A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Cardiovascular Diseases ◽  
General Practitioners ◽  
Older Patients ◽  
Metabolic Diseases ◽  
Treatment Plan ◽  
Age Groups ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
World Health ◽  
New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

scholarly journals Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaojie Dong ◽  
Xin Du ◽  
Shangxin Lu ◽  
Chao Jiang ◽  
Shijun Xia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Diseases ◽  
Risk Model ◽  
Age Groups ◽  
Gastrointestinal Disorder ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Unique Identifier ◽  
Clinical Registry

Abstract Background Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which has not been paid much attention to in practice. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients. Methods From August 2011 to December 2017, a total number of 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were prospectively selected for this study. We described the incidence, causes of hospitalization by age groups and sex. The Fine-Gray competing risk model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total hospitalizations); while patients aged 65–74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). We found patients complicated with heart failure (HF)[hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.02–1.18], established coronary artery disease (CAD) (HR 1.24, 95%CI 1.17–1.33), ischemic stroke/transient ischemic attack (TIA) (HR 1.22, 95%CI 1.15–1.30), diabetes (HR 1.14, 95%CI 1.08–1.20), chronic obstructive pulmonary disease (COPD) (HR 1.28, 95%CI 1.02–1.62), gastrointestinal disorder (HR 1.37, 95%CI 1.21–1.55), and renal dysfunction (HR 1.24, 95%CI 1.09–1.42) had higher risks of hospitalization. Conclusions More than one-third of AF patients included in this study were hospitalized at least once during over 3-year follow-up. The main cause for hospitalization among the elderly patients (≥ 65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated to reduce hospitalization in AF patients older than 65 years old. Clinical Registryhttp://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. The registration date is October 22, 2013.

Medical service demands of older patients in different age groups in a new model of free Telemedicine

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Type 2 Diabetes Mellitus ◽  
Heart Disease ◽  
Older Patients ◽  
Medical Service ◽  
Age Groups ◽  
New Model

Abstract Background Medical service for the older patients is a worldwide challenge for public health system. Telemedicine can provide convenient and effective medical service for older patients. But the existing telemedicine models rely upon a direct communication between a doctor and a patient via the Internet but the doctor would be unable to give the patient a direct physical examination, it may lead to diagnostic errors. A new model of telemedicine jointly performed by general practitioners in community health centers and specialists in a university teaching hospital has been established. It is supervised by the government health department and is free for older patients. However, medical service demands of older patients in different age groups applying the new telemedicine are not well characterized. This study is to analyze medical service demands of older patients in different age groups applying the new telemedicine. Methods 472 older patients (aged ≥ 60) were enrolled and were divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged ≥ 90) according to the age stratification for older people defined by World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. Results Coronary heart disease and type 2 diabetes mellitus were identified as the top two diseases in the older patients and the young older patients as well as the old older patients applying the new telemedicine. Conclusions The new telemedicine model can provide effective free medical services to older patients. Different medical service demands were identified in different age groups of older patients. Coronary heart disease and type 2 diabetes mellitus were the main diseases of the older patients and young older patients as well as the old older patients applying the new telemedicine. Results of this study will provide basis for the health administrative departments to formulate health policies for older patients. Familiar with the main diseases in different age groups of older patients may provide better medical services to older patients.

scholarly journals Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review

2020 ◽  
Vol 17 (21) ◽  
pp. 8098 ◽  
Author(s):  
Kunho Lee ◽  
Goo-Churl Jeong ◽  
JongEun Yim
Keyword(s):  
Mental Health ◽  
Age Groups ◽  
Risk Groups ◽  
The Elderly ◽  
World Health ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Induced Stress ◽  
Health Organization ◽  
Mental And Physical Health

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe treatment is available. COVID-19 can occur at any age. However, the maximum confirmed cases and deaths have occurred among the elderly. Particularly, the mental and physical health of the elderly aged above 60 and classified as high-risk groups is more vulnerable than other age groups, requiring more attention. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this study explores factors—including pandemic-induced stress, self-integration, self-efficacy, and resilience—in order to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity.

scholarly journals Leisure-Time Physical Activity Participation Trends 2014–2018: A Cross-Sectional Study in Poland

2019 ◽  
Vol 17 (1) ◽  
pp. 208 ◽  
Author(s):  
Elżbieta Biernat ◽  
Monika Piątkowska
Keyword(s):  
Physical Activity ◽  
Large Scale ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Occupational Status ◽  
Age Groups ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
World Health ◽  
Cross Sectional

