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Examining the Area Agencies on Aging nutrition program in response to the COVID-19 审查应对COVID-19的地区老龄机构营养计划
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-10-01 DOI: 10.36150/2499-6564-n383
Fang Fang
Background & aims. During the COVID-19 pandemic in the U.S., Area Agencies on Aging (AAA) became an essential source for older adults to maintain a healthy life after social isolation. It has developed different programs in response to the COVID-19 outbreak, such as home delivered meals to support older adults’ nutrition supply. The purpose of this study was to examine how well AAA has managed such important nutrition plans facing the COVID-19 changes. Methods. We integrated three databases, including 49 weeks (6 April 2020-14 March 2021) 33 Planning and Service Area (PSA) meal data, PSAs’ key characteristics from the California Department of Aging, and the COVID-19 cases from the California Department of Public Health. We examined the association between the number of meals and people served and the COVID-19 cases and PSA features, using the univariate analysis and the random effect model. Results. We observed a positive relationship between the number of meals served and the number of the COVID-19 cases, however, not the number of people served. We found a negative relationship between the number of rural older adults with both the number of meals served and people served. Additionally, non-English-speaking and minority played a positive and negative role respectively as to the number of meals served. Conclusions. These results indicated that the AAA should cover a wider population, especially in rural areas experiencing a shortage of volunteers in the pandemic, urging the collaboration with high-tech and third-party companies to improve delivery efficiency. © 2022, Pacini Editore S.p.A./AU-CNS. All rights reserved.
背景与目的。在美国新冠肺炎大流行期间,地区老龄机构(AAA)成为老年人在社会隔离后维持健康生活的重要来源。为应对COVID-19疫情,它制定了不同的方案,例如为老年人提供送餐服务,以支持老年人的营养供应。本研究的目的是研究AAA在面对COVID-19变化时如何管理这些重要的营养计划。方法。我们整合了三个数据库,包括49周(2020年4月6日- 2021年3月14日)33个规划和服务区(PSA)膳食数据、来自加州老龄化部门的PSA关键特征以及来自加州公共卫生部的COVID-19病例。我们使用单变量分析和随机效应模型检验了用餐次数和服务人数与COVID-19病例和PSA特征之间的关系。结果。然而,我们观察到餐食数量与COVID-19病例数量之间存在正相关关系,而不是服务人数。我们发现农村老年人的数量与提供的餐食数量和提供的人数之间呈负相关。此外,非英语国家和少数民族在用餐数量上分别起到了积极和消极的作用。结论。这些结果表明,AAA应覆盖更广泛的人口,特别是在大流行期间志愿者短缺的农村地区,并敦促与高科技和第三方公司合作,以提高服务效率。©Pacini Editore S.p.A./AU-CNS。版权所有。
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引用次数: 1
Functional mobility in older women with and without motoric cognitive risk syndrome: a quantitative assessment using wearable inertial sensors 患有和不患有运动认知风险综合征的老年女性的功能性移动性:使用可穿戴惯性传感器的定量评估
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-09-01 DOI: 10.36150/2499-6564-n259
M. Pau, I. Mulas, V. Putzu, Gesuina Asoni, D. Viale, Irene Mameli, G. Allali
Background. The Motoric Cognitive Risk (MCR) syndrome is defined in non-demented older adults by cognitive complaints and slow gait. Individuals with MCR are at higher risk of dementia and other poor clinical outcomes, such as falls. However, no data are available as regards functional mobility alterations associated with MCR. The main purpose of the present study is to quantitatively investigate such an aspect using the instrumented Timed-Up-and-Go (iTUG) test carried out using a wearable inertial measurement unit (IMU). Methods. Fifty-one women aged over 65 years underwent a geriatric and neuropsychologic assessment (which included the Mini Mental State Examination, MMSE and Addenbrooke’s Cognitive Examination Revised, ACE-R), instrumented gait analysis and iTUG performed using an IMU located on the lower back. Based on subjective cognitive complaints and slow gait, they were assigned either to the MCR (n = 24) or non-MCR (n = 27) group. IMU data allowed calculation of overall and sub-phases iTUG times.Results. Women with MCR were characterized by a significantly higher body mass and body mass index, lower normalized handgrip strength, and similar values of MMSE compared to non-MCRs. A trend was observed in terms of lower overall and sub-domain ACE-R score. They also performed iTUG at a significantly slower speed (22.4 s vs 14.1 of the non-MCR group, p < 0.001) and exhibited increased sub-phase times (29 to 31% higher with respect to non-MCRs).Conclusions. The findings of the present study suggest that the MCR syndrome impairs functional mobility, probably due reduced muscular strength and coordination, fear of falling and increased instability. The instrumental evaluation of functional mobility appears useful in the management of women with MCR, particularly in monitoring the progression of the motor impairments, verifying the effectiveness of interventions targeted in alleviating the impact on daily life of mobility limitations associated with MCR and in defining tailored rehabilitation programs.
