Influencing factors analysis of spontaneous knee joint osteoarthritis among middle aged and old aged pople in Xi'an

Objective:To explore the prevalence rate of knee joint osteoarthritis and its pathogenetic fea- tures among the middle-aged and old aged people in the urban and rural area of Xi'an.Methods:From May to October 2005,1538 Han nationality above 40 years in Xi'an were investigated according to strati- fied and cluster random sampling.The same questionnaire was delivered to subjects who had been given normotopia and lateral position radiographic examination in both knees.Excluded from etiological arthri- tis,some subjects with clinical symptoms and a radiographic grade (beyond Kellgren & Lawrence gradeⅡ) were finally diagnosed as spontaneous knee joint osteoarthritis.All analyses were performed with SPSS 13.0 and t test,U test.Single factor analysis and multiple logistic regression analysis were used to analyze dates.Results:The total prevalence of spontaneous knee joint osteoarthritis was 12.1% with 2.5% and 2.1% for right and left knees,respectively.The prevalence of knee joint osteoarthritis in wom- en was 2.5 times of that in men (17.2% vs 6.8%,P=0.000).the osteophyte prevalence in women was 2.3 times of that in men (26.5% vs 11.4%,P=0.000).The prevalence of knee joint osteoarthritis and osteophyte increased with the growth of age.So did the symptomatic knee,except for the age group of 56- 60 years and 66-70 years.The prevalence of symptomatic knee joint for urban area was significantly higher than that for rural area (56.3% vs 45.3%,P=0.003).In women,the prevalence of knee joint os- teoarthritis increased significantly with the increasing of body mass index,which had not been observed in men.Female and obesity are the risk factors for osteoarthritis,but bean and its products and meat could prevent the osteoarthritis.Conclusion:Old age,female and obesity serve as risk factors for knee joint os- teoarthritis.

Relationship between preoperative psychological stress and shortterm prognosis in elderly patients with femoral neck fracture

BACKGROUND Older adults are at high risk of femoral neck fractures(FNFs).Elderly patients face and adapt to significant psychological burdens,resulting in different degrees of psychological stress response.Total hip replacement is the preferred treatment for FNF in elderly patients;however,some patients have poor postoperative prognoses,and the underlying mechanism is unknown.We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress.AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF.METHODS In this retrospective analysis,the baseline data,preoperative 90-item Symptom Checklist score,and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected.We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score.RESULTS Anxiety,depression,garden classification of FNF,cause of fracture,FNF reduction quality,and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF(P<0.05).The areas under the curve for anxiety,depression,and length of hospital stay were 0.742,0.854,and 0.749,respectively.The sensitivities of anxiety,depression,garden classification of FNF,and prediction of the cause of fracture were 0.857,0.786,0.821,and 0.821,respectively.The specificities of depression,FNF quality reduction,and length of hospital stay were the highest at 0.880,0.783,and 0.761,respectively.Anxiety,depression,and somatization scores correlated moderately with Harris scores(r=-0.523,-0.625,and-0.554;all P<0.001).CONCLUSION Preoperative anxiety,depression,and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.

Cognitive clarity in colon surgery: The dexmedetomidine advantage

Colon cancer is one of the most prevalent cancers globally,especially in the older age group.A large number of older patients undergoing surgery for colon cancer suffer from postoperative cognitive dysfunction(POCD).The trial by Bu et al demonstrated that dexmedetomidine(Dex)significantly reduced the incidence of POCD compared to placebo in individuals undergoing colon cancer surgery.Additionally,better cerebral oxygenation and lower cerebral injury markers were reported with the use of Dex.The trial has some limitations,such as a single-center design and a smaller sample size,and further studies with larger patient populations and robust multi-center designs are warranted to establish these findings.

Age Identity and Elderly Job Participation in China

In the context of rising life expectancy,there is a significant discrepancy between Chinese seniors’self-perceptions of the start of old age and the expectations of society around this age.The traditional paradigm,which forecasts individual economic behavior and formulates economic policies based on societal standards of age,is put to the test by this disparity.This study,which draws from the China Longitudinal Aging Society Survey(CLASS),examines the factors,processes,and improvement strategies that affect how older people choose to work.The following are our conclusions:(i)Chinese elderly believe their old age starts from 70 years on average;delaying perceived old age is a denial of aging and raises the likelihood of finding work.Elders who are youthful at heart have a 2.4%higher chance of remaining employed than elders who are old at heart.(ii)In contrast to old-at-heart elders,young-at-heart elders are more likely to maintain their middle-age lifestyles,continue working,become motivated to engage in social activities,and gain the confidence to face challenges and continue in their career.(iii)If the perceived old age is above 70 years,the milestone event of aging is retirement from work,and there are external pressures,particularly pressures from family intergenerational support,the perception of old age will have a more proactive impact on older workers.(iv)Despite rising pension benefits,older people’s decision to remain in the workforce is still heavily influenced by their perception of their age.However,this effect is notably gender-specific,as older women’s decision to remain in the workforce is not greatly influenced by their own perception of their age.

