Pub Date : 2020-08-01DOI: 10.6890/IJGE.202008_14(3).0009
W. Ho, Kuan Liu, Hui-Ping Ng, Yu-Chen Lee
Background: This nationwide, retrospective cohort study was initiated to investigate the correlation between Bell's palsy (BP) and peptic ulcer disease (PUD). Methods: The Taiwan National Health Insurance statistics were used in this large case-control study to investigate the correlation of BP in patients with a history of PUD. We included 69,340 patients in whom PUD was newly diagnosed between January 2000 and December 2005. The PUD patients were tracked until 31 December 2011 or when BP was first diagnosed. For comparison, 208,020 patients without PUD were randomly selected using a 1:3 case-control matching of age, gender and the year of diagnosis of PUD. The correlation of BP in patients with and without PUD was computed using Cox's proportional hazards model. The cumulative incidence of BP in both cohorts was estimated using the Kaplan-Meier method. Results: Elderly patients aged 65 years or older with a history of PUD had a higher incidence rate of BP (at 1.21 per 1000 persons/year) compared to those without PUD (0.96 per 1000 persons/year). A significantly higher adjusted hazard ratio of 2.5 (95% CI 2.13-2.93; p ＜ 0.0001) was found in this group as compared to patients aged 40-65 years. Conclusions: A significant positive correlation between BP and a history of PUD was observed in elderly patients.
背景:这项全国性的回顾性队列研究旨在探讨贝尔氏麻痹(BP)与消化性溃疡病(PUD)之间的相关性。方法:本研究采用台湾全民健保统计资料，探讨有PUD病史患者血压的相关性。我们纳入了2000年1月至2005年12月期间新诊断为PUD的69,340例患者。追踪PUD患者至2011年12月31日或首次诊断出BP。为了进行比较，采用年龄、性别和PUD诊断年份1:3的病例对照匹配，随机选择208,020例无PUD患者。采用Cox比例风险模型计算合并和未合并PUD患者血压的相关性。使用Kaplan-Meier方法估计两个队列的BP累积发病率。结果:65岁及以上有PUD病史的老年患者BP发病率(1.21 / 1000人/年)高于无PUD患者(0.96 / 1000人/年)。校正后的风险比显著高于2.5 (95% CI 2.13-2.93;P < 0.0001)，与40-65岁的患者相比。结论:老年患者血压与PUD病史有显著正相关。
{"title":"Bell's Palsy in Elderly Taiwanese Patients with a History of Peptic Ulcer Disease: A Correlation Study","authors":"W. Ho, Kuan Liu, Hui-Ping Ng, Yu-Chen Lee","doi":"10.6890/IJGE.202008_14(3).0009","DOIUrl":"https://doi.org/10.6890/IJGE.202008_14(3).0009","url":null,"abstract":"Background: This nationwide, retrospective cohort study was initiated to investigate the correlation between Bell's palsy (BP) and peptic ulcer disease (PUD). Methods: The Taiwan National Health Insurance statistics were used in this large case-control study to investigate the correlation of BP in patients with a history of PUD. We included 69,340 patients in whom PUD was newly diagnosed between January 2000 and December 2005. The PUD patients were tracked until 31 December 2011 or when BP was first diagnosed. For comparison, 208,020 patients without PUD were randomly selected using a 1:3 case-control matching of age, gender and the year of diagnosis of PUD. The correlation of BP in patients with and without PUD was computed using Cox's proportional hazards model. The cumulative incidence of BP in both cohorts was estimated using the Kaplan-Meier method. Results: Elderly patients aged 65 years or older with a history of PUD had a higher incidence rate of BP (at 1.21 per 1000 persons/year) compared to those without PUD (0.96 per 1000 persons/year). A significantly higher adjusted hazard ratio of 2.5 (95% CI 2.13-2.93; p ＜ 0.0001) was found in this group as compared to patients aged 40-65 years. Conclusions: A significant positive correlation between BP and a history of PUD was observed in elderly patients.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"50 1","pages":"196-201"},"PeriodicalIF":0.3,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89886411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0004
C. Hsieh, Chun-Wei Lee, Y. Chiang, Fu-Fei Tsai, M. Su, Chun-Yen Chen
