No abstract

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.

Persistent population aging worldwide is focusing attention on modifiable factors that can improve later life health. There is evidence that religiosity and spirituality are among such factors. Older people tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide. Despite increasing research on religiosity, spirituality and health among older persons, population aging worldwide suggests the need for a globally integrated approach. As a step toward this, we review a subset of the literature on the impact of religiosity and spirituality on health in later life. We find that much of this has looked at the relationship between religiosity/spirituality and longevity as well as physical and mental health. Mechanisms include social support, health behaviors, stress and psychosocial factors. We identify a number of gaps in current knowledge. Many previous studies have taken place in the U.S. and Europe. Much data is cross-sectional, limiting ability to make causal inference. Religiosity and spirituality can be difficult to define and distinguish and the two concepts are often considered together, though on balance religiosity has received more attention than spirituality. The latter may however be equally important. Although there is evidence that religiosity is associated with longer life and better physical and mental health, these outcomes have been investigated separately rather than together such as in measures of health expectancy. In conclusion, there is a need for a unified and nuanced approach to understanding how religiosity and spirituality impact on health and longevity within a context of global aging, in particular whether they result in longer healthy life rather than just longer life.

This study clarifies the process by which mortality and disability interact to determine differences in active life expectancy by age, sex, race, and education for the U.S. population 70 years of age and over. The analysis is performed using data from the Longitudinal Study of Aging and multistate life tables constructed using the results of hazard models. Women spend more years than men both active and inactive at every age; however, the proportion of life that is expected to be active is smaller for women. These differences are largely due to mortality differences favoring women. Persons with less than a high school education have shorter total and active life expectancies but similar expected lengths of inactive life compared to those with more than a high school education. There are no significant race differences in total life expectancy for race-education groups of the older population; but Blacks have lower expected active life than non-Blacks because of worse functioning.

Intrinsic circuit of the superior colliculus (SC), in particular the pathway from the optic tract (OT) to neurons in the intermediate layer (SGI), was investigated by whole-cell patch-clamp recording in slice preparations obtained from 17- to 24-d-old rats. Stimulation of the OT induced monosynaptic EPSPs in neurons in the superficial gray layer (SGS) and the optic layer (SO), and disynaptic or polysynaptic EPSPs in a majority of SGI neurons. Stimulation of the SGS induced monosynaptic or oligosynaptic EPSPs in the SGI neurons. Both the monosynaptic EPSPs induced in the SGS/SO neurons by stimulation of the OT and those induced in the SGI neurons by stimulation of the SGS were mediated by AMPA- and NMDA-type glutamate receptors. Thus, we have clarified the existence of the glutamatergic excitatory pathway from the OT to the SGI neurons via SGS and SO neurons. The EPSPs in the SGI neurons induced by stimulation of the OT or SGS were remarkably enhanced by bicuculline, suggesting that the signal transmission in this pathway is under strong suppression by the GABAergic system.

The longitudinal study revealed a statistically significant relationship, controlling for other relevant factors, between DIS and the presence of depression three years later, but not between EMA or DMS and depression. Based on our findings, we recommend that the association between insomnia subtypes and depression be studied longitudinally in clinical settings.

The Longitudinal Study on Aging (LSOA) and the National Health Interview Survey (NHIS) are used to examine change in the prevalence of disability from 1982 through 1993 for persons 70 years of age and over. Changes in the likelihood of becoming disabled and the likelihood of recovering from disability also are investigated with the LSOA. There is some evidence for improving disability status among the old. The prevalence of disability is somewhat lower in more recent years in the NHIS; also, the incidence of disability is lower, and the rate of recovery higher during 1988-90 than in the 1984-86 interval. On the other hand, the prevalence of disability increases at some dates after 1984 in the LSOA sample. In both datasets, there is fluctuation rather than a clear trend in the prevalence of disability. Continued steady improvement in rates of onset and recovery and a consistent trend toward improving prevalence is needed before concluding that we are witnessing the beginning of an ongoing trend toward improving health among the older population.

The lack of significant differences in life expectancy by obesity status among the old suggests that obesity-related death is less of a concern than disability in this age range. Given steady increases in obesity among Americans at all ages, future disability rates may be higher than anticipated among older U.S. adults. In order to reduce disability among future cohorts of older adults, more research is needed on the causes and treatment of obesity and evaluations done on interventions to accomplish and maintain weight loss.