In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly...In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly care service models can no longer fully meet their needs.The integrated medical and elderly care model has emerged as the times require.It organically combines medical resources with elderly care resources to provide comprehensive and continuous health management services for the elderly,becoming an important approach to solving the problems of chronic disease management among the elderly.In this regard,this paper first elaborates on the role of integrated medical and elderly care in the management of chronic diseases among the elderly,and then puts forward application strategies of integrated medical and elderly care in the management of chronic diseases among the elderly,in order to provide certain reference for relevant researchers.展开更多
BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet the...BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.展开更多
Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleedi...Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleeding(UGIB).Methods:A prospective cohort study was conducted,and 126 middle-aged and elderly patients with UGIB admitted from August 2024 to August 2025 were selected as the study subjects.The patients were divided into the intervention group(63 cases)and the control group(63 cases)based on whether they received nursing intervention based on frailty prediction models.The control group received routine care,while the intervention group,on the basis of routine care,used the FRAIL scale combined with laboratory indicators(albumin,hemoglobin,etc.)to establish a predictive model to evaluate patients within 24 hours of admission,and implemented multi-dimensional targeted nursing intervention for pre-frailty or frailty patients screened out.The incidence of frailty,rebleeding rate,average length of stay,hospitalization cost,and nursing satisfaction during hospitalization were compared between the two groups.Results:The incidence of frailty during hospitalization in the intervention group was 11.1%(7 cases/63 cases),significantly lower than 31.7%(20 cases/63 cases)in the control group,and the difference was statistically significant(p<0.05).The rebleeding rate of 4.8%vs 12.7%,the average length of stay of(7.2±1.5)days vs(9.1±2.2)days,and the average hospitalization cost of(23,000±6,000)yuan vs(28,000±7,000)yuan in the intervention group were all lower than those in the control group(all p<0.05).The nursing satisfaction score of the intervention group(93.5±4.2)points was higher than that of the control group(86.3±5.8)points(p<0.05).Conclusion:The frailty prediction model applied to the peri-hospitalization care of middle-aged and elderly patients with UGIB can effectively identify frailty risk.Through early targeted intervention,the incidence of frailty and rebleeding rate can be reduced,the length of hospital stay can be shortened,medical expenses can be reduced,and nursing satisfaction can be improved,which has clinical promotion value.展开更多
With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service...With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service resources,uneven distribution,and prominent supply-demand contradictions have seriously affected service quality.Big data technology,with core advantages including data collection,analysis and mining,and accurate prediction,provides a new solution for the allocation of community elderly care service resources.This paper systematically studies the application value of big data technology in the allocation of community elderly care service resources from three aspects:resource allocation efficiency,service accuracy,and management intelligence.Combined with practical needs,it proposes optimal allocation strategies such as building a big data analysis platform and accurately grasping the elderly’s care needs,striving to provide operable path references for the construction of community elderly care service systems,promoting the early realization of the elderly care service goal of“adequate support and proper care for the elderly”,and boosting the high-quality development of China’s elderly care service industry.展开更多
This article reviews research advances in the application of early enteral nutrition(EEN)in elderly patients with severe acute pancreatitis(SAP).Elderly SAP patients are associated with higher mor tality rates due to ...This article reviews research advances in the application of early enteral nutrition(EEN)in elderly patients with severe acute pancreatitis(SAP).Elderly SAP patients are associated with higher mor tality rates due to age-related immune dysfunction,whereas EEN has been demonstrated to improve clinical prognosis,reduce infection and complication rates,and shor ten hospital stays.However,ongoing debates exist regarding the optimal timing,route selection,and complication management of EEN.Through a systematic review of the literature,this study synthesizes current evidence on EEN in elderly SAP populations,critically examines unresolved clinical controversies,and proposes future research priorities to inform evidence-based practice.展开更多
With the intensification of population aging in China,the problem of cognitive impairment in the elderly has become increasingly prominent,attracting widespread attention from all sectors of society.Geriatric cognitiv...With the intensification of population aging in China,the problem of cognitive impairment in the elderly has become increasingly prominent,attracting widespread attention from all sectors of society.Geriatric cognitive impairment is characterized by chronicity,which not only seriously threatens the health of the elderly and reduces their quality of life,but also imposes a heavy burden on families and society due to its long course.Attaching importance to and strengthening the chronic disease management of elderly cognitive impairment has profound significance for delaying disease progression,improving patients’quality of life,and reducing the burden of family care.Therefore,this paper first comprehensively understands elderly cognitive impairment by briefly elaborating on its definition and characteristics;on this basis,it focuses on exploring effective strategies for the chronic disease management of elderly cognitive impairment,hoping to provide new ideas and methods for the management of this condition and offer useful references for relevant clinical research and practice.