Social Work Today E-Zine

With 76 million baby boomers on the retirement horizon, “we need to develop a new paradigm where instead of seeing aging as loss, we see aging as something that involves gain," says John Krout, PhD, professor of gerontology and director of the Gerontology Institute at Ithaca College. He explains that a growing body of research shows the aging brain is not all a story of decline.

Under Krout’s leadership the Gerontology Institute recently launched a Center for Creativity and Aging—The Linden Center. “The Linden Center responds to a public imperative, on the local and national level, to explore and understand how older people can continue to flourish creatively and remain engaged,” says Krout. The center will provide grants to faculty and students funding research, model programs, internships, and public education on creativity in the later stages of life. Additionally, the center will develop community-linked programs involving elders exploring creative arts for the first time, as well as engaging college students with elders.

“We need to think of our aging population as a rich resource and I think boomers are the leading edge of a potential revolution in old age. They will change how our institutions relate to older adults and how we define old age for our family and ourselves. They [boomers] are astute politically and will demand solutions to their problems and the issues they care about, particularly about their quality of life; they will not retire to the front porch,” says Krout. “Boomers present new and exciting opportunities for greater creativity in all walks of life.”

— Source: Ithaca College

Older African Americans with HIV/AIDS frequently draw upon their spiritual beliefs to cope with the disease but rarely disclose it to friends inside or outside the church, according to a study conducted by University of Alabama (UA) researchers.

The study, presented at the International AIDS Conference in Mexico City, is one of the first to look at the stigma of AIDS in older, rural African Americans in the South. It is authored by Pamela Payne Foster, MD, MPH, a physician and deputy director of UA’s Rural Health Institute for Clinical and Translational Science, and Susan Gaskins, DSN, ACRN, a professor of nursing in UA’s Capstone College of Nursing.

Seventy-five percent of those in The University of Alabama study indicated they didn’t feel they could be open with others about their illness. “Nondisclosure is a way that people manage the stigma they experience,” Gaskins said. “It’s how they protect themselves.”

Because the disease is primarily spread by unprotected sex with an infected partner, women who contract the virus often fear others will think they are promiscuous, the researchers said.

Although 31% of all new HIV infections in the United States in 2006, according to statistics from the Centers for Disease Control and Prevention, occurred via heterosexual contact, the incorrect stereotype that HIV only affects homosexual men adds much to the stigma men feel, the researchers said.

Study participants who did disclose their disease most often told their moms and/or their sisters, the researchers found. Since disclosure was so limited, participants reported experiencing little to no direct stigma from others, but experienced the most stigma related to their internalized shame, the researchers said.

The 24 men and women in the four focus groups the UA researchers studied were all 50 and older and had a confirmed diagnosis of HIV. Most of them never considered themselves at risk of contracting the disease, the researchers said.

“They saw it as a young person’s disease,” said Foster. “They think they are immune … being over 50.”

— Source: University of Alabama

In the year following Hurricane Katrina, the health of survivors aged 65 and over declined nearly four times that of a national sample of older adults not affected by the disaster, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Researchers monitored enrollees of a New Orleans-area managed care organization and found morbidity rates increased 12.6% compared with 3.4% nationwide. The results are published in The American Journal of Managed Care.

“In the year following Hurricane Katrina, morbidity rates increased substantially,” says Lynda Burton, ScD, lead author of the study and an adjunct associate professor with the Bloomberg School’s department of health policy and management.

Researchers examined the managed care organization claims of 20,612 white and nonwhite residents of New Orleans, Jefferson, St. Tammany, and Plaquemines parishes who were over the age of 65 and enrolled in Peoples Health, a provider-owned managed care organization. Burton, along with colleagues, conducted an observational study to compare mortality, morbidity, and services used for one year before and after Hurricane Katrina.

The researchers found that emergency department visits increased 100% in the month following Katrina, and by 21% over the next year compared with the pre-Katrina year. Hospitalization rates increased 66% in the first month after Katrina and maintained an increase of 23% over the ensuing year.

“The enormous health burden experienced by older individuals and the disruptions in service utilization reveal the long-term effects of Hurricane Katrina on this vulnerable population,” says Jonathan Weiner, DrPH, senior author of the study and director of the Bloomberg School’s PhD Program in Health Services Research and Policy. “Although quick rebuilding of the provider network may have attenuated more severe health outcomes for this managed care population, new policies must be introduced to deal with the health consequences of a major disaster.”

— Source: Johns Hopkins Bloomberg School of Public Health

At least one in 25 older adults (about 2.2 million people in the United States) take multiple drugs in combinations that can produce a harmful drug-drug interaction, and one half of these interactions involve a nonprescription medication, researchers from the University of Chicago Medical Center report in The Journal of the American Medical Association.

"Older adults are the largest consumer of prescription drugs," says study author Stacy Tessler Lindau, MD, an assistant professor of obstetrics and gynecology and of medicine at the University of Chicago Medical Center. "We find that they commonly combine these prescription medications with over-the-counter medications and dietary supplements, which can increase their vulnerability to medication side-effects and drug-drug interactions."

