Klotho as a Novel Cardioprotective Protein in Aged Heart 2 2 In recent years, researchers have been looking for genes whose products can directly affect the aging process. Among these, the anti-aging protein klotho has attracted much attention. This single transmembrane protein is expressed in the renal tissues, parathyroid gland and choroid network of the brain and acts as a co-receptor for Fibroblast Growth Factor FGF. In this way, it contributes to calcium and phosphate homeostasis, which is in fact the classical function of this protein. The second extracellular protein of this protein can be released from cell surface by ectodomain shedding and get secreted into the blood, which, in turn, as an “endocrine factor”, affects the body in many ways. 35 36 2018/10/23 1397/8/1 2018/12/1 1397/9/10 Ali Dehghani Ali Dehghani Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Fatemeh Safari Fatemeh Safari Department of Physiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Klotho cardioprotective protein Kuro-o M. Klotho and aging. Biochim Biophys Acta. 2009; 1790 (10): 1049-58.##Ai F, Chen M, Li W, Yang Y, Xu G, Gui F, et al. Protective role of Klotho on cardiomyocytes upon hypoxia/reoxygenation via downregulation of Akt and FOXO1 phosphorylation. Molecular Medicine Reports. 2015; 11 (3): 2013-9.##Corsetti G, Pasini E, Scarabelli TM, Romano C, Agrawal PR, Chen-Scarabelli C, et al. Decreased expression of Klotho in cardiac atria biopsy samples from patients at higher risk of atherosclerotic cardiovascular disease. Journal of Geriatric Cardiology. 2016; 13 (8): 701-11.##Keles N, Caliskan M, Dogan B, Keles NN, Kalcik M, Aksu F, et al. Low serum level of klotho is an early predictor of atherosclerosis. The Tohoku Journal of Experimental Medicine. 2015; 237(1): 17-23.##Song S, Si LY. Klotho ameliorated isoproterenol-induced pathological changes in cardiomyocytes via the regulation of oxidative stress. Life Sciences. 2015; 135: 118-23.##Song S, Gao P, Xiao H, Xu Y, Si LY. Klotho suppresses cardiomyocyte apoptosis in mice with stress-induced cardiac injury via downregulation of endoplasmic reticulum stress. PLoS One. 2013; 8(12): 1-14.##Xiao NM, Zhang YM, Zheng Q, Gu J. Klotho is a serum factor related to human aging. Chinese Medical Journal (Engl). 2004; 117(5): 742-7.##Kitagawa M, Sugiyama H, Morinaga H, Inoue T, Takiue K, Ogawa A, et al. A decreased level of serum soluble Klotho is an independent biomarker associated with arterial stiffness in patients with chronic kidney disease. PLoS One. 2013; 8(2): 1-10.##Semba RD, Cappola AR, Sun K, Bandinelli S, Dalal M, Crasto C, et al. Plasma klotho and mortality risk in older community-dwelling adults. The Journal Gerontology. Series A, Biological Sciences and Medical Sciences. 2011; 66(7): 794-800.## ##

The Relationship between Social Support and Death Anxiety among the Elderly 2 2 Introduction: Social support is one of the most important indices affecting adaptation to aging process as well as the problems and complications of the aging period such as anxiety, death and social support. This study was aimed to determine the correlation of social support with death anxiety among the elderly of Tehran, Iran. Methods: In this correlational study, 208 elderly referring to the daycare centers of Tehran were selected through cluster random sampling. Data were collected by demographic questionnaire, Vaux Social Support Appraisals Scale (SS-A) and Templer death anxiety scale. Both social support and death anxiety scales have been validated in Iran and enjoy the required reliability. Results: From among the participant elderly, 5.3 % were male and 67 % were single, with their mean age of 66.6 years. Also, 60.1 % were under diploma in terms of education and 64.9 % lived in their personal houses with their families. The results showed the mean social support of 24.94 and mean death anxiety of 24.43 for the elderly. Further, Pearson correlation coefficient indicated a reverse correlation between social support and death anxiety (r = -0.020). Conclusion: Death anxiety was reduced with increased social support among the elderly. Social support, a component affecting the mental health and spirit of the elderly, can be considered a cheap source and a social capital in line with decreasing death anxiety, increasing dynamicity and improving the life quality of the elderly. 37 42 2018/10/232018/11/22 1397/9/1 2018/12/12018/12/11 1397/9/20 Banafsheh Ebrahimi Banafsheh Ebrahimi Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran b_ebrahimi23@yahoo.com Mohammadali Hosseini Mohammadali Hosseini Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran mahmaimy2020@gmail.com Vahid Rashedi Vahid Rashedi School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran Iran vahidrashedi@yahoo.com Social Support Anxiety Aged Statistical Center of Iran. Population and housing census. 2018; Available from: http://www.amar.org.ir/Default.aspx?1. Statistical Center of Iran. Population and housing census [Internet]. Iran: Statistical Center of Iran: 2018. Available from: http://www.amar.org.ir/Default.aspx?tabid=1190.##Eliopoulos C. Gerentological nursing. Phialdelphia: Lippincott Williams & Wilkins; 2010.##Rashedi V, Asadi-Lari M, Foroughan M, Delbari A, Fadayevatan R. Prevalence of disability in Iranian older adults in Tehran, Iran: a population-based study. Journal of Health and Social Sciences. 2016; 1(3): 251-62.##Khademi MJ, Rashedi V, Sajadi S, Gheshlaghi SM. Anxiety and loneliness in the Iranian older adults. International Journal of Psychology and Behavioral Sciences. 2015; 5(2): 49-52.##Darvishpour Kakhaki AD, Abed Saeidi ZH, Delavar A, Zakerin MS. Autonomy in the elderly: a phenomenological study. Hakim Research Journal. 2010; 12(4): 1-10. [Persian]##Rashedi V, Gharib M, Rezaei M, Yazdani AA. Social support and anxiety in the elderly of Hamedan, Iran. Archives of Rehabilitation. 2013; 14(2): 110-5. [Persian]##Burnston K, Johannesson M, Diderichsen F. Health related quality of life by disease and socioeconomic group in general population in Sweden. Health Policy. 2001; 55(1): 51-69.##Rashedi V, Asadi-Lari M, Foroughan M, Delbari A, Fadayevatan R. Mental health and pain in older adults: findings from urban HEART-2. Community Mental Health Journal. 2017; 53(6): 719-24.##Uchino BN, Holt-Lunstad J, Bloor LE, Campo RA. Aging and cardiovascular reactivity to stress: longitudinal evidence for changes in stress reactivity. Psychology and Aging. 2005; 20(1): 134-43.##Tajvar M, Grundy E, Fletcher A. Social support and mental health status of older people: a population-based study in Iran-Tehran. Aging & Mental Health. 2018;22(3):344-53.##Nabavi SH, Alipour F, Hejazi A, Rabani E, Rashedi V. Relationship between social support and mental health in older adults. Medical Journal of Mashhad University of Medical Sciences. 2014; 57(7): 841-6. [Persian]##Cobb S. Social support as a moderator of life stress. Psychosomatic Medicine. 1976; 38(5): 300-14.##Rashedi V, Rezaei M, Gharib M, Nabavi SH. Social support for the elderly: comparison between home and nursing home. Journal of North Khorasan University of Medical Sciences. 2013; 5(2): 351-6. [Persian]##Miller CA. Nursing for wellness in older adults theory and practice. Philadephia: Williams & Wilkins; 2003.