Journal of geriatric medicine and gerontology最新文献

{"title":"Primary Prevention of Alzheimer’s Disease (AD)","authors":"E. Bergamini, G. Cavallini","doi":"10.5772/INTECHOPEN.85418","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85418","url":null,"abstract":"Alzheimer dementia (AD) is a complex, aging-associated disease whose effects on the brain (an organ made up by nonreplaceable cells) are devastating. Disease is not curable, but progress in pathobiology shows that intervention on aging can make primary prevention of AD feasible. According to the amyloid-cascade hypothesis, mechanisms of AD include: an age-related alteration of free radical metabolism in membranes, leading to a higher yield in the toxic A β 1-42 peptide and an overwhelm-ing impact on the weaker repair mechanisms of the aging cells. The proposed intervention on aging with anti-AD effects includes a daily assumption of antioxidants (red wine polyphenols enriched with resveratrol), a reinforcement of membrane antioxidant defenses by the assumption of polyunsaturated fatty acids at the first meal after fasting, and an enhancement of cell repair function (at the proteasome and autophagy level by an intermittent feeding regimen and physical exercise plus the assumption of antilipolytic agents during time of fasting). The beneficial effects of diet and physical activity on the endogenous production of protective nerve growth factors are magnified by an enriched environment. Treatment has already been started on healthy individuals at a higher risk of AD in the city of Volterra .","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74959362","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":"Improvement in Nutritional Status is Associated with Achieving an Adequate Gait Speed at Discharge in Elderly Patients Hospitalized with Acute Heart Failure","authors":"Sakuragi Satoru, Kodera Nobuhisa, Iida Toshihiro, Yamada Takashi, Nakashima Mitsutaka, Moriwaki Atsushi, Koide Yuji, Wada Tadashi, Kawamoto Kenji, Tanaka Machiko, Katayama Yusuke","doi":"10.23937/2469-5858/1510068","DOIUrl":"https://doi.org/10.23937/2469-5858/1510068","url":null,"abstract":"Background: Elderly patients have impaired physical function, which is further reduced by the incidence of hospitalization for heart failure. In these patients, nutritional status also deteriorates during hospitalization, which may cause impairment in their physical function. In this study, we repeatedly measured physical function using gait speed (GS) during hospitalization, and evaluated the factors including nutritional status that are associated with GS at discharge in elderly patients with acute heart failure who underwent exercise training. Methods: From January to December 2015, we enrolled 93 consecutive patients over 80 years of age who were admitted to our hospital with acute heart failure. A 10 m walking test to measure GS was performed at the beginning of training (first time point) and at discharge (second time point). Nutritional status was assessed using the controlling nutritional status (CONUT) score. Results: At the first time point, five out of 93 patients (5%) had a GS of 30.8 m/s, whereas 24 patients (26%) achieved this speed at the second time point. Univariate logistic regression analysis revealed that age, sex, body weight, ADL before admission, handgrip strength, GS at the first time point, and improvement in CONUT score were associated with a GS of 30.8 m/s at the second time point. In the multivariate analysis, improvement in the CONUT score was associated with a GS of 30.8 m/s at discharge after adjustment for confounding factors. Conclusion: Change in nutritional status during hospitalization is associated with GS at discharge in elderly patients hospitalized with acute heart failure.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45352927","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":"Combined Spinal Epidural Anesthesia in a Geriatric Patient Undergoing Hartmann Colostmy","authors":"A. Tutak, Ö. Uludağ, M. Pektas, R. Kaya, M. Doğukan, A. Tutak","doi":"10.23937/2469-5858/1510067","DOIUrl":"https://doi.org/10.23937/2469-5858/1510067","url":null,"abstract":"Geriatric age group; Increased sensitivity to anesthetic drugs, respiratory, general anesthesia due to cardiac complicatioans and cognitive dysfunction in the postoperative period is restricted. Combined spinal epidural anesthesia compared to general anesthesia and cardiac and respiratory stabilization, the extension of the duration of anesthesia, rapid mobilization, postoperative pain control, the advantages of early discharge and a reduction in costs. High doses of spinal or epidural anesthesia alone hypotension, bradycardia, segment reduces the disadvantages of such involvement. Hartmann procedure is a method used in complex patients, especially in emergency left column pathologies. Due to sigmoid perforation emergency operations we planned 80-years-old, geriatric, severe chronic obstructive pulmonary disease (COPD) is located ASA-IV in male patients with combined spinal epidural technique for colostomy surgery, Hartmann procedure we aim to present our anesthetic experience.