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The Association between Delirium and In-Hospital Falls: A Cross-Sectional Analysis of a Delirium Screening Program. 谵妄与院内跌倒之间的关系:谵妄筛查项目的横断面分析。
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/1562773
Benjamin Kalivas, Jingwen Zhang, Kristine Harper, Meghan K Thomas, Jennifer Dulin, Justin Marsden, Patrick Robbins, Kelly J Hunt, Patrick D Mauldin, William P Moran, James Rudolph, Marc Heincelman

Methods: A cross-sectional study using delirium screening and falls reports was used to measure the association between delirium and falls. All inpatient data from August, 2018, to January, 2020, at a large academic medical center were analyzed. A multivariable logistic regression of 29,655 hospital admissions was used to understand the association between in-hospital delirium and falls.

Results: Analysis revealed a delirium rate of 12.5% (n = 3,707) of all admissions and 286 (0.9%) admissions with falls; of the falls studied, 37.6% of these patients screened positive for delirium during their admission. Relative to those who screened negative for delirium, admissions that screened positive for delirium had a 2.81 increased odds of falling.

Conclusions: Delirium and falls are related. This strong association should motivate health systems to look closely at both problems. Falls and delirium can both have immense impacts on the patient and the health system. The powerful association between them provides a window to reduce these additional patient harms. More specifically, a modern delirium screening tool should be used as part of routine risk assessment focused on reducing in-hospital falls.

方法:采用谵妄筛查和跌倒报告的横断面研究来衡量谵妄和跌倒之间的关系。分析了一家大型学术医疗中心2018年8月至2020年1月的所有住院患者数据。对29,655例住院患者进行多变量logistic回归,以了解院内谵妄与跌倒之间的关系。结果:分析显示,所有入院者中谵妄率为12.5% (n = 3,707),其中有跌倒入院者286例(0.9%);在研究的跌倒患者中,37.6%的患者在入院时谵妄筛查呈阳性。与那些精神错乱筛查呈阴性的人相比,精神错乱筛查呈阳性的入院者摔倒的几率增加了2.81。结论:谵妄与跌倒有关。这种紧密的联系应促使卫生系统密切关注这两个问题。跌倒和谵妄都会对患者和卫生系统产生巨大影响。它们之间的强大联系为减少这些额外的患者伤害提供了一个窗口。更具体地说,应该使用现代谵妄筛查工具作为常规风险评估的一部分,重点是减少住院跌倒。
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引用次数: 0
MAOA uVNTR Polymorphism Influence on Older Adults Diagnosed with Diabetes Mellitus/Systemic Arterial Hypertension. MAOA uVNTR多态性对老年人糖尿病/全身性动脉高血压的影响
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/8538027
Gabriel Moura Alves Seixas, Renata de Souza Freitas, Caroline Ferreira Fratelli, Calliandra Maria de Souza Silva, Luciano Ramos de Lima, Marina Morato Stival, Silvana Schwerz Funghetto, Izabel Cristina Rodrigues da Silva

Background: Monoamine oxidase (MAO) is involved in several biological processes associated with well-being and mental health, and alterations in its function might directly impact various mental disorders. Some mental disorders concomitantly occur in individuals with clinical characteristics, such as substance abuse and diabetes.

Objective: To analyze the functional MAOA uVNTR polymorphism genotype frequency in an older adult population with diabetes mellitus/arterial hypertension and associate this frequency with clinical characteristics impacting daily life. Methodology. Older adults diagnosed with diabetes mellitus, systemic arterial hypertension, or both (DM/SAH) were selected and had their MAOA gene genotyped for uVNTR polymorphism. The revised Beck Depression Inventory (BDI) and a questionnaire were also applied to determine their mental health and clinical characteristics.

