Conjunctival microbiota variations in a subset of middleaged and elderly individuals from Beijing,China

AIM:To isolate and identify the conjunctival microbiota of cataract patients and analyze the associated influencing factors.METHODS:This study recruited 216 participants(216 eyes)from April 2022 to July 2022.Under the condition of no antibiotic use prior to cataract surgery,sterile swabs were used to collect samples from the lower conjunctival sac.Bacterial cultures were then conducted,followed by species identification through 16S rDNA gene sequencing.Clinical factors associated with positive or negative bacterial isolation rates were analyzed,including age,gender,meibomian gland dysfunction(MGD),history of hypertension,history of diabetes,history of cancer,history of infectious diseases and the habit of wearing masks.RESULTS:Among the 216 eyes,78 eyes yielded isolates,with an isolation rate of 36.11%,detecting a total of 122 strains.Gram-positive rods accounted for 49.18%(60 strains),gram-positive cocci accounted for 45.08%(55 strains),gram-negative bacteria accounted for 4.92%(6 strains),and fungi accounted for 0.82%(1 strain).This study found that the most abundant genera in the conjunctival sac were Corynebacterium(42.62%),Staphylococcus(31.15%),Micrococcus(9.84%),Acinetobacter(4.10%),and Bacillus(3.28%).Furthermore,age(P=0.006),gender(P=0.039),diabetes(P=0.003),history of infectious diseases(P=0.02),and duration of mask replacement(P<0.001)were important factors influencing the positive bacterial culture of the conjunctival microbiota.Although hypertensive patients exhibited a higher isolation rate of conjunctival bacteria,it did not reach statistical significance,and the history of cancer did not affect the isolation rate of the conjunctival microbial community in cataract patients before surgery.CONCLUSION:Potential changes are observed in the conjunctival microbiota among a sample of middleaged and elderly individuals from Beijing,China.Notably,an increased isolation rate of Corynebacterium and Micrococcus is detected,suggesting a possible change in the microbial balance that requires further investigation and attention from the ophthalmological community.Advanced age,female gender,MGD,diabetes,a recent history of infectious diseases,and inadequate mask-wearing habits are potentially significant factors associated with the conjunctival microbiota.These factors should be considered in the development of strategies to prevent perioperative infections in cataract surgery patients.

Effectiveness of Extended Care in Preventing Falls in Disabled Elderly and Its Impact on Quality of Life

Objective:To analyze the value of extended care interventions for disabled elderly in preventing falls and optimizing quality of life.Methods:A sample of 60 cases of disabled elderly in a tertiary hospital from May 2022 to May 2023 was selected and grouped by the random number table method.The observation group received extended care,while the control group adopted routine care.The differences in complication rate,fall rate,36-Item Short Form Health Survey(SF-36)score,health knowledge awareness score,and nursing satisfaction were compared.Results:The complication rate and fall rate of the disabled elderly in the observation group were lower than those in the control group,P<0.05;the SF-36 score,health knowledge score,and nursing satisfaction of the observation group were higher than those of the control group,P<0.05.Conclusion:Extended care for the disabled elderly can reduce the risk of falls and complications related to disability,as well as optimize their cognition and improve their quality of life,which is efficient and feasible.

Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

Study of the Interior Design Based on Elderly People’s Psychological Behaviors and Requirements

Nowadays,the elderly have become an increasingly large group of people in China,but still many problems exist in their living space.This paper explores the physiological and psychological behavioral changes of the elderly,studies their living space requirements,and tries to put forward targeted design strategies in response.Therefore,making a better and more reasonable living space for the elderly as well as improving their living quality,finally helping the development of elderly-friendly design in China.

