Annals of Geriatric Medicine and Research最新文献

Background: The role of vitamin D in reducing the risk of falls in older adults has not been clearly demonstrated. This study examined the effectiveness of vitamin D supplementation in reducing the risk of falls in older adults.

Methods: Four databases (Cochrane Library, Embase, PubMed, and CINAHL) were searched without language restrictions or time limitations. These articles were comprehensively screened using EndNote version 20.1 software. A manual search of the reference lists of the identified studies was also performed. The analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The pooled evidence was analyzed using RevMan software version 5.4.

Results: Seventeen studies met inclusion criteria among 550 potentially relevant studies. The pooled analysis of 38,598 older adults showed that vitamin D supplementation decreased the odds of having at least one fall by 1% (odds ratio [OR]=1.01; 95% confidence interval [CI], 0.92-1.11; p=0.86); however, the difference was not statistically significant. Of eight studies with 19,946 older adults, the pooled analysis showed a 12% (OR=1.12; 95% CI, 0.97-1.29; p=0.11) decrease in the odds of having at least one fracture among older adults; however, the difference was also not statistically significant. Pooled subgroup analysis showed that neither low (<2,000 IU/day) nor high (≥2,000 and <4,000 IU/day) doses of vitamin D supplementation had any significant effect on the incidence of falls and fractures.

Conclusion: Vitamin D supplementation had no beneficial effect in reducing fall and fracture incidence among older adults.

Tetanus is an infectious disease caused by Clostridium tetani toxin. Although easily preventable through vaccination, over 73,000 new infections and 35,000 deaths due to tetanus occurred worldwide in 2019, with higher rates in countries with healthcare barriers. Here, we present a clinical case of C. tetani infection in an 85-year-old patient. Patient robustness and high functional reserve before infection are favorable predictors of survival for an otherwise fatal disease. However, the patient did not experience any severe complications. Therefore, this report is a strong call for tetanus vaccination.

Mucous membrane pemphigoid is a rare autoimmune blistering disease characterized by post-bullous erosion of mucous membranes. Herein, we present a case of a nonagenarian man who was referred to our department of dermatology presenting with painful erosion of the buccal mucosa. Physical examination revealed palate erosion associated with erosion of the buccal mucosa. A diagnosis of mucous membrane pemphigoid was confirmed, and the patient was successfully treated with topical corticosteroids.

Background: Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology.

Methods: We identified relevant articles on geriatrics and gerontology using the search terms "geriatrics," "gerontology," "older people," and "elderly." VOSviewer was used to perform bibliometric analysis.

Results: A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395).

Conclusion: These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them.

Background: In this study, we aimed to assess the ability to balance and quality of life (QoL) among older adults without a history of coronavirus disease 2019 (COVID-19) and those who had recovered from mild COVID-19.

Methods: We recruited 80 older adults and categorized them into the following two groups based on their history of COVID-19: those without COVID-19 (n=40) and those who had recovered from mild COVID-19 (n=40). We assessed the participants' ability to balance using the multi-directional reach test and timed up and go (TUG) test, and evaluated their QoL using the Short Form-36.

Results: Compared with older adults without a history of COVID-19, those who had recovered from mild COVID-19 demonstrated no differences in the scores of the forward, backward, right, and left directions (p>0.05), but a significantly longer duration for the TUG test (p=0.02) and a reduced QoL.

Conclusion: Our study results demonstrated decreased ability to balance and poor QoL among older adults who had recovered from mild COVID-19.

Background: Dysphagia is a common problem with potentially serious consequences including malnutrition, dehydration, pneumonia, and death. However, there are challenges in screening for dysphagia in older adults. We assessed the feasibility of using the Clinical Frailty Scale (CFS) as a risk assessment tool for dysphagia.

Methods: This cross-sectional study was conducted at a tertiary teaching hospital from November 2021 to May 2022 and included 131 older patients (age ≥65 years) admitted to acute wards. We used the Eating Assessment Tool-10 (EAT-10), which is a simple measure for identifying individuals at risk of dysphagia, to assess the relationship between EAT-10 score and frailty status as measured using the CFS.