Background: This study aimed to evaluate the effect of thiazolidinediones (TZDs) on re-hospitalization rates for revascularization after bare-metal stent (BMS) implantation. Methods: Data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, were analyzed from March, 2000 to December, 2006. Type 2 diabetes subjects treated with BMS implantations who used TZDs (either rosiglitazone or pioglitazone) were compared with subjects not on TZDs (non-TZD group) to evaluate the risk of readmission for coronary revascularization. Endpoints were acute coronary syndrome (ACS) and readmission for revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery) after 3, 6, and 12 months. Results: In total, 6911 type 2 diabetes patients were hospitalized for BMS implantation (average follow-up, 294.4 ± 108.9 days). Rosiglitazone treatment in patients who received BMSs was associated with a higher risk of re-hospitalization for revascularization at 6 and 12 months (hazard ratio (HR) = 1.33; 95% CI: 1.08-1.64 and HR = 1.20 95% CI: 1.01-1.43). However, there were no significant differences between the pioglitazone and non-TZD groups. Conclusion: The use of rosiglitazone in type 2 diabetes patients after BMS implantation may increase the risk of re-hospitalization for revascularization. Our study suggests that rosiglitazone should be used cautiously in diabetes patients with BMS implantation.
{"title":"Different Effects of Thiazolidinediones on Cardiovascular Events among Type 2 Diabetic Patients Implanted with Bare Metal Stents: A Nationwide Study","authors":"C. Hsieh, Chun-Wei Lee, Y. Chiang, Fu-Fei Tsai, M. Su, Chun-Yen Chen","doi":"10.6890/IJGE.202005_14(2).0004","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0004","url":null,"abstract":"Background: This study aimed to evaluate the effect of thiazolidinediones (TZDs) on re-hospitalization rates for revascularization after bare-metal stent (BMS) implantation. Methods: Data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, were analyzed from March, 2000 to December, 2006. Type 2 diabetes subjects treated with BMS implantations who used TZDs (either rosiglitazone or pioglitazone) were compared with subjects not on TZDs (non-TZD group) to evaluate the risk of readmission for coronary revascularization. Endpoints were acute coronary syndrome (ACS) and readmission for revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery) after 3, 6, and 12 months. Results: In total, 6911 type 2 diabetes patients were hospitalized for BMS implantation (average follow-up, 294.4 ± 108.9 days). Rosiglitazone treatment in patients who received BMSs was associated with a higher risk of re-hospitalization for revascularization at 6 and 12 months (hazard ratio (HR) = 1.33; 95% CI: 1.08-1.64 and HR = 1.20 95% CI: 1.01-1.43). However, there were no significant differences between the pioglitazone and non-TZD groups. Conclusion: The use of rosiglitazone in type 2 diabetes patients after BMS implantation may increase the risk of re-hospitalization for revascularization. Our study suggests that rosiglitazone should be used cautiously in diabetes patients with BMS implantation.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"9 1","pages":"109-114"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89305881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0013
D. Korovljev, T. Trivic, V. Štajer, P. Drid, Bunpei Sato, S. Ostojić
We analyzed the effects of 4-week H_2 inhalation on cognitive performance in women aged 65 and above. The participants (n = 13) were community-dwelling older women (age 68.0 ± 3.0 years; weight 66.9 ± 10.3 kg; height 161.1 ± 5.8 cm) who volunteered to participate in this open-label pilot trial (ClinicalTrials.gov, NCT02830854). The participants received H_2 by inhalation for 15 min once per day for 4 weeks. The cognitive function was assessed using the Mini Mental State Exam (MMSE) and Alzheimer disease assessment scale cognitive subscale (ADAS-Cog) at baseline and at follow up. H_2 intervention significantly increased total MMSE scores (for 14.2% on average; p ＜ 0.01), thereby improving cognitive function from mild dementia at baseline (a score of 25.6 out of 30) to normal cognition at follow up (above a cut score of 27). In addition, ADAS-Cog scores were significantly improved by H_2 inhalation, with better performance for word recall test (p ＜ 0.01), and improved word recognition (p = 0.01) at post-administration, respectively. This pilot trial seems to corroborate previous animal studies, suggesting that gaseous H_2 might be considered as a beneficial agent for age-related cognitive health.