Results: The allelic variants detected among the participants were the 2R, 3R, 4R, and 3R/4R heterozygous genotypes. Genotypes solely containing the 3R allele had patients who marked yes for smoking and alcoholism, and only those with the 3R genotypes (female 3R/3R homozygote or male 3R hemizygote) were significant. Although not statistically significant, only 3R and 3R/4R genotypes presented cases of severe depression per the revised BDI interpretations.

Conclusion: The MAOA uVNTR polymorphism's low-activity 3R allele presence in an older adult population diagnosed with DM/SAH may represent a risk for developing substance use (alcohol and smoking) dependence.

一些精神障碍在具有临床特征的个体中同时发生,如药物滥用和糖尿病。目的:分析老年糖尿病/高血压患者功能性MAOA uVNTR多态性基因型频率及其与影响日常生活的临床特征的关系。方法。选择诊断为糖尿病、全身性动脉高血压或两者兼有(DM/SAH)的老年人,并对其MAOA基因进行uVNTR多态性基因分型。经修订的贝克抑郁量表(BDI)和问卷调查也被用于确定他们的心理健康和临床特征。结果:参与者中检测到的等位基因变异为2R、3R、4R和3R/4R杂合基因型。仅含有3R等位基因型的患者在吸烟和酗酒方面标记为“是”,并且只有具有3R基因型(女性3R/3R纯合子或男性3R *半合子)的患者具有显著性。虽然没有统计学意义,但根据修订后的BDI解释,只有3R和3R/4R基因型出现严重抑郁症病例。结论:MAOA uVNTR多态性的低活性3R等位基因存在于诊断为DM/SAH的老年人群中,可能代表了发展物质使用(酒精和吸烟)依赖的风险。
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引用次数: 0
Anthropometric and Body Circumference Determinants for Hand Grip Strength: A Population-Based Mon-Timeline Study. 手掌握力的人体测量和身体围度决定因素:一项基于人群的非时间轴研究。
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/6272743
Agiimaa Byambaa, Indra Altankhuyag, Otgonbayar Damdinbazar, Tsolmon Jadamba, Oyuntugs Byambasukh

Background: Hand grip strength (HGS) is a tool for diagnosing sarcopenia. In this study, we examined some anthropometric and body circumference measurements as determinants for HGS.

Methods: This cross-sectional study was conducted with participants (Mongolians, n = 1080, aged 18-70, mean age of 41.2 ± 13.9 years, 33.7% of men) from the "Mon-Timeline" cohort study. To measure HGS, a digital grip strength dynamometer was used.

Results: Mean HGS in men was 40.1 ± 10.4 kg and in women was 24.5 ± 5.6 kg. Correlation analysis showed that the strongest correlation with HGS was height (r = 0.712, p < 0.001). Moreover, HGS was inversely correlated with age (r = -0.239, p < 0.001) and thigh circumference (r = -0.070, p < 0.01), while it was positively correlated with body weight (r = 0.309, p < 0.001), neck circumference (r = 0.427, p < 0.001), upper arm circumference (r = 0.108, p < 0.0001), lower arm circumference (r = 0.413, p < 0.0001), and calf circumference (r = 0.117, p < 0.0001). In the multivariate linear regression analysis (unstandardized B coefficient, 95% CI), age (-0.159, -0.188; -0.129), sex (-9.262, -10.459; -8.064), height (0.417, 0.357; 0.478), lower arm circumference (1.003, 0.736; 1.270), and calf circumference (-0.162, -0.309; -0.015) were significantly associated with HGS.

Conclusions: When detecting sarcopenia using HGS, it is important to take into account variables such as body height and body circumference.