Balance training in the intervention of fall risk in elderly with diabetic peripheral neuropathy: A review

Diabetic peripheral neuropathy(DPN)was the most common complications of elderly diabetic,which could contribute to an increased risk of falling.Despite the increased prevalence of elderly diabetic,high risk of falls and serious consequences of falls in elderly with DPN,It is necessary to adopt means of reducing the risk of falls in elderly with DPN.Impaired balance in the elderly with DPN was the most important risk factor of increasing falls.This review will introduce the epidemiology of falls in elderly with DPN,analysis the reasons for high risk of falls in elderly with DPN,provide a review of the development of balance training in the intervention of fall risk in elderly with DPN and offer recommendations to medical personnels on how to provide an efficient balance training for elderly with DPN.

Psychological risk factors associated with falls among elderly people in Baghdad city, Iraq

Background: Ageing of the population is one of the most important demographic facts that come to the foreground in the 21st century. Objective: To assess the relationship between psychological factors (depression, loneliness, using anti anxiety medication, fear from falls and internal displacement of the population) and falls among elderly people in Baghdad city, Iraq. Methods: A matched 1:1 community based case-control study involving 716 elderly respondents, recruited randomly from six Non Governmental Organization (NGO) in different areas of Baghdad. Interviews to each respondent were done accordingly. Geriatric depression scale (GDS) was used to assess the depression among the elderly people. Results: The minimum age for cases and controls was 60 years old while the maximum age for cases was 87 and for controls was 85 years old. The female was predominant than male, 53.6% to 46.4% respectively. The relation between depression, fear from fall, using anti anxiety medication, internal displacement and falls was statistically significant

Vision Based Real Time Monitoring System for Elderly Fall Event Detection Using Deep Learning

Human fall detection plays a vital part in the design of sensor based alarming system,aid physical therapists not only to lessen after fall effect and also to save human life.Accurate and timely identification can offer quick medical ser-vices to the injured people and prevent from serious consequences.Several vision-based approaches have been developed by the placement of cameras in diverse everyday environments.At present times,deep learning(DL)models par-ticularly convolutional neural networks(CNNs)have gained much importance in the fall detection tasks.With this motivation,this paper presents a new vision based elderly fall event detection using deep learning(VEFED-DL)model.The proposed VEFED-DL model involves different stages of operations namely pre-processing,feature extraction,classification,and parameter optimization.Primar-ily,the digital video camera is used to capture the RGB color images and the video is extracted into a set of frames.For improving the image quality and elim-inate noise,the frames are processed in three levels namely resizing,augmenta-tion,and min–max based normalization.Besides,MobileNet model is applied as a feature extractor to derive the spatial features that exist in the preprocessed frames.In addition,the extracted spatial features are then fed into the gated recur-rent unit(GRU)to extract the temporal dependencies of the human movements.Finally,a group teaching optimization algorithm(GTOA)with stacked autoenco-der(SAE)is used as a binary classification model to determine the existence of fall or non-fall events.The GTOA is employed for the parameter optimization of the SAE model in such a way that the detection performance can be enhanced.In order to assess the fall detection performance of the presented VEFED-DL model,a set of simulations take place on the UR fall detection dataset and multi-ple cameras fall dataset.The experimental outcomes highlighted the superior per-formance of the presented method over the recent methods.

Circumstances of falls and fall-related injuries among frail elderly under home care in China

This exploratory study investigated the circumstances of falls and fall-related injuries among frail elderly people under home care.A convenience sample of 500 frail elderly(60 e99 years old)from the Wanshoulu and Yuyuantan communities in Beijing's Haidian District during February 2013 and March 2014.Fall circumstances and related injuries were characterized by detailed interviews and questionnaires.The article reports the results of a study that the overall fall incidence was 41.5%,and higher for females than males.Falls mainly occurred in individuals who were over 80 years old(50.0%)and indoors(67.9%).The percentage of subjects who experienced a combined injury after the fall was 56.3%,whereas 19.0%fell causes a fracture.Approximately 35%of the subjects were hospitalized,and 27.6%of the subjects recovered more than 30 days.Results indicate that,falls in the frail elderly caused serious damage,and fall-related circumstances should be a great concern in this population.

