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Uncontrolled blood pressure among the established hypertensive elderly people in Jashore, Bangladesh: A cross-sectional type of observational study 孟加拉国贾肖尔地区已确诊的高血压老年人中血压失控的情况:一项横断面观察研究。
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-29 DOI: 10.1002/agm2.12348
Goutam Kumar Acherjya, Ali Mohammad, Tarafder Keya, Mohammad Touhidul Islam, Md. Selim Reza, Md. Shakur Ahmed, Huq Md. Zahirul, Biswas Debashis, Shamsuzzaman Sheikh, Alam Nur
<div> <section> <h3> Objectives</h3> <p>Hypertension is one of the major modifiable risk factors for cardiovascular mortality and morbidity throughout the world. Increased life expectancy leads to increase prevalence of non-communicable diseases among the elderly people including Bangladesh. However, different studies reported high prevalence of uncontrolled hypertension ranging from 52.6% to 67.9% among the elderly people in different countries. With this view, we aimed to assess the frequency of uncontrolled blood pressure (BP) among the elderly hypertensive people and its associated risk factors and treatment pattern in Bangladesh.</p> </section> <section> <h3> Methodology</h3> <p>This cross-sectional type of observational study recruited 246 eligible hypertensive elderly patients attending in 250 Bedded General Hospital, Jashore, Bangladesh dated from 1st July to 31st December 2022. A structured questionnaire was developed and data on associated risk factors, treatment pattern and current blood pressure (BP) measurement were collected by face-to-face interview for the purposive sampling technique.</p> </section> <section> <h3> Results</h3> <p>The mean age of our study patients was 72 ± 7 years with a male and female ratio nearly 1:1. Of the total hypertensive patients aged over 65 years or more, 56.5% remained with uncontrolled hypertension even on their prescribed antihypertensive medications. The mean systolic (SBP) and diastolic (DBP) blood pressure were significantly high (<i>P</i> < 0.001) as 167 ± 22 mm Hg and 95 ± 11 mm Hg, respectively, among the uncontrolled hypertensive patients. However, we noticed the mean SBP and DBP among the total hypertensive patients were also significantly high (<i>P</i> < 0.001) as 148 ± 27 mm Hg and 87 ± 13 mm Hg, respectively. In this study, we reported that the mean number of last prescribed antihypertensive medications used by the total patients was 2 ± 1 (<i>P</i> =0.224) which was similar among the controlled and uncontrolled hypertensive patient groups. Among the elderly hypertensive patients, the most commonly prescribed antihypertensive medications were Amlodipine 39.8% (<i>P</i> =0.006), Olmesartan 29.3% (<i>P</i> = 0.186), Losartan 24.4% (<i>P</i> = 0.127), Bisoprolol 15.0% (<i>P</i> = 0.266) and Atenolol 14.6% (<i>P</i> = 0.224).</p> </section> <section> <h3> Conclusion</h3> <p>We noticed high frequency of uncontrolled blood pressure among the elderly hypertensive patients, despite of using multiple antihypertensive medications in Jashore, Bangladesh.</p> </section>
目的:高血压是全世界心血管死亡和发病的主要可改变风险因素之一。预期寿命的延长导致包括孟加拉国在内的老年人非传染性疾病的发病率增加。然而,不同的研究报告显示,在不同国家的老年人中,未得到控制的高血压发病率很高,从 52.6% 到 67.9% 不等。有鉴于此,我们旨在评估孟加拉国老年高血压患者血压失控的频率及其相关风险因素和治疗模式:这项横断面观察研究招募了 246 名符合条件的老年高血压患者,他们于 2022 年 7 月 1 日至 12 月 31 日在孟加拉国贾肖尔拥有 250 张病床的综合医院就诊。研究人员编制了一份结构化问卷,并通过有目的的抽样技术进行面对面访谈,收集了相关风险因素、治疗模式和当前血压测量的数据:研究对象的平均年龄为 72 ± 7 岁,男女比例接近 1:1。在 65 岁以上的高血压患者中,56.5% 的患者即使服用处方降压药,高血压仍未得到控制。平均收缩压(SBP)和舒张压(DBP)明显偏高(P P P =0.224),在已控制和未控制的高血压患者组中情况相似。在老年高血压患者中,最常处方的降压药是氨氯地平 39.8% (P =0.006)、奥美沙坦 29.3% (P =0.186)、洛沙坦 24.4% (P =0.127)、比索洛尔 15.0% (P =0.266)和阿替洛尔 14.6% (P=0.224):我们注意到,在孟加拉国贾肖尔,尽管老年高血压患者使用多种降压药物,但血压失控的频率很高。
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引用次数: 0
Renal perfusion examination with contrast-enhanced ultrasound in vascular surgery 血管手术中的对比增强超声肾灌注检查。