背景:手部握力(HGS)是诊断肌肉减少症的一种工具。在这项研究中,我们检查了一些人体测量和身体周长测量作为HGS的决定因素。方法:本横断面研究的参与者(蒙古人,n = 1080,年龄18-70岁,平均年龄41.2±13.9岁,男性占33.7%)来自“Mon-Timeline”队列研究。为了测量HGS,使用了数字握力测功仪。结果:男性平均HGS为40.1±10.4 kg,女性为24.5±5.6 kg。相关分析显示,与HGS相关性最强的是身高(r = 0.712, p < 0.001)。HGS与年龄(r = -0.239, p < 0.001)、大腿围(r = -0.070, p < 0.01)呈负相关,与体重(r = 0.309, p < 0.001)、颈围(r = 0.427, p < 0.001)、上臂围(r = 0.108, p < 0.0001)、下臂围(r = 0.413, p < 0.0001)、小腿围(r = 0.117, p < 0.0001)呈正相关。在多元线性回归分析中(未标准化B系数,95% CI),年龄(-0.159,-0.188;-0.129),性别(-9.262,-10.459;-8.064),高度(0.417,0.357;0.478),下臂围(1.003,0.736;1.270),小腿围(-0.162,-0.309;-0.015)与HGS显著相关。结论:使用HGS检测肌少症时,应考虑身高、体围等变量。
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引用次数: 0
Age- and Gender-Related Differences in Renal Vascular Responses to Angiotensin II in Rats: The Role of the Mas Receptor. 大鼠肾血管对血管紧张素II反应的年龄和性别差异:Mas受体的作用。
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/3560468
Fatemeh Eshraghi-Jazi, Mehdi Nematbakhsh

Background: Renal hemodynamic is influenced by both gender difference and age. Also, the Mas receptor (MasR) as one of the depressor components of the renin-angiotensin system which has more expression in females could postpone some dysfunctions associated with age, although the association between MasR and age in renal vascular responses to angiotensin II (Ang II) in male and female rats was well undefined. Therefore, the current study examined the effects of age and sex on systemic and renal vascular responses to graded doses of Ang II in Wistar rats with or without MasR antagonists (A779).

Materials and methods: Anesthetized Wistar male and female rats with two age ranges of 8-12 and 24-28 weeks were exposed to cannulate venous and arterial vessels. After stability, mean arterial pressure (MAP), renal perfusion pressure (RPP), renal vascular resistance (RVR), and renal blood flow (RBF) were measured in response to the infusion of Ang II with or without A779.

Results: There were no significant differences in the base values of MAP, RPP, RBF, and RVR between the two genders in both the age ranges of 8-12 and 24-28 weeks. In addition, no significant gender difference was observed in the age ranges of the above mentioned parameters among the groups receiving vehicle or A779. Also, the infusion of vehicle or A779 could not significantly change the base values. On the other hand, the responses of RBF and RVR to Ang II revealed gender differences among 8-12-week groups (P < 0.05) but not in 24-28-week groups, while the blockade of MasR could not influence the responses in the age ranges.

Conclusion: It was concluded that age could impress sex difference in RBF and RVR responses to Ang II infusion and that MasR alone could not participate in these responses. In other words, MasR is not active under normal and acutely elevated Ang II levels.

