OBJECTIVES. This study investigated the role of low normal cognitive function in the subsequent loss of independence in activities of daily living. METHODS. Of the 678 elderly nuns who-completed cognitive and physical function assessments in 1992/93, 575 were reassessed in 1993/94. Mini-Mental State Examination scores were divided into three categories and related to loss of independence in six activities of daily living. RESULTS. Participants with low normal cognitive function at first assessment had twice the risk of losing independence in three activities of daily living by second assessment relative to those with high normal cognitive function. This relationship was largely due to a progression from low normal cognitive function at first assessment to impaired cognitive function at second assessment and was associated with an elevated risk of losing independence in the six activities. CONCLUSIONS. Progression from low normal to impaired cognitive function was associated with loss of independence in activities of daily living. Thus low normal cognitive function could be viewed as an early warning of impending cognitive impairment and loss of physical function.
This study found that alexithymia was more highly correlated with binge eating than with either anorexia or bulimia. In addition, a significant history of trauma and health problems for those who reported as binge eaters was reported. Implications for practice are discussed.
Objectives. Self-rated function is a new global measure. Previous findings suggest that self-rated function predicts future functional decline and is strongly associated with all-cause mortality. We hypothesized that the strength of the relationship of self-rated function to all-cause mortality was in part due to functional decline, such as would occur with brain infarcts.Methods. Self-ratings of function and health (on a 5-point scale, ranging from excellent to poor) were assessed annually on 630 participants in the Nun Study. Mortality surveillance extended from October 31, 1991 to March 1, 1998, and, among those who died, neuropathological examination determined postmortem evidence of brain infarcts. Cox regression modeling with self-rated function and health as time-dependent covariates and stratification by assessment period were used in these analyses.Results. Self-rated function and health ratings of good, fair, and poor were significantly associated with doubling of the risk of mortality, compared with ratings of very good and excellent. Self-rated function ratings of fair or poor were associated with a threefold increase in the risk of mortality with brain infarcts, but self-rated function and health ratings of fair and poor were comparable in their association with all-cause mortality and mortality without brain infarcts.Discussion. Self-rated function was significantly associated with mortality with brain infarcts, suggesting that brain infarcts may be experienced as functional loss but not recognized or labeled as disease. Our results suggest that self-rated function and health should be explored simultaneously in future research. S TUDIES in a variety of populations indicate a consistent association between self-ratings of health and risk of mortality
Background: Widespread negative attitudes toward aging in the U.S. are obstacles to training care providers and providing high quality care. Studies identifying educational effects on attitudes toward older people are still inconclusive. Objective: To examine the impact of learning experiences on university student attitudes toward older people. Methods: Design: A quasi-experimental design with a comparison group study. A total of 147 students registered in nursing and non-nursing programs completed three instruments measuring attitudes toward aging at three month intervals. All nursing students in the study were undertaking gerontology nursing course. Results: All participants expressed more positive attitudes in direct measures than indirect measures. Nursing students taking this gerontology course had significantly lower negative attitudes and negative feelings toward older adults, lower anti-age bias, and improvement in pro-age bias over time as compared to non-nursing students. Conclusions: The findings suggest that: 1) improved knowledge and clinical experience of aging reduce negative attitudes and are fundamental steps in developing positive attitudes for caring for older adults; and 2) comparative research using multiple measures provides a better understanding of attitudes toward older people.
Substantial gaps exist between the number of older adults requiring competent geriatric care and the number of nurses able to provide it. The purpose of this study was to develop, implement, and evaluate a geriatric nurse education program to ensure nurses meet the needs of the increasing elderly population. Establishing partnerships between individuals in academia and those in a clinical practice was imperative in the development of the program. Content for the program was created with the assistance of a geriatric nursing consultant and approved by the State Nurses Association. The program was piloted with 18 participating nurses. Using paired ttests, pretests and posttests revealed significant improvements in the level of knowledge and attitudes toward older adults. As a result of the program, participants showed improved attitudes toward and increased knowledge of older adults' needs, and further program development and dissemination are planned nationally and abroad.
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