1
|
Du X, Gu S, Wu Y, Zhao J, Liao H, Li S, Han D, Zhang M, Wang J. The association between dual sensory loss and healthcare expenditure: Mediating effect of depression. J Affect Disord 2024; 349:462-471. [PMID: 38199408 DOI: 10.1016/j.jad.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Previous studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous. OBJECTIVES The current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above. METHODS We first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE. RESULTS Depression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05). LIMITATIONS The DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias. CONCLUSION Significant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.
Collapse
Affiliation(s)
- Xinnan Du
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Shiping Gu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| |
Collapse
|
2
|
Deng L, Zhang B, Shi G, Zhang C. Elderly users' perceptions of signage systems from tertiary hospitals in Guangzhou. Heliyon 2024; 10:e25003. [PMID: 38317991 PMCID: PMC10840000 DOI: 10.1016/j.heliyon.2024.e25003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Wayfinding in hospitals today is a significant challenge for urban residents, especially for the elderly. This study investigated the perceptions and attitudes of the elderly toward existing hospital signage systems to identify the wayfinding needs in the healthcare environment. This study collected 762 elderly participants' perceptions and personal preferences regarding 12 features of the existing signage systems in three hospitals in the Yuexiu, Haizhu, and Liwan districts of Guangzhou using a questionnaire methodology. The study further explored the differences in perceptions and preferences for signage based on the gender, age, and educational level of the elderly participants. The findings indicate that most of the elderly participants experienced becoming lost in the hospital; they typically chose to ask others for directions first, followed by using the signage system. Most of the elderly participants had positive attitudes toward the current hospital signage system. Furthermore, they emphasized the importance of the signage system's graphics, texts, colors, and updates, which directly affects the readability and comprehensibility of signs. We found gender differences in perceptions and attitudes toward signage; male participants had more positive attitudes toward the hospital signage systems than female participants. Additionally, consistent with previous findings, the older the age of participants, the less comprehension they had regarding signage graphic symbols. We also found that the more educated elderly participants were, the more understanding of signage they had. At the same time, however, they were less satisfied, which is possibly because the more educated they were, the more aware they were of signage issues.
Collapse
Affiliation(s)
- Lujie Deng
- School of the Arts, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Bolun Zhang
- School of the Arts, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Guangyuan Shi
- School of Management, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Cheng Zhang
- School of the Arts, Universiti Sains Malaysia, Penang, 11800, Malaysia
| |
Collapse
|
3
|
López-López S, Abuín-Porras V, Berlanga LA, Martos-Duarte M, Perea-Unceta L, Romero-Morales C, Pareja-Galeano H. Functional mobility and physical fitness are improved through a multicomponent training program in institutionalized older adults. GeroScience 2024; 46:1201-1209. [PMID: 37493861 PMCID: PMC10828358 DOI: 10.1007/s11357-023-00877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023] Open
Abstract
Physical exercise has demonstrated its effectiveness in the management of the deleterious process of aging. However, it is less studied in institutionalized elderly people. This investigation aims to clarify the benefits of a multicomponent training program in institutionalized older adults. A randomized controlled trial was conducted with institutionalized older adults (≥ 70 years old). Intervention group (IG; N = 18) were submitted to a multicomponent training program based on muscle power training and interval endurance exercise, 2 times/week for 12 weeks. Control group (CG; N = 16) continued their usual mobility exercises. Independence was estimated with the Barthel index, and physical fitness and functional mobility were evaluated by the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, the 6-min Walking Test (6'WT), the 10-Meter Walking Test (10MWT), hand grip strength dynamometry, and lower limb muscle strength and power. The IG improved, compared with the CG, in TUG scores in -7.43 s (95% IC: 3.28, 11.59; p < 0.001); in 10MWT scores in -5.19 s (95% IC: 1.41, 8.97; p = 0.004) and -4.43 s (95% IC: 1.14, 7.73; p = 0.002), 6'WT scores in + 54.54 m (95% IC: 30.24, 78.84; p < 0.001); and SPPB in + 2.74 points (95% IC: 2.10, 3.37; p < 0.001). Maximum muscle power and maximum strength did not show statistically significant differences. The multicomponent training program based on muscle power and interval endurance exercise was shown to be safe, well tolerated and effective for the improvement of functional mobility and physical fitness, but not for independence in institutionalized older adults.
Collapse
Affiliation(s)
| | | | - Luis A Berlanga
- Department of Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Seville, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Luis Perea-Unceta
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Helios Pareja-Galeano
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|
4
|
Zhou W, Tong J, Wen Z, Mao M, Wei Y, Li X, Zhou M, Wan H. Prevalence and factors associated with dynapenia among middle-aged and elderly people in rural southern China. Prev Med Rep 2024; 38:102630. [PMID: 38375165 PMCID: PMC10874841 DOI: 10.1016/j.pmedr.2024.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 12/09/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
To estimate the prevalence of dynapenia and examine potential risk factors for dynapenia using a sample of rural middle-aged and elderly Chinese. A cross-sectional study of 253 Chinese adults aged 50 years and older was conducted from June to August in 2022 in Nanjing. A questionnaire was used to collect data on all socioeconomic variables. Body weight, height, body fat percentage, grip strength, waist circumference, calf circumference, and gait speed were measured. The prevalence of dynapenia was 69.6 %, 62.3 % in men and 72.7 % in women respectively. Binary logistic regressions indicated significant associations between dynapenia and age (odds ratio [OR] = 2.59; 95 % confidence interval [CI] 1.63, 4.12; p < 0.001), educational level (OR = 0.55; 95 % CI 0.38, 0.80; p = 0.002). Dynapenia was prevalent among rural middle-aged and elderly people in southern China. Age and lower education level were both associated with dynapenia. Nutrition and physical activity should be strongly recommended as important strategies to maintain and improve muscle strength.
Collapse
Affiliation(s)
- Wanqing Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Jiali Tong
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Zhiyu Wen
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Mao Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Yimin Wei
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Xiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Ming Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Hua Wan
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, 108 Longmian Avenue, Jiangning District, Nanjing 211166, China
| |
Collapse
|
5
|
Su W, Wang J, Chen K, Yan W, Gao Z, Tang X, Wan Q, Luo Z, Ning G, Mu Y. A higher TyG index level is more likely to have enhanced incidence of T2DM and HTN comorbidity in elderly Chinese people: a prospective observational study from the reaction study. Diabetol Metab Syndr 2024; 16:29. [PMID: 38287450 PMCID: PMC10826216 DOI: 10.1186/s13098-024-01258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) was related with both type 2 diabetes (T2DM) and hypertension (HTN). Prospective studies linking the TyG index to the incidence of T2DM and HTN comorbidity remain unclear. This study aimed to to explore the longitudinal association between TyG and new-onset T2DM with HTN. METHODS 4,434 subjects (1249 males and 3185 females) without initial T2DM and HTN were followed up for 7 years. This study was conducted from November 2011 to August 2018 in the Gucheng, Laoshan and Jinding communities of Beijing. The incidence of T2DM with HTN during the 7-year follow-up was identified as the endpoint. The TyG index was divided into four quartiles: the < 25% level, the 25-50% level, the 50-75% level and the ≥ 75% level. The relationships between the TyG index and T2DM with HTN were evaluated by Cox proportional hazards regression models. RESULTS During 7 years, the augmented trend of T2DM with HTN was observed in the participants. After adjusting for all confounding factors, compared with those in the lowest quartile of TyG index, the population in the highest quartile of TyG index had a higher risk of T2DM with HTN (hazard ratio (HR), 2.878; 95% confidence intervals (95% CI), 1.230-6.731, P = 0.015), however, the association remained significant only in the female population (HR 2.753, 95% CI, 1.061-7.139, p = 0.037). The TyG had superior predictive ability of increased risk of T2DM with HTN for the populations of older age (≥ 65 years) (HR 2.694, 95% CI 1.212-5.989, p = 0.015), higher eGFR (≥ 90 mL/(min·1.73 m2)) (HR 2.603, 95% CI 1.164-5.818, p = 0.020) or obesity (BMI ≥ 28 kg/m2) (HR 2.547, 95% CI 1.001-6.478, p = 0.020). CONCLUSION A population with a higher TyG index level was more likely to have an enhanced incidence of T2DM and HTN comorbidity. TyG index could have the significance of clinical in early protection against T2DM with HTN.
Collapse
Affiliation(s)
- Wanlu Su
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China
| | - Jie Wang
- Department of Endocrinology, Affiliated Beijing Chaoyang Hospital of Capital Medical University, No. 8 Workers Stadium South Road, Chaoyang District, Beijing, 100853, China
| | - Kang Chen
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wenhua Yan
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital, No. 826 Southwest Shahekou District Road, Dalian, 116033, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Department of Endocrinology, Center Hospital of Dalian, Dalian, Liaoning, China
| | - Qin Wan
- Department of Endocrinology, Affiliated Hospital of Luzhou Medical College, No. 25 Taiping Road, Luzhou, 646000, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guang Ning
- State Key Laboratory of Medical Genomics, Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.
| |
Collapse
|
6
|
Morris LD, McKay A, Cassidy T. A design evaluation tool for older adults using domestic information processing appliances. Appl Ergon 2024; 114:104106. [PMID: 37713928 DOI: 10.1016/j.apergo.2023.104106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 09/17/2023]
Abstract
Domestic information processing appliances include embedded digital technologies with which users interact. The designs of such appliances tend to be technology oriented and not well-suited to the needs of older adults. This is problematic because these appliances are essential in many activities of daily living and so affect the ability of people to live independently. This paper introduces a coding scheme for the analysis of users' interactions with such appliances and uses it to inform recommendations for the design of operational interfaces and associated instructional materials. The efficacy of the coding scheme as a design evaluation tool is illustrated by its application in a microwave oven case study. The coding scheme considers four aspects of users' interactions with this type of device: information processing activities, including the gathering and interpretation of information from the appliance, its user manual and cooking instructions from food packaging; interactions with the device's user interface; concurrent verbalisation supporting problem-solving; and impediments to the user's workflow.
Collapse
Affiliation(s)
- Lisa-Dionne Morris
- School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK.
| | - Alison McKay
- School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Thomas Cassidy
- School of Design, University of Leeds, Leeds, LS2 9JT, UK
| |
Collapse
|
7
|
Tan X, Ljunggren M, Kilander L, Benedict C, Lindberg E. Obstructive sleep apnea during rapid eye movement sleep and cognitive performance in adults. Sleep Med 2024; 113:34-40. [PMID: 37980842 DOI: 10.1016/j.sleep.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep is often characterized with more frequent and lengthy breathing events and greater oxygen desaturation than during other sleep stages. Current evidence suggests an association between OSA and cognitive decline, however whether OSA during REM sleep plays a vital role in this link is understudied. METHODS A cross-sectional sample of 728 men and women (aged 59.1 ± 11.3 years) underwent a full night polysomnography for determining apnea-hypopnea index (AHI) and sleep stages. Trail Making Test (TMT) part A and B were conducted during the following day for assessing participants' cognitive function. Linear regression analyses were performed to test the possible association between AHI and AHI during REM sleep with TMT-A and B results. Similar analyses were carried out in a subsample involving participants aged ≥60 years with ≥30 min of REM sleep (n = 356). RESULTS Despite a slight difference in TMT-B between participants with and without OSA (AHI ≥5 vs AHI <5, β-coefficient: 4.83, 95 % CI: [-9.44, -0.22], P = 0.040), no other association between AHI or REM-AHI and TMT results were found in the full sample. In older participants (aged ≥60 years), a REM-AHI ≥5 events/hour was associated with longer time taken to finish TMT-A (vs REM-AHI <5 events/hour, 3.93, [0.96, 6.90], P = 0.010). There was no association between REM-AHI and time taken to finish TMT-B in older participants. CONCLUSIONS The results indicate that OSA during REM sleep may be of particular concern for attention-related cognitive function in older adults.
