Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and ...BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.展开更多
Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAV...Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.展开更多
Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult v...Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult vascular injuries.Clinical deterioration is frequently subtle,with signs like fatigue or confusion mis-attributed to baseline status.In frail patients,these injuries may rapidly evolve into life-threatening scenarios.Conservative management,while standard,may be insufficient when vascular frailty or anticoagulation are present.Early clinical suspicion,serial hemoglobin checks,and multidisciplinary involvement are crucial.A dynamic assessment model that incorporates frailty,comorbidities,and physiological reserve alongside radiographic findings can better guide inter-vention and monitoring.Clinicians must lower the threshold for advanced imaging,such as computed tomography angiography,and consider early vascular consultation even in seemingly stable cases.Adopting a holistic,risk-based approach can mitigate complications and improve outcomes for this vulnerable population.展开更多
Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily a...Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily activities for over two years,resulting in widespread public health issues.展开更多
Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate th...Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.展开更多
Hypertension, often called the “silent killer”, is a major risk factor for heart attacks and strokes in the elderly. Its effective management is crucial to prevent damage to the heart, brain, and kidneys. Isolated s...Hypertension, often called the “silent killer”, is a major risk factor for heart attacks and strokes in the elderly. Its effective management is crucial to prevent damage to the heart, brain, and kidneys. Isolated systolic hypertension (ISH) is particularly critical in the elderly population. Cardiovascular risk factors, including pulse pressure and wave velocity, are closely associated with systolic blood pressure and influenced by arterial stiffness and wave reflections. Managing ISH is complex due to the potential negative effects of certain medications and individual variability in treatment response. This paper will address these issues, evaluating antihypertensive drugs, combination therapy, personalized treatment plans, and updated guidelines for managing ISH.展开更多
With the global population aging,the care of elderly cancer patients has become increasingly complex and significant.Comprehensive geriatric assessment(CGA),a multidimensional evaluation tool,has been widely implement...With the global population aging,the care of elderly cancer patients has become increasingly complex and significant.Comprehensive geriatric assessment(CGA),a multidimensional evaluation tool,has been widely implemented in oncology nursing to enhance the precision of treatment decisions and improve patient outcomes.This review examines the application of CGA in oncology nursing,drawing on literature published between 2010 and 2024 in major databases using keywords such as“Comprehensive Geriatric Assessment”and“Oncology Nursing”.It highlights how CGA contributes to optimizing treatment selection,monitoring the treatment process,and improving patients’quality of life and long-term outcomes.CGA provides a comprehensive evaluation of elderly cancer patients,including physical,psychological,and social aspects,enabling the identification of high-risk patients and reducing treatment-related side effects and complications.It also offers a critical foundation for developing personalized care plans.The article discusses various practical examples of CGA implementation across different countries and regions,including multidisciplinary collaborative models in France,the United States,and Australia,demonstrating CGA’s flexible application in diverse healthcare settings.Although significant progress has been made in applying CGA in oncology nursing,numerous challenges remain in its implementation,such as resource limitations and insufficient personnel training.Future research will focus on integrating CGA with emerging technologies,such as artificial intelligence and precision medicine,to further improve the quality of care and treatment outcomes for elderly cancer patients.By summarizing the current status and challenges of CGA in oncology nursing,this review provides guidance for future research and clinical practice,emphasizing the importance of advancing CGA application to meet the growing demands of elderly oncology care.展开更多
With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pre...With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pressure,the traditional family-based elderly care model is facing significant challenges and can hardly meet the elderly care needs.At present,the geriatric nursing models are relatively backward,which directly affects the quality of daily life,physical health and mental well-being of the elderly.Therefore,it is necessary to explore an appropriate geriatric nursing model to address the aging problem.Based on this,this paper analyzes and studies the current situation of geriatric nursing models under the background of healthy aging,providing references for relevant research and practice.展开更多