背景:肾脏血流动力学受性别差异和年龄的影响。此外,Mas受体(MasR)作为肾素-血管紧张素系统的抑制成分之一,在雌性中表达较多,可以延缓一些与年龄相关的功能障碍,尽管在雄性和雌性大鼠肾血管对血管紧张素II (Ang II)的反应中,MasR和年龄之间的关系尚不清楚。因此,目前的研究检查了年龄和性别对有或没有MasR拮抗剂的Wistar大鼠对分级剂量Ang II的全身和肾脏血管反应的影响(A779)。材料与方法:麻醉后8-12周、24-28周龄Wistar公、母大鼠分别暴露于静脉和动脉血管。稳定后,分别在输注或不输注A779的情况下测量Ang II的平均动脉压(MAP)、肾灌注压(RPP)、肾血管阻力(RVR)和肾血流量(RBF)。结果:8 ~ 12周龄和24 ~ 28周龄男女间MAP、RPP、RBF、RVR基数值差异无统计学意义。此外,在接受车辆组和A779组之间,上述参数的年龄范围没有明显的性别差异。同时,注射载体或A779均不能显著改变基值。另一方面,RBF和RVR对Ang II的反应在8-12周组之间存在性别差异(P < 0.05),而在24-28周组之间无差异,而阻断MasR对年龄范围内的反应没有影响。结论:年龄可以影响RBF和RVR对Angⅱ输注反应的性别差异,单独的MasR不能参与这些反应。换句话说,在正常和急性升高的Ang II水平下,MasR不活跃。
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引用次数: 0
The Impact of the COVID-19 Pandemic on the Mental Health of Older Primary Care Patients and Their Family Members COVID-19大流行对老年初级保健患者及其家庭成员心理健康的影响
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2022-10-15 DOI: 10.1155/2022/6909413
T. Seibert, Matthew W Schroeder, A. Perkins, Seho Park, Eleanor Batista-Malat, Katharine J. Head, T. Bakas, M. Boustani, Nicole R. Fowler
The COVID-19 pandemic introduced mandatory stay-at-home orders and concerns about contracting a virus that impacted the physical and mental health of much of the world's population. This study compared the rates of depression and anxiety in a sample of older primary care patients (aged ≥65 years old) and their family members recruited for a clinical trial before and during the COVID-19 pandemic. Participants were dyads enrolled in the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) trial, which included 1,809 dyads of older primary care patients and one of their family members. Mean scores on the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were measured and compared before and during the pandemic. We found no difference in depression and anxiety among dyads of older primary care patients and their family members recruited before and during COVID-19. Additionally, we found that older primary care patients and family members who reported their income as comfortable had significantly lower depression and anxiety compared to those who reported having not enough to make ends meet. Along with this, older primary care patients with a high school education or less were more likely to have anxiety compared to those with a postgraduate degree. Moreover, our findings support the notion that certain demographics of older primary care patients and family members are at a higher risk for depression and anxiety, indicating who should be targeted for psychological health interventions that can be adapted during COVID-19. Future research should continue monitoring older primary care patients and their family members through the remainder of the COVID-19 pandemic.
新冠肺炎大流行引入了强制居家令,并对感染影响世界大部分人口身心健康的病毒表示担忧。这项研究比较了新冠肺炎大流行之前和期间招募的老年初级保健患者(年龄≥65岁)及其家庭成员进行临床试验的样本中的抑郁和焦虑发生率。参与者是阿尔茨海默病筛查护理者结果(COADS)试验的二人组,该试验包括1809名老年初级保健患者及其一名家庭成员。在大流行之前和期间测量并比较了患者健康问卷-9(PHQ-9)和广泛性焦虑症量表-7(GAD-7)的平均得分。我们发现,在新冠肺炎之前和期间招募的老年初级保健患者及其家庭成员中,抑郁症和焦虑症没有差异。此外,我们发现,与那些报告入不敷出的人相比,报告收入舒适的老年初级保健患者和家庭成员的抑郁和焦虑情绪显著降低。除此之外,与研究生学历的患者相比,高中或以下学历的老年初级保健患者更有可能出现焦虑。此外,我们的研究结果支持这样一种观点,即老年初级保健患者和家庭成员的某些人口统计数据具有更高的抑郁和焦虑风险,这表明谁应该成为新冠肺炎期间可以适应的心理健康干预的目标。在新冠肺炎大流行的剩余时间里,未来的研究应继续监测老年初级保健患者及其家庭成员。
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引用次数: 2
Atherogenic Index of Plasma and Anthropometric Measurements among Osteoporotic Postmenopausal Sudanese Women: Possible Risk for Cardiovascular Disease. 苏丹绝经后骨质疏松妇女的血浆致动脉粥样硬化指数和人体测量指标:可能的心血管疾病风险。
IF 1.6 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1545127
Abdelgadir Elmugadam, Ghada A Elfadil, Abdalrahman Ismail Hamad, Ahlam Badreldin El Shikieri, Mawahib Aledrissy, Hisham N Altayb

Introduction: Data examining the health of menopausal women and the prevalence of osteoporosis remain to be limited in Africa, especially in sub-Saharan countries. Thus, in this current study, we aimed to assess the atherogenic index of plasma (AIP) and anthropometric measurements of osteoporotic postmenopausal women and determine their risk for cardiovascular disease (CVD).

