Analysis of the Effectiveness of Clopidogrel Combined with Aspirin in the Treatment of Coronary Heart Disease in Community-Dwelling Elderly

Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.

Analysis of Distribution of Public Toilets within Walking Range around Communities of the Elderly under the Model of Community Home-based Care for the Elderly: A Case Study of Changxindian, Fengtai District, Beijing

In recent years,under the influence of multiple factors such as traditional ideas and living economic conditions,the aging population in China continues to increase.Most of the elderly are more inclined to aged at home,and the first places for elderly activities are communities and the surrounding environment,which greatly affects the convenience of life and happiness of the elderly.In this paper,Changxindian area in Fengtai District of Beijing was as the research object,and detailed calculation and analysis were carried out by using POI data and arcGIS software.The relative location of residential areas and surrounding public toilets was explored,and the best location of public toilets in the daily walking area under the model of community home-based care for the elderly was further studied.

Analysis of the Relationship between Eating and Swallowing Function and Lifestyle of the Elderly Living in the Community-A Secondary Publication

Objectives:The relationship between eating and swallowing function,and lifestyle among community-dwelling elderly people has not been extensively studied.This study aimed to analyze the characteristics of eating and swallowing function and their association with the lifestyle among the elderly.Methods:A self-administered questionnaire survey was conducted on 419 elderly people who participated in the oral function improvement project operated by the Community Comprehensive Support Center.A total of 288 valid responses(58 males,230 females,average age 73.6 years)were analyzed.The survey items included basic demographics,health status,lifestyle,and eating and swallowing functions.The chi-square(χ2)test was used to compare for a difference in the risk of dysphagia.Results:72 patients(25.0%)were judged to be at risk for dysphagia,and 216(75.0%)were judged to be not at risk for dysphagia using the revised dysphagia risk assessment scale.The mean score for oral preparatory dysphagia was the highest,while the mean score for pharyngeal dysphagia was the lowest.The group at risk of dysphagia had significant difficulty in chewing and had bad sleep quality as compared to the group that was not at risk.Conclusion:Concerning the risk of dysphagia,there is a need to maintain and improve masticatory function.In addition,improving the swallowing function of the elderly may prevent insomnia and improve sleep quality.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Factors Affecting the Health-Related Quality of Life of Community-Dwelling Elderly in Japan: A Focus on Spirituality

This study aimed to explain factors affecting health-related quality of life among community-dwelling elderly individuals living in Japan. We conducted a questionnaire survey of 898 individuals at senior citizens clubs in a rural area near the Tokyo metropolitan area in 2015, and analyzed the responses of 715 who provided valid responses. The survey questions included basic attributes (e.g., age, economic affluence), state of health (e.g., whether s/he has heart disease or not), the Spirituality Rating Scale Related to Health in the Elderly (SP Health Scale, composed of, e.g., meaning and purpose of living, self-transcendence), the Abbreviated Lubben Social Network Scale, and the MOS 8-Item Short Form Health Survey (SF-8). Multiple regression analyses were performed using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 as dependent variables and all others as independent variables. Factors associated with improved PCS were economic affluence and SP Health Scale (meaning and purpose of living), while the factors associated with reduced PCS were age and state of health (heart disease, gastrointestinal disease, osteoarthritis, lower back pain, knee pain, and eligible for long-term care). Meanwhile, factors associated with improved MCS were economic affluence, while those that were associated with reduced MCS were state of health (cancer and headache) and SP Health Scale (self-transcendence). These results suggest the need to understand spirituality in addition to the subjective economic situation, age, and medical condition of elderly individuals in order to improve their physical and mental health.

Is Cognition a Determinant of Health Related Quality of Life in Community Dwelling Non Demented Elderly?

Quality of life (QOL) is an important topic in social and medical sciences, it has a multidimensional nature and is influenced by many factors. Aim of the Work: In this study we want to assess the impact of cognitive impairment on the health related quality of life (HR-QOL) of community dwelling non demented elderly. Subject and Method: 115 non demented elderly, 60 years and older recruited from outpatient geriatric clinic at Al Mansoura General Hospital, Dakahlia, Egypt. Each participant underwent, comprehensive geriatric assessment, assessing cognitive function using the mini-mental state examination (MMSE) and montreal cognitive function test, assessing the health related quality of life (HR-QOL) by the RAND-36 health survey. Results: We found that the elderly with impaired cognition by both MMSE and Montreal test were significantly older;the ones with lower education, with more depressive symptoms, had more functional impairment and had lower HR-QOL scores than the elderly with normal cognitive function, after controlling for confounders still cognition was a determinant of HR-QOL. Also by linear correlation coefficient a significant correlation between HR-QOL and age, function, cognition and depression was found. Conclusion: Cognition affects significantly HR-QOL of the elderly, so we can say that interventions targeting cognition in the elderly can significantly improve their QOL.

