Archives of Gerontology and Geriatrics Plus最新文献

Background

Aminoglycosides, maintaining antimicrobial efficacy, are considered for combating multidrug-resistant pathogens. Their contemporary use, combined with vigilant preventive strategies, may not universally lead to lasting renal complications in elderly inpatients.

Methods

This study examined data from the National Health Insurance Registry Database, focusing on elderly inpatients (aged 60 and above) hospitalized between 2000 and 2017 due to pneumonia, urinary tract infections, or bacteremia. Patients treated with aminoglycosides were compared to those receiving other antibiotics. Patient follow-up continued until the occurrence of renal disease, death, or for three months post-discharge, based on diagnoses coded in the International Classification of Diseases.

Results

Among 938,052 elderly inpatients admitted for infections, 29.19 % were prescribed aminoglycosides. Patients receiving aminoglycosides tended to be younger and had fewer associated health conditions compared to those treated with other antibiotics. The overall incidence of renal disease was 2.03 % during hospitalization and it increased to 17.45 % at the three-month follow-up. While no increased risk for renal disease was observed in the aminoglycoside group compared to other antibiotics, it correlated with higher rates of death and intensive care unit transfer. Specific comorbidities, such as diabetes mellitus, heart failure, and liver disease, exhibited a stronger association with the development of renal disease compared to aminoglycosides.

Conclusion

Current aminoglycoside use did not contribute to a higher incidence of lasting renal disease compared to other antibiotics but was linked to increased morbidity and mortality. Caution is crucial when administering aminoglycosides to elderly patients to prevent adverse outcomes.

Introduction

Falls present a significant public health concern in the United States as a primary cause of unintentional injury-related deaths among older adults. A fall risk assessment toolkit STEADI developed by the CDC has been shown to predict future falls. However, STEADI has issues with accurate evaluations due to the disagreement on cut-off scores in functional assessments and history-taking questionnaires. Wearable sensor technology offers a practical and quantifiable alternative for assessing an individual's movement performance in real-world environments. The use of Inertial Measurement Units (IMUs) offers considerable potential to enhance fall risk screening.

Purpose

The primary aim of this study is to test the agreement of STEADI functional assessment performance measured by the IMUs in comparison to human-based measurements.

Method

27 participants (Age: 74.37 ± 7.21) performed STEADI, including the Four-Stage Balance Test (4SBT), Timed Up & Go Test (TUG), 30-second Chair Stand (30sCS) with IMU placed at the fifth lumbar vertebra which is the proxy location of whole-body Center of Mass. By adopting an equivalent test, the STEADI agreement was tested between the human rater and IMU measurements, giving α = 0.05.

Result

Between the results from evaluators and IMU, the difference in TUG is -0.23 s, and the difference in 30sCS is 0.37, which is equivalent to within 4 % and 8 % for TUG and 30sCS, respectively. The difference in single-leg stance during the 4SBT is 0.59 s; however, the calculated equivalence zone is larger (22.7 %).

Conclusion

This study demonstrates the feasibility of using IMU sensors to enhance fall risk screening protocols based on the STEADI. Future refinement may still need to enable broader application and effective screening practices on a larger scale of the population.

Bedsores, commonly known as pressure ulcers, are a major healthcare issue with far-reaching effects on patient welfare and the healthcare system. This review provides an extensive summary of the existing body of knowledge on the management and prevention of bedsores. Traditional approaches for preventing bedsores include regular repositioning, nutritional assessments, the use of pressure-relief devices, and wound care protocols. Despite these approaches, the incidence of bedsores remains a challenge, and there is a need for further studies on customized pressure redistribution products and their impact on sleep quality. Technology-based prevention strategies for bedsores include the use of pressure-relieving support surfaces, such as smart mattresses and cushions, to monitor pressure, temperature, and humidity, allowing for adjustable firmness and contour redistribute pressure. Wearable sensors continuously monitor the pressure points, and pressure mapping systems assess the pressure distribution between the body and surface, providing real-time feedback. Telemedicine platforms and mobile apps for self-monitoring can also be employed to monitor patients remotely, assess skin conditions, and provide guidance for prevention and care. Clinical evidence assessing the effectiveness of various preventive tools and interventions suggests that they can improve patient outcomes and reduce the incidence of bedsores. It also outlines the complexities and limitations associated with managing pressure ulcers. The review explores several preventive techniques which highlights the economic and social burden of pressure ulcers

Objective

To investigate the mediating effect of decreased Intrinsic capacity(IC) between symptoms and ability to perform activities of daily living(ADL) in elderly patients with Heart failure(HF).

Methods

Using a convenience sampling method, 237 elderly patients with HF in the cardiology department of a Grade A Tertiary Hospital in Suzhou, China were selected from January 2022 to November 2022, and the General Information Questionnaire, Symptom Status Questionnaire-Heart Failure (SSQ-HF), Barthel Index Scale (BI), and IC Assessment Tool were applied to investigate the mediating effect of IC between HF symptoms and ADL using structural equation modeling.

Results

HF symptoms and decreased IC were associated with patients' ability to perform ADL (P=0.005, P<0.001), and decreased IC partially mediated the effect between HF symptoms and ADL, indirectly negatively predicting ADL with a mediating effect of -0.412, accounting for 59.11% of the total effect.