Analysis of hospitalization costs related to fall injuries in elderly patients

BACKGROUND With the aging world population,the incidence of falls has intensified and fallrelated hospitalization costs are increasing.Falls are one type of event studied in the health economics of patient safety,and many developed countries have conducted such research on fall-related hospitalization costs.However,China,a developing country,still lacks large-scale studies in this area.AIM To investigate the factors related to the hospitalization costs of fall-related injuries in elderly inpatients and establish factor-based,cost-related groupings.METHODS A retrospective study was conducted.Patient information and cost data for elderly inpatients(age≥60 years,n=3362)who were hospitalized between 2016 and 2019 due to falls was collected from the medical record systems of two grade-A tertiary hospitals in China.Quantile regression(QR)analysis was used to identify the factors related to fall-related hospitalization costs.A decision tree model based on the chi-squared automatic interaction detector algorithm for hospitalization cost grouping was built by setting the factors in the regression results as separation nodes.RESULTS The total hospitalization cost of fall-related injuries in the included elderly patients was 180479203.03 RMB,and the reimbursement rate of medical benefit funds was 51.0%(92039709.52 RMB/180479203.03 RMB).The medical material costs were the highest component of the total hospitalization cost,followed(in order)by drug costs,test costs,treatment costs,integrated medical service costs and blood transfusion costs The QR results showed that patient age,gender,length of hospital stay,payment method,wound position,wound type,operation times and operation type significantly influenced the inpatient cost(P<0.05).The cost grouping model was established based on the QR results,and age,length of stay,operation type,wound position and wound type were the most important influencing factors in the model.Furthermore,the cost of each combination varied significantly.CONCLUSION Our grouping model of hospitalization costs clearly reflected the key factors affecting hospitalization costs and can be used to strengthen the reasonable control of these costs.

Risk factors for accidental falls in the elderly and intervention strategy

As the population ages, older people's health and quality of life are becoming a matter of public concern increasingly. Through review of the literatures and analysis of the reasons for falls in older people, we worked out some measures to cope with such a situation, provided the self-care knowledge of falls prevention for older people and improved the quality life of older persons. The recovery process is long, if the old people fall down, which brings a lot of inconvenience to individuals and families, and it can also cause a lot of complications. If wary of fall risk factors, the quality of life of older persons can be improved. According to the different conditions of the elderly, we should take effective measures to create suitable living environment for senior citizens, and propagandize the knowledge of the old people's health care, which has the great significance in preventing the elderly's fall, and improving their living quality.

Syncope-related falls in the elderly

Age-related physiological impairments of heart rate, blood pressure and cerebral blood flow, in combination with comorbid conditions and concurrent medications, account for an increased susceptibility to syncope in older adults. Common causes of syncope are orthostatic hypotension, neurally-mediated syncope (including carotid sinus syndrome) and cardiac arrhythmias. A high proportion of older patients with cardiovascular syncope present with falls and deny loss of consciousness. Patients who are cognitively normal and have unexplained falls should have a detailed cardiovascular assessment.

Meta-analysis of Tai chi's fall prevention effect in the elderly

Objective:This study was intended to assess the effect of Tai Chi on the prevention of fall among the elderly.Methods:Relevant randomized controlled trials published since inception up to 6 January 2019 were selected in the electronic databases(PubMed,Cochrane Library,Web of Science,EMBASE,CBM,CNKI and Wan fang).Two researchers independently screened the literature,extracted data and evaluated the literature quality.Publication bias was assessed by Forest plot,Begg's test and Egger's test.STATA 14.0 software was used to do meta-analysis on the relationship between TAI Chi and fall.This study was registered at international prospective register of systematic Reviews(number:CRD42019122958).Results:A total of 6 RCTs were included.The results showed that,the incidence of fall among the elderly in Tai Chi group is less than that of blank group[RR=0.44(0.21-0.90)],but no statistical difference in the comparison of Tai Chi plus education and education[RR=0.96(0.76-1.22)],which was also supported by subgroup analysis.Meanwhile,similar result also appeared in the comparison of Tai Chi group and education group[RR=0.73(0.51-1.06)].Conclusion:Tai Chi could reduce the incidence of falls among the elderly,but the effect of Tai Chi plus education/Tai Chi on the incidence of falls is consistent with education alone.Therefore,we should pay attention to fall-related education among the elderly.

