Long-term follow-up results and risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation / 中华全科医师杂志

Objective:To investigate the long-term follow-up results and the risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation (NVAF).Methods:A total of 177 patients with NVAF admitted in Beijing Hospital from January 2016 to July 2016 were enrolled in the study, including 107 very elderly patients (aged≥80 years) and 70 elderly patients (aged 65-80 years). The demographic information, comorbid diseases, lifestyles, antithrombotic therapy, thromboembolism risks, bleeding risks, and medical history were documented. Patients were followed up for 5 years and the events of death, thromboembolism, bleeding and major bleeding were recorded.Results:There was no significant difference in the incidence of thromboembolic events between the two groups (15.9%(17/107) vs. 14.3%(10/70), P>0.05). The proportions of bleeding events and severe bleeding events in the very elderly group were higher than those in the elderly group (45.8%(49/107) vs.10.0%(7/70), 14.0%(15/107) vs. 1.4%(1/70), both P<0.05). According to the bleeding events during follow-up, very elderly patients were divided into bleeding group ( n=49) and non-bleeding group ( n=58). Compared with the non-bleeding group, patients in the bleeding group had an older age, a higher proportion of chronic cardiac insufficiency, chronic kidney disease, malignant tumor, bleeding history and higher bleeding risk score (HAS-BLED score) (all P<0.05). Multivariate logistic regression model analysis showed that age, HAS-BLED score, history of bleeding, and complicated malignant tumor were independent risk factors for bleeding events in very elderly patients with NVAF (all P<0.05). Conclusions:Very elderly patients with NVAF have a similar risk of thromboembolism compared with the younger elderly, but have significantly higher risk of the bleeding and major bleeding. Age, HAS-BLED score, bleeding history, and malignant tumor are independent risk factors for bleeding events in very elderly NVAF patients.

Safety of leadless pacemaker implantation in super-elderly patients / 中华全科医师杂志

Objective:To evaluate the safety of leadless pacemaker implantation in super-elderly patients.Methods:Eleven patients with average age of 90 (86, 92) years who underwent leadless pacemaker implantation in the Department of Cardiology, Peking University People′s Hospital from March 2021 to May 2022 were included. The clinical data and implantation information were collected. The complications (cardiac tamponade, myocardial infarction, cerebral infarction, pulmonary embolism, pacemaker reinfection, femoral vein hematoma) and death of patients were documented at 24 h, 3 d, and 1, 3, 6 months after pacemaker implantation.Results:There were 9 males and 2 females with the body mass index of 21(19, 23)kg/m 2. The underlying diseases were hypertension, diabetes, coronary heart disease, chronic kidney disease, chronic obstructive pulmonary disease, previous cerebral infarction and moderate to severe tricuspid regurgitation in 9, 9, 9, 6, 4, 4, 4 patients, respectively. The left ventricular ejection fraction was 49% (45%, 52%), the hemoglobin concentration was 118 (114, 122)g/L, 4 patients were taking anticoagulant drugs, and 6 patients were taking antiplatelet drugs. Eight patients were newly implanted with a leadless pacemaker, 2 patients were implanted after removal the old ones, and 1 case was implanted at the same time as removal. The implantation time was 45(40, 47) minutes, the X-ray exposure time was 14 (13, 15) minutes, the release time was 1 (1, 2), the threshold value was 0.50(0.38, 0.75)V/0.24 ms, the impedance was 730 (700, 770) Ω, and the perceived R-wave amplitude 8.2(6.7, 12.8) mV. During the follow-up period of 8 (6, 10) months, no patient had pacemaker dysfunction; and the threshold, R wave sensing, and impedance were stable and maintained within the normal range. No cardiac tamponade, myocardial infarction, cerebral infarction, pulmonary embolism, pacemaker reinfection or death occurred perioperatively and during the follow-up period; 1 patient had hematoma after femoral vein puncture, which improved after compression treatment. Conclusion:This single-center and small-sample study shows that leadless pacemaker implantation is safe for super-elderly patients.

