Introduction

Heart Failure (HF) is a major source of morbidity and mortality worldwide.In the United States,five million people carry this diagnosis.It accounts for in excess of one million hospitalizations and costs approximately $30 billion to treat. The elderly population is particularly affected since more than 80% of those hospitalized for HF are over age 65 years. Despite the development of evidence-based therapy and guidelines in the management of chronic HF for use by physicians and other health care providers,the mortality remains high. Heart failure in the geriatric population is particularly     

1340例老年人生存质量及影响因素的调查分析

目的 调查山西省长治市老年人生存质量,分析其影响因素.方法 采用基本情况调查表、SF-36生存质量量表和自理能力量表和社区健康服务量表对长治市1340例老年人的生存质量、自理能力及社区健康服务现状进行调查,并对结果进行相关分析和逐步回归分析.结果 共发放问卷1340份,有效问卷1328份(99.1%).根据老年人生存质量划分标准,生存质量处于中等(72.1～117.0分)1308例(98.5%).影响老年人群生存质量的主要因素是自理能力、健康状况、文化程度、经济收入和医疗支付形式;老年人对健康宣教、定期体检的需求高,老年人生存质量与社区健康服务需求情况呈负相关(P＜0.05).生存质量与社区提供健康服务情况呈正相关(P＜0.05).结论 长治市老年人生存质量总体处于中等水平,老年人社区健康服务需求与社区实际提供服务情况存在较大差距.

Abstract：

Objective To investigate the status of life quality in the elderly in Shanxi Province Changzhi City, and to analyze its influencing factors. Methods The quality of life, activities of daily living and status of community services were measured simultaneously by 36-Item Short Form Health Survey (SF-36). Activities of Daily Living Scale, Community Healthy Needs Scale and survey results were used and analyzed using t-test, correlation and stepwise regression analysis. Results According to the criterion of life quality in the elderly which were proposed by Zhang Lei, the quality of life in the elderly scored 72. 1-117.0, reached 98.5%. The quality of life in the elderly was impacted by the ability of caring oneself, marital status, degree of culture, economic situation and so on. The demand rate for health guidance and periodic physical examination was higher. Conclusions The quality of life in the elderly is at a medium level. There is a wide gap between the demand of community healthy services and the utilization of community healthy services.     

Application value of CT perfusion imaging with acetazolamide challenge test in the diagnosis of chronic cerebral insufficiency

<正>Objective To explore the CT perfusion imaging with acetazolamide(ACZ)challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT     

老年人消化性溃疡出血的相关危险因素分析

Objective To explore the risk factors for peptic ulcer bleeding in elderly patients.Methods The 414 patients with upper gastrointestinal ulcer bleeding in Xuanwu Hospital from January 2001 to January 2006 were enrolled.The patients were divided into elderly group (≥ 60years,n= 183 ) and non-elderly group ( ＜ 60 years,n= 231 ).The coexisting diseases and hemorrhage causes were compared and analyzed.Results The detection rate of coexisting diseases was significantly higher in elderly group than in non-elderly group (68.9% vs.10.0% ).The hemorrhage causes included the taking of drugs for cardiovascular and cerebrovascular diseases or osteoarthropathy in elderly group.And the fatigue,stress and dietary upset were the main causes in non-elderly group.Helicobacter pylori infection rate was 35.0% in the elderly and 58.0% in young patients.Conclusions It is very important to promote rational use of anticoagulant drugs and analgesic agents in elderly patients for managing peptic ulcer complication.     

老年人消化性溃疡出血的相关危险因素分析

Objective To explore the risk factors for peptic ulcer bleeding in elderly patients.Methods The 414 patients with upper gastrointestinal ulcer bleeding in Xuanwu Hospital from January 2001 to January 2006 were enrolled.The patients were divided into elderly group (≥ 60years,n= 183 ) and non-elderly group ( ＜ 60 years,n= 231 ).The coexisting diseases and hemorrhage causes were compared and analyzed.Results The detection rate of coexisting diseases was significantly higher in elderly group than in non-elderly group (68.9% vs.10.0% ).The hemorrhage causes included the taking of drugs for cardiovascular and cerebrovascular diseases or osteoarthropathy in elderly group.And the fatigue,stress and dietary upset were the main causes in non-elderly group.Helicobacter pylori infection rate was 35.0% in the elderly and 58.0% in young patients.Conclusions It is very important to promote rational use of anticoagulant drugs and analgesic agents in elderly patients for managing peptic ulcer complication.     