Arterial stiffness is considered an important indicator reflecting age-related changes in the vascular wall[1]and the risk of developing comorbidities,[2]primarily cardiovascular diseases.[3]Cardiovascular diseases re...Arterial stiffness is considered an important indicator reflecting age-related changes in the vascular wall[1]and the risk of developing comorbidities,[2]primarily cardiovascular diseases.[3]Cardiovascular diseases remain the leading cause of death worldwide.Many factors influence the rate of arterial aging.Research results have confirmed that arterial wall stiffness increases with an increasing number of risk factors,[4]as each of them acts independently through various mechanisms,adversely affecting the structure and function of the cardiovascular system.展开更多
AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 ...AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.展开更多
BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of an...BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.展开更多
Objective:To study the application effect of comprehensive geriatric assessment tool-oriented chronic disease trajectory nursing in community elderly hypertension.Methods:Sixty nine elderly hypertensive patients admit...Objective:To study the application effect of comprehensive geriatric assessment tool-oriented chronic disease trajectory nursing in community elderly hypertension.Methods:Sixty nine elderly hypertensive patients admitted to the hospital from April 2022 to April 2024 were randomly assigned to the intervention group(n=35)and the control group(n=34).The control group received routine community hypertension health management,while the intervention group underwent comprehensive geriatric assessment for comprehensive screening of elderly health issues based on routine management,and implemented targeted nursing interventions based on the characteristics of the chronic disease trajectory.After three months of intervention,the blood pressure,medication compliance,self-efficacy,and quality of life of the two groups were evaluated and analyzed.Results:After the intervention,the intervention group showed significant improvement in blood pressure control,medication compliance,self-management efficacy scores,and quality of life scores compared to the control group(P<0.05).Conclusion:Combining comprehensive geriatric assessment with the concept of chronic disease trajectory nursing in the management of community elderly hypertension can effectively optimize the effect of chronic disease management,which has important practical value.展开更多
Objective:To investigate the impact of applying PBL combined with virtual reality(VR)technology in clinical teaching of geriatric sarcopenia on students’knowledge acquisition,attitudes,and behaviors,providing practic...Objective:To investigate the impact of applying PBL combined with virtual reality(VR)technology in clinical teaching of geriatric sarcopenia on students’knowledge acquisition,attitudes,and behaviors,providing practical evidence for geriatric medicine teaching reform.Methods:Eighty clinical medicine undergraduate interns admitted to the geriatrics department of a hospital from January 2024 to June 2025 were randomly divided into an observation group(n=40)and a control group(n=40).The control group received traditional lecture-based instruction,while the observation group underwent PBL combined with VR technology.The two groups were compared on end-of-term theoretical knowledge assessment scores,clinical practice operation scores,teaching satisfaction,and clinical behavior observation scale scores.Results:Students in the observation group achieved significantly higher scores in basic theoretical knowledge(86.52±5.31)and clinical practice skills(88.15±4.26)compared to the control group(75.28±6.15)and(72.33±5.87),respectively(p<0.05).The observation group and control group students’awareness of geriatric sarcopenia and satisfaction with teaching methods were 95.00%and 97.50%,and 77.50%and 72.50%,respectively,with statistically significant differences(p<0.05);The observation group demonstrated significantly higher frequency of proactive sarcopenia screening,greater enthusiasm in participating in nutritional intervention plan development,and increased engagement in health education during clinical practice compared to the control group,with statistically significant differences(p<0.05).Conclusion:The application of a PBL combined with virtual reality(VR)technology teaching model in clinical teaching on geriatric sarcopenia significantly enhances students’foundational theoretical knowledge,improves their attitudes toward geriatric sarcopenia,and enhances their clinical practice behaviors.This represents a scientifically effective teaching method in geriatric medicine.展开更多
