Changes in health behaviors of elderly people (≥65 years old) in Brazil included in the National Health Survey 2013 (n=7,712) and 2019 (n=15,926) were analyzed. Cross-sectional study compared ...prevalence estimates and 95% confidence intervals (95% CI) of current and past smoking; alcohol abuse; leisure-time physical activity; consumption of fruit and vegetables. Differences were considered statistically significant at the 5% level. All positive health behaviors increased significantly over the period. The consumption of fruit and vegetables was the most prevalent, and smoking cessation the one that grew the most. The consumption of fruit and vegetables, physical activity during leisure time and alcohol abuse prevailed in the capitals, with current and past smokers prevailing in the interior. Men had higher estimates of current and past smoking and alcohol abuse. In younger women, alcohol abuse significantly increased. Leisure-time physical activity did not differ between the sexes. Women consumed more fruit at all ages and years, but vegetables depended on age and year. The prevalence of healthy behavior has increased in Brazil. However, individual and contextual inequalities have remained and affect the achievement of more positive levels of health.
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•A method for improved sustainability and resilience in elderly housing is proposed.•A control strategy is developed for space conditioning systems in elderly homes.•Multi-objective ...optimization is used to determine optimal refurbishing parameters.•The strategy reduced cooling energy by 61% while achieving elderly thermoneutrality.•Refurbishment reduced energy consumption by 38% & improved heatwave resilience.
Refurbishing buildings to minimize lifecycle costs and increase reliance on natural ventilation may reduce building resilience to extreme weather. This is critical for elderly whose health is affected by exposure to thermally stressful conditions. This study proposes a novel approach for refurbishing elderly houses to enhance their sustainability and heatwave resilience with the aim of supporting low-income groups. This approach involves using multi-objective optimization to identify refurbishment parameters and an autonomous control strategy to provide thermoneutral indoor conditions at a low cost.
The optimization procedure and control strategy were applied to a case study for a representative apartment in the Mediterranean climate using a validated building model. The strategy led to substantial reduction (61%) in cooling energy, while the optimization yielded Pareto solutions that showed trade-offs between lifecycle cost and resilience. A selected solution resulted in reduced electrical usage for heating (37%) and cooling (45%) and decreased indoor overheating during heatwaves. The study recommends design features for cost-effective and resilient elderly housing in the Mediterranean climate, such as limited window area, enhanced thermal properties, and a modest air conditioning system for low-income populations. Larger windows and AC systems are recommended for high income populations seeking reduced operational expenses and improved sustainability.
The study proposes an approach to assess a hidden aspect of energy poverty (EP) in Poland. We consider households' energy under-consumption driven by low energy efficiency and budgetary constraints. ...A household is exposed to hidden energy poverty (HEP) if it's total disposable income after deducting the expected housing cost falls under the established threshold. To approximate the expected total housing expenditures, the data from the EU-SILC dataset on dwellings parameters, households' attributes and regional characteristics of Poland is used.
The results show that in 2017 the scale of exposure to HEP in Poland was 23.7 per cent and this phenomenon is to some extent linked to income poverty. There is a clear distinction between subjective EP indicators and exposure to HEP. Two different profiles of exposed to HEP households in Poland are constructed. The first group lives in detached houses and is composed of households with dependent children. The second group consists of elderly people inhabiting blocks of flats. Both groups should be targeted by separate policies.
•A hidden aspect of energy poverty in Poland is considered.•A difference between exposure to hidden energy poverty and income poverty is revealed.•The scale of exposure to hidden energy poverty in Poland is about 24 per cent.•Two distinct profiles of exposed to hidden energy poverty households in Poland are constructed.
The prevalence of atrial fibrillation (AF) increases with age. The prescription of anticoagulation in very elderly patients is controversial and sometimes underused. Our objective is to report the ...incidence and predictors of major bleeding in anticoagulated nonagenarian patients with non valvular atrial fibrillation (NVAF).
We analyzed a large multicentre registry of anticoagulated nonagenarian patients diagnosed with NVAF from three health areas of Spain, between 2013 and 2017. Predictors of major bleeding were studied with a competing risk analysis and the impact of major bleeding with a time-dependent mortality analysis.
