Confronting ageism: The potential of intergenerational contemporary art events to increase understandings of older adults and ageing.

OBJECTIVE: To explore the impact of an innovative intergenerational art event showcasing retirement village life on attendees' understandings of older adults and ageing. METHODS: A survey of 93 art event attendees was conducted immediately after 16 sessions of the event (78% response rate). Respondents reported on their event experience and its impact on their understandings of older adults and attitudes towards ageing. Analysis of Variance (ANOVA) used to test for differences between age groups (18-34, 35-64 and 65+ years). RESULTS: Over 90% of attendees reported the art event helped them develop an understanding of the lives of older people, with the greatest impact on young and middle-aged adults. The majority of young and middle-aged adults, however, expressed concern about their own ageing. CONCLUSION: Results suggest that intergenerational art events have the potential to increase understandings of older adults and their lives, but this may not translate into personalised comfort with ageing.

Kindness in Australia: an empirical critique of moral decline sociology.

A new sociological agenda is emerging that interrogates how morality can be established in the absence of the moral certainties of the past but there is a shortage of empirical work on this topic. This article establishes a theoretical framework for the empirical analysis of everyday morality drawing on the work of theorists including Ahmed, Bauman and Taylor. It uses the Australian Survey of Social Attitudes to assess the state and shape of contemporary moralities by asking how kind are Australians, how is its expression socially distributed, and what are the motivations for kindness. The findings demonstrate that Australians exhibit a strong attachment and commitment to kindness as a moral value that is primarily motivated by interiorized sources of moral authority. We argue these findings support the work of theorists such as Ahmed and Taylor who argue authenticity and embodied emotion are legitimate sources of morality in today's secular societies. The research also provides new evidence that generational changes are shaping understandings and practices of kindness in unexpected ways.

Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

AIM: To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. METHODS: In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. RESULTS: All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. CONCLUSION: Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services.

A community-based exercise programme to improve functional ability in people with Alzheimer's disease: a randomized controlled trial.

RATIONALE: Dementia is a common neurodegenerative condition in older age associated with functional decline across multiple domains. This decline impacts not only on the person with dementia, but also on their informal carers and health and aged care systems. With the number of people with dementia rapidly increasing and few effective treatments, there is now a critical need for interventions to improve functional ability in those with the condition. AIMS AND OBJECTIVE: This study assesses the effectiveness of a community-based home exercise programme in improving cognitive and physical function and independence in activities of daily living (ADL) in people with Alzheimer's disease, the most common form of dementia. METHODS: In a 4-month randomized controlled trial, 40 community-dwelling patients diagnosed with Alzheimer's disease and their informal carers were randomly allocated to either the treatment (exercise plus usual treatment) or control (usual treatment) group. The exercise programme consisted of daily exercises and walking under the supervision of their carer. Patients were assessed at baseline and 4-months follow-up by a blinded assessor on primary outcome measures of cognitive and physical function and ADL using standardized assessment scales. RESULTS: Sixteen men and 24 women diagnosed with Alzheimer's disease participated in the study. They had a mean age of 74.1 years (range 51-89) and a mean Mini Mental State Examination score of 22.0 (range 10-28), indicating mild to moderate dementia. At 4-months follow-up, patients who exercised, compared with controls, had improved cognition (increased Mini Mental State Examination scores by 2.6 points, p < 0.001), better mobility (2.9 seconds faster on Timed Up and Go, p = 0.004) and increased Instrumental Activities of Daily Living scores by 1.6 (p = 0.007). CONCLUSION: This study suggests that participation in a community-based exercise programme can improve cognitive and physical function and independence in ADL in people with Alzheimer's disease.

A prospective study of ventriculo-peritoneal shunting for idiopathic normal pressure hydrocephalus.