Aging is an inevitable process that is usually measured by chronological age,with people aged 65 and over being defined as"older individuals".There is disagreement in the current scientific literature regard...Aging is an inevitable process that is usually measured by chronological age,with people aged 65 and over being defined as"older individuals".There is disagreement in the current scientific literature regarding the best methods to estimate glomerular filtration rate(eGFR)in older adults.Several studies suggest the use of an age-adjusted definition to improve accuracy and avoid overdiagnosis.In contrast,some researchers argue that such changes could complicate the classification of chronic kidney disease(CKD).Several formulas,including the Modification of Diet in Renal Disease,CKD-Epidemiology Collaboration,and Cockcroft-Gault equations,are used to estimate eGFR.However,each of these formulas has significant limitations when applied to older adults,primarily due to sarcopenia and malnutrition,which greatly affect both muscle mass and creatinine levels.Alternative formulas,such as the Berlin Initiative Study and the Full Age Spectrum equations,provide more accurate estimates of values for older adults by accounting for age-related physiological changes.In frail older adults,the use of cystatin C leads to better eGFR calculations to assess renal function.Accurate eGFR measurements improve the health of older patients by enabling better medication dosing.A thorough approach that includes multiple calibrated diagnostic methods and a detailed geriatric assessment is necessary for the effective management of kidney disease and other age-related conditions in older adults.展开更多
At present,China has entered an aging society,and there is an urgent need for a large number of high-quality geriatric nursing professionals.However,the existing geriatric nursing team is difficult to meet the actual ...At present,China has entered an aging society,and there is an urgent need for a large number of high-quality geriatric nursing professionals.However,the existing geriatric nursing team is difficult to meet the actual needs both in terms of quality and quantity.In this regard,under the background of the integration of medical and elderly care services,colleges and universities should strengthen the training of geriatric nursing talents.This paper conducts an in-depth analysis on the training of geriatric nursing teams under the background of the integration of medical and elderly care services,aiming to provide some references for promoting the reform of geriatric nursing talent training in colleges and universities and improving the level of geriatric nursing services in China.展开更多
Objective:To investigate the effectiveness of standardized patient scenario simulation teaching in geriatric medicine clinical education and provide references for improving teaching methods in geriatrics.Methods:Sixt...Objective:To investigate the effectiveness of standardized patient scenario simulation teaching in geriatric medicine clinical education and provide references for improving teaching methods in geriatrics.Methods:Sixty-five clinical physicians from other departments who rotated into the Geriatric Medicine Department for training between August 2024 and July 2025 were randomly divided into a control group(n=32)and an observation group(n=33).The control group received traditional centralized theoretical lectures combined with instructor-led clinical mentoring,while the observation group underwent standardized patient scenario simulation training.The two groups were compared on post-rotation examination scores and teaching satisfaction metrics.Results:The observation group achieved significantly higher post-rotation examination scores(88.37±3.04)than the control group(80.17±3.29)(p<0.01).Teaching satisfaction surveys revealed that trainees in the observation group demonstrated significantly higher satisfaction than the control group(p<0.05)regarding the teaching method’s effectiveness in enhancing learning interest,independent learning ability,comprehensive clinical problem-solving skills,patient communication skills,teamwork capabilities,and research conceptualization abilities.Conclusion:Standardized patient scenario simulation teaching effectively improves clinical teaching quality in geriatric medicine,enhances trainees’comprehensive clinical competencies,and holds value for broader application.展开更多
The prevalence of Helicobacter pylori(H. pylori) infection and its complications increase with age. The majority of infected individuals remain asymptomatic throughout the life but 10%-20% develops peptic ulcer diseas...The prevalence of Helicobacter pylori(H. pylori) infection and its complications increase with age. The majority of infected individuals remain asymptomatic throughout the life but 10%-20% develops peptic ulcer disease and 1% gastric malignancies. The incidence of ulcers and their complications are more common in the older population resulting in higher hospitalization and mortality rates. The increased use of medications causing gastric mucosal damage and the decreased secretion of protective prostaglandins in elderly are major factors increasing gastric mucosal sensitivity to the destructive effects of H. pylori. Due to higher prevalence of gastrointestinal(GI) malignancies,upper GI endoscopy is mostly