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44509265","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":"Predicting Suicide Attempt Risk in Older Adults","authors":"Sanchez David, Robles-Bello María Auxiliadora","doi":"10.23937/2469-5858/1510066","DOIUrl":"https://doi.org/10.23937/2469-5858/1510066","url":null,"abstract":"Introduction: Suicide attempts double death by suicide rates. To date it remains the only behavior that predicts more harmful future reattempts or deaths from suicide. However, few studies have analyzed the sociodemographic and clinical profiles of older adults who have suffered selfinflicted injuries or attempted suicide. Objective: To assess which sociodemographic and clinical variables are more predictive of a high-lethality or definitive future suicide reattempt in older adults who have suffered self-inflicted injuries or previous suicide attempts. Method: Digital data logged by emergency departments on people aged 50 and overadmitted for self-inflicted injuries or suicide attempt were collected. Results: The binary logistic regression analysis revealed the group of variables most predictive of suicide attempt as being female (OR = 2.70; 95% CI), aged between 61 and 90 years (OR = 6.99; 95% CI), widowed (OR = 3.12; 95% CI), with a pre-existing depressive condition (OR = 3.95; 95% CI) and physical pathologies (OR = 4.98; 95% CI), resorting to single methods (OR = 4.72; 95% CI), and usually discharged from emergency departments (OR = 6.89; 95% CI). Conclusions: There is an urgent need for specific healthcare protocols designed to prevent suicide attempts, adapted to the psychosocial characteristics of this age group. Improvements to social and healthcare warning actions for older adults exhibiting suicide risk profiles also need to be made.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45575743","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":"Could we Spare Carbapenems for Empiric Therapy in ESBL-Enterobacteriaceae Colonized Elderly with Community-Onset Sepsis?","authors":"M. Klevišar, L. Lusa, S. Terzić, M. Mueller–Premru, M. Pirs, D. Stupica","doi":"10.23937/2469-5858/1510059","DOIUrl":"https://doi.org/10.23937/2469-5858/1510059","url":null,"abstract":"The preference for empiric antibiotic therapy with carbapenems over non-carbapenems in all extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonized patients with sepsis warrants further investigation from an ecologic perspective; even more so in the elderly (≥ 65 years) because the proportion of ESBL-E in adults increases with patients’ age. In this retrospective observational study, enrolling 547 ESBL-E colonized elderly patients with community-onset sepsis, hospitalized at a single medical centre from 2011 to 2015, the positive predictive value of ESBL-E faecal colonization for ESBL-E aetiology of sepsis was significantly higher (66.1%) when sepsis originated from a urinary tract infection than from a respiratory tract infection (26.1%), other known origins (31.6%), or an unidentified origin (13.0%). Carbapenems were prescribed empirically in 145 patients (26.5%), and 402 received non-carbapenem antibiotics. Univariate analysis suggested a higher 30-day mortality in the non-carbapenem vs. carbapenem group. However, the estimated association was smaller and not significant (OR = 1.1, 95% CI, 0.6-1.9, P = 0.62) in the multiple regression analysis adjusted for age, sex, Charlson comorbidity index score, and severity, origin or aetiology of sepsis. Therefore, carbapenem-sparing empiric therapy seems appropriate for non-critically ill elderly ESBL-E carriers with community-onset sepsis, even more so when sepsis originates outside urinary tract.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42487815","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":"Integrating Traditional Chinese Medicine (TCM) into Health Care of Elderly-A Short Review","authors":"Yunwan Chen, Yu-Liang Chen, Ko Fu-Yang, Lo Lun-Chien","doi":"10.23937/2469-5858/1510060","DOIUrl":"https://doi.org/10.23937/2469-5858/1510060","url":null,"abstract":"Traditional Chinese Medicine (TCM) emphasizes the combination of: The physical, psychological, spiritual, social, and environmental aspects. These aspects encourage human beings to live in harmony with the rhythm of nature. We believe these principles match with up the ideas of holistic care, and the characteristics of TCM therapies are much gentler and safer for the elderly. Nowadays, significant evidence supports the effectiveness and safety of TCM for seniors’ health care. In this short review, we shall provide some brief illustrations for healthcare professionals to understand some of TCM’s concepts for Geriatrics.