武汉市某医院老年慢性阻塞性肺疾病住院患者发生衰弱现状及影响因素分析

目的 调查老年慢性阻塞性肺疾病(COPD)住院患者发生衰弱现状,并分析其影响因素。方法 采用便利抽样法选取2021年1月至2022年12月华润武钢总医院住院的260例老年COPD住院患者为研究对象。采用自制一般资料问卷对患者开展调查,使用临床衰弱量表对患者的衰弱状况进行评估,检测血红蛋白、25-羟基维生素D(25-OH-D)、白细胞介素-6(IL-6)水平,采用单因素及多因素logistic回归分析老年COPD住院患者发生衰弱的影响因素。采用SPSS 25.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。结果 本研究共发出调查问券260份,收回260份(100.00%),其中发生衰弱患者67例(25.77%)。性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度和肺功能是老年COPD住院患者发生衰弱的影响因素(P<0.05);衰弱组患者的血红蛋白、25-OH-D水平显著低于未衰弱组,IL-6水平显著高于为衰弱组,差异有统计学意义(P＜0.05);根据logistic回归分析得知性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度、肺功能、血红蛋白低表达、25-OH-D低表达、IL-6高表达是老年COPD住院患者发生衰弱的危险因素(OR＝3.174,1.556,3.162,1.735,2.649,5.089,2.162,1.314,1.974,2.173;P＜0.05)。结论 武汉市某医院老年COPD住院患者衰弱的发生率较高,性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度、肺功能、血红蛋白、25-OH-D、IL-6水平均有影响,临床上应进行合理的干预,从而减少衰弱的发生。     

老年心力衰竭住院患者发生衰弱的影响因素分析

目的 探讨老年心力衰竭（心衰）患者发生衰弱的影响因素。方法 选取2019年1月至2020年1月于华北理工大学附属医院住院的老年心衰患者201例。依据Frail衰弱评估方法将患者分为非衰弱组（153例）和衰弱组（48例）。比较两组患者的临床资料,并采用多因素Logistic回归分析老年心力衰竭患者发生衰弱的影响因素。结果 入选201例的患者中,合并衰弱的患者48例。与非衰弱组比较,衰弱组的心衰患者年龄大、住院天数长、合并症多、营养状态较差、心脏功能差（P均<0.05）。Logistic回归分析后发现年龄（OR=1.104,95%CI:1.031～1.183,P=0.005）、住院天数（OR=1.135,95%CI:1.051～1.249,P=0.049）、血红蛋白（OR=0.918,95%CI:0.881～0.958,P<0.001）、白蛋白（OR=0.829,95%CI:0.686～1.001,P=0.049）、N末端脑钠肽前体（NT-proBNP）(OR=1.003,95%CI:1.002～1.004,P<0.001)、左房内径（OR=1.138,95%CI:1.0...     

老年冠心病介入治疗患者衰弱发生情况调查及其影响因素分析

目的 探讨老年冠心病介入治疗患者衰弱发生情况及其影响因素。方法 以方便抽样方式选择2019年1月至2021年11月在本院行PCI手术治疗的124例老年冠心病患者为研究对象。分析老年冠心病介入治疗患者衰弱发生情况及其影响因素。结果 124例老年冠心病介入治疗患者中出现衰弱100例（80.65%）,无衰弱24例（19.35%）;单因素分析显示：年龄、家庭人均月收入、文化程度、合并症种类数、医疗费用方式、心功能分级与老年冠心病介入治疗患者衰弱有关,差异有统计学意义（P<0.05）;性别、病变血管数、婚姻状况、放入支架数量、饮酒史、吸烟史、手术时间与老年冠心病介入治疗患者衰弱无关,差异无统计学意义（P>0.05）;多因素分析显示：年龄≥75岁（β=1.057,OR=2.878,95%CI=1.127-7.350）、家庭人均月收入<3000元（β=1.322,OR=3.750,95%CI=1.419-9.910）、文化程度初中及以下（β=3.000,OR=20.077,95%CI=6.734-59.857）、合并症种类数≥3种（β=1.551,OR=4.714,95%CI=1....     