Collapse
Affiliation(s)
- Xiao Tan
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
| | - Mirjam Ljunggren
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
| |
Collapse
|
8
|
Orlando S, de Santo C, Mosconi C, Di Gaspare F, Chatzichristou P, Emberti Gialloreti L, Ciccacci F, Morciano L, Varrenti D, Liotta G, Palombi L. COVID-19 infection rate and mortality in a local health authority in Italy: Differences between home-dwelling and residential older adults. Public Health Pract (Oxf) 2023; 6:100448. [PMID: 38028255 PMCID: PMC10663662 DOI: 10.1016/j.puhip.2023.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The health emergency following the COVID-19 pandemic has seen hospital structures collapse and put in crisis nursing homes and other long-term care facilities worldwide. Our study aims to analyze and comparing the data relating to the infection rate and mortality for COVID-19 in the elderly over 75 living in the long-term care facilities and in the home-dwelling population. Study design The study adopts a retrospective cohort design and was conducted in Italy, in the Lazio region, in the area of the Local Health Authority (LHA) named "Azienda Sanitaria Locale Roma 6". Methods Data were extracted from the COVID-19 surveillance system of the Lazio region. The primary outcome is the SARS-CoV-2 incidence rate in the period between 1st September 2020 and 31st May 2021. The secondary outcome is the mortality rate. Results Living in a residential versus a home-dwelling setting was associated with a higher infection rate (OR 5.03, CI 4.67-5.43; p < 0.001). The mortality rate was higher for individuals living in a residential setting (19.3 %, CI 17.1%-21.7 %) than those living at home (13.0 %, CI 11.7%-14.5 %). Conclusions These findings confirm the high mortality in Long-Term Care Facilities and provide new information on the infection rate. The containment measures adopted in the Long-Term Care Facilities during the COVID-19 pandemic, show limited correlation with reduced risk of contagion, but could have created unintended harm for the residents by increasing the social isolation and all other causes of mortality.
Collapse
Affiliation(s)
- Stefano Orlando
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Carolina de Santo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Claudia Mosconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Di Gaspare
- Local Health Authority - Rome 6, Department of Prevention, Service of Hygiene and Public Health, Rome, Italy
| | | | | | - Fausto Ciccacci
- UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Laura Morciano
- Local Health Authority - Rome 6, Department of Prevention, Service of Hygiene and Public Health, Rome, Italy
| | - Donatella Varrenti
- Local Health Authority - Rome 6, Department of Prevention, Service of Hygiene and Public Health, Rome, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
9
|
Valieiny N, Pashaeypoor S, Poortaghi S, Sharifi F. The effects of simulated video education about falling on falling rate and fear of falling among hospitalized elderly people: a randomized clinical trial. BMC Nurs 2023; 22:351. [PMID: 37789297 PMCID: PMC10548683 DOI: 10.1186/s12912-023-01532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND AND AIM Management of falling and its consequences is a major challenge of elderly nursing care. An effective educational strategy is essential to prevent falling among elderly people. The aim of this study was to evaluate the effects of simulated video education (SVE) about falling on falling rate and fear of falling (FOF) among hospitalized elderly people. METHODS This randomized controlled clinical trial was conducted from May 2021 to February 2022. Participants were 132 elderly people conveniently selected from a leading hospital in Qom, Iran, and randomly allocated to an intervention and a control group through block randomization. Data collection instruments were a demographic and clinical questionnaire, a researcher-made falling rate questionnaire, and the Falls Efficacy Scale-International. Participants in the intervention group individually watched three simulated videos (fifteen minutes in total) and had access to the videos for frequent watching. Their FOF was assessed on the first day of hospitalization, hospital discharge, and one and three months after hospital discharge. The data were analyzed at a significance level of less than 0.05 using the SPSS software (v. 16.0). RESULTS Groups did not significantly differ from each other respecting baseline demographic and clinical characteristics (P > 0.05). After the intervention, falling rate in the intervention group was 46% less than the control group (incidence rate ratio = 0.5454, 95% CI = 0.307-0.968; P = 0.039). Moreover, the posttest mean score of FOF in the intervention group was significantly less than the control group (P < 0.001). CONCLUSION SVE is effective in significantly reducing falling rate and FOF. Context-based SVE is recommended to reduce falling rate and FOF among hospitalized elderly people. CLINICAL TRIAL REGISTRATION The effects of simulated video education about falling on falling rate and fear of falling among hospitalized elderly people. CLINICAL TRIAL REGISTRATION this research was registered (17/09/2021) in the https://www.irct.ir with registration number: IRCT20210910052427N1).
Collapse
Affiliation(s)
- Nasrin Valieiny
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pashaeypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sarieh Poortaghi
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Yap YY, Tan SH, Tan SK, Choon SW. Online grocery shopping intention: Elderly's perspective in Malaysia. Heliyon 2023; 9:e20827. [PMID: 37916123 PMCID: PMC10616124 DOI: 10.1016/j.heliyon.2023.e20827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/27/2023] [Accepted: 10/08/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose This study investigates the factors associated with the elderly's intention to use OGS. Building on the Technology Acceptance Model, we propose several elderly-specific and functional-ageing constructs related to the perceived ease of use and usefulness of OGS. Methods The questionnaire was distributed physically and digitally to non-OGS users aged above 60, living in the Klang Valley, Malaysia, using a non-probability sampling approach. A total of 302 data were analysed using PLS structural equation modelling. Results The findings indicate that perceived ease of use, functional ability, life-course events, and digital literacy are associated with the elderly's perception of OGS's usefulness, while life-course events, digital literacy, technology anxiety, and facilitating conditions are associated with the perceived ease of use. Conclusion This study contributes to the OGS literature by addressing ageing complexities with OGS adoption among the elderly population, thereby offering insights for marketers and the government to tailor services and provide relevant support.
Collapse
Affiliation(s)
- Yee-Yann Yap
- Faculty of Management, Multimedia University, Malaysia
| | - Siow-Hooi Tan
- Faculty of Management, Multimedia University, Malaysia
| | - Siow-Kian Tan
- Faculty of Management, Multimedia University, Malaysia
- School of Economics and Management, Xiamen University Malaysia, Malaysia
| | - Shay-Wei Choon
- Faculty of Management, Multimedia University, Malaysia
- School of Economics and Management, Xiamen University Malaysia, Malaysia
| |
Collapse
|
11
|
Prigent A, Blanloeil C, Serandour AL, Barlet F, Gagnadoux PF, Jaffuel D. A biphasic effect of age on CPAP adherence: a cross-sectional study of 26,343 patients. Respir Res 2023; 24:234. [PMID: 37759266 PMCID: PMC10537927 DOI: 10.1186/s12931-023-02543-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND As the prevalence of OSA increases in older patients, the proportion of elderly patients treated with CPAP is expected to become even higher. We studied CPAP-adherence in a real-life cohort involving a large population of elderly patients with OSA. METHODS eQUALISAS is a cross-sectional study of CPAP treated OSA patients for at least 4 months who received remote monitoring during 2021. CPAP adherence, device-reported residual AHI (AHICPAP) and 95th percentile non-intentional leaks were software collected during January 2021. Age and sex were also collected. RESULTS Data from 26,343 patients including 1656 patients aged [80-85] years and 639 patients aged ≥ 85 years were analysed. Median CPAP adherence increases from 6.3 h (< 50 years) to 7 h (75-80 years) and decreases after this age (p < 0.001). The decrease in CPAP adherence observed after the age of 80 was associated with an increase in the proportion of patients with a CPAP-adherence < 4 h/day (p < 0.001). Proportion of CPAP treated female, patients having AHICPAP mean ≥ 10 events per hour or 95th percentile non-intentional leaks mean over 24 l/min increase with aging of the population. However, for patients over 80 years old, Chi square test showed no association of adherence with gender, AHICPAP and leaks (p > 0.05). CONCLUSION This study demonstrates that adherence gradually increases with age until 80 years. The proportion of non-adherent patients grows with age after 80 years old. No significative relationship was found between adherence after 80 years old and gender, leaks and AHICPAP. TRIAL REGISTRATION The study is registered on Health Data Hub platform (No. F20220715144543).
Collapse
Affiliation(s)
- Arnaud Prigent
- Groupe Médical de Pneumologie, Polyclinique Saint-Laurent, 35000 Rennes, France
- Centre du Sommeil Polyclinique Saint Laurent, 35000 Rennes, France
| | | | | | | | - Pr Frédéric Gagnadoux
- Service de Pneumologie et Médecine du Sommeil, CHU d’Angers, Angers, France
- INSERM, CNRS, MITOVASC, Equipe CarME, SFR ICAT, Université d’Angers, Angers, France
| | - Dany Jaffuel
- Département de Pneumologie, Hôpital Arnaud de Villeneuve, CHRU de Montpellier, Montpellier, France
- Inserm U1046-CNRS 9214-Physiologie et Médecine Expérimentale Cœur et Muscle, Université de Montpellier, Montpellier, France
| |
Collapse
|
12
|
Wang PP, Lei JY, Wang Y, Wang HL, Sun L, Hu B, Wang SF, Zhang DM, Chen GM, Liang CM, Tao FB, Yang LS, Wu QS. The association between the essential metal mixture and fasting plasma glucose in Chinese community-dwelling elderly people. Ecotoxicol Environ Saf 2023; 263:115289. [PMID: 37499391 DOI: 10.1016/j.ecoenv.2023.115289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Epidemiological studies about the effect of essential metal mixture on fasting plasma glucose (FPG) levels among elderly people are sparse. The object of this study was to examine the associations of single essential metals and essential metal mixture with FPG levels in Chinese community-dwelling elderly people. METHODS The study recruited 2348 community-dwelling elderly people in total. Inductively coupled plasma-mass spectrometry was adopted to detect the levels of vanadium (V), selenium (Se), magnesium (Mg), cobalt (Co), calcium (Ca), and molybdenum (Mo) in urine. The relationships between single essential metals and essential metal mixture and FPG levels were evaluated by linear regression and Bayesian kernel machine regression (BKMR) models, respectively. RESULTS In multiple-metal linear regression models, urine V and Mg were negatively related to the FPG levels (β = - 0.016, 95 % CI: - 0.030 to - 0.003 for V; β = - 0.021, 95 % CI: - 0.033 to - 0.009 for Mg), and urine Se was positively related to the FPG levels (β = 0.024, 95 % CI: 0.014-0.034). In BKMR model, the significant relationships of Se and Mg with the FPG levels were also found. The essential metal mixture was negatively associated with FPG levels in a dose-response pattern, and Mg had the maximum posterior inclusion probability (PIP) value (PIP = 1.0000), followed by Se (PIP = 0.9968). Besides, Co showed a significant association with decreased FPG levels in older adults without hyperlipemia and in women. CONCLUSIONS Both Mg and Se were associated with FPG levels, individually and as a mixture. The essential metal mixture displayed a linear dose-response relationship with reduced FPG levels, with Mg having the largest contribution to FPG levels, followed by Se. Further prospective investigations are necessary to validate these exploratory findings.
Collapse
Affiliation(s)
- Pan-Pan Wang
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Jing-Yuan Lei
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Hong-Li Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang 236069, Anhui, China
| | - Su-Fang Wang
- School of Public Health, Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei 230032, Anhui, China
| | - Dong-Mei Zhang
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Gui-Mei Chen
- School of Health Services Management, Anhui Medical University, Hefei 230032, Anhui, China
| | - Chun-Mei Liang
- School of Public Health, Department of Health Inspection and Quarantine, Anhui Medical University, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Lin-Sheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China.
| | - Qing-Si Wu
- Department of Blood Transfusion, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| |
Collapse
|
13
|
Zhang P, Abudukelimu N, Sali A, Chen JX, Li M, Mao YY, Zhu Y, Zhu QX. Sociodemographic features associated with the MoCA, SPPB, and GDS scores in a community-dwelling elderly population. BMC Geriatr 2023; 23:557. [PMID: 37704972 PMCID: PMC10500811 DOI: 10.1186/s12877-023-04162-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/11/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND An accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population. METHODS This community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60-89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS). RESULTS The results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P < 0.01). However, the GDS score did not exhibit an age-related decrease (P = 0.09). Both sex and living alone influenced the MoCA score (P < 0.01 and P = 0.04, respectively), SPPB score (P < 0.01 and P = 0.04, respectively), and GDS score (P < 0.01 and P < 0.01, respectively). A higher education level was related to better MoCA and SPPB scores (all P < 0.01). Furthermore, age and sex had interactive effects on the MoCA score (P = 0.03) and SPPB score (P < 0.01). The kernel-weighted local polynomial smoothing curves exhibited similar trends. CONCLUSIONS It is imperative to develop a more sensitive evaluation of physical function, and to encourage various intellectually and emotionally stimulating social activity strategies to promote healthy aging, especially in elderly women and those living alone who have a low education level.
