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OBJECTIVE@#To compare the efficacy and safety of different chemotherapy regimens in elderly multiple myeloma (MM) patients with different Frailty scores.@*METHODS@#The clinical data of elderly patients with MM were retrospectively analyzed, including age, treatment regimen, efficacy, adverse reactions, and the Frailty score included in the activity of daily living score, the instrumental activity of daily living scale and the Charlson comorbidity index. The patients were divided into fit group, mediate fit group and frail group according to the scoring standard. The treatment efficiency and adverse reaction rates of elderly MM with different physical conditions treated by different chemotherapy regimens were analyzed.@*RESULTS@#Among the 70 patients, the effective rates of the patients in fit group, the mediate fit group, and the frail group were 79.5%, 81%, and 40%, and the effective rates of the fit patients in double and triple groups were 54.5% and 89.3%, 70% and 90.9% for mediate fit patients, 42.9% and 33.3% for frail patients, the triple regimen in fit patients showed obvious advantages, and the difference showed statistically significant (P<0.05), while the efficacy for mediate patients and frail patients showed no significant difference. During the induction of bortezomib, the incidence of adverse reactions for the patients in the triple group (78.6%) was higher than 67.9% in the double group, and the difference showed no statistically significant (P>0.05).There was no significant difference in the 1-year overall survival rate of the patients and with molecular genetic abnormalities among each groups.@*CONCLUSION@#The therapeutic effect is related to the patient's physical condition. For patients with healthy physique, the triple regimen should be used first. For patients with weak physical constitution, the chemotherapy regimen with low drug toxicity should be selected for safety.
Subject(s)
Aged , Humans , Bortezomib , Frailty , Multiple Myeloma/drug therapy , Retrospective StudiesABSTRACT
Background: In our country, the survey on mental condition of Mongolian elderly, in particularly on assessing the cognitive status has not provided yet. Goal: To determine the cognitive status of elderly and find out some factors which affect on it. Objectives:1. Determine the cognitive ability of Mongolian elderly2. Find out some factors which affect the cognitive ability of elderlyMaterials and Methods: In this cross sectional study, we had chosen randomizily 1 cluster from each 4 economic and geographic regions of Mongolia and Ulaanbaatar city, and totally comprised of 1207 elderly, of which 60 and over for male and 55 and over for female. The cognitive status of survey involved elderly was evaluated by mini mental examination test (MMET).Results: The mean age of survey involved elderly was 68.1±8.1 (68.9±6.5 in male and 65.7±8.5 in female). While 60.3(728) percent of elderly people were normal, 39.7(479) percent of them estimated to have cognitive decline. Out of elderly with cognitive decline, 59.5 percent had slight cognitive impairment, 35.1 percent moderate cognitive impairment and rest 5.4 percent had severe cognitive impairment. The cognitive impairment predominantly revealed in female and prevailed more in elderly who live in countryside compared to elderly who live in the city (P<0.001). The cognitive impairment was related to educational background of elderly who had cognitive decline. Along the decline of education estimated higher level of cognitive impairment, as well as 47.5 percent of male and 53.8 percent of female, who had lower education, shared most percentage of cognitive impairment, compared to other educational levels.The cognitive impairment is directly correlated to decline of Activity of daily living and Instrumental activity of daily living of elderly (p<0,0001).Conclusions:1. The decline of cognitive status of elderly is correlated to gender. The educational background, income and family are related to their cognitive impairment.2. Activity of daily living and Instrumental activity of daily living have direct correlation to cognitive impairment of elderly.
ABSTRACT
BACKGROUND: The limitation of activities of daily living (ADL) is a critical problem in dementia patients in addition to cognitive dysfunction. In spite of many previous studies about the relationship between cognitive dysfunction, ADL and the nature of functional changes, there have not been any clear explanations about the liaisons between them due to various results from the diversity of objects and methods. The purpose of this study is to evaluate the relationship between ADL and clinical features in patients with Alzheimer's disease. METHODS: One hundred thirty-four patients with Alzheimer's disease were enrolled to participate in the study. The physical activity of daily living (P-ADL) and the Korean instrumental activity of daily living (K-IADL) were evaluated in the patients. In addition, all subjects were tested by a Korean version of the expanded clinical dementia rating scale (CDR), and a Korean version of the mini-mental state examination (K-MMSE) and a Korean version of the neuropsychiatric inventory (NPI). RESULTS: ADL was significantly correlated with cognitive functioning (r>-0.75, p0.72, p<0.01). The ability to use the telephone was the most predictable item in K-IADL and bathing was the most predictable item in PADL. The deterioration of K-IADL showed rapid progression in the degree of CDR 2 and P-ADL showed rapid progression in the degree of CDR 4, respectively. CONCLUSIONS: The ADL decline induced by dementia may progress and have a close correlation with clinical manifestations of dementia including cognitive dysfunction, behavioral symptoms and psychological symptoms.