An original mathematical model,previously tested by the authors on other non-demographic objects,is proposed for describing and forecasting demographic systems—the population of the countries of the World using the e...An original mathematical model,previously tested by the authors on other non-demographic objects,is proposed for describing and forecasting demographic systems—the population of the countries of the World using the examples of the USA,China and Russia,as well as the number of mice in the“mouse paradise”experiment of the American scientist John Calhoun.The proposed approach allows us to describe the stages and features of this dynamics:population growth in the USA,growth and possible decrease in the population in China,loss of a part of the population of the Russian Empire and the USSR due to two world wars and the collapse of the USSR,biological degradation of the“mouse paradise”up to its complete extinction.The use of the kinetic model of aging of various types of living systems to predict the development of the number of demographic systems is based on the assumptions that the aging and development processes are related to each other and have the same statistical regularity,reflecting the fractal principle of Nature-the unity of structure and function.The results obtained suggest that a person,a population of the World,humanity and other biological species develop and simultaneously age like each other under the conditions of the always existing syndrome of general adaptation(stress)and according to the same pattern corresponding to the mathematical model proposed here.展开更多
Few studies examine the benefits from geriatric telepsychiatry in rural retirement communities.Objectives:1.To demonstrate that using telepsychiatry(a)standard approaches to psychiatric evaluation would yield diagnose...Few studies examine the benefits from geriatric telepsychiatry in rural retirement communities.Objectives:1.To demonstrate that using telepsychiatry(a)standard approaches to psychiatric evaluation would yield diagnoses in Diagnostic and Statistical Manual of Mental Disorders(DSM-V);(b)psychotherapies and pharmacotherapy could be effectively administered.2.To examine the relationships among cognition,mood,agitation and functions at baseline and the response to treatment over time.Design:Prospective longitudinal study.Measures:Geriatric Depression scale(GDS),Mini Mental State Exam(MMSE),Barthel Index(BI),Pittsburgh Agitation Scale(PAS).Setting:Video Teleconferencing.Interventions:Psychotherapy,psychopharmacology.Participants:428 Seniors over 55,met criteria for at least one DSM-V diagnosis.Results:Treatments were administered for a full range of psychiatric diagnoses and age-related medical conditions.The most frequently prescribed pharmacological agents were:antidepressants(78%)antipsychotics(64%),memory enhancers(38%).Participants(66%)received psychotherapy:individual(31%),couple(7%),family(13%).Variation in the MMSE scores were observed:55%remained stable,11%declined,18%improved.GDS Scores improved from baseline to 26 weeks(p=0.02,d=0.99:95%CI 0.39-1.56).PAS scores declined from baseline to 52 weeks(McNemar’s S=11.27,p=0.0008,d=1.17:95%CI 0.63-1.68).Function(BI)at week 26 was not statistically significantly different from baseline(t(26)=1.66,p=0.11,d=0.65:95%CI-0.16-1.42).Participants maintained independence(64.5%)at 52 weeks(McNemar’s S=6.23,p=0.013,d=0.79:95%CI 0.19-1.36)Conclusion:This study demonstrates the feasibility and benefit of providing a full complement of services via telepsychiatry to seniors and provides a rationale for more comprehensive reimbursement plans.展开更多
The growing and evolving use of emerging technology including Artificial Intelligence(AI)and Virtual Reality(VR),has significantly impacted the lives of two specific groups-the elderly and the disabled.This paper inve...The growing and evolving use of emerging technology including Artificial Intelligence(AI)and Virtual Reality(VR),has significantly impacted the lives of two specific groups-the elderly and the disabled.This paper investigates potential reasons for this phenomenon.Clearly,AI and VR Technology alters the everyday lives of people with disabilities and how they navigate the world.Technological developments increasingly work to address the isolation that people with disabilities as well as the elderly experience for they are often unable or limited in how they engage with their communities.This research paper outlines the way technology has improved social communication,information distribution,and day-to-day living for those with disabilities and the elderly.Undoubtedly,the internet has transformed social communication and interaction for most people.Socially isolated individuals with disabilities have gained exposure to social environments through social media.Moreover,the broad range of information available on the internet has increased access to resources such as government services,health services,and social services support.On a related point,assistive devices have enabled disabled people including many seniors to overcome motor,sensory,or cognitive difficulties that may have previously hindered them from performing daily tasks.However,although AI and VR technology has been effectively integrated in the lives of those with disabilities,many such individuals lack access to commonplace technologies,like a personal computer.This paper examines how AI and VR technology has enhanced communication,information access,and everyday activities for the disabled and aging communities despite such socio-economic limitations.展开更多
