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Objective:To analyze features of sarcopenia and its influencing factors in hospitalized patients at our department.Methods:This was a cross-sectional study.A total of 180 patients aged 80.3±6.7 years admitted to the geriatrics department of our hospital were consecutively recruited.Patients were divided into the non-sarcopenia group(n=80, 44.4%)and the sarcopenia group(n=100, 55.6%)based on the diagnostic criteria for sarcopenia of the Asian Sarcopenia Working Group.All subjects were evaluated by using the comprehensive geriatric assessment.Differences in comorbidity, physical function, nutrition, cognitive function, psychological characteristics, geriatric syndromes, medication and other aspects were analyzed between the two groups.The correlation of the above factors with sarcopenia was analyzed.Results:Scores on the Charlson comorbidity index and the cumulative illness rating scale were higher in the sarcopenia group than in the non-sarcopenia group(2.6±1.7 vs.2.1±1.1, 11.3±4.1 vs.7.9±1.8, P<0.05). Scores on mini-nutrition assessment and mini-cog, grip, chair-rising test(five times), timed get-up and go test(3 m), walking speed, and short physical performance battery were lower in the sarcopenia group than in the non-sarcopenia group[(12.8±2.1) vs.(11.2±1.7), (2.3±1.0) vs.(4.4±0.9), (21.2±5.8)kg vs.(27.6±6.2)kg, (31.4±15.3)s vs.(13.2±4.0)s, (24.2±9.5)s vs.(12.0±2.9)s, (0.6±0.2)m/s vs.(0.9±0.3)m/s, (6.1±1.9) vs.(9.8±1.3), respectively, P<0.05]. The incidences of geriatric syndromes such as incontinence, visual impairment, hearing impairment, sleeping disorders, oral problems, chronic pain, anxiety, depression and falls were higher in sarcopenia patients than in non-sarcopenia patients.Logistic regression analysis showed that body mass index, walking speed and the number of geriatric syndromes were risk factors for sarcopenia( OR=1.401, 1.286 and 3.654, P<0.05). Conclusions:The incidence of sarcopenia is high in hospitalized elderly patients.Comprehensive geriatric assessment can be used to achieve a more complete understanding of the characteristics and influencing factors for patients with sarcopenia and will help provide a basis for appropriate treatment plans.
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Objective To investigate the influence of fear of falling on clinical ,functional ,and gait variables in elderly patients with type 2 diabetes and to identify predictive factors for fear of falling in this population. Methods A total of 238 community-dwelling older persons with type 2 diabetes (aged 65 to 89 years ) were divided into two groups according to Falls Efficacy Scale-International scores.Participants with a score<23 were assigned to the no-fear group (n=118) and those with a score≥ 23 were assigned to the fear group (n= 120 ).Demographics ,anthropometrics ,number of diseases and medications ,physical activity level ,history of falls ,frailty level ,cognition ,depressive symptoms ,fasting glucose level ,and disease progression were collected. Timed Up and Go test (TUG) ,five times sit-to-stand test (5-STS) ,and tests for grip strength and pace were run. Results Participants in the fear group were more frail and presented more depressive symptoms and worse performance in the TUG and 5-STS tests than in the no-fear group.The fear group also showed a slower pace ,a shorter step length ,a longer step time ,and a longer swing time.Multivariate regression analysis revealed that the likelihood of having fear of falling increased by 1.32 times (OR :1.32 ,95％CI :1.09-1.58) for every one-point increase in the Geriatric Depression Scale (GDS-15) score and by 1.35 times (OR :1.35 ,95％ CI :1.06-1.70) for every one-second increase in TUG. Conclusions The fear of falling in community-dwelling elderly patients with type 2 diabetes mellitus is associated with frailty ,depressive symptoms ,dynamic balance ,functional mobility ,and abnormal gait. Furthermore , both GDS-15 and TUG test can predict fear of falling in this population.
