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Objective:To evaluate and analyze the health status of elderly people from the physical, psychological and social aspects using the Health Criteria for Older Adults in China(2022), and to understand the impact of social demographic characteristics on the overall health status of the elderly.Methods:159 elderly people aged 60 years and over in the Lanyuan community of Malianwa Subdistrict, Haidian District, Beijing were selected by the stratified sampling method, with a mean age of(70.7±7.9)years, including 74 men and 85 women.The physical, psychological, social and overall health status of the elderly were comprehensively evaluated and analyzed from data collected through a self-designed questionnaire with face-to-face interviews at respondents' homes.Results:The percentage of participants in this community who were considered overall healthy was 30.2%(n=48). The proportions of those meeting the criteria for physical, mental and social health were 79.2%(n=126), 90.6%(n=144)and 32.1%(n=51), respectively.For participants of 3 age groups(60-69, n=89; 70-79, n=44; ≥80, n=26), differences in percentages of people who were considered not healthy, largely healthy and healthy, measured using the overall, physical, mental and social health criteria, were statistically significant( χ2=24.683, 57.096, 12.801, 11.802, all P<0.05), and results of the χ2test for trend showed that the frequency distribution of people with overall, physical, mental and social health decreased with age( χ2=16.878, 31.600, 9.626, 9.626, all P<0.05). Multivariate Logistic regression analysis showed that education level( OR=2.142, 95% CI: 1.053-4.538, P=0.035)was an influencing factor for overall health status of the elderly. Conclusions:The overall health status of community-dwelling elderly people in Beijing is relatively poor and deteriorates with age.Education level is a factor affecting their health status.Health assessment for the elderly should be strongly advocated, and targeted health education should be provided for the elderly in disease prevention and mental health care.
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Objective:To evaluate the effect of procalcitonin(PCT)guiding anti-infection therapy on the prognosis of elderly patients.Methods:By searching PubMed, EMBASE database, Cochrane library, Cochrane clinical trial center registry and SinoMed database in Chinese, we searched for a randomized controlled clinical(RCT)study on the effect of PCT-guided anti-infection treatment on the prognosis of elderly patients, which was conducted according to the PRISMA statement.The main purpose of the study was to evaluate the time of antibiotic application.Results:After retrieval, 9 RCT clinical studies were finally included, involving 2 702 elderly patients, with an average follow-up of 3.5 months(1-12 months). The average age was(71.3±8.9)years old, with 52.8% of males and baseline levels of white blood cell(WBC)was 12.9×10 9/L, C-reactive protein(CRP)was 18.9 mg/L, PCT was 0.38 μg/L.Compared with conventional anti-infective therapy, PCT-guided anti-infective therapy can reduce the antibiotic application time of elderly patients[standard mean difference( SMD)=-2.39 days, 95% CI(-4.03, -0.75)days, P=0.004]. However, PCT-guided anti-infection treatment had no significant effect on the length of hospital stay[ SMD=-0.46 d, 95% CI(-0.05, 0.14)d, P=0.135], the rate of reinfection[ RR=0.87, 95% CI(0.73, 1.03), P=0.105]and the risk of all-cause death[ RR=1.02, 95% CI(0.80, 1.31), P=0.863]. Conclusions:PCT-guided anti-infection treatment can reduce the time of antibiotic application in elderly patients, but other clinical effects need to be verified by more large-scale studies
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Objective:To evaluate and analyze the health status of the elderly from physical health, mental health and social health, so as to understand the health status and health service needs of rural elderly.Methods:A total of 263 elderly people aged 60 years and over(mean aged 70.9±7.9 years, 113 males and 150 females, 125 aged 60-69 years, 98 aged 70-79 years and 40 aged 80 years and over)in Nanwangkong Village, Shaozhuang Town, Qingzhou City, Weifang City, Shandong Province were selected by cluster sampling method.The physical, mental, social and overall health status of the elderly were comprehensively evaluated and analyzed by self-designed questionnaire.Results:The overall health rate was 30%(79 cases), and the physical health, mental health and social health rates were 73.8%(194 cases), 84.0%(221 cases)and 34.6%(91 cases), respectively, in rural elderly in this area.The physical health was better in males than in females in 80~ years old groups( χ2=5.736, P<0.05). The overall health was better in males than in females in the total age group and the 60~69 years old groups( χ2=7.468 and 11.116, both P<0.01). The proportions of unhealthy, basic healthy and healthy people in the overall and the dimensions of physical health, mental health and social health had significant differences in the 60~69, 70~79 and 80~ years old groups( χ2=40.590, 29.342, 18.503 and 27.615, all P<0.01), and the Chi-square test for trend showed that there was a statistically significant downward trend of overall health grade distribution with age( χ2=21.994, 12.831, 16.570 and 22.595, both P<0.01). Conclusions:In this study, 30.0% of the rural elderly were considered healthy, 48.3% were basically healthy, and 21.7% were unhealthy.The health status of the elderly gradually deteriorates with age.The government should strengthen the multidimensional health assessment of the rural elderly and provide the comprehensive health guidance services and targeted interventions for the elderly in terms of disease control, psychological counseling and social participation.