Association of cognitive function, depression, and quality of sleep with statins among oldest-old individuals

Background: Oldest?old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest?old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi?square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted ORwith age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment – OR: 0.38; 95% CI: 0.16–0.91; depression – OR: 0.41; 95% CI: 0.17–1.02, and poor sleep quality – OR: 0.39; 95% CI: 0.16–0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists

The study of auscultation-assisted bedside blind placement of the nasojejunal feeding tube in oldest-old patients / 中国实用护理杂志

Objective:To evaluate the success rate and influencing factors of auscultation-assisted bedside blind placement of the spiral nasojejunal feeding tube in oldest-old patients.Methods:A case series study was conducted in those elderly hospitalized patients who met the indications for naso intestinal intubation from January 2019 to May 2021 in China-Japan Friendship Hospital. Auscultation-assisted bedside blind placement of the spiral nasojejunal feeding tube was implemented. In addition, abdominal X-ray imaging was performed to confirm the location of the catheter tip. The primary indicators included were the success rate and the first attempt success rate of nasojejunal tube placement;, while the secondary indicators included were the number of attempts and the time of insertion. The rate of operational-related adverse events was ustreated as to evaluate the indicator of safety. Logistic regression analysis was used to conduct multi factor analysis.Results:The total success rate and the first-attempt success rate of tube implantation reached were 90.1%(73/81) and 85.2%(69/81), respectively. The mean attempt per individual patient was (1.2 ± 0.2) times for each patient. The median length of operation time was 40.0(27.0, 45.0) minutes, more specifically, among which the median length time of nasogastric and gastrojejunal placement was 20.0(15.0, 25.0) and 18.0(12.5, 20.0) minutes, respectively; while the median lengthtime of nasogastric placement was greaterhigher than that of gastrojejunal placement ( Z = -2.78, P<0.05). As suggested by multivariate analysis, indicated that the conscious conditions of patients had a signific antlyimpact affect on the success rate of for tube implantation ( OR = 19.25, 95% CI 1.24-299.63, P<0.05). In addition, the incidence rate of operational-related adverse events was 37.0%(30/81). By contrast, there were no serious adverse events occurring during the study period. Conclusions:The auscultation-assisted bedside blind placement of the nasojejunal feeding tube technique is effective and safe for early nutrition support in oldest-old patients in terms of early nutritionsupport, the success rate of which is significant largely affected by the patients′ conscious conditions of patients.

Capacidade funcional de idosos longevos: análise transversal baseada em um modelo de decisão / Functional capacity in the oldest old: cross-sectional analysis based on a decision model

INTRODUÇÃO: Idosos com 80 anos ou mais, ou longevos, são o subgrupo etário que mais cresce no mundo. Nesse segmento, a incapacidade funcional (IF) é mais prevalente que em outras faixas etárias. OBJETIVO: Caracterizar a capacidade funcional e analisar potenciais associações em idosos longevos de uma capital brasileira, com base em um modelo de decisão. MÉTODO: Estudo transversal com 100 idosos longevos, não institucionalizados, assistidos pela Estratégia Saúde da Família do Recife (PE), selecionados por amostra probabilística. Foram avaliados dados sociodemográficos, econômicos e clínicos coletados por meio de entrevistas domiciliares, aferição de medidas antropométricas e buscas nos prontuários. Para análise bivariada, foi empregado o teste χ2 de Pearson, considerando o nível de significância p < 0,05, e para a multivariada foi construída uma árvore de decisão com base em um algoritmo Exhaustive CHAID. RESULTADOS: A prevalência de IF na amostra correspondeu a 67,0%. Na análise bivariada, contribuíram para esse desfecho: renda (p = 0,032), situação previdenciária (p < 0,01), situação nutricional (p = 0,010), doenças neurológicas (p < 0,01), neoplasias (p < 0,01), saúde autopercebida (p = 0,025) e rede de apoio social (p = 0,032), permanecendo na análise multivariada: renda (p = 0,003), rede de apoio social (p = 0,032) e situação nutricional (p = 0,040). A árvore de decisão possibilitou a identificação das variáveis mais associadas ao desfecho, sendo capaz de prever adequadamente a dependência moderada, com assertividade de 72,1%. CONCLUSÃO: O modelo de decisão mostrou-se uma ferramenta oportuna na dedução dos determinantes mais relevantes da IF. Seu uso potencialmente contribui para ampliar a precisão diagnóstica e identificação de populações de risco.