Gastrointestinal symptoms in a Japanese population： A health diary study

AIM： To investigate the incidence of gastrointestinal symptoms and the nature of consequent utilization of health care services in a Japanese population.
METHODS： Using self-report, we conducted a prospective cohort study of a nationally representative sample of the Japanese population over a one-month period to determine the incidence of gastrointestinal symptoms of all kinds and resultant health care utilization. Both information on visits to physicians and use of complementary and alternative medicine therapies were collected. RESULTS： From a total of 3568 in the recruitment sample, 3477 participants completed a health diary （response rate 97%）. The data of 112 participants with baseline active gastrointestinal diseases were excluded from the analysis, leaving 3365 participants in the study. The incidence of gastrointestinal symptoms was 250 and the mean number of symptomatic episodes was 0.66 in a month. Abdominal pain, diarrhea, nausea, constipation and dyspepsia were the most frequent symptoms. Female gender, younger age, and low baseline quality of life were risk factors for developing these symptoms. The participants were more likely to treat themselves, using dietary, complementary or alternative medicines, than to visit physicians, except in the case of vomiting.
CONCLUSION： Gastrointestinal symptoms are common in the Japanese population, with an inddence of 25%. Abdominal pain, diarrhea, nausea, constipation and dyspepsia are the most frequent symptoms. Risk factors for developing these symptoms include female gender, younger age, and low baseline quality of life.     

Long-term follow-up study of moderate chronic obstructive pulmonary disease in elderly patients

Objective To investigate the prognosis of moderate chronic obstructive pulmonary disease (COPD) in the elderly patients, and to evaluate the factors for long term survival. Methods From May 1993,a prospective cohort study was carried out,in which 191 elderly patients with moderate COPD were recruited in Shougang communities, Shijingshan District, Beijing. The general health     

Helicobacter pylori infection in older people

Since the discovery of Helicobacter pylori(H.pylori)infection as the major cause of gastroduodenal disorders three decades ago,H.pylori has been the focus of active research and debate in the scientific community.Its linkage to several diseases,such as peptic ulcer disease,gastritis and gastric malignancy is incontestable.In particular,it has been noticed that,as the aged population is increasing worldwide,older people are at increased risk of developing several gastroduodenal diseases and related complications.At the same time,gastric cancer is definitely more frequent in elderly than in adult and young people.In addition,it has been showed that peptic ulcer and related complications occur much more commonly in aged individuals than in young people,resulting in a significantly higher mortality.Although this infection plays a crucial role in gastrointestinal disorders affecting all age groups and in particular older people,only a few studies have been published regarding the latter.This article presents an overview of the epidemiology,diagnosis,clinical manifestations and therapy of H.pylori infection in elderly people.     

Comparisons of the prevalence and correlation factors of chronic kidney disease between the old urban and rural residents in Minhang district of Shanghai

正Objective To compare the prevalence and correlation factors of chronic kidney disease(CKD)in urban and rural areas in Minhang district of Shanghai through the social economic and clinical data of the elderly population.Methods Jiangchuan Street and Pujiang town were randomly selected to prepresent the urban and rural population in Minhang district of Shanghai,respectively.Based on the over-60-year old people health examination     

河北省燕郊社区717名老年人慢性病现况调查

目的 了解影响三河市开发区老年人健康状况的几种常见慢性病的现况，为开展社区老年卫生服务提供依据。方法 采用整群抽样方法对河北省燕郊年龄≥60岁717名老年人进行问卷调查。结果 老年人慢性病总患病率为92．1％，其中男性患病率91．2％，女性93．0％，两者差异无显著性。70．0％的老年人同时患有2种及以上慢性病。患病率位于前5位的病种依次是高血压(46．2％)、心脏病(26．9％)、骨关节炎或风湿性关节炎(21．9％)、口腔与牙病(16．2％)、颈椎病(16．0％)。文化程度、离退休前职业、医疗保障、居住状况、是否经常主动获得医疗保健知识、支付医疗保健费用有无困难是影响老年人患多种慢性病的因素。结论 慢性病是危害老年人健康的主要卫生问题，应充分考虑老年人疾病谱的特点，开展有针对性的社区卫生服务，提高老年人健康水平。     