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-19 DOI: 10.1002/agm2.12352
Zhiyuan Wu, Ning Zhao, Yongjun Li
<p>A recent consensus on the standardized evaluation of renal cortical perfusion with contrast-enhanced ultrasound in elderly patients in China was published. This paper mainly aimed to briefly introduce renal perfusion examination with CEUS in vascular surgery.</p><p>The kidneys, being the most vascularized organ in the human body, are highly susceptible to inadequate blood perfusion. In a resting state, the blood flow through both kidneys in healthy adults is approximately 1200 mL/min, equivalent to 25% of cardiac output.<span><sup>1</sup></span> Approximately 94% of this renal blood flow is directed to the renal cortex.<span><sup>2</sup></span> The kidneys maintain the ability to autonomously regulate blood flow within an arterial blood pressure range of 80–180 mmHg. Renal perfusion pressure typically refers to the difference between renal artery pressure and renal vein pressure. In 1991, Gosling et al.<span><sup>3</sup></span> introduced the concept of the critical closing pressure to reflect the actual renal perfusion.</p><p>Renal perfusion can be influenced by various factors including physiological, pathological, pharmacological, traumatic, and surgical factors. Physiological factors primarily involve hemodynamic parameters (blood pressure, blood volume, cardiac output, blood viscosity, etc.) and the sympathetic-parasympathetic nervous system. Specifically, renal diseases or renal vascular-related disorders constitute the primary pathological factors affecting renal perfusion. These renal vascular-related disorders can be categorized into primary and secondary renal vascular lesions. The former encompasses renal artery atherosclerotic stenosis, renal artery dysplasia, Takayasu arteritis, renal artery aneurysm, renal artery thrombosis or embolism, renal artery dissection, renal vein thrombosis, etc. Secondary renal artery lesions may include aortic dissection, para-renal or supra-renal abdominal aortic aneurysm,<span><sup>4</sup></span> renal artery metastatic cancer,<span><sup>5</sup></span> etc. Other rare renal vascular diseases such as renal arteriovenous fistula, congenital renal artery anomalies, nutcracker syndrome, can also impact renal perfusion. Among these, renal artery atherosclerosis, renal artery fibromuscular dysplasia, and Takayasu arteritis are currently the three most common causes of renal artery stenosis (RAS). Unlike Western populations, in the Chinese population, Takayasu arteritis is more commonly observed than renal artery fibromuscular dysplasia.</p><p>RAS can lead to renal dysfunction and renovascular hypertension. The reduction in renal blood flow caused by RAS results in decreased renal perfusion, triggering a series of pathological changes, including renal ischemia, glomerular atrophy and sclerosis, interstitial fibrosis, and tubular injury, ultimately leading to impaired renal function. RAS induces glomerular atrophy and sclerosis, leading to a decrease in glomerular filtration rate and affecting renal filtrati
总之,肾脏灌注评估,尤其是通过 CEUS 进行的评估,在血管外科手术中发挥着举足轻重的作用,它有助于评估肾脏供血、指导手术决策、预测术后并发症和评估手术效果。这些进步有助于提高手术干预的成功率,改善患者预后。ZW和NZ撰写了手稿。ZW修改了手稿。所有作者均审阅并批准了本稿件。李永军,与一个或多个组织没有经济利益/安排或附属关系,在本稿件的主题背景下可能被视为实际或明显的利益冲突。本工作得到了CAMS医学科学创新基金(CIFMS-2021-I2M-1-050)和PUMC学科建设项目(编号:201920102101)的支持。
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引用次数: 0
Analysis of mortality in Parkinson disease in China: Exploration of recent and future trends 中国帕金森病死亡率分析:近期和未来趋势探讨
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-19 DOI: 10.1002/agm2.12354
Jinxin Lan, Yifan Ren, Ge Song, Lu Liu, Mingyu Li, Renmu Zhang, Chunyu Yin, Hua Zhou, Xiangyuan Zhang, Bin Lv, Yaqi Ma

