Pub Date : 2019-08-02DOI: 10.23937/2469-5858/1510071
Yüksel Arif, Kulan Can Ahmet, Bilgin Rifat Reha, Ünsal Yaprak Özüm, Y. Nuri, Akçiçek Fehmi, Uluer Hatice
Objectives: As one gets older, some changes occur in swallowing mechanisms. The non-symptomatic swallowing disorders associated with aging for no reason are called presbyphagia. Whether or not presbyphagia has any cause other than the mechanisms of aging is not clear. In our study, we investigated the association of presbyphagia with hypertension, diabetes, and obesity. Early detection of presbyphagia is important, and it is also important to reveal its association with common diseases encountered in society. Early diagnosis of the elderly presenting with presbyphagia who carry the risk for dysphagia is of big importance. For this geriatric population, we designed a study to establish the relationship among hypertension, obesity and diabetes mellitus with the prevalence of presbyphagia. Methods: In study was conducted on elderly populations aged 65 and over who met exclusion criteria. To able to reach the number of sampling, “EAT-10 questionnaire”, which also has a validation, was used to eliminate those with symptomatic swallowing disorders. The number of patients we reached was 320, but 7 dropped out the study and therefore the study was carried out with a total of 313 samplings (Reached as 97.8% (up 95% G-power)). We used validated sEMG test in the quantitative (objective) detection of dysphagia limit and during subsequent water swallowing test of 20 ml. In this method, swallowing disorder was detected in 39 cases (12.4%) out of 313 cases. Of the 313 asymptomatic geriatric groups, (n = 39) asymptomatic swallowing disorders were detected. The population without swallowing disorder was n = 274. Of these, 71% (25.9%) was seen to be present with obesity, while (35.8%) had diabetes and 54.7% had hypertension. Results: Among the elderly group without symptoms, the prevalence of asymptomatic dysphagia, namely presbyphagia, was 12.4%. With a simple, non-invasive, inexpensive, yielding quantitative results in short time method, it is possible to screen the geriatric population with asymptomatic swallowing disorders. It may also be interesting to reveal its relationship with three common diseases in this group, apart from early precautions to be taken. There was no significant difference in the prevalence of diabetes between the group with and without swallowing disorder (p = 0.434). There was no significant difference in the prevalence of obesity between the groups with and without swallowing disorder (p = 0.190). Obesity and diabetes are closely related diseases and it was significant in terms of reliability that these groups gave similar results to those of asymptomatic dysphagia. We found a significant difference (p = 0.044) in terms of HT between the group detected to have asymptomatic swallowing disorder and the group which was not detected to have. The risk of dysphagia in elderly people with hypertension was 2.104 times higher compared to those without hypertension (OR = 2.104, p = 0.048, 95% GA = 1.007-4.397). Conclusion: There could be a signi
{"title":"Examination of the Relationship of Asymptomatic Swallowing Disorder Prevalence with Hypertension, Diabetes and Obesity in Elderly Population","authors":"Yüksel Arif, Kulan Can Ahmet, Bilgin Rifat Reha, Ünsal Yaprak Özüm, Y. Nuri, Akçiçek Fehmi, Uluer Hatice","doi":"10.23937/2469-5858/1510071","DOIUrl":"https://doi.org/10.23937/2469-5858/1510071","url":null,"abstract":"Objectives: As one gets older, some changes occur in swallowing mechanisms. The non-symptomatic swallowing disorders associated with aging for no reason are called presbyphagia. Whether or not presbyphagia has any cause other than the mechanisms of aging is not clear. In our study, we investigated the association of presbyphagia with hypertension, diabetes, and obesity. Early detection of presbyphagia is important, and it is also important to reveal its association with common diseases encountered in society. Early diagnosis of the elderly presenting with presbyphagia who carry the risk for dysphagia is of big importance. For this geriatric population, we designed a study to establish the relationship among hypertension, obesity and diabetes mellitus with the prevalence of presbyphagia. Methods: In study was conducted on elderly populations aged 65 and over who met exclusion criteria. To able to reach the number of sampling, “EAT-10 questionnaire”, which also has a validation, was used to eliminate those with symptomatic swallowing disorders. The number of patients we reached was 320, but 7 dropped out the study and therefore the study was