Personality and health in middle age as predictors for well-being and health in old age

In research literature, the question to what extent specific personality traits and health functioning in midlife can predict physical and psychological well-being in old age is still discussed controversially. The present study aims to shed light on this issue by using data from the Basel Longitudinal Study on Ageing. Structural equation modelling was performed in order to test the relation between personality dimensions, namely, self-preoccupation and emotional reactivity, as well as cardiovascular functioning (blood pressure) and medication intake (tranquilizer use) in middle age on psychological and physical well-being and health as assessed in old age 24 years later. Results show that high levels of self-preoccupation in middle age are negatively related to psychological and physical well-being in old age, but not to medical diagnoses. In addition, blood pressure and tranquilizer use in middle age predict physical well-being in old age; blood pressure is furthermore related to medical diagnoses. Our findings emphasize the importance for the adoption of a life-span approach and further interdisciplinary prospective studies in order to better predict pathways to well-being and health in old age.

Late-life Widowhood and Meaning in Life

The relationship between elders’ marital status and length of widowhood, as well as other personal and familial resources and the sense of meaning in life, as defined by logotherapy, was tested among 180 Israeli elderly community dwellers aged 64–95. Results show that an event such as late-life widowhood can create a loss of the sense of meaning in life. In addition, a significant difference was found between married and recently widowed elders in relation to meaning in life. Other variables that affected and explained meaning in life were subjective health, education, the quality of social support relationships, and activity level. The results support Frankl’s logotherapy approach, underscoring the importance of helping older people in general, and the widowed elders in particular, to discover and create new life meanings.

Autoimmune Lebererkrankungen

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A new comprehensive and international view on ageing: introducing the ‘Survey of Health,Ageing and Retirement in Europe’

This paper introduces the ‘Survey of Health, Ageing and Retirement in Europe’ (SHARE) to researchers on ageing. SHARE provides an infrastructure to help researchers better understand the individual and population ageing process: where we are, where we are heading to, and how we can influence the quality of life as we age, both as individuals and as societies. The baseline wave in 2004 provides data on the life circumstances of some 27,000 persons aged 50 and over in 11 European countries, ranging from Scandinavia across Western and Central Europe to the Mediterranean. SHARE has made great efforts to deliver truly comparable data, so we can reliably study how differences in cultures, living conditions and policy approaches shape the life of Europeans just before and after retirement. The paper first describes the SHARE data. In order to demonstrate its value, it then presents highlights from the three main research areas covered by SHARE, namely economics, sociology, and health.

How to understand and improve older people’s self-management of wellbeing

This paper addresses the question of how older people can be supported to actively self-manage their own process of ageing such that overall wellbeing is achieved and maintained for as long as possible. Starting from a resource-based approach, a new theory of self-management of wellbeing (SMW theory) is proposed, and it is shown how it can be used as a basis for the design of self-management interventions for ageing successfully. The main aspects of the theory, i.e. six key self-management abilities and the core dimensions of wellbeing, are presented as well as the theory-based ‘blueprint’ for the design of interventions. Empirical results of two intervention studies are briefly presented and show that the SMW theory may be a useful tool for the design and evaluation of interventions for successful ageing.

The Influence of Integration on the Expenditures and Costs of Mental Health and Substance Use Care: Results from the Randomized PRISM-E Study

We compared the healthcare costs associated with an integrated care model to an enhanced referral model for the treatment of depression, anxiety, and at-risk drinking from the randomized Primary Care Research in Substance Abuse and Mental Health for the Elderly study. We examined total healthcare costs and cost components, separately for Veterans Affairs (VA) and non-VA participants. No differences in total health expenditures were detected between study arms. No differences in behavioral health expenditures were detected for non-VA sites, but the VA integrated arm had slightly higher ($38; p < 0.05) behavioral health costs. Differences in other types of services use were detected.

Contribution of Lifestyle to Positive Ageing in Hong Kong

The Objective of this study is to examine the knowledge, use, and development of a healthy lifestyle, and the association with positive ageing, in a convenient sample of 2,970 community-living Hong Kong Chinese People aged 40–74 years stratified by age. A questionnaire containing items from these three domains (avoidance of disease, physical and cognitive functioning, engagement with life) was administered from which a positive ageing index was calculated. A lifestyle score was calculated from information regarding current knowledge, use, and development of a healthy lifestyle (relating to diet, exercise rest and relaxation, smoking habit and alcohol use). The association between lifestyle score and the positive ageing index was weaker compared with income and education level. We conclude that knowledge, use and development of a healthy lifestyle did not contribute greatly to the positive ageing process.

