Pasqualina Perrig-Chiello

Muscle strength in the elderly: Its relation to vitamin d metabolites

OBJECTIVE To identify a relation between loss of muscle strength and vitamin D deficiency in ambulatory elderly persons not receiving vitamin D supplementation. DESIGN Cross-sectional study. SETTING All measurements were taken at the Department of Geriatrics, University Hospital, Basel, Switzerland. SUBJECTS Three hundred nineteen patients (103 women, 216 men) selected by random sampling from participants in an ongoing interdisciplinary study on aging (mean age for women, 74.2 yrs; for men, 76.7 yrs). OUTCOME MEASURES Leg extension power (LEP) and body mass index (BMI); serum values of 25-hydroxyvitamin D [calcidiol, 25(OH)D], 1,25-hydroxyvitamin D [calcitriol, 1,25(OH)2D], and intact parathyroid hormone (iPHT). RESULTS Twelve percent of women and 18% of men had 25(OH)D values below the normal range (<12 ng/mL). Muscle strength was lower in older subjects (female: r = -.35; p = .0005/male: r = -.48; p < .0001) and was lower in women than in men (p < .0001). In men both 25(OH)D and 1,25(OH)2D was significantly correlated with LEP (r = 0.24; p = .0004/r = .14; p = .045). In women, only 1,25(OH)2D was significantly correlated with LEP (r = 0.22; p = .034). In an ANCOVA including all participants and explaining LEP by sex, age, BMI, 1,25(OH)2D, 25(OH)D, and iPTH, all factors showed significant effects except 25(OH)D and iPTH (r2 = .41). CONCLUSION Muscle strength declined with age in ambulatory elderly people and showed modest, but significant, positive correlation with 1,25(OH)2 vitamin D in both sexes and with 25(OH)D in male subjects. Therefore vitamin D deficiency appears to contribute to the age-related loss of muscle strength, which might be more pronounced in institutionalized elderly people with a high prevalence of vitamin D deficiency.

Impact of working memory training on memory performance in old-old adults

Memory impairments constitute an increasing objective and subjective problem with advancing age. The aim of the present study was to investigate the impact of working memory training on memory performance. The authors trained a sample of 80-year-old adults twice weekly over a time period of 3 months. Participants were tested on 4 different memory measures before, immediately after, and 1 year after training completion. The authors found overall increased memory performance in the experimental group compared to an active control group immediately after training completion. This increase was especially pronounced in visual working memory performance and, to a smaller degree, also in visual episodic memory. No group differences were found 1 year after training completion. The results indicate that even in old?old adults, brain plasticity is strong enough to result in transfer effects, that is, performance increases in tasks that were not trained during the intervention.

Apolipoprotein E genotypes and cognitive functions in healthy elderly persons

Objectives‐ We investigated whether apoE genotypes correlate with cognitive functions in clinically healthy persons. Methods ‐ In 1993 and 1995, we measured information processing speed, delayed free recall and semantic aspects of long‐term memory in 227 men and 105 women aged 65 and over, a randomly selected subsample of the prospective Basel Study. Cardiovascular risk factors and education were assessed. Results ‐E2 were more prevalent in old‐old (>75 years, 23.5% vs 15%) compared to E4 than in young‐old (<75 years, 19.3% vs 23.5%). Taking into account age and education, subjects with ɛ3/ɛ4 or ɛ4/ɛ4 alleles (E4) performed lowest in all 3 tests compared to those homozygous for ɛ3 (E3) or carriers of one or two ɛ2 alleles (E2) (reaction time P=0.009, free recall P=0.05, WAIS‐R vocabulary P<0.05). In old‐old there was a significant difference between E2 and E4 for reaction time (P=0.02) and free recall (P<0.02) but not for vocabulary (P=0.086). In all 3 groups there were no significant changes after 2 years. The subgroup with the genotype ɛ2/ɛ4 performed consistently best in the cognitive tests. Cholesterol was significantly increased in the E4 and E3 group compared to the E2 group. Conclusion ‐ ApoE genotype correlates with cognitive performance. The increased prevalence of E2 in the old‐old and the significantly lower plasma cholesterol levels suggest differential morbidity and mortality as important factors influencing the prevalence of cognitive disorders in late life.

Health control beliefs in old age-relationship with subjective and objective health, and health behaviour

The main purpose of this paper is to explore health control beliefs (internality, powerful others, chance) in different age cohorts of elderly people and to examine the relationship between health control beliefs and objective and subjective health, and health behaviour. This contribution shows data from an interdisciplinary longitudinal ageing study: (a) a descriptive analysis of age- and time-correlated changes in health control beliefs of different cohorts of elderly people by taking into account gender as a differential aspect; (b) group comparisons between objectively and subjectively healthy or sick people and their health control beliefs and health relevant behaviour. Participants are 442 community elderly, 309 men, 133 women, aged 65-94 years (mean age: 74.95 years). Our data demonstrate the dominance of chance control beliefs over internality and powerful others in all age cohorts. It can be concluded that internal control remains stable well into old age, whereas a significant age-correlated inc...

Personality and Memory in Old Age

We examined the impact of personality on episodic memory performance in a sample of 287 healthy adults aged 68-95 years. Extraversion and neuroticism were assessed with a standardized personality inventory. Episodic memory was assessed with an everyday task. Results from regression analyses controlling for the effects of age, gender, and education show that higher extraversion and lower neuroticism are associated with higher episodic memory performance. In addition, the strength of the correlations between neuroticism and episodic memory declined with increasing age in a male sub-sample, revealing an interaction between age and neuroticism.

