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The models of successful and/or active aging implicitly rely on the hypothesis of a strong biological limit to human longevity. This chapter explores this dimension of the models through three sections presenting the continuous increase in life expectancy, exploring the “rectangularization” of the survival curve and introducing the revolution of adult longevity. When we began to observe a decrease in mortality among the oldest old people, it was not understood that our species begun to change its longevity. The next three sections ask whether centenarians are a model of successful ageing, explore the variability of end-of-life trajectories and discuss the existence of a possible trade-off between longevity and functionality. It is clear that the majority of the centenarians do not meet the criteria for successful ageing. There is also a correlation between the age at death and the number of months spent with disability in the last year of life. These results suggest that the longer one lives, the more difficult it is to meet the criteria of successful ageing. Therefore, a more dynamic vision of successful ageing should be developed. Otherwise every advance in terms of longevity will be paid by an apparent decline in terms of successful ageing.
Recent studies show that more people than ever before are reaching old age in better health and enjoying that health for a longer time. This Handbook outlines the latest discoveries in the study of aging from bio-medicine, psychology, and socio-demography. It treats the study of aging as a multidisciplinary scientific subject, since it requires the interplay of broad disciplines, while offering high motivation, positive attitudes, and behaviors for aging well, and lifestyle changes that will help people to stay healthier across life span and in old age. Written by leading scholars from various academic disciplines, the chapters delve into the most topical aspects of aging today - including biological mechanisms of aging, aging with health, active and productive aging, aging with satisfaction, aging with respect, and aging with dignity. Aimed at health professionals as well as general readers, this Cambridge Handbook offers a new, positive approach to later life.
The increasing use of antidepressants (ADs) has raised concerns about their inappropriate use in old people.
To examine the prevalence of potentially inappropriate prescribing (PIP) of ADs, their associated factors, and their impact on mortality in a sample of old people in France.
The analysis used data from the SIPAF study, a cross-sectional study consisting of 2,350 people aged ≥ 70 years. Trained nurses interviewed participants at home between 2008 and 2010. Information was collected concerning socio-demographic and health characteristics, including medication use. The study population consisted of the 318 AD users from the SIPAF study (13.5%). PIP of ADs was defined according to national and international criteria. Factors associated with PIP of ADs were assessed using a multivariate logistic regression model. The influence of PIP of ADs on mortality was assessed using a Cox model (median follow-up 2.8 years).
Among the SIPAF study, 71% of AD users were female and the mean age was 84 ± 7 years. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed ADs (19.8%). We found PIP of ADs in 36.8% of the study population, mainly the co-prescription of diuretics with SSRIs (17.6%) and the prescription of tricyclics (12.9%). PIP of ADs was associated with polypharmacy (aOR5-9 drugs 2. 61, 95% CI 1.11–6.16 and aOR≥10 drugs 2.69, 95% CI 1.06–6.87) and comorbidity (aOR3-4 chronic diseases 2.59, 95%CI 1.04–6.44 and aOR≥5 chronic diseases 2.33, 95%CI 0.94–5.79), and increased the risk of mortality during follow-up (aHR 2.30, 95%CI 1.28–4.12).
This study shows that more than one third of AD prescriptions may be inappropriate in old people. PIP of ADs was related to polypharmacy and comorbidity and increased mortality among AD users.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
This study explores the relative contribution of the overall quality of attachment to the mother, to the father and to peers (Inventory of Parent and Peer Attachment scales), the style of attachment towards peers (Attachment Questionnaire for Children scale), the social rank variables (submissive behavior and social comparison), and sex and age variables in predicting the depression score (Center of Epidemiological Studies Depression Scale) on a non-psychiatric sample of 13-18 year old adolescents (n = 225). Results of our integrated model (adjusted R-Square of .50) show that attachment variables (overall quality of attachment to the father and to the mother), social rank variables (social comparison and submissive behavior), age and sex are important in predicting depressive symptoms during adolescence. Moreover, the attachment to peers variables (quality of attachment to peers, secure and ambivalent style of attachment) and sex are mediated by the social rank variables (social comparison and submissive behavior).