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Objective:To analyze changes in nutritional status and immune function of elderly men receiving regular physical examinations, and to investigate the effects of aging on the nutritional status and immune function among elderly men.Methods:A total of 209 elderly men aged 60-101(72.9±11.5)years and receiving regular physical check-ups were enrolled.All research subjects were subjected to nutritional risk screening(NRS2002)and monitoring of nutrition and immune-related indicators, including routine blood work, blood biochemistry, immunoglobulin and T lymphocyte subsets.Results:Body weight, body mass index, hemoglobin, total protein, albumin and serum iron of elderly men decreased with age( F=21.754, 6.257, 47.528, 12.285, 18.397, 18.667, all P<0.001), with those aged 80 and above showing more significant decline and a greater proportion with malnutrition( χ2=77.134, P<0.001). The B lymphocyte counts of elderly men aged 80 and above were significantly lower( P<0.05)while serum IgA and IgG levels were significantly higher( F=3.110, 3.866, P=0.047, 0.022)than those of the 70-79 year old group.In addition, the B lymphocyte count and B lymphocyte ratio in malnourished elderly men were significantly lower( t=2.512, 2.874, P=0.013, 0.005), and IgA was significantly increased( t=2.513, P=0.017), compared with those with normal nutrition. Conclusions:The risk of malnutrition and reduced immune function among elderly men aged 80 years and above is significantly increased, and assessment and screening of the risk of malnutrition in the elderly should be stressed.
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Objective:To investigate the correlation between decline of intrinsic capacity and falls in the elderly, in order to provide a new method and basis for fall risk assessment.Methods:A total of 125 elderly inpatients were selected between March 2019 and December 2019 for the survey.The intrinsic capacity of elderly inpatients was evaluated, and the history of falls in the past year were obtained through interviewing.The impact of intrinsic capacity on the risk of falls was analyzed by using logistics regression analysis.Results:Of 125 elderly patients, 37 had experienced falls in the past year, with an incidence of 29.6%(37/125). A decline of intrinsic capacity in varying degrees was found in 92.0%(115/125)of elderly patients and the average score of decline was 2.2(1.0, 3.0). The more intrinsic capacity decreased, the greater the risk of falls( OR=2.425, 95% CI: 1.132-4.848, P=0.016). After taking demographics into consideration, age( OR=1.786, 95% CI: 1.034-2.023)and decline of intrinsic capacity( OR=2.425, 95% CI: 1.132-4.848)were independent risk factors for falls. Conclusions:Decline of intrinsic capacity is closely related to the occurrence of falls.The five-dimension framework of intrinsic capacity provides new ideas and directions for predicting the risk of falls.
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Objective To perform a systematic review of the literature on the cost-effectiveness of stroke rehabilitation care ,and to provide evidence for medical insurance payment and clinical decision making on stroke rehabilitation care. Methods We included published randomized controlled trails (RCTs)which compared rehabilitation care (RC)and usual care(UC)on stroke ,and summarized clinical outcome ,resource use ,costs ,and other indexes as outcomes of interest. Results Among included eight RCT studies ,the results of four models of stroke care were found as following. (1)Four studies involving early supported discharge(ESD)showed lower costs in rehabilitation care ,but similar(n＝3) or better(n＝1)clinical outcome. (2)Two studies involving home-based rehabilitation showed similar costs in one and lower costs in the other ,with no difference in clinical outcome between two trials. (3) One study involving stroke unit care showed higher costs and better clinical outcome. (4)One trial involving integration stroke service was associated with lower costs ,but no difference in the effectiveness. Conclusions For patients with stroke ,rehabilitation care leads to significant improvements on cost-effectiveness. Promoting the clinical use of rehabilitation care will bring about clinical benefits ,increase the efficiency of medical resources use ,and improve patient's quality of life.
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Gut microbiota ,as the most important part of human microbial ecosystem ,develops with aging. For the past few years ,increasing studies focused on the potential association of microbiota with diseases and health of the total elderly population and found that multiple factors such as ageing , multiple medications ,life style ,diet ,etc.effectively affected the changes of gut microbiota.The changes of gut microbiota could be used in the future as a target for the comprehensive assessment ,dynamic surveillance or intervention therapy of frailty ,sarcopenia and chronic diseases. Therefore ,this review focused on gut microbiota composition ,influencing factors of gut microbiota ,the feature of gut microbiota in common geriatric diseases ,microbiota-based interventions therapy and the longevity microbial resources.
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Frailty is a geriatric syndrome that has been implicated as a causative and prognostic factor for cardiovascular disease (CVD).Frailty and CVD are often concurrent and mutually promotive.The prevalence of frailty ranges from 10％ to 60％ in patients with CVD,depending on different tools and cutoffs chosen to define frailty.Short-and long-term prognosis of CVD are both affected by frailty.The presence of frailty is correlated with an increase in complications,outpatient and emergency department visits,hospital admissions and stays,and mortality in patients with CVD.Early prevention and clinical intervention can delay or even reverse the development of frailty,thus improving the prognosis for CVD.
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Fifty six elderly patients with acute coronary syndrome (ACS) were divided into nonsmoking group (n =30) and smoking group (n =26).All patients received aspirin 100 mg/d + Clopidogrel 75 mg/d for 14 d.The expression of glycoprotein Ⅱ b/Ⅲa and P-Selectin on the surface of platelets in both groups were assessed with flow cytometry (FCM).The positive expression rates of GP Ⅱ b/Ⅲ a and P-Selectin before treatment were (67.86 ± 12.14)％,(70.37 ± 10.15)％ in non-smoking group and (79.47 ± 11.62) ％,(81.26 ± 9.74) ％ in smoking group.The positive expression rates of GP Ⅱ b/Ⅲ a and P-Selectin after treatment were significantly decreased to (50.18 ± 8.72) ％,(49.36 ± 11.43) ％ in nonsmoking group and to (61.15±9.29)％,(57.52±10.81)％ in smoking group(P＜0.01).Also the degree of decreasing expression rates of GP Ⅱ b/Ⅲ a and P-Selectin was nore markedly in non-smoking group than that in smoking group (P ＜ 0.05).The results indicate that expressions of GP Ⅱ b/Ⅲ a and P-Selectin on the surface of platelets are increased in the elderly smoker patients with ACS,and smoking may decrease the effect of anti-platelet agents.
