Factors associated with activities of daily living among the disabled elders with stroke

Objective:To determine the factors associated with activities of daily living(ADL)among the disabled elders post-stroke.Methods:A total of 158 patients were chosen from community health service stations in eighteen regions of Tianjin city by convenience sampling from March to November in 2013.The Barthel Index(BI)and the short-formmini-nutritional assessment(MNA-SF)were used to evaluate the ADL,the nutritional status respectively.Statistical analysis was performed using independent sample t-test,one-way ANOVA,Pearson correlation and multiple linear regression analysis.Barthel ADL index was the main outcome.Results:The mean score of ADL was 50.50±27.125.The multiple linear regression showed that the factors which had significant impact on ADL were stroke frequency,types of stroke,nutritional status,financial status,and age.Conclusions:Disabled elders with recurrent strokes,hemorrhagic stroke,dependent financial resources,older age,worse nutritional status and living with family had poorer strokerelated outcome.Healthcare providers can discover the high-risk groups of disability and implement individualized preventive interventions in accordance with the related factors.

Clinical use of low-dose aspirin for elders and sensitive subjects

The use of low-dose aspirin(LDA)has been a common preventive measure to reduce the risk of cardiovascular events.This is attributed to aspirin’s ability to inhibit platelet activation.On the other hand,the use of LDA in human subjects has been associated with the development of gastrointestinal injuries like ulcer and bleeding,especially for those sensitive subjects such as elder human subjects.This opinion review will summarize the recent clinical reports regarding the use of LDA and the development of gastrointestinal conditions in China.Based on these reports,it seems that the use of LDA is commonly associated with gastrointestinal injuries,and stopping its use leads to recovery in elderly subjects.Therefore,we would like to suggest that gastroduodenal health and conditions should be seriously taken into consideration when LDA is recommended to the elderly,or other alternative means to reduce the risk of cardiovascular events such as nutritional interventions should be suggested.

Detecting Dementia-Related Wandering Locomotion of Elders by Leveraging Active Infrared Sensors

For elders with dementia, wandering is among the most problematic, frequent and dangerous behavior. Managing wandering behavior has become increasingly imperative due to its high prevalence, negative outcomes and burden on caregivers. We study to propose an active infrared-based method to identify wandering locomotion by monitoring rhythmical repetition of an elder’s indoor motion events. Specifically, we utilize our customized active infrared sensors to collect human indoor motions that will be converted into motion events by using hardware redundancy technique. Each motion event is a directed motion obtained via introducing temporal and dimensions into the spatial motion data. Based on the most cited spatial-temporal patterns of wandering locomotion, a spatiotemporal model is then proposed to identify wandering locomotion from an ongoing sequence of motion events. Experimental evaluation on eight individuals’ real-world motion datasets has shown that our proposed method is able to effectively identify wandering locomotion from repetitive events collected from active infrared sensors with a value over 98% for both accuracy and precision based on properly chosen parameters. Wandering in elders with dementia that follow specific spatiotemporal patterns can be reliably identified by analyzing repetitive motion events collected from active infrared sensors based on the well-known spatiotemporal patterns of wandering locomotion.

Assessing Basic Rehabilitation Services for Elders with Mobility Impairment

The current research seeks to examine the basic rehabilitation services for elders with mobility impairment. The research relied upon a quantitative approach and primary data which was gathered through the Drop-Off and Pick-Up (DOPU) method. The targeted respondents of this study were made up of healthcare workers, such as nurses and doctors from a group of hospitals in Zimbabwe. Therapy, assistive technologies, rehabilitation medicine, community-delivered rehabilitation were identified as the basic rehabilitation services for elders with mobility impairment. To assess the effectiveness of these services, the strength of these services had to be tested on the successful implementation of rehabilitation programs using a Structural Equation Model. In addition, these services were regarded as the independent variables of this study;while the successful implementation of the rehabilitation program was treated as a dependent variable. Based on the findings of this study, therapy, assistive technologies, rehabilitation medicine, community-delivered rehabilitation have a positive effect on the successful implementation of a rehabilitation program. The study recommends that to preserve the function and mobility among elderly and ageing individuals, the healthcare practitioners should promote strategies such as maximizing function by decreasing pain, improving the ability to self-propel and prolonging mobility and endurance through ergonomics, individualized wheelchair selection and configuration, and adaptations for increasing the capacity to handle the daily mobility demands through training, strengthening, and exercise.

