Developing anautomatic scale to delirium detection based on the electronic medical record system / 医学研究生学报

ObjectiveAt present, there are many bedside tools for delirium, but these manual tools are time-consuming and poor feasible. The aim of this study was to establish a delirium screening scale, automatically extracting keywords from electronic medical records (EMR).MethodsWe selected electronic medical records of 779 elderly hospitalized patients in West China Hospital of Sichuan University from 2015 to 2017. Then, R software was used to automatically extract keywords to form a database undercritical ration, correlation coefficient and different analysis methods. Finally, the Delphi method and Analytic Hierarchy Process Weight were carried out to the construct weight coefficient, so as to form the formal scale.ResultsIn the study, we developed a formal scale consisting of 59 items and 11 dimensions. The score of the scale ranged from 0 to 53.4, with a mean value of 6.64, skewness of 2.6 and kurtosis of 8.2.ConclusionThe delirium screening scale based on the EMR can improve the recognition rate of delirium through intelligent and automatic warning, so as to early diagnosis and timely intervention of delirium.

Association between sleep quality and arterial blood pressure among Chinese nonagenarians/centenarians.

BACKGROUND: There is association between sleep quality and arterial blood pressure, but it is still unclear if the association also exists in the very elderly. We examined the individual association between sleep quality and arterial blood pressure among the very elderly. MATERIAL/METHODS: The present study analyzed data from a survey that was conducted on all residents aged 90 years or older in a district with 2,311,709 inhabitants in 2005. Sleep quality was measured using The Pittsburgh Sleep Quality Index (PSQI). RESULTS: The subjects included in the statistical analysis were 216 men and 444 women. There were no significant differences in sleep quality scores, sleep latency, and sleep efficiency percentage and prevalence of poor sleep quality between subjects with and without hypertension. None of the differences in systolic blood pressure, diastolic blood pressure, and prevalence of hypertension, systolic hypertension and diastolic hypertension among subjects with well, fairly and poor sleep quality were significant. Multiple logistic regressions showed that unadjusted and adjusted Odds Ratio (ORs) of poor sleep quality for increased risk for hypertension were significant. CONCLUSIONS: Among very elderly subjects, there was no association between sleep quality and arterial blood pressure.

Cognitive impairment and depression among Chinese nonagenarians/centenarians.

PURPOSE: In this study, we explored the association between cognitive impairment and depression in the very elderly using a sample aged 90-108 years. METHODS: A cross-sectional study. RESULTS: The sample included 682 unrelated Chinese nonagenarians/centenarians (67.25% women, mean age of 93.49 years). The mean depression score (measured with the brief 23-item Geriatrics Depression Scale-Chinese Edition was 8.45 (standard deviation [SD] = 3.30). The mean of cognitive function scores (measured with the 30-item Mini-Mental State Examination) was 15.54 (SD = 5.38). There was no significant difference in cognitive function scores between subjects with and without depression, and there was also no significant difference in depression scores between subjects with and without cognitive impairment. There was also no significant difference in the frequency of depression between subjects with and without cognitive impairment or in the frequency of cognitive impairment between subjects with and without depression. Both the odds ratio (OR) of depression (as a function of increased cognitive impairment) and the OR of cognitive impairment (as a function of increased depression) were found to be insignificant. Pearson Correlation also showed no significant correlation between depression scores and cognitive function scores. CONCLUSIONS: In summary, we found that depression was not directly correlated with cognitive impairment in Chinese nonagenarians and centenarians.

Health status and risk for depression among the elderly: a meta-analysis of published literature.

OBJECTIVE: the goal of this study was to determine the relationship between health status, including self-rated health status and chronic disease, and risk for depression among the elderly. METHOD: MEDLINE, EMBASE and The Cochrane Library Database were used to identify potential studies. The studies were classified into cross-sectional and longitudinal subsets. For each study, the numbers of the total participants, cases (for cross-sectional study) or incident cases (for longitudinal study) of depression in each health status group were extracted and entered into Review Manager 4.2. The quantitative meta-analysis of cross-sectional studies and that of longitudinal studies were performed, respectively. For prevalence and incidence rates of depression, odds risk and relative risk (RR) were calculated, respectively. RESULTS: the quantitative meta-analysis showed that, compared with the elderly without chronic disease, those with chronic disease had higher risk for depression (RR: 1.53, 95% confidence intervals (CI): 1.20-1.97). Compared with the elderly with good self-rated health, those with poor self-rated health had higher risk for depression (RR: 2.40, 95% CI: 1.94-2.97). CONCLUSIONS: despite the methodological limitations of this meta-analysis, both poor self-rated health status and the presence of chronic disease are risk factors for depression among the elderly. In the elderly, poor self-reported health status appears to be more strongly associated with depression than the presence of chronic disease.

Pro12Ala polymorphism in PPARgamma2 associated with depression in Chinese nonagenarians/centenarians.

BACKGROUND AND AIMS: The Pro12Ala polymorphism of peroxisome proliferator-activated receptor-gamma (PPARgamma) has been associated with decreased obesity, insulin resistance, type 2 diabetes and other age-associated diseases such as cognitive impairment, hypertension, cancer, osteoarthritis. Each one of these diseases had been linked to depression. Moreover, there is also an association between Pro12 Ala polymorphism in PPAR gamma2 and longevity. The aim of the study was to evaluate the association between Pro12 Ala polymorphism and depression in Chinese nonagenarians and centenarians. METHODS: The sample included 697 unrelated Chinese nonagenarians/centenarians (aged between 90-108 years, mean age: 93.5+/-3.35 years; 67.2% women). The Pro12Ala variant was examined using polymerase chain reaction-restriction fragment length polymorphism. Depression was measured with brief 23-item Geriatrics Depression Scale Chinese-edition (GDS-CD). RESULTS: In this sample, the genotype frequencies of the Pro12Ala polymorphism were 0% Ala12Ala, 9.2% Pro12Ala, 90.8% Pro12Pro and the prevalence of depression was 25.3%. Subjects who were 12Ala carriers had significantly lower prevalence of depression than those who were not 12Ala carriers (14.06 vs. 26.38%, p=0.034). Subjects without depression also had a higher frequency of 12Ala gene than those with depression (5.28 vs. 2.56%, p=0.031). Adjusting for certain clinical factors that may be associated with depression or with 12Ala carriers, multiple logistic regressions showed the 12Ala gene was associated with decreased incidence of depression. CONCLUSIONS: In summary, we found that among Chinese nonagenarians and centenarians, the Pro12Ala polymorphism in PPARgamma2 was associated with depression and that the 12Ala gene may be a factor for decreased depression.