Results: The mean age of the participants was 74.3±6.7 years, and 44.3% were male. Twenty-nine (22.1%) participants had an EAT-10 score ≥3. The CFS was significantly associated with an EAT-10 score ≥3 after adjusting for age and sex (odds ratio=1.48; 95% confidence interval [CI], 1.09-2.02). The CFS was able to classify the presence of an EAT-10 score ≥3 (area under the receiver operating characteristic [ROC] curve=0.650; 95% CI, 0. 544-0.756). The cutoff point for predicting an EAT-10 score ≥3 was a CFS of 5 according to the highest Youden index, with a sensitivity of 82.8% and a specificity of 46.1%. The positive and negative predictive values were 30.4% and 90.4%, respectively.

Conclusion: The CFS can be used as a tool to screen for the risk of swallowing difficulty in older inpatients to determine clinical management encompassing drug administration routes, nutritional support, prevention of dehydration, and further evaluation of dysphagia.

Background: This study aimed to identify the risk factors associated with coronavirus disease 2019 (COVID-19) infection and mortality among older adults in South Korea.

Methods: Using Korean National Health Insurance data from January 1, 2020, to March 31, 2022, we analyzed the impact of various factors, including age, comorbidity burden, and insurance type, on COVID-19 infection and mortality rates.

Results: Age was the most significant risk factor for mortality in older adults. A higher comorbidity burden was also associated with increased infection (odds ratio [OR]=1.33 for Charlson Comorbidity Index [CCI] ≥2, 95% confidence interval [CI] 1.321-1.339) and mortality (OR=1.537 for CCI ≥2, 95% CI 1.459-1.618) rates. While Medical Aid recipients exhibited lower infection rates (OR=0.898, 95% CI 0.89-0.906) than National Health Insurance beneficiaries, they had higher mortality rates (OR=1.692, 95% CI 1.623-1.763).

Conclusion: These results emphasized the need to prioritize vaccination and allocate healthcare resources for older adults, particularly those with multiple comorbidities. Addressing socioeconomic disparities and ensuring equitable access to testing and healthcare services are crucial for mitigating the impact of COVID-19 on older adults.

Background: Insulin resistance (IR) negatively affects several risk factors of chronic kidney disease (CKD). This cross-sectional study investigated whether the triglyceride-glucose (TyG) index, which reflects IR, was independently associated with CKD in a geriatric population, regardless of obesity and sex.

Methods: The analysis included 7,326 individuals (2,864 males and 4,462 females) aged ≥60 years. Non-obesity or obesity was evaluated using a body mass index cutoff of 25 kg/m2. The TyG index was calculated as ln [triglyceride concentration (mg/dL)×fasting plasma glucose concentration (mg/dL)]/2. All participants were categorized into three groups according to TyG tertiles. Moderate-to-severe CKD (MSCKD) was defined as an estimated glomerular filtration rate (eGFR) of <45.0 mL/min/1.73 m2.

Results: In males and females with or without obesity, a trend test showed a decreasing tendency in the eGFR from the lowest to highest TyG tertiles. Males without obesity and females with obesity in the middle and highest tertiles of the TyG index were 2.342 and 2.393, and were 2.313 and 3.516 times more likely to have MSCKD, respectively. Those with or without obesity in the highest tertile of the TyG index were 1.736 and 2.374 times more likely to have MSCKD, respectively.

Conclusion: Geriatric populations with an increased TyG index have a high risk of MSCKD regardless of obesity and sex. Our findings suggest that increased IR is associated with CKD in the geriatric population independent of obesity and sex.

Background: The 2-minute step test (2MST) is a simple and inexpensive functional test that measures an individual's ability to perform continuous stepping up and down on a step platform for two minutes. This study evaluated the 2MST as a tool for assessing functional fitness in older individuals with hypertension and determined the correlation between the 2MST and physical fitness tests.

Methods: A total of 91 older individuals with hypertension performed physical fitness tests, including the 2MST, 6-minute walk test (6MWT), five times sit-to-stand test (FTSST), grip strength and leg strength assessments, and timed up and go test (TUG) to collectively assess their physical fitness.

Results: A cutoff score of ≤60 steps in the 2MST had 87.50% sensitivity and 70.59% specificity in predicting functional exercise performance in older individuals with hypertension. Additionally, the number of steps in the 2MST was positively correlated with the distance covered in the 6MWT, isometric grip strength, and isometric leg strength and negatively correlated with the duration of the FTSST and TUG.

Conclusions: A cutoff score of ≤60 steps in the 2MST predicted functional exercise performance in older individuals with hypertension with 87.50% sensitivity and 70.59% specificity and was correlated with other physical fitness tests, suggesting that the 2MST is a useful tool for assessing functional exercise performance.