A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension： a cross-sectional study

Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients （age 79.5 ＋ 6.7 years, male 63.8%） were recruited to the study. Comprehensive geriatric assessment （CGA）, including measurements about activity of daily living （ADL）, nutrition, cognition, depression, numbers of prescription medication and number of clinical diagnosis, was conducted to evaluate the physical and mental status of each participants. Fall risk was evaluated by Morse fall scale, Tinetti perform- ance oriented mobility assessment （POMA） and history of fall in the recent years. Participants were grouped into tertiles according to CGA score. Correlation between CGA and fall risk was analyzed through SPSS 18.0. Results Participants with higher CGA score were likely to be older, had a lower body mass index （BMI）, and a higher prevalence of cardiovascular disease, chronic obstructive pulmonary disease （COPD）, cerebrovascular disease and osteoarthropathia. Participants in higher tertile of CGA score got increased prevalence of fall risk than those in lower tertile （P 〈 0.01 T3 vs. T1, P 〈 0.01 T3 vs. T2）. Correlation analysis and regression analysis showed significant association between CGA and Morse fall scale （P 〈 0.001）, as well as CGA and POMA （P 〈 0.001）. Meanwhile, CGA components also showed co-relationships with increase fall risks. After adjusting age, BMI, benzodiazepine use, cardiovascular disease, cerebrovascular disease, COPD and osteoarthropathia, both history of fall in the recent year and rising Morse fall scale were significantly associated with ADL im- pairment （OR： 2.748, 95%CI： 1.598-4.725）, （OR： 3.310, 95%CI： 1.893-5.788）. Decreased Tinetti POMA score was associated with Mini-Mental State Examination （MMSE） （OR： 4.035, 95%CI： 2.100-7.751）, ADL （OR： 2.380, 95%CI： 1.357-4.175） and shortened MNA form （MNA-SF） impairment （OR： 2.692, 95%CI： 1.147-6.319）. Conclusions In elderly adults with hypertension, impaired physical and mental function is associated with increased fall risk. Further study is required to investigate possible mediators for the association and effec- tive interventions.

Gastrointestinal discomforts and dietary intake in Chinese urban elders:A cross-sectional study in eight cities of China

BACKGROUND Gastrointestinal(GI)discomforts are common in the elderly population;however,whether such discomforts are associated with dietary intake has not been studied.AIM To evaluate GI discomforts in Chinese urban elders and the associated factors.METHODS The gastrointestinal symptom rating scale(GSRS)was used to identify GI discomforts in 688 elders from eight cities of China.The semi-quantitative food frequency questionnaire and one time of 24 h dietary recall were used to access the food intake,identify dietary pattern,and calculate the nutrients intake.RESULTS About 83%of studied elders experienced at least one of GI discomforts in the past 6 mo;dyspepsia was the most commonly reported(66.7%),followed by reflux(44.8%),abdominal pain(35.9%),constipation(35.8%),and diarrhea(34.7%).Female gender,lower education level,and lower family income were associated with a higher GSRS score.Participants who were diagnosed with a GI-related disease had a higher score of constipation,but a lower score of reflux.Chronic diseases were positively associated with certain GI discomforts.Three dietary patterns were identified by the method of principal component analysis,which were characterized as high intake of salt and tea;more frequent intake of tubers,fruits,aquatic products,and soybeans;and high intake of cereal,vegetables,and meat,respectively.However,no associations between dietary patterns and GSRS score were found.The elders with a higher GSRS score had significantly lower intake of bean products.The elders whose GSRS score was≥21 and 18-20 decreased their bean production intake by 7.2(0.3,14.3)g/d and 14.3(1.2,27.3)g/d,respectively,compared with those who had a GSRS score≤17.There were no differences in other food categories,calories,or nutrients intake among elders with different GSRS scores.CONCLUSION GI discomforts are common in Chinese urban elders.GI discomforts might be associated with the choice of food.

