The aim of this study was to evaluate the effects of geriatric day care on patients and caregivers. Day care patients (n = 43) were compared with an untreated matched control group (n = 40). Matching criteria were age, gender, physical and mental health status, and socioeconomic status. The mean age of both groups was 79.5 years. Data were collected at three measurement points: T1 took place during the first 10 days of service use, T2 was conducted 6 months later, and T3 took place 9 months after service use began. In addition, a short follow-up was conducted 6 months after T3. Well-being, dementia symptoms, health indicators, and activities of daily living were investigated. Individual growth curves of these patient variables were computed and analyzed with multivariate analyses of variance. The results show significant positive effects of day care on well-being and dementia symptoms. Patients in day care stabilized or improved on various measures, whereas the untreated control participants worsened. Follow-up data showed a significant decline in health in the control group in comparison with the day care users. Results concerning effects on caregivers were not that clear. Individual change parameters in subjective well-being and burden did not differ between the two groups of caregivers in the longitudinal follow-up. In a semistructured interview, however, caregivers of patients in the treatment group reported substantial positive change due to use of day care.

Background and Objectives A good person–environment-fit has positive effects on well-being in old age. As digital technologies are an integral part of older adults’ environments, we predicted that the use of information and communication technologies (ICT) is associated with subjective well-being among the oldest-old. Specifically, we compared different user groups of ICT devices (nonusers, users of nonweb-connected ICT, users of web-connected ICT) and analyzed the relations among ICT use and three domains of subjective well-being (loneliness, anomie, autonomy). Research Design and Methods We performed a quantitative data analysis using data from the first representative state-wide survey study in North-Rhine Westphalia, Germany on quality of life and well-being of the oldest-old (n = 1,698; age range: 80–103; 9% long-term care). Multiple regression analyses were applied. Results The findings revealed that 25.9% of all individuals aged 80 years and older reported using web-connected ICT, in contrast to 38.5% who do not use ICT at all. Individuals who used web-connected ICT reported lower levels of loneliness and anomie, and higher levels of autonomy. These differences remain significant when controlling for indicators of social inclusion and individual characteristics. Discussion and Implications This study investigated an underexplored group in terms of ICT use, shedding light on the relationship between ICT use and subjective well-being. The oldest-old generally use ICT in their everyday life but an age-related digital divide still exists. To avoid negative consequences of nonuse digital infrastructures and technology training for older adults need to be established.

Research has attested to the prevalence of a "dependency-support" and "independence-ignore" script characterizing the interactions between staff and elderly residents in long-term care institutions. To examine whether the scripts could be modified, a staff training program (focusing on communication skills, knowledge about aging, and basic behavior principles) was implemented in 3 different institutions. Observational data on staff-resident interactions in the context of self-care were collected pre- and postintervention. Findings revealed significant changes for the experimental group. Specifically, a decrease in dependence-supportive behavior of staff and an increase in their independence-supportive behavior, an increase in independent behavior of residents, and an increase in independence-related interaction patterns were demonstrated.

All outcomes indicate a good psychometrical quality of the DIA-S. The new instrument showed a considerably higher discriminatory power for the items internal consistency and test specificity than the GDS-15.

Purpose of the study. The Depression in Old Age Scale (DIA-S), a new screening tool for geriatric depression, was designed to be both practical and appropriate for use with medically ill geriatric patients. The diagnostic accuracy of the DIA-S and the short form of the Geriatric Depression Scale (GDS15) were tested and compared. Methods. Using the Montgomery and Asberg Depression Rating Scale (MADRS) as gold standard, the scales were validated with a sample of N = 331 geriatric inpatients. Results. ROC curves, AUC outcomes, sensitivity and specificity, and logistic regression models for impact factors on misclassification rates indicate good psychometrical qualities of the DIA-S, whereas the validity of the GDS15 was lower.

BackgroundIn Germany, the very old are the most rapidly growing proportion of the population. A comprehensive investigation of the conditions for a good quality of life in this group is relevant for both society and politics.ObjectiveThe project “Quality of life and subjective well-being of the very old in North Rhine-Westphalia” (NRW80+) at the University of Cologne surveys quality of life of the very old. Taking into account many specific methodological and theoretical challenges, it aims at setting up a specific theoretical framework and methodological approach.MethodsExisting studies on quality of life in old age in Germany and abroad as well as models on quality of life are reviewed with respect to their relevance for the very old and their specific living conditions, needs and interests. A theoretical framework of quality of life in very old age is developed. The NRW80+ study combines three levels: the empirical level of description of life situations and conditions, the explanative level of evaluating models of quality of life and the normative level of societal and ethical standards and norms.ResultsConsidering results of recently conducted studies with the very old, an integrative conceptual model for studying quality of life of very old persons is introduced. In the model of challenges and potentials (CHAPO), environmental and individual factors as well as life chances and life results are thereby taken into consideration from a subjective as well as an objective point of view, supplemented by the concept of successful life conduct.ConclusionStarting from the CHAPO model of quality of life, the representative study NRW80+ aims at challenging methodological standards for the inclusion of the very old in social research thus providing the basis for further research as well as for sustainable social politics especially for the very old.