##Gallagher LP, Trugli-Londrigan M. Community support:older adult's perceptions. Clinical Nursing Research. 2004; 13(1): 24-32.##Birditt KS, Antonucci TC, Tighe L. Enacted support during stressful life events in middle and older adulthood: An examination of the interpersonal context. Psychology and Aging. 2012; 27(3): 728-41.##Alipour F, Sajadi H, Forouzan A, Nabavi H, Khedmati E. The role of social support in the anxiety and depression of elderly. Salmand, Iranian Journal of Ageing. 2009; 4(1): 53-61. [Persian]##Goudarz M, Foroughan M, Makarem A, Rashedi V. Relationship between social support and subjective well-being in older adults. Salmand, Iranian Journal of Ageing. 2015; 10(3): 110-9. [Persian]##Krause N. Exploring age differences in the stress-buffering function of social support. Psychology and Aging. 2005; 20(4): 714-7.##Khosravi S. Epidemiology of mental disorders in among over 15 years old population in rural and urban area of Borujen, 1994. Journal of Shahrekord University Medical Sciences. 2003; 4(4): 31-9. [Persian]##Vaux A, Phillips J, Holly L, Thomson B, Williams D, Stewart D. The social support appraisals (SS-A) scale: Studies of reliability and validity. American Journal of Community Psychology. 1986;14(2):195-218.##Ebrahimi-ghavam S. Validity of locus of control, self-esteem and social support. Tehran: Islamic Azad University of Tehran; 1992.##Rajabi G, Bohrani M. Item factor analysis of the death anxiety scale. Journal of Psychology. 2002; 20(1): 331-43. [Persian]##Templer DI. The construction and validation of a death anxiety scale. The Journal of General Psychology. 1970; 82(2): 165-77.##Schumaker JF, Warren WG, Groth-Marnat G. Death anxiety in Japan and Australia. The Journal of Social Psychology. 1991; 131(4): 511-8.##Bengtson VL, Cuellar JB, Ragan PK. Stratum contrasts and similarities in attitudes toward death. Journal of Gerontology. 1977; 32(1): 76-88.##Masoudzadeh A, Setareh J, Mohammadpour RA, Modanloo Kordi M. A survey of death anxiety among personnel of a hospital in Sari. Journal of Mazandaran University of Medical Sciences. 2008; 18(67): 84-90. [Persian]##Aghajani M, Valiee S, Tol A. Death anxiety amongst nurses in critical care and general wards. Iran Journal of Nursing. 2011;23(67):59-68. [Persian]##Shapiro A, Keyes CL. Marital status and social well-being: are the married always better off?. Social Indicators Research. 2008; 88(2): 329-46.##Abdel-Khalek A. Love of life and death distress: Two separate factors. OMEGA-Journal of Death and Dying. 2007; 55(4): 267-78.##Fortner BV, Neimeyer RA. Death anxiety in older adults: a quantitative review. Death Studies. 1999; 23(5):387-411.##Comstock G, Partridge K. Church attendance and health. Journal of Chronic Diseases. 1972; 25(12): 665-72.##Khalili F, Sam S, Sharifirad G, Hassanzadeh A, Kazemi A. The relationship between perceived social support and social health of elderly. Health Research Journal. 2011; 7 (6): 1216-25. [Persian]##Barry LC, Kasl SV, Lichtman J, Vaccarino V, Krumholz HM. Social support and change in health-related quality of life 6 months after coronary artery bypass grafting. Journal of Psychosomatic Research. 2006; 60(2): 185-93.##Madnawat AV, Kachhawa PS. Age, gender, and living circumstances: discriminating older adults on death anxiety. Death Studies. 2007; 31(8): 763-9.##Nouhi E, Karimi T, Iranmanesh S. Comparing fear of death of the elderly settled in elderly’s home and inhabited in city houses of Isfahan. Salmand, Iranian Journal of Ageing. 2014; 8(4): 24-31. [Persian]##Vahdani Nia M, Goshtasebi A, Montazeri A, Maftoon F. Health-related quality of life in an elderly population in Iran: A population-based study. Payesh. 2005; 4(2): 113-20. [Persian]##Leung KK, Chen CY, Lue BH, Hsu ST. Social support and family functioning on psychological symptoms in elderly Chinese. Archives of Gerontology and Geriatrics. 2007; 44(2): 203-13.## ##

Comparative Study of Balance Exercises (Frenkel) and Aerobic Exercises (Walking) on Improving Balance in the Elderly 2 2 Introduction: Balance in the elderly is one of the important issues, and imbalance can create irreparable problems for the elderly. The aim of this study was to investigate the effect of Frenkel balance exercise and aerobic exercise (walking) on improving the balance of elderly patients in Kerman province in 2016-2017. Methods: We used a randomized block design, with 4 participants in each block; 48 elderly men and women living in the nursing homes of Kerman province were randomly assigned to two groups, balance (Frenkel) exercises and aerobic exercises (walking). The two groups performed Frenkel exercises and aerobic exercises (walking) for three 10- to 15-min sessions a week for five weeks. The balance time using the Sharpened Romberg test was recorded to measure static balance and the Get Up and Go test used to measure dynamic balance before and after the exercise program. To describe the variables studied, central tendency indicators and dispersion were used. Paired t-test was used to compare the time of balance before and after intervention and independent t-test to compare changes in balance time between two groups. Results: The mean static balance (with Sharpend Römberg test) was increased from 3.16 s to 6.01 s in Frenkel exercise, and from 3.33 s to 4.95 s in aerobic training group, indicating an improvement in the static balance after intervention. The mean time of dynamic balance (in the Get Up and Go test) during Frenkel exercise reduced from 17.07 s to 12.03 s, and during aerobic training from 17.08 s to 10.9 seconds, indicating an improvement in dynamic balance (p < 0.01). However, there was no significant difference in the mean changes in the duration of dynamic and static balance before and after intervention in the two groups. Conclusion: Both Frenkel exercise and walking equally improve static and dynamic balance in the elderly in different settings. 43 48 2018/10/232018/11/222018/11/14 1397/8/23 2018/12/12018/12/112018/12/8 1397/9/17 Mohammad Reza Vafaeenasab Mohammad Reza Vafaeenasab Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Athareh Amiri Athareh Amiri Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran tbh.amiri@gmail.com Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Seyedeh Mahdieh Namayande Seyedeh Mahdieh Namayande Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Hossein Abbaszade Tehrani Hossein Abbaszade Tehrani Management of Daily Rehabilitation-Training Center of Shahid Akbarinejad, Rafsanjan, Kerman, Iran Iran Balance Aerobic Exercise Walking Elderly Balance Matsumara B.A, Ambros A.F. Balance in the elderly. Clinics in Geriatric Medicine. 2006; 22(2): 395-412.##William E, Garrett JR, Donald T. Kirkendall. Exercise and sport science. Philadelphia: Lippincott Williams and Wilkins; 2000.##Aslan UB, Cavlak U, Yagchi N, Akdag B. Balance performance, aging and falling: a comparative study based on a Turkish sample. Archives of Gerontology and Geriatrics. 2008; 46(3): 283-92.##Mirmoezzi M, Amini M, Khaledan A, Khorshidi D. Effect of 8-week of selected aerobic exercise on static and dynamic balance in healthy elderly inactive men. Salmand, Iranian Journal of Ageing. 2016; 11(1): 202-9.[Persian]##Mehdizadeh Mollabashi L, Safavy Bayat Z, Yagmaey F, Mehraby Y. The effect of balanced exercises on balance level of elderly in nursing homes. Journal Urmia Nursing and Midwifery Faculty. 