Health Needs of the Elderly in Long-term Care Facilities: Using RAI-MDS-FC

PURPOSE: This study was to identify health needs of the elderly at nursing homes by long-term care grade. METHODS: The health needs of 116 elders at two nursing homes in Seoul were measured with resident assessment protocols (RAPs), activities of daily living (ADL), and cognitive performance scale (CPS), and pain and depression were measured by resident assessment instrument (RAI). RESULTS: With regard to RAPs, 11 out of 18 items had different distribution in the 3 groups significantly. The 1st-grade elders had a higher percentage of 9 items than the 2nd- and 3rd-grade ones but the 3rd-grade ones had the highest health needs related with activity. The 2nd-grade elders had similar health needs to the 1st-grade ones. In terms of functional level, the 1st-grade elders had the highest percentage of CPS and ADL but the 3rd-grade ones had the highest score of pain and depression out of the 3 groups. The standardized assessment instrument to identify specific health needs by the 3 groups should be developed. Therefore, care plans to meet health needs of the 3 groups will be made. CONCLUSION: It is suggested that nursing care is required to the elderly of the 1st- and 2nd-grade and safe activity and environment to the 3rd-graded ones.

Determinants of Limb-Bone Mineral Density in Healthy Men and Women Aged over 50 in Rural Area / 대한내분비학회지

BACKGROUND: Many studies have shown a strong inverse relationship between the bone mineral density (BMD) and osteoporotic fractures, with a doubling in the incidence of fractures for each standard deviation reduction in the BMD. Newer peripheral densitometry devices have recently been developed, with the advantages of a low cost and increased portability. In addition, studies focusing on the osteoporosis of rural populations are rare. The authors assessed the factors related with the BMD in rural areas, using peripheral bone densitometry. METHODS: 23 men (68.4+/-9.2[mean age+/-SD] years) and 32 women (63.9+/-8.3 years), living in rural areas, voluntarily participated in this community-based study. The BMD of the distal radius (BMDr) and calcaneus (BMDc) were measured using peripheral dual-energy X-ray absorptiometry. The BMI, waist to hip ratio, body composition, blood pressure, lipids, fasting glucose and insulin were measured. The sociodemographic characteristics and physical activities were investigated using questionnaires. RESULTS: 21.7% of the men and 34.4% of the women were diagnosed with osteoporosis according to the WHO definition. The BMDr and BMDc were 0.46+/-0.08 and 0.46+/-0.11 and 0.34+/-0.07 and 0.33+/-0.08g/cm2 in the men and women, respectively. In the men, age, BMI, physical activity and smoking were correlated with the BMDr, and age, lean body mass, physical activity, TV watching and smoking with the BMDc. In the women, age, weight and lean body mass were correlated with the BMDr, and age, weight, BMI, waist circumference, fat mass, lean body mass and year since menopause with the BMDc. From a multiple regression analysis, age and smoking in men, and year since menopause and lean body mass in women, respectively, had independent effects on the BMD. CONCLUSION: In the rural community studied, osteoporosis was as highly prevalent as in urban communities. Of the determinants for the BMD, smoking for men, and lean body mass for women, were modifiable factors. Education for quitting smoking in men, and maintenance of optimal weight in women, are required to prevent osteoporosis in rural areas.