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Health 2013年第6期5卷 122-127页

作者： Natalya Arkhipova Elena Popova Aleksandr Ariev Saint-Petersburg Medical Academy of Postgraduate Education St.-Petersburg Russia Yakutsk Science Centre of Complex Medical Problems of the Siberian Branch of the Russian Academy of Medical Science Ya- kutsk Russia Мedical Institute of the North-Eastern Federal University Named after M. K. Ammosov Yakutsk Russia

As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among geriatric patients is isolated systolic arterial hypertension (ISAH). The comparison of two ethnic groups of the population has showed higher levels of systolic and diastolic blood pressure (SBP and DBP) in the group of patients of non-indigenous nationality, rather than Yakut patients. Correlation was recorded in the group of non-indigenous patients as they age. Significant increase in the level of SBP was identified in the group of senile and long-livers than in the elderly. Detection of ECG signs of LVH showed the lowest specificity of Cornell voltage criterion comparing to Sokolow-Lyon criterion with its more often occurrence. ECG-signs of left ventricle hypertrophy are significantly more often established by Sokolow-Lyon criterion for men, Cornell voltage—for women. Correlation has been found between the presence of LVH and combination of Cornell voltage criterion with both Gubner-Ungerleider and Sokolow-Lyon criteria.

关键词： Arterial Hypertension Coronary Heart Disease geriatric Age Non-Indigenous and Yakut Patients Electrocardiographic Criteria of Left Ventricle Hypertrophy

Gender prevalence of cardiovascular diseases in the geriatric population of India: A meta-analysis using R

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World Journal of Meta-Analysis 2020年第1期8卷 15-26页

作者： Himani Nanda Vijay Kumar Shivgotra Department of Statistics University of Jammu

BACKGROUND Population ageing is an important challenge for developed as well as developing countries due to the downward trends in mortality rates.The elderly population is increasing worldwide.Cardiovascular diseases(CVDs)are one of the most common diseases in the geriatric population.These diseases involve the heart or blood vessels and include hypertension,rheumatic heart disease,heart failure,and heart attack.An estimated 17.7 million people in India will die from CVDs representing 31%of all global deaths.AIM To perform a systematic review and meta-analysis of the gender prevalence of CVDs in the geriatric population of India.METHODS In the present study,we searched databases such as Google Scholar,PubMed and MEDLINE from the year 2003 to 2019 to identify the prevalence of CVDs in the Indian geriatric population.A meta-analysis was conducted using the statistical software R version 3.4.3 and the random effect model was used to determine the pooled estimate of the prevalence of CVDs in the geriatric population of India along with the 95%confidence interval rather than using the fixed effect model.The random effect model takes into consideration the heterogeneity across the various studies.RESULTS The prevalence of CVDs in the Indian geriatric population was determined in 6586 male subjects from 32 studies and 8164 female subjects from 32 studies,respectively.The overall prevalence of CVDs in the Indian geriatric population was 36.6%(95%CI:31.9%-41.3%).In addition,calculation of the various heterogeneity statistics(Cochran’s Q=3836.85,I2=98.6%,Pgeriatric population was relatively higher than that in the male geriatric population.Policy makers must take immediate steps to prevent CVDs and impr

关键词： Ageing Cardiovascular diseases geriatric Systematic review Meta-analysis Prevalence

Ability of Comprehensive geriatric Assessment to Detect Frailty

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Advances in Aging Research 2014年第2期3卷 63-69页

作者： Moatassem S. Amer Tamer M. Farid Ekrami E. Abd El-Rahman Deena M. EL-Maleh Omar H. Omar Randa A. Mabrouk Clinical Pathology Department Faculty of Medicine Ain Shams University Cairo Egypt geriatrics and Gerontology Department Faculty of Medicine Ain Shams University Cairo Egypt Radiodiagnosis Department Faculty of Medicine Ain Shams University Cairo Egypt

Background and Aim of the Work: Frailty is a state of reduced physiological reserve associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. This work assessed the ability of comprehensive geriatric assessment to detect frailty in elderly patients. Subjects and Methods: A total number of 104 elderly patients (above 60 years old) were included in this study and they were subjected to a comprehensive geriatric assessment (CGA) including: (history and full clinical examination, Mini mental status examination (MMSE), geriatric depression scale (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008, each group included 52 patients. Results: There were no significant differences between the two groups regarding age gender or smoking habits. But there was higher percentage of ADL, IADL dependence in addition to higher incidence of depression and cognitive impairment among frail cases. Conclusion: Comprehensive geriatric assessment can be used to detect frailty and its associated impairment and comorbidities.