2011; 9 (4): 283-88. [Persian]##Ghadiri A. The effect of Frankl's exercises on the balance and coordination of the elderly man [dissertation]. Arak: Faculty of Literature and Humanities: 2013##Marques EA, Figueiredo P, Harris TB, Wanderley FA, Carvalho J. Are resistance and aerobic exercise training equally effective at improving knee muscle strength and balance in older women?. Archives of Gerontology and Geriatrics. 2017; 68: 106-12.##Mosayebi Samani K, Davari F, Faramarzi M. The effects of combined aerobic and balance training on balance in elderly women. Salmand, Iranain Journal of Ageing. 2015; 10(1): 26-35.[Persian]##Oviedo GR, Guerra-Balic M, Baynard T, Javierre C. Effects of aerobic, resistance and balance training in adults with intellectual disabilities. Research in Developmental Disabilities. 2014; 35(11): 2624-34.##Sauvage LR, Mylebust BM, Crow-pan J, Novak S, Millington P, Hoffman MO, et al. A clinical trial of strengthening and aerobic exercise to improve gait and balance in elderly male nursing home residents. American Journal of Physical Medicine & Rehabilitation. 1992; 71(6): 333-42.##Shimada H, Tiedemann A, Lord S, Suzukawa M, Makizako H, Kobayasaki K, et al. Physical factors underlying the association between lower walking performance and falls in older people: a structural equation model. Archives of Gerontology and Geriatrics. 2011; 53(2): 131-4.##Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991; 39(2): 142-8.##Arjmandi BH, Getlinger MJ, Goyal NV, Alekel L, Hasler CM, Juma S, et al. Role of soy protein with normal or reduced is flavone content in reversing bone loss induced by ovarian hormone deficiency in rats. The American Journal of Clinical Nutrition. 1998; 68(6): 1358–63.## ##

Associated Factors of Chronic Kidney Disease among Hyponatraemic Elderly Patients Attending a Primary Care Clinic 2 2 Introduction: Chronic kidney disease (CKD) emerges to be an important geriatric health issue. It may progress to end stage renal failure and affect the quality of life. However, little is known about the associated factors of CKD. So this study aimed to determine the associated factors of CKD among hyponatraemic elderly. Methods: This is a retrospective study of hyponatraemic patients aged ≥ 60 years attending outpatient clinic in 2014. Blood test results of glucose, potassium, creatinine, medical history, blood pressure, medication and demographic data were captured from patient records. Each patient’s estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI Creatinine Equation. CKD is defined as eGFR of < 60 ml/min/1.73m2. SPSS 21 was used to do the analysis. Results: Totally 257 patients with mean age of 72.9 ± 7.3 years were enrolled in this study. Of them 73 (28.4 %) elderly had CKD. The mean eGFR was 72.62 ± 24.14 ml/min/1.73m2, mean BP was (135.75 ± 18/10) mmHg. Of the participants, 134 (52.1 %) were men, 151 (58.8 %) were diabetics, 247 (96.1 %) had hypertension. The independent associated factors of CKD were increasing age (OR 1.08; 95 % CI 1.03-1.13; p = 0.002), hyperglycaemia (OR 1.10; 95 % CI 1.02-1.18; p = 0.017) and the use of loop diuretics (OR 5.15; 95 % CI 1.52-17.38; p = 0.008). Conclusion: Hyperglycaemia and loop diuretics usage are found to be significantly associated with CKD among elderly patients attending a primary care clinic. Hence every effort should be made to optimise glucose control and cautious in the usage of loop diuretics to retard the decline in renal function. 49 54 2018/10/232018/11/222018/11/142018/11/20 1397/8/29 2018/12/12018/12/112018/12/82018/12/10 1397/9/19 Chai Li Tay Chai Li Tay Department of Primary Care Medicine, Simpang Health Clinic, District of Larut, Matang and Selama, Taiping Perak, Ministry of Health, Malaysia Malaysia chailitay329@gmail.com Chronic Kidney Disease Aged Primary Health Care Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. The Journal of the American Medical Association. 2007; 298(17): 2038-47.##Kheder-Elfekih R, Yannoutsos A, Blacher J, London GM, Safar ME. Hypertension and chronic kidney disease: respective contribution of mean and pulse pressure and arterial stiffness. Journal of Hypertension. 2015; 33(10): 2010-15.##Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: Prevalence and risk factors. The American Journal of Medicine. 2013; 126(3): 256-63.##Lim LM, Tsai NC, Lin MY, Hwang DY, Lin HY, Lee JJ, et al. Hyponatremia is associated with fluid imbalance and adverse renal outcome in chronic kidney disease patients treated with diuretics. Scientific Reports. 2016; 6: 1-10.##Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, et al. A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney International. 2013; 84(5): 1034-40.##MacIsaac RJ, Ekinci EI, Premaratne E, Lu ZX, Seah JM, Li Y, et al. The chronic kidney disease-epidemiology collaboration (CKD-EPI) equation does not improve the underestimation of glomerular filtration rate (GFR) in people with diabetes and preserved renal function. BMC Nephrology. 2015; 16: 1-13.##Yusoff SN, Zulkifli Z. Rethinking of old age: the emerging challenge for Malaysia. International Proceedings of Economics Development and Research. 2014; 71(13): 69-73.##Malabu UH, Porter D, Vangaveti VN, Kazi M, Kennedy RL. Prevalence of hyponatremia in acute medical admissions in tropical Asia Pacific Australia. Asian Pacific Journal of Tropical Medicine. 2014: 7(1): 40-3.##Bash LD, Coresh J, Köttgen A, Parekh RS, Fulop T, Wang Y, et al. Defining incident chronic kidney disease in the research setting: the ARIC study. American Journal of Epidemiology. 2009; 170(4): 414-24.##Matsushita K, Mahmoodi BK, Woodward M, Emberson JR, Jafar TH, Jee SH, et al. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. The Journal of the American Medical Association. 2012; 307(18): 1941-51.##Fastbom J, Wills P, Cornelius C, Viitanen M, Winblad B. Levels of serum creatinine clearance over the age of 75: a study of an elderly Swedish population. Archives of Gerontology and Geriatrics. 1996; 23(2): 179-88.##Kummer S, Gersdorff VG, Kemper MJ, Oh J. The influence of gender and sexual hormones on incidence and outcome of chronic kidney disease. Pediatric Nephrology. 2012; 27(8): 1213-9.##Keane WF, Brenner BM, De Zeeuw D, Grunfeld JP, McGill J, Mitch WE, et al. The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. Kidney International. 2003; 63(4): 1499-507.##Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. American Journal of Kidney Diseases.2004; 43(5 suppl 1): S1-S290.##Loyd J, Wright P. Are thiazide diuretics an effective treatment for hypertension in patients with chronic kidney disease?. The Journal of Oklahoma State Medical Association. 2008; 101(5): 84-85.##Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH. Chronic kidney disease, fluid overload and diuretics: a complicated triangle. PLoS ONE. 2016; 11(7): 1-13.##Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, et al. Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third national health and nutrition examination survey (1988–1994). Archives of Internal Medicine. 2001: 161(9): 1207-16.##Nigwekar SU, Waikar SS. Diuretics in acute kidney injury. Seminars in Nephrology. 2011; 31(6): 523-34.##Cotter G, Metra M, Milo-Cotter O, Dittrich HC, Gheorghiade M. Fluid overload in acute heart failure-Re-distribution and other mechanisms beyond fluid accumulation. European Journal of Heart Failure. 2008: 10(2): 165–9.##McKie PM, Schirger JA, Benike SL, Harstad LK, Chen HH. The effects of dose reduction of furosemide on glomerular filtration rate in stable systolic heart failure. A Journal of the American College of Cardiology: Heart failure. 2014; 2(6): 675-7.##Vander AJ, Carlson J. Mechanism of the effects of furosemide on renin secretion in anesthetized dogs. Circulation Research. 1969; 25: 145-52.##American Heart Association Nutrition Committee, Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American heart association nutrition committee. Circulation. 2006; 114(1): 82-96.##Adler AI, Stratton IM, Neil HAW, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. The British Medical Journal. 2000; 321(7258): 412-9.##Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation. 2003; 107(22): 2864-9.## ##