The study used data collected for the National Social Life, Health and Aging Project, a nationally representative multipurpose survey of adults aged 57 to 85 administered between July 2005 and March 2006. The survey team interviewed 3,005 participants in their homes about the medications they used every day or every week. About 2,970 respondents completed the interview and medication log.

Of those that responded, 91% regularly used at least one medication and 29% took more than five prescription medications; 68% of those who took prescription drugs also used over-the-counter medications or dietary supplements; men were more likely to take over-the-counter medicines, while women were more likely to use supplements in addition to their prescription; and nearly one half of the drug-drug interactions identified could cause bleeding problems.

"Physicians and pharmacists need to ask their patients about the use of nonprescription medications," said Lindau. "Patients need to inform their providers about all medications they use--prescription and nonprescription--and should ask their physician or pharmacist about interactions any time they start a new drug, on their own or following the doctor's recommendation."

— Source: University of Chicago Medical Center

A study in the Journals of Gerontology: Psychological Science found that older people tend to feel about 13 years younger than their chronological age. The researchers analyzed the responses of 516 men and women aged 70 and older who participated in the Berlin Aging Study, tracking how their perceptions about age and their satisfaction with aging changed over a six-year period.

"People generally felt quite a bit younger than they actually were, and they also showed relatively high levels of satisfaction with aging over the time period studied," says Jacqui Smith, PhD, a psychologist at the University of Michigan Institute for Social Research.

"We examined individual changes over time, and expected the gap to increase. But we were surprised to find that it was maintained, on average. Perhaps feeling about 13 years younger is an optimal illusion in old age," Smith says.

Smith and colleagues found that some of the oldest participants did feel even younger over time. But poor health reduced the gap between felt age and actual age.

In general, women perceived their appearance as being closer to their actual age, Smith says. "Women saw themselves as about four years older than their male peers," she says. "There are several likely reasons for this gender gap in subjective physical age. One is that women may be more aware of their appearance than men, especially given the negative stereotypes of older bodies."

Initially, men were more satisfied than women with their own aging. But over the six-year period studied, men's satisfaction decreased more than women's. Poor health magnified these patterns, Smith says.

"Feeling positive about getting older may well be associated with remaining active and experiencing better health in old age," she says. "Thus, studies on self-perceptions of aging can contribute to our understanding of potential indicators of resilience in older adults and the aging self."

— Source: University of Michigan Institute for Social Research

Precautionary health measures such as mammograms and cholesterol tests that identify the risk of heart disease are critical for the well-being of women over 50. Add the responsibility of providing sustained care for a grandchild, and these preventive examinations become even more important.

“Given that this group is already at risk for poor health outcomes because of their advanced age and vulnerability to chronic conditions, poor preventive behavior might precipitate a decline in health over time, a situation which could render the grandmother unable to care for her grandchild,” explains lead author, Lindsey Baker, a postdoctoral fellow at the University of Southern California Davis School.

In a recent paper in the Journal of Gerontology, researchers looked at five types of protective health behaviors. Their findings indicate that grandmothers in the early stages of caring for a grandchild were significantly less likely than grandmothers not raising grandchildren to undergo flu vaccination or cholesterol screening. They were also less likely to get Pap tests, the researchers found.

However, after two years of caring for a grandchild, what was once a health burden becomes a potential health benefit. Researchers found that caregiving grandmothers were increasingly health conscious once they made the transition into full-time care, becoming more likely than those not raising grandchildren to adopt preventative health measures such as flu vaccinations and monthly breast self-exams.

“Long-term caregivers are particularly motivated to maintain a healthy lifestyle, in order to be prepared to care for the child in the future. As grandmothers adapt to their new role, this motivation begins to outweigh constraints on service use,” Baker says.

The lower incidence of preventive healthcare in the first two years of raising a grandchild was true even among grandmothers for whom raising a grandchild was not a financial or emotional strain, according to the study.

“This implies that even grandparents and grandchildren in households traditionally seen as stable and therefore not generally targeted by state and federal programs, may be at adverse risk if lower use of health screening results in greater prevalence of disease and disability among caregiving grandparents,” Baker says.

— Source: University of Southern California

Compared to their younger counterparts, older problem gamblers who ask casinos to bar them from returning are three to four times more likely to do so because they fear they will kill themselves if they don’t stop betting, according to a new study.

Researchers Lia Nower, JD, PhD, of the Rutgers University Center for Gambling Studies, and Alex Blaszczynski, PhD, of the University of Sydney, Australia, looked at 1,601 self-described problem gamblers who asked between 2001 and 2003 to be banned from Missouri casinos. The results of their study were published in Psychology and Aging.

Older adults, aged 55 and older in this study, reported gambling an average of 17 years before “self-exclusion”—more than twice the length of time reported by younger adults. All participants were asked to cite the main reason or reasons why they sought to be barred from casinos. Younger, middle-aged, and older adults all gave as the primary reasons gaining control, needing help, and hitting rock bottom. However, nearly 14% of older adults surveyed, a higher proportion than any other group, indicated they sought help because they wanted to prevent themselves from committing suicide.

“This is particularly troubling because, irrespective of age, problem gamblers have reported rates of suicidal ideation and/or attempts as high as six times those found in the general population,” Nower says.

— Source: American Psychological Association