Impairments to Thermoregulation in the Elderly During Heat Exposure Events

Heat waves represent a public health risk to elderly people, and typically result in an increased rate of hospital admissions and deaths. Studies of thermoregulation in this cohort have generally focused on single elements such as sweating capacity. Sweating capacity and skin blood flow reduce with age, reducing ability to dissipate heat. Perception of effort during heat exposure is emerging as an area that needs further investigation as the elderly appear to lack the ability to adequately perceive increased physiological strain during heat exposure. The role of the gut and endotoxemia in heat stress has received attention in young adults, while the elderly population has been neglected. This shortcoming offers another potential avenue for identifying effective integrated health interventions to reduce heat illnesses. Increasing numbers of elderly individuals in populations worldwide are likely to increase the incidence of heat wave-induced deaths if adequate interventions are not developed, evaluated, and implemented. In this narrative-style review we identify and discuss health-related interventions for reducing the impact of heat illnesses in the elderly.

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The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽

10.1177/1460408620949725 ◽

2021 ◽

pp. 146040862094972

Author(s):

Ahmed Fadulelmola ◽

Rob Gregory ◽

Gavin Gordon ◽

Fiona Smith ◽

Andrew Jennings

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Hospital Admissions ◽

The Elderly ◽

Primary Outcome Measure ◽

Time To Death ◽

Significant Difference ◽

The Mean ◽

The Impact ◽

Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

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Health-Related Quality of Life of Elderly Women with Fall Experiences

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157804 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7804

Author(s):

Jiyoung Song ◽

Eunwon Lee

Keyword(s):

Quality Of Life ◽

Elderly Women ◽

The Elderly ◽

Basic Data ◽

Health Related Quality ◽

High Quality ◽

Related Quality ◽

Health Related ◽

The Impact

This study aimed to describe the health-related quality of life of elderly women with experience in fall treatment as well as to prepare basic data for the development of interventions to improve the quality of life for this group. The study was based on raw data from the 2019 Korea Community Health Survey. Using the SPSS program, the characteristics of the subjects were tested by frequency, percentage, and chi-square test. To establish the impact of fall experience on the health-related quality of life of elderly women, the OR and 95% CI were calculated using multiple logistic regression analysis. Of the 4260 people surveyed, 44.7% of the elderly women said they had a high quality of life, whereas 55.3% of the elderly women said they had a low quality of life. A younger age was associated with a better-rated health-related quality of life. Those who lived in a city and had a high level of education tended to describe a high quality of life. The quality of life was considered high by those who exercised, but low by those who were obese or diabetic. The results of this study can lead to a better understanding of the experiences of elderly women who have experienced falls, and they can be used as basic data for the development of related health programs.

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Abstract P069: Heat, Heat Waves and Hospital Admissions in Indianapolis, Indiana

Circulation ◽

10.1161/circ.135.suppl_1.p069 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Yi Wang

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Relative Risk ◽

Heat Wave ◽

Hospital Admissions ◽

Heat Waves ◽

Global Climate ◽

Extreme Heat ◽

Apparent Temperature ◽

The Impact

Background: The association between heat and hospital admissions is well studied, but in Indiana where the regulatory agencies cites lack of evidence for global climate change, local evidence of such an association is critical for Indiana to mitigate the impact of increasing heat. Methods: Using a distributed-lag non-linear model, we studied the effects of moderate (31.7 °C or 90 th percentile of daily mean apparent temperature (AT)), severe (33.5 °C or 95 th percentile of daily mean apparent temperature (AT)) and extreme (36.4 °C or 99 th percentile of AT) heat on hospital admissions (June-August 2007-2012) for cardiovascular (myocardial infarction, myocardial infarction, heart failure) and heat-related diseases in Indianapolis, Indiana located in Marion County. We also examined the added effects of moderate heat waves (AT above the 90 th percentile lasting 2-6 days), severe heat waves (AT above the 95 th percentile lasting 2-6 days) and extreme heat waves (AT above the 99 th percentile lasting 2-6 days). In sensitivity analysis, we tested robustness of our results to 1) different temperature and lag structures and 2) temperature metrics (daily min, max and diurnal temperature range). Results: The relative risks of moderate heat, relative to 29.2°C (75 th percentile of AT), on admissions for cardiovascular disease (CVD), myocardial infarction (MI), heart failure (HF), and heat-related diseases (HD) were 0.98 (0.67, 1.44), 6.28 (1.48, 26.6), 1.38 (0.81, 2.36) and 1.73 (0.58, 5.11). The relative risk of severe heat on admissions for CVD, MI, HF, and HD were 0.93 (0.60, 1.43), 4.46 (0.85, 23.4), 1.30 (0.72, 2.34) and 2.14 (0.43, 10.7). The relative risk of extreme heat were 0.79 (0.26, 2.39), 0.11 (0.087, 1.32), 0.68 (0.18, 2.61), and 0.32 (0.005, 19.5). We also observed statistically significant added effects of moderate heat waves lasting 4 or 6 days on hospital admission for MI and HD and extreme heat waves lasting 4 days on hospital admissions for HD. Results were strengthened for people older than 65. Conclusions: Moderate heat wave lasting 4-6 days were associated with increased hospital admissions for MI and HD diseases and extreme heat wave lasting 4 days were associated with increased admissions for HD.