关键词： Frailty Comprehensive geriatric Assessment

Factors Affecting Clinical Depression in Diabetic geriatric Population

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Journal of Diabetes Mellitus 2015年第4期5卷 238-244页

作者： Shailesh Jain Bhavana Mocharla Yulia Belopolsky Jamal Islam Department of Psychiatry Texas Tech University Health Sciences Center Odessa USA Department of Family and Community Medicine Texas Tech University Health Sciences Center Odessa USA Texas Tech University Health Sciences Center Odessa USA

Introduction: Diabetes mellitus is a common metabolic disorder affecting about 10% - 25% of the elderly population. The mechanisms, linking diabetes and major depressive disorders are unknown. Obesity is the risk factor for both diabetes mellitus and depression. The goal of this study was to explore if BMI of elderly diabetic patients with depression differed from BMI of the diabetic individuals without depression. Further, we aimed to explore the association of age, gender, health insurance status, ethnicity influence and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with clinical depression in geriatric diabetics. Methods: Nursing home residents were recruited from an outpatient internal medicine clinic in a teaching university setting. After given written consent, patients received Public Health Questionnaire-9 (PHQ-9) in either English or Spanish language. Results: While the clinically depressed diabetic participants did not differ from that of the non-depressed diabetic participants with respect to age (70.6 ± 6.1 vs. 72.1 ± 4.8;p = 0.111), gender (47.2% of males vs. 57.1% of females;p = 0.754), or ethnicity (69% explain vs. 71%, p = 1.000), race did appear to differ in depression status: Caucasian, African-American, and others were respectively 37%, 48%, and 15% vs. 32%, 16%, 52%, p = 0.0003). Neither the BMI (p > 0.499) nor Hemoglobin A1c (p > 0.839) differed between the clinically depressed and non-depressed participants when controlled for these race differences. Conclusion: In our sample, diabetic African Americans are three times more likely to be depressed. Diabetic Caucasians also experience higher rates of clinical depression. However, diabetics with depression did not differ from diabetics without depression with regard to their age, gender, BMI, HbA1C, health insurance status, systolic blood pressure or diastolic blood pressure.

关键词： geriatric Depression Diabetes Mellitus Ethnicity BMI

Characteristics of geriatric Health Service Facilities Designated as Sites of Death

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Health 2015年第10期7卷 1275-1282页

作者： Mitsumi Ono Hideyuki Kanda Yuko Takeda Sachiko Hara Department of Community Health and Gerontological Nursing Faculty of Medicine Shimane University Izumo Japan Department of Environmental Medicine and Public Health Faculty of Medicine Shimane University Izumo Japan

There are many deaths occurring among the aged population in Japan. geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was to clarify the characteristics and related factors, including physical signs first noticed by staff at the end-of-life period, in GHSFs designated as sites of death, using a nationwide survey in Japan. We administered a questionnaire to 3971 GHSFs in Japan. Eligible responses for the study were obtained from 854 GHSFs. We found that GHSFs designated as sites of death were more likely to have basic policies and documented preferences regarding end-of-life care. We also found that staff members in GHSFs designated as sites of death were less likely to first notice physical signs of pain. We found that GHSFs designated as sites of death tended to identify earlier symptoms, such as reduced oral intake and less vigor. Our results would enable elderly persons, their families, and staff in GHSFs to prepare for the elderly’s death more efficiently though earlier identification of the end-of-life period. We hope that GHSFs have an important role to play in end-of-life care provision to elderly persons in Japan, through the strengthening of these intermediate facilities.

