فصلنامه سالمند
پیاپی 40 (بهار 1395)

With increasing the older adults’ population, the old age diseases increase, as well as older people’s dependency and need for care. This issue further highlights the importance of attention to family caregiving and experiences. Among the concepts related to family caregiving, the concept of selfappraisal of caregiver has a special role in acceptance, continuance, and outcomes of caregiving. This study aimed to review all aspects of caregiving appraisal concept in family caregivers.
Methods & Materials :The current study is a review study. To examine the concept of family caregiver appraisal, all articles without time limitation were searched in databases of Google Scholar, ProQuest, Scopus, and PubMed with keywords of “appraisal,” “caregiving,” “family caregiving,” “burden,” “satisfaction,” “positive aspect,” “negative aspect,” “older adults,” and “elderly.” The Iranian databases of IranMedex, IranDoc, and SID were also searched with equivalent Persian Keywords.
Many factors such as social, cultural, and personal characteristics can influence the caregivers’ perception. This subjective appraisal makes caregivers not to perceive their conditions the same, in spite of stressful situation of caregiving. Some caregivers have positive experiences in this condition and some perceive stress more than what actually exist. This will create negative outcomes for the health and welfare of the caregivers.
Caregiving appraisal is a multidimensional concept, which has positive and negative aspects. By taking into account all aspects of this concept, one can better understand and ultimately has a more comprehensive assessment of the status of caregivers, and implement effective interventions towards improving the health of this group.

Old age is associated with irregularities in many aspects of body immune system function. During this period, the immune responses decline with increasing age. In other words, with decreasing number of immune cells, which are responsible for detecting and direct attack to contaminated cells, the immune response decreases and results in failure of the immune system. As sports activities could affect the immune system and old age is associated with progressive immune failure, the study of the effects of exercise on the immune system function in old age becomes important. Therefore, this study aimed to investigate the effects of selected combined exercises (aerobic and resistance training) on the serum level of cortisol and immunoglobulins in inactive elderly men.
Methods & Materials :In this quasi-experimental study, 24 subjects were selected by convenience sampling method. Their age and body mass index ranged 60–70 years and 22–25 kg/m2, respectively. Then, they were randomly assigned into 2 groups (experimental [n=12] and control [n=12]). The experimental group started the combined training exercise, and the control group continued their inactive usual routines. The combined training exercise (aerobic-resistance) included running on a treadmill for 20 minutes per session, 3 sessions per week, for 8 weeks, with an intensity of 60% to 70% HRR. Furthermore, the resistance training comprised 10 circling stationary movements of leg flexion, leg extension, leg press, scott, underarm stretch, chest press, iron cross with dumbbells, biceps flexion, triceps extension, and rowing motion with rope. This training included an intensity of 60% to 70% of one maximum repetition with extra load and 10 repetitions in 2 successive times with 30 seconds rest between each repetition and 2 minutes’ rest between each movement. In this study, the blood samples were taken 24 hours before the exercise and 24 hours after the last session of the exercise. We used nephelometer instrument and binding kit site to measure the IgG, IgM, and IgA levels. The cortisol level was measured by Gamacounter and RIA kit by the immunoradiometric method. To evaluate the consumed oxygen, we used the protocol on treadmill instrument. In order to compare intra- and inter-group mean variables, we used analyses of variance for repeated measures. The significant level was set at PThe results indicated that the combined exercises reduced IgG level (12.75%) in the elderly people (P=0.04). Although the level of serum IgM was also reduced (15.93%), this decrease was insignificant (P=0.31). Furthermore, no significant change was seen in the IgA level (P=0.90). The cortisol level was significantly increased (8.33%) in the experimental group P=0.001). Based on the results, the mean intergroup changes in the levels of IgA, IgA, and IgM were not significant (P>0.05). However, a significant difference was seen between 2 groups with regard to serum cortisol level (PDoing physical activities is one of the key factors in changing the function of the immune system. This issue is associated with the intensity, duration, kind of exercise, body readiness, nutrition, mental status, and hormonal factors. Based on the results, long and intensive exercises with an increase in the catabolic process may weaken the immune system of the older people.

The inability to allocate attention to balance when performing concurrent tasks may cause the older adults to fall. Therefore, thisstudy aimed to investigate the effect of 2 types of dual-task training on the balance of older adults.
Methods & Materials :This quasi-experimental study included 36 eligible older adults (aged > 65 years) living in Kerman City, Iran. The selected participants were randomly divided into 3 groups based on the Berg balance scale scores, and each group consisted of 12 older adults. Our training groups comprised dual-task group under fixed priority, dual-task group under variable priority balance training, and control group. The experimental groups received 45-minute individualized training session, 3 times a week for 1 month (4 weeks). The training comprised of 3 kinds of activities: standing, transferring, and walking. The training was administered based on 2 principles of difficulty of moving task and individual’s safety as well as corresponding with the classification of Gentile’s moving task. We used the Berg balance test and sitting and walking times test for 2 conditions of single and dual tasks to evaluate balance in older people. For data analysis, we performed analysis of covariance and Bonferroni post hoc test with SPSS version 18 (PIt was found that there were significant differences (P≤0.05) between the control group and dual-task groups with fixed and variable priorities with regard to the balance performance test and the time of walking and sitting under single-task condition. In other words, 2 dual-task groups had better performance than the control group. However, no significant difference was seen between the 2 training groups of dual-task (P>0.05) with fixed and variable priorities in the test of the single-task condition. Moreover, the results of tests of sitting and walking time under dual-task condition showed significant differences between the control group and the dual-task groups with fixed or variable priorities and also between the 2 dual-task training groups with fixed and variable priorities (P≤0.05). Thus, this indicates that the training groups with dual tasks (fixed or variable priority) had better performance than the control group. In addition, the training dual-task group with variable priority had better performance than the same group with fixed priority.
The superiority of training with dual-task over single one and the superiority of dual-task training with variable priority over the fixed one (under dual-task condition) may be due to the “limited capacity of attention” theory, which explains the reduction in performance when performing imultaneous tasks. This difference and dominance may also be explained by other mechanisms, such as the capability of attention and focus on doing tasks simultaneously, involved in this process. Therefore, by designing balance training based on dual-task methods, especially training based on the ability to turn the focus of cognitive capabilities and their suitable allocation, the attention to these tasks improves and consequently, the risk of falling decreases in the older adults.

