUE OF LONELINESS AND SOCIAL ISOLATION - DO THEY DIFFER?
GLOBAL FEELINGS OF LONELINESS AND INSECURITY IN OLD AGE - OVERLAPPING CONCEPTS?
LONELINESS IN OLD AGE - METHODOLOGICAL AND COMPARATIVE PERSPECTIVES
Chair(s)
Kaisu Pitkälä Höylätie 5 A 01650 Vantaa [email protected] +358503385546
Jylhä Marja Tampere University [email protected] +358405889100
____________________________________________________________________________________________________________
ID: 209
NURSING BEST PRACTICE GUIDELINE IMPLEMENTATION: KNOWLEDGE TRANSLATION FOR IMPROVED OUTCOMES
Lynn McCleary (Brock University, Department of Nursing, Canada)
Lynn McCleary, Canada (1) Dawn Prentice, Canada (1) Katherine McGilton, (2)
(1) Brock University (2) Toronto Rehab
The purpose of this symposium is to describe methods for evaluating the effects of implementing nursing best practice guidelines.
Knowledge translation defined as the “interaction between decision makers and researchers (that) results in mutual learning through the process of
planning, producing, disseminating, and applying existing new research in decision-making” (Canadian Health Services Research Foundation, cited in
Graham, et al., 2006, p. 15) is essential for improved health outcomes. Best practice guidelines are an important tool for knowledge translation but
examples of research demonstrating an impact of guidelines on patient care are limited. Much of the research about knowledge translation has been
conducted with physicians with less research about how to influence health systems. Furthermore, there is limited knowledge translation research in
the field of elder care.
This symposium is based on the authors’ experiences conducting research about the implementation of nursing best practice guidelines created by the
Registered Nurses Association of Ontario (RNAO). The three case studies will each focus on a different guideline (Client Centred Care, Assessment
and Management of Foot Ulcers in Diabetic Patients, and Screening and Caregiving for Delirium, Dementia, and Depression). The guidelines were
implemented with nurses or interdisciplinary health care professionals of older persons in community, hospital, long term care, and rehabilitation
programs.
Each case study will include: the process of planning for implementation (e.g., setting, stakeholder evaluation, resources, timeline); multi-faceted
implementation strategies (e.g., creation of new documentation systems, creation of patient education tools, inservice education); research methods
for evaluating impact and outcomes for health care providers and patients (e.g., pre-post surveys, focus groups, interviews, analysis of existing data);
and results of each implementation evaluation. The symposium will include challenges and lessons learned from rigorous evaluation of best practice
guideline implementation. The importance of researcher-research user partnerships for success will be emphasized.
The presenters are each conducting funded research evaluating the outcome of implementation of a nursing best practice guideline. Dr. McCleary is a
founding board member and Dr. McGilton is a current board member of the National Initiative for Care of the Elderly, a national and international
Centre of Excellence for knowledge translation in for care of older persons that is funded by the Government of Canada.
IMPLEMENTING THE RNAO CLIENT CENTRED CARE BEST PRACTICE GUIDELINE IN ACUTE AND COMPLEX CONTINUING CARE
SETTINGS: IMPACT ON CLIENT CENTRED CARE AND FAMILY INVOLVEMENT IN CARE
EVALUATION OF THE RNAO BEST PRACTICE GUIDELINE: ASSESMENT AND MANAGEMENT OF FOOT ULCERS FOR PEOPLE WITH
DIABETES
IMPLEMENTING THE RNAO BEST PRACTICE GUIDELINE ON SCREENING AND CAREGIVING FOR DELIRIUM, DEMENTIA, AND
DEPRESSION: INCREASING THE SUCCESS OF REHABILITATION FOR ELDERS WITH COGNITIVE IMPAIRMENT IN A REHABILITATION
SETTING
Chair(s)
Lynn McCleary Department of Nursing, Brock University, St. Catharines, ON, Canada, L2S 3A1 [email protected] 905-688-5550 ext. 5160
Prentice Dawn Department of Nursing, Brock University, St. Catharines, ON, Canada, L2S 3A1 [email protected] 905-688-5550 ext. 5161
____________________________________________________________________________________________________________
ID: 230
HEALTHY AGEING AND PREVENTABLE INFECTIOUS DISEASES VACCINES
OK
Jean-Pierre MICHEL (EUGMS - European Union Geriatric Medicine Society, Rehabilitation & Geriatrics , Switzerland)
Stefania MAGGI, Italy (1) Jean-Pierre MICHEL, Switzerland (2) Jean-Pierre BAYENS, Belgium (3) Joël BELMIN, France (4)
(1) EUGMS (2) EUGMS (3) IAGG-ER (4) Université Paris 6
Vaccines which have drastically reduced the burden of childhood diseases are not yet accepted as contributing to improving healthy ageing. The
absence of sustainability in vaccine programmes does not enable maintenance of life-long protection against such childhood diseases as measles and
pertussis, which may result soon in increasing incidence of these diseases in adults. Moreover, infectious diseases remain a significant cause of
morbidity and mortality in the increasing population of adults over 65. The high burden of infectious diseases in this part of the population is
disproportionate considering that many of these diseases are vaccine-preventable. The heterogeneous and generally low immunization rates in this
population in Europe are probably related to highly divergent clinical recommendations and public health policies.
Longer life expectation necessitates vaccine guidelines based on better knowledge of the process of immunosenescence. Adaptation of vaccine
recommendations to older adults and different subgroups such as those living in the community and the institutionalized oldest old are needed. The
main focus of these European clinical vaccine guidelines, consensually produced at the request of the two European geriatric and gerontological
societies (EUGMS and IAGG-ER) is to promote preventive aspects in geriatric medicine, concerning both life threatening-diseases (tetanus,
pneumococcal pneumonia, and influenza) and diseases which adversely impact patient's quality of life (pertussis and herpes zoster).
These guidelines are designed to complement existing information and provide practical guidance to health care professionals dealing with the older
people (or to their family members) regarding the willingness to vaccinate and being vaccinated. Innovative policy and tools are detailed.
VACCINE AND HEALTHY AGEING
THE UPDATED VACCINE GUIDELINES FOR AGEING AND AGED CITIZENS OF EUROPE
ENSURING THE WILLINGNESS TO VACCINATE AND BEING VACCINATED
EDUCATIONAL VACCINE TOOLS: THE FRENCH INITIATIVE
Chair(s)
Paul Knight Registrar, Royal College of Physicians and Surgeons of Glasgow. Honorary Professor, Clinical Leadership, University of Glasgow.
[email protected] +44 141 211 4926
Cruz jentoft Alfonso Unidad de Geriatria, Hospital Ramon y Cajal, Madrid [email protected] +34 918 035 830
____________________________________________________________________________________________________________
ID: 217
AMBIENT ASSISTED LIVING TECHNOLOGIES IN AN AGING WORLD
Victor Hirth (University of South Carolina / Palmetto Health, Division of Geriatrics, United States)
Michael Huch, Germany (1) Elizabeth Steinhagen-Thiessen, Germany (2) Juegen Nehmer, Germany (3) Victor Hirth, United States of America (4)
(1) VDI/VDE (2) Charite Hospital (3) Fraunhofer IESE (4) Palmetto Health / University of South Carolina
The aging of the population is occurring worldwide but especially in the Western hemisphere. Unfortunately, with this process there will be an
increasing number of older adults with both physical and cognitive impairments that will affect their ability to live independently. The associated costs
to both societies and families will be substantial. The field of Ambient Assisted Living (AAL) is developing rapidly and offers the promise of enhancing
the quality of life as well as the potential for saving costs for health plans and individuals.
This symposium will address the problems and demands of this aging population both on health care systems and communities level.
Central to each AAL solution is a sound awareness of the elders’ situation and their actual need for assistance and an adequate presence of the
solutions. In particular, Ambient Assisted Living provides
automated support to carry out daily activities
health and activity monitoring
enhanced safety and security
access to social, medical, and emergency systems
promotion of social contacts
context-based infotainment and entertainment.
This workshop will bring together experts from academia and industry to identify and discuss specific demands, approaches, and solutions with regard
to awareness and presence in the AAL domain. This series of four talks will cover the problems, situations and conditions of the aging older adult in
Western societies, practical AAL solutions currently being utilized, the current state of AAL technologies including robotics and finally research and
policy as it applies to AAL.
PROBLEMS AND ISSUES FACING AN AGING GENERATION
AAL SOLUTIONS ALREADY IN USE
AAL TECHNOLOGY THE PRESENT AND FUTURE
RESEARCH AND DEVELOPMENT OF AAL SOLUTIONS AND IMPACT OF POLICY
Chair(s)
Paul Eleazer 3010 Farrow Road, Suite 300A, Columbia, SC 29203 [email protected] 001 803 434 4330
____________________________________________________________________________________________________________
ID: 221
DIFFERENT PATHWAYS FOR A COMMON PURPOSE:
TEACHING GERIATRIC MEDICINE FOR UNDERGRADUATES STUDENTS
Roberto Kaplan (National University of Buenos Aires, Faculty of Medicine, Argentina)
Gustavo Duque, Australia (1) David Galinsky, Israel (2) Juan F. Macías Nuñez, Spain (3) José R. Jauregui, Argentina (4)
(1) Sidney University (2) Bengurion University (3) Salamanca University (4) Buenos Aires University
It has been and it´s still traditionally hard to incorporate innovatives changes in undergraduate programmes in medical teaching.
The case of geriatric medicine, actually seems to show additional issues produced by differents kinds of influencies.
We will try to discuss how and why, this kind of influencies, as demographie, epidemiologycal, income levels, health resources, aged opinions and
scientific development, faces the medical teaching model up to this challenges.
We will describe four different degrees of development on the subject matter-undergraduate geriatric education- in different Medical Schools, in Spain,
Argentina, Israel and Australia
Prof. Duque: "How to design teaching programs in geriatrics for undergraduates"
Prof. Galinski: "Teaching Geriatrics in Israel: From the first chair up to present"
Prof. Macías Nuñez: "State of Art of Geriatric Education for undergraduates in Spain"
Prof. Jauregui: "A 40 years uneven story about a geriatric chair in an Argentine University"
Chair(s)
Roberto Kaplan Gascon 450 [email protected] +5411 4959020 ext 3103
____________________________________________________________________________________________________________
ID: 225
HOW TO OPTIMIZE DRUG THERAPY IN OLDER PATIENTS?
Joel BELMIN (Hop Charles Foix and Universite Paris 6, Geriatrics, France)
René Amalberti, France (1) Neil Wenger, United States of America (2) Joel Belmin, France (3) Anne Spinewine, Belgium (4)
(1) Haute Autorité de Santé (2) University of California at Los Angeles (UCLA) (3) Hop Charles Foix et Université Paris 6 (4) Clinique universitaire de Mont Godinne
To improve patient safety is a major concern of the health care system. Old individuals are particularly susceptible to adverse drug events (ADE) and
their consequences. A large body of literature has documented that ADE incidence rate markedly increases with age and the number of drugs
prescribed. In addition, research has shown that up to a third of ADE could have been avoided if standard knowledge about drug prescribing for older
adults had been applied. This knowledge has been summarized in clinical guidelines like the consensus-based list of potentially inappropriate drugs
for older patients and guidelines for drug utilisation in the elderly with specific diseases.
Despite these advances, numerous studies report drug utilisation to be far from optimal in the elderly, whatever the setting (primary care, hospital or
nursing home). Little is know about the interventions capable to improve the way physicians prescribe to older patients. Classical educational
interventions have been tried but failed or only achieved transient effects. More recently, implementation of quality of care criteria in electronic software
used by physicians to prescribe drugs has made it possible to provide alerts to physicians at the time they write orders. Collaborative approaches
between physicians and pharmacists in the clinical setting have been also proposed. Intervention studies showed that these approaches were
effective in improving the quality of drug utilisation. In this view, the development of new quality of care indicators for drug prescription in the elderly
and their use in intervention studies combining several approaches, such as education, electronic prescription systems and collaborative care, might
be a promising way to prompt better use of drugs in older patients in clinical practice.
The symposium will explore recent advances and directions to improve drug therapy in older patients. The first presentation will analyse the causes of
DAE in older patients. Human factors and barriers to changes in prescribing will be discussed. The second will review the quality indicators used to
assess drug prescribing in frail and older individuals. The third will discuss drug prescribing in old patients with renal failure and present the results of
an intervention study designed to improve drug prescribing in these patients. The last will present a collaborative approach in a geriatric hospital ward
involving geriatricians and pharmacists and and the results of an intervention study that documents its efficacy.
MEDICATION SAFETY FOR OLDER PATIENTS: A TYPOLOGY OF ADVERSE EVENTS CAUSES (R. AMALBERTI)
MEASURING THE QUALITY OF PHARMACOLOGIC CARE FOR ELDERS (N. WENGER)
OPTIMIZING DRUG THERAPY FOR OLD ADULTS WITH IMPAIRED RENAL FUNCTION (J. BELMIN)
COLLABORATIVE CARE TO OPTIMIZE DRUG THERAPY IN THE ELDERLY (A. SPINEWINE)
Chair(s)
Jean-Pierre Michel EUGMS - European Union Geriatric Medicine Society [email protected] + 41 22 305 65 00
Wenger Neil University of California at Los Angeles (UCLA) - 911 Broxton Plaza [email protected]
____________________________________________________________________________________________________________
ID: 227
THE AGING EYE – EPIDEMIOLOGY, QUALITY OF LIFE AND ULTRA-CENTENARIAN VISION
MARCELA CYPEL (UNIFESP, Ophthalmology, Brazil)
MARCELA CYPEL, Brazil (1) SOLANGE SALOMÃO, United States of America (1) RUBENS BELFORT, (1) FLAVIO HIRAI, (2)
(1) Opthalmology DepartmentUNIFESP/Instituto da Visão (2) Departament of Epidemiology Johns Hopkins Bloomberg School of Public Health
Vision plays an important role in the quality of life in older people. The impact of visual loss on personal, economic and social life is profound. Visual
impairment in older population is associated with difficulties with general vision, near activities, vision related social functioning and dependency on
other to perform visual tasks. Studies present results that when seeing badly the old person has twice more risk of falling down, three times more risk
of getting depressed, twice more risk of losing his independence and normally are left earlier in to an institution.
Prevalence of blindness and visual impairment increases with age and among women because of their socioeconomic vulnerability. Recent studies on
this area have brought significant epidemiological data helping us to guide healthcare policies for older adults. Some of the important data that came
up were that the refractive errors are a cause of vision impairment and blindness as important as cataract and age related macular degeneration; and
age related macular degeneration shows to be the principal disease when we talk about the very old people.
Centenarians and ultracentenarians are a very special and unique group yet deserving attention when studying old populations. Data on eye disorders
and vision related quality of life from 40 centenarians have been recently studied in Brazil.
In this symposium we will present ophthalmologic findings on studies guided by World Health Organization, explain the most frequent eye diseases
found on older people and give also a special focus on centenarian data, bringing the ophthalmology together with gerontology and geriatrics.
Publications of our group:
Salomão SR., Berezovsky A., Araüjo-Filho A., Belfort RJr.,Ellwein LB. et al. Prevalence and Causes of Vision Impairment and Blindness in Older
Adults
in
Brazil:
The
São
Paulo
Eye
Study.
Ophthalmic
Epidemiology,
15:3,
167-175,
2008.
http://www.informaworld.com/smpp/content~db=all?content=10.1080/09286580701843812
Araujo-Filho A., Salomão SR., Berezovsky A., Belfort RJr. et al. Prevalence of visual impairment, blindness, ocular disorders and cataract surgery
outcomes
in
low-income
elderly
from
a
metropolitan
region
of
São
Paulo
-
Brazil.
Arq
Bras
Oftalmol.
71(2):246-53,
2008.
http://www.abonet.com.br/abo/72/246-253.pdf
Cypel
MC,Belfort
RJr
et
al.
Ocular
findings
in
patients
older
than
99
years.
Arq.
Bras.
Oftalmol.
69(5):665-9,
http://www.scielo.br/pdf/abo/v69n5/a08v69n5.pdf
EPIDEMIOLOGICAL DATA ON AGING EYE
ACTUAL STUDIES FOR AGING AND VISION BY THE WORLD HEALTH ORGANIZATION
MOST FREQUENT EYE DISEASES ON THE OLD POPULATION
THE EYE AT 100 YEARS OF AGE
Chair(s)
Marcela Cypel Rua Simão Álvares, 1015 cep 05417-030 Brazil [email protected] 005511.91982134
Belfort Jr Rubens Rua Augusta, 2529 cep 01413-100 Brazil [email protected] 005511. 30610517
____________________________________________________________________________________________________________
2006.
ID: 232
SKELETAL MUSCLE POWER AND AGING: BIOLOGICAL DETERMINANTS AND FUNCTIONAL IMPLICATIONS.
Roger Fielding (Tufts University, Nutrition, Exercise Physiology, and Sarcopenia Laboratory, United States of America)
Lars Larsson, Sweden (1) Marco Narici, United Kingdom (2) Sarianna Sipila, Finland (3) Roger Fielding, United States of America (4)
(1) University of Uppsala (2) Manchester Metropolitan University (3) University of Jyvaskyla (4) Tufts University
With the continuing rise in the population of individuals over the age of 65, there will continue to be an increase in the prevalence of mobility
limitations. Limitations in mobility in tasks such as rising from a chair and walking have been shown to be predictive of subsequent disability. Although
a large number of studies have established the role of muscle strength (maximum force generating capacity) as a predictor of functional limitations in
older adults, peak muscle power or the maximum capacity to perform muscular work per unit time may be a more critical variable in understanding the
relationship between impairments, functional limitations, and resultant disability with advancing age. Peak muscle power has only recently been
examined as an outcome variable distinct from muscle strength, and has been reported to decline earlier and more precipitously with advancing age.
Peak lower extremity power has also been associated with functional limitations and falling risk in institutionalized elders.
This symposium will discuss the state of current work examining our understanding of the proximal determinants of muscle power output and their
relationship to mobility limitations and disability. Presenters will specifically focus on the underlying age-related changes in motor systems associated
with reduced muscle power. In addition, the presenters will discuss novel therapeutic interventions targeted at restoring muscle power in older
individuals.
Serving as chair for this symposium will be Dr. Roger Fielding from Tufts University, Boston, USA. Participants will include Dr. Fielding, Dr. Lars
Larsson from the University of Uppsala, Sweden, Dr. Marco Narici from Manchester Metropolitan University, United Kingdom, and Dr. Sarianna Sipila
from the University of Jyvaskyla, Finland. Dr. Larsson will discuss the mechanisms underlying the age-related slowing of muscle contraction. Dr.
Narici will focus on the origins of skeletal muscle weakness with advancing age. Dr. Sipila will present new information of the effects of hormone
replacement therapy on muscle power. Finally, Dr. Fielding will discuss the results of recent intervention trials on muscle power and provide a
summary of the implications of this work in relationship to function and disability in the elderly.
This symposium will bring together four international researchers who have been at the forefront of research in this area. The results of this
symposium will clarify the importance of lower extremity muscle power as critical determinant of physical functioning among older adults.
MECHANISMS UNDERLYING THE AGING-RELATED SLOWING OF MUSCLE CONTRACTION FROM THE MOTOR UNIT, MUSCLE CELL TO
THE MOTOR PROTEIN LEVEL.
ORIGINS OF MUSCLE WEAKNESS IN OLD AGE.
HORMONE REPLACEMENT THERAPY AND SKELETAL MUSCLE POWER IN POST-MENOPAUSAL WOMEN.
CAN EXERCISE TRAINING INTERVENTIONS ALTER AGE-RELATED CHANGES IN SKELETAL MUSCLE POWER?
Chair(s)
Roger Fielding Tufts University, 711 Washington Street, Boston MA 02111 [email protected] 617-556-3016
____________________________________________________________________________________________________________
ID: 243
DEPRESSION AS A COMORBIDITY WITH CHRONIC ILLNESS: LONGITUDINAL RESEARCH FROM THE DEVELOPED AND DEVELOPING
WORLD.
Parkinson Lynne (University of Newcastle, Research Centre for Gender, Health and Ageing, Australia)
Lynne Parkinson, Australia (1) Agnes Vitry, Australia (2) Gillian Hawker, Canada (3) Paola Zaninotto, United Kingdom (4)
(1) University of Newcastle (2) University of South Australia (3) University of Toronto (4) University College of London
Depression is one of the most common mental disorders and a leading cause of functional impairment, disability, and days lost from work in
industrialized countries (Schmitz etal, 2007). Several recent studies (Moussavi etal, 2007; Scott etal, 2007; Aragones etal, 2007; Egede, 2007; Wong
etal, 2008) have suggested an increased risk of depression associated with several chronic diseases. However, it is not yet clear how depression
influences health outcomes associated with comorbidities and how screening and treatment of depression may improve health outcomes.
This symposium will draw on longitudinal cohort studies data from three developed countries (Australia, Canada, UK) and World Health Surveys to
examine the link between depression and other chronic disease, in terms of prevalence, incidence, burden of illness and management.
*Dr Lynne Parkinson, Senior Research Fellow, University of Newcastle, Australia, will present research from Australian Longitudinal Study on Womens
Health (http://www.alswh.org.au/) which tracks burden of illness (physical and mental) and management of Arthritis, particularly pharmacotherapy
(using linked survey and pharmaceutical administrative data).
*Dr Agnes Vitry, Senior Lecturer, Sansom Institute, University of South Australia; project leader, “Optimal ageing for people with multiple chronic
conditions” study (http://www.unisa.edu.au/sansominstitute/researchactivities/groups/qumprc.asp) based around Australian Longitudinal Study on
Ageing and Australian Department of Veterans’ Affairs health databases, will present data on antidepressant medication use and depression with
regards to comorbidities.
*Dr Gillian Hawker, Physician-in-Chief, Department of Medicine, Womens College Hospital; FM Hill Chair, Academic Womens Medicine; Director,
Canadian Osteoarthritis Research Program, University of Toronto (http://www.osteoarthritisresearch.ca/index.html), will present research on the
interrelationships among pain, fatigue/sleep and mood in older people with osteoarthritis from longitudinal surveys of people with hip and knee
Osteoarthritis, linked to provincial administrative databases to explore health care utilization.
*Ms Paola Zaninotto, English Longitudinal Study on Ageing (http://www.ifs.org.uk/elsa/) statistician; PhD student, University College London, will
explore the mediating effect of symptoms of depression on quality of life for those with angina or history of myocardial infarction.
* Dr Somnath Chatterji , Coordinator, Study on Global Ageing and Adult Health; Team Leader, Multi-Country Studies Unit, World Health Organization,
Geneva, Switzerland (chatterjis&who.int) who has authored numerous papers on the dynamics of physical and mental health, will act as symposium
discussant for, introducing the perspective of lower income countries and links to higher income countries.
ARTHRITIS AND DEPRESSION: THE BURDEN OF SUFFERING FOR OLDER AUSTRALIAN WOMEN.
DEPRESSION AND CHRONIC ILLNESS: LONGITUDINAL ADMINISTRATIVE DATA FOR AUSTRALIAN VETERANS.
OSTEOARTHRITIS AND DEPRESSION: LONGITUDINAL FINDINGS FROM CANADA.
THE ROLE OF DEPRESSION IN THE RELATIONSHIP BETWEEN CORONARY HEART DISEASE AND QUALITY OF LIFE: RESULTS FROM
ELSA.
Chair(s)
Lynne Parkinson Research Centre for Gender, Health and Ageing, University of Newcastle University Drive Callaghan NSW 2308 Australia
[email protected] +61 249138232
Chatterji Somnath WHO, Geneva 27, Switzerland [email protected] +61 249138232
____________________________________________________________________________________________________________
ID: 296
FOSTERING THE PARTICIPATION OF OLDER SUBJECTS IN CLINICAL TRIALS
Antonio Cherubini (EUGMS, Gerontology and Geriatrics, Italy)
Alfonso Cruz Jentoft, Italy (2) Antonio Cherubini, Spain (1) Susanna Del Signore, United Kingdom (3) Roberto Bernabei, Italy (4)
(1) University of Perugia (2) Hospital Universitario Ramón y Cajal (3) European Medicine Agency (4) Università Cattolica
Older people are still excluded from clinical trials. Despite Regulatory Agencies, such as EMEA in Europe and FDA in the USA, released guidelines
supporting the inclusion of older people in clinical trials, recent reviews demonstrated that in many cases older subjects, particularly those with multiple
diseases and disability, are commonly excluded from clinical trials. This limits the generalizability of the findings of clinical trials and expose older
subjects to a higher risk of inappropriate prescription and adverse drug events. After the approval of the Pediatric regulation by EU, which is aimed at
guaranteeing high quality research for drugs to be used in children, the EUGMS wrote to the European Commission to highlight that a similar problem
was also present in older people. The European Commission answered the EUGMS and asked the EMEA to re-evaluate the topic. After this letter a
series of initiatives were promoted both by EMEA and by the EUGMS to revise the whole area. Recently the Italian Drug Agency established a
geriatric working group to address the peculiarity of pharmacotherapy and drug evaluation in older people and to advance the whole field. In this
symposium there will be a thorough discussion of the state of the art of the area of drug evaluation in older people.
The exclusion of older people from clinical trials
THE POINT OF VIEW OF THE EUROPEAN UNION GERIATRIC MEDICINE SOCIETY
THE POINT OF VIEW OF EMEA
THE EXPERIENCE AND THE FUTURE OF THE GERIATRIC WORKING GROUP IN ITALY
Chair(s)
Jean Pierre Baeyens Gen. Jungbluthlaan, 11 - B-8400 OOSTENDE, Belgium [email protected] 0032475266820
Bernabei Roberto Centro di medicina dell'invecchiamento, Università cattolica del sacro cuore, Roma, Italy [email protected]
0039063388546
____________________________________________________________________________________________________________
ID: 260
ETHNOGERIATRICS - DIFFERENCE IN SCREENING FOR GASTROINTESTINAL CANCER IN ELDERLY BETWEEN ORIENTALS AND
WESTERNS
Chang Won Won (Kyunghee University, College of Medicine, Family Medicine, Korea, Republic of)
Hyung Joon Yoo, Korea, Republic of (1) Dong Ho Lee, Korea, Republic of (2) William R. Hazzard, United States of America (3) Chang Won Won, Korea, Republic of (4)
(1) Internal Medicine, Hangan Hallym University Hospital (2) Internal Medicine, Bundang Seoul National University Hospital (3) Geriatrics & Extended Care VA Puget
Sound Health Care System Professor of Medicine University of Washington (4) Family Medicine, Kyunghee Medical Center
▪ the scientific purpose and content of the proposal
1.understanding of the difference in incidence and screening strategy of Gastric cancer and colon cancer between Orientals and Westerns
2.understanding of differences in clinical behaviors between Korean - and American geriatricians in gastrointestinal cancer screening for a Korean
elderly who have just immigrated to USA
▪ explain the choice of participants
participants are composed of a Korean gastroenterologist, two Korean geriatricians, and one American geriatricians.
▪ present its novelty and scientific interest in the context of international research
Gastric cancer is one of the most common cancers in Korea (and in many Asia) and colon cancer is less common. But in America (and in many
western country), colon cancer is much more common than gastric cancer. As many American doctors don’t have idea of these differences, they are
not likely to recommend gastrofiberscopy for Korean-Americans, especially who have immigrated recently.
We recently surveyed about Clinical behavior of Korean- and American Geriatricians as regards periodic Gastro-Intestinal cancer screening
examination for Korean-American older adults. The results will be presented and help Western geriatricians understand the higher incidence of gastric
cancer in Asians and screening strategy for them.
1. INTRODCTION - DR. YOO, HYUNG JOON (CHAIR OF THE FEDERATION KOREAN GERONTOLOGICAL SOCIETIES, HALLYM UNIVERSITY)
2. CHARACTERISTICS AND SCREENING OF GASTROINTESTINAL CANCER IN KOREANS - DR. LEE, DONG HO (DEPT OF INTERNAL
MEDICINE, SEOUL NATIONAL UNIVERSITY)
3. CHARACTERISTICS AND SCREENING OF GASTROINTESTINAL CANCER IN AMERICA - WILLIAM R. HAZZARD (UNIVERSITY OF
WASHINGTON)
4. DIFFERENCE IN CLINICAL BEHAVIOR OF GERIATRICIANS ABOUT PERIODIC GASTRO-INTESTINAL CANCER SCREENING EXAMINATION
FOR KOREAN-AMERICAN OLDER ADULTS. -DR. WON, CHANG WON(KYNGHEE UNIVERSITY)
Chair(s)
____________________________________________________________________________________________________________
ID: 262
OBESITY IN OLD AGE
Marjolein Visser (VU University Amsterdam, Institute of Health Sciences, The Netherlands)
Marjolein Visser, (1) Moniek Van Zutphen, (2) Noor Heim, (1) Sari Stenholm, United States of America (3)
(1) VU University Amsterdam (2) National Institute of Public Health and the Environment (3) VU University Amsterdam (4) National Institute on Aging
The continuing obesity epidemic and demographic changes in the developed countries will increase the number of obese older adults. From 2000 to
2010, the total number of obese adults will increase with 9.3 million in the United States, of whom 8.3 million are aged 50 years and older. Similar
trends are observed in European countries. The burden of obesity is therefore likely to shift to the older age ranges.
In aging research only recently the focus on undernutrition and frailty is shifting towards more research focusing on the problem of overnutrition in old
age. Interesting results from obesity research recently conducted in older persons warrant the organization of this symposium.
The aim of this symposium is to inform the audience about the obesity problem in the older population, its specific consequences for health and
functioning, and to discuss issues related to the assessment of obesity in older persons. The participants work at different research institutes or
universities from two different countries and are currently actively involved in obesity research with a specific focus on older persons.
Several key issues related to obesity in old age will be presented during the symposium. First, an overview of the current and expected prevalence of
obesity in the older population will be given. Attention will also be paid to the perception of body weight and obesity by older persons since this may
have consequences for the development of prevention strategies. Secondly, the association between obesity in old age and disease-specific mortality
will be presented. While the impact of obesity in old age on overall mortality is controversial, much less in known about disease-specific mortality using
a competing risk model. The third issue to be presented is the applicability of commonly used cut points to assess obesity in older persons. Current cut
points and new cut points (developed according to the same methodology) will be applied and the associated risk of poor physical functioning will be
presented. The final presentation will introduce the concept of sarcopenic-obesity and discuss its development and consequences.
The proposed symposium will provide state-of-the-art knowledge on several key issues related to obesity in old age which is based on high-quality,
international research.
TRENDS IN OBESITY AND PERCEPTION OF BODY WEIGHT IN THE OLDER POPULATION
OBESITY IN OLD AGE AND DISEASE-SPECIFIC MORTALITY
CAN COMMONLY USED CUT POINTS FOR OBESITY BE APPLIED TO OLDER PERSONS?
DEVELOPMENT AND CONSEQUENCES OF SARCOPENIC OBESITY
Chair(s)
Marjolein Visser VU University [email protected] +31 20 598 9282
____________________________________________________________________________________________________________
ID: 272
COGNITION AND ANTIHYPERTENSIVE TREATMENT
Olivier Hanon (Broca hospital, Geriatrics, France)
Sandra Black, Canada (1) Olivier Hanon, France (2) Naoyuki Sato, Japan (3) Gordon Wilcock , United Kingdom (4)
(1) Division of Neurology, Sunnybrook and Women's College Health Sciences Centre (2) Broca hospital (3) Division of Clinical Gene Therapy, Graduate School of Medicine
(4) John Radcliffe Hospital, University of Oxford
Many studies over the last decade have shown an association between hypertension and cognitive decline or dementia, including Alzheimer’s
disease. Several pathophysiological mechanisms may explain this association. Hypertension gives rise to vascular modifications which affect blood
flow and cerebral metabolism. Moreover, disorders of cerebral microcirculation and endothelial function may also be responsible for cognitive
disorders in hypertensive patients.
However, the role of antihypertensive therapy on cognitive function remains uncertain.
There are few randomised placebo controlled studies, although some of these have produced positive results, the effect of antihypertensive therapy on
cognition remains controversial.
Results of three recent meta-analyses are inconsistent, possibly due to methodological issues or a class effect of the antihypertensive therapy used.
Some trials suggest that the disruption of calcium homeostasis may be one of the molecular basis of the pathogenesis of Alzheimer’s disease and
have speculated that the calcium channel blockers may have particular advantages for the prevention of cognitive disorders through a specific
neuroprotective action. Other trials suggest a key role of brain rennin angiotensin system in the pathophysiology of cognitive impairment and
Alzheimer’s disease, suggesting the interest of Angiotensin Conversion Enzyme Inhibitors or Angiotensin Receptor blockers (ARB).
In this symposium we will discuss
1.The relationship between hypertension and cognition (on the basis of experimental and epidemiological studies)
2.The data of therapeutic trials evaluating the effects of antihypertensive therapy on cognition
3.The pharmacodynamic mechanisms on cognition of antihypertensive drugs
4.The optimal antihypertensive therapy for preventing cognitive decline in the elderly hypertensive patients
AGE-RELATED BLOOD PRESSURE INCREASE AND COGNITIVE DECLINE
CEREBROVASCULAR LESION AND COGNITIVE DECLINE
PHARMACODYNAMIC MECHANISMS ON COGNITION OF ANTIHYPERTENSIVE DRUGS
EFFECT OF ANTIHYPERTENSIVE THERAPY ON COGNITIVE DECLINE
Chair(s)
Françoise FORETTE Fondation nationale de gérontologie, Paris france [email protected] 33144083503
HANON Olivier broca hospital Paris, france [email protected] 33144083502
____________________________________________________________________________________________________________
ID: 292
NUTRITION AS A DETERMINANT OF SUCCESSFUL AGING : LONGITUDINAL AND INTERDISCIPLINARY PERSPECTIVES FROM THE NUAGE
STUDY
Hélène Payette (Research Center on Aging - HSSC-UIGS, Faculty of Medicine and Health Sciences - University of Sherbrooke, Canada)
Bryna Shatenstein, Canada (1) Pierrette Gaudreau, Canada (2) Roula Barake, Canada (3) Lucie Richard, Canada (4)
(1) University of Montreal (2) University of Montreal (3) University McGill (4) Université of Montreal
NuAge is a longitudinal study of nutrition and aging that recruited 1,793 men and women aged 67 to 84 years, in the areas of Montreal and
Sherbrooke (Québec, Ca), and followed them for 4 years (2003-2008). At recruitment, NuAge subjects had good levels of physical and functional
capacity, low rates of self-reported chronic health conditions, including depression, good cognitive function and high levels of self-assessed well-being.
Each year, participants provided a series of nutritional, functional, medical, biological, behavioral and social measurements. Data were gathered using
computer-assisted personal interviews, validated dietary assessment techniques and questionnaires, standardized tests of physical function and
muscle strength, DXA and biological measures. As a research platform, the NuAge cohort is a rich data source for studying the impact of changes in
diet, body composition and biological markers in the course of aging on transitions between different health states, while considering the complex
interrelationships between biological, physical, psychosocial and societal factors that affect healthy aging.
More specifically, this symposium
addresses how diet quality and biological markers affect indicators of healthy aging, and examines determinants of social participation, a key
determinant of successful aging, in the NuAge cohort. The first paper examines whether adherence to dietary guidelines by older adults over time
signals optimal body weight, and better muscle strength and physical performance.
The second paper reports on the associations between
macronutrient intake, and insulin and IGF-1 serum levels, along with the potential of these biomarkers to predict changes in body composition during
aging. The third paper aims to clarify the whether or not the previously reported link between vitamin D status and functional decline is confounded by
dietary intake of other important foods or nutrients or by physical activity. The final paper describes trajectories of social participation (defined as the
involvement of the person in the community) as determined by personal (i.e. physical and mental health, perceived functioning) and environmental (i.e.
neighbourhood living conditions, including housing facilities and access to healthy foods) factors. By permitting determination of nutrient requirements
and guidelines for optimal nutrition in the elderly and elucidating mechanisms whereby inappropriate nutrition accelerates functional decline, the
NuAge cohort study will have a significant impact on development of population-based strategies for promoting healthy aging and preventing disability
based on nutrition, a modifiable lifestyle factor. Supported by CIHR and FRSQ.
IS ADHERENCE TO DIETARY GUIDELINES OVER A 2-YR ASSOCIATED WITH THE MAINTENANCE OF OPTIMAL BODY WEIGHT, MUSCLE
STRENGTH AND PHYSICAL PERFORMANCE?
DIETARY MODULATION OF INSULIN AND FREE IGF-1 SERUM LEVELS, AND THEIR ROLE AS INDICATORS OF CHANGES IN BODY
COMPOSITION, MUSCLE STRENGTH AND FUNCTIONAL CAPACITY.
DOES VITAMIN D STATUS PREDICT DECLINE IN FUNCTIONAL STATUS?
PERSONAL AND ENVIRONMENTAL DETERMINANTS OF TRAJECTORIES OF SOCIAL PARTICIPATION.
Chair(s)
Hélène Payette Centre de recherche sur le vieillissement, 1036 Belvédère S, Sherbrooke, Qc, Canada, J1H 4C4 [email protected]
819-821-1170*45636
____________________________________________________________________________________________________________
ID: 297
THE INTERNATIONAL DATABASE INQUIRY ON FRAILTY (FRDATA): A COMMON APPROACH TO A COMPLEX PROBLEM
Howard Bergman (Jewish General Hospital - McGill University, Geriatric Medicine, Canada)
Christina Wolfson, Canada (1) Nadia Sourial, Canada (2) Martine Puts, United States of America (2) Jack Guralnik, (3)
(1) McGill University (2) Jewish General Hospital (3) National Institute of Aging
PURPOSE AND CONTENT
There is no consensus concerning the characteristics that constitute the syndrome of frailty. The International Database Inquiry on Frailty (FrData) is a
research initiative that aims to improve our understanding of frailty. The first objective of FrData is to explore the associations among seven candidate
characteristics of frailty (nutrition, physical activity, mobility, strength, endurance/energy, mood and cognition); the second objective is to test the ability
of these characteristics, individually and in combination, to predict adverse health outcomes. Data from 9 longitudinal studies of aging from 5 countries
(Canada, US, Mexico, Italy, and the Netherlands) will be presented and findings across differing elderly populations will be compared and discussed.
PARTICIPANTS
Christina Wolfson, PhD, is co-Principal Investigator of FrData and has unique expertise in epidemiology and biostatistics as well as research on aging.
Her input was critical in developing a clinically and statistically appropriate methodology for FrData. She will present the methodological challenges
involved in studying this complex syndrome.
Nadia Sourial, MSc, is the lead biostatistician responsible for the development and application of the methodology. She will present an overview of the
results obtained across the various studies and discuss the similarities and differences in the findings.
Martine Puts, PhD, is a post-doctoral fellow in epidemiology with a strong background in frailty and an in-depth understanding of the LASA study. She
will explain in detail the application of the FrData methodology and results from the LASA data.
Jack Guralnik, MD, MPH, PhD, is chief of the Laboratory of Epidemiology, Demography and Biometry at the National Institute on Aging. He has
worked extensively in the area of frailty and measures of physical performance. He will discuss the challenges in choosing suitable measures for the
characteristics of frailty.
NOVELTY AND SCIENTIFIC INTEREST IN THE CONTEXT OF INTERNATIONAL RESEARCH
There are several studies in the literature that have reported on the predictive validity of various operational definitions of frailty. However, there has
been little research exploring the associations among the proposed characteristics and comparing their predictive validity individually and in
combination. These forms of empirical evidence are essential to elucidate whether particular characteristics belong to the construct of frailty.
Replication of a rigorous methodological approach and statistical analysis using data from multiple studies will allow us to evaluate the robustness of
the findings.
CHRISTINA WOLFSON:
THE APPLICATION OF A NOVEL STATISTICAL METHODOLOGY TO AN IMPORTANT GERIATRIC ISSUE
NADIA SOURIAL:
FRDATA: AN OVERVIEW OF THE RESULTS ACROSS INTERNATIONAL DATABASES
MARTINE PUTS:
RESULTS FROM THE LONGITUDINAL AGING STUDY AMSTERDAM (LASA)
JACK GURALNIK:
CHALLENGES IN CHOOSING THE “BEST” MEASURES OF FRAILTY
Chair(s)
Howard Bergman Division of Geriatric Medicine, Jewish General Hospital 3755 Côte-Ste-Catherine Montréal, QC Canada H3T 1E2
[email protected] 514-340-8222 ext. 4352
____________________________________________________________________________________________________________
ID: 318
MULTIMORBIDITY: THE SYNDROME OF THE AGING POPULATION
Laura Fratiglioni (Aging Research Center, Karolinska Institute, NVS, Sweden)
Alessandra Marengoni, Sweden (1) Luigi Ferrucci, United States of America (2) Jack Guralnik, United States of America (3) Mats Thorslund, Sweden (4)
(1) Aging Research Center; Karolinska Institute (2) Longitudinal Studies Section; National Institute on Aging; National Institutes of Health (3) Laboratory of Epidemiology,
Demography and Biometry; National Institute on Aging; National Institutes of Health (4) Aging Research Center; Karolinska Institute
This symposium will address the critical issue of multimorbidity (the co-occurrence of diseases in the same person (van den Akker & Buntinx, 1998)) in
aging populations. The global phenomenon of population aging has been well-established. Furthermore, the elderly are the demographic greatest
affected by chronic disease (van den Akker, et al., 1998, Wolff 2002). The prevalence of multimorbidity increases with age, peaking in persons aged
80+ (Marengoni, 2008). People aged 80+ are also the fastest growing segment of the population (Kinsella 2005) in developed countries. The ongoing
demographic changes are expected to lead to an exacerbation of the problem of multimorbidity, in terms of prevalence as well as the patterns and
severity of comorbid conditions (Yach et al., 2004; Gijsen et al., 2001).