preferred in elderly for the diagnosis of infection. Therefore,"endoscopy and treat" strategy may be more appropriate instead of "test and treat" strategy for dyspeptic patients in older age. Urea breath test and stool antigen test can be used for control of eradication,except for special cases requiring follow-up with endoscopy. The indications for treatment and suggested eradication regimens are similar with other age groups; however,the eradication failure may be a more significant problem due to high antibiotic resistance and low compliance rate in elderly. Multidrug usage and drug interactions should always be consid-ered before starting the treatment. This paper reviews briefly the epidemiology,diagnosis,disease manifesta-tions,and treatment options of H. pylori in the geriatric population.展开更多
Objective: To investigate the research hotspots and development trends of Chinese geriatric medicine by analyzing the high-frequency keywords, core authors, research institutions and their collaborations in papers pub...Objective: To investigate the research hotspots and development trends of Chinese geriatric medicine by analyzing the high-frequency keywords, core authors, research institutions and their collaborations in papers published in the Chinese Journal of Geriatrics.Methods: Bibliometric methods and information visualization software(CiteSpace Ⅲ) were used to analyze the following 3 aspects: keywords, institutions and authors.Results: Overall, the number of papers published in the Chinese Journal of Geriatrics grew between 1994 and 2015. The top 3 institutions with the greatest numbers of published papers were Beijing Hospital,People's Liberation Army General Hospital and the Second Xiangya Hospital of Central South University.The authors with high productivity were Pulin Yu, Jianye Wang and Xiaoying Li. The terms "Diabetes","hypertension" and "myocardial infarction" were hotspot words that drew sustained attention in this field.Conclusions: Research on geriatric medicine is growing steadily in China. Hospitals and teaching hospitals are major contributors to publications. The collaboration of authors is more common within the same institutions or in the same regions. Clinical research is still the focus of current research. In the future, basic research should be strengthened, and collaborations between different institutions and regions should be promoted to achieve coordinated and integrated development in Chinese geriatric medicine.展开更多
Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 ...Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.展开更多
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
文摘BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.
文摘Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.
文摘Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult vascular injuries.Clinical deterioration is frequently subtle,with signs like fatigue or confusion mis-attributed to baseline status.In frail patients,these injuries may rapidly evolve into life-threatening scenarios.Conservative management,while standard,may be insufficient when vascular frailty or anticoagulation are present.Early clinical suspicion,serial hemoglobin checks,and multidisciplinary involvement are crucial.A dynamic assessment model that incorporates frailty,comorbidities,and physiological reserve alongside radiographic findings can better guide inter-vention and monitoring.Clinicians must lower the threshold for advanced imaging,such as computed tomography angiography,and consider early vascular consultation even in seemingly stable cases.Adopting a holistic,risk-based approach can mitigate complications and improve outcomes for this vulnerable population.
基金supported by the Convergence Medical Institute of Technology Policy Research Project(CMIT PRP 2022-03)at Pusan National University Hospital.
文摘Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily activities for over two years,resulting in widespread public health issues.
基金supported by grants from the Joint Tackling Project of Pudong Health Committee of Shanghai(PW2022D08)Medical Discipline Construction Project of Pudong Health Committee of Shanghai(PWZxq2022-6)+1 种基金Health and Family Planning Research Project of Pudong Health Committee of Shanghai(PW2021A-38)Youth Scientific Research Cultivation Fund Project of Shanghai Oriental Hospital(DFPY2022020).
文摘Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.
文摘Hypertension, often called the “silent killer”, is a major risk factor for heart attacks and strokes in the elderly. Its effective management is crucial to prevent damage to the heart, brain, and kidneys. Isolated systolic hypertension (ISH) is particularly critical in the elderly population. Cardiovascular risk factors, including pulse pressure and wave velocity, are closely associated with systolic blood pressure and influenced by arterial stiffness and wave reflections. Managing ISH is complex due to the potential negative effects of certain medications and individual variability in treatment response. This paper will address these issues, evaluating antihypertensive drugs, combination therapy, personalized treatment plans, and updated guidelines for managing ISH.