Objectives

Parkinson disease (PD) is the third leading cause of mortality among middle-aged and older individuals in China. This study aimed to explore the trends and distribution features of PD mortality in China from 2013 to 2021 and make predictions for the next few decades.

Methods

Relevant data were obtained from the Chinese Center for Disease Control and Prevention Disease Surveillance Point system. The joinpoint regression model was used to evaluate trends. The R software was used to predict future trends.

Results

Age-standardized mortality rate (ASMR) of PD increased from 0.59 per 100,000 individuals to 1.22 per 100,000 individuals from 2013 to 2021, with an average annual percent change (AAPC) of 9.50 (95% CI: 8.24–10.78). The all-age ASMR of PD were higher in male individuals than in female individuals, and ASMR increased with age. The number of deaths and ASMR increased gradually from west to east and from rural to urban areas. Furthermore, ASMR is expected to increase to 2.66 per 100,000 individuals by 2040.

Conclusions

The heightened focus on the ASMR of PD among male individuals, urban areas, eastern China, and individuals aged ≥85 years has become a key determinant in further decreasing mortality, thereby exhibiting novel challenges to effective strategies for disease prevention and control.

目的 帕金森病(PD)是导致中国中老年人死亡的第三大原因。本研究旨在探讨2013-2021年中国帕金森病死亡率的变化趋势和分布特征,并对未来几十年的帕金森病死亡率进行预测。 方法 相关数据来自中国疾病预防控制中心疾病监测点系统。采用连接点回归模型评估趋势。使用 R 软件预测未来趋势。 结果 从2013年到2021年,PD的年龄标准化死亡率(ASMR)从每10万人中0.59例增加到每10万人中1.22例,平均年变化率(AAPC)为9.50(95% CI:8.24-10.78)。男性发病率高于女性,随着年龄的增长,发病率也在增加。死亡人数和ASMR由西向东、由农村向城市地区逐渐增加。此外,到 2040 年,ASMR 预计将增至每 10 万人 2.66 例。 结论 对男性、城市地区、中国东部地区和年龄≥85 岁的人群中脊髓灰质炎的 ASMR 的高度关注已成为进一步降低死亡率的关键决定因素,从而对疾病预防和控制的有效策略提出了新的挑战。
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引用次数: 0
The efficacy of neoadjuvant immunotherapy combined with chemotherapy in elderly patients with gastric cancer: A subgroup analysis of the NEOSUMMIT-01 study 新辅助免疫疗法联合化疗对老年胃癌患者的疗效:NEOSUMMIT-01研究的分组分析
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-18 DOI: 10.1002/agm2.12356
Nan An, Run-cong Nie, Feng Wang, Shu-qiang Yuan

Based on a subanalysis of the NEOSUMMIT-01 study, it was revealed that perioperative immune checkpoint blockade (ICB) combined with chemotherapy has therapeutic effects in elderly patients with locally advanced gastric cancer, providing a new strategy for the treatment of elderly gastric cancer patients.