Few data exist on the etiologic and pathogenic mechanisms of multimorbidity (Gijsen et al, 2001). Pleiotropic risk factors that contribute to multiple
diseases, and to frailty, (e.g. chronic inflammation, oxidative stress and obesity) require consideration. Treatment and care strategies may differ by
multimorbidity status. Finally, knowledge remains limited on the different pathways leading to negative outcomes such as functional dependence and
mortality.
In this symposium, a panel of four experts has agreed to present information regarding the descriptive epidemiology, determinants, consequences,
and care strategies of multimorbidity:
1) Dr. Alessandra Marengoni has recently completed a thorough examination of the prevalence and impact of multimorbidity in the elderly. She will
share important findings from this innovative work related to the occurrence and patterns of multimorbidity in the elderly.
2) Dr. Luigi Ferrucci is Chief of the Longitudinal Studies section at the NIA, NIH, USA. He has made important advancements to the concept of frailty.
He will discuss the biological basis of frailty in the elderly, and share his recent work which addresses how multimorbidity is related to frailty.
3) Dr. Jack Guralnik is Chief of the Laboratory of Epidemiology, Demography and Biometry at the NIA, NIH, USA. He is an expert regarding how
specific chronic diseases impact outcomes of functional limitation (FL) and disability in the elderly. He will share findings related to the impact of
multimorbidity on FL and disability.
4) Dr. Mats Thorslund is a professor at Karolinska Institute and the project leader of the SWEOLD (the Swedish Panel Study of Living Conditions of
the Old). Dr. Thorslund has agreed to share important findings related to the care of persons suffering with multimorbidity.
OCCURRENCE AND PATTERNS OF MULTIMORBIDITY
THE BIOLOGICAL BASIS OF FRAILTY IN THE ELDERLY PERSON
FUNCTIONAL LIMITATIONS IN SUBJECTS WITH MULTIMORBIDITY
MULTIPLE HEALTH PROBLEMS IN THE POPULATION: CHALLENGES FOR CARE PROVISION
Chair(s)
Mårten Lagergren Gävlegatan 16, 11330 Stockholm, Sweden [email protected] +46.8.690.5812
Fratiglioni Laura Gävlegatan 16, 11330 Stockholm, Sweden [email protected] +46.8.690.5818
____________________________________________________________________________________________________________
ID: 304
PSYCHOLOGY OF FRAILTY
Howard Fillit (Alzheimer's Drug Discovery Foundation, , United States)
Howard Fillit, United States of America (1) Robert Butler, United States of America (2) Kenneth Rockwood, Canada (3) Linda Fried, United States of America (4)
(1) Alzheimer's Drug Discovery Foundation (2) International Longevity Center-USA (3) Dalhousie University / Capital Health (4) Columbia University Medical Center
Frailty is a common and central problem of old age. Yet the psychological aspects of frailty have received little attention. Recent research defines
frailty either as an accumulation of deficits or as a distinct clinical syndrome involving specific co-morbid physical disorders and functional impairment.
Early detection, management and counseling with regard to the psychological components of frailty have implications for the health and quality of life
of the frail individual, their loves ones and caregivers and for society.
The proposed symposium will provide an overview of the psychology of frailty. The contribution of psychological factors to current definitions of frailty
will also be discussed.
OVERVIEW OF THE PSYCHOLOGY OF FRAILTY
SHOULD PSYCHOLOGICAL FACTORS BE CONSIDERED PART OF SYNDROMAL FRAILTY?
ARE PSYCHOLOGICAL FACTORS ANOTHER ACCUMULATED DEFICIT?
COUNSELING, MANAGEMENT & TREATMENT
Chair(s)
Howard Fillit 1414 Avenue of the Americas, Suite 1503, New York, NY 10019 [email protected] 212-935-2402
Butler Robert 60 E. 86th Street, New York, NY 10028 [email protected] 212-517-1315
____________________________________________________________________________________________________________
ID: 305
ANTI-AGEING MEDICINE: A REALITY OR FICTION?
Domenico Cucinotta (Villa laura hospital, Geriatric medicine, Italy)
Astrid Stuckelberger, Switzerland (1) Jean-Pierre Bayens, Belgium (2) Hans joachim Von kondratovitz, Germany (3) Domenico Cucinotta, Italy (4)
(1) President Geneva International Network on Ageing (2) Belgian Society of Geriatrics and Gerontology (3) Deutche Centrum fuer Alterfragen (4) Consultant Villa Laura
Hospital
Symposium submitted by Pr Domenico Cucinotta on behalf of the Executive Committee of IAGG Europe
Anti-Ageing Medicine (AAM) is shaking the traditional geriatric establishment and practice, from basic treatment to re-activation measures . While
some interventions and products have become part of the daily health care routine, other new practices and devices hold high risks for the population
or remain science-fiction. Research in the prevention and treatment of aging symptoms has reached a point where a new paradigm of human
development has taken place: reversal of aging symptoms, regeneration processes, human enhancement, etc.
From a research perspective we will sketch out broad issues to stimulate productive interactions and understanding in the overall research of
European Countries in the field of AAM and longevity. AAM has to be based on assessment and management of adult, young old and old persons by
means of screening tools for prevention, evaluating vitality parameters ,body composition, physical performance , cognition, affectivity , sensory
functioning , along with social and biological aspects. Developing a cure for pathological aging might take a while: in the meantime it is necessary to
counteract the diseases of interest . Programs of evaluation and management designed to prevent functional decline have the potential of AAM, when
maintaining active ageing and fighting frailty. AAM has to improve quality of life and life satisfaction: the new gerontology is “preventive gerontology”, to
promoting Active Ageing. Any education program of either biological, social, mental, physical or nutritional aspects will be a necessity , to enable
individuals to deal with their biological heritage, to counteract accelerated ageing . The findings and data about AAM are proliferating along with a
growing market of technological medicine and products . AAM tools aiming at preventing, arresting or reversing the age-related decline and functions
of the elderly will be discussed in this symposium, analyzing the evidence of what works or does not works ,and the results, and providing
recommendations (policy, legislative, pharmaceutics, research) on developments in preventive care and interventions. AAM can become an
irreversible worldwide phenomenon and may have an impact on the quality, cost and accessibility of care, and also the ability of citizens to remain
healthy and active . AAM could be ‘shaping care, aid and assistance’ in unprecedented ways but AAM should not lead us to dehumanize care but to
utilize and humanize safe technology for the optimal care of each and every person.
ANTI-AGEING MEDICINE:HOW FAR IS THE REVOLUTION SPEAKER: ASTRID STUCKELBERGER
ANTI-AGEING MEDICINE AND TECHNOLOGICAL DEVELOPMENTS: SPEAKER: JEAN PIERRE BAEYENS
ANTI-AGEING MEDICINE AND THE SOCIAL SCIENCES:BETWEEN AMBIVALENCE AND ENTHOUSIASM
SPEAKER: HANS JOACHIM VON KONDRATOVITZ
ANTI-AGEING MEDICINE TO FIGHTING FRAILTY
SPEAKER: DOMENICO CUCINOTTA
Chair(s)
Vladimir Khavinson 3, Dynamo pr. St. Petersburg Russia [email protected] +78122306067
Moulias Robert FNG 49 rue Mirabeau 75016 Paris France [email protected] +33145202639
____________________________________________________________________________________________________________
ID: 307
GERIATRIC CO-MANAGEMENT OF PROXIMAL FEMUR FRACTURES: A TOTAL QUALITY MANAGEMENT APPROACH FOR FRAIL OLDER
ADULTS
Susan Friedman (University of Rochester, Medicine, United States)
Robert McCann, United States of America (1) Stephen Kates, (1) Daniel Mendelson, (1) Susan Friedman, (1)
(1) University of Rochester
Hip fractures in older adults are a common event, leading to substantial morbidity and mortality. As countries around the world experience continued
growth of the older adult population, the financial and human costs of caring for hip fracture patients will continue to increase. As a result, optimizing
the hospital care of patients with fragility fractures will become ever more critical.
Hip fractures have been previously described as a “geriatric, rather than orthopaedic disease.” Fracture patients have a high prevalence of comorbidity
with a high risk of complications. For this reason, geriatricians, who are trained to identify frailty and to manage multiple comorbidities, may improve
outcomes of care. A variety of different models of co-management of hip fracture patients by orthopaedic surgeons and geriatricians or hospitalists
have been described in many countries, with varying results, but have rarely been developed in the United States.
We describe a co-managed Geriatric Fracture Center (GFC) program that has been in operation for 5 years and has resulted in lower-than-predicted
length of stay and readmission rates, with short time to surgery, low complication rates, and low in-hospital mortality. The program is based on the
principles of early patient evaluation, ongoing co-management, protocol-driven and geriatric-focused care, and early discharge planning. This is a
potentially replicable model of care that uses the expertise of geriatricians to optimize the management of a common and serious condition and
complements the work of orthopaedic surgeons.
Dr. Robert McCann, geriatrician and Chief of Medicine at Highland Hospital, will present the demographics of hip fractures, falls, and osteoporosis. Dr.
Stephen Kates, orthopaedic surgeon and co-founder of the GFC at the University of Rochester, will present the structure and development of the
program. Dr. Daniel Mendelson, geriatrician and co-founder of the GFC, will present geriatric issues related to optimizing care of hip fracture patients.
Finally, Dr. Susan Friedman, geriatrician and health services researcher, will present outcomes data from the GFC team.
DEMOGRAPHICS OF HIP FRACTURES, FALLS, AND OSTEOPOROSIS
DEVELOPMENT OF A GERIATRIC FRACTURE CENTER PROGRAM
OPTIMIZING THE CARE OF HIP FRACTURE PATIENTS: A GERIATRICIAN'S PERSPECTIVE
OUTCOMES OF CARE IN A GERIATRIC FRACTURE CENTER PROGRAM
Chair(s)
Susan Friedman 1000 South Ave, Box 58, University of Rochester School of Medicine, Rochester, NY, USA [email protected]
585-341-6648
____________________________________________________________________________________________________________
ID: 309
VITAMIN D IN THE PATHOPHYSIOLOGY AND TREATMENT OF THE FRAILTY SYNDROME
Gustavo Duque (Nepean Clinical School - University of Sydney, Geriatric Medicine, Australia)
Gustavo Duque, Australia (1) Heike Bischoff-Ferrari, Switzerland (2) Manuel Montero-Odasso, Canada (3)
(1) Nepean Clinical School-University of Sydney (2) Institute for Physical Medicine (3) University of Western Ontario
This symposium will explore the mechanism of action of vitamin D in organs affected by the frailty syndrome focusing on osteopenia and sarcopenia.
While it is generally well accepted that vitamin D is critical for the maintenance of skeletal integrity, it also plays a very important role in other organ
systems. Increasingly, there are exciting basic science and clinical studies demonstrating that vitamin D can enhance quality of life by acting on these
and other tissues. The speakers will focus on recently described effects of vitamin D on the elements of the frailty syndrome with emphasis on the
clinical applications of these effects. The participants will be able to integrate the clinical evidence and basic science aspects related to the effect of
vitamin D on osteopenia, sarcopenia, falls and frailty.
Goals of the symposium are:
1) to assist clinicians in understanding the role of vitamin D as a hormone
2) to correlate the basic science evidence with the new clinical aplications of vitamin D from a translational research perspective.
3) to provide the participants with an evidence-based practical guide about the new indications of vitamin D in older adults including dose, frequency,
administration and potential side effects.
4) to summarize the current ongoing clinical research in vitamin D especially in frailty.
The proposed speakers are well known geriatricians and investigators in the field of vitamin D. The first speaker (Dr. Duque) is a bone biologist who
has reported new mechanisms of action of vitamin D. The second speaker (Dr. Bischoff-Ferrari) is one of the most respected researchers in the field
of clinical applications of vitamin D world-wide. The third speaker (Dr. Montero-Odasso) is also a geriatrician and clinician scientist who pursues active
research in vitamin D, falls and sarcopenia. Dr. Duque will discuss the integration between the action of vitamin D in bone, Subsequently, Dr
Bischoff-Ferrari will review the role of vitamin D in sarcopenia and the most recent evidence on the use of vitamin D in fall prevention. Finally, Dr.
Montero-Odasso will describe the the effect of vitamin D defficiency on neuromuscular function, and the current use of vitamin D as a therapeutic
approach for frailty . In summary, the participants will be able to integrate the basic and clinical aspects of vitamin D function with its new potential for
therapeutic applications in the frailty syndrome.
VITAMIN D AND OSTEOPENIA
VITAMIN D AND SARCOPENIA
THERAPEUTIC USES OF VITAMIN D IN THE FRAILTY SYNDROME
Chair(s)
Gustavo Duque level5, South Block, Nepean Hospital, Penrith, NSW, Australia 2750 [email protected] +61247344279
____________________________________________________________________________________________________________
ID: 311
SUPPORT PROGRAMS FOR COMMUNITY-DWELLING FRAIL ELDERLY PATIENTS AT THE HOSPITAL-COMMUNITY INTERFACE: A HONG
KONG EXPERIENCE
Tak Kwan Kong (Hong Kong Geriatrics Society, , Hong Kong)
Peter Millard, United Kingdom (1) LH Tsui, Hong Kong (2) BC Tong, Hong Kong (3) KY Sha, Hong Kong (4) PM Fung, Hong Kong (5) YM Wu, Hong Kong (6)
(1) St. George's, University of London (2) Hospital Authority (3) Princess Margaret Hospital (4) United Christian Hospital (5) Kowloon Hospital (6) Haven of Hope Hospital
I (Dr. TK Kong, ex-officio and immediate past president of the Hong Kong Geriatrics Society) organized this symposium to demonstrate how
comprehensive geriatric assessment targeted at hospitalized frail elders coupled with discharge support interventions with close collaboration of health
and social systems of care can be effective in maintaining elders living at home and reduce hospital utilization.. The symposium also shows how
mathematical modeling of risk prediction and patient flows can facilitate patient targeting and enlighten the care processes and interfaces of care
systems for frail elders.
Professor Peter Millard (Emeritus Professor of Geriatrics, St. Georges, University of London), who is renowned for his mathematical modeling of
patient flow, will demonstrate why a Top Down fast track acute medical service requires a Bottom-Up-slow stream enabling system of care; and that
cost effective and efficient health and social care systems depend on excellence at the interface within and between the sub systems of care and a
symbiotic relationship between the health and social systems of care. A statistician, Miss Eva Tsui (Hospital Authority, Hong Kong), will show how a
prediction model (HARRPE) developed into an electronic alert system can be used as a daily screening tool to identify elderly inpatients at high risk of
emergency readmissions within 28 days, either upon admission or at discharge. The HARRPE model enables hospitals to implement different types of
upstream intervention programmes to support those high-risk elders and to reduce avoidable hospitalizations, such as the “elderly care at home
programme” piloted in 2007 and “integrated discharge support programme (IDSP)” piloted in 2008, targeting especially at those with recent functional
decline and inadequate social support.
The symposium will be co-chaired by the programme directors of the first two pilots of IDSP in Hong Kong, Drs. TK Kong and MF Leung, who is also
the President of the Hong Kong Association of Gerontology. The other speakers are geriatricians in Hong Kong who have implemented and evaluated
the discharge support programs. This is intended to be a 90-minute symposium under the section of “Health sciences / Geriatric Medicine” and fitting
in the themes of either “frailty” or “integrated models of care.” There will be 6 speakers, each allotted 10 min with 2 minutes for the interchange
between speakers, and 18 min for discussion for the whole symposium.
1. INTERFACE BETWEEN THE DIFFERENT STREAMS OF PATIENT FLOW: TOWARDS MEDICO-SOCIAL COLLABORATION (PROF. PETER
MILLARD, UK; E-MAIL: [email protected])
2. RISK PREDICTION MODEL ON ELDERLY EMERGENCY ADMISSIONS: THE HARRPE MODEL (MS. EVA LH TSUI, HOSPITAL AUTHORITY,
HONG KONG; E-MAIL: [email protected])
3. HOW FRAIL AND COMPLEX ARE THE HARRPE PATIENTS? (DR. BC TONG, PRINCESS MARGARET HOSPITAL, HONG KONG; E-MAIL: )
[email protected])
4. POST-DISCHARGE PROGRAM FOR ELDERLY HEART FAILURE PATIENTS (DR. KY SHA, UNITED CHRISTIAN HOSPITAL, HONG KONG;
E-MAIL: [email protected])
Chair(s)
Tak Kwan KONG Department of Medicine & Geriatrics, Lai King Building, Princess Margaret Hospital, 10 Lai Kong Street, Kwai Chung, Kowloon,
Hong Kong [email protected] 852 27498228
LEUNG Man Fuk Department of Medicine & Geriatrics, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong
[email protected] 852 35134825
____________________________________________________________________________________________________________
ID: 312
NATION WIDE IMPLEMENTATION OF EVIDENCE BASED FALL PREVENTION PROGRAMMES
John Campbell (University of Otago, Medical & Surgical Sciences, New Zealand)
John Campbell, New Zealand (1) Clare Robertson, New Zealand (1) Ngaire Kerse, New Zealand (2) Tania Grieve, (3)
(1) University of Otago (2) University of Auckland (3) Accident Compensation Corporation
New Zealand, through its no fault Accident Compensation Corporation, has implemented national fall and fracture prevention strategies for older
people. These strategies have been informed by our 20 year research programme consisting of i) a series of epidemiological studies to determine the
risk factors for falls, ii) randomised controlled trials (RCTs) to test the efficacy of a range of interventions based on the risk factor identification, iii)
pragmatic trials, iv) RCTs to test methods of delivery, and v) economic evaluations.
Our RCTs have determined the effectiveness of a number of interventions in specific populations. Effective interventions we have designed and tested
include the Otago Exercise Programme for strength and balance retraining, now used internationally, home safety and behaviour modification for
elderly people registered blind, and psychotropic drug withdrawal for those 65 years and over who are taking these medications. The research has
also shown a number of interventions, including some multifactorial interventions, that do not work in certain populations. We have also demonstrated
important intervention interactions which will affect the implementation of prevention programmes.
The fall prevention literature has grown immensely over recent years. Despite the proven effectiveness of a number of interventions in specific
populations, few countries have implemented nation wide fall prevention strategies designed as public health measures available to the large number
of older people at risk of falls.
Although all but the most recent of our studies have been published in peer reviewed journals, in this symposium we will cover new ground of practical
importance. We shall:
i) present the overview and conclusions of a comprehensive and systematic research programme investigating falls and their prevention
ii) discuss the most cost effective means of fall prevention in the community and care homes, and outline current research questions and programmes
iii) discuss the nation wide implementation of targeted fall prevention strategies.
Fall prevention in older people is possible but needs to be available to the large number at risk. There must be a suitably trained workforce to deliver
the programme and it must make best use of health resources. It must be sustainable. We shall present our data on the development, research base
and implementation of such a programme.
RESEARCH EVIDENCE FOR EFFECTIVE COMMUNITY FALL PREVENTION STRATEGIES
RESEARCH EVIDENCE FOR FALL PREVENTION STRATEGIES IN RESIDENTIAL CARE
OPTIMISING VALUE FOR MONEY IN FALLS PREVENTION
IMPLEMENTATION OF A NATION WIDE PROGRAMME TO PREVENT FALLS AND INJURIES
Chair(s)
John Campbell Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand [email protected] +64 2148 8429
____________________________________________________________________________________________________________
ID: 317
HEART FAILURE IN THE ELDERLY
Olivier Hanon (Broca hospital, Geriatrics, France)
Richard Hobbs, United Kingdom (1) Olivier Hanon, France (2) Michel Komajda, France (3) Yves Juillière, France (4)
(1) Department of Primary Care and General Practice, Primary Care Clinical Sciences Building (2) department of geriatrics (3) department of cardiology (4) department of
cardiology
The prevalence of heart failure increases markedly with age. Heart failure is associated with high mortality, prolonged and frequent hospitalisations in
the elderly. Clinical diagnosis is complicated by atypical or difficult-to-interpret symptoms and by the concomitant presence of other diseases,
particularly pulmonary disease, cognitive impairment or neurological disorders.
Most of the classical symptoms of heart failure are less specific in the elderly. This atypical presentation of heart failure in the elderly necessitates
investigating for comorbidities and frailty. Among the additional investigations, echocardiography remains underused. Impairment of diastolic left
ventricular function is frequent. The value of plasma natriuretic peptide assays as diagnostic tools has not been determined in very elderly populations
and the plasma B-type natriuretic peptide increases with age. In the absence of specific studies on elderly or very elderly subjects, most of the
recommendations have been extrapolated from the data based on the evidence generated in younger populations. Epidemiological studies have
indicated an under prescription of recommended heart failure medications in the older patients. Special precautions for the use of heart failure drugs
are due to comorbidities and the pharmacokinetic and pharmacodynamic changes related to aging. Drugs dosage increase is to be cautious and
carefully monitored for adverse reactions. Therapeutic education is taking a more and more important place in heart failure. Its value has been proved,
and its importance in the multidisciplinary management in the elderly heart failure patients has been confirmed in terms of improving the prescription of
medical treatment and allowing a better quality of life. The therapeutic programs in which multidisciplinary teams are involved reduce the number and
duration of hospitalisations and the costs generated by the disease.
In this symposium we will discuss :
1.Specificities of the diagnostic of heart failure in the elderly (Pr Richard Hobbs, UK)
2.Comorbidities and heart failure in the elderly (Pr Olivier Hanon, France)
3.Specificities of the treatment of heart failure in the elderly (Pr Michel Komajda, France)
4.
Therapeutic education for heart failure: a necessity in the elderly (Pr Yves Juilliere, France)
SPECIFICITIES OF THE DIAGNOSTIC OF HEART FAILURE IN THE ELDERLY
COMORBIDITIES AND HEART FAILURE IN THE ELDERLY
SPECIFICITIES OF THE TREATMENT OF HEART FAILURE IN THE ELDERLY
THERAPEUTIC EDUCATION FOR HEART FAILURE: A NECESSITY IN THE ELDERLY
Chair(s)
Michel Komajda Paris [email protected] (33) 1 42 16 30 03
Hanon Olivier Paris [email protected] (33) 144083503
____________________________________________________________________________________________________________
ID: 340
STATE OF THE ART AND RESEARCH AGENDA FOR MALNUTRITION IN THE ELDERLY
Marco Inzitari (Institute on Aging of the Autonomous University of Barcelona, , Spain)
Lisette De Groot, The Netherlands (1) Antoni Salvà, Spain (2) Cornel Sieber, Germany (3) Ibrahim Elmadfa, Austria (4)
(1) Wageningen University (2) Institute on Aging of the Autonomous University of Barcelona (3) University Erlangen-Nurnberg (4) University of Vienna
Nutritional deficiency is common in older adults, and contributes to the development of disability e.g. through its negative impact on cognitive and
physical functions. This process can finally lead to dramatic events such as institutionalization and death. Although malnutrition is a potentially
modifiable condition, it is often not recognized. One of the reasons why nutritional assessment may often be omitted in the clinical arena might be the
lack of consolidation of scientific evidence. As a result, screening might not have penetrated the consciousness of clinicians.
This symposium will report the results of a consensus process promoted by the clinical section of IAGG/European Region, with the aim of summarizing
the state of the art on malnutrition in the elderly to finally identify the lines of future research.
As a first step of the consensus process, which will be carried out over the whole year before the IAGG conference, four panels of five recognized
European experts on malnutrition will review the evidence about four specific topics, and will prepare review documents to be discussed during a
plenary workshop, to be held in November 2008. Through an open group discussion, the workshop participants will determine which clinical
recommendations can be inferred from the available evidence, will determine which are the major gaps in knowledge and research, and will identify
which actions are required to fill these gaps. Finally, the leader of each of the four panels will present the results of their work during the IAGG
symposium (Paris 2009).
The first speaker will be Prof de Groot (the Netherlands), a recognized nutritional epidemiologist, who will illustrate the epidemiology of malnutrition in
Europe and in other developed countries using data from different multicenter studies. Two European geriatricians and aging research leaders will
take care of another two communications: the second speaker (Dr Salvà, Spain) will cover the effects of malnutrition in the disablement process, in
particular disentangling the association of malnutrition with cognitive and physical dysfunctions and frailty. The third speaker (Prof Sieber, Germany)
will talk about the assessment of malnutrition in the elderly through either clinical or more technologic instruments. The fourth and last speaker (Prof
Elmadfa, Austria), who was involved in different international intervention studies on nutrition, and participated to implement practical nutritional
recommendations in Europe, will finally discuss interventions aimed at preventing and reversing malnutrition and delaying or preventing its
consequences.
EPIDEMIOLOGY OF NUTRITION IN THE ELDERLY
NUTRITION AND FRAILTY
NUTRITIONAL ASSESSMENT
INTERVENTIONS TO REDUCE UNDERNUTRITION
Chair(s)
Marco Inzitari Institute on Aging, Universitat Autònoma de Barcelona Sant Antoni Maria Claret, 171, 08041 Barcelona, Spain [email protected]
0034934335073
Topinková Eva Department of Geriatrics, 1st Faculty of Medicine, Charles University, 120 00 Prague, Czech Republic [email protected] +420 222
520 690
____________________________________________________________________________________________________________
ID: 348
NEW INSIGHTS INTO THE PATHOPHYSIOLOGY AND TREATMENT OF GERIATRIC ANOREXIA/CACHEXIA
Shing-shing Yeh (Northport VAMC, Medicine-geriatrics, United States)
John Morley, United States of America (1) Stefan Anker, Germany (2) Michael Schuster, United States of America (3) Giovanni Mantovanni, Italy (4)
(1) St. Louis University (2) Charité, Campus Virchow-Klinikum (3) NY hospital-Cornell Med School (4) Università di Cagliari
This symposium will explore recent advances that have been made in understanding the complex etiology of anorexia/cachexia in the elderly and
review new treatment options that are currently available or in clinical trials. A recent NIH consensus conference brought together experts in the field to
agree on a definition of cachexia. Results from the conference will be discussed, and cachexia will be differentiated from age-related sarcopenia. The
role of common intercurrent medical problems seen in the elderly such as heart failure and cancer will be reviewed in light of their contribution to
cachexia. The central role of inflammatory cytokines in mediating muscle loss in the elderly will be examined with a discussion of new insights from
laboratory experiments. Limitations of currently available agents with a review of exciting new classes of drugs that are currently in clinical trials will be
presented.
The speakers are all leaders in the field and have, through their experimental and published work, help define the issues in the field and bring
advances into the clinical realm. They are also all editors of the recently published, definitive textbook of cachexia and are in a unique position to share
their insights with a general audience.
MUSCLE WASTING IN AGEING: CACHEXIA VERSUS SARCOPENIA
JOHN MORLEY, ST. LOUIS,
HEART FAILURE, CACHEXIA AND THE OLDER CARDIAC PATIENT
STEFAN ANKER, BERLIN,
THE ROLE OF CYTOKINES IN GERIATRIC CACHEXIA
MICHAEL W. SCHUSTER, NEW YORK
MANAGING CANCER-RELATED ANOREXIA/CACHEXIA IN THE ELDERLY
GIOVANNI MANTOVANNI, CAGLIARI, ITALY
TREATMENT OF GERIATRIC CACHEXIA
SHING-SHING YEH, NEW YORK,
Chair(s)
John Morley St Louis [email protected] department of geriatrics
Schuster Michael new york [email protected] 212-746-2119
____________________________________________________________________________________________________________
ID: 350
GERIATRIC COMPETENCIES FOR MEDICAL STUDENTS
Francisco Faye (Mount Sinai School of Medicine, Brookdale Department of Geriatrics and Adult Development, United States)
Rosanne Leipzig, United States of America (1) Janet Gordon, Canada (2) Vasi Naganathan, Australia (3) Jasneet Parmar, Canada (4)
(1) Mount Sinai School of Medicine (2) Dalhousie University (3) University of Sydney (4) University of Alberta
Almost all doctors will care for older adults. At least three countries and the World Health Organization (WHO) have developed minimal learning
objectives or competencies for medical students in geriatrics. This symposium is intended to facilitate conversation among medical educators around
the world on how best to develop, implement and assess geriatric competencies for their respective medical students.
The practice of establishing benchmarks to define competence in particular areas is catching on in the field of geriatrics. Canada recently developed a
set of geriatric competencies for medical students which were endorsed by the Canadian Geriatrics Society in April 2008 ; the International Association
of Gerontology and Geriatrics, in conjunction with the World Health Organization, drew up “Basic Contents for Undergraduate Medical Teaching” in
Geriatrics ; and the Australian Society for Geriatric Medicine wrote a position statement for “Education and Training in Geriatric Medicine for Medical
Students”, detailing essential areas of knowledge, skills, and attitudes in Geriatric Medicine that require competency by medical students .
In July 2007, the Association of American Medical Colleges and the John A. Hartford Foundation hosted a National Consensus Conference on
Competencies in Geriatric Education in the United States. The charge was to attain consensus on a minimum set of behaviorally-based graduating
medical student competencies to assure safe care of older patients by new interns. Face validity was judged by surveying program directors, faculty
and deans. This document is only half facetiously referred to as the “Don’t Kill Granny” competencies. These competencies are intended to guide
educators by establishing standards that medical school graduates can be expected to demonstrate at the start of their internships to provide
competent care of older adults .
These examples reflect the effort to standardize the geriatric content taught to medical students. Although these competencies vary in their specificity
and scope, they all independently clarify the need for medical students to be proficient in their understanding and treatment of geriatric patients. Each
of the speakers—Rosanne M. Leipzig, MD, PhD from the United States; Janet Gordon, MD, FRCPC and Jasneet Parmar, MBBS, Dip. COE from
Canada; and Vasi Naganathan, MD from Australia—has been intimately involved with the development of geriatric competencies in the United States,
Canada, or Australia. They will compare and contrast the competencies identified in each of their countries, describe ways of teaching and assessing
medical students’ competence in geriatric medicine, and discuss their plans for implementing these competencies nationally.
10 MINUTES: JASNEET PARMAR, MBBS, DIP.COE -"INTRODUCTIONS"
15 MINUTES: ROSANNE M. LEIPZIG, MD, PHD- "MEDICAL STUDENT COMPETENCIES IN THE UNITED STATES: DEVELOPMENT AND
IMPLEMENTATION"
15 MINUTES: JANET GORDON, MD- "MEDICAL STUDENT COMPETENCIES IN CANADA: DEVELOPMENT AND IMPLEMENTATION"
15 MINUTES: VASI NAGANATHAN, MD- "MEDICAL STUDENT COMPETENCIES IN AUSTRALIA: DEVELOPMENT AND IMPLEMENTATION"
Chair(s)
Rosanne M. Leipzig, MD PhD 1468 Madison Ave. Box 1070 New York, NY 10029 [email protected] +00-1-212-241-4274
Parmar, MBBS, Dip. COE Jasneet University of Alberta Edmonton, AB, Canada [email protected] +00-1-780-735-8800
____________________________________________________________________________________________________________
ID: 354
A NEW APPROACH TO FALLS AND OSTEOPOROTIC FRACTURES IN AGEING POPULATION
Manuel Montero Odasso (University of Western Ontario, Department of Medicine, Division of Geriatrics, Canada)
Manuel Montero Odasso, Canada (1) Robert Cumming, Australia (2) Gustavo Duque, Australia (3)
(1) Departmen of Medicine and Geriatrics, University of Western Ontario (2) Centre for Education and Research on Ageing, University of Sydney (3) Aging Bone Research
Program, University of Sydney
1-Background
Falls and fractures are a major issue in health care for the elderly. With ageing, the incidence of falls and osteoporosis and thus, osteoporosis
fractures, increases dramatically. Several falls risk factors have been identified but it is not clear if all the risk factors should be targeted with the same
intensity. Typically, the treatment of osteoporosis has been intended for increasing bone mineral density and decreasing fracture rates without a
clinical approach to the prevention of falls, which, in geriatric populations, are the major factors for morbidity and mortality. Current evidence indicates
that the treatment of osteoporosis in older populations should include not only the gain in bone mass, but also the prevention of falls. Recently, a new
approach to the assessment and intervention of osteoporosis and falls has been implemented. This intervention consists of a risk quantification that
combines both risk of falls and fractures. Depending on the level of risk, an intervention plan is designed. We consider this a most effective approach
for the Geriatric population which could be easily implemented in geriatric clinics with outstanding results on the quality of care for the elderly.
2-Learning objectives
•To approach fall risk factors in light of the available evidence.
•To propose an innovative approach to the treatment of osteoporosis based on combined risk assessment and intervention plan.
•To illustrate gait and balance assessment as a very important tool for the prevention of osteoporotic fractures.
•To discuss the advantages of Falls and Fractures Clinics and its effectiveness in the reduction of disability associated with fractures.
•To explain the basic principles of Falls & Fractures Clinic.
3-Participants/Methodology
This symposium is oriented to a multidisciplinary audience. There will be a three lectures followed by Q&A. Clinical cases will be presented to
illustrate the proposed approach to falls and fractures.
4-Speakers/Contents
We propose three speakers with recognized expertise in this field
Dr. Robert Cumming, Professor Epidemiology and Geriatric Medicine. University of Sydney, Australia.
•Epidemiology of falls.
•Approaching falls risk factors based on available evidence.
•Dr. Gustavo Duque, Associate Professor of Medicine, University of Sydney, Australia.
•The characteristics of senile osteoporosis.
•Goals for the treatment for osteoporosis.
•The principles of Falls and Fractures Clinics.
•Dr. Manuel Montero Odasso, Assistant Professor of Medicine, University of Western Ontario, Canada
•Gait and mobility assessment for falls prevention
•Dual-tasking and gait as an early marker of falls in older adults
•DR. ROBERT CUMMING. RISK FACTORS FOR FALLS. WHAT IS NEW ON THE MENU?
LECTURE: 20 MINUTES
QUESTIONS & ANSWERS: 10 MINUTES
•DR. MANUEL MONTERO ODASSO. FALLS PREVENTION. THE VALUE OF GAIT ASSESSMENT AND DUAL-TASKING.
LECTURE & CASE DISCUSSION: 20 MINUTES
•DR GUSTAVO DUQUE. FALLS AND FRACTURES CLINICS. A UNIFIED APPROACH FOR RISK STRATIFICATION FOR OSTEOPOROTIC
FRACTURES.- LECTURE & CASE DISCUSSION: 20 MINUTES
•DR MANUEL MONTERO ODASSO CLOSING REMARKS AND PROPOSED APPROACH. DISCUSSION: 10 MINUTES
Chair(s)
Manuel Montero-Odasso Parkwood Hospital. 801 Commissioners Rd. E. Rm A-280 London, ON N6C 5J1CANADA [email protected] Tel (519) 685
4292 Ext 42369
Cumming Robert N/A [email protected] Tel (519) 685 4292 Ext 42369
____________________________________________________________________________________________________________
ID: 367
NUTRITIONAL SUPPORT IN NURSING HOMES
Juergen Bauer (University of Erlangen-Nuremberg, Department of Geriatric Medicine, Germany)
Tommy Cederholm, Sweden (1) Juergen Bauer, Germany (2) Yves Rolland, France (3) Rainer Wirth, Germany (4)
(1) Institution for Public Health and Care, Uppsala University (2) Department of Geriatric Medicine, University of Erlangen-Nuremberg (3) Service de Médecine Interne et
Gérontologie Clinique, Hôpital La-Grave-Casselardit (4) Abteilung für Geriatrie, St. Marien Hospital Borken
Malnutrition and especially protein deficiency with the consequence of sarcopenia and functional decline are very frequent in nursing homes, with
prevalence numbers up to 75%. As the impact of malnutrition in this frail population is often not known, the problem in itself often remains undetected.
To overcome this problem, easy to use but still sensitive and specific assessement tools are mandatory. Such a proper diagnostic tool should then
lead to the implementation of adapted therapeutic nutritional interventions. By improving nutritional status such therapies should guarantee
preservation of functionality, independence and finally quality of life. As sarcopenia has also an important interface to osteoporosis, vitamin D
deficiency can be taken as a metaphor for the problems inherent to malnutrition in (oldest) old persons.
Nutritional intervention in this patient group also often implies an ethical decision making process. As up to three thirds of elderly persons living in
nursing homes suffer from dementia, decisions about nutrition at the end of life are a daily challenge.
This symposium aims to cover the wide spectrum of malnutrition in nursing homes and the impact of therapeutic strategies.
THE PREVALENCE AND IMPACT OF AN UNDERDETECTED PROBLEM.
TOMMY CEDERHOLM
SCREENING AND ASSESSMENT OF MALNUTRITION IN NURSING HOMES. JUERGEN BAUER
VITAMIN D DEFICIENCY AND ITS IMPACT ON FUNCTIONALITY IN NURSING HOMES. YVES ROLLAND
TO PEG OR NOT TO PEG. RAINER WIRTH
Chair(s)
Graziano Onder Universita Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, I-00168 Roma, Italy [email protected] +390630154341
Raynaud-Simon Agathe Geriatrics Department, Bichat University Hospital, 46 rue Henri Huchard, 75877 Paris Cedex 18, France
[email protected]
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ID: 445
THE WAR AGAINST POLYPHARMACYRETHINKING AND RE-EVALUTION NEEDED FOR EACH AND EVERY DRUG IN THE ELDERLY
DORON GARFINKEL (SHOHAM GERIATRIC MEDICAL CENTER, EVALUATION & REHABILITATION AND PALLIATIVE UNIT, Israel)
DORON GARFINKEL, Israel (1) DEE MANGIN, New Zealand (2) JOHN ELLERSHAW, United Kingdom (3) CHRISTIAENS THIERRY, Belgium (4)
(1) SHOHAM GERIATRIC MEDICAL CENTER (2) UNIVERSITY OF OTAGO (3) MARIE CURIE PALLIATIVE CARE INSTITUTE, UNIVERSITY OF LIVERPOOL (4) Ghent
University
Improved medical technology is associated with a significant extension in life expectancy in elders, including frail elders (FE) and patients with limited
life expectancy & decreased quality of life (PLEDQoL). Guidelines for drug use in younger people are based on a single disease model.
However, the reality for most elders is complexity, with multiple co-morbidities. The symposium demonstrates how linear models are inappropriate in
older populations, where the sum total of negative impacts of the resulting polypharmacy & inappropriate medication use (IMU), may outweigh the sum
total of the potential beneficial effects of all specific drugs.
Using a geriatric-palliative algorithm for drug discontinuation (DD), beneficial effects on QoL were proven from a trial carried out in nursing wards (1)
The annual mortality rate & referral rate to acute care facilities significantly decreased in the DD arm compared to controls and was associated with a
substantial decrease in the costs of both drugs and hospitalizations. New data will be presented showing beneficial effects of DD on QoL (functional,
mental and cognitive status) in elders in community settings, with no significant adverse effects. We will draw on our previous work demonstrating the
unintended consequences of current methods for assessing for preventive treatments; in some instances application of preventive treatment models
may change cause of death without extending life (2) Our current model means it is impossible for either physicians or patients to discern this effect.
We will propose a new model that provides a more rational approach for research and provision of guidelines on preventive & curative prescribing in
elders.
We promote the idea that in older populations, particularly FE & PLEDQoL, rethinking is needed for each and every curative as well as preventive drug
prescribed. The medical, nursing, social, ethical and economic implications of applying these approaches worldwide will be discussed.
The participants bring a range of perspectives and backgrounds to a discussion of this complex issue.
DG brings a background in specialist internal medicine, geriatrics & gerontology. DM brings a primary care and public health perspective.
JE brings the palliative care (Hospice) angle & CT the pharmacological perspective.
References
1) Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: A new, cost effective, Geriatric - Palliative approach for improving drug therapy
in disabled elderly people. Isr Med Assoc J 2007; 9: 430-4.
2) Mangin D McSweeney K Heath I. Preventive Care in the Elderly Needs Rethinking
BMJ 2007;335:285- 287.