Comparative study on ghrelin level change and its related factors in hypertensive elders with psychological distress

Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress.Methods A total of 300 elders,who were screened with Hamilton Anxiety Scale(HAMA),Hamilton Rating Scale for Depression(HAMD),and the Symptom Checklist-90(SCL-90)for psychological stress and somato-psychological manifestations respectively,were divided into hypertension group(n=148)and non-hypertension group(n=152).Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day.Results The incidences of anxiety and depression were 27.7% and 11.7%,respectively,in all the enrolled elders.However,the rates of psychological distress,particularly anxiety,were significantly higher in the hypertensive elders than in the non-hypertensive ones(43.2% vs.12.5%).Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level,and the latter two were negatively correlated with each other.Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level,which then adversely affects blood pressure in elders with psychological distress.Therefore,ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.

Role of ghrelin in cognitive impairment of hypertensive elders with chronic psychological distress

Objective:To investigate ghrelin level change in combination with psychological stress in the hypertensive old people with cognitive impairment and to explore its effect as well as possible mechanism.Methods:The study population of 300 elders was divided into 2 groups,148 with hypertension and 152 non-hypertension,who were screened for psychological distress and cognition function,and had blood drawn to measure plasma levels of ghrelin and total cortisol on the same day.Results:The rates of anxiety and cognitive impairment were higher in the hypertension elders,which were negatively correlated with plasma ghrelin level,resulted from chronic cortisol response to anxiety.Conclusion:Chronic plasma cortisol increase to long-term anxiety leads a reduce in ghrelin level which then adversely affects blood pressure and cognitive function in old people.So measuring ghrelin of elders may be a diagnostic tool to predict cognitive development and ghrelin may be a selective antihypertensive medicine for cognitive impairment elders with or without chronic psychological stress.

Situational Diagnosis of the Social Sphere of Elders Living in Retirement Homes

A situational diagnosis of the social sphere of elder permanent residents at retirement homes in Chihuahua City was created with the aid of the Social Resource Scale instrument. From the 51 participants, there were 30 female and 21 male elders. The results and conclusions of the present study highlight two major needs: a systematic assessment of permanent residents in retirement homes and the implementation of a physical activation program. The proposed physical activation program must focus on both, the recovery of motor independence and the increase of socialization activities which allows members of the retired community to improve their daily routine performance and lessens the work load on their caretakers.

The Effect of Signs Design of Wayfinding to Elders in Hospital： Take National Taiwan University College of Medicine for Example

Taiwan had officially entered aging society in 1993, and meantime the birthrate reaches its lowest point again and again. The constitution of population dramatically turns into an elder and low-birthrate society. Therefore, the ratio of elders living along is increasing yearly. When the elders need to deal the illness and go to hospital along, decays come from degeneration might have affect on their activity in accessible environment in hospital. Signs is a vital tool for delivering and communicating information in the road sign system. Whether the elders can identify the signs in hospital clearly becomes an important issue in the current research. To understand the affect of signs design in hospital to elders, the research reviewed and gained insight of degeneration in both physical and psychological of elders and the proper principal of signs design for elders. The research surveys in Taipei City, which has densest medical center, and mainly focus on National Taiwan University College of Medicine, which has hundred years of history （founded in 1895）. The research conducts field survey in both old and new buildings of National Taiwan University College of Medicine in August, 2015. The survey includes five types of signs design： Public Facilities, Prohibition, Safety, Warning, and Commercial Facilities. The result from article review indicates the most salient psychological degenerations includes the change in cognitive function, decay of memory, and deceleration of information processing; physical degenerations includes the decay of vision. As a result, the following properties should be taken into consideration when designing sings for elders： （1） The proper ratio of graphic and text. （2） Avoid using colors or matches difficult to identify by elders, like purple, blue, and green. （3） Take the visibility, legibility, identity, attention, and memory into consideration, there should be 70% differentiation in contrast between text of sign and background. （4） Avoid using multi-meaning graphic, keep the design simple. The result from the survey of National Yaiwan University College of Medicine indicates： （1） Using mainly on graphic and text as subsidiary, part of the sign design using both Chinese and English, and make sure the appropriateness of ratio between graphic and text. Use more of sans-serif font, which has better legibility. （2） Match the color mainly as yellow background with black graphic, blue background with white graphic, white background with black graphic, white background with blue graphic, a strong contrast between background and graphic on brightness and chroma matches the principle of visibility, legibility, and identity. （3） Simplify the signs design may safeguard its visibility. When elder need to handle illness comes from degeneration alone and go to large and complex hospitals frequently, the decay of their mental and physical might have a huge negative affect. Therefore, the signs design in hospital should understand their properties and design signs that match their requirement, to safeguard their live independency.