carried out with a total of 313 samplings (Reached as 97.8% (up 95% G-power)). We used validated sEMG test in the quantitative (objective) detection of dysphagia limit and during subsequent water swallowing test of 20 ml. In this method, swallowing disorder was detected in 39 cases (12.4%) out of 313 cases. Of the 313 asymptomatic geriatric groups, (n = 39) asymptomatic swallowing disorders were detected. The population without swallowing disorder was n = 274. Of these, 71% (25.9%) was seen to be present with obesity, while (35.8%) had diabetes and 54.7% had hypertension. Results: Among the elderly group without symptoms, the prevalence of asymptomatic dysphagia, namely presbyphagia, was 12.4%. With a simple, non-invasive, inexpensive, yielding quantitative results in short time method, it is possible to screen the geriatric population with asymptomatic swallowing disorders. It may also be interesting to reveal its relationship with three common diseases in this group, apart from early precautions to be taken. There was no significant difference in the prevalence of diabetes between the group with and without swallowing disorder (p = 0.434). There was no significant difference in the prevalence of obesity between the groups with and without swallowing disorder (p = 0.190). Obesity and diabetes are closely related diseases and it was significant in terms of reliability that these groups gave similar results to those of asymptomatic dysphagia. We found a significant difference (p = 0.044) in terms of HT between the group detected to have asymptomatic swallowing disorder and the group which was not detected to have. The risk of dysphagia in elderly people with hypertension was 2.104 times higher compared to those without hypertension (OR = 2.104, p = 0.048, 95% GA = 1.007-4.397). Conclusion: There could be a signi","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46905392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.
{"title":"Application of Evidence-based Nursing in Elderly Patients with Arrhythmia after Acute Myocardial Infarction","authors":"Xiong Wang, Man Xu","doi":"10.30564/JGR.V1I01.677","DOIUrl":"https://doi.org/10.30564/JGR.V1I01.677","url":null,"abstract":"Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79676643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study was designed to get epidemiological characteristics, etiology characteristics, prognosis assessment and prognostic factors of hospital-acquired bloodstream infection (HABSI) in the elderly in Chinese PLA General Hospital and aimed at providing a reference for HABSI in the elderly on clinical diagnosis and treatment to improve the prognosis. Methods: The clinical data and pathology data of 210 cases of the elderly patients with HABSI from 2009 to 2012 in geriatric wards were retrospectively analyzed. Compare the clinical assessment effects of APACHE-II score, SAPS-II score and SOFA score to HABSI prognosis in the elderly by plotting the receiver operating characteristic curve. Use univariate and multivariate logistic regression analysis to get prognostic factors of HABSI in the elderly. Results: Univariate analysis of mortality: Day 1 apache -> 18 II score, lung infection, invasive ventilation, chronic hepatic insufficiency, chronic renal insufficiency, substantive organ malignant tumor, deep venipuncture, indwelling gastric tube indwelling ureter, complicated with shock and acquired bloodstream infections in the elderly patients with 7 days survival state association is significant. Day-1 SOFA score>7, chronic liver dysfunction, chronic renal insufficiency, concurrent shock, hemodialysis and 28-day survival status of patients with acquired bloodstream infection in elderly hospitals were significantly associated. Multivariate unconditioned logistic regression analysis related to death: Day-1APACHE-II score>18, parenchymal malignant tumors, and concurrent shock are independent risk factors for 7-day death in elderly patients with acquired bloodstream infection. Day-1 SOFA score>7, chronic renal insufficiency, and concurrent shock are independent risk factors for 28-day mortality in elderly patients with acquired bloodstream infection. Conclusion: The incidence of acquired bloodstream infections in the elderly was 1.37%. The 7-day and 28-day mortality rates were 8.10% and 22.38%, respectively. Concurrent shock is 26.7%. The 28-day mortality rate of concurrent shock patients was 48.21%. The best outcome score for the 7-day prognosis of elderly patients with acquired bloodstream infection was the Day-1APACHE-II score, followed by the Day-1 SOFA score. The best score for the 28-day prognostic assessment was the Day-1 SOFA score.