三河市开发区老年人健康状况的多维评价

目的：对老年人躯体健康、日常生活功能、精神健康、健康自评状况以及主要影响因素进行调查，以了解影响老年人健康的主要卫生问题。方法：采用整群抽样方法对三河市开发区717名60岁及以上老年人进行问卷调查。结果：老年人两周患病率为56．3％，慢性病患病率为92.1％，其中70．0％的老年人同时患有两种及以上慢性疾病，残疾率18％；日常生活活动能力(ADL)和工具性日常生活活动能力(IADL)受损率为1．8％和7．0％；生活满意度指数(LSIA)平均记分29分，21分及以上者占87．1％；健康自评不好的老年人占9.3％，63.1％的老年人认为健康问题对于日常想做事情没有影响；目前工作状况、慢性病指数、症状指数、高血压、LSIA是影响老年人健康自评的主要因素。结论：三河开发区老年人慢性病患病率高，日常生活功能受损率低，生活满意度高，健康自评状况较好。有必要针对不同情况采取不同的社区干预措施，以提高老年人整体健康水平。     

福州城市社区老年人抑郁状况及与生活质量的关系

目的 了解福州城市社区老年人的抑郁状况及其与生活质量的关系.方法 采用分层随机抽样方法,应用老年抑郁量表(GDS)和SF-36健康调查简表对福州市12个社区共3285例≥60岁的老年人进行问卷调查.结果 福州城市社区老年人抑郁症状者1981例,发生率为60.3％,老年女性抑郁症状发生率高于男性(x2=7.561,P＜0...     

长沙市城乡老年人日常生活能力调查

目的 调查长沙市城乡老年人日常生活能力损害情况,分析其影响因素.方法 采用问卷调查法,对2339名60～91岁的老年人进行日常生活能力调查,分析其性别、年龄、婚姻状况、家庭结构、教育程度、职业、常见慢性病、医疗保健意识对老年人日常生活能力的影响.结果 躯体生活自理能力中,损害率最高的是定时上厕所(18.2%),工具性日常生活能力损害率最高的是购物(26.3%).年龄、丧偶、独居、患病、医疗保健意识缺乏是影响日常生活能力的主要因素.结论 日常生活能力是反映老年人健康状况的重要指标,对高龄、丧偶、独居、患有多种慢性疾病、医疗保健意识缺乏者等老年高危人群应加强健康教育和老年保健,提高其生活质量.     

北京市太阳宫、香河园地区老年居民健康状况及卫生服务需求调查

目的了解北京市太阳宫、香河园地区老年人群的健康状况及卫生服务需求,为进一步工作提供信息。方法自行设计问卷对相关辖区内做免费体检的60岁以上老年人进行问卷调查。结果老年人对健康自我评价为一般和差的比例分别为76.5%和7.2%。老年人慢性病患病率达74.6%,其中患有两种及以上慢性病老年人达38.0%。老年人对健康体检的需求为72.4%,对健康指导、上门医疗及家庭病床的需求分别为45.5%,35.2%及21.2%,并且不同年龄、不同文化程度的老年人需求不同。结论慢性病已成为这两个地区的主要健康问题,今后应加强做好防控工作。应针对老年人群的不同需求,开展多种形式与层次的服务。     

运用慢性病管理模式在社区开展糖尿病前期健康教育的体会

随着人口老龄化速度的加剧以及老年人群慢性病的患病率的增长,卫生保健系统在对慢性病患者组织管理与卫生保健服务的提供方面显得力不从心。这些问题引起了学术界的广泛关注与探索,在此背景下,一套由六大领域构成的完善的慢性病管理模式诞生了,鉴于国内对慢性病管理模式的报道较少以及我们在利用慢性病管理模式的核心元素在社区慢性病管理方面取得的一些成功,考虑到对我国的慢性病的管理具有一定的借鉴,本文将对慢性病管理模式的理论体系以及我们在社区开展糖尿病（前期）健康教育的一些成功的经验进行介绍。     