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Objective To investigate the effect of combined anti-platelets drugs on platelet activation in the elderly patients with acute coronary syndrome (ACS).Methods Totally 72 elderly patients with ACS were divided randomly into two groups according to age ≤ 80 years and ＞ 80 years.Aspirin 100 mg/d plus clopidogrel 75 mg/d were used in all the patients for 2 weeks.The positive glycoprotein Ⅱb/Ⅲa and P-selectin expressions on the surface of platelets were assessed with flow cytometry (FCM) after the platelets were activated by adenosine diphosphate (ADP) and arachidonic acid.Results The expressions of GP Ⅱb/Ⅲa and P-selectin were (73.5± 11.0,71.2±8.7) ％ at baseline and (51.3±9.1,57.3±12.4)％ after anti-platelets medicine more than 14 days in group of age≤80 years.than 14 days.The expression of GP Ⅱb/Ⅲa and P-selectin were (78.3 ±12.7,75.8±8.6)％ on the surface of platelet at baseline in group of age＞ 80 years,after anti-platelets medicine treatment were (41.2±8.5,47.3±10.3)％.The positive expressions of GP Ⅱb/Ⅲa and P-selectin in group of age＞ 80 years were decreased compared with those in group of age≤ 80 years after combination of medicines treatment (P＜0.05).Conclusions Combined aspirin and Clopidogrel treatment have a more strong effect in inhibiting the activation of platelets in the elderly patients more than 80-year with ACS.
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Objective To investigate the prevalence of chronic kidney disease (CKD) and its risk factors in Chinese elderly persons.Methods All of the people who underwent physical examination and treatment in the geriatric department of Beijing Hospital during January 2004 to January 2007 were included in the study.Age, body height, body mass index and blood pressure were recorded.Bloody urine was ascertained by phase-contrast microscope, and urine protein was measured by dipstick test.The hemoglobulin, serum eretinine, blood urea nitrogen, blood lipid and serum uric acid were measured by autobiochemical analyzer.HbsAg was checked by enzyme-linked immunosorbent assay (ELISA).Glomerular filtration rate (GFR) was estimated by Crockeroft-Gauh equation and abbreviated MDRD equation.Binary logistic regression analysis was used to test the risk factors for proteinuria and CKD.Results The prevalence of proteinuria was 4.9% in 1082 elderly persons.And 47.23% of the elderly suffered from decreased renal function.The morbidity of CKD was 48.43%.Binary logistic regression analysis showed that diabetes(OR= 2.257) and microscopic hematuria(OR=5.324) were the risk factors of proteinuria (both P<0.05).And the risk factors for CKD were hypertension(OR= 1.459), coronary arth'erosclerotic heart disease(OR=3.290), chronic obstructive lung diseases(OR=2.094), malignant tumor(OR=2.072), hyperuricemia(OR= 1.928),anemia(OR=8.122)and hematuria( OR= 1.604) (all P<0.05).Conclusions The morbidity of CKD in Chinese elderly persons was 48.43%.And the related risk factors were diabetes,hypertension, hyperuricemia, coronary artherosclerotic heart disease and chronic obstructive lung disease.
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Objective To compare the safety and efficacy of varied treatments for cardioversion of paroxysmal atria] fibrillation (AF) in the aged patients and to explore choice of electrical cardioversion with direct current. Methods Clinical data of cardioversion with lanatoside (cedilandid) or propafenone, a sodium channel blocker prolongs refractoriness, for 57 aged patients with paroxysmal AF were summarized to observe their cardioversion and control of heart rate. And, synchronous electrical cardioversion will be offered to those with severe complications and ineffective with drug treatment within 24 h after the onset of AF. Results An emergency cardioversion ratio was 28.1 % with lanatoside within 24 h with a satisfactory control of ventricular rate, as compared with that of 62.2% with propafenone (P
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Objective To explore the clinical characteristics and effects of thrombolytic and anti coagulation treatment in over 70 year old patients with pulmonary thromb embolism(PTE). Methods The clinical findings, diagnostic techniques, effects of thrombolytic therapy and anti coagulation in 58 over 70 year old patients with PTE were analyzed retrospectively. Results Deep venous thrombosis (DVT) in lower limbs (74 1%) was the most common thrombolism prone factors in our study. Limitation of movement and long term stay in bed due to a variety of causes were in the next place. The clinical findings were atypical, associated with a false diagnostic ratio of 46 5% in elderly patients with PTE. Undefined causal and different degree of dyspnea along with sudden and persistent hypoxemia were the main characteristics. Spiral CT and radioactive nuclear ventilation perfusion scan were important methods for diagnosis of PTE with positive finding of 95 7% and 62 5%, respectively. The effective and cure rate of thrombolytic therapy combined with anti coagulation, anti coagulation and anti platelet therapy was 91 3%, 75 8%, 0 and 47 8%, 17 2%, 0, respectively. Conclusions The most common risk factors of PTE in the elderly was DVT and the long term stay in bed or stay without active moving. The clinical symptoms were not only atypical but also variable. Thrombolytic with anti coagulation therapy is safe and effective, but anti platelet coagulation alone is not benefit.