Discussion on Strategies for Prevention and Treatment of Senile Encephalopathy from Kidney / 世界科学技术-中医药现代化

The principles and methods of prevention and treatment of Chinese medicine for senile encephalopathy are diverse, reflecting the flexibility of syndrome differentiation and treatment. Kidney essence deficiency is one of the main pathogenesis of senile encephalopathy. According to the correlation between brain and kidney, this paper systematically analyzed the strategy of preventing and treating senile encephalopathy based on the theory of "kidney visceral manifestation", in order to provide theoretical basis for guiding clinical treatment.

Changes in Length of Stay for Neurological Geriatric Diseases in Korea between 2003 and 2007

BACKGROUND AND PURPOSE: The elderly population and the prevalence of stroke, dementia, and Parkinson's disease are increasing rapidly in Korea. The aim of this study was to establish the length of stay (LOS) for neurological geriatric diseases, and analyze this parameteraccording to healthcare institutions. METHODS: We used data from the Health Insurance Review and Assessment Service from 2003 to 2007. Nineteen neurological geriatric diseases were classified into four groups: dementia, cerebral hemorrhage, cerebral infarction, and Parkinson's disease. LOS was analyzed according to gender, age, insurance type, disease group, and type of healthcare institution. RESULTS: The LOS for neurological geriatric diseases lengthened from 5,550,193 days (10.8% of the total National Health Insurance admission days) in 2003 to 14,749,671 days (19.7%) in 2007. The mean LOS was 40.8 days in 2003, and lengthened to 71.2 days in 2007. After stratification by disease group, the mean LOS for long-term-care hospitals lengthened by 1.43 times (from 81.7 to 116.6 days) in the cerebral infarction group, 1.35 times (from 85.6 to 115.2 days) in the cerebral hemorrhage group, and 1.28 times (from 82.7 to 105.7 days) in the Parkinson's disease group. CONCLUSIONS: The LOS for neurological geriatric diseases has lengthened markedly, which isdue to an increasesin the number of hospitalized patients and the mean LOS, which have increased most rapidly in long-term-care hospitals. These results may be useful in developing geriatric health policies.

The Factors Associated with the Selection of a Regular Doctor

BACKGROUND: The rapid increase in population of old people has been emphasized as a serious social problem even in medical world. Geriatric disease has special characters that can be mentioned as a non-contagious chronic degenerative disease. 'Regular Doctor System' can be considered as one of the efficient ways to care for it continuously. The purpose of this study was to promote the introduction of family doctor system gradually and care of geriatric disease through examination of old people's thinking about 'Regular Doctor System'. METHODS: The result of this study was based on the questionnaire survey on 292 old people(aged 65 and more, response rate 73%) at 2 welfare centers in Seoul, located at Yeongdeungpo-gu and Guro-gu, and 1 college for old people, for 2 weeks from May, 2003. The contents of surveywere consisted of many questions for understanding of old people's thinking about 'Regular Doctor System'. The response method was self-reported. RESULTS: Comparing with other age group surveys, this old people's survey has special character that it has higher affirmative answer rate for the question of 'Do you have a regular doctor?'. The old people's favorite natures of regular doctor were considerateness( 26.9%) and kindness(26.2%). And the most desirable service from their regular doctor was comprehensive health examination( 45.2%). The factors reflecting on selecting of doctor were separately questioned into two aspects, as factors related to doctor's behavior and the others. Among the factors related to doctor's behavior, the effect of medical treatment(22.7%) was top ranked and 'being aware of my disease'(17.3%), 'easy explanation'(15.5%) were followed. The other factors were medical specialty(24,1%), easy access(19.3%) and short waiting time(10.5%). The reasons for changing of doctor were 'to receive specialist's medical treatment'( 37.2%), 'no improvement of patient's condition'(13.1%) and 'distrust of diagnosis'(9.0%). CONCLUSION: The old people wanted considerate and kind attitude from their doctors. The factors, related to doctor's behavior that the old people wanted, were 'good effect of medical treatment', 'being aware of my disease well' and 'easy explanation'. The other factors they wanted were medical specialty, easy accessibility and short waiting time.

The Screening of Middle-aged and Geriatric Diseases for 2,021 Residents over 39 Years of Age in Hwasun County, Korea / 대한내과학회지

OBJECTIVE: Middle-aged and geriatric diseases are becoming prevalent in developing countries and some industrialized nations. The present study was undertaken to determine the prevalence of middle-aged and geriatric diseases in Hwasun County, a rural area of Korea, and to examine the correlation between them and various clinical parameters. METHODS: Population-based cross-sectional study by random cluster sampling of registered residents over 39 years of age was performed. Out of the 3,138 subjects scheduled for the survey, 2,021 residents (male 812, female 1,209) underwent the actual examinations (response rate:64.4%). We examined their weight, height, blood pressure, diet pattern, past and family history, alcohol-drinking and smoking history, and various laboratory parameters. RESULTS: The mean body mass index (BMI) was 22.8+/-3.8. In BMI criteria, the crude prevalence of obesity was found to be 24.6% (grade I obesity; 22.9%, grade II obesity; 1.7%). We found the increasing hypertension, diabetes mellitus, hypercholesterolemia as BMI increased. Overall crude prevalence was 21.4% for hypertension defined as BP (blood pressure) > or =140/90 mmHg or subject on medication, and 16.1% for BP > or =160/100 mmHg or subject on medication. The crude prevalence of diabetes mellitus, hypercholesterolemia, alcoholic liver disease, ischemic heart disease diagnosed by electrocardiography were 6.2%, 6.0%, 4.4%, and 2.3%, respectively. These prevalence were found to be relatively lower than those of reported elsewhere in the world. CONCLUSION: These data indicate that middle-aged and geriatric diseases in the rural area of korea are becoming prevalent, although they are less prevalent than in the urban area or advanced countries. We hope that the present study contributes to understand the prevalence of middle-aged and geriatric diseases in the rural area of Korea, and to prevent and control them adequately.

Geriatric Diseases and Medical Service for the Aged in Korea

There has been growing concern over potential health problems and medical care needs of the aged in Korea. The increasing aged population requires more medical services, especially in medical services for chronic diseases and disabilities. The proportion of the aged population to the whole shows an apparent increasing trend, from 3.2 % in 1960 to 5.0 % in 1990, and is expected to reach 6.8 % in the year 2000 and 12.5 % in 2020, forecasting that Korea will indeed enter the era of an aging society in the early 21st century. In Korea, geriatric diseases have the characteristic structure having multiple entities. The most common medical problem is arthralgia(with 57.8 % of 65 and older). Second is chronic back pain and the third is diseases of digestive system. There are three kinds of medical care programs for the aged : medical insurance, medical assistance, and health screening. Korea is making efforts to improve medical services in order to cope with not only the demand for health care but also the quality of life of the aged.