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A continuity care program in chronic, complex and frail patients: the PRO-CCF study protocol 慢性、复杂和体弱患者的持续护理计划:PRO-CCF 研究方案
IF 0.4 Q4 Medicine Pub Date : 2024-02-01 DOI: 10.36150/2499-6564-n689
S. Damanti, Giuseppe A Ramirez, E. Bozzolo, Carla Desa Pedroso, Gaia Deonette, Gianmaria Brambilla, Barbara Rizzi, Giada Lonati, M. Tresoldi
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引用次数: 0
Exploring age-related changes in acoustic voice analysis parameters: insights from a study on older people 探索声学语音分析参数与年龄有关的变化:老年人研究的启示
IF 0.4 Q4 Medicine Pub Date : 2024-02-01 DOI: 10.36150/2499-6564-n612
Giada Cavallaro, M. Fiorella, Francesco Barbara, N. Quaranta, Vincenzo Di Nicola
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引用次数: 0
Self-reported and performance-based disability measures have a different impact on the degree of social integration among older Americans 自我报告和基于表现的残疾衡量对美国老年人的社会融合程度有不同的影响
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.36150/2499-6564-n288
Rie Suzuki, Michael J. McCarthy
Objectives. To examine the differences of self-reported versus performance- based disability on social integration among older adults, as well as the direct and potential moderating role of the physical and social environment on these relationships. Methods. Using data from the 2015 National Health and Aging Trends Study (n = 2,700), two indicators of disability (self-reported, performance- based), chronic health conditions, and home environment were examined as predictors of social integration using multinomial logistic regression. Results. Compared to older adults with self-reported disabilities, older adults with performance-based disabilities were less likely to be nonintegrated. The presence of chronic conditions moderated these associations. Home environment had a direct effect on social integration, although it did not account for disability-related differences in outcomes. Discussion. Careful selection of disability measures and the inclusion of physical and social environmental factors is important when investigating determinants of social integration among older adults.
目标。研究老年人自我报告残疾与表现残疾在社会融合方面的差异,以及物理环境和社会环境对这些关系的直接和潜在调节作用。方法。使用2015年国家健康和老龄化趋势研究(n = 2,700)的数据,使用多项逻辑回归检验了残疾(自我报告,基于绩效),慢性健康状况和家庭环境这两个指标作为社会融合的预测因子。结果。与自我报告残疾的老年人相比,表现残疾的老年人不太可能融入社会。慢性疾病的存在缓和了这些关联。家庭环境对社会融合有直接影响,尽管它不能解释与残疾有关的结果差异。讨论。在调查老年人社会融合的决定因素时,仔细选择残疾措施并纳入身体和社会环境因素是重要的。
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引用次数: 0
Influence of family and social detachment on city-dwelling elderly demographic’s risk factors for malnutrition in South Korea: Social detachment and elderly’ malnutrition 家庭与社会疏离对韩国城市老年人营养不良危险因素的影响:社会疏离与老年人营养不良
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.36150/2499-6564-n592
Jeoung-Gyu Lee, Woo-Kyung Chung, Ae-Son Om
Objective. This study investigated the influence of social detachment and its associated factors on the prevalence of malnutrition in elderly residents of South Korean cities. Methods. We performed secondary analysis using the results of the 2020 Survey of Living Conditions and Welfare Needs of Older Persons in Korea conducted on the elderly population, aged 65 or older, in 969 survey districts, totalling 10,097 people. Hierarchical linear regression modelling was performed to identify the step-by-step influences on the risk for malnutrition. Results. Based on the baseline survey, two-sevenths of elderly people living alone (ELA), one-fifth living with only their spouse (ELS), and one-fortieth living with children (ELC) were classified as at moderate risk of malnutrition, according to the criteria in the NSI (Nutrition Screening Initiative) Checklist. Physical (ΔR2 = 0.017 of ELA, ΔR2 = 0.026 of ELS, ΔR2 = 0.012 of ELC, p < 0.001) and cognitive impairment (ΔR2 = 0.002 of ELA, ΔR2 = 0.002 of ELS, p < 0.01) appeared to increase the risk for malnutrition in all living arrangements with age. Noticeably, contact with separately living children, as another factor of family social capital, appeared to be associated with a decreased risk for malnutrition in the order of ELA, ELC and ELS, as confirmed in the cross-validated estimates of ΔR2 (ΔR2 = 0.043 of ELA, ΔR2 = 0.01 of ELC, ΔR2 = 0.009 of ELS, p < 0.001). Conjugal relationships appeared to be more important than parent-child relations for nutritional care of the elderly population. Conclusions. The demographic of elderly people living alone was the most vulnerable, as two-fifths of the ELA population is at double or triple the risk of malnutrition than those living with a spouse or with children. In all groups, social detachment, excluding conjugal relationships, was found to be a significant underlying determining factor connected to malnutrition in the elderly groups investigated in this study.