Objective, the aim is an analysis of sociodemographic factors that had an essential relation with undertaking leisure-time physical activity—LTPA (with particular emphasis on World Health Organization (WHO) health recommendations) by adult Poles from a time-trend perspective. Methods, the paper is based on data retrieved from five large-scale surveys carried out on the representative samples of Poles aged 15–69 in 2014–2018 (n = 7347). In each wave, the Polish long version of the International Physical Activity Questionnaire was used. Results, the participation of Poles in LTPA constantly increases (p < 0.001) and the percentage of people meeting the dose of PA required for health recommendations is growing (on average, met by 43.9% of Polish men and 43.5% of women), which indicates a trend of behaviour of citizens of this country. The probability of realisation of WHO norms was determined by sex, age, place of residence and occupational status. Conclusion: it seems reasonable to develop Polish recommendations and guidelines for specific groups, including females and males, those who live in the villages and in the towns, different age groups: children/adolescents, adults (aged 50 to 59—most vulnerable to physical inactivity), the elderly, and various professional groups (especially farmers and physical workers).

scholarly journals STUDI LITERATUR: PENGARUH TERAPI PIJAT REFLEKSI KAKI TERHADAP KUALITAS TIDUR LANJUT USIA

2021 ◽  
Vol 7 (1) ◽  
pp. 8-13
Author(s):  
Chaerun Nissa ◽  
Ashar Prima ◽  
Fauziah Hamid Wada ◽  
Puji Astuti ◽  
Salamah T Batubara
Keyword(s):  
United States ◽  
Literature Review ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Age Groups ◽  
The Elderly ◽  
Scientific Paper ◽  
The United States ◽  
Google Scholar ◽  
World Health

WHO states that Indonesia's population is the fourth largest population after China, India, and the United States. According to the 2013 World Health Statistics data, the population of China is 1.35 billion, India is 1.24 billion, the United States 313 million, and Indonesia is in fourth place with 242 million WHO population predicts that by 2020 the estimated number of Indonesia's elderly will be around 80,000,000. Cases of insomnia in the elderly are higher than in other age groups, which is 12–39%. One therapy that can overcome sleep disorders in the elderly is foot reflexology massage therapy. This literature review aims to determine the effect of foot reflexology massage in the elderly who experience sleep disorders. The design in this scientific paper is a literature review search using an electronic data base that is google scholar and pubmed. The keywords used in the search are elderly, foot reflexology, sleep of quality. The inclusion criteria used in the article are full text accessible in English and Indonesian, the year of the journal used is limited to the last ten years. The results found 1 article from Google Scholar and 2 articles from PubMed discussing the effectiveness of foot reflexology massage on improving sleep quality in the elderly. Literature review results from the three articles show that foot reflexology is effective in improving sleep quality in the elderly.  

scholarly journals 509 A biochemical approach to atrial fibrillation in older patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giulia Ricciardi ◽  
Giuseppe Pieraccini ◽  
Claudia Di Serio ◽  
Giancarlo La Marca ◽  
Stefano Fumagalli
Keyword(s):  
Atrial Fibrillation ◽  
Amino Acids ◽  
Healthy Subjects ◽  
Older Patients ◽  
Metabolic Diseases ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Untargeted Metabolomics ◽  
Clinical Approach ◽  
Laboratory Activity

Abstract Aims Atrial fibrillation (AF) is the most common arrhythmia among the elderly. It is characterized by a disordered electrical activity of the atria and is associated with increased morbidity and mortality. The pathogenesis of AF is not completely understood as it depends on a multifactorial combination of electrical and structural remodelling and inflammation. Metabolomics is the study of the small molecules present in a given biological sample and it has been widely used to determine the metabolic signatures of certain diseases. Untargeted metabolomics consists of a comprehensive screening of all measurable metabolites to identify patterns related to a certain disease, while targeted metabolomics aims at analysing a defined group of metabolites belonging to a specific metabolic pathway or class of compounds. Mass spectrometry (MS), coupled with gas chromatography (GC) and liquid chromatography (LC) offers the possibility of performing quantitative analyses with high selectivity and sensitivity. Aims of this project were to understand the biomolecular mechanisms underlying the onset of AF. Methods We compared plasma samples of older patients with AF with those of healthy subjects. We started from untargeted metabolomics to explore the whole metabolome; then we focused on the lipidomic profile, and, finally, we measured the plasma concentration of acylcarnitines and some amino acids, known to be diagnostic markers of certain metabolic diseases. Fifty patients (age: 76 ± 6 years) and 26 healthy subjects (age: 65 ±19 years) were recruited for the study. A blood sample was drawn by each patient. Samples for metabolomics and lipidomics were processed, respectively, with a GC-MS platform and with high-resolution LC-MS. Results Differences in diseased and healthy metabolomic and lipidomic profiles were not detected, while the concentration of some acylcarnitines and amino acids resulted to be significantly different in the two groups. In particular, two long-chain acylcarnitines (LCACs), C14 and C18:1, were more abundant in the plasma of AF patients, while glycine, which has scavenger properties, had a lower concentration. High levels of circulating LCACs have been associated with cardiovascular diseases and they are known to alter the heart electrophysiology, thus representing a possible marker of the development of arrhythmias. We can hypothesize that the different concentrations we found possibly reflect a higher oxidative and metabolic stress induced by the arrhythmia. Conclusions The alterations of the LCACs we found in AF patients could represent the basis to guide specific therapeutic interventions aimed at reducing the incidence of the hemodynamic and embolic complications of the arrhythmia. In particular, recent guidelines for the management of AF patients introduced the acronym ABC, which means ‘Avoid stroke’—A, ‘Better symptoms management’—B, and ‘Cardiovascular risk and comorbidity management’—C. In this sense, the present research represents an attempt to join and enrich the traditional clinical approach with data derived from laboratory activity, to improve the outcome of the oldest segment of cardiac patients, often presenting rhythm alterations.