Final title Not decided yet
Chair(s)
DORON GARFINKEL Shoham Geriatric Medical Center, Pardes-Hana, ISRAEL 37000 [email protected] 972-506261823
MANGIN DEE Department of Public Health and General Practice Christchurch School of Medicine University of Otago P.O. Box 4345 Christchurch
[email protected] 64 3 3643636
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ID: 371
SUPPORTIVE CARE OF THE OLDER CANCER PATIENT
Muriel Rainfray (SFGG, , France)
Maryska Janssen-Heijnen, The Netherlands (1) Jean-Pierre Droz, France (2) Lodovico Balducci, United States of America (3) Frédérique Retornaz, France (4)
(1) Eindhoven Cancer Registry - Comprehensive Cancer Centre (2) CLCC Louis Bérard (3) H.Lee Moffitt Cancer Center (4) Centre Gérontologique Départemental
More than 60% of cancers occur today after 65 years and cancer mortality is about 70% in this raw of age. With the promotion of curative and
palliative treatment procedures, more and more old people live with (or having had) cancer today. Quality of life remains a major issue for the old
cancer patients and represents a large field of clinical research. Unfortunately,late complications of chemotherapy, hormonotherapy or surgery may
lead to increased morbidity and impaired quality of life. To improve the follow-up of old cancer patients, oncologists and geriatricians have to build an
innovative and fruitful collaboration. The main goals of the symposium include :
-to be acquainted with the reality of old cancer survivors
-to alert the geriatricians on the complications of cancer treatment: timely recognition, timely management
- to alert the geriatricians of increased risk of leukemia and congestive heart failure in older patients treated with chemotherapy
-to emphasize the place of geriatricians in the follow-up of old cancer survivors patients
The symposium is supported by the SFGG oncogeriatrics working group.
- OLDER CANCER SURVIVORS - EPIDEMIOLOGY (MRS MARYSKA JANSSEN-HEIJNEN)
- LONG TERM COMPLICATIONS OF CHEMOTHERAPY IN THE AGED (J-P DROZ)
- PREVENTION AND MANAGEMENT OF MYELOTOXICITY. (L.BALDUCCI)
- THE PLACE OF THE GERIATRICIAN IN THE FOLLOW-UP OF OLD PEOPLE WITH CANCER (DR FRéDéRIQUE RETORNAZ)
Chair(s)
Muriel Rainfray Centre de Gériatrie Henri Choussat 33600 Pessac [email protected] 33(0)557 65 65 57
Teillet Laurent Hop Ste Périne - Rue Chardon-Lagache 75016 Paris [email protected] 33(0)144 96 31 31
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ID: 399
SARCOPENIA: DEFINITIONS, RISK FACTORS AND TREATMENT
Stefan Czerwinski (Wright State University, Lifespan Health Research Center, United States)
Yves Rolland, France (1) W. Cameron Chumlea, United States of America (2) Stefan Czerwinski, United States of America (2) Steven Heymsfield, (3)
(1) CHU Toulouse-Department of Geriatric Medicine (2) Lifespan Health Research Center-Wright State University (3) Merk Research Laboratories
Age-related muscle loss, or sarcopenia, is a complex disease characterized by decreased muscle mass, strength and function. Sarcopenia is
associated with metabolic, physiologic, and functional impairments as well as disability. Despite knowledge of the significant health risks associated
with sarcopenia, its public health significance has, until recently, remained largely unknown due primarily to the lack of a standard clinical definition
and the lack of pertinent population-level data assessing both muscle mass and function. The proposed symposium will examine several topics
related to sarcopenia providing an overview of the current state of research. Speakers in the symposium will examine issues related to establishing a
clinical definition, describing the prevalence and risk factors for sarcopenia, and examining current pharmacological treatments.
The speakers and topics are outlined below.
1. Yves Rolland, "A Consensus Definition of Sarcopenia".
Dr. Rolland is a clinician and an internationally recognized expert in aging research. He has written extensively in the area of aging including topics
such as nutrition, sarcopenia, and Alzheimer’s disease.
Dr. Rolland will discuss issues and obstacles related to developing a consensus definition of sarcopenia for clinical purposes.
2. W. Cameron Chumlea, “Epidemiology of Sarcopenia”.
Dr. Chumlea is an internationally recognized expert in body composition assessment and aging. Dr. Chumlea has served on numerous national and
international advisory panels.
Dr. Chumlea will discuss the body composition changes that occur with aging. The presentation will also examine population and age-related
prevalence for sarcopenia using various definitions from the literature. Dr. Chumlea will also discuss the risk factors associated with age-related
muscle loss.
3. Stefan A. Czerwinski, “Genetic Epidemiology of Sarcopenia Risk”
Dr. Czerwinski is a genetic epidemiologist and Associate Director of the Lifespan Health Research Center at Wright State University. He is currently
funded by the National Institutes of Health (US) to conduct genetic studies of aging.
Dr. Czerwinski will examine genetic factors as they relate to aging muscle. He will discuss recent work examining the genetic epidemiology of muscle
traits including heritability studies and genome-wide linkage studies.
4.Steven B. Heymsfield, "Pharmacological Treatments of Sarcopenia"
Dr. Heymsfield is an international expert on body composition assessment and is currently Global Director, Scientific Affairs, Clinical Research,
Metabolism for Merck Research Laboratories.
Dr. Heymsfield will discuss the current state of pharmacological research as it relates to aging and frailty. His presentation will examine current
treatment options and potential future therapies.
A CONSENSUS DEFINITION OF SARCOPENIA
EPIDEMIOLOGY OF SARCOPENIA
GENETIC EPIDEMIOLOGY OF SARCOPENIA RISK
PHARMACOLOGICAL TREATMENTS OF SARCOPENIA
Chair(s)
Stefan Czerwinski 3171 Research Blvd, Kettering, OH 45420 [email protected] 9377751440
Chumlea Cameron 3171 Research Blvd, Kettering, OH 45420 [email protected] 9377751428
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ID: 406
PHYSICAL FUNCTIONAL PERFORMANCE IN OLDER ADULTS IN ITALY, SWITZERLAND, AND THE UNITED STATES
M. Elaine Cress (University of Georgia, Department of Kinesiology and Gerontology Center, United States)
M. Elaine Cress, United States of America (1) Reto W. Kressig, Switzerland (2) Stefania Orini, Italy (3) Robert Wood, United States of America (4)
(1) University of Georgia (2) University Hospital of Basel (3) University of Brescia (4) Husson University
Factors contributing to disability and limitations in function are culturally and contextually dependent. This symposium will provide data on functional
ability, self-reported disability and dependence in living status from older adults in four sites and three different countries. Each study used the
Continuous Scale Physical Functional Performance (CS-PFP) to measure functional performance. The CS-PFP is a reliable and valid measure of
function, particularly useful for independent living older adults and those on the threshold of dependency. Comparisons of self-report and performance
based function data from frail older adults in northern Italy living in a retirement community to older adults living in a retirement community in
Southeastern United States.
CS-PFP and self reported independent living older Swiss citizens will be compared to normative data of older adults
throughout the United States categorized by age and sex. The final presentation will place the functional performance measures within the context
“disability” (vis-à-vis the Disablement or International Classification of Disablement Handicap framework) and an index of “participation” (vis-à-vis the
WHO International Classification of Functioning (ICF) model) and Frailty. A discussion of the influences of culture, disease and health care services
on disability and independent living will follow the presentations.
FUNCTIONAL PERFORMANCE IN OLDER ADULTS LIVING IN A RETIREMENT COMMUNITY IN ITALY AND THE UNITED STATES.
SELF-RATED AND PERFORMANCE BASED FUNCTION IN INDEPENDENT LIVING OLDER ADULTS IN SWITZERLAND.
DEPRESSION AND NUTRITIONAL STATUS AS PREDICTORS OF PERCEIVED STRESS AND FUNCTIONAL PERFORMANCE IN RETIREMENT
COMMUNITY AND INDEPENDENT LIVING OLDER ADULTS IN SOUTHEASTERN REGION OF THE UNITED STATES.
PHYSICAL FUNCTION, DYSPNEA AND PAIN AS PREDICTORS OF DISABILITY IN OLDER RESIDENTS OF LOUISIANA, UNITED STATES.
Chair(s)
M. Elaine Cress University of Georgia 300 River Road. Athens GA 30602-6554, USA [email protected] +01 706-542-2202
Kressig Reto W. Universitaatsspital Basel, Petersgraben 4 CH-4031 Basel Switzerland [email protected] +41 612652998
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ID: 414
INCREASING THE PARTICIPATION OF THE ELDERLY IN CLINICAL TRIALS (PREDICT)
Gary Mills (Royal Hallamshire Hospital and MERCS, Intenisve Care Unit, R floor, United Kingdom)
Andrew Beswick, United Kingdom (1) Antonio Cherubini, Italy (2) Eva Topinkova, Czech Republic (3) Peter Crome, United Kingdom (4)
(1) Bristol University (2) Perugia University (3) Charles University (4) Keele University Medical School
The population of many countries is ageing and Europe comprises the oldest population of any continent on earth. However the elderly are often
excluded from clinical trials, even though in clinical practice the elderly will inevitably consume at least 40% of prescribed medication. The exclusion of
the elderly from clinical trials therefore represents a significant public health problem. This needs to be addressed if we are to know whether the
benefits of new treatments outweigh the risks in a population with a high level of coexisting ill-health. The aim of PREDICT (Increasing the
PaRticipation of the ElDerly In Clinical Trials) is therefore to systematically review the medical literature, looking for evidence of under representation
of the elderly. Ongoing trial databases will be accessed to assess the inclusion or exclusion of the elderly in current research.
The subsequent aim is to investigate the perceptions of health and other professionals working with the elderly, (geriatricians, general medical
practitioners, nurses, clinical researchers, ethicists, pharmacologists/pharmacists) patients and their carers on whether and why the elderly are
under-represented in clinical trials. Lastly, depending on the findings of the work, a “Patient Charter” will be developed by a multidisciplinary team of
experts, including ethicists for the elderly for use in clinical trials.
The symposium will comprise:
a) Brief Introduction: Can the elderly really benefit from medical intervention? (Gary Mills)
b) What evidence is there that the elderly have been excluded from clinical trials? (Andy Beswick)
c) Are new and current clinical trials now including provision for the elderly? (Antonio Cherubini)
d) Why would clinicians, other professionals, patients or carers want the elderly including in clinical trials?: the BENEFITS (Eva Topinkova)
e) The DRAWBACKS: Why do we not include the elderly in clinical trials?
Could the inclusion of the elderly drive research away: Do we need a worldwide charter for the inclusion of the elderly in clinical trials? (Peter Crome)
WHAT EVIDENCE IS THERE THAT THE ELDERLY HAVE BEEN EXCLUDED FROM CLINICAL TRIALS?
ARE CURRENT CLINICAL TRIALS INCLUDING THE ELDERLY?
INCLUSION OF THE ELDERLY IN CLINICAL TRIALS- OPINIONS OF CLINICIANS, OTHER PROFESSIONALS, PATIENTS AND CARERS
ON THE BASIS OF THE PREDICT PROJECT FINDINGS, DO WE NEED A CHARTER FOR THE ELDERLY IN RESEARCH?
Chair(s)
Gary Mills Dept of Intensive Care, R floor, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK [email protected] 00441142309240
Oristrell Joaquim Sabadell Hospital, Parc Tauli 15, Sabadell 08208, Spain [email protected] 0034617376274
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ID: 427
HOW TO ASSESS AND MODIFY THE FALLING RISK AMONG OLDER ADULTS ?
Athanase BENETOS (University Hospital, Geriatric department, France)
Severine BUATOIS, France (1) Reto KRESSIG, Switzerland (2) France MOUREY, France (3) George C. SPATHARAKIS, Greece (4)
(1) University Hospital Nancy (2) University Hospital Basel (3) Service de Médecine Interne Gériatrique, CHU Dijon (4) Health Center of Itea
For many older persons, the aging process adversely affects gait and balance control, involving a restriction in daily activities and an increase in risk of
falling. Falls are a leading cause of disability, injury and death among the elderly, occurring each year in over 30% and 50% of the population aged
over 65 and 80, respectively. Approximately 50% of elderly people suffer a second fall in the year following the first one. At least 10% of falls are
associated with serious injury, and one-third of older people report a fear of falling after at least one fall, which can be associated with loss of
confidence, decreased satisfaction of life, increased frailty and restricted activity.
In recent years in France, there is an emphasis on determining any changes that occur in gait and posture patterns in elderly in order to reduce the
frequency of falls, to identify diagnostic measures that are reliable predictors of fall-prone elderly and finally to develop programs for preventing such
falls.
The use of several clinical balance tests (one-leg-balance, Timed-up-and-Go, sit-to-stand) has been widely proposed in primary care in order to
identify elderly subjects with postural instability and high risk of falling. Moreover, new technologies are increasingly used in assessing dynamic
balance control and gait disorders in a quantitative way.
Many studies have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory.
In this context, the aim of this symposium is to discuss around the major issue: how to assess and modify the falling risk among older adults?
During the symposium, the following topics will be presented by three national and international scientific experts :
- Clinical assessment of risk of falls. (Buatois S)
- Spatio-temporal gait analysis: new technologies for assessment of dynamic balance, gait disorders and falling risk. (Kressig R)
- Influence of rehabilitation and physical activities in preventing falls. (Mourey F)
The main research interests of the three speakers concern:
- Predictive value of posturography and clinical balance test in the estimation of the risk of recurrent falls
-Postural control and gait biomechanics, exercise and physical function in relation to principles of geriatric rehabilitation and fall prevention,
-Relation between cognitive impairment and motor control (dualtasking paradigm)
-Spatio-temporal gait analysis and fall prevention
-Fall prevention by specific rehabilitation and physical intervention program such as Tai Chi, dance
CLINICAL ASSESSMENT OF RISK OF FALLS
SPATIO-TEMPORAL GAIT ANALYSIS: NEW TECHNOLOGIES FOR ASSESSMENT OF DYNAMIC BALANCE, GAIT DISORDERS AND FALLING
RISK
INFLUENCE OF REHABILITATION AND PHYSICAL ACTIVITIES IN PREVENTING FALLS
WHY DO FALLS OCCUR IN OLDER ADULTS?
Chair(s)
Athanase Bénétos CHU de Nancy [email protected] 03.83.15.33.22
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ID: 437
EUROPEAN PERSPECTIVES ON TEACHING GERIATRIC MEDICINE.
A JOINED EUGMS AND IAGG-ER SYMPOSIUM
Eva Topinkova (Charles University in Prague, Dpt Geriatrics, 1st Faculty of Medicine, Czech Republic)
Alfonso Cruz-Jentoft, Spain (1) Ian Hastie, United Kingdom (2) Cornel Sieber, Germany (3) Eva Topinkova, Czech Republic (4)
(1) Jefe del Servicio de Geriatría. Hospital Universitario Ramón y Cajal (2) Department of Geriatric Medicine, 3rd Floor Lanesborough Wing,St George's Hospital (3) Innere
Medizin-Geriatrie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinikum Nürnberg Nord (4) Dept. of Geriatrics, Charles University in Prague
The purpose of this joined EUGMS and IAGG-ER symposium is to provide cross-national European perspective on teaching of geriatric medicine in
European region.
Originally, geriatric medicine developed as a hospital-based specialty. Only in 1970s it started expanding to other health sectors – being it out-patient
department, home care geriatrics and chronic care facilities on the one hand and preventive anti-aging strategies on the other. This direction has
changed the spectrum of patients and required new knowledge and skills. However, the concept of geriatrics did not changed substantially, neither its
core curriculum for trainees. In the first presentation A. Cruz-Jentoft, Past President EUGMS will present the current situation in geriatric education in
Europe. Where do we stand in our effort to harmonize the process in Europe? The results of a recent survey will be presented and compared with data
from earlier EUGMS survey. The commonalities and differences between countries will be discussed. The second speaker, I. Hastie, President of
UEMS-GMS will deal with the important question: what is the contemporary definition of geriatric medicine and that of geriatric patient? How did it
changed during the last 20 years? He will present the consensus definition of the UEMS and suggest changes in geriatric curriculum for new
generation of geriatricians. Since 1980s it was recognized that the advancement of the field is impossible without excellent professional leadership.
The need to train new academic leaders was filled in by creation of EAMA. The 14-years experience in training the expert and leaders in ageing
medicine will be presented by C. Sieber, current EAMA President. The last speaker, E. Topinkova will discuss what is the real versus ideal model of
geriatric training? She would explain the GRECC experience as a starting point for a new model of integrative training. Several conditions are required
for successful implementation of “integrative model”: geriatrics as an independent medical specialty, high quality research and full integration of
geriatric medicine into health care system with a broad spectrum of geriatric services.
The team of speakers, representing four European organizations in the area of ageing will bring a broad international perspective on geriatric
education and training and respond to the new challenges for future development of the field and the specialty of geriatric medicine. Europe as the
oldest continent should take the lead in innovative approaches to train specialists for its ageing citizens.
GERIATRIC EDUCATION IN EUROPE: IS IT REALLY IMPROVING?
GERIATRIC MEDICINE AND “GERIATRIC PATIENT” DEFINITION – DOES IT REFLECT THE NEW SPECIALTY CHALLENGES? UEMS
CONSENSUS.
EUROPEAN ACADEMY FOR MEDICINE OF AGEING - 14 YEARS OF EXPERIENCE
MODELS OF GERIATRIC TRAINING IN EUROPE – FROM UNIVERSITIES TO CLINICAL PRACTICE
Chair(s)
Jean-Pierre Michel Geneva, Switzerland [email protected] + 3422 379 51 11
Baeyens Jean Pierre Ostend, Belgium [email protected] + 32 59 501111
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ID: 452
RESPIRATORY TRACT INFECTIONS IN THE ELDERLY : CHALLENGES IN 2009
Gaëtan Gavazzi (Clinique Universitaire de médecine gériatrique , Pôle pluridiciplinaire de Médecine, France)
Gaëtan Gavazzi, France (1) Karl Weiss, Canada (2) Mark Loeb, Canada (3)
(1) University Hospital of Grenoble (2) Département de microbiologie et d infectiologie , Hôpital Maisonneuve-Rosemont (3) McMaster University , Faculty of Health
Sciences,
Respiratory tract infection (RTI) is the main infection in the elderly population. Although numerous studies examine the relationship beetween RTI and
ageing population, it remains numerous challenges in 2009; 3 speakers, of important implications in the field of infection in elderly will present 3
aspects of these challenges.
1) The burden of RTI in the elderly: Challenges in diagnosis (G.Gavazzi, France)
Objective: To review the epidemiology and the impact of RTI in the elderly and to understand the diagnostic challenges in both community and
institutional settings.
The annual incidence of community-acquired pneumonia in the elderly can range as high as 52.3 cases per 1000 individuals to 2.5 cases per 1000
patient-days in long term care facilities. Individual, environmental and health-care associated risk factors leads to these high incidences. Although the
definition of pneumonia is clearly stated by International medical societies, the diagnosis remains difficult in day to day practice with unique challenges
depending on the health care setting.
2) Challenges in antibiotics resistance for RTI (Karl Weiss, Canada).
Objectives:. to understand the causes and solutions related to emerging antibiotic resistance., to review the clinical inplications of antibiotic resistance
for the elderly population and to compare the dynamic of antibiotic resistance for respiratory tract pathogens in different parts of the world Antibiotics
resistance is one of the most critical issues in today's medicine. The burden of RTI in the elderly population in terms of morbidity and mortality puts the
issue of resistance at the forefront of daily clinical decisions by practising physicians. Therefore, it would be essential to understand the roots of
increasing antibiotics resistance and the ways to curtail this emerging threat.
3)Preventing RTI in the elderly: current challenges (Mark Loeb, Canada).
Objectives: To review the clinical evidence for influenza and pneumococcal vaccines in the elderly, to present immunological challenges to mounting
an immune response in the elderly
and to review new and emerging strategies, including immunization of children
Influenza and pneumococcal infections pose a major threat to the health of older adults. This session will review : the evidence for the benefit of these
vaccines in the elderly including current controversies in the estimates of efficacy; clinical data on immunogenicity of these vaccines in the elderly,
along with a discussion of immunologic changes that occur with aging; new strategies, such as the indirect benefit to adults of immunizing healthy
children in community.
THE BURDEN OF RTI IN THE ELDERLY: CHALLENGES IN DIAGNOSIS (G.GAVAZZI, FRANCE)
CHALLENGES IN ANTIBIOTICS RESISTANCE FOR RTI (KARL WEISS, CANADA).
PREVENTING RTI IN THE ELDERLY: CURRENT CHALLENGES (MARK LOEB, CANADA)
Chair(s)
Gaëtan GAVAZZI Clinique Universitaire de Gériatrie , CHU de Grenoble, Grenoble 38043 France [email protected] 00 33 476 76 54 21
PACCALIN Marc Pôle de Gériatrie, CHU La Milétrie, 86021 Poitiers, France [email protected] 00 33 549 44 44 27
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ID: 454
INTEREST FOR MEASURING BLOOD PRESSURE AND ARTERIAL STIFFNESS FOR THE EVALUATION OF CARDIOVASCULAR RISK IN
INSTITUTIONALIZED ELDERLY PEOPLE OVER 80
Athanase Benetos (University hospital of Nancy, Geriatric, France)
Michel Safar, France (1) Athanase Benetos, France (2) Angelo Scuteri, Italy (3) Ulrich Vischer, Switzerland (4)
(1) Hotel Dieu University of Paris (2) University hospital of Nancy (3) UO Geriatria, INRCA-IRCCS (4) Hôpital des Trois-Chêne
Large artery stiffness is the major consequence of aging and involves changes in the structural organization of various components of the arterial wall.
Clinical studies have been able to demonstrate a direct relationship between these clinical manifestations of arterial stiffness and cardiovascular
morbi-mortality. Hence, the use of non-invasive techniques for measuring arterial stiffness could rapidly become a very useful tool towards a more
accurate assessment of cardiovascular risk.
However, the interest for measuring arterial stiffness in subjects over 80 remains unclear. Moreover, especially in institutionalized subjects it is
possible that blood pressure measurements cannot assess cardiovascular risk since blood pressure is greatly modified by co-morbidities. In that case
arterial stiffness could better estimate cardiovascular risk since it is less influenced than blood pressure by co-morbidities such as cardiac failure,
neurodegenerative disease, deshydratation etc. The aim of this symposium is to present the latest data on the role of Blood pressure and arterial
stiffness measurements in institutionalized elderly people over 80.
STRUCTURAL DETERMINANTS OF ARTERIAL STIFFNESS
RELATIONSHIPS BETWEEN BLOOD PRESSURE AND ARTERIAL STIFFNESS IN INSTITUTIONALIZED ELDERLY PEOPLE OVER 80: RESULTS
OF THE PARTAGE MULTICENTRIC STUDY
ARTERIAL FUNCTION IN THE VERY ELDERLY
BLOOD PRESSURE CONTROL AND QUALITY OF LIFE IN THE VERY ELDERLY
Chair(s)
Athanase Bénétos CHU de Nancy [email protected] 03.83.15.33.22
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ID: 460
VISION AND HEARING IMPAIRMENT IN THE ELDERLY – IMPLICATIONS FOR HEALTH, FUNCTION AND SOCIAL LIFE
Else Vengnes Grue (Diakonhjemmet University College, Department of Research and Development, Norway)
Else Vengnes Grue, Norway (1) Helle K Falkenberg, Norway (2) Jorunn Solheim, Norway (3) Else Marie Svingen, Norway (4)
(1) Diakonhjemmet University College (2) Buskerud University College (3) Lovisenberg Diakonale Hospital (4) Skådalen Resource center for hearing impaired and deafblind
In the older population, vision and hearing deficits are common, with their prevalence increasing with age. An increase in life expectancy has been
observed world-wide. Accordingly the number of seniors with sensory impairment will increase. Loss of hearing ability may result in communication
difficulties and pervade multiple domains of functions in older people, give depressive symptoms and complicate assessment of cognitive ability.
Vision loss also affects multiple areas of functions and may limit the competence of an older individual to orient oneself and to move safely around.
Vision and hearing impairment in combination is shown to exacerbate the effect of other impairments on disability.
A cross-national study of home care clients has showed a significant difference between clients with recently impaired vision function in participating in
social life and self-reported health compared to others (1).
Also in a study of home dwelling people with impaired hearing, quality of life was affected. Managing life with hearing loss takes time. Recurring
individual guidance is necessary particularly among the oldest to handle hearing impairment and technical aids (3).
Home care clients with dual sensory loss are in need of major support to manage their everyday lives. An earlier identification, rehabilitation and follow
up are required. Interventions towards this group are shown to be successful (4).
The prevalence of vision and hearing impairment is high among hip fracture patients. In the care for these patients we believe that detection of vision
and hearing impairment and intervention to improve such functions are important not only to prevent future falls, but also for the rehabilitation process
(1).
A study with nursing home residents showed that hearing and vision care could be improved by regular examinations to ensure hearing aids and up to
date glasses, regular eye health care routines and record keeping as well as follow-ups. The study revealed that the staffs were lacking understanding
of how to improve sensory quality of older people (2).
An Internet education program is developed to give knowledge in vision and hearing impairment and how to improve and handle impairment
(http://www.sansetap.no) (4).
When older persons attend health services it is paramount to screen sensory function by subjective and objective methods and identify possible
sensory loss. Rehabilitation programs need to accommodate and provide clients and carers with proactive strategies to defeat these difficulties
particular in those with duel impairment because this will have implications
1.SENSORY IMPAIRMENT IN HIP-FRACTURE PATIENTS 65 YEARS OR OLDER AND EFFECTS OF HEARING/VISION INTERVENTIONS ON
FALL FREQUENCY.
AND
RECENT LOSS OF VISION IN HOME CARE CLIENTS – A HEALTH HAZARD WITH IMPACT ON SOCIAL LIFE
2.IS THE HEARING AND VISION CARE PROVIDED TO NORWEGIAN NURSING HOME RESIDENTS ADEQUATE?
3.SOCIAL CONSEQUENCES OF HEARING IMPAIRMENT IN OLDER PEOPLE.
4.SEVERE COMBINED VISION AND HEARING IMPAIRMENT IN OLDER PEOPLE.
Chair(s)
Else Vengnes Grue Diakonveien 14 [email protected] +4722451853
____________________________________________________________________________________________________________
ID: 467
DEFINING SARCOPENIA--- SUMMING UP AN EVIDENCE-BASED APPROACH FROM POPULATION STUDIES
Tamara Harris (Laborarory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, United
States)
Zhao Chen, United States of America (1) Lynn Marshall, United States of America (2) Marjolein Visser, The Netherlands (3) Tamara Harris, United States of America (4)
(1) Univ of Arizona School of Public Health (2) Univ of Oregon School of Public Health (3) Vrije Universiteit Amsterdam (4) National Institute on Aging
The involuntary age-related decline in muscle mass among relatively healthy elderly adults has been termed sarcopenia. Sarcopenia may underlie
functional deterioration ultimately leading to disability, may cause changes in metabolism contributing to chronic diseases, and may lead to increased
risk for falls and osteoporotic fractures among older populations among other effects.
Although sarcopenia is associated with all of these frailty-associated traits, it is not clear that sarcopenia itself is the major contributing factor. Change
in muscle composition and in muscle quality expressed as decline in strength or power may be of greater importance.
Over the past ten years, a
number of large population studies have accumulated data on change in muscle mass as well as changes in muscle quality and composition.
However, as yet, there are few papers that compare, in a rigorous manner, different operational definitions of sarcopenia and how these relate to
health.
This symposium will include presentations of data from five major studies involving body composition, prediction of functional status, and other health
outcomes. By the time of the meeting in Paris, efforts will have been ongoing for over a year to compare results of these cohorts and to validate these
results in other longitudinal cohort studies. This meeting will be the forum for presentation of final recommendations and the data that underlie them
using an evidence-based approach. From these efforts, a standard definition of sarcopenia to facilitate the advancement of sarcopenia research,
clinical management, and development of prevention programs should emerge.
ZHAO CHEN, PH.D., M.P.H.- “SARCOPENIA DEFINED BY LONGITUDINAL BODY COMPOSITION AND HEALTH IN THE WOMEN’S HEALTH
INITIATIVE”
MARJOLEIN VISSER, PHD - “MUSCLE MASS OR QUALITY: SARCOPENIA OR STRENGTH? THE LONGITUDINAL AGING STUDY OF
AMSTERDAM STUDY”
TAMARA HARRIS, MD, MS – “MUSCLE MASS OR MUSCLE FAT: SARCOPENIA OR MYOSTEATOSIS? THE HEALTH, AGING, AND BODY
COMPOSITION STUDY”
LYNN MARSHALL, PH.D.– “MUSCLE MASS OR FUNCTION: SARCOPENIA OR POWER? THE STUDY OF OSTEOPOROSIS IN MEN”
Chair(s)
Zhao Chen University of Arizona [email protected] 520-626-9011
Harris Tamara National Institute on Aging [email protected] 301-496-1178
____________________________________________________________________________________________________________
ID: 468
FUNCTIONAL NEUROIMAGING CONTRIBUTIONS TO THE STUDY OF COGNITION IN HEALTHY AGING AND NEURODEGENERATIVE
DISEASES.
Oury Monchi (Montreal Geriatric's Institute, University of Montreal, Functional Neuroimaging Unit, Canada)
Roberto Cabeza, United States of America (1) Yves Joanette, Canada (2) Oury Monchi, Canada (2) Antonio P. Strafella, (3)
(1) Center for Cognitive Neuroscience, Duke University (2) Institut Universitaire de Gériatrie de Montréal, Université de Montréal (3) CAMH & Toronto Western Hospital,
University of Toronto
Over the past decade, we have seen a large explosion of anatomical and functional neuroimaging techniques, allowing exciting investigation of new
aspects of the human brain functions with respect to cognition, learning, and memory. These developments have occurred with respect to the
machinery (diverse methods of acquisition), the methods for analysis, and the extent of clinical applications. In particular these methods have provided
us with an unprecedented manner of studying non-invasively the neural origins of the cognitive evolution or decline associated with aging and the
cognitive deficits observed in neurodegenerative diseases such as Parkinson’s disease (PD). In this symposium, some state of the art neuroimaging
studies of the cognitive decline observed with healthy aging and PD will be presented. In particular Dr. Roberto Cabeza, a pioneer in the field of
cognitive neuroscience of aging, will present some studies using Positron Emission Tomography (PET), functional Magnetic Resonance Imaging (MRI)
and models of effective connectivity that address the issue of compensatory brain activity in healthy older adults for cognition and memory. Dr. Yves
Joanette, a renowned expert in language and aging, will use the example of language to argue that the patterns of compensatory brain activity
observed with functional neuroimaging in healthy aging in the context of cognition may be task dependent. Dr. Oury Monchi will present studies using
functional and microstructural ananatomical MRI to study the neural origins of cognitive deficits observed in PD and healthy aging. In particular a new
theory will be presented that proposes that the pattern of cortical activity observed in PD during the performance of executive tasks is dependant on
the striatal requirement for the task. Finally, Dr. Antonio Strafella, a pioneer in the combination of Transcranial Magnetic Stimulation and PET will
present studies combining these two methodologies as well as Deep Brain Stimulation in PD, that are giving us new insights about the origins of
cognitive deficits and L-DOPA induced addictive behavior observed in PD. These studies are also showing that the functionality of specific subcortical
structures (such as the STN and PPN) is more complex than previously thought.
Together these presentations should provide for a stimulating symposium by exhibiting a representative sample of the latest development in the use
functional neuroimaging for the study of cognition in healthy aging and neurodegenerative diseases associated with aging. This symposium should
therefore be of interest to both researchers and clinicians in Geriatrics and Gerontology.
COMPENSATORY BRAIN ACTIVITY IN HEALTHY OLDER ADULTS.
NEUROFUNCTIONAL REORGANIZATION IN AGING: A SPECIAL CASE FOR LANGUAGE?
FUNCTIONAL NEUROIMAGING STUDIES OF COGNITIVE DEFICITS IN PARKINSON'S DISEASE
FRONTO-STRIATAL FUNCTIONAL ABNORMALITIES IN PARKINSON'S DISEASE
Chair(s)
Oury Monchi CRIUGM, 4565 chemin Queen Mary, Montréal, QC, H3W 1W5 Canada [email protected] +1 (514) 340-3540 ext.4013
____________________________________________________________________________________________________________
ID: 472
EXPERIENCES OF ASSISTIVE TECHNOLOGIES FOR OLDER AGE
Elisabeth Steinhagen-Thiessen (Charite Universitätsmedizin Berlin, Geriatric Medicine, Germany)
Mehmet Gövercin, Germany (1) William D. Kearns, United States of America (2) Michael Schellenbach, Germany (3) Charles G Willems, Netherlands Antilles (4)
(1) Charite Universitätsmedizin Berlin (2) University of South Florida (3) MPI for human development (4) Lector Saxion University of applied sciences Enschede
With growing life expectancy due to demographic changes, age related resources and declines shape the picture of the aged individual. The diversity
of the aging process needs a very sophisticated and at the same time holistic point of view. The tasks of geriatric medicine go beyond coping with
diseases in a classic medical way. Geriatric medicine furthermore tries to prevent diseases, helps caregivers to maintain a social network and assists
elderly in their home environment to avoid hospitalization. Geriatric medicine therefore looks very carefully at quality of life, caregiver burden,
independency in daily life, enabling resources of the elderly and on the other hand the equitable distribution of resources in a growing population. The
medical-economic paradox describes the increasing need of medical assistance for elderly in contrast to decreasing economic resources. Assistive
technologies have the potential to address the medical-economic paradox.
This work deals with first experiences of assistive technologies which support elderly people in their daily living, control chronic medical conditions and
help people living independently at home. The topic “Informatics-based Integrated Telehomecare: Lessons Learned from Field Tests” reports from a
series of field tests in the US, UK and the Netherlands as well as on the development of a mobile caregiving informatics system, the HomeCare
Assistant. Enabling resources in elderly people by assisting mobile functions through navigational assistance is the content of “Designing assistive
technologies for spatial navigation in old age”. The relationship between navigation performance and changes in gait patterns is the subject of this
project. Controlling chronic medical conditions to prevent functional decline and to assist health care professionals in their work load through sensor
based rehabilitation is the issue of “Sensor Based Hip Rehabilitation in Practice”. The topic: “Evaluation of Wandering by Residents in an Assisted
Living Facility (ALF) using Ultra Wideband Radio RTLS” demonstrates how technology can assist demented people in assisted living facilities in the
near future.
In summary this work demonstrates experiences with assistive technologies in the context of geriatric health maintenance trough different points of
view in different cultural and environmental settings. Main results include the usability and the impact of developed solutions. The multifaceted view
gives an important insight for researchers and health care professionals concerning the implementation of assistive technologies in health care
systems through Europe and North America.
Integrating remote monitoring in national Telehomecare: a report from the netherlands
DESIGNING ASSISTIVE TECHNOLOGIES FOR SPATIAL NAVIGATION IN OLD AGE
SENSOR BASED HIP REHABILITATION IN PRACTICE
EVALUATION OF WANDERING BY RESIDENTS IN AN ASSISTED LIVING FACILITY (ALF) USING ULTRA WIDEBAND RADIO RTLS
Chair(s)
Elisabeth Steinhagen-Thiessen Reinickendorfer Str. 61 [email protected] +493045941901
Gövercin Mehmet Reinickendorfer Str. 61 [email protected] +4930450553127
____________________________________________________________________________________________________________
ID: 474
SUBSTITUTIVE HOSPITAL AT HOME MODELS AROUND THE WORLD: IMPACT ON HEALTH AND WEALTH IN OLD PATIENTS
Nicoletta Aimonino (San Giovanni Battista Hospital, Geriatrics, Italy)
Nicoletta Aimonino, Italy (1) Gideon Caplan, Australia (2) Bruce Leff, United States of America (3) Jochanan Stessman, Israel (4)
(1) San Giovanni Battista Hospital (2) Prince of Wales Hospital (3) Johns Hopkins University School of Medicine (4) Hadassah-Hebrew University Medical Center
Older patients are an increasing proportion of hospital in-patients. They are at high risk for many hazards of hospitalisation, including mortality and
adverse events. Providing acute hospital-level care in a patient’s home can be a safe and efficacious alternative to hospital care. Technologically
advanced devices, once found only in the hospital, are now relatively common in the home and can expand the capabilities of home care.
The purpose of the symposium is to discuss the results and the perspectives of hospital-level health treatments delivered at the patient’s home.
Hospital at home is a clinical discipline that takes practitioners, technologies and skills normally resident only in acute hospitals in the community
setting.
Little data are so far available in the literature on hospital-level home care. The present knowledge suggests that this model of care provides
high-quality and cost-effective care.
The invited speakers are involved in the care and in the research on hospital at home in different countries.
Dr Aimonino (Italy) will describe the Torino Hospital at Home service, a clinical unit model operating since 1984 as an alternative to inpatient care
mainly for frail elderly subjects with acute illnesses taken from the Emergency Department. Published data show positive outcomes in terms of
effectiveness and efficiency.
Prof. Caplan (Australia) will illustrate his recent meta-analysis on Hospital in the Home. Previous meta-analysis included studies where home care was
an add-on and not a substitute for hospital admission. This new meta-analysis of randomised controlled trials that provide substitutive care found a
significant decrease in mortality and cost, with a consistent increase in patient satisfaction.
Prof. Leff (USA) will describe the challenges of disseminating Hospital at Home (HaH) in the US healthcare system. In fact, most HaH models have
been developed in countries with single-payer health systems. In the US, no such system of health care financing exists, and this poses special
challenges to HaH development. The lessons learned from the US experience will inform HaH dissemination efforts worldwide.
Dr Stessman (Israel) will present his model of physicians-led medical care at home, which has remained unchanged for over 18 years, and has
repeatedly proven itself to be viable both in clinical and financial terms. He will also discuss the high satisfaction of the patients, their families, as well
as the health providers and the medical and nursing staff.
HOSPITAL AT HOME AS A LINK BETWEEN THE HOSPITAL AND THE COMMUNITY: THE EXPERIENCE OF TORINO
META-ANALYSIS OF HOSPITAL IN THE HOME (HITH): THE EFFECT OF SUBSTITUTING CARE AT HOME FOR CARE IN HOSPITAL
SPECIAL CHALLENGES IN DISSEMINATING HOSPITAL AT HOME IN THE US HEALTHCARE SYSTEM: LESSONS FOR THE FIELD
HOME HOSPITALIZATION IN JERUSALEM: 18 YEARS OF COST EFFECTIVE CARE
Chair(s)
Alain Franco Laboratoire Interuniversitaire de Gérontologie de Grenoble [email protected] 0476765541
____________________________________________________________________________________________________________
ID: 481
EMERGENCY MEDICINE IN THE ELDERLY: HOW TO IMPROVE MANAGEMENT ?
Jacques BODDAERT (CHU Pitié-Salpêtrière - APHP, Geriatric center, France)
Jacques Boddaert, (1) Pierre Hausfater, (2) Patrick Ray, (2) Fabio Salvi, (3)
(1) Geriatric center. Pitie-Salpetriere hospital. APHP. UPMC Paris 6. (2) Emergency department. Pitie-Salpetriere hospital. APHP. UPMC Paris 6. (3) Department of internal
medicine. University Politecnica delle marche
Elderly patients represent a growing proportion of patients in emergency department (ED), with several comorbid conditions and polypharmacy. In ED
and after discharge, this population is chacterized by atypical presentations, altered mental status, high frequency of readmissions with a higher risk of
functionnal decline and death.
The aim of this session is to discuss what can be done to improve management in emergency elderly patients. The first presentation will report what
useful evaluation can be done in the ED, to improve immediate amangement and discharge, and raise the question of the benefice of a Geriatric
Assessment in this conditions. The second speaker will talk about infectious disease in elderly emergency patients, and how to improve the diagnosis
and prognosis, raising the question of how to optimize intensive care unit referral. The interest of markers (CRP, procalcitonin) will be discussed. The
third speaker will talk about dyspnea and heart failure in emergency elderly patients, which remains a difficult diagnosis with a poor prognosis. The
interest of markers (clinical parameters as well as BNP, pro-BNP) will be discussed. Finally, the last speaker will talk about its experience of a geriatric
emergency department, an ED dedicated to the elderly, and will highlight the interest as well as the difficulties related to this type of management.
Overall, the session will offer an updated view of what appears to be usefull in the ED context, from useful assessment to markers to improve
emergency management, and will finish with the discussion about geratric EDs and their place in the future.
EMERGENCY DEPARTMENT: PLACE FOR STRATIFICATION TOOLS AND GERIATRIC ASSESSMENT ?
INFECTIOUS DISEASES: HOW TO IMPROVE DIAGNOSIS AND PROGNOSIS IN EMERGENCY ELDERLY PATIENTS
DYSPNEA AND HEART FAILURE: HOW TO IMPROVE DIAGNOSIS AND PROGNOSIS IN EMERGENCY ELDERLY PATIENTS
GERIATRIC EMERGENCY DEPARTMENT: IS THERE AN INTEREST COMPARED WITH CONVENTIONAL EMERGENCY DEPARTMENT ?