目标。本研究探讨社会疏离及其相关因素对韩国城市老年居民营养不良患病率的影响。方法。我们利用2020年韩国老年人生活条件和福利需求调查的结果进行了二次分析,该调查对969个调查地区的65岁及以上老年人口进行了调查,共有10,097人。采用层次线性回归模型来确定对营养不良风险的逐步影响。结果。根据基线调查,根据NSI(营养筛查倡议)检查表中的标准,七分之二的独居老人(ELA),五分之一的仅与配偶生活(ELS),以及四十分之一的与子女生活(ELC)被归类为中度营养不良风险。物理(ELA = ΔR2 = 0.017, ELS = ΔR2 = 0.026, ELC = ΔR2 = 0.012, p <0.001)和认知障碍(ELA = ΔR2 = 0.002, ELS = ΔR2 = 0.002, p <0.01)似乎增加了营养不良的风险随着年龄的增长。值得注意的是,作为家庭社会资本的另一个因素,与单独生活的儿童接触似乎与ELA、ELC和ELS的营养不良风险降低有关,这一点在交叉验证的估算中得到了证实:ΔR2 (ELA ΔR2 = 0.043, ELC ΔR2 = 0.01, ELS ΔR2 = 0.009, p <0.001)。夫妻关系比亲子关系对老年人的营养护理更为重要。结论。独居老人是最脆弱的,因为五分之二的ELA人口营养不良的风险是与配偶或子女一起生活的人的两倍或三倍。在所有群体中,社会疏离(不包括夫妻关系)被发现是与本研究调查的老年人营养不良相关的重要潜在决定因素。
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引用次数: 0
Relationship between grip strength and minimal clinically important differences in cognitive function in older adults with dementia in a long-term residential facility 长期居住设施中老年痴呆患者握力与认知功能最小临床重要差异的关系
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.36150/2499-6564-n639
Shigeya Tanaka, Tetsuya Yamagami
Objective. Non-pharmacological approaches effectively improve cognitive function in older adults with dementia in institutionalised settings. We aimed to investigate the physical characteristics of older adults with dementia achieving a minimal clinically important difference (MCID) on the Mini-Mental State Examination (MMSE) following interventions for cognitive rehabilitation based on exercise. Methods. This retrospective analysis included 25 participants with dementia residing in a long-term care facility who underwent group exercise in a quasi-randomised controlled study. We calculated the MCID on the MMSE using a distribution-based method. The rounded values of the standard deviation (SD) of the MMSE at baseline of approximately 0.4 and 0.5 were considered an MCID. Based on intervention outcomes, the participants were divided into MCID achievers and non-achievers. We compared changes in physical function based on grip strength, maximum knee extension strength, maximum 10-m gait time, and 5-m wheelchair driving time.Results. MCID achievers had significantly higher grip strength at baseline than non-achievers for both 0.4 × SD and 0.5 × SD. A multiple logistic regression analysis including age, sex, and MMSE at baseline revealed that grip strength was significantly associated with MCID achievement at 0.4 × SD (odds ratio [OR], 1.614; 95% confidence interval [CI], 1.04-2.51) and 0.5 × SD (OR, 1.585; 95% CI, 1.04-2.42). Conclusions. The importance of measuring grip strength was demonstrated by considering the achievement of an MCID for cognitive function. Assessing objective changes using a distribution-based method may help evaluate rehabilitation outcomes. Higher grip strength at baseline was significantly associated with MCID improvement in the MMSE in institutionalised older adults with dementia.