Sleep disorders are prevalent among elderly patients admitted to coronary care units (CCUs). Moreover, the sleep disorders intensify with age-related changes. Thus, this study aimed to determine the effect of white noise on the sleep of elderly patients admitted to CCUs.
Methods & Materials :This quasi-experimental research included 40 patients who were admitted to CCU. The sampling was done by convenience sampling method and by following the inclusion criteria. In this study, sleep duration and sleep latency of the patients were measured on the first day of hospital admission and 1 week after hospitalization in CCU in both the control group and experimental group. The experimental group received “white noise” (ocean sound) for 2 hours each day before bedtime for 1 week while the control group received no such noise. The obtained data were analyzed by statistical tests (Chi-squared test, independent t-test, and paired t-test) through SPSS, version 18.
The mean (SD) age of the participants was 68.75 (6.19) years in the control group and 67.05 (5.15) years in the experimental group. Most participants were men (57.5%). In addition, most of them were hospitalized with acute coronary syndrome (80%), and 65% had a history of hospitalization. The mean (SD) sleep duration in the control group was 7.16 (0.86) hours before the intervention, which decreased to 4.69±0.56 hours after the study. The mean (SD) sleep latency in the control group increased from 20±5.4 minutes to 28±5.4 minutes after the intervention, which shows a significant reduction in sleep quantity after hospitalization (POur results showed that white noise did not significantly change the sleep quality of old patients; however, it prevented the decrease in sleep duration and the increase in sleep latency duration. White noise with regard to its effects on increasing auditory stimulation threshold, its sleep induction, and suitable cost-effectiveness, can be used for some old patients hospitalized in CCUs.

This research was conducted with the aim of explaining the dysfunctional attitudes of hospitalized cardiovascular patients through dysfunctional metacognitive beliefs.
Methods & Materials :This cross-sectional study was conducted in Shariati Hospital in Isfahan, Iran, in 2012. The statistical population was the hospitalized cardiovascular patients of Shariati Hospital in Isfahan. Out of them, 87 patients were selected using simple random sampling method. Research instruments were the dysfunctional metacognitive beliefs questionnaire (Cartwright-Hatton and Wells) and dysfunctional attitudes scale (Wiseman and Beck). Data were analyzed using SPSS version 18 through performing multiple regression analysis and the Pearson correlation coefficient.
The results of regression analysis revealed that “need to control thoughts” has significant predictive power for the “others’ satisfaction” (PFindings of this research revealed that dysfunctional metacognitive beliefs have predictive power for dysfunctional attitudes, which may affect health of cardiovascular patients.

Objectives Alzheimer’s disease is the most common kind of dementia in the old age, and its incidence increases with age. Previous studies have shown that cytokines are proteins that play an important role in inflammation, and their level changes in inflammatory diseases. Since Alzheimer’s disease is an inflammatory disease, cytokines may influence the occurrence of this disease. IL16 is a cytokine whose role has been proved in many inflammatory diseases. This gene is one of the coding genes of cytokines of the inflammatory process. It may be responsible for inflammatory pathology seen around old age plaques in Alzheimer’s disease. It can also associate with the pathology of Alzheimer’s disease. Therefore, the aim of this study was to investigate the effects of 2 polymorphisms of gene IL16 (rs1131445 and rs4072111) on the risk of patients diagnosed with Alzheimer’s disease in the Iranian population.
Methods & Materials In this study, the intervention group consisted of 144 individuals who were diagnosed with Alzheimer’s disease by psychologists based on a clinical test (DSM-IV), and the control group included 173 healthy individuals with no psychological disorders. DNA was extracted by salting out technique. The PCR response was conducted (for replicating the mentioned pieces) for any polymorphism in optimized conditions by using designed primers. The product of PCR was first checked for the confirmation of accurate function of PCR using polyacrylamide gel electrophoresis (PAGE). Next, the PCR product was dissected by restriction fragment length polymorphism (RFLP) method with intended confining enzyme, and then the genotype of the samples was determined by PAGE. Individual genotypes were determined using the PCR-RFLP method. Statistical analyses were done using OpenEpi 2.3.1 and SPSS 11.5.
Results The study of allelic analysis between the control and intervention groups by considering the confidence interval (CI=90%) and significant level (0.05) for rs1131445 showed that the C allele had no significant association with Alzheimer’s disease (P=0.656). The TC genotype did not show any significant difference with TT genotype (P=0.614). However, the study of allelic analysis for rs4072111 polymorphism between 2 groups showed that the relationship of T allele with the disease is significant, and this allele has a protective role in creating the disease (P=0.008). In addition, TC genotype as a protective status showed a significant association with Alzheimer’s disease (P=0.007).
Conclusion The existence of polymorphism in some genes of the inflammatory pathway could make people susceptible to Alzheimer’s disease. The genetic changes in DNA sequence of gene IL16 could result in changes in cytokine product or its function. The association between rs4072111 and Alzheimer’s disease supports the presumptions and shows a probable role of this polymorphism in Alzheimer disease. Besides, the association between rs1131445 and Alzheimer disease cannot be proven due to the small number of samples (Power: 8.23%).