基金Supported by Henan Province Key Research and Development Program,No.231111311000Henan Provincial Science and Technology Research Project,No.232102310411+2 种基金Henan Province Medical Science and Technology Key Project,No.LHGJ20220566 and No.LHGJ20240365Henan Province Medical Education Research Project,No.WJLX2023079Zhengzhou Medical and Health Technology Innovation Guidance Program,No.2024YLZDJH022.
文摘With the global population aging,the care of elderly cancer patients has become increasingly complex and significant.Comprehensive geriatric assessment(CGA),a multidimensional evaluation tool,has been widely implemented in oncology nursing to enhance the precision of treatment decisions and improve patient outcomes.This review examines the application of CGA in oncology nursing,drawing on literature published between 2010 and 2024 in major databases using keywords such as“Comprehensive Geriatric Assessment”and“Oncology Nursing”.It highlights how CGA contributes to optimizing treatment selection,monitoring the treatment process,and improving patients’quality of life and long-term outcomes.CGA provides a comprehensive evaluation of elderly cancer patients,including physical,psychological,and social aspects,enabling the identification of high-risk patients and reducing treatment-related side effects and complications.It also offers a critical foundation for developing personalized care plans.The article discusses various practical examples of CGA implementation across different countries and regions,including multidisciplinary collaborative models in France,the United States,and Australia,demonstrating CGA’s flexible application in diverse healthcare settings.Although significant progress has been made in applying CGA in oncology nursing,numerous challenges remain in its implementation,such as resource limitations and insufficient personnel training.Future research will focus on integrating CGA with emerging technologies,such as artificial intelligence and precision medicine,to further improve the quality of care and treatment outcomes for elderly cancer patients.By summarizing the current status and challenges of CGA in oncology nursing,this review provides guidance for future research and clinical practice,emphasizing the importance of advancing CGA application to meet the growing demands of elderly oncology care.
文摘With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pressure,the traditional family-based elderly care model is facing significant challenges and can hardly meet the elderly care needs.At present,the geriatric nursing models are relatively backward,which directly affects the quality of daily life,physical health and mental well-being of the elderly.Therefore,it is necessary to explore an appropriate geriatric nursing model to address the aging problem.Based on this,this paper analyzes and studies the current situation of geriatric nursing models under the background of healthy aging,providing references for relevant research and practice.
文摘Arterial stiffness is considered an important indicator reflecting age-related changes in the vascular wall[1]and the risk of developing comorbidities,[2]primarily cardiovascular diseases.[3]Cardiovascular diseases remain the leading cause of death worldwide.Many factors influence the rate of arterial aging.Research results have confirmed that arterial wall stiffness increases with an increasing number of risk factors,[4]as each of them acts independently through various mechanisms,adversely affecting the structure and function of the cardiovascular system.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.
文摘BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.
基金Nanjing Medical University 2023 Education Research Project(Project No.:2023LX103):Design and Practice of a Primary Care Chronic Disease Management Course Based on the BOPPPS Model-A Case Study of Taizhou RegionTaizhou People’s Hospital Nursing Research Special Project(Project No.:HLYB202411):The Impact of 5A Model-Based Exercise Rehabilitation Guidance on Exercise Adherence in Young and Middle-Aged Hypertensive Patients.
文摘Objective:To study the application effect of comprehensive geriatric assessment tool-oriented chronic disease trajectory nursing in community elderly hypertension.Methods:Sixty nine elderly hypertensive patients admitted to the hospital from April 2022 to April 2024 were randomly assigned to the intervention group(n=35)and the control group(n=34).The control group received routine community hypertension health management,while the intervention group underwent comprehensive geriatric assessment for comprehensive screening of elderly health issues based on routine management,and implemented targeted nursing interventions based on the characteristics of the chronic disease trajectory.After three months of intervention,the blood pressure,medication compliance,self-efficacy,and quality of life of the two groups were evaluated and analyzed.Results:After the intervention,the intervention group showed significant improvement in blood pressure control,medication compliance,self-management efficacy scores,and quality of life scores compared to the control group(P<0.05).Conclusion:Combining comprehensive geriatric assessment with the concept of chronic disease trajectory nursing in the management of community elderly hypertension can effectively optimize the effect of chronic disease management,which has important practical value.