{"title":"Clinical Analysis of Hospital-acquired Bloodstream Infection in the Elderly","authors":"Bao-hua Sun","doi":"10.30564/JGR.V1I01.728","DOIUrl":"https://doi.org/10.30564/JGR.V1I01.728","url":null,"abstract":"Objective: This study was designed to get epidemiological characteristics, etiology characteristics, prognosis assessment and prognostic factors of hospital-acquired bloodstream infection (HABSI) in the elderly in Chinese PLA General Hospital and aimed at providing a reference for HABSI in the elderly on clinical diagnosis and treatment to improve the prognosis. Methods: The clinical data and pathology data of 210 cases of the elderly patients with HABSI from 2009 to 2012 in geriatric wards were retrospectively analyzed. Compare the clinical assessment effects of APACHE-II score, SAPS-II score and SOFA score to HABSI prognosis in the elderly by plotting the receiver operating characteristic curve. Use univariate and multivariate logistic regression analysis to get prognostic factors of HABSI in the elderly. Results: Univariate analysis of mortality: Day 1 apache -> 18 II score, lung infection, invasive ventilation, chronic hepatic insufficiency, chronic renal insufficiency, substantive organ malignant tumor, deep venipuncture, indwelling gastric tube indwelling ureter, complicated with shock and acquired bloodstream infections in the elderly patients with 7 days survival state association is significant. Day-1 SOFA score>7, chronic liver dysfunction, chronic renal insufficiency, concurrent shock, hemodialysis and 28-day survival status of patients with acquired bloodstream infection in elderly hospitals were significantly associated. Multivariate unconditioned logistic regression analysis related to death: Day-1APACHE-II score>18, parenchymal malignant tumors, and concurrent shock are independent risk factors for 7-day death in elderly patients with acquired bloodstream infection. Day-1 SOFA score>7, chronic renal insufficiency, and concurrent shock are independent risk factors for 28-day mortality in elderly patients with acquired bloodstream infection. Conclusion: The incidence of acquired bloodstream infections in the elderly was 1.37%. The 7-day and 28-day mortality rates were 8.10% and 22.38%, respectively. Concurrent shock is 26.7%. The 28-day mortality rate of concurrent shock patients was 48.21%. The best outcome score for the 7-day prognosis of elderly patients with acquired bloodstream infection was the Day-1APACHE-II score, followed by the Day-1 SOFA score. The best score for the 28-day prognostic assessment was the Day-1 SOFA score.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79648801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To analyze and discuss the quality of life of elderly patients with chronic diseases and its influencing factors. The aim of this study was to provide a theoretical basis for targeted intervention of influencing factors of chronic diseases and improvement of the quality of life of patients. Methods: A total of 1000 elderly patients with chronic diseases in our health center were randomly selected as the study subject. Questionnaire survey was conducted by self-designed questionnaire. The SF-36 quality of life scale was used to evaluate their quality of life; and linear regression model was used to explore the relevant influencing factors. Result: The SF-36 score showed that there was a correlation between the six dimensions, including overall health, physiological function, somatic pain, vitality, social function and mental health, and the number of chronic diseases in elderly patients. With the increase of chronic diseases, the scores of each dimension showed a downward trend. Linear regression analysis showed that age, anxiety and poor sleep quality were the main factors affecting the quality of life in elderly patients with chronic diseases. Conclusion: The quality of life of elderly patients with chronic diseases in our city is poor. In community work, targeted nursing and intervention should be given according to the types of diseases suffered by the elderly.