Objective:To identify the dilemma of elderly patients’access to outpatient services,develop strategies to improve the environment and functions of the outpatient department,and encourage the elderly to access medical...Objective:To identify the dilemma of elderly patients’access to outpatient services,develop strategies to improve the environment and functions of the outpatient department,and encourage the elderly to access medical services independently.Methods:By observing and interviewing,this paper studies the environment,behavior,and experiences of elderly patients when accessing medical services,identifies and classifies the key issues,and provides corresponding suggestions.Results:Existing signs and voice prompt systems fail to guide elderly patients to access to medical services;Elderly patients have difficulty in finding places to transit and rest when accessing to outpatient services;Elderly patients have problems in using AI(artificial intelligence)technologies when they access to outpatient services;There are communication barriers between elderly patients and medical staffs.Conclusion:Optimizing the guiding signs and voice prompt systems according to the characteristics of elderly patients;Designing the areas of transition and rest reasonably;Enhancing the ability of elderly patients to use self-service equipment;Promoting the medical treatment process to the elderly in a humanized way.展开更多
This document provides some guidelines to authors for submission in order to work towards a seamless submission process.While complete adherence to the following guidelines is not enforced,authors should note that fol...This document provides some guidelines to authors for submission in order to work towards a seamless submission process.While complete adherence to the following guidelines is not enforced,authors should note that following through with the guidelines will be helpful in expediting the copyediting and proofreading processes,and allow for improved readability during the review process.展开更多
To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cata...To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cataract.METHODS:The medical records of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of demographic data,past ophthalmic history,indications for surgery were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation,slit lamp findings of cornea(scar,haze,vascularisation,stromal folds with bullae),anterior chamber,lens details,intraocular pressure status,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study.Of 120 patients,25(20.83%)were male and 95(79.17%)were female.Mean age of these patients was 42.45+/-15.85 years(range 9 to 75 years).The mean postoperative follow up was 15.08+/-12.8 months(range,1.5 to 49 months).Failed therapeutic grafts(42.5%)-was the common indication found for surgery.Preoperatively,intraocular pressure was increased in 11(9.16%)patients.Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL)was performed in 114(95%)eyes,01(0.83%)eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL),and secondary intraocular lens implantation(PK+IOL)in 05(4.17%)eyes.CONCLUSION:Triple procedure is an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive outcome especially in high risk grafts situation.展开更多
India is one of the nations in the world where the population is undergoing anomalous demographic changes.The increase in longevity and decrease fertility lead to the boom of older people aged 60 and above both in rel...India is one of the nations in the world where the population is undergoing anomalous demographic changes.The increase in longevity and decrease fertility lead to the boom of older people aged 60 and above both in relative and absolute terms.Due to the rise in number,it creates pressure not only on the family but the responsibility shifts to the government also.This issue becomes a significant social problem not only in India but across the globe.The government had taken action by creating policies and programs to provide services to them.Still,the majority of the elderly population is lacking behind in these areas like health facilities,infrastructure,living arrangements suffering from isolation,loneliness,abuse,crime.Nowadays,smart city initiatives are taken by the government across the country but still in process.To involve and facilitate more cities for“age-friendly”,the World Health Organization develop the Global Age-Friendly Cities Guide and a manual“Checklist of Essential