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of pr...BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of prognosis.AIM To explore the effect of visceral obesity on postoperative complications and oncological outcomes in elderly patients with CRC.METHODS A total of 150 elderly patients who underwent radical surgery for CRC at Inner Mongolia Medical University and Inner Mongolia Autonomous Region People’s Hospital from January 2021 to June 2024 were retrospectively analyzed.Patients were divided into the abdominal[visceral fat area(VFA)≥100.00 cm^(2),n=80]and non-abdominal(VFA<100.00 cm^(2),n=70)obesity groups according to the VFA measured by preoperative computed tomography.The two groups showed no significant differences in age,sex,tumor location,tumor-node-metastasis stage,and underlying disease(P>0.05).All patients underwent standardized laparoscopic assisted surgery and received unified perioperative management.Complications,nutritional status,changes in biochemical indicators,and tumor recurrence and metastasis were evaluated postoperatively.RESULTS The overall incidence of postoperative complications was significantly higher in the abdominal obesity group than in the non-abdominal obesity group(P<0.05).The pulmonary infection on postoperative day(POD)3(P=0.038),anastomotic leakage on POD 7(P=0.042),and moderate-to-severe complications(Clavien-Dindo class III,P=0.03)were significantly different.With respect to biochemical indicators,the white blood cell count,neutrophil percentage,and C-reactive protein level in the abdominal obesity group continuously increased after surgery(P<0.05);the albumin level on POD 1 was even lower(P=0.024).Regarding tumor markers,carcinoembryonic antigen(P=0.039)and carbohydrate antigen 19-9(P=0.048)levels were significantly higher in the abdominal obesity group at 3 months after surgery,and local recurrence rates were higher than those in the non-abdominal obesity group at 30 days and 3 months after surgery(P<0.05).Abdominal obesity was an independent risk factor for postoperative complications(odds ratio:3.843,P=0.001),overall survival[hazard ratio(HR):1.937,P=0.011],and disease-free survival(HR:1.769,P=0.018).CONCLUSION Visceral obesity significantly increases the risk of postoperative complications in elderly patients with CRC and may adversely affect short-term tumor prognosis.Preoperative risk identification and interventions for abdominal obesity should be strengthened to improve perioperative safety and postoperative rehabilitation quality.展开更多
Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving re...Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving responsibilities often results in burnout,adding to the burden on caregivers.This issue also affects society and healthcare systems through increased costs and greater demands for support services.Understanding the factors contributing to caregiver burden is crucial for creating effective interventions to address these challenges.The aim of this study is to describe the extent of caregiver burden and identify some factors related to burden among caregivers of chronically ill elderly people.By gaining insight into these relationships,this study seeks to identify strategies to reduce the burden on caregivers.Methods:This study utilized a cross-sectional design to examine caregivers of the elderly with chronic diseases receiving treatment in the public healthcare facility.Data collection involved administering structured questionnaires that gathered information on the demographic characteristics of both the elderly and their caregivers,the level of social support received,the functional status of patients as measured by daily activity indices,and the level of caregiver burden.Description was used to elaborate the characteristics of participants.Mann-Whitney,Kruskal-Wallis,and Spearman's correlation test were applied to explore the relationship between variables.Statistical significance was determined at P value<0.05.Results:Caregivers of the elderly with chronic diseases had a moderate care burden score(22.62±11.24,CI:95%).The patients'level of dependence,relationship with the patients,and time spent as a caregiver were factors related to caregiver burden(P<0.05).Conclusions:Those who care for elderly people with chronic diseases suffered great burden.The finding had found a number of factors that influence the caregivers'weight loss.Healthcare providers should consider these relevant factors when developing intervention plans to reduce caregiver burden.展开更多
Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screenin...Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screening tool in HF outpatients. In this study, we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting individual risk of adverse prognosis.Methods Frailty was assessed at the initial visit using both a multimodal approach, incorporating Barthel Index, Older American Resources and Services scale, Pfeiffer Test, abbreviated Geriatric Depression Scale, age > 85 years, lacking support systems,and VES-13. Patients scoring ≥ 3 on VES-13 or meeting at least one multimodal criterion were classified as frail. Endpoints included all-cause mortality, a composite of death or HF hospitalization, and recurrent HF hospitalizations.Results A total of 301 patients were evaluated. VES-13 identified 40.2% as frail and the multimodal assessment 33.2%. In Cox regression analyses, frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for allcause mortality(HR = 3.70 [2.15–6.33], P < 0.001 vs. 2.40 [1.46–4.0], P = 0.001) and the composite endpoint(HR = 3.13 [2.02–4.84], P< 0.001 vs. 1.96 [1.28–2.99], P = 0.002). Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment. Additionally, stratifying patients by VES-13 tertiles provided robust risk differentiation.Conclusions VES-13, a simple frailty tool, outperformed a comprehensive multimodal assessment and could be easily integrated into routine HF care, highlighting its clinical utility in identifying patients at risk for poor outcomes.展开更多
Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip f...Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip fracture admitted to our hospital from January 2023 to January 2024 were selected and divided into the observation group(25 cases)and the control group(25 cases)by random number table method.The control group received routine nursing,while the observation group received early rehabilitation training on the basis of routine nursing.The balance ability(Berg Balance Scale,BBS)and quality of life(SF-36)of the two groups were compared.Results:The BBS scores of the observation group at all postoperative time points were significantly higher than those of the control group(p<0.05),and the quality-of-life scores of the observation group were also significantly higher than those of the control group(p<0.05).Conclusion:Early postoperative rehabilitation training for elderly patients with hip fracture can improve their balance ability,enhance their quality of life,and reduce the incidence of postoperative complications,which is worthy of clinical promotion.展开更多
Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney...Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Methods:Using convenience sampling,100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects.They were randomly divided into an experimental group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine health education and telephone follow-up,while the experimental group,in addition to the control group’s interventions,underwent combined exercise intervention based on the hospital-community-family model.Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores in five dimensions of intrinsic capacity(exercise,cognition,psychology,vitality,and sensation)were measured before the intervention,at 4 weeks of intervention,and at 12 weeks of intervention for both groups.Results:Before the exercise intervention,there were no statistically significant differences(p>0.05)between the two groups in terms of fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores across five dimensions of intrinsic capacity:mobility,cognition,psychology,vitality,and sensation.After 12 weeks of intervention,the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate,6-minute walk distance,and the dimensions of mobility,cognition,and vitality within intrinsic capacity,with all differences being statistically significant(p<0.05).Conversely,the experimental group showed significantly lower scores than the control group in fasting blood glucose,2-hour postprandial blood glucose,and the psychological dimension of intrinsic capacity,with these differences also being statistically significant(p<0.05).Conclusion:Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease,thereby improving their quality of life.The effectiveness of the intervention is positively correlated with the duration of the intervention.展开更多
BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a ...BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a higher prevalence of sleep disorders,anxiety,and depression owing to various factors.AIM To investigate the epidemiological characteristics and psychological factors associated with arrhythmia in the elderly and to establish a theoretical foundation for its prevention and treatment in older adults.METHODS A retrospective analysis was performed on 169 elderly patients admitted to the Shangqiu First People’s Hospital from December 2022 to December 2023.All subjects underwent 24-hour electrocardiogram monitoring to record heart rate,heart rate variability,and 24-hour ambulatory electrocardiogram data.Additionally,patients’medical records were reviewed to gather information on their general condition,including age,gender,underlying diseases,and other relevant factors.Patients were divided into four groups based on their Hamilton Anxiety(HAMA)and Hamilton Depression Rating Scale(HAMD)scores:Group A(HAMA scores≥7),Group B(HAMD scores≥7),Group C(both HAMA and HAMD scores≥7),and Group D(HAMA and HAMD scores<7).Psychological factors such as depression,anxiety,sleep status,and quality of life were analyzed.Pearson correlation was used to examine the relationship between scores from the Pittsburgh Sleep Quality Index(PSQI),HAMA/HAMD scales,and the Short Form 36-item Health Survey(SF-36)with the presence of arrhythmia.RESULTS Among the 169 patients,87(51.5%)had concurrent arrhythmia.Atrial arrhythmias constituted the largest proportion at 34.8%(30 out of 87),followed by sinustachycardia at 24.1%(21 out of 87),and ventricular arrhythmias at 9.2%(8 out of 87).Factors such as advanced age,coronary heart disease,hypertension,smoking,exposure to secondhand smoke,and residing in rural areas significantly increased the risk of developing arrhythmia.There was a statistically significant difference between the two groups regarding PSQI,HAMA-14,HAMD-17,and SF-36 scores.Pearson correlation analysis revealed that PSQI,HAMA-14,and HAMD-17 scores were positively correlated with arrhythmia in the elderly,while the SF-36 score was negatively correlated.The anxiety,depression,and combined anxiety–depression groups exhibited significantly higher PSQI,HAMA-14,and HAMD-17 scores compared to the nonanxiety and non-depression group.CONCLUSION Arrhythmia among the elderly is primarily found in individuals with advanced age and existing health conditions.It is also linked to psychological factors such as depression,anxiety,reduced quality of life,and sleep disturbances.展开更多
The concept of the elderly defined by age division and their rights argument have fallen into a theoretical predicament due to limited interpretative power and the suspicion of bias.This dilemma can be resolved throug...The concept of the elderly defined by age division and their rights argument have fallen into a theoretical predicament due to limited interpretative power and the suspicion of bias.This dilemma can be resolved through a holistic understanding of age.As a cognitive tool for human lifespan,age encompasses three meanings:duration of time,sequence of time,and dynamism of time.A holistic understanding of age allows us to reinterpret the image of the elderly as subjects and their claims to rights.In terms of subjectivity,the elderly represent the temporal characteristics of human individuals pursuing lifelong development in the dynamic life course of aging.Their proactive and active subject status is demonstrated through autonomous life planning,participation in social cooperation,and promotion of social development.Based on this subject construction,the content of elderly rights can be elaborated into a three-tiered structure from the inside out:the right to lifelong development under autonomous life planning,the right to equal implementation of life planning,and the right to receive assistance in cases of planning failure.展开更多