文摘Objective:To investigate the impact of applying PBL combined with virtual reality(VR)technology in clinical teaching of geriatric sarcopenia on students’knowledge acquisition,attitudes,and behaviors,providing practical evidence for geriatric medicine teaching reform.Methods:Eighty clinical medicine undergraduate interns admitted to the geriatrics department of a hospital from January 2024 to June 2025 were randomly divided into an observation group(n=40)and a control group(n=40).The control group received traditional lecture-based instruction,while the observation group underwent PBL combined with VR technology.The two groups were compared on end-of-term theoretical knowledge assessment scores,clinical practice operation scores,teaching satisfaction,and clinical behavior observation scale scores.Results:Students in the observation group achieved significantly higher scores in basic theoretical knowledge(86.52±5.31)and clinical practice skills(88.15±4.26)compared to the control group(75.28±6.15)and(72.33±5.87),respectively(p<0.05).The observation group and control group students’awareness of geriatric sarcopenia and satisfaction with teaching methods were 95.00%and 97.50%,and 77.50%and 72.50%,respectively,with statistically significant differences(p<0.05);The observation group demonstrated significantly higher frequency of proactive sarcopenia screening,greater enthusiasm in participating in nutritional intervention plan development,and increased engagement in health education during clinical practice compared to the control group,with statistically significant differences(p<0.05).Conclusion:The application of a PBL combined with virtual reality(VR)technology teaching model in clinical teaching on geriatric sarcopenia significantly enhances students’foundational theoretical knowledge,improves their attitudes toward geriatric sarcopenia,and enhances their clinical practice behaviors.This represents a scientifically effective teaching method in geriatric medicine.
文摘Aging is an inevitable process that is usually measured by chronological age,with people aged 65 and over being defined as"older individuals".There is disagreement in the current scientific literature regarding the best methods to estimate glomerular filtration rate(eGFR)in older adults.Several studies suggest the use of an age-adjusted definition to improve accuracy and avoid overdiagnosis.In contrast,some researchers argue that such changes could complicate the classification of chronic kidney disease(CKD).Several formulas,including the Modification of Diet in Renal Disease,CKD-Epidemiology Collaboration,and Cockcroft-Gault equations,are used to estimate eGFR.However,each of these formulas has significant limitations when applied to older adults,primarily due to sarcopenia and malnutrition,which greatly affect both muscle mass and creatinine levels.Alternative formulas,such as the Berlin Initiative Study and the Full Age Spectrum equations,provide more accurate estimates of values for older adults by accounting for age-related physiological changes.In frail older adults,the use of cystatin C leads to better eGFR calculations to assess renal function.Accurate eGFR measurements improve the health of older patients by enabling better medication dosing.A thorough approach that includes multiple calibrated diagnostic methods and a detailed geriatric assessment is necessary for the effective management of kidney disease and other age-related conditions in older adults.
文摘At present,China has entered an aging society,and there is an urgent need for a large number of high-quality geriatric nursing professionals.However,the existing geriatric nursing team is difficult to meet the actual needs both in terms of quality and quantity.In this regard,under the background of the integration of medical and elderly care services,colleges and universities should strengthen the training of geriatric nursing talents.This paper conducts an in-depth analysis on the training of geriatric nursing teams under the background of the integration of medical and elderly care services,aiming to provide some references for promoting the reform of geriatric nursing talent training in colleges and universities and improving the level of geriatric nursing services in China.
