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Example research essay topic: Elderly Population Life Expectancy - 1,571 words

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... sexual activities. Health issues are also influenced by the physical differences between young men and young women and by their different ethnic groups. An estimated 8 percent of all 15 to 25 year-olds living in households have at least one disability that limits their daily activities. The most common disability is physical (affecting mobility and / or agility), followed by sensory limitations (which are not fully corrected with glasses, contact lenses or a hearing aid). Most young people with disabilities have only one limitation, although 46 percent have more than one disability.

Young people aged 10 to 24 years assess their health more positively than people aged 25 years and over. Less than 4 percent of young people aged 10 to 24 years consider their health to be not so good or poor compared with 11 percent of people aged 25 and over. From a total of 381 young people with autism, 180 could be matched for age, sex, and IQ level with children from an epidemiological sample of non autistic children with ID (Case Study No 28, 1999). This ID sample was obtained in 1990 - 1991, when children aged 4 - 18 years in receipt of any health, education, or welfare services for an ID (IQ < 70, N = 581) were identified in six census regions in the Australian states of New South Wales and Victoria. This provided a representative sample of Australian young people with ID with respect to socioeconomic class, urban and rural distribution, and ethnic mix. The ascertainment of those with IQ < 50 is likely to be virtually complete.

The ascertainment of those with mild levels of ID (IQ > 50) is probably biased to those receiving health, education, or welfare services including those with emotional and behavioral problems. A medical assessment and cause of ID was completed for everyone in the sample, and children known to have autism in the representative sample were excluded from the matching process. For those children with autism and normal IQ, a matched control from their school class was obtained contemporaneously in 1995 - 1996. The autism and the control matched sample groups each had a mean age of 8. 9 years. The autism assessment clinics served the same regions that provided the control samples. Therefore, the mix of socioeconomic class, urban and rural distribution, and ethnicity is likely to be similar.

The children with autism and the control sample of normal range IQ were obtained in 1995 - 1996, but the control sample with ID was obtained in 1990 - 1991. Therefore, a cohort bias of indeterminate effect might be possible. The autism group was a clinical sample rather than an epidemiological group, and this might account for some of the distinction between them. Further studies to establish the utility and validity of the DBC-ASA across varying populations are needed. Cultural factors might also provide a possible source of bias. The regions that provided both the autism and control samples in this study are representative of the diverse and broad Australian community in terms of spread of ethnic background, socioeconomic status, and urban and rural environments (Case Study No 28, 1999).

It is likely that the core features and phenomenology of autism are consistent around the world, but there is a wide variety of culturally different approaches to management and service provision. The findings of this New Zealand study are likely to be of international relevance, although replication of the findings for versions of the DBC in other languages and cultures is necessary. The effects of disability on an aging population's health and welfare in NZ are an important issue in gerontological research. The rapid growth of the elderly population and increases in longevity have led to an ongoing debate about whether longer lives can be matched by longer active lives that are free from disability. After a detailed review of current disability literature, the authors discuss the impact of disability in the elderly, defining disability and reviewing three classes of disability -- physical, mental and social. Both subjective and objective disability measures are described, and disability trends and prevalence rates are reviewed and compared cross culturally, by gender, by age, and over time.

The path from chronic disease to disability is described and the consequences of living with disability are discussed in terms of family burdens and the increased need for medical care. Two important measures related to the disability process and to aging itself are life expectancy and active life expectancy. Life expectancy is the number of years a particular group can expect to live from a given point of time until death. In New Zealand, life expectancy at birth in 1995 was 72. 5 years for men and 78. 9 years for women, representing increases since 1900 of 25 years for men and 30 years for women. Gains in life expectancy were initially attributable to decreasing infant mortality, better sanitation and living conditions, and pharmacological treatment of parasitic diseases, such as malaria, and bacterial diseases, such as influenza, pneumonia, and tuberculosis. Recently, increases in longevity have been attributed to better medical management of chronic disease (especially cardiovascular disease), changes in lifestyle (behavioral and social changes emphasizing health promotion), and improved nutrition.

Large life expectancy increases have also occurred among older people, with the elderly population projected to increase in size and proportion relative to the overall NZ population. It is projected that 18. 5 % of the NZ population will be 65 years old and over by 2025, up from 12. 8 % in 1996, with the oldest old (85 years and older) the most rapidly growing segment. The rapid growth in the number and proportion of elderly, relative to the overall NZ population, has raised important quality of life issues. One important issue is whether increases in longevity will translate into increases in disability-free or active life expectancy. In the older population, disability has been defined as the inability to perform or complete particular tasks or roles that previously could be accomplished without difficulty or the help of another person.

This definition suggests a deterioration or reduction in ability over time. Disability has also been defined as a difference, or gap, between an older individual's capability to complete a particular task and the demand imposed by the task. By changing or altering either capability or demand, the disability gap can either increase or decrease. For instance, if the demand of a task is held constant, decreasing capability widens the disability gap. New Zealand Royal Commission informs that a widening gap typically results in increasing difficulty, eventually resulting in loss of independence. Loss of independence, in turn, increases the risk for institutionalization and death.

Conversely, to reduce or slow the widening disability gap, individuals may use medical interventions (eg, medication) or adjust their lifestyles to accommodate or manage their disabilities better. Relying on formal or informal supports or on mechanical devices such as walkers, for example, may reduce the disability burden. The disability gap may also be reduced by reducing the demand of the task. For example, ramps or elevators can be used in place of steps, and living arrangements can be adjusted to decrease the individual's need to climb stairs. By recognizing and implementing change where needed, elderly individuals, even those mildly to moderately disabled, can maintain an active, independent life. Older individuals who maintain an active life tend to be healthier, live longer, experience less disability, and be less likely to be institutionalized than those who are inactive.

Mann JL, Crooke M and Fear H. in their work have suggested the importance of evaluating the level of difficulty in performing a task or in maintaining social roles instead of dependency. Dependency refers to reliance upon an outside agency (human or mechanical), whereas difficulty measures how handicapped a person has become over a period of time. A person experiencing increasing difficulty with daily activities may at some point require assistance. Thus, dependence may be thought of as the extreme end of a difficulty continuum. Another issue is whether the impairment that leads to a limitation or restriction in activity or participation is temporary or permanent.

For some impairment, such as those relating to mobility, whether the impairment was temporary would not be important: the same kinds of accommodations would be needed as for someone with a permanent impairment. The issue is again more complex with regard to invisible impairments. If an impairment can be cured (as with recovery from an addiction or as a result of psychotherapy), should that be considered a disability? Or is it a disability until it is cured?

The problem becomes more complex when there is potential discrimination against persons who were diagnosed as having an impairment leading to a disability that was subsequently alleviated, as in the case of successful therapy. Should the former existence of a disability be considered in the definition? Words: 3002 Bibliography: New Zealand Royal Commission on Social Policy (April 2002), The April Report; Richmond, D et al. (1995) Care for Older People in New Zealand. Report to the National Advisory Committee on Core Health and Disability Services; Case Study No 28: Young, Adult, and Old Disabled People. Wellington, 1999; Mann JL, Crooke M, Fear H et al. Guidelines for Recognizing and Dealing With Disabilities.

NZ Med J 1998; Code of Health and Disability Services Consumers Rights. Wellington, NZ Health and Disability Commissioner; Reed, P. (1997). The Medical Disability Advisor. Waikanae, N. Z.


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Research essay sample on Elderly Population Life Expectancy

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