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42772080","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":"Clinical and Etiological Study of Onychomycosis in Institutionalized Elderly in Goiânia City, Goiás State, Brazil","authors":"Oliveira Jefferson Teixeira, S. M. Silva, Naves Wesley Vieira, Costa Hygor Lima, S. Santana, Freitas Vivianny Aparecida Queiroz, Silva Maria do Rosário Rodrigues, Junior Milton Camplesi, Silva Antonio Márcio Teodoro Cordeiro, Ataides Fábio Silvestre","doi":"10.23937/2469-5858/1510062","DOIUrl":"https://doi.org/10.23937/2469-5858/1510062","url":null,"abstract":"Background: Onychomycosis is fungal nail infection, which can be associated with some factors, such as decreased nail growth and immunodeficiency, makes the elderly predisposed to onychomycosis. The objective of this study was to investigate the frequency of onychomycosis in elderly institutionalized, and to verify the effects that the infection had in their daily routine. Methods: This study was carried in gerontological complexes of Goiânia, Goiás, Brazil, with 58 elderly who exhibited clinical suspicion of onychomycosis and a questionnaire was provided to the elderly regarding the effects that the infection had in their daily routine. Results: Among the 33 cases of the onychomycosis confirmed, 63.6% were female and 36.4% male. The participant ages ranged from 55 to 86 years (51.3 years ± SD = 32.8). In this study, no statistically significant between age (p = 0.362) and sex (p = 0.234) associated of Onychomycosis in institutionalized elderly. The etiological agents Trichophyton rubrum were isolated in 9.1% and Fusarium spp. in 15% of the positive samples. The genus Candida was identified in 46.5% of the samples, and Candida parapsilosis (30.3%) was the most frequent species. The applied questionnaire verified that more than 90% of participants answered that other people notice the presence of the nail lesion; That the of nail injuries influences their choice of shoes; and that perceive the difference in nail characteristics, such as thickness and discoloration. Conclusions: This study found a higher frequency of onychomycosis in women, and the main etiological agents were Candida spp. and Fusarium spp. The onychomycosis significantly changes the routine of its patients, with most participants reporting that people find it unpleasant to look at their nails and note the problem and they are uncomfortable with the appearance of the lesion. In clinical question, the participants also notice the change in the characteristics of their nails, difficulty in cutting and, nail and finger/toe pain.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45860217","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":"Effect of Vitamin D Level and Physical Exercise on the Physical Performance and Functional Test Results in Elderly Women","authors":"Nascimento Neide Ap, Moreira Patricia Fp, A CarvalhoVanessa, Aragão Levy, Marin-Mio Rosangela Villa, Lazaretti-Castro Marise, S CendorogloMaysa","doi":"10.23937/2469-5858/1510061","DOIUrl":"https://doi.org/10.23937/2469-5858/1510061","url":null,"abstract":"Background: Physical exercises are highly effective in slowing muscle wasting and loss of function. However, whether vitamin D deficiency can interfere with this process in elderly individuals remains unclear. The objective of this study was to investigate the effect of 25(OH)D supplementation along with physical exercise in elderly women in an intervention study design. Methods: We analyzed data from elderly women aged ≥ 60 years (mean age, 67 ± 5 years) who exercised regularly for at least one year at the Social Service of Commerce Santana, Community Center. We included 146 elderly women in the aquatic training program (AT), 99 elderly women in the multifunctional fitness program (MF), and 100 communitydwelling elderly women who had not been exercising for the last year as the control group (CT). In each group, we administered cholecalciferol to those who had 25(OH)D levels below the median levels. The individuals in the aquatic training supplemented group (ATSG), multifunctional fitness supplemented group (MFSG), and control supplemented group (CTSG) received one bottle of cholecalciferol each. They were instructed to consume 21,000 IU/week (4 drops/ week) of cholecalciferol for 12 months. The timed up-andgo (TUG) test, 2-min step (2MST), 30-s chair stand (CS), functional reach (FRT), unipedal balance test with visual control (UB), and a portable dynamometer for the strength of hip flexors (HS) were conducted, and the serum 25(OH)D and intact parathyroid hormone (PTH) levels were measured at the beginning and end of the 12 months. The treatments were compared using a general linear model for repeated measures, with p < 0.005. Results: There was a significant increase in 25(OH)D levels in ATSG (p < 0.001), MFSG (p < 0.001), and CTSG (p < 0.001). The relationship between 25(OH)D levels and physical exercise was significant in TUG (p = 0.005), UB (p = 0.03), HS (p < 0.001), CS (p = 0.04), and 2MST (p = 0.02). Conclusion: We found an interaction of 25(OH)D levels with physical exercise in elderly women for maintaining independence in daily activities and performance.