目标。非药物方法有效改善老年痴呆患者在机构设置的认知功能。我们的目的是研究在基于运动的认知康复干预后,在迷你精神状态检查(MMSE)中达到最小临床重要差异(MCID)的老年痴呆患者的身体特征。方法。这项回顾性分析包括25名住在长期护理机构的痴呆症患者,他们在一项准随机对照研究中进行了小组锻炼。我们使用基于分布的方法计算了MMSE上的MCID。基线时MMSE的标准偏差(SD)的四舍五入值约为0.4和0.5被认为是MCID。根据干预结果,参与者被分为MCID完成者和非完成者。我们比较了基于握力、最大膝关节伸展力、最大10米步态时间和5米轮椅驾驶时间的身体功能变化。在0.4 × SD和0.5 × SD时,MCID成果者在基线时的握力显著高于未成果者。包括年龄、性别和基线时MMSE在内的多元logistic回归分析显示,握力与MCID成绩显著相关,比值比为0.4 × SD (OR, 1.614;95%置信区间[CI], 1.04-2.51)和0.5 × SD (OR, 1.585;95% ci, 1.04-2.42)。结论。通过考虑认知功能的MCID实现来证明测量握力的重要性。使用基于分布的方法评估客观变化可能有助于评估康复结果。在住院的老年痴呆患者中,基线时较高的握力与MMSE的MCID改善显著相关。
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引用次数: 0
Laying the Foundation for Developing an Item Bank Measuring Presby-function Based on the International Classification of Functioning, Disability and Health 为建立基于国际功能、残疾和健康分类的先行功能测量题库奠定基础
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.36150/2499-6564-n669
Liang Zhou, Chun Feng, Li-Juan Zhong, Jing Gao, Na Liu, Feng Lin, Zhong-Li Jiang
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引用次数: 0
Evaluation of exercise capacity by means of cardiopulmonary exercise testing (CPET) in older adult cancer patients undergoing antineoplastic treatments 用心肺运动试验(CPET)评价接受抗肿瘤治疗的老年癌症患者的运动能力
Q4 Medicine Pub Date : 2023-09-01 DOI: 10.36150/2499-6564-n638
Antonio Carannante, Umberto Attanasio, Alessandra Cuomo, Paolo Parrella, Giacomo Campi, Martina Iengo, Francesco Fiore, Lidia Cicia, Ester Topa, Remo Poto, Giancarlo Marone, Luigi Formisano, Roberto Bianco, Chiara Carlomagno, Marco Picardi, Carminia Maria Della Corte, Morena Fasano, Erika Martinelli, Stefania Napolitano, Teresa Troiani, Nicola Ferrara, Pasquale Abete, Valentina Mercurio, Carlo Gabriele Tocchetti
Background and aims. Functional capacity measured with cardiopulmonary exercise testing (CPET) is extensively studied in patients with cardiovascular diseases. In the current prospective study, we aim at exploring the role of CPET in oncologic patients and at evaluating exercise capacity and its variation with the administration of oncologic treatments. Material and methods. We analyzed 77 maximal CPETs from older adult cancer patients and assessed exercise capacity. CPETs were performed before starting (t0), during (t1) and at the end of (t2) oncologic treatments. The main outcome was death for all causes. Results. CPETs performed at t0 and t1 showed a reduced percent predicted peak VO2, compared to CPETs performed at t2. In addition, at t2 we observed higher peak achieved workload and longer exercise time compared to t0 and t1. Intriguingly, achieved workload and oxygen uptake at Anaerobic Threshold were lowest in CPETs performed at t1, while Respiratory Exchange Ratio (RER) was higher in t1. Predicted Vo2/HR and oxygen pulse (Vo2/HR), were higher after therapy and lower during oncologic treatments. These abnormalities were even more evident in CPETs of patients who underwent anthracyclines-based treatments, and when comparing patients who then died later during follow-up (G1) vs patients who survived (G2). Conclusions. CPET can be useful to evaluate exercise capacity and muscular metabolic alterations in older adult cancer patients. The effectiveness of this technology in predicting survival or the increased incidence of cardiovascular events in cancer patients is not fully understood; further studies are needed to define the role of CPET in assessing the benefits of aerobic exercise and its potential “therapeutic” prescription in cancer patients.