In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:du...In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:during the decision-making stage of whether to choose appointed guardianship,the lack of professionalism and availability of appointed guardians can easily hinder the elderly from choosing to apply it;during the establishment stage of appointed guardianship,the limited rules related to the appointed guardianship agreement can easily lead to the frustration of the elderly’s subjective will;during the operation stage of appointed guardianship,the insufficient accountability mechanisms for appointed guardians can easily lead to the infringement of the personal or property rights of the elderly.By reflecting on its jurisprudential causes,it can be found that the current law largely ignores the orientation of appointed guardianship as a welfare for the elderly in social law,the concept of substantive equality in the appointed guardianship agreement,and the theoretical attributes of the appointed guardianship as a fiduciary relationship.Therefore,the appointed guardianship system in China should be systematically improved to fully release its institutional potential in the protection of the rights and interests of the elderly based on these jurisprudential principles.In particular,it is possible to consider actively promoting the“trust+appointed guardianship”model and cultivating a team of appointed guardians by the state based on the concept of elderly welfare;strengthening the protection of notarization procedures and the reasonable design of the appointed guardianship agreement based on the concept of substantive equality;and refining the fiduciary standards of appointed guardians and strengthening guardianship supervision based on the nature of fiduciary relationship.展开更多
Against the backdrop of the accelerated aging of the population,the elderly care model integrating medical and elderly care services has become a crucial approach to addressing the challenges of elderly care.As direct...Against the backdrop of the accelerated aging of the population,the elderly care model integrating medical and elderly care services has become a crucial approach to addressing the challenges of elderly care.As direct providers of integrated medical and elderly care services,the professional competence of elderly caregivers directly affects the quality of services and the quality of life of the elderly.This paper aims to conduct an in-depth study on the professional competence of elderly caregivers under the integrated medical and elderly care model.Firstly,it clarifies the components of elderly caregivers’professional competence,analyzes the existing problems in their current professional competence,and proposes targeted improvement strategies.The purpose is to build a high-quality and professional team of elderly caregivers,provide strong support for the development of the integrated medical and elderly care cause,and promote the professionalization of integrated medical and elderly care services.展开更多
The protection of the rights and interests of the elderly is increasingly becoming a core element in advancing Chinese modernization,actively responding to population aging,and ensuring the living security and rights ...The protection of the rights and interests of the elderly is increasingly becoming a core element in advancing Chinese modernization,actively responding to population aging,and ensuring the living security and rights protection of the elderly.The existing policy and legal system for the elderly is continuously being perfected,with related laws,regulations,rules,and policy measures constantly improving.The standards and regulatory systems for the construction,operation,and development of the elderly care service system are becoming more robust,and the coverage of the protection of the rights and interests of the elderly is expanding rapidly.However,with the high-quality development of the economy and society,the deep transformation of social structure,form,culture,and institutions brings new challenges to the construction of the policy and legal system for the elderly.In the new era,the comprehensive rights and interests of the elderly,such as consumer rights,equal access to age-friendly products,information security protection,and social participation and development rights,need to be strengthened.Starting from the national strategy of actively responding to population aging,it is urgent to focus on the extended space of the protection of the rights and interests of the elderly in the new era,coordinate the development plans and institutional arrangements for the elderly cause,and construct and improve the policy and legal system for the elderly that is adapted to Chinese modernization.展开更多
BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and ...BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.展开更多
Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have fac...Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.展开更多
文摘In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly care service models can no longer fully meet their needs.The integrated medical and elderly care model has emerged as the times require.It organically combines medical resources with elderly care resources to provide comprehensive and continuous health management services for the elderly,becoming an important approach to solving the problems of chronic disease management among the elderly.In this regard,this paper first elaborates on the role of integrated medical and elderly care in the management of chronic diseases among the elderly,and then puts forward application strategies of integrated medical and elderly care in the management of chronic diseases among the elderly,in order to provide certain reference for relevant researchers.
基金Supported by Foundation of Shanghai Baoshan Science and Technology Commission,No.2024-E-66Shanghai Nursing Association Scientific Research Project,No.2024MS-B02.
文摘BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.