Methods: This is a cross-sectional, community-based study. Postmenopausal women (n = 300), aged ≥45 years, were recruited from Khartoum state, Sudan. Dual-energy X-ray absorptiometry was used to assess bone density. Weight, height, and waist circumference were measured twice. Fasting blood samples (5 ml) were collected to determine total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). AIP was calculated as an indicator of CVD risk.

Results: The mean age of the postmenopausal women was 61.6 ± 10.2 years (range 47-90 years). Women (n = 80) had the normal T-score, and an equal number had osteoporosis (n = 110) and osteopenia (n = 110). The prevalence of osteoporosis was 36.7%. Many postmenopausal women with normal T-scores suffered from general (71.2%) and central (94%) obesity. Postmenopausal women had high TC (24.4%), TG (25.6%), LDL-C (13.7%), and low HDL-C (76.0%) levels. Osteoporotic women (36.4%) were found to have a medium to high risk of CVD as determined by AIP. Women with normal T-scores had a higher number of CVD risk factors. A positive correlation was noted between AIP and TC among osteopenic (r = 0.292; P=0.002) and osteoporotic women (r = 0.265; P < 0.001).

Conclusion: Osteoporosis was prevalent among Sudanese postmenopausal women who also had an increased risk for CVD. Public health education about osteoporosis and CVD risk is thus recommended.

导言:在非洲,尤其是撒哈拉以南国家,有关绝经妇女健康和骨质疏松症患病率的数据仍然有限。因此,在本研究中,我们旨在评估绝经后骨质疏松症妇女的血浆致动脉粥样硬化指数(AIP)和人体测量数据,并确定她们罹患心血管疾病(CVD)的风险:这是一项基于社区的横断面研究。方法:这是一项基于社区的横断面研究,从苏丹喀土穆州招募了年龄≥45 岁的绝经后妇女(300 人)。采用双能 X 射线吸收测量法评估骨密度。体重、身高和腰围测量两次。采集空腹血样(5 毫升)以测定总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。计算的 AIP 是心血管疾病风险的指标:绝经后妇女的平均年龄为 61.6 ± 10.2 岁(47-90 岁不等)。妇女(人数=80)的 T 值正常,骨质疏松症(人数=110)和骨质疏松症(人数=110)的人数相等。骨质疏松症的发病率为 36.7%。许多 T 值正常的绝经后妇女患有全身性肥胖(71.2%)和中心性肥胖(94%)。绝经后妇女的总胆固醇(24.4%)、总胆固醇(25.6%)、低密度脂蛋白胆固醇(13.7%)水平较高,而高密度脂蛋白胆固醇(76.0%)水平较低。根据 AIP 测定,骨质疏松妇女(36.4%)患心血管疾病的风险为中高。T 值正常的女性具有更多的心血管疾病风险因素。在骨质疏松(r = 0.292; P=0.002)和骨质疏松症(r = 0.265; P < 0.001)妇女中,AIP 和 TC 之间呈正相关:结论:骨质疏松症在苏丹绝经后妇女中很普遍,她们患心血管疾病的风险也增加了。因此,建议开展有关骨质疏松症和心血管疾病风险的公共健康教育。
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引用次数: 0
Antiplatelets and Vascular Dementia: A Systematic Review. 抗血小板和血管性痴呆:一项系统综述。
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2022-09-19 eCollection Date: 2022-01-01 DOI: 10.1155/2022/9780067
Peter Alexander, Shakthi Visagan, Sara Jawhar, Amogh Kare, Noor Issa, Reem Issa, Abbas Jawhar, Sneha Thomas, Vasavi Gorantla