INTRODUCTION: The oldest old adults, aged 80 years and above, is the fastest growing age group in the world. In this section of the population, functional disability (FD) is more prevalent compared to other age groups. OBJECTIVE: To characterize functional capacity and analyze potential associations in the oldest old from a Brazilian capital city, based on a decision model. METHODS: Cross-sectional study of 100 non-institutionalized oldest old participants assisted at the Family Health Strategy of Recife, in the Brazilian northeastern state of Pernambuco, selected by probabilistic sample. Sociodemographic, economic, and clinical data were collected by means of home interviews, anthropometric measurements, and medical records. For bivariate analysis, Pearson's chi-square test was used, establishing significance at p < 0.05. For the multivariate analysis, a decision tree was built from the Exhaustive CHAID algorithm. RESULTS: The prevalence of FD in the sample corresponded to 67.0%. In the bivariate analysis, the following data contributed to this outcome: income (p = 0.032), social security status (p < 0.01), nutritional status (p = 0.010), neurological diseases (p < 0.01), neoplasms (p < 0.01), self-perceived health (p = 0.025) and social support network (p = 0.032), remaining in the multivariate analysis: income (p = 0.003), social support network (p = 0.032), and nutritional status (p = 0.040). The decision tree allowed the identification of the variables most strongly associated with the outcome, being able to adequately predict moderate dependence, with 72.1% assertiveness. CONCLUSION: The decision model proved to be a timely tool in deducing the most relevant determinants of FD. Its use potentially contributes to increase the accuracy of the diagnosis and to identify populations at risk.

A relação entre os mecanismos que influenciam o propósito de vida e seus impactos na longevidade em idosos com mais de 80 anos / The relationship between the mechanisms that influence purpose in life and its impacts on longevity in the oldest-old / La relación entre los mecanismos que influyen en el propósito de la vida y sus impactos sobre la longevidad en las personas mayores de 80 años

Revisão integrativa da literatura que investigou a relação entre mecanismos que influenciam o propósito de vida (PDV) e seus impactos na longevidade,em idosos com mais de 80 anos. Encontraram-se oito trabalhos (bases de dados: LILACS, Medline, CINAHL, Web of Science, Scopus e SciELO).O PDV elevado aumenta as chances de um envelhecimento bem-sucedido e melhores desfechos em saúde; porém, não protege de depressão no futuro.O PDV deve ser fortalecido por intervenções que considerem questões existenciais e subjetivas de longevos.

Integrative literature review investigated the relationship between the mechanisms that influence purpose in life (PIL) and its impacts on longevity in the oldest-old. Eight papers were selected (databases: LILACS, Medline, CINAHL, Web of Science, Scopus and SciELO). High levels of PIL increases chances of successful aging and better outcomes in health. However, it does not protect against depression in the future.PIL must be strengthened through interventions considering existential and subjective issues of the oldest-old.

Revisión de literatura integradora que investigó la relación entre los mecanismos que influyen en el propósito de la vida (POS) y sus impactos en la longevidad, en personas mayores de 80 años. Se encontraron ocho estudios (bases de datos: LILACS, Medline, CINAHL, Web of Science, Scopus y SciELO). POS elevado aumenta las posibilidades de envejecimiento exitoso y mejores resultados de salud; sin embargo, no lo protege de la depresión en el futuro. El POS debe fortalecerse mediante intervenciones que tengan en cuenta los problemas existenciales y subjetivos de las personas de larga vida.

