A comparison of physical health and psychosocial variables as predictors of reaction time and serial learning performance in elderly men

Psychosocial and Physiomedical Factors Affecting Outplacement of the Medically Disabled Elderly

Patients in a Veterans Administration medical center were classified according to whether or not they presented significant outplacement problems on discharge. Those with discharge problems were older and suffered more often from multiple medical problems. Pulmonary, cardiovascular, central nervous system, and behavioral problems all occurred significantly more often in this group. Based on the Older Americans Resources and Services (OARS) interview technique, these patients were also significantly more impaired in "social resources, " "mental health, "and "activities of daily living " than patients without discharge problems. These data contribute to establishing the validity of the OARS in the context of outplacement of the medically disabled elderly and suggest a profile of medical and nonmedical variables related to overall dysfunctioning in the medically disabled elderly person.

Exercise and aging. Issues for the practitioner

The elderly present the health care system with a number of challenges, the most important of which centers on the declining functional capacity associated with aging. It remains to be clarified the degree to which these changes are related to the interactions among aging, disease, illness, injury, lifestyle, genetics, and other variables. While these issues are being clarified, however, it is clear that a well-designed exercise program that is of low to moderate intensity may be the single, most cost-effective means of maintaining function. The exercise program needs to be goal-oriented and goal congruent, yet it must be individualized to account for existing impairments. General guidelines, such as those in Table 7, may be useful in maintaining a perspective on the regimen. Regardless of the degree of functional limitations, all elderly can derive some benefit from engaging in an exercise program. The emphasis of any regimen should be on quality-of-life issues, such as improving flexibility, strength, and mobility. For the vast majority of elderly, a simple walking program is probably the safest, most effective form of activity.

How Exercise Can Benefit Older Patients

In brief Physical activity has both preventive and therapeutic benefits for the frail elderly, and the ultimate goal is improved quality of life. The greatest impact on functional capacity comes from physiologic changes that affect mobility. Walking programs and flexibility and strength training can prevent muscle weakness and impaired gait and balance, which are risk factors for falls in the elderly. In addition, changes in functional capacity can result in greater independence in daily living. Physical activity also provides therapeutic benefits for patients who have arthritis or dementia.

Age-related decline of psychomotor speed: effects of age, brain health, sex, and education

A cross-sectional study into age-related decline of psychomotor speed is reported. A newly introduced choice response task was used, involving three conditions: simple reaction time (SRT), choice reaction time (CRT), and CRT with stimulus-response incompatibility. Subjects were 247 volunteers, aged 20 to 80 yr. in seven age levels. Although all subjects thought themselves to be normal and healthy, a post hoc division could be made based on biological life events (BLE, mild biological or environmental factors that can hamper optimal brain functioning, such as repeated general anesthesia). Performance was poorer by subjects who had experienced one or more such event: slowing was comparable to the effect of age, especially in the more difficult task conditions. There were significant effects of sex and education, men being consistently faster than women, and more highly educated subjects performing better than subjects with only low or medium education. These findings replicate observations from other test methods. They are also in line with several other studies giving interactions between the effects of aging and physical fitness. This study questions the validity of much research on aging, as the data suggest that a more rigorous health screening for biological life events in subjects recruited from the normal, healthy population can reduce performance effects normally ascribed to aging.

Some determinants of attrition in prospective studies on aging

Demographic measures, psychosocial variables, and objective and subjective measures of physical impairment were assessed in elderly men twice at intervals of 12 to 18 months. Canonical discriminant function analysis of the relationship between these predictor variables on the first testing and whether participants (a) returned for retesting, (b) did not return because of apparent disinterest, or (c) did not return because of illness or death, revealed two significant canonical variates. The first, characterized by decreased mental and physical capacity, discriminated between the deceased/ill group and the other two groups. The second was characterized by decreased social interaction and life satisfaction, and increased life events, and distinguished between the disinterested group and the other two groups. However, both groups that failed to return for retesting showed evidence of impaired physical health and a general disengagement from social and personal activities, compared to the retested group.

Attitudes towards aging and physical health

Brief narrative descriptions of four hypothetical individuals who differed in age and physical health were developed and presented to people who differed in age and sex. Each participant read only one of the four profiles. After reading the profile, the participant rated the profiled individual on the Rosencrantz and McNevin (1969) semantic differential scale of attitudes towards aging. Respondents were divided into a young group (29 years or younger), a middle-aged group (30-49 years), and an old group (50 years and older). No participant gender effects were found. All three age groups rated the older and younger profiles of persons in poor health more negatively than those describing healthy persons on each of the three dimensions of the Rosencrantz-McNeven scale. Older respondents tended to view the younger healthy profile and to a lessor extent the younger-sick profile more positively than the older profiles, but the young and middle-aged respondents viewed the older profiles more positively than the younger profiles on all three dimensions of the scale. These findings suggest that (a) a major component of negative attitudes toward the aged may be related to the more likely occurrence of physical illness in this age group, and (b) more negative attitudes toward the aged are more likely to occur in older than younger respondents regardless of health status.

The Older Americans Resources and Services interview and the medically disabled elderly

To determine which dimensions of the Older Americans Resources and Services (OARS) would best predict the status of the medically disabled elderly, veteran inpatients, outpatients, and nonpatient volunteers were administered the multidimensional functional assessment portion of the OARS. To determine whether any of the OARS subscales would be related to age-related functional deficits in this population, serial learning and differential reaction time were also assessed in these three groups of participants. Inpatients showed significantly more impaired ratings on all five of the OARS subscales than the outpatients and nonpatients, while outpatients were more impaired than nonpatients on two of the subscales (mental health and activities of daily living). However, physical health and mental health were the only OARS subscales consistently related to serial learning and reaction time performance. These data provide information about the validity of the OARS when used to assess the medically disabled elderly, and suggest a profile of variables that may contribute to overall dysfunctioning in the medically disabled elderly person.

Physical health correlates of attitudes toward aging in the elderly

Attitudes toward aging were assessed in three groups of elderly men (age 65-85), including: hospitalized veterans, veteran outpatients, and a group of non-hospitalized "healthy" veteran volunteers, using the Rosencranz and McNevin Semantic Differential Scale. Social objects rated included an "old man", a "young man", and the participant, himself, ("self"). Attitudes toward "old men" were significantly more negative than attitudes toward "young men" in all three groups. In addition, significant group by "object-rated" interactions were obtained on the autonomous/dependent and instrumental/ineffective dimensions of this scale. These interactions were attributable to a more negative "self" rating by the hospitalized group. These results suggest that within the population studied, older persons in poor health tend to view themselves more like the stereotyped "old person" than do healthy old people, who tend to perceive themselves as being more like a "young person".