Collapse
Affiliation(s)
- Peng Zhang
- School of Management, Hainan Medical University, Haikou, Hainan, 571199, China
| | - Nazhakaiti Abudukelimu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Ayijiamal Sali
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, Xinjiang Uygur Autonomous Region, 844099, China
| | - Jin-Xia Chen
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Min Li
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yan-Yan Mao
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yi Zhu
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
| | - Qian-Xi Zhu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
| |
Collapse
|
14
|
Lu K, Wu YM, Shi Q, Gong YQ, Zhang T, Li C. The impact of acute-phase reaction on mortality and re-fracture after zoledronic acid in hospitalized elderly osteoporotic fracture patients. Osteoporos Int 2023; 34:1613-1623. [PMID: 37247006 DOI: 10.1007/s00198-023-06803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
This study involving 674 elderly osteoporotic fracture (OPF) patients undergoing orthopedic surgery investigated the long-term outcomes of acute phase reaction (APR) after initial zoledronic acid (ZOL). Those who had an APR had a 97% higher risk of mortality and a 73% lower rate of re-fracture than patients who did not. INTRODUCTION Annual infusion of ZOL efficiently decreases the risk of fracture. A temporary APR, consisting of flu-like symptoms, myalgia, and fever, is frequently observed within 3 days after the first dose. This work aimed to identify whether the occurrence of APR after initial ZOL infusion is a reliable indicator of drug efficacy for mortality and re-fracture in elderly OPF patients undergoing orthopedic surgery. METHODS This retrospectively observed work was constructed on a database prospectively collected from the Osteoporotic Fracture Registry System of a tertiary level A hospital in China. Six hundred seventy-four patients 50 years old or older with newly identified hip/morphological vertebral OPF who received ZOL for the first time after orthopedic surgery were included in the final analysis. APR was identified as a maximum axillary body temperature greater than 37.3 °C for the first 3 days after ZOL infusion. We utilized models of multivariate Cox proportional hazards to compare the risk of all-cause mortality in OPF patients with APR (APR+) and without APR (APR-). Competing risks regression analysis was used to examine the association between the occurrence of APR and re-fracture when mortality was taken into account. RESULTS In a fully adjusted Cox proportional hazards model, APR+ patients had a significantly higher risk of death than APR- patients with a hazard ratio [HR] 1.97 (95% CI, 1.09-3.56; P-value = 0.02). Furthermore, in an adjusted competing risk regression analysis, APR+ patients had a significantly reduced risk of re-fracture compared with APR- patients with a sub-distribution HR, 0.27 (95% CI, 0.11-0.70; P-value = 0.007). CONCLUSIONS Our findings suggested a potential association between the occurrence of APR and increased mortality risk. An initial dose of ZOL following orthopedic surgery was found to be protective against re-fracture in older patients with OPFs.
Collapse
Affiliation(s)
- K Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Y-M Wu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Q Shi
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University, Suzhou, Jiangsu, China
| | - Y-Q Gong
- Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - T Zhang
- Chronic Disease Department, Kunshan Center For Disease Control and Prevention, Suzhou, Jiangsu, China
| | - C Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China.
| |
Collapse
|
15
|
Succurro E, Novella A, Nobili A, Giofrè F, Arturi F, Sciacqua A, Andreozzi F, Pietrangelo A, Sesti G. Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register. Intern Emerg Med 2023; 18:1049-1063. [PMID: 36964858 PMCID: PMC10326139 DOI: 10.1007/s11739-023-03254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria.
Collapse
Affiliation(s)
- Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| | - Alessio Novella
- Department of Health Policy, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, 20156, Milan, Italy
| | - Alessandro Nobili
- Department of Health Policy, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, 20156, Milan, Italy
| | - Federica Giofrè
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Antonello Pietrangelo
- Division of Internal Medicine 2nd Center for Haemochromatosis, University Hospital of Modena, 41124, Modena, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy
| |
Collapse
|
16
|
Mohamed AA, Khaled E, Hesham A, Khalf A. Effectiveness and safety of subthreshold vibration over suprathreshold vibration in treatment of muscle fatigue in elderly people. World J Clin Cases 2023; 11:3434-3443. [PMID: 37383890 PMCID: PMC10294188 DOI: 10.12998/wjcc.v11.i15.3434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/29/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Muscle fatigue is common in many populations, particularly elderlies. Aging increases the incidence of muscle fatigue and delays its recovery. There is a huge debate about the current treatments for muscle fatigue, particularly in elderlies. Recently, it has been discovered that mechanoreceptors have an important role as a sensory system in sensing muscle fatigue which could enhance the body's response to muscle fatigue. The function of mechanoreceptors could be enhanced by applying either suprathreshold or subthreshold vibration. Although suprathreshold vibration improves muscle fatigue, it can cause desensitization of cutaneous receptors, discomfort, and paresthesia, which are barriers to clinical use. Subthreshold vibration has been approved as a safe and effective method of training for mechanoreceptors; however, its use and effectiveness in muscle fatigue have never been tested or explained. Possible physiological effects of subthreshold vibration in the treatment of muscle fatigue include: (1) Enhancing the function of mechanoreceptors themselves; (2) Increasing the firing rate and function of alpha motor neurons; (3) Increasing blood flow to fatigued muscles; (4) Decreasing the rate of muscle cell death in elderlies (sarcopenia); and (5) Driving motor commands and allow better performance of muscles to decrease fatigue incidence. In conclusion, the use of subthreshold vibration could be a safe and effective treatment for muscle fatigue in elderlies. It could enhance recovery from muscle fatigue. Finally, Subthreshold Vibration is safe and effective in treating muscle fatigue in comparison to suprathreshold vibration.
Collapse
Affiliation(s)
- Ayman A Mohamed
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
- Physical Therapy, Beni-Suef University, Beni Suef 32456, Egypt
| | - Esraa Khaled
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| | - Asmaa Hesham
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| | - Ahmed Khalf
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| |
Collapse
|
17
|
Martínez I, González F. Wireless standard-compliant e-health solution for elderly people with multiuser identification. Heliyon 2023; 9:e15394. [PMID: 37113793 PMCID: PMC10126905 DOI: 10.1016/j.heliyon.2023.e15394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Objective One of the main problems in e-health environments for developing an accurate multiuser identification is in the large number of patients, especially with itinerant medical devices and elderly people. This paper aims to contribute with two approaches to be included in ISO/IEEE 11073 family of standards as a standardized procedure for multiuser identification that can be used for a large variety of medical devices, regardless of their brand or model. From this contribution and to validate it, this work proposes a standardized e-health solution, including multiuser identification, implementing it in real health environments for elderly people, and evaluating their usability, interoperability, and adoption in daily living. Materials and methods This works implements the internationally recommended Personal Health Devices ISO/IEEE 11073 standards as a multiplatform environment (Windows/Linux/Mac OS) and fulfils the paradigms of scalability, modularity, portability, maintainability, and robustness. The standard e-health solution has been implemented in 26 health environments in several cities in Spain (Madrid, Barcelona, Sevilla, Zaragoza, etc.), consisting of 118 health professionals, 319 senior patients, and 18 technical professionals. Results The proposed multiuser identification reduces the human error rate (from 13.3% to less than 5%) with positive evaluation: almost 70% of users are satisfied, with usability and time savings that are more than 50% in all the groups (nursing, medicine, and caregiving) and environments (residences, health centres, and hospitals). Discussion The use of e-health solutions within multiuser identification, as it is proposed through two standard-compliant approaches, permits advanced services and data analysis for a large variety of medical devices, regardless of their brand or model. Conclusion This paper contributes an open interoperable e-health solution as alternative to the closed and commercial solutions and enables third-party developers to work collaboratively and extend the already implemented features, owing to the design based on plugins, value-added services, and multiple transport technologies and protocols.
Collapse
|
18
|
Yan Y, Ou J, Shi H, Sun C, Shen L, Song Z, Shu L, Chen Z. Plantar pressure and falling risk in older individuals: a cross-sectional study. J Foot Ankle Res 2023; 16:14. [PMID: 36941642 PMCID: PMC10029259 DOI: 10.1186/s13047-023-00612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Falls are commonplace among elderly people. It is urgent to prevent falls. Previous studies have confirmed that there is a difference in plantar pressure between falls and non-falls in elderly people, but the relationship between fall risk and foot pressure has not been studied. In this study, the differences in dynamic plantar pressure between elderly people with high and low fall risk were preliminarily discussed, and the characteristic parameters of plantar pressure were determined. METHODS Twenty four high-fall-risk elderly individuals (HR) and 24 low-fall-risk elderly individuals (LR) were selected using the Berg Balance Scale 40 score. They wore wearable foot pressure devices to walk along a 20-m-long corridor. The peak pressure (PP), pressure time integral (PTI), pressure gradient (maximum pressure gradient (MaxPG), minimum pressure gradient (MinPG), full width at half maximum (FWHM)) and average pressure (AP) of their feet were measured for inter-group and intra-group analysis. RESULTS The foot pressure difference comparing the high fall risk with low fall risk groups was manifested in PP and MaxPG, concentrated in the midfoot and heel (p < 0.05), while the only time parameter, FWHM, was manifested in the whole foot (p < 0.05). The differences between the left and right foot were reflected in all parameters. The differences between the left and right foot in LR were mainly reflected in the heel (p < 0.05), while it in the HR was mainly reflected in the forefoot (p < 0.05). CONCLUSIONS The differences comparing the high fall risk with low fall risk groups were mostly reflected in the midfoot and heel. The HR may have been more cautious when landing. In the intra-group comparison, the difference between the right and left foot of the LR was mainly reflected during heel striking, while it was mainly reflected during pedalling in the HR. The sensitivity of PP, PTI and AP was lower and the newly introduced pressure gradient could better reflect the difference in foot pressure between the two groups. The pressure gradient can be used as a new foot pressure parameter in scientific research.
Collapse
Affiliation(s)
- Yifeng Yan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jianlin Ou
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hanxue Shi
- School of Future Technology, South China University of Technology, Guangzhou, China
| | - Chenming Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Longbin Shen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhen Song
- School of Future Technology, South China University of Technology, Guangzhou, China
- School of Microelectronics, South China University of Technology, Guangzhou, China
| | - Lin Shu
- School of Future Technology, South China University of Technology, Guangzhou, China.
- Institute of Modern Industrial Technology of SCUT in Zhongshan, Zhongshan, China.
- Pazhou Lab, Guangzhou, China.
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
| |
Collapse
|
19
|
Zhang Y, Lv Z, Li X, Zhao K, Huang S, Chen Y, Fu Y, Peng C, Cao T, Ke Y, Xia X. Occurrence and risk assessment of antibiotics in feces of elderly individuals in Shenzhen. Environ Sci Pollut Res Int 2023; 30:44943-44951. [PMID: 36697981 DOI: 10.1007/s11356-023-25522-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/19/2023] [Indexed: 06/17/2023]
Abstract
The occurrence of antibiotics in the feces of elderly individuals in Shenzhen, China, was investigated by monitoring 78 compounds to understand the adverse effects and its association with antibiotic residues in animal products collected from local markets. In total, 18 compounds belonging to 5 classes of antibiotics were identified in 74 of 140 fecal samples. Furthermore, 17.9% of the fecal samples contained at least two antibiotics, and 14.3% of the samples showed antibiotic concentrations higher than 100 μg/kg. Cephalothin exhibited the highest detection frequency (22.1%), followed by azithromycin (15.7%) and tilmicosin (12.9%). Oxytetracycline, norfloxacin, and azithromycin showed extremely high concentrations (> 1000 μg/kg). Eight antibiotics were detected in the animal products, with detection frequencies ranging from 4.8 to 40.0%. Five antibiotics exhibited similar detection frequencies and strong correlations between the human fecal and animal product samples. Health risk assessment based on hazard quotients showed that ciprofloxacin in animal products and human feces posed a medium and high risk, respectively. The hazard quotients of oxytetracycline, norfloxacin, and azithromycin in the feces were greater than 1, indicating a high health risk. These findings suggest that the elderly individuals were frequently exposed to antibiotics via the food chain and faced health risks posed by these antibiotics.
Collapse
Affiliation(s)
- Yuan Zhang
- National Key Laboratory of Veterinary Public Health Security, College of Veterinary Medicine, China Agricultural University, Beijing, 100193, China
| | - Ziquan Lv
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Xiaowei Li
- National Key Laboratory of Veterinary Public Health Security, College of Veterinary Medicine, China Agricultural University, Beijing, 100193, China
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, China Agricultural University, Beijing, 100193, China
| | - Kunxia Zhao
- National Key Laboratory of Veterinary Public Health Security, College of Veterinary Medicine, China Agricultural University, Beijing, 100193, China
| | - Suli Huang
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
- Department of Environmental Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Yuhua Chen
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
- Chemical Analysis & Physical Testing Institute, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Yulin Fu
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Changfeng Peng
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Tingting Cao
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Yuebin Ke
- Central laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Xi Xia
- National Key Laboratory of Veterinary Public Health Security, College of Veterinary Medicine, China Agricultural University, Beijing, 100193, China.
