{"title":"[Management of malignant tumors (systemic cancer therapy) using CGA].","authors":"","doi":"10.3143/geriatrics.62.32","DOIUrl":"https://doi.org/10.3143/geriatrics.62.32","url":null,"abstract":"","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 1","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754883","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}
{"title":"[Introduction of a smart insulin pen in an elderly patient with type 1 diabetes mellitus].","authors":"Arina Yamasaki, Shiho Egashira, Yuka Komatsu, Hitomi Minagawa, Hiroki Takayanagi, Hirokazu Takahashi, Keizo Anzai","doi":"10.3143/geriatrics.62.93","DOIUrl":"10.3143/geriatrics.62.93","url":null,"abstract":"<p><p>In elderly diabetes patients with an impaired cognitive function and activities of daily living, multiple daily insulin injection (MDI) therapy is associated with poor injection rates. However, patients with insulin-dependent conditions, such as type 1 diabetes, need to continue insulin therapy. Intermittently scanned continuous glucose monitoring (isCGM) and smart insulin pens have recently emerged as devices for blood glucose management. Smart insulin pens are devices that automatically record the insulin injection time and injection units of insulin and wirelessly transfer the data to a smartphone application. We herein report an elderly patient with type 1 diabetes who was treated with a smart insulin pen.An 84-year-old woman was diagnosed with type 1 diabetes at 45 years old and had been receiving MDI therapy. She had frequent unconscious hypoglycemia and thus had isCGM introduced at 80 years old. Her Mini-Mental State Examination score was 20 points, indicating mild cognitive decline, and isCGM revealed repeated hyperglycemia due to forgetting her insulin injection and hypoglycemia due to over-dose of insulin. When she was hospitalized for diabetic ketosis at 84 years old, a smart insulin pen was introduced. Following this introduction, her family and medical staff checked her insulin records and encouraged her to perform injections. She subsequently no longer experienced hyperglycemic crisis or severe hypoglycemia.Elderly patients with type 1 diabetes often have difficulty with self-management of MDI therapy. Smart insulin pens are expected to reduce the rate of forgetting insulin injections and improve injection rates.</p>","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 1","pages":"93-99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754881","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}
{"title":"[Circumstances and issues of support in home care services for older adults requiring insulin therapy].","authors":"Shinobu Watanabe, Akiko Wakui-Kimura","doi":"10.3143/geriatrics.62.166","DOIUrl":"https://doi.org/10.3143/geriatrics.62.166","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated the issues experienced by home care workers in providing home care support for older adults on insulin therapy.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with six home care workers, and the resulting data were coded. Data with approximate semantic content were aggregated, organized, and divided into categories and subcategories. The participants were asked about the nature of the support they provided to older adults with diabetes requiring insulin therapy, the difficulties they experienced in doing so, and their thoughts on solutions.</p><p><strong>Results: </strong>A total of 290 codes were extracted from the narratives of home care workers. The codes were then aggregated and categorized. Support provided to diabetic older adults requiring insulin therapy was organized into seven categories, such as \"substitution of family care\"; problems in providing this support were organized into eight categories, such as \"substitution of medical care\" and \"gap between the system and needs\"; and ideas on solutions for the future were organized into five categories, such as \"improvement of expertise in home care,\" \"creation of an organization and system for providing support to diabetic older adults requiring insulin therapy,\" and \"information sharing and establishment of a cooperative system with medical personnel.\"</p><p><strong>Conclusion: </strong>Home care workers provide support to older adults with diabetes who require insulin therapy in place of medical personnel and family caregivers. Furthermore, home care workers cannot cooperate with medical personnel. These findings suggest that the system for training home care workers to provide support to older adults with diabetes requiring insulin therapy and the scope of their duties should be reviewed. In addition, information on insulin therapy should be shared among professionals related to home care, and a system of cooperation and collaboration should be established to ensure that home care workers do not need to replace medical care workers.</p>","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 2","pages":"166-177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530010","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}
{"title":"[Utilization of comprehensive geriatric assessment (CGA) in geriatric nursing].","authors":"","doi":"10.3143/geriatrics.62.37","DOIUrl":"https://doi.org/10.3143/geriatrics.62.37","url":null,"abstract":"","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754901","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}
