Artificial Intelligence Providing a More Optimized Assessment Tool for Comprehensive Geriatric Assessment

With the continuous development of science and technology,artificial intelligence(AI)is coming into our lives and changing our lives.Since China entered the aging society in 2000,the degree of population aging has deepened.Comprehensive geriatric assessment(CGA)is now the accepted gold standard for the care of older people in hospitals.However,some problems limit the clinical application,such as complexity and time consuming.Therefore,by analyzing previous studies,we summarize some existing AI tools in order to find a more optimized assessment tool to complete the entire CGA process.

Role of comprehensive geriatric assessment in screening for mild cognitive disorders

BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis.Using Petersen as the diagnostic gold standard,healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group.The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed.Patients'Montreal Cognitive Assessment(MoCA)and CGA screening results were compared,and the sensitivity and specificity were calculated to assess the screening role of CGA.RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA.The results of the multivariate regression analysis showed no correlation of gender,age,body mass index and literacy with cognitive function.Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals(P<0.05).In the CGA scale,patients with mild cognitive impairment showed significantly lower Mini-mental State Examination,Miniature Nutritional Assessment and Berg Balance Scale scores,and higher Activity of Daily Living,Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals(P<0.05),whereas the other assessment scales showed no significant differences(P>0.05).The CGA provides higher diagnostic sensitivity and specificity than the MoCA(P<0.05).CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity,facilitating timely and effective intervention,and is thus recommended for clinical use.

Value of a comprehensive geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

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

BackgroundFall 和严肃的秋天损害为长辈成为了一颗主要健康担心。包括血压和反高血压的药申请的许多因素作为秋天的危险被报导。这研究的目的 342 个老高血压病人是决定年龄是否联系了与 hypertension.MethodsA 在老病人与增加的秋天风险联系的全身的功能的衰落全部的(年龄 79.5 &#x000b1；6.7 年，男性 63.8%) 被招募到学习。全面衰老老人评价(CGA ) 包括关于每日的生活的活动(ADL ) 的大小，营养，认知，消沉，药方药的数字和临床的诊断的数字，被进行评估每个参加者的物理、心理的地位。秋天风险被莫尔斯秋天规模评估， Tinetti 性能面向的活动性评价(POMA ) 和最近的年里的秋天的历史。参加者根据 CGA 分数被组织进 tertiles。在 CGA 和秋天风险之间的关联与更高的 CGA 通过社会科学统计套装软体 18.0 .ResultsParticipants 被分析分数是可能的更旧，一个更低的身体团索引(BMI ) ，和心血管的疾病，长期的妨碍的肺的疾病(COPD ) ，脑血管的疾病和 osteoarthropathia 的更高的流行。在 CGA 的更高的 tertile 的参加者在更低的 tertile 比那些获得秋天风险的得到的增加的流行(P &#x0003c；0.01 T3 对 T1， P &#x0003c；0.01 T3 对 T2 ) 。关联分析和回归分析显示出在 CGA 和莫尔斯秋天规模之间的重要协会(P &#x0003c；0.001 ) ，以及 CGA 和 POMA (P &#x0003c；0.001 ) 。同时， CGA 部件也与增加秋天风险显示出合作关系。在调整年龄， BMI， benzodiazepine 使用，心血管的疾病，脑血管的疾病， COPD 和 osteoarthropathia 以后，最近的年和升起的莫尔斯秋天规模里的秋天的两历史显著地与 ADL 缺陷被联系(或：2.748， 95%CI：1.598-4.725 ) ，(或：3.310， 95%CI：1.893-5.788 ) 。减少的 Tinetti POMA 分数与微型心理的州的检查(MMSE ) 被联系(或：4.035， 95%CI：2.100-7.751 ) ， ADL (或：2.380， 95%CI：1.357 &#x02212； 4.175 ) 并且弄短的 MNA 形式(MNA-SF ) 缺陷(或：2.692， 95%CI：1.147 &#x02212； 6.319 ).ConclusionsIn 有高血压的老成年人，损害了物理、心理的功能与增加的秋天被联系风险。进一步的学习被要求为协会和有效干预调查可能的调停人。

Ability of Comprehensive Geriatric Assessment to Detect Frailty

Background and Aim of the Work: Frailty is a state of reduced physiological reserve associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. This work assessed the ability of comprehensive geriatric assessment to detect frailty in elderly patients. Subjects and Methods: A total number of 104 elderly patients (above 60 years old) were included in this study and they were subjected to a comprehensive geriatric assessment (CGA) including: (history and full clinical examination, Mini mental status examination (MMSE), Geriatric depression scale (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008, each group included 52 patients. Results: There were no significant differences between the two groups regarding age gender or smoking habits. But there was higher percentage of ADL, IADL dependence in addition to higher incidence of depression and cognitive impairment among frail cases. Conclusion: Comprehensive geriatric assessment can be used to detect frailty and its associated impairment and comorbidities.