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, China Agricultural University, Beijing, 100193, China.
| |
Collapse
|
20
|
Lin H, Gao Y, Qiu Y, Du W, Zhu H, Li J, Wang P, Xu Y, Feng Y. Impact of age group on bloodstream infection risk evaluation in immunosuppressed patients: a retrospective, single-centre, 5-year cohort study. Aging Clin Exp Res 2023; 35:357-366. [PMID: 36394798 DOI: 10.1007/s40520-022-02299-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Elderly patients in immunosuppressive status may have an increased occurrence of illness and risk of poor prognosis. It is a generally overlooked population that we should pay more attention to their risk factors of sickness and mortality. METHODS Eight hundred and nine patients who were diagnosed with bloodstream infection in immunosuppressive states during accepting treatment in our hospital were selected from 2015 to 2019.The demographic data, underlying diseases, comorbidity, inducement, complications, pathogen sources, etiologies, and the antibiotics therapy were analyzed between ages > 65 years groups and ages < 65 years groups. RESULTS The clinical characteristics of totally 809 immunosuppressed people diagnosed with bloodstream infection were analyzed, and among those people about 371 were ages > 65 years. By univariate logistic regression analysis and multivariate logistic regression analysis, we found that hypertension (OR: 2.864, 95% CI 2.024-4.051, P < 0.0001), cerebral Infarction (OR: 4.687, 95% CI 2.056-10.686, P < 0.0001), coronary heart disease (OR: 1.942, 95% CI 1.168-3.230, P = 0.011), acute pancreatitis (OR: 3.964, 95% CI 2.059-7.632, P < 0.0001), infective endocarditis (OR: 6.846, 95% CI 1.828-25.644, P = 0.004), aortic dissection (OR: 9.131, 95% CI 3.190-26.085, P < 0.0001), chemotherapy (OR: 3.462, 95% CI 1.815-6.603, P < 0.0001), transplant status (OR: 20.031, 95% CI 4.193-95.697, P < 0.0001), and respiratory tract infection (OR: 2.096, 95% CI 1.269-3.461, P = 0.004) were significantly different between ages > 65 years groups and ages < 65 years groups. CONCLUSION Hypertension, cerebral Infarction, coronary heart disease, acute pancreatitis, infective endocarditis, aortic dissection, chemotherapy, transplant status, and pathogen source of respiratory tract were the independent risk factors of ages > 65 years in immunosuppressed patients, which would have the benefit to discriminate the prognostic factors in immunosuppressive elderly people with bloodstream infection.
Collapse
Affiliation(s)
- Hongxia Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China
| | - Yulian Gao
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China
| | - Yanli Qiu
- Department of Anesthesia, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wei Du
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China
| | - Haixing Zhu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China
| | - Junjie Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China
| | - Ping Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China.
| | - Yumin Xu
- Department of Hospital Infection Management, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yun Feng
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Institute of Respiratory Diseases, School of Medicine, Shanghai Jiaotong University, Shanghai, 20025, China.
| |
Collapse
|
21
|
Mizukami K, Kodama M, Fukuda M, Hirashita Y, Tsutsumi K, Fukuda K, Ogawa R, Okamoto K, Okimoto T, Murakami K. Comparison of the improvement in gastric mucosal tissue after Helicobacter pylori eradication between young and elderly people. Arab J Gastroenterol 2023:S1687-1979(23)00007-2. [PMID: 36720666 DOI: 10.1016/j.ajg.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/13/2022] [Accepted: 01/08/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND STUDY AIMS Helicobacter pylori (H. pylori) infection has been clearly shown to be a cause of gastric cancer, and the incidence of gastric cancer has been shown to decrease with eradication. However, few reports have described the utility of eradication therapy in elderly people. Thus, an investigation focusing on how much actual histological improvement is obtained with eradication therapy in elderly people was conducted. PATIENTS AND METHODS This was a retrospective study conducted using medical information of patients diagnosed with H. pylori-associated gastritis and who underwent eradication therapy. The histological improvement was assessed based on changes in the atrophy and intestinal metaplasia scores of the Updated Sydney system from before to after eradication. We investigated the rates of histological improvement in atrophy and intestinal metaplasia one year after and long term more than five years after H. pylori eradication in an elderly group and a younger group. RESULTS This study included 221 patients (elderly group 123, younger group 98). In histological atrophy, higher rates of improvement were seen in the corpus than in the antrum, and the rates of cure in the antrum were lower in elderly group than in younger group (p = 0.0282). With regard to intestinal metaplasia, the rates of improvement in the antrum were lower in elderly group than in younger. In long term observation, although the rates of cure in the antrum were lower in elderly, improvements were seen in atrophy scores in most of the patients and intestinal metaplasia scores in about half of patients. CONCLUSION Though there is more obvious improvement in the gastric mucosa when H. pylori eradication therapy is performed at a young age, some mucosal improvement can be expected in about half of patients after eradication, even in elderly people.
Collapse
Affiliation(s)
- Kazuhiro Mizukami
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan.
| | - Masaaki Kodama
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Masahide Fukuda
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Yuka Hirashita
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Koshiro Tsutsumi
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Kensuke Fukuda
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Ryo Ogawa
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Kazuhisa Okamoto
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Tadayoshi Okimoto
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Oita University, 1-1, Idaigaoka, Hasama, Yufu, Oita 879-5593, Japan
| |
Collapse
|
22
|
Kioi Y, Yorifuji H, Katada Y. Superior mesenteric vein thrombosis and osteoporotic vertebral fractures. Radiol Case Rep 2023; 18:1021-1023. [PMID: 36684626 PMCID: PMC9849937 DOI: 10.1016/j.radcr.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 01/07/2023] Open
Abstract
Superior mesenteric vein (SMV) thrombosis is relatively rare disease with unspecific symptoms. Thrombus formation within the SMV eventually leads to congestive intestinal necrosis. In most cases, the lack of specific symptoms makes early diagnosis difficult. Therefore, it is important to suspect the disease and actively investigate it, given a causative factor. Here, we report a case of SMV thrombosis with a novel predisposing factor, compression of SMV by deformed spine, found on contrast medium-enhanced computed tomography. Treatment with intravenous heparin followed by oral anticoagulants resulted in favorable outcome. This is the first picture showing the novel mechanism of SMV thrombus formation relating to spinal deformity. Treating osteoporosis before spinal deformity could prevent SMV thrombosis with such a mechanism.
Collapse
|
23
|
Liu Y, Sun J, Tuo K. Zanubrutinib in the Maintenance Treatment of Elderly People with Primary Central Nervous System Lymphoma: A Report of 2 Cases. Case Rep Oncol 2023; 16:227-233. [PMID: 37069896 PMCID: PMC10105325 DOI: 10.1159/000529315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/17/2023] [Indexed: 04/19/2023] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma. The predominant subtype is diffuse large B-cell lymphoma (DLBCL), and no systematic lesion is identified at diagnosis. BTKi (Bruton's tyrosine kinase inhibitor) has demonstrated significant clinical activity in DLBCL. We retrospectively reported on 2 patients who began with memory deterioration or right limb movement disabilities. A cranial magnetic resonance imaging (MRI) scan and a brain biopsy were used to diagnose PCNSLs. Middle-dose methotrexate (MD-MTX) regimens were initiated for induction treatment. Zanubrutinib was chosen as the maintenance regimen due to the patients' inability to tolerate continuous MTX regimens. For 1 patient, he achieved sustained complete remission (CR) demonstrated by MRI. Another patient achieved partial remission (PR). The two patients are both alive until now. We successfully extended the PFS and OS in elderly PCNSL patients treated with zanubrutinib.
Collapse
Affiliation(s)
- Ying Liu
- The Second People's Hospital of Guiyang, The Second Guiyang Hospital Affiliated to Guizhou Medical University, Guiyang, China
| | - Jie Sun
- The Second People's Hospital of Guiyang, The Second Guiyang Hospital Affiliated to Guizhou Medical University, Guiyang, China
| | - Kangxin Tuo
- The Second People's Hospital of Guiyang, The Second Guiyang Hospital Affiliated to Guizhou Medical University, Guiyang, China
| |
Collapse
|
24
|
Azushima K, Wakui H, Tamura K. Impact of the COVID-19 pandemic on physical and psychological activities in elderly patients with hypertension. Hypertens Res 2023; 46:266-7. [PMID: 36380203 DOI: 10.1038/s41440-022-01106-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022]
|
25
|
Kajihara T, Yahara K, Yoshikawa M, Haruta A, Kawada-Matsuo M, Le MNT, Arai C, Takeuchi M, Kitamura N, Sugawara Y, Hisatsune J, Kayama S, Ohta K, Tsuga K, Komatsuzawa H, Ohge H, Sugai M. Oral and Rectal Colonization by Antimicrobial-Resistant Gram-Negative Bacteria and Their Association with Death among Residents of Long-Term Care Facilities: A Prospective, Multicenter, Observational, Cohort Study. Gerontology 2023; 69:261-272. [PMID: 36202072 DOI: 10.1159/000525759] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 06/11/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of antimicrobial-resistant bacteria (ARB) in long-term care facilities (LTCFs) remains unclear. Furthermore, the effect of ARB colonization on the clinical outcomes of LTCF residents has not been explored. METHODS We conducted a prospective multicenter cohort study and investigated the residents (N = 178) of six Japanese LTCFs (three Welfare Facilities for the Elderly Requiring Long-term Care and three Geriatric Health Service Facilities) for oral and rectal carriage of ARB. The clinical outcomes of the residents were evaluated based on isolating bacterial strains and subjecting them to whole-genome sequencing. RESULTS Of the 178 participants, 32 belonging to Geriatric Health Service Facilities with no information on their clinical outcome were excluded, and the remaining 146 were followed up for at most 21 months. Extended-spectrum β-lactamases (ESBL)-producing Enterobacterales and Pseudomonas aeruginosa were detected in 42.7% (n = 76) and 2.8% (n = 5) of the rectal swabs and 5.6% (n = 10) and 3.4% (n = 6) of the oral swabs, respectively. Detection of ARB in the oral and rectal cavities showed remarkable association with enteral nutrition. Further, P. aeruginosa was significantly associated with an increase in mortality of the residents, but there were not significant association between ESBL-producing Enterobacterales and mortality. Core-genome phylogeny of P. aeruginosa revealed a wide-spread distribution of the isolated strains across the phylogeny, which included a cluster of ST235 strains with substantially higher biofilm formation ability than the other isolated P. aeruginosa strains. DISCUSSION/CONCLUSION This study is the first to investigate the carriage of both oral and rectal ARB, genomic relatedness and determinants of antimicrobial resistance in isolated strains, and clinical outcomes of LTCF residents. Our study provides the first direct evidence for the burden of antimicrobial resistance in LTCFs.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Miki Kawada-Matsuo
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.,Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mi Nguyen-Tra Le
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.,Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Chika Arai
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Maho Takeuchi
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yo Sugawara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Shizuo Kayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hitoshi Komatsuzawa
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.,Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroki Ohge
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.,Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
26
|
Lien TC, Tabata T. Regional incidence risk of heat stroke in elderly individuals considering population, household structure, and local industrial sector. Sci Total Environ 2022; 853:158548. [PMID: 36096227 DOI: 10.1016/j.scitotenv.2022.158548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
This study aims to clarify the regional characteristics of heat stroke incidence patterns inside and outside residences among the elderly from the perspective of working and living conditions. The study area comprised 41 municipalities belonging to Hyogo Prefecture in Japan. Based on information on heat stroke emergency medical evacuees in each municipality from 2011 to 2020, the regional differences in the incidence risk of heat stroke were analyzed. The results revealed that the number of cases and the proportion of males and females among them were related to the demographic structure of each municipality. A grouping analysis was conducted to classify the characteristics of each municipality based on the relationship between the incidence risk of heat stroke and the industrial structure. A factor analysis and binomial logistic regression analysis were also conducted to investigate the effect of demographic structure on the incidence risk of heat stroke. The results indicate that the incidence risk of heat stroke is correlated with industrial and demographic structures, and the risk is likely to vary regionally.
