Stress perception among the elderly and its effect on some muscle strength parameters

Background: With improvement in living conditions in the population and the availability of treatments for various communicable and non-communicable diseases, the life expectancy and consequently the elderly population have increased. Stress leads to mental and physical problems. Aim and Objective: The aim of this study was to assess the effect of stress on muscle functions in the elderly. Materials and Methods: One hundred apparently healthy persons (50 males and 50 females) took part in the study. Perceived stress scale was used to measure their level of stress. Maximum voluntary contraction (MVC) and endurance time were measured with the help of a handgrip dynamometer. Results: The elderly population sample in our study showed a moderate level of stress, but there was no significant difference between the three age groups under study. Conclusion: A significant positive correlation between MVC and stress level was observed in our study subjects.

Saúde mental do idoso institucionalizado / The mental health of institutionalized older adults / Salud mental de los ancianos institucionalizados

Introdução: O processo de acolhimento dos longevos em instituições de longa permanência de idosos (ILPI) tem se tornado uma constante por parte das famílias, principalmente ao observar-se o panorama de ageísmo atual. Dessa forma, seja pela falta de condições emocionais, seja pela praticidade em fornecer o cuidado por meio terceirizado, inúmeros idosos são obrigados a se adaptar a um novo ambiente, rotina e conviventes. Assim, faz-se clara a percepção de inúmeras dificuldades por parte desses indivíduos em lidar com os obstáculos inerentes ao processo fisiológico do envelhecimento, somada à tempestade de sentimentos advindos do abandono e da incapacidade. Além disso, por se tratar de uma porção vulnerável da população, torna-se importante trazer à tona a visão dos idosos a respeito de sua percepção de saúde e da forma como se sentem quanto à convivência nesse espaço e com suas famílias. Objetivo: Compreender a influência do contato familiar e das relações interpessoais na saúde mental de idosos residentes em ILPI no noroeste do Paraná. Métodos: Estudo descritivo exploratório, de abordagem qualitativa, realizado por meio da aplicação de um questionário associado a uma entrevista semiestruturada com idosos residentes em uma ILPI, no ano de 2021. Entre as informações abordadas estão a autoavaliação do estado mental, a forma de ingresso na instituição, o contato familiar e o relacionamento dentro da instituição. As entrevistas foram gravadas, transcritas e analisadas, segundo semelhança de conteúdos. Resultados: Por meio dos dados coletados, observou-se que o processo de ingresso da maioria dos entrevistados foi consentida e estabelecida por concordância entre idoso, família e assistente social. Também se viu que, mesmo com as adversidades da pandemia de COVID-19, os familiares buscaram estar presentes por intermédio de chamadas de vídeo, seguindo os protocolos de prevenção à doença. Outro ponto investigado foi o relacionamento entre os residentes e os profissionais da instituição, a qual foi estabelecida como não conflituosa, sendo considerada impessoal pela maioria, obtendo-se poucos relatos que a considerassem como familiar. Por fim, constatou-se pelos relatos uma boa condição cognitiva (bom estado de saúde mental), mantida por meio da boa convivência e da implementação de atividades coletivas e individuais de lazer por parte da instituição. Conclusões: Os idosos entrevistados consideraram sua estadia, convivência e rotina na ILPI de ótima qualidade. Ao contrário do esperado, a maioria dos internos apresentou boa condição cognitiva (bom estado de saúde mental), constatada no decorrer das entrevistas. Há poucos idosos residentes na instituição, e o diagnóstico de depressão é apresentado nos prontuários.