Vascular dementia (VD) is a neurocognitive disorder whose precise definition is still up for debate. VD generally refers to dementia that is primarily caused by cerebrovascular disease or impaired cerebral blood flow. It is a subset of vascular cognitive impairment, a class of diseases that relate any cerebrovascular injury as a causal or correlating factor for cognitive decline, most commonly seen in the elderly. Patients who present with both cognitive impairment and clinical or radiologic indications of cerebrovascular pathology should have vascular risk factors, particularly hypertension, examined and treated. While these strategies may be more effective at avoiding dementia than at ameliorating it, there is a compelling case for intensive secondary stroke prevention in these patients. Repeated stroke is related to an increased chance of cognitive decline, and poststroke dementia is connected with an increased risk of death. In general, most physicians follow recommendations for secondary stroke prevention in patients with VD, which can be accomplished by the use of antithrombotic medicines such as antiplatelets (aspirin, clopidogrel, ticlopidine, cilostazol, etc.). In individuals with a high risk of atherosclerosis and those with documented symptomatic cerebrovascular illness, antiplatelets treatment lowers the risk of stroke. While this therapy strategy of prevention and rigorous risk management has a compelling justification, there is only limited and indirect data to support it. The following systematic review examines the role of antiplatelets in the management of vascular dementia in published clinical trials and studies and comments on the current evidence available to support their use and highlights the need for further study.

