Cross-Country Validation of the Association Between Oral Health and General Health in Community-Dwelling Older Adults

Source: JAMDA

International scientific literature shows that oral health is associated with general health outcomes, functional performance, and wellbeing.  Several studies identify poor oral health as a major risk factor of aspiration pneumonia. Reduction in saliva flow, which is often a side effect from medication use, leads to a higher risk of oral infections such as caries or periodontitis, which in turn is associated with increased risk for diabetes and cardiovascular disease. Also impaired chewing function can affect a person’s general health andwell-being. A recently published Belgian longitudinal study showed higher risk of poor general health status for older people having poor oral health. This study showed evidence of the predictive association of oral health for general health (and vice versa). This second study aims at examining and comparing the association between oral health and general health in 3 cross-country databases of older people receiving long-term home care services. Another objective is to examine the predictive associations between the current oral health and general health status and their future status.  This study is exploratory. The rationale of the study is to apply a set of algorithms in different country databases to explore the longitudinal associations between oral health and general health and vice versa, making predictions for future assessments. No assumptions are made about how the results differ or are similar across countries. The goal is rather to verify whether associations between oral health and general health are held across samples.

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OnSeptember 27, 2019, posted in: News by

“Not on the Radar”: Dentists’ Perspectives on the Oral Health Care of Dependent Older People

Source: Wiley Online Library

The New Zealand population is steadily ageing: about 5% of the 580,000 New Zealanders aged 65 or more are currently in long-term care, and another 9.5% receive publicly-funded, home-based support for housework and personal care assistance. It has been estimated that almost half of our older population will end up in residential aged-care at some stage during their lives, and only a small proportion of those will return to their own homes. From 2003 to 2007, 34% of those aged 65 + who died did so in hospital, 38% of them died in a rest home and only 28% died at home. There have been substantial increases in the proportion of people entering old age with at least some remaining natural teeth. The increase in tooth retention is due to both disease-related and socio-cultural reasons. The health system is now faced with greater numbers of older people with more of their own teeth, and those dentate older people are entering residential aged-care homes. Dental caries remains the major oral health problem of older age: longitudinal data show that older people living in the community have a caries increment (decay rate over time) which is at least as great as that observed in younger people. The caries increment among older people in residential care facilities is more than twice that seen among those in the community; among those who suffer from dementia, that rate is twice as high again. Thus, dental caries in those facilities is a major clinical problem which is going to get worse as more and more dentate older people enter care.

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OnSeptember 27, 2019, posted in: News by

Notice of NZAG Annual General Meeting & Agenda

All NZAG Life Members, Officers and members are invited to attend
Tuesday 1 October 2019
3.30 pm to 4.30 pm

Room AE114A, AUT Akoranga Campus
90 Akoranga Drive, Northcote, Auckland

View Notice of Meeting and Agenda here >

Download Proxy Voting Form here >

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OnSeptember 9, 2019, posted in: Gerontology Events, Home page feature by

New Zealand – Facilitating Equitable Prevention and Management of Gout for Māori in Northland, New Zealand, through a Collaborative Primary Care Approach

Source: The Royal New Zealand College of General Practitioners
Gout, a common type of inflammatory arthritis, is a chronic disease that occurs with elevation of serum urate, causing the formation and deposition of monosodium urate crystals within joints. Although a chronic condition, patients often present with recurrent flares, which are acute and extremely painful events. Metabolic syndrome, renal impairment, hereditary factors and diuretics are key risk factors for gout.

In 2016, it was estimated that gout affected ~5.2% of New Zealanders. 3 In Northland, gout prevalence was 7.7%.  In Māori and Pacific peoples, the prevalence of gout is higher than for non-Māori/non-Pacific people.  Sixty percent of the variation in urate levels between individuals can be attributed to inherited genetic variants. Māori and Pacific peoples increased prevalence of gout can be partly explained by reduced renal excretion
of uric acid. Key proteins for the renal excretion of uric acid are affected by the genes SLC2A9 and ABCG2, with the SLC2A9 genetic variant more prevalent in Māori and Pacific people.

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OnAugust 30, 2019, posted in: News by

International – Variation in GP Decisions on Antihypertensive Treatment in Oldest-old and Frail Individuals Across 29 Countries

Source: BMC Geriatrics
Hypertension is the most important preventable cause of poor cardiovascular outcome and is responsible for disability and deaths from stroke, myocardial infarction and other diseases. Treating hypertension is beneficial and (since the 1990s) it is known that treatment also reduces stroke rates and myocardial infarction in patients aged >60 years. As life expectancy has increased worldwide, a new term was needed to describe those in the fastest-growing age group expected to triple within the next 35 years, i.e. the group ‘oldest-old’ is now defined as those aged >80 years. 

The population of the oldest-old is heterogeneous. Some oldest-old are very healthy whereas others are multimorbid with complex problems. Although the group of multimorbid oldest-old is rapidly increasing, most trials still exclude them. Messerli et al. highlighted this commonly-applied exclusion by applying exclusion criteria taken from 13 hypertension trials with oldest-old participants, to a primary care cohort of hypertensive patients aged >60 years: in this case, ≥70% of the oldest-old would have been excluded and they were both older and sicker.

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OnAugust 30, 2019, posted in: News by

Grants Available for Age-friendly Community Projects

Applications are now open for Community Connects grants.