Developed Fall Detection of Elderly Patients in Internet of Healthcare Things

Falling is among the most harmful events older adults may encounter.With the continuous growth of the aging population in many societies,developing effective fall detection mechanisms empowered by machine learning technologies and easily integrable with existing healthcare systems becomes essential.This paper presents a new healthcare Internet of Health Things(IoHT)architecture built around an ensemble machine learning-based fall detection system(FDS)for older people.Compared to deep neural networks,the ensemble multi-stage random forest model allows the extraction of an optimal subset of fall detection features with minimal hyperparameters.The number of cascaded random forest stages is automatically optimized.This study uses a public dataset of fall detection samples called SmartFall to validate the developed fall detection system.The SmartFall dataset is collected based on the acquired measurements of the three-axis accelerometer in a smartwatch.Each scenario in this dataset is classified and labeled as a fall or a non-fall.In comparison to the three machine learning models—K-nearest neighbors(KNN),decision tree(DT),and standard random forest(SRF),the proposed ensemble classifier outperformed the other models and achieved 98.4%accuracy.The developed healthcare IoHT framework can be realized for detecting fall accidents of older people by taking security and privacy concerns into account in future work.

Effects of Mild and Severe Knee Joint Pain on the Frequency of Falls and Fall Risk in Elderly Females

This study aimed to examine differences in the frequency of falls during the past year and fall risk among 392 elderly females was categorized into five groups on the basis of the knee pain expe-rienced: no knee pain, mild unilateral knee pain, mild bilateral knee pain, severe unilateral knee pain, and severe bilateral knee pain. The subjects participated in a fall risk survey comprising 50 items representing five risk factors: “symptoms of falling”, “disease and physical symptoms”, “en-vironment”, “behavior and character”, and “physical function”. The frequency of falls during the past year, score for each risk factor, and the total fall risk score were not significantly different between the mild unilateral and mild bilateral knee pain groups, and between the severe unilateral and severe bilateral knee pain groups. Therefore, these groups were pooled to form a mild knee pain group and a severe knee pain group and analyzed. The severe knee pain group had experienced a significantly greater number of falls during the past year compared with the no knee pain group. Furthermore, the symptom of falling score was significantly higher in the severe knee pain group than in the no knee pain group, while the disease and physical symptoms score was significantly higher in the mild and severe knee pain groups than in the no knee pain group. The physical function score and total fall risk score were significantly higher in the following order: the severe knee pain group, the mild knee pain group, and the no knee pain group. Our results indicate that for elderly females who can achieve ADL independently, the degree of knee pain (mild or severe) has a marked effect on fall risk, irrespective of laterality of the pain (unilateral or bilateral). Factors such as symptoms of falling, disease and physical symptoms, and physical function are also related to fall risk in this population. Furthermore, elderly individuals with severe knee pain experience frequent falls.

Salsa Dance Could Improve Effectively to Body Balance in Elderly with Risk of Falls

Currently the number of elderly in Indonesia tends to increase. Based on 2014 Susenas data, the number of elderly in Indonesia reaches 20.24 million people (8.03%). One of the most common physical disorders in the elderly is disruption of the body’s balance and risk to falls. The risk of falling in the elderly can be prevented by doing physical exercise in the form of Salsa dance. Salsa dance has movements that can improve stability, flexibility, mobility and body balance. This study aims to analyze the effectiveness of Salsa dance on body balance in the elderly. The research method used quasi-experimental with the pre test-post test design control group. As many as 70 elderly who experienced balance disruption in the Puskemas Sarijadi had participated in this study. The sample was taken by using consecutive sampling, then divided equally between the control group and the intervention group. The instrument used to measure elderly balance is Short Physical Performance Battery (SPPB). Data analysis is carried out in two stages, namely univariate analysis using the mean, standard deviation, maximum value and minimum value and percentage;then followed by bivariate analysis using the Wilcoxon signed rank test and independent T test. The result shows that there are differences in the balance of the elderly before and after the intervention in the treatment group, whereas in the control group there were no significant differences. Therefore, it can be concluded that Salsa dance can significantly improve elderly body balance, especially if done regularly. The increase will appear significant after the intervention carried out for 10 and 20 times. It is suggested that nurses utilize Salsa dance as an alternative in dealing with symptoms of body balance disorders in the elderly. This intervention can be implemented along with other activities of the elderly in community centre health services.