Introduction: The process of welcoming long-lived individuals in Long-term Care Facilities (LTCFs) for older adults has become a constant on the part of families, especially when observing the current panorama of ageism. Thus, either due to the lack of emotional conditions or to the practicality of providing outsourced care, countless older people are forced to adapt to a new environment, routine, and peers. It is evident the perception of countless difficulties on the part of these individuals in dealing with the obstacles inherent in the physiological process of aging, along with the storm of emotions arising from abandonment and incapacity. Moreover, as this is a vulnerable portion of the population, it is worth bringing to light the vision of older adults about their perception of health and how they feel about the interaction in this space and with their families. Objective: To understand the influence of family contact and interpersonal relationships on the mental health of older adults residents of a LTCF in northwestern Paraná. Methods: A descriptive exploratory study with a qualitative approach was carried out by applying a questionnaire, associated with a semi-structured interview, to older adults residents of a LTCF in the year 2021. Among the addressed information are the self-assessment of mental state, the way of admission to the institution, family contact, and the relationship within the institution. The interviews were recorded, transcribed, and analyzed, according to similarity of content. Results: According to the collected data, the process of admission of most of the interviewees was consented and established by agreement between the older adult, their family, and social workers. Even with the adversities of the COVID-19 pandemic, the family members sought to be present through video calls, following the protocols of prevention to the disease. Another investigated aspect was the relationship between the residents and the professionals of the institution, which was established as nonconflicting, being mostly considered impersonal, with few reports that considered it as familiar. Finally, by the reports, we verified a good status of mental health, maintained through good coexistence and the implementation of collective and individual leisure activities by the institution. Conclusions: The interviewed older adults considered their stay, coexistence, and routine at the LTCF of great quality. Contrary to what was expected, most of the residents presented a good mental health status, as verified during the interviews. Few older adults residents in the institution presented a diagnosis of depression in their medical records.

Introducción: El proceso de acogida de los ancianos en las instituciones de larga permanencia de ancianos (ILPIs), se ha convertido en una constante por parte de las familias, principalmente al observar el panorama actual de discriminación por edad. Así, ya sea por la falta de condiciones emocionales o por la practicidad de la atención externalizada, muchos ancianos se ven obligados a adaptarse a un nuevo entorno, rutina y convivencia. Así, es evidente la percepción de numerosas dificultades por parte de estos individuos para afrontar los obstáculos inherentes al proceso fisiológico del envejecimiento, junto con la tormenta de sentimientos derivados del abandono y la discapacidad. Además, al tratarse de una parte vulnerable de la población, es importante llevar a cabo la visión de los niños respecto a su percepción de la salud y la forma en que se sienten respecto a la convivencia en este espacio y con sus familias. Objetivos: Comprender la influencia del contacto familiar y de las relaciones interpersonales en la salud mental de los individuos residentes en los ILPIs en el noroeste de Paraná. Métodos: Estudio descriptivo exploratorio, de abordaje cualitativo realizado mediante la aplicación de un cuestionario asociado a una entrevista semi-estructurada junto a los individuos residentes en un ILPIs, en el año 2021. Entre las informaciones abordadas están la autoevaluación del estado mental, la forma de ingreso en la institución, el contacto familiar y la relación dentro de la institución. Las entrevistas se grabaron, se transcribieron y se analizaron, según la similitud del contenido. Resultados: A través de los datos recogidos, se observó que el proceso de ingreso de la mayoría de los entrevistados fue consentido y establecido por acuerdo entre el anciano, la familia y el trabajador social. También se analizó que, al igual que las adversidades de la pandemia de COVID-19, los familiares buscan estar presentes a través de las cámaras de video, siguiendo los protocolos de prevención de la enfermedad. Otro punto investigado fue la relación entre los residentes y los profesionales de la institución, que se estableció como no conflictiva, siendo considerada impersonal por la mayoría, obteniendo pocos informes que la consideraban como una familia. Por último, se constató a través de los relatos, un buen estado de salud mental, mantenido por medio de la buena convivencia y la implementación de actividades colectivas e individuales de ocio, por parte de la institución. Conclusiones: Los ancianos entrevistados consideran de gran calidad su estancia, convivencia y rutina en el ILP. Al contrario de lo esperado, la mayoría de los internos presentaban un buen estado de salud mental, constatado en el decurso de las entrevistas. Pocos ancianos residentes en la institución presentaban un diagnóstico de depresión en sus historias clínicas.

Review on exposure characteristics and health effects of per- and poly-fluoroalkyl substances / 环境与职业医学

Per- and poly-fluoroalkyl substances (PFAS) are a new type of persistent organic pollutants that have received extensive attention in recent years. This article reviewed the population characteristics of environmental exposure to PFAS, as well as the potential health effects. Previous studies have verified that people are exposed to PFAS mainly through ingestion, and food and water are the dominant contributors. In terms of exposure characteristics, geographical, gender, age, and occupational differences have an impact on the level of PFAS exposure in the corresponding populations by influencing their behavioral characteristics and metabolic levels, with occupational exposure receiving more attention, especially in the exploration of novel PFAS. PFAS associate with a variety of adverse health effects caused by hepatorenal toxicity, immunotoxicity, reproductive toxicity, neurotoxicity, and carcinogenicity. However, some of the conclusions are not completely consistent, and the published epidemiological studies have focused on children and young people, lacking relevant data of the elderly. Future research can pay more attention to the elderly population and carry out validation exploration on controversial conclusions.

