The Elderly
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(FIVE YEARS 20025)



2021 ◽  
pp. 1-3
Mannjunath Haridas ◽  
Venkata Jaya Divya Tenneti ◽  
Divya Poduri ◽  

Anal necrosis is an extremely rare and uncommon disease. It has a rich collateral blood supply. The most common etiology of anal necrosis in the elderly is ischemic secondary to atherosclerosis but anal necrosis in young with no predisposing factor is infrequent thus impeling the authors to write a report. A young middle aged male presented to our emergency department with pain and foul smelling discharge from the anal canal. There was prior history of anal fistula and a recent treatment with herbal medication. The patient underwent computed tomography and magnetic resonance imaging confirming anal canal necrosis with infection. The patient was in septic shock. Antibiotics and supportive volume resuscitation was carried out for managing sepsis. He also underwent prompt debridement with defunctioning loop colostomy. Early reconstruction of the anal canal spinchters and flap construction of the skin and subcutaneous tissue was done to prevent loss of anal canal spinchters control and further morbidity.

2021 ◽  
Vol 9 ◽  
Xiaotuo Qiao ◽  
Bo Wang ◽  
Haifeng Guo

Background: The incidence of chronic diseases has increased dramatically due to rapid aging and lifestyle changes of China in recent decades. The population aged more than 45 years is an important participant in the labor force market, and the health status directly affects their labor force participation decision. This study aims to explore the relationship between chronic diseases and the labor force participation among the elderly Chinese population aged more than 45 years.Method: We employ a multivariate probit (MVP) model to construct five structural equations for an analysis. The advantage of this model is that it can deal with the endogeneity of chronic diseases.Results: Firstly, compared with the elderly, younger people are more likely to participate in the labor force market; the influence of chronic diseases is the largest for presenile women in the decision-making of labor force participation; the impact of psychological problems on labor force participation cannot be ignored, especially for men aged more than 45 years. In addition, sociodemographic factors such as geographical location and marital status also have direct effects on the probability of labor force participation while the impact of both family wealth and family number is much smaller. Finally, unhealthy lifestyles through chronic diseases have negative and indirect marginal effects on labor force participation.Conclusions: This article proves that chronic diseases have a negative impact on the labor force participation for Chinese aged more than 45 years. The public should give more tolerance and opportunities to these groups. The population aged more than 45 years are more vulnerable and face more psychological problems, which will lead to a decline in labor force participation. Psychological health counseling and services are urgently needed. As the urban areas enjoy more social welfare, Chinese welfare policy needs to be tilted toward the rural elderly. For individuals, maintaining healthy lifestyles can help you stay away from chronic diseases and stay in the labor force market.

2021 ◽  
Zhao Hu ◽  
Baohua Zheng ◽  
Atipatsa Chiwanda Kaminga ◽  
Huilan Xu

Abstract Background Elderly residents in nursing homes are at high risk for dysphagia. However, the prevalence estimates of this condition and its risk factors among this population were inconsistent. Objective To estimate the prevalence of dysphagia and examine its risk factors among the elderly in nursing homes. Methods Electronic database of PubMed, Web of science, Embase for English language, Wangfang, VIP and CNKI for Chinese language were systematically searched to identify relevant observational studies published not later than July 4, 2021. Studies conducted in nursing homes and reported dysphagia assessment methods were included. Results In total, 43 studies involving 56,746 participants were included in this systematic review and meta-Analysis. The overall pooled crude prevalence of dysphagia was 35.9% (95%CI: 29.0%, 43.4%), with high heterogeneity (I2 = 99.5%). There was a statistically significant difference in prevalence estimates with respect to study locations, methods of assessment of dysphagia, dysphagia assessment staff, representativeness of samples, and validity of assessment tools. Pooled estimates indicated that male (OR = 1.13, 95%CI: 1.00, 1.27), cognitive impairment (OR = 2.47, 95%CI: 1.59, 3.84), functional limitation (OR = 2.59, 95% CI: 1.75, 3.84), cerebrovascular disease (OR = 2.90, 95%CI: 1.73,4.87), dementia (OR = 1.50, 95%CI: 1.15, 1.96) and Parkinson’s disease (OR = 1.81, 95%CI: 1.06, 3.08) were significant risk factors for dysphagia. Conclusions The prevalence of dysphagia in nursing homes is relatively high, and with high heterogeneity. Also, many factors were associated with the risk of dysphagia. Further research is needed to identify strategies for management and interventions targeted at these disorders in this population.