{"title":"[Cross-sectional association between social isolation and nutritional status among older urban adults: The Itabashi Longitudinal Study on Aging].","authors":"Lena Käläntär, Tatsunosuke Gomi, Keiko Motokawa, Misato Hayakawa, Yurie Mikami, Maki Shirobe, Masanori Iwasaki, Narumi Kojima, Yosuke Osuka, Hiroyuki Sasai, Hiroki Inagaki, Fumiko Miyamae, Ayako Edahiro, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata","doi":"10.3143/geriatrics.62.70","DOIUrl":"10.3143/geriatrics.62.70","url":null,"abstract":"<p><strong>Aim: </strong>The social isolation of older Japanese adults with infrequent contact with others diminishes appetite, reduces food intake, and worsens their nutritional status. However, there is insufficient evidence regarding the association between social isolation and nutritional status, with studies primarily confined to rural and suburban areas. This cross-sectional study aimed to investigate the association between social isolation and nutritional status among older adults residing in urban areas.</p><p><strong>Methods: </strong>This cross-sectional analysis included 1,052 adults (mean age, 78 years). Nutritional status was assessed using the Mini Nutritional Assessment<sup>®</sup> Short Form, with a score of 11 or below indicating malnutrition. Applying the abbreviated Lubben Social Network Scale, a score < 12 was considered indicative of social isolation. Logistic regression was applied to the entire population, then the population was separated by sex, with social isolation as the independent variable and malnutrition as the dependent variable. The covariates included age, living alone, economic status, health, daily activities, smoking habits, drinking habits, and years of education.</p><p><strong>Results: </strong>Social isolation was observed in 41.7% (n = 439) of the total population, while malnutrition was observed in 27.4% (n = 288). Social isolation was significantly associated with malnutrition (odds ratio: 1.41, 95% confidence interval: 1.06-1.88). Sex subgroup analyses revealed that a significant association was retained only among female participants.</p><p><strong>Conclusions: </strong>Social isolation has been associated with malnutrition among older urban adults in Japan. Future longitudinal studies of the nutritional status of socially isolated individuals are essential.</p>","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 1","pages":"70-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754876","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}
{"title":"[Dietary therapy in elderly patients with CKD].","authors":"","doi":"10.3143/geriatrics.62.134","DOIUrl":"https://doi.org/10.3143/geriatrics.62.134","url":null,"abstract":"","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 2","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530013","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}
Eiji Matsumoto, Tomoaki Hama, Yasuhiro Isami, Kenya Sakai
{"title":"[Myocarditis following the third dose of a COVID-19 mRNA vaccination in an older woman].","authors":"Eiji Matsumoto, Tomoaki Hama, Yasuhiro Isami, Kenya Sakai","doi":"10.3143/geriatrics.62.250","DOIUrl":"https://doi.org/10.3143/geriatrics.62.250","url":null,"abstract":"<p><p>Myocarditis is a group of inflammatory diseases that primarily affect the myocardium. It includes various pathological conditions. In addition to viruses, which are the main etiological agents, other causal agents, including bacteria, toxic substances, autoimmunity, and drugs, including vaccines, can also induce the disease.In Japan, an outbreak of coronavirus disease 2019 (COVID-19) began in January 2020, and COVID-19 messenger RNA (mRNA) vaccinations have been widely used since February 2021.Myocarditis after vaccination is reported to be more common in young males, particularly after the second vaccination. We report the case of an 80-year-old woman with no history of cardiovascular disease who was hospitalized with acute pulmonary edema one week after receiving her third dose of mRNA vaccine. She had elevated myocardial markers, new complete left bundle branch block, and a decreased left ventricular ejection fraction relative to before the onset; however, there was no stenosis or coronary artery occlusion that could have caused the disease. Although a myocardial biopsy could not be performed, myocarditis after vaccination was diagnosed based on detailed clinical findings. With noninvasive positive pressure ventilation and diuretics without steroids, the patient improved and was discharged on the 11th day. However, 1.5 years later, she developed a complete atrioventricular block and a permanent pacemaker was implanted. This case suggests that even older women can develop myocarditis after the third vaccination dose. We should carefully consider whether vaccination should be administered, even in older patients.</p>","PeriodicalId":35593,"journal":{"name":"Japanese Journal of Geriatrics","volume":"62 2","pages":"250-255"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530019","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}