Relationship between Demographic Factors and the Performance of Teacher Education
Demographic Research a free, expedited, online journal Appendix: Impact of imputed relationship status data on results. Harmonised Concepts and Questions for Social Data Sources. Primary Principles . Demographic Information,. Household Composition and Relationships. Examine the relationship of demographics and health conditions, alone and in combination, on objective measures of cognitive function in a large sample of.
In short, what can the oldest-old tell us about the process of aging itself? The group initially evaluated the general concept of mortality rate plateaus as well as several potential models for understanding mortality in general. In the process of deliberating over the proposed late-life plateau in mortality rates and what it could represent, the group also discussed a number of different angles from which to approach the problem: Because the task group was charged with trying to understand what happens during the mortality rate plateau, the group spent a long time earnestly discussing whether disability and disease also plateau.
This is significant, because if disability increases exponentially while mortality rates plateau, it could mean that individuals are surviving with long-term mortality rates, aging, and functional human healthspan 45 debilitating illnesses. On the other hand, if disability or disease plateaus, there may be a fundamental difference in the very old that could reveal secrets about aging in general.
The state of those in late life is also criti- cal to understanding the question of healthspan and to recognizing the societal and financial implications of late-life mortality plateaus in human populations.
In this context the group thought it was important to draw a clear distinction between disability and impairment.
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To some extent disability depends on the technology and assistance available to the individual. Impairment, on the other hand, is related to the loss of a specific function or set of functions that can be measured objectively e. The group also bandied about ideas about just how big a part the underlying biology plays in the late-life mortality plateau. Published data showing a late plateau in age-specific fecundity in large fruit fly populations suggests there are fundamental biological differences in the latest stages of life.
As well, one group member noted that the mortality rate plateau was initially interpreted as evidence for plasticity in lifespan. There was a great deal of discussion within the group about this interpretation and how we should define plasticity, if at all.
For example, one option was that the mortality plateau might represent more permissive genetic heritage than previously imagined. Some suggestions included everything from technology that assessed voice and motion to cognitive tests to molecular markers such as cytokines. While the group did not reach a conclusion about the most ef- fective tests or how frequently sampling should be, the general consensus was that it would be advantageous to sample as often and as completely as feasible.
One group member noted that in Drosophila even with the fecundity plateau, female fecundity decreases rapidly a few days before death, suggest- ing there may be markers in other species that indicate healthspan decline.
If so, there may well be opportunities to manipulate the projected time of death and to decrease the amount of time before death spent with degraded health.
Relationship of demographic and health factors to cognition in older adults in the ACTIVE study.
On Thursday morning the task group presented their preliminary report to the other meeting attendees. But the feedback was mixed.
Some 46 the future of human healTHspan seemed unconvinced about the demographic evidence for a mortality pla- teau.Pearson Correlation - SPSS
Gerontologists pointed out that their oldest-old patients may survive longer, but they continue becoming frailer with time. Others suggested that selective survival explained the plateau in impairment and declining risk factors observed in some studies. It was back to the meeting room for more diligent debate. For instance, at least one group member suggested that it might be rash to draw analo- gies between fruit fly and human plateaus, given less convincing evidence for mortality plateaus in nonhuman mammalian systems such as mice.
Future Challenges and Recommendations The group concluded that the demographic data suggested potential qualitative differences in late-life biology. For example, not just mortality but also disease load might plateau or even decline in later life. The question is whether these phenomena are related and, if so, how.
To adequately evaluate this, the group recommended creating adequate measures for disability and impairment in late life as well as exploiting the appropriate measures that already exist. For individual and population measures already available, this includes determining the precision, bias, information, and applicability.
The group also noted that several kinds of data, assessed on multiple scales, would likely be required to get to the bot- tom of the mortality plateau conundrum. Once appropriate measures are available, it should be possible to evalu- ate the age-associated changes both across populations and within individu- als in late life.
Relationship of Demographic and Health Factors to Cognition in Older Adults in the ACTIVE Study
This could be useful in addressing the broader questions of mortality and healthspan. For instance, better measures of impairment and disease might reveal distinct groups and vulnerabilities within these groups.
Throughout the meeting the group struggled to reconcile the demo- graphic data with the broader concepts of healthspan and aging. The model represents a mathematical interconnection between aging, mortality rates, aging, and functional human healthspan 47 mortality rate, and healthspan that can theoretically accommodate various kinds of data. For example, age and healthspan can be related to each other based on the absence of disability or impairment, but also other measures of health.
Relationship between Demographic Factors and the Performance of Teacher Education
Since mortality is not always a function of age, the process of aging itself could theoretically be broken down into a Gompertz phase and a non-Gompertz phase. This could also help to distinguish between total life expectancy and active life expectancy. The group narrowed its focus to look at the example of a very healthy year-old.
They speculated that if it were possible to have perfect knowledge about the individual, it might also be possible to understand the relationship of age with healthspan and mortality.
For instance, if death and health declines are completely stochastic, it might not be possible to predict health declines or death. On the other hand, one mechanism might start an inevitable decline in health ending in death, making it relatively simple to predict both decline and death.
It is crucial that the most appropriate way of comparing the effectiveness of treatment interventions for RA is determined. Previous research suggests that there are inconsistencies in the measurement of health utility HUa key component of cost-effectiveness analysis CEA. This problem is thought to be particularly evident among patients with chronic illnesses like RA. CEA is a balanced way to assess whether a treatment for RA is financially justifiable, taking into account health benefits and treatment costs.
Such assessment is particularly important for weighing the considerable costs of recently developed biological therapies against the costs of uncontrolled RA [ 3 ]. Methods of deriving HU must use a scale that is reliable and valid [ 7 ]. HU commonly ranges from 0 to 1, where 1 usually represents perfect health and 0 is generally equated to death.
The first two of these are direct instruments, involving gambling on a hypothetical medication that may cause perfect health or death SGor trading off part of future life for reduced time in perfect health TTO.
Indirect methods of obtaining HU involve reports of current health on a standardized questionnaire such as the parsimonious EQ-5D; HU for responses have previously been estimated from HU reported in large population-based surveys using TTO [ 12 ]. It is essential that HU measures are consistent and reflect improvement or deterioration in disease, and direct instruments may not be able to provide this adequately for patients with chronic illnesses like RA.
Inconsistencies between different HU measures among RA patients may make it difficult or impossible to provide comparable cost-effectiveness figures [ 9—1113 ]. There is also a debate about whether HU is best elicited directly or indirectly [ 1415 ]. Although SG and TTO are the preferred means of measuring HU from economic perspectives, indirect methods are more frequently implemented due to ease of administration and stronger correlation with other measures of health status [ 13 ].
It can also be argued that for economic decision-making in public healthcare systems, such as the British National Health Service NHSthe assessment of the utility of health states should be determined by the public the tax payers rather than individual patients, making indirect methods preferable.
Recent studies [ 1113 ] suggest that there are considerable variations in HUs across different indirect measures, but have not compared these with direct HU instruments. It is important to understand why the same HUs are not elicited by different measures. One of the problems with direct measures of HU is the assumption that decision-makers are rational individuals with no reference to demographic or psychosocial context.
Furthermore, while questionnaires differ clearly in the dimensions used to construct a health state [ 9—11 ], it is not clear what attributes patients include in the construct of their health state in SG and TTO [ 1617 ]. This study is the first to examine in detail the health state construct underlying the main HU measures among people with RA.