背景驾驶认知风险(MCR)综合征是由认知障碍和步态迟缓在非痴呆老年人中定义的。MCR患者患痴呆症和其他不良临床结果(如跌倒)的风险更高。然而,没有与MCR相关的功能移动性改变的可用数据。本研究的主要目的是使用可穿戴惯性测量单元(IMU)进行的仪器化Timed Up and Go(iTUG)测试来定量研究这一方面。方法。51名65岁以上的女性接受了老年和神经心理评估(包括迷你精神状态检查、MMSE和Addenbrooke认知检查修订版(ACE-R))、仪器步态分析和使用位于下背部的IMU进行的iTUG。根据主观认知主诉和步态迟缓,他们被分为MCR(n=24)组或非MCR(n=27)组。IMU数据允许计算整个和子阶段iTUG时间。后果与非MCRs相比,患有MCR的女性的特征是体重和体重指数显著较高,标准化握力较低,MMSE值相似。观察到总体和亚结构域ACE-R评分降低的趋势。他们还以明显较慢的速度进行iTUG(非MCR组为22.4s,非MCR组14.1 s,p<0.001),并表现出亚相时间增加(非MCR高出29%至31%)。结论。本研究的结果表明,MCR综合征损害了功能活动能力,可能是由于肌肉力量和协调能力下降、害怕跌倒和不稳定性增加。功能性行动能力的工具性评估似乎有助于管理患有MCR的女性,特别是在监测运动障碍的进展、验证旨在缓解与MCR相关的行动能力限制对日常生活的影响的干预措施的有效性以及制定量身定制的康复计划方面。
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引用次数: 1
Determinants of physical function in community dwelling old people 社区居住老年人身体功能的决定因素
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-09-01 DOI: 10.36150/2499-6564-n261
O. Geirsdottir, M. Chang, K. Briem, P. Jónsson, I. Thorsdottir, A. Ramel
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引用次数: 0
Radiographic pulmonary description of bilateral multifocal patchy with ground-glass opacifications needs careful evaluation in the Era of SARS-CoV-2 严重急性呼吸系统综合征冠状病毒2型时代需要仔细评估双侧多灶斑片状磨玻璃样混浊的肺部影像学描述
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-09-01 DOI: 10.36150/2499-6564-n324
S. Gabriele, S. Minervini, R. Schepisi, M. Peroni, Marlene Dall’Alda, Daniela Broch, D. Recchi, D. Longo, Marco Camin, Renzo Girardello
In the COVID-19 Era, multilobe ground-glass opacities (GGOs) and septal thickening on chest Computed Tomography (CT) have been recognized as a radiological finding highly suggestive for SARS-CoV-2 pneumonia. However, these findings can be misleading. Here, we report about an 81-year-old woman, evaluated in the Emergency Room (ER) for a traumatic hip fracture, who, despite negative molecular testing on the nasopharyngeal sample for SARS-CoV-2, was admitted to a COVID-Unit because of flu-like symptoms with GGOs and interlobular septal thickening on the chest CT. During the hospital stay, focusing on the patient’s medical history, the interstitial lung disease was defined to be a chronic complication of long-term use of Amiodarone and rheumatoid arthritis. Therefore, especially during SARS global pandemic, CT pathological findings suggestive for interstitial pneumopathy should be critically analyzed considering patient history. They can reflect, in fact, other pathological conditions different from SARS-CoV-2 infection as other viral and non-viral infections or chronic inflammatory diseases. © by Società Italiana di Gerontologia e Geriatria (SIGG).