Idiopathic normal pressure hydrocephalus (INPH) is a potentially treatable form of dementia but its diagnosis is difficult and the effectiveness of shunting remains controversial. This study investigates the clinical outcomes of ventriculo-peritoneal shunting in a controlled trial of 33 consecutive patients with INPH. Mean age was 77.2 years (range 58-92 years) and the duration of symptoms was 4.6 years (3 months-14 years). Nineteen patients underwent shunt surgery. At 3-4 months follow-up, patients who had undergone shunt surgery, compared to those who had not (controls), had significantly better global change ratings (median Clinician's Interview Based Impression of Change with Carer Input rating of 2 [moderately improved] versus 6 [moderately worsened], respectively, p<0.001), had increased Mini Mental State Examination scores by 5 points (p<0.001) and were 6.3s faster on the Timed "up and go" test (p=0.008). We conclude that ventriculo-peritoneal shunting is associated with improved clinical outcomes for patients with INPH.

The metabolic syndrome and Alzheimer disease.

BACKGROUND: The metabolic syndrome is a risk factor for cardiovascular diseases, which have been linked to Alzheimer disease. However, a link between Alzheimer disease and the metabolic syndrome has not yet been established. OBJECTIVE: To investigate the relationship between the metabolic syndrome and Alzheimer disease. DESIGN, SETTING, AND PARTICIPANTS: Case-control study of 50 consecutive patients diagnosed with probable Alzheimer disease from the Memory Disorders Clinics, Launceston, Australia, and Bristol, England, and 75 cognitively normal controls. MAIN OUTCOME MEASURES: The odds ratio of the metabolic syndrome as defined by the National Cholesterol Education Program Adult Treatment Panel III. RESULTS: Compared with controls, patients with Alzheimer disease had a significantly larger mean waist circumference, higher mean plasma concentrations of triglycerides and glucose, and a lower mean plasma concentration of high-density lipoprotein cholesterol, but they had lower mean systolic blood pressure. The metabolic syndrome was associated with Alzheimer disease (odds ratio, 3.2; 95% confidence interval, 1.2-8.4; P = .02), and this association was strengthened when the hypertension component was excluded (odds ratio, 7.0; 95% confidence interval, 2.7-18.3; P < .001). All of the analyses were adjusted for age, sex, and location. CONCLUSIONS: This study suggests that Alzheimer disease is associated with the metabolic syndrome. This could have implications for the prevention and treatment of Alzheimer disease.

Obesity, abdominal obesity and Alzheimer disease.

BACKGROUND/AIMS: Obesity has a strong association with vascular and metabolic diseases, which have been linked with Alzheimer disease (AD). While recent studies have reported an association between mid-life obesity and dementia, the role of later-life obesity is less clear. This study investigated the relation between AD, obesity and abdominal obesity at later-life in a case-control study. METHODS: Participants were 50 consecutive patients with probable AD from memory disorders clinics in Launceston, Australia, and Bristol, England, and 75 cognitively normal controls. Height and weight [from which body mass index (BMI) was calculated] and hip and waist circumferences (from which waist-hip ratio was calculated) were measured. Participants were classified according to their BMI as: underweight (BMI <20.0 kg/m2); normal weight (BMI 20.0-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2), or obese (BMI > or = 30 kg/m2). They were classified as abdominally obese if their waist-hip ratio was >0.9 (men) or >0.8 (women). RESULTS: AD was associated with obesity [OR 9.5, 95% CI 2.4-37.3, p = 0.001], underweight (OR 5.4, CI 0.9-33.7, p = 0.07) and abdominal obesity (OR 2.5, CI 1.1-5.7, p = 0.027) using logistic regression analyses adjusted for age, sex and location. The inclusion of metabolic risk factors in the model increased the ORs for obesity (OR 12.6, CI 2.8-56.5, p = 0.001) and underweight (OR 7.9, CI 1.0-66.3, p = 0.056). CONCLUSION: AD may be associated with obesity, underweight and abdominal obesity at later life. Larger prospective studies are required to investigate this further.