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Preface -- About the authors -- The field of social gerontology -- The growth of social gerontology -- Aging in other countries and across cultures in the united states -- The biological and physiological context of social aging -- The social consequences of physical aging -- Managing chronic diseases and promoting well-being in old age -- The psychological context of social aging -- Cognitive changes with aging -- Personality and mental health in old age -- Love, intimacy, and sexuality in old age -- Social theories of aging -- The importance of social supports : family, friends, neighbors, and communities -- Opportunities and challenges of informal caregiving -- Living arrangements and social interactions -- Productive aging : paid and nonpaid roles and activities -- Death, dying, bereavement, and widowhood -- The resilience of elders of color -- The resilience of older women -- The societal context of aging -- Social policies to address social problems -- Health and long-term care policy and programs -- Health and long-term care policy and programs -- Index -- Photo credits

ARSTRACTVery little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre‐ and post‐treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medicai history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre‐ and post‐treatment data were obtained on 76 subjects following their treatment (mean four months later). The groups members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/‐ 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.1%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre‐ and post‐treatment, reflecting high physical and psychosocial OHQOL and low leveis of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre‐ and post‐treatment (r=‐.24, r=‐.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=‐.23, p<.05). Elders with more teeth reported higher GOHAI pre‐ and post‐treatment (r=.36, r=.37 respectively, p<.002). Paired t‐tests comparing pre‐ and post‐treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on‐site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well‐being.

As part of a series of studies on oral health behaviors of older persons, 81 elderly Japanese Americans were interviewed regarding their dental service utilization patterns, oral health attitudes, and dental status. The sample consisted of 35 Issei (first generation) and 46 Nisei (second generation) Japanese Americans. Because of the significant age difference between the Issei and Nisei, it was difficult to examine generational differences between the two groups. When age differences were controlled, there was no difference between the two generations in interval since their last dental visit. However, reasons for dental visits differed between the two groups, with the Issei more likely to seek help with dentures or general restorative work while the Nisei were more likely to schedule appointments for dental check‐ups and cleaning. The best predictors of dental service utilization for the entire sample were the use of complete dentures, age, and education (R2= .38), but when the respondent's perceived importance of oral health was entered into the equation, this variable accounted for more variance than age or education. The combination of complete dentures, importance, and age accounted for 41% of the variance in recency of dental service utilization. Locus of control, the belief component of attitudes, and overall attitude scores did not add significantly to the prediction of dental utilization.

ABSTRACTThis study examines age differences in causes, characteristics, and outcomes of facial trauma seen in a major trauma hospital. A retrospective analysis was undertaken of 615 cases of facial trauma that had occurred during a 5‐year period. The greatest proportion of patients were aged 20 to 29; those older than age 60 represented just 6.8% of the total cases. Gender differences were not observed in the oldest age groups. The oldest patients (older than 70 years) were more likely to have had pedestrian accidents and less likely to have been assaulted than other age groups. Older patients had more multiple injuries but fewer treatment procedures than other age groups. Significant differences were found in death rates; the older patients were more likely to die as a result of their injuries. Implications for patient management based on age and treatment needs are discussed.

ABSTRACTThere is limited information regarding oral health status and other predictors of oral health‐related quality of life. An association between oral health status and perceived oral health‐related quality of life (OHQOL) might help clinicians motivate patients to prevent oral diseases and improve the outcome of some dental public health programs. This study evaluated the relationship between older persons' OHQOL and their functional dentition, caries, periodontal status, chronic diseases, and some demographic characteristics. A group of 733 low‐income elders (mean age 72.7 ISD=4.71, 55.6% women, 55.1% members of ethnic minority groups in the U.S. and Canada) enrolled in the TEETH clinical trial were interviewed and examined as part of their fifth annual visit for the trial. OHQOL was measured by the Geriatric Oral Health Assessment Index (GOHAI); oral health and occlusal status by clinical exams and the Eichner Index; and demographics via interviews. Elders who completed the four‐year assessment had an average of 21.5 teeth (SD=6.9). with 8.5 occluding pairs (SD=4.6), and 32% with occlusal contacts in all four occluding zones. Stepwise multiple regressions were conducted to predict total GOHAI and its subscores (Physical, Social, and Worry). Functional dentition was a less significant predictor than ethnicity and being foreign‐bom. These variables, together with gender, years since immigrating, number of carious roots, and periodontal status, could predict 32% of the variance in total GOHAI, 24% in Physical, 27% in Social, and 21 % in the Worry subscales. These findings suggest that functional dentition and caries influence older adults' OHQOL, but that ethnicity and immigrant status play a larger role.