Chair(s)
Dominique Pateron Emergency Department. CHU Saint Antoine. 184 rue du faubourg Saint Antoine. [email protected] 0149282000
Boddaert Jacques Geriatric department and Emergency Department. CHU Pitie-Salpêtrière. 47-83 boulevard de l'hôpital. 75651 Paris cedex 13
____________________________________________________________________________________________________________
ID: 496
PERSPECTIVES ON HEALTHY AGING
Anne B. Newman (University of Pittsburgh, Graduate School of Public Health, Epidemiology and Medicine, United States)
Henning Tiemeier, The Netherlands (1) Anne B. Newman, United States of America (2) Tamara B. Harris, United States of America (3) Joanne M. Murabito, United States
of America (4)
(1) Erasmus Medical Center (2) University of Pittsburgh (3) National Institute on Aging (4) Boston University School of Medicine
The population is aging rapidly, but is morbidity compressed? Are we aging better; are we gaining healthy life years as quickly as we are increasing
lifespan? These questions need to be addressed. Healthy aging has great appeal as an important target of prevention and interventions throughout
the lifespan. Factors that promote this outcome of aging are of great interest and are not necessarily the same as the factors related to premature
death. To promote healthy aging, we first need to better define it. Epidemiologic studies that have followed individuals into and through late life can
provide insights into the various aspects of healthy aging. In this symposium, we will draw from several major ongoing cohorts including the Rotterdam
Study, the Framingham Heart Study, the Cardiovascular Health Study and the Health Aging and Body Composition Study. We will address the
potential benefits of research that focuses on healthy aging and other positive health outcomes in old age. Dr. Tiemeier will review conceptual and
operational approaches and major findings to date regarding the critical factors that lead to good health outcomes. Dr. Newman will discuss chronic
health conditions and their influence on function at the subclinical level. Studies of disease at the subclinical level illustrate the rarity of truly healthy
aging and have implications for defining health in old age. Dr. Harris will then discuss trajectories of health in old age, focusing on body composition
remodeling as a fundamental marker of transitioning from robust to frail health. Finally, Dr. Murabito will discuss genetic factors that promote healthy
aging and longevity, drawing from recent findings from the CHARGE consortium founded in 2008 to discover new genes involved in complex traits in
five population-based cohort studies, including the Rotterdam Study, CHS, Framingham Heart Study (FHS), Atherosclerotic Risk in Communities
(ARIC) and Age, Gene/Environment Susceptibility—Reykjavik (AGES) Study, using genome-wide association analyses.
Participants in the symposium will learn about the current conceptualizations of this important aging outcome, the potential for health in old age,
important determinants, potential targets for interventions and future research needs in this area.
DEFINITIONS AND DETERMINANTS OF HEALTHY AGING: THE ROTTERDAM STUDY
CHRONIC DISEASE BURDEN, FUNCTION AND MORTALITY: THE CARDIOVASCULAR HEALTH STUDY (CHS)
HEALTH, WEIGHT AND BODY COMPOSITION: THE HEALTH, AGING AND BODY COMPOSITION STUDY (HEALTH ABC)
GENOME-WIDE ASSOCIATION STUDIES OF HEALTHY AGING AND LONGEVITY: THE COHORTS FOR HEART & AGING RESEARCH IN
GENOME EPIDEMIOLOGY
(CHARGE) CONSORTIUM OF LONGITUDINAL POPULATION-BASED COHORT STUDIES.
Chair(s)
Anne Newman 130 N. Bellefield Avenue [email protected] 724-934-1892
Kritchevsky Stephen Sticht Center on AgingMedical Center Boulevard Winston-Salem, NC 27157 [email protected] 336 - 713-8987
____________________________________________________________________________________________________________
ID: 506
THE MNA® REVISITED: WHAT DOES THE DATA TELL US?
Patricia Anthony (Nestlé Nutrition, HealthCare Nutrition, Switzerland)
Yves Guigoz, Switzerland (1) Juergen Bauer, Germany (2) Tommy Cederholm, Sweden (3)
(1) Nestlé Nutrition (2) University of Erlangen-Nuremberg (3) Uppsala University
The Mini Nutritional Assessment (MNA®), the most validated nutrition screening tool for the elderly and a part of the Comprehensive Geriatric
Assessment was originally validated in the early 1990’s and now has over 400 publications using the tool. In 2006 an expert review of the MNA (15
years later) was done at which concerns were raised about the applicability and usability of the MNA across care settings (acute, long-term,
community, free-living) and cultures. Thus a study, the MNA 2008 International Initiative, was initiated to combine multiple MNA data sets from the
literature (annum 2000+) in an attempt to address these concerns, with the goal of strengthening the MNA across elderly patient groups and care
settings. The results of this study will be presented in this session.
The chairman, Bruno Vellas and first speaker, Yves Guigoz were the leaders of the original development of the MNA tool and a vital part of the 2006
expert review. B Vellas uses the MNA clinically and both continue to publish on the MNA.
Cornel Sieber (participant of 2006 expert review) and Juergen Bauer are principle investigators in the MNA 2008 International Initiative. Both use the
tool in clinical practice and have published on the MNA, specifically comparing it to other screening tools.
Tommy Cederholm has published extensively on the MNA and uses the tool clinically. He participated in the 2006 expert review.
THE MNA IN RESEARCH AND PRACTICE: FROM BIRTH TO PRESENT (YVES GUIGOZ)
NEW INSIGHTS FROM AN INTERNATIONALLY POOLED DATABASE (JUERGEN BAUER)
FUTURE APPLICATIONS OF THE MNA (TOMMY CEDERHOLM)
Chair(s)
Bruno Vellas Toulouse Geriatric Center [email protected] +33 (-561) 777649
Sieber Cornel University of Erlangen-Nuremberg [email protected] +49 (0) 9113982434
____________________________________________________________________________________________________________
ID: 507
FALLS IN THE ELDERLY: RECENT FINDINGS AND ONGOING RESEARCH ON DETECTION OF ‘AT-RISK’ ELDERLY POPULATIONS.
Frederic Bloch (Hopital Broca (AP-HP), Service de gerontologie 1, France)
Mary Tinetti, United States of America (1) Frederic Bloch, France (2) Gilles Kemoun, France (3) Anne-Sophie Rigaud, (2)
(1) Yale New Haven hospital (2) Hopital Broca (AP-HP) (3) CHU La Miletrie
Morbidity, loss of autonomy and mortality related to fall are frequently encountered in older adults as the incidence and severity of acute complications
increase along with age. Research in the field of falls is perhaps the greatest challenge with which a gerontologist may be confronted, especially as
regards risk factors.
A fall is a brutal and fortuitous event. The ageing of the body leads to many physical changes that tend to increase the number of risk factors. In
addition, dangerous or inadequate conditions may assume a decidedly major role. And, lastly, the administration of numerous drugs can lead to a
rising number of iatrogenic falls attributable to various mechanisms.
The combination of risk factors can vary for each individual and be different for each fall. This helps to explains why it may be quite difficult, after a fall,
to determine its cause.
Ability to determine the degree of risk of falling for each elderly subject would both facilitate implementation of appropriate preventive measures, and
optimize care
We therefore performed a search in numerous databases by keywords "Accidental Falls/statistics and numerical data" and "Risk Factors". We
selected articles concerning (i) subjects aged> 60 years, (ii) falls in everyday life and (iii) in French or in English. Any articles on falls in the elderly
devoid of focusing on risk factors were not selected.
Of the 3747 articles identified by the initial research, 726 articles on several different risk factors were identified. Within this group, only 563 articles on
clinical studies were kept. Each study was classified according to its methodology (prospective cohort study or retrospective study case/control) and
its quality. Using a meta-analysis method, we combined data from each study to calculate an odds ratio for each isolated risk factor
With these results, we are working to create an algorithm taking into account the value attached to each risk factor. This algorithm will help to define an
individualized risk index to be used in personalized screening of the elderly population.
Detecting at-risk’ elderly populations will permit to prevent any new fall in this group by remembering that falls are caused by the interaction of
numerous factors. One objective will be to reduce the time elapsed between a fall and an alert; this would enhance chances of a favourable outcome.
Another objective could be multidisciplinary interventions aimed at reducing these falls and adapted to each risk factor encountered.
1- SYNTHESIS OF THE DIFFERENT RISK FACTORS OF FALLS
2- META-ANALYSIS LIKE STUDY ON RISK FACTORS OF FALLS IN AN ELDERLY POPULATION
3- CASE-BY-CASE ASSESSMENT METHOD TO DETECT RISK FACTORS OF FALLS
4- REVIEW OF NEW METHODS OF EARLY DETECTION AND SECONDARY PREVENTION OF FALLS IN THE ELDERLY POPULATION
Chair(s)
Mary Tinetti Yale University [email protected] (203) 737 1800
____________________________________________________________________________________________________________
ID: 585
CACHEXIA: A NEW GERIATRIC SYNDROME?
Yann Colardelle (LMS Group, , France)
William Evans, United States of America (1) Josep Argiles, Spain (2) Stefan Anker, Germany (3) John Morley, Germany (4)
(1) Nutrition, Metabolism, and Exercise Laboratory, Donald Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences (2) Unitat de Bioquímica i
Biologia Molecular B, Departament de Bioquímica i Biologia Molecular, Facultat de Biologia, (3) Center for Cardiovascular Research, CHARITÉ - UNIVERSITÄTSMEDIZIN
BERLIN (4) St Louis Univ School of Medicine Div of Geriatric Medicine
The prevalence of severe denutrition in hospitalized geriatric patients is very high: between 40 and 60% according to studies.
Weight loss is associated with increased mortality among elderly people discharged from a hospital; in elderly nursing home patients a 5% or greater
weight loss in a month is associated with a 10-fold increased risk for death.
In elderly people, weight loss and undernutrition affect functional and cognitive abilities, and the immune response. Resulting complications include
difficulty in swallowing, dehydration, and pressure sores. Poor nutritional status also leads to decreased lean body mass, and lessened muscular
strength and aerobic capacity. These changes contribute to a state of chronic fatigue, as well as alterations in gait and balance, which increase the
probability of falls and fractures. For many older people, this sequence of events leads to a deterioration in their overall quality of life, causing the
affected individual to become increasingly dependent on others. The ultimate cost to the individual and society is great.
This implies that the nutritional problem must be part and parcel of the therapeutic priorities for hospitalized elderly patients.
Recently, cachexia has come under scrutiny and some term it a “new geriatric syndrome”. However, the underlying mechanisms causing cachexia are
not well understood and the medical community lacks an operational definition of cachexia.
This symposium will:
•Review the basic science of cachexia;
•Propose a new definition of cachexia based on two consensus meetings held in 2006 and 2008;
•Review how cachexia is different from starvation, malabsorption, hyperthyroidism, dehydration or sarcopenia;
•Explain why even though malnutrition is often present in cachexia, the clinical characteristic of cachexia is that it cannot be successfully treated with
nutrition alone;
•Provide an overview of nutrional aspects in the elderly population and discuss prevention options;
•Review treatment options;
•Develop prospects for the management of cachexia.
Speaker choice:
William Evans is director of the Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas, research scientist in the Geriatric Research,
Education and Clinical Center and Professor of Geriatrics, Physiology, and Nutrition. Josep Argiles is Professor at the Dept of Biochemisty and
Molecular Biology, Barcelona University, Spain. Stefan Anker is Professor for Applied Cachexia Research, Dept of Cardiology, Charité University,
Berlin, Germany. John Morely is Professor and Director of the Division of Geriatric Medicine at Saint Louis University, MO, USA.
"CACHEXIA – A NEW DEFINITION"
OUTLINE:
•EXAMINE THE CONTROVERSIES RELATED TO CACHEXIA DEFINITION;
•UNDERSCORE THE IMPORTANCE FOR A CONSENSUAL DEFINITION IN CLINICAL PRACTICE AND IN RESEARCH;
•PROPOSE AND DISCUSS A NEW DEFINITION;
•DISCUSS INTERACTION WITH MALNUTRITION.
"PATHOPHYSIOLOGY OF CACHEXIA"
OUTLINE:
•EXAMINE THE UNDERLYING MECHANISMS FOR THE DEVELOPMENT OF CACHEXIA;
•DISCUSS NUTRITIONAL CONSIDERATIONS.
"CLINICAL ASPECTS – IS INVOLUNTARY WEIGHT LOSS CACHEXIA?"
OUTLINE:
•DISCUSS THE OVERALL CONCEPT OF WEIGHT LOSS AND ITS IMPACT ON MORTALITY AND MORBIDITY;
•EVALUATE THE CONTRIBUTION OF THE FOUR MAJOR CAUSES OF WEIGHT LOSS IN OLDER PERSONS (ANOREXIA [-> MALNUTRITION],
SARCOPENIA, CACHEXIA AND DEHYDRATION);
•SHOW HOW TO ASSESS WEIGHT LOSS AND EVALUATE THE ROLE OF THE FOUR MAJOR CAUSES;
•UNDERSCORE THE ROLE OF MALNUTRITION AND EXAMINE THE INDICATIONS FOR NUTRITIONAL SUPPORT.
"PERSPECTIVES IN THE MANAGEMENT OF CACHEXIA"
OUTLINE:
•EXAMINE THE AVAILABLE THERAPEUTIC OPTIONS INCLUDING NUTRITIONAL SUPPORT AND ITS PLACE;
•OVERVIEW OF ON-GOING RESEARCH FOR NEW THERAPEUTIC AGENTS, PRELIMINARY RESULTS AND PERSPECTIVES.
Chair(s)
william evans University of Arkansas for Medical Sciences , 4301 W. Markham St., Little Rock, AR 72223, USA [email protected]
0015015265701
Morley John St. Louis Department of Veterans Affairs Medical Center , 1402 South Grand Boulevard , Saint Louis, MO 63104 , USA [email protected]
0013144986597
____________________________________________________________________________________________________________
ID: 525
OUTCOME ASSESSMENTS AMONG GERIATRIC PATIENTS IN INTENSIVE CARE MEDICINE
Hans Juergen Heppner (University Erlangen-Nuremberg, Klinikum Nuremberg - Geriatrics, Germany)
Dominique Somme, France (1) Hans Juergen Heppner, Germany (2) Katrin Schmitt, Italy (2) Niccolo Marchionni, (3)
(1) Hôpital Européen Georges Pompidou, Service de Gériatrie Pôle Urgences Réseaux (2) University of Erlangen-Nuremberg; Acute Geriatric Department-Intensive Care
Unit (3) University of Florence
One of the consequences of the demographic shift seen in Western societies is that more and more elderly persons are treated in Intensive Care Units
(ICUs). In ICUs, we face two extremes of Geriatric Medicine. First, the problem of ageist behaviour meaning that the chance for a (frail) elderly person
being admitted to an ICU is diminished compared to younger patients because age is still a restrain from being admitted. Second, the challenge of
switching from intensive care to palliative care in some of the patients over a short period of time. To react adequately to this dilemma in decision
making, ICUs need to include Geriatricians as part of their core team of specialists. Nevertheless, in order to implement this, we need to overcome
existing barriers also with regard to the priority setting of Geriatricians themselves. This is the focus of this symposium where existing data aim to
foster the development of clinical trials and thereafter guidelines for the care of (oldest) old persons in ICUs.
Topics to be covered include: Intensity of care and mortality in ICUs for the elderly; Prognostic factors in the elderly of severe infections in ICUs;
Prognostic factor for elderly patients suffering from myocardial infarction; factor for elderly patients after resucitation. Outcome measurements are also
of great importance as they provide information that will influence patients will and medical decision-making. Administrative databases give us an
opportunity to assess morbidity, mortality and outcome parameters of elderly ICU patients.
In conclusion, the symposium aims not only to present existing (scarce) data for this clinical challenge, but also to stimulate future research in this fast
emerging area for the sake of a high standard of care of elderly ICU patients due the impact on ethical, medical, social and socio-economical aspects.
HOSPITAL MORTALITY AND INTENSITY OF CARE OF ELDERLY PATIENTS IN ICU
PROGNOSTIC FACTORS FOR SEVERE INFECTIONS IN GERIATRIC PATIENTS.
PROGNOSTIC FACTORS FOR CARDIO-PULMONARY RESUSCITATION IN GERIATRIC PATIENTS
PROGNOSTIC FACTORS FOR GERIATRIC PATIENTS IN ICU WITH ACUTE MYOCARDIAL INFARCTION
Chair(s)
Cornel Prof. Dr. Sieber University of Erlangen- Nuernberg, Prof.-E.-Nathan-Str. 1, 90419 Nuernberg, Germany [email protected] 0049
911 398 2434
Prof. Dr. Marchionni Niccolo University of Florence , Via delle Oblate 4, 50141, Florence, Italy [email protected]
____________________________________________________________________________________________________________
ID: 534
SUPPORT TO DEVELOP GERIATRIC MEDICINE IN COUNTRIES WITHOUT ACCEPTED SPECIALTY
Dieter Luettje (Klinikum Osnabrueck, Geriatric Medicine, Germany)
Hastie Ian, United Kingdom (1) Luettje Dieter, Germany (2) Frühwald Thomas, Austria (3) Sieber Cornel, Germany (4) Van der Cammen Tischa, The Netherlands (5)
(1) St George's Hospital (2) Klinikum Osnabrueck (3) Krankenhaus Hietzing (4) Klinikum Nürnberg Nord (5) Erasmus University Medical Center
To develop Geriatric Medicine in "developing Countries" i.e. countries without acknowledgement of Geriatric Medicine as medical specialty several
steps are necessary. First you have to define the specialty, training structures(undergraduate / graduate) have to be defined as well as quality of
training facilities and of future trainers. A supranational examination helps to define those who aquired knowledge on supranational level. Out of these
group future academic teachers have to be trained. If possible "train the trainers&teachers" can be started parallel out of academically qualified
presons of other specialties with special interest in Geriatric Medicine.
Section Geriatric Medicine of the European Union of Medical Specialist has provided all the necessities mentioned above, together with the activities
of the European Academy of Medicine for Aging a complete programm is existen and has already led to major improvement in Europe and beyond
(u.a. Mediterranian region, Lati America)
DEFINITION OF THE GERIATRIC PATIENT - DEVELOPMENT AND CONSENSUS (SGM UEMS)
QUALITY ASPECTS AND CONSENSUS RECOMMENDATION FOR TRAINIG (UNDERGRAD./POSTGRAD.), TRAINING FACILITIES AND
TRAINERS
SUPRANATIONAL EXAMINATION IN GERIATRIC MEDICINE
FROM EAMA TO ALMA, TRAIN AND TEACH THE (FUTURE) TRAINER AND TEACHERS
Chair(s)
Helgi Kolk Tartu University Clinics, Puusepa str. 8, Tartu 51014, Estonia [email protected] + 372 7 318282
Franco Alain Université Joseph Fourier – Grenoble I, Geriatrie Sud, CHU, 38043 Grenoble Cdx, France [email protected] +33 (0)476 765541
____________________________________________________________________________________________________________
ID: 539
HEALTHY AGEING: POPULATION STUDIES ON BIOLOGICAL, CLINICAL AND PSYCHOSOCIAL DETERMINANTS
Thomas Kirkwood (Newcastle University, Institute for Ageing and Health, United Kingdom)
Carol Jagger, United Kingdom (1) Karen Davies, United Kingdom (2) Rudi Westendorp, Netherlands Antilles (3) Thomas Von Zglinicki, United Kingdom (1)
(1) University of Leicester (2) Newcastle University (3) Leiden University (4) Newcastle University
The symposium highlights findings from state-of-the-art multidisciplinary studies of healthy ageing in the very old, drawing together findings from the
Newcastle (UK) and Leiden (NL) 85+ studies and from genetic studies in long-lived families. Those over 85 constitute the fastest growing sector of the
population in many countries, yet they are still those for whom the least information is available. By focusing specifically on cohorts in Newcastle and
Leiden, within each of which the participants share only their year of birth and city of residence, the studies reveal highly detailed information about the
variability of health in the age group and they provide important new information about the different factors associated with the maintenance of health.
The four complementary presentations examine (i) results describing comprehensive assessment of the state of health of 85-year olds in the 21st
century, including detailed functional studies as well as data on cognition, socioeconomic circumstances and lifestyle, (ii) practical and ethical issues
about conducting research in this age group in ways that can include a great variety of individual differences, so that the research can truly present a
complete cross-section, (iii) information about the contribution of genetics in explaining healthy longevity within family groups where two or more
siblings have survived into their 90s together with information on how a family background of healthy longevity confers improved health and survival
expectancy in the subsequent generation, and (iv) evidence from studies exploring the development of biological indicators (biomarkers) of healthy
ageing. The presentations will be given by leading experts from the teams in Leiden and Newcastle (in association with Leicester) and will highlight
opportunities for cross-comparison between studies in different countries. The speakers (in order of topic) will be Professor Jagger (University of
Leicester) who is an epidemiologist with long experience of population studies on healthy ageing and a member of several major ongoing
investigations in the UK and Europe, Ms Davies (Newcastle University) who leads the research nurse team in the Newcastle 85+ Study, Professor
Westendorp who is a clinical gerontologist leading the Leiden 85+ and family-based genetics studies, and Professor von Zglinicki who is a
biogerontologist with wide expertise in developing biomarkers of ageing.
BEING 85 IN THE 21ST CENTURY
RESEARCH ENGAGEMENT WITH THE VERY OLD
GENETIC CONTRIBUTIONS TO HEALTHY LONGEVITY
BIOMARKER ASSESSMENTS OF HEALTHY AGEING
Chair(s)
Tom Kirkwood Institute for Ageing and Health, Newcastle University, NE4 5PL, UK [email protected] +44 191 248 1103
Gussekloo Jacobijn Department of Public Health and Primary Care, Leiden University Medical Centre, NL [email protected] +31 71 526 8444
____________________________________________________________________________________________________________
ID: 543
TELEMEDICINE AND TELEHEALTH SERVICES IN THE HOME OF THE ELDERLY: EXPERIENCES AND BLOKERS
Pierre Rumeau (CHU-Toulouse, Geriatrics , France)
Pascal Lochelongue, France (1) Pierre Rumeau, France (2) Käte Alrutz, Sweden (3) Olivier Clément, France (4)
(1) Talhès Alenia Space (2) European Institute of Telemedicine (3) Länskliniken ÖNH, University Hospital University Hospital (4) Serviligne
Population ageing will increase the number of sick or handicapped elderly persons. The number of caregivers will drop ; Societies will have provide
tools to ease care and limit time and money lost in activities such as transportation. Telemedicine gives access to expertise and humanitarian support
for socially excluded elderly citizens. Successful local initiatives have great difficulties in generalizing, the cultural embedding that makes their success
being one of the reasons. We think that an ethical approach base on medical deontology and a service driven state of mind may help in generalizing
the working approaches.
P. Lochelonge from TAS will give an overview of the technical possibilities and the tailored choice of connectivity that should prevail. He will stress the
importance of interoperability, with preexisting telemedicine networks and digital personal medical data systems, using his experience of telemedicine
systems deployment in various European countries as acquired during European projects.
L. Lareng, founder of the Midi Pyrénées Regional Telemedicine Network, connecting over 100 care facilities from University Hospitals to private GP
practices, will describe the deployment of a telemedicine system with terminals that can be deployed in less than 5 minutes in any room of a nursing
home and connect the residents directly to the practice of their own family doctor, or any endpoint in the telemedicine network. He will stress the
importance for telemedicine deployers to respect the already existing care networks, as chosen by the patient and his caregivers. Data sharing and
protection of medical records will be discussed.
K. Alrutz, Head of Department of Speech Pathology , Umeå University Hospital, will show how telemedicine can reach local communities and give
elderly people the opportunity to benefit from a rehabilitation program that otherwise they would have never been offered, adding the feeling of being
supported to answering the technical need for rehabilitation.
O. Clément from Serviligne, service providing company, will discuss the service model that has to be implemented for the elderly sick or handicapped
home dwellers, considering teleassistance systems only as a gateway to a global service system that has to fight isolation, while empowering the
end-user and that way avoiding intrusivity.
H. Mignot, lawyer and consultant with an experience in European telemedicine projects, will facilitate a panel discussion with the audience on the main
points that could help in deploying telemedicine and telehealth home services for the elderly in the broadest type of cultural and
TECHNICAL TOOLS TO FIT IN HOME TELEMEDICINE PRACTICE
HOMETELEMEDICINE : PROVIDING THE NATURAL MEDICAL NETWORKS WITH UP TO STANDARD TELEMEDICINE FACILITIES
SPEACH THERAPY REHABILITATION BY TELEMEDICINE: PROVIDING AT HOME
A PRACTICAL EXPERIENCE OF A TELEASSISTANCE INTEGRETED IN AN ANTI-ISOLATION SERVICE
Chair(s)
Louis Lareng Institut Européen de Télémédecine Hôtel Dieu Saint Jacques 2 rue Viguerie TSA 80035 31059 Toulouse Cedex 9
[email protected] +33561778640
Rumeau Pierre Institut Européen de Télémédecine Hôtel Dieu Saint Jacques 2 rue Viguerie TSA 80035 31059 Toulouse Cedex 9
[email protected] +33561778639
____________________________________________________________________________________________________________
ID: 577
WHY PALLIATIVE CARE NEEDS GERIATRICS
Giovanni Gambassi (Università Cattolica Sacro Cuore, Center on Aging, Italy)
R. Sean Morrison, United States of America (1) Chiara Catananti, Italy (2) Miel Ribbe, The Netherlands (3) Agis Tsouros, Denmark (4)
(1) Mount Sinai School of Medicine (2) Università Cattolica Sacro Cuore (3) VU University Medical Center (4) World Health Organization
People are dying when they have illnesses such as advanced dementia or severe congestive heart failure, in addition to illnesses more routinely
recognized as terminal, such as advanced cancer. Care of dying patients also encompasses patients who have elected to forgo available treatments
that might forestall death, such as dialysis for end stage renal disease.
Palliative Care in geriatrics covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and
cultural context of old age and frailty, this symposium will detail specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes,
dementia, etc.) as well as individual symptoms (e.g., pain, fatigue, anxiety, etc.). The aim of this symposium is really to document that palliative care is
the best approach to the care of chronically ill and frail elderly because of its focus on: quality of life; support for functional independence; and the
centrality of the patient's values and experiences in determining the goals of medical care. Despite all of these considerations end-of-life care for older
adults is recognized to be poor across the planet. WHO is actively involved both in the diffusion of the culture of palliative care but also in the collection
of what are currently considered the best practices and the most successful examples of palliative are services implementation.
PALLIATIVE CARE AND GERIATRICS: PLANNING FOR THE FUTURE
PALLIATIVE MEDICINE IN GERIATRICS, NOT ONLY CANCER
PALLIATIVE CARE AND TERMINAL STAGE DEMENTIA
WHO GUIDELINES FOR A BETTER PRACTICE
Chair(s)
Giovanni Gambassi Centro Medicina Invecchiamento, Università Cattolica, Largo A. Gemelli, 8 00168 Rome, Italy [email protected]
39-06-3015-6390
Michel Jean-Pierre Geriatric Department, Geneva University Hospitals, CH-1226 Thonex, Geneve, Switzerland [email protected]
____________________________________________________________________________________________________________
ID: 598
EUROPEAN DIABETES WORKING PARTY FOR OLDER PEOPLE (EDWPOP)- PRESENTATION OF REVISED CLINICAL GUIDELINES FOR TYPE
2 DIABETES
Alan Sinclair (University of Bedfordshire , Medicine, United Kingdom)
Alan Sinclair, United Kingdom (1) Giuseppe Paolisso, Italy (2) Leo Rodriguez Manas, Spain (3)
(1) University of Bedfordshire (2) II University of Naples (3) Hospital Universitario de Getafe
These are well established and recognized guidelines which have recently been updated with new clinical trial evidence. These guidelines will be
available for distribution at IAGG Paris 2009 .
DEVELOPMENT OF THE EDWPOP GUIDELINES AND THE ENDORSEMENT PROCESS THROUGH THE IAG, IDF, AND EASD
EXAMINING THE EVIDENCE BASE: DRUG THERAPY FOR DIABETES IN OLDER PEOPLE
INTERVENTION STRATEGIES IN DIABETIC VASCULAR DISEASE
Chair(s)
Alan Sinclair The Old Barn, Rugby Road, Princethorpe, Warwickshire CV23 9PN, UK [email protected] 07801 136112
Paolisso Giuseppe Department of Geriatric Medicine and Metabolic Diseases, Second University of Naples, Naples, Italy [email protected]
00 39 081 5665134
____________________________________________________________________________________________________________
ID: 561
THE CALIFORNIA FALL PREVENTION CENTER OF EXCELLENCE: A MODEL WITH INTERNATIONAL APPLICATIONS
Laurence Rubenstein (UCLA-VA Medical Center, USC-CSUF-VA California Fall Prevention Center of Excellence, United States of America)
Laurence Rubenstein, United States of America (2) Jon Pynoos, United States of America (1) Debra Rose, United States of America (3) Phoebe Liebig, (1) Josea Kramer,
(2) Gretchen Alkema, (2) Kali Peterson, (2) Anna Nguyen, (1)
(1) USC Andrus Gerontology Center (2) UCLA-VA Medical Center GRECC (3) CSU Fullerton
The Fall Prevention Center of Excellence (FPCE), funded by the Archstone Foundation, is a research, education, training and advocacy center
dedicated to identifying and testing best practices in fall prevention and helping communities offer fall prevention programs to older people at risk.
FPCE builds on the efforts and expertise of a public-private interdisciplinary partnership drawn from four organizations: University of Southern
California’s Andrus Gerontology Center; Center for Successful Aging at California State University, Fullerton; UCLA/VA Greater Los Angeles
Healthcare System Geriatric Research, Education and Clinical Center; and California’s Department of Health Services, State and Local Injury Control
Section.
The FPCE website – www.stopfalls.org – is a comprehensive, worldwide resource and clearinghouse of information for service providers, individuals,
families, researchers, and educators. FPCE produces a wide range of educational products for multiple audiences, including fact sheets, technical
assistance briefs, advocacy toolkits, exercise brochures, fall-risk pocket guides and evidence-based protocols.
FPCE features two types of regional projects: coalition development (CD) and program expansion (PE) projects. The CD projects create local and
county-wide networks of diverse organizations to improve coordination, program development & education about fall prevention. The PE projects
promote the inclusion of additional program components within existing fall prevention programs, so as to establish a multifactorial approach. In
addition, FPCE is creating of a statewide network to coordinate these local and regional initiatives.
Central to FPCE is the development and evaluation of the senior-center based, multifactorial fall prevention program, Increasing Stability Through
Evaluation and Practice (InSTEP). InSTEP incorporates three key fall-prevention components -- medical risk assessment, exercise, and home risk
assessment and modification. FPCE is analyzing the relative effectiveness and cost-effectiveness of six different InSTEP models, which vary by
intensity (high, medium, low) and the addition of a behavior-change intervention. This project will demonstrate how organizations with different levels
of resources can create effective and sustainable fall prevention programs.
The symposium will include presentations on: 1) formation of the FPCE; 2) key educational products; 3) regional coalition development and statewide
networking projects; and 4) research comparing the effectiveness of the InSTEP model programs.
THE CALIFORNIA FALL PREVENTION CENTER OF EXCELLENCE: HISTORY AND VISION
KEY EDUCATIONAL PROGRAMS AND PRODUCTS
REGIONAL AND STATEWIDE COALITIONS AND NETWORKING
THE INSTEP MODEL PROGRAMS: EVALUATION AND COST-EFFECTIVENESS
Chair(s)
Laurence Rubenstein UCLA-VA Medical Center - GRECC (11E); 16111 Plummer St.; Sepulveda, CA 91343 USA [email protected]
818-895-9311
Pynoos Jon USC Andrus School of Gerontology; Los Angeles, CA, USA [email protected] 310-780-0313
____________________________________________________________________________________________________________
ID: 568
ANEMIA IN THE ELDERLY:EMERGING CONCEPTS IN OCCURRENCE, CAUSE, AND TREATMENT
William Ershler (National Institute on Aging, NIH, Clinical Research Branch, United States)
Jack Guralnik, United States of America (1) Kushang Patel, United States of America (1) Luigi Ferrucci, (1) Andrew Artz, (2) William Ershler, (1)
(1) National Institute on Aging, NIH (2) University of Chicago
Anemia (hemoglobin < 12g/dL in women and < 13 g/dL in men) is common in people over the age of 65 years, occurring in 10% of those living in the
community, and in more than 50% of those residing in institutions. Over the past decade anemia has been demonstrably associated with impaired
physical function, reduced cognition, increased propensity to fall, exaggerated comorbidities, diminished quality of life and increased mortality.
Although anemia occurs more commonly in Blacks, there remains a question whether the criteria used (as above) are applicable, as data has shown
the functional consequences to be less in African-Americans, particularly for mild anemia. For one third to one half of anemic elderly, a specific cause
for the anemia is not readily apparent (unexplained anemia, or UA) and defining the pathogenesis in these cases has been the focus of much current
research. Inflammatory pathways, including hepcidin have been implicated under certain circumstances. Bone marrow stem cell proliferative capacity
also declines somewhat with age, but experiments in laboratory animals suggest that this decline alone would be insufficient to result in anemia.
However, myelodysplasia does increase in frequency with advancing age, and in some cases this bone marrow disorder will present as anemia
without white blood cell or platelet abnormalities apparent on the peripheral blood smear. Thus, some cases of UA may ultimately be attributed to
MDS, although it is unclear how large this component is. Two clinical trials of erythroid stimulating agents (epoetin alfa, and darbepoetin alfa) for
treatment of anemia in the elderly have been completed and early results indicate that these agents can be used safely under carefully-controlled
circumstances. Additional, large scale trials are called for to determine which, if any, of the adverse associations mentioned above will be ameliorated
by the correction of anemia.
ANEMIA IN OLDER PEOPLE, EPIDEMIOLOGICAL CONSIIDERATIONS
RED CELL DISTRIBUTION WIDTH: AN EMERGING VARIABLE OF EPIDEMIOLOGIC SIGNIFICANCE
THE PATHOGENESIS OF UNEXPLAINED ANEMIA IN THE ELDERLY
DEFINING MYELODYSPLASIA IN UNEXPLAINED ANEMIA
Chair(s)
William Ershler NIA, 3000 Hanover Street, Baltimore, MD, USA 21225 [email protected] 410--350-3922
____________________________________________________________________________________________________________
ID: 576
SMALL-SCALE, PERSONALIZED NURSING HOMES: A GLOBAL PHENOMENON?
Rosalie A Kane (University of Minnesota, School of Public Health, United States)
Rosalie A Kane, United States of America (1) Hilde Verbeek, The Netherlands (2) Anja Declercq, Belgium (2) Po-Tsung (Wenbert) Chen, Taiwan (2)
(1) Sch of Public Health, University of Minnesota (2) Sch for Public Health & Primary Care, University of Maastricht (3) Katholiekke Universtiteit (4) Dept of Architecture,
National Cheng Kung University
Transforming the culture of nursing homes to normalized social environments with opportunities for individualization, privacy, community, and a good
quality of life is a world-wide trend.
This trend includes creating small-scale units (or households) within larger nursing homes or entirely
self-contained small houses (several of which may be combined under a single administrative authority). This symposium presents experience and
data from 4 countries (United States, Netherlands, Belgium and Taiwan) regarding small-scale facilities for older people, and suggests the benefits
and challenges of smaller-scale settings, including for people with dementia.
The small-scale nursing homes are discussed in the context of other
trends for long-term care each country.
In the United States “households” within large-scale nursing homes are already an established trend. “Small-house nursing homes” represent the
extreme of this development where about 10 heavy care residents are served in entirely self-contained buildings, where all cooking and dining take
place within the house.
Green House ® is a trademarked model of small-house nursing home that dramatically alters the scale, physical
environments, staff configuration and roles, and philosophy and programs of a traditional nursing home. Kane’s presentation describes positive
outcomes for residents, family, and staff from 4 Green Houses, which were evaluated in a quasi experimental design with 2 comparison groups, and
identifies ways Green Houses and small houses have expanded and how they can be classified according to characteristics that may affect outcomes.
In the presentation from the Netherlands, where small-scale nursing homes are common, Verbeek et al report findings from a recent cross-sectional
study performed in the south of the Netherlands that identified and explored characteristics and experiences with small-scale living arrangements and
studied how they worked for people with dementia. Also described are results from a cross-sectional study in which functional status and cognition
between residents in small-scale living facilities are compared with residents in regular psychogeriatric wards. Decercq discusses the development of
small-scale nursing homes in Belgium, including factors inhibiting their development compared to the experience in the Netherlands; she considers
ways that the concepts could nonetheless be introduced into traditional nursing homes.
Chen and You describe a small nursing home further
configured into living units of 10-12 in an urban area of Tainan, Taiwan; this facility is a hub for a variety of care and social programs in the
neighborhood.
LEARNING ABOUT SMALL-HOUSE NURSING HOMES FROM EARLY GREEN HOUSE PROJECTS
CHARACTERISTICS OF SMALL-SCALE NURSING HOMES IN THE NETHERLANDS AND HOW THEY WORK IN DEMENTIA CARE
SMALL-SCALE NURSING HOMES IN BELGIUM
INNOVATIVE NURSING HOME CARE WITH SMALL-SCALE LIVING IN AN INNER CITY ENVIRONMENT IN TAWIAN
Chair(s)
Rosalie Kane School of Public Health, University of Minnesota, 420 Delaware, SE, Box 917, Minneapolis, MN USE 55455 [email protected]
612-624-5171
Verbleek Hilde Maastricht University, Faculty of Health Medicine & Life Sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD
Maastricht [email protected] +31 43 3881513
____________________________________________________________________________________________________________
ID: 591
OPTIMAL PHARMACOTHERAPY IN OLDER PERSONS
Tischa Van der Cammen (Erasmus University Medical Center, Section of Geriatric Medicine, The Netherlands)
Graziano Onder, Italy (1) Mirko Petrovic, Belgium (2) Nathalie Van der Velde, The Netherlands (3) Birgit Böhmdorfer, Austria (4)
(1) Catholic University of the Sacred Heart (2) Ghent University Hospital, (3) Erasmus University Medical Center (4) Krankenhaus Hietzing
Adverse Drug Reactions (ADR) are a major burden on health care. One strategy for preventing them is to identify those patients at high risk of an ADR
and to target interventions toward this group. Several patient attributes that may make an ADR more likely have been suggested by various
investigators, including age, number of drugs the patient is receiving, co-morbidity, cognitive function, depression and factors that alter drug
distribution or metabolism, such as renal or hepatic insufficiency, congestive heart failure, and anemia. Members of the GERONTONET-group have
performed a pilot study on the development and validation of an ADR risk score, which has been designed to facilitate early detection of ADR. In
addition, we will present data on optimal prescribing for older persons, including data on safe withdrawal of fall-risk increasing drugs and
benzodiazepines.
1. THE DEVELOPMENT AND VALIDATION OF AN ADR RISK SCORE (GRAZIANO ONDER, ROME, ITALY; ON BEHALF OF THE
GERONTONET-GRANT GROUP)
2.WITHDRAWAL OF BENZODIAZEPINES: HOW TO DO IT? (MIRKO PETROVIC, GHENT, BELGIUM)
3. WITHDRAWAL OF FALL-RISK-INCREASING DRUGS: WHEN AND HOW/ EFFECTS ON FALL RISK AND MOBILITY TESTS (NATHALIE VAN
DER VELDE, ROTTERDAM, THE NETHERLANDS)
4. EFFECTS OF GERIATRIC ADMISSION ON OPTIMAL PRESCRIBING(BIRGIT BöHMDORFER AND THOMAS FRUEHWALD, VIENNA,
AUSTRICH)
Chair(s)
Tischa Van der Cammen Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The
Netherlands [email protected] +31107035979
Petrovic Mirko Department of Geriatrics and Gerontology, Ghent University Hospital, Ghent, Belgium [email protected] +3293322366
____________________________________________________________________________________________________________
ID: 596
HYPERTENSION IN VERY ELDERLY HYPERTENSIVE PATIENTS: LESSONS FROM THE HYVET STUDY
Nigel Beckett (Imperial College London, Care of the Elderly , United Kingdom)
Olivier Hanon, France (1) Nigel Beckett, United Kingdom (2) Ruth Peters, United Kingdom (2) Brian Williams, United Kingdom (3)
(1) Broca Hospital (2) Imperial College London (3) Imperial College London (4) University of Leicester
The symposium will cover the rationale behind the HYpertension in the Very Elderly trial (HYVET) and detail why such a trial was needed. The deisgn ,
study population , main results, result by subgroups will be covered as well as results related to cognition, depression, QoL and possibly ABPM. THe
impact of these results on the management of very elderly hypertensives will then be covered.
WHY THE INTEREST IN HYPERTENSION IN VERY ELDERLY PATIENTS?