Collapse
Affiliation(s)
- Tzu-Chen Lien
- Graduate School of Human Development and Environment, Kobe University, Japan
| | - Tomohiro Tabata
- Graduate School of Human Development and Environment, Kobe University, Japan.
| |
Collapse
|
27
|
Pan Y, Chen Y, Cui P, Waili N, Li Y. Association between community environment and dependency among the elderly people from a service provision perspective. BMC Geriatr 2022; 22:960. [PMID: 36513995 PMCID: PMC9749336 DOI: 10.1186/s12877-022-03687-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The incidence of dependency is high among the elderly people worldwide and increases with increasing life expectancy. The purpose of this study was to establish from the perspective of resource demand the association between community environmental resources and dependency among the elderly people. METHODS This study is a cross-sectional design based on community from 22 locations in China. A multistage sampling method was used to select the study objects. The questionnaires were used to collect the survey data by face-to-face interviews. A total of 950 individuals completed the survey, and 913 individuals were available for this analysis. Dependency and community environment were measured using the standard instruments. Logistic regression analysis was performed to identify the community environment factors associated with dependency. Cluster analysis was used and demonstrated that dependency was mainly associated with community primary preventive care service resources. RESULTS In the group aged under 70 years, the utilization of electronic health records and the need for health assessments, and rehabilitation equipment rentals were significantly associated with the levels of dependency scores: the OR was 2.81, 2.25 and 2.13 (P < 0.05), respectively. In the group aged 70 years and over, a short-term care home was strongly associated with levels of dependency: the OR was 4.01 (P = 0.002). The daycare and nursing service, transportation service, and regular lectures on health knowledge were associated with levels of dependency: the OR was 2.41, 1.86 and 1.93 (P < 0.05). In the group with low social support, an emergency call or monitoring system, transportation services, the need for health assessment, and regular lectures on health knowledge were significantly associated with levels of dependency: the OR was 2.42, 2.19, 1.89 and 1.98 (P < 0.05), respectively. CONCLUSIONS Community environment resources were significantly associated with dependency. These results suggest that the dependent on local environment resources may consider as the resource needs among elderly people.
Collapse
Affiliation(s)
- YiYang Pan
- grid.13402.340000 0004 1759 700XDepartment of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou, 310058 Zhejiang China
| | - Yuan Chen
- grid.13402.340000 0004 1759 700XDepartment of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou, 310058 Zhejiang China
| | - PingYu Cui
- grid.13402.340000 0004 1759 700XDepartment of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou, 310058 Zhejiang China
| | - Nuremaguli Waili
- grid.13402.340000 0004 1759 700XDepartment of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou, 310058 Zhejiang China
| | - Ying Li
- grid.13402.340000 0004 1759 700XDepartment of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou, 310058 Zhejiang China
| |
Collapse
|
28
|
Goldin S, Adler L, Azuri J, Mendel L, Haviv S, Maimon N. BNT162b2 mRNA COVID-19 (Comirnaty) Vaccine Effectiveness in Elderly Patients Who Live in Long-Term Care Facilities: A Nationwide Cohort. Gerontology 2022; 68:1350-1357. [PMID: 35134810 PMCID: PMC9059015 DOI: 10.1159/000521899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/06/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION In early 2020, the novel SARS-CoV-2 virus began to spread around the world and claim victims. Initially, in the Western world, COVID-19-related mortality was due to illness in long-term care facilities (LTCFs). To manage the COVID-19 crisis in LTCFs in Israel, the Ministry of Health established a task force named "Senior Shield." The task force executed a screening program of weekly polymerase chain reaction (PCR) SARS-CoV-2 tests for LTCF residents and caregivers, and at a later stage, the task force led the Ministry of Health vaccination program at LTCFs. This study aimed to estimate the effectiveness of the BNT162b2 mRNA COVID-19 (Comirnaty) vaccine in reducing COVID-19 morbidity and mortality in LTCF residents. METHODS We designed a nationwide cohort study utilizing data from the Senior Shield task force. Residents had received the vaccines starting December 2020. The study follow-up period was 5 months (ending May 2021). We defined four outcomes: (a) documented SARS-CoV-2 infection, defined by a positive PCR test, (b) COVID-19 death, defined by a positive PCR test followed by death, (c) all-cause mortality, defined as death regardless of the result of a PCR test, and (d) a composite endpoint which included documented SARS-CoV-2 infection or death, the earliest of both. We used Kaplan-Meier curves with a log-rank comparison and Cox regression with a time-dependent covariate model to estimate adjusted hazard ratios for vaccine effectiveness (VE). The index date was the date of the first vaccine dose. In unvaccinated residents, the index date was the first date of vaccination in their LTCF. RESULTS A total of 43,596 residents with a mean age of 83 years living in 454 LTCFs were found eligible for this study. Ninety-one percent of the study population received the first vaccine dose (39,482) and 86% received the second vaccine dose (37,656). Estimated VE 28 days after the first vaccine dose (approximately 7 days after the second vaccine dose) was 81.2% for SARS-CoV-2 infection, 85.3% for COVID-related death, 63.7% for all-cause mortality, and 71.1% for the composite endpoint (SARS-CoV-2 infection or death). CONCLUSION This study shows that the BNT162b2 mRNA COVID-19 vaccine effectively prevents SARS-CoV-2 infection, COVID-19-related death, and all-cause mortality in LTCF residents. Further research is warranted on the effect of the third vaccine (booster) in this population.
Collapse
Affiliation(s)
- Sivan Goldin
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Limor Adler
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,*Limor Adler,
| | - Joseph Azuri
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liran Mendel
- Department of Statistics, School of Mathematics, Tel Aviv University, Tel Aviv, Israel
| | - Shay Haviv
- Department of Industry and Management, Aman Consultant, Tel Aviv, Israel
| | - Nimrod Maimon
- Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Department of Internal Medicine B, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Israel Ministry of Health, Senior Shield Project, Jerusalem, Israel
| |
Collapse
|
29
|
Srisaphonphusitti L, Manimmanakorn N, Manimmanakorn A, Hamlin MJ. Effects of whole body vibration exercise combined with weighted vest in older adults: a randomized controlled trial. BMC Geriatr 2022; 22:911. [PMID: 36443661 PMCID: PMC9703755 DOI: 10.1186/s12877-022-03593-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To evaluate the training effects of whole body vibration (WBV) combined with weighted vest (WV) in older adults. METHODS This randomized controlled trial study was conducted in healthy older adults living in the community. Fifty-one participants were randomly allocated into 3 groups: group 1 (n = 17), WBV alone, training on WBV at a frequency 30 Hz, amplitude 2 mm, 10 sets of 1 min squats, with 60 s rest, group 2 (n = 15), WV alone, squat exercise, 10 sets of 1 min, with 60 s rest, while WV loaded with 10% body weight and group 3 (n = 19), WBV + WV, combining WBV exercise with the addition of a WV. All groups completed training 3 times per week for 8 weeks. The outcomes were total muscle mass, muscle thickness, maximal isometric strength, single-leg-stance and timed-up-and-go evaluated at baseline and after training. RESULTS As a result of training all groups improved their isometric muscle strength with little difference between groups. The single-leg-stance significantly improved only in WBV + WV group 25.1 ± 10.8 s (mean ± 95% CI, p < 0.01). The timed-up-and-go improved in all groups, but the improvement was significantly greater in the WBV + WV group (17.5 ± 6.9%) compared to the WV (8.5 ± 3.2%) and WBV groups (9.2 ± 5.4%, p = 0.043, 0.023 respectively). Rectus femoris muscle thickness and total muscle mass were significantly increased in all groups equally with little difference between groups. CONCLUSION The combined WBV + WV had a greater effect on the single-leg-stance and the timed-up-and-go compared to WV or WBV alone. TRIAL REGISTRATION TCTR20190306001. Thai Clinical Trials Registry ( www.thaiclinicaltrials.org ). Date of registration: 6 March 2019.
Collapse
Affiliation(s)
- Lertwanlop Srisaphonphusitti
- grid.9786.00000 0004 0470 0856Exercise and Sports Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
| | - Nuttaset Manimmanakorn
- grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apiwan Manimmanakorn
- grid.9786.00000 0004 0470 0856Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Michael John Hamlin
- grid.16488.330000 0004 0385 8571Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| |
Collapse
|
30
|
Fujita A, Ihara K, Kawai H, Obuchi S, Watanabe Y, Hirano H, Fujiwara Y, Takeda Y, Tanaka M, Kato K. A novel set of volatile urinary biomarkers for late-life major depressive and anxiety disorders upon the progression of frailty: a pilot study. Discov Ment Health 2022; 2:20. [PMID: 37861875 PMCID: PMC10501039 DOI: 10.1007/s44192-022-00023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/22/2022] [Indexed: 10/21/2023]
Abstract
Mood and anxiety disorders are frequent in the elderly and increase the risk of frailty. This study aimed to identify novel biomarkers of major depressive disorder (MDD) and anxiety in the elderly. We examined 639 participants in the community-dwelling Otassha Study (518 individuals considered healthy control, 77 with depression, anxiety, etc.), mean age 75 years, 58.4% of female. After exclusion criteria, we analyzed VOCs from 18 individuals (9 healthy control, 9 of MDD/agoraphobia case). Urinary volatile and semi-volatile organic compounds (VOCs) were profiled using solid-phase microextraction and gas chromatography-mass spectrometry. Six urinary VOCs differed in the absolute area of the base peak between participants with MDD and/or agoraphobia and controls. High area under the receiver-operating characteristic curve (AUC) values were found for phenethyl isothiocyanate (AUC: 0.86, p = 0.009), hexanoic acid (AUC: 0.85, p = 0.012), texanol (AUC: 0.99, p = 0.0005), and texanol isomer (AUC: 0.89, p = 0.005). The combined indices of dimethyl sulfone, phenethyl isothiocyanate, and hexanoic acid, and texanol and texanol isomer showed AUCs of 0.91 (p = 0.003) and 0.99 (p = 0.0005) and correlated with the GRID-HAMD and the Kihon Checklist (CL score), respectively. These VOCs may be valuable biomarkers for evaluating MDD and/or agoraphobia in the elderly.
Collapse
Affiliation(s)
- Akiko Fujita
- Faculty of Life Sciences, Kyoto Sangyo University, Motoyama, Kamigamo, Kita-Ku, Kyoto, 603-8555, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Graduate School of Medicine and School of Medicine, Hirosaki University, 5 Zaifu-Cho Hirosaki City, Aomori, 036-8562, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Kita13, Nishi7, Kita-Ku, Sapporo, Hokkaido, 060-8586, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yoichi Takeda
- Department of Biotechnology, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Masashi Tanaka
- Department of Neurology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Keiko Kato
- Faculty of Life Sciences, Kyoto Sangyo University, Motoyama, Kamigamo, Kita-Ku, Kyoto, 603-8555, Japan.
| |
Collapse
|
31
|
Yangming H, Rengui G, Long Z. Neighborhood health effects on the physical health of the elderly: Evidence from the CHRLS 2018. SSM Popul Health 2022; 20:101265. [PMID: 36281247 PMCID: PMC9587335 DOI: 10.1016/j.ssmph.2022.101265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/24/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background There are more than 26 million elderly people in China, and due to the Health China strategy proposed in 2020, “Elderly Health” has become an important topic of concern for all sectors of society. Neighborhoods provide important social relationships. However, Chinese researchers have not extensively explored the impact of these relationships on the physical health of the elderly. Methods Based on the data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we constructed a comprehensive research framework integrating ordinary least square (OLS) regression, heterogeneity analysis, IV-2SLS, robustness testing, and Karlson–Holm–Breen (KHB) mediating effect analysis, which can be used to thoroughly examine neighborhood health effects (NHEs) in relation to the physical health of the elderly. Results The OLS results showed that the NHEs (B = 0.4689, p < 0.01) had a positive influence on the physical health of the elderly, and were lower than the NHEs estimated by IV-2SLS (B = 0.5018, p < 0.01). The mediating effects of social networks and social relationships were analyzed using KHB, and both the total (B = 0.6056, p < 0.01) and indirect (B = 0.0800, p < 0.01) effects on neighborhood health were significant, with the total effect being 10 times larger than the direct effect and 13.24% of the total effect coming from the mediating variable. Conclusions Firstly, the NHEs positively influence the physical health of elderly persons, but there are heterogeneous differences. Secondly, the IV-2SLS estimation results suggest that not controlling for endogeneity leads to underestimation of the role of the NHEs. Thirdly, using the county-level NHEs, self-rated health, and health changes to replace variables, and grouping by smokers (small sample) and never smoked (large sample), the influence of the NHEs on the physical health of the elderly is robust. Finally, social networks and social relationships are important transmission mechanisms of the NHEs when it comes to the physical health of the elderly. NHEs are robust and significant in the Chinese social background. Community (county) level NHEs are positive for the positive health of the elderly. NHEs have a positive impact on self-rated health and health changes in older adults. Endogenous issues would underestimate the role of NHEs. •Social networks and social relationships are transmission mechanisms of the NHEs.
