Gerontology and Geriatric Medicine最新文献

One dementia prevention strategy that is effective for older adults is frequent participation in leisure time physical activity. However, research gaps exist in our understanding of the longitudinal relationship between different levels of leisure time physical activity participation and the cognitive function of older adults with mild cognitive impairment. Thus, we investigated this relationship using Health and Retirement Study data from 2012 to 2020. Results from Repeated Measures Multivariate Analysis of Covariance indicated that both the mid (Mean Difference = -0.45) and high level (Mean Difference = -0.82) leisure time physical activity groups showed higher levels of memory function compared to the low-level leisure time physical activity group. Additionally, the mid (Mean Difference = -0.21) and high level (Mean Difference = -0.37) leisure time physical activity groups reported better working memory function, and the mid (Mean Difference = -0.02) and high level (Mean Difference = -0.02) leisure time physical activity groups showed higher levels of attention and processing speed than the low-level leisure time physical activity group. These findings suggest that older adults with mild cognitive impairment who engage either vigorously or moderately in leisure time physical activity (more than three times a week) experience improvements in cognitive function compared to those who do not. This study provides valuable insights for clinicians on the optimal level of leisure time physical activity required to mitigate cognitive decline in older adults with mild cognitive impairment.

Purpose: Medication-related osteonecrosis of the jaw (MRONJ) caused by bisphosphonates (BPs) and denosumab (Dmab) is still a major oral adverse event caused by cancer treatment and may be under-recognized by private dental services. With the aim of reducing the prevalence of MRONJ, this study, which is a pilot study for a planned future large-scale survey, compared knowledge about MRONJ between dental hygienists (DHs) in private dental clinics and those in cancer center hospitals. Methods: We conducted a questionnaire-based survey regarding MRONJ between 1 November 2023 and 31 January 2024 on DHs at a cancer base hospital and a private clinic in Saitama, Japan. We statistically analyzed the data collected using the χ² test or Fisher's exact test with the level of significance set at 5%. Results: This study included 10 in-hospital and 53 private clinic DHs. The in-hospital DHs had appropriate knowledge of MRONJ. However, compared with the in-hospital DHs, although the private clinic DHs knew that BPs are used for osteoporosis, significantly fewer had knowledge of Dmab (p < .001) or knew that BPs and Dmab could also be used to treat cancer (both p < .001). In addition, few private clinic DHs were aware of MRONJ cases refractory to antibiotic treatment alone (p = .012). Conclusion: These findings suggest that private clinic DHs have less knowledge of MRONJ than those in cancer base hospitals.

Objective: Previous studies suggest older patients with multiple health conditions and medications may experience adverse interactions, leading to negative outcomes. However, there's limited research on this in older adults receiving home medical care. This study assesses whether polypharmacy is linked to falls or other clinical outcomes. Methods: The study population included 217 participants, aged ≥65 years, receiving home medical care, who consented to participate in the Osaka Home Care Registry (OHCARE) study in Japan. The survey examined the association between polypharmacy and clinical outcomes. We defined "polypharmacy" as six or more medications taken regularly. Results: Of the participants, 135 (62.6%) had polypharmacy and were significantly more likely to have hypertension or diabetes. Common medications included those for hypertension, diabetes, and mental disorders. Participants with polypharmacy experienced significantly more falls. Multivariate analysis showed an association between polypharmacy and falls (odds ratio: 2.81, 95% confidence interval [1.34, 5.92]). Conclusion: Even in older patients receiving home health care, the use of six or more medications poses a risk of falls. Careful observations and life support by medical stuffs are necessary to prevent falls in older patients with polypharmacy receiving home medical care.

The most adverse outcomes of the COVID-19 pandemic include high post-infection mortality among long-term care (LTC) home residents. Research about mortality over a longer period after contracting COVID-19 and in different pandemic years is limited. In the current study, we examined outcomes for 1,596 LTC residents from the day of a positive COVID-19 test until January 31, 2023. We reported all-cause mortality 30 days after contracting COVID-19 and monthly throughout the follow-up, up to 35 months after the pandemic start. We also examined mortality among 2,724 residents residing in the same LTC homes, with no history of COVID-19 during the same period. The results underscored a large number of deaths in the first month post-infection, with 30-day mortality substantially decreasing over the years-from 28% (95% CI [24.3, 31.8]) among residents contracting COVID-19 in 2020, to 8.3% (95% CI [7.4, 9.2]) in the 2022 cohort. Observed over longer periods, monthly mortality among residents with a COVID-19 history was similar to mortality in the No-COVID residents, and no evidence was found of increased mortality risk in the COVID group beyond the first post-infection month. We discuss mortality in LTC during the pandemic and a continuing need to reduce mortality in the acute phase of COVID-19.

The occurrence rate of frailty is high among patients with chronic diseases. However, the assessment of frailty among these patients is still far from being a routine part of clinical practice. The aim of this study is to develop a validated predictive model for assessing frailty risk in patients with chronic illnesses. This study recruited 543 patients with chronic diseases, and 237 were included in the development and validation of the predictive model. A total of 57 frailty related indicators were analyzed, encompassing sociodemographic variables, health status, physical measurements, nutritional assessment, physical activity levels, and blood biomarkers. There were 100 cases (42.2%) presenting frailty symptoms. Multivariate logistic regression analysis revealed that gender, age, chronic diseases, Mini Nutritional Assessment score, and Clinical Frailty Scale score were predictive factors for frailty in chronic disease patients. Utilizing these factors, a nomogram model demonstrated good consistency and accuracy. The AUC values for the predictive model and validation set were 0.946 and 0.945, respectively. Calibration curves, ROC, and DCA indicated the nomogram had favorable predictive performance. Altogether, the comprehensive nomogram developed here is a promising and convenient tool for assessing frailty risk in patients with chronic diseases, aiding clinical practitioners in screening high-risk populations.

