Chapter 8

If we want more evidence-based practice, we need more practice-based evidence.*

Chapter 8
Aging and Health of Older Populations

Table of Contents

REFERENCES - since publication of 8th edition




Even Occasional Exercise Can Extend Life for Older People
July 2, 2004

Fitness standards track elderly. WASHINGTON (AP, June 4, 1999)- Just because one is 75, one shouldn't have trouble lifting a bag of groceries or getting up from a chair. But for millions of older Americans, those simple activities are a daily struggle. Disabling frailty doesn't have to be part of aging. In fact, studies have found that even 90-year-olds can rebuild lost muscle with some careful exercise. It would be better to never become so frail in the first place, and researchers have come up with a way to help: Fitness performance standards to let anyone 60 and older assess quickly if they're in good physical condition for their age, or if they're at risk of a downhill slide that could lead to a nursing home. See the April 1999 edition of the Journal of Aging and Physical Activity for the study results.

WHO Launches Project to Support Africa's Elderly - Senegal.
(Panafrican News Agency - May 26, 1999). - The team leader of WHO's program on "Ageing and Health" (AHE), Dr. Alexandre Kalache, said the project which begins in July will, among other things, involve the collection and analysis of relevant data from Ghana, Tanzania, South Africa and Nigeria.

Panel stumped on Medicare overhaul.
WASHINGTON (AP, Mar. 10, 1999) - Is restructuring Medicare  enough, or will more money be needed to provide adequate health care for growing numbers of elderly Americans? A commission that is supposed to recommend Medicare changes has so far been unable to
resolve that question and other serious differences delaying its report to Congress and President Clinton. "We are not in agreement yet and it remains quite doubtful that we will be," said commission member Stuart Altman, a health policy professor at Brandeis University in Waltham, Mass. Both Republican congressional leaders and the president have said they'd prefer not to resort to tax increases to bolster Medicare. But Clinton has suggested using federal budget surpluses that are expected in coming years.

UN conference on aging concludes UNITED NATIONS
(AP, Feb. 12, 1999) - Secretary-General Kofi Annan concluded a U.N. conference on aging Thursday by celebrating the graying of society, in particular the contributions of older women. The two-day conference on aging praised increased longevity as one of mankind's greatest achievements, with improved health, hygiene and nutrition extending most life spans despite such diseases as AIDS. According to U.N. population figures, dramatic increases in longevity have caused global life expectancy to climb 20 years since 1950 to its current level of 66 years. Figures for developed countries like Japan, Sweden and the United States are higher, and lower for places like Russia and Mali.

No Alzheimer's-fillings link found.
LEXINGTON, Ky. (AP, Feb. 8, 1999) - There appears to be no link between Alzheimer's disease and mercury used in dental fillings, say University of Kentucky researchers. Such a link has been speculated on in the past, as scientists took closer looks at the effects of heavy metals on the brain. But the University of Kentucky study said there appears to be no harm from mercury fillings.

"Although very small amounts of mercury are released from dental amalgam - generally when rubbed or abraded due to brushing or eating - it is not taken up by the brain," said Dr. Stanley Saxe, one of the authors of the study published in Monday's (Feb. 8, 1999) Journal of the American Dental Association.

Study refutes hypertension research.
CHICAGO (AP, Feb. 5, 1999) – Contrary to previous research, a new study found no direct link between high blood pressure and a decline in thinking ability as people age. "I'd hoped to find a really compelling relationship here, but...we just have very little information about what people can do to protect (themselves) from loss of their cognitive function," said the lead researcher,Dr. Robert J. Glynn of Brigham and Women's Hospital in Boston. He emphasized that controlling blood pressure is still vital to prevent heart disease and strokes, and that hypertension is often undertreated in the elderly.

For related news stories pre-1999, please click here. 



Seniors Participatory and Community Quality of Life Projects: and

Web sites on aging and the health of seniors:

Education on living options for seniors:

Social Security Administration - updates, information, services, research, questions, etc.

Information on building retirement income, managed health care, trends, etc. in Canada:

Coalition '99 Partnership for an Aging Society Focusing on the International Year of Older Persons and Beyond. Web site includes goals and events associated with the Year of Older Persons.

From the Globe and Mail’s <> special supplement on The International Year of the Older Person on May 22, 1999.

United Nations Division for Social Policy Development

UN Association in Canada

Canadian federal IYOP site

Health Canada Division of Aging and Seniors





U.S. Department of Health and Human Services


Connell, C. M. (1999). Older adults in health education research: some recommendations. . HEALTH EDUCATION RESEARCH 14(3): 427-431.