Capacidade funcional no idoso longevo: revisão integrativa / The functional capacity in the older elderly person: an integrative review / Capacidad funcional en ancianos de larga vida: revisión integradora

Este artigo tem como objetivo analisar, tanto a produção científica que versa sobre a manutenção da capacidade funcional em idosos longevos, quanto aquela que trata dos possíveis agravantes à saúde desse grupo etário. Para tanto, foi realizada uma revisão integrativa; houve, porém, muita dificuldade em encontrar literatura cientifica voltada para este grupo etário. Pode-se observar que, além das doenças que acometem estes idosos, fatores psicossociais, como a depressão e o isolamento são responsáveis pela perda de autonomia e independência deste grupo.

This article aims to analyze both the scientific production that deals with the maintenance of functional capacity in the elderly, as well as the one that deals with the possible health problems of this age group. To this end, an integrative review was performed; However, it was very difficult to find scientific literature for this age group. It can be observed that, in addition to the diseases that affect these elderly, psychosocial factors such as depression and isolation are responsible for the loss of autonomy and independence of this group.

Este artículo tiene como objetivo analizar tanto la producción científica que se ocupa del mantenimiento de la capacidad funcional en los ancianos, como la que se ocupa de los posibles problemas de salud de este grupo de edad. Con este fin, se realizó una revisión integradora; Sin embargo, fue muy difícil encontrar literatura científica para este grupo de edad. Se puede observar que, además de las enfermedades que afectan a estos ancianos, los factores psicosociales como la depresión y el aislamiento son responsables de la pérdida de autonomía e independencia de este grupo.

Prevalence of chronic diseases and associate factors on daily activities in male oldest-olds / 中华流行病学杂志

Objective@#To investigate the prevalence of chronic diseases in aged ≥80 oldest-olds and related factors influencing their daily activities.@*Methods@#This survey was conducted in the retired cadres in Beijing from 2012 to 2014. A unified questionnaire was used to investigate the general characteristics of the oldest-olds and the activities of daily living (ADL). Information on chronic diseases was extracted from related medical records.@*Results@#A total of 4 472 male oldest- olds, with an average age as (87.1±3.9) years (80-102 years), were included. Nearly half of the elderly people were suffering from 5 or more kinds of chronic diseases, with 43.9% of them having disability on basic daily activities (BADL) with 13.4% of those classified as moderate or severe cases. 38.8% of them had instrumental activities of daily living (IADL) disability, with 28.7% of them were moderate or severe cases. The ADL disability showed an increasing trend along with the increase number of chronic diseases. The proportion of BADL disability increased from 40.5% to 50.6%. Compared with the ones having fewer chronic diseases (≤2 kinds), those with more (≥7 kinds) had an increase of 50.5% risk on BADL disability and 199.4% on IADL disability.@*Conclusion@#We noticed that the male oldest-olds suffered from multiple chronic diseases. The impairment of ADL was higher than the younger elderly. Comorbidity showed heavier impact on ADL, especially on the instrumental activities of daily living.

Blood pressure level, hypertension prevalence and control status in oldest old in China / 中华流行病学杂志

Objective@#To investigate blood pressure level, hypertension prevalence and control status in the oldest old in China.@*Methods@#A cross-sectional data set of Chinese Longitudinal and Health Longevity Study (CLHLS) in 2014 was used to investigate the blood pressure level and hypertension prevalence and control status in the oldest old.@*Results@#A total of 4 587 elderly people aged ≥80 years were surveyed with mean age (91.3±7.8) years old, including 1 896 males (41.3%). The mean SBP was (139.5±22.0) mmHg, DBP was (79.6±11.8) mmHg, and the pulse pressure difference was (60.0±18.7) mmHg. The prevalence rate of hypertension was 56.5% (95%CI: 55.1%- 58.0%), the awareness rate of hypertension was 52.2% (95%CI: 50.3%-54.1%), the control rate was 11.5% (95%CI: 10.3%-12.5%), and the control rate of those with awareness of hypertension was 22.2% (95%CI: 19.9%-24.4%). Age, gender, BMI, residence place and living area were related to blood pressure level and control status of the oldest old.@*Conclusions@#The blood pressure level and the prevalence of hypertension in the oldest old in China were different from those in developing countries and adults in China, while similar to that in the younger elderly in China. The prevalence rate of hypertension was high and the control rate was low. Age, gender, BMI, residence place and living area were related with blood pressure level, hypertension prevalence and control status.