Collapse
|
32
|
Abraham MD, Massobrio E, Niclis C, Butinof M, Aballay LR. [Environmental sociodemographic conditions associated with health-nutrition profiles among elderly people, Córdoba-Argentina]. Rev Esp Geriatr Gerontol 2022; 57:278-281. [PMID: 36195509 DOI: 10.1016/j.regg.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities. OBJECTIVE To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020. METHODOLOGY Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews. RESULTS The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m2). The presence of obesity (BMI≥30kg/m2) was associated (OR=2.05; CI 1.007-3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation. CONCLUSION The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process.
Collapse
Affiliation(s)
| | - Esteban Massobrio
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
| | - Camila Niclis
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba; Instituto de Investigaciones en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Córdoba
| | - Mariana Butinof
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.
| | - Laura Rosana Aballay
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
| |
Collapse
|
33
|
Wei Y, Sun Y, Li Y, Chen X, Wu Y, Fang X, Zhu R. Investigation and research on elderly people's willingness to combine medical and health care and related factors in coastal cities in eastern China. PeerJ 2022; 10:e14004. [PMID: 36097524 PMCID: PMC9463997 DOI: 10.7717/peerj.14004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/13/2022] [Indexed: 01/19/2023] Open
Abstract
Background The problem of global aging was becoming increasingly prominent. At present, the empty nest and miniaturization of family structure reduce the function of home-based elderly care. Methods A questionnaire survey was conducted on 347 elderly people in multiple communities and nursing homes in eastern coastal cities of China, and 13 institutional staff members of eight nursing institutions that carried out the medical-nursing integration model were interviewed as the research objects. The survey mainly focuses on the basic characteristics of the elderly, the family support system, and the acceptance of medical care and health care. The influencing factors were screened by t test, univariate analysis and multivariate logistic regression analysis. SPSS software was used to test the reliability and validity of the questionnaire, and the Crobach's was 0.792, which can be considered that the questionnaire had good internal reliability. The classification of the questionnaire was reasonable, the reliability of the questionnaire was high, and the internal consistency of the scale was high. According to KMO and Bartlett test, KMO = 0.826, χ2 = 853.731, the degree of freedom was 36, and the P value was 0.000. Results The proportion of male and female respondents was 48.1% and 51.9% respectively. Multivariate logistic regression analysis results showed that gender had no statistical significances on the degree of support for combine medical and health care in the elderly (P > 0.05). The results showed that gender, age, marital status, medical insurance type and old-age insurance type had little effect on the support of the combination of medical care and health care for the elderly (P > 0.05). Compared with the control group with education below primary school, the elderly with bachelor's degree or above are more willing to support the combination of medical care and health (P < 0.05). The registered residence type is more obvious than that of the urban residents (P < 0.05). Compared with the enterprise employees in the control group, the elderly who were employed as migrant workers before retirement were more willing to support the combination of medical care and health (P < 0.05). From the perspective of family monthly income, the elderly with family income ≥10,000 RMB have more obvious support for the combination of medical care and health than the elderly with family monthly income <3,000 RMB in the control group (P < 0.05). In terms of the degree of understanding, the degree of understanding and support in different degrees are significantly higher than that in the control group (P < 0.05). Conclusion Through multivariate logistic regression analysis, education level, registered residence, pre-retirement occupation and family income are more obvious for the elderly to support medical care and health. It is necessary to increase investment in elderly activity centers, actively carry out activities.
Collapse
Affiliation(s)
- Yehong Wei
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanxiang Sun
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuting Li
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Xufeng Chen
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Yingyu Wu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Xindi Fang
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Ruichen Zhu
- Zhejiang Hospital, Hangzhou, China,Affiliated Zhejiang Hospital Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
34
|
Bocquier A, Jacquemot AF, Dubois C, Tréhard H, Cogordan C, Maradan G, Cortaredona S, Fressard L, Davin-Casalena B, Vinet A, Verger P, Darmon N, Arquier V, Briclot G, Chamla R, Cousson-Gélie F, Danthony S, Delrieu K, Dessirier J, Féart C, Fusinati C, Gazan R, Gibert M, Lamiraud V, Maillot M, Nadal D, Trotta C, Verger EO, Viriot V. Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study"). BMC Geriatr 2022; 22:643. [PMID: 35927684 PMCID: PMC9351201 DOI: 10.1186/s12877-022-03260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION Version 3.0 (November 5, 2021).
Collapse
Affiliation(s)
- Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. .,Université de Lorraine, APEMAC, F-54000, Nancy, France.
| | - Anne-Fleur Jacquemot
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France
| | | | - Hélène Tréhard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Agnès Vinet
- Avignon Université, UPR EA4278, F-84000, Avignon, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Wess T, Steiner W, Dür M, Janssen J. Reablement - relevant factors for implementation: an exploratory sequential mixed-methods study design. BMC Health Serv Res 2022; 22:959. [PMID: 35902845 PMCID: PMC9336056 DOI: 10.1186/s12913-022-08355-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reablement is a multi-professional and internationally established home-based health care service for mainly older people with the aim to reduce the need for long-term care and to promote self-determination. However, it is unknown which factors would facilitate the implementation of reablement in health care services. Therefore, the aim of this work was to identify relevant factors for the implementation process and to elucidate their importance based on the perspectives of experts. METHODS Within an exploratory sequential mixed-methods design, a literature search followed by framework analysis was carried out using the five domains of the Consolidated Framework of Implementation Research (CFIR) to collect potentially relevant factors for implementation of reablement. A survey was then drawn up encompassing the factors identified. Within the survey international reablement - experts were asked to rate the relevance of these factors . RESULTS The literature search identified 58 publications that served as sources for the framework analysis, where 40 potentially relevant factors were clustered into the five CFIR domains. These 40 factors were rated by experts in an online-survey. Based on the analysis of survey-data, 35 factors were considered as relevant for implementation of reablement services. The CFIR-domain characteristics of individuals, including teamwork and communication skills, was seen as most relevant. CONCLUSIONS The implementation of reablement services is complex and requires the consideration of numerous factors, especially regarding the CFIR-domain characteristics of individuals. From the perspective of the survey´s participants one important factor of a successful implementation was the engagement of the persons involved. It requires team members with a strong, shared vision. Communication skills are highly important to promote teamwork and intensive training is needed to establish these skills. Further research on the implementation of reablement services is essential to realize its full potential.
Collapse
Affiliation(s)
- Theres Wess
- Department of Physiotherapy, University of Applied Sciences, Favoritenstraße 226, 1100, Vienna, Austria.
| | | | | | - Jessie Janssen
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
| |
Collapse
|
36
|
Aierken A, Ding X, Pan Y, Chen Y, Li Y. Association between dependency on community resources and social support among elderly people living in rural areas in China: a cross-sectional study. BMC Geriatr 2022; 22:589. [PMID: 35842579 PMCID: PMC9288718 DOI: 10.1186/s12877-022-03247-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of dependency personality disorder (DPD) is high among elderly people living in rural areas. This study aims to explore the association between dependency on community resources and social support among elderly individuals living in rural areas. METHODS A cross-sectional study was conducted in 26 locations in China. A total of 1160 participants aged ≥ 60 years were selected using a complex multistage sampling design. All data were obtained using questionnaires via face-to-face interviews. DPD was measured using the Minnesota Multiphasic Personality Inventory-II in the standardized Chinese version. Self-efficacy was assessed using the Chinese version of the General Self-Efficacy Scale. Social support was measured using the Chinese version of the questionnaires of the Older American Resources and Services scale. Community services and resources comprised 44 items. The association between DPD and levels of social support and self-efficacy was evaluated using a logistic regression model. The association between social support and self-efficacy was assessed using analysis of covariance. RESULTS Univariate analysis results showed that elderly people living in rural areas had higher DPD scores and lower levels of self-efficacy compared with those living in urban areas (P < 0.001). Logistic regression analysis showed that DPD was positively associated with the received frequencies of community health service, contracted family doctor services, and regular lectures on health knowledge among the elderly people with odd ratios of 1.58 (P < 0.001), 2.03 (P = 0.013), and 2.67 (P = 0.005), respectively. Logistic regression analysis showed significant interaction between social support and self-efficacy effect on DPD was found in the additive model (P < 0.001). CONCLUSION DPD was associated mainly with the community resources among elderly people living in rural areas. Social support and self-efficacy were commonly associated with DPD through a synergistic effect. These results suggest that DPD among elderly people may be reduced through effective social support to directly and indirectly promote the elderly's use of community resources and improve their self-efficacy.
Collapse
Affiliation(s)
- Ayizuhere Aierken
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - XiWen Ding
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - YiYang Pan
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China.
| |
Collapse
|
37
|
Hajika Y, Kawaguchi Y, Tanaka T, Hamazaki K, Kumeda Y. [Switching insulin degludec to insulin glulisine improved nocturnal hypoglycemia and ventricular arrythmia in an elderly type 1 diabetes patient with chronic heart failure: A case report]. Nihon Ronen Igakkai Zasshi 2022; 59:237-243. [PMID: 35650058 DOI: 10.3143/geriatrics.59.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The patient was 82-year-old man with type 1 diabetes mellitus. He had been using insulin degludec (IDeg) and insulin glulisine (IGlu) for treatment. He was admitted to our hospital due to diabetic ketoacidosis. As he started eating after recovery, we restarted intensive insulin therapy for glycemic control. Although he had eaten almost whole meals, his fasting blood glucose was extremely low, and the existence of nocturnal hypoglycemia was apparent. We reduced the dose and changed the injection time (evening→morning) of IDeg. We also stopped the evening IGlu injection; however, his nocturnal hypoglycemia did not improve. We decided to switch IDeg to insulin glargine U300 and to attach an intermittently scanned continuous glucose monitor (isCGM). His nocturnal hypoglycemia improved three days later. Since he had chronic heart failure and premature ventricular contractions, we used a Holter electrocardiogram to investigate the difference in arrythmia during hypoglycemia and non-hypoglycemia. As a result, the number of premature ventricular contractions was apparently high during hypoglycemia. In the present case, which involved an elderly patient with type 1 diabetes mellitus, chronic heart failure and nocturnal hypoglycemia, switching IDeg to insulin glargine U300 improved nocturnal hypoglycemia. IDeg differs from insulin glargine U300 in that it has a fatty acid side chain, which leads IDeg to combine with serum albumin. We thought that the increased level of free fatty acid due to hypoglycemia was competing against albumin combined IDeg, which increased free IDeg, and as a result, encouraged hypoglycemia.
Collapse
Affiliation(s)
- Yuriko Hajika
- Department of Internal Medicine, Minami Osaka Hospital
| | | | - Takako Tanaka
- Department of Clinical Laboratory, Minami Osaka Hospital
| | | | - Yasuro Kumeda
- Department of Internal Medicine, Minami Osaka Hospital
| |
Collapse
|
38
|
Hernández Gómez MA, Sánchez Sánchez NJ, Fernández Domínguez MJ. [Analysis of ageism during the pandemic, a global elder abuse]. Aten Primaria 2022; 54:102320. [PMID: 35715025 PMCID: PMC9194783 DOI: 10.1016/j.aprim.2022.102320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 11/20/2022] Open
Abstract
El edadismo es una forma de maltrato que tiene influencia negativa en las personas mayores. Aunque la COVID-19 afecta a personas de todos los grupos de edad, ha incrementado el efecto del mismo, limita el acceso de los mayores a diversos recursos, entre ellos, los sanitarios. El edadismo se asocia con sobrecostes, con peor salud y mortalidad precoz. Desde el «Grupo de Trabajo (GdT) de Atención al Mayor de la Sociedad Española de Medicina de Familia y Comunitaria (semFYC)» realizamos una serie de propuestas para combatirlo basándonos en actividades comunitarias que favorezcan las relaciones intergeneracionales y la educación en envejecimiento que permitan una correcta integración de los mayores en la sociedad.