Objectives In recent decades, due to decreasing birth rate, better health facilities, implementation of prevention programs, and increasing life expectancy, the population of older people has increased in different countries. This phenomenon is considered graying of the population or mandatory retirement. A review of the literature shows that most old age people are facing physical and mental problems such as movement problems, chronic pain, sleeping problems, seclusion, and depression. Thus, it is necessary to allocate a good share of health and treatment resources in any society to old age people and attend their problems. This study aimed to examine the relationship between sleep quality and the level of depression in people residing in nursing homes of 3 districts of Tehran City, Iran, in 2013.
Methods & Materials This descriptive-analytical study included people living in nursing homes of Tehran Welfare Organization. The study sample consisted of 90 older people who were selected through cluster random sampling considering the proportion of the northern, central, and southern regions of Tehran and observing their level of consciousness, ability to respond, and willingness to participate in the study. To obtain the data, we used 2 questionnaires of Pittsburgh sleep quality index and geriatric depression scale. Then, the obtained data were analyzed through multivariate regression.
Results Older women constituted 60% of the participants. The findings revealed that there was a negative and significant relationship (PConclusion There is a causal and mutual relationship between sleep disturbances and depression, in such a way that sleeplessness could end in depression, and if the depression signs are ignored, it will gradually affect sleep quality. Generally, sleep disturbances are mutually associated with depressive mood and low quality of life. Therefore, to enhance sleep quality and decrease the level of depression in people residing in nursing homes, the necessity of special care programs in the old age should be emphasized. With regard to limitations of this study, we cannot generalize our results to all old population as our study was confined to only 3 districts of Tehran. In addition, since some variables like education and economic status of old age people were not considered in this study, there is a need to generalize the findings. Finally, it is recommended that future studies should investigate the relationship between sleep quality, lifestyle, and daily activities in the nursing homes.

Objectives The perception of time is a fundamental and complicated cognitive skill, which allows us to perceive a series of events and activities and anticipate some events in the future. The passage of time is influenced by different contributions of the brain regions and basic cognitive processes, especially attention and memory. With regard to changes in the mentioned functions in different ages, this research aimed to determine the differences in time perception between young and older people.
Methods & Materials This causal-comparative study included young (20-30 years) and elderly (60-70 years) women and men living in Tabriz and Marand cities, Iran. The study samples were recruited via convenient sampling method and comprised 64 individuals who were assigned to 2 groups: young (n=30; 15 males and 15 females) and elderly subjects (n=27; 12 males and 15 females). The measurements included mini-mental state examination test, Beck depression inventory, and time reproduction task. At first, the time reproduction task was individually performed for each subject. To prevent fatigue and its impact on time perception, Beck depression inventory and mini-mental state examination test were performed after the time reproduction task. In time reproductiontask, a circle was randomly presented in standard durations of 400, 500, and 600 ms, as short time, andstandard durations of 1800, 2000, and 2200 ms, as long time, successively. In total, 80 trials (40 trials for short times and 40 attempts for long times) were randomly and successively presented. Subjects should hold downthe space key to reproduce similar duration to the stimulus that had been previously presented. The data of all the subjects were analyzed by multivariate analyses test.
Results Our findings showed significant differences between 2 age groups (young and old) with regard to perception variable (PConclusion Research findings indicate that age affects time perception so that perceived time in the elderly people is shorter than the real physical time. Our findings also showed that if sources pay less attention to the passage of time or the memory capacity declines, the time estimation will be less. Based on cognitive changes in old age, the cognitive abilities of older people were found to decrease with increasing age. As the accurate processing of time intervals relates to memory capacity and attention, the changes in any cognitive process could affect the differences in the perception of time. Probably due to these factors, the reproduction of time in the older people shortens.