基于NEOSUMMIT-01研究的一项子分析显示,围手术期免疫检查点阻断(ICB)联合化疗对老年局部晚期胃癌患者具有治疗效果,为老年胃癌患者的治疗提供了一种新策略。
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引用次数: 0
The increasing prevalence of cancer in the elderly: An investigation of epidemiological trends 老年人癌症发病率不断上升:流行病学趋势调查。
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-18 DOI: 10.1002/agm2.12347
Ramya Prathap, Sherlin Kirubha, Aravindhan Thiyaga Rajan, Santhosh Manoharan, Karthikeyan Elumalai

Cancer poses a significant health threat to the elderly, accounting for a substantial proportion of cancer patients aged 65 and above. As life expectancy continues to rise and the population ages, the incidence of cancer in the elderly is expected to increase further. Age is a major risk factor for the majority of common cancers, with the incidence and prevalence rising as individuals grow older. Factors such as chemoprevention and environmental carcinogen elimination may influence the process of carcinogenesis. Studies reveal that the incidence and mortality rates of various cancers in the elderly and extremely old individuals are on the rise worldwide, with most types peaking around the age of 75 to 90, followed by a sharp decline. Birth cohort and period effects also play a complex role in the connection between aging and cancer risk. Clinical trials often exclude older individuals, limiting our understanding of cancer treatments' effects on this particular age group. More research is needed to focus on the unique requirements of older adults with cancer.

癌症对老年人的健康构成重大威胁,在 65 岁及以上的癌症患者中占很大比例。随着预期寿命的不断延长和人口的老龄化,预计老年人的癌症发病率将进一步上升。年龄是大多数常见癌症的主要风险因素,随着年龄的增长,癌症的发病率和流行率也在上升。化学预防和消除环境致癌物等因素可能会影响致癌过程。研究显示,全球老年人和高龄老人的各种癌症发病率和死亡率呈上升趋势,大多数类型的癌症在 75 至 90 岁左右达到峰值,随后急剧下降。出生组群和时期效应在老龄化与癌症风险之间也起着复杂的作用。临床试验通常将老年人排除在外,这限制了我们对癌症治疗对这一特殊年龄组的影响的了解。我们需要开展更多的研究来关注老年癌症患者的独特需求。
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引用次数: 0
Vitamin B12 status and skeletal muscle function among elderly: A literature review and pilot study on the effect of oral vitamin B12 supplementation in improving muscle function 老年人的维生素 B12 状态与骨骼肌功能:关于口服维生素 B12 补充剂改善肌肉功能效果的文献综述和试点研究。
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-17 DOI: 10.1002/agm2.12346
Sowmya Sharma, Rohini Bhadra, Sumithra Selvam, Sucharita Sambashivaiah

Objectives

The objective of this study is to understand the role of vitamin B12 supplementation in improving skeletal muscle function among the elderly.

Methods

A literature review in the Medline database was conducted to understand the association between vitamin B12 and muscle function in Section A. In Section B, 28 healthy elderly participants aged ≥60 years were recruited in a cross-sectional design for estimation of plasma vitamin B12 status and assessment of upper limb muscle strength Maximal voluntary contraction (MVC) and muscle quality (expressed as MVC/total muscle mass). Participants were grouped based on vitamin B12 status into vitamin B12-depleted (<148 pmol/L) and replete (≥148 pmol/L) groups. In a quasi-experimental study design, the vitamin B12-depleted group (n = 14) received daily oral vitamin B12 supplementation of 100 μg for 3 months. All the study measures were repeated post-supplementation.

Results

Vitamin B12 deficiency was identified to contribute adversely to muscle strength, quality, and physical performance among older people in the extensive literature review. The pilot intervention study showed significant improvement in MVC and muscle quality (p < 0.050) post-vitamin B12 supplementation, comparable to the vitamin B12-replete group.

Conclusions

Vitamin B12 may have a crucial role in the maintenance of muscle function. 3-month oral vitamin B12 supplementation among subclinical vitamin B12 deficient elderly improved muscle strength and quality and reached levels similar to the vitamin B12 replete group.