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Quantifying the impact of air pollution on the urban population of Brazil

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007001600013 ◽

2007 ◽

Vol 23 (suppl 4) ◽

pp. S529-S536 ◽

Cited By ~ 15

Author(s):

Izabel Marcilio ◽

Nelson Gouveia

Keyword(s):

Air Pollution ◽

Urban Population ◽

Hospital Admissions ◽

Age Groups ◽

The Elderly ◽

Impact Factors ◽

Pollution Levels ◽

Time Series Studies ◽

The Impact ◽

Respiratory Causes

This study aimed to quantify air pollution impact on morbidity and mortality in the Brazilian urban population using locally generated impact factors. Concentration-response coefficients were used to estimate the number of hospitalizations and deaths attributable to air pollution in seven Brazilian cities. Poisson regression coefficients (beta) were obtained from time-series studies conducted in Brazil. The study included individuals 65 years old and over and children under five. More than 600 deaths a year from respiratory causes in the elderly and 47 in children were attributable to mean air pollution levels, corresponding to 4.9% and 5.5% of all deaths from respiratory causes in these age groups. More than 4,000 hospital admissions for respiratory conditions were also attributable to air pollution. These results quantitatively demonstrate the currently observed contribution of air pollution to mortality and hospitalizations in Brazilian cities. Such assessment is thought to help support the planning of surveillance and control activities for air pollution in these and similar areas.

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The importance of anemia and health-related quality of life in the elderly

Zinc supplementation improves heme biosynthesis in rats exposed to lead ◽

10.18051/univmed.2020.v39.135-149 ◽

2020 ◽

Vol 39 (2) ◽

pp. 135

Author(s):

Raditya Wratsangka ◽

Rully Ayu Nirmalasari Haryadi Putri

Keyword(s):

Quality Of Life ◽

Hemoglobin Concentration ◽

The Elderly ◽

World Population ◽

Health Related Quality ◽

Wide Range ◽

Related Quality ◽

Health Related ◽

The Impact

Anemia is a global health problem with an extremely high prevalence and occurring in nearly 25% of the world population, particularly in the elderly group. Currently Indonesia is facing a rapid growth of the elderly population, with around 21 million elderly (8.2% of the total population), that is projected to increase to 33.7 million (11.8%) in the year 2025. Anemia in the elderly is frequently neglected, although the facts show that low hemoglobin concentration is an important marker of physiological decline and functional limitations. Although the factor of intrinsic aging may cause low hemoglobin concentration, anemia in the elderly is known to have a wide range w88ith regard to etiology, underlying disorders, and possible mechanisms, such that it should be clinically followed up. Whatever its causes or underlying pathophysiological, anemia in the elderly has been proven to play a role in their morbidity and mortality, and may decrease their quality of life, that comprises all aspects of physical, mental, and social health, known as health-related quality of life (HRQoL). The impact of anemia on HRQoL has been studied in various populations, and most studies report the presence of an association between HRQoL and anemia in elderly individuals, which on the subscale level is particularly associated with physical health. Early diagnosis of anemia is important to prevent aggravation of the condition, to retard the progress of the disease, and to improve the health-related quality of life (HRQoL) of the patient. Prior to determining the treatment plan, the primary diagnosis and the comorbidities, especially treatable disorders, had better be identified first. The available data show that the overall prognosis will improve for anemia in patients with well-managed and corrected chronic disorders.