MAJOR BENEFITS OBSERVED WITH HYPERTENSION MANAGEMENT IN VERY ELDERLY PATIENTS
ADDITIONAL BENEFITS BEYOND CARDIOVASCULAR EVENTS
IMPACT OF HYVET ON THE MANAGEMENT OF VERY ELDERLY HYPERTENSIVE PATIENTS
Chair(s)
Françoise Forette Hôpital Broca, Université Paris V [email protected] +33 1 55 74 67 27
Bulpitt Christopher Imperial College London, CAre of the Elderly, Du Cane Road, London, W12 0NN UK [email protected] +44 2083833958
____________________________________________________________________________________________________________
ID: 599
UPDATE: DEVELOPMENT OF THERAPIES AND DIAGNOSTICS FOR THE TREATMENT OF ALZHEIMER’S DISEASE
Maria Carrillo (Alzheimer's Association, Medical & Scientific Relations, United States)
Sam Gandy, United States of America (1) Dale Shenck, United States of America (2) Nick Fox, United Kingdom (3) Ronald Petersen, United States of America (4)
(1) Mt. Sinai School of Med. (2) Elan Corporation (3) ION, University College London (4) Mayo Clinic
This symposium will provide an update on the latest developments of potential therapeutic targets for AD. Speakers have been selected to evaluate
research strategies ranging from basic biology to biomarkers and early detection strategies designed to slow the progression of biological and clinical
processes characteristic of Alzheimer’s disease.
NEW MOLECULAR TARGETS EMERGING FROM BASIC SCIENCE WITH A FOCUS ON AMYLOID STRATEGIES
NEW MOLECULAR TARGETS EMERGING FROM BASIC SCIENCE WITH A FOCUS ON PLEIOTROPIC STRATEGIES
Imaging biomarkers for evaluation of disease progression in clinical trials
Moving the Therapeutic Targets Earlier in Alzheimer's Disease
Chair(s)
Bruno Vellas Toulouse [email protected] +33 (0)561145932
Petersen Ronald Mayo, Rochester, MN [email protected] (507) 538-0487
____________________________________________________________________________________________________________
ID: 613
ORAL HEALTH IN FRAIL GERIATRIC PATIENTS
Frauke Müller (University of Geneva, Gerodontology and removable Prosthodontics, Switzerland)
Ross Bryant, Canada (1) Ina Nitschke, Switzerland (2) Mario Brondani, Canada (3) Frauke Müller, Switzerland (4)
(1) Division of prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia (2) University of Zurich (3) University of British
Columbia (4) University of Geneva
It is well known that demographic developments indicate an increasing proportion of the elderly in the population as well as an augmenting life
expectancy of the individual. However, it is less well known, that this ageing population will retain their natural teeth for longer due to progress in
restorative techniques and preventive measures. Equally, the first removable denture is more often inserted later in life when adaptation has become
difficult. This trend will change the profile of geriatric dentistry and present a considerable quantitative and qualitative challenge to both, dental and
medical professionals. Oral health is largely neglected in elderly adults along with an impaired vision, taste, smell, manual dexterity and a lack of
motivation to effectuate frequent and effective hygiene measures. Especially in cognitively impaired, fragile and institutionalised individuals the
utilisation of dental services is often limited by various barriers, consequently periodontal disease and root caries show a high prevalence. In addition,
more than a third of institutionalised persons suffer from a dry mouth, mostly a side effect of their numerous medications. However, scientific evidence
indicates an increasing impact of the oral condition on the patient’s general health, especially cardiovascular diseases and diabetes as well as
aspiration pneumonia in the bed-bound population. It can be concluded, that oral heath care in old age may have a significant impact on the general
health, the nutritional state and the well-being of elderly adults.
PREVENTING DENTAL NEGLECT AS A CONSEQUENCE OF FRAILTY: A GLOBAL PERSPECTIVE
HOW TO PROVIDE ACCESS TO DENTAL CARE FOR THE INSTITUTIONALISED POPULATION – BARRIERS AND SOLUTIONS
COMMUNITY SERVICE LEARNING IN LONG-TERM CARE FACILITIES: DENTAL STUDENTS
TOOTH LOSS, DENTAL PROSTHESES AND NUTRITION IN THE ELDERLY POPULATION
Chair(s)
Jean-Pierre Michel University of Geneva and Geneva Hospitals [email protected] +41223056500
Ferrari Serge University of Geneva and Geneva Hospitals [email protected] +41223056375
____________________________________________________________________________________________________________
ID: 617
NEW APPROACHES IN AD PREVENTION
BRUNO VELLAS (CHU, MEDECINE INTERNE ET GERONTOLOGIE CLINIQUE, France)
Nicola COLEY, France (1) Sophie GILLETTE, France (2) Alan SINCLAIR, United Kingdom (3) Michael W WEINER, United States of America (4)
(1) 1 (2) 2 (3) 3 (4) 4
In the absence of a curative treatment for Alzheimer’s disease (AD), prevention is currently a major issue, and will continue to be so in the future.
Effective preventive strategies could potentially decrease the number of AD cases dramatically. These trials are relatively new in the field of AD.
Participants are generally those considered to be at greater risk of developing dementia, such as elderly persons (60–75 years onwards) or subjects
with another defined risk factor (e.g. memory complaints, family history of AD). There are two possible primary outcomes for prevention trials:
conversion to dementia or cognitive decline. Due to the difficulties in assessing conversion to AD, changes in cognitive function may be a suitable
alternative outcome for a number of reasons. Firstly, trial duration may be reduced, which in turn may reduce the attrition rate. Changes in the slope
of cognitive outcome measures are becoming increasingly discussed as a means of demonstrating a stabilisation or slowing down of deterioration.
One of the difficulties with the “cognitive decline” outcome is determining the clinical relevance of the neuropsychological changes observed. However
capturing activities of daily living or quality of life assessments as co-primary endpoints can help establish the clinical relevance of the difference found
in the primary endpoint. The development of the most widely used outcomes was based on experience obtained in other contexts and expert
judgment.
Current evidence suggests that multiple risk factors are associated with the AD progression. It is therefore probable that the prevention of AD could be
assured by multidomain interventions acting on different physio-pathological pathways leading to AD. In this symposium, international experts will
review the potential impact of physical and cognitive exercise, nutrition, and prevention of metabolic and vascular risk factors. Interventions based on
these multiple domains could prove useful not only for dementia prevention but also as part of the design and validation of a care plan for patients.
These topics will be presented in this symposium, along with a discussion of what we have learned from the ADNI study.
COGNITIVE DECLINE VERSUS CONVERSION TO DEMENTIA IN ELDERLY PERSONS WITH SUBJECTIVE COMPLAINTS
A MULTIDOMAIN APPROACH
VASCULAR AND METABOLIC INTERVENTION FOR AD PREVENTION
WHAT WE HAVE LEARNED FROM ADNI
Chair(s)
Jacques Touchon Service de Neurologie, CM2R du Languedoc-Roussillon, Inserm E 361, CHU Montpellier [email protected] +33 (0)4 67
33 60 29
Gauthier Serge McGill Center for Studies in Aging, Alzheimer’s Disease Research Unit, Montréal, Canada [email protected] +1-514-766-2010
____________________________________________________________________________________________________________
ID: 618
EUROPEAN ALZHEIMER DISEASE CONSORTIUM (EADC) INITIATIVE
BRUNO VELLAS (CHU, MEDECINE INTERNE ET GERONTOLOGIE CLINIQUE, France)
Winblad BENGT, Sweden (1) Giovani FRISONI, Italy (2) Pierre-Jean OUSSET, France (3) Pieter J VISSER, The Netherlands (4)
(1) Neurotec Department (2) IRCCS San Giovanni di Rio, FBF (3) CHU (4) Universiteit Medical Center
The EADC is a fully functional network of European centres of excellence working in the field of Alzheimer's disease. It provides a setting in which to
increase the basic scientific understanding of and to develop ways to prevent, slow, or ameliorate the primary and secondary symptoms of Alzheimer's
Disease. This is done by facilitating large Europe wide research studies. The EADC is funded by the European Commission. Two EADC studies will
be presented during this symposium.
The Impact of treatment with acetylcholinesterase Inhibitors (AChEIs) on Europeans with Alzheimer’s disease is being assessed in the ICTUS study
(Impact of Cholinergic Treatment Use). The primary objective of this study is to take advantage of the differences in prescription rates across Europe
in order to examine whether long-term treatment with AChEIs modifies the rate of change of the Clinical Dementia Rating scale (CDR; a score
providing a global rating of the severity of dementia) in European AD patients. The secondary objectives are to determine the natural history of AD in
Europe (cognitive impairment, and non cognitive domains of activities of daily living, behavioral disorders, and dependency), the impact of AChEI
treatment on the natural history and caregiver burden of AD, and the impact of AChEI treatments on the financial burden of AD in Europe.
The development of screening guidelines and diagnostic criteria for predementia Alzheimer's disease is the focus of the DESCRIPA study. The
primary goal of this project will be to perform a concerted action in order to reach an evidence-based European consensus on the identification of
subjects with AD in the predementia stage.
EUROPEAN ALZHEIMER DISEASE CONSORTIUM (EADC) INITIATIVE
NEURO-IMAGING AND BIOMARKERS: RATIONAL FOR PREVENTION
THE ICTUS STUDY
THE DESCRIPA STUDY
Chair(s)
Bengt WINBLAD Karolinska Institute, Alzheimer's Disease Research Center, Division of Geriatric Medicine, Stockholm, Sweden [email protected]
+46 8-524 800 00
Vellas Bruno Inserm U558, Gerontopole, Department of Geriatric Medicine, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
[email protected] +33 5 61 77 76 49
____________________________________________________________________________________________________________
ID: 1
Theme: Social Research, Policy and Practice
INFORMAL CAREGIVING : FROM OBSERVATION TO ACTION
ALAIN GRAND (Université Toulouse 3, Département de Santé Publique, France)
Alain Grand, France (1) Sandrine Andrieu, United States of America (1) Steven Zarit, United States of America (2) Mary Mittelman, (3)
(1) Département de Santé Publique, Université Toulouse 3 (2) Penn State University (3) Department of Psychiatry, New York University, Langone Medical Center
Informal caregiving has been thoroughly explored since the 1980’s. Both quantitative and qualitative aspects of informal caregiving networks are now
well documented. The impact of caregiving in various settings and socio-cultural contexts has been studied as well. Numerous disciplines have been
involved in this abundant research (epidemiology, sociology, psychology, demography, etc.).
More recently, studies have evaluated the efficacy of different types of psychosocial interventions, designed to improve patient and caregiver and
well-being (e.g., to reduce problem patient behaviors, alleviate the caregiver’s burden and depression, etc.). They are now yielding interesting results.
The object of the Symposium is to establish links between these two lines of research. Intervention studies must be based on a comprehensive
understanding of sound research on the characteristics and needs of caregivers. At the same time, academic analyses must take into account the
necessity for intervention practitioners to simplify reality, in order to design relevant programs. The dialogue is not easy, because the goals are
potentially in conflict.
The Symposium presentations will be organized in order to reinforce the bridge between both research trends and fuel a dialogue:
-
The introduction will be devoted to a sociological analysis of informal caregiving, so as to give the conceptual framework of research (Professor
Alain GRAND, Public Health and Health Sociology).
-
The second presentation will describe the state of knowledge resulting from quantitative approaches to the study of informal caregiving
(Professor Sandrine ANDRIEU, Epidemiology and Gerontology).
-
The third presentation will tackle the issue of describing the consequences of caregiving, notably with regard to the concept of burden (Professor
Steven ZARIT, Human Development).
-
The fourth presentation will be devoted to the analysis of the most important results of previous intervention studies, and current efforts to
improve these interventions and implement them in various health care settings (Professor Mary MITTELMAN, Epidemiology and Biostatistics).
The debate will be focused on the following issue: “How to design feasible and practical intervention studies, while taking into account the complexity
of the issues faced by informal caregivers?”
INFORMAL CAREGIVING : A CONCEPTUAL FRAMEWORK (A. GRAND)
QUANTITATIVE APPROACHES : THE STATE OF KNOWLEDGE (S. ANDRIEU)
PROCESS AND OUTCOMES FOR CAREGIVERS : NEW MULTIDIMENSIONAL MEASUREMENT APPROACHES (S. ZARIT)
CAREGIVER INTERVENTION RESEARCH : PAST RESULTS AND FUTURE DIRECTIONS (M. MITTELMANN)
Chair(s)
Marie Aline Bloch Caisse Nationale de Solidarité pour l'Autonomie, 66, avenue du Maine, 75682 Paris cedex 14 [email protected]
0153912863
____________________________________________________________________________________________________________
ID: 15
JURISPRUDENTIAL GERONTOLOGY: THE CONCEPTUALIZATION OF LAW AND AGEING
Israel Doron (Haifa University , Departement of Gerontology, Israel)
Israel Doron, Israel (1) Richard Kaplan, United States of America (2) Kim Dayton, United States of America (3) Doug Surtees, Canada (4)
(1) Haifa University, D. of Gerontolgy (2) U. of Illinois at Urbana-Champaign (3) William Mitchell College of Law (4) College of Law, University of Saskatchewan
The goal of this session is to introduce and discuss the broad spectrum of new attempts to theorize and conceptualise the theoretical relationships
between law and aging.
While very little attention was given to "Jurisprudential Gerontology" within social gerontology, "elder law" has been flurishing within the legal society,
especially in North America.
This session will present legal theories to social gerontology audience, and try to connect gerontological theories and approaches with legalistic ones.
1. THE NEED FOR "JURISPRUDENTIAL GERONTOLOGY"
2. A FEMINIST APPROACH TO ELDER LAW
3. THE "LAW AND ECONOMICS" APPROACH TO LAW AND AGEING
4. WHAT CAN ELDER LAW LEARN FROM DISABILITY LAW?
Chair(s)
Israel Doron Departement of Gerontology, Haifa University, Haifa Israel 31905 [email protected] 97248249954
____________________________________________________________________________________________________________
ID: 600
AGEING IN PLACE: OPTIONS FOR OLDER PEOPLE IN DEVELOPED COUNTRIES
Anthea Tinker (King's College London, Institute of Gerontology, United Kingdom)
Anthea Tinker, United Kingdom (1) Gloria Gutman, Canada (2) Duncan Boldy, Australia (3)
(1) King's College London (2) Gerontology Research Centre (3) Curtin University of Technology
Ageing in place (i.e. staying at home) has been a feature of policies in developed countries for many years. This has been in response to the views of
older people, dislike of institutional care and the policy belief that it is cheaper than alternatives.
However questions are now being asked about the extent to which this is viable and desirable
This is due to a number of factors including the
growing numbers of people with increased frailty especially dementia, limitations in community services, problems for carers, problems with the
housing stock and new ways of living which are developing.
This presentation critically examines the perceived wisdom about staying at home options, some of the ways this can be achieved and looks at some
of the new options which are emerging from international research. This includes increased attention to the economic costs of caring and modifying
housing.
Some of the emerging ways of enabling older people to stay at home/age in place which have been evaluated include the following. Building to
Lifetime standards, Home modifications (including their cost effectiveness) and emerging forms of supported housing. The latter includes new
research on problems with remodelling existing buildings and new ways of providing care. Other options to be discussed include the potential of
technology and how realistic this is for most people. Ethical issues are to the fore here. The symposium will also look at some new options to enable
people to stay outside institutional care such as the use of hotels and cruise ships.
The presenters will draw on their experience from Europe, Canada and Australia. They are:
Professor Anthea Tinker from King’s College London who will present research from the UK focussing particularly on remodelling existing buildings
and the use of technolgy.
Professor Gloria Gutman from Simon Fraser University, Vancouver, Canada who will discuss Canadian home care options together with supported
housing and assisted living. Both of these are seen from a policy perspective as filling the gap between independent living and institutions. Whether
they do or not, and for whom and for what duration are key questions.
Professor Duncan Boldy from Curtin University, Perth will review Australian research on new models to facilitate ageing in place.
AGEING IN PLACE: THE UK EXPERIENCE BY ANTHEA TINKER
AGEING IN PLACE: THE CANADIAN EXPERIENCE BY GLORIA GUTMAN
AGEING IN PLACE: THE AUSTRALIAN EXPERIENCE BY DUNCAN BOLDY
Chair(s)
Anthea Tinker King's College London, Institute of Gerontology, The Strand, 6th floor, London WC"R 2LS [email protected] 07802423388
____________________________________________________________________________________________________________
ID: 68
AGING, A CONSIDERABLE ACHIEVEMENT FOR HUMANITY – THE ILC PERSPECTIVE
Françoise Forette (ILC France, , France)
Shigeo Morioka, Japan (1) Monica Ferreira, South Africa (2) Sara Carmel, Israel (3) Sally Greengross, United Kingdom (4)
(1) International Longevity Center Japan (2) International Longevity Center South Africa (3) International Longevity Center Israel (4) International Longevity Center UK
Since the turn of the twentieth century, the world’s developed nations have experienced increased longevity. This is a considerable achievement for
humanity. At the same time, in the developing world 1.3 billion people experience “shortgevity”, bearing 99% of the burden of global maternal deaths
and 95% of deaths in children. These statistics highlight the urgent need for improved health and functional status, with an emphasis on prevention.
Leaders on aging from developing and developed nations will discuss related issues that are central to the advancement of healthy aging.
(Françoise Forette-France-)
1. Do health and longevity create wealth?
Economists across the political spectrum agree that improvements in health and longevity promote the wealth of nations. Self interest as well as
humanitarian concerns must motivate developed nations in their response to the poverty, starvation, and malnutrition in the developing world, for the
simple reason that the global market requires healthy and productive consumers. Nations that export, which eventually should include all nations,
require consumers who have the means to buy their products and services. (Shigeo Morioka- Japan –and Dominican Republic)
2. Healthy aging and disease prevention.
Health is a political and economic factor of vast importance. The ability of individuals to reach and secure an independent income for their advanced
years can be greatly affected by their health conditions over a lifetime. The enormous differences in mean life expectancy between countries rest on
socioeconomic factors, that is, the prevalence of poverty, poor sanitation, poor nutrition, and the presence of epidemics.
(Monica Ferreira- South Africa- and Netherlands)
3. Status and role of women in an aging society.
The promotion of gender equality and empowerment of women requires that nations develop a life-cycle approach to women’s health, including
affordable quality health care, information and appropriate services relating to their reproductive lives and to sexually-transmitted diseases. Providing
financial assistance through pensions or some kind of social security net is essential. (Sara Carmel-Israel- and India)
4. Ensuring human rights and fighting discrimination throughout the world
The overriding challenge facing nations of the world is to promote intergenerational quality of life, and to guarantee that economic pressure does not
compromise the rights of an aging population. To reach this goal, we must reduce racial and sexual inequalities based on age.
(Sally Greengross-UK- and Argentina)
Conclusion: The new Declaration for the Rights of Older Persons(Robert N .Butler,MD)
DO HEALTH AND LONGEVITY CREATE WEALTH?
HEALTHY AGING AND DISEASE PREVENTION.
STATUS AND ROLE OF WOMEN IN AN AGING SOCIETY.
ENSURING HUMAN RIGHTS AND FIGHTING DISCRIMINATION THROUGHOUT THE WORLD
Chair(s)
Françoise Forette 49 rue Mirabeau 75016 Paris France [email protected] 33 6 03 15 95 58
Butler Robert 60 East 86th Street, New York, NY, 10028 USA [email protected] 1 212 517 1295
____________________________________________________________________________________________________________
ID: 48
COMPARISONS OF GENERATIONAL AND CULTURAL CHANGE IN THE ‘DEVELOPED’ WORLD: THE IMPACT OF THE BABY BOOMERS ON
POLICY AND IDENTITY.
Simon Biggs (King's College London, Institute of Gerontology, United Kingdom)
Moody Harry, United States of America (0) Karisto Antti, Finland (0) Kendig Hal, Australia (0) Biggs Simon, United Kingdom (0)
(1) AARP (2) Helsinki University (3) University of Sydney (4) King's College London
Internationally, many of the traditional associations about adult aging are being questioned. In Policy terms, the challenge of an ageing population and
the need to discover new solutions to ‘the problem of ageing’ has become associated with the baby boomers. Boomers are mentioned in discourse
surrounding the OECD, the EU Lisbon Agenda and the EC green paper ‘Confronting Demographic change’. Older people, at least in the developed
world, are living longer, and appear to be both richer and fitter than in the past. This is in part due to the growth in the value of pensions, the
development of adequate health care, and the influence of new social attitudes, associated with the ‘baby boomer’ generation. Research suggests that
consequences of these changes include tensions around the relative ease with which different boomer groups can define who they are for themselves,
increasing similarity between different generations, their tastes and lifestyles, and, expectations of behaviour based on certain age-stages. If such a
form of ‘Boomer Based Aging’ is emerging, it will influence changing relations between different generations, and the roles available to older adults, as
producers and consumers in an ageing society. Wider, and perhaps more subtle tension may also be felt between the expression of individuality
arising from processes of increased maturity and the need to conform to new expectations of how to ‘age well’. A number of studies are now emerging
worldwide that can help contextualise policy development. Experts from the USA, Australia, the UK and Finland will be brought together to facilitate
international comparisons and draw out possible policy implications.
‘THE IMPACT OF THE BABY BOOMERS ON US PERCEPTIONS OF AGEING AND POLICY’.
’GENERATION FORMATION OF THE BABY BOOMERS. THE CASE OF FINLAND’
‘Boomer Identity and Changing Policy Stances an Australian perspective’
‘ THE BABY BOOMERS IN THE UK: CONSUMERS OR THE NEW PRODUCERS?’
Chair(s)
Simon Biggs Institute of Gerontology King's College London. [email protected] +44 207 848 2529
____________________________________________________________________________________________________________
ID: 57
END OF LIFE CARE IN LONG TERM CARE FACILITIES: THEORETICAL AND PRACTICE PERSPECTIVES
Deborah Parker (The University of Queensland, The University of Queensland/Blue Care Research and Practice Development Unit,
Australia)
Deborah Parker, Australia (1) Jo Hockley, United Kingdom (2) Katherine Froggatt, United Kingdom (3) Kevin Brazil, Canada (4)
(1) University of Queensland (2) Edinburgh University (3) Lancaster University (4) McMaster University
In most Western industrialised countries a significant proportion of older people live and die in long term care facilities. Increasing attention is paid to
ensuring that high quality end of life care is provided for older people residing in such settings. However, our knowledge about living and dying in these
settings remains largely descriptive and limited.
This symposium will:
1.Identify the challenges of caring for older people dying in long term care facilities.
2.Present a framework that can direct research and service development
3.Demonstrate the application of this framework to identify strategies to improve care.
This symposium will present two empirical studies in which theory has been used to illuminate new understandings of end of life care practice in long
term care facilities in two different countries. On the basis of these studies, we present a theoretically based framework developed to steer the design,
and evaluation of research and practice in this area. The application of this framework to identify strategies to improve care of the dying in long term
care facilities is proposed.
This presentation presents a novel and innovative approach to addressing the increasing challenges of caring for older people dying in long term care
facilities.
The presenters are all internationally renowned experts within the field of end of life care in long term care facilities.
Kevin Brazil specialises in health services research and organisational change strategies with a particular focus on end of life care.
Katherine Froggatt has researched the development of end of life care practices in long term care facilities for over 10 years using a range of
descriptive and participatory research methods.
Jo Hockley worked as a specialist palliative care nurse for many years, but latterly has focused upon end of life care, from a clinical and organisational
change perspective.
Deborah Parker has expertise in health sociology with a background in aged care and palliative care.
LONG TERM CARE FACILITIES AS DISCURSIVE ENVIRONMENTS: IMPLICATIONS FOR END OF LIFE CARE
DR DEBORAH PARKER, UNIVERSITY OF QUEENSLAND, AUSTRALIA
END OF LIFE CARE FOR OLDER PEOPLE IN LONG TERM CARE: A SYSTEM AND LIFE WORLD PERSPECTIVE.
DR JO HOCKLEY, UNIVERSITY OF EDINBURGH and ST CHRISTOPHERS HOSPICE, UNITED KINGDOM
A CONTESTED STATE IN A CONTESTED PLACE: THEORETICAL UNDERSTANDINGS OF LIVING AND DYING FOR OLDER PEOPLE IN LONG
TERM CARE FACILITIES.
DR KATHERINE FROGGATT, LANCASTER UNIVERSITY, UNITED KINGDOM
TRANSLATING THEORY INTO PRACTICE: STRATEGIES FOR TRANSFORMING LONG TERM CARE FACILITIES
DR KEVIN BRAZIL, MCMASTER UNIVERSITY, ONTARIO CANADA
Chair(s)
Deborah Parker PO Box 1539, Milton, Brisbane Queensland Australia [email protected] +61(0)7 33773310
Froggatt Katherine Bowland Tower East, B222 Lancaster University, UK [email protected] +44 (0)1524 593308
____________________________________________________________________________________________________________
ID: 62
EVIDENCE BASED PSYCHOSOCIAL INTERVENTIONS FOR OLDER ADULTS
Nancy Kropf (Georgia State University, School of Social Work, United States)
Sherry Cummings, United States of America (1) Carmen Morano, United States of America (2) Vaughn DeCoster, United States of America (3) Nancy Kropf, United States
of America (4)
(1) University of Tennessee (2) Hunter College (3) University of Arkansas (4) Georgia State University
Over the past decade, there has been tremendous growth in the movement to enhance the delivery of quality services through the use of evidence
based interventions. It is now widely agreed that in order to ensure the delivery of the best services to meet clients’ needs, practitioners’ decisions
must go beyond clinical judgment and expertise to include knowledge of evidence based practices. For this reason, in the last decade evidence based
practice (EBP) has emerged as one of the most important movements to improve the effectiveness of clinical care. EBP can be understood as “the
conscientious, explicit and judicious use of current best evidence in making decisions about the care of individuals” (Sackett, Richardosn, Rosenberg,
& Haynes, 1997). Although there is a body of evidence supporting the effectiveness of certain interventions for older adults, few have examined that
status of psychosocial interventions for the older population. The purpose of this symposium is to address this gap by presenting systematic reviews
of research-based psychosocial interventions for older adults and their caregivers.
Three papers will be presented within this symposium, and span various psychosocial issues that impact health. Each presentation will use a
standardized format to discuss the prevalence of the problem, the demographics of those affected, and the nature and consequences of the problem.
The empirical literature will then reviewed using specific parameters. The following criteria for evidence based treatment are utilized:
Level 1 - evidence is obtained from a meta-analysis of all relevant randomized controlled studies (RCS) or from a systematic review of RCS
Level 2 - evidence is obtained from at least one properly designed RCS
Level 3 - evidence is obtained from well-designed controlled studies without randomization
Level 4a - evidence is obtained from non-controlled studies
Level 4b- evidence consists of consensus reviews that represent the opinions of respected authorities based on clinical experience or reports of expert
committees.
The first paper will be on EBP for persons with dementia. A second is for older adults with substance addictions. The final paper will be on EBP in
diabetes care and management.
Finally, a discussion will synthesize findings across all papers and highlight practice implications. In addition, future areas for research on EBP for
older adults will be highlighted.
EVIDENCE BASED INTERVENTIONS FOR PERSONS WITH DEMENTIA
EVIDENCE BASED INTERVENTIONS FOR PERSONS WITH SUBSTANCE ABUSE ADDICTION
EVIDENCE BASED INTERVENTIONS IN DIABETES TREATMENT
Chair(s)
Nancy Kropf 140 Decatur St., Urban Life 1240, Atlanta, GA 30303 USA [email protected] 404-413-1052
Morano Carmen
____________________________________________________________________________________________________________
ID: 70
SPINNING STRAW INTO GOLD: EXPANDING OPTIONS FOR ELDERS AS HUMAN AND SOCIAL CAPITAL IN RAPIDLY AGING ASIA-PACIFIC
Takeo Ogawa (Yamaguchi Prefectural University, Graduate School of Health and Welafre, Japan)
Takeo Ogawa, Japan (1) Donghee Han, Korea, Republic of (2) Cullen Hayashida, United States of America (3) Xiaoxian Cheng, China (4)
(1) Yamaguchi Prefectural University (2) Research Institute of Science for the Better Living of the Elderly (3) Kapiolani Community College (University of Hawaii) (4) Dongdu
Cultural Media
By 2050, individuals age 65+ will comprise 37% of the population of Korea, 36% of Japan, and 23% of China. For Korea and Japan, this represents a
quintupling of elders in just 50 years. For China, this represents a tripling.
The Active Aging Consortium for Asia Pacific (ACAP) was established in 2005 to promote Active Aging in East Asia, the “process of optimizing
opportunities for health, participation, and security in order to enhance quality of life as people age” (WHO). For East Asian countries, with mandatory
retirement at 55 or 60, Active Aging necessitates a paradigm shift, i.e., we can no longer think of elders as “non-contributors.” Individuals must take
responsibility to stay healthy, and government needs to set standards for healthy communities, support life-long education and work opportunities, and
reward savings and volunteering.
This session features speakers from ACAP. Dr. Takeo Ogawa, from the Yamaguchi Prefectural University in Japan, will moderate after providing a
brief overview of rapid aging in East Asia.
Dr. Donghee Han, from the Research Institute for the Study of Better Living for the Elderly in Busan, will describe three programs that involved senior
volunteers in reducing the digital divide—a senior mentor program called Cyber Navigators, a peer group programs that supports elders as internet
instruction, and an intergenerational program that links students and seniors through cyberspace as well as “off-line” events.
Dr. Xiao Xian Chen, of Donghu Cultural Media in Shanghai, will speak about social participation of Chinese elderly people. She will discuss the
situation of aged people in Chinese cities and feature several programs that are increasing elder participation of social and civic activities.
Dr. Takeo Ogawa will give examples of active aging efforts in Japan. Rural Yamaguchi Prefecture is tracking the impact of its “Active Aging
Communities” policy. Fukuoka-city has developed the Aging Asia Business Center to incubate ideas and products for an aging city and the "Fukuoka
Aging Open Museum."
Drs. Cullen Hayashida, from the University of Hawaii, will focus on technology in an aging society. For frail elderly, technology is expanding options for
continued community dwelling, through emergency response systems and medication dispensers, and remote caregiving. Well elderly have been
engaged as oral historians to document community history and traditions, promoting active aging and positive images of older adults.
These examples may stimulate other rapidly aging nations to embrace and operationalize the Active Aging concept.
ACTIVE AGING EFFORTS IN JAPAN
CHANGING IMAGES AND ROLES OF ELDERS IN KOREA THROUGH SOCIAL DRAMA AND DIGITAL LIFE
LONG-TERM CARE DEVELOPMENT COORDINATOR
SOCIAL PARTICIPATION OF CHINESE ELDERLY PEOPLE
Chair(s)
Takeo Ogawa 2896-1 Ogori-shimogo, Yamaguchi-city, Yamaguchi 754-0002, Japan [email protected] +81-83-972-3667
____________________________________________________________________________________________________________
ID: 72
CROSS-NATIONAL STANDARDS OF QUALITY INDICATORS IN MULTIPLE SECTORS
John Morris (Hebrew SeniorLife, Institute for Aging Research, United States)
John Morris, United States of America (1) Katherine Berg, Canada (2) Magnus Björkgren, Finland (3) Pálmi Jónsson, Iceland (4)
(1) Hebrew SeniorLife (2) University of Toronto (3) Chydenius Institute (4) University of Iceland
This symposium describes the application of state-of-the-art, case-mix adjusted quality indicators for use in nursing homes, home care, and post-acute
care. They describe the quality of care delivered in these care giving settings, providing information relevant to internal quality control, external
oversight, and consumer choice. The measures cover a broad range of functional and clinical areas and, wherever possible, the same measures are
used in multiple settings. The adjustment models involve both standard patient-level covariates and an innovative approach to direct standardization.
The latter ensures that all facilities are distributed comparably on the most crucial covariate. The use of these dual procedures permits, for the first
time, true cross-site comparability on the key factors that would otherwise confound use of the quality indicators. The analyses employed to develop
the adjustment models were cross-national in scope, employing samples from North America, Europe, and Asia. The strongest covariates were
almost always summary measures that reflected overall patient complexity, i.e., measures of physical function, cognition, mood, and the need for more
intense services. The quality indicators reflect rates of decline, rates of improvement, incidence events, and in a few instances cross-sectional
prevalence measures. The individual indicators can also be accumulated to a summary quality indicator, capturing simultaneously measures of
function, cognition, communication, continence, mood, pain, behavior, pressure ulcers, and delirium, and this indicator is based on a balance of
improving and declining measures. For example, the highest positive score ( a +5) is reserved for programs that have improved beyond chance
(based on a standard deviation model) in five or more areas, and have not declined beyond chance in any of these areas. In the long-term care sector,
the four lowest QI Summary Index categories, representing the most problematic facilities, encompass 26% of all long term care homes in the
reference sample. The three middle categories, representing average facilities, encompass 59% of the facility distribution. The four top categories,
representing the best facilities, encompass 15% of the distribution. Using this summary measures, as well as the many separate quality indicators, we
will describe cross-national differences in quality outcomes within three health-care sectors: nursing homes, home, care, and post-acute care.
A NEW APPROACH TO ADJUSTING FOR SELECTION BIAS IN QUALITY INDICATORS
CROSS-NATIONAL COMPARISON OF NURSING HOME QUALITY INDICATORS
CROSS-NATIONAL COMPARISON OF HOME CARE QUALITY INDICATORS
CROSS-NATIONAL COMPARISON OF POST-ACUTE CARE QUALITY INDICATORS
Chair(s)
John Morris 1200 Centre Street, Boston, MA 02131 USA [email protected] 00 + 1 + 617.363.8543
____________________________________________________________________________________________________________
ID: 74
STATE SOCIAL POLICIES FOR FAMILY CAREGIVERS IN FOUR COUNTRIES: WHAT LESSONS CAN WE LEARN?
Kalyani Mehta (National University of Singapore, Social Work, Singapore)
Iris Chi, United States of America (1) Kate Davidson, United Kingdom (2) Mary Luszcz, Australia (3) Kalyani Mehta, Singapore (4)
(1) School of Social Work,University of Southern Californi (2) Dept of Sociology, University of Surrey (3) School of Psychology, Flinders University (4) National Dept of
Social Work, University of Singapore
The symposium addresses the importance and implications of state policies for family caregivers in ageing societies. The expert speakers represent
four developed countries with different sociopolitical systems i.e. United Kingdom, United States of America, Australia and Singapore. While human
needs of family caregivers have similarities, state policies are determined by the ideological, political, economic and cultural contexts, hence they tend
to diverge. The meeting of the needs of family caregivers by state policies and services ultimately has implications for the care recipients as their
quality of life is, to a large extent dependent on the care and support they receive from their caregivers.
The expert panel of speakers, from the four nations mentioned above, has been selected based upon their deep knowledge of policies and the welfare
systems of their respective countries. Two of these nations i.e. U.K. and Australia, practice the “welfare state” ideology. However, the implementation
of this philosophy varies in each of the countries.
The USA, on the other hand, has designed its own welfare system, which is a mixed economy of the public and private sectors. The National Family
Caregivers Program was implemented across the nation a few years ago, and the speaker from USA will review the current status quo.
The last country Singapore, stands in contrast to the others, as it is the only Asian country as well as a city state. The state policies have a strong
family orientation, and the philosophy of filial piety undergirds all its social policies. The choice of nations represented in the Symposia panel would
appeal to an international audience as the state policies and strategies have similarities as well as differences. The strengths and the inadequacies of
each country’s state policies as well as their implementation will provide opportunities for academic comparison and scientific enquiry.
Within the context of the global aging phenomenon, and the reality that in most countries family caregivers are the single most important source of
caregiving for older people, we ask ourselves the question, how can these caregivers be best sustained? How can the state shape appropriate and
effective policies for family carers? By comparing the status quo in a variety of countries, what lessons can we learn?
FAMILY CAREGIVER POLICY IN USA
STATUTORY AND INFORMAL CARE PARTNERSHIP POLICIES: A UK PERSPECTIVE
POLICIES RELATED TO FAMILY (INFORMAL) CAREGIVERS OF OLDER PEOPLE IN AUSTRALIA
TIME TO EXAMINE SINGAPORE'S SOCIAL POLICIES FOR FAMILY CAREGIVERS OF OLDER PEOPLE
Chair(s)
Kalyani Mehta BlkAS3#04-08,Dept of Social Work, 3 Arts Link,National University of Singapore, Singapore 117570,Republic of Singapore
[email protected] (65)65166117
____________________________________________________________________________________________________________
ID: 132
URBAN AGING: GLOBAL PERSPECTIVES
Victor Rodwin (International Longevity Center -USA, World Cities Project, United States)
Victor Rodwin, United States of America (1) Michael Gusmano, United States of America (1) Ruth Finkelstein, France (2) Emmanuelle Cadot, (3)
(1) International Longevity Center (2) New York Academy of Medicine (3) U 822 INSERM-INED
Urban Aging: Global Perspectives
Moderator: Dr. Robert N Butler
Declining birth rates, increasing longevity, and urbanization have created a new challenge for cities: how to respond to an aging population. Not
enough is known about how policies, institutions, and neighborhood characteristics shape the social interactions and health of older city residents. As
Klinenberg found in his book on Chicago’s heat wave of 1995, social isolation led to death for some older residents of poor neighborhoods. In contrast,
those living in equally poor, but more socially connected neighborhoods did not die. Klinenberg’s findings highlight the importance of neighborhoods
and social connections on the health of older persons in cities. Despite these important findings, we have limited knowledge of the health status and
quality of life of community-dwelling older people in cities. Recently, studies in public health, urban planning, political science, geography and
sociology have examined the effects of a neighborhood’s built environment and collective resources on social interaction and population health, but
few explore the implications for the quality of life and well-being of older people. Researchers in gerontology, geriatrics and economics have
investigated healthy and productive aging, but most of this literature ignores the role of place.
In this symposium, we extend the work of Gusmano and Rodwin from their book, Growing Older in World Cities: New York, London, Paris and Tokyo
(Vanderbilt U. Press, 2006), and explore the impact of neighborhood characteristics – socio-economic and demographic factors, the quality of the built
environment, housing arrangements and social connections – on the health and quality of life of older persons in New York City, Paris and London.
We will present three papers on the importance of neighborhoods in affecting the quality of life of older persons. The first paper (Cadot and Spira) will
explore the lessons learned from the French heat wave in improving safety and quality of life for older persons in Paris. This paper draws on the
survey research as well as epidemiologic analysis of excess mortality rates by arrondissement, in Paris. The second paper (Finkelstein) reports on
recent research at the New York Academy of Medicine in exploring the dimensions of “age-friendly communities.” This paper draws on the analysis of
data from focus groups, community forums, and expert roundtables held throughout New York City. The third paper (Gusmano and Rodwin) updates
the status of the ILC-USA’
LESSONS FROM THE HEAT WAVES IN PARIS, (EMMANUELLE CADOT AND ALFRED SPIRA)
IS NEW YORK AN ELDERLY FRIENDLY CITY? (RUTH FINKELSTEIN)
GROWING OLDER IN NEW YORK, PARIS AND LONDON: RECENT FINDINGS FROM THE WORLD CITIES PROJECT (MICHAEL K. GUSMANO
AND VICTOR G. RODWIN
INTRODUCTION TO URBAN AGING: GLOBAL PERSPECTIVES (ROBERT N. BUTLER)
Chair(s)
Robert Butler 60 E. 86th St. [email protected] 212-517-1316
Rodwin Victor 60 E. 86th St. [email protected] 917-400-0980
____________________________________________________________________________________________________________
ID: 136
ARE THERE VALID REASONS FOR AGE-BASED INEQUALITIES IN MEDICAL TREATMENT?
Constantina Safiliou-Rothschild (50+Hellas and ADEG, , Greece)
Matthias Pfisterer, Switzerland (1) Joel Ankri, France (2) Gretchen G. Kimmick, United States of America (3) Vassilis Voudris, Greece (4)
(1) University Hospital (2) Universite de Versailles St-Quentin en Yvelines (3) Duke University Medical Center (4) Onassis Cardiac Surgery Center
The symposium organizer analysed 300 European and North American medical research articles dealing with comparisons of medical treatments
received by patients over 65 years old (and even more by patients over 70) and by patients under 65 with the same medical conditions. The analysis
examined the extent to which patients age (holding other factors constant)influences the type of medical treatment received in large European and
North American hospitals and determines health outcomes. Overall, the analysis pointed to clear-cut age-based inequalities in medical treatment
resulting in older patients less efective treatment due ot their age and not to their medical condition.
The symposium primarily deals with health sciences/geriatric medicine although it also touches the theme of social sciences, policy and practice.
The inclusion of this symposium is of great importance because it must be examined in the light of valid medical research whether or not such
age-based inequalities are justified and if they are not justified, why they persist despite the formulation of medical recommendations to end them. Also
the importance of this symposium is heithened by the fact that the European Parliament and the European Commission are actually planning to extend
legislation of equal opportunities (of old and other discriminated groups)to goods and serices, including health services.
Due to symposium limitations, it is not possible to include all documented types of age-based inequalities in medical treatment. The outstanding
medical researchers who have accepted to participate are presenting their research on some of the vital areas of the medical treatment of older
persons.
1. INTENSIVE THERAPY VERSUS MEDICAL THERAPY IN PATIENTS 75 YEARS OLD AND OLDER WITH CHRONIC ANGINA. AND CHRONIC
HEART FAILURE.