Features of Age-Friendly Cities”.Cooperating with 35 urban communities from developed and developing nations,the WHO oversees eight highlights for age-accommodating urban areas in the space of urban life.This paper had an objective to study and understand exiting literature on age-friendly communities in developed and developing countries and draw attention to the need to create age-friendly cities in India.The realization of the needs and demands of older people,the Indian government should give attention to promote and implement more age-friendly communities all over the country.This initiative till now taken in 3 states,i.e.,Delhi,Udaipur,and Kolkata-which involved in age-friendly community initiatives collaborated with WHO.In this era of a rapid aging sphere,the communities have to enhance in such a manner where the older population can meet their needs quickly without any conflicts and problem.To conclude,the government and policymaker should emphasize the policies into practices to build age-friendly communities across the country and make better living conditions for“allages”.For timely action and productive recommendation,it is an urgent need on the part of the government,policymakers,researchers,social workers to develop and enhance the community’s facilities,which can gain confidence and wellbeing of the elderly in India.展开更多
With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be e...With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.展开更多
This was an advanced male(87-year-old)with refractory chronic eczema for over 40 years,based on his allergic constitution,accompanied with chronic kidney disease due to primary hypertension(CKD,phase 3).It was so diff...This was an advanced male(87-year-old)with refractory chronic eczema for over 40 years,based on his allergic constitution,accompanied with chronic kidney disease due to primary hypertension(CKD,phase 3).It was so difficult to tolerate the severe itching that the glucocorticoids(GC)had to be applied to it,but some new-onset respiratory symptoms,such as cough,dyspnea after exertion etc.,occurred to this patient.Some classical IPA images were found on his pulmonary CT scanning,which were further comfirmed by the positive findings of GM-test,and then a final diagnosis of IPA was accordingly established.Unfortunately,a persistent fever emerged after starting an antifungal therapy to the patient,and his IL-2 level was detected to be superhigh.As a response to allergic fever,GC was carefully given intravenously again to treat it,and it turned out to be totally improved since then;suggesting that systemic thinking(integrated with the other clinical evidences)is essential to diagnose IPA,and GC can also be used to improve its symptoms with the existence of antifungal therapy.展开更多
What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,oc...What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,occurred with an accelerated episode of cough,productive sputum and a dropping down to 86%in SatO₂due to a cold weather.A diagnosis of pulmonary encephalopathy(PE)was made on the basis of the subsequent agitation and delirium,and the sedatives,such as quatiepine and haloperidol,had to be given for her mental excitation respectively,but she still pulled out indwelling needle herself and refused to any infusion therapy.As an alternative,a vaporized therapy integrated with tea herb drinking had to be applied to relieving her agitation,being designed as the vaporization of the inhaled oxygenation by means of high-flow oxygenation device(HFOD),with an ampoule of ambroxol mixed into the inhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles when being infected.We thought that a better efficacy would be achieved for hypercapnic encephalopathy due to AECOPD if we concentrate on a good ventilation of small airway through the vaporized therapy.展开更多
Neurosurgical treatment for psychiatric disorders features a long and controversial history.This article explores a“spectrum of psychosurgery”,describing how old-fashioned and controversial prefrontal lobotomy gradu...Neurosurgical treatment for psychiatric disorders features a long and controversial history.This article explores a“spectrum of psychosurgery”,describing how old-fashioned and controversial prefrontal lobotomy gradually evolved into modern day,mainstream scientific deep brain stimulation(DBS).We focus on the rise,fall and possible re-emergence of psychosurgery as a therapeutic intervention today.We journey through historic indiscriminate use of prefrontal lobotomy,which evoked stern criticism from both public and professionals,through to the development of modern day DBS-performed for patients suffering from severe,treatment resistant symptoms of obsessive-compulsive disorder(OCD),epilepsy and movement disorders.We hope this article will provide a basis for understanding the availability of existing treatment options and potential future opportunities,whilst simultaneously challenging any public/professional preconceptions of psychosurgery,which may indirectly be obstructing patient care.Additionally,we carried out a qualitative survey displayed in WordCloud Format,capturing the intellection of 38 mental health professionals working for North West Boroughs NHS Healthcare Foundation Trust,on“psychosurgery”,“prefrontal lobotomy”and“DBS”,which may well reflect wider public opinion.In summary,the article provides a brief,yet comprehensive overview of the controversial history of psychosurgery,present-day practice,and future trends of neurosurgery for psychiatric disorders.展开更多