Objectives Although the physiologic aging process does not necessarily end in illness, a lot of people contract several diseases, including psychological disorders because of lack of knowledge or proper background. With regard to increasing aging population in Iran, depression severely decreases the “quality of life” in this age group and successively seclusion and getting away from society and social activities will ensue. Depression not only severely affectsnot only in older adults but also their families. This issue is regarded as one of the important challenges of the future. Therefore, this study aimed to determine the relationship between “quality of life” and depression among the retired older people.
Methods & Materials This cross-sectional and correlational study included 200 retired elderly people who worked in Ahvaz Oil Industry, Iran using convenience sampling method. The data were collected by the quality of life questionnaire (SF-12) and depression questionnaire (GDS) and then analyzed by the Pearson correlation coefficient, ANOVA, and regression analysis using SPSS version 16.
Results It was found that the older people in the age range of 61–65 years had the highest frequency (46.5%) and the older people in the age ranges of 71–75 and 76–80 years had the lowest frequencies (0% and 5%, respectively). In this study, the mean (SD) age of the participants was 65 (4) years. The older people in different age groups expressed pretty similar “quality of life” and depression signs and symptoms, and there were no significant differences among them with respect to dependent variables (“quality of life” and depression) (P>0.05, F=1.57). In terms of education, the highest frequency was seen in the under diploma group (44%), and the lowest frequency was seen in the postgraduate group (1.5%). With regard to the history of internal diseases, the elderly with hypertension had the highest frequency (37%). The mean (SD) score of “quality of life” among the old subjects was 27.9 (6.4) and depression signs and symptoms was 4.35 (4.2). There is a significant and negative relationship between depression and “quality of life” among the elderly (P0.05, F=1.57). There were significant differences between normal elderly people and sick elderly people who suffered from diabetes, hypertension, or cancer with respect to “quality of life.”
Conclusion Our study results showed a significant relationship between depression and “quality of life” in the old age. Therefore, the relevant factors to the “quality of life” among the older people must be considered. The self-confidence in the elderly people can be increased by establishing peaceful relations, involving them in constructive activities, and by promoting hope for their future. Prevention and reducing the causes of depression a well as its treatment can improve the quality of life for the older people.

Objectives Studies have shown that doing dual tasks during walking could radically change the pattern of walking even in healthy older people. The study of spatial-temporal parameters and their changes in walking with dual tasks, symmetry in right and left legs functions as well as changes in these parameters have received scant attention from researchers. Therefore, the purpose of this study was to evaluate the changes in spatialtemporal parameters of walking due to their simultaneous execution with cognitive dual-task in older people with impaired balance.
Methods & Materials Thirty older adults with weak balance voluntarily participated in this study. The study subjects were selected through Berg and Mini-Mental State Examination (MMSE) tests. The subjects who got scores lower than 52 in the Berg test were allowed to participate in the study. On the other hand, those who got scores lower than 23 in the MMSE test were excluded from the study. After subjects’ familiarity with the measurements and taking their informed consents, they walked 12 meters under 2 conditions; normal walking and walking with a cognitive dual-task. Spatial-temporal kinematic parameters were recorded by Vicon cameras. Then, by using the Polygon software, the variables of cadence, walking speed, step length, stride
length, duration of step and stride, duration of stance and swing, time of single leg support and double leg support, separation of other leg, touching of other leg to the ground, and time of separation of fingers were calculated in terms of percentages of walking cycle. The obtained data were analyzed using repeated measures ANOVA at a significant level of PResults The results showed that among the examined parameters, the variables of cadence and walking speed during walking with dual-task were reduced significantly compared to normal walking. The duration of the step, stride, time of double support, time of single leg support, the time of standing and swing in walking along with dual-task compared to normal walking showed a significant reduction (PConclusion The results showed that the duration of double reliance and stance increase when walking with dual task than when normal walking. Therefore, in the elderly with poor balance, doing dual-task with walking could increase the risk of fall. With regard to increase in asymmetry in walking with dual-task, it seems that mutual harmony and symmetry is very sensitive to concurrent cognitive task. This asymmetry in the function of legs is considered a risk factor in falling. Thus, based on the results, walking of the elderly with poor balance needs better cognitive performance. Doing concurrent cognitive tasks could intervene with attention sources and consequently change the walking pattern. Therefore, we recommend that the older people with weak balance and prone to falling should refrain from cognitive dual-task during walking and focus on walking itself.

Objectives With the increasing aging population, attention to their problems in society has found vast and new dimensions. The professional rehabilitation teams in day-care centers have aimed at providing services to the elderly to prevent their admission into residential boarding centers. To this end, the Welfare Organization has designed a special service package for the day-care centers. The main objective of this study was to compare the quality of life of older adults in a day center before and after receiving the rehabilitation module of the Welfare Organization.
Methods & Materials This is a descriptive-analytic study with 2 groups and pretest/posttest design. The study population consisted of all older adults referred to day-care centers for older adults. The study sample comprised 50 older adults in the Kahrizak Rehabilitation Center No.2, located in Mohammad Shahr Karaj, Iran in 2014-2015. They were selected through the convenient sampling method and by following the inclusion criteria. They were randomly allocated to the experimental and control groups with 25 older adults in each group. To observe the research ethics, the control group was put on the waiting list for receiving the services. The research instruments included SF-36 quality of life and demographic questionnaires. The SF-36 questionnaire was implemented before, 1 month, and 3 months after receiving the services in both groups. The data were analyzed using SPSS-20. Data analysis was performed using 1-way ANOVA with repeated measures.
Results In this study, the mean age of the control and experimental groups were 66.43 and 68.1 years, respectively. T-test showed that there was no significant difference between the control and experimental groups with regard to their ages (P=0.722). Furthermore, there were no significant differences between 2 groups with regard to sex, education degrees, and history of hospitalization. The mean scores of quality of life in the intervention group at baseline, 1 month and 3 months after the study were 43.95, 56.30, and 74.38, respectively. The values for the same parameters in the control group were 44.74, 49.79, and 57.82, respectively. The lowest score in the quality of life questionnaire was 24.72, and the highest was 86.11. In addition, there was no significant difference between 2 groups with regard to mean scores of their quality of life at baseline (P=0.816); however, there were significant differences for 1 and 3 months after the study (respectively, PConclusion The results showed that the day-care services significantly increased the quality of lives of older people. Therefore, it is hoped that these services can be used along with other conventional services as an effective method. Furthermore, the non-pharmaceutical interventional module can be used in promoting the quality of lives of older people. Rehabilitation services designed by the Welfare Organization for use in the day-care centers for older adults have a positive impact on the elder's quality of lives, and it can be considered as an efficient intervention in rehabilitating older adults.