Application of Structured Health Education and Combined 5A Nursing Model in Self-control of Vulnerable Chronic Diseases: Take Coronary Heart Disease as an Example

Objective:To explore the intervention effect of the Structured Health Education course and 5A nursing model for self-control of elderly patients with coronary heart disease.Methods:Using the random sampling method,124 elderly CAD patients admitted to the First Affiliated Hospital of Bengbu Medical University were randomly divided into an experimental group and a control group.The control group line routine health education,experimental group take structured health education combined with 5A nursing before and after the intervention using a coronary heart disease assessment questionnaire,coronary heart disease self-control scale evaluation of two groups of intervention,compare two groups before and after intervention blood pressure,blood sugar,body mass index,lipid index level and complications within 8 months after discharge.Results:After the course intervention,the disease cognition and self-behavior of the experimental group were higher than that of the control group,and the differences were statistically significant(all P<0.1).Conclusion:This course is suitable for elderly patients with coronary heart disease.The 5A model improves the cognitive and management ability of elderly patients to a certain extent,which is worthy of clinical application.

The Age of the Old Transgression Sequence in the Pearl River Delta, China

The Pearl River Delta （PRD） is located in the north coast area of the South China Sea （SCS）. As one of the largest delta in China, only the two latest events among the several tens of eustatic fluctuations occurring in the Quaternary were recorded in almost whole area of the PRD.

3omorbidity and survival of patients selected for radica prostatectomy at an age of 75 years or older

Radical prostatectomy in elderly patients is controversial. To identify very old candidates for radical prostatectomy with the highest probability of long-term survival, we studied 47 consecutive men who underwent radical prostatectomy between 1992 and 2005 at an age of 75 years or older. A heuristic approach was used to search for subgroups with particularly high long-term survival. Several two-sided comorbidity measures and combinations of these measures were investigated to find classifications best identifying healthy, long-living elderly candidates for radical prostatectomy. Four of the 25 two-sided comorbidity classifications or combinations reached the significance level with hazard ratios between 4.00 and 4.80. After 10 years, patients identified as healthy patients according to these comorbidity measurements had exhibited relative survival rates between 129% and 137% and overall survival rates between 86% and 95%, whereas those with comorbidities had exhibited relative survival rates of only 66%-84% and overall survival rates of 44%-58%. In conclusion, classifying comorbidity may identify a meaningful proportion of men selected for radical prostatectomy at an age of 75 years or older with an excellent long-term survival probability superseding that of the general population.

Delirium,insulin-like growth factor I,growth hormone in older inpatients

BACKGROUND Delirium is a common disorder in elderly medical inpatients with serious adverse outcomes and is characterized by sudden onset,disturbance in attention,awareness,consciousness and cognition,and often with behavioural disturbances.Central to understanding delirium,is understanding mechanisms by which body and brain wellbeing are linked and in particular how brain responses to bodily homeostatic stress is mediated.A number of studies have investigated the relationship between insulin-like growth factor I(IGF-I)and delirium in medically ill hospitalised patients with conflicting results.However,none have investigated growth hormone(GH)which is related to IGF-I via negative feedback.AIM To investigate the relationship between serum levels of IGF-I and GH,and the occurrence of delirium.METHODS Prospective,longitudinal,observational study.Consecutive elderly inpatients(aged 70+),were assessed twice weekly with Montreal cognitive assessment(MoCA),Confusion assessment method(CAM),Acute Physiology and Chronic Health Evaluation II.Delirium was defined using CAM.Previous history of dementia was evaluated with the Informant Questionnaire on Cognitive Decline in the Elderly.IGF-I and GH levels were estimated with the ELISA method.Generalized estimating equations(GEE)model was applied for the first five assessments to analyze those longitudinal data.RESULTS The sample consisted of 198 participants(mean age 80.63±6.81;range 70-97).Of these 92(46.5%)were females.Eighty six(43.4%)were identified with a history of dementia.Incident or prevalent delirium during hospitalisation was identified with CAM in 40 participants(20.2%).Evaluation of missing values with Little's MCAR test indicated that they were missing completely at random(MCARχ2=12.24,u:9,P=0.20).Using GEE for the analysis we found that low MoCA scores,low levels of IGF-I and high levels of GH were significantly associated with any delirium(prevalence,incident,or fluctuating,during the study period(Waldχ2=12.231;u:1,P<0.001,Waldχ2=7.196,u:1,P=0.007,Waldχ2=6.210;:u:1,P=0.013 respectively).CONCLUSION The results show that low levels of IGF-I,high levels of GH and low scores in cognition are independently associated with the occurrence of any delirium during the hospitalisation of medically ill older people.The results of the study supports the hypothesis that deficits in the immunoreactivity of the brain(low cerebral reserve)may be associated with delirium.