研究目的本研究旨在了解补充维生素 B12 在改善老年人骨骼肌功能方面的作用:A部分通过Medline数据库进行文献综述,以了解维生素B12与肌肉功能之间的关系;B部分采用横断面设计,招募了28名年龄≥60岁的健康老年参与者,以估算血浆维生素B12状态,并评估上肢肌肉力量最大自主收缩(MVC)和肌肉质量(以MVC/肌肉总质量表示)。根据维生素 B12 状态将参与者分为维生素 B12 贫乏组(n = 14),每天口服 100 μg 维生素 B12 补充剂,为期 3 个月。补充维生素 B12 后,重复所有研究措施:在大量文献综述中发现,维生素 B12 缺乏会对老年人的肌肉力量、质量和体能表现产生不利影响。试点干预研究显示,老年人的肌肉力量和肌肉质量有明显改善(P维生素 B12 在维持肌肉功能方面可能起着至关重要的作用。亚临床维生素 B12 缺乏症老年人口服维生素 B12 补充剂 3 个月后,肌肉力量和质量得到改善,达到了与维生素 B12 补充组相似的水平。
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引用次数: 0
The effectiveness of group music reminiscence therapy for people thriving with dementia: A systematic review of randomized controlled trials 集体音乐回忆疗法对痴呆症患者的疗效:随机对照试验的系统回顾
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-17 DOI: 10.1002/agm2.12344
Alwin Ru Kiet Wong, Li Ting Eileen Ng, Ming Hao Lee, James Lai Hock Yeow, Yong Jia Lim, Kah Hui Yap

Dementia is characterized by a progressive decline in cognition, behavioral and psychological symptoms (BPSD), and quality of life (QoL). The lack of curative therapies has led to a psychosocial discourse prioritizing QoL of people thriving with dementia (PTD). Group reminiscence therapy (RT) is a relatively inexpensive intervention, with music prompts being a preferred choice, owing to robust musical memory in the early disease stage. However, a synthesis of current evidence is needed to inform research and clinical use of group music RT in dementia care. Therefore, we conducted a systematic review on PubMed, Scopus, CINAHL, APA PsycInfo, and APA PsycArticles to critically appraise published randomized controlled trials examining group music RT to improve cognition, BPSD, and QoL in PTD. Of 14,725 articles, two RCTs involving 102 PTD were included. All studies used prerecorded music for group music RT. All studies were deemed of good quality, adhering to intention-to-treat analysis and assessor blinding. Based on the American Academy of Neurology guidelines, we assigned a Level C recommendation for group music RT for cognition and Level B recommendations for BPSD and QoL (ineffective). In conclusion, group music RT may be useful for symptomatic management in PTD. However, heterogeneous study designs, disease severity, dementia subtype, and outcome measures are likely barriers to meaningful clinical translation. Therefore, the rating of recommendations only serves as a point of reference. Future avenues include live performances as prompts for group music RT.

