社区老年人相关健康知识调查分析

目的 了解社区老年人对相关健康知识的掌握情况。方法 对滨州市滨城区192名老年人进行问卷调查。结果 社区老年人的健康知识水平偏低，文化程度与健康知识水平有相关性。结论 社区老年人的健康教育应是面向所有老年人群的健康常识的教育。     

上海市黄浦区豫园社区2017名65岁以上老年人缺牙情况的调查分析

目的了解上海市黄浦区老年人缺牙情况，关心老年人口腔健康。方法2008年1至2月，对上海市黄浦区豫园社区2017名≥65岁老年人进行口腔检查，并对其牙列缺损和缺失情况进行统计分析。结果受检者中有1780例存在缺牙，占88．25％，其中80例为全口无牙；失牙均数女性（8．36）高于男性（6．73）；缺牙数随年龄的增加而增多；第一磨牙缺失最多，尖牙缺失最少。结论缺牙在老年人中有相当高的检出率，老年人缺牙有其自身规律。     

不同剂型胰岛素应用于老年2型糖尿病患者的疗效比较

目的对比预混人胰岛素和短效胰岛素治疗高血糖状态下的老年2型糖尿病患者的疗效及安全性。方法选择40例空腹血糖〉15mmol／L，餐后2h血糖〉20mmol／L的2型糖尿病患者，按等量随机分配的原则，分为A、B两组，A组以诺和灵30R早晚餐前30min分2次皮下注射，B组以诺和灵R早中晚餐前30min分3次皮下注射，少数患者睡前加用小剂量的中效胰岛素1次。胰岛素的剂量根据患者的血糖调整。主要监测患者早中晚餐前30min、餐后2h、睡前共7次血糖，每2～3d监测血糖。结果组A和组B的性别、病程、体重指数、空腹血糖和餐后2h血糖值的差异均无统计学意义，但达到相同血糖控制水平所需要的治疗天数以及低血糖发生次数的差异均有统计学意义（P〈0．05）。结论预混人胰岛素治疗天数长，易发生低血糖，而短效胰岛素达到相同血糖水平所需要的治疗天数短，低血糖发生少，适合高血糖状态下老年2型糖尿病的治疗。     

老西门社区独居老年人慢性病现患状况分析与对策探讨

目的了解本社区独居老年人慢性病患病状况，为开展有效健康干预提供依据。方法采用随机抽样方法对社区中418名≥60岁的独居老人作慢性病患病情况的问卷调查。结果独居老年人的慢性病患病率高，心血管病、骨质疏松症等疾病顺位靠前，92．82％的老人同时患有1至数种慢性疾病。结论要重视独居老年人慢性病的防治和管理，以降低患病率，提高独居老年人生活与生命质量。     

Variability of post-void residual urine volume in the elderly

Residual urine volume, though clinically important as a diagnostic tool, is reported to be variable and unreliable. Variability was examined among 14 geriatric patients, mean age 77 years. Residual urine was measured by ultrasound at three different times of day on each of two visits separated by 2–4 weeks. Results were examined by analysis of variance. Mean residual urine was 154 ml. Between-patient variability was large [standard deviation (SD) 246 ml]. There was no significant difference between values in men and women, nor between visits. Within-patient variability was large because of a large systematic variation with time of day (SD 128 ml), with greatest volumes in the early morning. The inherent, random variability of the measurement was much smaller than this (SD 44 ml). If the physiological factors causing the temporal variation could be controlled more reproducible measurements would be possible.     

