Regular physical activity could represent an important and potent protective factor for cognitive decline and dementia in elderly persons.

A MGAT can target rural dwelling, frail older persons, perform in-home CGA, and develop an intervention strategy. Although the intervention did not prolong life or delay institutionalization, clinically important benefits were observed.

Seniors are most vulnerable to conjugal bereavement. Although social support buffers the effects of bereavement, widows and widowers have lower levels of social support than married individuals. Self-help/support groups can supplement support from their depleted natural networks. Accordingly, the aim of this demonstration project was to examine the impact of support groups on widowed seniors' loneliness, affect, and perceived support. Four face-to-face support groups for widowed seniors were conducted weekly for a maximum of 20 weeks. Participants completed pretest, posttest, and delayed posttest measures of support need and support satisfaction, positive and negative affect, and loneliness/isolation. The statistically significant impacts of the intervention were enhanced support satisfaction, diminished support needs, and increased positive affect. There was a trend toward decreased social isolation and emotional loneliness. In postintervention semistructured interviews, bereaved seniors reported increased hope, improved skills in developing social relationships, enhanced coping, new role identities, and less loneliness. Community health nurse researchers could conduct randomized controlled trials of face-to-face and telephone support groups for bereaved people of all ages. Community health nurse practitioners could benefit from lessons learned about timing, duration, and selection of sensitive outcomes.

While early diagnosis of autism spectrum disorders (ASD) is essential for ensuring timely access to early intervention services, there is limited existing literature investigating factors that delay this diagnosis. This population-based cohort study explored the age at which children in Nova Scotia, Canada, are diagnosed with ASDs and the factors associated with this age. Children diagnosed with an ASD between January 1992 and December 2005 were identified from a cohort of live births in the province between 1990 and 2002. Demographic and clinical variables were extracted from population-based perinatal and administrative health databases and evaluated as predictors of age at ASD diagnosis. Of 122,759 live births, 884 cases of ASDs were identified during the study period. The median age at diagnosis within the cohort was 4.6 years. In adjusted linear regression analysis, a one year increase in maternal age at delivery was associated with a 0.06 decrease in age at ASD diagnosis (p= .0007). Children who were residents of Halifax County received their diagnoses 0.52 years later than residents of other counties (p= .0054). A diagnosis of attention-deficit/hyperactivity disorder (ADHD) was associated with a 1.29-year increase in age at diagnosis (p< .0001). These results suggest that potential exists for improving early detection of ASDs in the province. Future research in this field has the potential to contribute to our understanding of the causal pathways linking the demographic and clinical variables we have identified and the age at diagnosis of ASDs.

Regular exercise in elderly people has beneficial health effects. We examined exercise frequency and intensity from the Canadian Study of Health and Aging Risk Factor Questionnaire (RFQ). The reliability and validity of these two questions individually, and when combined to form a scale, are reported. Agreement between the self-administered RFQ and an interviewer-administered Add-on Study was examined using intraclass correlations, which were 0.80 for frequency (95% CI 0.77-0.82, p < ,001) and 0.75 for intensity (95% CI 0.71-0.78, p = .012). Individuals reporting high levels of exercise frequency, intensity, and a combination of the two showed a smaller proportion of adverse health markers than those reporting no regular exercise. Predictive validity assessed by Cox proportional hazards modeling of mortality showed that the high and moderate levels of frequency, intensity, and combined exercise groups differed significantly (allp < .OOl) from the no exercise group. We have found that these exercise questions, though simple, appear reliable and valid. The finding that even comparatively crude exercise questions can demonstrate an important relationship to death suggests that the signal for exercise is a strong one, and future studies should seek to better examine mechanisms by which exercise benefit is conferred. Regular exercise in elderly people has beneficial health effects including aerobic fitness, muscle strength and feeling of vigor (Engels et al., 1998), increased physiological and cognitive functioning