Eye ◽  
2021 ◽  
Alison J. Clare ◽  
Jian Liu ◽  
David A. Copland ◽  
Sofia Theodoropoulou ◽  
Andrew D. Dick

AbstractAge-related macular degeneration (AMD), a degenerative disease affecting the retinal pigment epithelium (RPE) and photoreceptors in the macula, is the leading cause of central blindness in the elderly. AMD progresses to advanced stages of the disease, atrophic AMD (aAMD), or in 15% of cases “wet” or neovascular AMD (nAMD), associated with substantial vision loss. Whilst there has been advancement in therapies treating nAMD, to date, there are no licenced effective treatments for the 85% affected by aAMD, with disease managed by changes to diet, vitamin supplements, and regular monitoring. AMD has a complex pathogenesis, involving highly integrated and common age-related disease pathways, including dysregulated complement/inflammation, impaired autophagy, and oxidative stress. The intricacy of AMD pathogenesis makes therapeutic development challenging and identifying a target that combats the converging disease pathways is essential to provide a globally effective treatment. Interleukin-33 is a cytokine, classically known for the proinflammatory role it plays in allergic disease. Recent evidence across degenerative and inflammatory disease conditions reveals a diverse immune-modulatory role for IL-33, with promising therapeutic potential. Here, we will review IL-33 function in disease and discuss the future potential for this homeostatic cytokine in treating AMD.

2021 ◽  
Jaehoon Jeong ◽  
Sungmin Kim ◽  
Nahyeon Kim ◽  
Yoonjoo Lee ◽  
Daechang Kim

Abstract Background: The biggest problem in an aging society is the development of degenerative brain disease in the elderly. Neurodegenerative brain disease can cause cognitive dysfunction and rapidly increase the prevalence of dementia and Parkinson's disease, posing a huge economic and social burden on the elderly. A computerized cognitive rehabilitation training system has been developed to prevent and train cognitive dysfunction, showing various clinical effects. However, few studies have analyzed components of contents such as memory and concentration training. In this study, the clinical effects and characteristics of the color, number and words elements were analyzed by subdividing the memory and concentration contents into elements, difficulty, and training methods.Methods: Using a total of eight contents developed based on neuropsychology, 24 normal subjects with an average age of 60.58 ± 3.96 years were conducted 3 times a week, and training was received for 30 to 45 minutes per session. To determine the training effect, MMSE-K, an evaluation tool most closely related to cognitive therapy, was used. The number of errors and problem solving time used in the analysis were dataized by measuring the number of incorrect answers selected by the subject and the time spent solving the problem, respectively. Using t-test, the significance of different between before and after training was determined. Correlation between the number of errors and problem-solving time by week was determined using a trend line. All experimental procedures and evaluations were conducted after obtaining IRB approval from Dongguk University Ilsan Hospital (DUIH2020-07-001).Results: The subjects' MMSE-K scores were 27.88 ± 1.70 points before intervention to 28.63 ± 1.69 points after three weeks of intervention. In each subdivided component, color element showed an effect of improving complex difficulty, number element had the most effective training effect, and word element had a predictive effect on cognitive decline. Conclusions: A detailed analysis results of the components used in a computerized cognitive rehabilitation training system will help develop degenerative brain disease contents to be developed later, and is expected to contribute to a prevention-oriented medical paradigm

2021 ◽  
Vol 15 ◽  
Anne Sophie Grenier ◽  
Louise Lafontaine ◽  
Andréanne Sharp

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.