Assessment methods and services for older people with cancer in the United Kingdom

BACKGROUND National cancer strategy calls for comprehensive assessments for older people but current practice across the United Kingdom is not well described.AIM To identify current assessment methods and access to relevant supporting services for older people with cancer.METHODS A web-based survey(SurveyMonkey)targeting health professionals(oncologists,cancer surgeons,geriatricians,nurses and allied health professionals)was distributed January-April 2016 via United Kingdom nationally recognised professional societies.Responses were analysed in frequencies and percentages.Chi Square was used to compare differences in responses between different groups.RESULTS 640 health care professionals responded.Only 14.1%often/always involved geriatricians and 52.0%often/always involved general practitioners in assessments.When wider assessments were used,they always/often influenced decision-making(40.5%)or at least sometimes(34.1%).But 30.5%-44.3%did not use structured assessment methods.Most clinicians favoured clinical history taking.Few used scoring tools and few wished to use them in the future.Most had urgent access to palliative care but only a minority had urgent access to other key supporting professionals(e.g.geriatricians,social workers,psychiatry).69.6%were interested in developing Geriatric Oncology services with geriatricians.CONCLUSION There is variability in assessment methods for older people with cancer across the United Kingdom and variation in perceived access to supporting services.Clinical history taking was preferred to scoring systems.Fostering closer links with geriatricians appears supported.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Comprehensive geriatric assessment and its role in oncology:a brief review

As the global population ages,the incidence of cancer among older adults is increasing.The management of older patients with cancer poses unique challenges due to the age-related physiological changes,multiple comorbidities,and functional decline often observed in this population.Comprehensive Geriatric Assessment(CGA)has emerged as a valuable tool in oncology to evaluate the overall health and functional status of older cancer patients in order to optimise cancer care for older adults.This comprehensive approach acknowledges the unique challenges faced by elderly patients with cancer and seeks to optimize outcomes by considering their specific circumstances and individual requirements.

Is frailty associated with short-term outcomes for elderly patients with acute coronary syndrome？

BackgroundFrailty 由于老化并且逐渐地是在心血管的药的一个新预示的因素老病人的复杂自然。有希望地分析在哪个脆弱与 .MethodsPatients 变老的急性冠的症候群(交流) 为老病人预言短期的结果的方式有用、有意义 &#x02265；65 年，与从心病学的交流的诊断，部门和医学部门被包括从单个中心。包括医学症候群的临床的数据用全面医学评价被收集。脆弱根据临床的脆弱规模被定义，风险上的合作病态的影响被冠的动脉疾病(CAD ) 确定 &#x02014；特定的索引。病人们被跟随在上面由临床的访问或电话，咨询和中部的后续时间是 120 天。后面起来项目包括了所有原因死亡， unscheduled 回来访问，在里面医院和周期性的主要不利心血管的事件。Multivariable 回归幸存分析用考克斯 regression.ResultsOf 被执行 352 个病人，(43.18%) 152 根据学习仪器被认为脆弱(5 &#x02212； 7 在规模上) ，并且(26.42%) 93 中等或严重地被考虑脆弱(6 &#x02212； 7 在规模上) 。包括不能自制，秋天历史，视觉缺陷，听觉缺陷，便秘，长期的疼痛，睡觉混乱，牙齿的问题，焦虑或消沉的医学症候群，和谵妄比在非脆弱的病人更经常在脆弱的病人( P = 0.000 ， 0.031 ， 0.009 ， 0.014 ， 0.000 ， 0.003 ， 0.022 ， 0.000 ， 0.074 ，和 0.432 ，分别地)。为性别调整了，年龄，冠的动脉疾病的严厉(离开了主要冠的动脉损害) 并且由考克斯幸存分析的合作病态(CAD 特定的索引) ，脆弱被发现到强烈并且独立地为主要合成结果与风险被联系：所有原因死亡[危险比率(HR )= 5.393；95% CI：1.477 &#x02212； 19.692， P = 0.011 ] 并且 unscheduled 回来访问(HR = 2.832；95% CI：1.140 &#x02212； 7.037， P = 0.025 ).ConclusionsComprehensive 医学评价和临床的脆弱的规模在有交流的老病人的评估是有用的。脆弱强烈并且独立地与交流为老病人与短期的结果被联系。