Safety and Efficacy of Anti-dementia Agents in the Extremely Elderly Patients with Dementia

BACKGROUND: There are debates on representation and generalizability of previous randomized controlled trials about anti-dementia agents in the oldest old population. In this context, we aimed to investigate the efficacy and safety of anti-dementia agents in the very elderly patients with dementia. METHODS: We conducted a retrospective study of patients with dementia 1) who were 85 years or older, 2) got started anti-dementia agents, and 3) went through follow-up evaluation about one year thereafter. As a control, patients with dementia who were less than 85 years old with similar inclusion criteria were randomly selected during the same period. The adverse drug effects and discontinuation rates were investigated with self-reported complaint after starting or increasing anti-dementia drugs. For efficacy outcome, we also analyzed the change in neuropsychological results during follow-up period. RESULTS: A total of 77 dementia patients who were at least 85 years were enrolled. As a control group, 78 patients with dementia who were younger than 85 was analyzed. The adverse drug effects were observed in 26 (33.3%) patients in the younger old and in 26 (33.8%) in the oldest old (P = 0.095). Twenty-one patients (26.9%) in the younger old group and 13 patients (16.9%) in the oldest old group discontinued their medication (P = 0.131). There were no differences between the two groups about changes of Mini-Mental State Examination and Instrumental Activity of Daily Living scores over time. CONCLUSION: The use of anti-dementia agents in the oldest old dementia patients may be safe and effective as the younger old dementia patients.

Ultrasonographic assessment of thyroid volume in oldest-old individuals

ABSTRACT Objective The aim of this study was to describe the relationship between thyroid volume and age, gender, anthropometric characteristics, and echogenicity in oldest-old subjects in an iodine-sufficient area. Subjects and methods The study included 81 independent elderly individuals aged ≥ 80 years (65 [80.2%] women). We determined these individuals' anthropometric characteristics, body mass index (BMI), and lean body mass, as well as thyroid volume and echogenicity by ultrasonography. Results We observed that octogenarians and nonagenarians had different profiles of thyroid echogenicity. The volume of the thyroid was smaller in nonagenarians than octogenarians (p = 0.012, r = 0.176), and subjects aged 80-89 years had more often hypoechoic glands than those aged ≥ 90 years (p = 0.01 versus 0.602). Conclusion The identification of ultrasonographic differences in oldest-old individuals will contribute to establishing preclinical markers, such as echogenicity, to identify individuals at risk of developing autoimmune thyroid disease. Future prospective studies should identify if 80-89-year-old individuals with hypoechoic glands progress to hypothyroidism, and if the absence of changes in echogenicity (i.e. a normal thyroid parenchyma) would have a positive impact on longevity among nonagenarians.

Analysis of the Clinicopathological Characteristics of Gastric Cancer in Extremely Old Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Gastric cancer is the third-leading cause of cancer-related death in Korea. As the Korean population is ageing, the number of extremely old patients with this disease is increasing. This study examined the clinicopathological characteristics of gastric cancer in extremely old (over 85 years) patients who received treatment or conservative observations and compared the treatment outcomes according to the treatment modality. MATERIALS AND METHODS: A total of 170 patients over 85 years of age were diagnosed with gastric cancer. Of these, 81 underwent treatment for gastric cancer and 89 received conservative observations. The clinicopathological characteristics of the treatment and conservative groupswere compared. RESULTS: The mean age of the patients was 86.5 years. The conservative group included significantly more patients with older ages, macroscopically advanced cancer and upper-middle located cancer. The overall survival rate of the treatment group was significantly higher than that of the conservative group. The disease-specific mortality rate was significantly lower in the treatment group than in the conservative group. Multivariate analysis revealed the clinical course, alarm sign, and macroscopic classification to be independent prognosis factors. CONCLUSION: By itself, the chronological age should not be used as a strategy to determine whether treatmentwill be administered for gastric cancer. Patients who have early gastric cancer or lower-risk preexisting comorbidities should not be discouraged from treatment, even if they are older than 85 years.