The Body in Old Age and Dependency： A Territory of Threat and Uncertainty

This paper explores the image of the body in physically dependent elderly men and women and the way in which this image reconfigures their identity creating new meanings. In old age, the body becomes related with illness, with disablement and with its own material finiteness. Representations of the body are thus constructed around pain, deficiency, and fragility. The research was carried out from a qualitative perspective, performing in-depth interviews, with participant observation and a subject ID card as data collecting techniques. The identity of the interviewees who consented to be recorded was protected. The data were analyzed constructing concepts and theoretical and empirical categories with the support of the Etnograph V.5 software for qualitative data. The findings reflect discourses on the body that turn on its deterioration and limitations that prevent old people from functioning adequately in life. Metaphors were identified telling of a sense of＂deteriorated identity＂; most participants saw themselves as ＂a burden＂. They also showed symptoms of annoyance and shame regarding their sick or fragile bodies, as well as a constant memory of the healthy or ＂ideal＂ body of the past, which is hegemonic in our culture.

Wisdom and Old --age Pension： Reflections on China＇s Elderly Care Model

The care of the elderly is both a human basic human rights and a manifestation of social civilization. ＂Family pension＂ has always been the main pension model in China for thousands of years. However, with the transformation of social structure and population structure, the traditional ＂family pension＂ model is facing increasing challenges. While other emerging ＂institutions pension＂, ＂community pension＂ and failed to become a ＂family pension＂ alternative options, the role is limited. With the development of a variety of integrated technology, a new integrated technology based on the wisdom of the pension model began to emerge, wisdom pension as a new pension model has been in China with a preliminary attempt, it can maximize the elimination of the Chinese labor force The risk of population loss, the greatest extent to meet the needs of the elderly, the risk of dealing with old age, improve pension efficiency, and give the elderly equalization of power and ability, so as to fundamentally enhance the subjectivity of the elderly. But as a new exploration, but also faced with manyproblems, it is worth our in-depth thinking.

The Role of Government in the Socialization of Old- age Service

In the different stages of the development of the old-age service, the responsibility and function of the government will be different. In the new period, the government should redefine its role in advancing the socialization of the old-age service. The level of socialization of old-age services is not high, the lack of vitality of the pension market, the imperfect system and other problems arise because the government is not clear. The government should deal with the relationship between the main body of the market and avoid the ＇double failure＇ of the government and the market. The government should play a guiding role in the policy, laws and regulations and other aspects of good service work for the social services of the elderly to provide a good development environment.

The Construction of the Aged Carers under the Internationa Comparative Perspective

Objective： To explore how to learn from foreign experience to promote the construction of nursing staff in China.Methods：Based on the social background and the problems faced by nursing staffin China, we selected Germany and Japan as the social environment and problems of nursing staffin China. Germany, Japan and Japan to find out how to solve the dilemma of nursing service personnel to meet the pension needs of Germany and Japan to compare whether the strategy adopted by the current development of nursing staff in China, and finally combined with the analysis of China＇s aging care workers How to draw lessons from international experience to promote the construction of nursing staff in China.Conclusion： In drawing on the experience of foreign nursing service personnel, we must first analyze the reasons for such measures, whether our country has the conditions to implement such measures is not able to solve The experience of other countries must be suitable for our country, we must combine the social environment in which our country in contrast, selectivity and targeted research.