基金Construction and Application of Frailty Trajectory Prediction Model for Middle-aged and Elderly Patients with Upper Gastrointestinal Bleeding,Project Source:Sichuan Vocational College of Nursing(Project No.:2024ZRY25)。
文摘Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleeding(UGIB).Methods:A prospective cohort study was conducted,and 126 middle-aged and elderly patients with UGIB admitted from August 2024 to August 2025 were selected as the study subjects.The patients were divided into the intervention group(63 cases)and the control group(63 cases)based on whether they received nursing intervention based on frailty prediction models.The control group received routine care,while the intervention group,on the basis of routine care,used the FRAIL scale combined with laboratory indicators(albumin,hemoglobin,etc.)to establish a predictive model to evaluate patients within 24 hours of admission,and implemented multi-dimensional targeted nursing intervention for pre-frailty or frailty patients screened out.The incidence of frailty,rebleeding rate,average length of stay,hospitalization cost,and nursing satisfaction during hospitalization were compared between the two groups.Results:The incidence of frailty during hospitalization in the intervention group was 11.1%(7 cases/63 cases),significantly lower than 31.7%(20 cases/63 cases)in the control group,and the difference was statistically significant(p<0.05).The rebleeding rate of 4.8%vs 12.7%,the average length of stay of(7.2±1.5)days vs(9.1±2.2)days,and the average hospitalization cost of(23,000±6,000)yuan vs(28,000±7,000)yuan in the intervention group were all lower than those in the control group(all p<0.05).The nursing satisfaction score of the intervention group(93.5±4.2)points was higher than that of the control group(86.3±5.8)points(p<0.05).Conclusion:The frailty prediction model applied to the peri-hospitalization care of middle-aged and elderly patients with UGIB can effectively identify frailty risk.Through early targeted intervention,the incidence of frailty and rebleeding rate can be reduced,the length of hospital stay can be shortened,medical expenses can be reduced,and nursing satisfaction can be improved,which has clinical promotion value.
文摘With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service resources,uneven distribution,and prominent supply-demand contradictions have seriously affected service quality.Big data technology,with core advantages including data collection,analysis and mining,and accurate prediction,provides a new solution for the allocation of community elderly care service resources.This paper systematically studies the application value of big data technology in the allocation of community elderly care service resources from three aspects:resource allocation efficiency,service accuracy,and management intelligence.Combined with practical needs,it proposes optimal allocation strategies such as building a big data analysis platform and accurately grasping the elderly’s care needs,striving to provide operable path references for the construction of community elderly care service systems,promoting the early realization of the elderly care service goal of“adequate support and proper care for the elderly”,and boosting the high-quality development of China’s elderly care service industry.
基金supported by the Scientific Research Project of the Health Commission of Shanxi Province(No.2024003)。
文摘This article reviews research advances in the application of early enteral nutrition(EEN)in elderly patients with severe acute pancreatitis(SAP).Elderly SAP patients are associated with higher mor tality rates due to age-related immune dysfunction,whereas EEN has been demonstrated to improve clinical prognosis,reduce infection and complication rates,and shor ten hospital stays.However,ongoing debates exist regarding the optimal timing,route selection,and complication management of EEN.Through a systematic review of the literature,this study synthesizes current evidence on EEN in elderly SAP populations,critically examines unresolved clinical controversies,and proposes future research priorities to inform evidence-based practice.
文摘With the intensification of population aging in China,the problem of cognitive impairment in the elderly has become increasingly prominent,attracting widespread attention from all sectors of society.Geriatric cognitive impairment is characterized by chronicity,which not only seriously threatens the health of the elderly and reduces their quality of life,but also imposes a heavy burden on families and society due to its long course.Attaching importance to and strengthening the chronic disease management of elderly cognitive impairment has profound significance for delaying disease progression,improving patients’quality of life,and reducing the burden of family care.Therefore,this paper first comprehensively understands elderly cognitive impairment by briefly elaborating on its definition and characteristics;on this basis,it focuses on exploring effective strategies for the chronic disease management of elderly cognitive impairment,hoping to provide new ideas and methods for the management of this condition and offer useful references for relevant clinical research and practice.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
文摘BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of prognosis.AIM To explore the effect of visceral obesity on postoperative complications and oncological outcomes in elderly patients with CRC.METHODS A total of 150 elderly patients who underwent radical surgery for CRC at Inner Mongolia Medical University and Inner Mongolia Autonomous Region People’s Hospital from January 2021 to June 2024 were retrospectively analyzed.Patients were divided into the abdominal[visceral fat area(VFA)≥100.00 cm^(2),n=80]and non-abdominal(VFA<100.00 cm^(2),n=70)obesity groups according to the VFA measured by preoperative computed tomography.The two groups showed no significant differences in age,sex,tumor location,tumor-node-metastasis stage,and underlying disease(P>0.05).All patients underwent standardized laparoscopic assisted surgery and received unified perioperative management.Complications,nutritional status,changes in biochemical indicators,and tumor recurrence and metastasis were evaluated postoperatively.RESULTS The overall incidence of postoperative complications was significantly higher in the abdominal obesity group than in the non-abdominal obesity group(P<0.05).The pulmonary infection on postoperative day(POD)3(P=0.038),anastomotic leakage on POD 7(P=0.042),and moderate-to-severe complications(Clavien-Dindo class III,P=0.03)were significantly different.With respect to biochemical indicators,the white blood cell count,neutrophil percentage,and C-reactive protein level in the abdominal obesity group continuously increased after surgery(P<0.05);the albumin level on POD 1 was even lower(P=0.024).Regarding tumor markers,carcinoembryonic antigen(P=0.039)and carbohydrate antigen 19-9(P=0.048)levels were significantly higher in the abdominal obesity group at 3 months after surgery,and local recurrence rates were higher than those in the non-abdominal obesity group at 30 days and 3 months after surgery(P<0.05).Abdominal obesity was an independent risk factor for postoperative complications(odds ratio:3.843,P=0.001),overall survival[hazard ratio(HR):1.937,P=0.011],and disease-free survival(HR:1.769,P=0.018).CONCLUSION Visceral obesity significantly increases the risk of postoperative complications in elderly patients with CRC and may adversely affect short-term tumor prognosis.Preoperative risk identification and interventions for abdominal obesity should be strengthened to improve perioperative safety and postoperative rehabilitation quality.
