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Prevalence of arthritis according to age, sex and socioeconomic status in six low and middle income countries: analysis of data from the World Health Organization study on global AGEing and adult health (SAGE) Wave 1

Prevalence of arthritis according to age, sex and socioeconomic status in six low and middle income countries: analysis of data from the World Health Organization study on global AGEing and adult health (SAGE) Wave 1

Background: In higher income countries, social disadvantage is associated with higher arthritis prevalence; however, less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE). Methods: SAGE Wave 1 (2007 – 10) includes nationally-representative samples of older adults ( ≥ 50 yrs), plus smaller samples of adults aged 18-49 yrs., from China, Ghana, India, Mexico, Russia and South Africa (n = 44,747). Arthritis was defined by self-reported healthcare professional diagnosis, and a symptom-based algorithm. Marital status and education were self-reported. Arthritis prevalence data were extracted for each country by 10-year age strata, sex and SEP. Country-specific survey weightings were applied and weighted prevalences calculated.

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Disability and ageing in China and India – decomposing the effects of gender and residence. Results from the WHO study on global AGEing and adult health (SAGE)

Disability and ageing in China and India – decomposing the effects of gender and residence. Results from the WHO study on global AGEing and adult health (SAGE)

A few recent epidemiological studies have specifically compared and commentated on health and ageing in China and India using comparable self-reported data on health status (variously defined), risk factors, and chronic disease. In one of the first such studies the authors re- ported declines in health with increasing age, with a steeper gradient in India than in China [5]. Subsequent cross-country analyses of the health of adults aged 50 and above showed that respondents in China reported better health and less disability than those in India [6, 30]. The authors of a study of rural only adults in China and India identified significant wealth inequalities for functional limitation and disability (measured by activities of daily living) in both countries as well as better health status in rural China [14]. Urban rural differences were also highlighted in a more recent analysis that investigated the impact of out-of-pocket-health-expenditure on impov- erishment in China and India. The authors concluded that, in both countries, residing in a rural area increased the likelihood of falling below the poverty line [31].

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Attitudes towards bearing the cost of care in later life: evidence from the HSBC global ageing study on the future of retirement.

Attitudes towards bearing the cost of care in later life: evidence from the HSBC global ageing study on the future of retirement.

Studies on the public attitudes towards personal care for older people are rare across the globe. This is essential to understand and compare the attitudes of people across many countries. The most recent British Social Attitudes (BSA) surveys 2004 and 2005 allowed us to compare the attitudes to care for older people between England and Scotland. One of the key messages is that more people in Scotland than in England favour the idea of providing personal care for older people free of charge (Ormston and Curtice, 2007). Perhaps Scotland is a unique example in modern era where the government has agreed to pay for any personal care assistance to its older people irrespective of people‟s ability to cover the cost themselves and thereby introduced a policy of providing free personal and nursing care to its elderly in 2002. Data show that a majority of the Scottish public was in favour of universal free personal care rather than means testing. Six in ten said the government should pay for personal care all older people, irrespective of how well off they are. Since implementing the free personal and nursing care for elderly people in Scotland, local government are now in tremendous pressure of financial crisis to sustain the project and facing a threat of funding gap up to £63million (Horton, 2008). Critics also argued that the policy must be better funded, planned and managed if it is to continue in an ageing society. In contrast, no other country in the UK has such a policy and therefore, the sustainability of the policy in practice in Scotland remains to be uncertain and questionable.

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Scenarios for Global Ageing: An Investigation with the INGENUE 2 World Model. ENEPRI Research Reports No. 9, 1 July 2005

Scenarios for Global Ageing: An Investigation with the INGENUE 2 World Model. ENEPRI Research Reports No. 9, 1 July 2005

This paper explores the consequences of pension reforms in Western Europe in a world economy setting. Whereas various economic and social consequences of ageing have been investigated in OECD countries, very few analyses have explic- itly taken the worldwide aspect of the problem into account. In order to do so, we rely on the new version of the INGENUE model. This applied, international, overlapping-generations, general-equilibrium model of the world economy has been built noticeably to analyze the international capital flows and growth dy- namics induced by differential ageing of the various regions of the world. After a description of the major features of the baseline scenario of the model for the world economy over the next 50 years, we explore the domestic and international macroeconomic consequences of two scenarios of pension reforms in Western Europe as well as their intergenerational distributional effects. We compare these scenarios with a specific migration scenario, which is allowed by the new features of the INGENUE 2 model.

