Prolonged course of Paxlovid administration in a centenarian with COVID-19:A case report

BACKGROUND According to the population statistics in 2023,there were 110000 people aged over 100 years in China,and the experience of using Paxlovid(nirmatrelvir/ritonavir)for centenarians is particularly valuable.This article reports our experience of using Paxlovid in a centenarian with the novel coronavirus disease 2019(COVID-19)infection.CASE SUMMARY A 103-year-old female with mild COVID-19 and renal insufficiency was given sufficient Paxlovid for 2 days and a half dose for 3 days.During treatment,the patient was complicated with lung infection and heart failure,and nucleic acid remained positive.After expert consultation,a full dose of Paxlovid was given again on the 9th day of admission for 2 days and a half dose for 3 days.Meanwhile,anti-heart failure and antibiotics were administered;the heart failure and pulmonary infection were improved.Finally,on the 33^(th) day of admission,nucleic acid turned negative,body temperature returned to normal,cough and sputum,fatigue,poor appetite and other symptoms basically improved.The patient was given Paxlovid via nasal feeding for 2 courses without deterioration of liver and kidney function,diarrhea,nausea and vomiting,myalgia,chest tightness and other side effects,and was discharged from hospital with good recovery.CONCLUSION This case suggests that Paxlovid can be used cautiously in centenarians with renal insufficiency and two courses of treatment can be considered in patients with persistent positive nucleic acid.

A survey on hearing acuity of centenarians in Hainan Province

Objective: This study aimed to investigate hearing acuity of centenarians in Hainan Province and provide basis for interventional considerations.Method: Door-to-door follow-up was conducted to investigate hearing acuity of centenarians(aged 100 years or above) in Hainan Province. Physical examination, pure tone audiometry and acoustic impedance test were performed, and the results were analyzed.Result: A total of 460 centenarians(920 ears) were tested by pure tone audiometry. The rate of normal hearing was 0.2%, the rate of mild hearing loss was 1.5%, 12% for moderate hearing loss, 33.9% for moderate to severe hearing loss, 37.4% for severe hearing loss is and 15% for profound hearing loss. Acoustic impedance test was performed in 340 centenarians(668 ears). Tympanogram was type A in 41.2% of the ears, type As in 34.1% ears,type Ad in 6.4%, type B in 11.8%, and type C in 4.9% of the ears, while no response was elicited in 1.5% of the ears.Conclusion: Age related sensorineural hearing loss is prevalent among centenarians in Hainan Province. A probably beneficial intervention may be the use of hearing aids for effective communication.

CETP polymorphism confer genetic contribution to centenarians of Hainan,south of China

Objective:In this paper,we will discuss if the CETP polymorphism contributes to the centenarians in Hainan island.Methods:We tested the Taq IB and I405 V polymorphisms of CETP gene among 276 centenarians and 301 matched healthy individuals by AS-PCR and analyzed the data with SPSS software package(Version 19.0).Results:Our data indicated that allele B1 and V have the significant differences between centenarians and healthy control groups with P<0.001.Further analysis implied that genotypes B1B1(P<0.001,OR=0.148,95% CI=0.095-0.230) and VV(P<0.001 and OR=0.353,95% CI=0.237-0.525) were significantly different between centenarians and matched controls.The combination of B and V,such as B1B1-II(P<0.001,OR=0.128,95% CI=0.049-0.329),B1B1-IV(P<0.001,OR=0.115,95% CI=0.056-0.237),B1B2-VV(P<0.05,OR=0.534,95% CI=0.310-0.920),and B2B2-VV(P<0.001,OR=0.198,95% CI=0.086-0.453) have significant differences between centenarians and matched healthy individuals from Hainan.Conclusion:Our results implied that allele B1B1 and VV,as well as the combination B1B1-II,B1B1-IV,B1B2-VV and B2B2-VV may contribute to the longevity in centenarians of Hainan,south of China.