{"title":"Short-Term H_2 Inhalation Improves Cognitive Function in Older Women: A Pilot Study","authors":"D. Korovljev, T. Trivic, V. Štajer, P. Drid, Bunpei Sato, S. Ostojić","doi":"10.6890/IJGE.202005_14(2).0013","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0013","url":null,"abstract":"We analyzed the effects of 4-week H_2 inhalation on cognitive performance in women aged 65 and above. The participants (n = 13) were community-dwelling older women (age 68.0 ± 3.0 years; weight 66.9 ± 10.3 kg; height 161.1 ± 5.8 cm) who volunteered to participate in this open-label pilot trial (ClinicalTrials.gov, NCT02830854). The participants received H_2 by inhalation for 15 min once per day for 4 weeks. The cognitive function was assessed using the Mini Mental State Exam (MMSE) and Alzheimer disease assessment scale cognitive subscale (ADAS-Cog) at baseline and at follow up. H_2 intervention significantly increased total MMSE scores (for 14.2% on average; p ＜ 0.01), thereby improving cognitive function from mild dementia at baseline (a score of 25.6 out of 30) to normal cognition at follow up (above a cut score of 27). In addition, ADAS-Cog scores were significantly improved by H_2 inhalation, with better performance for word recall test (p ＜ 0.01), and improved word recognition (p = 0.01) at post-administration, respectively. This pilot trial seems to corroborate previous animal studies, suggesting that gaseous H_2 might be considered as a beneficial agent for age-related cognitive health.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"15 1","pages":"149-150"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90975404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0002
Ayuko Tanaka, T. Nakai
Background: In terms of epidemiology and safety for older adults, self-reported questionnaires on activities of daily living, that is, screening tools are often applied as subjective measures, though objective measures provide concrete quantitative information of physical function through direct observation regardless of age. We aimed to clarify whether or not the screening tool for older adults at risk of dependency (SRD) utilized in Japan as subjective measures could predict objective measures on physical function among older adults. Methods: The study was conducted with 81 community-dwelling older adults aged 60 years and over. They completed SRD as subjective measures and underwent physical performance battery (PPB) as objective measures. The association between SRD and PPB was statistically explored. Results: SRD was significantly associated with one of the four domains in PPB; locomotion of the whole body, F(4, 73) = 8.04, p ＜ .001. The significant predictors were falling experience, β = 0.25, t = 2.42, p = .018, and falling anxiety, β = 0.24, t = 2.27, p = .026, in SRD. The significant regression models explained 23% of the association. Conclusions: The two questions of SRD could predict objective measures on locomotion of the whole body among older adults. SRD needs to be revised to ensure every aspect of activities of daily living, not only locomotion, also change of posture, manipulation of the upper limb, and manual dexterity. Self-reported questionnaires can be utilized to identify older adults at risk of dependency, only if with appropriate questions.