The incidence rate of major bleeding was 5 per100 person-year (95% Confidence Interval CI: 4.59–6.35), similar in the group of patients with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOAC). In the VKAs group we found as predictors of major bleeding: previous admission for bleeding (sub-distribution hazard ratio sHR 3.25, 95% CI: 1.48–7.13), creatinine (sHR 1.38, 95% CI: 1.16–1.64,) and control out-of-range INR (sHR 1.90, 95% CI: 1.02–3.55). In DOAC group, male sex (sHR 1.92, 95% CI: 1.18–3.13) and the history of previous admission for bleeding (sHR 2.60, 95% CI 1.33–5.06) were found as a predictor. The HAS-BLED was not associated with major bleeding. Major bleeding was associated with increased mortality in both VKAs and DOAC groups without significant differences.
We found an incidence rate of major bleeding with relative low values, similar in those treated with VKAs and those treated with DOAC, with different predictors of major bleeding in each group. Major bleeding was associated with increased mortality, with no significant difference by oral anticoagulation therapy (OAT).
•The incidence rate of major bleeding in nonagenarian patients underwent oral anticoagulation therapy (OAT) is low.•Different predictors of bleeding were found for vitamin K antagonists (VKAs) and direct oral anticoagulants (DOAC). 3) HAS-BLED was not a predictor of major bleeding in our study with nonagenarians.
The aim of this study was to evaluate the quality of life of the elderly and compare it between men and women. In this cross-sectional study, four elderly homes in the city of Ardabil were randomly ...selected (two male elderly homes and two female elderly homes) and then 60 elderly (36 female and 24 male) They were asked to answer the SF-36 questionnaire and then the data were analyzed using SPSS 21 software and descriptive and inferential statistics. The results showed that the mean scores of elderly residents of Ardabil in the nursing home in each of the eight sub-scales of the quality of life questionnaire were lower than those of non-elderly people in similar research. Also, the mean scores of these people's quality of life were lower than other elderly people in other studies, and they only had higher scores in terms of energy-fatigue. Another finding of this study was that elderly men had significantly higher scores in energy-fatigue subscales (t = 2.73, p = 0.008), emotional well-being (t = 2/05, p = 0.04) and physical pain (t = 0.22, p = 0.05). According to the results, it seems that the elderly residents of the elderly homes of Ardebil are not well-positioned in terms of quality of life. Although it is inevitable to reduce the quality of life in old age, failure to address the conditions of the elderly and their quality of life can impose material and immaterial costs on the society and these people themselves.
This study classifies municipalities according to the demography of the population aged 75 and over, and identifies the years in which the population aged 75 and over peaks in each municipality. We ...classified the population dynamics of the 75 years old and over in municipalities into ten types and showed them on a national map. We found that 14.45% of the target municipalities have already reached their peak, and that 40.31% of them will reach their peaks in 2030. This means that around 2030 is the period of maximum demand for senior care facilities in Japan.
This systematic review reports the most recent literature regarding the effects of physical exercise on muscle strength, body composition, physical functioning and inflammation in older adults. All ...articles were assessed for methodological quality and where possible effect size was calculated.
Thirty-four articles were included - four involving frail, 24 healthy and five older adults with a specific disease. One reported on both frail and nonfrail patients. Several types of exercise were used: resistance training, aerobic training, combined resistance training and aerobic training and others. In frail older persons, moderate-to-large beneficial exercise effects were noted on inflammation, muscle strength and physical functioning. In healthy older persons, effects of resistance training (most frequently investigated) on inflammation or muscle strength can be influenced by the exercise modalities (intensity and rest interval between sets). Muscle strength seemed the most frequently used outcome measure, with moderate-to-large effects obtained regardless the exercise intervention studied. Similar effects were found in patients with specific diseases.
Exercise has moderate-to-large effects on muscle strength, body composition, physical functioning and inflammation in older adults. Future studies should focus on the influence of specific exercise modalities and target the frail population more.
In elderly chronic kidney disease (CKD) patients, isolated systolic hypertension is common, the rate of renal function decline is slow, and there is a high possibility of physical damage due to side ...effects such as drug use-related orthostatic hypotension. Therefore, there are still many questions about whether lowering blood pressure in elderly patients will actually improve prognosis. Since many blood pressure-related clinical studies exclude advanced CKD and the elderly, it is particularly difficult to define target blood pressure in these populations. A randomized controlled trial is needed to establish optimal blood pressure targets and treatment strategies in elderly patients with CKD. This review seeks to summarize the guidelines available at this time.