Article History Investigation and analysis of the quality of life of centenarians in Chongming area of Shanghai

Objective:To investigate the status quo and influencing factors of the quality of life of the elderly aged≥100 years old in Chongming area of Shanghai,and provide a basis for the construction of a world-class ecological island in Chongming area and promote the cause of healthy aging.Methods:A cross-sectional survey was conducted to screen 71 elderly people who were 100 years old and reached the age of 100.The interview was conducted with a face-to-face questionnaire survey.Results:The SF-36 health questionnaire of the centenarians in Chongming area scored and in the physiological functions,physiological functions,physical pain,general health status,energy,social function,emotional function and mental health is(36.35±13.45),(36.62±38.69),(62.56±21.57),(47.04±6.06),(67.23±18.76),(71.83±25.85),(60.09±45.29),(78.70±22.20).The total physical health assessment and mental health assessment scores are(181.577±50.271)and(277.855±81.636).Univariate statistics show that different genders,education levels,marital status,economic sources,urban or rural areas,insurance categories,chronic diseases,number of children,old-age patterns,preferred forms of residence,interval between child care,and whether children are in the same city Factors such as≥2 in the family,long-term diet,diet,eating habits,drinking habits,tea drinking habits,physical examination,lack of sleep 4h,nap habits and other factors in the different dimensions of the SF-36 scale,the difference is statistically significant(P<0.05);multivariate stepwise regression showed that the relevant influencing factors were pension mode,dietary preference,location(urban/rural),chronic disease,preferred lifestyle,lack of sleep 4 h,education level,marital status(P<0.05).Conclusion:The centenarians in Chongming area have a medium quality of life rating and a high overall mental health assessment.The centenarians in Chongming have a good psychological state.The life behavior pattern of the centenarians is worth learning.It is recommended to implement the family mutual aid public service project to alleviate the problem of loneliness of the elderly.It is recommended to strengthen the chronic disease health management for the elderly,encourage regular medical examinations,and promote the improvement of the old-age care.

Diagnosing heart failure in centenarians

Background As a consequence of the demographic development with increasing proportion of older people,the prevalence of heart failure(HF)is expected to rise with considerable economic and societal costs.However,knowledge on cardiac structure and function among population-based samples of the exceptional old is lacking.Methods Population-based study of all persons(no exclusion criteria)living in the western part of Denmark and turning 100 years in the year 2015.In-home face-to-face interviews were conducted,and echocardiography and blood sampling for plasma Brain Natriuretic Peptide(BNP)were offered to those who were able to give consent.Results Out of 303 eligible,238(79%)participated,of which 125(53%)accepted echocardiography.Left ventricular(LV)dysfunction was present in 68(54%)of the participants of whom less than half had HF symptoms.Pulmonary hypertension was present in 31(42%)with no correlation to LV function.The well-known association between increased level of BNP and the prevalence of LV dysfunction could not be confirmed.Conclusions This in-home echocardiographic study shows that more than half of the participants had LV dysfunction,although mostly asymptomatic.There was no association between heart failure symptoms and LV dysfunction.Furthermore,BNP seems to have lost its biomarker potential to rule out heart failure in centenarians.Due to the latter,and the questionable symptom validity among centenarians,the current criteria to diagnose HF might be less valid in a centenarian population than in younger olds.

Echocardiography in centenarians： characteristics, utility and follow-up

Background Echocardiography has been shown to be a valuable resource in the diagnosis of many cardiac conditions, and can be used in all age groups, from the fetus to the oldest old. In the context of an increasingly aging population, the impact and utility of echocar- diography in centenarians is largely unknown. This study is to determine whether echocardiography in centenarians aids in making clinical patient management decisions. Methods A retrospective review of echocardiograms from 1986 to 2014, at two affiliated tertiary centers, in individuals who were 100 years or older at the time of the examination. Patient and echocardiogram characteristics, management decisions based on echocardiography, and mortality were documented. Results 114 centenarians had echocardiograms, with ages ranging from 100 to 107 years （101 - 1.4 years）. In 82 of the centenarians evaluated （72%）, no changes in management occurred as a consequence of the echocardiogram. From all management changes directly related to the echocardiogram, 81% （n = 26） of these corresponded to medication adjustments; interventional or surgical procedures followed the echocardiogram only in 4% （n = 5） of the total number of centenarians. Echocardiogram-based changes in management were only significant in patients that were referred for congestive heart failure （P = 0.02）. After the echocardiogram was performed, 1-month and 1-year mortality were 15% and 47%, respectively. The median survival after the echocardiogram was obtained was 13 months （range 0.03 to 145 months）, with no difference if there was a change or no change in manage- ment （P = 0.21）. Conclusions Among centenarians undergoing echocardiography, despite additional diagnostic information, echocardio- grams in centenarians influence management in a minority of cases, most commonly in the form of medication changes for treatment of heart failure. A significant proportion of centenarians are deceased within a year of undergoing echocardiographic assessment. These findings may question the overall utility of echocardiography in these late survivors.