背景:在老年人的流行病学和安全性方面，自我报告的日常生活活动问卷即筛查工具往往被用作主观测量，而客观测量通过直接观察提供了具体的定量的身体功能信息，而不考虑年龄。我们的目的是澄清日本使用的老年人依赖风险筛查工具(SRD)作为主观测量是否可以预测老年人身体功能的客观测量。方法:对81名60岁及以上的社区老年人进行研究。他们完成了SRD作为主观测量，并进行了物理性能电池(PPB)作为客观测量。对SRD与PPB的关系进行统计学探讨。结果:SRD与PPB的四个结构域之一有显著相关性;全身运动能力，F(4,73) = 8.04, p < 0.001。SRD的显著预测因子为跌倒经历(β = 0.25, t = 2.42, p = 0.018)和跌倒焦虑(β = 0.24, t = 2.27, p = 0.026)。显著回归模型解释了23%的关联。结论:SRD的两个问题可以预测老年人全身运动的客观指标。SRD需要修改，以确保日常生活活动的各个方面，不仅是运动，还包括姿势的改变，上肢的操作和手的灵巧性。自我报告的问卷可以用来识别有依赖风险的老年人，只要有适当的问题。
{"title":"Effect of Screening Tool as Subjective Measure to Identify Older Adults at Risk of Dependency in Japan: Multivariate Regression Analysis between Objective and Subjective Measures","authors":"Ayuko Tanaka, T. Nakai","doi":"10.6890/IJGE.202005_14(2).0002","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0002","url":null,"abstract":"Background: In terms of epidemiology and safety for older adults, self-reported questionnaires on activities of daily living, that is, screening tools are often applied as subjective measures, though objective measures provide concrete quantitative information of physical function through direct observation regardless of age. We aimed to clarify whether or not the screening tool for older adults at risk of dependency (SRD) utilized in Japan as subjective measures could predict objective measures on physical function among older adults. Methods: The study was conducted with 81 community-dwelling older adults aged 60 years and over. They completed SRD as subjective measures and underwent physical performance battery (PPB) as objective measures. The association between SRD and PPB was statistically explored. Results: SRD was significantly associated with one of the four domains in PPB; locomotion of the whole body, F(4, 73) = 8.04, p ＜ .001. The significant predictors were falling experience, β = 0.25, t = 2.42, p = .018, and falling anxiety, β = 0.24, t = 2.27, p = .026, in SRD. The significant regression models explained 23% of the association. Conclusions: The two questions of SRD could predict objective measures on locomotion of the whole body among older adults. SRD needs to be revised to ensure every aspect of activities of daily living, not only locomotion, also change of posture, manipulation of the upper limb, and manual dexterity. Self-reported questionnaires can be utilized to identify older adults at risk of dependency, only if with appropriate questions.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"51 1","pages":"99-103"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85271471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0008
Jae Hee Lee, Y. Choi
Background: In this study, we developed the Screening Test for At-risk Drinking in the Elderly (STAD-E), a new abbreviated version of the Alcohol Use Disorders Identification Test (AUDIT) intended for use in the elderly populations. This test comprises three questions that reflect the structure of the AUDIT 10 questionnaire and the characteristics of the Korean population and was developed using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We performed exploratory factor analysis for each question from the AUDIT questionnaire that was responded by elderly (≥ 65 years) participants of KNHANES IV-V to derive our abbreviated test based on the structure of each AUDIT item. For validation, we analyzed the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the new abbreviated test using KNHANES VI datasets (excepting KNHANES VI-2). Results: We selected question (Q) 1, Q3, and Q7 on the three-factor structure for the elderly population. The cut-off values of STAD-E were 4 for elderly males and 3 for elderly females. During the validation test, STAD-E yielded significantly greater AUROC values than AUDIT-QF and similar values to AUDIT-C. Conclusions: Unlike previous abbreviated tests, STAD-E reflects the item structure of AUDIT and the alcohol consumption patterns in an elderly population. Therefore, it can be used as a simple and reliable screening test for at-risk drinking in clinical settings.
