scholarly journals Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juopperi Samuli ◽  
Sund Reijo ◽  
Rikkonen Toni ◽  
Kröger Heikki ◽  
Sirola Joonas
Keyword(s):  
Chronic Diseases ◽  
Musculoskeletal Disorders ◽  
Population Sample ◽  
The Elderly ◽  
Primary Objective ◽  
Baseline Body Mass Index ◽  
Functional Tests ◽  
Physical Capability ◽  
Study Population

Abstract Background Good physical capability is an important part of healthy biological ageing. Several factors influencing physical capability have previously been reported. Long-term reports on physical capability and the onset of clinical disorders and chronic diseases are lacking. Decrease in physical capacity has been shown to increase mortality. This study focuses on the prevalence of chronic diseases. The primary objective of the study was to reveal the association between physical capability and morbidity. Secondary objectives included the validity of self-reported physical capability and the association between baseline physical capability and mortality. Methods The OSTPRE (Kuopio Osteoporosis Risk Factor and Prevention Study) prospective cohort involved all women aged 47–56 years residing in the Kuopio Province, Finland in 1989. Follow-up questionnaires were mailed at five-year intervals. Physical capability questions were first presented in 1994. From these women, we included only completely physically capable subjects at our baseline, in 1994. Physical capability was evaluated with five scale self-reports at baseline and in 2014 as follows: completely physically capable, able to walk but not run, can walk up to 1000 m, can walk up to 100 m and temporarily severely incapable. The prevalences of selected chronic diseases, with a minimum prevalence of 10% in 2014, were compared with the change in self-reported physical capability. Additionally, associations between long-term mortality and baseline physical capability of the whole 1994 study population sample were examined with logistic regression. The correlation of self-reported physical capability with functional tests was studied cross-sectionally at the baseline for a random subsample. Results Our study population consisted of 6219 Finnish women with a mean baseline age of 57.0 years. Self-reported physical capability showed statistically significant correlation with functional tests. Cardiovascular diseases and musculoskeletal disorders show the greatest correlation with decrease of physical capability. Prevalence of hypertension increased from 48.7% in the full physical capability group to 74.5% in the “able to walk up to 100 metres” group (p < 0.001). Rheumatoid arthritis showed a similar increase from 2.1 to 7.4% between these groups. Higher baseline body mass index (BMI) decreases long-term capability (P < 0.001). Women reporting full physical capability at baseline had a mortality rate of 15.1%, in comparison to 48.5% in women within the “able to walk up to 100 m” group (p = 0.357). Mortality increased steadily with worsening baseline physical capability. Conclusions The results of this study show that chronic diseases, particularly cardiovascular and musculoskeletal disorders, correlate with faster degradation of physical capability in the elderly. Similar results are shown for increase in BMI. We also demonstrate that the risk of mortality over a 20-year period is higher in individuals with poor baseline physical capability.

scholarly journals Changing social burden of Japan’s three major diseases including Long-term Care due to aging

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Koki Hirata ◽  
Kunichika Matsumoto ◽  
Ryo Onishi ◽  
Tomonori Hasegawa
Keyword(s):  
Heart Disease ◽  
Chronic Diseases ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Content Type ◽  
Social Burden ◽  
The Social ◽  
Mortality Cost

PurposeThe purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.Design/methodology/approachA modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.FindingsThe C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.Social implicationsThe LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.Originality/valueThe C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

scholarly journals Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

2020 ◽  
Author(s):  
Esther Nadine van der Zee ◽  
Lianne M. Noordhuis ◽  
Jelle L. Epker ◽  
Nikki van Leeuwen ◽  
Bas P.L. Wijnhoven ◽  
...  
Keyword(s):  
Performance Status ◽  
Primary Objective ◽  
University Hospital ◽  
Prior History ◽  
Ecog Performance Status ◽  
Chi Square ◽  
Icu Admission ◽  
Study Population ◽  
Long Term Mortality

Abstract Background Intensive Care Unit (ICU) triage decisions in patients with a malignancy can be difficult as clinicians have concerns about potential unfavourable outcomes. Therefore, clinicians may have doubts about the appropriateness of an ICU admission. The aim of this study was to assess the long-term mortality and performance status of critically ill patients with an active malignancy or a malignancy in their prior history admitted unplanned to the ICU. Furthermore, we aimed to compare the long-term mortality of those patients to the mortality of patients without a malignancy. Methods We conducted a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned admission to the ICU in 2017 in two groups: 1) the study population consisting of patients with an active malignancy and patients with a malignancy in their medical history (complete remission, CR) and 2) patients without a malignancy. Pearson’s Chi-square tests and Independent Samples T-Tests or the Mann-Whitney U tests were used to evaluate the long-term mortality, the primary objective was 2-year mortality. Results Of the 1046 unplanned ICU admissions, 125 (12%) patients had an active malignancy, 41 (3.9%) < 5 year CR and 33 (3.2%) ≥ 5 year CR. The 2-year mortality in the study population was significantly higher than in the population without a malignancy (67.4% and 40.2%, P < 0.001). The median performance status at 2 years after ICU admission in the study population was 1 (IQR 0–2). SOFA score (OR 1.25; 95% CI 1.10–1.42) and ECOG performance status of 2 (OR 11.23; 95% CI 2.66–47.33), 3 (OR 5.91; 95% CI 1.77–19.79) and 4 (OR 13.16; 1.85–93.74) were independently associated with 2-year mortality. Conclusions Two thirds of the study population died within 2 years after ICU admission, which is higher than in the population without a malignancy. However, the majority of the study population had a good performance status at 2 years after ICU admission. The severity of the critical illness and the performance status before ICU admission are independently associated with 2-year mortality and should be considered as main factors in ICU triage.

