Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis

Objective:

to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice.

Method:

this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors.

Results:

the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045), presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028), foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033) and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145).

Conclusion:

the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice.     

Risk of Exclusion From Stroke Rehabilitation in the Oldest Old

Objective

To investigate whether oldest-old age (≥85y) is an independent predictor of exclusion from stroke rehabilitation.

The Effects of Functional Training,Bicycle Exercise,and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial

Objectives

To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD).

Knowledge,facilitators and barriers to the practice of person-centred care in aged care workers: a qualitative study

The current study describes aged care workers' interpretation of the concept of person-centred care; and identifies the barriers that exist to impede its practice, and the facilitators that encourage person-centred care practice. Data were collected from interviews with aged care workers from two residential aged care facilities providing both high and low care for residents with and without physical and psychological issues based in Australia. Data were analysed to identify and explore categories of meaning for barriers and facilitators. Analysis is grounded in Brooker's VIPS framework for person-centred dementia care which is utilised as a comparative tool for analysing participants' understanding of person-centred care. Findings revealed that aged care workers have a reasonable but incomplete understanding of person-centred care. Insufficient time and residents' dementia behaviours acted as barriers to care workers' provision of person-centred care. Teamwork was found to facilitate person-centred care by increasing instrumental and relationship resources     

上海市徐汇区和长宁区老年2型糖尿病患者结核分枝杆菌潜伏感染筛查情况及影响因素分析

目的: 分析上海市老年2型糖尿病患者结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)筛查情况及其影响因素。方法: 顺序纳入2019年9—12月在上海市徐汇区和长宁区参加公共卫生服务项目体格检查且符合入组标准的60岁及以上老年2型糖尿病患者,共计885例(长宁区430例,徐汇区455例),采用γ-干扰素释放试验检测其LTBI状况。采用调查问卷收集研究对象社会人口学信息、行为生活方式、既往糖尿病和其他慢性病病史及肺结核患者接触史,以及体格检查情况等信息。采用非条件二分类logistic回归分析的方法分析老年糖尿病患者发生LTBI的影响因素。结果: 885例研究对象检出LTBI阳性者130例,阳性率为14.7%;其中,长宁区研究对象LTBI阳性率(17.4%,75/430)高于徐汇区研究对象(12.1%,55/455),差异有统计学意义(χ²=5.057,P=0.025);吸烟者LTBI阳性率(22.5%,20/89)明显高于不吸烟者(13.8%,110/796),差异有统计学意义(χ²=4.783,P=0.039)。logistic回归分析显示,吸烟是老年糖尿病患者发生LTBI的危险因素[OR(95%CI)=1.891(1.031~3.468)]。结论: 上海市老年2型糖尿病患者LTBI阳性率处于较低水平,可对检测阳性患者采取增加随访频次及加强健康教育等措施,并对有吸烟史的老年糖尿病患者开展LTBI筛查。     

老年呼吸衰竭与补体5a活性水平关系的研究

目的　探讨老年呼吸衰竭与补体 5a(C5a)活性水平的关系以及临床意义。　 方法 　采用体外C5a诱导粒细胞聚集的方法 ,检测了 197例 60岁以上正常老年人、2 3例老年呼吸衰竭患者以及 15 4例常见疾病患者C5a活性水平。　 结果 　老年呼吸衰竭患者C5a活性水平为 ( 2 5 74± 4 86)U·ml-1,比正常老年人 ( 5 5 5± 4 5 3 )U·ml-1以及常见疾病患者如癌症 ( 7 0 7± 5 3 8)U·ml-1明显提高 (P <0 0 1)。　 结论　C5a活性水平与老年呼吸衰竭密切相关 ,可作为老年呼吸衰竭诊断的重要指标。     

健康老年人外周血自然杀伤细胞活性的研究

本文应用~(125)IUdR标记K_(562)靶细胞技术测定健康老年人(60～87岁)和健康青年人(21～28岁)外周血淋巴细胞自然杀伤(NK)活性。结果表明,健康老年人NK细胞活性与健康青年人相比没有显著性差异(P>0.05)。对照前人的研究,该结果认为NK细胞活性不存在明显的随龄变化。     