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Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE)

Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE)

Publications on falls epidemiology use various terms and definitions, making cross-country comparisons difficult. This is the first study of its kind to utilize nationally rep- resentative, comparable, population survey data to inves- tigate past-year injury-related falls in older adults in China, Ghana, India, Mexico, the Russian Federation and South Africa. With population ageing proceeding rapidly in LMICs, there is more than ever a need for an evidence-based public health policy focus on falls pre- vention in older adults in these countries [9, 28]. The findings provide evidence of prevalence and risk factors associated with self-reported fall-related injury in older adults, and the extent to which fall-related injury affects disability in this group of six LMICs.

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Use of traditional medicine in middle income countries : a WHO SAGE study

Use of traditional medicine in middle income countries : a WHO SAGE study

Study participants were adults aged 18 years and over who were part of the WHO Study on Global AGEing and Adult Health (SAGE) (available at http://www.who.int/healthinfo/sage/cohorts/ en/index2.html). Participants were surveyed between 2007 and 2010 (Wave 1) in six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. SAGE used a clustered household sampling strategy designed to generate nationally repre- sentative cohorts of older people (over 50 years of age) with data collected on younger people for comparison. One household ques- tionnaire was completed for each selected household in face-to-face interviews, and individual questionnaires were collected from one randomly selected individual aged 18–49 years and all individuals aged over 50 years (including by proxy where an individual was un- able to complete the questionnaire). Individual response rates var- ied—53% in Mexico, 68% in India, 75% in South Africa, 81% in Ghana, 83% in Russia and 93% in China. Further details of SAGE have been published elsewhere (Kowal et al. 2012) Although the main interest of this article lies in examining use of TM in Asian and

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Edentulism and quality of life among older Ghanaian adults

Edentulism and quality of life among older Ghanaian adults

Methods: Secondary analysis of WHO ’ s Study on global AGEing and adult health (SAGE) Wave 1 in Ghana was conducted using self-reported edentulism as the dependent variable. Participants included a nationally representative sample of adult ’ s aged 50 years and older living in Ghana. Quality of life was measured using the 8 item WHOQOL measure and a single item measure which was a question “ How would you rate your overall quality of life? ” . To assess the association between edentulism and the independent variables, a bivariate analysis was carried out. A Poisson regression model was then performed, adjusting for age, sex, income, education and the diagnosis of a chronic disease condition. A Spearman ’ s correlation analysis was also carried out between the single and multi item measure of quality of life to assess how well they correlate.

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2012   That was the year that was

2012 That was the year that was

Geriatric medicine has an encyclopaedic sweep, re fl ecting the complexity of both the ageing process and of our patient group. Keeping up with, and making sense of, the relevant scienti fi c literature is challenging, especially as ageing has increased in prominence as a focus of research across many branches of the sciences and the humanities. This review of re- search published in 2012 in generalist, geriatric medicine and gerontology journals has been compiled with a view to extract- ing those aspects of research into ageing which could be considered relevant not only to the practice of geriatric medicine, but also to our understanding of the ageing process and the relationship of geriatric medicine to other medical specialties and public health. The research discussed includes new insights into global ageing and the compression of morbidity; noso- logical, clinical and therapeutic aspects of dementia; an innovative study on the microbiome and ageing; epidemiological perspectives into multi-morbidity; an overview of the impact of the fi rst waves of Baby Boomers; fresh thinking on geriatric syndromes such as orthostatic hypotension, kyphosis, urinary incontinence after stroke, frailty and elder abuse; an update of the Beers criteria and the fi rst stirrings of recognition of the longevity dividend in the biomedical literature.