Effect of Education on Physical Activity among the Rural Elderly in Zabol City 2 2 Introduction: One of the most important causes of chronic diseases in elderly people is lack of physical activity. Studies have shown that lack of physical activity in the elderly causes osteoporosis, obesity, depression and sudden death from cardiovascular disease, type 2 diabetes and colon cancer. The aim of this study was to determine the effect of an educational intervention on knowledge and practice of physical activity among the rural elderly in Zabol city. Methods: In this semi-experimental study, 200 elderly people over 60 years of age living in rural areas of Zabol city who were selected by multi-stage random sampling were divided into two groups: intervention and control. The data collection instrument was a researcher-made questionnaire that comprised 3 parts: demographic and background variables, knowledge and practice. Before the intervention, the questionnaires were completed by intervention and control group. The educational content for the intervention group was the Healthy Lifestyle Handbook and face-to-face training which included a practical representation of six smooth movements. However, no intervention was performed in the control group. After 2 months, the same questionnaire was completed again and the data were analyzed using SPSS software. Results: Before the intervention, there was no difference in the mean score of knowledge and practice of the participants, but these differences were significant in the post intervention (p < 0.001). The mean of knowledge and practice scores in the control group in pre-intervention stage was 35.17 ± 2.05 and 6.24 ± 2.82, respectively, Which was 35.59 ± 1.82 and 5.91 ± 2.64 in the post-intervention phase, respectively, But the mean score of knowledge and practice in the intervention group in pre intervention stage increased from 35.6 ± 2.47 and 6.73 ± 3.43 to 37.85 ± 1.38, and 12.83 ± 9.09 in the post-intervention phase, respectively. Conclusion: Educational intervention is effective in increasing awareness and overall level of physical activity among the elderly. 55 59 2018/10/232018/11/222018/11/142018/11/202018/05/27 1397/3/6 2018/12/12018/12/112018/12/82018/12/102018/12/1 1397/9/10 Mohammad Saeed Jadgal Mohammad Saeed Jadgal Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran kh_jadgal@yahoo.com Saeedeh Sadeghi Saeedeh Sadeghi Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mahlasadeghi1385@yahoo.com Ehsan Movahed Ehsan Movahed Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ehsanmovahed89@yahoo.com Morad Ali Zareeipour Morad Ali Zareeipour Health Center of Urmia, Urmia University of Medical Sciences, Urmia, Iran Iran z.morad@yahoo.com Sayed Mustafa davoudi Sayed Mustafa davoudi Department of Health Education and Promotion, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran Iran davudisistan@gmail.com Educational Intervention Knowledge Practice Physical Activity Elderly De Rezende LFM, Rey-López JP, Matsudo VKR, Do Carmo Luiz O. Sedentary behavior and health outcomes among older adults: a systematic review. Biomedcentral Public Health. 2014; 14(333): 1-9.##Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population-health science of sedentary behavior. Exercise and Sport Sciences Reviews. 2010; 38(3): 105-13.##Aghamolaei T, Tavafian SS, Hassani L. Exercise self-efficacy, exercise perceived benefits and barriers among students in Hormozgan University of Medical Sciences. Iranian Journal of Epidemiology. 2009; 4(3,4): 9-15. [Persian]##Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. American Journal of Epidemiology. 2008; 167(7): 875-81.##Shahbazi MR, Mirkhani M, Hatamizadeh N, Rahgozar M. Disability assessments in Tehranian elderly, 2007. Salmand, Iranian Journal of Ageing. 2008; 3(3,4): 84-92. [Persian].##Salehi L, Taghdisi M, Ghasemi H, Shokervash B. To Identify the facilitator and barrier factors of physical activity among elderly people in Tehran. Iranian Journal of Epidemiology. 2010; 6(2): 7-15. [Persian].##Nejati V, Ashayeri H. Health related quality of life in the elderly in Kashan. Iranian Journal of Psychiatry and Clinical Psychology. 2008; 14(1): 56-61. [Persian]##Amirzadeh Iranagh J, Motallebi S. The effect of health belief model based on education intervention on physical activity of elderly women. Journal of Urmia Nursing and Midwifery Faculty. 2016; 13(12): 1050-8. [Persian].##Hejazi S, Sahbaiee F, Fesharaki M, Abdollahi A. The effect of education about health-promoting behaviors on the knowledge of the elderly in the geriatric nursing residences in Tehran (2009). Journal of Birjand University of Medical Sciences. 2012; 19(1): 114-21. [Persian].##Moeini B, Rahimi M, Hazaveie S M, Allahverdi Pour H, Moghim Beigi A, Mohammadfam I. Effect of education based on trans-theoretical model on promoting physical activity and increasing physical work capacity. Journal of Military Medicine. 2010; 12(3): 123-30.##Nanbakhsh F, Mohaddesi H, Amirai A, Haji Shafiha M, Broomand F, Bahadori F, et al. The effect of health education on elderly women life quality. Journal of Payavard Salamat. 2011; 5(1): 47-57. [Persian].##Sattari B. Studying the social status and health concerning rural elderly using the plan for rural empowering. Salmand, Iranian Journal of Ageing. 2007; 1(2) :132-9. [Persian].##Tabatabaei S, Taghdisi M, Sadeghi A, Nakhaei N, Balali F. The effect of education in physical activities on knowledge, attitude and behavior of Kerman health center’s staff. Journal of Research & Health. 2012; 2: 137-44.##Seyed Emami R, Eftekhar Ardebili H, Golestan B. Effect of a health education intervention on physical activity knowledge, attitude and behavior in health volunteers. Journal of hayat. 2011; 16(3,4): 48-55. [Persian].##Estebsari F. Effects of interventional educational program in physical activity. Journal of Payavard Salamat. 2009; 2(4): 56-63 [Persian].##Karimi Z, Majlesi F, Tol A, Rahimi Foroushani A, Sahaf R, Ali Gol M et al. The Effect of educational intervention on the promotion of physical activities of the elderly men in Qom city: application of Trans-Theoretical Model. Salmand Iranian Journal of Ageing. 2015; 10(3): 182-91. [Persian]##Dinger MK, Heesch KC, McClary KR. Feasibility of a minimal contact intervention to promote walking among insufficiently active women. American Journal of Health Promotion. 2005; 20(1): 2-6.##Hortz B, Petosa R. Impact of the “Planning to be Active” leisure time physical exercise program on rural high school students. Journal of Adolescent Health. 2006; 39(4): 530-5.##Hazavehei SMM, Asadi Z, Hassanzadeh A, Shekarchizadeh P. Comparing the effect of two methods of presenting physical education Π course on the attitudes and practices of female students towards regular physical activity in Isfahan University of Medical Sciences. Iranian Journal of Medical Education. 2008; 8(1): 121-31. [Persian].##Teymouri PA, Niknami SH, Ghofranipour F. Effects of a school-based intervention on the basis of pender’s health promotion model to improve physical activity among high school girls. Armaghane Danesh Bimonthly Journal. 2007; 12(2): 47-59. [Persian].##Sallis JF, Calfas KJ, Nichols JF, Sarkin JA, Johnson MF, Caparosa S, et al. Evaluation of a university course to promote physical activity: Project GRAD. Research Quarterly for Exercise and Sport. 1999; 70(1): 1-10.## ##