{"title":"Quality of Life and its Influencing Factors in Urban Elderly Patients with Chronic Diseases","authors":"Jun Zheng, Hong-lei Zhao, Xinru Wu","doi":"10.30564/JGR.V1I01.690","DOIUrl":"https://doi.org/10.30564/JGR.V1I01.690","url":null,"abstract":"Objective: To analyze and discuss the quality of life of elderly patients with chronic diseases and its influencing factors. The aim of this study was to provide a theoretical basis for targeted intervention of influencing factors of chronic diseases and improvement of the quality of life of patients. Methods: A total of 1000 elderly patients with chronic diseases in our health center were randomly selected as the study subject. Questionnaire survey was conducted by self-designed questionnaire. The SF-36 quality of life scale was used to evaluate their quality of life; and linear regression model was used to explore the relevant influencing factors. Result: The SF-36 score showed that there was a correlation between the six dimensions, including overall health, physiological function, somatic pain, vitality, social function and mental health, and the number of chronic diseases in elderly patients. With the increase of chronic diseases, the scores of each dimension showed a downward trend. Linear regression analysis showed that age, anxiety and poor sleep quality were the main factors affecting the quality of life in elderly patients with chronic diseases. Conclusion: The quality of life of elderly patients with chronic diseases in our city is poor. In community work, targeted nursing and intervention should be given according to the types of diseases suffered by the elderly.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87731602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: In accordance with the exclusion criteria,700 cases of elderly patients with AF were selected. The average age was 77.1±6.9 years old. There were 316 cases of male (45.1%) and 384 cases of female (54.9%).Age and GenderThe chosen patients were divided into three groups (65-74 years old, 75-84 years old, 85 years old and above). The number of AF was increased with age, and the largest proportion (49.9%) was 75-84 years old group. In every group, female was more than male (P>0.05).Relative CausesThe number of different causes of elderly AF: 481 cases of coronary heart disease(68.7%), 406 cases of hypertension (58.0%), 341 cases of heart failure (48.7%), 191 cases of diabetes (27.3%), 105 cases of valvular disease(15.0%), 25 cases of myocardiopathy (3.6%), 21 cases of sinus sick syndrome (3.0%), 20 cases of pulmonary heart disease(2.9%), 15 cases of lone AF (2.1%), 2 cases of congenital heart disease (0.3%). Then, 41 cases of rheumatic valvular disease, accounting for 39. 0% of the valvular disease, 5.9% of the total.Types of AFThere were 595 cases of nonvalvular AF, accounted for 85.0% of the total. The ratio of male to female was 1:1.2. In volvular AF, the ratio of male to female: was 1:1.3. In 314 cases of PAF, the ratio of male to female: was 1:1.3. In 386 cases of persistent AF, the ratio of male to female: was 1:1.1. Female was the most popular in all types (P>0.05).Clinical Data ComparisonThe age was older, the size of left atria diameter, CRP, uric acid and the incidence of heart failure, hypertension, cardiac valvular disease were higher while the LVEF was lower in PeAF group than in PAF group (P<0.05).Spearman Correlation AnalysisThere was age, heart failure, valvular disease, CRP, uric acid and left atrial diameter, which were positive correlations (P<0.05). LVEF was a negative correlation.Logistic Regression AnalysisThe risk factors for PeAF were analyzed by multivariate logistic regression analysis. It showed that left atria diameter and uric acid level were the independent risk factors of elderly PEAF.Conclusion:In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes o
