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
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are e...BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.展开更多
BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization r...BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.展开更多
BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postope...BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.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
Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of diffe...Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.展开更多
Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 ...Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.展开更多
According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the re...BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the research trends in anesthesia management for elderly patients undergoing gastroenteroscopy.METHODS We performed a literature search using the Web of Science database to identify articles published between 2004 and 2023.Bibliometric and visual analyses were conducted using CiteSpace,R,and VOSviewer to explore the current research landscape of anesthesia administration in painless gastroenteroscopy for elderly patients and to identify future research directions by examining trends and emerging hotspots in this domain.RESULTS A total of 800 articles were examined,revealing a rising trend in annual pub-lication counts.The United States led with 181 articles,followed by China with 112,collectively contributing over 35%of the studies among the top ten countries.The majority of publications appeared in the United States journals,with the top three being Gastrointestinal Endoscopy[impact factor(IF)=7.7,H-index=26],Digestive Diseases and Sciences(IF=3.1),and Endoscopy(IF=9.3).Six primary research clusters were identified:Obstructive sleep apnea and airway manage-ment,surveillance and risk factors,colorectal cancer examination and treatment,sedation and safety of propofol and midazolam,patient satisfaction,and mortality and complications.These findings underscore the pivotal focus areas in anesthesia for elderly patients undergoing gastroenteroscopy.CONCLUSION A comprehensive understanding of current research trends and hotspots will aid anesthesiologists in developing more evidence-based practices,thereby improving the safety and outcomes for elderly patients undergoing gastroenteroscopy.展开更多
BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a p...BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients,ultimately achieving more standardized and effi cient SAE management.METHODS:We performed a literature search in four databases-PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang-from inception to April 2025 using bilinguals(Chinese and English).RESULTS:The diagnostic criteria for SAE in elderly individuals include the following:(1)sepsis;(2)new-onset neurological dysfunction;and(3)exclusion of other causes of neurological dysfunction.Physicians should develop tailored empiric anti-infective plans for elderly SAE patients,considering comorbidities,organ function,infection site,local bacterial spectrum,and resistance.The treatment protocol can be adjusted once the pathogen is identifi ed.Stabilizing hemodynamics and ensuring cerebral perfusion are two fl uid resuscitation strategies used in elderly SAE patients.An individualized approach to fl uid resuscitation using restrictive fl uid volumes should be employed.Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation,controlling blood glucose levels,and correcting internal imbalances.Early rehabilitation,nutritional support,cognitive training,and family-based emotional support are important components of comprehensive care.CONCLUSION:The diagnosis and management of SAE in elderly patients support early recognition and timely intervention.展开更多
Objective:To analyze the application value of remazolam compound alfentanil anesthesia regimen in fiberoptic bronchoscopy in elderly debilitated patients.Methods:Seventy-two cases of elderly debilitated patients who u...Objective:To analyze the application value of remazolam compound alfentanil anesthesia regimen in fiberoptic bronchoscopy in elderly debilitated patients.Methods:Seventy-two cases of elderly debilitated patients who underwent fiberoptic bronchoscopy in the Department of Respiratory Medicine of a hospital from August 2023 to July 2024 were selected,and were divided into the control group and the observation group using the mean score method,with 36 cases in each group.In both groups,7–10μg/kg alfentanil was injected intravenously after oxygen denitrification,and 1 min later propofol 1.5 mg/kg was given intravenously in the control group and remazolam 0.3 mg/kg was given intravenously in the observation group.Subsequently,mivacurium chloride 0.1mg/kg IV was given to both groups.Propofol 5mg/(kg-h)was given in the control group and remazolam 0.5mg/(kg-h)was given intravenously pumped in the observation group during anesthesia maintenance.Changes in vital signs such as HR,MAP and SpO_(2) and the occurrence of adverse reactions were recorded in the two groups before anesthesia administration(T_(1)),at the moment of placing fiberoptic bronchoscope(T_(2)),at the moment of placing the tracheal tube(T_(3)),and at 1 min after placing the tracheal tube(T4).Results:Compared with T1,patients in the observation group had lower MAP at T_(2),T_(3),T_(4) and lower SpO_(2) at T_(3),T_(4)(P<0.05);in the control group,HR slowed down at T_(2),T_(3),T_(4) and MAP and SpO_(2) decreased at T_(2),T_(3),T_(4)(P<0.05).SpO_(2) at T_(3) and T_(4) was lower in both groups compared with that at T2(P<0.05).SpO_(2) at T_(4) was lower in the control group compared with that at T_(3)(P<0.05).Compared with the control group,patients in the observation group suffered from increased HR and elevated MAP at T_(2),T_(3),and T_(4),and increased SpO_(2) at T_(3) and T4(P<0.05).The incidence of intraoperative hypotension and bradycardia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of intraoperative choking and coughing,postoperative hypoxemia,nausea and vomiting,and dizziness were found in the patients of both groups,drowsiness and other adverse reactions incidence rate comparison,the difference are not statistically significant(P>0.05).Conclusion:Remazolam and alfentanil are used in fiberoptic bronchoscopy for elderly debilitated patients with remarkable effect,which can effectively improve the vital signs of patients,reduce the risk of intraoperative hypotension,bradycardia,and other adverse reactions,and have high anesthetic effectiveness and safety.展开更多
Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a...Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.展开更多
The nutritional situation of the elderly is closely related to the occurrence and development of many diseases.How to reduce the damage of surgery,and improve the postoperative survival rate and quality of life in mal...The nutritional situation of the elderly is closely related to the occurrence and development of many diseases.How to reduce the damage of surgery,and improve the postoperative survival rate and quality of life in malnourished elderly patients is very important.Through the elderly malnutrition perioperative risk factors analysis,we make strategies for risk factors of perioperative-related prevention,from preoperative,intraoperative,and postoperative management of patients,to improve the patient’s life.展开更多
The global increase in life expectancy poses challenges related to the safety and well-being of the elderly population,especially in relation to falls.While falls can lead to significant cognitive impairments,timely i...The global increase in life expectancy poses challenges related to the safety and well-being of the elderly population,especially in relation to falls.While falls can lead to significant cognitive impairments,timely intervention can mitigate their adverse effects.In this context,the need for non-invasive,efficient monitoring systems becomes paramount.Although wearable sensors have gained traction for monitoring health activities,they may cause discomfort during prolonged use,especially for the elderly.To address this issue,we present an intelligent,non-invasive Software-Defined Radio Frequency(SDRF)sensing system,tailored red for monitoring elderly people’s falls during routine activities.Harnessing the power of deep learning and machine learning,our system processes the Wireless Channel State Information(WCSI)generated during regular and fall activities.By employing sophisticated signal processing techniques,the system captures unique patterns that distinguish falls from normal activities.In addition,we use statistical features to streamline data processing,thereby optimizing the computational efficiency of the system.Our experiments,conducted for a typical home environment while using treadmill,demonstrate the robustness of the system.The results show high classification accuracies of 92.5%,95.1%,and 99.8%for three Artificial Intelligence(AI)algorithms.Notably,the SDRF-based approach offers flexibility,cost-effectiveness,and adaptability through software modifications,circumventing the need for hardware overhaul.This research attempts to bridge the gap in RF-based sensing for elderly fall monitoring,providing a solution that combines the benefits of non-invasiveness with the precision of deep learning and machine learning.展开更多
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.
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.
文摘BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.
文摘BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.
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.
文摘Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.
文摘Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
文摘BACKGROUND Administering anesthesia to elderly patients undergoing gastroenteroscopy necessitates careful attention due to age-related physiological changes and an increased risk of complications.AIM To analyze the research trends in anesthesia management for elderly patients undergoing gastroenteroscopy.METHODS We performed a literature search using the Web of Science database to identify articles published between 2004 and 2023.Bibliometric and visual analyses were conducted using CiteSpace,R,and VOSviewer to explore the current research landscape of anesthesia administration in painless gastroenteroscopy for elderly patients and to identify future research directions by examining trends and emerging hotspots in this domain.RESULTS A total of 800 articles were examined,revealing a rising trend in annual pub-lication counts.The United States led with 181 articles,followed by China with 112,collectively contributing over 35%of the studies among the top ten countries.The majority of publications appeared in the United States journals,with the top three being Gastrointestinal Endoscopy[impact factor(IF)=7.7,H-index=26],Digestive Diseases and Sciences(IF=3.1),and Endoscopy(IF=9.3).Six primary research clusters were identified:Obstructive sleep apnea and airway manage-ment,surveillance and risk factors,colorectal cancer examination and treatment,sedation and safety of propofol and midazolam,patient satisfaction,and mortality and complications.These findings underscore the pivotal focus areas in anesthesia for elderly patients undergoing gastroenteroscopy.CONCLUSION A comprehensive understanding of current research trends and hotspots will aid anesthesiologists in developing more evidence-based practices,thereby improving the safety and outcomes for elderly patients undergoing gastroenteroscopy.
基金supported by the Beijing Clinical Key Specialty Project(2023).
文摘BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients,ultimately achieving more standardized and effi cient SAE management.METHODS:We performed a literature search in four databases-PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang-from inception to April 2025 using bilinguals(Chinese and English).RESULTS:The diagnostic criteria for SAE in elderly individuals include the following:(1)sepsis;(2)new-onset neurological dysfunction;and(3)exclusion of other causes of neurological dysfunction.Physicians should develop tailored empiric anti-infective plans for elderly SAE patients,considering comorbidities,organ function,infection site,local bacterial spectrum,and resistance.The treatment protocol can be adjusted once the pathogen is identifi ed.Stabilizing hemodynamics and ensuring cerebral perfusion are two fl uid resuscitation strategies used in elderly SAE patients.An individualized approach to fl uid resuscitation using restrictive fl uid volumes should be employed.Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation,controlling blood glucose levels,and correcting internal imbalances.Early rehabilitation,nutritional support,cognitive training,and family-based emotional support are important components of comprehensive care.CONCLUSION:The diagnosis and management of SAE in elderly patients support early recognition and timely intervention.