Socio-Demographic Determinants of Quality of Life among Older People, a Population-Based Study 2 2 Introduction: Social participation is considered one dimension and also determinant of quality of life. The level of social participation of the elderly is influenced by various components such as socio-economic and demographic factors. The present study aimed to assess the relationship between social participation, quality of life, and some socio-economic factors in community dwelling elderly in Kerman, Iran. Methods: This cross-sectional study was conducted on 250 communities dwelling old people in Kerman in 2017 selected through random sampling. The data were collected using researcher-made Social Participation questionnaire and WHOQOL-BREF questionnaires. The data were analyzed using Pearson’s correlation coefficient, t-test, one-way ANOVA, and linear regression analysis. Results: The results revealed the participants’ mean score of social participation was above fifty. Social participation was significantly associated with age (p < 0.001), marital status (p = 0.004), education level (p < 0.001), and occupation (p = 0.021). A significant direct correlation was also observed between social participation and quality of life (p < 0.001), and social participation determined 21 % of variance of life quality score (p < 0.001). Conclusion: With the increase in social participation of the elderly, their quality of life improves. Establishing nongovernmental organizations, charities, and associations for retirement and aging can increase the level of social participation of the elderly. 60 67 2018/10/232018/11/222018/11/142018/11/202018/05/272018/10/12 1397/7/20 2018/12/12018/12/112018/12/82018/12/102018/12/12018/12/16 1397/9/25 victoria momenabadi victoria momenabadi Department of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran vici.momeni@yahoo.com Mohammad Hossein kaveh Mohammad Hossein kaveh Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran kaveh@sums.ac.ir Mahin Nazari Mahin Nazari Department of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran manazari@sums.ac.ir Leila Ghahremani Leila Ghahremani Department of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran ghahramanl@sums.ac.ir, Aged Social Participation Quality of Life Borhaninejad V, Kazazi L, Haghi M, Chehrehnegar N. Quality of life and its related factors among elderly with diabetes. Salmand, Iranian Journal of Ageing. 2016; 11(1): 162-73. [Persian]##Heller DA, Gold CH, Ahern FM, Pringle KE, Brown TV, Margaret RG. Change in elderly women’s health-related quality of life following discontinuation of hormone replacement therapy. Biomedicine Women Health. 2005; 5(7): 1-15.##Levasseur M, Desrosiers J, Noreau L. Is social participation associated with quality of life of older adults with physical disabilities?. Disability and Rehabilitation. 2004; 26(20): 1206-13.##Khademi MJ, Rashedi V, Sajadi S, Moradi Gheshlaghi S. Anxiety and loneliness in the Iranian older adults. International Journal of Psychology and Behavioral Sciences. 2015; 5(2): 49-52.##Ameri GH, Govari F, Nazari T, Rashidinejad M, Afsharzadeh P. The adult age theories' definitions. Hayat Journal. 2002; 8(1): 4-13. [Persian]##Lips P, Van Schoor NM. Quality of life in patients with osteoporosis. Osteoporosis International. 2005; 16(5): 447-55.##Alipoor F, Sajadi M, Ameneh F, Biglaryan A, Jalilian A. Elderly quality of life in district Tehran's district two. Salmand, Iranian Journal of Ageing. 2008; 3(3, 4): 75-83. [Persian]##Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Quality of Life Research. 2013; 22(4): 791-9.##Khooshemehri G, Kaviani M, Asmari M, Rajabian H, Naserkhaki V. Comparison of quality of life for elderly men and women elderly nursing home resident by Alborz province in 1390. Alborz University Medical Journal. 2013; 2(1): 19-24. [Persian]##Alizadeh S, Mohseni M, Khanjani N, Momenabadi V. Correlation between social participation of women and their quality of life in Kerman. Journal of Health Promotion Management. 2014; 3(2): 34-42. [Persian]##Zhang W, Feng Q, Liu L, Zhen Z. Social engagement and health: findings from the 2013 survey of the shanghai elderly life and opinion. International Journal of Aging and Human Development. 2015; 80(4): 332-56.##Darvishpoor Kakhki A, Abed Saeedi ZH, Abbaszadeh A. Social participation, barriers, and related factors in older people in Tehran. Journal of Health Promotion Management. 2014; 3(4): 65-73. [Persian]##Levasseur M, Desrosiers J, Whiteneck G. Accomplishment level and satisfaction with social participation of older adults: association with quality of life and best correlates. Quality of Life Research. 2010; 19(5): 665-75.##Levasseur M, Richard L, Gauvin L, Raymond É. Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science & Medicine. 2010; 71(12): 2141-9.##Levasseur M, Gauvin L, Richard L, Kestens Y, Daniel M, Payette H. Associations between perceived proximity to neighborhood resources, disability, and social participation among community-dwelling older adults: Results from the VoisiNuAge study. Archives of Physical Medicine and Rehabilitation. 2011; 92(12): 1979-86.##Moradi SH, Fekrazad H, Mousavi MT, Arshi M. The study of relationship between social participation and quality of life of old people who are member of senior association of Tehran City in 2011. Salmand, Iranian Journal of Ageing. 2013; 7(4): 41-6. [Persian]##Sirven N, Debrand T. Social participation and healthy ageing: an international comparison using SHARE data. Social Science & Medicine. 2008; 62(12): 2017-26.##Lee HY, Jang SN, Lee S, Cho SI, Park EO. The relationship between social participation and self-rated health by sex and age: a cross-sectional survey. International Journal of Nursing Studies. 2008; 45(7): 1042-54.##Handry F, McVittie C. Is quality of life a healthy concept? Measuring and understanding life experiences of older people. Qualitative Health Research. 2004; 14(7): 961-75.##Saxena S, Carlson D, Billington R. The WHO quality of life assessment instrument (WHOQOL-Bref): the importance of its items for cross-cultural research. Quality of Life Research. 2001; 10(8): 711-21.