血管性痴呆(VD)是一种神经认知障碍,其确切定义仍存在争议。VD一般是指主要由脑血管疾病或脑血流受损引起的痴呆。它是血管性认知障碍的一个子集,是一类将任何脑血管损伤作为认知能力下降的因果或相关因素的疾病,最常见于老年人。同时存在认知障碍和脑血管病理临床或放射学指征的患者应检查和治疗血管危险因素,特别是高血压。虽然这些策略在避免痴呆症方面可能比改善痴呆症更有效,但在这些患者中强化继发性卒中预防是一个令人信服的案例。反复中风与认知能力下降的几率增加有关,中风后痴呆与死亡风险增加有关。一般来说,大多数医生都遵循心血管疾病患者继发性卒中预防的建议,这可以通过使用抗血小板药物(阿司匹林、氯吡格雷、噻氯匹定、西洛他唑等)来实现。在动脉粥样硬化高危人群和有记录的有症状的脑血管疾病患者中,抗血小板治疗可降低中风的风险。虽然这种预防和严格风险管理的治疗策略有令人信服的理由,但只有有限的间接数据支持它。下面的系统综述检查了已发表的临床试验和研究中抗血小板在血管性痴呆管理中的作用,并对支持其使用的现有证据进行了评论,并强调了进一步研究的必要性。
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引用次数: 4
Simultaneous Dual-Task Interventions That Improve Cognition in Older Adults: A Scoping Review of Implementation-Relevant Details 同时双任务干预改善老年人认知:实施相关细节的范围审查
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2022-03-29 DOI: 10.1155/2022/6686910
Natasha Versi, K. Murphy, C. Robinson, Mitchell Franklin
Cognitive change occurs as a person ages and may result in decreased cognitive functioning in older adults (60 years and older). Simultaneous dual-task (SDT) interventions—activities that require the person to engage physically and cognitively at the same time—are effective in improving cognition in this group. This scoping review analysed published implementation-relevant details about effective SDT interventions, to assist the translation of the available evidence into various practice needs and contexts. A total of 23 databases were searched for relevant studies published between 2009 and 2020 inclusively. Randomised controlled trials (RCTs) that revealed statistically significant improvement in one or more aspects of cognitive function were appraised for methodological quality, using the Joanna Briggs Institute RCT checklist. The 14 RCTs scoring over 50% on the checklist were further analysed. Implementation-relevant data—for example, intervention nature, session length and frequency, equipment and space requirements, target group, and outcomes—were extracted, collated, and synthesised. The effective SDT interventions varied considerably in their nature and outcomes, meaning that suitable SDT interventions exist for a range of contexts. However, the resources required to implement some of the interventions either were not reported and/or may be prohibitive in some real-world practice contexts. Whilst “challenge” and “group interaction” were common features of effective SDT interventions, most studies failed to report on key implementation details required to facilitate translation into practice. It also remains unclear for how long the cognitive benefits are sustained following an effective SDT intervention. In future, more consistent publication of information about how to implement effective SDT interventions, for whom these interventions are engaging/enjoyable, and why would help to translate the available research into improved cognitive outcomes for older adults.
认知变化随着年龄的增长而发生,可能导致老年人(60岁及以上)的认知功能下降。同时双任务(SDT)干预——需要一个人同时进行身体和认知活动的活动——在改善这一群体的认知方面是有效的。这项范围界定审查分析了已公布的关于有效SDT干预措施的实施相关细节,以帮助将现有证据转化为各种实践需求和背景。共检索了23个数据库,包括2009年至2020年期间发表的相关研究。使用乔安娜·布里格斯研究所随机对照试验检查表,对显示认知功能一个或多个方面有统计学显著改善的随机对照试验(RCT)的方法质量进行评估。对检查表中得分超过50%的14项随机对照试验进行了进一步分析。提取、整理和综合了与实施相关的数据,例如干预性质、会话长度和频率、设备和空间要求、目标群体和结果。有效的SDT干预措施在性质和结果上有很大差异,这意味着存在适用于各种情况的适当SDT干预。然而,实施一些干预措施所需的资源要么没有报告,要么在一些现实世界的实践环境中可能令人望而却步。虽然“挑战”和“群体互动”是有效SDT干预措施的共同特征,但大多数研究都没有报告促进转化为实践所需的关键实施细节。目前还不清楚在有效的SDT干预后,认知益处能持续多久。未来,更一致地发布关于如何实施有效的SDT干预措施的信息,这些干预措施对谁有吸引力/令人愉快,以及为什么有助于将现有研究转化为改善老年人的认知结果。
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引用次数: 0
Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis 老年血液透析患者肌肉减少症与胰岛素样生长因子-1、肌肉生长抑制素和胰岛素抵抗的关系
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2022-03-23 DOI: 10.1155/2022/1327332
Novira Widajanti, S. Soelistijo, U. Hadi, M. Thaha, Aditiawardana, Widodo, H. Firdausi, Y. Nurina, MiraDelima Asikin, Hersih Srinowati, N. Syakdiyah
Sarcopenia is common in hemodialysis patients, especially in the elderly patients undergoing hemodialysis. Various factors may contribute to the occurrence of sarcopenia, such as anabolic and catabolic imbalance. This study aims to investigate the correlation of insulin-like growth factor-1 (IGF-1) levels as an anabolic factor, myostatin levels, and insulin resistance as catabolic factors with sarcopenia in the pathogenesis of sarcopenia in elderly patients undergoing hemodialysis. A total of 40 subjects aged 60 years or more who undergoing hemodialysis in Dr. Soetomo Hospital Surabaya were included in this cross-sectional study. Sarcopenia was diagnosed according to Asian Working Group Sarcopenia 2019 criteria. IGF-1, myostatin, and insulin resistance levels were measured once before hemodialysis. Subjects with sarcopenia diagnosis were 33 (82.5%), that is, 19 (47.5%) men and 14 (35%) women. There were 28 (70%) of the subjects diagnosed with severe sarcopenia. Furthermore, there were significant differences in the characteristics and geriatric parameters between the sarcopenia and nonsarcopenia groups. There were differences between the two groups in hemoglobin levels, IGF-1 levels, myostatin levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, muscle mass, handgrip strength, body mass index status, mini nutritional assessment status, and physical activity scale for elderly status (all p < 0.05). Correlation analyses showed that IGF-1 levels negatively correlated with sarcopenia status in elderly patients undergoing hemodialysis (p < 0.05). On the contrary, myostatin and HOMA-IR levels were positively correlated with sarcopenia status in elderly patients undergoing hemodialysis (all p < 0.05). Based on this recent study, IGF-1, myostatin, and insulin resistance were significantly correlated with sarcopenia in elderly patients undergoing hemodialysis.
Sarcopenia在血液透析患者中很常见,尤其是在接受血液透析的老年患者中。多种因素可能导致少肌症的发生,如合成代谢和分解代谢失衡。本研究旨在探讨在接受血液透析的老年患者少肌症发病机制中,作为合成代谢因子的胰岛素样生长因子-1(IGF-1)水平、作为分解代谢因子的肌肉生长抑制素水平和胰岛素抵抗与少肌症的相关性。共有40名年龄在60岁或以上、在泗水Soetomo医生医院接受血液透析的受试者被纳入本横断面研究。根据亚洲工作组2019年Sarcopenia标准诊断为Sarcopenia。在血液透析前测量一次IGF-1、肌肉生长抑制素和胰岛素抵抗水平。诊断为少肌症的受试者有33人(82.5%),即19名(47.5%)男性和14名(35%)女性。28名(70%)受试者被诊断为严重少肌症。此外,少肌症和非少肌症组在特征和老年参数方面存在显著差异。两组在血红蛋白水平、IGF-1水平、肌肉生长抑制素水平、稳态模型评估胰岛素抵抗(HOMA-IR)水平、肌肉质量、握力、体重指数状态、迷你营养评估状态和老年人体力活动量表方面存在差异(均p < 相关性分析显示,在接受血液透析的老年患者中,IGF-1水平与少肌症状态呈负相关(p < 相反,在接受血液透析的老年患者中,肌生长抑制素和HOMA-IR水平与少肌症状态呈正相关(均p < 0.05)。根据最近的研究,在接受血液透析的老年患者中,IGF-1、肌肉生长抑制素和胰岛素抵抗与少肌症显著相关。
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引用次数: 9
Investigating Relationships between Balance Confidence and Balance Ability in Older Adults. 老年人平衡信心与平衡能力的关系研究。
IF 4.7 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2021-11-26 eCollection Date: 2021-01-01 DOI: 10.1155/2021/3214366
Lara A Thompson, Mehdi Badache, Joao Augusto Renno Brusamolin, Marzieh Savadkoohi, Jelani Guise, Gabriel Velluto de Paiva, Pius Suh, Pablo Sanchez Guerrero, Devdas Shetty