Collapse
Affiliation(s)
- Mercedes Adelaida Hernández Gómez
- GdT Atención al Mayor semFYC, Centro de Salud Novoa Santos de Ourense, Servicio Galego de Saúde. Grupo I-Saúde, Fundación Biomédica Galicia Sur, Ourense, Galicia, España.
| | - Néstor Javier Sánchez Sánchez
- GdT Atención al Mayor semFYC, Centro de Salud de Maceda (Ourense), Servicio Galego de Saúde, Ourense, Galicia, España
| | - María José Fernández Domínguez
- GdT Atención al Mayor semFYC, Centro de Salud de Leiro-Ribadavia (Ourense) Servicio Galego de Saúde, Grupo I-Saúde, Fundación Biomédica Galicia Sur, Ourense, Galicia, España
| |
Collapse
|
39
|
de Arriba-Pérez F, García-Méndez S, González-Castaño FJ, Costa-Montenegro E. Automatic detection of cognitive impairment in elderly people using an entertainment chatbot with Natural Language Processing capabilities. J Ambient Intell Humaniz Comput 2022; 14:1-16. [PMID: 35529905 PMCID: PMC9053565 DOI: 10.1007/s12652-022-03849-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Previous researchers have proposed intelligent systems for therapeutic monitoring of cognitive impairments. However, most existing practical approaches for this purpose are based on manual tests. This raises issues such as excessive caretaking effort and the white-coat effect. To avoid these issues, we present an intelligent conversational system for entertaining elderly people with news of their interest that monitors cognitive impairment transparently. Automatic chatbot dialogue stages allow assessing content description skills and detecting cognitive impairment with Machine Learning algorithms. We create these dialogue flows automatically from updated news items using Natural Language Generation techniques. The system also infers the gold standard of the answers to the questions, so it can assess cognitive capabilities automatically by comparing these answers with the user responses. It employs a similarity metric with values in [0, 1], in increasing level of similarity. To evaluate the performance and usability of our approach, we have conducted field tests with a test group of 30 elderly people in the earliest stages of dementia, under the supervision of gerontologists. In the experiments, we have analysed the effect of stress and concentration in these users. Those without cognitive impairment performed up to five times better. In particular, the similarity metric varied between 0.03, for stressed and unfocused participants, and 0.36, for relaxed and focused users. Finally, we developed a Machine Learning algorithm based on textual analysis features for automatic cognitive impairment detection, which attained accuracy, F-measure and recall levels above 80%. We have thus validated the automatic approach to detect cognitive impairment in elderly people based on entertainment content. The results suggest that the solution has strong potential for long-term user-friendly therapeutic monitoring of elderly people.
Collapse
Affiliation(s)
- Francisco de Arriba-Pérez
- Information Technologies Group, atlanTTic, School of Telecommunications Engineering, University of Vigo, Campus Lagoas-Marcosende, 36310 Vigo, Spain
| | - Silvia García-Méndez
- Information Technologies Group, atlanTTic, School of Telecommunications Engineering, University of Vigo, Campus Lagoas-Marcosende, 36310 Vigo, Spain
| | - Francisco J. González-Castaño
- Information Technologies Group, atlanTTic, School of Telecommunications Engineering, University of Vigo, Campus Lagoas-Marcosende, 36310 Vigo, Spain
| | - Enrique Costa-Montenegro
- Information Technologies Group, atlanTTic, School of Telecommunications Engineering, University of Vigo, Campus Lagoas-Marcosende, 36310 Vigo, Spain
| |
Collapse
|
40
|
Okan F, Zincir H, Deveci K. The Effect of Sun Light Exposure to the Level of Vitamin D in Elderly People Living in Nursing Home. J Clin Densitom 2022; 25:261-271. [PMID: 33888407 DOI: 10.1016/j.jocd.2021.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Elderly people are considered to be in the risk group for vitamin D deficiency. The aim of the present study was to determine the effect of nursing interventions and sunlight exposure to reach optimum 25-hydroxyvitamin D [25(OH)D] levels by individuals living in nursing homes. METHODOLOGY Randomized controlled experimental study was carried out in June-August 2018 period in the nursing home. The question form, standardized mini mental test, Fitzpatrick skin typing questionnaire and Katz Index of activities of daily living were applied. Individuals in the intervention group (n=20) was exposed to sunlight five days a week for four weeks in July with an average duration of 21 ± 5 minutes (min 15 - max 30 minutes). For the participants in the control group (n=20), sunbathing was not offered. 25(OH)D, calcium, parathormone, phosphorus, alkaline phosphatase and albumin levels of all individuals were measured at the beginning and end of the study. RESULTS At the end of the study, the 25(OH)D was significantly higher in the intervention group than in the control group (8.06 ng/ml and 0.96 ng/ml, respectively; p = 0.008). It was observed that in the intervention group, sunlight exposure increased the 25(OH)D regardless of gender and age. Increases were observed in intervention groups for calcium and albumin levels. At the beginning of the study, 25(OH)D was sufficient only in five elderly people in the intervention group, while at the end, 11 elderly people had sufficient levels of 25(OH)D. CONCLUSION At the end of the study, it was concluded that sunlight exposure was a sufficient source to increase 25(OH)D in most elderly people living in the nursing home. Organizing sunbathing sessions as an independent nursing intervention is recommended for the elderly people living in nursing homes in order to prevent vitamin D deficiency and related consequences.
Collapse
Affiliation(s)
- Fatih Okan
- Tokat Gaziosmanpaşa University, Faculty of Health Science, Public Health Nursing Department, Taşlıçiftlik, Tokat, TURKEY.
| | - Handan Zincir
- Kayseri Erciyes University, Faculty of Health Science, Public Health Nursing Department, Kayseri, TURKEY
| | - Köksal Deveci
- Tokat Gaziosmanpaşa University, Faculty Of Medicine, Biochemistry Department, Tokat, TURKEY
| |
Collapse
|
41
|
Uchida S, Shimada C, Sakuma N, Kagitani F, Kan A, Awata S. Olfactory function and discrimination ability in the elderly: a pilot study. J Physiol Sci 2022; 72:8. [PMID: 35365090 PMCID: PMC10717643 DOI: 10.1186/s12576-022-00832-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/23/2022] [Indexed: 11/10/2022]
Abstract
We recently reported that subjects with a higher olfactory identification threshold for rose odor declined more in attentional ability in the elderly. This study focuses on discrimination ability and olfactory identification threshold in twelve elderly subjects living in a community (age: 80.9 ± 1.6). Olfactory function was assessed by the rose odor identification threshold. We assessed the discrimination ability by distinguishing 5 similar odor pairs. Our results showed that the subjects with a higher olfactory identification threshold (≥ 5) declined more in discrimination ability (14% ± 14%, p = 0.03) compared to those with a lower threshold (≤ 4) (averaged value set at 100%). As discrimination ability is related to the basal forebrain cholinergic system, our results suggest that olfactory impairment links to the decline in cognitive function relating the cholinergic system.
Collapse
Affiliation(s)
- Sae Uchida
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Chiho Shimada
- Department of Exploring End-of-Life Care for the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Faculty of Humanities and Social Science, Saku University, Nagano, Japan
| | - Naoko Sakuma
- Department of Dementia and Mental Health Research, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Fusako Kagitani
- Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Akiko Kan
- Department of Health Services Research, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well With Dementia, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| |
Collapse
|
42
|
Oliveira MR, Sudati IP, Konzen VDM, de Campos AC, Wibelinger LM, Correa C, Miguel FM, Silva RN, Borghi-Silva A. Covid-19 and the impact on the physical activity level of elderly people: A systematic review. Exp Gerontol 2022; 159:111675. [PMID: 34954282 PMCID: PMC8695515 DOI: 10.1016/j.exger.2021.111675] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Social isolation and lifestyle changes provoked by the COVID-19 pandemic have negatively affected the level of physical activity of the elderly people. OBJECTIVE To evaluate the available evidence related to the level of physical activity (PA) of elderly people during the COVID-19 pandemic. METHODS This is a systematic review, registered on PROSPERO (CRD42021241116), which included cross-sectional and cohort studies. Embase, Pubmed, Cochrane, Web of Science and Scopus databases were used to search for the studies. Finally, the New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies. RESULTS 25 studies were found, being 14 cross-sectional and 11 cohort studies. The studies showed that the elderly population was highly affected in relation to the level of physical activity and lifestyle during restrictions, quarantine and lockdowns caused by the COVID-19. There was a significant reduction in physical activity levels, leading to declines in physical fitness and increased sedentary lifestyle, factors directly related to the increase in frailty in this population. CONCLUSION The level of physical activity in the elderly population decreased during the quarantine period of COVID-19 worldwide. Strategies to maintain physical condition must be encouraged with physical exercises that meets the needs of the elderly in the current pandemic scenario, in order to maintain and improve the health of this population.
Collapse
Affiliation(s)
| | | | | | | | | | - Clisman Correa
- Lutheran University of Brazil, Cachoeira do Sul, Rio Grande do Sul, Brazil
| | | | | | | |
Collapse
|
43
|
de Farias Panet M, de Araújo VMD, de Araújo EHS. Thermal sensation index for elderly people living in Brazil. Int J Biometeorol 2022; 66:469-480. [PMID: 35091854 DOI: 10.1007/s00484-021-02194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 07/09/2021] [Accepted: 09/19/2021] [Indexed: 06/14/2023]
Abstract
With the aging of the human body, some physiological changes occur, compromising thermoregulatory mechanisms, negatively influencing the individual's thermal sensation. Given this fact, the present study aimed to build a predictive model to determine the thermal sensation index for elderly people (TSIEP) in a hot climate region, considering their sensitivity in the perception of climate change in the city of Campina Grande, in the semi-arid region of Paraíba/Brazil. For this purpose, an observational study was carried out from April to December 2016 with elderly people inside their homes. The responses of the sample units (elderly people) to the categories of thermal sensation (hot, comfortable, and cold) were transformed into probit estimates, and, using the multivariate modeling statistical technique (canonical correlation), the TSIEP was determined. Finally, TSIEP showed that the thermal sensation of elderly people residing in Campina Grande tends to be more sensitive to cold and less sensitive to heat.
Collapse
Affiliation(s)
- Miriam de Farias Panet
- Federal University of Campina Grande - UFCG, Architecture and Urbanism Course, CM block. Rua Aprígio Veloso, 882 - Universitário, Campina Grande, PB, 58428-830, Brazil.
| | | | | |
Collapse
|
44
|
Huh Y, Kim DH, Jung JH, Park YG, Roh YK, Kim SM, Cho KH. Risk Assessment of Mortality in Elderly Individuals: A Nationwide Cohort Study. Gerontology 2022; 68:1266-1275. [PMID: 35100599 DOI: 10.1159/000521725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There are several methods that are used to predict emergency room visits or rehospitalization for the elderly. However, existing risk assessment models of mortality in elderly people are limited. The purpose of this study was to ascertain the factors that affect all-cause mortality and to show the risk assessment model of mortality in elderly Koreans. METHODS This was a cohort study conducted using the health checkup data of 246,422 individuals aged ≥60 years, which was provided by the National Health Insurance Service of South Korea between January 1, 2009, and December 31, 2012. The hazard ratios and 95% confidence intervals (CIs) of several conditions and all-cause deaths were estimated using a multivariable Cox proportional hazards model. A nomogram was constructed to visualize the risk factors of mortality; a calibration plot and area under the curve (AUC) were also used to verify the nomogram. RESULTS Being 85 years or older (100 points) had the greatest influence on all-cause mortality, followed by being underweight (57 points), having more than five chronic diseases (49 points), and ages 78-84 years (45 points); smoking and lack of regular exercise affected mortality to a similar degree. The calibration curves showed good agreement between predictions and observations. The AUC of our nomogram was 0.73 (95% CI: 0.72-0.73). CONCLUSIONS Our results showed the relationship between each condition and mortality rate among elderly individuals in Korea. Our nomogram showed a satisfactory performance in the assessment of the risk of all-cause mortality in elderly Korean people.