Esophageal Adenocarcinoma: Pseudo-Nutcracker Esophagus

Pseudoachalasia due to adenocarcinoma is well known. We report a case of nutcracker esophagus in the setting of outflow obstruction from esophageal adenocarcinoma. Endoscopy is warranted to exclude similar lesions in patients with “pseudo-nutcracker esophagus”.

ElderLynk: A Community Outreach Model for the Integrated Treatment of Mental Health Problems in the Rural Elderly

In 2000, a rural consortium of health care education and service providers established a geriatric mental health outreach program (ElderLynk) for the underserved elderly (aged 65 and older) in ten rural counties in northeast Missouri. ElderLynk evaluated the efficacy of an integrated community-based treatment model through the creation and evaluation of a clinical database. Ten rural counties in northeast Missouri were chosen because they were designated as mental health shortage areas (MHSAs) and because their elderly population approximates the projected level of elderly in the USA in 2020. All patients were managed by a geriatric nurse with treatment planning and oversight provided by a community-based interdisciplinary team which included a psychiatrist, geriatrician, psychologist, and social worker. Using the Geriatric Depression Scale (GDS); the Government Performance and Results Act data (GPRA) to assess life satisfaction, independence/autonomy, psychosocial functioning, and overall health; the Instrumental Activities of Daily Living (IADL); the Mini-Mental Status Examination (MMSE); and patterns of service usage (number of hours of case management and number of counseling sessions), ElderLynk patients improved significantly in overall psychological functioning, level of depression, and reported life satisfaction despite significant declines in mental status, daily function, and overall health.

Kleinzelliges Lungenkarzinom (SCLC)

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Stellenwert des kontrastverst?rkten Ultraschalls bei der Beurteilung des Morbus Crohn

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Pleuraerkrankungen

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Diabetische Neuropathie – eine facettenreiche Krankheitskomplikation

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Nierenbeteiligung bei Systemkrankheiten

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Sport und Bewegungstherapie bei chronischen Lungenkrankheiten

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Physikalische und chemische Lungensch?den

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Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004

The objective is to assess if longer life in Belgium is associated with more healthy years through the evaluation of trends (1997–2004) in health expectancy indicators at ages 65 and 80 covering different health domains: self-perceived health, chronic morbidity, disease clusters, and disability. Information was obtained from Belgian Health Interview Surveys. Health expectancies were calculated using the Sullivan method. Among males at age 65, the increase in years expected to live without chronic morbidity, without a disease cluster or without disability exceeded the increase of the life expectancy (LE). The rise in LE in good self-perceived health was equal to the gain in LE. Among women at age 65 and among men and women at age 80, none of the changes in the expected years of life in good health in any health domain were statistically significant. At age 65 among women, the increase in LE was smaller than the increase in years without chronic disease or without disability. The increase in years without disease clusters was less that the LE increase. At age 80 among men, the years without disability increased as the LE, with a shift toward years with moderate limitations. In any other health domains for men (except co-morbidity) and in all domains for women the years in good health either decreased or increased less than the LE. The recent rise in life expectancy in Belgium is, among the youngest old and especially among males, accompanied by an improved health status. At age 80 and particularly among women expansion of unhealthy years prevails.

Diabetesbehandlung im Krankenhaus – Dringender Bedarf für strukturiertes Vorgehen

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Sip-Sizing Behaviors in Natural Drinking Conditions Compared to Instructed Experimental Conditions

To understand disordered physiology, it is first necessary to determine what constitutes normal function. Liquid sip size during swallowing in healthy individuals has been investigated with varied results. Bolus size is a variable that is manipulated in both research studies and clinical swallowing assessments, so defining normal sip size has relevance in both domains. This study looked at sip size under instruction in experimental tasks and compared it to sip size in free drinking while participants were unaware that drinking was being observed. A statistically significant difference was found in water sip volume between natural drinking (mean = 16 ml) and instructed experimental drinking tasks (mean = 6.6–6.8 ml). This difference far exceeded the magnitude of sip-size variation observed between instructed drinking tasks using different stimuli and as a function of participant’s gender or age group.