Mutations in the tumor suppressor von Hippel-Lindau (VHL) disease gene are responsible for almost all hereditary and most sporadic renal cell carcinomas. 1 Restoration of vhl gene expression is sufficient to suppress kidney tumor formation in vivo, suggesting that tumorigenesis is a direct effect of the loss of both VHL alleles. 2,3 pVHL, the protein encoded by the VHL gene, is evolutionarily conserved and serves as part of an E3 ubiquitin ligase complex that inhibits hypoxic signaling in the presence of oxygen through degradative ubiquitination of proteins of the hypoxia-inducible factor (HIF) family. 4,5 In addition, loss of VHL induces the formation of renal cysts and the development of polycystic kidney disease. Studies demonstrated a critical role for pVHL in controlling microtubule polarization and the formation of monocilia on various cell types linking pVHL to known pathways of cystogenesis. 6 -9 These findings provided a novel link between the formation of kidney cysts and renal carcinogenesis. 10 Despite recent advances in the understanding of pVHL function, the cell biologic and molecular basis of VHL-dependent cancer formation is far from being entirely understood. To address the in vivo function of pVHL, we analyzed the phenotype of vhl-1-defective nematode worms. Surprising, knockout of vhl-1 significantly increased lifespan in these animals as compared with wild-type controls ( Figure 1A). This result could be confirmed by knocking down vhl-1 through RNA interference (RNAi; Figure 1B). Taking into account the wellconserved role of vhl-1 in the degradative ubiquitination of hif-1, it may be speculated that altered levels of hif-1 are involved in the longevity phenotype as well. 11,12 Using hif-1;vhl-1 double knockout worms, we could show that the increase in lifespan is partly dependent on hif-1. In contrast to observations of Mehta et al., 12 loss of hif-1 partially but not entirely abrogated increased longevity (Supplemental Figure 1), suggesting a combination of hif-1-dependent and hif-1-independent effects. The lifespan of Caenorhabditis elegans (and of other species) is regulated by both genetic and environmental influences. [13][14][15] One study identified specific signaling components that regulate lifespan and demonstrated that loss-of-function mutations in the insulin/IGF-1-like (DAF-2) signaling pathway can dramatically increase the lifespan of the nematode. 16 Insulin signaling negatively regulates the forkhead (FOXO) transcription factor DAF-16, which ultimately functions to regulate both positively and negatively transcription of metabolic, ABSTRACTMany genes are responsible for the modulation of lifespan in model organisms. In addition to regulating adaptive biologic responses that control stress signaling and longevity, some of these genes participate in tumor formation. The mechanisms that determine longevity and link regulation of lifespan with tumorigenesis are poorly understood. Here, we show that the tumor suppressor von Hippel-Lindau (VHL), which has widely known roles in ren...

This study examined trajectories of awareness of age-related change (AARC; Diehl & Wahl, 2010) across 2 years in a large representative sample of very old adults. We also examined the predictive role of health, functional status, cognitive functioning, and engagement with life for AARC change. The initial sample comprised 1,863 individuals aged 80 years or older. Of the 1,612 individuals recontacted 2 years later, 912 took part in the follow-up. Measures included the AARC-Short Form, assessing perceived AARC Gains and AARC Losses. Measures of multimorbidity and functional health, a cognitive screening test, and indicators of engagement with life (e.g., leisure activity) were examined as predictors of AARC change, using semi-cross-lagged fixed effects modeling. Higher overall levels of AARC Gains were observed compared to AARC Losses for all but respondents aged 90 years or older. Intra-individual levels of AARC Gains decreased significantly over the 2-year period, whereas a significant increase was found for AARC Losses. AARC Losses across time were predicted by loss of instrumental activities of daily living (IADL) independence, but not by change in multimorbidity, cognitive performance, or engagement with life. One indicator of engagement with life, reduced leisure activity, predicted smaller AARC Gains at wave 2. These results were robust in models controlling for potential reverse causation. These findings suggest that a significant increase in perceived AARC Losses appears to be an inherent characteristic of very old age. Very old age may be a stage in life in which changes in multimorbidity and cognitive performance no longer impact individuals’ views on aging.