This study utilized 1985 United States National Ambulatory Medical Care Survey data to explore the relationship between the drug prescribing phenomenon, measured by inappropriate prescribing and by prescription volume, and patient age. Inappropriate prescribing was relabelled potentially undesirable prescribing because limited medico-social patient information restricting circumstantial knowledge could result in an oversimplified and unduly critical judgment of prescribing. Categories of potentially undesirable prescribing were developed: 1) more than one drug in the same class; 2) drug classes not to be combined; 3) drugs serving sub-optimal treatment; and 4) drugs and diagnoses not to be combined. Of 67 different generic drugs representing 13 drug classes studied, 242 products were prescribed to the sample of 33,574 patients age 45+ years. Potentially undesirable prescribing was found to be a common problem regardless of type of medical practice and the sex of the patient: it is related to the age of the patient. The adverse effect of visiting a general practitioner is greater for older patients; and the adverse effect of attending a practice in a non-metropolitan area is larger for the older patients.

Geriatric consultation programs have been developed to service elderly patients in a number of acute care hospitals. Evaluation studies examining their utility have shown variable results. Suggested explanations for these inconsistent findings include differing study designs, various service delivery strategies, differing outcome measurements, and site-specific factors. The evidence suggests that the critical variable may well be the methods utilized in patient recruitment. Further work is required in a number of areas such as: (1) development of optimal targeting strategies, (2) determination of appropriate service composition and function, (3) study of how these programs interact with other components of a comprehensive geriatric program, (4) documentation of the long-term (1 year) impact on assessed patients, and (5) evaluation of the institutional impacts of these programs.

This paper examines subjective well-being among Native and non-Native elderly persons. Though much has been written about Natives as a disadvantaged group in terms of income, education and health, studies which examine the subjective well-being of Natives are virtually non-existent. Subjective well-being is measured as general satisfaction with life and loneliness in this paper. Independent variables include demographic, health and social indicators. Natives have significantly lower life satisfaction than non-Natives. However, logistic regression analyses indicate that health and social factors are the major predictors of quality of life. While Natives experience a lower quality of life, it is accounted for by their worse health and disadvantaged social circumstances and is not attributable to being Native per se.

There has been considerable speculation relating the neuroanatomic changes during normal aging with corresponding neuropsychological sequelae. This paper examines the empirical support for the hypothesis that the greatest structural changes in normal aging occur in the frontal-subcortical axis, and that these produce a similar pattern of neuropsychological performance to that seen in younger individuals with subcortical damage. In this study, 14 normal elderly, 12 younger patients with HIV encephalopathy, and 14 young neurologically intact control subjects were studied with a neuropsychological test battery. The results demonstrated that the normal elderly and HIV encephalopathy patients evidenced a strong similarity in both level and pattern of neuropsychological performance despite their considerable age disparity. These results support the notion that normal aging differentially affects functions subserved by frontal-subcortical brain regions.

This study investigated the speed of short-term memory scanning in two groups of patients: patients with Parkinson's disease (PD) (primarily subcortical pathology) and patients with a presumptive diagnosis of dementia of the Alzheimer type (DAT) (primarily cortical pathology). Non-demented PD patients (M age = 58.3), mildly demented DAT patients (M age = 67.0), and normal control (NC) subjects (M age = 58.9) were compared to one another in order to determine whether the presence of slowed scanning differentiates subcortical from cortical pathology. The three groups did not differ significantly on the memory scanning task. Slowed scanning speed does appear to occur in some patients with PD, however. This may relate to age, duration of disease, or an interaction between these two. Despite normal scanning speed, most DAT patients required highly structured instructions to be able to carry out the item-recognition task, and many remainedunable to perform this task even with additional instructions.

