Frailty and the older man.

Frailty is a wasting syndrome of advanced age that leaves a person vulnerable to falls, functional decline, morbidity, and mortality. The cause of this syndrome is complex but likely has a biologic basis. Studies by the authors' research group have validated a phenotype of frailty [table: see text] and have established a gender difference in prevalence with women twice as likely to develop the syndrome as men. Using a biologic model that includes sarcopenia, neuroendocrine decline, and immune dysfunction as potential causes, several physiologic gender differences may explain these differing levels of frailty. First, higher baseline levels of muscle mass may protect men from reaching a threshold of weakness and muscle mass loss that may put them into a category of frailty. Specific neuroendocrine and hormonal factors that may make men less likely to develop frailty than women include testosterone and GH, which may provide advantages in muscle mass maintenance, and cortisol, which is likely less dysregulated in older men as compared to older women. There is also evidence of immune system dimorphism that is, in part, responsive to sex steroids, perhaps making men more vulnerable to sepsis and infection and women more vulnerable to chronic inflammatory conditions and muscle mass loss. The net effect of the hormonal dysregulation and immune system dysfunction is an accelerated loss of muscle mass. There is also evidence that lower levels of activity and lower caloric intake in women as compared to men may also influence the phenotype of frailty and make women more vulnerable then men to the syndrome.     

Frailty in older adults: insights and interventions

Frailty is a state of vulnerability that carries an increased risk of poor outcomes in older adults. Common signs and symptoms are fatigue, weight loss, muscle weakness, and progressive decline in function. Frail older adults are among the most challenging for medical management. However, awareness of this syndrome and its risks can help us care for these patients more confidently and decrease their risk for adverse outcomes.     

老年肿瘤患者衰弱的研究进展

该文通过回顾国内外老年肿瘤患者衰弱的相关研究文献,从衰弱的定义与模型、衰弱评估的的必要性、衰弱对老年肿瘤患者不良结局的预测作用、老年肿瘤患者衰弱评估工具与干预措施等进行综述,以期为医务人员对衰弱的老年肿瘤患者进行治疗与护理提供参考。     

Bereavement visiting: older people's and nurses' experiences

A review of the relevant literature failed to find material specifically related to the older person's experience of bereavement visiting by community nurses. Since the community nurse's role includes actively visiting older people who have been bereaved it was considered worthwhile to explore the service from the perspectives of both older bereaved people and community nurses. The study has addressed a number of issues in the wider literature and highlighted certain models of care which this literature advocates. This ongoing study uses qualitative and survey approaches; a sample of 20 community nurses and 10 older people were interviewed and the interviews were then analysed in order to identify core concepts. The core concepts from older people were found to be relationships and their perceptions of self. The core concepts from the viewpoint of community nurses were relationships, practice and organizational aspects of care.     

养老机构老年人衰弱状况对生活质量影响的作用路径

目的:探讨养老机构老年人衰弱对生活质量影响的作用路径。方法:采用便利抽样法选取四川省成都市8所养老机构中符合纳入与排除标准的436名老年人作为调查对象,于2019年8月—12月应用一般资料调查表、衰弱表型(FP)、微型营养评定量表简表(MNA-SF)、日常生活活动能力量表(ADL)、社会支持评估量表(SSRS)、中文版健康调查量表(SF-36)对老年人进行调查。结果:养老机构436名老年人衰弱发生率为58.0%。非衰弱、衰弱老年人MNA-SF得分、ADL总分及各维度、SSRS总分及对支持的利用度维度、SF-36各维度得分比较差异均有统计学意义(P<0.05)。结构方程模型分析显示:老年人衰弱对生活质量的总效应为-10.326(P<0.001),直接效应为-4.215(P<0.001),通过营养状态、日常生活活动能力、社会支持对生活质量的间接效应为-6.111(P<0.001),间接效应占总效应的59.2%。结论:养老机构老年人衰弱的发生率高,衰弱既可直接影响老年人生活质量,亦可通过营养状态、日常生活活动能力、社会支持间接作用于生活质量。应重视对养老机构老年人衰弱...     

Making better use of older people's narratives

For some nurses, conversations with an older patient are simply the backdrop to caregiving; they represent social pleasantries that help to dignify the sometimes intimate work of the nurse. However, the narratives that patients share through conversations, the way in which incidents or feelings are expressed, can provide valuable additional information that can be used to improve care. This article explores what analysis of narratives has to offer the care of older people and a way of nursing that works more closely with patients' experience of illness, treatment and support. Narrative analysis is portrayed as one means to make nursing care more patient centred.     

Peer-tutoring理论及其在护理教学中应用的意义

Peer-tutoring作为一种辅助性教学方法,是同学之间的相互帮助学习,学生承担教与学的责任.护理教学中应用Peer-tutoring,对护生认知获得、促进交流、提高自信以及社会支持方面非常有益.     

Peer-tutoring理论及其在护理教学中应用的意义

Peer-tutoring作为一种辅助性教学方法，是同学之间的相互帮助学习，学生承担教与学的责任。护理教学中应用Peer-tutoring，对护生认知获得、促进交流、提高自信以及社会支持方面非常有益。     

Frailty and its association with the Mediterranean diet,life-space,and social participation in community-dwelling older people

Frailty is a common and vulnerable state in older people, which leads to a higher risk of adverse health outcomes. This cross-sectional study examined the association between frailty and its phenotypic components with the Mediterranean diet, life-space, and social participation in community-dwelling older people. 263 community-dwelling older people recruited from three community centers in Hong Kong completed the study (robust = 85, pre-frail = 120, frail = 58). The results showed that the Mediterranean diet (OR = 0.29), life-space (OR = 0.32), and social participation (OR = 0.31) were associated with frailty. All factors were preferentially associated with slowness. The Mediterranean diet and social participation were additionally associated with weakness and low activity, respectively. To reduce the risk of frailty among diverse populations of older people in community settings, eliminating foods considered detrimental in the Mediterranean diet is advocated. Older people's satisfaction with social participation should be taken into consideration. Environmental designs should accommodate slow-walking older people to maximize their life-space