背景和目的。心肺运动试验(CPET)测量心血管疾病患者的功能能力被广泛研究。在当前的前瞻性研究中,我们旨在探索CPET在肿瘤患者中的作用,并评估运动能力及其随肿瘤治疗的变化。材料和方法。我们分析了来自老年癌症患者的77例最大cpet并评估了运动能力。cpet分别在肿瘤治疗开始前(t0)、治疗期间(t1)和治疗结束时(t2)进行。主要结果是各种原因导致的死亡。结果。与t2进行的cpet相比,在t0和t1进行的cpet显示预测峰值VO2的百分比降低。此外,与t0和t1相比,在t2我们观察到更高的峰值工作量和更长的运动时间。有趣的是,在t1时进行的cpet中,达到的工作量和厌氧阈值的摄氧量最低,而呼吸交换比(RER)在t1时更高。预测Vo2/HR和氧脉冲(Vo2/HR),治疗后较高,肿瘤治疗期间较低。这些异常在接受蒽环类药物治疗的患者的cpet中更为明显,并且当比较随访期间死亡的患者(G1)与存活的患者(G2)时。结论。CPET可用于评估老年癌症患者的运动能力和肌肉代谢改变。这项技术在预测癌症患者生存率或心血管事件发生率增加方面的有效性尚不完全清楚;需要进一步的研究来确定CPET在评估有氧运动的益处及其对癌症患者的潜在“治疗”处方中的作用。
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引用次数: 0
Changes in cholesterol homeostasis associated with aging and with age-related conditions: pathophysiological and clinical implications 与衰老和年龄相关疾病相关的胆固醇稳态变化:病理生理和临床意义
Q4 Medicine Pub Date : 2023-09-01 DOI: 10.36150/2499-6564-n637
Marco Bertolotti, Giulia Lancellotti, Chiara Mussi
The increase in life expectancy is leading to a progressive rise in the percentage of older people in the general population, and consequently in the prevalence of chronic diseases, often leading to disability. Age-related modifications in cholesterol homeostasis, the increase in plasma cholesterol levels due to aging, represents a cardio- and cerebrovascular risk factor in adjunct to age itself. Direct knowledge about the pathophysiological alterations of cholesterol metabolism is limited. Clinical-experimental evidence about cholesterol lowering treatment suggests that the benefits observed in the general population are also observed in older age groups. However, patients enrolled in clinical trials often do not represent real-life clinical scenarios, limiting the generalizability of research findings. Issues of complexity and frailty are mostly inadequately addressed in published studies and guidelines. Further, effects of cholesterol itself and cholesterol lowering on cognitive function are still controversial. This narrative review focuses on current evidence about the pathophysiology and clinical implications of the relationship between cholesterol and aging. Some suggestions will be provided, underlining the need for careful, personalized evaluation of the patient’s functional status, along with clinical competence and geriatric skills.