2. AGE-BASED INEQUALITIES IN PRESCRIBING EFFECTIVE DRUGS
3. AGE-BASED INEQUALITIES IN BREAST CANCER TREATMENT.
4. CORONARY ARTERY STENTING AMONG PATIENTS OLDER THAN 70 YEARS OLD IN COMPARISON WITH YOUNGER PATIENTS.
Chair(s)
Konstantina Safiliou Kassou 15, Pireas, 18539, Greece [email protected] 30-210-4281079
____________________________________________________________________________________________________________
ID: 138
RECONCILING EMPLOYMENT AND FAMILY CARE IN EUROPEAN WELFARE STATES
António Fonseca (Catholic University of Portugal, , Portugal)
Zsuzsa Széman, Hungary (1) Jolanta Perek-Bialas, Poland (2) Sarmite Mikulioniene, Lithuania (3) Hanneli Dohner, Germany (4) Antonio Fonseca, Portugal (5)
(1) Hungarian Academy of Sciences (2) Warsaw School of Economics (3) Mykolas Romeris University (4) University Medical Center Hamburg-Eppendorf (5) Catholic
University of Portugal
Research indicates very different solutions to the challenges of caring an ageing population. Even when we emphasize the availability of state
solutions, we find varied degrees of that availability: (i) universal state coverage with uniform standards of provision and professional carers; (ii) ensure
public expenditure savings and focus on subsidiarity, (iii) mixed provision with home-based informal sector and support from public sector. The
purpose of this Symposium is to elucidate trends in conciliation between employment and family carers identified by previous research as particularly
vulnerable – those combining the conflicting demands of employment and family care. We shall address different topics such as gender aspect,
economic aspects, legal framework, and positive and negative aspects of reconciliation between employment and family care.
Participants in this Symposium represent different welfare state regimes – Central Europe; Eastern Europe; South Eastern Europe, considering that
multi-facetted implications of population ageing can only be adequately addressed through a multidisciplinary approach. Hence, participants come
from various relevant scientific fields, such as economics, sociology, gerontology and social policy.
In the context of globalised, flexible labour markets and public policy reforms, an increasing number of adult and even older workers caring for elderly
dependents will find it hard to cope with the contradictory demands of employment and family care. There are clearly major individual, social and policy
implications arising from such phenomenon that need to be discussed looking for new solutions. Examples of reconciliation between employment and
family care will be presented.
PROBLEMS OF EMPLOYMENT AND CARE FOR OLDER PEOPLE IN HUNGARY
APPROACHES TO FINDING THE BEST WAY BETWEEN THE DILEMMA: CONTINUE WORK OR TAKE CARE OF ELDERLY PARENT? – THE
CASE OF POLAND AND LITHUANIA
PROBLEMS TO COMBINE CARE WITH PAID WORK AND THE REACTION GIVEN BY THE GERMAN LTCI REFORM
ADDRESSING SOCIAL AND PSYCHOLOGICAL ASPECTS OF RECONCILING EMPLOYMENT AND FAMILY CARE IN PORTUGAL
Chair(s)
António M. Fonseca R. Diogo Botelho, 1327; 4169-005 Porto; Portugal [email protected] + 351965061036
____________________________________________________________________________________________________________
ID: 441
AGEING AND POLITICS IN EUROPE
Alan Walker (University of Sheffield, Sociological Studies, United Kingdom)
Tine Rostgaard, Denmark (1) Jean-Phillipe Durandel, France (2) Gerd Naegelt, Germany (3) Zsuzsa Szeman, Hungary (4)
(1) Danish National Institute of Social Research (2) Université de Franche Comté (3) University of Dortmund (4) Hugarian Academy of Sciences
The politics of ageing and ageing societies is a very neglected aspect of Gerontological research. Yet there have been remarkable developments in
the politics of ageing in all developed societies over the past two decades. This symposium focuses primarily on the European dimension because,
first of all, there is a growing interest in this topic within Europe; secondly, with regard to political participation, it is sensible to compare similar systems
and, thirdly, there is an explicitly European aspect to this topic.
This integrated symposium will bring together some of the leading European analysts on this subject and subject their conclusions to discussion from a
North American perspective. Each presenter will provide a carefully structured account of developments in the politics of ageing on three different
levels: micro, meso and macro. Together they will provide a detailed picture of this topic from different national perspectives.
THE POLITICS OF AGEING IN DENMARK
SENIOR CITIZENSHIP AND PUBLIC POLICY ON AGEING
THE POLTICS OF AGEING IN GERMANY
TRENDS OF POLITICS OF AGEING IN HUNGARY
Chair(s)
Alan Walker Deparment of Sociological Studies, University of Sheffield, Northumberland Road, S10 2TU, UK [email protected] +44-114 222
6467
Binstock Bob School of Medicine, Room WG-43, Case Western Reserve University, Cleveland, OH 44106 [email protected] +1-216 368
3717
____________________________________________________________________________________________________________
ID: 156
SOCIAL CLASS AND AGE RELATIONS IN LATER LIFE
(CONVENED BY MARVIN FORMOSA AND PAUL HIGGS)
Marvin Formosa (University of Malta, European Centre of Gerontology, Malta)
Paul/Marvin Higgs/Formosa, United Kingdom (1) Ian Rees Jones, United Kingdom (2) Toni/Neal Calasanti/King, United States of America (3) James Nazroo, United
Kingdom (4)
(1) University College London (2) Bangor University (3) Vigenia Tech and State University (4) Manchester University
This aim of this symposium is to reflect on and discuss that interface between social class and later life. This symposium is opportune because whilst
recent years witnessed much interest from social scientists in investigating the ‘novel’ character of class relations in late modern societies, class
research tended to remain located in, and around, the younger and adult ‘territories’ of the life course. Indeed, the role of older persons in class
relations is generally overlooked in academic debate due to the assumption that the class positions of retirees can only be understood in terms of
those class positions to which they were linked prior to retirement. Following the premise that one feature of retirement in a period of reflexive
modernization results in the development of new types of inequalities alongside the continuation of traditional social divisions, social inequality in
contemporary later life becomes redefined and experienced in different ways to those apparent in earlier periods of modernity, this symposium has
three distinct goals. First, to problematise the common location of the class position of older persons to either their last occupation prior to retirement
or that of the household head. Second, to discuss how by working within ‘conventional’ theries of class gerontologists fail to provide an age-relevant
framework for class research that is sensitive to the ways in which class relations in later life interlock with other inequalities. And finally, to examine
the extent that generational interests in later life interact with other lifelong divisions. Bringing together this symposium will facilitate the study of an
overlooked dimension of later life and allow it to integate with other aspects of the social patterning of age.
THEORISING SOCIAL CLASS IN LATER LIFE: POWER, IDENTITY AND LIFESTYLE
MARVIN FORMOSA AND PAUL HIGGS
SOCIAL CLASS, SOCIAL CAPITAL AND DIVERSITY IN LATER LIFE: A SECONDARY ANALYSIS OF THE BRITISH REGIONAL HEART STUDY
(1978-2003) USING MULTIPLE CORRESPONDENCE ANALYSIS
IAN REES JONES
AN INTERSECTIONAL APPROACH TO CLASS IN OLD AGE
TONI CALASANTI AND NEAL KING
CLASS, IDENTITY AND STRATIFICATION IN LATER LIFE: WHAT CAN A FOCUS ON ETHNICITY TELL US?
JAMES NAZROO
Chair(s)
Marvin Formosa European Centre of Gerontology, Universoty of Malta, Msida MSD 2080, Malta [email protected] 00356 23403103
Higgs Paul University College London, Charles Bell House 67-73, Riding House Street, London W1W 7EJ, UK [email protected] 0044 207 679 9466
____________________________________________________________________________________________________________
ID: 161
SOCIOECONOMIC INEQUALITIES IN HEALTH IN OLDER PEOPLE
Hans Bosma (Maastricht University, Social Medicine, The Netherlands)
Farizah Mohd Hairi, The Netherlands (1) Martin Bobak, United Kingdom (2) Danielle Groffen, The Netherlands (3) Morten Wahrendorf, Germany (4)
(1) Department of Public Health, Erasmus MC (2) Department of Epidemiology and Public Health, University College London (3) Department of Social Medicine, Maastricht
University (4) Department of Medical Sociology, University of Dusselfdorf
Lower socioeconomic status groups generally have lower life expectancies, higher morbidity rates, and worse health-related functioning. We are only
beginning to understand the specificities of socioeconomic inequalities in health in older age. In an attempt to address these specificities, four expert
researches from different European top institutes in the field of socioeconomic health inequalities will present.
Farizah Mohd Hairi:
Wealth and disability in 11 European countries: results from the SHARE study.
Few studies have examined whether socioeconomic status relates to disability differently across countries with different policy structures. No
overviews of disability in Europe using comprehensive measures of disability have been reported. Here, we measure physical disability among older
persons using four scale measures and examine the extent to which these are affected by differences in wealth.
Martin Bobak:
Do childhood and adult socioeconomic circumstances explain the within and between country differences in the birth cohort effects on cognitive
functioning in older adults in central and eastern Europe? Results from the HAPIEE study.
The decline of physical functioning with age is faster in Russia than in other countries. A similar pattern is seen for cognitive functioning. This is
probably a birth cohort effect. Data on over 29,000 persons in Russia, Poland and the Czech Republic will be used to assess the contribution of
childhood and adult socioeconomic circumstances to the birth cohort effect in cognition.
Danielle Groffen:
Personality and health as predictors of income decrease in old age: indirect and direct selection as explanation of socio-economic health differences?
There is a renewed interest in the health selection perspective regarding socio-economic health differences. Using Dutch longitudinal findings, it is
examined whether adverse personality and poor physical health are determinants of both income decrease and deteriorating health in old age and
whether selection mechanisms might be important for the explanation and prevention of socio-economic health differences.
Morten Wahrendorf:
Health inequalities in early old age: the role of participation in socially productive activities.
In order to understand health inequalities in early old age, associations between socioeconomic status, social productivity, and health are studied.
Particularly, three types of activities (voluntary work, informal help and care for a person) and their exchange characteristics (reciprocity vs.
non-reciprocity) are analysed. It will be shown that social reward in productive activities is associated with better health and that the socially graded
participation contributes to the explanation of health inequalities.
WEALTH AND DISABILITY IN 11 EUROPEAN COUNTRIES: RESULTS FROM THE SHARE STUDY.
DO CHILDHOOD AND ADULT SOCIOECONOMIC CIRCUMSTANCES EXPLAIN THE WITHIN AND BETWEEN COUNTRY DIFFERENCES IN THE
BIRTH COHORT EFFECTS ON COGNITIVE FUNCTIONING IN OLDER ADULTS IN CENTRAL AND EASTERN EUROPE? RESULTS FROM THE
HAPIEE STUDY.
PERSONALITY AND HEALTH AS PREDICTORS OF INCOME DECREASE IN OLD AGE: INDIRECT AND DIRECT SELECTION AS EXPLANATION
OF SOCIO-ECONOMIC HEALTH DIFFERENCES?
HEALTH INEQUALITIES IN EARLY OLD AGE: THE ROLE OF PARTICIPATION IN SOCIALLY PRODUCTIVE ACTIVITIES.
Chair(s)
Hans Bosma Maastricht University, Social Medicine [email protected] +31 43 3882818
____________________________________________________________________________________________________________
ID: 171
GLOBAL AGEING AND THE RECONCILIATION OF EMPLOYMENT AND CARE FOR OLDER FAMILY MEMBERS – DO DIFFERENT CULTURAL
CONTEXTS RESULT IN VARYING RECONCILIATION STRATEGIES? AFRICAN, ASIAN, EUROPEAN AND NORTH AMERICAN RESPONSES
Andreas Hoff (Oxford University, Oxford Institute of Ageing, United Kingdom)
Andrea Principi, Italy (1) Anne Martin-Matthews, Canada (2) Lola Kola, Nigeria (3) Henglien Chen, United Kingdom (4)
(1) Italian National Research Centre on Ageing (INRCA) (2) University of British Columbia (3) University of Ibadan (4) University of Lincoln
Ageing societies are increasingly becoming a global phenomenon. The United Nations identified population ageing as one of the key challenges of the
21st century (UN 2002) – by the year 2050 2 billion people worldwide will be aged 60 years and over, three quarters of them living in less developed
countries (UN 2007). The number of older people in their 80s and older is estimated to rise to more than 350 million worldwide, with approximately 250
million of them living in less developed countries. Many of the latter will be in need of care – but who will provide that?
In spite of profound cultural differences, the ageing societies of the world face similar challenges in respect to the provision of care. Primary care
responsibility for older people rests with the family – and hereby with the middle generation actually providing the care. At the same time, however,
members of this generation also need to earn their and their families’ livelihood. The contradictory demands of employment and care for older family
members cannot easily be reconciled. This dual responsibility is further complicated by the increasing geographical mobility of labour following after
increasingly mobile jobs in the globalised economy.
It will be the objective of this symposium to explore differences and similarities in the reconciliation strategies employed by family carers in Africa, Asia,
Europe, and North America. Although they share the same challenge in principle, these societies vary in their solutions to this problem: Europeans and
North Americans developed institutional solutions where care is provided by professional carers, in Europe predominantly paid for by taxation or social
insurance contributions and in North America predominantly paid for privately, while still retaining family responsibility for organising care. On the other
hand, African societies still entirely rely on the caring capacity of the family. The situation in Asia has become more differentiated, with institutional
solutions (Japan, for example) in some countries and sole family responsibility in most others.
This symposium for the first time brings together academics researching the reconciliation of employment and care for the elderly from these four
continents. They will compare reconciliation strategies in their different cultural and societal contexts and discuss their benefits and disadvantages.
"Work restrictions experienced by midlife family carers of older people in six European countries: findings from the EUROFAMCARE project"
"Aging and Caring at the Intersection of Work and Home Life in Canada: Public and Private, Linkage and Boundary"
“Caregiving to elderly persons: context and correlates in the Ibadan Study of Ageing”
“Confucianism in transition? Migration, work and care of older people in East Asia"
Chair(s)
Andreas Hoff Oxford Institute of Ageing, Oxford University, Manor Road, Oxford OX1 3UQ, UK [email protected] +44-1865-286190
____________________________________________________________________________________________________________
ID: 320
MIGRANT LONG-TERM CARE WORK AS A RISING CHALLENGE FOR ELDER CARE RESEARCH, POLICY AND PRACTICE (II):
INTERNATIONAL DEVELOPMENTS
Virpi Timonen (Trinity College Dublin, School of Social Work and Social Policy, Ireland)
Gloria Gutman, Canada (1) Esther Iecovich, Israel (2) Kalyani Mehta, Singapore (3) Torres Sandra, Sweden (4)
(1) Simon Fraser University (2) Ben-Gurion University of the Negev (3) National University of Singapore (4) Linköping University
This symposium aims – parallel to a twin-symposium focused on European developments – at providing insights into how the increasing numbers of
migrant workers providing care to frail elders both in institutional and community settings around the world is affecting gerontological practice. The fact
that their presence as live-in homecare providers has increased dramatically over the past few years in some countries means also that migrant care
workers are now affecting traditional patterns of family care as well. Based on ongoing research projects addressing the impact that migrant care
workers have on the elder care sectors in which they work and on the families they serve, speakers will describe their insights into the benefits and
drawbacks of this new phenomenon. Departing from the different angles of study that the speakers have taken to approach the research question of
how these workers affect the care settings that are now their workplaces, this symposium will address the complexity of this matter as well as the
challenges and possibilities that migrant care workers pose to gerontological research, policy and practice. Among the issues to be discussed are: the
specific social and legal aspects of employing migrants as live-in homecare workers; the way in which migrant care workers affect long term care; the
effects that these workers have on both co-worker relationships in elder care settings and the lives of the care recipients and families that they serve;
the challenges they pose to diversity management in these settings; the way in which stereotypical assumptions regarding migrants affect the delivery
of user-friendly care; the need for protection of both workers and care recipients and the challenges involved in efforts to bring about professional,
timely and user-centered home care arrangements in some countries. The presentations will highlight how pervasive this phenomenon has become in
some national contexts and try to explain why this form of elder care provision is becoming so appealing in some parts of the world while at the same
time proving to be a bigger challenge than expected in others. The four participants are internationally known researchers in the fields of gerontology,
long-term care and family care of older people. The different policy frameworks regulating the employment of migrant care workers in their countries
(reflecting different welfare regimes on three different continents) make them suitable to provide a comprehensive overview of the opportunities and
challenges raised.
GLORIA GUTMAN: MIGRANT WORKERS PROVIDING LONG TERM CARE TO OLDER PERSONS: CANADIAN POLICY AND EXPERIENCE
ESTHER IECOVICH: MIGRANT HOMECARE WORKERS CARING FOR FRAIL ELDERLY PEOPLE IN ISRAEL: CHALLENGES AND PROBLEMS
KALYANI MEHTA: MIGRANT CARE WORKERS IN SINGAPORE - THE ASIAN EXPERIENCE
SANDRA TORRES: CROSS-CULTURAL ENCOUNTERS IN ELDERLY CARE: THE CHALLENGES THAT MIGRANT CARE WORKERS POSE TO
GERONTOLOGICAL PRACTICE
Chair(s)
Virpi Tijmonen School of Social Work and Social Policy, Trinity College Dublin, Dublin 2, Ireland [email protected] +353 1 896 2950
____________________________________________________________________________________________________________
ID: 196
ADDRESSING THE CHALLENGES OF POPULATION AGEING THROUGH CAPACITY BUILDING AND TRAINING
Joseph Troisi (International Institute on Ageing, , Malta)
Monica Ferreira, South Africa (1) Gloria Gutman, Canada (2) Pedro Paolo Marin, Chile (3) Joseph Troisi, Malta (4)
(1) International Longevity Centre, University of Cape Town (2) Simon Fraser University Vancouver (3) Centre of Geriatrics and Gerontology, Universidad Católica de Chile
(4) Institute of Gerontology, University of Malta
Issues: A serious deficiency being faced by many developing countries in meeting the challenges of population ageing is the acute shortage of trained
personnel at all levels. This need has been highlighted both in the Vienna and the Madrid International Plans of Action on Ageing. Both Plans also
recognized the importance of improved training of all of those associated with providing health and social care in ageing populations
While there have been many developments across the globe in the fields of gerontological and geriatric education it is not clear that there has been
any systematic strategic approach to providing good quality training in these fields at sufficient level to meet the emerging needs.
Greater cooperation is clearly necessary between governments, academic institutions and professional bodies to improve the scope, coverage and
delivery of education and training programs in ageing especially in the developing world.
This symposium aims at reviewing and analysing some national and international attempts being made to meet this need. It also identifies innovative,
imaginative and sustainable education and training initiatives that are paving the way for a more effective response to meeting the objectives proposed
in the Madrid International Plan of Action on Ageing.
The panelists, will discuss how the education and training in the various aspects of ageing are to be made available at all levels ranging from high
specialisation at university level as well as at the grass roots’ level Special attention is given to the cultural differences in developed and developing
countries.
Though the basic issues dealt with are the same, the approach differs.
1. ISABELLA ABODERIN / MONICA FERREIRA .... AGEING IN SUB-SAHARAN AFRICA:MAJOR CHALLENGES FOR CAPACITY BUILDING AND
TRAINING
2. GLORIA GUTMAN .... GERONTOLOGY AND GERIATRICS EDUCATION AND TRAINING IN THE GLOBAL CONTEXT: THE NEED FOR
STANDARDS AND GUIDELINES
3. PEDRO PAULO MARIN .... TRAINING IN THE FIELD OF AGEING IN LATIN AMERICA AND THE CARIBBEAN : SOME GOOD PRACTICES
4. JOSEPH TROISI .... IMPLEMENTING THE MADRID INTERNATIONAL PLAN OF ACTION ON AGING THROUGH CAPACITY BUILDING AND
MANPOWER TRAINING
Chair(s)
Joseph Troisi Institute of Gerontology, University of Malta, Msida, Malta MSD 2080 [email protected] +356 21 319526
____________________________________________________________________________________________________________
ID: 606
CULTURAL KNOWLEDGE AND BELIEFS ABOUT DEMENTIA
Robert Schrauf (Pennsylvania State University, PSU Gerontology Center, United States)
Perla Werner, Israel (1) Annette Leibing, Canada (2) Madelyn Iris, United States of America (3) Robert Schrauf, United States of America (4)
(1) University of Haifa (2) University of Montreal (3) Council for Jewish Elderly (4) Pennsylvania State University
Dementia, particularly in its most common form of Alzheimer’s disease, presents an array of symptoms that are often difficult to distinguish from
age-related memory impairment and other psychosocial changes that occur in normal aging. In addition, many researchers and clinicians emphasize
the importance of recognizing and treating non-memory symptoms, collectively termed ‘behavioral and psychological symptoms of dementia’ (BPSD).
Thus, lay recognition of the disease and diagnosis-seeking involve separating out some behavior as “symptom” from other behavior as “normal.” Both
concepts are inherently cultural constructions. Further, the disease itself carries different social meanings in different societies. For instance, the
mere fact of the diagnosis can be a kind of “social death sentence” for an individual, who is often deprived of agency and personhood by the medical
establishment and even professional caregivers. In response, there is a growing movement to shift from a biomedically framed focus on cognitive
losses and behavioral changes to a person-centered focus on the deeper self and a kind of social-environmental ‘scaffolding’ of preserved abilities.
These phenomena (lay disease recognition, professional diagnosis, symptom manifestation, social stigma, and treatment models) are inherently tied
to cultural frames of reference, and as cultures differ, so do the construction of these phenomena. Cross-cutting traditional cultural distinctions (e.g.
Anglo American vs. Russian; Brazilian vs. Canadian, etc) are numerous other cultural distinctions, among which “lay” vs. “biomedical professional” is
probably the most ubiquitous. This session addresses cultural differences in beliefs about Alzheimer’s disease and its place in society across three
national contexts: Israel, Brazil, and the United States. Perla Werner (University of Haifa, Israel) addresses stigma beliefs about the disease among
Jewish and Arab lay persons in Israel. Madelyn Iris (Council for Jewish Elderly and Northwestern University, USA) looks at multiethnic differences in
lay beliefs about symptoms in the US. Annette Leibing (University of Montreal, Canada) questions whether and how ethnicity is a useful concept for
studying Alzheimer’s disease in Brazil. Robert Schrauf (Pennsylvania State University, USA) looks at cultural differences in beliefs about AD and
normal age-related memory impairment among several ethnic groups in the US. In addition to the substantive contributions to our knowledge and
understanding of cultural beliefs about Alzheimer’s disease, the presenters will demonstrate a variety of mixed methods in social research ranging
from ethnographic through survey methods and techniques of metric scaling in reporting their results.
STIGMA BELIEFS ABOUT ALZHEIMERS DISEASE: A REPRESENTATIVE STUDY COMPARING JEWISH AND ARAB LAY PERSONS IN ISRAEL.
PERLA WERNER (UNIVERSITY OF HAIFA)
IS ETHNICITY A USEFUL CONCEPT FOR STUDYING DEMENTIA? THE EXAMPLE OF ALZHEIMERS DISEASE IN BRAZIL. ANNETTE LEIBING
(UNIVERSITY OF MONTREAL)
INTER-ETHNIC VARIATION IN BELIEFS ABOUT SYMPTOMS OF ALZHEIMERS DISEASE IN THE US. MADELYN IRIS (COUNCIL FOR JEWISH
EDERLY, USA) AND ROBERT SCHRAUF (PENNSYLVANIA STATE UNIVERSITY, USA)
SEPARATING OUT CULTURAL BELIEFS ABOUT ALZHEIMERS DISEASE AND AGE-RELATED MEMORY IMPAIRMENT. ROBERT SCHRAUF
(PENNSYLVANIA STATE UNIVERSITY, USA) AND MADELYN IRIS (COUNCIL FOR JEWISH EDERLY, USA).
Chair(s)
Robert Schrauf 305 Sparks Bldg / University Park, PA 16801 / USA [email protected] 814.865.9622
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ID: 205
PRISMA : IMPLEMENTATION AND IMPACT OF A COORDINATION-TYPE INTEGRATED SERVICE DELIVERY (ISD) SYSTEM FOR FRAIL OLDER
PEOPLE
Réjean Hébert (Health and Social Services Centre – Sherbrooke University Geriatrics Institute , Research Centre on Aging, Canada)
Réjean Hébert, Canada (1) Suzanne Durand, (1) Yves Couturier, (1)
(1) Research Centre on Aging, Sherbrooke
Several models of Integrated Service Delivery (ISD) networks are presently experimented in Canada and elsewhere, but most of them are designed
according to a full integration model (PACE, S-HMO, SIPA). PRISMA is the only example of a coordinated-type model to be developed and fully
implemented with a process and outcome evaluation.
The PRISMA model includes the following components to enhance the integration: 1)
co-operation between decision-makers and managers of all services and institutions, 2) the use of a single entry point with a case-finding instrument
(PRISMA-7), 3) case management process, 4) Individualized Service Plans, 5) a unique disability-based assessment tool (SMAF) with a case-mix
system (Iso-SMAF profiles) and case-finding instrument, and 6) a computerized system for communicating between institutions and professionals. The
PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and research was carried out using
both qualitative and quantitative data to evaluate its process and impact. The impact study was population-based with a quasi-experimental design.
From a random selection of people over 75 years old, a sample of 1501 persons identified at risk of functional decline was recruited in the 3
experimental areas (n=751) and 3 comparison zones (n=800). Subjects were measured at baseline and yearly for four years on functional autonomy,
satisfaction with services and empowerment. Information on utilization of health and social services (public, private and community) was collected by
bi-monthly phone questionnaires. Cost associated with these services was also calculated. When the last two years (where implementation rate was
over 75%) were compared with first two years, the experimental group presented a difference of 6.3% on functional decline prevalence (p=0.03).
Satisfaction and empowerment were significantly higher (both p<0.001) in the experimental group. For health services utilization, a 20% reduction of
visits to emergency room (p0.001) was observed in the experimental cohort. The hospitalization rate was also lower in the experimental
group but the difference was not statistically significant (p=0.19). No significant effect was observed on other services. There overall cost was not
higher in the experimental group, even when implementation cost was included. The PRISMA model improves the health of frail older people and the
effectiveness of the health care system without additional cost.
HEBERT, REJEAN: DESCRIPTION AND IMPLEMENTATION OF THE PRISMA ISD SYSTEM IN QUéBEC.
COUTURIER, YVES: THE CASE-MANAGERS IN PRISMA: A LOOK ON THEIR ROLE.
HEBERT, REJEAN: POPULATION IMPACT OF PRISMA ON FRAIL OLDER PEOPLE AND UTILIZATION OF HEALTH AND SOCIAL SERVICES.
DURAND, SUZANNE: ANALYZING THE COST AND THE BENEFIT OF THE PRISMA MODEL: IS IT EFFICIENT?
Chair(s)
Michel Raiche Research Centre on Aging, Sherbrooke [email protected] 1-819-829-7131
Hébert Réjean Research Centre on Aging, Sherbrooke [email protected] 1-819-564-5201
____________________________________________________________________________________________________________
ID: 206
AN INTERNATIONAL PERSPECTIVE ON PREVENTION OF PHYSICAL RESTRAINT USE
Gabriele Meyer (University of Witten/Herdecke, Faculty of Medicine, Institute of Nursing Science, Germany)
Jan Hamers, The Netherlands (1) Elisabeth Capezuti, United States of America (2) Claudia Lai, China (3) Sascha Köpke, Germany (4)
(1) Maastricht University, Faculty of Health, Medicine, and Life Sciences (2) New York University College of Nursing, Hartford Institute for Geriatric Nursing (3) The Hong
Kong Polytechnic University, School of Nursing (4) University of Hamburg, Unit of Health Sciences and Education
Physical restraint (PR) of older adults has been reported as common practice in nursing homes and hospitals in different countries.
Reported prevalence of PR in latest publications ranges between 40 and 70% in nursing homes and 30% to 70% in hospitals. The wide variation can
be explained by different underlying definitions of PR, data collection techniques, different sample sizes, characteristics of care settings, legislation,
and nursing traditions.
Consistently, the use of PR has been claimed to be based on safety reasons, primarily prevention of falls. Also, control of disruptive behaviour such as
wandering and disruption of medical treatments has been reported.
Restraint-free patient care has been proposed as standard of care. Programmes to reduce PR use of older adults were first introduced in the US in the
1980s. Since then, a number of studies have been conducted in hospitals and nursing homes evaluating multi-faceted interventions. Study findings
reveal conflicting evidence on effectiveness of restraint reduction approaches. Thus, the question remains what kind of intervention can be successful
under which conditions.
The scientific purpose of the symposium is to describe the evidence concerning restraint reduction approaches, to compare different approaches and
implementation conditions from different countries and health care systems, and to compare and discuss barriers of PR reduction approaches. The
symposium intends to provide an overview about ongoing and unpublished work in this field from European, American and Asian investigators and to
suggest further research needs.
The invited speakers have a special expertise in the field. Elisabeth Capezuti and Jan Hamers have published several studies on physical restraints
and restraint reduction approaches in the USA and The Netherlands, respectively. Claudia Lai has been involved in restraint reduction interventions in
Hong Kong for a number of years. Sascha Köpke and Gabriele Meyer (who would be happy to chair the session and speak closing notes on
similarities and differences in restraint reduction approaches) have recently conducted a large epidemiological study on physical and chemical
restraints in nursing homes in Germany. They are currently preparing an evidence-based guideline on restraint management in nursing homes as well
as a Cochrane review on restraint reduction programmes.
HAMERS J: EXBELT: REDUCING PHYSICAL RESTRAINTS IN NURSING HOMES. RESULTS OF A PILOT STUDY.
CAPEZUTI E: IMPACT OF HOSPITALS' PARTICIPATION IN THE NICHE PROGRAM ON RESTRAINT USE.
LAI C, CHIU M: WHAT WORKS IN A RESTRAINT REDUCTION PROGRAM? FINDINGS FROM RESEARCH PROJECTS IN REHABILITATION
SETTINGS.
KOEPKE S: EVIDENCE-BASED GUIDELINE ON PHYSICAL RESTRAINT REDUCTION IN NURSING HOMES.
Chair(s)
Gabriele Meyer Witten University, Faculty of Medicine, Institute of Nursing Science, Stockumer Straße 12, 58453 Witten [email protected]
+49 2302 926 317
____________________________________________________________________________________________________________
ID: 239
OLDER PEOPLE IN EMERGENCIES:EDUCATION FOR HEALTH PROFESSIONALS
Rory Fisher (Sunnybrook Health Science Centre, Medicine, Canada)
Sandi Hirst, Canada (1) Robert Roush, United States of America (2) Laurie Mazurik, Canada (3) Louise Plouffe, Canada (4)
(1) University of Calgary (2) Baylor College of Medicine (3) Sunnybrook Health Science Centre (4) Public Health Agency of Canada
Frequent humanitarian disasters are of major international importance.Examples include European heatwaves(2003),Hurricane Katrina,typhoons in
Myanmar, earthquakes in China(2008)and conflicts in Darfur and Lebanon.The threat of pandemics continues to be ever present.
Older people are disproportionately vulnerable to the consequences of such disasters.The frail elderly are particularly at risk. Older people have the
highest rate of morbidity and mortality.Little is done to address the specific needs of this vulnerable group.
A key component is to ensure that health professionals responding to emergencies have appropriate education in the needs and vulnerability of the
elderly.Education of health professionals is important in decreasing morbidity and mortality amongst older people,mitigating damage,and reducing long
term adverse effects.
The presenters will address gaps in the training of health professionals,present examples of innovative programs,and make recommendations for
future steps.Sandi Hirst will report on an environmental scan on what should be taught to student health professionals to promote an effective elder
specific disaster management response.A survey was sent to Canadian nursing programs, and Canadian health degree programs were reviewed.The
results will be discussed and the implications for gerontological health educators explored.
Robert Roush will present the geriatric medical and psychosocial issues older people face that are exacerbated by natural and human caused
disasters,including bioterrorism. He will describe the recommendations of a vulnerable population collaborative group formed by the US Centers for
Disease Control and Prevention and the Association of Schools of Public Health.These recommendations cover a wide knowledge for health
professionals about the pre-event,event,and post event phases.
Laurie Mazurik will discuss the Interprofessional Disaster and Emergency Action Network.This group of Canadian institutions has developed a
web-based education program on emergency preparedness, which includes participation in community disaster exercises.
Louise Plouffe will discuss the directions for educating health professionals identified by the other presenters in light of a WHO analysis of response
issues in sixteen disaster case studies around the world, and from work underway to provide guidance to the Inter-Agency Standing Committee to
improve care of older persons in emergencies.
NATURAL DISASTERS THAT REVEAL CRACKS IN GERONTOLOGICAL NURSING PRACTICE
WHAT HEALTH CARE PROVIDERS NEED TO KNOW ABOUT OLDER PEOPLE IN DISASTERS. ROBERT ROUSH
THE EDUCATIONAL INITIATIVE OF THE INTERPROFESSIONAL DISASTER AND EMERGENCY ACTION STUDY NETWORK(IDEAS) LAURIE
MAZURIK
DISCUSSANT. LOUISE PLOUFFE
Chair(s)
Rory Fisher Sunnybrook Health Science Centre, Room L101B, 2075 Bayview Ave,Toronto,Ontario,Canada,M4N 3M5 [email protected] 416
480 6858
____________________________________________________________________________________________________________
ID: 241
SOCIAL ROLES OF OLDER ADULTS IN MULTIGENERATIONAL FAMILIES: STRUCTURAL, CULTURAL, AND NATIONAL CONSIDERATIONS
Merril Silverstein (University of Southern California, School of Gernology, United States)
Claudine Attias-Donfut, France (0) Kristine Ajrouch, United States of America (0) Linda Burton, United States of America (0) Merril Silverstein, United States of America
(0)
(1) Caisse National d’Assurance Vieillesse (2) Eastern Michigan University (3) Duke University (4) University of Southern Califofornia
This symposium brings together four empirical papers that focus on family roles of older adults across diverse, structural, cultural, and national
settings. Study populations include transnational immigrant families in France, multigenerational Arab families in Lebanon, low-income couples and
grandparents in the United States, and grandparent-headed families in rural China.
Participants were chosen based on their prominence in the field of intergenerational relations and aging, the social importance and timeliness of the
issues they are addressing, and the extent to which they collectively represent a diverse set of populations.
The family is often portrayed as a social institution of great importance to older adults; however, older adults are also greatly important TO their
families. The invited papers focus on how older people across diverse social and national settings and within the context of their particular cultural
templates actively strengthen the integrity of their families and benefit other generations.
Attias-Donfut uses national data from mature migrants in France to investigate how solidarities and exchanges between generations are part of a
coordinated strategy to aid social mobility in immigrant families. Ajrouch, & Abdulrahim analyze qualitative data from several focus groups to study
how older men in Lebanese families adapt a cultural norm of connectivity to shape negative and positive accounts of their family relationships. Burton
uses a large longitudinal ethnographic data set to examine how grandparents serve as levelers of inequality among grandchildren in low-income
families with multi-partner fertility. Finally, Silverstein, Cong, and Guo apply a vignette method in a longitudinal survey of older adults in rural China to
directly compare norms of filial responsibility for youth and the elderly.
INTERGENERATIONAL RELATIONSHIPS AND SOCIAL MOBILITY AMONG TRANSNATIONAL FAMILIES IN FRANCE
CLOSE AT A DISTANCE--CONNECTIVE STRUCTURES IN AGING LEBANESE FAMILIES
THE LEVELING EFFECTS OF GRANDPARENTS ON SIBLING INEQUALITY IN MULTI-PARTNER FERTILITY FAMILY STRUCTURES IN THE
UNITED STATES
NORMS OF INTERGENERATIONAL RESPONSIBILITY AMONG OLDER PEOPLE IN RURAL CHINA
Chair(s)
Merril Silverstein 3715 McClintock St., Los Angeles, CA 90089 [email protected] 213-740-4060
____________________________________________________________________________________________________________
ID: 246
AMBIENT ASSISTED LIVING AND QUALITY OF LIFE IN ELDERLY
Millán José C. (University of A Coruña, Medicine / Gerontology, Spain)
Millán José C., Spain (1) Rigaud Anne-Sophie, France (2) Van Berlo Ad, Netherlands Antilles (3) Fugger Erwin, Austria (4) Ana Maseda, Spain (5)
(1) University of A Coruña (2) Broca, Assistance Publique-Hôpitaux de Paris (3) Smart Homes (4) Austrian Research Centers GmbH-ARC (5) University of A Coruna. Fac.
Health Sciencies. Campus de Oza
The ageing of Europe’s population is a crucial challenge for the 21st century. Important increases at international level in the number of elderly is
causing a growing demand for caring services for promoting life quality, supporting the personal autonomy, preventing and promoting the health of the
people.
The symposium will have four speakers; they are researchers with experience in ICT for helping elderly, including the development of specific
gerontology resources, adaptation of smart homes for elderly and computerized stimulation of the cognitive functions in elders with mild cognitive
impairment. All speakers are collaborating as partners into an European consortium developing the CompanionAble project (Grant Agreement number
216487) funded by the European Commission within the 7th Framework Programme.
The scientific purpose of this symposium will be to divulgate innovative Information and Communication Technologies (ICT) based solutions to elderly,
which means innovative products, systems or services for supporting identified needs of these users. ICT-supported services are expected to make it
possible for elderly to remain in their homes, rather than have to move into institutions. All these benefits using ICT in elderly care include a better
access to information for health professionals, quality of life improvements and care-cost savings.
In this sense, speakers will talk about Telegerontology as a new home gerontological resource which includes an “online” cognitive Rehabilitation
system, among other functionalities; Computerized cognitive stimulation and webconferencing for patients suffering from cognitive impairment and
their carers; Experiences with smart homes applications and services for older persons and care workers in the past 8 years; and Lessons learnt from
MPOWER – a European project focussing on the development of a middleware platform for eM-POWERing cognitive disabled and elderly.
TELEGERONTOLOGY: A NEW GERONTOLOGY RESOURCE
COMPUTERIZED COGNITIVE STIMULATION AND WEBCONFERENCING FOR PATIENTS SUFFERING FROM COGNITIVE IMPAIRMENT AND
THEIR CARERS
EXPERIENCES FROM FIRST GENERATION SMART HOUSES FOR OLDER PEOPLE
LESSONS LEARNT FROM THE MPOWER PROJECT - MIDDLEWARE PLATFORM FOR EM-POWERING COGNITIVE DISABLED AND ELDERLY
Chair(s)
José C. Millán University of A Coruna. Fac. Health Sciencies. Campus de Oza, Oza s/n. 15006 A Coruña-Spain [email protected] +34 981 167000, ext.
5865
Maseda Ana University of A Coruna. Fac. Health Sciencies. Campus de Oza, Oza s/n. 15006 A Coruña-Spain [email protected] +34 981 167000,
ext. 5890
____________________________________________________________________________________________________________
ID: 263
USE OF AN INTEGRATION INDEX TO COMPARE HOME CARE DELIVERY FOR OLDER PERSONS IN 11 EUROPEAN COUNTRIES
Jean-Claude Henrard (Versailles University, Health and Ageing Unit UPRES 25 06, France)
Jean-Claude Henrard, France (1) Graziano Onder, Italy (2) Gunnar Ljunggren, Sweden (3) Joël Ankri, France (1)
(1) Versailles university (2) Catholic University (3) Stockholm County Council (4) Versailles University
This symposium describes the application of an integration index designed for comparing home care services for elderly persons in cities of 11
European countries. Since integration is a mean to improve the services in relation to quality of health and social care home care delivery integration
was based on two dimensions of Donadebian framework on quality of care referring to organisational structure approach and process-centred
integration. Structure involves bringing together staff and resources for different benefits in one single organisation under a single unified hierarchical
structure This allows a single home care agency to provide assistance with different social care (e.g. for instrumental, personal activities of daily living
and surveillance), primary health nursing care (e. g. bandaging, catheter management), secondary health care such as therapies. The process-centred
integration focuses on caring activities, collaborative actions or activity undertaken between health and social services organisations and practitioners.
This means working arrangements within and between services e.g. comprehensive clinical assessment, case manager and hospital discharge
management. Items considered as part of both dimensions according to an expert consensus (face validity) were extracted from a standardized
questionnaire used in “Aged in Home care” (AdHoc) study to capture basic characteristics of home care services. Their summation leads to a services’
delivery integration index. This index applied to AdHoc services ranks home care services in four groups according to their score. The results of a
factor analysis complete the theoretical constructs by identifying two factors: a first opposes working arrangement within service to organisational
structure bringing together provisions for social care; a second corresponds to basic nursing care and therapies. Differences between settings’
integration are better seen when examining the combination of those three domains. It appears that they are various models of service delivery
integration due to various combinations of domains. The third dimension of Donadebian framework is outcomes expressed, in the case of home care,
in terms of death, hospitalisation, institutionalisation, functional decline. There relationships with the different models will be presented.
The four papers presented in the symposium will discuss the general framework and the relationships of outcomes with three models of answer to
disability of older persons: the medical model (e.g. Monza, Italy) the social model (e.g. Stockholm) the fragmented one (e.g. Amiens, France).