Construção e utilização de instrumento de estratificação de risco para vacinação de idosos contra a Covid-19 / Construction and use of a risk stratification instrument for vaccination of elderly against Covid-19 / Construcción y uso de un instrumento de estratificación de riesgo para la vacunación del anciano contra el Covid- 19

Objetivo: Relatar a experiência da construção e utilização de um instrumento de estratificação de risco para vacinação de idosos contra a COVID-19. Métodos: Relato da experiência desenvolvida no município de Massapê ­ Ceará, durante o ano de 2021, a partir do início da campanha de vacinação de idosos contra a COVID-19. Descrição da Experiência: Por conta da escassez de imunobiológicos, na fase inicial da vacinação contra a COVID-19, a Secretaria da Saúde do município de Massapê, estado do Ceará, criou um instrumento para estratificação de riscos sanitários, epidemiológicos e sociais dos idosos, contendo seus dados sociodemográficos e as comorbidades. Após o estabelecimento das variáveis, foram estabelecidos escores para os estratos de risco, que foram classificados em baixo (um a três pontos), médio (quatro a seis pontos), alto (sete a nove pontos) e muito alto (dez pontos e mais). Considerações Finais: O estudo mostra que, apesar da pandemia de COVID-19, uma crise sanitária global sem precedentes como já dito, ações pontuais, mesmo que localizadas, podem ter efeito em cadeia e ser replicadas em outros cenários e momentos.

Objective: To report the experience of building and using a risk stratification instrument for vaccinating the elderly against COVID-19. Methods: Report of the experience developed in the municipality of Massapê - Ceará, during the year 2021, from the beginning of the vaccination campaign for the elderly against COVID-19. Experience Description: Due to the scarcity of immunobiologicals, in the initial phase of vaccination against COVID-19, the Department of Health of the municipality of Massapê, state of Ceará, created an instrument to stratify the health, epidemiological and social risks of the elderly, containing sociodemographic data and comorbidities of the elderly. After establishing the variables, scores were established for the risk strata, which were classified as low (one to three points), medium (four to six points), high (seven to nine points) and very high (ten points and more). Final Considerations: The study shows that, despite the COVID-19 pandemic, an unprecedented global health crisis as already mentioned, specific actions, even if localized, can have a chain effect and be replicated in other scenarios and times.

Objetivo: Relatar la experiencia de construcción y uso de un instrumento de estratificación de riesgo para la vacunación de ancianos contra la COVID-19. Métodos: Informe de la experiencia desarrollada en el municipio de Massapê - Ceará, durante el año 2021, desde el inicio de la campaña de vacunación de ancianos contra la COVID-19. Descripción de la Experiencia: Debido a la escasez de inmunobiológicos, en la fase inicial de la vacunación contra la COVID-19, la Secretaría de Salud del municipio de Massapê, estado de Ceará, creó un instrumento para estratificar los riesgos sanitarios, epidemiológicos y sociales de los ancianos, que contiene datos sociodemográficos y comorbilidades de los ancianos. Luego de establecer las variables, se establecieron puntajes para los estratos de riesgo, los cuales se clasificaron en bajo (uno a tres puntos), medio (cuatro a seis puntos), alto (siete a nueve puntos) y muy alto (diez puntos y más). Consideraciones finales: El estudio muestra que, a pesar de la pandemia de COVID-19, una crisis sanitaria mundial sin precedentes como ya se mencionó, las acciones específicas, aunque sean localizadas, pueden tener un efecto en cadena y replicarse en otros escenarios y tiempos.

Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018 / 预防医学

Objective@#To investigate the trends in prevalence of depression symptoms among middle-aged and elderly residents at ages of 45 years and older in China from 2011 to 2018, so as to provide insights into depression prevention and control among middle-aged and elderly residents. @*Methods@#Demographic features and evaluation data of depressive symptoms were collected from middle-aged and elderly residents at ages of 45 years and older recorded during four follow-ups in the China Health and Retirement Longitudinal Study (CHARLS), and the depressive symptoms were screened using the Center for Epidemiological Studies Depression Scale (CES-D). Following sampling weights, non-response weights, and post-stratification weighting, the detection of depressive symptoms was analyzed among the middle-aged and elderly residents with different demographics, and the trends in prevalence of depressive symptoms were identified using annual percent change (APC). @*Results@#A total of 48 223 middle-aged and elderly residents were enrolled, including 12 624, 10 427, 12 144, and 13 028 residents in 2011, 2013, 2015 and 2018, with mean ages of (58.8±9.4), (58.9±9.2), (59.0±9.2), and (61.1±9.2) years, respectively. The prevalence of depressive symptoms was 34.5% (95%CI: 33.3%-35.8%), 29.6% (95%CI: 28.5%- 30.8%), 30.6% (95%CI: 29.4%-31.8%), and 35.0% (95%CI: 33.6%-36.4%) among middle-aged and elderly residents in 2011, 2013, 2015 and 2018, respectively, with no remarkable changing trends seen (APC=0.4%, t=0.188, P=0.868). Higher detection was seen among residents at advanced ages, among women than among men, among rural residents than among urban residents, among residents with lower educational levels, among widowed and unmarried residents than among married residents, among unemployed residents than among employees, and among residents that had lower per capita personal consumption expenditures than mean expenditures than among residents that had higher per capita personal consumption expenditures than mean expenditures (all P<0.05). @*Conclusions@#There were no obvious trends in prevalence of depressive symptoms among middle-aged and elderly residents in China from 2011 to 2018, and individuals with advanced ages, women, urban residents and those with low educational and economic levels should be given a high priority for depression control.

Epidemiological characteristics of infected patients aged 60 years and older during the outbreak of SARS-CoV-2 Omicron variant in Sanya, Hainan in 2022 / 中国热带医学

@# or older during the outbreak epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Sanya City, Hainan Province, August-September 2022, and to provide scientific and effective basis for formulating strategies for the prevention and treatment of COVID-19 in the elderly in the future. Methods　The data of 1 785 COVID-19 cases aged ≥60 years reported from August 1 to September 8, 2022 in Sanya City, and 537 local COVID-19 inpatients aged ≥60 years treated in Sanya Central Hospital were collected and analyzed using WPS Office 2018 software for data cleaning, database assistance, and drawing, and SPSS 22.0 software was used to statistically describe and analyze the counting data. Results　A total of 1 785 local COVID-19 cases aged ≥60 years were reported in China's Disease Prevention and Control Information System, including 1 509 confirmed cases (84.54%) and 276 asymptomatic cases (15.46%). Of the confirmed cases, 1 448 were mild cases (95.96%), 40 were common cases (2.65%), 10 were severe cases (0.66%), and 11 were critical cases (0.73%), and no deaths were reported. The ratio of male to female was 0.88∶1. The youngest was 60 years old, the oldest age was 107 years old, with a median age of 67 years old. Most of them (1 559 cases, 87.34%) were non-social employed personnel. Among them, 952 (53.33%) were from Tianya District and 733 (41.06%) from Jiyang District. Among the 537 COVID-19 elderly infected patients hospitalized in Sanya Central Hospital, infected patients with underlying diseases accounted for 287 (53.45%) cases of hypertension, diabetes and other types of basic diseases (chronic kidney disease, hyperlipidemia, chronic gastritis, gastric ulcer, etc.), and there were serious infections. Conclusions　Most of the elderly infected with Omicron variants were mild cases with few symptoms, but the elderly infected with Omicron variants were difficult to recover or even worsen the condition due to old age and underlying diseases. Therefore, by analyzing the various aspects of elderly infected cases, scientific and effective basis can be provided to prevent and control the epidemic situation in the future, and reduce the occurrence of severe, critical and death cases of COVID-19 in the elderly.

Association analysis of various obesity-related indices and vitamin D deficiency in middle-aged and elderly population in Lanzhou / 中华临床营养杂志

Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.