Personalities and health in older cat and dog owners: A HUNT-study

The aim of this population study was to identify personality traits among older (>65 years) male and female owners of cats and dogs and to compare their general health status in relation to their personality. Further, the aim was to examine whether current cat and dog ownership could be predicted by the owners’ personality and health. Data were collected from the North-Tr&#248ndelag Health Study (HUNT) in Norway. Included were a total of 1897 cat or dog owners between the ages of 65 years and 101 years. The results showed that there were a higher proportion of introverted male cat owners than extraverted ones. Moreover, a majority of women with cats reported that their health was not good. Furthermore, female cat owners who displayed higher scores on neurotic traits experienced significantly poorer health compared to those female cat owners that experienced good health. The same was true for female cat owners who considered themselves to be introverted. Neither personality nor health could predict pet-ownership, but it was more likely for older individuals (80-101 years) to own a cat than a dog. This study has shown that human personality is associated with cat and dog ownership, but there are other factors connected with pet ownership as well.

What will I be like at eighty? How human values contribute to expected real and ideal self-images in old age in a Germanic/Austrian cultural context

According to Grawe’s Consistency Theory, congruence between an individual’s aims and reality is fundamental for psychological health. We examined the real and ideal self-images of N = 440 participants in a Germanic/Austrian cultural context as perceived in presence and as anticipated for an age of 80 years and examined their relationship to value orientations as a coping resource. From adjective ratings on the Semantic Differential for the real self-image at presence, two dimensions were extracted, one representing Warmth (W) and one representing Competence (C) in the sense of the Stereotype Content Model. Cluster analysis yielded one type of respondents with a cautiously optimistic, and one with a moderately pessimistic view of the present and the future. A third cluster devalued W and C in favor of Religiosity and Conservatism and had the highest degree of congruence between real and ideal self-images. Thus, hypotheses with regard to Religiosity and Conservatism as coping resources were confirmed.

An Age Old Challenge

We all get older - it＇s a part of nature that is irreversible. But China has seen faster growth of the elderly population. China National Work-ing Commission on Ageing says that by the end of 2017, the number of people aged 60 and above reached 241 million. That＇s 17.3 percent of the total population. Even more alarming is the fact that the UN predicts this number will exceed 480 million by 2050 - with those over age 80 totaling 110 million.

Solving an Age Old Problem A new law requires children to visit their aging parents

MORE than 10 years ago, the song Come Home As Often As You Can to See Your Parents became popular in China, reminding young people of their obli- gation to set aside their hectic lives and return to their hometowns to visit their aging parents. Today, the idea expressed in this song has been codified in Chinese law.

Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery

BACKGROUND A femoral neck fracture is a common and frequently reported issue in orthopedics, with a greater rate of incidence among the elderly. Due to their advanced age and the presence of some primary diseases, both anesthesia and surgery are increasingly difficult in elderly patients with a femoral neck fractures. In fact,general anesthesia can easily induce complications such as cognitive dysfunction,which is not conducive to postoperative recovery.AIM To analyze the efficacy of dexmedetomidine in inducing anesthesia for elderly patients undergoing hip replacement surgery.METHODS A total of 98 elderly patients undergoing hip replacement in our hospital from June 2020 to June 2021 were randomly divided into control group(49 cases) and observation group(49 cases). The control group was given general anesthesia, and the observation group was combined with dexmedetomidine for anesthesia on the basis of the control group. Both groups were observed until the patients were discharged. The vital signs, serum inflammatory factors and renal function indexes of the two groups were compared before, during and 6 h after operation.The postoperative recovery and adverse events of the two groups were statistically analyzed.RESULTS Compared with the mean arterial pressure of the two groups, the intraoperative and postoperative 6 h was higher than that before the operation, the intraoperative was lower than the postoperative 6 h(P < 0.05);the blood oxygen saturation of the two groups was higher than that before operation and 6 h after operation, and the observation group was higher than the control group 6 h after operation(P < 0.05). The heart rate of the two groups was lower during and 6 h after operation than that before operation, and higher at 6 h after operation than that during operation(P < 0.05).The levels of serum C-reactive protein, tumor necrosis factor-α, interleukin-1β and kidney injury molecule-1 in the two groups were higher during operation and 6 h after operation than those before operation(P < 0.05). The level of serum urea nitrogen in the two groups was higher than that before operation, and that in the observation group was lower than that in the control group(P < 0.05). During hospitalization, the first time of getting out of bed, recovery time of grade Ⅱ muscle strength, recovery time of grade Ⅲ muscle strength and hospitalization time in the observation group were shorter than those in the control group(P < 0.05).CONCLUSION Dexmedetomidine can effectively improve the vital signs of elderly patients undergoing hip replacement surgery, reduce the body’s inflammatory response and renal function damage, and promote postoperative recovery. Meanwhile, dexmedetomidine showcased a good safety profile and a good anesthetic outcome.