Observation on the Risk of Falling and Self-efficacy in Elderly Patients with Hip Fracture

Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture.Methodology:Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from April 2018 to April 2019,and were enrolled into this study.All patients were assessed by using the Morse Fall Scale(MFS)and Falls Efficacy Scale(FES).The basic situation of the patients with hip fractures caused by falling and the scores of MFS and FES before and after falling were evaluated.Results:Results showed that the number of patients with femoral neck fractures accounted for 70%out of all patients,and the number of patients with intertrochanteric fractures accounted for the remaining 30%of the patients.The number of patients with academic qualification below primary school is 16,the number of patients with middle high school education is 11 and the number of patients with high school education and above is 13.Slipping is the cause of hip fracture that accounted for the most in patients,followed by outing activities,whereas least patients with hip fractures was caused by falling in nursing home.There were 29 patients’who used crutches or walking aids and this number was more than that of those who required the devices.After the MFS and FES analyses,the results(scores of MFS and FES)showed that the risk before the fall was lower.In contrast,the risk of fracture and post-surgery after the fall was greatly increased.Conclusion:The elderly patients with hip fractures were found to have increased risk of falling and thus,these patients require good care.

Assessment of Falls among the Elderly in the Emergency Department of the Idrissa Pouye General Hospital in Dakar, Senegal: A Cohort of 100 Cases

Background: Falls in the elderly are a global public health problem with serious medical and socio-economic consequences, especially in low and middle-income countries. The aim of this study was to describe the characteristics of falls among the elderly in trauma units in Senegal. Materials and Methods: This was a descriptive, prospective study from April 20, 2022 to October 30, 2022 among people aged at least 60 and admitted to the surgical emergency department of Idrissa Pouye Hospital in Dakar following a fall. Socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using Sphinx Plus 2 and Excel 2019 for Windows software. Results: Out of 730 elderly people seen during this period, 100 met the criteria, representing a prevalence of 13.69%. The average consultation time was 3.25 +/? 4 days. The average age was 73 +/? 8.43 years, with women predominating (74%). Medical expenses were mainly covered by the family (73%). Most falls occurred during the day (68%), at home (82%), especially in the bedroom (30%), with stumbling (32%) as the main mechanism. The majority of patients (86%) spent less than 30 minutes on the floor. Predisposing factors were dominated by visual disorders (56%) and precipitating factors were mainly environmental (62%). Geriatric syndromes were dominated by frailty (22%). Complications were dominated by fractures (86%), and almost half (47%) had lost their autonomy for post-fall Activities Daily Living (ADL). Prescription medication was almost systematic (98%), dominated by analgesics (98%). Surgery was indicated in 58% of patients. The average waiting time for surgery was 25.36 +/? 19 days. A death rate of 1% was recorded in the emergency department. Conclusion: Falls in the elderly are a frequent occurrence in traumatological emergencies, with etiological factors that are often multiple and interrelated, leading to significant morbidity. Raising awareness among people at risk and setting up an orthogeriatric service would help prevent falls and optimize care in the short and long term.