Conclusion

Decreased IC in elderly patients with HF is a mediating variable between HF symptoms and ADL. Healthcare professionals can use the multidimensional assessment framework of IC to identify early the risk of impaired ADL in elderly HF patients and to provide targeted rehabilitation interventions for this group of patients.

Purpose

This study aimed to investigate the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and cognitive function.

Methods

Data, including cognition assessment, general characteristics, lifestyle attributes, disease-related factors, and blood indicators, were extracted from older people from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 database. Statistical analysis included the Mann-Whitney U test, chi-square test, spearman correlation, and multiple linear regression.

Results

A total of 2452 participants were included, with 631(25.7 %) identified as having low-level cognition. HRR was significantly lower in the lower cognition group (P < 0.001) and positively associated with cognition score (P < 0.001). Multiple linear logistic regression analysis indicated that HRR remained associated with cognition even after adjusting for general characteristics, lifestyle attributes, disease-related factors, and blood indicators (P = 0.046).

Conclusion

Lower HRR is an independent risk factor for low cognitive performance in older adults. However, further investigation is needed to elucidate the precise mechanism underlying the impact of HRR on cognitive function.

This paper explores the synergy between humans and generative AI in the context of diabetes and biochemical analysis for endocrinologists. It underscores the necessity for human intervention to supplement the information that the AI has not yet learned, using search engines as a tool. The paper is crafted to be user-friendly, catering to both novices and those without a programming background. It covers human-centric for code verification, while the generative AI is tasked with creating Python code for data visualization automatically. The paper introduces a succinct set of guidelines for interacting with these AI tools, with the aim of minimizing unnecessary interactions. It guides readers on how to harness the power of the latest generative AI to assist and expedite research, using various search operators or options. While acknowledging the limitations of these generative AI tools, the paper emphasizes their potential in streamlining scientific research by reducing time and cost. It provides tangible examples, such as the visualization of graphs for the HbA1c dataset. In conclusion, despite their limitations, the paper champions the use of generative AI tools to propel advancements in science and technology. It highlights their significant potential in reducing time and cost, thereby catalyzing the pace of research.

Volunteering in the advancing years has received abundant attention amongst the ageing population. A mini review of past studies on the key concepts of volunteerism with regard to the research area on the well-being of OAs and the types of evidence available is conducted. Developing and implementing the search strategy for this review occurred in two stages: the search was conducted at the university's digital library and using manual search. A total of 17 articles were included in the final literature review. The current study reviews the effect of volunteering on various health outcomes such as emotional health, physical health, levels of happiness and life satisfaction, purpose in life, and greater feelings of personal control.

Aim

This study investigated the association between participation in social activities and incident dementia among physically and socially independent older adults with or without diseases (hypertension and/or diabetes mellitus) in a Japanese age-specific cohort (the NISSIN Project).

Methods

We conducted a prospective cohort study of 1,856 Japanese individuals (953 men and 903 women) aged 64/65 years. Information on medical status, demographics, and lifestyle characteristics was collected using a baseline questionnaire and health checkup (2000–2005). Incident dementia were confirmed among these received long-term care certifications using the nationally standardized dementia scale proposed by the Ministry of Health, Labor, and Welfare. A competing risk model was used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for dementia incidence. We treated the censored cases of death as competing events.

Results

During a median of 16.0 years of follow-up, incident dementia occurred in 332 participants. The presence of diseases and nonparticipation in social activities were associated with a significantly higher risk of incident dementia (HR 1.65; 95 % CI 1.21–2.26) after adjusting for potential confounders compared with participants without diseases and those who participated in social activities.

Conclusions

In this age-specific cohort study, participants with diseases and those who did not participate in social activities were more likely to have incident dementia than those without diseases and those who participated in social activities. For older people with hypertension and/or diabetes mellitus, engaging in social activities could be a beneficial strategy for reducing the risk of developing dementia.

Objective

Falls are a major challenge to public health, particularly among older adults. Understanding factors that influence fall risk is pivotal in the prevention of falls and fall-related injuries. This study evaluated the timing of emergency medical service (EMS) activations for falls and transport patterns for adults age ≥65.

Methods

A patient care report system at a single fire-based emergency medical service agency in a suburban, Midwest city was retrospectively reviewed. Type of call (lift assist/fall), time of injury (time, day, and month), and demographics (sex, age) were collected for residents age ≥65 who activated 9–1–1 for a lift assist or fall.

Results

1169 calls met inclusion criteria. Mornings and afternoons were the time of day associated with falls (33 % and 36 % of EMS activations, respectively, vs. 21 % and 10 % for evenings and nights, respectively; p = 0.002) while day of the week and month were not associated with falls or lift assists. More males requested lift assists than females (256 vs. 238) and more females called for falls than males (408 vs. 267; p < 0.001). Falls were more likely to be associated with transport to the hospital than lift assists (78% vs. 7 %). Female sex was associated with increased risk for transport to the hospital (60 % of females vs. 40 % of males; p < 0.001).

Conclusions

Mornings and afternoons were associated with increased risk for falls and sex (female) with increased risk for transport to the hospital.