Adverse Effects and Intervention of Frailty on Elderly Cancer Patients

Purpose:To study the adverse effects of frailty on elderly cancer patients and explore effective interventions.Methods:The convenience sampling method was used to select 362 elderly cancer patients who were consecutively admitted to the Oncology Department of the Affiliated Hospital of Hebei University from April 2020 to March 2021.The patients had five physical dimensions of activity tested and were divided into a frail group(n=128)and a non-frail group(n=234)based on the test results.The Chinese version of the Vulnerable Elders Questionnaire was formed on the basis of the Vulnerable Elders Survey-13(VES-13).The two groups of patients were surveyed within three days of admission.The questionnaire includes general information(age,gender,education level,marital status,monthly income,living area,smoking,and alcohol history,hearing,vision,and sleep status),Geriatric Depression Scale(GDS),Mini Nutritional Assessment(MNA),Mini-Mental State Examination(MMSE),and Charlson Comorbidity Index(CCI).Results:(1)By comparing the general information of the two groups of patients,it was found that the gender,education level,marital status,living area,and history of tobacco and alcohol had no statistical significance(P>0.05).In contrast,the frail group’s age,hearing status,vision status,and sleep status are significantly worse than those of the non-frail group(P<0.05);(2)Analysis of Vulnerable Elderly Questionnaire results found that the GDS scores in the frail group were higher than those in the non-frail group,and the MNA and MMSE scores were lower than those in the non-frail group(P<0.05).This indicated that the patients in the frail group had more severe depression,poor nutritional status,and specific impairments in cognitive function.Conclusion:Frailty adversely affects elderly cancer patients,and effective measures should be taken to intervene.

面临养老:第一代独生子女父母的心态与认识

利用对全国五大城市1005名准老年人的调查资料,以同龄非独生子女父母为参照对象,对第一代独生子女父母的养老心态和认识进行描述分析。结果表明,两类父母对未来养老生活的担心程度基本相同;3/4都将生病照料和日常生活照料看作老年生活中的最大担忧。但是,独生子女父母对生病照料的担心比例明显高于非独生子女父母,也更多地表现出对子女赡养自己所面临的客观困难的理解。两类父母都认为,为了孩子的前途,应该让他们去更好的地方,自己的养老将主要依靠自己解决。

Importance of serum phosphate in elderly patients with diabetes mellitus

BACKGROUND Metabolic disturbances including changes in serum calcium,magnesium or phosphate(P)influence the prevalence of type 2 diabetes mellitus(DM).We assessed the importance of serum P in elderly patients with type 2 DM vs nondiabetes mellitus(non-DM)in relation to renal function.AIM To determine the association between serum P and serum glucose or insulin resistance in diabetic and non-diabetic patients.METHODS One hundred-ten subjects with a mean age of 69.02±14.3 years were enrolled.Twenty-nine of the participants had type 2 DM(26.4%).The incidence of hypertension,smoking and receiving vitamin D(vitD)derivates were recorded.The participants were classified by both estimated glomerular filtration rate(eGFR)and albuminuria categories according to the Kidney Disease Improving Global Outcomes 2012 criteria.RESULTS We divided the patients in two groups according to the P cut-off point related to DM value.A comparison between high and low P showed that body mass index 30.2±6.3 vs 28.1±4.6(P=0.04),mean glucose 63.6 vs 50.2(P=0.03),uric acid 6.7±1.6 vs 6.09±1.7(P=0.05),mean intact-parathyroid hormone 68.06 vs 47.4(P=0.001),systolic blood pressure 147.4±16.7 vs 140.2±16.1(P=0.02),mean albuminuria 63.2 vs 50.6(P=0.04)and eGFR 45.6±22.1 vs 55.4±21.5(P=0.02)were significantly different.χ^2 tests showed a significant association between high P and DM,hypertension,receiving vitD,smoking and eGFR stage(χ^2=6.3,P=0.01,χ^2=3.9,P=0.03,χ^2=6.9,P=0.009,χ^2=7.04,P=0.01 andχ^2=7.36,P=0.04,respectively).The adjusted model showed that older age,female gender and increased body mass index were significant predictors of type 2 DM when entering the covariates.CONCLUSION High serum P contributes to vascular and metabolic disturbances in elderly patients with type 2 DM and renal impairment.