{"title":"Screening Test for At-Risk Drinking in the Elderly: Abbreviated Version of the Alcohol Use Disorders Identification Test for the Elderly Population","authors":"Jae Hee Lee, Y. Choi","doi":"10.6890/IJGE.202005_14(2).0008","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0008","url":null,"abstract":"Background: In this study, we developed the Screening Test for At-risk Drinking in the Elderly (STAD-E), a new abbreviated version of the Alcohol Use Disorders Identification Test (AUDIT) intended for use in the elderly populations. This test comprises three questions that reflect the structure of the AUDIT 10 questionnaire and the characteristics of the Korean population and was developed using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We performed exploratory factor analysis for each question from the AUDIT questionnaire that was responded by elderly (≥ 65 years) participants of KNHANES IV-V to derive our abbreviated test based on the structure of each AUDIT item. For validation, we analyzed the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the new abbreviated test using KNHANES VI datasets (excepting KNHANES VI-2). Results: We selected question (Q) 1, Q3, and Q7 on the three-factor structure for the elderly population. The cut-off values of STAD-E were 4 for elderly males and 3 for elderly females. During the validation test, STAD-E yielded significantly greater AUROC values than AUDIT-QF and similar values to AUDIT-C. Conclusions: Unlike previous abbreviated tests, STAD-E reflects the item structure of AUDIT and the alcohol consumption patterns in an elderly population. Therefore, it can be used as a simple and reliable screening test for at-risk drinking in clinical settings.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"684 ","pages":"129-132"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72434695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0010
Shih-Ming Chuang, Chao-Hung Wang, Sung-Chen Liu, M. Chien, Wei-Che Chen
Background: Although adding insulin glargine to oral antidiabetic drugs (OADs) has demonstrated efficacy in patients with type 2 diabetes, evidence supporting specific regimens is lacking. The aim of this study was to compare the efficacy of combination therapy of insulin glargine with either sulfonylurea (SU) or metformin (Met) in patients with poorly controlled type 2 diabetes receiving ≥ 2 OADs. Methods: This was a 48-week prospective, open-label, randomized, parallel trial. Patients with type 2 diabetes poorly controlled with ≥ 2 OADs were randomized to the insulin glargine with Met (Met-group) or insulin glargine with SU (SU-group). Results: Mean glycosylated hemoglobin (A1C) reduction were significant in the Met-group and SU-group (-1.42 ± 0.28% and -1.00 ± 0.28%, respectively), but no statistically significant difference between groups (-0.40 ± 0.3%, p = 0.234). There was no difference in the proportion of patients achieving A1C of ＜ 7% (12.8% and 6.8%, respectively).Mean FPG reduced significantly in both groups (-120.3 ± 8.8 mg/dL and -90.2 ± 11.1mg/dL, respectively), with greater reductions in the Met-group (-34.8 ± 10.0mg/dL, p ＜ 0.001). More proportions of patients in the Met-group achieved the FPG target of ＜ 130 mg/dL (80.9% and 40.9%, respectively, p ＜ 0.001). The percentages of patients experiencing episodes of symptomatic hypoglycemia (Met-group: 23.4%, SU-group: 19.6%) and the percentages of nocturnal hypoglycemia (Met-group: 8.5%, SU-group: 6.5%) were similar among the two groups. Conclusion: In patients with type 2 diabetes poorly controlled on ≥ 2 OADs, glycemic control was comparable among the two regimens.