In an experimental evaluation of a “friendly visitor” type of program in which adolescents visited senior citizens, it was found that general attitudes toward elderly people (measured by the Semantic Differential developed by Rosencranz and McNevin) improved following weekly contact with specific elderly persons. One of the weaknesses in research on this type of intervention has been the assumption that the quality of the contact was uniform, and the impact of quality was rarely assessed. In the present study, the perceived quality of the experience was found to have a significant impact on improving attitudes. Programs such as the one evaluated here can, therefore, have two outcomes: the provision of service to elderly individuals and the change of negative attitudes toward elderly people.

Inappropriate prescribing to the elderly is a serious problem and is one factor contributing to adverse drug reactions in this group. It is well-known that reliance on promotional literature for prescribing information leads to less appropriate prescribing. This study surveyed ads in two major Canadian medical journals which portrayed people who appeared to be over 65 years of age. The elderly were shown in just over 7 per cent of the ads. These ads did not appear to take into account the special drug needs of the elderly. Ads featuring the elderly could lead to inappropriate prescribing because of their pictorial content, their written content or a combination of both. Further research into this area is needed, specifically directed at factors which influence prescribing to the elderly. In the meantime physicians dealing with the elderly should critically analyse the message in drug advertisements and be aware of the risks of using them for therapeutic information.

This study evaluates the leisure participation of tenants, living in two apartment buildings in relation to sex, maternal language, education, leisure motivation and participation in a senior citizen's club. The data analysed through a general linear model revealed five statistically significant types of leisure activities: (a) parochial, (b) physical, (c) popular, (d) social, and (e) organized groups. The implications of these results for recreation specialists working with the elderly in apartment buildings are discussed.

The Fraboni Scale of Ageism (FSA) is introduced in this study with reports of its factor structure, internal consistency reliability, and its relationship to The Acceptance of Others Scale, The Facts on Aging Quiz, and The Marlowe-Crowne Social Desirability Scale (N = 231). The FSA construct is derived from Butler's (1978) definition of ageism, and is intended to measure the affective component of attitude to supplement the cognitive aspect measured by other instruments. The FSA was found to have adequate construct validity and high internal reliability. Relationships to the other constructs measured supported the uniqueness of the FSA and revealed a lack of influence from social desirability. Sex was found to account for some variance in FSA scores.

There is currently a scientific debate over the question of the existence of profiles of cognitive decline in old age which would be independent of social, health, generational factors and psychometric artefacts. This essay is a critical literature review which comes to the conclusion that evidence from neurology and neuropsychology strongly suggests the existence of such profiles. In addition, it is shown that the currently dominant neuropsychological model of aging postulates a decline of executive and mnemonic functions as a direct result of deterioration of frontal and temporal brain systems with advancing age.

This book contains a collection of works revolving around the care given to the elderly affected by cognitive defects. This text is particularly significant because it identifies the problems relating to the delivery of care within the institutions, and home care. As well, the book helps direct the development of palliative care. Although it appears to be primarily intended for nursing personnel, professional as well as non–professional care givers would find it a useful source of information.

Cultured Type II Diabetic Fibroblasts displayed no in vitro age-related changes in insulin - or serum-stimulated hexose transport. Additionally, the use of a dexamethasone amplified response protocol allowing use of near physiological concentrations of insulin (6.7 nM) also showed no in vitro age-related change in insulin-stimulated hexose transport in these cultured Type II Diabetic fibroblasts. The data indicate that Type II Diabetic fibroblasts express no differential in response to insulin or serum during aging in vitro.

Controversy continues over the relationship between calcium intake and bone density in women. Epidemiological evidence does not strongly support the conclusion that high levels of dietary calcium during the postmenopausal years influence the extent or rate of bone loss. Dietary calcium in the growing years may be a determinant of peak adult bone density attained at maturity. Experimental trials do not appear to support the contention that calcium supplementation will restore lost bone in healthy or osteoporotic postmenopausal women. However, an increased calcium intake to an optimal individual level may slow the rate of bone loss in postmenopausal women. The cross-sectional and controlled investigations regarding the relationship between calcium intake and bone density will be discussed in this review.