THE GENERAL FRAMEWORK OF INTEGRATION TO FACILTATE COMPARISON OF HOME CARE OUTCOMES
INTEGRATION CHARACTERITICS AND HOME CARE OUTCOMES OF THE MEDICAL MODEL FACING DISABILITY IN OLDER PERSONS
INTEGRATION CHARACTERITICS AND HOME CARE OUTCOMES OF THE SOCIAL MODEL FACING DISABILITY IN OLDER PERSONS
INTEGRATION CHARACTERITICS AND HOME CARE OUTCOMES OF THE FRAGMENTED MODEL FACING DISABILITY IN OLDER
Chair(s)
Jean-Claude Henrard Laboratoire Santé Vieillissement, 49 rue Mirabeau 75016 Paris [email protected] 33 1 44 96 32 04
____________________________________________________________________________________________________________
ID: 270
TERRITORIES AND ICT AS REGARDS AGEING: WHAT PUBLIC POLICIES?
Liliane Piot (Caisse des dépots et Consignations , Paris , France)
Jean-François Legrand, France (1) Grahame Blair, United Kingdom (2) Pedro Rodriguez Delgado , Spain (3) Liliane Piot, France (4)
(1) Conseil général de la Manche (2) Head of Social Policy of the West Lothian Council (3) Fondacion Andaluza de servicios sociales (4) Caisse des dépots
This symposium organized by the “Caisse des Dépots” will present, through three European country projects, how public policies contribute to senior
autonomy.
The ageing of the population is already in effect and it has important consequences on territories, which face increased demand for care services,
specialized housing, transportation, in-home services, senior information …
With the increase of life expectancy, the senior needs and behaviours are becoming more heterogeneous and more complex to fulfill, from active life
to illness or dependency for a part of them.
Actual solutions often present a lack of coordination and are difficult to access for elderly both in terms of usage and money.
What are the public strategies going on in order to facilitate, support and finance senior autonomy ? How to enable seniors to stay at home as long as
they wish ? How to sustain senior families and professionals and inform them ?
In the three projects presented – a department in France, a council area in Scotland and a Region in Spain – the public policies behind will be
discussed : political dimension, financial aspects and cooperation between territories, partnerships and organizational change, socio-economic
impacts, use of information and communication technologies through platform of services.
The three speakers :
Jean-François Legrand, président du Conseil général de la Manche , France
E-senior project, a portal of information and access to a bunch of senior services concerning retirement, health, housing, home services, leisure,
administrative formalities... It aggregates national and local information for seniors, their families and professionals.
Pedro Rodriguez, Director , FASS, public service provider, Andalusia, Spain
A law voted in Spain concerning the right to all citizens to enjoy health protection and care is laid down in the Spanish Constitution. FASS, “Fundación
Andaluza de Servicios Sociales”, contributes financially to social and every day life services for seniors over 65 years of age and
provides
tele-assistance services.
Kent Turner, Professor, University of Stirling, Council area of West Lothian, Scotland
In West Lothian, the concentration in terms of organization and budget of the three crucial components of autonomy – housing, health and social care
– makes easier the development of senior services even for heavy dependency.
INTERNET PUBLIC SERVICES FOR AN AGEING ACTIVE LIFE AND AUTONOMY
FASS:A PUBLIC TOOL FOR LIFE , HEALTH AND CARE AT HOME OVER 65 YEARS
BRINGING TOGETHER PUBLIC HOUSINGN HEALTH AND SOCIAL CARE BUDGETS TO DEVELOP GLOBAL SERVICES FOR AGEING
POPULATION
TERRITORIES , ICT AS REGARDS AGEING: WAT PUBLIC POLICIES ?
Chair(s)
Pascal Buleon 14 allée des genets 14000 Caen [email protected] 33 (0)6 11 97 26 45
Piot Liliane 72 avenue pierre mendes France 75914 Paris cedex 13 [email protected] 33 (0)6 08 74 77 83
____________________________________________________________________________________________________________
ID: 282
DIGITAL AGING
Donghee Han (Research Institute of Science for the Better Living of the Eldely, Research & Program Design, Korea, Republic of)
Donghee Han, Korea, Republic of (1) Hyunsook Yoon, Korea, Republic of (1) Ogawa Takeo, Japan (1) Braun Kathryn, United States of America (1)
(1) Research Institute of Science for the Better Living of the Elderly (2) Hallym University (3) Yamaguchi Prefectural University (4) University of Hawaii
It is the wish of all societies that older adults enjoy a healthy old age and has opportunities to interact with younger generations and contribute to
society. In the 21st century – the information age – everyone needs to know how to access information and to communicate by cell phone, emergency
alarm system, computers, and other devices. But only a minority of seniors in Korea, Japan, and the US are familiar with digital technology. Life-long
learning programs are needed to surmount the digital-divide between the generations. Expanded use of these new technologies can decrease
isolation, improve quality of life, and provide opportunities for contributing to community health.
Our symposium will feature best-practices in
technology with digital aging among Korea, Japan, and the United States.
This session features speakers from 3 countries. Dr. Heung Bong, Cha, Chairman, Organizing Committee for the 20th World Congress of IAGG will
moderate after providing a brief overview of digital aging concepts.
Dr. Donghee Han, from the Research Institute for the Study of Better Living for the Elderly in Busan, Korea, will explain why digital life should be
provided to older adults in future. She then will describe concept of digital aging and efforts Korean society for digital aging. Cyber family programs, all
of which have been successful in increasing senior participation, contribution, and intergenerational interactions.
Dr. Takeo Ogawa, from Yamaguchi Prefectural University in Yamaguchi, Japan, will describe best practices in rural Japan in which older persons are
using ICT for their businesses. For example, in Kamikatsu, 70-year-old farmers working in mountainous areas are using customized personal
computers to getting market information, and this helping them maximize income.
Dr. Hyunsook Yoon, from Hallym University in Korea, will present on the “ubiquitous health care” program (u-Health care), developed to monitor health
conditions of older persons living alone. Health data collected thru sensor systems are directly sent to university information center. Hospitals and
welfare centers are informed of any abnormal movements, and help can be sent immediately.
Dr. Cullen Hayashida and Dr. Kathryn Braun from the University of Hawaii will demonstrate how digital and assistive technologies can support family
caregivers and promote aging-in-place-at-home.
Featured technologies include the 4th generation Personal Emergency Response Systems (PERS), Internet-based Medication Dispensing Systems,
Wireless Tele-health Monitors, Passive Activity Monitors and Web-Cams technologies.
THE DEVELOPMENT AND FUTURE DIRECTION OF DIGITAL AGING IN KOREA
U-HEALTH CARE PROGRAM THROUGHT SENSOR SYSTEM FOR OLDER PERSONS LIVING ALONE
THE BEST PRACTICE OF ACTIVE AGEING IN RURAL JAPAN BY ICT
SUPPLEMENTING THE DECLINING HEALTHCARE WORKFORCE SUPPLY WITH HIGH TECH & HIGH TOUCH ASSISTIVE TECHNOLOGIES
Chair(s)
Hungbong Cha The Federation of Korean Gerontological Societies [email protected] 82-11-9003-8633
____________________________________________________________________________________________________________
ID: 439
NEW PERSPECTIVES ON RURAL AGEING
Catherine Hennessy (University of Plymouth, School of Nursing and Community Studies, United Kingdom)
Norah Keating, Canada (1) Catherine Hennessy, United Kingdom (2) Simon Evans, United Kingdom (3) Vanessa Burholt, United Kingdom (4)
(1) University of Alberta (2) University of Plymouth (3) University of the West of England (4) University of Swansea
Growing older in contemporary rural areas is experienced against a backdrop of changing lifestyles, landscapes and livelihoods, all of which have
implications for ageing identities, attachment to place and participation in community life. This symposium explores changes in the international
contexts and populations of rural areas and their implications for the quality of later life. The participants in this forum are all actively engaged in
research on rural elders in a number global settings. Their presentations address a new theoretical approach to older people in rural environments,
review evidence on older rural people’s involvement in civic society and their changing forms of social interaction and interests, and identify directions
for future international research on rural ageing.
In the first presentation, Keating introduces original theoretical work conceptualizing how physical, community, and family contexts influence the
interrelationships between older people and their rural settings. She discusses how Critical Human Ecology theory can frame interrogations of
questions about various physical, social, community and policy environments of older adults to
set an agenda for global research on rural ageing.
In the second presentation, Hennessy focuses on older people’s engagement in civic society in rural communities through a review of research in
areas including volunteering, citizenship and participation in cultural activities. Barriers and facilitators influencing participation and contributions to
civic society are highlighted and approaches to promoting older people as community capital in rural areas are discussed.
In the third presentation, Evans and Means discuss an increasing focus on older people as active consumers and through this a growing exploration of
both communities of interest (an orientation towards organising one’s life around enthusiasms and hobbies rather than family and place) and also
friendship (not necessarily bound by place). Connected to all of this is what is bound to be a massive growth in the use of the Internet by older people
in the coming years. This paper will review these theoretical developments and their empirical underpinning and draw out their implications for rural
elders.
The final presentation by Burholt reviews recent international research on rural ageing and explores new areas that will emerge over the coming
decade. These include: inequalities in rural areas between and within
countries and the impact on migration and public health; climate change and energy; and governance and democracy. She indicates gaps in current
knowledge and domains in which it will become important to undertake rural gerontological research.
A FRAMEWORK FOR RESEARCH ON RURAL AGEING
OLDER PEOPLE'S INVOLVEMENT IN CIVIC SOCIETY IN RURAL AREAS
COMMUNITIES OF INTEREST OR COMMUNITIES OF PLACE? REFLECTIONS ON AN EMERGING DEBATE AND ITS IMPLICATIONS FOR
RURAL ELDERS
THE NEXT DECADE OF RESEARCH ON RURAL AGEING
Chair(s)
Catherine Hennessy 2 St. Lawrence Road, Plymouth PL4 6HN United Kingdom [email protected] 44 1752 600 337
____________________________________________________________________________________________________________
ID: 351
“THE KEY ROLE OF THE UNIVERSITIES OF THE THIRD AGE IN ACTIVE AGING”
Rosita Kornfeld-Matte (P. Universidad Católica de Chile, Eldery Program, Chile)
Rocio Fernandez-Ballesteros, Spain (1) Stanley Miller, United Kingdom (2) Rosita Kornfeld, Chile (3) Marisol Rapso, Costa Rica (4)
(1) Universidad Autonoma de Madrid (2) AIUTA International Association of third Age Universities (3) P.Universidad Católica de Chile (4) Universidad de Costa Rica
The International Association of Open Third Age Universities (AIUTA) was created in 1976 by Professor Pierre Vellas in Toulouse, France, to promote
Third Age Universities (UTA´s) in the world. Universities that will be involved principally in: (i) multidisciplinary training open to all older adults without
prerequisites or age limitations; (ii) applied research on aging-related topics; and (iii) community service.
This symposium will review the effective role of UTAs in the promotion of active aging, particularly the basis of the hypothesis that active aging is
sustained by life-long learning, and will present an evaluation of existing UTAs in the world, particularly those affiliated to the AIUTA. The results of a
successful UTAs interaction program set-up in Latin America on the basis of Chilean know-how and the financial support of the Finnish government
will be presented, an in depth analysis of results obtained in Chile, Peru, Nicaragua and Costa Rica.
Rocío Fernandez-Ballesteros, Department of Biological Psychology and Health, Universidad Autonoma de Madrid, Spain will review the basis and
consequences of the fact that a strong predictor of successful aging is the existence of life long education.
Stanley Miller, President of the International Association of Universities of the Third Age, UK, will show how UTAs today are instrumental and a clear
reflection of the potential for a systematic response to the challenges of aging through empowered civil society groups, capable of assuming greater
responsibilities.
Rosita Kornfeld, founder and Director of the Elders’ Program, University of the Third Age (UTA), Catholic University, Chile, will review the experience
of targeting low-income elderly in gerontological training, and the set up of a regional program to empower civil society groups, trained by UTAs. This
approach by the UTAs is consistent with the pursuit of a new intergenerational social contract, mandating greater balance between citizen rights and
responsibilities, compatible with the fiscal constraints faced by the public sector in many Latin-American countries.
Marisol Rapso, University of the Third Age (UTA), University of Costa Rica, Costa Rica, will review the local impact in Costa Rica and Nicaragua of a
model intervention successfully performed in 2007 by the regional training network set up from Chile. In Latin America and the Caribbean the
demographic aging transition is clearly in rapid progress. Models to facilitate this process should be characterized and the role of local and regional
UTAs needs to be maximized.
LIFE-LONG LEARNING, THE BEST FOR ACTIVE AGING (ROCIO FERNANDEZ-BALLESTEROS)
THE ROLE OF UNIVERSITIES OF THE THIRD AGE IN PROMOTING ACTIVE AGEING (STANLEY MILLER)
STRATEGY AND IMPLEMENTATION OF A REGIONAL LATIN AMERICAN UTE TRAINING PROGRAM IN FOUR COUNTRIES. (ROSITA
KORNFELD)
THE IMPACT ON ELDERS FROM NICARAGUA AND COSTA RICA OF AN UTA TRAINING COLLABORATIVE NETWORK (MARISOL RAPSO)
Chair(s)
Rosita Kornfeld Alameda 390 , Piso 3, Santiago de Chile [email protected] 56 2 354 2418
____________________________________________________________________________________________________________
ID: 361
MIGRANT LONG TERM CARE WORK AS A RISING CHALLENGE FOR ELDER CARE RESEARCH, POLICY AND PRACTICE (I): RECENT
DEVELOPMENTS IN EUROPE
Gloria Gutman (Simon Fraser University, Gerontology Research Centre, Canada)
Haneli Dohner, Germany (0) Giovanni Lamura, Italy (0) Ewa Fratczak, Poland (0) George Leeson, United Kingdom (0)
(1) Medical Univeristy Center Hamburg-Effendorf, Dept of Medical Sociology (2) INRCA (Italian National Research Centre on Aging) (3) Institute of Statistics and
Demography (4) Oxford Institute of Ageing
The aim of this symposium - parallel to a twin-symposium focussed on international developments- is to provide insights on reasons why increasing
numbers of migrant workers are providing care to frail elders both in institutional and community settings in Europe. Speakers will describe the main
benefits and drawbacks to both sending and receiving countries, also the need for protection of both workers and care recipients. The presertations
will highlight how pervasive this phenomenon has become in some national contexts and try to explain why this form of care provision is becoming so
common. On the one hand, this can be attributed to the decreased availability of informal care due to changing family structures and roles, increasing
female participation in the labour market, longer working life and reduced support from social networks. On the other hand, financial constraints
affecting the provision of publically funded long-term-care services are jeapardizing the possibility to ensure a professionally qualified, timely and
user-centered care, due to staff shortages and cuts in the acute care section not compensated by adequate developments in the home care and
residential care sectors, but rather more widespread imprementation of cash-for-care schemes. Although these can be seen as a legitmate recognition
of unpaid care work, they are increasingly used to emply foreign migrant care workers, often on a live-in basus, thus impacting on traditional patterns
of both family and service care provision, including institutionalization rates. The presentations will also address some basic policy, legal and practice
questions, by identifying existing gaps in care quality,risks of exploitation and abuse as well as of "care drain" in sending countries, and the options
available to internationally deal with them.
MIGRANT HOUSEHOLD AND CARE WORKERS IN GERMANY: PRACTICE AND POLICY
MIGRANT CARE WORKERS IN LONG TERM CARE: LESSONS FROM ITALY
MIGRANT CARERS AND THE PROVISION OF SOCIAL CARE IN THE UNITED KINGDOM - POLICY, PRACTICE AND RESEARCH
DISCUSSION AND SYNTHESIS
Chair(s)
Gloria GUTMAN Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings Street, Vancouver, Canada V6B5K3;
[email protected]. Tel: +1-778-782-5063; Fax: +1-778-782-5066;
Lamura Giovanni INRCA (Italian National Research Centre on Ageing), Department of Gerontological Research, V. S. Margherita 5, 60124 Ancona,
Italy; [email protected]. Tel.: ++039-071-8004797; Fax: ++39-071-35941;
____________________________________________________________________________________________________________
ID: 362
A CROSS-CULTURAL EXAMINATION OF INFORMAL AND FORMAL SYSTEMS OF ELDERCARE IN INDIA, JAPAN AND THE U.S.
Denise Burnette (Columbia University , School of Social Work, United States)
Asha Banu Soletti, India (1) Denise Burnette, United States of America (2) Li-Mei Chen, Japan (3) Philip Rozario, United States of America (4)
(1) Tata Institute of Social Sciences (2) Columbia University (3) Kwansei Gakuin University (4) Adelphi University
Due to social, economic, and political transformation of societies around the world, caregiving for older adults in many countries have altered from the
traditional provisions of care, respectively. In particular, modernization of families and social values coupled with the growth of formal care provided by
both public and private sectors have increasingly diversified how care is provided. Such changes in the culture of caregiving is an international concern
for many countries as they struggle to find the right balance of formal and informal care according to their unique social, political, and economic
environments, respectively. The symposia will focus on studies from three countries witnessing a rapidly aging population: United States, India, and
Japan. Soletti and Burnette will present a study investigating the strengths and needs of a large community of older Indians in India' s
largest city, Mumbai. With rapid modernization, globalization and urbanization, older adults' needs have changed. Hence, this study will
identify today' s needs for developing new care programs for older adults. Chen will present a study on predictors of institutionalization
among Japanese beneficiaries of the national long-term care insurance (NLTCI). Specifically, the effect of both informal and formal care use will be
examined. Japan is one of the two countries with a mandatory enrollment for long-term care insurance. After seven years since the inception of NLTCI,
substantive data is finally available to examine the experiences of older Japanese enrolled in NLTCI. Finally, Rozario and Zodikoff will present a study
examining the increasing heterogeneity in caregiving experiences among African American women informal caregivers. By employing a within-race
and gender approach, they will discuss today' s African American women caregivers' coping strategies to deal with their life
demands.
THE CHANGING BALANCE OF INFORMAL AND FORMAL SUPPORT IN THE CONTEXT OF
GLOBALIZATION: OLDER ADULTS AND THEIR FAMILIES IN INDIA
THE EFFECTS OF INFORMAL AND FORMAL CARE ON INSTITUTIONALIZATION AMONG NATIONAL LONG-TERM CARE INSURANCE
BENEFICIARIES IN JAPAN
COPING STRATEGIES OF AFRICAN AMERICAN WOMEN CAREGIVERS: PREDICTORS AND OUTCOMES
Chair(s)
Denise Burnette 1255 Amsterdam Avenue New York, NY 10027 [email protected] 212.851.2188
____________________________________________________________________________________________________________
ID: 376
ELDER ABUSE : THE NEEDS FOR THEORY
Ariela Lowenstein (University of Haifa, Center of Research on Aging, Israel)
Simon Biggs (2nd convenor)king's college Zvi Eisikovitz, Israel (1) Thomas Goergen, Germany (2) Bridget Penhale, United Kingdom (3) Françoise Busby, France (4)
(1) University of Haifa (2) Deutsche Hochschule der Polizei (3) School of Nursery, University of Sheffield (4) Alma-France
A growing number of prevalence studies world-wide are providing evidence that elder abuse and neglect is a significantly social problem that can be
expected to increase with gmobal ageing. While prevalence studies provide base-data on numbers, little is known about tke detail of different forms of
abuse (financial, physical, psychilogical, sexual, and statutory) and neglect, their effects on relationships and the dynamics of effective intervention.
Thus while growth of knowledge and increased efforts to use it in policy development and practice are laudable, the field is developing by and large
as a-theoritical, or by importing various theoritical foundations from other fields of inquiry, such as child protection or intimate partner violence, which
may not be wholly relevant. Theoritical under-development hampers the collection of systematic cumulative knowledge which is based on universally
agreed and standardized tools, and reduces the dicovery of unifying themes and their relationship to local idiosyncrasies existing in the field. So far,
there has been little attempt to develop theoritical knowledge grounded in validated data from the field of elder abuse which reflect both the
experience of victims and perpetrators, contextual, organizational and cultural
causation and the acumulating knowledge generated
by both
practitionners and scientists working in various professional contexts. So to follow and prevent elder abuse and neglect, competences of different
fields need to be met at proximity levels. Such cumulative and contextualized knowledge would be particularly timely as international awareness of
the problem develops and changing patterns of care.
SIMON BIGGS (CO- CONVENOR): THE DYNAMICS OF ELDER MISTREATMENT
ZVI EISIKOVITZ : THE PHENOMENOLOGY OF FAMILY VIOLENCE
THOMAS GOERGEN : CRIMINOLOGICAL THEORY AND ELDER ABUSE RESEARCH
BRIGET PENHALE : ELDER MISTREATMENT :SOCIAL ASPECTS
FRANçOISE BUSBY : 3977: A NATIONAL AND PROXIMTY NETWORK FOR LISTENING AND INTERVENTION
Chair(s)
Ariela Lowenstein Gerontology Dept.,Haifa Univrsity, Haifa 31905, Israel [email protected] 972-4-8240815
Biggs, Simon Institute of Gerontology, Kings College, London, UK [email protected] +44 (0)207 848 2529
____________________________________________________________________________________________________________
ID: 384
RECONCEPTUALIZING THE EXPERIENCE OF LIVING WITH DEMENTIA: FROM PASSIVE RECIPIENT TO ACTIVE CITIZEN
Ruth Bartlett (University of Bradford, Bradford Dementia Group, United Kingdom)
Deborah O'Connor, Canada (1) Ruth Bartlett, United Kingdom (2) Tula Brannely, New Zealand (3)
(1) University of British Columbia (2) University of Bradford (3) Massey University
The purpose of this symposium is to discuss the subject of social status in relation to older people with dementia. In particular, it explores how the
status of this social group is influenced by the concepts of personhood and citizenship and upheld by an ethic of care. It is argued that while the
concept of personhood raises consciousness about the status of people with dementia, as people, intrinsically worthy of respect, it unhelpfully
positions an older person with dementia as passively dependent upon others for affirmation. In contrast, the concept of citizenship, with its active
promotion of rights and responsibilities, does position a person as an active agent, however, it tends to assume the self-cognizance to exercise rights
and responsibilities, and as such demotes the status of people with advanced dementia for whom the demands of citizenship may be too much. Both
concepts are problematic then in regard to promoting the social status of people with dementia. An ethic of care provides not only a bridge between
these concepts, it has the ability to accommodate all the actors involved, including carers, as well as people with dementia.
The presenters share an interest in and are committed to promoting the social status of older people with dementia. O’Connor’s paper will focus on the
concept of personhood and discusses the ways in which it influences understanding of social status. Bartlett ‘s paper provides a conceptual analysis of
citizenship in relation to people with dementia within and beyond the care setting. Brannelly’s paper will examine how an ethic of care may bridge
these two understandings. Combined, these papers provide new theoretical insights regarding the social status of older people with dementia and will
be of interest to others in the dementia field throughout the world. In particular, they aim to contribute to work within the World Health Organisation.
BROADENING THE DISCUSSION AROUND DEMENTIA: THE SHIFT FROM PERSONHOOD TO CITIZENSHIP
A CONCEPT ANALYSIS OF CITIZENSHIP IN RELATION TO OLDER PEOPLE WITH DEMENTIA.
AN ETHIC OF CARE: ANALYZING CITIZENSHIP IN PRACTICE
Chair(s)
John Bond Institute of Health and Society and Institute for Ageing and Health Newcastle University [email protected] 0191 222 6777
____________________________________________________________________________________________________________
ID: 386
EMERGING TRENDS OF POPULATION AGING: DEMOGRAPHIC PERSPECTIVE
Peng Du (Renmin University of China, Institute of Gerontology, China)
Peng Du, China (1) Kevin Kinsella, United States of America (2) David R. Phillips, Hong Kong (3) Rajagopal Dhar Chakraborti, India (4)
(1) Renmin University of China (2) U.S. Census Bureau (3) Lingnan University (4) Calcutta University
21st century is characterized by population ageing, with the further decline in fertility and increase in life expectancy; population aging has been
recognized to be a prominent challenge both for the developed and developing countries of the world in the next decades. Some new demographic
changes have been experienced and attracted more and more attention on the impacts of the emerging issues in this process. India will exceed China
in the size of population in three decades; China will have a declined population number but more rapid population ageing than expected. Along with
the change of the two largest populations, what will happen to the global ageing trend and what are the emerging issues and impacts of global
population ageing need to be examined. Little is known what will happen to the society when the new trend of population ageing proceeds and what
the issues in society to be brought up are.
The invited symposium intend to address the emerging issues of population aging in the world and two
biggest populations in the world from a demographic perspective, and to examine the new trend in population aging in terms of its impact on the
population growth, population structure, population distribution, and gender differentials, and what will be the likely scenarios of the population aging in
the world and its impacts on the society and economic development as well.
Four speakers have been chosen according to their expertise in this field:
Dr. Kevin Kinsella and Prof. David R. Phillips, both are the leading scholars on global ageing studies, they will present a paper on Emerging
demographic trends and global implications.
Prof. Rajagopal Dhar Chakraborti, a leading demographer in Indian will present a paper on Emerging trend of population ageing and its implications in
India, focusing on the new trend of population ageing and its socioeconomic impacts in India and the world.
Prof. Du Peng, will present a paper on New trend of population ageing and its implications in China, focus on the new trend of population ageing in
China and its socioeconomic impacts and policy response.
EMERGING DEMOGRAPHIC TRENDS AND GLOBAL IMPLICATIONS
BY DR. KEVIN KINSELLA AND PROF. DAVID R. PHILLIPS.
THIS PRESENTATION WILL ADDRESS GLOBAL DEMOGRAPHIC AND SOCIOECONOMIC TRENDS, WITH A FOCUS ON NEW
DEVELOPMENTS THAT WILL IMPACT FUTURE GENERATIONS OF OLDER PEOPLE. TOPICS INCLUDE SIMULTANEOUS AGING AND
POPULATION DECLINE, CHILDLESSNESS, RISING LEVELS OF DIVORCE, SEPARATION AND FAMILY RECONFIGURATION, INCREASES IN
SKIP-GENERATION HOUSEHOLDS, THE COMPOSITION OF HEALTH-CARE WORKFORCES, RESTRUCTURED PENSION SYSTEMS, AND
THE MOVEMENT TOWARD UNIVERSAL PENSIONS.
EMERGING TREND OF POPULATION AGEING AND ITS IMPLICATIONS IN INDIA
BY PROF. RAJAGOPAL DHAR CHAKRABORTI
THIS PRESENTATION FOCUS ON THE NEW TREND OF POPULATION AGEING AND ITS SOCIOECONOMIC IMPACTS IN INDIA AND THE
WORLD.
NEW TREND OF POPULATION AGEING AND ITS IMPLICATIONS IN CHINA.
BY PROF. DU PENG
THIS PRESENTATION WILL FOCUS ON THE NEW TREND OF POPULATION AGEING IN CHINA AND ITS SOCIOECONOMIC IMPACTS AND
POLICY RESPONSE.NEW TREND OF POPULATION AGEING AND ITS IMPLICATIONS IN CHINA
Chair(s)
Peng Du Institute of Gerontology, Renmin University of China, Beijing 100872 [email protected] 86-13501275637
____________________________________________________________________________________________________________
ID: 389
IMMIGRATION, EMIGRATION AND AGING: MULTISOCIETAL PERSPECTIVES
Sara Carmel (Ben Gurion University of the Negev, The Center for Multi-Discplinary Research in Aging, Israel)
Terence Seedsman, Australia (1) Sara Carmel, Israel (2) JoAnn Damron- Rodriguez, United States of America (3) Fernando M. Torres- Gil, Australia (3) Susan Feldman,
(4)
(1) Victoria University (2) Ben Gurion University (3) UCLA (4) Monash University
Background: Immigration and emigration are widespread phenomena in our times. Emigration is one of the most profound sources of human stress. It
is a process of being uprooted from one’s physical, cultural and social environments and having to adapt to a new world. The adaptation process
involves facing new challenges while dealing with losses and stress, and recruiting all the already weakened psychosocial and economic resources
towards striking roots in the new society. This process is especially difficult for weak population groups such as elderly persons and puts a
cumbersome burden on their families and society.
The outcomes of this stressful process are apparent in the immigrants socioeconomic status, health, and wellbeing. Notably, the unique needs of
immigrants, as well as their impact on society, create changes and new challenges, which must be addressed by the absorbing societies. The
symposium focuses on societal experiences in dealing with immigration and aging, as well as on insights and responses of three immigration
countries; Australia, USA, and Israel.
Implications: The demographics of the cross-national comparison are a backdrop for differences in policies and programs with varying outcomes for
their diverse older citizens and their caregivers. These experiences are applicable for other countries with changing dynamics of age, immigration,
and care giving.
Contents: Terence Seedsman (Australia) in his paper - The Older Immigrant and the Helping Professions: Perspectives on Change, Transitions, Loss
and Grief will focus on some of the psychosocial difficulties faced by immigrants and their implications for helping professions and policy makers; Sara Carmel
(Israel) in a paper entitled: Psychosocial Resources, Health, Functioning and Wellbeing of Old Immigrants to Israel: A Comparative Longitudinal
Observation, will present a twelve year observation of health and wellbeing of old immigrants in comparison to their Israeli counterparts; JoAnn
Damron-Rodriguez (USA) will shed light on informal and formal aspects of care giving in her paper - Aging, Immigration, and Family Care Giving: A
Cross-National Comparison: Australia, Israel, & the USA; Fernando M. Torres-Gil (USA) in a paper on The Politics of Global Aging: Lessons from
Three Nations, will describe trends in political participation of old immigrants; and Susan Feldman (Australia) in her paper – Research Challenges in
Recruitment and Retention of Migrant Older People from Cultural Diverse Communities - will present some methodological difficulties in studying old
immigrants. This group of scholars published together, in 2007, two edited volumes entitled “Lessons on Aging from Three Nations” (Baywood
SEEDSMAN, T. (VICTORIA, AUSTRALIA) - THE OLDER IMMIGRANT AND THE HELPING PROFESSIONS: PERSPECTIVES ON CHANGE,
TRANSITIONS, LOSS AND GRIEF
CARMEL, S.(BEN-GURION, ISRAEL)- PSYCHOSOCIAL RESOURCES, HEALTH, FUNCTIONING AND WELLBEING OF OLD IMMIGRANTS TO
ISRAEL: A COMPARATIVE LONGITUDINAL OBSERVATION
DAMRON-RODRIGUEZ, J. (UCLA,USA)- AGING, IMMIGRATION, AND FAMILY CARE GIVING: A CROSS-NATIONAL COMPARISON: AUSTRALIA,
ISRAEL, & THE USA
TORRES-GIL, F. (UCLA,USA)- THE POLITICS OF GLOBAL AGING: LESSONS FROM THREE NATIONS
Chair(s)
Sara Carmel Ben-Gurion Univ. Israel [email protected] 972 86460584
Damron-Rodriguez JoAnn UCLA - Public Affairs-USA [email protected] 310-206-3233
____________________________________________________________________________________________________________
ID: 390
ETHICAL ISSUES WITH ADVANCING AGE
Robert Moulias (Espace Ethique AP-HParis, Groupe ethique et vieillesse, France)
Robert Moulias, France (1) Norah Keating, Canada (2) Rosita Kornfeld, Chile (3) Astrid Stuckelberger, Switzerland (4)
(1) Espace Ethique AP-HParis (2) University of Alberta (3) Catholic University (4) Université de Genève
- Conceptual misunderstandings are linked with inappropriate use of the same words in different meanings. What is the precise gerontological
acceptation of words as Autonomy, Dependency, Disability, Capacity,Validity, Lucidity, Consent, etc ? Gerontological jargon needs precise definitions
with determining scales for assesment. Otherwise decision-makers may be induced on false tracks. Who is really totally "autonomous" or totally
"dependent"?
The word "dementia" has not the same sense in medicine, law or common language. "Progressive Cogntive Deficiency Syndrome" would be clearer.
"Agins of population", a pejorative expression , is used to describe longevity of individuals, a positive phenomenon, etc. Semantic consensus avoids
misinterpretations and mistreatments. Old age sciences and practices need to unufy its vocabulary for a more ethical look on its issues.
Do we need specific Laws and Rights for older persons ? It may be a risk for positive discriminations. It will be more equitable to define specific rights
and protections for vulnerable disabled persons whatever will be their age and intergenerationnal Rights and Duties. The main issue is to avoid in the
facts a loss of rights for weaker persons or for persons with any difficulties to express themselves. How to represent a person unable to give its
opinion ?
For older workers, the Right to retirement must not become a duty to leave its work. Old persons are commonly excluded of social responsible life. In
the same time, we accumulate evidence of the benefits of an active life for older persons and on the high risks of sedentarity, isolation, and inactivty.
The society cannot exclude progressively 15 to more than 25 % of the population.
Ageism is the more ancient and hidden form of racism. It remains strongly developed in all systems, specially in health systems. It is a major factor for
low quality of life and for risks of isolation and withdrawal. It may lead old persons to a feeling of guiltiness and depression. In spite of existing laws in
many countries, ageism is rarely or never condemned.
This symposium may be on the aegis of Federation Internationale des Associations de Personnes Agées (FIAPA)and Conseil de l'Europe
THE ETHICAL NEED FOR A SEMANTIC CONSENSUS ON A GOOD USE OF THE GOOD WORDS IN GERONTOLOGY
INTERGENERATIONNAL RIGHTS AND DUTIES : THE MISSING LINK FOR SOCIAL COHESION
THE RIGHT TO REMAIN AN ACTIVE MEMBER OF THE SOCIETY
AGEISM AND AGE DISCRIMINATION : NEGLECT IN ETHICS RESEARCH, PRACTICE AND POLICY
Chair(s)
robert moulias 12 av Pdt Kennedy 75016 Paris France [email protected] 33145202639
keatings norah univ of alberta Edmonton [email protected]
____________________________________________________________________________________________________________
ID: 402
SUPPORTING SUSTAINABLE INFORMAL CARE – THE EUROCARERS FRAMEWORK
Henk Nies (Vilans, Netherlands Centre of Expertise for Long-term Care, Board, The Netherlands)
Giovanni Lamura , Italy (1) Hanneli Döhner, Germany (2) Elizabeth Hanson, Sweden (3) Geraldine Visser, The Netherlands (4) Caroline Glendinning , United Kingdom (5)
Benedicte De Koker , Belgium (6) Therese Jacobs, (6)
(1) I.N.R.C.A. (2) University Medical Center Hamburg-Eppendorf (3) Carers Sweden, Swedish Family Care Competence Centre Sweden, (4) Vilans, Centre of expertise
for long-term care (5) SPRU Social Policy Research Unit, University of York (6) University of Antwerp - Dept. Sociology
Demographic and epidemiological trends increase the need for informal care. EUROCARERS is a European network aiming to improve the situation
of carers in Europe. Members are carers’ organizations and research-organizations. This symposium will address the main topics that are relevant to
informal carers and that are covered by research of Eurocarers’ research-members. We will use an innovative symposium format: it outlines our
conceptual framework (Henk Nies/Geraldine Visser), presents the papers in an ‘academic speed dating’ format and offers participants the choice
between three or four papers with the option to interact with the particular researchers. Papers are:
1.Support for carers (Giovanni Lamura): the EUROFAMCARE project highlights the most common carers’ difficulties and preferences, as well as the
challenges characterizing the different EU care systems.
2.Technology based services for carers (Elizabeth Hanson/Lennart Magnusson). A presentation about the ‘state of art’ and innovative examples of
telehealth and telecare services for carers.
3.Cash for care: implications for carers (Caroline Glendinning/Hilary Arksey). Many countries are introducing cash allowances or vouchers to offer
disabled and older people greater choice, stimulate service markets and support family care. The papers addresses the impact on carers.
4.Information, advice, advocacy and training for carers (Susanne Kohler/Hanneli Döhner/ Sebastian Fischer). European research shows the
importance of information, advice, advocacy and training for carers. Insight into barriers for usage and positive responses is necessary to address the
needs of carers and shape future programs of support.
5.Experiences of carers in using formal support by Benedicte de Koker/Therese Jacobs (Belgium). Quantitative and qualitative data provide insight
into family differences in the perception and the role of formal support.
6.Assessment of carers (Tiina Autio). Assessing the caring situation is important for good support. The Finnish carers’ association presents a web
based holistic tool, and research about assessment.
7.Reconciliation of work and care (Sue Yeandle). There is an increasing emphasis on the need to support carers in combining work and care. The
many different ways in which social systems and working lives can respond positively to the new challenges of this changed situation will be
highlighted.
8.The paradox of respite care (Henk Nies/Geraldine Visser). Although carers are much in need for respite care, they rarely use it. They postpone using
it until they are heavily burdened. Given this context, how can respite care be effective?
1.SUPPORT FOR CARERS AND THE IMPORTANCE OF INFORMATION, ADVICE, ADVOCACY AND TRAINING
2.TECHNOLOGY BASED SERVICES FOR CARERS
3.CASH FOR CARE: IMPLICATIONS FOR CARERS
4.EXPERIENCES OF CARERS IN USING FORMAL SUPPORT
Chair(s)
Henk Nies PO Box 8228, 3503 RE Utrecht, The Netherlands [email protected] 0031307892330
____________________________________________________________________________________________________________
ID: 410
ELDER ABUSE: A MULTI-COUNTRY COMPARATIVE STUDY OF SOCIAL POLICY AND PRACTICE.
LIA Susana DAICHMAN (Intl Network for the Prevention of Elder Abuse, ILC Argentina, President, Argentina)
Marie Beaulieu, Canada (1) Nicolas Berg, Belgium (2) Laura Machado, Brazil (3) Susan Somers, United States of America (4) Mala Kapur Shankardass, India (0)
(1) University of Sherbrooke (2) Institution CAPAM (3) InterAge Consultoria em Gerontologia (4) Somers Law Firm (5) Maitreyi College, Delhi Univ
Elder Abuse became recognized as an important social problem in the late "70. Since then certain counties have framed policy, laws or plans of
action, and others have yet to give clear direction to address this important social problem. The time has come to critically address the content of
existing policies, to compare them and to discuss the advantages and limits of different approaches in order to build on and influence the choice of
different pathways that will be taken all around the world. In this session, we will expose different polices enacted in important regions of the world
(South America, and Europe and we will discuss them from an international point of view (including voices of North America, both from the US and
Canada (Francophone minority) and Asia (INDIA). In our discussions, we will not only focus on the content of the policies but also on the different
ways that they shape the intervention in the medical, legal, and social science fields.
"A PLAN OF ACTION TO REDUCE MISTREATMENT OF OLDER ADULTS: A CASE STUDY FROM THE COLLABORATIVE INTERSECTORIAL
PROCESS UNDERTAKEN BY THE QUéBEC GOVERNMENT (A PROVINCE OF CANADA) IN 2008-2009"
"OVERVIEW AND IMPACT OF LEGISLATION TO REDUCE MISTREATMENT OF OLDER ADULTS ADOPTED IN MAY 2008 IN THE WALLOON
REGION (BELGIUM) "
ELDER ABUSE IN LATIN AMERICA: ADVANCES IN POLICY SINCE MIPPA 2002
“PROTECTING VULNERABLE OLDER PERSONS, “FROM SEA TO SHINING SEA”, THE MULTI-FACETED U.S.A. EXPERIENCE OF FIFTY
STATES OVER THREE DECADES”
Chair(s)
Lia Daichman, MD Arenales 1391 8* "B" (1061) [email protected] + 54 48119590
Kapur Shankardass Mala D 104 Anand Niketan, New Delhi 110021, India malakapurshankardass@ + 9818138553
____________________________________________________________________________________________________________
ID: 412
SENIOR CITIZENSHIP : FROM MYTH TO REALITY.
CHALLENGES AND CROSS-NATIONAL PERSPECTIVES ON SENIOR CITIZENSPARTICIPATION TO DECISION MAKING
MIch¨¨le CHARPENTIER (UQAM/ REIACTIS, Social Work, Canada)
Jean-François BICKEL, Switzerland (1) Jean-Philippe VIRIOT DURANDAL, France (2) Guy BEDARD, Burkina Faso (3) Michèle CHARPENTIER, Canada (4)
(1) University of Fribourg (2) UNiverit¨¦ de Franche Comt¨¦ (3) Association Internationale des Ain¨¦s francophones (4) Universit¨¦ du Qu¨¦bec ¨¤ Montr¨¦al
In 1999, within the International Year of Older Persons, the UN adopted an ambitious slogan, calling for ¡®a society for all ages¡¯. Going beyond
institutional formulas, social scientist involved in comparative studies on public policies on ageing, decided to use this theme as a start for a global
research. The initial focus was on understanding the various types of involvement or exclusion of of ¡®elderly¡¯ people in contemporary societies in
different parts of the world.
The REIACTIS, (Reseau dEtude International sur lAge, la Citoyennet¨¦ et lInt¨¦gration SOcio¨¦conomique) an International Network on Age, Citizenship
and Socio-economic Integration) is an academic network created to carry out research in this field. Its recent research program on senior citizenship
and participation to public and private decision making is supported by the UN.