Real-world characteristics of hospitalized frail elderly patients with atrial fibrillation： can we improve the current prescription of anticoagulants？

BackgroundIn 老病人，特别比 80 年旧的那些， atrial 纤维性颤动(AF ) 与击的几乎 25% 增加的风险被联系。有抗凝剂的击预防高度因此被推荐。在这些病人与药方和坚持的更低的率被联系了到抗凝剂治疗的因素的流行几乎不被知道。有或没有 AF，学习是探索老题目的临床的特征的这的目的连续地承认了一个尖锐衰老老人单位，讨论可以减少的因素击预防治疗上的坚持。我们也加亮可能的策略克服障碍调节在 population.MethodsA 的这个片断的口头的抗凝剂的当前的 underuse 回顾的观察学习有或没有进入圣 Gerardo 医院的尖锐衰老老人单位的 AF 在老病人的一个队上被执行( Monza ，意大利 ) .ResultsCompared 到没有 AF 的病人( n = 1216 )，那些与 AF ( n = 403 )有一个更高的 Charlson Comorbidity 索引( 3 对 2 ， P &#x0003c ；0.001 ) ，管理的药的数字(4 对 3， P &#x0003c；0.001 ) ，心失败的率(36.5% 对 12% ， P &#x0003c；0.001 ) 并且长期的肾疾病(20.6 对 13.2， P &#x0003c；0.001 ) 。有 AF 的许多病人是脆弱的(54%) 或 pre 脆弱(29%).ConclusionsElderly，有 AF 的病人有影响坚持到传统的抗凝剂治疗的条件的更高的率(维生素 K 对手， VKA ) 。新直接口头的抗凝剂(DOA ) 能帮助克服这个问题。为了规定最适当的 VKA 或 DOA，与最好的功效 / 安全侧面和最高的依从，一个全面衰老老人评价应该总是为 thrombotic 和出血性的风险层化伴随分数。

Treatment patterns and a prognostic scoring system for elderly acute myeloid leukemia patients:a retrospective multicenter cohort study in China

Objective:Acute myeloid leukemia(AML)is primarily a malignant disorder affecting the elderly.We aimed to compare the outcomes of different treatment patterns in elderly AML patients and to propose a prognostic scoring system that could predict survival and aid therapeutic decisions.Methods:Patients aged≥60 years who had been diagnosed with AML at 7 hospitals in China were enrolled(n=228).Treatment patterns included standard chemotherapy,low intensity therapy,and best supportive care(BSC).Results:The early mortality rates were 31%,6.8%,and 6.3%for the BSC,low intensity therapy,and standard chemotherapy groups,respectively.The complete remission rate of the standard chemotherapy group was higher than that of the low intensity therapy group.The median overall survival(OS)was 561 days and 222 days for the standard chemotherapy and low intensity therapy groups,respectively,and were both longer than that of the BSC group(86 days).Based on multivariate analyses,we defined a prognostic scoring system that enabled classification of patients into 3 risk groups,in an attempt to predict the OS of patients receiving chemotherapies and low intensity therapies.Low and intermediate risk patients benefited more from standard chemotherapies than from low intensity therapies.However,the median OS was comparable between standard chemotherapies and low intensity therapies in high risk patients.Conclusions:Our prognostic scoring system could predict survival and help select appropriate therapies for elderly AML patients.Standard chemotherapy is important for elderly AML patients,particularly for those categorized into low and intermediate risk groups.

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

思政元素融入护生老年综合评估实习的效果评价

目的评价思政元素融入护生老年综合评估实习的效果,分析其可行性和重要性。方法以2022年6—10月在老年医学科实习的105名护生为研究对象,随机分为试验组(53人)和对照组(52人),对照组进行传统模式的老年综合评估实习,试验组在此基础上融入思政元素。比较实习前后两组对老年人的态度、共情能力、出科考试成绩,评价实习效果。结果实习后,两组对老年人的态度和共情能力比较差异有统计学意义,出科考试成绩比较差异无统计学意义。共收回53份思政日记,提取8个关键词:尊老敬老、孝顺、关爱、理解、责任心、换位思考、交流沟通、创新精神。结论思政元素融入护生老年综合评估实习,有助于转变护生对老年人的态度,激发护生学习兴趣,提高其共情能力。