Impact of physical and psychological resources on functional autonomy in old age

Abstract Functional autonomy is a core condition of successful ageing. To maximize autonomous functioning is not only a claim of social policy but also primarily an individual need. Part of the challenge of preventing unnecessary dependence in old age is to recognize the diversity among the elderly and the different availability of their physical, psychological and social resources. The aim of this study is to examine the age- and time-related changes in functional autonomy (activities of daily living, ADL, and instrumental activities of daily living, IADL) and the psychophysical resources correlated with these changes in a sample of 441 healthy elderly persons aged 65 – 95. Furthermore, we are interested in the long-term predictive power of physical resources (objective and subjective health, physical strength) and psychological resources (memory) on functional autonomy. Results show significant age- and time-related deteriorations in functional autonomy and in most psychophysical resources. Structural equation model analyses were performed to test the long-term predictive power of these resources. Results suggest that ADL is better predicted by physical resources than by psychological ones, but for IADL the reverse is the case; here memory variables play a dominant role. Physical and psychological variables are thus specifically related to different components of functional autonomy. This has to be taken into account in the development of preventive and intervention programmes.

Health and well-being in old age - the pertinence of a gender-mainstreaming approach in research

Background: The demographic and societal changes of the past decades, such as longevity and improvements in public health, have created new and often very distinct realities for men and women. However, these diversities have only marginally and fragmentally been the topic of research endeavours. There is a growing awareness of the societal phenomenon ‘feminization of old age’, yet the topic and its psychosocial and health-related consequences have not attracted the scientific interest they deserve. Due to scientific neglects and limitations, state of the art research in the field of gender, health and ageing is still sketchy and often contradictory. Objective: In the present article, the complex pattern of roles and values that define what is thought of as ‘masculine’ and ‘feminine’ and its significant impact on health-related lifestyles will be examined. Based on current research, we try to give answers to questions such as: ‘Do older women really have more physical and mental health problems than older men, or are these findings influenced by a gender bias, due to a different awareness and understanding of health and illness?’ It will be shown that it is impossible to find satisfactory answers to such questions without considering the cultural and social contexts of the individuals studied. The inclusion of gender as a social reality in the broadest sense is therefore an absolute prerequisite for gaining valid information. Conclusion: Gender has played only a marginal role in the hitherto existing geriatric and gerontological research and practice. Therefore, a gender-fair approach in research and practice is indicated, i.e. an approach that takes into account differences and commonalities of women and men and considers their differing circumstances and specific problems (gender mainstream). Gender mainstreaming entails on the one hand horizontal justice (denoting equal treatment and benefits for equal needs of men and women) and on the other hand vertical justice (indicating differential treatment and benefits for differential needs of the 2 sexes).

Aging parents and their middle-aged children: demographic and psychosocial challenges

The aim of this paper is to investigate the impact of an extended lifespan of parents on middle-aged women and men from a demographic, sociological and psychological perspective. Based on Swiss data, three main research questions are investigated and discussed in three different sections: (a) How far has the common lifespan of children and parents been extended and how does it affect kinship structures? (b) How accurate is the term of “sandwich generation” in this context? (c) Which are the psychological concomitants—in terms of filial maturity—of being reinvolved with one’s old parents in mid-life? The demographic analyses illustrate a considerable extension of common lifespan of children and parents. Combined with low fertility rates this results in rapidly increasing parent-support ratios. A sociological approach analysing the concept of “sandwich generation” indicates that, for women, a new kind of double burden (professional work and family care) is more widespread than being ‘sandwiched’ between the youngest and the oldest generation. Finally, in the third section, results are reported from a longitudinal study of middle-aged persons living in different social contexts (such as living or not living with a partner and/or children) on the intrapsychic concomitants of becoming reinvolved with one’s parents. The response patterns reveal a considerable intergenerational ambivalence. Although the possibility to help old parents depends heavily on living context and is a question of available resources, the willingness to help is also closely related to psychological variables such as attachment.

Role Involvement and Well-Being in Middle-Aged Women

ABSTRACT Objectives: The aim of this research was to shed light on the relation of social role experiences and health to well-being outcomes of 198 middle-aged (40–55 years old) Swiss women living in various familial contexts (double-track women, i.e., partnered working mothers, homemakers, single mothers, single women). Results: Our results revealed that the way roles were experienced was primarily a function of a specific living context and satisfying social resources. Double-track women and homemakers showed the highest social role satisfaction rates and had better health and well-being outcomes than other women. Common to all groups was a considerable difference between actual and desired role investment. Discussion: The findings are discussed in terms of a resource-oriented model of well-being.

Psychological interventions for infertile patients: a review of existing research and A new comprehensive approach

Abstract The usefulness of psychological support for infertile patients has been highlighted in the literature over the past number of years. This article provides a review of existing research on psychological interventions for infertile patients, and presents the Fertility Group Intervention as an example of the application of existing research. There is clear empirical evidence of high levels of depressive symptoms, anxiety, and distress among infertile patients undergoing assisted reproductive treatment (ART). Infertile patients need and require increased psychological support. Various studies indicate the efficacy of psychological interventions for infertile patients with respect to their mental health and, in part, pregnancy rates. However, many such studies exhibit methodological problems. Therefore, in future research, additional studies of high-quality design are needed to achieve more definitive answers on the efficacy and indication of psychological interventions for infertile patients. Current...