预期寿命的延长导致老年人在总人口中的比例逐步上升,从而导致慢性病的流行,往往导致残疾。与年龄相关的胆固醇稳态改变,即由于衰老导致的血浆胆固醇水平升高,是伴随年龄本身的心脑血管危险因素。关于胆固醇代谢病理生理改变的直接知识是有限的。有关降胆固醇治疗的临床实验证据表明,在普通人群中观察到的益处在老年群体中也可以观察到。然而,参加临床试验的患者往往不能代表真实的临床情况,限制了研究结果的普遍性。在已发表的研究和指南中,复杂性和脆弱性问题大多没有得到充分解决。此外,胆固醇本身和降低胆固醇对认知功能的影响仍存在争议。本文综述了目前有关胆固醇与衰老之间关系的病理生理学和临床意义的证据。将提供一些建议,强调需要对患者的功能状态进行仔细、个性化的评估,以及临床能力和老年技能。
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引用次数: 0
COVID-19 impacts and interventions for older adults: implications for future disasters COVID-19对老年人的影响和干预措施:对未来灾害的影响
Q4 Medicine Pub Date : 2023-09-01 DOI: 10.36150/2499-6564-n622
Denise M. Mitchell, Andrea J. Henry, Richard D. Ager
The literature suggests that older adults have developed mental health problems and health challenges since the emergence of the COVID-19 pandemic. Pandemic-related isolation, job loss, lack of social support, the inability to access healthcare services, and financial distress increased stress, loneliness, and depression. However, a few studies have contradicted this hypothesis, reporting that older adults experienced fewer depressive symptoms than their younger cohorts during the COVID-19 pandemic. Nevertheless, older adults who experience depressive symptoms are at risk for detrimental physical, emotional, and social outcomes. Currently, limited research has addressed what types of interventions could prevent the occurrence or severity of COVID-associated depressive symptoms in older adults. This qualitative study aims to identify the impacts of pandemic-associated changes on older adults and realistic interventions that healthcare, community, and faith-based organizations could implement to support and reduce the severity of these impacts. Researchers interviewed participants (n = 14) recruited from a senior center in New York. Data were collected and thematically analyzed. Findings suggest opportunities to find connection, tangible assistance, medical resources, compassionate education, and grief support services are interventions that may buffer older adults from pandemic-related distress. Implications for social work practice, advocacy, and further research are discussed.
文献表明,自2019冠状病毒病大流行出现以来,老年人出现了心理健康问题和健康挑战。与大流行相关的隔离、失业、缺乏社会支持、无法获得医疗保健服务以及经济困境加剧了压力、孤独和抑郁。然而,一些研究反驳了这一假设,报告称,在2019冠状病毒病大流行期间,老年人的抑郁症状比年轻人少。然而,经历抑郁症状的老年人面临有害的身体、情感和社会后果的风险。目前,有限的研究已经解决了哪些类型的干预措施可以预防老年人中与covid - 19相关的抑郁症状的发生或严重程度。本定性研究旨在确定与大流行相关的变化对老年人的影响,以及医疗保健、社区和信仰组织可以实施的现实干预措施,以支持和减少这些影响的严重程度。研究人员采访了从纽约一家老年中心招募的参与者(n = 14)。收集数据并进行主题分析。研究结果表明,寻找联系的机会、切实的援助、医疗资源、富有同情心的教育和悲伤支持服务是可以缓解老年人与大流行相关的痛苦的干预措施。对社会工作实践、倡导和进一步研究的影响进行了讨论。
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引用次数: 0
Relationship between oral rehabilitation and nutrients intake in the independent elderly: a systematic review of the literature 独立老年人口腔康复与营养摄入的关系:文献系统综述
IF 0.4 Q4 Medicine Pub Date : 2023-07-01 DOI: 10.36150/2499-6564-n561
Elisabetta Bellia, C. Monagheddu, V. Notaro, P. Ceruti, F. Bassi
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引用次数: 0
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Journal of Gerontology and Geriatrics
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