关键词： geriatric Health Service Facility End-of-Life Care Basic Policy Preference Documented Physical Signs

A Pilot Study on Health Care Utilization: Outpatient Aftercare for geriatric Patients and Their Relatives

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International Journal of Clinical Medicine 2012年第2期3卷 92-97页

作者： Richard R. Gaugeler Brigitte B. Jenull Ingrid I. Salem Department of Psychology Alps-Adria University Klagenfurt Austria Public Hospital Waiern Feldkirchen Austria

Increasing life expectancy correlating highly with polymorbidity, frequently causes recurring inpatient stays at geriatric hospital wards. After discharge from hospital, an offer for physical and psychological after-care seems necessary for most patients. Purpose of this project was the development, implementation and primary assessment of an out-patient after-care intervention program for elderly, multimorbid patients and their relatives. During a period of eight months an interdisciplinary team offered psychological interventions as well as medical advice, nursing care and social casework. Primary goal was the investigation of health care utilization conduct and effectiveness of this after-care service in regard to sustainable stabilization of former inpatients. Preliminary results show higher demand of psychological and psychotherapeutic groups, whereas medical questions and nursing care problems were of minor concern to the patients. Contrary to our presumptions, even geriatric patients with a diagnosis of depression or anxiety disorder, showed to be reliable and constructive participants in psychological group settings. Situation and problems of (nursing) relatives could be identified accurately, although they represented an independent target group, possibly in need of more specific interventions.

关键词： Aftercare Interdisciplinarity geriatric Patient

Patients’ Expectations in a geriatric Rehabilitation Ward: Matching with Actual Outcomes

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Health 2017年第11期9卷 1597-1604页

作者： Mauro Colombo Carla Facchini Achim Rusu Eleonora Marelli Giuseppe Procino Rosella Capuano Cristina Miramonti Antonio Guaita geriatric Rehabilitation Unit/Intermediate Care Geriatric Institute “Camillo Golgi” Agency for Services to Persons (ASP) Golgi Redaelli Milano Italy Golgi Cenci Foundation Abbiategrasso Italy Sociology Department University of Milan Milano Italy

Aim: Person-centered care is a core issue in rehabilitation;the study aims at: 1) enquiring the outcome expectations of patients in a geriatric rehabilitation ward;2) matching outcome expectations with actual outcomes. Methods: Expectations of 186 patients [79.4 (8.7) years, 70% females] analyzed through a questionnaire. 80.6% of patients were discharged home;functional recovery = 17.7 (22) points in Barthel Index total score, and 5 (4.2) points in Barthel Index walking subscore;also conditions with nursing needs improved significantly. Results: Patients’ expectations were coded as: functional (31.4%), overall (29.6%), and clinical improvement (21.5%), discharge home (7%);no answers or explicit lack of expectations (7.5%). Walking ability recovery differed according to outcome expectations. Highest improvements were achieved by patients wishing clinical improvement, followed by those expecting functional or overall improvement (5 points) [p = 0.009 (Welch)/p = 0.041 (Brown- Forsythe)];worst improvement in walking ability (2.8 points) were got by patients faulting or declaring explicit failure of expectations. Conditions with nursing needs improved most in those expecting clinical improvements [p = 0.029 (Brown-Forsythe)], and less in case of expectation default. No further matching was found. Conclusions: Improvement in actual outcomes matched expected improvements in two circumstances: recovery in walking ability and in conditions with nursing needs. The high yield of different favorable outcomes may have masked the statistical significance for correspondence between actual and expected results. Special attention is worthy towards patients short of expectations, as their actual outcomes result poorer.

关键词： Expectations Outcomes geriatric Rehabilitation Person-Centered Care

Prognostic Factors in geriatric Patients with Metastatic Colon Cancer

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Journal of Cancer Therapy 2019年第10期10卷 779-788页

作者： Kenji Ina Megumi Kabeya Shu Yuasa Yuko Kato Satoshi Kayukawa Takae Kataoka Ryuichi Furuta Department of Medical Oncology Nagoya Memorial Hospital Nagoya Japan Department of Phamacy Nagoya Memorial Hospital Nagoya Japan Medical Social Work Consultation Room Nagoya Memorial Hospital Nagoya Japan Department of Clinical Oncology Nagoya Memorial Hospital Nagoya Japan.