Listeria monocytogenes bacteremia in a centenarian and pathogen traceability:A case report

BACKGROUND Early diagnosis and appropriate antibiotic treatment are important to survival of Listeria monocytogenes(L.monocytogenes)bacteremia.Penicillin tends to be the most commonly used antibiotic.However,there are limited data on antibiotic use in elderly patients with serious complications.We describe the clinical presentation,antibiotic therapy,and traceability of L.monocytogenes in a centenarian with a history of eating frozen food.CASE SUMMARY A 102-year-old man suffered from high fever with chill after hematochezia.Tentative diagnoses were lower gastrointestinal hemorrhage and localized peritonitis.Meropenem and ornidazole were the empirical therapy.The patient did not respond and developed multiple system dysfunction even after teicoplanin was added to the therapy.L.monocytogenes was identified from blood cultures on day 5 of admission.The patient had a history of consuming frozen dumplings.Meropenem/ornidazole/teicoplanin were replaced with meropenem/linezolid.The patient gradually became afebrile.He received meropenem/linezolid for 10 d,and piperacillin/tazobactam was applied as step-down treatment for 2 wk with good clinical results.There was no sign of relapse during follow-up after discharge.L.monocytogenes isolates from the patient and frozen dumplings belonged to different serotypes and sequence types(STs):1/2b and ST5 from the patient and 1/2c and ST9 from the dumplings.CONCLUSION More awareness of listeriosis should be raised.Linezolid might be an option for listeriosis in elderly people with serious complications.

An Interciew with Chen Hansheng,a Centenarian Professor

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Epidemiological characteristics of centenarian deaths in China during 2013-2020:A trend and subnational analysis

Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods:Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China,including date,place of death(PoD),and underlying cause of death(CoD).Descriptive analyses were performed to understand the epidemiological characteristics,and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs,CoDs among centenarians,and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.Results:There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females(73.10%)and 12,627 males(26.90%).January(12.05%),February(9.99%),and December(9.74%)were the top three months with the highest number of deaths.The proportions of deaths that occurred in homes,hospitals,and nursing homes were 81.71%,13.63%,and 2.68%,respectively.The proportion of deaths in nursing homes increased by 9.60%(95%confidence intervals[CIs],6.4-12.9%)from 2014 to 2020.Heart disease(35.72%)was the leading cause of death,followed by respiratory diseases(17.63%),cerebrovascular disease(15.60%),and old age(11.22%).The proportion of respiratory diseases decreased by 4.8%(95%CI,-8.8 to-0.7%),and the proportion of deaths from old age decreased by 2.3%(95%CI,-4.4 to-0.1%)per year.Shanghai had the highest proportions of deaths in hospitals(39.38%)and nursing homes(14.68%).Sichuan had the highest proportion of deaths attributed to respiratory diseases(32.30%),while Jiangsu(26.58%)and Zhejiang(23.61%)had the highest proportions of deaths from old age.Conclusion:Unlike other countries,centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths,and this death pattern differs across provinces.