Prevalence of Anemia among Community Dwelling Elderly in Dakahlia as a Representative of Rural Areas in Egypt and Its Impact on Their Functional Status

Background: Anemia is a common problem with serious consequences in older person but is often overlooked despite considerable evidence that low hemoglobin levels indicate physiologic decline in these patients. Multiple studies demonstrate that anemia is an independent risk factor for increased morbidity and mortality, and decreased quality of life in community-dwelling older persons. Increasing functional deterioration is associated with decreasing hemoglobin concentration in an inverse and linear manner. Aim: to assess the prevalence of anemia in free-living elderly subjects living in an urban community of Meet Abbad-Nabaroh, Dakahlia. Egypt and its impact on their functional level. Methodology: A cross-sectional study was done including 93 elderly ≥ 60 ys old, both males and females recruited from Meet Abbad-Nabaroh, Dakahlia, Egypt. All subjects underwent a complete medical history taking, clinical evaluation then blood hemoglobin level was measured, and anemia was defined according to the World Health Organization definition of anemia (hemoglobin level less than 13 g per dL [130 g per L] in men and less than 12 g per dL [120 g per L] in women). Results: The study revealed that the prevalence of anemia is 15.05% among the studied participants (14.5% among the male group and 16.1% among females), 14% had mild anemia and 1% had moderate anemia, with significant increase with age as there was significant difference (p = 0.042) between the different age groups of the studied participants, also history of blood loss and anemia showed positive significant correlation (p-value = 0.001), and highly significant correlations between intake of non steroidal anti inflammatory drugs (NSAID) and anemia (p-value = 0.000). The impact of anemia on functional status and risk of fall respectively showed significant difference between anemic and non anemic as regards instrumental activity of daily living (IADL) (p = 0.007), and timed up and go test (p-value = 0.01), also there is significant correlation between anemia and mini mental state examination (MMSE) (p-value 0.046) with worse performance among the anemic ones. Conclusion & Recommendation: anemia represents a health problem of significance among the community dwelling elderly with bad drawback on their functional level;their need for health & community services has a financial impact so this problem needs more assessment for better prevention and treatment.

Outcomes of Integrated Community Care Interventions for Frail Elderly People: A Literature Review

This study aimed to summarize the outcome measures and the significant outcome of effective integrated community care for frail elderly people through a literature review. A literature search was conducted using the Cochrane Library and PubMed for articles published up to November 2016 with the following search terms: Integrated community care, primary care, community, frail elderly, and effectiveness. A total of 106 articles were identified, of which eight with an interventional research design the inclusion criteria. All outcome measures were classified into the three categories: Functional abilities, quality of life, and health. As the significant effect, the physical function was perceived in four references, the quality of life in one reference, and the mental health in one reference. The evidence of the effectiveness of integrated community care seemed to be lacking. More studies will need to be conducted.

The Study on Community Health Education of Empty Nest Elderly

Objective:To study the demands of community health education on the empty nest elderly and analyse the related factors. Methods:The 36-Item Short-Form Health Survey(SF-36), activities of daily living (ADL) and the community health services satisfaction scale were used to investigate the community health service demand and supply of 358 empty nesters. Results:The results showed that the ability of self-care was worse and needed more nursing or caring from others in the empty nest elderly;the empty nest elderly, in comparison with the non-empty-nest elderly, had lower physical and mental scores. With the age changing, the requirements of community health services were different in empty nest elderly and the satisfaction of community health service was low in the empty nest (39.1%). Conclusions: Empty nest elderly generally needed the different degree of community health education demands. The utilization rates of community health education were low.

Renovation of Outdoor Environment in Old Residential Communities Suitable for the Elderly against the Background of Population Aging

More old residential communities have become unsuitable for the elderly because of the aging of outdoor physical environment and functional degradation. This paper investigated behaviors and mental activities of the elderly, problems of outdoor environment in old residential communities, and proposed strategies for the renovation of old residential communities from the perspectives of outdoor environment, road, greening and public supporting facilities according to demands of the elderly on outdoor environment, so as to provide them a comfortable and reasonable outdoor environment.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

Spatial Optimization and Reconstruction of Old Communities under the Background of Aging

As aging becomes increasingly serious,how to make the life of the elderly more convenient and comfortable has become one of the social problems to be solved urgently.Old residential areas are one of spaces where the elderly gather.In this paper,the prominent problems in the community space of existing old residential areas that are not conducive to the life of the elderly were analyzed,and corresponding countermeasures to transform the community space were put forward.It is hoped that public space can play its due value and make old residential areas glow with new vitality.

Relationship between Social Capital and Cognitive Functions among Community-Based Elderly

The concept of social capital encompasses all relationships and networks among people in a local community or society as a whole. It has been found to be associated with the health and daily living status of people. Furthermore, an association between social capital and cognitive functions among the elderly has been suggested in recent years. However, the number of such reports is very few. Hence, the present study aims to evaluate the relationship between social capital and cognitive functions among the elderly living in a local community in Japan. A questionnaire survey was administered to 192 elderly individuals belonging to 10 neighborhood elderly groups. A regression analysis was conducted to determine the relationship between cognitive functions and the level of engagement with the local community, after adjusting for age, gender, and symptoms of depression. Valid responses were collected from 145 participants (mean age: 75.3 years). An analysis of the data concerning the level of engagement with the local community revealed a significant difference in the cognitive function scores between the group of people who indicated that they had someone they could consult (n = 69) and the group that indicated they had no one to consult (n = 76) (regression coefficient: -0.61, p = 0.0038, 95% confidence interval: -1.02 to -0.20). This result indicates the existence of a significant correlation between social capital and cognitive functions of the elderly living in a local community. In future studies, we need to investigate the same with a larger number of participants from a wider geographical area, and by incorporating more indicators for a comprehensive evaluation of social capital.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

Role of community health nurse in the prevention of elderly dehydration:A mini-review

As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.