Nível de atividade física e hábitos no lazer de idosos centenários / Physical activity level and habits in leisure elderly centenarians

O objetivo deste estudo é comparar o nível de atividade física com a prática de determinadas atividades no lazer de idosos centenários de Florianópolis (SC), Brasil, e seus efeitos sobre os idosos. A amostra foi de 23 centenários, com média de idade de 101,7 (DP=2,0 anos). A média de passos/dia foi de 641,23 (DP=655,83) e os idosos que "visitam parentes e amigos" e "fazem compras", ambas as atividades realizadas fora do ambiente domiciliar, apresentaram melhor nível de atividade física em relação aos que não praticavam estes hábitos no lazer, respectivamente.

The aim of this study is to compare the level of physical activity with the practice of certain leisure activities of centenarian Florianópolis (SC), Brazil. The sample consisted of 23 centenarians, with a mean age of 101.7 (SD = 2.0 years). The average steps / day was 641.23 (SD = 655.83) and the elderly that "visiting relatives and friends" and "shopping", both activities outside the home, showed better level of physical activity than those who did not practice these leisure habits, respectively.

Association between anemia and 3-year all-cause mortality among oldest old people in longevity ;areas in China / 中华流行病学杂志

Objective To explore the association between anemia and 3-year all-cause mortality among the oldest old people in longevity areas in China. Methods In August 2012, questionnaire survey,health examination and blood test were conducted among 929 old people aged≥80 years in 7 longevity areas in China,who were included in Chinese Longitudinal Healthy Longevity Survey(CLHLS)2009. Cox regression model was used to evaluate the association between anemia or different hemoglobin levels and mortality. Results Among the 929 subjects,the prevalence of anemia was 49.6%,the main form of anemia was normocytic anemia. During the three year follow-up period,a total of 447 subjects died,the overall mortality was 49.8%(56.0%in subjects with anemia and 43.3% in subjects without anemia). Compared with the subjects without anemia,the mortality risk increased by 25% in the subjects with anemia after adjusting confounding factors(HR=1.25, 95%CI:1.03-1.52). Macrocytic anemia,simplex microcytic anemia and microcytic hypochromic anemia were all associated with the increased mortality in the oldest old people. Compared with the subjects with low hemoglobin concentration,the subjects with high hemoglobin concentration had a lower mortality risk,and the association was more obvious in women. Conclusion Anemia and low hemoglobin concentration were associated with higher mortality risk in the oldest old people in China, indicating the importance of anemia prevention and treatment among this population.

Association between anemia and 3-year all-cause mortality among oldest old people in longevity ;areas in China / 中华流行病学杂志

Objective To explore the association between anemia and 3-year all-cause mortality among the oldest old people in longevity areas in China. Methods In August 2012, questionnaire survey,health examination and blood test were conducted among 929 old people aged≥80 years in 7 longevity areas in China,who were included in Chinese Longitudinal Healthy Longevity Survey(CLHLS)2009. Cox regression model was used to evaluate the association between anemia or different hemoglobin levels and mortality. Results Among the 929 subjects,the prevalence of anemia was 49.6%,the main form of anemia was normocytic anemia. During the three year follow-up period,a total of 447 subjects died,the overall mortality was 49.8%(56.0%in subjects with anemia and 43.3% in subjects without anemia). Compared with the subjects without anemia,the mortality risk increased by 25% in the subjects with anemia after adjusting confounding factors(HR=1.25, 95%CI:1.03-1.52). Macrocytic anemia,simplex microcytic anemia and microcytic hypochromic anemia were all associated with the increased mortality in the oldest old people. Compared with the subjects with low hemoglobin concentration,the subjects with high hemoglobin concentration had a lower mortality risk,and the association was more obvious in women. Conclusion Anemia and low hemoglobin concentration were associated with higher mortality risk in the oldest old people in China, indicating the importance of anemia prevention and treatment among this population.