非小细胞肺癌患者衰弱特点及其影响因素

目的对表皮生长因子受体(EGFR)突变阳性、非鳞状不可手术Ⅲ期非小细胞肺癌(NSCLC)老年患者序贯化放疗后奥希替尼维持治疗和Ⅳ期NSCLC老年患者局部立体定向放疗联合奥希替尼维持治疗后的衰弱状况进行评估,并分析其影响因素。方法回顾性分析2020年6月至2021年12月山西省肿瘤医院收治的238例老年Ⅲ~Ⅳ期EGFR突变阳性、非鳞状NSCLC非手术患者的临床资料,对连续3个月奥希替尼靶向维持治疗后的疼痛数字评分(NRS)、深静脉血栓量表(Caprini)、抑郁量表(PHQ-9)、老年8项筛查工具(G8)进行评估,并依据G8评分将患者分成衰弱组(n=197)和非衰弱组(n=41)。采用SPSS 19.0统计软件进行数据分析。根据数据类型,分别采用t检验、χ^(2)检验或Fisher确切概率法检验进行组间比较。采用logistic回归分析衰弱的影响因素。结果衰弱组高龄、Caprini评分高危及以上、共病患者比例高于非衰弱组;合并静脉血栓栓塞(VTE)患者比例低于非衰弱组;抑郁评分、NRS评分、胱抑素C水平高于非衰弱组;G8评分低于非衰弱组,差异均有统计学意义(均P<0.05)。logistic回归分析显示,年龄(OR=1.395,95%CI 1.133~1.717)、抑郁(OR=1.525,95%CI 1.290~1.803)、疼痛(OR=7.908,95%CI 2.301~27.181)、共病(OR=5.490,95%CI 1.181~25.522)、合并VTE(OR=7.530,95%CI 1.022~55.501)及胱抑素C(OR=1.215,95%CI 1.084~1.361)是老年不可手术Ⅲ~Ⅳ期EGFR突变阳性NSCLC患者衰弱的危险因素。结论EGFR突变阳性非鳞状不可手术Ⅲ~Ⅳ期NSCLC老年患者衰弱率高,存在营养流失、疼痛、躯体活动和认知能力受损、负性情绪、共病等老年综合征及肾功能损伤,快速识别其影响因素并采取有效的康复治疗干预措施对患者有积极意义。

置信职业行为在老年医学住院医师老年综合评估培训中的应用

人口老龄化是我国社会当前和今后相当长一段时间的显著特征,如何应对老年人口增长给医疗领域带来的压力、如何实现健康老龄化,是当前面临的重大任务。老年综合评估以老年患者为中心,包含躯体疾病、心理健康、生活环境、社会支持等全方位内容,是实现个体化诊疗、促进健康老龄化的有效方法。鉴于老年综合评估过程复杂,传统的培训方法难以让学习者迅速掌握相关内容,也无法用量化指标体现学习者的掌握程度,不利于指导教师对他们进行有效评价。浙江大学医学院附属第一医院老年医学科将置信职业行为应用于老年医学住院医师老年综合评估培训中,将老年综合评估过程中所有关键环节提取出来,并设定分级标准,为学习者提供了明确的学习框架,描述了不同阶段应当达到的置信等级,这有助于弥合教学理论和临床实践之间的差距,在教学实践中亦初步展现了良好的效果。在今后的工作过程中,应该完善置信职业行为的评价方法及其在老年综合评估培训中的应用,同时探索其在老年医学住院医师规范化培训等其他教学方面的价值,促进学习者和教学者的共同进步,为健康老龄化发挥积极的作用。

A new tool for comprehensive geriatric assessment in elderly patients with acute myeloid leukemia:a pilot study from China

Background:Acute myeloid leukemia(AML)is a common type of hematological malignancy in elderly people.Geriatricians developed comprehensive geriatric assessment(CGA)methods for elderly patients;however,the tools used for CGA in AML are not uniform.Thus,we aimed to validate the instrumental activities of daily living(IADL)scales,age,comorbidities(Charlson Comorbidity Index),and albumin(IACA)index,which is a new tool for CGA,in elderly patients with AML.Methods:Patients aged>60 years who had been diagnosed with AML were screened for eligibility.Among the IACA low-,intermediate-,and high-risk groups,continuous variables were compared using the Mann-Whitney U test,and categorical variables were compared using/2 and Fisher exact tests.In addition,probabilities of overall survival(OS)were estimated using the Kaplan-Meier method.Results:A total of 21,34,and 6 patients were categorized into IACA low-risk(0 point),intermediate-risk(1-2 points),and high-risk(>3 points)groups,respectively.The rates of relapse/progression-related mortality were 23.8%,58.8%,and 100.0%in the IACA low-,intermediate-,and high-risk groups,respectively(χ^2=12.81,P<0.001).The 2-year probabilities of OS were 47.7%(95%confidence interval[CI]22.8%-72.6%)and 20.2%(95%CI 5.9%-34.5%)in the IACA low-and intermediate-risk groups,respectively(χ^2=5.99,P=0.014),which were significantly higher than those in the high-risk group(low-risk[47.7%(95%CI 22.8%-72.6%)]vs.high-risk[0],/=20.80,P<0.001;intermediate-risk[20.2%(95%CI 5.9%-34.5%)]vs.high-risk[0],χ^2=7.56,P=0.006;respectively).In the IACA low-risk group,the 2-year probability of OS in patients receiving induction chemotherapy(50.8%[95%CI 24.1%-77.5%])was significantly higher than that in those receiving best supportive care(0,χ^2=25.74,P<0.001).Conclusion:We suggest that the IACA index might be a simple and effective tool for comprehensive geriatric assessment in elderly AML patients.