不同死亡率标准下区域长寿死亡占比指标一致性分析

目的 分析死亡漏报对区域长寿相关死亡占比水平的影响,以期为利用人口死亡登记数据开展区域长寿水平评价提供依据。方法 基于2019年全国人口死亡登记数据计算各个区县的粗死亡率。按照不同的粗死亡率标准(粗死亡率≥4.5‰,≥5.0‰,≥6.0‰,≥7.0‰)分别计算相应纳入标准情况下百岁老人、长寿老人、高龄老人死亡占比等9个指标的全国水平,采用标准差和变异系数评价各个指标的稳定性。在省级和地市水平分别计算纳入全部监测区县和只纳入粗死亡率≥6.0‰区县情况下的9个死亡占比指标,采用基于百分位数法的Bland-Altman散点图法评价两种情况下各个指标的一致性。结果 在全国水平,100岁及以上死亡占比指标的标准差最小(0.01~0.02),其次是90岁及以上死亡占比指标(0.13~0.18),80岁及以上死亡占比指标的标准差最大(0.20~0.33);变异系数最小的指标是80+/60+和100+/90+(0.43~0.44),变异系数最大的指标是100+/all和90+/all(1.69~1.80)。在省级水平和地市水平,9个死亡占比指标的95%LoA均超出了相应的专业可接受范围,意味着两种情况下的指标测量结果不可互相替换。结论 死亡漏报对全国水平长寿死亡占比指标影响较小,但是对省级水平和地市水平影响较大。在依托人口死亡登记数据报告区域长寿死亡占比指标时须遴选数据完整性较高(粗死亡率≥6.0‰)的区县进行测算,以保证结果的准确性。

Mitochondrial haplogroups associated with Japanese centenarians, Alzheimer's patients, Parkinson's patients, type 2 diabetic patients and healthy non-obese young males

The relationships between five classes of Japanese people （i.e., 96 centenarians, 96 Alzheimer＇s disease （AD） patients, 96 Parkinson＇s disease （PD） patients, 96 type 2 diabetic （T2D） patients, and 96 healthy non-obese young males） and their mitochondrial single nucleotide polymorphism （mtSNP） frequencies at individual mtDNA positions of the entire mitochondrial genome were examined using the radial basis function （RBF） network and the modified method. New findings of mitochondrial haplogroups were obtained for individual classes. The five classes of people were associated with the following haplogroups： Japanese centenarians-M7b2, D4b2a, and B5b; Japanese AD patients-G2a, B4cl, and N9b1; Japanese PD patients-M7b2, B4e, and B5b; Japanese T2D patients-B5b, M8al, G, D4, and F1; and Japanese healthy non-obese young males-D4g and D4b1b. From the points of common haplogroups among the five classes, the cente- narians have the common haplogroups M7b2 and B5b with the PD patients and common haplogroup B5b with the T2D patients. In addition, the 112 Japanese semi-supercentenarians （over 105 years old） recently reported were also examined by the method proposed. The results obtained were the haplogroups D4a, B4c1a, M7b2, F1, M1, and B5b. These results are different from the previously reported haplogroup classifications. As the proposed analysis method can predict a person＇s mtSNP constitution and the probabilities of becoming a centenarian, AD patient, PD patient, or T2D patient, it may be useful in initial diagnosis of various diseases.

A survey of the dietary nutritional composition of centenarians

Objective To make a survey of the nutritional composition of the diets of centenarians.Methods Thirty-four centenarians were selected as subjects. Retrospective surveys were made on the variety and amounts of food consumed and their nutritional composition. Physical examinations with laboratory tests such as cardiograms, ultrasonic B rays, and blood, urine and hair tests were performed.Neutron activation testing was done on hair content. The transmission turbidimetric method was used to measure apolipoprotein content.Results The main food of the centenarians showed the characteristics of low calories, protein and fat but high fiber and mineral content. Laboratory results showed that the content of the elements of Cu, Se and Mn in hair was higher ( P ＜ 0.01 ). Zn was normal. The apoA1/apoB100 ratio was higher than in the control group ( P ＜ 0.01), and total cholesterol (TC) was lower than in the control group ( P ＜ 0.01 ).Conclusions The variety of diet and its nutritional composition may be the main factors influencing not only the content of elements in body, but also the levels of apoA1 and apoB100, which may be helpful in preventing arteriosclerosis and forming and maintaining immunity. The diet of these centenarians might aid in preventing cardiovascular and cerebrovascular diseases and malignant tumors.