The elderly patient

2013 ◽  
Author(s):  
Fraser Birrell ◽  
Janice O’Connell
Keyword(s):  
Elderly Patient ◽  
United Kingdom ◽  
Older Patients ◽  
Clinical Presentation ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
Musculoskeletal Conditions ◽  
Diagnosis And Management ◽  
The United Kingdom ◽  
Rheumatological Diseases

In this chapter, we describe how the process of ageing can itself affect the diagnosis and treatment of musculoskeletal conditions. We outline general principles concerning the clinical presentation of rheumatological diseases in older patients, as well as providing specific guidance on the diagnosis and management of the commoner conditions encountered in practice in the United Kingdom.

Adjuvant or Palliative Chemotherapy for Colorectal Cancer in Patients 70 Years or Older

1999 ◽  
Vol 17 (8) ◽  
pp. 2412-2412 ◽  
Author(s):  
R. A. Popescu ◽  
A. Norman ◽  
P. J. Ross ◽  
B. Parikh ◽  
D. Cunningham
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Older Patients ◽  
Palliative Chemotherapy ◽  
Performance Status ◽  
Age Groups ◽  
Response Rates ◽  
The Elderly ◽  
Younger Patients ◽  
Royal Marsden Hospital

PURPOSE: The surgical treatment of colorectal cancer (CRC) in elderly patients (age 70 years or older) has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remain scarce. Elderly patients are underrepresented in clinical trials, and results for older patients are seldom reported separately. PATIENTS AND METHODS: Using a prospective database, we analyzed demographics, chemotherapy toxicity, response rates, failure-free survival (FFS), and overall survival (OS) of CRC patients receiving chemotherapy at the Royal Marsden Hospital. The cutoff age was 70 years. RESULTS: A total of 844 patients received first-line chemotherapy with various fluorouracil (5-FU)-containing regimens or raltitrexed for advanced disease, and 543 patients were administered adjuvant, protracted venous infusion 5-FU or bolus 5-FU/folinic acid (FA) chemotherapy. Of the 1,387 patients, 310 were 70 years or older. There was no difference in overall or severe (Common Toxicity Criteria III to IV) toxicity between the two age groups, with the exception of more frequent severe mucositis in older patients receiving adjuvant bolus 5-FU/FA. For patients receiving palliative chemotherapy, no difference in response rates (24% v 29%, P = .19) and median FFS (164 v 168 days) were detected when the elderly were compared with younger patients. Median OS was 292 days for the elderly group and 350 days for the younger patients (P = .04), and 1-year survival was 44% and 48%, respectively. The length of inpatient hospital stay was identical. CONCLUSION: Elderly patients with good performance status tolerated adjuvant and palliative chemotherapy for CRC as well as did younger patients and had similar benefits from palliative chemotherapy.

scholarly journals International strategies in the face of aging population

2016 ◽  
Vol 126 (2) ◽  
pp. 55-58
Author(s):  
Bartłomiej Drop ◽  
Marian Jędrych ◽  
Agnieszka Barańska ◽  
Ewelina Firlej ◽  
Mariola Janiszewska
Keyword(s):  
Population Aging ◽  
Age Groups ◽  
Aging Population ◽  
The Elderly ◽  
Developed Countries ◽  
World Health ◽  
Modern World ◽  
The European Union ◽  
The Face ◽  
International Strategies

Abstract Introduction. Population aging poses many important economic, social, and health challenges to the modern world. This applies mostly to developed countries. The phenomenon requires joint action of Member States of the European Union, the World Health Organization, the United Nations, the Council of Europe as well as some unified strategies for the actions taken by these entities. Aim. The aim of this study was to demonstrate international strategies implemented in the face of demographic changes. Material and methods. The authors analyzed the documents outlining strategies for both organizations and entities, as well as recommendations for international scientific consultation on strategy of the aging population. Results. Analysis of changes happening to the oldest age groups showed the need for cooperation between countries. An overview of the strategies being taken at the moment and those that had been undertaken previously by international entities can contribute to modify the arrangements of the elderly; in order to improve the living conditions in multidimensional aspect. Conclusions. The key to achieving the desired effect through implementing the policies of individual countries is to monitor them on a regular basis.

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