scholarly journals Association between Potentially Inappropriate Medication Use and Chronic Diseases in the Elderly

2019 ◽  
Vol 16 (12) ◽  
pp. 2189 ◽  
Author(s):  
Tzu-Chueh Wang ◽  
Pou-Jen Ku ◽  
Hai-Lin Lu ◽  
Kung-Chuan Hsu ◽  
Damien Trezise ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Chronic Diseases ◽  
Inappropriate Medication ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Potentially Inappropriate Medications ◽  
Continuous Exposure ◽  
Cross Sectional

Long-term continuous exposure to potentially inappropriate medications (PIMs) can lead to adverse events in the elderly. However, the effects of long-term exposure of the elderly to PIM and the relationship between PIM and chronic diseases remain unclear. The objective of this study was to investigate the continuous use of PIMs in a community-dwelling elderly population. A cross-sectional population-based study was conducted using community pharmacy–filed dispensing records from the Hcare system. Twenty-three community pharmacies were sampled from 2013 to 2015 to obtain records of patients above 65 years-old with continuous prescriptions. PIM were identified according to the 2015 Beers Criteria. The prevalence of patients using PIM was highest in patients with co-morbid mental disorders (40.05%), followed by neurological system disorders (28.91%). Patients who were prescribed a PIM were more than three times as likely to have a mental disorder as those (odds ratio 3.16, 95% confidence interval: 3.06–3.28) with non-chronic diseases. The most prescribed PIM agents were central nervous system drugs (53.16%), and benzodiazepines (35.15%). Patients with mental disorders had the highest rate of long-term persistent PIM exposure, with benzodiazepines being the most frequently dispensed. Drug safety concerns should be closely monitored in elderly patients with the abovementioned conditions.

The sustainability of a quality improvement initiative

2020 ◽  
Vol 33 (5) ◽  
pp. 195-199
Author(s):  
Veronica Belostotsky ◽  
Catherine Laing ◽  
Deborah E. White
Keyword(s):  
Quality Improvement ◽  
Elderly Population ◽  
Functional Decline ◽  
Cost Effective ◽  
The Elderly ◽  
Primary Objective ◽  
Quality Improvement Initiative ◽  
Cross Sectional ◽  
One Year

Functional decline in seniors admitted to hospital is due in part to lack of mobilization. Many Quality Improvement (QI) initiatives targeting mobilization of the elderly population in acute care exist; however, their long-term effectiveness is not well-documented. Mobilization of Vulnerable Elders (MOVE) was a grant-funded initiative that started in Ontario and spread to Alberta. The primary objective of this project was to ascertain the sustainability of the MOVE project 1 year post implementation at two hospital sites in Alberta, Canada. Qualitative and quantitative cross-sectional data were gathered from multidisciplinary healthcare professionals. Our findings suggest MOVE was not well-sustained one year post implementation. Examination of specific survey questions provided an indication of strengths and weaknesses of the MOVE QI. Sustainable and cost-effective QI targeted at this elderly patient demographic could alleviate some of the demand on the healthcare system. Modifications to improve the sustainability of MOVE are summarized.

Clinical outcome and long-term survival following radical esophagectomy in the elderly

2001 ◽  
Vol 120 (5) ◽  
pp. A747-A748
Author(s):  
S DRESNER ◽  
A IMMMANUEL ◽  
P LAMB ◽  
S GRIFFIN
Keyword(s):  
Clinical Outcome ◽  
The Elderly ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
Long Term Survival

Status and Degree of Dysphagia in the Elderly-A Comparison Study of Long-Term Care Elderly People in an Outpatient Clinic

2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  
Keyword(s):  
Elderly People ◽  
Outpatient Clinic ◽  
Long Term Care ◽  
The Elderly ◽  
Comparison Study ◽  
Term Care

Historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries

2020 ◽  
pp. 49-57
Author(s):  
Lyudmila Kaspruk
Keyword(s):  
Health Care ◽  
Social Services ◽  
Social Protection ◽  
The Elderly ◽  
Primary Role ◽  
Primary Health ◽  
Geriatric Service ◽  
Delivery Of Medical Care ◽  
Older Citizens

When analyzing the historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries not only obvious achievements in this sphere, but also a number of problems requiring solution were identified. The primary role in the delivery of medical care to geriatric patients is assigned to the primary health care sector. However the work of the geriatric service in the format of a single system for the provision of long-term medical and social care based on the continuity of patient management between differ- ent levels of the health care system and between the health and social protection services is not well organized. There is no clear coordination and interaction between health care and social protection institutions, functions of which include providing care to older citizens, and it significantly reduces the effectiveness of the provision of both medical and social services.

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