Life Expectancy

Objectives This study aimed to assess the effectiveness of self-care empowerment training on life expectancy,
happiness, and quality of life of the elderly in Iranian elderly care centers in Dubai.
Methods & Materials This study was a quasi-experimental research conducted in the form of pre-testpost-
test with control group. The statistical population of this study included all Iranian elderly in the
elderly care centers in Dubai. Of these individuals, a sample of 40 elderly people (20 women and 20 men)
was selected and were involved randomly in two experimental groups (n=20; 10 women and 10 men) and
one control group (n=20; 10 women and 10 men). In this study, the experimental group received self-care
education during 12 sessions for 3 months and a weekly two-hour session, and the control group was put
on a waiting list. The experimental and control groups completed the Snyder Hope Scale (SHS), the Oxford
Happiness Inventory (OHI), and the World Health Organization Quality of Life scale (WHOQOL) in the pretest
and post-test phases. The data were analyzed using Multivariate Analysis of Covariance (MANCOVA).
Results The findings showed that in post-test, self-care empowerment training significantly increased the
hope, happiness, and quality of life in the elderly.
Conclusion Self-care empowerment training in the elderly can be effective in increasing hope, happiness,
and quality of life of these individuals.

Objective.-To examine the effect of hormone replacement therapy on life ex-cer. However, these average populatior pectancy in postmenopausal women with different risk profiles for heart disease, level benefits associated with harmon breast cancer, and hip fracture.

The growing trend of aging phenomenon poses the need to pay attention to the issues of the elderly as a social necessity. The decrease of the life expectancy and psychological hardiness can cause difficulties in the elderly. Therefore, the aim of this study was to determine the effectiveness of group reminiscence on psychological hardiness and life expectancy of the elderly in Tehran, Iran. This was a quasi-experimental study with pretest-posttest design with a control group. The statistical papulation included all the elderly residing in nursing homes in Tehran among which Kahrizak nursing home was selected using convenience sampling method. Thirty elderly were selected according to the inclusion criteria of the study and assigned randomly into experimental (n=15) and control (n=15) groups. The experimental group received eight 2-hour weekly sessions of reminiscence intervention and the control group remained on the waiting list. Cliff's Mental Strength and Miller's life expectancy Questionnaires were applied to collect data. The results of Univariate Covariance Analysis (ANCOVA) indicated that the reminiscence has a significant effect on psychological Hardiness and its components including challenge, life control, self-confidence, interpersonal trust (P<0.05) and has no significant effect on commitment and emotional control components (P<0.05). Moreover, the significant effect of the intervention on life expectancy was confirmed (P<0.05). The findings of this study illustrate the effectiveness of group reminiscence intervention in the elderly. Therefore, it is recommended that psychologists and therapists take advantages of this method in order to improve the psychological problems of the elderly.

Objective: Though the surgical treatment of esophageal cancer is increasingly accepted for elderly people defined as aged over 70 years, less is reported about the results in patients over 75. This study is a single institution retrospective analysis of outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Methods: All consecutive patients 76 years old and over undergoing curative esophagectomy for cancer in the period 1991-2006 were analyzed as to comorbidities, outcome and long-term survival. All the data had been prospectively collected in a database. Postoperative mortality risk was assessed by P-POSSUM and O-POSSUM score for in-hospital mortality and by the recently published Steyerberg's score system [Steyerberg EW, Neville BA, Koppert LB, Lemmens VEPP, Tilanus HW, Coebergh JWW, Weeks JC, Earle CC. Surgical mortality in patients with esophageal cancer: development and validation of a simple risk score. J Clin Oncol 2006;24:4277-84.] for 30-day mortality. Five-year survival was compared to the standardized survival in the general population. Results: One hundred and eight patients fulfilling the abovementioned criteria were found (76 males and 32 females, mean age 79.5 years, mean standardized life-expectancy: 7.36 years). Among them, 69% had esophageal tumors and 31% GEJ tumors. The predominant histology was adenocarcinoma (74%). Eighty-six (79.6%) presented with one or more major comorbidities or a history of previous major upper-GI surgery, potentially affecting the surgical outcome. All underwent resection with curative intent (R 0 83.3%, R 1 12%, R 2 4.6%). The overall postoperative morbidity rate was 51.9%, pulmonary complications (37%) being the most frequent. Postoperative mortality, mainly due to cardiopulmonary complications, was 7.4%, which was consistent with that predicted by P-POSSUM score (7.2%) and lower than that predicted by O-POSSUM score (15.1%). Thirty-day mortality was 5.5%, being consistent with that predicted by the Steyerberg's score (6.8%). Overall 5-year survival was 35.7%, while R 0 overall survival 42% and cancer specific R 0 survival 51.7%. Conclusions: Patients 76 years old and over with esophageal or GEJ cancer should not be denied surgery solely on the basis of age. Outcome and long-term results in the selected elderly are not differing from those reported for younger patients. However, despite thorough preoperative assessment being applied in the selection of the candidates for surgery, a practical and reliable individual riskanalysis stratification is still lacking. #

Studies on the effect of ageing on health care expenditure (HCE) have revealed the importance of controlling for time-to-death (TTD). These studies, however, are subject to possible endogeneity if HCE influences the remaining life expectancy. This paper introduces a 10-year observation period on monthly HCE, socioeconomic characteristics and survivor status to first predict TTD and then use the predicted values as an instrument in the regression for HCE. While exogeneity of TTD has to be rejected, core results concerning the role of TTD rather than age as a determinant of HCE (the &#x27;red herring&#x27; hypothesis) are confirmed.

Epilepsy carries a risk of premature mortality, but little is known about life expectancy in people with the condition. The UK National General Practice Study of Epilepsy is a prospective, population-based study of people with newly diagnosed epilepsy. A cohort of 564 patients with definite epilepsy has been followed for nearly 15 years and there have been 177 deaths. These data have been used to estimate life expectancy of people in this cohort by employing a parametric survival model based on the Weibull distribution. Life expectancy in people with epilepsy was estimated as a function of age at, and time from, diagnosis according to two broad aetiological groups. These estimates were then compared with life expectancy in people of the same age and sex in the general population. Reduction in life expectancy can be up to 2 years for people with a diagnosis of idiopathic/cryptogenic epilepsy, and the reduction can be up to 10 years in people with symptomatic epilepsy. Reductions in life expectancy are highest at the time of diagnosis and diminish with time. Our model provides broad estimates, but it appears that the higher mortality rates in people with newly diagnosed epilepsy translate into decreased life expectancy.