基金Da Nang University of Medical Technology and PharmacyDa Nang C Hospital for the invaluable support they provided in facilitating this research。
文摘Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving responsibilities often results in burnout,adding to the burden on caregivers.This issue also affects society and healthcare systems through increased costs and greater demands for support services.Understanding the factors contributing to caregiver burden is crucial for creating effective interventions to address these challenges.The aim of this study is to describe the extent of caregiver burden and identify some factors related to burden among caregivers of chronically ill elderly people.By gaining insight into these relationships,this study seeks to identify strategies to reduce the burden on caregivers.Methods:This study utilized a cross-sectional design to examine caregivers of the elderly with chronic diseases receiving treatment in the public healthcare facility.Data collection involved administering structured questionnaires that gathered information on the demographic characteristics of both the elderly and their caregivers,the level of social support received,the functional status of patients as measured by daily activity indices,and the level of caregiver burden.Description was used to elaborate the characteristics of participants.Mann-Whitney,Kruskal-Wallis,and Spearman's correlation test were applied to explore the relationship between variables.Statistical significance was determined at P value<0.05.Results:Caregivers of the elderly with chronic diseases had a moderate care burden score(22.62±11.24,CI:95%).The patients'level of dependence,relationship with the patients,and time spent as a caregiver were factors related to caregiver burden(P<0.05).Conclusions:Those who care for elderly people with chronic diseases suffered great burden.The finding had found a number of factors that influence the caregivers'weight loss.Healthcare providers should consider these relevant factors when developing intervention plans to reduce caregiver burden.
文摘Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screening tool in HF outpatients. In this study, we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting individual risk of adverse prognosis.Methods Frailty was assessed at the initial visit using both a multimodal approach, incorporating Barthel Index, Older American Resources and Services scale, Pfeiffer Test, abbreviated Geriatric Depression Scale, age > 85 years, lacking support systems,and VES-13. Patients scoring ≥ 3 on VES-13 or meeting at least one multimodal criterion were classified as frail. Endpoints included all-cause mortality, a composite of death or HF hospitalization, and recurrent HF hospitalizations.Results A total of 301 patients were evaluated. VES-13 identified 40.2% as frail and the multimodal assessment 33.2%. In Cox regression analyses, frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for allcause mortality(HR = 3.70 [2.15–6.33], P < 0.001 vs. 2.40 [1.46–4.0], P = 0.001) and the composite endpoint(HR = 3.13 [2.02–4.84], P< 0.001 vs. 1.96 [1.28–2.99], P = 0.002). Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment. Additionally, stratifying patients by VES-13 tertiles provided robust risk differentiation.Conclusions VES-13, a simple frailty tool, outperformed a comprehensive multimodal assessment and could be easily integrated into routine HF care, highlighting its clinical utility in identifying patients at risk for poor outcomes.
基金Chongqing Education Science Planning Project.Project Name:Research on Talent Training of Community Rehabilitation Major in Higher Vocational Colleges Based on OBE Concept(Project No.:K23ZG3420222)。
文摘Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip fracture admitted to our hospital from January 2023 to January 2024 were selected and divided into the observation group(25 cases)and the control group(25 cases)by random number table method.The control group received routine nursing,while the observation group received early rehabilitation training on the basis of routine nursing.The balance ability(Berg Balance Scale,BBS)and quality of life(SF-36)of the two groups were compared.Results:The BBS scores of the observation group at all postoperative time points were significantly higher than those of the control group(p<0.05),and the quality-of-life scores of the observation group were also significantly higher than those of the control group(p<0.05).Conclusion:Early postoperative rehabilitation training for elderly patients with hip fracture can improve their balance ability,enhance their quality of life,and reduce the incidence of postoperative complications,which is worthy of clinical promotion.