{"title":"Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly","authors":"H. Li","doi":"10.30564/JGR.V1I01.735","DOIUrl":"https://doi.org/10.30564/JGR.V1I01.735","url":null,"abstract":"Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: In accordance with the exclusion criteria,700 cases of elderly patients with AF were selected. The average age was 77.1±6.9 years old. There were 316 cases of male (45.1%) and 384 cases of female (54.9%).Age and GenderThe chosen patients were divided into three groups (65-74 years old, 75-84 years old, 85 years old and above). The number of AF was increased with age, and the largest proportion (49.9%) was 75-84 years old group. In every group, female was more than male (P>0.05).Relative CausesThe number of different causes of elderly AF: 481 cases of coronary heart disease(68.7%), 406 cases of hypertension (58.0%), 341 cases of heart failure (48.7%), 191 cases of diabetes (27.3%), 105 cases of valvular disease(15.0%), 25 cases of myocardiopathy (3.6%), 21 cases of sinus sick syndrome (3.0%), 20 cases of pulmonary heart disease(2.9%), 15 cases of lone AF (2.1%), 2 cases of congenital heart disease (0.3%). Then, 41 cases of rheumatic valvular disease, accounting for 39. 0% of the valvular disease, 5.9% of the total.Types of AFThere were 595 cases of nonvalvular AF, accounted for 85.0% of the total. The ratio of male to female was 1:1.2. In volvular AF, the ratio of male to female: was 1:1.3. In 314 cases of PAF, the ratio of male to female: was 1:1.3. In 386 cases of persistent AF, the ratio of male to female: was 1:1.1. Female was the most popular in all types (P>0.05).Clinical Data ComparisonThe age was older, the size of left atria diameter, CRP, uric acid and the incidence of heart failure, hypertension, cardiac valvular disease were higher while the LVEF was lower in PeAF group than in PAF group (P<0.05).Spearman Correlation AnalysisThere was age, heart failure, valvular disease, CRP, uric acid and left atrial diameter, which were positive correlations (P<0.05). LVEF was a negative correlation.Logistic Regression AnalysisThe risk factors for PeAF were analyzed by multivariate logistic regression analysis. It showed that left atria diameter and uric acid level were the independent risk factors of elderly PEAF.Conclusion:In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes o","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80964452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate blood pressure variability of Elder hypertensives with type 2 diabetes and its relationship with cognition. Methods: A total of 143 elderly hypertensives were enrolled and divided into diabetic group (59 cases) and non-diabetic group (84 cases). The difference of general clinical characteristics, biochemical parameters, carotid ultrasound, a neuropsychological Scales and 24-hour ambulatory blood pressure (24hABPM) parameters between the two groups of subjects were compared. Then, the two groups (diabetic group and non-diabetic group) were further divided into (Mild cognitive dysfunction) subgroup (MMSE>26) and normal cognition subgroup (MMSE≤26), respectively. On the basis of MMSE scores, the difference of the parameters of ABPM between the two subgroups was analyzed. Results: Compared with the control group, 24hSBP, 24hPP, dSBP, dPP, nSBP, nPP, 24hSSD, dSSD, nSSD, 24hSCV, dSCV and nSCV were significantly higher in the diabetic group (p<0.05). However, cognition was lower in the diabetic group. No significant difference was found in the circadian pattern of blood pressure between the two groups. 24hSSD, dSSD, nSSD, 24hSCV, dSCV, nSCV were significantly higher in the MCI subgroup than normal cognition subgroup in both diabetic and non-diabetic groups(p<0.05), and they were negatively associated with scores of MMSE, the correlation coefficient were -0.235, -0.246, -0.341, -0.158, -0.222, -0.238 (0.001≤P<0.05). Conclusion: The study showed that in the elderly with hypertension, the mean systolic blood pressure and blood pressure variability were both higher in the diabetic group, and the cognition was lower instead. Whether or not with diabetes, blood pressure variability was always higher in the MCI subgroup. Blood pressure variability increased in patients with diabetes, and was associated with cognitive decline.
