Does Locomotive Syndrome, Associated with Sarcopenia or otherwise, Influence Quality of Life in Individuals Aged over 80 years? Third Wave of the LOCOMOV Project

Introduction: Locomotion is a determinant of intrinsic capacity ofolder people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome (LoS). Knowledge on locomotiveproblems and sarcopenia, and their interface with quality of life, in theoldest old in the literature is scarce.Objective: To evaluate the correlation between LoS and sarcopenia andtheir influence on quality of life in oldest old.Methods: A cross-sectional study of an observational, descriptive andanalytical epidemiological survey in independent older adults aged 80and over from São Paulo, Brazil and who participated in the third waveof the LOCOMOV Project, was carried out. Sociodemographic data,comorbidities, functioning in activities of daily living, physical functioning,quality of life, and presence of sarcopenia and LoS were assessed. Thestatistical analyses included the Test-for-Comparing-Two-Proportions,Pearson's Correlation Coefficient, the chi-Square test and Student´s t-test.Results: Thirty oldest old with a mean age of 89.1 years were evaluated.The prevalence of LoS was high (53.3%) and correlated significantly withchronic pain (p-value 0.024), worse performance on the SPPB and Gaitspeed (p-value <0.001). Sarcopenia was not correlated with LoS, but worsequality of life on the physical domain was significantly associated with LoS(p-value <0.001) regardless of the presence of sarcopenia.Conclusions: LoS was highly prevalent among the oldest old studied andnegatively impacted their quality of life, regardless of the presence ofsarcopenia.

An Introduction of the Vaporized Therapy with Tea Herb Drink for Relieving Agitation due to Pulmonary Encephalopathy

What methods would you choose apart from increasing sedatives foragitation in an advanced patient with hypercapnic encephalopathy dueto AECOPD? This is a 94-year-old female who suffered from COPD forover 30 years, occurred with an accelerated episode of cough, productivesputum and a dropping down to 86% in SatO₂ due to a cold weather. Adiagnosis of pulmonary encephalopathy (PE) was made on the basis of thesubsequent agitation and delirium, and the sedatives, such as quatiepineand haloperidol, had to be given for her mental excitation respectively, butshe still pulled out indwelling needle herself and refused to any infusiontherapy. As an alternative, a vaporized therapy integrated with tea herbdrinking had to be applied to relieving her agitation, being designedas the vaporization of the inhaled oxygenation by means of high-flowoxygenation device (HFOD), with an ampoule of ambroxol mixed into theinhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles whenbeing infected. We thought that a better efficacy would be achieved forhypercapnic encephalopathy due to AECOPD if we concentrate on a goodventilation of small airway through the vaporized therapy.

The Necessity of Community Connectedness in Iranian Older Adults during the COVID-19 Pandemic

In last decade, COVID-19 outbreak was one of the major crises encountered the world(1). During the COVID-19 pandemic, Iranian people have been advised to stay at home and far away others. If it is essential to leave their residence, people have been urged to avoid gathering and maintain physical distance from others. Community disconnectedness for older adults was primary prevention specially for elders with comorbidities (2). For the first time, most of Iranian older adults were experiencing an unwanted and prolonged separation from others.

Neuropsychological and Physical Trajectories in Neurotypical and High-cognitive Performing Older Adults

The maintenance of high cognitive performance in old age has increasinglybecome a public health interest due to associations between cognition,well-being, longevity, and autonomy. The objective of the researchis to investigate cognitive, physical, and psychological trajectories ofneurotypical older adults (NOAs) and high performing older adults(HPOAs). An exploratory study to investigate 21 NOAs and six HPOAs(mean age 71, SD = ± 3.59), followed up for one year. The older adultswere submitted to physical fitness, quality of life, anxiety, depression,RAVLT, ACE-R, and Stroop tests, being assessed at three moments:baseline, six months after the cognitive (MEMO) or stimulation (Stimullus)interventions, and six months after the multimodal interventions, whichcould be physical or psychopedagogical interventions (health educationlectures). Nonparametric statistical tests (Mann-Whitney and Wilcoxon)were performed with p≤0.05. The results demonstrated that the cognitivemeasures were good predictors of cognitive performance and we observedpositive correlations between cognitive and mood measures. The olderadults with high performance had a lower prevalence of depressivesymptoms. There were gains in global cognitive performance, mood, and inphysical fitness variables associated with multimodal interventions, evidentin the neurotypical group

A Royal Jelly Mixture with Berberine for Dressing Change on a Refractory Skin Ulcer: A Case Report

It has been reported that a 92-year-old female had got a bruise superficialwound on her right leg one and a half years ago, developing into refractoryskin ulcer due to improper management before. A prepared cream, mixedroyal jelly with berberine for dressing change, was made on the scenethrough the crush of berberine tablets, working with fresh royal jelly.Topical dressing change with the cream was done every 3 days, and twomonths later, such the ulcer became clean and was covered fully with freshgranulation tissue. This kind of cream consists of the ingredients of TCMpurely, free of antibiotic, and being quite effective clinically, also helpfulfor proper use of antibiotic.