A multi-center analysis of thyroid-stimulating hormone level in apparently healthy elderly population in China / 南方医科大学学报

OBJECTIVE@#To investigate serum thyroid stimulating hormone (TSH) level and its changes with age in apparently healthy Chinese elderly population and analyze the differences between TSH levels detected using Roche and Snibe electrochemiluminescence immunoassay analyzers.@*METHODS@#General clinical data and frozen fasting serum samples were collected from 5451 apparently healthy Chinese elderly individuals (> 60 years) from 10 centers in different geographic regions in China. Thyroid function indexes including TSH level were detected using Roche and Snibe electrochemiluminescence immunoassay analyzer, and the median (2.5% and 97.5% quantiles) TSH level was calculated. The variations of TSH level among the participants with geographic regions, gender, and age (with an interval of 5 years) were analyzed to determine the influence of these factors on TSH level.@*RESULTS@#The reference ranges of serum TSH level established using Roche and Snibe electrochemiluminescence immunoassay analyzers were 0.42-9.47 mU/L and 0.36-7.98 mU/L, respectively, showing significant differences between the two methods (P < 0.001). The TSH levels measured at two centers in Western China were significantly higher than those at the other centers (P < 0.05). In elderly male population, serum TSH level tended to increase with age, which was not observed in elderly female population. At the age of 60-75 years, women generally had higher serum TSH level than men, but this difference was not observed in the population beyond 75 years.@*CONCLUSION@#In elderly population, serum TSH level can vary with geographic region, gender, and age, but there was no need for establishing specific reference ranges for these factors. The differences between different detection methods should be evaluated when interpreting the detection results of TSH level.

The safety profile of COVID-19 Vaccination among 1373 elderly population

Introduction: COVID-19 infection caused by the SARS COV-2 virus is one of the largest pandemics and has affected every nation worldwide. The introduction of different vaccines against COVID-19 infection has bought new hope in the fight against COVID-19, which would decrease the ongoing crisis. These vaccines were approved for emergency purposes, which had fewer clinical trials involving elderly populations. Hence, this study intends to know the safety profile of the COVID-19 vaccine in the elderly population. Methods: In a cross-sectional study, we have collected data regarding the onset of symptoms within 72hrs following first dose of COVID-19 Vaccination among elderly people through a direct interview and by phone call, using a questionnaire. Results: Among 1373 elderly, 445 (32.41%) had no symptoms, while the remaining 928 (67.54%) had developed symptoms. The commonest symptoms were fever 738 (53.75%), pain at local site 536 (39.01%), and body ache 382 (27.82%). All these symptoms were relieved by taking Paracetamol 650mg tablet provided by the vaccination center. The commonest co-morbidities observed were hypertension, diabetes, and ischemic heart disease. There was no mortality. Conclusion: So far, very few studies have been conducted on the elderly population. Our study has an advantage where it has involved a large number of elderly populations. The majority of the elderly in our study received covishield vaccine. We conclude covishield and covaxin vaccines had minor side effects which were selflimiting and can be considered safe in the elderly population despite having multiple co-morbidities. This study endorses that vaccines are safe in the elderly population irrespective of co-morbidities and increasing age.

Effect of gender on the quality of life among elderly population: A survey report on quality of life among elderly individuals ages 60 years and above residing in Delhi NCR Region

Introduction: The twenty?first century has shown a boost in the geriatric population. Looking at the trends, this group of population is expected to outnumber the other population groups, therefore has become one of the focus points for researchers these days. As the age of an individual increase, due to slowed metabolism and other biological reasons, the physical activity levels and body functioning tends to get affected, thereby also affecting their motor skills. This age group is also an age group which tends to face changes in psychological conditions. The kind of environment which they live in and their social status are also one of contributing factors to such changes in their lives and also how their perception of life and quality of life (QOL). Maintaining a good QOL has therefore become an important issue in the geriatric population so that they can lead a better life until senescence. QOL according to the World Health Organization depends on different factors and has been measured through four domains. The four domains include the physical state, psychological domain, social domain, and environmental domain. Aim: This article aims at studying the effect of the gender of an individual on the QOL, and what steps can be taken to improve the perception of life among the population by improvements in the QOL by assessing all the four domains of a group of 100 individuals, both male and female of 60 years and above through online survey. Materials and Methods: A standardized questionnaire developed by the WHO was adopted to measure the scores obtained by both males and females in the different domains. Data obtained through this survey were tested and validated, and a comparison between the QOL scores of males and females was done using appropriate statistical tests. Results: Results showed no significant difference in the scores of males and females. Conclusion: It was concluded that the gender of an individual does not influence the QOL