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Integrated care pathways for airway diseases (AIRWAYS-ICPs)

Integrated care pathways for airway diseases (AIRWAYS-ICPs)

ABSTRACT The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYS- ICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).

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alloy in a 3.5wt% NaCl were generated from the potentiostat with the view to improve the corrosion resistance of the alloy in a novel double thermal ageing treatment. The corrosion rate of all the samples studied showed a smaller passive region (cathodic) and prolong active region (anodic). Observations from the results indicated that the corrosion rates are very similar in trend for all the examined samples irrespective of the treatment. This is because the samples were from the same alloy which was cast and solidified in similar conditions and cooling rate. However, the corrosion rate increases with increasing ageing time (Figures 1-3) for all the DTAT samples. This is in agreement to those reported in literature [12, 13, 14].

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Ageing and globalization: a global analysis

Ageing and globalization: a global analysis

In Africa, as in other traditional societies such as those in India or China, older people have traditionally been viewed in a positive light, as repositories of information and wisdom. And while African families are generally still intact, development and modernization are closely connected with social and economic changes that can weaken traditional social values and networks that provide care and support in later life. Africa has long carried a high burden of disease, including malaria and tuberculosis; today it is home for more than 60 % of all people living with HIV – some 25.8 million in 2005. The vast majority of those affected are still in their prime wage-earning years, at an age when, normally, they would be expected to be the main wage earners and principal sources of financial and material support for older people and children in their families. Many older people have had to deal with the loss of their own support while absorbing the additional responsibilities of caring for their orphaned grandchildren. Increasingly, then, it appears that African societies are being asked to cope with population ageing with neither a comprehensive formal social security system nor a well-functioning tra- ditional care system in place (HIV/AIDS Alliance and HelpAge International 2004).

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Is healthcare really equal for all? Assessing the horizontal and vertical equity in healthcare utilisation among older Ghanaians

Is healthcare really equal for all? Assessing the horizontal and vertical equity in healthcare utilisation among older Ghanaians

Ghana’s National Policy on Ageing [22] represents an important step towards ensuring better health in general for older Ghanaians. Unfortunately, not much has been achieved yet in terms of its implementation. Currently, no clear standards and guidelines on older persons care provision and rehabilitation services exists nor is there a clear implementation plan on how health staff would in- tegrate geriatric care into healthcare delivery at any level [45]. The guidelines can, for example, provide a frame- work for prioritising the needs of older persons. These should hopefully provide some framework for achieving vertical equity in outpatient utilisation.

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Ageing characteristics of bone indicated by transcriptomic and exosomal proteomic analysis of cortical bone cells

Ageing characteristics of bone indicated by transcriptomic and exosomal proteomic analysis of cortical bone cells

Compared with young bones, aged bones displayed sig- nificant decreases in bone mass indicated by the reduced micro-CT parameters of BV/TV, Tb.N, and CBT (Fig. 1a–g). Histological analysis showed a decreased number of osteocytes and an increased number of empty lacunae in aged relative to young cortical bone (Fig. 1l). Compared with young bone, the inner surface of aged cortical bone was less smooth with more visible resorp- tion pits, below which empty lacunae were easily ob- served (Fig. 1h–k). To further investigate the condition of the extracellular matrix, Toluidine Blue, Masson, and Sirius Red staining were performed. The results showed abundant dendrites connecting into a network around young osteocytes in young bone (Fig. 1m), while con- tinuous dendrites were rare in aged cortical bone (Fig. 1n). Masson staining revealed predominantly blue staining in young cortical bone (Fig. 1o); in aged bone, however, bone matrix was mainly stained in red (Fig. 1p), indicating a change in collagen composition in bone matrix during ageing. Sirius Red staining demonstrated poor densification and loose tissue structure of collagen fibres in aged bone matrix (Fig. 1q, r). Further, morpho- logical abnormalities in the shapes of cell bodies, den- drites, and nuclei were shown by TEM (Fig. 2). The