Hyponatremia, characterized by serum sodium <135 mEq/L, poses a significant health concern, particularly among the elderly. This case report explores chronic hyponatremia, with a focus on the Tea and Toast Syndrome, prevalent in individuals with atypical dietary habits. We present a 69-year-old female presenting with chronic hyponatremia, revealing dietary factors as key contributors. Thorough diagnostic workup ruled out common causes, emphasizing the importance of meticulous approaches. The patient's adherence to recommended dietary changes resulted in significant improvement, showcasing the pivotal role of targeted nutritional interventions. Pathogenetic mechanisms, such as reduced water-excretory capacity and solute excretion, were explored, with differentiation between AVP-mediated and non-AVP-mediated hyponatremia highlighted. The case underscores the intricate interplay between dietary habits, aging, and chronic hyponatremia, emphasizing the need for adjusted interventions in this vulnerable population. Addressing the nutritional aspects of chronic hyponatremia emerges as a crucial aspect, offering an opportunity for targeted management and improved patient care, especially in the aging demographic.

Major depressive disorder (MDD) and Restless legs syndrome (RLS) present complex clinical challenges, often coexisting and complicating treatment strategies. While the relationship between MDD and RLS remains somewhat elusive, emerging evidence suggests a potential interplay between antidepressant medications and the worsening of RLS symptoms. This case report illuminates an instance where mirtazapine, a tetracyclic antidepressant commonly used in MDD, precipitated a resurgence of RLS symptoms in a patient with a previously controlled presentation.

Introduction: Thailand's aging population is increasing. While the societal impact of aging is recognized, formal programs to support pre-retirement planning are currently lacking. This study aimed to develop and evaluate a program specifically designed to address this gap and support individuals to prepare for a healthy and fulfilling later life. Methods: We employed a quasi-experimental, one-group pre-test/post-test design to evaluate a newly developed program focused on pre-retirement preparation. The program consisted of four, 3-hr modules delivered weekly. Voluntary participants (N = 25) were aged 50 to 59 years, physically active, and committed to attending all modules. Participants' knowledge and self-reported preparedness for aging were assessed before and after program completion. Results: The program led to a statistically significant increase in participants' overall knowledge of aging (z = -2.010, p < .05). While specific areas of preparation did not show statistically significant individual differences, mean scores improved across all aspects of preparation. This may reflect the existing health knowledge of some participants and their proactive approach to aging preparation (80% reported some prior preparation). Conclusion: This study demonstrates the effectiveness of a pre-retirement preparation program in enhancing knowledge and self-reported preparedness for aging. Findings suggest that such programs can stimulate middle-aged adults to plan for their future well-being. This study underscores the need for a more holistic approach to pre-retirement preparation. Future programs should consider incorporating content beyond health and finances, potentially including social life planning as identified in this research. Future research could explore program modifications, such as extended formats and content tailored to specific needs.

This pilot study examines Ohio's licensed nursing home administrators and state tested nursing assistant's perspectives about job satisfaction, future career and employment plans, potential beneficial changes to their organizations, and their thoughts on reducing turnover rates in their field. Ohio Board of Executives of Long-Term Services and Supports provided their contact list of all 1,969 licensed nursing home administrators in Ohio in the fall of 2023. Two surveys were created for licensed nursing home administrators and state tested nursing assistants. Results were analyzed for themes within the open-ended responses; 28 surveys were received from licensed nursing home administrators and 17 surveys were received from state tested nursing assistants. Residents and their families are among the top reasons for job satisfaction, many employees face symptoms of burnout, and wages are a concern among both state tested nursing assistants and licensed nursing home administrators. Future career plans differed between the two professions and had distinct driving factors. A discussion of licensed nursing home administrators' opinions on improving retention and turnover rates should include more accountability, personal responsibility, and adding opportunities for professional growth and development.

Introduction: Obesity and income (wage) distribution have emerged as one of the most serious public health concerns but in this research, the study is continued under body mass index (BMI) and body shape and size index (BSSI) among children and adults in Pakistan.

Methods: This cross-sectional study investigated the health-related behaviors and outcomes of 2,223 children and adults aged 2 to 19 years from Multan, Pakistan, including both males and females, providing a comprehensive understanding of the health status in this population. Data about gender, weight, height, age, family income and other demographic measures are recorded. For the measurement of BMI and BSSI, the latest formulas and methods were used. Different variables were applied through statistical description understudy. To check out the wage distribution in BSSI and BMI, the comparative approach was used and performed a role in making charts for BSSI and BMI against family income, age group and gender.

Results: The mean BMI and BSSI for complete data are 18.00 and 0.23 for the age group of 2 to 5 years of children with family income less than 10,000. Similarly, these figures are 20.59 and 0.29 for the family income greater than 50,000.

Conclusion: Most important things have been observed by this study, that income greatly affected the rate of obesity. BMI and BSSI increased by increasing the family income of children and adults in Pakistan. BMI and BSSI show high figures for female respondents as compared to male ones, observed by this research.