Objectives The present study aimed to examine the life meaningfulness among the elderly people living in nursing homes of Isfahan, Iran based on their perceived social support from 3 sources of family, friends, and significant others.
Methods & Materials In this research, a total of 120 older people (68 men and 52 women) were selected from the nursing homes of Isfahan through convenience sampling method, and their data were analyzed using Zimet et al. perceived social support and the life meaningfulness questionnaires (1988).
Results The results of stepwise and multiple regression analyses showed that 28.2% of individual differences regarding the life meaningfulness in the elderly people were related to the personal differences in their perceived social support (from family, friends, and significant others), in which the family and other significant persons had the most prominent effect on explaining the changes and in predicting the meaningfulness of life among the elderly. This correlation was statistically significant (P=0.001). Based on analysis of variance, the explained regression model is also significant and linear because the value of F test for determining the effect of independent variables on life meaningfulness of the older people equals 15.353, which is significant (P=0.001). The significance of regression coefficients shows that the family significantly predicts the life meaningfulness of the elderly people. This means that 19.8% of variance is common between family and life meaningfulness of older people. This figure increases to 27.1% by adding significant others to the equation.
Conclusion The results showed that the older people who receive stronger social support also have significantly stronger feelings of meaning in their lives. In other words, the feeling of meaning in the life is significantly related to perceived strong social support. In a way, an important part of individual differences in meaningfulness of the older people’s lives is related to their different perceived social support.
Therefore, today with regard to social changes and busy life of children and accordingly their low relation with old parents, it is anticipated that the low perceived support from the family of the older people (which is the most important predicting factor of life meaningfulness among other factors of perceived social support) will affect the meaningfulness of their lives. Considering what older people told in their interviews with regard to the role of the family on promoting the quality of life among them and reaching a joyful experience of life meaningfulness, it is expected that by increasing the quality and quantity of relationship of the family members with older people, their needed support could be provided. This activity requires family members to sufficiently know and understand the physical and mental condition of the older people. Considering the effectiveness of perceived social support of older people on their life meaningfulness, this study generally showed that a higher attention to components of perceived social support is felt among this vulnerable group of older people.

Objectives The eye refractive errors, including myopia, hyperopia, and astigmatism, are the most important visual impairments worldwide. Based on the existing evidence suggests, the visual impairment could contribute to falling in the elderly. Therefore, this study aimed to determine the influence of vision impairment of older adults with eye refractive errors on the occurrence of falls and postural control.
Methods & Materials The older people referred to the health center of the 9th district of Tehran municipality for ophthalmic examination were examined (using ophthalmoscope and Snellen chart) by skilled ophthalmologists. Then, certain information such as their age, sex, history of special eye disease or operation, history of fall during the last 12 months, etc. was gathered through questionnaires from the older people who accepted to participate in this study after giving their informed consents. Based on eye screening results, 77 older adults with refractive errors of hyperopia (n=19, mean [SD] age=67 [5.85] y); astigmatism (n=22, mean [SD] age=70.32 [5.60] y); and both hyperopia and astigmatism (n=36, mean [SD] age=69.78 [7.69] y), as well as 23 older healthy adults, mean (SD) age=70.29(5.29) y, without any obvious eye disorders were enrolled in this study. Their history of falls and postural control were evaluated. The postural control was determined using the Timed Up and Go (TUG) test. The statistical tests were analysis of variance (ANOVA) for comparing the groups with regard to postural control and the Chi-square test for comparing the prevalence of falls between groups with refractive errors and the healthy group.
Results The studied subjects comprised 23% (n=23) healthy ones, 19% (n=19) people with hyperopia, 22% (n=22) people with astigmatism, and 36% (n=36) people with both hyperopia and astigmatism. About 70% of them were women, and 30% were men. The results of our study showed that 15.8% of study participants with normal vision, 26.1% with hyperopia, 22.7% with astigmatism, and 38.9% with both hyperopia and astigmatism had experienced at least 2 falls in the past 12 months. The people with refractive errors showed a higher prevalence of falls; however, the result of the Chi-square test did not reveal any significant differences among these groups (P=0.25). Furthermore, the results of ANOVA for comparing TUG test (test of postural control) results showed no differences among these groups (P=0.64).
Conclusion Vision impairment of older adults due to refractive error is not associated with an increase in falls. Furthermore, TUG test results did not show balance disorders in these groups. Further research, such as assessment of postural control with advanced devices and considering other falling risk factors is also needed to identify the predictors of falls in older adults with eye refractive errors.