文摘Objective:To investigate the effectiveness of standardized patient scenario simulation teaching in geriatric medicine clinical education and provide references for improving teaching methods in geriatrics.Methods:Sixty-five clinical physicians from other departments who rotated into the Geriatric Medicine Department for training between August 2024 and July 2025 were randomly divided into a control group(n=32)and an observation group(n=33).The control group received traditional centralized theoretical lectures combined with instructor-led clinical mentoring,while the observation group underwent standardized patient scenario simulation training.The two groups were compared on post-rotation examination scores and teaching satisfaction metrics.Results:The observation group achieved significantly higher post-rotation examination scores(88.37±3.04)than the control group(80.17±3.29)(p<0.01).Teaching satisfaction surveys revealed that trainees in the observation group demonstrated significantly higher satisfaction than the control group(p<0.05)regarding the teaching method’s effectiveness in enhancing learning interest,independent learning ability,comprehensive clinical problem-solving skills,patient communication skills,teamwork capabilities,and research conceptualization abilities.Conclusion:Standardized patient scenario simulation teaching effectively improves clinical teaching quality in geriatric medicine,enhances trainees’comprehensive clinical competencies,and holds value for broader application.
文摘The prevalence of Helicobacter pylori(H. pylori) infection and its complications increase with age. The majority of infected individuals remain asymptomatic throughout the life but 10%-20% develops peptic ulcer disease and 1% gastric malignancies. The incidence of ulcers and their complications are more common in the older population resulting in higher hospitalization and mortality rates. The increased use of medications causing gastric mucosal damage and the decreased secretion of protective prostaglandins in elderly are major factors increasing gastric mucosal sensitivity to the destructive effects of H. pylori. Due to higher prevalence of gastrointestinal(GI) malignancies,upper GI endoscopy is mostly preferred in elderly for the diagnosis of infection. Therefore,"endoscopy and treat" strategy may be more appropriate instead of "test and treat" strategy for dyspeptic patients in older age. Urea breath test and stool antigen test can be used for control of eradication,except for special cases requiring follow-up with endoscopy. The indications for treatment and suggested eradication regimens are similar with other age groups; however,the eradication failure may be a more significant problem due to high antibiotic resistance and low compliance rate in elderly. Multidrug usage and drug interactions should always be consid-ered before starting the treatment. This paper reviews briefly the epidemiology,diagnosis,disease manifesta-tions,and treatment options of H. pylori in the geriatric population.
基金supported and funded by the National Natural Science Foundation of China(No.71403155)supported by the Shanxi Federation of Social Science Circles(No.SSKLZDKT2014084)the Scientific and Technological Innovation Programs of Higher Education Institutions in Shanxi(No.2017SY043)
文摘Objective: To investigate the research hotspots and development trends of Chinese geriatric medicine by analyzing the high-frequency keywords, core authors, research institutions and their collaborations in papers published in the Chinese Journal of Geriatrics.Methods: Bibliometric methods and information visualization software(CiteSpace Ⅲ) were used to analyze the following 3 aspects: keywords, institutions and authors.Results: Overall, the number of papers published in the Chinese Journal of Geriatrics grew between 1994 and 2015. The top 3 institutions with the greatest numbers of published papers were Beijing Hospital,People's Liberation Army General Hospital and the Second Xiangya Hospital of Central South University.The authors with high productivity were Pulin Yu, Jianye Wang and Xiaoying Li. The terms "Diabetes","hypertension" and "myocardial infarction" were hotspot words that drew sustained attention in this field.Conclusions: Research on geriatric medicine is growing steadily in China. Hospitals and teaching hospitals are major contributors to publications. The collaboration of authors is more common within the same institutions or in the same regions. Clinical research is still the focus of current research. In the future, basic research should be strengthened, and collaborations between different institutions and regions should be promoted to achieve coordinated and integrated development in Chinese geriatric medicine.
基金supported by a key Program of the Chongqing Scientific and Technological Commission(Grant Number.CSTB2022TIAD-KPX0165).
文摘Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.
