8^th International Conference on Geriatrics Gerontology & Palliative Nursing July 30-31, 2018 | Barcelona, Spain

Nina Gorshunova is a Doctor of Medicine, Professor, Head of the Polyclinic Therapy & General Practice Department of Kursk State Medical University, Russia. She is a Head of local scientific center of Global Aging Research Network supported by the International Association of Gerontology and Geriatrics. She is a Member of Governing Board in Scientific Gerontological society of the Russian Academy of Sciences, the member of the International Advisory Board of academic journal Advances of Gerontology. The main scientific trends are: Gerontology and geriatrics in general practice, cardiovascular problems of elderly people, age-related disorders of hemostasis; mediсo-social rehabilitation; organization and methodical problems of the general medical practice, educational technologies for prevention of premature ageing. She is an author of more than 600 scientific publications. In 2012, she was awarded by gold medal of European scientific industrial chamber for original investigations in gerontology.

The progression of involutive changes in older people is accompanied by the development of polyfunctional deficiency leading to the appearance of physical and cognitive frailty, limitations of life activity (reduced self-service abilities, independent movement). To determine the older people needs in medico-social care, a comprehensive geriatric evaluation of 417 people older than 80 years was performed, with the expression of osteopenia and sarcopenia, decreased muscle strength and walking pace, attention and memory. The assessment of physical frailty is performed by the dynamometry, muscle and bone mass by bioimpedance analysis, cognitive functions on the Montreal scale (MoCA), psychological disorders - on the geriatric depression scale. The possibility of self-service is determined using the Barthel and Katz scales, preserving the skills of instrumental daily activity on the Lawton-Brody scale. It has been established that in patients over 80 years the severity of muscle mass, its strength, bone reduction, limitations of self-service and

movement depend on the age and degree of functional insufficiency. Markers of cognitive frailty: Reduction of visual, constructive skills and memory with an increase of depression is significant in 45% of patients. It is revealed that about 70% of them need in social assistance, 52% in rehabilitation, 44% in psychological support and 35% in palliative care. Older people with physical pre-frailty to prevent the development of self-care restrictions and self-movement should recommend a diet rich in high-grade proteins, regular isometric exercise under the control of heart rate and blood pressure. Patients with predementia cognitive disorders can be recommended training programs aimed at activating attention, memory and perception. Immobile patients are shown therapeutic exercises, timely prophylaxis of bedsores. Palliative care programs are developed by general practitioners and implemented under their supervision by nurses. The importance of developing clinical recommendations for differentiated provision of palliative care is highly significant.

Purnima Sreenivasan is passionate about aging and aging services and has served as CEO of Health Aim Inc, which she founded in 2004 serving the seniors in the San Francisco Bay Area, CA, and USA. Currently she is also the founder of a health tech startup miHygge. She has helped seniors, health professionals, facilities with

resources, mentoring, consulting and also serving as medical director for home health, hospice, skilled nursing facility (nursing home) and as a member of the Board of Directors of Meals on Wheels in the past. She now provides Aging Life care Services, Public Health consultations, a career in writing and public speaking locally and globally! Health Aim Inc believes in education, empowerment, enrichment, encouragement, inspiring and making a genuine difference in people’s lives, a legacy for the future.

Dementia is a leading topic not just for researchers but also for families and caregivers involved in the care of patients suffering from them. Dementia is not a sign or symptom of “Health Aging”! Dementia is loss of memory as a function of the brain. Dementia is not Alzheimer’s and vice versa. Despite the advances in dementia, the research and the medications available to slow the progress of dementia, the understanding goes far and beyond the common man. To some it is a dreadful thing to happen in later age and to some it is a burden for the rest of the patient’s life and to others it is sense of disconnection to the society or community and family. What have we learned about dementia? What have we unlearned about dementia? What have we not thought or even considered in dementia research? What have we missed in our focus on dementia? Pharmaceuticals, nutraceuticals, nutrition, physical activity, mental activity and more have been considered. We still cannot figure why some suffer from dementia and some do not. In my own career of more than 15 years caring for persons and their caregivers in the world of dementia, I have learned a few salient points. One size does not fit all and nor should it? Don’t you agree? If so, come join me in unmasking dementia as a Health care futurist, dementia and aging life care specialist/consultant and healthtechentrepreneur!.

Alex W Costley is an Associate Professor of Gerontology and Health Education at City University of New York and the Coordinator of the Bachelor of Science degree program in Gerontology. His research interests and publications explore aging from cultural, political, and clinical perspectives, from understanding the development of ageism among healthcare provider to practical interventions to improve problem-solving and communication with older adults in primary care. His more recent presentations and publications examine issues of urban planning, zoning, and the social and environmental barriers to civic engagement and aging-in-place in New York City. He has a background in cultural-anthropology, medical education, and public policy.

Statement of Problem: Reduced intake of healthy food is a growing public health problem for all ages in the US, but older adults often have less access to food due to several social and behavioral factors. In communities lacking full-service supermarkets or (food deserts), more research is needed to understand the factors that make older adults even more vulnerable to food insecurity.

 

Methodology & Theoretical Approach: In a larger community-based survey research project on access to food and nutrition (N=422), data were coded in SPSS 22 by postal (zip) code to identify residents in a documented food desert (n =297) and by age, over 65 (119 or 40%) and 18-64 (178 or 60%) to explore significant differences (p<0.05) in income, behavior, and social barriers using chi-square (X2) analyses.

 

Findings: With similar distance to supermarkets (p=0.914), the majority of younger and older adults (84% and 73%) said they could walk to a large supermarket, if needed (p=0.121), but older adults had more physical limitations (p=0.000) for getting food back home. Income distributions were similar (p=0.234), but older-adults appeared less likely to eat fast foods (p=0.04), but not more likely to eat fresh vegetables daily (p=0.060). However, older adults were more likely to live alone (p=0.007) and have difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) (p<0.013) affecting daily function.

 

Conclusion & Significance: Even in more challenging environments (i.e. food deserts), the data suggest that distance to supermarkets alone is not the biggest barrier. Older adults, however, appear to face other social and physical limitations that require additional resources beyond existing nutritional programs and municipal plans to increase retail food infrastructure.