痴呆症的特点是认知能力、行为和心理症状(BPSD)以及生活质量(QoL)逐渐下降。由于缺乏治疗方法,社会心理方面的讨论将痴呆症患者的生活质量放在首位。集体回忆疗法(RT)是一种成本相对较低的干预措施,由于在疾病早期阶段音乐记忆力较强,因此音乐提示是首选。然而,我们需要对目前的证据进行综合分析,以便为痴呆症护理中小组音乐回忆疗法的研究和临床应用提供参考。因此,我们在 PubMed、Scopus、CINAHL、APA PsycInfo 和 APA PsycArticles 上进行了系统性综述,对已发表的随机对照试验进行了批判性评估,这些试验研究了集体音乐 RT 如何改善 PTD 患者的认知、BPSD 和 QoL。在 14725 篇文章中,纳入了两项涉及 102 例 PTD 的 RCT。所有研究均使用预先录制的音乐进行集体音乐 RT。所有研究均被认为质量良好,坚持进行意向治疗分析和评估者盲法。根据美国神经病学学会的指南,我们将集体音乐 RT 在认知方面的建议定为 C 级,在 BPSD 和 QoL 方面的建议定为 B 级(无效)。总之,集体音乐 RT 可用于 PTD 的症状管理。然而,不同的研究设计、疾病严重程度、痴呆亚型和结果测量可能会阻碍有意义的临床转化。因此,建议的评级只能作为一个参考点。未来的途径包括将现场表演作为集体音乐 RT 的提示。
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引用次数: 0
Standardized evaluation methodology for renal cortical blood perfusion in elderly patients using contrast-enhanced ultrasound: A Chinese expert consensus (2024 edition) 使用对比增强超声对老年患者肾皮质血流灌注进行标准化评估的方法:中国专家共识(2024 年版)》。
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-17 DOI: 10.1002/agm2.12345
Ren Junhong, He Wen

As a sensitive and non-invasive method for assessing changes in renal cortical blood perfusion in the elderly, contrast-enhanced ultrasound (CEUS) can indirectly reflect changes in kidney filtration and reabsorption function, thus providing feasibility for early evaluation of renal function changes. However, significant differences exist among researchers in terms of operational methods, contrast agent selection, post-data analysis, and many other aspects, leading to substantial heterogeneity in results. This hinders horizontal comparisons and greatly limits the clinical application of contrast-enhanced ultrasound for evaluating renal cortical blood flow perfusion. Based on the latest domestic and overseas literature and discussions with clinical experts, this consensus provides recommended guidelines for the evaluation of renal cortical blood flow perfusion using contrast-enhanced ultrasound. It is hoped that this consensus will promote a better understanding of CEUS among medical practitioners at all levels and standardize the examination of renal cortical blood flow perfusion with CEUS.

造影剂增强超声(CEUS)是评估老年人肾皮质血流灌注变化的一种敏感而无创的方法,可间接反映肾脏滤过和重吸收功能的变化,从而为早期评估肾功能变化提供可行性。然而,研究人员在操作方法、造影剂选择、后期数据分析等诸多方面存在明显差异,导致研究结果存在很大的异质性。这阻碍了横向比较,极大地限制了对比增强超声评估肾皮质血流灌注的临床应用。本共识基于国内外最新文献及与临床专家的讨论,为使用对比增强超声评估肾皮质血流灌注提供了推荐指南。希望本共识能促进各级医务人员对 CEUS 的进一步了解,并规范 CEUS 对肾皮质血流灌注的检查。
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引用次数: 0
Renal cortex blood perfusion contrast-enhanced ultrasound: Assisting diagnosis and treatment of renal artery disease 肾皮质血液灌注对比增强超声:协助诊断和治疗肾动脉疾病
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-14 DOI: 10.1002/agm2.12355
Guo Yaming, Chen Zuoguan, Li Yongjun, Zhang Wayne W

Renal cortical blood perfusion CEUS can evaluate the structure and microcirculation of renal cortex, which is expected to provide a safer and more convenient evaluation system for clinicians in the diagnosis and treatment of early renal artery disease.

肾皮质血流灌注CEUS可评估肾皮质的结构和微循环,有望为临床医生诊断和治疗早期肾动脉疾病提供更安全、更便捷的评估系统。
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引用次数: 0
Promote the integrated care in China 在中国推广综合护理
IF 2.2 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-12 DOI: 10.1002/agm2.12351
Minglei Zhu, Lin Kang, Xiaohong Liu

This article presents a brief overview of the researches on ICOPE in China, the barriers influencing the implementation of ICOPE are identified, and the recommendations are proposed to advance the ICOPE practice in China.

本文概述了中国的 ICOPE 研究,指出了影响 ICOPE 实施的障碍,并提出了推进中国 ICOPE 实践的建议。
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引用次数: 0
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Aging Medicine
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