Risk Factors for Fall in Elderly Patients:Follow-Up Study after Hospital Discharge

Introduction: Increased occurrences of falls after discharge are reported, especially in elderly people. Falls are a major cause of disability and identification of risk factors associated with falls is required to plan preventive actions. This study aims to determine the occurrence of falls in the three months after discharge and risk factors in elderly patients. Materials and Methods: 100 patients over 65 admitted to an Internal Medicine Ward participated. Questionnaires were given during hospitalization and three months after discharge. Follow-up information was unavailable for 31 patients (25 deceased, 6 unreachable). Results: Of those analyzed 52% were males with 80 ± 8.1 years (mean ± SD). Polymedication (p = 0.002), use of psychoactive drugs (p = 0.007), analgesics (p = 0.034) and walking devices (p = 0.006) were associated with a higher incidence of falls 6 months before hospitalization. Post-discharge follow-up was obtained for 69 patients: 18 reported falling during the follow-up. There was a higher risk of fall in patients with a history of falls in the 6 months before admission (p = 0.015 RR = 2.76). Patients who had one or more falls after discharge had a significantly shorter length of hospital stay compared to those who didn’t fall (p = 0.012). In multivariate logistic regression, we found that patients who were hospitalized more than 7 days had a lower risk of falling in the post-discharge period (OR = 0.195, p = 0.017) independently of the history of falls 6 months prior to admission. Conclusions: Further studies are required to validate the risk factors identified after discharge and to evaluate preventive measures. Elderly patients discharged from an Internal Medicine Ward should be screened to determine the risk of falls, specifically previous history of falls and medication. These patients should integrate a fall prevention program.

Elderly Fall Detection by Sensitive Features Based on Image Processing and Machine Learning

The world’s elderly population is growing every year.It is easy to say that the fall is one of the major dangers that threaten them.This paper offers a Trained Model for fall detection to help the older people live comfortably and alone at home.The purpose of this paper is to investigate appropriate methods for diagnosing falls by analyzing the motion and shape characteristics of the human body.Several machine learning technologies have been proposed for automatic fall detection.The proposed research reported in this paper detects a moving object by using a background subtraction algorithm with a single camera.The next step is to extract the features that are very important and generally describe the human shape and show the difference between the human falls from the daily activities.These features are based on motion,changes in human shape,and oval diameters around the human and temporal head position.The features extracted from the human mask are eventually fed in to various machine learning classifiers for fall detection.Experimental results showed the efficiency and reliability of the proposed method with a fall detection rate of 81%that have been tested with UR Fall Detection dataset.

Falls and health-related quality of life (SF-36) in elderly people—ISACAMP 2008

Falls are accidental events and harmful to the healthy elderly. Its consequence can lead to the disability and the death. Accordingly, it becomes important to assess the relation between falls and quality of life. This theme is little studied in Brazil and internationally, especially in areas with large population bases. Objective: To identify the association between occurrence of fall and health-related quality of life (HRQL) using the SF-36 according to gender, age and schooling, among the elderly population of Campinas/Brazil. Methods: A cross-sectional, population-based study, using data from ISACAMP 2008. The present study analyzed only the population with 60 years old or more, totaling 1432 elderly individuals. The dependent variables were the eight SF-36 scale, version 2. The main independent variables were the falls occurred in the last 12 months and the limitation in activities daily living due to the falls. Analysis were carried out with the simple and multiple linear regression model in order to determine the associations between the dependent and main independent variables, using svy commands of STATA 11.0. Results: The prevalence of falls in the last year was 6.3%. The elderly individuals who referred to fall in the last 12 months exhibited the lowest score in seven of eight SF-36 scales, comparing with non-fallers. The association between fall and HRQL was greater in the male population. The elderly individuals who are older (75 or more) and located in the lower schooling stratum, and experienced falls also exhibited the lowest SF-36 scale scores, in physical and social functioning. Stratifying falls, considering those who cause limitations and those who do not, can be observed with the lowest scores in physical functioning, role physical, role emotion and social functioning, and only in the stratum of people who have limitations in daily living. Conclusion: The occurrence of falls can cause important limitations in the elderly individuals, and the limitations are associated with the worst health condition and quality of life. It is important to consider that the fragile elderly, especially in physical, social functioning, with pain, and role physical, are most vulnerable to experience falls, principally those who cause limitation.