##Nejati S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh SR. The world health organization quality of Life (WHOQOLBREF) questionnaire: translation and validation study of the Iranian version. Journal of School of Public Health and Institute of Public Health Research. 2006; 4(4): 1-12.##Aghanori A, Mahmoodi M, Salehi H, Jaferian K. Quality of life in elderly people covered by health centers in urban areas in Markazi province, Iran. Salmand, Iranian Journal of Ageing. 2012; 6(4): 20-9. [Persian]##Abbasimoghadam MA, Dabiran S, Safdari R, Djafarian K. Quality of life and its relation to sociodemographic factors among elderly people living in Tehran. Geriatrics & Gerontology International. 2009; 9(3): 270-5.##Nejati V, Ashayeri H. Health related quality of life in the elderly in Kashan. Iranian Journal of Psychiatry and Clinical psychology. 2008; 14(1): 56-61. [Persian]##Ahmadi F, Salar A, Faghihzadeh S. Quality of life in Zahedan elderly population. Journal of Hayat. 2004; 10(3): 61-7. [Persian]##Alboukordi M, Ramazani MA, Arizi FS. A study on the quality of life among elderly Shahinshahr area of Isfahan province in year 2004. Scientific Medical Journal. 2007; 5(4): 701-7. [Persian]##Baraz S, Rostami M, Farzianpor F, Rasekh A. Effect of orem self-care model on elderlies' quality of life in health care centers of Masjed Solaiman in 2007-2008. Journal of Arak University of Medical Sciences. 2009; 2(12): 51-9.##Counsell SR, Callahan CM, Clark DO, Tu W, Buttar AB, Stump TE, et al. Geriatric care management for low-income seniors: a randomized controlled trial. The Journal of the American Medical Association. 2007; 298(22): 2623-33.##Tsai SY, Chi LY, Lee LS, Chou P. Health-related quality of life among urban, rural, and island community elderly in Taiwan. Journal of the Formosan Medical Association. 2004; 103(3): 196-204.##Rantakokko M, Portegijs E, Viljanen A, Iwarsson S, Rantanen T. Life-space mobility and quality of life in community-dwelling older people. Journal of the American Geriatrics Society. 2013; 61(10): 1830-2.##Sartor-Glittenberg C, Lehmann S, Okada M, Rosen D, Brewer K, Bay RC. Variables explaining health-related quality of life in community-dwelling older adults. Journal of Geriatric Physical Therapy. 2014; 37(2): 83-91.##Zahmatkeshan N, Bagherzade R, Akaberiyan SH, Yazdankhah MR, Mirzaei K, Yazdanpanah S, et al. Assessing quality of life and related factors in Bushehr’s elderlies 1387-8. Journal of Fasa University of Medical Sciences. 2012; 2(1): 53-8. [Persian]##Virtuoso Junior JS, Guerra RO. Factors associated to functional limitation in elderly of low income. Revista da Associacao Medical Brasileira. 2008; 45(5): 430-5.##Keshvari M, Hedayati B, Moeini M, Alhani F. A survey on the effect of implementation of a family-centered empowerment model on blood pressure and empowerment dimensions in the elderly people with hypertension. Journal of Education and Health Promotion. 2015; 4(94).##Tajvar M, Arab M , Montazeri A. Determinants of health-related quality of life in elderly in Tehran, Iran. Biomedicine Public Health. 2008; 8(323): 1-8.##Kirchengast S, Haslinger B. Gender difference in health-related quality of life among healthy aged and old-aged Australians: cross-sectional analysis. Gender Medicine. 2007; 5(3): 270-8.##Lima MG, Barros MB, César CL, Goldbaum M, Carandina L, Ciconelli RM. Health related quality of life among the elderly: a population-based study using SF-36 survey. Cadernos de Saúde Pública. 2009; 25(10): 2159-67.##Williams RE, Kristen BL, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas Journal. 2009; 62(2): 153-9.##Alexandre TS, Cordeiro RC, Ramos LR. Factors associated to quality of life in active elderly. Revista de Saude Publica. 2009; 43(4): 613-21.##Dello Buono M, Urciuou O, De Leo D. Quality of life and longevity: a study of centenarians. Age and Ageing. 1998; 27(2): 207-16.## ##

Rural-Urban Differences in Stroke Types, Risk Factors, Severity and Prognosis in Babol, Northern Iran 2 2 Introduction: Stroke recognized as the third most common cause of death. Stroke survivors often suffer a large amount of physical and mental disability. Due to assess difference between stroke types, progression and distribution of risk factors according residential status, to get correct information for prevention planning and management, this study was conducted. Methods: This descriptive cross-sectional study on stroke patient from 2016 to 2017 that admitted to Ayatollah Rohani Hospital of Babol was conducted. Type of stroke, their severity, risk factors, and urban or rural area of residence of patients were recorded in the checklist. The chi-square test was used to compare frequencies of gender, and stroke risk assessment between the urban and rural residents. Binary logistic regression modeling was used to estimate the association of risk factors with living in urban and rural areas. The results were expressed as multivariable-adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs). A two-sided p < 0.05 was considered statistically significant. All data analyses were performed, using SPSS statistical analysis software. Results: Of 241 stroke patients, 133 patients (55 %) were female and 213 patients (88.4 %) were ischemic. Also, 140 cases were (58 %) rural. Embolic strokes more in urban population and thrombotic strokes were more in rural populations. Hyperlipidemia was more in urban than rural p = 0.01. Severity of stroke in admission time (p = 0.03) and at discharge (p = 0.005) was more in rural than urban. The mortality was higher in rural 12 (8.6) vs. 2 (2) urban resident,( p = 0.03). Conclusion: Rural patients had more severity, thrombotic type and mortality than urban. Suitable policy regard to residential parameter is suggested. 68 74 2018/10/232018/11/222018/11/142018/11/202018/05/272018/10/122018/07/14 1397/4/23 2018/12/12018/12/112018/12/82018/12/102018/12/12018/12/162018/12/16 1397/9/25 Payam Saadat Payam Saadat Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran sepanta1968@yahoo.com Alijan Ahmadi Ahangar Alijan Ahmadi Ahangar Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran ahmadiahangaralijan@yahoo.com Soraya Khafri Soraya Khafri Department of Statistic and Epidemiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran Iran rohanresearch88@gmail.com Mandana Kalantar Mandana Kalantar Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran mandanakalantari90@gmail.com Azin Dariaie Azin Dariaie Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran crdu.rohan@mubabol.ac.ir Shayan Alijanpour Shayan Alijanpour Education, Research and Planning Unite, Pre-hospital Emergency Organization, Babol University of Medical Sciences, Babol, Iran Iran rohanresearch8@gmail.com Roghayyeh Mortazavinejhad Roghayyeh Mortazavinejhad Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran Sekineh Faraji Sekineh Faraji Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran Fatemeh Frajzadeh Fatemeh Frajzadeh Clinical Research Development Center, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran Iran Stroke Risk Factors Rural Urban Esenwa C, Gutierrez J. Secondary stroke prevention: challenges and solutions. Vascular Health and Risk Management. 2015; 11: 437-50.##O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P. Risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010; 376(9735): 112-23.##Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. The Lancet Neurology. 