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Objective To examine changes in bone mineral density,serum bone turnover markers and serum cytokines after health education intervention in elderly patients with osteoporosis.Methods Two hundred and twenty elderly patients with osteoporosis were randomly divided into two groups.The control group(n=110)was given routine treatment,including anti-osteoporosis drugs and daily supplements of calcium and vitamin D.In addition to routine drug treatment,the observation group(n=110)also underwent health education intervention,which included instructions on lifestyle,diet,and exercise.After one year follow up,levels of bone mineral density(BMD),propeptide of type Ⅰ procollagen(PINP),β crosslaps (β-CTX),parathyroid hormone (PTH),25-dihydroxyvitamin D [25(OH) VD],interleukin-2 (IL-2),and insulin-like growth factor-1 receptor (IGF-1 R) were analyzed.Results After one year follow-up,all indicators,except the β-CTX level,were significantly improved in the observation group compared with those in the control group(all P＜0.05).Mean while,compared with pre-treatment levels,both groups had significantly increased levels of BMD(both P＜ 0.05),which were markedly higher in the observation group (P ＜ 0.05).Furthermore,improvement was achieved in cognitive ability and lifestyle in the observation group (both P ＜ 0.05).Conclusions Health education intervention can effectively improve BMD in elderly patients with osteoporosis,significantly improve lifestyle,and play an important role in integrated management of osteoporosis.
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Objective To explore the relationship of insulin resistance with serum 25-hydroxyvitamin D levels and arterial stiffness in elderly patients.Methods A total of 162 elderly inpatients (aged 60 years or over) were recruited from 2012 to 2014.Levels of fasting serum insulin,fasting serum glucose,creatinine and vitamin D were determined.Insulin resistance (IR) was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR).The patients were divided into the following three groups according to HOMA-IR:the low IR group with HOMA-IR less than 2 (n=78),the median IR group with HOMA-IR between 2 and 6 (n=43),and the high IR group with HOMA-IR greater than 6 (n=41).Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV).Arterial stiffness and serum vitamin D levels were compared among the three groups.Results cfPWV was increased and the serum 25-hydroxyvitamin D level was decreased in the high insulin resistance group compared with the low insulin resistance group[(13.2± 5.7) μg/L vs.(17.8±6.2) μg/L,(14.3±5.2) m/s vs.(11.9±3.0) m/s].Multiple liner regression analysis showed that IR was negatively correlated with the serum 25 hydroxyvitamin D level (r=-0.63,P＜0.05) and positively correlated with arterial stiffness (r=0.45,P＜0.05) after adjustment for age,sex and other confounders.Conclusions Elderly patients with high insulin resistance may have lower levels of serum vitamin D and higher arterial stiffness.
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Objective To examine the association of serum 25-hydroxyvitamin D levels with arterial stiffness and left ventricular hypertrophy (LVH) in elderly hypertension patients.Methods We recruited 166 elderly patients [mean age,(80.8 ± 6.2) years] with primary hypertension.Arterial stiffness was assessed by carotid femoral pulse wave velocity (cfPWV).Left ventricular mass index (LVMI) was determined according to the Devereux formula.Based on serum 25-hydroxyvitamin D levels,the patients were divided into two groups,the low 25-hydroxyvitamin D group (＜20 μg/L)and the high 25-hydroxyvitamin D group (≥20 μg/L).Results Faster cfPWV and larger LVMI values were observed in the low 25-hydroxyvitamin D group as compared with the high 25-hydroxyvitamin Dgroup [(15.00±3.04) m/s vs.(11.26±3.09) m/s;(120.14±25.82) g/m2 vs.(96.74±23.10) g/m2 ; t=-6.79,-5.16,respectively; both P=0.000].Multiple liner regression analysis showed that the 25-hydroxyvitamin D level was independently associated with LVMI (β=0.215,P=0.001) and cfPWV (β=-0.469,P＜0.001).Conclusions Serum 25-hyroxyvitamin D is independently associated with arterial stiffness,LVH Vitamin D may play an important role in the pathogenesis of arterial stiffness and LVH in elderly hypertension patients.
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Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum glucose, hepatic and renal function, routine urine analysis (UA) were measured in 50 healthy subjects, and in 50 elderly patients with hypercholesterolemia before and after 4 weeks treatment with simvastatin (20mg daily for 4 weeks). Results 1. After simvastatin treatment for 4 weeks, the fasting serum level of lipids in elderly patients with hypercholesterolemia was significantly lower than before treatment (P＜0.01). 2. CD63 and CD41a were decreased after treatment compared with before, respectively (1.36 0.34) vs (4.26 1.06), (P＜0.01) and (123.54 19.73) vs (253.78 16.75), (P＜0.01).3. Changes in serum lipid level tended to be positively correlated with the declines in CD63 and CD41a, but there was no statistical significance (P＞0.05). Conclusions The results suggested that lipid lowering therapy with simvastatin inhibit platelet activity.