老年维持性血液透析患者衰弱的危险因素分析

【摘要】目的 调查老年维持性血液透析（maintenance hemodialysis,MHD）患者衰弱发生情况并分析其相关因素。方法 采用横断面研究 纳入2021年10月~2022年4月在安徽医科大学第二附属医院住院及门诊行MHD治疗的130例老年患者,收集患者一般资料、实验室指标、人体学指标,采用Fried衰弱表型量表评估患者衰弱状况。比较两组患者一般资料、实验室指标、跌倒风险、日常生活活动能力、营养状况得分及人体测量指标的差异。采用SPSS26.0统计软件进行数据分析。根据数据类型,组间比较分别采用X2检验,独立样本T检验及秩和检验。采用偏相关分析评估衰弱评分与各指标的相关性,多因素Logistic逐步回归分析探索老年MHD患者衰弱的相关因素。结果130例老年MHD患者衰弱发生率为40%,相关性分析显示衰弱与营养不良-炎症得分（malnutrition-inflammation score,MIS ）（r＝0.521,P＜0.001）、跌倒评估（r＝0.330,P＜0.001）、C反应蛋白（r＝0.236,P＝0.012）呈显著正相关,与Barthel 指数（Barthel index, BI）（r＝-0.424,P＜0.001）、中臂肌围（r＝-0.438,P＜0.001）、血清白蛋白（r＝-0.478,P＜0.001）、血红蛋白（r＝-0.332,P＜0.001）呈负相关。多因素Logistic 逐步回归分析显示：MIS评分、血清白蛋白水平、BI、年龄是MHD患者发生衰弱的相关因素。（MIS评分:OR＝1.156,95%CI：1.002~1.333,P＝0.047;白蛋白：OR＝0.851,95%CI ：0.687~0.931,P＝0.013;BI：OR＝0.972,95%CI ： 0.947~0.988,P＝0.032;年龄：OR＝1.107,95%CI ：1.018~1.204,P＝0.017）。结论 衰弱在老年MHD患者中发生率高,跌倒风险、营养不良炎症评分、CRP水平与老年MHD患者衰弱得分呈正相关,而日常生活能力、Hb、Alb、MAMC与衰弱得分呈负相关,其中MIS评分、血清白蛋白水平、BI、年龄是衰弱发生的相关因素。     

老年男性慢阻肺患者骨质疏松相关危险因素分析

目的通过检测老年男性慢性阻塞性肺疾病(COPD)患者外周血甲状旁腺素(PTH)、骨钙素(OC)及25-羟维生素D3(25-OH-D3)水平,探讨老年男性COPD患者骨代谢的变化,并分析其发生骨质疏松及骨量减少的相关危险因素。方法纳入首都医科大学附属北京友谊医院轻中度老年男性COPD患者68例,重度极重度老年男性COPD患者37例,老年男性对照组55例,完善肺功能及骨密度检查,并使用全自动电化学发光分析仪检测外周血PTH、OC及(25-OH-D3)水平。结果①老年男性COPD患者出现骨量减少及骨质疏松的患病率为38.1%,高于正常对照组(P0.05);②正常对照组、轻中度COPD组及重度极重度COPD组三组间外周血25-OH-D3水平依次为21.75±5.89、19.44±5.32及18.77±5.61(ng/mL),差异具统计学意义(P0.05);三组间外周血PTH水平依次为39.54±14.63,44.85±14.24及47.48±15.96(pg/mL),差异具统计学意义(P0.05);三组间外周血OC水平无明显差异(P0.05)。③logistic回归分析结果显示肺功能FEV_1%(第一秒呼气量占预计值百分比)(OR=1.106)、体重指数(BMI)(OR=3.307)及外周血25-OH-D3水平(OR=1.641)是老年男性COPD患者出现骨质疏松及骨量减少的危险因素。结论老年男性COPD患者骨质疏松及骨量减少的发病率高于同龄健康男性;且存在外周血25-OH-D3减低及PTH升高;肺功能FEV_1%减低、体重指数下降及外周血25-OH-D3水平减低是引起老年COPD患者出现骨质疏松及骨量减少的可能原因。     