湖南省中老年人健康素养影响因素的有序Logistic回归分析

目的 探讨湖南省中老年人健康素养的影响因素. 方法采用多阶段抽样方法抽取湖南省6个居委会或行政村45岁及以上的居民,用中国健康教育中心编制的中国居民健康素养调查问卷,以面对面询问的方式进行入户调查,通过单因素和有序Logistic回归(Ordinal回归)分析,探讨湖南省中老年人健康素养的影响因素. 结果共调查1158...     

Factors associated with municipality officers' recognition of relief for elderly life in each municipalities: the community health care white paper survey

To elucidate the present condition about health, medicine and welfare, and to evaluate factors associated with relief for elderly life in each community, a questionnaire survey was conducted among officers of all the municipalities in Japan. We asked officers about their recognition whether older people can live feeling relieved or not, and other factors about health, medicine and welfare condition in each municipality. Demographic data of each municipality were also used as dependent variables. Odds ratios and their 95% confidence intervals for the officers' evaluation of relief for life of the elderly were calculated using unconditional logistic models. Of the 3.252 municipalities, 3,059 (94%) responded to the survey. Of the respondents, 2,957 municipalities (91%) answered questions about relief for elderly life. "Receiving satisfactory medical home care service", "cooperative function between medicine, health, and welfare sections", and "receiving complete welfare service" were associated with their recognition about relief for elderly life in both of cities and rural towns. In addition, "the rate of elderly households" and "the easiness to maintain nursing staff" were associated in the cities. This study indicated that more arrangements are needed not only about health and welfare aspects, but also about medical service, especially medical home care service systems to support older peoples' life in the community.     

Gender and rural-urban differences in reported health status by older people in Bangladesh

The study aims to (i) describe regional variation and gender differences in health status of older people (60 years and older) in Bangladesh, indicated by self-reported health problems and functional ability; (ii) explore influence of socio-economic factors on health status of older people. In a cross-sectional study in rural and urban Bangladesh, 696 older persons were asked about their health problems and ability to manage activities of daily living (ADL). More than 95% of older people reported health problems. Approximately 80% of elderly women in both the regions reported having four or more health problems compared with 42% and 63% elderly men in the urban and rural regions, respectively. More women (urban: 55%; rural: 36%) than men (urban: 32%; rural: 22%) also reported difficulties with ADL. Irrespective of age, sex and area of residence, those reporting greater number of health problems were more likely to report difficulty with at least one ADL task. Reporting pattern of specific health problems varied between urban and rural regions. Socio-economic indicators were found to have little influence on reporting of health problems, particularly in the rural region. Observed regional difference may be related to the influence of social and environmental factors, and level of awareness concerning certain health conditions.     

结合慢病防治开展老年人艾滋病健康教育模式效果分析

目的了解南宁城区老年人艾滋病知识知晓率,探讨老年人艾滋病健康教育的有效模式。方法在南宁市西乡塘区8个街道办,随机抽取1个社区的≥50岁老年人为对象,以知情、自愿为原则,进行血脂4项免费检查,吸引老年人参与包含艾滋病健康教育的讲座,面对面咨询。以问卷调查评估健康教育模式的效果。结果活动结束后,老年人艾滋病知识知晓率从65．1％（215／292）提高至91．9％（361／395）,健康教育前后差异有统计学意义（χ2=76．976,P=0．000）;老年人在性行为中使用安全套意愿从健康教育前的19．18％（56／292）提高到健康教育后的91．39％（351／395）,差异有统计学意义（χ2=2328．38,P=0．000）。结论结合慢病防治开展艾滋病健康教育讲座、面对面咨询的老年人艾滋病健康教育模式可行,有效提高了老年人艾滋病防控知识知晓率,促进了高危行为的改变。