The Community Connects fund supports communities to become Age-friendly. We offer grants up to $15,000, from an annual budget of $100,000. There are up to two grant rounds each financial year.

The fund supports projects to either:

·         start development of an Age-friendly Communities Plan, or

·         implement an Age-friendly Community project.

Who can apply?

Any New Zealand council, community organisation, or registered not-for-profit organisation can apply. (Non-council applications must have support from their City or District council).

The grant is not open to businesses or individuals.

Closing date

Applications close on 13 October, 2019.

More information

The application form and application guidelines (including evaluation criteria) are available at http://www.superseniors.msd.govt.nz/age-friendly-communities/community-connects/community-connects-grants.html

Alternatively, contact us at Community_Connects@msd.govt.nz 

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OnAugust 16, 2019, posted in: Gerontology Projects, Home page feature by

Validation of the Nutrition Screening Tool ‘Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II” Among Octogenarians

Source: The Journal of Nutrition, Health & Aging

Those aged 85 years-plus are the fastest growing age group within the 65-plus population in New Zealand and most live independently in the community. This group are the highest consumers of health and disability expenditure. Older people are known to be at disproportionate risk of malnutrition and have an increased risk of developing health problems as a result of inadequate food and nutrition intake. Nutrition screening allows early identification of those who are malnourished or at risk of becoming malnourished. The detection of impaired nutrition in older adults can be difficult as a wide range of health, social and economic constraints affect the nutrition status of community living older adults. There is no gold standard for the detection of malnutrition in community-dwelling older adults and it remains underdiagnosed and under treated. Whilst a dietitian has the expertise to assess and detect malnutrition, dietetic resources are limited in the community setting. A simple, valid and cost effective method to detect nutrition risk prior to the development of overt malnutrition in people of advanced age is required.

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OnJuly 25, 2019, posted in: News by

Caregiving, Ethnicity and Gender in Maori and Non-Maori New Zealanders of Advanced Age: Findings from LiLACS NZ Kaiawhina (Love and Support) Study

Source: Australasian Journal on Ageing

Caregiving in home settings is a cornerstone of “ageing in place” policies in New Zealand and many other countries. Families and neighbours have long been the primary source of care for people in advanced age although, for social and demographic reasons, the pool of informal (usually unpaid) caregivers is diminishing even as need becomes greater. Ongoing shifts in the balance of care away from residential institutions are occurring and, while more home support services are now provided, informal caregiving remains the backbone of home care.

Research is fundamental to the development of policies providing supports to assist older people to live well at home even with frailty, disability or illness. Due to the gendered nature of caregiving, identifying patterns of sex and ethnicity in informal caregiving should be part of this research effort.  The Kaiāwhina (Love and Support) study, a sub‐study of Te Puāwaitanga O Ngā Tapuwae Kia Ora Tonu/ Life and Living in Advanced Age, a Cohort Study in New Zealand (LiLACS NZ), provides research data that are relevant to understanding how gender and ethnicity relate to informal caregiving.

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OnJuly 25, 2019, posted in: News by

Being Well and Wellbeing: Better Understanding of Patient Priorities in Primary Care

Source: The Royal New Zealand College of General Practitioners

General practice in New Zealand (NZ) is facing increasing demands from funders, providers and users of its services. The dynamic environment is not unique internationally, but the NZ health system’s limited resources and challenges of our particular patient demographic, including Māori and Pacific peoples’ health-care access inequality, make consideration of how best to care for our patients and achieve desired health outcomes a critical and perpetual issue.

Doctors are trained in health, disease prevention and treatment, and survival for their patients, to fight the perceived failure that is death. They are monitored and measured against standards of good medical practice. However, they are seldom asked to consider what exactly they are fighting for in their relationships with patients. Wilson and Cunningham discuss the dissonance of the biomedical model, describing a mismatch between the theory and reality of medicine, where the biomedical model is insufficient to achieve whole-person care for patients and creates anomalies that leave both clinicians and patients dissatisfied. Kleinman identifies the dangers of the medical model in its denial of a person’s moral significance through a technical process that only superficially touches on a person. Wilson and Cunningham describe the superiority of a biopsychosocial model of care, coupled with valuing emotional quotient (EQ, the capacity for engaging well with others). A functional doctor–patient relationship is highly dependent on making empathic and caring connections within this model.

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OnJuly 25, 2019, posted in: News by

The Dialogic Educational Pathway as a Strategy of Care with Elderly Women in Sexuality

Source: Esc Anna Nery

Discussions around sexuality, although still fraught with prejudices and prohibitions, have long evoked power relations and denounced strategies of control of the individual and of the population, a characteristic of modern society. It turns out, however, that control and power are asymmetrical in gender relations and sexuality is a strong ally in the normalization of female conduct in all age groups, mediated by the control of man.

Regarding elderly women, the domestication of female behavior in the past decades must be considered, coupled with the conception that the elderlies are asexual. This reality implies insufficient health care in this area and needs to be overcome, since sexuality in aging is usually neglected by health professionals due to the lack of preparation and appreciation of the young, healthy and sexually active body in our culture – reinforcement for the prejudice towards sexuality in aging as well as its wider understanding.


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OnJune 28, 2019, posted in: News by