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The elderly are a special group, with their unique pathophysiology and disease characteristics.The measures and goals of diagnosis and treatment for the elderly are different from those for children, young and middle-aged people.Taking into consideration of the national and international literature, the insight from our long-term clinical practice and in-depth reflections, the authors have written this article as a reference for our colleagues in geriatric care.
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Sarcopenia is an age-related syndrome characterized by progressive and systemic loss of skeletal muscle mass and strength with age.Sarcopenia in the elderly not only leads to falls, fractures, disability, and reduced exercise ability, but also increases their risk of death and financial burden.At present, a number of professional organizations and institutions have published consensus on the assessment and diagnosis of sarcopenia, but the included parameters are not completely consistent.In this paper, the diagnostic criteria and related parameters of each consensus are reviewed.
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Objective:To evaluate and analyze elderly health on the physical, psychological and social dimensions, so as to understand the health status and care needs of community-dwelling elderly residents.Methods:A cross-sectional study was carried out in the Meiyuan community, Malianwa Street, Haidian District of Beijing during July 22 to August 26, 2021.A total of 404 people aged 60 and above(70.6±8.6 years old)including 169 men and 235 women were enrolled through cluster sampling.All information about community-dwelling elderly residents was collected with face-to-face interviews and a standardized structured questionnaire for the evaluation and analysis of their physical, mental, social and overall health.Results:The rate of overall healthy residents was 21.3%(86), and the rates of physically, mentally and socially healthy residents were 66.8%(270), 86.6%(350) and 24.3%(98), respectively, in this community.There was a sex difference in social health in the whole group( χ2=9.008, P=0.011)and a higher proportion of men than women were considered generally healthy( χ2=8.963, P=0.003). People in the three age groups(224 in the 60-69 group, 109 in the 70-79 group and 71 in the ≥80 group)showed statistically significant differences in overall, physical, mental and social health( χ2=18.473, 61.186, 43.026 and 18.310, P<0.001), which declined with increasing age( χ2=13.172, 23.515, 26.806 and 10.068, P<0.001 or 0.01). Conclusions:s The overall healthy rate is not high among community-dwelling elderly residents in Beijing.The health status of the elderly gradually deteriorates with age.Health assessment for the elderly should be emphasized and targeted health education and prevention should be provided to promote disease prevention and mental health.
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Objective:To develop a set of indexes for the assessment of healthy older adults in China, in order to provide a reference and basis for developing aging-related national policies, standardizing and guiding health management services for the elderly.Methods:A set of indexes for the assessment of healthy older adults in China was established based on a literature review, expert discussions, 2 rounds of Delphi surveys, expert consultations and a cross-sectional study assessing the indexes.Results:The positive coefficients for 2 rounds of expert consultations were 86.25%(69/80)and 94.52%(69/73), respectively.All surveyed experts(100%)specialized in the area of geriatric health and came from 22 provincial-level administrative regions in China.In the two rounds of consultations, the familiarity degree coefficients were 0.706-0.915 and 0.835-0.922, and the authority coefficients were 0.762-0.921 and 0.863-0.932, respectively.The mean importance scores of each index were 6.10-9.74 scores and 7.87-9.56 scores, with perfect score rates of 43%-99% and 75%-99%, respectively.The mean coefficients of variation(CV)were 0.19±0.05(0.07-0.34)and 0.16±0.03(0.10-0.21), respectively.The set of indexes for the assessment of healthy older Chinese adults covered multi-dimensions including physical health, mental health and social health, with 3 primary indexes, 11 secondary indexes and 17 tertiary indexes.Conclusions:The construction process of the set of indexes for the assessment of healthy Chinese adults was scientific and rigorous, and the panelists had a high level of agreement, strong authority and active participation.The set of indexes has comprehensive coverage and an inclusive framework, and indexes at each level are scientific and feasible.It can serve as a reference for the comprehensive assessment of health status of the elderly and for aging-related government policy formulation in the future.