Objectives This study aimed to assess disability and its relationship with depression, cognitive status, and morale in older people.
Methods & Materials This descriptive-analytic research was conducted in a day-care rehabilitation center of Kahrizak charity foundation. A total of 90 older adults were selected by total enumeration sampling method. For the evaluation of study participants, we used The World Health Organization Disability Assessment 2.0 (WHODAS II) (36 items). This questionnaire examines the person’s disability in 6 domains of cognition, mobility, self-care, getting along, life activities, and social participation. The depression status was determined by Geriatric Depression Scale (GDS-15), cognitive status by Abbreviated Mental test (AMT), and morale of older people by Lawton’s Philadelphia Geriatric Center Morale Scale. The Chisquare test, Independent t-test, Mann-Whitney U-test, Kruskal-Wallis, and the Spearman correlation coefficient were carried out to analyze the data in SPSS version 16.
Results About 34% (n=31) of the participants were male and 65.6% (n=59) were females. The mean (SD) age of the sample was 72.39 (6.75) years. There were significant differences between men and women with regard to age, marital status (PConclusion Disability in older people had a significant relationship with their depression, cognitive status, and morale. Thus, the degree of their disability can be lowered by prevention and early treatment of depression, promotion of memory, delaying cognitive disorders, as well as providing morale enhancement programs, creating a positive attitude toward old age, and increasing life satisfaction in older people.

Objectives Today, aging has become a global phenomenon, and attention to its problems is a social necessity. In this age, self-efficacy is associated with psychological dimensions like loneliness. Considering healthy aging as a right for every human highlights the importance of aging phenomenon, prevention of older people problems, and finally presents a better caring service to this vulnerable group. Also, it made the promotion of self-efficacy level and psychological aspects of older people the purposes of health system authorities of the society. This research aimed to study self-efficacy and loneliness between the older people residing in nursing homes and those who live with their families in Shahrekord, Iran.
Methods & Materials It was cross-sectional study. The samples comprised 100 women and men aged 60 years old and over. The study subjects were recruited by convenience sampling method. Data collection tools were 3-part questionnaire of Sherer self-efficacy and loneliness feeling questionnaire. For data analysis, we used independent t-test, analysis of variance (ANOVA), and the Spearman correlation coefficient. The statistical analyses were conducted by SPSS version 16.
Results The results showed that most participants in both groups were women (n=40, 80%). The mean (SD) age of the subjects living with their families was 75.58 (8.22) years and for those living in nursing homes was 77.78 (7.93) years. The mean (SD) score of self-efficacy in the elderly living with their families (51.76 [11.48]) was more than the elderly residing in nursing homes (48.44 [5.26]). Based on the results, self-efficacy had a significant association with employment status and satisfaction with family members (in older adults living with their families). In addition, significant associations were observed between self-efficacy and variables of age, residence place, and satisfaction with nursing home. There was also a significant relationship between loneliness and variables of educational level and satisfaction with nursing home. Our study showed that the degree of loneliness in the elderly people residing in nursing homes is higher (121.36 [11.01]) compared to the elderly living with their families (120.94 [24.25]). Moreover, there was a reverse and significant relationship between all dimensions of loneliness with self-efficacy in older adults living with their families (P=0.001).
Conclusion With regard to the low mean score of self-efficacy of older adults residing in nursing homes, the authorities of nursing homes should pay attention to the needs of older adults and provide general education about promoting the tradition of caring older people by their families. Furthermore, all institutions and organizations that have important goals such as healthy older adults should advance toward their goals by planning, education, and consultation with families that care about their older adults. Finally, with regard to the results about the association of self-efficacy with loneliness, self-efficacy assessment should be considered one of the effective factors in psychological dimensions of the people and a way to support the self-care of older adults because promoting self-efficacy will result in managing stress and improving the mental health.

Objectives Old age is a period accompanied by automatic, gradual, and advancing corrosive changes in most organs and physiological systems of the body. One such important change is in the systems involved in balance control, which could expose older people to serious damages, such as bone fractures that are associated with high medical costs, due to poor balance. Therefore, the main purpose of this study was to investigate the effect of yoga and Pilates exercises on motor performance of the elderly people.
Methods & Materials This study was conducted using a quasi-experimental design. A total of 60 obese subjects (mean [SD] age: 62.2 [1.6] years) were randomly assigned into 3 groups of yoga (n=20), Pilates (n=20), and control (n=20). Yoga practices, which comprised Asana training, Pranaya training, and meditation, were done 3 times a week, for 8 weeks. The Pilates course had 3 sections of warming up, major practices, and cooling down. These practices were done in positions of lying down, sitting, and standing. The movements started from simple activities and gradually got more complicated. Motor performance tests of static and dynamic balance, flexibility, and lower extremity strength were administered. The Stork test was used to evaluate standing balance in terms of seconds and milliseconds. In this test, the old person stands on the dominant foot and put the other foot on the medial part of bearing knee in such a way that the toes point downward and the hands rest on the iliac crests. Then, with the sign of the examiner, the subject lifts his or her dominant heel and try to keep the balance as much as possible. The flexibility was evaluated with Welz test. The subject sits on the ground with legs straight and attaches his or her feet to the flexometer box, then leans forward without bending knees, move the box levers to the front and leans forward as much as possible. The test of climbing stairs up and down was used to measure dynamic stability. In this test, the subjects climb up and down 7 times from a 20-cm height or chair. The subject climbs with one leg and then lifts another leg. Next, he or she brings down the first leg and then another leg. Each climbing is considered one time. When the subject did this activity 7 times, the time is recorded. The standing chair test is used to evaluate the muscle strength of lower extremity and legs. While sitting on the edge of the chair, the subject should stand with the best of his or her power in 30 seconds and then returns to sitting position. The mean of number of activities during two 30-second cycle is regarded as the final record. To analyze the data, we used 1-way ANOVA test and post hoc Tukey test.
Results The results indicated that both Pilates and yoga exercises significantly improved the scores of static balance, dynamic balance, power of lower extremity muscles, and flexibility (PConclusion According to our research findings, yoga and Pilate’s exercises can improve static and dynamic balance and lower extremities strength. Since the improvement in the variables of movement performance has a significant effect on preventing falling of older people, we recommend that these exercises should be followed by the older people.