老年综合评估联合预见性护理对老年高血压患者的影响研究

目的:探讨老年综合评估(CGA)联合预见性护理在老年高血压患者中的应用。方法:采用整群抽样的方法选择2021年6月—2022年5月南昌市第一医院收治的120例老年高血压患者,按照随机数字表法将其分为研究组和对照组,各60例。对照组采用预见性护理干预,研究组采用CGA联合预见性护理干预。比较两组血压控制情况、服药依从性、高血压相关不良事件发生情况。结果:干预后,两组血压、血压变异系数均低于干预前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。研究组服药依从性高于对照组,差异有统计学意义(P<0.05)。研究组跌倒发生率低于对照组,差异有统计学意义(P<0.05);两组其他不良事件发生率比较,差异均无统计学意义(P>0.05)。结论:CGA联合预见性护理的干预模式能提高老年高血压患者服药依从性,强化血压控制,减少跌倒事件发生。

老年综合评估在国外长期护理体系中的应用现状及思考

综述国外长期护理体系中老年综合评估的应用现状,通过总结我国长期护理体系,特别是评估工具中存在的问题,深入探讨老年综合评估在我国长期护理体系中的应用价值,指出我国现阶段还存在配套政策缺失、标准尚未统一、专业人员不足等问题,阻碍其在长期护理体系中的应用,建议基于国外实践经验进行深入的相关研究与实践,实现老年综合评估在我国长期护理体系中的标准化应用,进而完善长期护理体系,实现我国的健康老龄化。

老年综合评估在冠心病患者合并衰弱状态护理中的应用效果

目的研究老年综合评估(CGA)在冠心病患者合并衰弱状态护理中的应用效果。方法选择安徽省亳州市人民医院老年科2021年3月至2022年8月接受治疗的76例老年冠心病合并衰弱状态患者,按照随机数字表法,将其分为常规组(常规护理)与观察组(CGA+常规护理),各38例。比较两组干预前后运动功能、睡眠质量、自我护理能力评分。结果干预后,两组上、下肢及Fugl-Meyer运动功能评定量表总分高于干预前,且观察组高于常规组(P<0.05)。干预后,两组匹兹堡睡眠质量指数量表评分低于干预前,且观察组低于常规组(P<0.05)。干预后,两组健康知识、自我责任感、自我概念、自我护理技能评分高于干预前,且观察组高于常规组(P<0.05)。结论老年冠心病伴衰弱状态患者行CGA干预,效果显著,有助于患者身体健康。

老年冠心病病人应用基于CGA的专科干预与反馈式健康宣教的效果观察

目的:探讨基于老年综合评估(CGA)的专科干预结合反馈式健康宣教在老年冠心病病人中的应用效果。方法:选取2020年10月—2022年10月本院收治的100例老年冠心病病人,采用随机数字表法分为甲组和乙组,各50例。甲组采用常规老年护理及健康教育,乙组予以基于CGA的专科干预联合反馈式健康宣教。观察两组应对方式、健康教育需求、自我管理能力及心脏不良事件发生情况。结果:与干预前相比,两组随访6个月的医学应对方式问卷(MCMQ)面对维度评分均升高,回避、屈服维度评分均降低,且乙组面对维度评分高于甲组,回避、屈服维度评分低于甲组,差异有统计学意义(P<0.05);两组随访6个月的心脏康复信息需求表(INCR)评分均低于干预前,冠心病自我管理量表(CSMS)评分均高于干预前,且乙组INCR评分较甲组低,CSMS评分较甲组高,差异有统计学意义(P<0.05);乙组随访6个月内心脏不良事件发生率低于甲组,差异有统计学意义(P<0.05)。结论:CGA下专科干预联合反馈式健康宣教能够改善老年冠心病病人对应对方式,满足其心脏康复健康教育需求,有助于提高病人自我管理能力,改善心脏不良事件控制效果。