Postural hypotension and diuretic therapy in the elderly.

Blood pressures were recorded in 319 ambulatory subjects, largely men, age 50 to 99 years. The mean systolic pressures were maximal in the seventh and eighth decades (136.0 and 132.1 mm Hg with the subjects supine and erect, respectively), whereas the mean diastolic pressures fell progressively after age 69. The distribution of postural changes in mean blood pressure was similar in each decade; a decrease of 20 mm Hg on more was noted in 3.4% of the subjects aged 80 to 99 years and in 4.1% of those aged 50 to 79 years. The frequency of postural hypotension was 4.6% in subjects treated with diuretics and 3.4% in those not so treated. Blood pressures and the frequency of postural hypotension did not progressively increase in age in this elderly population.     

Postural control adaptability to floor oscillation in the elderly

We established a method to evaluate postural control adaptability, applying it to 341 subjects, aged 18-29 years (young subjects) and 50-79 years, in order to investigate the influences of age and gender on adaptability. Subjects stood with eyes closed on a force plate fixed to a floor oscillator, which was sinusoidally oscillated in the anteroposterior direction with 0.5 Hz frequency and 2.5 cm amplitude. Five trials of 1-minute oscillation were conducted, with a short rest between trials. The mean speed of fluctuation of the center of foot pressure (CFP), as detected by the force plate, was calculated as an index of postural steadiness. Mean CFP speed decreased significantly in all age groups with trial repetition. The adaptability capability of elderly subjects was categorized as "good," "moderate," or "poor," as evaluated against a standard value, based on the variation of the regression of mean CFP speed between the 1st and 5th trials in young subjects. Results showed that the magnitude of reduction in the mean speed, with practice, was linearly related to the initial mean speed. We found a general decline in adaptability, and increase in initial mean speed, in subjects aged 60 years and older, with no gender difference detected in any age group. The proportion of subjects exhibiting moderate and poor adaptability increased gradually with age. In conclusion, age, but not gender, appears to affect adaptation of postural sway with short-term practice, although some elderly subjects maintain postural sway velocity and adaptability capabilities similar to those of young subjects.     

Postural stability and occlusal status among Japanese elderly

doi: 10.1111/j.1741‐2358.2011.00596.x
Postural stability and occlusal status among Japanese elderly Background: There are still no data available on the relationship between postural stability and occlusal status among the elderly. Objectives: To examine relationships between postural stability and occlusal status through a cohort study among elderly Japanese. Method: Oral examination, occlusal status, postural stability and a questionnaire were conducted and given to 87 community‐dwelling Japanese at enrolment. Results: The average occlusal pressure of the female group was statistically higher than the male group while average occlusal pressure and postural stability length were lesser in the group with more remaining teeth. Postural stability area and number of remaining teeth showed statistically significant correlations. Postural stability length was lesser in the group with strong occlusal force. Furthermore, the number of decayed teeth was fewer in the good hygiene group. Conclusions: This study identified a close relationship between occlusal status and postural stability of Japanese older individuals. Occlusal hypofunction was observed more in those with occlusal problems, and a decrease in their occlusal functions resulted in postural instability.     

Hearing impairment and mental state in the elderly living at home.

Altogether 153 (60%) out of a sample of 253 people aged 70 years and over living in their own homes were found to have impaired hearing when tested by pure-tone audiometry. This is almost twice the prevalence found in all other studies, in which deafness was assessed clinically or by self-reporting. The prevalence of deafness increased with age. Evidence of organic brain syndrome (dementia), as determined by questionnaire, was present in 39 (16%) out of 245 respondents, and of depression in 82 (35%). Dementia and depression were both age related. An apparent association between deafness and dementia was shown to be due to age alone. A significant relation between deafness and depression was independent of age and socioeconomic state. The use of audiometric techniques of assessment established that an association exists between deafness and depression that is not simply a function of differential reporting reflecting the emotional state of the respondent.     

Postural sway parameters using a triaxial accelerometer: comparing elderly and young healthy adults

The purpose of this study was to evaluate the sensitivity of 16 parameters derived from acceleration to detect changes caused by age and visual conditions during quiet standing and detect and minimise possible sources of unwanted variability that could affect accelerometer measures on the trunk. Twenty-seven healthy subjects, including 16 elderly (age, 69.3 ± 3.6 years) and 11 young (age, 23.6 ± 2.2 years) subjects, were evaluated. The parameters evaluated include root-mean-square values, fractal dimensions, path length, range, frequency dispersion and power spectrum among others derived from these values. These 16 parameters evaluated for each axis of movement and/or derivations resulted in 59 sub-parameters. These 59 sub-parameters were analysed in the elderly and young groups and under the open-eye and closed-eye conditions. The results showed that 30 sub-parameters detected differences for an age effect with open eyes, 18 detected differences with closed eyes, 25 detected differences for the young group standing with closed-open eyes and 37 detected differences for the elderly with closed and open eyes (p < 0.01). We used simple signal processing for the accelerometry signals to minimise the effects of unwanted variability that could affect the results. The results showed better performance compared with those results published previously using force platforms to evaluate postural sway. The results presented here should be useful for researchers who want to use accelerometry to evaluate steady postural balance.     

Association between dental health behaviours, mental/physical function and self-feeding ability among the elderly: a cross-sectional survey

Objectives : The aim of this study was to determine the association between dental health behaviour, mental/physical function and self‐feeding ability among the elderly. Subjects : A total of 414 elderly dental patients aged 65 years and older participated in this study. Methods : A survey was carried out for three years and seven months starting in January 1998 at the Chubu National Hospital. The patients or their carers were examined/interviewed about the severity of senile dementia, dental health behaviour, ability to rinse their mouths, ability to manage dentures, and ability to sit at a table during meals. To assess the association with self‐feeding ability among the elderly, cut‐offs were given for these variables, and then the odds ratios were calculated. Results : The strongest association to self‐feeding ability was marked by inability to rinse their own mouth, followed by inability to manage dentures, inability to sit at a table during meals, severe senile dementia and less frequency of toothbrushing. Conclusion : Elderly who have lost the feeding ability often could not maintain their dental health by themselves. Carers must provide not only a feeding service with acknowledgement of aspiration but oral care to prevent dental disease and fatal pneumonia in the elderly.     

Postural sway parameters using a triaxial accelerometer: comparing elderly and young healthy adults

The purpose of this study was to evaluate the sensitivity of 16 parameters derived from acceleration to detect changes caused by age and visual conditions during quiet standing and detect and minimise possible sources of unwanted variability that could affect accelerometer measures on the trunk. Twenty-seven healthy subjects, including 16 elderly (age, 69.3 ± 3.6 years) and 11 young (age, 23.6 ± 2.2 years) subjects, were evaluated. The parameters evaluated include root-mean-square values, fractal dimensions, path length, range, frequency dispersion and power spectrum among others derived from these values. These 16 parameters evaluated for each axis of movement and/or derivations resulted in 59 sub-parameters. These 59 sub-parameters were analysed in the elderly and young groups and under the open-eye and closed-eye conditions. The results showed that 30 sub-parameters detected differences for an age effect with open eyes, 18 detected differences with closed eyes, 25 detected differences for the young group standing with closed–open eyes and 37 detected differences for the elderly with closed and open eyes (p < 0.01). We used simple signal processing for the accelerometry signals to minimise the effects of unwanted variability that could affect the results. The results showed better performance compared with those results published previously using force platforms to evaluate postural sway. The results presented here should be useful for researchers who want to use accelerometry to evaluate steady postural balance.