International Journal of Gerontology最新文献

{"title":"Cognitive Effect of Repetitive Transcranial Magnetic Stimulation with Cognitive Training: Long-Term Mitigation Neurodegenerative Effects of Mild Alzheimer's Disease","authors":"Juyoun Lee, E. Sohn, E. Oh, C. Song, S. Jeong, A. Lee","doi":"10.6890/IJGE.202005_14(2).0009","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0009","url":null,"abstract":"Background: Despite several studies having reported on the cognitive effects of repetitive transcranial magnetic stimulation (rTMS) in Alzheimer's disease (AD), no studies, to date have addressed the long-term effects of rTMS with cognitive training (CT). This study was aimed to investigate the long-term effects of rTMS-CT in mild AD. Methods: Patients with mild AD (Mini-mental Status Examination [MMSE] score of 21-26), diagnosed based on the diagnostic and statistical manual of mental disorders-IV, were recruited and randomly allocated to two groups, treatment and sham, in a 2:1 ratio. We matched the acetylcholinesterase inhibitor (AChEI)-only group to the treatment group to comparing the long-term effect of rTMS-CT. Treatment group was treated for 6 weeks with high-frequency (10 Hz) rTMS-CT, whereas the other group received 6 weeks of the sham management. These groups underwent neuropsychological tests at baseline, immediately after rTMS-CT, and 6 weeks after the last rTMS-CT. Data of AChEI-only and treatment groups were analyzed changes of cognitive scores (MMSE, and clinical dementia rating-sum of boxes scales) over 3 years. Results: Among the 44 enrolled mild AD (mean age, 72.5 years; females, 36.4%), the rTMS-CT group (n = 30) showed improvement on the ADAS-Cog score for 12 weeks compared with the sham group (n = 14). The rTMS-CT group showed slower rates of neurodegeneration than those in the AChEI-only group (n = 60) during the 3 years of follow-up. Conclusions: Compared to the administration of AChEI only, the use of rTMS-CT might be a useful supplementary interventional strategy in mild AD for long-term mitigation of neurodegeneration.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"2 1","pages":"133-137"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79201144","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}

{"title":"Impact of Immediate Treatment Within Four Days on Prognosis in Severe Traumatic Brain Injury Patients Without Vasospasm","authors":"J. Lin, Cheng-Chia Tsai, T. Tsai, Yu-Jen Chen","doi":"10.6890/IJGE.202005_14(2).0011","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).0011","url":null,"abstract":"Background and objectives: Traumatic brain injury (TBI) is associated with high mortality rate and long-term disability. Application of the Brain Trauma Foundation's ＂Guidelines for the management of severe traumatic brain injury＂ would reduce the prevalence of morbidity and mortality. However, the prevalence of some predictors of TBI have not been studied well with respect to the guidelines, for example, vasospasm. This study evaluated the correlation between the prognostic factors and outcome in patients without vasospasm. Materials and Methods: All patients were treated as per the aforementioned guidelines. Ten patients were prospectively recruited and nine were examined by computed tomography angiography (CTA). The cerebral perfusion pressure (CPP) was measured before and on the fourth postoperative day and was maintained at ≥ 60 mmHg. The results of Glasgow outcome scale (GOS) and Glasgow coma scale (GCS) were collected after four weeks, three months, one year, and two years after admission. Results: There was no vasospasm noted in any of the assessed patients. Current results showed that the elderly (≥ 65 years) had poor GOS (5/6, 83.3%), whereas the younger group had better GOS (3/3, 100%) (p ＜ 0.05). Lower GCS was associated with lower GOS. The subgroup with GCS ≤ 6 (p ＜ 0.05) had a lower GOS. We also observed a better outcome when GCS was higher than 9 (≥ 10) (5/5, 100%) on the fourth postoperative day (p ＜ 0.05). Conclusions: The use of CTA to evaluate vasospasm could be a reference while following the guidelines to manage patients with severe TBI. Aggressive treatment within the first four days could help in obtaining better brain resuscitation in severe TBI patients.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"73 1","pages":"142-145"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91201680","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}