老年糖尿病患者衰弱现状及相关因素分析

目的 探讨老年糖尿病患者衰弱患病现状并分析其相关因素，为老年糖尿病患者衰弱的干预提供指导。方法 采用便利抽样法选取2022年12月~2023年4月北京市某三甲医院8个医学中心内分泌科及一家一级丙等糖尿病专科医院住院治疗的老年糖尿病患者301例，采用现场面对面问卷调查的方式采集患者相关资料。根据衰弱评估结果分为衰弱组和非衰弱组，比较两组患者各指标差异，确定衰弱的独立影响因素。结果 301例老年糖尿病患者中，衰弱患者71例（23.6%），非衰弱（衰弱前期、健壮）患者230例（76.4%）。单因素分析结果显示，衰弱与非衰弱患者在年龄、运动习惯、共病状态、听力状况、近一年跌倒史、睡眠质量、是否合并糖尿病慢性并发症、是否使用胰岛素、营养状况、抑郁状况、孤独感、是否轻度认知障碍方面差异有统计学意义（P＜0.05）。多因素分析结果显示：增龄（OR=1.094，95%CI 1.037~1.154）、高共病状态（OR=2.898，95%CI 1.164~7.210）、使用胰岛素（OR=1.978，95%CI 1.003~3.904）、营养不良（OR=9.968，95%CI 1.915~51.896）、抑郁（OR=2.165，95%CI 1.033~4.536）是老年糖尿病患者衰弱的独立危险因素，规律运动（OR=0.289，95%CI 0.127~0.655）是其保护因素。结论 老年糖尿病患者衰弱患病状况不容乐观，营养、运动及心理干预是潜在的干预靶点，未来的研究可制定针对行的干预措施，减少老年糖尿病患者衰弱的发生。     

老年心力衰竭患者衰弱影响因素的Meta分析

目的 系统评价老年心力衰竭患者衰弱的影响因素。方法 计算机检索Web of Science、PubMed、Cochrane Library、CNKI、维普及万方数据库,搜索关于老年心力衰竭患者衰弱影响因素的研究,检索时限均从建库至2022年10月31日。由2名研究者按照标准独立进行文献筛选,提取相关数据并进行质量评价,采用Revman5.4软件进行Meta分析。结果 共纳入18篇文献,总样本量为4 994例。Meta分析结果显示,年龄（OR=1.08,95%CI:1.03～1.14）;左心房内径（OR=1.14,95%CI:1.07～1.21）;合并疾病数量（OR=4.14,95%CI:1.41～12.15）;多重用药（OR=2.38,95%CI:1.57～3.61）;纽约心功能分级（OR=3.58,95%CI:2.63～4.86）;负性情绪（OR=3.98,95%CI:2.39～6.64）;脑血管疾病病史（OR=2.26,95%CI:1.49～3.42）;营养风险（OR=2.43,95%CI:1.40～4.21）是老年心力衰竭患者发生衰弱的危险因素（P均<0.05）。结论 老年...     

老年慢性阻塞性肺疾病患者衰弱及衰弱前期影响因素分析

目的 探讨老年慢性阻塞性肺疾病(COPD)患者衰弱期及衰弱前期的影响因素。方法 采用便利抽样法,选取2021年11月至2022年5月于新疆维吾尔自治区人民医院呼吸内科住院的326例老年COPD患者作为研究对象,采用一般资料调查表、Morse跌倒风险评估量表、COPD评估测试量表、匹兹堡睡眠质量指数量表、微型营养评定量表、简版老年抑郁量表、社会支持评定量表进行问卷调查,同时收集患者实验室相关指标,采用无序多分类logistic回归分析影响老年COPD患者衰弱的因素。采用SPSS 26.0软件进行统计分析。根据数据类型,组间比较分别采用方差分析、秩和检验及χ²检验。结果 老年COPD患者衰弱患病率为39.57％(129/326),衰弱前期患病率为34.05％(111/326)。无序多分类logistic回归分析结果显示,女性、多重用药、存在睡眠问题、营养不良以及高B型利钠肽是其共同的影响因素。而高龄(OR=1.090,95％CI 1.027~1.157;P=0.004)、体质量指数＜23.9kg/m²(OR=0.109,95％CI 0.042~0.283;P＜0.001)、社会支持(OR=4.621,95％CI 1.222~17.470;P=0.024)和高血红蛋白(OR=1.042,95％CI 1.007~1.078;P=0.018)只对老年COPD患者衰弱前期有影响;COPD评估测试量表评分(OR=11.962,95％CI 3.056~46.831;P＜0.001)、肺功能分级在重度及以上水平(OR=8.094,95％CI 1.862~35.188;P=0.005)和抑郁(OR=27.177,95％CI 2.811~262.705;P=0.004)只对老年COPD患者衰弱期有影响。结论 老年COPD患者衰弱及衰弱前期的发生率相对较高,不同程度的衰弱影响因素存在差异,应采取不同的个性化干预措施,预防衰弱前期的发生,同时控制并逆转衰弱。     