Analysis of chronic kidney disease staging with different estimated glomerular filtration rate equations in Chinese centenarians

Background: Accurate estimation of the glomerular filtration rate (GFR) and staging of chronic kidney disease (CKD) are important. Currently, there is no research on the differences in several estimated GFR equations for staging CKD in a large sample of centenarians. Thus, this study aimed to investigate the differences in CKD staging with the most commonly used equations and to analyze sources of discrepancy. Methods: A total of 966 centenarians were enrolled in this study from June 2014 to December 2016 in Hainan province, China. The GFR with the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Berlin Initiative Study 1 (BIS1) equations were estimated. Agreement between these equations was investigated with the k statistic and Bland-Altman plots. Sources of discrepancy were investigated by partial correlation analysis. Results: The k values of the MDRD and CKD-EPI equations, MDRD and BIS1 equations, and CKD-EPI and BIS1 equations were 0.610, 0.253, and 0.381, respectively. Serum creatinine (Scr) explained 10.96%, 41.60% and 17.06% of the variability in these three comparisons, respectively. Serum uric acid (SUA) explained 3.65% and 5.43% of the variability in the first 2 comparisons, respectively. Gender was associated with significant differences in these 3 comparisons (P<0.001). Conclusions: The strengths of agreement between the MDRD and CKD-EPI equations were substantial, but those between the MDRD and BIS 1 equations and the CKD-EPI and BIS 1 equations were fair. The difference in CKD staging of the first 2 comparisons strongly depended on Scr, SUA and gender, and that of CKD-EPI and BIS1 equations strongly depended on Scr and gender. The incidence at various stages of CKD staging was quite different. Thus, a new equation that is more suitable for the elderly needs to be built in the future.

Combined Therapy with Chinese Medicine and Percutaneous Transradial Coronary Intervention for a Centenarian Patient with Acute Myocardial Infarction

There are not enough clinical data about centenarians with acute myocardial infarction(AMI) undergoing percutaneous coronary intervention(PCI).A 104-year-old woman exhibited sharp chest pain and severe dyspnea.In routine examinations,her electrocardiogram showed 1-3 mm ST-segment elevation from V1 to V4 leads,the cardiac enzymes were also elevated:creatine kinase(CK)-MB was 45.7 U/L,and cardiac specific troponin I was 40μg/L.A two-dimensional echocardiography showed anteroseptal akinesia with severely depre...

Oral mucosal conditions and some related factors in 140 Uygur centenarians

Objective To investigate the condition of the oral mucosae in Xinjiang Uygur centenarians and explore some related factors Methods The oral mucosae and mucosal exfoliative cells of 140 Xinjiang Uygur centenarians were examined Saliva and blood were collected from some centenarians Salivary immunoglobulins (IgA, IgM, IgG), complements (C 3 and C 4), nitrous oxide (NO), 10 trace elements, serum sex hormones, thyroid hormones and osteocalcin (OST) were analysed using immunoglobulin, complement and NO kits, an ionochromatophotometer, and the kits for sex hormones and thyroid hormones, and fluorescence enzyme linked immunosorbent assay, respectively Results Most centenarians (64 29%) had normal labial, buccal, palatal and gingival mucosae The abnormal changes in mucosae were mainly vascular nevus patches and senile plaques Their mucosal exfoliative cells showed similar characteristics to those in elderly Han The centenarians who had normal mucosae had higher level of the trace element molybdenum (Mo) in their saliva than who had abnormal mucosae ( P <0 01) Conclusion The oral mucosal condition of Uygur centenarians was generally good The abnormal changes in oral mucosae of the centenarians were lesions not harmful to health and may be related to the lower level of Mo in their saliva

Centenarian Looks to the Past

XIE Zhao was 72 before she retired from her nursing post at the Beijing Yucai School. Today, the 103-year-old is a great grandmother,and her family has expanded to 53 members. In recent years she has been living with her 65-year-old daughter—