基金2024 Medical Science Research Project Plan of Hebei Province:Research on the Rehabilitation Effect of Combined Exercise Intervention Based on a Hospital-Community-Family Model for Elderly Patients with Chronic Diseases(Project No.:20240083)Youth Science and Technology Project of the Hebei Provincial Health Department:Research on the Standardization Level of Self-Management in Patients with Diabetic Foot and Related Factors Affecting Wound Healing(Project No.:20190002)。
文摘Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Methods:Using convenience sampling,100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects.They were randomly divided into an experimental group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine health education and telephone follow-up,while the experimental group,in addition to the control group’s interventions,underwent combined exercise intervention based on the hospital-community-family model.Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores in five dimensions of intrinsic capacity(exercise,cognition,psychology,vitality,and sensation)were measured before the intervention,at 4 weeks of intervention,and at 12 weeks of intervention for both groups.Results:Before the exercise intervention,there were no statistically significant differences(p>0.05)between the two groups in terms of fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores across five dimensions of intrinsic capacity:mobility,cognition,psychology,vitality,and sensation.After 12 weeks of intervention,the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate,6-minute walk distance,and the dimensions of mobility,cognition,and vitality within intrinsic capacity,with all differences being statistically significant(p<0.05).Conversely,the experimental group showed significantly lower scores than the control group in fasting blood glucose,2-hour postprandial blood glucose,and the psychological dimension of intrinsic capacity,with these differences also being statistically significant(p<0.05).Conclusion:Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease,thereby improving their quality of life.The effectiveness of the intervention is positively correlated with the duration of the intervention.
文摘BACKGROUND Irregular heart rhythms are a primary manifestation of cardiovascular disease,considerably contributing to global morbidity and mortality rates.Moreover,patients with cardiac arrhythmias often experience a higher prevalence of sleep disorders,anxiety,and depression owing to various factors.AIM To investigate the epidemiological characteristics and psychological factors associated with arrhythmia in the elderly and to establish a theoretical foundation for its prevention and treatment in older adults.METHODS A retrospective analysis was performed on 169 elderly patients admitted to the Shangqiu First People’s Hospital from December 2022 to December 2023.All subjects underwent 24-hour electrocardiogram monitoring to record heart rate,heart rate variability,and 24-hour ambulatory electrocardiogram data.Additionally,patients’medical records were reviewed to gather information on their general condition,including age,gender,underlying diseases,and other relevant factors.Patients were divided into four groups based on their Hamilton Anxiety(HAMA)and Hamilton Depression Rating Scale(HAMD)scores:Group A(HAMA scores≥7),Group B(HAMD scores≥7),Group C(both HAMA and HAMD scores≥7),and Group D(HAMA and HAMD scores<7).Psychological factors such as depression,anxiety,sleep status,and quality of life were analyzed.Pearson correlation was used to examine the relationship between scores from the Pittsburgh Sleep Quality Index(PSQI),HAMA/HAMD scales,and the Short Form 36-item Health Survey(SF-36)with the presence of arrhythmia.RESULTS Among the 169 patients,87(51.5%)had concurrent arrhythmia.Atrial arrhythmias constituted the largest proportion at 34.8%(30 out of 87),followed by sinustachycardia at 24.1%(21 out of 87),and ventricular arrhythmias at 9.2%(8 out of 87).Factors such as advanced age,coronary heart disease,hypertension,smoking,exposure to secondhand smoke,and residing in rural areas significantly increased the risk of developing arrhythmia.There was a statistically significant difference between the two groups regarding PSQI,HAMA-14,HAMD-17,and SF-36 scores.Pearson correlation analysis revealed that PSQI,HAMA-14,and HAMD-17 scores were positively correlated with arrhythmia in the elderly,while the SF-36 score was negatively correlated.The anxiety,depression,and combined anxiety–depression groups exhibited significantly higher PSQI,HAMA-14,and HAMD-17 scores compared to the nonanxiety and non-depression group.CONCLUSION Arrhythmia among the elderly is primarily found in individuals with advanced age and existing health conditions.It is also linked to psychological factors such as depression,anxiety,reduced quality of life,and sleep disturbances.
基金the major project“Protection of Rights of Particular groups in the Digital Age,”a major project(Project Approval Number 22JJD820038)funded by the National Human Rights Education and Training Base.