老年糖尿病患者衰弱发生率及影响因素的Meta分析

目的 系统评价老年糖尿病患者衰弱现状及影响因素。方法 计算机检索PubMed、The Cochrane Library、中国知网等中英文数据库中关于我国老年糖尿病患者衰弱发生率及影响因素的相关文献,检索时限为2018年1月—2022年11月。由两名研究者独立完成文献筛选、资料提取及偏倚风险评价,采用Stata15.0软件进行Meta分析。结果 最终纳入11项研究,均为横断面研究,共3 579例老年糖尿病患者。Meta分析结果显示,我国老年糖尿病患者的合并衰弱发生率为34.00%[95%CI(0.22,0.47)]。影响老年糖尿病患者衰弱发生的主要因素为年龄[OR=1.14,95%CI(1.09,1.18),P<0.001]、糖化血红蛋白水平[OR=1.91,95%CI(1.73,2.10),P<0.001]、营养状况[OR=0.76,95%CI(0.59,0.93),P<0.001]、合并多病[OR=6.82,95%CI(2.26,11.37),P=0.003]、抑郁[OR=3.04,95%CI(1.81,4.27),P<0.001]。结论 我国老年糖尿病患者衰...     

老年HIV/AIDS患者衰弱现状及影响因素研究

目的 调查老年HIV/AIDS患者的衰弱现状并分析影响因素。方法 于2021年11月至2022年6月在上海市公共卫生临床中心、深圳市第三人民医院、云南省传染病医院,使用便利抽样法招募老年HIV/AIDS患者,以一般资料调查问卷、衰弱表型、蒙特利尔认知评估、医院焦虑抑郁、Jenkins睡眠量表进行横断面调查。采用多因素Logistic回归分析老年HIV/AIDS患者衰弱现状的影响因素。结果 477名有效样本中,老年HIV/AIDS患者衰弱发生率为11.9%。多因素分析结果表明,年龄（OR=4.157;95%CI:2.002～8.629）、并发症数量（OR=2.420;95%CI:1.105～5.298）、当前CD4细胞计数（OR=2.582;95%CI:1.351～4.935）、睡眠障碍（OR=2.844;95%CI:1.540～5.253）与老年HIV/AIDS患者衰弱显著相关。结论 老年HIV/AIDS患者衰弱患病率较高。当前CD4细胞计数对发生衰弱有重要作用,改善睡眠有利于延缓衰弱,未来应进一步开展前瞻性、纵向研究,对睡眠与衰弱间的相关性做深入分析。     

Endocrine and inflammatory markers as predictors of frailty

OBJECTIVE: To examine the association of serum concentrations of 25-hydroxyvitamin D [25(OH)D], interleukin-6 (IL-6), C-reactive protein (CRP) and IGF-1 with prevalent and incident frailty. DESIGN: The Longitudinal Aging Study Amsterdam (LASA), a prospective cohort study with 3-yearly measurement cycles. Setting General population-based sample. PARTICIPANTS: The respondents were men and women aged 65 and over, who participated at T1 (1995/1996, N = 1720) and T2 (1998/1999, N = 1509). Blood samples were obtained at T1 (N = 1271). Measurements The presence of frailty at T1 and 3-year incidence of frailty. Frailty is defined as the presence of three out of nine frailty indicators. RESULTS: At T1, 242 (19.0%) of all respondents were frail. Those who were frail at T1 had higher CRP and lower 25(OH)D levels. Serum 25(OH)D remained associated with frailty after adjustment for potential confounders with an odd ratios (OR) of 2.60 [95% confidence interval (95% CI) 1.60-4.21] for 25(OH)D < 25 nmol/l and 1.72 (95% CI 1.19-2.47) for 25(OH)D 25-50 nmol/l vs. high levels of 25(OH)D. Of the nonfrail at T1, 125 respondents (14.1%) became frail at T2. After adjustment, moderately elevated CRP levels (3-10 microg/ml) (OR 1.69, 95% CI 1.09-2.63) and low 25(OH)D (OR 2.04, 95% CI 1.01-4.13) were associated with incident frailty. No consistent associations were observed for IL-6 and IGF-1. CONCLUSION: Low 25(OH)D levels were strongly associated with prevalent and incident frailty; moderately elevated levels of CRP were associated with incident frailty.     