Backgrounds: Colorectal cancer is an important contributor to cancer morbidity and mortality. Given that many older adult patients often have concomitant diseases and impairments in organ function, they are at increased risk for chemotherapy toxicity. Therefore, it is important to identify prognostic factors in older patients undergoing chemotherapy. Methods: We performed a retrospective chart review of colorectal cancer patients treated at Nagoya Memorial Hospital between 2012 and 2017 and selected those who received chemotherapy for metastatic colon cancer. Overall survival was calculated from the beginning of chemotherapy until death or the most recent follow-up date. We used the Kaplan-Meier method to plot survival curves and performed a statistical comparison using a log-rank test. In addition, multivariate analysis was performed using stepwise Cox proportional hazards models. Finally, a comprehensive geriatric assessment was conducted for older patients. The chart review was approved by the ethics committee of Nagoya Memorial Hospital. Results: The overall survival of metastatic colon cancer patients was not markedly different between patients aged ≥ 65 years of age (N = 37). Neither lesion site nor the RAS status affected survival, whereas the usage of three kinds of cytotoxic agents prolonged longevity. In a multivariate analysis of patients ≥ 65 years of age, the only independent prognostic factor for survival was the functional capacity, as measured by the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. Conclusions: A combination of the comprehensive geriatric assessment and TMIG index was useful for predicting the longevity in patients with metastatic colon cancer ≥ 65 years of age.

关键词： Metastatic Colon Cancer Chemotherapy Comprehensive geriatric Assessment TMIG Index of Competence

Modification in self-rated health in patients discharged by a geriatric rehabilitation ward

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Health 2013年第6期5卷 94-98页

作者： Eleonora Marelli Giuseppe Procino Maria Cottino Giorgio Previderè Silvio Giorgi Davide Dell’Acqua Santina Bruno Marco Cairati Danila Ferrari Rosella Capuano Mauro Colombo geriatric Institute “Camillo Golgi” Milan Italy geriatric Institute “Camillo Golgi” Milan Italy

Self-rated health is a valuable outcome in geriatric rehabilitation besides objective results. The present work aims at measuring and analyzing overall health as it is perceived at admission into and at discharge from a geriatric rehabilitation ward. Overall health was self-appraised through a visual-analogue scale (VAS), spanning from 0 (worst) to 10 (best). We studied 1997 patients (70% females), aged 79 (standard deviation, s.d. 8.7) years;most were frail, either functionally, clinically and cognitively. 80% of patients were discharged to home after a length of stay lasting 47.5 (s.d. 22.7) days. At admission, 3/5 patients appraised favorably their overall health (VAS ≥ 6/10): at discharge, the proportion rose to 3/4, with a mean (s.d.) gain = 2 (2) points. The improvement in self-perceived health score positively correlates with the grade expressing clients’ overall satisfaction for the stay (p 0.001), and with discharge versus admission differences in: Barthel Index (BI) total score (p geriatric Depression Scale (5?items GDS), pain (VAS 0 to 10). A Linear regression model predicting the changes in self-perceived health included changes in BI, MMSE, GDS, pain, dropping Tinetti test. Changes in self-rated health were positively correlated to functional gain adjusted for pre-morbid level, and to relative functional gain. By analysis of variance, health self-appraisal changed more favorably in patients discharged to home than for other social outcomes (all p < 0.001). As expected, trends in self-perceived health parallel improvements in objective functional gauges and subjective indicators.

关键词： Cognition Functional Gains geriatric Rehabilitation Mood Pain Self-Rated Health

Study on the Effect of the Intervention on Traditional Chinese Medicine Negative Heel Shoes in geriatric Orthopedics Patients

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Journal of Clinical and Nursing Research 2018年第6期2卷 5-7页

作者： Jiabin Zhai Lianjun Ren Qirong Wang Inner Mongolia Medical University Medical College Hohhot Inner Mongolia 010110 Shenzhen Yikang Shou Culture Research Institute Shenzhen Guangdong 518125

In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.

关键词： orthopedics geriatric bedridden patient Chinese medicine negative heel shoes health care effects