老年人高尿酸血症与冠心病的相关性研究

目的 研究老年血尿酸（UA）水平与冠心病病变程度的关系。方法将164例行冠状动脉造影的老年患者分为冠心痛组和正常对照组，尿酸酶法检测其血UA浓度，采用直线相关和回归分析血UA和冠脉病变两因素之间的相关性。结果 冠心病组血UA较对照组显著升高（P〈0．01），血UA和冠脉病变计分呈显著正相关（r=0．232，P〈0．01）。多元逐步回归分析显示血UA对冠脉病变计分呈独立的正相关影响。结论血UA升高可能是老年冠心痛的危险因素之一。     

Long-term alcohol consumption in the rat affects femur cross-sectional geometry and bone tissue material properties

BACKGROUND: Alcohol consumption previously has been demonstrated to reduce the density and strength of cortical bone of young, actively growing rats. Osteoblast activity and trabecular bone volume were also significantly lower. A germane question arising from these studies is whether the detrimental effects would persist into adulthood. To address this issue, a long-term study was undertaken with animals that consumed alcohol throughout their life and into old age. METHODS: One-month-old female Sprague-Dawley rats were divided into three diet groups: alcohol-fed, pair-fed, and chow-fed. The alcohol-fed animals received a modified Lieber-DeCarli diet that contained 35% ethanol-derived calories. The pair-fed group served as a caloric-equivalent control, and the chow-fed animals served as a completely untreated control. Animals were euthanized after five time periods on the diets that represented three stages of the life span: young (3 months), adult (6, 9, 12 months), and aged (18 months). The left femur was isolated and mechanically tested in 3-point bending for mechanical properties. RESULTS: In the young animals, alcohol consumption produced dramatic reductions in both extrinsic (whole bone) and intrinsic (tissue material) properties, which is consistent with results from previous studies on growing rats. For the adult animals, however, the alcohol groups were only slightly lower and the differences were not statistically significant. The aged animals showed diminished properties due to alcohol, but only for the intrinsic material properties. The extrinsic properties remained similar to controls as a result of greater radial expansion in the femur diaphysis. Despite the cross-sectional areas being the same, this expansion gave rise to higher cross-sectional moment of inertia values in the alcohol animals. The thickness of the cortical wall was lowest in the alcohol group at all time points. CONCLUSIONS: Long-term alcohol consumption produced two major effects in the oldest animals studied: the quality of the cortical bone tissue was diminished, as evidenced by reduced elastic modulus and ultimate strength values, and the bone seemed to compensate for this by expanding the cross-section to produce larger cross-sectional moment of inertia values. The reduced bone tissue quality is consistent with the lower ash percent values in the alcohol animals, but other factors such as the quality of the collagen and mineral crystal may also be important contributors.     

老年糖尿病脂餐后脂代谢变化规律的进一步研究

目的探讨老年糖尿病脂餐后脂代谢变化规律。方法测定30例老年糖尿病患者空腹与脂肪餐后2、4、6、8h的总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B（ApoB），并与10例健康老人及10例老年单纯高脂血症患者作对照。结果①老年糖尿病组空腹及餐后2、4、6、8h5个时点的HDL-C及ApoA，明显低于对照组（P〈0．05），其他脂代谢指标各时点组间差异均无显著性。②老年糖尿病组空腹及餐后2、4、6、8h等5个时点的TC明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、8h4个时点的TG明显低于高脂血症组（P〈0．05）；老年糖尿病组餐后4、6、8h3个时点的LDL-C明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、6、8h5个时点的HDL-C与高脂血症组比较，差异均无显著性；老年糖尿病组餐后2、4、6h3个时点的ApoA，明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、6、8h5个时点的ApoB明显低于高脂血症组（P〈0．05）。⑧老年糖尿病组HDL-C．曲线下面积（AUC）及ApoA1-AUC明显小于对照组（P〈0．05）；老年糖尿病组LDL-C-AUC及ApoA1-AUC明显小于高脂血症组（P〈0．05）。结论HDL-C及ApoA1下降是老年糖尿病患者空腹及餐后脂代谢紊乱的主要特征。3组人群空腹血脂指标高低决定餐后血脂的变化，与是否患有糖尿病无关。