Characteristic Autonomic Nervous Activity of Institutionalized Elders with Dementia

This study clarified the characteristic autonomic nervous activity of institutionalized elders diagnosed with dementia using Hasegawa’s Dementia Scale-Revised. Twenty-six healthy adult persons (HPs) in their 20 s - 40 s met the inclusion criteria, and 16 persons (27.6 ± 8.2 years old) completed the research procedure. Of 70 persons with dementia (PDs) residing at the one geriatric health services facilities, only 24 persons met the inclusion criteria, and only nine (N = 9, 83.44 ± 9.45 years old) completed the procedure. Actigraph and ambulatory electrocardiographic instruments measuring autonomic nervous activity were attached to the subjects for 24 hours. Activities and behaviors of PDs and HPs were observed by clinically experienced staff nurses and care workers. High frequency (HF) power indicating parasympathetic activity and LF/HF ratio indicating sympathetic activity were calculated. When awake, PDs’ LF/HF ratio was significantly lower than HP’s (Z = -2.60, p < 0.01), showing significant differences in the LF/HF ratios between waking and sleeping, more than those of the PDs (p < 0.001). Similarly, when awake, significant positive correlations were observed in the LF/HF ratio and actigraph activity count (AC) in 11 HPs and 3 PDs (range r = 0.17 to 0.49, p < 0.05);however, significant negative correlation was found in HF and AC of 12 HPs and 3 PDs (range r = -0.55 to -0.18, p < 0.05). While sleeping, significant positive correlations were observed in LF/HF and AC of 3 HPs and 1 PD (range r = 0.35 to 0.42, p < 0.05) and significant negative correlation was found in the HF and AC of 1 HP (r= -0.32, p < 0.001) and 1 PD (r = -0.32, p < 0.05). The mean value of LF/HF in a wakeful state was significantly lower for PDs than HPs. Combined results of behavioral observation, actigrapy and heart rate variability (HRV) analyses suggested that PDs showed positive correlations between LF/HF and AC in a wakeful state. Compared to those who showed no positive correlation, they did not require much nursing care.

Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique

BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.

Efficacy and safety of endoscopic submucosal dissection for early gastric cancer and precancerous lesions in elderly patients

BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients.METHODS Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were se-lected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022.Among them,39 patients treated with ESD were included in an experimental group,and 39 patients treated with endoscopic mucosal resection(EMR)were included in a control group.We compared the basic intraoperative conditions,postoperative short-term recovery,long-term recovery effects and functional status of gastric mucosa between the two groups;the basic intraoperative conditions included lesion resection,intra-operative bleeding and operation time;the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complic-ations;and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoper-atively;and we compared the preoperative and predischarge serum pepsinogen I(PG I)and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge.RESULTS The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group.The intraoperative bleeding volume was higher in the experimental group than in the control group.The operation time was longer in the experimental group than that in the control group,and the rate for base residual focus was lower in the experimental group than that of the control group,and the differences were all statistically significant(all P<0.05).The length of hospital stay was longer in the experi-mental group than in the control group,and the incidence of surgical complications,1-year postoperative recu-rrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group,and the differences were statistically significant(all P<0.05).However,the difference in the 1-year postoperative survival rate was not statistically significant between the two groups(P>0.05).Before discharge,PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period,and the above indexes were higher in the experimental group than those in the control group,and the differences were statistically significant(both P<0.05).Moreover,before discharge,PG II level was lower in both groups compared with the preoperative period,and the level was lower in the experimental group than in the control group,and the differences were all statistically significant(all P<0.05).CONCLUSION Compared with EMR,ESD surgery is more thorough.It reduces the rate of base residual focus,recurrence rate,surgical complications,and promotes the recovery of gastric cells and glandular function.It is safe and suitable for clinical application.

Effect of remimazolam vs. propofol on hemodynamics during general anesthesia induction in elderly patients: Single-center, randomized controlled trial

The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.

Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and metaanalysis

BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

Effect of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction

BACKGROUND The aging of the population has become increasingly obvious in recent years,and the incidence of cerebral infarction has shown an increasing trend annually,with high death and disability rates.AIM To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.METHODS Between January 2020 and December 2023,we treated 98 cases of elderly acute insula,patients with cerebral infarction in the cerebral infarction acute phase(3-4 weeks)and for the course of 6 months in Montreal Cognitive Assessment Scale(MoCA)for screening of cognition.Notably,58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group,respec-tively.In patients with cerebral infarction,magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions,the relationship between the parts of the infarction volume,and analysis of acute insula cognitive disorder in elderly patients with cerebral RESULTS The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment(P<0.05).The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group,and the difference was statistically significant(P<0.05).The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group(P<0.05).In the cognitive impairment group,the infarct volumes in the basal ganglia,thalamus,and mixed lesions were negatively correlated with the total MoCA score,with correlation coefficients of-0.67,-0.73,and-0.77,respectively.CONCLUSION In elderly patients with acute insular infarction,infarction in the basal ganglia,thalamus,and mixed lesions were more likely to lead to cognitive dysfunction than in other areas,and patients with large infarct volumes were more likely to develop cognitive dysfunction.The infarct volume in the basal ganglia,thalamus,and mixed lesions was significantly negatively correlated with the MoCA score.

Underlying Mechanisms of Tai-Chi-Chuan Training for Improving Balance Ability in the Elders

Objective： To compare balance ability between elderly individuals who practiced Tai-Chi-Chuan （TCC） for average 9.64 years and elderly individuals who did not practice TCC and its relationship with lower extremity muscle strength and ankle proprioception. Methods： Twenty-five elderly volunteers were divided into two groups according to their TCC practcing experience. Sixteen were TCC group and the other nine were control population. Subjects completed a static balance test and ankle proprioception test using a custom-designed evaluation system, and concentric and eccentric knee extensor and flexor muscle strength tests. Subjects stood on the plate form to measure the proprioception in functional standing position which was differed from the previous studies. Multiple linear regressions were also used to predict the important factor affecting balance. Results： TCC group performed better than the control group in balance, proprioception, and muscle strength of lower extremity. The proprioception was the most important factor related to balance ability and it can be accounted for explaining 44% of variance in medial-lateral sway direction, and 53% of variance in antero-posterior sway direction. The proprioception may be a more important factor which affecting the balance ability. Conclusion： TCC training is recommended to the elders; as it can improve balance ability through better proprioception.

Exploring the associations between skeletal muscle echogenicity and physical function in aging adults:A systematic review with meta-analyses

Background:Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis,treatment,and injury/disease prevention.The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases.However,relationships between muscle echogenicity and clinical functional assessments require authoritative analysis.Thus,we aimed to(a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults(≥60 years),(b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function,and(c) perform sub-analyses to determine between-muscle relationships.Methods:CINAHL,Embase,MEDLINE,PubMed,and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults.Risk-of-bias assessments were conducted along with funnel plot examination.Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function.Fisher's Z was back-transformed to Pearson's r for interpretation.Results:Fifty-one articles(n=5095,female=~2759,male=~2301,72.5± 5.8 years,mean±SD(1 study did not provide sex descriptors))were extracted for review,with previously unpublished data obtained from the authors of 13 studies.The rectus femoris(n=34) and isometric knee extension strength(n=22) were the most accessed muscle and physical qualities,respectively.The relationship between quadriceps echogenicity and knee extensor strength was moderate(n=2924,r=-0.36(95% confidence interval:-0.38 to-0.32),p <0.001),with all other meta-analyses(grip strength,walking speed,sit-to-stand,timed up-and-go) resulting in slightly weaker correlations(r:-0.34 to-0.23,all p <0.001).Sub-analyses determined minimal differences in predictive ability between muscle groups,although combining muscles(e.g.,rectus femoris+vastus lateralis) often re sulted in stronger correlations with maximal strength.Conclusion:While correlations are modest,the affordable,portable,and noninvasive ultrasonic assessment of muscle quality is a consistent predictor of physical function in older adults.Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic.Therefore,practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition,while researchers should consider combining multiple muscles to strengthen the model.