文摘Objective:To analyze the application value of remazolam compound alfentanil anesthesia regimen in fiberoptic bronchoscopy in elderly debilitated patients.Methods:Seventy-two cases of elderly debilitated patients who underwent fiberoptic bronchoscopy in the Department of Respiratory Medicine of a hospital from August 2023 to July 2024 were selected,and were divided into the control group and the observation group using the mean score method,with 36 cases in each group.In both groups,7–10μg/kg alfentanil was injected intravenously after oxygen denitrification,and 1 min later propofol 1.5 mg/kg was given intravenously in the control group and remazolam 0.3 mg/kg was given intravenously in the observation group.Subsequently,mivacurium chloride 0.1mg/kg IV was given to both groups.Propofol 5mg/(kg-h)was given in the control group and remazolam 0.5mg/(kg-h)was given intravenously pumped in the observation group during anesthesia maintenance.Changes in vital signs such as HR,MAP and SpO_(2) and the occurrence of adverse reactions were recorded in the two groups before anesthesia administration(T_(1)),at the moment of placing fiberoptic bronchoscope(T_(2)),at the moment of placing the tracheal tube(T_(3)),and at 1 min after placing the tracheal tube(T4).Results:Compared with T1,patients in the observation group had lower MAP at T_(2),T_(3),T_(4) and lower SpO_(2) at T_(3),T_(4)(P<0.05);in the control group,HR slowed down at T_(2),T_(3),T_(4) and MAP and SpO_(2) decreased at T_(2),T_(3),T_(4)(P<0.05).SpO_(2) at T_(3) and T_(4) was lower in both groups compared with that at T2(P<0.05).SpO_(2) at T_(4) was lower in the control group compared with that at T_(3)(P<0.05).Compared with the control group,patients in the observation group suffered from increased HR and elevated MAP at T_(2),T_(3),and T_(4),and increased SpO_(2) at T_(3) and T4(P<0.05).The incidence of intraoperative hypotension and bradycardia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of intraoperative choking and coughing,postoperative hypoxemia,nausea and vomiting,and dizziness were found in the patients of both groups,drowsiness and other adverse reactions incidence rate comparison,the difference are not statistically significant(P>0.05).Conclusion:Remazolam and alfentanil are used in fiberoptic bronchoscopy for elderly debilitated patients with remarkable effect,which can effectively improve the vital signs of patients,reduce the risk of intraoperative hypotension,bradycardia,and other adverse reactions,and have high anesthetic effectiveness and safety.
基金supported by Science and Technology Planning Project of Guangzhou City(2024A04J4474).
文摘Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.
基金supported by Emerging Industry Leading Talent Project of Shanxi Province(No.2020587).
文摘The nutritional situation of the elderly is closely related to the occurrence and development of many diseases.How to reduce the damage of surgery,and improve the postoperative survival rate and quality of life in malnourished elderly patients is very important.Through the elderly malnutrition perioperative risk factors analysis,we make strategies for risk factors of perioperative-related prevention,from preoperative,intraoperative,and postoperative management of patients,to improve the patient’s life.
基金supported in part by the Institute of Advanced Technology,University of Science and Technology of China (USTC) under Grant PF02023001Ythe Zayed Health Center at United Arab Emirates University (UAEU) under Grant G00003476COMSATS University Islamabad,Attock Campus。
文摘The global increase in life expectancy poses challenges related to the safety and well-being of the elderly population,especially in relation to falls.While falls can lead to significant cognitive impairments,timely intervention can mitigate their adverse effects.In this context,the need for non-invasive,efficient monitoring systems becomes paramount.Although wearable sensors have gained traction for monitoring health activities,they may cause discomfort during prolonged use,especially for the elderly.To address this issue,we present an intelligent,non-invasive Software-Defined Radio Frequency(SDRF)sensing system,tailored red for monitoring elderly people’s falls during routine activities.Harnessing the power of deep learning and machine learning,our system processes the Wireless Channel State Information(WCSI)generated during regular and fall activities.By employing sophisticated signal processing techniques,the system captures unique patterns that distinguish falls from normal activities.In addition,we use statistical features to streamline data processing,thereby optimizing the computational efficiency of the system.Our experiments,conducted for a typical home environment while using treadmill,demonstrate the robustness of the system.The results show high classification accuracies of 92.5%,95.1%,and 99.8%for three Artificial Intelligence(AI)algorithms.Notably,the SDRF-based approach offers flexibility,cost-effectiveness,and adaptability through software modifications,circumventing the need for hardware overhaul.This research attempts to bridge the gap in RF-based sensing for elderly fall monitoring,providing a solution that combines the benefits of non-invasiveness with the precision of deep learning and machine learning.