文摘The concept of the elderly defined by age division and their rights argument have fallen into a theoretical predicament due to limited interpretative power and the suspicion of bias.This dilemma can be resolved through a holistic understanding of age.As a cognitive tool for human lifespan,age encompasses three meanings:duration of time,sequence of time,and dynamism of time.A holistic understanding of age allows us to reinterpret the image of the elderly as subjects and their claims to rights.In terms of subjectivity,the elderly represent the temporal characteristics of human individuals pursuing lifelong development in the dynamic life course of aging.Their proactive and active subject status is demonstrated through autonomous life planning,participation in social cooperation,and promotion of social development.Based on this subject construction,the content of elderly rights can be elaborated into a three-tiered structure from the inside out:the right to lifelong development under autonomous life planning,the right to equal implementation of life planning,and the right to receive assistance in cases of planning failure.
基金the National Social Science Fund of China Youth Project“Research on the Application Dilemma and Solutions of the Appointed Guardianship Clauses in the Civil Code”(Project Approval Number 20CFX075).
文摘In a deeply aging society,the appointed guardianship system,as an important arrangement for the protection of the rights and interests of the elderly,still faces many practical difficulties.Typical examples include:during the decision-making stage of whether to choose appointed guardianship,the lack of professionalism and availability of appointed guardians can easily hinder the elderly from choosing to apply it;during the establishment stage of appointed guardianship,the limited rules related to the appointed guardianship agreement can easily lead to the frustration of the elderly’s subjective will;during the operation stage of appointed guardianship,the insufficient accountability mechanisms for appointed guardians can easily lead to the infringement of the personal or property rights of the elderly.By reflecting on its jurisprudential causes,it can be found that the current law largely ignores the orientation of appointed guardianship as a welfare for the elderly in social law,the concept of substantive equality in the appointed guardianship agreement,and the theoretical attributes of the appointed guardianship as a fiduciary relationship.Therefore,the appointed guardianship system in China should be systematically improved to fully release its institutional potential in the protection of the rights and interests of the elderly based on these jurisprudential principles.In particular,it is possible to consider actively promoting the“trust+appointed guardianship”model and cultivating a team of appointed guardians by the state based on the concept of elderly welfare;strengthening the protection of notarization procedures and the reasonable design of the appointed guardianship agreement based on the concept of substantive equality;and refining the fiduciary standards of appointed guardians and strengthening guardianship supervision based on the nature of fiduciary relationship.
文摘Against the backdrop of the accelerated aging of the population,the elderly care model integrating medical and elderly care services has become a crucial approach to addressing the challenges of elderly care.As direct providers of integrated medical and elderly care services,the professional competence of elderly caregivers directly affects the quality of services and the quality of life of the elderly.This paper aims to conduct an in-depth study on the professional competence of elderly caregivers under the integrated medical and elderly care model.Firstly,it clarifies the components of elderly caregivers’professional competence,analyzes the existing problems in their current professional competence,and proposes targeted improvement strategies.The purpose is to build a high-quality and professional team of elderly caregivers,provide strong support for the development of the integrated medical and elderly care cause,and promote the professionalization of integrated medical and elderly care services.
基金the National Social Science Fund for Youth Project“Research on the Transformation of Multi-Dimensional Demographic Dividend Based on High-Quality Population Development”(Project Approval Number 24CRK001).
文摘The protection of the rights and interests of the elderly is increasingly becoming a core element in advancing Chinese modernization,actively responding to population aging,and ensuring the living security and rights protection of the elderly.The existing policy and legal system for the elderly is continuously being perfected,with related laws,regulations,rules,and policy measures constantly improving.The standards and regulatory systems for the construction,operation,and development of the elderly care service system are becoming more robust,and the coverage of the protection of the rights and interests of the elderly is expanding rapidly.However,with the high-quality development of the economy and society,the deep transformation of social structure,form,culture,and institutions brings new challenges to the construction of the policy and legal system for the elderly.In the new era,the comprehensive rights and interests of the elderly,such as consumer rights,equal access to age-friendly products,information security protection,and social participation and development rights,need to be strengthened.Starting from the national strategy of actively responding to population aging,it is urgent to focus on the extended space of the protection of the rights and interests of the elderly in the new era,coordinate the development plans and institutional arrangements for the elderly cause,and construct and improve the policy and legal system for the elderly that is adapted to Chinese modernization.
基金Supported by National High Level Hospital Clinical Research Funding(Youth Clinical Research Project of Peking University First Hospital),No.2023YC27Capital’s Funds for Health Improvement and Research,No.2022-2-40711National High Level Hospital Clinical Research Funding(Interdepartmental Research Project of Peking University First Hospital),No.2024IR20.
文摘BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.
基金Supported by Post-Subsidy Funds from the National Clinical Research Center,Ministry of Science and Technology of China,No.303-01-001-0272-08Beijing Municipal Administration of Hospitals Incubating Program,No.PX2022032Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI),No.JYY2023-13.
文摘Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.