Objectives Diabetes is a common chronic disease in the elderly that affects their quality of lives. As “quality of life” is one of the most important factors and indicators of health, this study examined the “quality of life” in the diabetic elderly people.
Methods & Materials This descriptive-analytic study was conducted on diabetic elderly people living in Kerman, Iran, in 2013. A total of 120 patients were randomly selected with multistage sampling method. For data collection, the demographic and SF-36 questionnaires were used. Then, the obtained data were analyzed by SPSS version 18 by conducting t-test, correlation coefficient, and analysis of variance (ANOVA).
Results The results showed that the mean age of the subjects was 71.5 years. The total “quality of life” score of diabetic patients was 46.48. The elderly showed that the highest mean among the 8 dimensions of “quality of life” in physical health dimension belonged to general health (47.87), and with regard to mental health dimension, the highest score was in social function (49.78). The total score of physical dimension was 44.89, and the total score of mental dimension was 48.07. Furthermore, the results of t-test and 1-way ANOVA indicated that there were significant correlations between “quality of life” and variables of sex, educational level, complications of diabetes, income, age, duration of diabetes, and body mass index (P≤0.05).
Conclusion In our society, no normative standard has been set for the “quality of life.” However, the mean value of 50 with standard deviation of 10 can be an acceptable and standard score for the “quality of life” among the elderly. The mean score of “quality of life” among diabetic elderly people in this study was 46.48 which was lower than our standard. Also, in studying the 8 dimensions of “quality of life,” the mean score of all dimensions was lower than 50. Prevalence of chronic diseases like diabetes among the older people could end in lowering the mean score of physical dimensions as compared to mental dimensions of “quality of life.” Something that was mentioned in the present study, too.The lower quality of life among women could be due to gender inequality in using health system. As a result, the women are more vulnerable to problems as well as mental and physical diseases which decreases their quality of lives. There was a significant relationship between the educational level of diabetic older people and their quality of lives. Those with higher educational level enjoyed a better quality of life. The effect of higher education on the “quality of life” could be due to the people’sawareness of the importance of diet, exercise, proper medication, and control of risk factors of chronic diseases like diabetes. Furthermore,he higher education could increase quality of life through promotion of social class, increasing income, and self-esteem. Also, the people with higher education, armed with their health knowledge and using self-care methods provide the grounds for increasing their quality of lives.As regards the increasing rate of diabetic patients in ageing population and considering that chronic diseases affect and lower physical and mental aspects of “quality of life” in older people, and in line with improving the “quality of life” in these people, we suggest that policymakers and authorities pay proper attention to physical, mental, and social support of this group.

Objectives Establishing social relationships and creating and reinforcing social networks among the elderly people may create social capital. Thus, this research aimed to translate Onyx and Bullen social capital questionnaire into Persian version and evaluate its validity and reliability for elderly people.
Methods & Materials This cross-sectional study was conducted among 192 elderly people over 60 years old. To translate social capital instrument from English into Persian, we used the international quality of life assessment approach. Criterion validity of the instrument was using Geriatric Depression Scale (5 items), social health, and general health questionnaires. The obtained data were statistically analyzed.
Results According to our findings with regard to quality of the translation (clarity of translation, common language use, and conceptual equivalence, as well as general quality of translation), translators 3 and 4 found most items had clarity of translation (86.6%), usage of common perception (76.3%), conceptual consistency (76.3%), and overall quality of translation (78.9%). In other words, all were at a satisfactory level. The results showed that from experts’ points of view, the Persian version of the questionnaire was good with regard to translation quality and acceptable at other aspects. In other words, it was not unacceptable with regard to any aspect. Interclass correlations (ICC) of the dimensions were more than 0.7. The Cronbach coefficient α was calculated as 0.96 for the overall scale. Factor analysis of this study among Iranian elderly found 7 factors, which had discreet differences with Onyx configuration. Thus, the questions related to neighborhood relations were put in the same factor with social cooperation, and some items related to social efficiency were put in the factor of social cooperation and some in the factor of trust feeling. These 7 factors all together explained 48.71% of the variance (KMO=0.835). The distribution of the variance of scores for 7 factors was as follows: social cooperation, 58.11%; trust feeling, 48.8%; life worthwhile, 44.8%; work relations, 83,6%; accepting differences, 79.6%; family relationships, 58.6%; and local solidarity, 83.6%. Our findings also showed a negative and significant relationship between depression level and social capital (P=0.001). There was also a positive and significant association between social and general health level with social capital (P=0.001).
Conclusion The Persian version of the questionnaire for this population has acceptable levels of face validity based on clarity, simplicity, and understandability of the questions, answers, and explanations of the Persian version of the social capital questionnaire. This version of the questionnaire also had acceptable levels in terms of suitability of the translation of the questionnaire, its suitability for Iranian community, its understandability, and suitability for needs assessment, discriminate validity (the internal consistency of the Persian version of questionnaire), test-retest reliability (absolute, and relative), and internal consistency. Therefore, this instrument is suitable for evaluating the level of social capital among the Iranian elderly people.