Population ageing is an issue of worldwide importance.People are living longer due to advances in education,technology,medicine,food distribution,and public health.While the COVID-19 pandemic has significant global im...Population ageing is an issue of worldwide importance.People are living longer due to advances in education,technology,medicine,food distribution,and public health.While the COVID-19 pandemic has significant global impacts,in many countries the elderlyface threats and challenges that are unique and disproportionately severe.One such threat is that aging results in a decline in immune function,meaning elderly bodies respond more slowly and less effectively to external threats like COVID-19.Responses at individual,family,community and societal levels should take into account the heightened vulnerability of older adults during this pandemic.展开更多
Parkinson’s disease(PD)is a complex fatal chronic neurodegenerative disease most common in elderly people.The early genome-wide association studies(GWAS)found that the minor allele variant of PARK16 rs708730 polymorp...Parkinson’s disease(PD)is a complex fatal chronic neurodegenerative disease most common in elderly people.The early genome-wide association studies(GWAS)found that the minor allele variant of PARK16 rs708730 polymorphism is a significant protective factor for PD in Caucasian populations.However,these results cannot be repeated by the following studies in Caucasian populations and other populations.We considered that the inconsistency of the findings may be caused by the small-scale samples or the heterogeneity among different populations.Therefore,in this study,we synthesized the previous related GWAS studies through three authoritative sources,and used the large-scale samples(10,645 PD cases and 30,499 controls)to reevaluate the association between rs708730 polymorphism and PD.The results showed that there is no association between them in Asian ancestry population.While,in European ancestry population,we found that the minor allele variant(G)of rs708730 polymorphism is significantly associated with a decreased risk of PD.Collectively,our findings further verified the association of rs708730 with PD and show its genetic heterogeneity among different populations,which can help to develop a better understanding of the PD’s pathogenesis.展开更多
Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial i...Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.展开更多
Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflam...Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflammatory markers.However,few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose:This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods:Participants were elderly caregivers living together with elderly Alzheimer’s-type dementia patients.We performed logistic regression analysis,with levels of adrenaline,noradrenaline,and dopamine(indicators of catecholamine)as dependent variables.Results:Caregiver BMI had a significant impact on adrenaline levels(OR:0.792;95%CI:0.654-0.960)and noradrenaline levels(OR:1.210;95%CI:1.009-1.451),whereas age had a significant impact on dopamine levels(OR:1.162;95%CI:1.019-1.324).Discussion:While caregiver BMI significantly impacted adrenaline and noradrenaline levels,the mechanism underlying these relationships is unclear.One possibility is that obesity(BMI)and a rise in sympathetic nerve activity contributed to hypertension.Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion:There is a need to identify factors which increase BMI in caregivers.Future studies aimed at gaining a better understanding of the lifestyle habits of caregivers and intervention studies aimed at reducing their BMI are warranted.展开更多
A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States.The present ecological exploratory study uses secondary a...A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States.The present ecological exploratory study uses secondary aggregate data from the fifty United States in the year of 2019.The purpose of this study was to address the disparities in Alzheimer’s in minority populations in the US and explore associated factors.The“minority”populations considered were African American and Hispanic populations,and the“majority”population was referred to as“white”.The data were extracted from the United States Census Bureau,the CDC National Center for Health Statistics,and the Behavioral Risk Factor Surveillance System(BRFSS)Dataset.The prevalence rates of Alzheimer’s disease are greatest in both older Hispanic(12.2%)and African Americans(13.8%),compared to older whites(10.3%)in the investigated time period.Our results showed that being over 65 years old(p=.009),with a below-average($62,843)median household income(p=.024),history of stroke(p=.029),and being a part of the Hispanic population(p=.036),were significantly associated with Alzheimer’s mortality rates in the United States.By identifying disparities in access to Alzheimer’s healthcare and at-risk communities,more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s education and resource allocation for minority populations.展开更多