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Strategies for optimising musculoskeletal health in the 21st century

Strategies for optimising musculoskeletal health in the 21st century

A European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Dis- eases (ESCEO) taskforce looked at dietary protein and vitamin D and calcium supplementation and recom- mended higher protein intake in combination with phys- ical exercise particularly in post-menopausal women at risk of developing menopause-associated musculoskeletal disease, such as OP [29]. Physical exercise programmes improve strength and balance in ageing women with OP [30]. Fragility fracture risk, associated with OP, can be de- creased by following an exercise programme, as exercise increases bone density and reduces inflammatory markers [31]. However, the incidence of OP is usually highest in elderly females who are most unlikely to perform the dy- namic exercises needed for bone modelling/remodelling [32]. This highlights the challenge of preventing OP and OP-related fractures in elderly females that cannot per- form ballistic exercise. Some medications are available for these frail patients but having an active lifestyle from an early age and following recommendations for exercise could be more beneficial. The same principle applies to frailty in ageing companion animals, where life-long spontaneous exercise significantly slows down the progression of frailty [33].

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“Big Data” in neuroscience: open door to a more comprehensive and translational research

“Big Data” in neuroscience: open door to a more comprehensive and translational research

The first session, moderated by Dr Le Novère, from the Babraham Institute, Cambridge, UK), began with a keynote presentation by Dr. Sean Hill, co-Director of the Blue Brain Project [3] and co-Director of Neuroinformatics in the European Union funded Human Brain Project (HBP) at the École Polytechnique Fédérale de Lausanne (EPFL). This large project (involving more than 250 researchers), supported by EU in- formation technology funding, aims to provide innovative tools to the global Neurosci- ence community in order to model and simulate the human brain. Sean Hill, one of the coordinators of this flagship European program, introduced the audience with an im- pressive data infrastructure built over the first 10 years of work. Electrophysiological re- cordings, gene expression patterns, morphological studies, among others, are stored and integrated with rich semantic metadata in order to inform mathematical models of neuronal circuits. He then presented preliminary simulations of the electrical behavior of neocortical columns, built upon the compilation of the large amount of data de- scribed above [4]. Such complex models require large amount of storage and comput- ing power (the simulations are currently using a Blue Gene computer). The HBP still faces significant challenges when developing a platform to generate and make access- ible for the whole community the huge amount of data required for understanding the entire brain function.

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Ageing in urban spaces : developing inclusive urban environments for older people in Global South cities

Ageing in urban spaces : developing inclusive urban environments for older people in Global South cities

Thirdly, this region is burdened by the high prevalence of communicable diseases (e.g. HIV/AIDS), a high mortality rate in childhood and various other social ills. Far less public assistance to persons with HIV/AIDS is usually available in developing countries, thus necessitating greater reliance on informal care, which is often provided by elderly children. Chronic poverty is entrenched in sub-Saharan Africa and is seen as an inability of individuals, households or entire communities to manage sufficient resources for a socially acceptable minimum standard of living (Hoffman, 2015). In Africa, 47 per cent of the population live in extreme poverty – on under USD1.25 per day (UNDP, 2013). The range of problems that older people in Africa are facing is constantly increasing as societies are locked up in conflicts, experience huge economic problems, natural disasters, disease and a deterioration of family relationships. This implies that population ageing in Africa is largely unfolding in contexts of acute social ills, resource constraints and widespread economic strain (Aboderin, 2010b). All these factors represent different (and probably more immediate) priorities in public policy agendas (Teguo, Kuate- Tegueu, Dartigues, & Cesari, 2015).