Objectives Alzheimer’s disease is a progressive and degenerative disease of the brain that severely damages the thinking and memory functions of human beings. This disease is the most common form of dementia, which comprises a set of signs and symptoms such as loss of memory, judgment, and reasoning that subsequently changes the attitude, behavior, and communication ability. Taking care of people with Alzheimer’s disease can become very stressful for their families. Group cognitivebehavioral therapy has played an important role in teaching how to use compatible coping strategies. Thus, this research aimed to investigate the effectiveness of group cognitive-behavioral therapy on strategies for coping with stress of family caregivers of patients with Alzheimer’s disease.
Methods & Materials This research was conducted using a quasi-experimental design. The study sample comprised 32 voluntary caregivers as per Iran's Alzheimer Community Care in 2011. They were selected by convenience sampling method and were randomly assigned into experimental and control groups. We used the questionnaire of coping inventory with stressful situations (CISS), which was completed before group therapy and after the treatment course in 3 stages of pretest, posttest, and follow-up. Data analysis was performed by analysis of covariance, multivariate analysis of covariance, and repeated measures.
Results The results showed that the components of compatible strategies (problem-oriented and social entertainment) in the experimental group were significantly increased compared to pretest and control group due to cognitive-behavioral therapy (P=0.001). However, the components of incompatible strategies (emotionoriented and attention processing) due to cognitive-behavioral therapy was significantly decreased in the experimental group compared to the pretest and control group (P=0.001). The results of repeated measuring plan between 3 stages of pretest, posttest, and follow-up showed that the effects of cognitive-behavioral therapy on increasing compatible coping style (problem-oriented and social entertainment) and decreasing
incompatible coping style (emotion-oriented and attention processing) as well as the effect of intergroup actions and repetition were significant. There was also a significant difference between experimental group and control group. With regard to the above-mentioned results, cognitive-behavioral group therapy could have significant effects on increasing use of coping strategies with compatible stress and decreasing use of coping strategies with incompatible stress in the family members of Alzheimer’s patients. Moreover, the time factor was ineffective in lowering the effect of cognitive-behavioral therapy from posttest to follow-up period.
Conclusion Based on the results, the group cognitive-behavioral therapy can increase the use of compatible strategies for coping with stress and decrease the use of incompatible strategies. This issue is related to factors such as complete understanding of Alzheimer’s disease and its effects, creating an atmosphere for presentation and an opportunity for social interaction, understanding the importance of sport and allocating time for recreational activities, learning body relaxation in stressful situations, understanding life problems, solving problem techniques, feeling of control, and time management. Thus, we recommend using group cognitivebehavioral therapy as a low-cost treatment for family caregivers of patients with Alzheimer’s and patients with chronic diseases.

Objectives Old age refers to years near or passed the middle age and therefore, near to the end of life cycle. Old-aged people have limited reviving capability and are more at risk of catching diseases, syndromes, and ailments. Falling is one of the most common problems in the elderly that occur due to their inability to maintain balance. This study aimed to examine the effect of aerobic exercises on static and dynamic balance in healthy elderly inactive men.
Methods & Materials This quasi-experimental research was done in older people living in a nursing home in Qazvin, Iran. The study population included 200 elderly men (65-75 years old); of them, 26 healthy, inactive men were randomly selected and assigned to the experimental (13 subjects) and control (13 subjects) groups. The experimental group participated in selected exercise programs for 8 weeks. We used personal information questionnaire to check the inclusion criteria that comprised independency in doing daily chores, lack of problems in vision or fall during the last year, and not having joints dislocation, chronic arthritis or vertigo. In the case of having these problems, the subjects were excluded from the study. Stork balance test and Timed Up and Go test were used to measure the static and dynamic balance of subjects before the initiation and after the termination of the program. The statistical analyses were done by paired and independent t-tests.
Results The results of independent t-test did not indicate any significant differences between 2 groups with regard to age, height, and weight (P>0.05). Homogeneity was observed in the 2 groups with respect to individual features affecting balance and walking. After performing the aerobic exercise program, the dynamic balance in the experimental group increased significantly (PConclusion Our results showed that regular aerobic exercise improves dynamic balance in elderly men. We also found that jogging and walking improved dynamic balance. The improvement in balance may be due to the increase in nervous compatibility (due to exercise); increase in fitness, strength, and motion domain; improvement in aerobic status, response time and mental status; improvement in neuromuscular control, including a decrease in changing movement units; and improvement in simultaneous movement units. Furthermore, there is a positive relationship between body composition and movement with balance. Therefore, regular aerobic activities are recommended as a suitable training method for improving balance.