Dantha Bhagya Scheme-A Way Forward for People with Edentulism in India

Oral health problems are emerging as one of the major public health concerns. Elderly people have to face many difficulties in utilizing oral health services, especially the below-the-poverty-line population. Taking into Consideration Dantha Bhagya Yojana was launched in Karnataka, for the Below poverty line population as dental services are highly-priced. Databases, media articles, and government official websites providing information regarding Dantha Bhagya Yojana were considered. The scheme aims to provide complete and partial dentures to the senior citizens of Karnataka, belonging to the below poverty line category. The program works under public-private partnership lines and is proving to be helpful to the beneficiaries in Karnataka province. These services are made available in public as well as private dental colleges of Karnataka. The community healthcare workers' role is to identify the edentulous patients and refer them to the nearby dental college for treatment.

Shanghai expert consensus on clinical protocol for traditional Chinese medicine treatment of COVID-19 among the elderly population (second edition) / 中西医结合学报

This document is the revised edition of the previously issued Shanghai Expert Consensus on Clinical Protocol for Traditional Chinese Medicine Treatment of COVID-19 among the Elderly Population. Based on the clinical experience and the Protocol for Diagnosis and Treatment of COVID-19 (Trial 9th Edition), this revised edition provides treatment approaches and recommendations to proactively cope with Omicron variant and increase the therapeutic efficacy for coronavirus disease 2019 among the elderly population in Shanghai, China.

Health literacy and promotion strategies among the elderly populations / 预防医学

Abstract@#The aging process is increasingly accelerating in China, and the improvement of health literacy is a prerequisite to achieving health for all, and is an important strategy to promote healthy aging. Based on recent studies pertaining to health literacy among the elderly, this review, from the perspective of aging, summarizes the level and common influencing factors of health literacy among Chinese elderly populations, and discusses the health literacy promotion strategies among the elderly, so as to provide insights into improving the health literacy surveillance and promotion quality and health literacy levels among the elderly.

Trends in mortality of injury among the elderly in Huzhou City from 2010 to 2020 / 预防医学

Objective@#To investigate the trends in mortality of injury among elderly populations at ages of 60 years and greater in Huzhou City from 2010 to 2020, so as to provide the evidence for proposing preventive and control interventions of injury among the elderly.@*Methods @#The death of injury among registered residents at ages of 60 years and older in Huzhou City from 2010 to 2020 were collected from Zhejiang Provincial Information Management System for Chronic Disease Surveillance. The mortality and main causes of injury were descriptively analyzed among the elderly, and the trends in mortality were analyzed using annual percent change ( APC ).@*Results@#Totally 13 360 deaths occurred due to injury among elderly populations in Huzhou City from 2010 to 2020, and the mortality of injury appeared a tendency towards a rise with years ( APC=3.87%, P<0.05 ). The annual mean mortality and standardized mortality of injury were 199.89/105 and 192.68/105 among elderly populations in Huzhou City from 2010 to 2020. The overall mortality of injury was higher in men than in women during the period from 2010 to 2017, and higher mortality was seen in women than in men in 2020 ( P<0.05 ). The injury mortality in men and in women, and the overall mortality of injury all appeared a tendency towards a rise with ages ( P<0.05 ). The five most common causes of injury included fall ( 82.89/105 ), motor vehicle traffic accidents ( 26.45/105 ), suicide ( 18.52/105 ), drowning ( 16.88/105 ) and shipping accidents except motor vehicle ( 13.77/105 ), which accounted for 79.30% of all deaths due to injury. The mortality of fall in women ( APC=8.87%, P<0.05 ) and the overall mortality of fall ( APC=10.63%, P<0.05 ) both appeared a tendency towards a rise with years.@*Conclusion@#The mortality of injury appeared a tendency towards a rise and increased with ages among the elderly in Huzhou City from 2010 to 2020. Fall is the leading cause of death due to injury among the elderly.

Evaluation of immunogenicity of trivalent split-vinus influenza vaccine among elderly populations / 预防医学

Objective@#To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations.@*Methods@#The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination.@*Results@#There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ).@*Conclusions@#Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.