Identifying frailty in hospitalized older adults with significant coronary artery disease

OBJECTIVES: To characterize physiological variation in hospitalized older adults with severe coronary artery disease (CAD) and evaluate the prevalence of frailty in this sample, to determine whether single-item performance measures are good indicators of multidimensional frailty, and to estimate the association between frailty and 6-month mortality. DESIGN: Observational cohort study. SETTING: Inpatient hospital cardiology ward. PARTICIPANTS: Three hundred nine consecutive inpatients aged 70 and older admitted to a cardiology service (n = 309; 70% male, 84% white) with minimum two-vessel CAD determined using cardiac catheterization. MEASUREMENTS: Two standard frailty phenotypes (Composite A and Composite B), usual gait speed, grip strength, chair stands, cardiology clinical variables, and 6-month mortality. RESULTS: Prevalence of frailty was 27% for Composite A versus 63% for Composite B. Utility of single-item measures for identifying frailty was greatest for gait speed (receiver operating characteristic curve c statistic = 0.89 for Composite A, 0.70 for Composite B) followed by chair-stands (c = 0.83, 0.66) and grip strength (c = 0.78, 0.57). After adjustment, composite scores and single-item measures were individually associated with higher mortality at 6 months. Slow gait speed (< or =0.65 m/s) and poor grip strength (< or =25 kg) were stronger predictors of 6-month mortality than either composite score (gait speed odds ratio (OR)=3.8, 95% confidence interval (CI) = 1.1-13.1; grip strength OR = 2.7, 95% CI = 0.7-10.0; Composite A OR = 1.9, 95% CI = 0.60-6.1; chair-stand OR = 1.5, 95% CI = 0.5-5.1; Composite B OR = 1.3, 95% CI = 0.3-5.2). CONCLUSION: Gait speed frailty was the strongest predictor of mortality in a population with CAD and may add to traditional risk assessments when predicting outcomes in this population.     

Inflammation and frailty in older women

OBJECTIVES: To evaluate relationships between white blood cell (WBC) count and interleukin-6 (IL-6) and prevalent frailty. DESIGN: Cross-sectional study. SETTING: Two population-based studies, the Women's Health and Aging Studies (WHAS) I and II, Baltimore, Maryland. PARTICIPANTS: Five hundred fifty-eight women aged 65 to 101 from WHAS I and 548 women aged 70 to 79 from the merged WHAS I and II cohorts. MEASUREMENTS: Frailty was determined using validated screening criteria. WBC counts and IL-6 levels were measured using standard laboratory methods. Odds ratios (ORs) for frailty were evaluated across tertiles of baseline WBC counts and IL-6 levels, adjusting for age, race, education, body mass index, and smoking status. RESULTS: In WHAS I, those in the top tertile of WBC count and IL-6 had ORs of 4.25 (95% confidence interval (CI)=1.89-9.58) and 3.98 (95% CI=1.76-9.00), respectively, for frailty (both P<.001). In the combined models, participants in the top tertile of WBC count had an OR of 3.15 (95% CI=1.34-7.41), adjusting for IL-6 (P<.01), and those in the top tertile of IL-6 had an OR of 2.81 (95% CI=1.19-6.64), adjusting for WBC count (P<.05). Furthermore, participants in the top tertiles of WBC count and IL-6 had an OR of 9.85 (95% CI=3.04-31.99), and those in the middle/top tertiles had an OR of 5.40 (95% CI=1.83-15.92) (P<.001, trend test) for frailty. These results were validated in the merged WHAS I and II. CONCLUSION: Higher WBC counts and IL-6 levels were independently associated with prevalent frailty in community-dwelling older women.     

Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: The FRALLE survey

The aim of this study was to assess the prevalence of frailty and to identify factors associated with frailty in older people living in the community through a cross-sectional study of community-dwelling persons age 75 and older. A total of 640 individuals were interviewed using the FRALLE survey between 2009 and 2010. This survey measures frailty through the five Fried criteria, and through questions on sociodemographics, health habits, health status, social relations and data on health-related quality of life. The mean age of the participants was 81.3±5.0; 39.7% were men. The prevalence of frailty was 9.6% (95% confidence interval (CI): 7.6-11.5) and that of pre-frailty was 47% (95% CI: 42.7-51.2). After the logistic regression, age (over 85 years) (odds ratio (OR): 3.61; 95% CI: 1.65-7.91; p<0.001), depressive symptoms (OR: 3.13; 95% CI: 1.37-7.13; p=0.0006), comorbidity (OR: 5.20; 95% CI: 1.78-15.16; p=0.0002), cognitive impairment (OR: 3.22; 95% CI: 1.48-7.02; p=0.0003), poor social ties (OR: 0.57; 95% CI: 0.43-0.77; p<0.001) and poor physical health (OR: 0.98; 95% CI: 0.97-0.98; p<0.001) were significantly associated with frailty. There is great variability in the prevalence of frailty depending on the study considered. The lack of homogeneity in the measurement of the five criteria, the age of participants and the degree of dependence could explain the differences observed. Here, the factors associated with frailty were age, comorbidity, cognitive impairment and depressive symptoms, while the diversity of social interaction and health-related physical function were protective factors.     

Low nutrient intake is an essential component of frailty in older persons

BACKGROUND: Poor nutrient intake is conceptualized to be a component of frailty, but this hypothesis has been little investigated. We examined the association between low energy and nutrient intake and frailty. METHODS: We used data from 802 persons aged 65 years or older participating to the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) study. Frailty was defined by having at least two of the following criteria: low muscle strength, feeling of exhaustion, low walking speed, and reduced physical activity. The European Prospective Investigation into Cancer and nutrition (EPIC) questionnaire was used to estimate the daily intake of energy and nutrients. Low intake was defined using the value corresponding to the lowest sex-specific intake quintile of energy and specific nutrients. Adjusted logistic regression analyses were used to study the association of frailty and frailty criteria with low intakes of energy and nutrients. RESULTS: Daily energy intake < or =21 kcal/kg was significantly associated with frailty (odds ratio [OR]: 1.24; 95% CI: 1.02-1.5). After adjusting for energy intake, a low intake of protein (OR: 1.98; 95% CI: 1.18-3.31); vitamins D (OR: 2.35; 95% CI: 1.48-3.73), E (OR: 2.06; 95% CI: 1.28-3.33), C (OR: 2.15; 95% CI: 1.34-3.45), and folate (OR: 1.84; 95% CI: 1.14-2.98); and having a low intake of more than three nutrients (OR: 2.12; 95% CI: 1.29-3.50) were significantly and independently related to frailty. CONCLUSIONS: This study provides evidence that low intakes of energy and selected nutrients are independently associated with frailty.     

老年临终期肿瘤患者合并肺部感染的危险因素分析

目的：分析老年临终期恶性肿瘤患者肺部感染的发生情况及其危险因素。方法回顾性地分析2012年10月至2013年11月期间在北京老年医院住院治疗的143例老年临终期恶性肿瘤患者的临床资料,采用多因素logistic回归分析方法对87例并发肺部感染病例（观察组）及56例未并发肺部感染病例（对照组）进行比较分析。结果 logistic多因素逐步回归分析显示,肺癌[比值比（ OR）＝4.137,95%置信区间（ CI）为1.967～14.479]、意识障碍（ OR＝3.728,95%CI为1.313～8.315）、低蛋白血症（ OR＝2.960,95%CI为1.300～6.739）、住院天数（ OR＝2.611,95%CI为1.056～6.451）、体力状况（ OR＝2.187,95%CI为1.345～4.071）、糖尿病（OR＝1.937,95%CI为1.159～3.238）、慢性阻塞性肺疾病（OR＝1.823,95%CI为1.056～3.891）与老年临终期恶性肿瘤患者并发肺部感染有相关性（均P＜0.05）。结论肺部感染是老年临终期恶性肿瘤患者的常见并发症,肺癌、伴有意识障碍、低蛋白血症、住院时间长、卧床以及合并慢性基础病（糖尿病和慢性阻塞性肺疾病）者是老年临终肿瘤患者并发肺部感染的危险。     