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At present, about 50 million people worldwide suffer from sarcopenia, and the number is expected to reach 500 million by 2050.Sarcopenia in the elderly will be one of the major global health problems in the future.In this article, current research status and progress of the pathogenesis, diagnosis, its correlation with other diseases and treatment of sarcopenia were analyzed.
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The elderly are the main body of people with sarcopenia which not only seriously affects the quality of life of the elderly, but also brings a heavy burden to the family and society.Maintaining and improving the function of the elderly and preventing the occurrence of sarcopenia in the elderly are the important measures in the health management of the elderly.In order to effectively carry out health education on sarcopenia in the elderly and to popularize relevant health care knowledge, the National Center of Gerontology and the Chinese Geriatrics Society have formulated the "Chinese expert consensus on the core information for the prevention of sarcopenia in the elderly(2021)" , relying on the expert team after several rounds of expert discussions.It provides scientific basis for the management and early intervention of sarcopenia.Let us now try to interpret the consensus on the key knowledge points of the core information sequence.
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Objective:To analyze the process of Chinese expert consensus on the core information on prevention of sarcopenia in the elderly(2021)in China, so as to realize the early diagnosis and treatment of sarcopenia and to improve the quality of life in the elderly.Methods:The index system framework was established by literature review and expert questionnaire discussion, and Delphi expert consultation method was adopted to construct the index system.Results:A total of 109 experts(128 person-times)in Geriatrics from various fields participated in Delphi expert consultation.Positive coefficient for four rounds of expert consultation were 88.9%, 100.0%, 100.0% and 100.0% respectively, with expert authority factors being concentrated on 0.78~0.90.Through 4 rounds of Delphi expert surveys, the core information index system for sarcopenia prevention in the elderly has been definitive: Chinese Expert Consensus(2021)consists of nine indicators including "enhancing public scientific awareness of myosis, and so on."Conclusions:The core information index system for sarcopenia prevention in the elderly has high levels of overall convergence, comprehensive coverage, strong authority, stability, comprehensiveness and popularity.
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With the development of medical technology and the rapid growth of the elderly population, complex ethical issues have become increasingly prominent.This article analyzes the current domestic and international situation of geriatric medical ethics, including disease response, palliative treatment, pre-life advice, ethical issues in the application of artificial intelligence, ethical education, distribution of medical and health resources and health policies.
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Objective:To comprehensively evaluate the utilization of some essential medicines among elderly people in clinic settings in China, in order to provide a reference for the selection of fully reimbursed medicines for the elderly.Methods:Expert consultations were conducted to evaluate the utilization of 58 essential medicines related to eight major therapeutic areas, including neurology, psychiatry, cardiovascular diseases, respiratory diseases, among elderly people.The evaluation indexes included safety, efficacy, compliance by medical staff, compliance by patients, clinical value, and pharmaceutical economics.Results:Except for psychiatry, authority coefficients for drugs related to the other therapeutic areas were greater than 0.7, indicating that experts were familiar with the indications of the medications.According to the comprehensive evaluation scores, 10 medicines, i.e., nitroglycerin, metoprolol tartrate, isosorbide dinitrate, omeprazole, metformin, amlodipine, aspirin, acarbose, valsartan, and clopidogrel, could be considered as the first choices for guaranteed essential drugs for the elderly.Meanwhile, another 10 medicines, including nifedipine, estazolam, tamsulosin, simvastatin, alfacalcidol, enalapril, bisoprolol, beclomethasone dipropionate, ipratropium, and salbutamol, could be considered as the second choices for guaranteed essential drugs for elderly people.Conclusions:The first choices recommended by experts as guaranteed essential drugs for the elderly are mainly cardiovascular, endocrine and respiratory medicines, in line with the disease spectrum of the elderly.The selection of essential medications with full cost reimbursement for elderly patients should be those frequently used and with a burden of high medicine costs.
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The elderly often suffer from a variety of chronic diseases and geriatric syndromes at the same time.Compared with the traditional specialist consultation model, the geriatric interdisciplinary team(GIT)approach becomes an important diagnosis and treatment model of patient-centered healthcare for elderly through individualized and integrated treatment, rehabilitation and nursing services, so as to maximize the maintenance and recovery of functional status and quality of life.This article reviews the GIT model and examines current research at home and abroad.