Association between frailty and lifestyle factors among middle-aged and elderly populations / 预防医学

Objective@#To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations.@*Methods @#Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model.@*Results@#A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years.@*Conclusion@#Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.

Atividade física para idosos: Guia de Atividade Física para a População Brasileira / Physical activity for older adults: Physical Activity Guidelines for the Brazilian Population

Por iniciativa do Ministério da Saúde, em colaboração com pesquisadores nacionais, elaborou-se o primeiro Guia de Atividade Física (AF) para a População Brasileira, incluindo recomendações para as várias fases da vida e populações especiais. O objetivo deste estudo é apresentar o processo me-todológico e os resultados do capítulo de recomendações de AF para idosos. O Grupo de Trabalho Idosos (GT Idosos) contou com a participação de 11 pesquisadores/profissionais que realizaram reuniões virtuais semanais, revisão sistemática de revisões, que incluiu 50 artigos ao final, e escutas com profissionais de Educação Física (n = 143), gestores (n = 17) e com idosos (n = 22), de todas as regiões do país, por meio de entrevistas telefônicas e formulários eletrônicos. Baseado nos resultados da revisão e das escutas, elaborou-se uma primeira versão das recomendações de AF para idosos, que foi submetida à consulta pública. No total foram recebidas 46 sugestões válidas, das quais 34 foram aceitas e incorporadas ao texto final por possuírem relevância técnica e/ou social. Como resultados, o Guia destaca os principais benefícios da AF para idosos, como melhora dos aspectos físicos, mentais e sociais, e recomenda um mínimo de 150 minutos por semana de AF de intensidade moderada, ou 75 minutos de intensidade vigorosa, considerando as AF no tempo livre, no deslocamento, no trabalho/estudo ou nas tarefas domésticas. Acredita-se que o Guia auxiliará os idosos e profissionais de saúde a conhecerem os benefícios da AF, a quantidade recomendada e as diversas possibilidades de prática, por meio de mensagens e exemplos culturalmente apropriados

At the Ministry of Health initiative, in collaboration with national researchers, the first Physical Activity (PA) Guidelines for the Brazilian Population was prepared, including recommendations for the various stages of life and special populations. This study aims to present the methodological process of the chapter on PA recommendations for the elderly. The Elderly Work Group had 11 researchers/professionals who held weekly virtual meetings, made a systematic review of reviews, which included 50 articles, and promoted a listening among elderly (n = 22), managers (n = 17) and professionals (n = 143) from all country regions, through telephone interviews and online forms. Based on the review and the listening results, a first version of the PA Guidelines for the elderly was elaborated, which was submitted to public consultation. Forty-six valid suggestions were received for the Guide's writing, of which 34 were accepted and incorporated into the final text since they had technical and/or social relevance. As results, the Guidelines highlight the major benefits of PA for the elderly, such as enhancement of the physical, mental and social aspects, and recommends a minimum of 150 minutes of moderate PA or 75 minutes of vigorous PA per week, considering PA in leisure time, commuting and domestic activities, as well as in work/study time. It is believed that these Guidelines will help the elderly and health professionals to get to know the benefits of PA, the recommended amount, and the different possibilities of practice through culturally appropriate messages and examples. Politically, it will reinforce the central role of PA in the prevention and control of chronic non-communicable diseases, boosting actions for its dissemination and implantation

Como que as mudanças nas taxas de mortalidade e expectativa de vida afetam a projeção da população idosa no estado de São Paulo? / How do changes in mortality and life expectancy affect the elderly population projection in the state of Sao Paulo, Brazil?

Resumo Introdução O Brasil experimentou, ao longo do século XX, uma profunda mudança em relação à expectativa de vida ao nascer. Nesse processo, foi importante não somente a queda do nível da mortalidade para o grande aumento da expectativa de vida, mas também a mudança no padrão da mortalidade. Recentemente, vêm sendo discutidas mudanças no padrão de mortalidade nas idades mais avançadas, bem como o impacto no envelhecimento populacional. Entretanto, no Brasil, as discussões sobre a longevidade e o comportamento da mortalidade nas idades avançadas ainda são incipientes. Especialistas sugerem que projeções de mortalidade incorporem novas tendências de desaceleração da mortalidade em idades avançadas e explorem abordagens de coortes para suas formulações de tendências. Objetivo Estudar o efeito causado pelas mudanças no comportamento da mortalidade e da expectativa de vida na predição do tamanho da população idosa do estado de São Paulo. Método Método estendido de coortes componentes. Resultados Alterações no nível e no padrão da mortalidade têm um efeito maior na predição da população de 80 anos ou mais em comparação com a população de 60 anos ou mais. Ademais, considerar o gap da expectativa de vida entre os sexos é relevante para determinar o número futuro de idosos. Conclusão Ao utilizar países em diferentes estágios da transição epidemiológica como cenário futuro do padrão e do nível da mortalidade de São Paulo, o método estendido de coortes componentes se torna uma possibilidade metodológica interessante para avaliar o impacto dessas modificações para a projeção da população idosa, podendo ser uma ferramenta para a avaliação de políticas públicas.