{"title":"How Do We Identify Older Adults at Risk of Dependency? Objective or Subjective Measures","authors":"H. Tseng","doi":"10.6890/IJGE.202005_14(2).EC","DOIUrl":"https://doi.org/10.6890/IJGE.202005_14(2).EC","url":null,"abstract":"world, the population of numerous countries continues to cross the threshold of different stages of aging: becoming firstly an aging society, then aged society, and finally, a super-aged society. Taiwan, for instance, is estimated to become a super-aged society in 2026. This aging tendency leads to the rising importance of cultivating a generation of robust elderlies, i.e., a healthy old population, for it will enable elder people to contribute their unique talent, which further ensures the rate of senior social engagement. Therefore, investing in health for frail old adults is a critical issue. The purpose of clinical care for frail people is to prevent disability and further improve their overall life quality. To achieve this aim, an objective multidisciplinary Comprehensive Geriatric Assessment (CGA) is applied. CGA includes the assessment of cognitive, mood, comorbidities, polypharmacy, falls, functional status of daily activities, nutritional and social support. As known, Geriatrics is a medical field that requires professionals to conduct a holistic assessment on elderlies, and a team to intervene in older adults at risk of dependency accordingly. The hope is that the early interventions and health investment made by the medical teams can collectively and effectively reduce the elderlies’ chance of disability, timely reversing their frailty. However, even though objective measures such as CGA can give reliable assessment results to assist medical professionals in identifying older adults who are at risk of dependency, the process of conducting a CGA is rather time-consuming and requires a great deal of professionalism as well as work, causing it to lack efficiency. Compared to objective measures such as the aforementioned CGA or Physical Performance Battery (PPB), subjective measures such as the “Self-Reported screening tool for older adults at risk of Dependency (SRD)” has become a pleasant alternative due to insufficient resources to conduct objective measures. With SRD, patients can reflect on their life experience and answer the health assessment questionnaire with the help of their caregivers, and report back to the medical professionals their health condition. In this case, considering the amount of time and labor saved, adopting SRD for assessment will undoubtfully boost the efficiency of the process to identify frail elderlies. Besides, Tanaka et al. present the effectiveness of two questions from a 25-question self-reported SRD that could predict the objective measures of PPB on the physical function among old adults. Since one of the major causes for elderlies to reduce to dependency is falls, the two questions are, therefore, “Have you experienced a fall in the past year?” and “Do you feel anxious about falling while walking?” Nevertheless, if necessary, medical professionals are free to apply other self-reported questionnaires with appropriate questions to identify older adults at risk of dependency. It is of utmost significance","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"1 1","pages":"89-89"},"PeriodicalIF":0.3,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89657235","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}

{"title":"Lived Experiences in the Illness Trajectory for Elderly Patients with Ovarian Cancer in Taiwan: A Phenomenological Study","authors":"Li-Yun Tsai, Shu-chen Lee, Chen-Yuan Hsu, Jung-Mei Tsai, Shiow-Luan Tsay","doi":"10.6890/IJGE.202002_14(1).0013","DOIUrl":"https://doi.org/10.6890/IJGE.202002_14(1).0013","url":null,"abstract":"Background: Elderly patients with ovarian cancer have complex emotional responses to the cancer diagnosis and treatment such as worry about performing daily routines. As cancer treatment progress, these patients need support from family, community, and health care professionals to cope with physical and psychological symptoms and impairments. Methods: Giorgi's phenomenological methodology was employed to explore the essence for elderly patients' lived experiences amid the illness trajectory of ovarian cancer. Results: Fifteen interviews were conducted. Four themes and 10 subthemes emerged from the verbatim transcripts: (1) hopelessness regarding loss of health: treatment side effects exceed expectations, worries about loss of energy hindering the cancer battle, and interruption of daily activities and interpersonal relationships; (2) endeavoring to fight for life: optimism and difficulty in establishing a new perspective on life, and cooperation with prescribed treatment; (3) managing uncertainty: realizing the impermanence of life and seizing the moment, self-reflection on the meaning of life, and attempting to regain physical health; and (4) learning to face early death: perceiving the upcoming end of life, and seeking peace of mind for lasting love. Conclusion: The low cure rate of ovarian cancer forces elderly patients to face the possibility of death. Medical teams must provide urgent and long-term medical care and value the medical autonomy of elderly patients with ovarian cancer to offer timely professional opinions and adequate care. Medical professionals should help patients develop adjustment strategies and establish a support system by integrating social resources for the holistic well-being of the patient.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"28 1","pages":"61-65"},"PeriodicalIF":0.3,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90153026","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}