{"title":"Efficacy of Combination of Insulin Glargine with either Metformin or Sulfonylurea in Patients with Poorly Controlled Type 2 Diabetes","authors":"Shih-Ming Chuang, Chao-Hung Wang, Sung-Chen Liu, M. Chien, Wei-Che Chen","doi":"10.6890/IJGE.202005_14(2).0010","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0010","url":null,"abstract":"Background: Although adding insulin glargine to oral antidiabetic drugs (OADs) has demonstrated efficacy in patients with type 2 diabetes, evidence supporting specific regimens is lacking. The aim of this study was to compare the efficacy of combination therapy of insulin glargine with either sulfonylurea (SU) or metformin (Met) in patients with poorly controlled type 2 diabetes receiving ≥ 2 OADs. Methods: This was a 48-week prospective, open-label, randomized, parallel trial. Patients with type 2 diabetes poorly controlled with ≥ 2 OADs were randomized to the insulin glargine with Met (Met-group) or insulin glargine with SU (SU-group). Results: Mean glycosylated hemoglobin (A1C) reduction were significant in the Met-group and SU-group (-1.42 ± 0.28% and -1.00 ± 0.28%, respectively), but no statistically significant difference between groups (-0.40 ± 0.3%, p = 0.234). There was no difference in the proportion of patients achieving A1C of ＜ 7% (12.8% and 6.8%, respectively).Mean FPG reduced significantly in both groups (-120.3 ± 8.8 mg/dL and -90.2 ± 11.1mg/dL, respectively), with greater reductions in the Met-group (-34.8 ± 10.0mg/dL, p ＜ 0.001). More proportions of patients in the Met-group achieved the FPG target of ＜ 130 mg/dL (80.9% and 40.9%, respectively, p ＜ 0.001). The percentages of patients experiencing episodes of symptomatic hypoglycemia (Met-group: 23.4%, SU-group: 19.6%) and the percentages of nocturnal hypoglycemia (Met-group: 8.5%, SU-group: 6.5%) were similar among the two groups. Conclusion: In patients with type 2 diabetes poorly controlled on ≥ 2 OADs, glycemic control was comparable among the two regimens.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"1 1","pages":"138-141"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78656213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0003
P. Tasar, O. Karaşahin, O. Timur, Filiz Yıldırım, S. Şahin
Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. The aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 ± 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. Of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level ＜ 3.2 mg/L with 2.12-fold reduction in survival time. In addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score ＞ 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) ＞ 6.5, and 1.98-fold shorter with albumin levels ＜ 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level.
{"title":"Factors Determining Mortality in Geriatric Palliative Care Patients","authors":"P. Tasar, O. Karaşahin, O. Timur, Filiz Yıldırım, S. Şahin","doi":"10.6890/IJGE.202005_14(2).0003","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0003","url":null,"abstract":"Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. The aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 ± 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. Of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level ＜ 3.2 mg/L with 2.12-fold reduction in survival time. In addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score ＞ 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) ＞ 6.5, and 1.98-fold shorter with albumin levels ＜ 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"9 1","pages":"104-108"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77736743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0007
Taeko Fukuda, S. Imai, Masaya Nakadera, Shunji Shimoda, H. Horiguchi
Background: Postoperative functional status is a concern in elderly patients. Previously, we reported that administration of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with maintenance of activities of daily living (ADL) scores in elderly patients after hip fracture surgery. The aim of the present study was to investigate whether perioperative NSAIDs administration is related to ADL scores in other age groups after a wide range of surgeries. Methods: The medical records of 368,859 patients aged ≥ 15 years who underwent surgery under general anesthesia were reviewed. Results: The ADL deterioration ratios of patients aged 70 years or older were significantly higher than those of the younger cohort. NSAIDs administration was associated with postoperative ADL maintenance in elderly patients who underwent various surgeries. However, administration of NSAIDs was not related to ADL maintenance in the younger patients. Conclusions: Postoperative ADL deterioration incidences were higher in elderly patients than in younger patients. Perioperative administration of NSAIDs was associated with postoperative ADL maintenance in various surgeries in elderly patients but not in younger patients. The mechanisms of postoperative ADL deterioration are likely different in elderly and younger patients.