On the basis of the basic model of the kinetic theory of aging of living systems,mathematical modeling of various characteristics of aging of mankind,state,generation,human body,organs and cells has been carried out.T...On the basis of the basic model of the kinetic theory of aging of living systems,mathematical modeling of various characteristics of aging of mankind,state,generation,human body,organs and cells has been carried out.These results are compared with experimental and calculated data of other authors.The analysis of the works presented here and those carried out earlier gave reason to believe that the basic mathematical model of the evolution of aging of living dynamic systems of various hierarchical levels and nature is the invariant differential equation of the kinetic theory of aging,as a manifestation of the fractality property of living systems.展开更多
Ageing work force is one of the leading causes behind the depletion in the growth rate of the labor force in construction industries.Construction industry is a paramount source of employment worldwide after agricul...Ageing work force is one of the leading causes behind the depletion in the growth rate of the labor force in construction industries.Construction industry is a paramount source of employment worldwide after agricultural industry explicitly in urban areas.Manual material handling in construction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body.Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty.To analyze the level of exertion,ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce.20 male construction workers in the age group of i)20 to 30 years(golden age group);ii)50 years and above were selected from a local construction site in Mumbai.Demographic data like age,height,weight,BMI,body fat,waist hip ratio and risk assessment by questionnaires study comprising QEC,NMQ,VAS,and LEFS were collected.Compared to the golden age group,the elderly subjects were found to feel more discomfort in their lower back,knee and calf regions of lower limb due to immoderate forces and motions tolerated by their lower limbs during their daily work.Muscle pliability and proper coordination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures.For elderly workers,age related limitations become an additional factor to maintain their normal work-life.展开更多
The aim of the study was to identify the impact of COVID-19 lockdown on continuation of treatment among the OPD geriatric patients.Quantitative research study has been conducted.A descriptive research design and...The aim of the study was to identify the impact of COVID-19 lockdown on continuation of treatment among the OPD geriatric patients.Quantitative research study has been conducted.A descriptive research design and convenience sampling technique were used to pick a total of 100 samples,(n=100).Self-structured socio demographic questionnaire and self structured interview method were used to collect the data in November 2020 at tertiary care hospitals,Bhubaneswar,Odisha,India.The collected data were analyzed through descriptive and inferential statistics.Comparison of three categories of COVID-19 pandemic factors affecting in availing OPD services reveals that the psychological factor has more effect(73%)followed by hospital related factors(68%)and the availability of public transportation and resources(62%)has less effect in availing OPD services among patients during COVID-19 pandemic.Application of chi square test reveals that there is no significant relationship of intensity of COVID-19 pandemic factors affecting in availing OPD services among patients with selected socio demographic variables.These findings suggest that facility for sanitization of hospital premises,facility for social distancing in registration counter,waiting area and other areas of hospital are not quite satisfactory.Factors like availability of public transport,availability of healthcare personnel’s in OPD,adequacy of treatment facility,cost of medical services,availability of diagnostic services,are highly affecting geriatric patients in availing OPD services during COVID-19 pandemic and need to be taken care.展开更多