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47236913","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":"Influencers of Health Related Quality of Life in People with Faecal Incontinence","authors":"Inat Stephanie L, Gill Tiffany K, Avery Jodie C","doi":"10.23937/2469-5858/1510065","DOIUrl":"https://doi.org/10.23937/2469-5858/1510065","url":null,"abstract":"Background: Faecal Incontinence (FI) is a common debilitating condition that, significantly decreases healthrelated quality of life (HRQoL). However, there is uncertainty about its prevalence and the factors that modulate the relationship between FI and HRQoL, which reduces the efficiency and effectiveness of clinical and public-health interventions. Objective: To assess the prevalence of FI, its risk factors, and determine which factors influence the FI HRQoL relationship. Design: Data was taken from the 2004 representative cross-sectional population South Australian Health Omnibus, n = 3015 men and women aged 15 and over. The main outcome measures were the prevalence and severity of FI, urinary incontinence (UI), other comorbidities and various demographic variables. The SF-36v2 Quality of Life questionnaire was also administered. Results: Prevalence of FI was found to be 1.7% (95% CI: 1.3-2.2%). Univariate analysis found increased reporting in females, those aged 55 and over, separated/divorced, with annual household income < $A30,000 and economically inactive, to be associated with increased reporting. Comorbid UI, depression and obesity also conferred greater risk. HRQoL was decreased in FI compared to those without. Respondents aged over 55 years, being economically inactive and having comorbid depression were associated with significantly more negative HRQoL scores (p < 0.05). Severity of symptoms, gender, annual income and comorbid UI were not associated with any significant difference in HRQoL. Nor were marital status, education status, country of birth, area of residence, comorbid diabetes or Body Mass Index. Conclusions: FI results in a decreased HRQoL, most extreme with increased age, unemployment and those with comorbid depression. Future research is needed to further explore and validate these relationships in order to guide public health interventions and resource allocation.","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43648684","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":"A Submandibular Mass in an Elderly Patient","authors":"Figueiredo Inês Rego de, Alves Rita Vieira, Castro Sara Guerreiro, Lourenço Filipa, Antunes Ana Margarida, Martins-Green Manuela, Gruner Heidi, Panarra António","doi":"10.23937/2469-5858/1510064","DOIUrl":"https://doi.org/10.23937/2469-5858/1510064","url":null,"abstract":"The diagnosis of a neck mass can present a challenge. In the adult the most common diagnosis is malignancy, and both primary and metastatic tumors should be considered. Other frequent options are infectious processes. We present the case of an 88-year-old female patient with a submandibular mass with inflammatory signs, unresponsive to antibiotic therapy, with fine needle aspiration biopsy showing an inflammatory lesion. The mass developed over a month with associated anorexia resulting in admission for diagnosis with open biopsy. Following admission, an invasive carcinoma of the right breast was diagnosed, and the Mycobacterial culture of the submandibular mass biopsy was positive for Mycobacterium tuberculosis. Immunosenescence the elderly contributes to vulnerability to cancers but also infections which can present atypically and thus result in delayed diagnosis. The physical characteristics of the mass are also important for differential diagnosis. Solid, hard, or fixed, with irregular limits are suggestive of solid malignancies; multiple soft and rubbery masses suggest lymphoma; masses with inflammatory signs suggest infectious causes [6]. Inflammatory masses can result from inflammation of lymph nodes (cervical adenitis), which are usually self-limited and resolve spontaneously [2]. Chronic inflammation of submandibular or parotid glands with chronic sialadenitis is also possible [2]. Infectious causes can be viral, bacterial or fungal in nature [2,6]. Viral infections such as Cytomegalovirus (CMV), Epstein-Barrvirus (EBV), measles, Adenovirus, Echovirus, Rhinovirus and Respiratory Syncitial Virus (RSV) [2,6] usually present with multiple lymph nodes with cervical adenitis. Bacterial infections can cause necrosis, with abscess formation, spontaneous drainage and even chronic fistula formation [2]. Other agents should also be considered namely mycobacterial [2,6], cat-scratch disease by Bartonella [6,7], actinomycosis [2,6], Toxoplasma gondii [8]. Other less frequent causes are gout [9], inflammatory pseudotumor [10], Kimura’s disease [11], Castleman’s disease [12] and sarcoidosis [13]. Diagnosis is usually made by fine needle aspiration cytology, which is a rapid and sensitive method [1,6]. If the diagnosis remains unclear, an open biopsy may be necessary [1,6]. Laboratory tests vary with presentation, but should include inflammatory parameters including CASe RePoRt","PeriodicalId":91314,"journal":{"name":"Journal of geriatric medicine and gerontology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44657727","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}