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Ageing, frailty and resilience in Botswana: rapid ageing, rapid change  Findings from a national working group meeting and literature review

Ageing, frailty and resilience in Botswana: rapid ageing, rapid change Findings from a national working group meeting and literature review

BDG 3: ensure healthy lives and promote well-being for all The stated goal to prevent “premature mortality from NCDs” generally refers to adults aged up to 69 years [39]. This could be considered an arbitrary and prema- ture cut off given the rapidly ageing population of Botswana, although currently the population over 60 years old in Botswana is still only 6% [40]. There is a risk of impoverishment related to personal healthcare spend but current data are lacking. The 2002–2003 Botswana Household Income and Expenditure Survey described 11 and 7% of households facing catastrophic expenditure at threshold of 20 and 40% respectively [41].

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The move to abolish mandatory retirement age: the case of the United Kingdom

The move to abolish mandatory retirement age: the case of the United Kingdom

grounds of age – had been an issue of political, economic and social relevance since the implementation of the First Action Programme on Ageing and culminated with the European Employment Directive 2000/78/EC (European Commission, 2004). Legislation outlawing age discrimination in employment and vocational training in the European Union under that directive came into force by 2006 – and the UK waited until that time to introduce its own legislation in the area. This EU directive prohibits employment discrimination on the grounds of religion or belief, disability, age or sexual orientation. However, the directive did not specifically mandate the elimination of mandatory retirement by individual countries, or indicate a specific age at which mandated retirement would be considered a discriminatory workplace or labour market practice.

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A new concept to improve the lithium plating detection sensitivity in lithium ion batteries

A new concept to improve the lithium plating detection sensitivity in lithium ion batteries

Further, an attempt to understand the interaction between lithium plating and ageing is made. The study by Ansean et al. concluded that plating is completely reversible and does not cause capacity loss as long as the negative electrode capacity is higher than the positive electrode capacity [5]. As the Loss of Active Material (LAM) occurs at the electrode, negative electrode loses capacity. Once, the electrode capacity drops below the positive electrode’s capacity level, part of the lithium plating becomes irreversible. Their simulation models show that the LAM is the cause for the ageing associated with the plating. On the other hand, Yang et al. have attributed the onset of lithium plating to the drop of negative electrode porosity coupled with SEI growth [3]. There is some ambiguity about the reasons for the ageing induced plating because these conclusions are based on the models they developed. In this study, SEI growth impact on the plating is analysed with the help of Electrochemical Impedance Spectroscopy (EIS) plots and VRFs. Finding the causes of the ageing induced plating may allow modifying the plating control according to the ageing mechanism.

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The uses and functions of ageing celebrity war reporters

The uses and functions of ageing celebrity war reporters

In the case of age-related aspersions, what is distinctive about distinction-making practices is that they are experienced not so much rationally as viscerally. The star quality of the celebrity war reporter is by definition ineffable, something which exceeds that for which we can find words. But the repugnant banality of ageing celebrity flesh is something all too describable; the celebrity is rendered not just human but knowable. This is the indictment that lies at the heart of the shift from integrity to indignity: it is a shift from the celebrity as cultural subject, wielding game-changing, unpredictable powers of consecration, to cultural object, something that is very much the sum of its parts. We don’t want to think about Martin Bell’s sex life or Kate Adie dancing in her knickers – not only for aesthetic or moral reasons but because it is simply too graspable. There is a parallel demystification in the example of silent film stars whose voices in the transition to talkies revealed them to be fatally knowable, but I would argue that ageing is different because its knownness is corporeal. There’s much to be said for the extensive literature that explains our cultural revulsion to ageing flesh, but for present purposes let us focus on the finitude of corporeality. Again following Bourdieu, subjectivity is something structured at the level of the body; structuration need never emerge to consciousness but it makes its presence felt in the way we move and talk. As the object of corporeal structuration the subject is incapable of conceiving of its own corporeality, of our phenomenal status as bodies – to put it practically, it is difficult to grasp the extent to which the way we laugh is a learned, mimetic performance, incited discourse in Butler’s (1997) phrase. But in this unknowability lies the strategic possibility of esotericisation: it is here that the potency of the words “there’s just something about them” is realised.

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