Background:Epidemiological studies have demonstrated associations between higher levels of vascular risk factors in midlife and later development of dementia,particularly Alzheimer’s disease(AD).However,in elderly su...Background:Epidemiological studies have demonstrated associations between higher levels of vascular risk factors in midlife and later development of dementia,particularly Alzheimer’s disease(AD).However,in elderly subjects with dementia,some studies have shown that these associations may decrease or even reverse.Therefore,the study aimed to find the association between late life cardiovascular risk factors and neurodegenerative dementia in general and AD in particular.Methods:It is a retrospective case control study using electronic medical records that included elderly patients that were reviewed in Ahmadi hospital geriatric clinic,Kuwait,from the period of 1/7/2019 to 1/2/2020.Two hundred and three(203)elderly patients with neurodegenerative dementia(study group)were recruited for this retrospective study and compared to two hundred and one(201)controls with normal cognition for the presence of vascular risk factors.Results:The study included 404 subjects.Age ranged from 60 to 107 years(mean age 78.79,±8.13 SD).AD was found to be the most prevalent type of dementia in the study group,as 49.3%(100/203)of the demented patients were diagnosed with AD.No significant statistical association was found between vascular risk factors and dementia(P>0.05),except for obesity which showed a negative association(P<0.001).Regarding AD,no statistical significance was found between AD and diabetes,hyperlipidemia,smoking nor atrial fibrillation.On the other hand,the authors found obesity and hypertension more prevalent in the normal cognition group(negative association with P value<0.001,0.05 respectively).Conclusions:The results of the study support an emerging concept that,while elevated levels of vascular risk factors in midlife increase the risk of development of dementia and AD later in life,once dementia begins,these associations may be diminished or reversed in the elderly.展开更多
文摘An original mathematical model,previously tested by the authors on other non-demographic objects,is proposed for describing and forecasting demographic systems—the population of the countries of the World using the examples of the USA,China and Russia,as well as the number of mice in the“mouse paradise”experiment of the American scientist John Calhoun.The proposed approach allows us to describe the stages and features of this dynamics:population growth in the USA,growth and possible decrease in the population in China,loss of a part of the population of the Russian Empire and the USSR due to two world wars and the collapse of the USSR,biological degradation of the“mouse paradise”up to its complete extinction.The use of the kinetic model of aging of various types of living systems to predict the development of the number of demographic systems is based on the assumptions that the aging and development processes are related to each other and have the same statistical regularity,reflecting the fractal principle of Nature-the unity of structure and function.The results obtained suggest that a person,a population of the World,humanity and other biological species develop and simultaneously age like each other under the conditions of the always existing syndrome of general adaptation(stress)and according to the same pattern corresponding to the mathematical model proposed here.
文摘Few studies examine the benefits from geriatric telepsychiatry in rural retirement communities.Objectives:1.To demonstrate that using telepsychiatry(a)standard approaches to psychiatric evaluation would yield diagnoses in Diagnostic and Statistical Manual of Mental Disorders(DSM-V);(b)psychotherapies and pharmacotherapy could be effectively administered.2.To examine the relationships among cognition,mood,agitation and functions at baseline and the response to treatment over time.Design:Prospective longitudinal study.Measures:Geriatric Depression scale(GDS),Mini Mental State Exam(MMSE),Barthel Index(BI),Pittsburgh Agitation Scale(PAS).Setting:Video Teleconferencing.Interventions:Psychotherapy,psychopharmacology.Participants:428 Seniors over 55,met criteria for at least one DSM-V diagnosis.Results:Treatments were administered for a full range of psychiatric diagnoses and age-related medical conditions.The most frequently prescribed pharmacological agents were:antidepressants(78%)antipsychotics(64%),memory enhancers(38%).Participants(66%)received psychotherapy:individual(31%),couple(7%),family(13%).Variation in the MMSE scores were observed:55%remained stable,11%declined,18%improved.GDS Scores improved from baseline to 26 weeks(p=0.02,d=0.99:95%CI 0.39-1.56).PAS scores declined from baseline to 52 weeks(McNemar’s S=11.27,p=0.0008,d=1.17:95%CI 0.63-1.68).Function(BI)at week 26 was not statistically significantly different from baseline(t(26)=1.66,p=0.11,d=0.65:95%CI-0.16-1.42).Participants maintained independence(64.5%)at 52 weeks(McNemar’s S=6.23,p=0.013,d=0.79:95%CI 0.19-1.36)Conclusion:This study demonstrates the feasibility and benefit of providing a full complement of services via telepsychiatry to seniors and provides a rationale for more comprehensive reimbursement plans.