{"title":"Blood Pressure Variability and Its Relationship with Cognitive Function in Elderly Patients with Essential Hypertension and Type 2 Diabetes","authors":"Man Xu","doi":"10.30564/JGR.V1I01.727","DOIUrl":"https://doi.org/10.30564/JGR.V1I01.727","url":null,"abstract":"Objective: To investigate blood pressure variability of Elder hypertensives with type 2 diabetes and its relationship with cognition. Methods: A total of 143 elderly hypertensives were enrolled and divided into diabetic group (59 cases) and non-diabetic group (84 cases). The difference of general clinical characteristics, biochemical parameters, carotid ultrasound, a neuropsychological Scales and 24-hour ambulatory blood pressure (24hABPM) parameters between the two groups of subjects were compared. Then, the two groups (diabetic group and non-diabetic group) were further divided into (Mild cognitive dysfunction) subgroup (MMSE>26) and normal cognition subgroup (MMSE≤26), respectively. On the basis of MMSE scores, the difference of the parameters of ABPM between the two subgroups was analyzed. Results: Compared with the control group, 24hSBP, 24hPP, dSBP, dPP, nSBP, nPP, 24hSSD, dSSD, nSSD, 24hSCV, dSCV and nSCV were significantly higher in the diabetic group (p<0.05). However, cognition was lower in the diabetic group. No significant difference was found in the circadian pattern of blood pressure between the two groups. 24hSSD, dSSD, nSSD, 24hSCV, dSCV, nSCV were significantly higher in the MCI subgroup than normal cognition subgroup in both diabetic and non-diabetic groups(p<0.05), and they were negatively associated with scores of MMSE, the correlation coefficient were -0.235, -0.246, -0.341, -0.158, -0.222, -0.238 (0.001≤P<0.05). Conclusion: The study showed that in the elderly with hypertension, the mean systolic blood pressure and blood pressure variability were both higher in the diabetic group, and the cognition was lower instead. Whether or not with diabetes, blood pressure variability was always higher in the MCI subgroup. Blood pressure variability increased in patients with diabetes, and was associated with cognitive decline.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83565496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-17DOI: 10.5772/INTECHOPEN.86204
Sabina Vatter, I. Leroi
Long-term partnerships are important as they can determine happiness, influence physical and mental health and lengthen one’s lifespan. However, complex neurodegenerative conditions, such as Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB), can disrupt long-term relationships and even lead to dissolution of the partnership. The majority of studies in this field have focused on exploring the effect of PDD and DLB on care partners’ outcomes but the impact of these conditions on dyadic, long term relationships is less well understood. We conducted a series of studies with people with PDD or DLB and their caregiving life partners using quantitative and qualitative methods. We demonstrated that PDD and DLB has a tremendous impact on the caregiving life partners and reduces relationship satisfaction. We argue for more studies in this field and recommend that future research focuses on strengthening dyadic relationships, which can ultimately preserve relationships and delay institutionalisation of the person with PDD and DLB, which has cost saving implications.
{"title":"Long-Term Partnerships in Lewy Body Dementias","authors":"Sabina Vatter, I. Leroi","doi":"10.5772/INTECHOPEN.86204","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.86204","url":null,"abstract":"Long-term partnerships are important as they can determine happiness, influence physical and mental health and lengthen one’s lifespan. However, complex neurodegenerative conditions, such as Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB), can disrupt long-term relationships and even lead to dissolution of the partnership. The majority of studies in this field have focused on exploring the effect of PDD and DLB on care partners’ outcomes but the impact of these conditions on dyadic, long term relationships is less well understood. We conducted a series of studies with people with PDD or DLB and their caregiving life partners using quantitative and qualitative methods. We demonstrated that PDD and DLB has a tremendous impact on the caregiving life partners and reduces relationship satisfaction. We argue for more studies in this field and recommend that future research focuses on strengthening dyadic relationships, which can ultimately preserve relationships and delay institutionalisation of the person with PDD and DLB, which has cost saving implications.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91258799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-07DOI: 10.5772/INTECHOPEN.85096
A. Keskin, Nazlı Durmaz, G. Uncu, E. Erzurumluoglu, Z. Yıldırım, N. Tuncer, D. O. Adapınar
Alzheimer’s disease is an age-related progressive neurodegenerative disorder. The two major neuropathologic hallmarks of Alzheimer’s disease (AD) are extracellular Amyloid beta (A β ) plaques and intracellular neurofibrillary tangles (NFTs). A number of additional pathogenic mechanisms, possibly overlapping with A β plaques and NFTs formation, have been described, including inflammation, oxidative damage, iron dysregulation, cholesterol metabolism. To date, only symptomatic treatments exist for this disease, all trying to counterbalance the neurotransmitter disturbance. To block the progression of the disease they have to interfere with the pathogenic steps responsible for the clinical symptoms, including the deposition of extracellular amyloid β plaques and intracellular neurofibrillary tangle formation, inflammation and stem cell. In this review, we discuss new potential disease-modi-fying therapies for AD that are currently being studied in phase I–III trials.