This symposium will bring together some of this experts researchers from different countries (Canada, Suisse, France), and also includes the African
chairman of a large international organization of senior citizens.
The aim of the event is to open discussion on conceptual frameworks and point of views on the issues of senior citizenship.
How can we define concepts such as social exclusion, inclusion and participation, citizenship, grey power, and how can we assess them? How can
public policy, professional practice, and research integrate elderly in public and private decisions ?
- Some of the key issues of the symposium are
¡Ì Organized groups: How do the elderly as citizens play an institutional or informal role in international, national and local policy-making? To what
extent does a public decision maker matter?
¡Ì Grey power and senior citizenship : How can democracies deal with ageing-related interests groups in the context of social policy reform? Can we
talk of intergenerational inequality? Should we fear an imbalance between public policies aimed at younger people and old age policy?
¡Ì Empowerment of older persons How to asses the current situation of seniors and frail elderly in decision-making that affects them in every day life.
How can seniors and frail elderly people continue to be in control of their lives and their life choices? How can public policy and professional practice
help individuals participate in the decisions taken at various stages of decision making?
This symposium will also be an opportunity to promote in-depth research work over time, encouraging researchers and participants to develop new
avenues of research and make proposals for the future.
WHAT DOES SENIOR CITIZENSHIP MEANS?
BY: JEAN-FRAN&CCEDIL;OIS BICKEL , PH.D, SENIOR LECTURER, UNIVERSITY OF FRIBOURG, DEPARTMENT OF SOCIAL WORK AND
SOCIAL POLICY , (SWITZERLAND)
GREY POWER : MYTH AND REALITY
BY JEAN PHILIPPE VIRIOT-DURANDAL, PHD, VISITING SCHOLAR, CENTER FOR EUROEPAN STUDIES, HARVARD UNIVERSITY (USA) AND,
SENIOR LECTURER IN SOCIOLOGY, UNIVERSIT¨¦ DE FRANCHE COMT¨¦, (FRANCE) :
COLLECTIVE AND INTERNATIONAL ACTIONS FOR AND BY THE SENIOR CITIZENS.
BY ALIMATA SALEMBERE (OR REPRESENTANT), BOARD OF DIRECTION OF THE F¨¦D¨¦RATION INTERNATIONALE DES AIN¨¦ES
FRANCHOPHONES, (BURKINA FASO, AFRICA)
FROM SOCIAL EXCLUSION TO INCLUSION. CHALLENGES FOR POLICIES, PRACTICES AND RESEARCH ON AGING.
BY MICH¨¨LE CHARPENTIER, PH.D, PROFESSOR OF SOCIAL WORK, UQAM, QUEBEC, CANADA,:
Chair(s)
Michèle Charpentier Université du Québec à Montréal [email protected] 514-987-3000 (2080)
Viriot-Durandal Jean-Philippe Université Belfort, France viriotdurandalhotmail.com
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ID: 417
“AGEING AND SEXUALITY – THE POSSIBILITIES FOR CARE”
Andrew King (Kingston University, Faculty of Arts and Social Sciences, United Kingdom)
Ann Cronin, United Kingdom (1) Andrew King, United Kingdom (2) Jill Manthorpe, United Kingdom (3) Elizabeth Price, United Kingdom (4)
(1) University of Surrey (2) Kingston University (3) Kings College London (4) University of Hull
Until relatively recently mainstream gerontology has had little to say about sexuality in later life. Although there is some evidence to suggest that this is
changing, much of the research reflects a biomedical model, with little consideration given to the psychological and sociological factors affecting
sexuality amongst the older population. Furthermore, where such research has been conducted, it has almost exclusively focused on heterosexuality,
with the experiences of older lesbian, gay and bisexual (LGB) adults either being ignored, marginalised or misrepresented.
However, there is a small but growing body of social research committed to exploring the experiences of this cohort of older adults and the
communities to which they belong. This symposium, which examines the experiences of care amongst older LGB adults, consists of four papers that
represent the diversity of not only these older LGB adults’ lives, but the means of researching them. Cronin’s paper, through a cross-cultural
examination of the lives of older lesbian women living in the UK, USA and Australia, reflects on the relationship between social support and care
practices in later life. She highlights the diversity of experience amongst this older group of women and the implications this contains for well being in
later life. King critically considers the notion of ‘care’, with particular attention paid to the caring experiences of older gay men. He notes both
theoretical and methodological challenges to established models of care, drawing on insights from sociological theory and empirical data. Manthorpe’s
paper reports on findings from the midpoint evaluation of the National Service Framework for Older People (NSFOP), discussing the challenges for
researchers, regulators and service providers in seeking the views of older people
who are gay and lesbian. Both methodological lessons and research findings are discussed. Finally, Price presents findings from a study that explored
the experiences of gay men and lesbian women who care, or have cared for, a person with dementia. It focuses upon the ways in which gay and
lesbian carers managed disclosures of their sexuality to dementia care service providers and the ways in which providers' responses impacted upon
their care giving experiences. Overall, the symposium provides an insight into the range of research that is being conducted in the UK. Its aim is to
encourage debate with those from other countries who are also engaged in this field and open possibilities for future cross-national dialogue and
collaboration.
DR ANN CRONIN – “COMMUNITY CARE? SEXUALITY, SOCIAL NETWORKS AND CARE IN LATER LIFE”
DR ANDREW KING – “A QUEER KIND OF CARE”
PROFESSOR JILL MANTHORPE – “FROM MARGIN TO MAINSTREAM: CHALLENGES IN CONSIDERING THE VIEWS OF ALL OLDER PEOPLE
IN THE EVALUATION OF THE NATIONAL SERVICE FRAMEWORK FOR OLDER PEOPLE IN ENGLAND”
DR ELIZABETH PRICE – “GAY AND LESBIAN CARERS
Chair(s)
Andrew King 28 Kings Road Kingston upon Thames Surrey England KT2 5HS [email protected] 0208 547 2000 Ext 62347
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ID: 418
RECENT PREVALENCE RESEARCH IN ELDER ABUSE: EUROPEAN PERSPECTIVES
Bridget Penhale (University of Sheffield, UK, Centre for Health and Social Care Studies and Service Development, United Kingdom)
Thomas Goergen, Germany (0) Isobel Iborra, Spain (0) Simon Biggs, United Kingdom (0) Zvi Eisikovits, Israel (0)
(1) German Police University (2) Queen Sofia Centre (3) King's College London (4) University of Haifa
Over the last ten years there has been increasing global recognition of the abuse and neglect of vulnerable older adults as a social problem in need of
attention. A number of European countries have been working in this area but are at different stages of development. The identification of abuse
remains problematic. Techniques of intervention are in quite early stages of development, although some recent progress has been made. The extent
of research on elder abuse is variable, with some countries able to undertake more studies than others, but with an overall paucity of research on a
global level. In order to respond effectively to elder mistreatment it is necessary to know the scale of the problem. However, the full extent of the
problem is as yet unknown and only a small number of prevalence studies have taken place, with several of these occurring some time ago; for
example US and Canada in the late 1980s, whilst Netherlands and Poland both undertook studies in the early 1990s.
This symposium will present the findings from the most recent studies of prevalence of elder abuse that have taken place in Europe. These studies
were conducted in Germany, Spain, UK and Israel and all of the studies have been completed in the last year. Each of the four researchers will
present key findings from the studies undertaken in their country. There will then be discussion of the commonalities and differences in the findings
between the studies, with consideration of the implications of these for the study of elder abuse in general terms. This will be followed by deliberation
on and comparison of the approaches taken within the studies. There will also be consideration of a number of the methodological challenges in this
area. This will include the question of whether it is possible to develop a methodology for studies of elder abuse prevalence in future that could be
used internationally and which would therefore render prevalence findings comparable between nations and regions across the world.
Professor Toni Antonucci of the US will act as discussant for this symposium.
PREVALENCE DATA IN ELDER ABUSE RESEARCH -REFLECTING RESULTS OF A RECENT GERMAN STUDY
FIRST NATIONAL STUDY ON ELDER ABUSE IN THE FAMILY IN SPAIN
THE FIRST UK PREVALENCE STUDY ON ELDER MISTREATMENT: LESSONS AND OBSERVATIONS
THE ISRAELI NATIONAL SURVEY ON ELDER ABUSE AND NEGLECT: SO WHAT IF WE KNOW IT NOW?
Chair(s)
Bridget Penhale University of Sheffield, Sheffield, UK [email protected] +44 114 226 9606
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ID: 428
URBANISATION AND AGEING: NEIGHBOURHOOD INFLUENCES ON SOCIAL INTEGRATION AND HEALTH INEQUALITY.
Chris Phillipson (Keele University, Centre for Social Gerontology, United Kingdom)
Chris Phillipson, United Kingdom (1) Fleur Thomese, The Netherlands (2) Catherine Bonvalet , France (3) Jessica Kelley-Moore, United States of America (4)
(1) Keele University (2) VU University (3) Institut National d'Etudes Demographiques (4) Case Western Reserve University
The growth of urbanisation raises major issues for population ageing and the networks supporting older people. In countries of the Global North, the
focus of this symposium, neighbourhoods experience, on the one hand, the rapid growth of so-called ‘global cities’ and, on the other hand, the decline
of areas subject to de-industrialization. Such developments create different pressures on social networks in old age along with new forms of inequality.
This symposium draws upon a multi-country perspective to examine key issues in respect of neighbourhood change in later life. Professor Chris
Phillipson has expertise linking research in urban sociology with that in social gerontology. He will examine some of the main social and economic
changes accompanying urbanisation in post-industrial cities, and the implications for the lives of older people. He will give particular focus to the
emergence of new spaces and communities within urban environments, and the challenges these raise for lifestyles in old age. Dr. Thomese, an
authority on neighbourhood issues and ageing, will examine the impact of changes affecting the organisation of urban communities. Her paper
explores changes to personal networks in old age, drawing on cohort data from the Longitudinal Aging Study Amsterdam. This study is used to
consider evidence for declining levels of neighbourhood commitment and integration, and implications for social participation and loneliness in later
life. Dr. Catherine Bonvalet and Dr. Jim Ogg apply their expertise relating to population and family change, to exploring new residential strategies
among older people in France. They will highlight the transformation in the housing experience of older people, with high rates of home ownership
among current cohorts. Arising from this may come new forms of residential mobility, with greater attachment to urban areas but links to other
communities, through for example ownership of second homes.
Professor Kelly-Moore is an authority on neighbourhood and environmental
influences on health outcomes. Her paper will utilise cumulative advantage/disadvantage theory to explain how those who live in specific types of
communities may have a shared life path, reflecting early and mid-life opportunities resulting in similar physical functions in later life. The paper draws
on ten-year panel data from older adults living in a range of communities in North Carolina, USA. Her paper will play particular attention to racial health
disparities in disability in later life, highlighting community type as a key explanatory variable.
URBANISATION AND AGEING: SOCIAL DIVISIONS AND NEIGHBOURHOOD CHANGE
THE ONSET OF THE THIRD AGE IN LATE MODERNITY: CONSEQUENCES FOR NEIGHBOURHOOD INTEGRATION IN EARLY OLD AGE
THE HOUSING SITUATION AND RESIDENTIAL STRATEGIES OF OLDER PEOPLE
CUMULATIVE DIS/ADVANTAGE, COMMUNITY TYPE, AND DISABILITY: RE-EXAMINING RACIAL HEALTH DISPARITIES IN OLDER
ADULTHOOD
Chair(s)
Christopher Phillipson Keele University, Keele, Staffordshire, UK, ST5 5BG [email protected] + 44 1782 621111
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ID: 448
SYMPOSIUM ON SUPPORTING ELDERLY PEOPLE DISCHARGED FROM HOSPITALS
Edward Leung (United Christian Hospital, Department of Medicine and Geriatrics, Hong Kong)
Edward Leung, Hong Kong (1) Philip Poi, Malaysia (2) Michal Boyd, New Zealand (3) Peter Hunter, Australia (4)
(1) United Christian Hospital (2) University Malaya Medical Centre (3) Waitemata District Health Board (4) Caudfield General Medical Centre
It is a clear trend of increasing use of hospitals with population ageing. Various initiatives have been advocated in reducing the demand on elderly
people in use of hospitals and also to improve the care of older people in their own environment by community health care strategy. The Asia Pacific is
one of the most rapidly ageing areas in the world. To better prepare for the future population ageing it is important to develop programmes in the
region to reduce the reliance on expensive hospital resources and enhance health care in the community especially for the frail and high risk older
patients. The present symposium has bring together experts from various countries in Asia Pacific Region to share the recent initiatives of enhancing
care of frail elderly patients prone to be admitted to hospitals and its outcome. Dr. Edward Leung will share an initiative by the Hong Kong Government
to implement the Integrated Discharge Support Programme for Elderly Patients in Hong Kong. The programme cover all elderly patients with high risk
including hip fracture, stroke, recurrent admission due to heart failure, dementia, repeated falls and failing carer status. A total of 3000 high risk elderly
patients are screened each year for intervention in promoting early rehabilitation and recovery with early relocation back to the community through
enhanced home care services. In the symposium the details of the programme and its outcome will be discussed. Dr. Philip Poi of Malaysia will share
the recent initiatives in Malaysia on enhancing the discharge of elderly patients by discharge support services for frail elderly and their carers and to
shift the health care provision from institutions back to home and community based settings. Dr. Michal Boyd from New Zealand will discuss on
Residential Aged Care Integration Programme with the aim of providing Gerontology Nurse Specialist support to residential aged care facilities in New
Zealand to increase care co-ordination between aged care facilities and secondary services. Preliminary outcome data indicated that the intervention
resulted in decreased acute care episodes. Dr. Peter Hunter from Australia will be speaking on the topic of Victorian HARP – CDM experience. The
Victorian HARP programme has been implemented for few years and have targeted on chronic disease management in reducing the utilization of
acute hospitalization for specific disease groups like Diabetes, Dementia, Heart Failure. The presentation will discuss the intervention procedure and
its outcome.
INTEGRATED DISCHARGE SUPPORT PROGRAMME FOR ELDERLY PATIENTS IN HONG KONG - DR. EDWARD LEUNG
CURRENT DISCHARGE SUPPORT PROGRAMMES FOR THE FRAIL ELDERLY PATIENTS IN MALAYSIA - DR. PHILIP POI
RESIDENTIAL AGED CARE INTEGRATION PROGRAMME - DR. MICHAL BOYD
VICTORIAN HARP - CDM EXPERIENCE - DR. PETER HUNTER
Chair(s)
Edward Leung United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong [email protected] 852 3513 4822
Hunter Peter Caufield General Medical Centre, 260 Kooyong Road 3162, Caufield, Victoria, Australia [email protected]
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ID: 456
OLDER WORKERS UNDER GLOBALIZATION – EMPLOYMENT AND RETIREMENT IN TIMES OF RAPID SOCIAL CHANGE
Dirk Hofaecker (State Institute for Family Research, -, Germany)
Dirk Hofaecker, Germany (1) Sandra Buchholz, Germany (2) Paul Schmelzer, Germany (3) Heike Schroeder, United Kingdom (4)
(1) State Institute for Family Research (2) Otto Friedrich University of Bamberg (3) University of Leipzig (4) Middlesex University
Due to increasing life expectancy and decreasing fertility rates, the age structure of the population in most industrialized nations is changing
considerably. Simultaneously, the majority of individuals leave the labour market well before reaching the formal retirement age. These developments
have confronted modern societies with serious challenges for the sustainability of social security systems and for the qualitative as well as quantitative
availability of an adequately qualified labour force.
Little research, however, has linked these developments to recent socio-economic processes, often summarized under the term “globalization”. It has
triggered a trend of strong economic restructuring and increasing labor market flexibility. These developments have put especially older workers under
increasing labor market pressure as they are usually at a comparatively higher risk to have outdated occupational qualifications and to be perceived as
a more expensive and less flexible workforce in comparison to their younger counterparts.
Previous research has indicated that the effects of globalization depend both on individual and firm or industry characteristics but also on national
educational systems or welfare and labor market regimes. Challenging questions for social research therefore are how globalization affects
employment careers of senior workers across countries and consequently their monetary incomes and material wellbeing over time.
Within the field “Social Research, Policy and Practice” we propose a symposium consisting of the following presentations:
1)An opening paper will outline a theoretical framework for analyzing the development of globalization and its effects on older workers and retirement
patterns with illustrations from twelve modern societies.
2)A comparative analysis based on longitudinal micro data will outline the employment situation of older workers in three different welfare regimes
(Germany, Denmark and the United Kingdom) and the individual economic consequences arising from it.
3)Subsequently, a comparative analysis of linked employer/employee data from German and British firm panel surveys will explicitly focus on the
organizational level context older workers are situated in.
4)The final symposium contribution will discuss the public policy implications of the previous findings and point towards lessons that can be learned
from different European societies for improving the employment situation of older workers.
Symposium presenters come from different research projects in social sciences that have thoroughly analyzed the effects of globalization on older
workers. The multidisciplinary composition of symposium participants as well as the country-specific expertise from three different nations guarantees
that symposium participants will cover the topic in its entire complexity.
CONCEPTUAL FRAMEWORK: CAREER EXITS UNDER GLOBALIZATION – BECOMING RETIRED IN TIMES OF RAPID SOCIAL CHANGE
THE EMPLOYMENT SITUATION OF OLDER WORKERS AND ITS ECONOMIC CONSEQUENCES – A COMPARISON OF GERMANY, DENMARK
AND THE UNITED KINGDOM
HUMAN RESOURCE MANAGEMENT POLICIES FOR OLDER WORKERS: TOWARDS INCREASING EMPLOYMENT INTEGRATION? EVIDENCE
FROM GERMAN AND BRITISH FIRM PANEL DATA
THE TREND TOWARDS EARLY RETIREMENT IN GERMANY IN THE GLOBALIZATION PROCESS: WHAT COULD BE LEARNED FROM OTHER
EUROPEAN SOCIETIES TO INCREASE OLD AGE EMPLOYMENT RATES SUCCESSFULLY?
Chair(s)
Julia Marold State Institute for Family Research, heinrichsdamm 4, 96047 Bamberg, Germany [email protected] +49 (0)951 9652515
Jabsen Annika State Institute for Family Research, heinrichsdamm 4, 96047 Bamberg, Germany [email protected] +49 (0)951
9652515
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ID: 461
LONG-TERM CARE INSURANCE COMPARISON USA-EUROPE
Thomas Klie (Protestant University of Applied Sciences, Freiburg, Social Gerontology, Germany)
Thomas Klie, Germany (1) Donald Redfoot, United States of America (2) Heinz Rothgang, Germany (3) Anabel Pelham, United States of America (4)
(1) Protestant University of Applied Sciences, Freiburg (2) American Association of Retired Persons (3) University of Bremen (4) San Francisco State University
Notwithstanding different demographic regimes and a different intensity in activating volunteer work in the welfare states of USA and of Germany, both
countries are at present under the pressure to develop new financiable models in managed long term care of the aged which are of high
responsiveness to the diversity of needs of those to be cared for. In the US one can see an increase in the establishment of a publicly or privately
operating and financed geriatric care manager. This promises not only to take into account the variety of care needs but particularly to concentrate on
the provision of LTC to those impoverished groups of the population which are still without general health insurance and - in case of being in need of
care -are clients of Medicaid . While this type of geriatric management underlines the importance of additionally mobilized supportive informal care
work, the existence of a universal LTC insurance in Germany allows the establishment of care models which places the financial and systematic
responsibility in a coproduction of family caregivers and the case manager. In both countries the networking between informal and formal care work as
well as between different professional groups in the process of rendering care are of utmost importance for fulfilling the promise of need-sensitive
delivery of care. But the countries differ in the design and implementation as well as in the accompanying philosophy of their models of care: the
symposium will devote its attention to differences as well to similiarities in processing these models of care and will identify its different agents.
An approach on budgets - a chance for Europe
Learning from Europe? The discussio about covering long-term care in the US
European long-term care systems in comparison
LTC Insurance: Filling Gaps and Meeting Needs for Care
Chair(s)
Marja Vaarama University of Lapland [email protected] +358-16-3412601
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ID: 475
SOCIAL PENSIONS AND OLDER PEOPLE IN DEVELOPING COUNTRIES
Peter Lloyd-Sherlock (University of East Anglia, Development Studies, United Kingdom)
Peter Lloyd-Sherlock, United Kingdom (1) Armando Barrientos, United Kingdom (2) Giang Thanh Long, Viet Nam (3) Wade Pfau, Japan (4)
(1) University of East Anglia (2) University of Manchester (3) National Economics University (4) Graduate Institute for Policy Studies
Over the past decade, the focus of pension policy in developing countries has shifted away from the reform and privatisation of contributory pension
funds to the extension of non-contributory "social pensions". Based on the apparently successful experiences of countries such as Brazil, South Africa,
Nambia and Mauritius, social pensions have come to be seen as a key policy tool for reducing poverty and vulnerability in later life in low and middle
income countries. Several new schemes have recently been set up in countries as diverse as Mexico, Bolivia, Lesotho and Bangladesh. The
symposium will open with a general review of these important developments by Peter Lloyd-Sherlock and Armando Barrientos. Drawing on substantial
original research from an ESRC (and joint research council)-funded new Dynamics of Ageing project, Lloyd-Sherlock and Barrientos will also review
the evidence of the effects of established social pension schemes in Brazil and South Africa. The final paper in the symposium will be given by Giang
Thanh Long and Wade Pfau. It will review recent moves to establish a social pension scheme in Vietnam, assessing the case for this policy, and
simulating its potential impacts on older people.
SOCIAL PENSIONS AND OLDER PEOPLE IN DEVELOPING COUNTRIES: AN INTRODUCTION.
SOCIAL PENSIONS AND OLDER PEOPLE: EVIDENCE FROM BRAZIL AND SOUTH AFRICA
SIMULATING THE POTENTIAL IMPACTS AND COSTS OF AN EXTENDED SOCIAL PENSION SCHEME IN VIETNAM
Chair(s)
Peter Lloyd-Sherlock University of East Anglia [email protected] 44 1603 592327
Barrientos Armando University of Manchester [email protected] 44 161 306 6699
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ID: 502
PSYCHOSOCIAL INTERVENTIONS IN DEMENTIA CARE: EFFECTIVENESS AND IMPLEMENTATION
Myrra Vernooij-Dassen ( Radboud University Nijmegen Medical Centre, IQ Health Care, The Netherlands)
Myrra Vernooij-Dassen, The Netherlands (0) Inge Cantegreil, France (0) Esme Moniz-Cook, United Kingdom (0) Rabih Chattat, Italy (0) Ulla Ulla Eloniemi-Sulkava , Finland
(0)
(1) UMCN (2) Hôpital Broca (3) University Hull (4) University Bologna (5) Central union Welfare
The sense of having ‘nothing to offer’ has paralyzed dementia care for decades. Meanwhile the quality of psychosocial interventions has been
improved by sound research that has advanced psychological and social theory to the applied setting with evaluation in ‘real world’ settings. In the
past five years there is now much to offer, including a toolkit of interventions for use in daily practice. However, a strategy to ensure that effective
interventions are used remains lacking. This symposium aims to provide an overview of the most effective interventions and ways in which these may
be implemented. We will therefore outline the evidence to date, provide an overview of current interventions, including those that show promise and
summarise work from a recent study on European quality indicators, as a means of enabling what exists to be used more widely. Papers presented
reflect some of the co-ordinated focus of the INTERDEM (http://interdem.alzheimer-europe.org/) a multi-professional group who have research and
practice expertise on psychosocial intervention across Europe.
MULTI-COMPONENT, TAILORED INTERVENTIONS IN COMMUNITY CARE AND IN LONG-TERM INSTITUTIONAL CARE
INNOVATIVES PRACTICES TO SUPPORT FAMILIES OF DEMENTIA PATIENTS
OBSTACLES IN APPLYING PSYCHOSOCIAL INTERVENTIONS IN
DEMENTIA CARE
THE PROCESS OF
IMPLEMENTATION OF PSYCHOSOCIAL INTERVENTIONS: QUALITY INDICATORS FOR PSYCHOSOCIAL
INTERVENTIONS IN EUROPE
Chair(s)
Esme Moniz-Cook University Hull, UK [email protected] 00441482633673
Vernooij-Dassen Myrra IQHealthcare 114, Radboud University Medical Centre Nijmegen PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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ID: 524
BUILDING THE HEALTH CARE WORKFORCE TO SERVE AN AGING AMERICA
Alexandre Kalache (The New York Academy of Medicine, Senior Advisor to the President on Global Aging, United States)
John Rowe, United States of America (1) Terry Fulmer, United States of America (2) Carol Raphael, United States of America (3) Patricia Volland, United States of America
(4) Alexandre Kalache, (4)
(1) Columbia University Mailman School of Public Health (2) New York University College of Nursing (3) Visiting Nurse Service of New York (4) The New York Academy of
Medicine
Similar to nations across the globe, America is getting older. A demographic tide will turn in 2030 when at least twenty percent of the population will
be 65 years or older. As the population ages, older Americans, like many of their global counterparts, will be increasingly diverse in terms of race,
ethnicity, education and socio-economic background. This demographic shift will influence not only the proportion and number of older adults in the
United States; it will also have a direct impact on the health care workforce and its ability to deliver high-quality care to a population that utilizes more
health care services and has more complex needs.
In 2008, the Institute of Medicine (IOM) issued a landmark report outlining a call to action for all those involved in the health and social service
professions that serve older adults. The report proposes: (1) expanded initiatives to recruit and train health professionals from all disciplines to the
field of aging; (2) changes to academic infrastructure that reflect the need for increased geriatric training and the infusion of competency-based
education into all curricula; and (3) the need for fundamental reform of the healthcare delivery system, including broader dissemination of
interdisciplinary care models that evolve from best practices in aging care.
This symposium will present in greater detail the three-pronged approach to workforce development contained in the IOM report, as well as the
participation by The New York Academy of Medicine in public-private partnerships led by the IOM. The symposium participants will discuss the need
for concerted action to promote the implementation of improved models of care, enhanced recruitment and retention strategies, and educational
initiatives in geriatric care. To provide a multi-disciplinary perspective on these challenges, each of the panelists will present on their specific area of
expertise, including medicine, nursing, and social work. They will report on successful programs and strategies, and the current state of readiness to
disseminate these initiatives more broadly.
The recommendations of the IOM report, and the formation of alliances on the state and national level to see this work through to completion, will have
relevance for those in the international community encountering similar demographic trends. The establishment of public-private partnerships that act
quickly and efficiently to address pressing healthcare needs is a universal challenge. In this instance, the continued health and longevity of an aging
population depend upon meeting these challenges.
THE FUTURE GERIATRIC WORKFORCE: THE CHALLENGE TO PHYSICIANS TO PREPARE FOR AN AGING AMERICA
THE CRITICAL NEED FOR BUILDING CAPACITY IN THE FIELD OF GERIATRIC NURSING
RETOOLING FOR AN AGING AMERICA: THE RESPONSE FROM SOCIAL WORK AND FAMILY CAREGIVERS
TOMORROW
Chair(s)
Alexandre Kalache 1216 Fifth Avenue New York 10029 [email protected] 212-8227359
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ID: 531
BRIDGING RESEARCH AND PRACTICE: TOWARD A GLOBAL MODEL OF GERONTOLOGY EDUCATION
Ed Rosenberg (Appalachian State University, Sociology, United States)
Tiina-Mari Lyyra, Finland (1) Marja Aartsen, The Netherlands (2) Pornchai Jullamate, Thailand (3) Ryo Takahashi, India (4) Martha Meyer, Germany (5) Suzanne Kunkel,
United States of America (6)
(1) University of Jyvaskyla (2) Vrije Universiteit (3) Burapha University (4) Andhra University (5) Hochschule fur Technik und Wirtschaft des Saarlandes - University of
Applied Sciences (6) Director, Scripps Gerontology Center - Miami University of Ohio
Research is valuable for policy and practice, but the translation of research into policy/practice usually occurs through the medium of education. Thus
education bridges gaps and promotes a symbiotic relationship between research and policy/practice. Different nations have gerontology education
systems of different types and different levels of development. Presenters, who direct and teach in university-level gerontology education programs,
will explore the session theme in two ways: 1) describing gerontology education in their countries/cultures, and how it facilitates and promotes linking
research to policy/practice, and; 2) discussing the need for a truly international, cooperative, collaborative approach to gerontology education. The
latter focus respects various cultural views of and approaches to gerontology education, yet seeks “best practices” and works toward a set of
“universal” gerontology education delivery structures and processes. The ultimate goal is to institutionalize global gerontology education within an
organization such as IAGG or the Association for Gerontology in Higher Education.
GEROCENTER: BRIDGING EDUCATION, RESEARCH AND PRACTICE IN FINLAND
GERONTOLOGY EDUCATION IN THE NETHERLANDS AND THE BENEFITS OF A EUROPEAN UNION MASTERS IN GERONTOLOGY
GERONTOLOGICAL NURSING EDUCATION IN THAILAND: PAST, PRESENT AND FUTURE
THE DA VINCI PROJECT: COLLABORATIVE DEVELOPMENT OF A UNIVERSAL GERONTOLOGY CURRICULUM
INTERGERO: A EUROPEAN-AMERICAN GRADUATE GERONTOLOGY COLLABORATION
Chair(s)
Edwin Rosenberg Dept. of Sociology, Appalachian State University, Boone, NC 28608 USA [email protected] +1-828-262-6146
____________________________________________________________________________________________________________
ID: 560
UNDERSTANDING AND COMPARING PUBLIC AND PRIVATE GUARDIANSHIP IN THE UNITED STATES AND IN FRANCE
Pamela Teaster (University of Kentucky, Graduate Center for Gerontology, United States)
Pamela Teaster, United States of America (1) Karen Roberto, United States of America (2) Erica Wood, United States of America (3) Marie Mercat-Bruns, France (4)
(1) University of Kentucky (2) Virginia Tech (3) American Bar Association, Commission on Law and Aging (4) Sciences Po
Guardianship is a relationship created by law in which a court gives one person (the guardian) the duty and power to make personal and/or property
decisions for another (the ward or incapacitated person). The appointment of a guardian occurs when a judge decides that an individual lacks capacity
to make decisions on his or her own behalf. Adult guardianship protects at-risk individuals and provides for their needs while at the same time
removing most of their fundamental rights. Guardianship can “unperson” individuals and make them “legally dead.” Guardianship can be a
double-edged sword, or, according to one commentator, guardianship is “half Santa and half ogre.” Guardianship can be both public and private.
Private guardians can be family members or trained professionals, often paid by the estate of an incapacitated person. Public guardians serve in a
last resort function. Because, under public guardianship, the incapacitated person is usually indigent, the state typically pays for the guardianship.
Once a guardianship is instituted, it generally lasts the rest of the life of the individual deemed incapacitated. Although the reach of guarianship over
the freedom of an incapacitated adult is vast, surprisingly little is known about the phenomenon.
The purpose of this symposium is to provide an understanding and comparison of laws and practices for public and private guardianship in the United
States and in France. Research findings from the most comprehensive evaluation of public guardianship in the United States will inform both private
and public guardianship laws and practices.
UNDERSTANDING LAW AND PRACTICE OF GUARDIANSHIP IN THE UNITED STATES
RESULTS FROM A NATIONAL STUDY OF PUBLIC GUARDIANSHIP IN THE UNITED STATES
FINDINGS FROM THE EVALUATION OF PUBLIC GUARDIANSHIP IN THE COMMONWEALTH OF VIRGINIA
UNDERSTANDING LAW AND PRACTICE OF GUARDIANSHIP IN FRANCE
Chair(s)
Pamela Teaster 306 Wethington Health Sciences Building, 900 South Limestone, University of Kentucky, Lexington, Kentucky 40536-0200
[email protected] 859.257.1450 x80196
____________________________________________________________________________________________________________
ID: 562
FROM SENSORS TO INFORMATICS-BASED TELEHOMECARE: MAKING REMOTE MONITORING WORK
Mary Parker (MKHP Associates, LLC, , United States)
Andrew Sixsmith, Canada (1) David Kutzik, United States of America (2) Anthony Glascock, United States of America (3) Charles Willems, The Netherlands (4)
(1) Simon Fraser University (2) Drexel University (3) Drexel University (4) Vilans
For the last decade remote monitoring of behavior and vital signs has been promoted as an effective means of enhancing patient centered care in the
home. Yet widespread adoption by care provision systems has not occurred in the US or anywhere in the world. Speakers will address the reasons for
this lack of large scale adoption by focusing on what needs to be done to overcome systemic impediments.
Findings, both positive and negative, will be presented from studies of remote monitoring systems deployed in a variety of care provision settings in
the US, Canada and the Netherlands. Four levels of analysis will be addressed: technology (sensor-based data gathering), implementation (integration
into the specific care provision practices of each site), care (how information from monitoring affected care provision), and, informatics (the
presentation and use of actionable information by care providers).
The papers will report on the use of behavioral, vital signs and environmental extreme remote monitoring applications in the field. Appropriate ‘user
centered’ design issues will be discussed from development to implementation with respect to the transformative impact of these technologies, i.e.
how they transform the way care is delivered.
The presenters represent leading researchers and developers of telecare and tele-rehabilitation technologies.
Andrew Sixsmith will provide a
conceptual framework based on his wide ranging experience with ICT development projects in Europe and Canada with a focus on how to improve the
design and development process to ensure that new technologies are centered on the needs of elderly and frail populations rather than the needs of
engineers. David Kutzik will analyze the role of care provision protocols which integrate information from monitoring systems into the care delivery
practice, the essential component for successful use of remote monitoring as a tool for enhanced care provision. Anthony Glascock will discuss the
leading role played by information and informatics in remote monitoring and argue that a paradigm shift from a focus on sensor technology to “care
informatics” is necessary in order to move beyond an obsession with gadgetry to person-centered homecare. Charles Willems will discuss the
problems and potential of informatics-based remote monitoring based on a series of field experimental studies of the use of such technologies by care
providers in the Netherlands.
Following the individual presentations, there will be an open discussion led by Mary Parker, focusing on the next steps to effectively use remote
monitoring in care provision.
DEVELOPING USER-DRIVEN APPROACHES TO RESEARCH AND DEVELOPMENT FOR AMBIENT TECHNOLOGIES
IT’S ALL ABOUT IMPLEMENTATION: LESSONS LEARNED FROM THE USA, THE UK AND THE NETHERLANDS
CARE INFORMATICS: THE MISSING LINK IN REMOTE MONITORING IMPLEMENTATION
INTEGRATING BEHAVIORAL MONITORING IN TELEHOMECARE: A REPORT FROM THE NETHERLANDS
Chair(s)
Mary Parker 920 South Alfred Street, Alexandria, VA 22314
[email protected] 703-519-8621
____________________________________________________________________________________________________________
ID: 589
ACADEMIC CAREERS IN GERIATRICS: AN INTERNATIONAL COMPARISON ABOUT DEMANDS AND SUCCESS
Cornel Sieber (Friedrich-Alexander-Universität, Lehrstuhl für Innere Medizin-Geriatrie, Germany)
Cornel Sieber, Germany (1) Sebastien Weill-Engerer, France (2) Pierre-Olivier Lang, Switzerland (3) Mustafa Cankurtaran, Turkey (4)
(1) Friedrich-Alexander-Universität (2) Hopital Rothschild (3) Hopital des Trois Chênes (4) Hacettepe Universitesi Hastanesi
This symposium will focus on the situation of universitary positions an academic careers in geriatrics in several countriesac, and the comparsion
between countries, with two main points:
- Number and proportion of geriatricians having a universitary position in their country, and evolution.
- Conditions needed, theoretically and practically, to achieve a universitary position in each country, mean age of nomination, and evolution.
The speakers will attempt to draw a picture of the situation and perspective of academic carreer in several countries, and will try to adress the
perspectives of evolution.
Speakers will use the European Academy for Medicine of Aging (EAMA) network to assess global situations of different countries, including their own.
ACADEMIC CAREERS IN GERIATRICS: SITUATION IN NORTHERN EUROPE
ACADEMIC CAREERS IN GERIATRICS: SITUATION IN SOUTHERN EUROPE
ACADEMIC CAREERS IN GERIATRICS: SITUATION IN EASTERN EUROPE
ACADEMIC CAREERS IN GERIATRICS: SITUATION IN MIDDLE EAST ASIA
Chair(s)
N. N. N. [email protected] N.
N. N. N. [email protected] N.
____________________________________________________________________________________________________________
ID: 595
LIFTING THE VEIL: THE SLOW EMERGENCE OF ELDER ABUSE AND ELDER JUSTICE IN THE INTERNATIONAL CONSCIOUSNESS
Marie-Therese Connolly (Wilson Centre, Law and Policy, United States)
Marie-Therese Connolly, United States of America (1) Laura Watts, Canada (2) Dominque Predali, France (3) Laura Mosqueda, United States of America (4)
(1) Wilson Centre (2) Canadian Centre for Elder Law (3) Dominque Predali (4) University of California, Irvine
Elder abuse, neglect and exploitation has eluded meaningful public attention for decades and has been the subject of insufficient resources, training,
research, infrastructure and legislation around the world. Why? This symposium will provide a snapshot of current challenges faced in many
countries. It will also discuss some promising and groundbreaking programs designed to address the issue, particularly in the United States and
Canada, in the areas of health care, law, social services and advocacy.
VISITOR TO MANY COUNTRIES, CITIZEN OF NONE - HOW ELDER ABUSE WENT MISSING FROM THE US LANDSCAPE
A STEP IN THE RIGHT DIRECTION - SETTING A NATIONAL AGENDA ON ELDER ABUSE FOR CANADA (THE NATIONAL INITIATIVE FOR
CARE OF THE ELDERLY)
12+ ANGRY GERIATRICIANS -INTERNATIONAL SNAPSHOTS OF ELDER ABUSE
BEYOND CSI: PROMISING MEDICAL AND FORENSIC PRACTICES IN ELDER ABUSE
Chair(s)
____________________________________________________________________________________________________________
ID: 612
SILVER WORKERS INSTITUTE SESSION
Yung-Ping Chen (University of Massachusetts Boston, Gerontology, United States of America)
Genevieve Reday-Mulvey, Switzerland (1) Roland Sigg, Switzerland (2) Peter Buckle, United Kingdom (3) Jurgen Deller, Germany (4) Leena Maxin, Germany (5) Bert
Lokhorst, The Netherlands (6)
(1) Geneva Association (2) International Social Security Association (3) University of Surrey, Robens Centre for Public Health Ergonomics (4) Leuphana University of
Lüneburg, Faculty of Business Administration, Behavioural Sciences and Law, Department of Business Psychology (5) Leuphana University of Lüneburg, Faculty of
Business Administration, Behavioural Sciences and Law, Department of Business Psychology (6) Expertisecentrum LEEFtijd
The proposed symposium, "Silver Worker Institute Session," is designed to introduce and discuss a number of initiatives and developments on older
worker employment in several European countries such as the UK, Germany, The Netherlands, and France. After the first speaker points out the key
policies and practices for older workers in Europe, another speaker will discuss how to retain and recruit older workers from the point of view of
ergonomics (i.e., re-design of work and of workplace). Following it, one speaker will present and discuss the findings of a major survey in Germany of
retired staff in paid and non-paid work, another speaker will report on the progress of providing part-time employment to older workers in the
Netherlands, and finally, the last speaker will discuss the measures and problems in employing older workers in France.
As background, it should be noted that the proposed symposium has been organized with the full support of the "Silver Workers Institute," which was
created in 2007 after years of intense work on the employment of older persons at the Geneva Association. The Institute is part of the Four Pillars
Programme, established in 1987 at the Geneva Association, formally known as the International Association for the Study of Insurance Economics,
founded in 1973 and based in Geneva, Switserland. The Four Pillars Programme has been dedicated to research on social security, occupational
pensions, insurance and savings, and employment of older people. And the Silver Workers Insitute is a research and policy advisory centre on
productive aging of the Geneva Association.
It should also be noted that the proposed symposium contributes to the ongoing discussions of population aging with its far-reaching implications for
many fields including but not limited to social, psychological, economic, and political. The proposium is also timely and important in light of a recent
OECD publication, "Living Longer, Working Longer."
KEY POLICIES AND PRACTICES FOR SILVER WORKERS IN EUROPE (BY GENEVIEVE REDAY-MULVEY AND ROLAND SIGG)
UNDERSTANDING THE WORKPLACE DESIGN FOR OLDER WORKERS (BY PETER BUCKLE)
AN EMPIRICAL STUDY OF ECONOMIC AND VOLUNTARY WORK OF RETIRED STAFF (BY JURGEN DELLER AND LEENA MAXIN)
PROGRESS TOWARDS THE EMPLOYMENT OF SILVER WORKERS THROUGH PART-TIME WORK (BY BERT LOKHORST)
Chair(s)
Yung-Ping Chen 1897 Beacon Street, Newton, MA, USA [email protected] 0011+ 1+ 617+ 2440080
____________________________________________________________________________________________________________

ID: 36 Theme: Behavioural and psychological sciences

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