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

提高老年人的平衡信心对于提高他们的生活质量和减少活动回避是很重要的。在这里,我们调查了平衡信心(感知能力)和平衡表现(能力)是否相互关联,并在平衡训练后得到改善。在不同条件下(如限制视力、修改体感线索和支持基础),平衡自信与平衡表现的关系进行了探讨。我们试图确定在几周的训练后,平衡信心和能力以及它们之间的关系是否会发生变化。27名健康的参与者接受了数周的站立和步行训练。此外,7名失衡导致跌倒风险较高的参与者(中风幸存者)也接受了培训。在训练前和训练后,分别通过平衡误差评分系统(BESS)和特定活动平衡置信度(ABC)量表评估平衡能力和信心。两组均表现出平衡能力的改善(即训练后BESS错误显著减少)。健康组的平衡信心显著高于卒中组;然而,ABC结果表明,训练后的平衡信心并没有显著增加。探讨平衡能力与平衡置信度之间的关系。令人鼓舞的是,健康参与者在BESS误差和ABC之间表现出负相关(即,平衡信心的增强(ABC量表结果的增加)与平衡能力的改善(BESS误差的减少)相关)。对于卒中参与者,尽管平衡能力有所改善,但我们的结果显示,该组的平衡信心(即BESS误差和ABC之间没有相关性)与平衡信心无关。
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引用次数: 2
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Journal of Aging Research
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