在新冠肺炎时代,胸部计算机断层扫描(CT)上的多叶基底层混浊(GGOs)和间隔增厚已被认为是严重提示SARS-CoV-2肺炎的放射学发现。然而,这些发现可能具有误导性。在这里,我们报道了一名81岁的女性,她在急诊室(ER)接受了创伤性髋部骨折的评估,尽管鼻咽样本中的严重急性呼吸系统综合征冠状病毒2型分子检测呈阴性,但由于GGO和胸部CT上的小叶间隔增厚的流感样症状,她还是住进了新冠肺炎病房,间质性肺病被定义为长期使用胺碘酮和类风湿性关节炎的慢性并发症。因此,特别是在SARS全球大流行期间,应根据患者病史对提示间质性肺病的CT病理结果进行批判性分析。事实上,它们可以反映与严重急性呼吸系统综合征冠状病毒2型感染不同的其他病理状况,如其他病毒和非病毒感染或慢性炎症疾病。©意大利老年医学协会(SIGG)。
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引用次数: 0
Evaluation of the relationship between lower urinary tract symptoms and fall risks in male patients over 65 years old 65岁以上男性患者下尿路症状与跌倒风险关系的评估
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-09-01 DOI: 10.36150/2499-6564-n359
S. Aksu, Güzin Zeren Öztürk, Memet Taşkın Eğici, C. Ardic
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引用次数: 0
Cardiac amyloidosis awareness among residents/specialists in Geriatrics: an Italian national survey 老年病学居民/专家对心脏淀粉样变性的认识:一项意大利全国调查
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-06-15 DOI: 10.36150/2499-6564-n374
Diana Lelli, C. Pedone, D. Leosco, R. Incalzi
Objective. Cardiac amyloidosis (CA) among older adults is less infrequent than usually considered, and often underdiagnosed. Geriatricians’ awareness and knowledge of CA is unknown. Objectives of the study are to assess actual CA knowledge among residents/specialists in Geriatrics, and their usual clinical practice in managing suspected CA. Methods. In this Nation-wide survey carried out by the Italian Society of Gerontology and Geriatrics in April-August 2020, we administered to residents/specialists in Geriatrics a questionnaire divided in three sections: socio-demographical, procedural and knowledge. Results were stratified by qualification (resident/specialist) and by performance (best/worst performers). Results. 289 residents and 104 specialists participated. The overall proportion of correct answers was 57.9% (58.4% residents, 56.1% specialists); knowledge about clinical (89% of correct answers, 91% residents and 84% specialists, P = 0.062), ECG (72% of correct answers, no differences between groups), and echocardiographic (86% of correct answers, no differences between groups) signs of CA was good. However, only 8% participants knew how to diagnose ATTRwt CA (no differences between groups), and 19% which diuretic is indicated in CA (22% residents, 13% specialists, P = 0.069). Only 25% of the participants knew the natural history of ATTRwt (19% residents, 41% specialists, P < 0.001), and 37% was aware of the target of the ATTR treatment. Prevalence of CA was underestimated by 57% specialists and 37% residents (P = 0.001). Conclusions. Knowledge of CA among residents/specialists in Geriatrics is uncomplete. Education campaigns on this topic are desirable, to improve physicians’ awareness of CA, thus reducing the number of potential misdiagnosis/delay in correct diagnoses.
客观的老年人心脏淀粉样变性(CA)的发病率比通常认为的要低,而且往往诊断不足。老年医生对CA的认识和知识尚不清楚。本研究的目的是评估老年医学住院医师/专家的实际CA知识,以及他们在管理疑似CA方面的常规临床实践。方法。在意大利老年病学和老年医学学会于2020年4月至8月进行的这项全国性调查中,我们向居民/老年医学专家发放了一份问卷,问卷分为三个部分:社会人口学、程序学和知识。结果按资格(住院医师/专家)和表现(表现最好/最差)进行分层。后果289名居民和104名专家参加了会议。正确答案的总体比例为57.9%(58.4%为居民,56.1%为专家);对CA的临床(89%的正确答案,91%的住院医生和84%的专家,P=0.062)、心电图(72%的正确答案、组间无差异)和超声心动图(86%的正确答案和组间无差别)体征的了解良好。然而,只有8%的参与者知道如何诊断ATTRwt CA(各组之间没有差异),19%的参与者知道哪种利尿剂适用于CA(22%的居民,13%的专家,P=0.069)。只有25%的参与者知道ATTRwt的自然病史(19%的居民,41%的专家,P<0.001),37%的参与者知道ATTR治疗的目标。57%的专家和37%的居民低估了CA的患病率(P=0.001)。居民/老年医学专家对CA的了解并不全面。这一主题的教育活动是可取的,以提高医生对CA的认识,从而减少潜在的误诊/正确诊断延迟的数量。
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引用次数: 0
Management of balance problems in an elderly with multiple system atrophy with predominant cerebellar ataxia (MSA-C) and sick sinus syndrome 老年人多系统萎缩伴小脑性共济失调(MSA-C)和病态窦综合征平衡问题的处理
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-06-15 DOI: 10.36150/2499-6564-n262
A. Eker, P. Yiğitoğlu, H. Duygu, E. Tan
Multiple system atrophy (MSA) is a late-onset, sporadic, progressive, neurodegenerative disorder clinically characterized by autonomic failure and either poorly levodopa-responsive parkinsonism or cerebellar ataxia. There isn’t any effective treatment on disease progression. Current therapeutic strategies are primarily based on dopamine replacement and improvement of autonomic failure. Clonazepam, propranolol, baclofen, amantadine, gabapentin, buspirone have also been used for symptomatic treatment of ataxia in MSA patients, but their efficacy known modest and transient. Herein we describe a MSA-C patient with disabling ataxia and sick sinus syndrome who showed distinct improvement in her symptoms after amantadine treatment and cardiac pacemaker implantation.