A complication of becoming a centenarian

About three years ago a blind patient of mine reached his 100th birthday.He held an open house at his home,a fisherman' scottage perched high up overlooking the whole of Swansea bay.I was invited,as were many others,and even the mayor called in.A few days later,he consulted me in my surgery,as he still does,with his daughter-in-law.Since his birthday he had been ahospital inpatient under a medical team, who had diagnosed a stroke on the basis of weakness in his right arm.As usual,we

南京市百岁老人生活质量概念框架、指标构建与评价

百岁老人作为老年人口中最脆弱的社会群体,其生活质量的改善对于实现“健康老龄化”与“和谐社会”具有重要的现实意义。本文基于“美好生活”理论框架,从4个维度(躯体健康、心理健康、家庭社会支持、社会经济地位)构建了百岁老人生活质量概念框架;结合探索性因子分析法对百岁老人生活质量的潜在结构进行探究,进而开展全面评价。结果表明:(1)南京市百岁老人生活质量处于中等水平,生活质量主要由躯体健康、心理支持、社会经济地位和感官能力4个维度构成。(2)百岁老人心理支持处于中等偏高水平,社会经济地位、躯体健康和感官能力处于中等偏低水平。(3)不同社会经济属性的百岁老人生活质量差异显著。本文为深入了解百岁老人生活质量提供较好的实证案例,同时为“健康老龄化”政策选择提供理论依据。

百岁老人的构成及健康状态——以南京市百岁老人为例

对南京市百岁老人的增长速度、基本构成进行了调查,分析了百岁老人和其家庭、社会环境的关系,了解了百岁老人的经济收入情况和他们的生理、心理健康状况等。主要结论如下:(1)南京百岁老人在中心城区居住的比例高、女性比例高、低龄百岁老人比例高,近20年年均增长速度在10%以上。(2)百岁老人对自己的婚姻和家庭满意程度较高;百岁老人大多与子女或子女配偶居住;百岁老人受教育程度和年经济收入有显著的性别差异,男性老人受教育程度和收入都高于女性。(3)2018年南京有24%、10%和7.5%的百岁老人患有1种、2种和3种以上经医院确诊的慢性病;百岁老人患高血压、白内障的最多;大部分南京百岁老人的听力和视力都存在障碍。(4)百岁老人日常生活能力呈两级分化的趋势,健康老人和重度失能老人的比例都比较大。(5)南京百岁老人工具性失能比例高于生活失能比例,对亲朋依赖较大。(6)百岁老人外出串门、交流的比例低,社会活动少;女性百岁老人平均抑郁程度略高于男性,生活压力感知能力略低于男性;相对于男性,女性百岁老人抑郁程度和感知生活压力情况呈现两极分化状态。因曾经的城乡居民年龄管理并不正规、完善,故老人年龄数据存在误差,需进一步进行修正。

住院百岁老人的临床特点及转归情况

目的分析住院百岁老人的主要诊断及共病、实验室指标、营养状况、转归情况。方法回顾性分析中国科学技术大学附属第一医院(安徽省立医院)老年医学科住院百岁老人的一般情况、主要诊断及共病、实验室指标、营养状况、转归情况。结果纳入21例住院百岁老人资料,年龄范围100~105岁,其中男性18例,女性3例。主要诊断中肺部疾病(28.6%)比例最高,其次是神经系统疾病(23.8%);患病比例最高的急性疾病为感染性疾病(12例,57.1%),患病种比例最高的慢性疾病为高血压病(15例,71.4%)。21例住院百岁老人中有18例(85.7%)存在贫血,7例(33.3%)存在肝功能异常,3例(14.3%)肌酐升高,18例(85.7%)存在低蛋白血症,3例(14.3%)总胆固醇升高。营养风险筛查显示7例(33.3%)患者存在营养风险,控制营养状况评分显示15例(78.9%)患者存在营养不良。死亡主要原因为肺部感染(8例,72.7%)。结论百岁老人住院普遍存在失能、多病共存及营养不良的特点,死亡病因主要为肺部感染。