Study on Community Care Needs and Influencing Factors of the Urban Elderly in Shandong Province, China

Objective: To understand community care needs of the urban elderly in Shandong Province. To analysis the influencing factors and community care needs of the urban elderly in Shandong Province. Methods: Shandong Province was divided into four levels according to the level of economic development, multi-stage stratified cluster random sampling method was used. Each city collected the old aged 60 years or older served by 5 community health service centers. A total of 3390 questionnaires were distributed, the recovery rate was 100%, it had 3363 effective questionnaires, and an effective rate was 99.20%. SPSS17.0 software was used for univariate and multivariate analysis. Results: Analysis results show that, the influencing factors of community care needs of health promotion dimension have medical time (t = 3.239, P = 0.001) and EQ-5D score (t = 9.104, P - 6.239, P - 17.276, P - 3.762, P - 8.341, P Conclusions: Community care needs of the urban elderly in Shandong Province are at a medium level and have many influencing factors, the scores of each dimension from high to low are health promotion, disease care and disease prevention. In community nursing work, we should meet the care needs of the elderly, we need to enhance elderly self-care and safety awareness and promote the physical and mental health of the elderly.

Spatial Layout of Environmental Landscapes in Elderly Community

As China enters the aging society, the old-age care problems have grown increasingly serious. Influenced by the only-child policy, traditional old-age support system fails to adapt to new social situation, the institutions have become major subjects in the future old-age support system. Researches on the elderly-fi t architectural design have achieved many fruits, but those on the landscape design of the elderly community has been less reported. This paper studied landscape design of the old-age support institutions from the perspective of both theory and practice, and tried to explore the spatial layout of environmental landscapes in the elderly community. On the basis of sorting out specifi c psychological needs of the elderly group in China and their needs for the layout of landscape spaces, this paper proposed some effective solutions in view of successful elderly communities in overseas countries, then analyzed the development of elderly communities in China, so as to fi gure out landscape design approaches capable of promoting physical and mental health of the elderly group in the old-age support institutions.

Health Status of Urban Medium-Low-Income Elderly at the Community

Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. Subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. Survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: Systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.

Research on the Adaptability of Rural Elderly People Moving to Urban Communities

In recent years, under the background that the country actively promotes population urbanization, a large number of young people migrate to cities and towns through employment or schooling and take root in the urban construction. However, the left-behind elderly people in rural areas are in a dilemma, and they will face many problems in their lives whether living in cities or staying behind, the quality of life is lowered generally. After going into the city, many elderly people in rural areas, due to their own physiological and psychological characteristics, do not adapt to living in urban areas, and the qualities of lives are not improved. By investigating the status quo of the elderly in rural areas migrating to urban areas, this paper analyses the reasons for and existing problems of migrating to urban areas and puts forward suggestions for improving community adaptability from the perspective of social work.

Age-Friendly Communities: Creating a Conducive Environment for the Elderly in India

India is one of the nations in the world where the population is undergoing anomalous demographic changes.The increase in longevity and decrease fertility lead to the boom of older people aged 60 and above both in relative and absolute terms.Due to the rise in number,it creates pressure not only on the family but the responsibility shifts to the government also.This issue becomes a significant social problem not only in India but across the globe.The government had taken action by creating policies and programs to provide services to them.Still,the majority of the elderly population is lacking behind in these areas like health facilities,infrastructure,living arrangements suffering from isolation,loneliness,abuse,crime.Nowadays,smart city initiatives are taken by the government across the country but still in process.To involve and facilitate more cities for“age-friendly”,the World Health Organization develop the Global Age-Friendly Cities Guide and a manual“Checklist of Essential Features of Age-Friendly Cities”.Cooperating with 35 urban communities from developed and developing nations,the WHO oversees eight highlights for age-accommodating urban areas in the space of urban life.This paper had an objective to study and understand exiting literature on age-friendly communities in developed and developing countries and draw attention to the need to create age-friendly cities in India.The realization of the needs and demands of older people,the Indian government should give attention to promote and implement more age-friendly communities all over the country.This initiative till now taken in 3 states,i.e.,Delhi,Udaipur,and Kolkata-which involved in age-friendly community initiatives collaborated with WHO.In this era of a rapid aging sphere,the communities have to enhance in such a manner where the older population can meet their needs quickly without any conflicts and problem.To conclude,the government and policymaker should emphasize the policies into practices to build age-friendly communities across the country and make better living conditions for“allages”.For timely action and productive recommendation,it is an urgent need on the part of the government,policymakers,researchers,social workers to develop and enhance the community’s facilities,which can gain confidence and wellbeing of the elderly in India.