多系统萎缩(MSA)是一种迟发性、散发性、进行性神经退行性疾病,临床特征为自主神经功能衰竭和左旋多巴反应不良的帕金森病或小脑性共济失调。目前还没有有效的治疗方法。目前的治疗策略主要是基于多巴胺替代和自主神经衰竭的改善。氯硝西泮、心得安、巴氯芬、金刚烷胺、加巴喷丁、丁螺环酮也曾用于MSA患者共济失调的对症治疗,但其疗效一般且短暂。在此,我们描述了一位MSA-C患者,她患有致残性共济失调和病态窦综合征,在金刚烷胺治疗和心脏起搏器植入后,她的症状有明显改善。
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引用次数: 0
Dabigatran-induced acute liver injury in older patients: case report and literature review 老年达比加群所致急性肝损伤病例报告及文献复习
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-06-15 DOI: 10.36150/2499-6564-n345
A. Calabrese, V. Calsolaro, R. Franchi, S. Rogani, D. Guarino, C. Okoye, F. Monzani
Objective. Dabigatran, a direct inhibitor of thrombin, represents an effective alternative to warfarin. Despite the good tolerance and predictable pharmacokinetic profile, dabigatran may be associated to adverse reactions, including gastrointestinal disorders. Here we report on a case of hepatotoxicity along with an extensive revision of the available literature on dabigatran induced liver injury.Methods & results. An 84 years old man attended the Emergency Department after experiencing fatigue for a few days. He suffered from atrial fibrillation and had been initiated on dabigatran (110 mg bid) in the last four weeks. Clinical examination revealed tachycardia, scleral icterus in the absence of signs of chronic hepatic disease. Blood chemistry showed altered liver function tests: AST 809 IU/L, ALT 1629 IU/L, total bilirubin 2.42 mg/dL, gGT 381 IU/L, ALP 388 IU/L, LDH 552 IU/L. Screening laboratory investigations for infectious, autoimmune or metabolic hepatotoxic pathology were unremarkable. The abdominal ultrasound examination excluded vascular causes, revealing non-homogeneous echo-structure consistent with mild hepatic steatosis. At admission to our Geriatric ward dabigatran was discontinued and fondaparinux was introduced. Resolution of the hepatitis and normalization of blood chemistry was observed within two weeks. Few cases are described regarding hepatotoxicity likely caused by the recent onset of treatment with dabigatran. Conclusions. DOACs associated hepatotoxicity is rare but potentially harmful and should be kept in mind, especially in comorbid patients with unexplained liver injury. The mechanism of liver injury during dabigatran therapy is unknown and, not related to cytochrome P450 enzymes since the drug does not affect CYP450 activity.
目标。达比加群是一种凝血酶的直接抑制剂,是华法林的有效替代品。尽管达比加群具有良好的耐受性和可预测的药代动力学特征,但它可能与不良反应有关,包括胃肠道疾病。在这里,我们报告了一个肝毒性病例,并对达比加群引起的肝损伤的现有文献进行了广泛的修订。方法与结果。一位84岁的老人在感到疲劳几天后到急诊科就诊。他患有心房颤动,并在过去四周开始服用达比加群(110毫克/次)。临床检查显示心动过速,巩膜黄疸,无慢性肝病征象。血液化学显示肝功能改变:AST 809 IU/L, ALT 1629 IU/L,总胆红素2.42 mg/dL, gGT 381 IU/L, ALP 388 IU/L, LDH 552 IU/L。对感染性、自身免疫性或代谢性肝毒性病理的实验室检查无显著差异。腹部超声检查排除血管原因,显示非均匀回声结构,符合轻度肝脂肪变性。在我们的老年病房入院时,停用达比加群,改用氟达哌啶。两周内肝炎消退,血液化学恢复正常。很少有病例描述了可能由最近开始使用达比加群治疗引起的肝毒性。结论。DOACs相关的肝毒性是罕见的,但有潜在的危害,应该记住,特别是在合并不明原因肝损伤的患者中。达比加群治疗期间肝损伤的机制尚不清楚,与细胞色素P450酶无关,因为药物不影响CYP450活性。
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引用次数: 0
Biological diagnosis of Alzheimer’s disease and the issue of stigma 阿尔茨海默病的生物学诊断与耻辱问题
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-06-15 DOI: 10.36150/2499-6564-n327
F. Ronchetto, Martina Ronchetto