Abstract Background Brazil experienced a significant change in life expectancy at birth in the 20th century. In this process, it is important to observe not only the decrease in mortality level and the increase in life expectancy, but also the change in mortality pattern, that is, how mortality occurred and which ages were most impacted. Recently, these changes in the mortality pattern at more advanced ages and their impact on population aging have been discussed more intensively. However, in Brazil, discussions about human longevity and mortality behavior in advanced ages are still incipient. Experts suggest that future studies and mortality projections incorporate new trends in decelerating mortality at advanced ages and explore cohort approaches in their trend formulations. Objective To study the effect of changes in mortality and life expectancy on predicting the elderly population size in the state of Sao Paulo, Brazil. Method Extended cohort-component study. Results Changes in the level and pattern of mortality have a greater effect on the population aged ≥80 compared with that on the population aged ≥60. In addition, considering the life expectancy gap between sexes is relevant to determine the future number of older people. Conclusion The extended cohort component method is an interesting methodological approach to assess the impact of mortality changes on the elderly population projection by using different stages of the epidemiological transition as a future scenario

Effects of nurse-led interRAI-based multidisciplinary team management on body composition and metabolic parameters among elderly patients with metabolic syndrome / 中华临床营养杂志

Objective:To investigate the effects of nurse-led interRAI-based multidisciplinary team management on body composition and metabolic parameters among elderly patients with metabolic syndrome.Methods:100 elderly patients aged 60-74 with the diagnosis of metabolic syndrome were randomized into control group ( n=50) and study group ( n=50). The control group was followed up after routine physical examination. Based on interRAI assessment, the study group received nurse-led individualized intervention which integrated management regarding geriatric internal medicine, clinical nutrition, psychology and physical rehabilitation. This 12-week study measured body composition indexes body protein, body fat mass (BFM), skeletal muscle mass (SMM), body mass index (BMI), waist-to-hip ratio (WHR) and biochemical indexes [triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin (HbA1c)] on the first day and 12 weeks after enrollment and compared those parameters between the two groups. Results:After 12 weeks of intervention, compared with the control group, the study group showed significantly increased body protein [(10.48±2.02) kg vs (9.72±1.65) kg, P=0.043], SMM [(29.61±6.07) kg vs (27.36±4.96) kg, P=0.046], BFM [(17.86±3.42) kg vs (19.64±5.07)kg, P=0.042], WHR (0.88±0.05 vs 0.89±0.03, P=0.021) and TG [(2.31±0.42) mmol/L vs (2.95±0.52) mmol/L, P=0.014]. There was no significant difference in BMI [(25.06±3.41) kg/m 2vs (24.40±2.48) kg/m 2, P=0.272], HDL-C [(0.94±0.10) mmol/L vs (0.91±0.31) mmol/L, P=0.246] and HbA1c [(6.11±0.51)% vs (6.37±0.42)%, P=0.185]. After 12 weeks of intervention, body fat [(17.86±3.42) kg vs (20.71±5.98) kg, P=0.004], WHR (0.88±0.05 vs 0.91±0.05, P=0.001), TG [(2.30±0.42)mmol/L vs (2.75±0.37) mmol/L, P=0.032] and HbA1c [(6.11±0.51) mmol/L vs (6.35±0.63) mmol/L, P=0.015] in the study group were significantly lower compared with baseline and there was no difference in those parameters at baseline and 12 weeks after enrollment in the control group. Conclusion:The nurse-led multidisciplinary management model based on interRAI assessment can effectively improve the body composition and certain metabolic indexes of the elderly with metabolic syndrome.