Effects of age on balance control during walking

OBJECTIVE: To determine the effects of aging on balance control during walking. DESIGN: Two-group repeated-measures design. SETTING: Gait laboratory in Australia. PARTICIPANTS: Convenience sample of 20 healthy older subjects (mean age, 72y) and 20 healthy young subjects (mean age, 24y). INTERVENTIONS: Changes in locomotor performance in response to perturbations to balance were quantified for healthy older adults compared with healthy young adults for (1) straight line walking at preferred speed, (2) straight line walking at fast speed, (3) figure-of-eight walking at preferred speed, and (4) figure-of-eight walking while performing a secondary motor task. MAIN OUTCOME MEASURES: Gait speed, stride length, cadence, and double-limb support duration, using a footswitch system. RESULTS: Healthy older people screened for pathology had gait patterns comparable to young adults for straight line walking at preferred speed. However, multivariate analysis of variance (MANOVA) showed a significant interaction between age and speed when balance was perturbed by requiring subjects to change from walking at preferred to fast speeds (Pillai-Bartlett trace=.259, F(4,35)=3.06, P<.029, partial eta(2)=.259). This occurred because older people did not increase their speed (F(1,38)=7.65, P<.01, partial eta(2)=.168) or stride length (F(1,38)=12.23, P<.01, partial eta(2)=.243) as much as did the young adults. MANOVAs did not show statistically significant interactions between age and turning conditions or age and dual task conditions, although older people walked more slowly and with shorter steps when turning or performing a secondary task. CONCLUSIONS: Balance strategies during gait are task specific and vary according to age. In response to challenges to balance imposed by the requirement to change from preferred to fast walking, older people did not increase their speed and stride length to the same extent as did younger adults. This was possibly a strategy to maintain their stability.     

Cardiac parasympathetic dysfunction related to depression in older adults with acute coronary syndromes

OBJECTIVE: To determine whether depression is associated with cardiac autonomic alterations in elderly patients with recent acute coronary syndromes (ACSs). METHODS: Cross-sectional study on the association between a major depressive episode or isolated depressive symptoms (21-item Hamilton depression score) and heart rate variability abnormalities in 56 adults (31 women, 55%) 60 years of age and older with a recent (24-72 h) myocardial infarction (MI) or unstable angina (UA). RESULTS: Spectral and nonspectral parameters of respiratory sinus arrhythmia, indicative of parasympathetic activity on the heart, were decreased in patients with depression (high-frequency heart rate variability [log ms(2)] 2.12+/-0.4 vs. 2.52+/-0.5, P=.024; pNN50 [%] 1+/-2 vs. 9+/-15, P=.006; and rMSNN [ms] 16+/-6 vs. 28+/-22, P=.009). Also, high-frequency heart rate variability decreased with increasing depressive symptom severity. CONCLUSION: In a sample of older adults suffering from ACSs, depression was associated with impaired parasympathetic control of the heart.     

Deprescribing opportunities for elderly inpatients in an academic,safety-net health system

BackgroundDeprescribing is one way to reduce inappropriate polypharmacy in older adult patients. Although algorithms have been published to guide practitioners in deprescribing, it is still unknown how applicable these algorithms are to the general older adult population.ObjectivesThe primary objective was to assess the applicability of published deprescribing protocols in hospitalized older adult patients.MethodsThis retrospective study included patients aged 65 years or greater who were discharged from an internal medicine team between January 1, 2017 and June 30, 2017. Along with age and admission to internal medicine wards, other eligibility criteria were extracted from published deprescribing protocols. The primary endpoint was the proportion of patients eligible for deprescribing based on published algorithms. Secondary endpoints included the proportion of patients receiving medications which were included in an algorithm, proportion of patients using medications included in the algorithms who were eligible for deprescribing, and proportion of patients with medications deprescribed during the hospital stay.ResultsTwo hundred sixty-seven patients were included and 124 (46.4%) used a medication with a published deprescribing algorithm. Thirty-four percent of all patients and 74% (92/124) of patients prescribed medications included in algorithms were eligible for deprescribing. Seven percent (6/92) of patients eligible for deprescribing had medications deprescribed during the hospital stay.ConclusionThe application of deprescribing algorithms in hospitalized older adults identified a significant opportunity to initiate deprescribing practices.