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Objective:To evaluate the frailty status, and to explore its related factors among the community-dwelling elderly people in Beijing, so as to provide scientific basis for taking corresponding measures to delay the frail process of the elderly.Methods:From November 2015 to January 2016, a cross-sectional study was performed among elderly adults of Longtan Community in Dongcheng District, Beijing.Persons aged 60 years and over were selected using a stratified cluster sampling method, and the geriatric frailty-related information was collected through face-to-face household interview.The frailty index(FI)was used to evaluate the frailty status.Multivariate linear regression analysis was used to explore influencing factors on FI value among the elderly.Results:Of the 1 557 interviewees, the median(quartile)value of FI was 0.09(0.08); and women had a higher FI median value than men[0.10(0.08) vs.0.08(0.07)]( Z=5.376, P=0.000). The FI value increased with age( H=329.698, P=0.000). In addition, multivariate linear regression analysis showed that female, older age, disability, being hospitalized in the previous year, being hospitalized during the past 3 years, being unsatisfied to living conditions had relatively higher FI value than the control group( β=0.082, 0.236, 0.336, 0.065, 0.089, 0.193, all P<0.05); and people with high education level, family harmony, a large number of friends who gave support and help, more frequency of participating in organization activities, regular physical examination, and routine exercise had lower FI value than the control group( β=-0.049, -0.052, -0.089, -0.047, -0.045, -0.219, all P<0.05). For FI value, physiological disability was the greatest influencing factor, followed by ageing and not often physical exercise. Conclusions:Similar to foreign studies, the FI method is an effective method to evaluate the frailty status and characteristics among older adults, and is also applicable for the elderly in China.Frailty in elderly people is related not also to intrinsic factors, such as physiology and disease, but also to interventionable factor, such as society, psychology and behavior.Therefore, comprehensive measures should be adopted to delay the process of frailty among the elderly.
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Objective@#To develop a core information index system of disability for the elderly, which is suitable for the elderly in China and has educational and guiding significance and universal application value.@*Methods@#The index system framework was established through an extensive literature review and expert discussions, and the index system was constructed by the Delphi expert consultation method.@*Results@#A total of 74 experts (84 person-times)from various fields participated in the Delphi expert consultations.The positive coefficients of experts for the five rounds of expert consultations were 94.55%, 100.00%, 100.00%, 100.00% and 100.00%, respectively.The authoritative coefficients of experts ranged from 0.75 to 0.90.Based on the five rounds of Delphi expert surveys, the core information index system of disability for the elderly was composed of 16 indicators including health literacy of the elderly, nutritional status, musculoskeletal function, vaccination, prevention of falls, attention to mental health, social function, etc.@*Conclusions@#The core information index system of disability for the elderly is comprehensive, covering all components considered essential by a consensus from experts in various fields, and it is authoritative, extendable, scientific, influential, stable and popular.
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Objective To develop a core information index system of disability for the elderly,which is suitable for the elderly in China and has educational and guiding significance and universal application value.Methods The index system framework was established through an extensive literature review and expert discussions,and the index system was constructed by the Delphi expert consultation method.Results A total of 74 experts (84 person-times)from various fields participated in the Delphi expert consultations.The positive coefficients of experts for the five rounds of expert consultations were 94.55 ％,100.00 ％,100.00 ％,100.00 ％ and 100.00 ％,respectively.The authoritative coefficients of experts ranged from 0.75 to 0.90.Based on the five rounds of Delphi expert surveys,the core information index system of disability for the elderly was composed of 16 indicators including health literacy of the elderly,nutritional status,musculoskeletal function,vaccination,prevention of falls,attention to mental health,social function,etc.Conclusions The core information index system of disability for the elderly is comprehensive,covering all components considered essential by a consensus from experts in various fields,and it is authoritative,extendable,scientific,influential,stable and popular.
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Objective To synthesise evidences from randomised controlled trials (RCTs)to evaluate the effectiveness of exercise and nutrition interventions on functioning,muscle strength and body composition in older people with frailty.Methods A systematic review and meta analysis was performed.The electronic databases of Pubmed,Ovid,Web of Science EMBASE and Cochrane were consulted.We included RCT trials of exercise and nutrition interventions for older people with frailty identified through a validated frailty scale of Fried phenotype.The related articles were extracted and cross-checked independently by two reviewers.Methodological quality of trials was evaluated according to Cochrane Handbook criteria.Meta analysis was conducted using RevMan software.The outcomes of performance-based physical function such as gait speed,timed up and go(TUG),muscle strength(knee extension strength or leg extension strength)and body lean mass,fat mass,appendicular lean mass (ALM)were assessed.Results We included 13 articles reporting on 9 trials of exercise interventions (total n=1 034 participants)and included 5 trials of nutrition interventions(n=423 participants).Overall,exercise interventions had a significant beneficial effect on knee extension strength post-intervention compared to usual care control[standardised mean differences (SMD) =1.20,95 ％ CI:0.32-2.08,Z =2.67,P =0.008,I2 =62.0％].We found no effects upon gait speed or TUG time (both P＞0.05).Exercise and nutrition interventions had some effects on ALM,but no significant different(SMD 0.45,95％CI:-0.18-1.09,Z=1.40,P =0.163,I2 =82.2％)compared to control.There were no differences in gait speed or leg extension strength after nutrition interventions (both P＞0.05).The effects of exercise and nutrition interventions on body composition index were inconsistent.Conclusions Exercise interventions had some positive effects on functioning for older people with frailty,but these were based on small,low quality studies.Further large scale and high quality studies of rigorously RCT interventions are needed.