Liao, Y. L., McGee, D. L., Cao, G. C., Cooper, R. S. (1999). Black-white differences in disability and morbidity in the last years of life. AMERICAN JOURNAL OF EPIDEMIOLOGY 149 (12): 1097-1103.
    ABSTRACT: To assess black-white differences in disability and morbidity in the last years of life, the authors analyzed data from the National Health Interview Survey from 1986 to 1994, with mortality follow-up through December 1995. A baseline household interview was conducted for 10,187 decedents aged 50 years and over within 2 years before death. Data collected included long-term limitation of activity, number of chronic conditions, number of bed days, doctor visits, and days of short hospital stay during the year preceding the interview. For both blacks and whites, educational attainment was inversely associated with disability/morbidity indices. Black decedents had greater morbidity compared with whites, and this difference was consistent across educational levels. Adjustment for education reduced the black-white difference in limitation of activity score by 32%, bed days by 59%, and hospital stay days by 40%, This study from a national representative US sample indicates that black decedents experienced greater disability/morbidity and worse quality of life through their last few months or years of life. Educational attainment was associated with morbidity before death and accounted for much of the black-white difference.

Moyer, A., Coristine, M., MacLean, L., & Meyer, M. (1999). A model for building collective capacity in community-based programs: The Elderly In Need Project. PUBLIC HEALTH NURSING 16 (3): 205-214.
    ABSTRACT: As the focus of health promotion moves from individuals to organizations, communities and broader social policy, the models that guide public health program planning and development need reexamination. Public health nurses are gaining experience in strengthening and supporting the ability of communities to grow and change. This study aimed to illuminate the process. Data, gathered as part of an action research project to develop individual and community-based strategies to decrease isolation in frail older adults, provided a rich source of qualitative data. Analysis was directed toward identifying the factors and processes of capacity-building. The emerging model was clarified and partially validated with academics and practitioners from health promotion programs across the age span. Four stages of building collective capacity were identified: identifying common ground, working cooperatively, working in partnership, and working across the community. At each stage, processes of relationship building, project management and capacity-building resulted in stage specific products. A model of building collective capacity, grounded in community health practice and supported by the Literature provides a base for developing practice indicators, and practice guidelines which will strengthen the ability to reach health goals.

Odom, D. (1999). Editorial note. Child health, dissertation abstracts, new technology and revised contact information. EUROPEAN JOURNAL OF PUBLIC HEALTH 9 (2): 85.

Ryan, A. A. (1999). Medication compliance and older people: a review of the literature. INTERNATIONAL JOURNAL OF NURSING STUDIES 36 (2): 153-162.
    ABSTRACT: This critical review of the literature pertaining to medication compliance among older people included (a) a critique of the more commonly cited compliance theories, (b) an analysis of the key variables influencing medication compliance among older people and (c) a critical evaluation of the literature that examines these phenomena. Additional studies that explore the benefits of Self-Administration of Medication Schemes are examined for their coverage of the educational component as well as the behavioral component of a well-organized patient education program. The review covers material published in English since 1980 excluding literature on compliance theories that originated in previous decades. Search terms included medication, compliance, older people, self-medication and education. The literature was then critically reviewed using the criteria identified by Roe (1993) [Roe, B., 1993. Undertaking a critical review of the literature. Nurse Researcher 1(1), 35-46.] which emphasizes the need for clarity in key areas such as research design, sample selection, research methods, results, discussion and conclusions. Empirical studies that met these criteria were included in the review and in the main, were found in academic rather than professional journals. The review concludes with a summary of the main points and a discussion of the implications for nursing practice, education and research.

Sloan, F. A., Taylor, D. H. Jr, & Picone, G. (1999). Costs and outcomes of hip fracture and stroke, 1984 to 1994. AMERICAN JOURNAL OF PUBLIC HEALTH 89 (6): 935-937.
    The Journal’s Home Page is:
    ABSTRACT: Objectives. This study quantified changes in Medicare payments and outcomes for hip fracture and stroke from 1984 to 1994. Methods. We studied National Long Term Care Survey respondents who were hospitalized for hip fracture (n = 887) or stroke (n = 878) occurring between 1984 and 1994. Changes in Medicare payment and survival were primary outcomes. We also assessed changes in functional and cognitive status. Results. Medicare payments within 6 months increased following hip fracture (103%) or stroke (51%). Survival improved for stroke(P < .001) and to a lesser extent for hip fracture (P = .16). Condition-specific improvements were found in functional and cognitive status. Conclusions. During the period 1984 to 1994, Medicare payments for hip fracture and stroke rose and there were some improvements in survival and other outcomes.

Wilkins, K., Parsons, G. F., Gentleman, J. F., & Forbes, W. F. (1999). Deaths due to dementia: An Analysis of Multiple-cause-of-death Data. CHRONIC DISEASES IN CANADA 20 (1): 26-35.

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