{"title":"Deterioration of Postoperative Daily Living Activities in Elderly Patients: Incidence and Associated Factors","authors":"Taeko Fukuda, S. Imai, Masaya Nakadera, Shunji Shimoda, H. Horiguchi","doi":"10.6890/IJGE.202005_14(2).0007","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0007","url":null,"abstract":"Background: Postoperative functional status is a concern in elderly patients. Previously, we reported that administration of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with maintenance of activities of daily living (ADL) scores in elderly patients after hip fracture surgery. The aim of the present study was to investigate whether perioperative NSAIDs administration is related to ADL scores in other age groups after a wide range of surgeries. Methods: The medical records of 368,859 patients aged ≥ 15 years who underwent surgery under general anesthesia were reviewed. Results: The ADL deterioration ratios of patients aged 70 years or older were significantly higher than those of the younger cohort. NSAIDs administration was associated with postoperative ADL maintenance in elderly patients who underwent various surgeries. However, administration of NSAIDs was not related to ADL maintenance in the younger patients. Conclusions: Postoperative ADL deterioration incidences were higher in elderly patients than in younger patients. Perioperative administration of NSAIDs was associated with postoperative ADL maintenance in various surgeries in elderly patients but not in younger patients. The mechanisms of postoperative ADL deterioration are likely different in elderly and younger patients.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"28 1","pages":"124-128"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88165715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.6890/IJGE.202005_14(2).0005
O. Altın, S. Kaya
Introduction: With the increase in global life expectancy, more elderly patients are being treated in outpatient clinics of hospitals. Morbidity and mortality rates are higher in elderly patients than in non-elderly patients after laparoscopic surgery because of the high incidence of comorbidities, such as cardiac, pulmonary and renal disease, and decreased performance. The aim of this study was to compare the outcomes of total extraperitoneal laparoscopic surgery for inguinal hernia repair between elderly and non-elderly patients. Materials and Methods: Between March 2012 and January 2019, 210 patients underwent laparoscopy for inguinal hernia repair. Patients were categorised into two groups based on age: group 1 (＜ 65 years) and group 2 (≥ 65 years). Demographic data and surgical outcomes of patients were retrospectively analysed from hospital records. Results: In total, 108 (51.4%) patients in group 1 and 102 (48.6%) patients in group 2 with mean ages of 46.5 and 70.8 years, respectively, underwent surgery. Thirty six patients in group 1 and 102 patients in group 2 had comorbidities. The incidences of postoperative complications were eight (7.4%) and three (2.9%) in groups 1 and 2, respectively. The mean follow-up period was 28.4 and 26.7 months in groups 1 and 2, respectively. Although three cases of recurring hernia were identified in group 1, one was reported in group 2. Conclusion: Although morbidity and mortality are higher in elderly patients, laparoscopic inguinal hernia repair can be performed safely.
{"title":"Comparison of Total Extraperitoneal Laparoscopic Surgery for Inguinal Hernia Repair between Elderly and Non-Elderly Patients","authors":"O. Altın, S. Kaya","doi":"10.6890/IJGE.202005_14(2).0005","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0005","url":null,"abstract":"Introduction: With the increase in global life expectancy, more elderly patients are being treated in outpatient clinics of hospitals. Morbidity and mortality rates are higher in elderly patients than in non-elderly patients after laparoscopic surgery because of the high incidence of comorbidities, such as cardiac, pulmonary and renal disease, and decreased performance. The aim of this study was to compare the outcomes of total extraperitoneal laparoscopic surgery for inguinal hernia repair between elderly and non-elderly patients. Materials and Methods: Between March 2012 and January 2019, 210 patients underwent laparoscopy for inguinal hernia repair. Patients were categorised into two groups based on age: group 1 (＜ 65 years) and group 2 (≥ 65 years). Demographic data and surgical outcomes of patients were retrospectively analysed from hospital records. Results: In total, 108 (51.4%) patients in group 1 and 102 (48.6%) patients in group 2 with mean ages of 46.5 and 70.8 years, respectively, underwent surgery. Thirty six patients in group 1 and 102 patients in group 2 had comorbidities. The incidences of postoperative complications were eight (7.4%) and three (2.9%) in groups 1 and 2, respectively. The mean follow-up period was 28.4 and 26.7 months in groups 1 and 2, respectively. Although three cases of recurring hernia were identified in group 1, one was reported in group 2. Conclusion: Although morbidity and mortality are higher in elderly patients, laparoscopic inguinal hernia repair can be performed safely.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"57 1","pages":"115-118"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85003571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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