白细胞介素-1β基因多态性与慢性阻塞性肺疾病易感性的系统评价

目的通过Meta分析探讨IL-1β基因多态性与慢性阻塞性肺疾病（COPD）易感性的关系。方法计算机及手工检索1980年1月至2013年1月发表的关于IL-1β基因多态性和COPD易感性关系的文献资料。根据纳入及排除标准筛选文献并提取数据。Meta分析采用RevMan5．0．25和Stata11．0软件进行。合并效应采用比值比（OR）和95％可信区间（95％CI）进行评价。发表偏倚通过漏斗图直观判断和Egger回归法、Begg秩相关法定量检测。敏感性分析为剔除不符合H—W平衡的文献后重新进行Meta分析。5篇文献（6项研究）被纳入Meta分析,共有749例COPD患者及923例对照纳入研究。结果Meta分析结果表明,IL-1β-511C／T基因多态性与COPD易感性无关联（TvsC：OR=0．97,95％CI=0．76～1．24：TTvsCC：OR：0．93,95％CI=0．55—1．59;CT＋TYvsCC：OR=1．25,95％CI=0．98～1．58;TTvsCT＋CC：OR=0．82,95％CI：0．64—1．05）,IL-1β-31T／C基因多态性与COPD易感性亦无明显联系（CUST：OR=0．99,95％CI=0．86～1．15;CCvsTF：OR=0．99,95％CI=0．72～1．35;CT＋TTvsCC：OR=1．21．95％CI=0．94—1．55;TTvsCT＋CC：OR=0．80,95％CI=0．63～1．03）。结论IL-1β-511C／T、-31T／C基因多态性与COPD易感性无关。     

Oral findings and health status among hospitalized patients with physical disabilities, aged 60 or above

The purpose of the study was to determine oral health status and the prevalence of oral mucosal lesions among hospitalized elderly patients with physical disabilities. The study group consisted of 111 (43 male and 68 female) elderly patients with physical disabilities. Clinical examination and interview methods were employed. Clinical examination revealed that 45.9% of the elderly patients had one or more oral mucosal lesions. Xerostomia (58.6%), coated-hairy tongue (54.1%) and halitosis (46.8%) were the most frequently encountered oral findings and mucosal lesions. As the most interesting finding discovered in elderly patients, macroglossia (30.6%) seems to depend on physical disability. Coated or hairy tongue was commonly related to poor oral hygiene, with both crude odds ratio (OR) of 3.25 (95% CI: 1.26-8.36) (P=0.021) and the logistic regression OR of 3.36 (95% CI: 1.21-9.33) (P=0.020). Halitosis and bruxism were commonly related to dentate patients [logistic regression OR of 0.29 (95% CI: 1.12-0.74) (P=0.009) and 0.21 (95% CI: 0.06-0.74) (P=0.016); respectively]. Increase in dental problems may have negative impacts on chewing, nutrition, aesthetics and phonation in elderly patients. It is particularly noteworthy that physical disability in elderly patients limits their ability to effectively follow oral hygiene procedures.     

Asthma,COPD and comorbidities in elderly people

Co-morbidities are a significant problem in the elderly population but are rarely presented and analyzed for interdependencies among the various coexisting chronic diseases. Objective: The aim of this study was to present a profile of comorbidities in elderly patients with and without asthma and COPD. Methods: Respondents were recruited at 20 sites in Poland. Stratified random sampling from patient databases resulted in 15,973 patients older than 60 years of age. A retrospective analysis of medical history and ICD-10 codes was performed. In addition, patients underwent a spirometry test with a bronchial reversibility test and were administered questionnaires on the prevalence of chronic diseases by doctors. Results: The study population consisted of 1023 asthmatic patients, 1084 patients with COPD and 1076 control subjects without any signs of bronchoconstriction and with correct spirometry. Patients with asthma exhibited a similar distribution of cardiovascular and metabolic co-morbidities as the control group. However, asthmatic patients had a higher prevalence of arterial hypertension and depression with an odds ratio (OR) = 1.48 (95% CI: 1.38–1.62) and OR = 1.52 (95% CI: 1.44–1.68), respectively. Coronary disease (OR = 2.12; 95% CI: 1.97–2.33), cor pulmonale (OR = 3.1; 95% CI: 2.87–3.22) and heart failure (OR = 2.71; 95% CI: 2.64–3.11) were predominantly observed in patients with COPD. Patients with severe asthma exhibited a greater predisposition to cardiovascular and neuropsychiatric diseases. Conclusion: Asthma coexisted frequently with arterial hypertension and depression in elderly patients. Patients with COPD have a more exaggerated profile of coexisting diseases, specifically cardiovascular problems.