Rehabilitation Strategy to Improve Physical Function of Oldest-Old Adults

In recent, oldest-old adults over 85 years are increasing rapidly. Major geriatric problems such as frailty, fall, osteoporosis, sarcopenia, gait disturbance in this population are higher prevalent and more severe than those in older adults under 85 years. Therefore, strategy to evaluate and manage them with combined medical problems and related impairments should be considered to prepare for super aged society in the near future. We introduced comprehensive geriatric physical performance battery to examine a variety of physical function in multidomains, which can be applied to prescribe exercise, nutrition and medications as single or combined therapy specific to the level of physical function. It would be desirable that modality-specific exercise intervention to prevent from functional decline of oldest-old adults will be integrated with clinical setting. Eccentric biased strengthening exercise is highlighted as an appropriate exercise intervention for sarcopenic oldest-old because of low energy expenditure and utilization of the aged muscle stiffness. Furthermore, specially designed exercise machines enabling them to do exercise are developed for severe deconditioned patients that can't participate in the conventional strengthening exercise. Oldest-old adults are expected to become a major patient group in geriatric medicine sooner or later. Basic principles of management for oldest-old adults are not different from geriatric management of frailty and sarcopenia in general old population. Along with the assessment of the multidomain of physical parameters, multidimensional modality-specific interventions should be developed based on each individual physical profiles.

Anthropometric Index, Dietary Habits and Nutrient Intake of the Oldest-old Population Aged 95 and Over Living in Seoul / 대한지역사회영양학회지

The population aged 95 years and older in Seoul approximately increased to five-fold over the past 10 years, while nationwide rates increased to three-fold. In order to examine the dietary habit and nutritional status of oldest-old population living in Seoul, we recruited 87 subjects (25 males and 62 females) aged 95 years and older. The prevalence of underweight (BMI or = 25 kg/m2) were 18.2% and 18.2% in males, and 20.8% and 9.4% in females, respectively. In self-assessment of health, only 25.3% answered to be unhealthy. More males exercised regularly and reported a wide range of activities than females. The average of %Kcal from carbohydrate, protein and fat (C : P : F) was 64.9 : 13.8 : 21.2 in males and 68.1 : 14.2 : 17.7 in females. The average daily energy intake was 1,307 kcal in males and 1,304 kcal in females. More than 75% of subjects were taking under estimated average requirements (EAR) for vitamin B1, B2 & C and Ca. The average of mean adequacy ratio (MAR) was 0.66 in males and 0.70 in females, and 28.8% of males and 12.9% of females were in MAR < 0.50. Based on MAR, 32.0% of males and 14.5% females were classified as normal and 16.0% of males and 25.8% of females were classified as malnourished. Our subjects were taking more animal food, especially milk and its products, compared to those living, in rural areas. However, a significant proportion did not meet the EAR for vitamin B1, B2 & C and Ca.

Effect of Radiofrequency Thermocoagulation Guided by Spiral CT on Severe Trigeminal Neuralgia in the Oldest Old Patients: 21 Cases Report / 中国康复理论与实践

@#Objective To investigate the efficacy and safety of radiofrequency thermocoagulation guided by spiral CT on severe trigeminal neuralgia in the oldest old patients. Methods 21 patients above 80 with severe idiopathic trigeminal neuralgia were treated with radiofrequency thermocoagulation guided by spiral CT. They were assessed with numeric rating scales (NRS) and the complication were observed. Results The scores of NRS decreased significantly after treatment (P<0.01). No serious complication was observed after treatment. One patient recurred 23 months after operation, and the pain released after radiofrequency thermocoagulation once again. Conclusion Radiofrequency thermocoagulation guided by spiral CT is effective and safe for severe trigeminal neuralgia in the oldest old patients.