{"title":"Sarcopenia and Frailty in Elderly: Manifestations, Impacts on Diseases, and Management","authors":"Wen-Chi Chao, Shen-Yung Wang","doi":"10.6890/IJGE.202002_14(1).0001","DOIUrl":"https://doi.org/10.6890/IJGE.202002_14(1).0001","url":null,"abstract":"Aging population is frequently associated with a progressive function decline. Sarcopenia and frailty are common in elderly. Sarcopenia, defined by loss of muscle mass and strength and function, is a crucial driver for frailty. Sarcopenia can result from aging process, malnutrition, inactivity, and chronic diseases. Sarcopenia is highly prevalent in frail individuals. Frailty is a geriatric syndrome connected to adverse clinical outcomes. Frailty is associated with disability or increased mortality in elderly. Sarcopenia and frailty are prevalent in various diseases such as heart failure, chronic kidney disease, chronic obstructive pulmonary disease, and critical illness. Adequate nutritional support with higher protein ingestion in addition to exercise are crucial to improve physical performance in sarcopenic or frail elderly.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"49 1","pages":"2-5"},"PeriodicalIF":0.3,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85901480","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}

{"title":"A Cross-sectional Assessment of Oral Health-related Quality of Life in Institutionalized Older People","authors":"Yao-Ming Cheng, S. Lan, S. Lan, Y. Hsieh","doi":"10.6890/IJGE.202002_14(1).0015","DOIUrl":"https://doi.org/10.6890/IJGE.202002_14(1).0015","url":null,"abstract":"","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"1368 1","pages":"71-76"},"PeriodicalIF":0.3,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85550118","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}

{"title":"Acute Dacryocystitis Complicated with Preseptal Cellulitis in Elderly","authors":"C. Hsieh, Wei-Jing Lee","doi":"10.6890/IJGE.202002_14(1).0019","DOIUrl":"https://doi.org/10.6890/IJGE.202002_14(1).0019","url":null,"abstract":"","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"45 1","pages":"87-87"},"PeriodicalIF":0.3,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81750867","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}

{"title":"Acute Fatal Chest Pain: Spontaneous Massive Hemothorax in a Patient with Neurofibromatosis Type I","authors":"K. Hsu, Wenqun Huang, Chin-Wang Hsu, Yi-Chung Yu","doi":"10.6890/IJGE.202008_14(3).0019","DOIUrl":"https://doi.org/10.6890/IJGE.202008_14(3).0019","url":null,"abstract":"NF-1 is a genetic disorder with a rare incidence rate of approximately 1 in 3000. Arterial stenosis due to connective tissue dysplasia is a well-known vascular complication of NF-1, as well as aneurysms, which constitutes 3.6% of people diagnosed with this disease. Spontaneous hemothorax is one of the rare complications of NF-1. It is potentially fatal with a mortality rate as high as 36% and postoperative mortality of 33%. Massive and potentially fatal hemothorax caused by vascular complications is extremely uncommon. We present a rare case of massive hemothorax in a 62-year-old woman with NF-1 due to a spontaneous rupture of the right intercostal artery.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"54 1","pages":"251-252"},"PeriodicalIF":0.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80324261","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}