Collapse
Affiliation(s)
- Youn Huh
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Daejeon, Republic of Korea,
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Daejeon, Republic of Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Kyun Roh
- Department of Family Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
45
|
Rojas Huerta AV. Trajectories of frailty and related factors of elderly people in Mexico. Poblac Salud Mesoam 2022; 19:10.15517/psm.v19i2.46929. [PMID: 35846347 PMCID: PMC9286518 DOI: 10.15517/psm.v19i2.46929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Frailty is an indicator of health status in old age and a common clinical syndrome in older adults that carries an increased risk of poor health outcomes, including falls, incidents of disability, hospitalization, and mortality. This study aimed to identify the different trajectories of frailty and the factors related to frailty among Mexican older adults over time. Methods Data are from a four-wave panel composed of older Mexican adults from 2001 to 2015 of the Mexican Health and Aging Study (MHAS). Frailty is the accumulation of deficits using a frailty index. A multilevel analysis, using hierarchical models, was applied to know the changes of frailty trajectories and what factors are related to it. Results Being female, older, being widowhood, and having a lower level of education were risk factors for having a high frailty index and lower financial satisfaction doing activities at home have adverse effects. Conclusion The findings of this work present information about the prevalence of frailty considering the proportion of deficits that individuals possess and their main associated components in older Mexican adults. It is necessary to improve socioeconomic health conditions in phases before old age to avoid developing frailty in the future.
Collapse
|
46
|
Miyai N, Uchiba K, Tomiyama H, Matsumoto C, Kinoshita A, Vlachoupolos C, Nilsson PM, Arita M. District Differences in the Measured Values of Arterial Stiffness in Japan. Circ Rep 2021; 3:620-624. [PMID: 34703940 PMCID: PMC8492401 DOI: 10.1253/circrep.cr-21-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022] Open
Abstract
Background: In Japan, district differences in the prevalence of cardiovascular disease (CVD) are well-known. This study examined district differences in Japan in measured values of arterial stiffness, an independent risk factor for CVD. Methods and Results: Local residents participating in health checkups conducted in the Wakayama (n=461) and Nagano (n=186) prefectures in 2018 were recruited to the study. Brachial-ankle pulse wave velocity (baPWV) was evaluated as an index of arterial stiffness. After multivariate adjustment, baPWV was significantly higher in the Wakayama than Nagano district in subjects aged ≥70 years (mean [±SE] 1,912±25 vs. 1,763±30 cm/s; P<0.01), but not in subjects aged <70 years. Multivariate linear regression analysis demonstrated that the Wakayama/Nagano district difference was significantly (P<0.01) associated with baPWV. Conclusions: District differences were observed in the measured values of arterial stiffness in Wakayama and Nagano. The Wakayama and Nagano prefectures are representative areas with a relatively high and relatively low prevalence of CVD, respectively, in Japan. Therefore, based on the results of the present study, we propose to conduct a study to examine whether district differences in arterial stiffness underlie district differences in the prevalence of CVD.
Collapse
Affiliation(s)
- Nobuyuki Miyai
- School of Health and Nursing Science, Wakayama Medical University Wakayama Japan
| | | | | | - Chisa Matsumoto
- Department of Cardiology, Tokyo Medical University Tokyo Japan
| | - Azuna Kinoshita
- School of Health and Nursing Science, Wakayama Medical University Wakayama Japan
| | - Charalambos Vlachoupolos
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens Athens Greece
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital Malmo Sweden
| | - Mikio Arita
- Department of Cardiology, Sumiya Rehabilitation Hospital Wakayama Japan
| |
Collapse
|
47
|
Opsommer E, Chevalley O, Pegito I, Demeulenaere P. Transcultural adaptation and validation of a French version of the University of California, Los Angeles geriatrics attitudes scale (UCLA-GAS-F). Arch Physiother 2021; 11:21. [PMID: 34493332 PMCID: PMC8423334 DOI: 10.1186/s40945-021-00114-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background In the context of demographic aging, active aging must be encouraged. In addition, the increase in life expectancy requires specific care for the elderly. Therefore, it is important to ensure appropriate training and education to caregivers. Educational institutions put value in positively influencing the attitudes and behaviours towards elderly people in order to ensure the quality of patient care in the future. Questionnaires are often used to assess attitudes. Among them, the University of California, Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) was developed to assess attitudes towards older people and caring for older patients. This scale has been used to evaluate attitude of healthcare professionals and students including undergraduate physiotherapy students. To our knowledge, there is no scale that assesses the same concept in French. Therefore, this study aimed to translate and adapt the UCLA-GAS into French and to test its psychometric properties. Methods We conducted this study in two phases. First, we translated and adapted the UCLA-GAS from English into French following the five recommended stages of cross-cultural adaptation. Second, we validated the French version of the scale with undergraduate physiotherapy students. One hundred nineteen students participated from the first to the third academic years. We estimated reliability and validity of the scale. We performed correlation analyses between the French version of the UCLA-GAS (UCLA-GAS-F) with the Aging Stereotypes and Exercise Scale (ASES) and the Attitudes to Aging Questionnaire (AAQ). Results The scale was translated and adapted into French. Results of the validation phase showed that the UCLA-GAS-F had high test-retest reliability (ICC 0.83, 95%CI 0.74–0.89), but internal consistency below 0.7 (Cronbach’s alpha 0.49 to 0.57). The scale showed no ceiling or floor effect. As expected, the French version showed a weak correlation to the ASES (r = 0.28, p = .003) and to the AAQ (r = 0.32, p = .001). Conclusions Despite low internal consistency, the French version of the UCLA-GAS showed appropriate psychometric properties. Further validation should include healthcare professionals and other healthcare students. Supplementary Information The online version contains supplementary material available at 10.1186/s40945-021-00114-1.
Collapse
Affiliation(s)
- Emmanuelle Opsommer
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland.
| | - Odile Chevalley
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Irene Pegito
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Philippe Demeulenaere
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| |
Collapse
|
48
|
Cho MJ, Shin HE, Amano A, Song KB, Choi YH. Effect of Molar Occlusal Balance on Cognitive Function in the Elderly. Int Dent J 2021; 72:331-337. [PMID: 34376281 PMCID: PMC9275330 DOI: 10.1016/j.identj.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Elderly people with dementia, who are increasing at a rate comparable to the rate at which theelderly population is growing, are becoming a serious social problem in Korea. Therefore, the purpose of this study was to investigate the association between molar occlusal balance and cognitive function among Koreans aged 65 years and older. METHODS A total of 308 participants aged 65 years and older who attended a senior center were recruited for the study with their consent. The Korean version of the Mini-Mental State Examination (MMSE-DS) was used to assess cognitive function, and masticatory ability was measured according to the ability to chew food, the number of remaining teeth, and the self-perceived perceived masticatory function. Relative molar occlusal balance was measured using the T-scan Ⅲ system. All collected data were analysed using SPSS version 23.0. RESULTS There was a significant association between cognitive function and molar masticatory ability (P < .05). The participants with relative molar occlusal balance had a higher MMSE-DS score when compared to those with relative incision occlusal balance, adjusted for sociodemographic factors and number of remaining teeth, subjective masticatory ability, chewing ability, occlusion time, and denture use. Cognitive function was higher when relative molar occlusion was greater compared to anterior occlusion in anterior-posterior teeth balance. CONCLUSIONS Cognitive function in elderly people was higher when the relative molar occlusal balance was greater. Mastication with posterior teeth may have a more important effect on stimulation of cognitive function. Therefore, oral health care focusing on maintenance of molar teeth may be crucial for elderly persons.
Collapse
Affiliation(s)
- Min-Jeong Cho
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea; Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea
| | - Hae-Eun Shin
- Division of Health and Nutrition Survey, Korea Centers for Disease Control & Prevention, Cheongju, Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea; Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Korea.
| |
Collapse
|
49
|
Takahashi AME, do Nascimento ABB, Barros AS, Gaspar MB, Silva MO, Machado FP. COVID-19 Infection in Octagenarian Patients: Imaging Aspects and Clinical Correlations. Gerontology 2021; 68:261-271. [PMID: 34515129 PMCID: PMC8450843 DOI: 10.1159/000516166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/26/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Computed tomography (CT) of the chest, although not a screening test or diagnosis of infection with the new coronavirus, has a fundamental role in assessing the extent of lung involvement and complications such as pleural effusion. Considering the higher morbidity and mortality of elderly patients due to this infection, the objective of this study was to evaluate the imaging aspects and clinical correlations of an extreme age (≥80 years) with a confirmed diagnosis for COVID-19. METHODS This was a retrospective and single-center cohort study. CT scans were categorized qualitatively and quantitatively. In the first case, 3 descriptors were used to describe CT findings: "compatible" (findings of greater specificity for COVID-19: opacities with attenuation in ground glass with peripheral and bilateral distribution, with rounded morphology, with or without consolidations, crazy-pavement aspect, inverted halo sign, or organizing pneumonia findings), "doubtful" (findings not specific or unusual for COVID-19: opacities with attenuation in ground glass with nonrounded morphology, central, diffuse, or unilateral distribution, with or without consolidation, lobar or segmental consolidation without ground-glass opacity, small centrilobular nodules with the appearance of "tree-in-bud," excavations, pleural effusion, and thickening of interlobular septa), and "negative" (absence of pneumonia signs). For the quantitative assessment, which referred to the extent of pulmonary involvement, a tomographic severity classification was used: grade 1 (lung involvement ≤25%), grade 2 (pulmonary involvement between 26 and 50%), and grade 3 (pulmonary involvement >50%). RESULTS A total of 138 patients were evaluated, with an average age of 86.2 years (84 women and 34 men). The mean time interval between onset of symptoms and tomography was 5.63 days. The most prevalent comorbidity was systemic arterial hypertension (81.2%). Compatible, doubtful, and negative tests were 117 (84.7%), 20 (14.4%), and 1 (0.7%), respectively. As for compatible exams, the most common findings were opacities in peripheral ground glass and rounded morphology, followed by crazy paving. The prevalence of pleural effusion was 28.2% and consolidation was 63.7%, and none of these findings were influenced by the duration of symptoms (p = 0.08 and p = 0.2, respectively). The exams classified as grade 1, grade 2, and grade 3 were 57 (41.6%), 46 (33.6%), and 34 (24.8%), respectively. There were statistically significant associations between the classification of tomographic severity and outcomes such as invasive ventilation (p = 0.004), admission to the intensive care unit (p < 0.001), and death (p < 0.001). DISCUSSION/CONCLUSION Our results show that patients ≥80 years old present tomographic manifestations similar to those described for the general population (ground-glass opacities and "crazy paving") and that the extent of lung involvement is associated with the need for intensive care, invasive ventilation, and death. Although the literature describes an association between the stage of the disease and the appearance of consolidations and pleural effusion, this correlation was not observed in our study, which may suggest that this age-group is more predisposed to the appearance of such findings, typically described in the more advanced stages of infection.
Collapse
Affiliation(s)
- Alessandra Marumi Emori Takahashi
- Department of Radiology and Diagnostic Imaging at Prevent Senior, São Paulo, Brazil
- Department of Radiology and Diagnostic Imaging at A. C. Camargo Cancer Center, São Paulo, Brazil
| | | | - André Santos Barros
- Department of Radiology and Diagnostic Imaging at Prevent Senior, São Paulo, Brazil
| | - Márcio Barros Gaspar
- Department of Radiology and Diagnostic Imaging at Prevent Senior, São Paulo, Brazil
| | | | | |
Collapse
|
50
|
Scheckel B, Stock S, Müller D. Cost-effectiveness of group-based exercise to prevent falls in elderly community-dwelling people. BMC Geriatr 2021; 21:440. [PMID: 34311698 PMCID: PMC8314607 DOI: 10.1186/s12877-021-02329-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical studies indicate that strength-balance training for active fall prevention can prevent fractures in older people. The present modelling study evaluates the cost-effectiveness of fall prevention exercise (FPE) provided to independently living older people compared to no intervention in Germany. METHOD We designed a Markov model to evaluate the cost-effectiveness of a group-based FPE-program provided to independently living people ≥75 years from the perspective of the German statutory health insurance (SHI). Input data was obtained from public databases, clinical trials and official statistics. The incremental cost-effectiveness ratio (ICER) was presented as costs per avoided hip fracture. Additionally, we performed deterministic and probabilistic sensitivity analyses and, estimated monetary consequences for the SHI in a budget impact analysis (BIA). RESULTS For women, the costs per hip fracture avoided amounted to €52,864 (men: €169,805). Results of deterministic and probabilistic sensitivity analyses confirmed the robustness of the results. According to the BIA, for the reimbursement of FPE additional costs of €3.0 million (women) and €7.8 million (men) are expected for the SHI. CONCLUSIONS Group-based FPE appears to be no cost-effective option to prevent fall-related hip fractures in independently living elderly. To allow a more comprehensive statement on the cost effectiveness of FPE fracture types other than hip should be increasingly evaluated in clinical trials.
Collapse
Affiliation(s)
- Benjamin Scheckel
- Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany.
| | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany
| | - Dirk Müller
- Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany
| |
Collapse
|