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Objective To investigate the associations of cognitive function with apolipoprotein E (APOE) gene polymorphism and chronic diseases among long-lived people in Zhongxiang City of Hubei Province.Methods A total of 110 long-lived elderly residents aged 90 years and over were collected.Their cognitive function was determined face-to-face using questionnaires by trained interviewers.According to mini-mental state examination(MMSE) scores,subjects were divided into a no dementia risk group and a high dementia risk group.General demographic characteristics,activities of daily living,depression state and nutrition status were compared between the two groups.Correlations of dementia with APOE gene polymorphism and chronic diseases were analyzed.Results The average MMSE score was 22.3±4.8.Among the 110 long-lived people,18 cases had a high risk for dementia,accounting for 16.4％,and 92 cases had no risk of dementia,accounting for 83.6％.The risk of dementia in long-lived elderly people was correlated with activities of daily living,mental state,nutritional status and falls(all P＜0.05).There were 8 cases with the APOE gene ε4/ε3 genotype in the high dementia risk group and 16 cases with the APOE gene ε4/e3 genotype in the no dementia risk group,with the former group showing a higher frequency of the APOE ε4/ε3 genotype (44.4％ vs.17.4％,x2 =6.46,P＜0.05).The former group also seemed to have a higher APOE ε4 frequency,but the difference was not statistically significant(22.2 ％ vs.10.3 ％,x2 =3.96,P =0.055)Chronic diseases prevalent in the long-lived people were hypertension(86 cases,78.2 ％),hearing loss (72 cases,65.5％),hyperlipidemia(56 cases,50.9％),anemia(43 cases,39.1％),impaired vision(39 cases,35.5 ％),chronic kidney diseases(25 cases,22.7 ％),chronic heart diseases (18 cases,16.4 ％) and osteoarthritis(18 cases,16.4％).No correlation was found between the risk of dementia and chronic diseases(P＞0.05).Conclusions Cognitive function is highly correlated with activities of daily living,mental state and nutritional status among long-lived elderly people in Zhongxiang City.The risk of dementia has a correlation with the APOE gene e4/e3 genotype but not with chronic diseases in long-lived people.
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Objective To evaluate the frailty status and understand the relationship between the incidence of fall and frailty status in the elderly in Beijing.Methods A cross-sectional study was conducted in old people aged ≥ 60 years in Longtan community of Dongcheng district in Beijing from November 2015 to January 2016.The information about any fall during the past year and frailty status of the elderly were collected with a standardized structured questionnaire in face-to-face interviews.The frailty status of elderly people was assessed with frailty index (FI) method.Logistic regression analysis was used to explore the relationship between fall and frailty status among the elderly.Results Among 1 557 old people surveyed,the incidence of fall was 17.8％ (277/1 557) during the past year.The incidence of fall in women (21.0％,192/277) was statistically higher than that in men (13.3％,85/277) (x2=15.288,P=0.000).The median (quartile) value of FI of the elderly surveyed was 0.09 (0.08);and women had a higher FI median value than men [0.10 (0.08) versus 0.08 (0.07)](Z=5.376,P=0.000).The median FI value (quartile range) of 277 old people with history of fall in previous year was 0.12 (0.11),which was higher than the median FI value of 0.08 (0.07) of 1 280 old people without fall history (Z=7.501,P=0.000).Logistic regression analysis showed that higher FI value was associated with more risks for fall;and FI value showed the greatest impact on the incidence and frequency of fall (OR =1.093,2.234) compared with other related factors of fall,such as age and gender.Conclusion Frailty status has a greater impact on both incidence and frequency of fall compared with other factors in elderly people in Beijing;more attention should be paid to weak and old adults in the prevention of fall.