{"title":"Which Japanese Older Adults are Least Likely to Enjoy Favorable Dietary Practices","authors":"A. Ishida, Emiko Ishida","doi":"10.6890/IJGE.201912_13(4).0013","DOIUrl":"https://doi.org/10.6890/IJGE.201912_13(4).0013","url":null,"abstract":"Background: With Japan becoming a super-aged society, extending healthy life expectancies resulting from favorable dietary practices in old age becomes an important policy agenda to curb the rapid increase in government healthcare expenditures. We clarify the comprehensive relationship between dietary practices among community-dwelling older adults and family structure. Methods: Individual data on dietary practices of older adults aged over 65 were obtained from the 2012 Survey of Attitudes toward Shokuiku (Food and Nutrition Education), which was conducted nationwide by the Cabinet Office of Japan in 2012. We applied ordered logistic regression for 483 valid respondents' data. Results: Among respondents separated by family composition and gender, dietary practices were found to be least favorable among single men. Although the majority of parameters regarding family composition were significant, no significant results were seen among single women, as compared to single men. Adjusting for possible covariates, it was found that irrespective of gender, single older adults living alone are less likely to (a) pursue well-balanced dietary habits, (b) follow a well-balanced diet, (c) attempt to enjoy eating meals, or (d) enjoy their meals. Besides family structure, subjective health status and knowledge regarding food significantly affect dietary practices among Japanese community-dwelling older adults. However, subjective economic status and place of residence were not significant predictors. Conclusion: Poor dietary habits can have significant consequences for single older adults, especially single old men, living alone.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"12 1","pages":"330-334"},"PeriodicalIF":0.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89627172","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}

{"title":"Promoting Physical Activity and Reducing Frailty of Middle-Aged and Older Adults in Community: The Effects of a Health Promotion Program Combining Smart Phone Learning and Exercise","authors":"Shu-chen Lee, Jung-Mei Tsai, Li-Yun Tsai, Li-Jen Liang, Ching-Ping Wu","doi":"10.6890/IJGE.201912_13(4).0011","DOIUrl":"https://doi.org/10.6890/IJGE.201912_13(4).0011","url":null,"abstract":"Background: To intervene the health and frailty of middle-aged and older adults lived in community is an important subject for health-related professions as society fostering healthy aging. Engaging in proper physical activity and adequate usage of smart phone are beneficial. This study explored the effects of a health promotion program on enhancing heath and reducing frailty of middle-aged and older adults. Methods: A quasi-experimental, two-group study design was conducted with purposive sampling of middle-aged and older adults from eight community care centers. The study period expanded from January to September, 2019. An intervention of smart phone learning and balance/flexibility exercise introduced to the experimental. A structural questionnaire used to collect pretest and posttest data: demographics; self-reported assessment of health, exercise, and frailty; measurement of handgrip and body mass. Descriptive and inferential statistical analyses were performed using SPSS 20.0. Results: Completed dataset consisted of 93 subjects: 39 in experimental and 54 control. For within-group comparison, exercise frequency improved significantly (p ＜ .05) in the experimental group. For between-group comparison, exercise intensity and exercise duration improved significantly at posttest. Furthermore, frailty measuring by Study of Osteoporotic Fracture (SOF) index reduced significantly for both within- and between-group comparisons. Conclusion: The health promotion program combining smart phone learning of and the moderate exercise was effective to encourage physical activity and reduce frailty for middle-aged and older adults in community. The study could provide valuable information for future studies investigating healthy aging and frailty.","PeriodicalId":50321,"journal":{"name":"International Journal of Gerontology","volume":"2 1","pages":"320-324"},"PeriodicalIF":0.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75235523","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}