2008; 7(10): 915-26.##Daneshfard B, Izadi S, Shariat A, Toudaji MA, Beyzavi Z, Niknam L. Epidemiology of stroke in Shiraz, Iran. Iranian Journal of Neurology. 2015; 14(3): 158-63.##Ahangar AA, Ashraf Vaghefi SB, Ramaezani M. Epidemiological evaluation of stroke in Babol, northern Iran (2001–2003). European Neurology. 2005; 54(2): 93-7.##Romero JR, Morris J, Pikula A. Stroke prevention: modifying risk factors. Therapeutic Advances in Cardiovascular Disease. 2008; 2(4): 287-303.##Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology. 2009; 8(4): 355-69.##Yew KS, Cheng EM. Diagnosis of acute stroke. American Family Physician. 2015; 91(8): 528-536.##Muchada M, Rubiera M, Rodriguez-Luna D, Pagola J, Flores A, Kallas J, et al. Baseline national institutes of health stroke scale–adjusted time window for intravenous tissue- type plasminogen activator in acute ischemic stroke. Stroke. 2014; 45(4): 1059-63.##Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. 18th. New York: Mc Grow-Hill. 2012.##Dadjou Y, Kermani-Alghoraishi MK, Sadeghi M, Talaei M, Yousefy A, Oveisgharan S, et al. The impact of health-related quality of life on the incidence of ischaemic heart disease and stroke; a cohort study in an Iranian population. Acta Cardiologica. 2016; 71(2): 221-6.##Hashemi-Fard A, Saffari SH, Adnan R. Analysis of hospitalization length for cerebrovascular accident patients in Sabzevar Vaseyee hospital using count regression models. Daneshvar Medicine. 2014; 21(109): 17-24. [Persian]##Lashkaripour K, Moghtaderi A, Sajadi SAR, Faghihinia M. Prevalence of post stroke depression and its relationship with disability and lesion location. Journal of Fundamentals of Mental Health. 2008; 10(3): 191-7.##Mazaheri SH, Beheshti F, Hosseinzadeh A, Mazdeh M, Ghiasian M. Epidemiologic study of cardinal risk factors of stroke in patients who referred to Farshchian hospital of Hamadan during 2014-2015. Scientific Journal of Hamadan University of Medical Sciences. 2016; 22(4): 331-7. [Persian]##Farghaly WM, El-Tallawy HN, Shehata GA, Rageh TA, Abdel-Hakeem NM, Elhamed MA, et al. Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga district, new valley, Egypt. Neuropsychiatric Disease and Treatment. 2013; 9: 1785.##Kaur P, Verma SJ, Singh G, Bansal R, Paul SP, Singla M, et al. Stroke profile and outcome between urban and rural regions of Northwest India: Data from Ludhiana population-based stroke registry European Stroke Journal. 2017; 2(4): 377–384.##Harwell TS, Blades LL, Oser CS, Fogle CC, Helgerson SD, Gohdes D, et al. Rural community knowledge of stroke warning signs and risk factors. Preventing Chronic Disease. 2005; 2(2).##Young J, Forster A. Review of stroke rehabilitation. British Medical Journal. 2007; 334(7584): 86-90.##Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum stroke registry. Stroke.2009; 40(4): 1212–8.##Mi T, Sun S, Du Y, Guo S, Cong L, Cao M, et al. Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China. Brain and Behavior. 2016; 6(5).##Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. The Journal of the American Medical Association. 2013; 310(9): 959–68.##Nakibuuka J, Sajatovic M, Nankabirwa J, Furlan AJ, Kayima J, Ddumba E, et al. Stroke-risk factors differ between rural and urban communities: population survey in Central Uganda. Neuroepidemiology. 2015; 44(3): 156-65.##Correia M, Silva MR, Matos I, Magalhães R, Lopes JC, Ferro JM, et al. Prospective community-based study of stroke in Northern Portugal: incidence and case fatality in rural and urban populations. Stroke. 2004; 35(9):2048-53.##Xu F, Ah Tse LA, Yin X, Yu IT, Griffiths S. Impact of socio-economic factors on stroke prevalence among urban and rural residents in Mainland China. BioMed Centeral Public Health. 2008; 8(170).##Kaup AO, Dos Santos BF, Victor ES, Cypriano AS, Lottenberg CL, Cendoroglo Neto M, et al. Georeferencing deaths from stroke in São Paulo: an intra-city stroke belt?. International Journal of Stroke. 2015; 10(100): 69-74.##Howard G, Kleindorfer DO, Cushman M, Long DL, Jasne A, Judd SE, et al. Contributors to the excess stroke mortality in rural areas in the United States. Stroke. 2017; 48(7): 1773-8.##Nishi N, Sugiyama H, Kasagi F, Kodama K, Hayakawa T, Ueda K, et al. Urban–rural difference in stroke mortality from a 19-year cohort study of the Japanese general population: NIPPON DATA80. Social Science & Medicine. 2007; 65(4): 822-32.##Patra J, Taylor B, Irving H, Roerecke M, Baliunas D, Mohapatra S, et al. Alcohol consumption and the risk of morbidity and mortality for different stroke types-a systematic review and meta-analysis. BioMed Central Public Health. 2010; 10(258).##Baalwa J, Byarugaba BB, Kabagambe E, Otim A. Prevalence of overweight and obesity in young adults in Uganda. African Health Sciences. 2010; 10(4): 367-73. ##Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A, et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban south India—the Chennai urban rural epidemiology study (CURES-17). Diabetologia. 2006; 49(6): 1175-8.## ##

Predictors of Physical Activity in Older Adults in Northwest of Iran 2 2 Introduction: There are strong evidences to support the relation between Physical Activity (PA) and improved health in older adults. So this study aimed to determine the predictors of PA among a group of older adults in northwest of Iran. Methods: In 2016, a randomly sample size of 340 older people in urban regions of Maku, West Azerbaijan, Iran, was recruited to complete Physical Activity Scale for the Elderly (PASE) and individual factors questionnaires. Results: The mean score of PA was 94.02 ± 3.41. Logistic regression analysis showed that age was the strongest predictor of PA; among younger elderly with higher level education, who had less comorbidity were significantly more active than their counterparts. (β = -2.72, SE = 0.47, P- value = 0.001) Conclusion: In this study the level of PA among the older adults was low and interventions to promote PA in this population is recommended. 75 80 2018/10/232018/11/222018/11/142018/11/202018/05/272018/10/122018/07/142018/06/17 1397/3/27 2018/12/12018/12/112018/12/82018/12/102018/12/12018/12/162018/12/162018/12/18 1397/9/27 Batool Ahmadi Batool Ahmadi Department of Health Education and Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran Iran baahmadi30@yahoo.com Nayyereh AminiSanii Nayyereh AminiSanii Department of Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran Iran aminisani_n@hotmail.com Fahim Bani Fahim Bani Health Affaire of Urmia University of Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran Iran fahim_bani@yahoo.com Fatemeh Bakhtari Fatemeh Bakhtari Department of Health Education and Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran Iran fatemeh.bakhtari@gmail.com Physical Activity Aged Individual Factors Khazaee-Pool M, Sadeghi R, Majlessi F, Rahimi Foroushani A. Effects of physical exercise programme on happiness among older people. Journal of psychiatric and mental health nursing. 2015; 22(1): 47-57.##Sadrollahi A, Hosseinian M, Alavi NM, Khalili Z, Esalatmanesh S. Physical activity patterns in the elderly kashan population. Iranian Red Crescent Medical Journal. 2016; 18(6): 1-8.##Sun F, Norman IJ, While AE. Physical activity in older people: a systematic review. BioMed Central Public Health. 