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The Impact of Cold and Heat on Years of Life Lost in a Northwestern Chinese City with Temperate Continental Climate

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193529 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3529 ◽

Cited By ~ 2

Author(s):

Jiangtao Liu ◽

Yueling Ma ◽

Yuhong Wang ◽

Sheng Li ◽

Shuyu Liu ◽

...

Keyword(s):

Respiratory Diseases ◽

Heat Waves ◽

Age Groups ◽

The Elderly ◽

Years Of Life Lost ◽

Weather Variables ◽

Distributed Lag ◽

Heat Effects ◽

The Impact ◽

Continental Climate

Cold spells and heat waves in a changing climate are well known as great public-health concerns due to their adverse effects on human health. However, very few studies have quantified health impacts of heat and cold in the region of Northwestern China. The purpose of the present study was to evaluate the effects of cold and heat on years of life lost (YLL) in Lanzhou, a city with temperate continental climate. We compiled a daily dataset including deaths, weather variables, and air pollutants in Lanzhou, China, from 2014–2017. We used a distributed lag non-linear model to estimate single-day and cumulative effects of heat and cold on daily YLL. Results indicated that both cold and heat were associated with increased YLL for registered residents in Lanzhou. Estimated heat effects appeared immediately in the first two days, while estimated cold effects lasted over a longer period (up to 30 days). Cold significantly increased the YLL of all residents except for males and those with respiratory diseases (≥65 years). Our results showed that both heat and cold had more pronounced effects on cardiovascular diseases compared to respiratory diseases. Males might be more vulnerable to heat, while females might suffer more YLL from cold. The effects of cold or heat on the elderly might appear earlier and last longer than those for other age groups.

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The Impact of Heat, Cold, and Heat Waves on Hospital Admissions in 8 Cities in Korea

ISEE Conference Abstracts ◽

10.1289/isee.2014.o-092 ◽

2014 ◽

Vol 2014 (1) ◽

pp. 1901

Author(s):

Jiyoung Son* ◽

Michelle Bell ◽

Jong-Tae Lee

Keyword(s):

Hospital Admissions ◽

Heat Waves ◽

The Impact

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The influence of changes in activity-based financing on hospital readmissions for the elderly

Nordic Journal of Health Economics ◽

10.5617/njhe.992 ◽

2016 ◽

Vol 4 (2) ◽

pp. 72-81 ◽

Cited By ~ 2

Author(s):

Jun Yin ◽

Fredrik A. Dahl ◽

Terje P. Hagen ◽

Hilde Lurås

Keyword(s):

Readmission Rate ◽

Hospital Admissions ◽

Cox Regression ◽

Average Length ◽

Hospital Readmissions ◽

Random Effect ◽

The Elderly ◽

Patient Specific ◽

Readmission Rates ◽

The Impact

Activity-based financing of Norwegian hospitals was implemented in 1997. An earlier study shows that when the activity-based component increases, the average length of stay for the elderly is reduced. If this reduction entails premature discharge, an increased activity-based component may have the undesirable side effect of increasing readmission rates. Yearly the Norwegian government decides the size of the activity-based component, and all hospitals face the same size. In this paper, we investigate whether the level of activity-based financing is associated with the readmission rates for acute-care patients above 70 years of age. The sample consisted of 468 010 hospital admissions among elderly patients in the period from 2000 to 2007. Using repeated cross-sectional data extracted from the Norwegian Patient Registry, a Cox regression model was used to estimate factors that may influence the hazard rate of a readmission within 30 days. The overall 30-day readmission rate was 6.6%. The results demonstrate that the activity-based component had no significant effect on the readmission rate. Patient-specific factors such as age, gender, diagnoses, comorbidities, as well as the time trend, were important predictors of readmission rates. We also found a statistically significant random effect of hospitals, although this effect was less substantial than the impact of patient characteristics. Our results show that the effect of the activity-based component on the readmission rate was negligible when it varied between 40% and 60%.Published: Online May 2016. In print August 2016.

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