Effects of Free Time on Quality of Life in Elderly Caregivers

背景： COVID-19の世界的な広がりは、家族介護者のストレスレベル、介護者の負担、燃え尽き症候群を大幅に増加させることが報告されています。したがって、家庭での健康を改善し、COVID-19感染を防ぐ方法を考案する必要があります。この研究は、認知症患者の高齢介護者の健康関連の生活の質に対する自由時間の影響を調べることを目的とした。方法：介入群では、介護者は患者の世話を続けながら、週に2回30分ごとに自由時間を取っておきます。自由時間中、介護者は家で自由に時間を過ごし、好きなことをすることができました。対照群は通常のケアのみを受けた。介入期間は6ヶ月でした。結果： SF-36の活力サブスケールスコアは、参加者の半数以上（57.1％）がベースラインと比較してこのサブスケールのランクに改善または変化がないことを示したにもかかわらず、介入群で有意に減少しました。ランク検定（有意ではありません）。考察：介護者は、毎日の介護が肉体的疲労の蓄積をもたらし、精神的な余裕がほとんどないことを示しました。介護者も自由時間を確保することが困難であり、活力の向上を妨げている可能性があります。結論： COVID-19感染を防ぐために、介護者のストレスを軽減し、彼らの生活の質を改善することができる在宅プログラムを開発する必要があります。

A study on the prevalence of musculoskeletal disorders among ageing workforce of Indian construction industry

Ageing work force is one of the leading causes behind the reduction in the rate of growth of the labour force in construction industries. Construction industry is a major source of employment worldwide after agriculture, and generally the primary one in urban areas. Manual material handling in construction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body. Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty. To analyze the level of exertion, ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce. 20 male construction workers in the age group of i) 20 to 30 years (golden age group); ii) 50 years and above were selected from a local construction site in Mumbai. Demographic data like age, height, weight, BMI, body fat, waist hip ratio and risk assessment by questionnaires study comprising QEC, NMQ, VAS, and LEFS were collected. Compared to the golden age group, the elderly subjects were found to feel uncomfortable to their lower back, knee and calf due to the immoderate forces and motions applied to their lower limbs during their daily work. Muscle pliability and proper coordination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures. For elderly workers, age related limitations become an additional factor to maintain their normal work life.

Postoperative Delirium in Elderly Patients May Be Associated with Perioperative Blood Pressure Fluctuations

Aim. Postoperative delirium (PD) is a common complication of surgery in elderly patients, but its pathophysiological mechanism remains unclear. In order to clarify the role of intraoperative hypotension and fluctuation of blood pressure in the development of PD, we conducted a follow-up study in elderly patients with intraoperative hypotension and fluctuation of blood pressure. Methods. Patients who underwent hip surgery in 2018-2019 were selected. One day before the operation, the mentality of patients were evaluated by Mini-mental State Examination (MMSE), and the sex, age, height and weight of the patients were recorded. Radial artery puncture was performed in all patients before anesthesia, intraoperative SBP, MAP and DBP were recorded, and the surgical events of the patients was recorded. The markers associated with PD (TNF-α, IL-6 and S-100β ) were determined before and after surgery. Perioperative delirium（PD） was assessed by the prevailing standard of assessment, Confusion of Consciousness Assessment (CAM).. Cognitive assessment was evaluated using the Mini-mental State Examination (MMSE). In addition, the timing and type of delirium were recorded. Result. There were 158 patients which were accorded with the inclusion criteria came into the study. The results of our data showed that delirium occurred in 41 patients (25.9%) during the first week after surgery. In the comparison between the PD group and the non-PD group, it was found that the patients with postoperative delirium were older, lower body mass index and higher MMSE score before operation. Intraoperative blood pressure is low, usually more than 30% lower than preoperative blood pressure. The levels of TNF- α, IL-6 and Smur100 β were higher after operation. Conclusion. The increased incidence of postoperative delirium may be related to intraoperative hypotension and intraoperative blood pressure fluctuation. The pathophysiological mechanism may be that hypotension causes low cerebral perfusion, which in turn causes local inflammation in the brain. In addition, postoperative delirium is also more likely to occur in older patients with lower body mass index.

Parkinson disease patient with wheezing manifestations: a case report

The dosing of anti-Parkinson drugs is considered as the optimal control of the symptoms of PD, and increasing the dose of drugs is a common method to treat the aggravate state of PD. However, this is a case of PD elderly patient who had nephritic syndrome, with an increase in the dose, the symptoms did not get improved，but a series of other adverse effects appeared.

Hourly Rounding and Fall Prevention among the elderly in long term care: A change process.

Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization. Hourly rounding® is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs. This helps with positive fall prevention outcome. This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit. The implementation of the intervention took place in a long-term care facility located in Dallas, Georgia. The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission. Twenty staff members were included in the sample, age 18 years and 60 years. The unit has 41 residents who were included in the pilot case study design. Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database. Competency checklist was completed prior to implementation and post implementation to evaluate staff understanding of the main tenets of the 4 P’s (potty, pain, possession, and position). For this project, descriptive statistics was used to help determine fall rates. Minitab was used to analyzed data and to determine if it was clinically significant. In the ten weeks following the hourly rounding implementation, participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet. The results indicated that it is statistically significant and with a P-values = -<0.0001 and t-value = -5.81.Keywords: Rounding and education; fall risk; fall reduction; older adult patients; quality improvement; fall prevention; fall and fall related injury.