2021 ◽  
Vol 11 (1) ◽  
Jung-Hee Lee ◽  
Kyung-Chung Kang ◽  
Ki-Tack Kim ◽  
Yong-Chan Kim ◽  
Tae-Soo Chang

AbstractA known prevalence of concurrent cervical and lumbar spinal stenosis was shown to be 5–25%, but there is a lack of evidence regarding direct relationships in canal dimension and canal-body ratio between cervical and lumbar spine. Total 247 patients (mean age: 61 years, male: 135) with cervical and lumbar computed tomography scans were retrospectively reviewed. Midsagittal vertebral body and canal diameters in reconstructed images were measured at all cervical and lumbar vertebrae, and canal-body ratios were calculated. The canal diameter and ratio were also compared according to the gender and age, and correlation analysis was performed for each value. There were significant correlations between cervical (C3–C7) and lumbar (L1–L5) canal dimension (p < 0.001). C5 canal diameter was most significantly correlated with L4 canal diameter (r = 0.435, p < 0.001). Cervical canal-body ratios (C3–C7) were also correlated with those of lumbar spine (L1–L5) (p < 0.001). The canal-body ratio of C3 was most highly correlated with L3 (r = 0.477, p < 0.001). Meanwhile, mean canal-body ratios of C3 and L3 were significantly smaller in male patients than female (p = 0.038 and p < 0.001) and patient’s age was inversely correlated with C5 canal diameter (r = − 0.223, p < 0.001) and C3 canal-body ratio (r = − 0.224, p < 0.001). Spinal canal dimension and canal-body ratio have moderate degrees of correlations between cervical and lumbar spine and the elderly male patients show the tendency of small canal diameter and canal-body ratio. This relationship of cervical and lumbar spine can be an important evidence to explain to the patients.

2021 ◽  
Vol 9 (211) ◽  
pp. 1-16

The elderly population has grown considerably in recent decades with a significant increase in psychic diseases, including depression, considered one of the major causes of functional decline and decreased quality of life. The purpose of this research was to understand depression in institutionalized elderly and to relate which levels of depression interfere with their functional capacity. The applied methodology consists of an integrative review based on scientific production, used as inclusion criteria, articles selected from the databases of the Virtual Health Library (VHL): LILACS, SciELO and MEDLINE, which were published between 2006 to 2016 and collected in the first half of 2017, in Portuguese and English. The results of this review are expected to contribute to the reflection on the needs of psychological support to the elderly living in the institutional context. Thus, it is important for health professionals to understand about the necessary knowledge about the symptoms of depression to serve as subsidies in the performance of humanized and integral care, with appropriate guidance for the prevention of this mental disorder and functional capacity in the elderly.

2021 ◽  
Vol 2 (2) ◽  
pp. 70-84
Franseda Sihite ◽  
Sri Wahyuni ◽  
Timotius Sukarna ◽  
Muner Daliman

The purpose of this study how to face death itself. For this reason, the readiness to accompany and teach about the overall condition of death and after death according to the Bible really makes a person ready to respond to a situation. The research used descriptive quantitative methods with field research study approach. This implementation of the Teaching of the Apostle Paul Preparing dying based on 1 Thessalonians 4:13-18 in the Elderly in the Church is in the category of being declared accepted. It is known from the results of calculations using Confidence Interval statistics at a significance level of 5% resulting in Lower Bound and Upper Bound 119.2812 – 122.0299. This shows that the Level of Implementation of the Teachings of the Apostle Paul Preparing dying based on 1 Thessalonians 4:13-18 in the Elderly in the Church is in the "medium" category. This is supported by the conclusions drawn from the first hypothesis compared with the results of calculations for each dimension (D1 – D3) as exogenous variables that show a more specific level of endogenous Variables that both state the level in the "medium" criteria.

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