Starting from the early years of the 21st century a shift occurred in the conceptualization of Alzheimer’s disease (AD). Thanks to advances in the biomolecular field, new criteria of diagnosis and a new lexicon such as “preclinical AD”, “prodromal AD”, “at risk for AD” have been introduced. The disease has been reconceptualized as a slow and progressive pathological process beginning decades before clinical symptoms of dementia occurrence. Today, due to biomarkers detected in cerebrospinal fluid and on neuroimaging, there is the opportunity of a preclinical diagnosis of dementia in asymptomatic or minimally symptomatic individuals. The key characteristic of biomarkers is that they appear to reflect earlier brain changes eventually leading to clinical dementia. Originally reserved for research purposes, biological diagnosis and new lexicon seem to be now progressively included in clinical practice. If this trend is in line with the most advanced scientific achievements, on the other hand it raises some ethical concerns, mainly linked to stigma and discrimination expected toward people with a diagnosis of pre-dementia and their family caregivers. It is good to keep in mind that there is no currently certainty that asymptomatic will become symptomatic individuals and consequently further studies are needed. The purpose of this article is to offer a historical overview and ethical discussion about the conceptual changes in Alzheimer’s disease, from Alois Alzheimer to current era.
从21世纪初开始,阿尔茨海默病(AD)的概念发生了转变。由于生物分子领域的进步,新的诊断标准和新的词汇如“临床前AD”、“前驱AD”、“AD风险”被引入。这种疾病被重新定义为一种缓慢而渐进的病理过程,开始于痴呆临床症状发生前几十年。今天,由于在脑脊液和神经成像中检测到生物标志物,有机会在无症状或轻度症状的个体中进行痴呆症的临床前诊断。生物标志物的关键特征是,它们似乎反映了最终导致临床痴呆的早期大脑变化。最初保留的研究目的,生物诊断和新词汇似乎现在逐步纳入临床实践。如果这一趋势与最先进的科学成就相一致,另一方面,它引发了一些伦理问题,主要与被诊断为痴呆症前期的人及其家庭照顾者可能遭受的耻辱和歧视有关。值得注意的是,目前还不确定无症状的个体是否会成为有症状的个体,因此需要进一步的研究。本文的目的是提供一个历史概述和伦理讨论关于阿尔茨海默病的概念变化,从阿洛伊斯阿尔茨海默病到当前的时代。
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引用次数: 1
The first case of nasal chondromesenchymal hamartoma in an octogenarian: description and literature review 第一例八旬老人鼻腔软骨间充质错构瘤的描述和文献复习
IF 0.4 Q4 GERONTOLOGY Pub Date : 2021-06-15 DOI: 10.36150/2499-6564-n362
S. Millarelli, F. Mammarella, A. Loperfido, F. Stella, G. Bellocchi
Nasal Chondromesenchymal Hamartoma (NCMH) is a rare tumour of the sinonasal tract with a benign clinical behaviour. Locally destructive symptoms may occur. Due to the extreme rarity of this entity, only a few case reports are present in literature and most of them describe paediatric patients, usually under 12 years. Occasionally it may occur in adults. Symptoms are usually due to nasal localization, as nasal obstruction or mass effect or local compression caused by the lesion itself, as visual disturbances or facial pain. Cases described in the adult population are exceedingly rare. We describe the eldest case reported in literature of NCHM with peculiar features: geriatric patient, septal localization and asymptomatic clinic despite its voluminous size. The treatment of choice should be radical surgical resection however the best management strategy should be defined after multidisciplinary assessment of frailty in elderly patients.
鼻软骨间充质错构瘤(NCMH)是一种罕见的鼻道肿瘤,临床表现为良性。可能出现局部破坏性症状。由于这种情况极为罕见,文献中只有少数病例报告,其中大多数描述的是儿童患者,通常在12岁以下。偶尔也会发生在成人身上。症状通常是由于鼻腔定位,如病变本身引起的鼻塞或肿块效应或局部压迫,如视觉障碍或面部疼痛。在成年人群中所描述的病例极为罕见。我们描述了文献中报道的最年长的NCHM病例,具有特殊的特征:老年患者,鼻中隔定位和无症状的临床,尽管其体积大小。治疗的选择应是根治性手术切除,但最好的管理策略应在多学科评估老年患者虚弱后确定。
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引用次数: 0
期刊
Journal of Gerontology and Geriatrics
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