Dietary Behavior Factors for Desirable Nutrient Intakes of the Oldest-old Population in Sunchang County / 대한지역사회영양학회지

In order to identify valuable factors for improving dietary quality of Korean rural elderly, the consumption frequency of food groups, dietary habits and health behaviors related to nutrient intakes of the elderly over 85 of Sunchang County were studied. The 171 subjects (61 males and 110 females) were chosen from Sunchang Province by stratified sampling. Among food groups, the consumption frequency of meat and fish groups influenced significantly on their nutrient intakes than the other groups. The subjects consuming more than 4 times per week of meat or fish had significantly higher nutrient intakes level than the other groups. The group consuming milk and milk products everday was higher in vitamin B2 intake level than the other groups. Among dietary habits, the groups with good appetite and regular mealtime compared with the groups with low appetite and irregular mealtime had significantly higher nutrient intake levels. The family type was the determining factor of nutrient intakes. The subjects living with family members consumed higher nutrient intakes than the subjects living alone. The smoking and the alcohol consumption themselves did not affect nutrient intakes, but the subjects having alcohol consumption frequently more than once a day had lower nutrient intakes than the others. The group with dentures did not differ significantly from the without denture group in nutrient intakes; however, those who had chewing problems showed the lower nutrient intakes compared to those who did not have chewing problems. The subjects with more than two kinds of clinical symptoms had lower nutrient intakes than the subjects with less than two kinds of clinical symptoms. These results indicate that the identifying factors for desirable nutrient intakes of rural elderly were characterized as appropriate consumption frequencies of meat and fish, good appetite, living with family, regular mealtime, chewing without difficulty, and low incidence of chronic disease.

Nutritional Status of the Oldest-elderly Population in Sunchang County / 대한지역사회영양학회지

This study was investigated nutrient intakes and dietary evaluation index of the healthy subjects over 85 of Sunchang County to explore the improved dietary pattern for healthy aging of the elderly. The survey was conducted by personal interview to 161 elderly subjects (59 males and 102 females over 85) in 2006, and their daily dietary intake was assessed by 24-hr recalls and weighing one meal. The daily energy intakes of males were 1,335 +/-67 kcal, and those of females were 1,095 +/-38 kcal comprised of 66.8% and 68.4% of the EER for the age group of 75. The proportions of energy from carbohydrate : protein : lipid were 70.7 : 14.6 : 14.6 for males and 68.6 : 14.0 : 17.4 for females. The average protein intakes were 95.4% for males and 85.0% for females of RI, and the average calcium intakes were 54.3% for males and 43.6% for females of RI. The daily vitamin intakes were below 70% except vitamin A, vitamin B6, and vitamin E. The proportion of the relative risk groups of protein, phosphate, iron and vitamin A ranged 40-49% of RI over 75 year groups. The other nutrient intakes showed that there were over 50% risk groups. Especially for nutrients such as calcium, vitamin B1, vitamin B2, vitamin C, folate and niacin over 70% of the subjects were under risk. The median value of all nutrient intakes did not reach AI. The INQ of nutrients were over 0.8 except for folate and vitamin C. Calcium intakes were relatively low and needed attention. However, the ratio of calcium and phosphate showed 1 : 1.6, which appeared to be superior to the other districts. The DVS were higher as the dietary balance scores, KDDS were higher, and the groups with high KDDS had high intakes of nutrients compared to the groups with low KDDS. The high risk groups as judged by simple nutrition screening test had lower nutrient intakes than the groups of middle risk or low risk groups. The subjects in Sunchang area had relatively low intakes of several nutrients. However, judging from the desirable patterns of the energy proportion from three major nutrients, ratio of calcium and phosphate and INQ of nutrients there is a possibility that extended healthy aging might be related to the quality of nutrients and relative ratio between nutrients. To improve nutrient status of the elderly of the surveyed area further application involving KDDS and DVS appeared to be required.