2013; 13(449): 1-17.##Chodzko-Zajko WJ, Proctor DN, Singh MAF, Minson CT, Nigg CR, Salem GJ, et al. Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise. 2009; 41(7): 1510-30.##Moran M, Van Cauwenberg J, Hercky-Linnewiel R, Cerin E, Deforche B, Plaut P. Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies. International Journal of Behavioral Nutrition and Physical Activity. 2014; 11(79): 1-12.##Pan SY, Cameron C, DesMeules M, Morrison H, Craig CL, Jiang X. Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study. BioMed Central Public Health. 2009; 9(21): 1-12.##Yi X, Pope Z, Gao Z, Wang S, Pan F, Yan J, et al. Associations between individual and environmental factors and habitual physical activity among older Chinese adults: A social–ecological perspective. Journal of Sport and Health Science. 2016; 5(3): 315-21.##Ishii K, Shibata A, Oka K. Environmental, psychological, and social influences on physical activity among Japanese adults: structural equation modeling analysis. International Journal of Behavioral Nutrition and Physical Activity. 2010; 7(61): 1-8.##Gellert P, Witham MD, Crombie IK, Donnan PT, McMurdo ME, Sniehotta FF. The role of perceived barriers and objectively measured physical activity in adults aged 65–100. Age and Ageing. 2015;44(3):384-90.##Ethisan P, Somrongthong R, Ahmed J, Kumar R, Chapman RS. Factors related to physical activity among the elderly population in rural thailand. Journal Prim Care Community Health. 2017; 8(2): 71-6.##Florindo AA, Hallal PC, Moura ECd, Malta DC. Practice of physical activities and associated factors in adults, Brazil, 2006. Revista de Saude Publica. 2009; 43: 65-73.##Statistical Center of Iran. Selection of the results of the Population and Housing Census [Internet]. Iran: Statistical Center of Iran: 2012. Available from: http://www.amar.org.ir/##Eshaghi SR, Shahsanai A, Ardakani MM. Assessment of the Physical Activity of Elderly Population of Isfahan, Iran. Journal of Isfahan Medical School. 2011; 29(147): 939-46. [Persian]##Motefaker M, Sadrbafghi MS, Rafiee M, Bahadorzadeh L, Namayandeh SM, Karimi M, et al. Suicepidemiology of physical activity: a population based study in Yazd cityide attempt and its relation to stressors and supportive systems: a study in Karaj city. Tehran University Medical Journal. 2007; 65(4): 77-81. [Persian]##Salehi L, Tagdisi MH, Gasemi H, Shekarvash B. To identify the facilitator and barrier factors of physical activity among elderly people in Tehran. Iranian Journal of Epidemiology. 2010; 6(2): 7-15. [Persian]##Borji M, Motaghi M. The relationship between physical activity, social support and Fatigue Severity of elderly Ilam in 2016. Iran Journal Rehabilitation Research in Nursing. 2017; 3(4): 50-7. [Persian]##Fisher KL, Harrison EL, Bruner BG, Lawson JA, Reeder BA, Ashworth NL, et al. Predictors of physical activity levels in community-dwelling older adults: a multivariate approach based on a socio-ecological framework. Journal of Aging and Physical Activity. 2018; 26(1): 114-20.##Bakhtri Aghdam F, Baghiani Moghaddam MH, Asghari Jafarabadi M, Allahverdipour H, Dabagh Nikookheslat S, Noorizadeh R. Explaining the role of personal, social and physical environment factors on employed women's physical activity: a structural equation analysis. Global Journal of Health Science. 2013; 5(4): 189-99.##Bakhtari Aghdam F, Sahranavard H, Jahangiry L, Asghari M. The effect of a physical activity intervention on sedentary behavior in female teachers: a randomized, controlled trial. Health Scope. 2016; 7(1): 1-8.##Washburn RA, Smith KW, Jette AM, Janney CA. The physical activity scale for the elderly (PASE): development and evaluation. Journal of Clinical Epidemiology. 1993; 46(2): 153-62.##Dunlop DD, Song J, Semanik PA, Sharma L, Chang RW. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Arthritis & Rheumatism. 2011; 63(1): 127-36.##Alqarni AM, Vennu V, Alshammari SA, Bindawas SM. cross-cultural adaptation and validation of the arabic version of the physical activity scale for the elderly among community-dwelling older adults in saudi Arabia. Clinical Interventions in Aging. 2018; 13: 419-27.##Ishaghi R, Mahmoudian SA, Asgarian R, Sohrabi A. Effect of faith-based education on physical activity on the elderly. Iranian Journal of Medical Education. 2011; 10(5): 1281-8. [Persian]##Shiraly R, Shayan Z, Keshtkar V, Hamed M. Self-reported factors associated with engagement in moderate to vigorous physical activity among elderly people: a population-based study. International Journal of Preventive Medicine. 2017; 8(26).##Souza AM, Fillenbaum GG, Blay SL. Prevalence and correlates of physical inactivity among older adults in Rio grande do Sul, Brazil. PloS One. 2015; 10(2).##Imani A, Dastgiri S, Azizi A. Population aging and burden of diseases ( review study). Health Image. 2015; 6(2): 54-61. [Persian]##Momenan A, Delshad M, Mirmiran P, Ghanbarian A, Safarkhani M, Azizi F. Physical inactivity and related factors in an adult Tehranian population (Tehran lipid and glucose study). Iranian Journal of Endocrinology and Metabolism. 2012; 13(5): 493-503. [Persian]##Layne AS, Hsu F-C, Blair SN, Chen S-H, Dungan J, Fielding RA, et al. Predictors of change in physical function in older adults in response to long-term, structured physical activity: the life study. Archives of physical medicine and rehabilitation. 2017;98(1):11-24.##29. Mourao AR, Novais FV, Andreoni S, Ramos LR. Physical activity in the older adults related to commuting and leisure, Maceió, Brazil. Revista de Saude Publica. 2013; 47(6): 1112-22.##30. Vagetti GC, Barbosa Filho VC, Moreira NB, de Oliveira V, Mazzardo O, de Campos W. The prevalence and correlates of meeting the current physical activity for health guidelines in older people: a cross-sectional study in Brazilian women. Archives of Gerontology and Geriatrics. 2013; 56(3): 492-500.##31. Mooney SJ, Joshi S, Cerdá M, Quinn JW, Beard JR, Kennedy GJ, et al. Patterns of physical activity among older adults in New York City: a latent class approach. American Journal of Preventive Medicine. 2015; 49(3): 13-22.##Murtagh EM, Murphy MH, Murphy NM, Woods C, Nevill AM, Lane A. Prevalence and correlates of physical inactivity in community-dwelling older adults in Ireland. PloS One. 2015; 10(2): e0118293.##McKee G, Kearney PM, Kenny RA. The factors associated with self-reported physical activity in older adults living in the community. Age and Ageing. 2015; 44(4): 586-92.##Shaw BA, Spokane LS. Examining the association between education level and physical activity changes during early old age. Journal of Aging and Health. 2008; 20(7): 767-87.##Jenkins KR, Fultz NH. The relationship of older adults' activities and body mass index. Journal of Aging and Health. 2008; 20(2): 217-34.##Nicklas BJ, Beavers DP, Mihalko SL, Miller GD, Loeser RF, Messier SP. Relationship of objectively-measured habitual physical activity to chronic inflammation and fatigue in middle-aged and older adults. The Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2016; 71(11): 1437-43.##Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T. Barriers to physical activity in older adults in Germany: a cross-sectional study. The International Journal of Behavioral Nutrition and Physical Activity. 2011; 8(1): 121.## ##