{"title":"Future Treatment of Alzheimer Disease","authors":"A. Keskin, Nazlı Durmaz, G. Uncu, E. Erzurumluoglu, Z. Yıldırım, N. Tuncer, D. O. Adapınar","doi":"10.5772/INTECHOPEN.85096","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85096","url":null,"abstract":"Alzheimer’s disease is an age-related progressive neurodegenerative disorder. The two major neuropathologic hallmarks of Alzheimer’s disease (AD) are extracellular Amyloid beta (A β ) plaques and intracellular neurofibrillary tangles (NFTs). A number of additional pathogenic mechanisms, possibly overlapping with A β plaques and NFTs formation, have been described, including inflammation, oxidative damage, iron dysregulation, cholesterol metabolism. To date, only symptomatic treatments exist for this disease, all trying to counterbalance the neurotransmitter disturbance. To block the progression of the disease they have to interfere with the pathogenic steps responsible for the clinical symptoms, including the deposition of extracellular amyloid β plaques and intracellular neurofibrillary tangle formation, inflammation and stem cell. In this review, we discuss new potential disease-modi-fying therapies for AD that are currently being studied in phase I–III trials.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"4999 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82018017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-02DOI: 10.23937/2469-5858/1510070
Naschitz Prof. Jochanan E
Background: Diagnosing dehydration in frail older persons is challenging. Objective: In residents of long-term geriatric and palliative care to appraise which clinical signs and laboratory data are associated with dehydration. Methods: Study Part I is a cross-sectional point of care assessment of data which might distinguish dehydrated from euhydrated subjects. Twelve potential markers of dehydration were evaluated: inadequate fluid intake, vomiting, diarrhea, bleeding, diuretic treatment, serum sodium, serum urea and creatinine, urea/creatinine ratio, estimated glomerular filtration rate, hemoglobin and serum albumin. Study Part II is a longitudinal survey of patients at risk of dehydration under changing clinical conditions. He clinical and laboratory data were prospectively followed and related to the patients’ hydration state. Results: By point-of-care assessment (Study Part I) no single clinical or laboratory parameter correlated with dehydration. On longitudinal survey (Study Part II), useful in the diagnosing of dehydration were patient history corroborated with clinical and laboratory parameters designed ‘potential markers of dehydration’. Seven case studies illustrate a variety of scenarios under which dehydration may occur. Conclusions: Diagnosing dehydration in residents of longterm geriatric and palliative care is challenging. Useful to this aim are the day-to-day examination of the patient by the same clinician, with or without the support of conventional ‘laboratory markers of dehydration’. Overemphasis and dependence on laboratory markers may be mislead the physician.
{"title":"Dehydration Prevention and Diagnosis: A Study in Long-Term Geriatric and Palliative Care","authors":"Naschitz Prof. Jochanan E","doi":"10.23937/2469-5858/1510070","DOIUrl":"https://doi.org/10.23937/2469-5858/1510070","url":null,"abstract":"Background: Diagnosing dehydration in frail older persons is challenging. Objective: In residents of long-term geriatric and palliative care to appraise which clinical signs and laboratory data are associated with dehydration. Methods: Study Part I is a cross-sectional point of care assessment of data which might distinguish dehydrated from euhydrated subjects. Twelve potential markers of dehydration were evaluated: inadequate fluid intake, vomiting, diarrhea, bleeding, diuretic treatment, serum sodium, serum urea and creatinine, urea/creatinine ratio, estimated glomerular filtration rate, hemoglobin and serum albumin. Study Part II is a longitudinal survey of patients at risk of dehydration under changing clinical conditions. He clinical and laboratory data were prospectively followed and related to the patients’ hydration state. Results: By point-of-care assessment (Study Part I) no single clinical or laboratory parameter correlated with dehydration. On longitudinal survey (Study Part II), useful in the diagnosing of dehydration were patient history corroborated with clinical and laboratory parameters designed ‘potential markers of dehydration’. Seven case studies illustrate a variety of scenarios under which dehydration may occur. Conclusions: Diagnosing dehydration in residents of longterm geriatric and palliative care is challenging. Useful to this aim are the day-to-day examination of the patient by the same clinician, with or without the support of conventional ‘laboratory markers of dehydration’. Overemphasis and dependence on laboratory markers may be mislead the physician.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45500825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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