文摘The growing and evolving use of emerging technology including Artificial Intelligence(AI)and Virtual Reality(VR),has significantly impacted the lives of two specific groups-the elderly and the disabled.This paper investigates potential reasons for this phenomenon.Clearly,AI and VR Technology alters the everyday lives of people with disabilities and how they navigate the world.Technological developments increasingly work to address the isolation that people with disabilities as well as the elderly experience for they are often unable or limited in how they engage with their communities.This research paper outlines the way technology has improved social communication,information distribution,and day-to-day living for those with disabilities and the elderly.Undoubtedly,the internet has transformed social communication and interaction for most people.Socially isolated individuals with disabilities have gained exposure to social environments through social media.Moreover,the broad range of information available on the internet has increased access to resources such as government services,health services,and social services support.On a related point,assistive devices have enabled disabled people including many seniors to overcome motor,sensory,or cognitive difficulties that may have previously hindered them from performing daily tasks.However,although AI and VR technology has been effectively integrated in the lives of those with disabilities,many such individuals lack access to commonplace technologies,like a personal computer.This paper examines how AI and VR technology has enhanced communication,information access,and everyday activities for the disabled and aging communities despite such socio-economic limitations.
文摘Objective:To identify the dilemma of elderly patients’access to outpatient services,develop strategies to improve the environment and functions of the outpatient department,and encourage the elderly to access medical services independently.Methods:By observing and interviewing,this paper studies the environment,behavior,and experiences of elderly patients when accessing medical services,identifies and classifies the key issues,and provides corresponding suggestions.Results:Existing signs and voice prompt systems fail to guide elderly patients to access to medical services;Elderly patients have difficulty in finding places to transit and rest when accessing to outpatient services;Elderly patients have problems in using AI(artificial intelligence)technologies when they access to outpatient services;There are communication barriers between elderly patients and medical staffs.Conclusion:Optimizing the guiding signs and voice prompt systems according to the characteristics of elderly patients;Designing the areas of transition and rest reasonably;Enhancing the ability of elderly patients to use self-service equipment;Promoting the medical treatment process to the elderly in a humanized way.
文摘This document provides some guidelines to authors for submission in order to work towards a seamless submission process.While complete adherence to the following guidelines is not enforced,authors should note that following through with the guidelines will be helpful in expediting the copyediting and proofreading processes,and allow for improved readability during the review process.
文摘To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cataract.METHODS:The medical records of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of demographic data,past ophthalmic history,indications for surgery were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation,slit lamp findings of cornea(scar,haze,vascularisation,stromal folds with bullae),anterior chamber,lens details,intraocular pressure status,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study.Of 120 patients,25(20.83%)were male and 95(79.17%)were female.Mean age of these patients was 42.45+/-15.85 years(range 9 to 75 years).The mean postoperative follow up was 15.08+/-12.8 months(range,1.5 to 49 months).Failed therapeutic grafts(42.5%)-was the common indication found for surgery.Preoperatively,intraocular pressure was increased in 11(9.16%)patients.Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL)was performed in 114(95%)eyes,01(0.83%)eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL),and secondary intraocular lens implantation(PK+IOL)in 05(4.17%)eyes.CONCLUSION:Triple procedure is an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive outcome especially in high risk grafts situation.
文摘India is one of the nations in the world where the population is undergoing anomalous demographic changes.The increase in longevity and decrease fertility lead to the boom of older people aged 60 and above both in relative and absolute terms.Due to the rise in number,it creates pressure not only on the family but the responsibility shifts to the government also.This issue becomes a significant social problem not only in India but across the globe.The government had taken action by creating policies and programs to provide services to them.Still,the majority of the elderly population is lacking behind in these areas like health facilities,infrastructure,living arrangements suffering from isolation,loneliness,abuse,crime.Nowadays,smart city initiatives are taken by the government across the country but still in process.To involve and facilitate more cities for“age-friendly”,the World Health Organization develop the Global Age-Friendly Cities Guide and a manual“Checklist of Essential Features of Age-Friendly Cities”.Cooperating with 35 urban communities from developed and developing nations,the WHO oversees eight highlights for age-accommodating urban areas in the space of urban life.This paper had an objective to study and understand exiting literature on age-friendly communities in developed and developing countries and draw attention to the need to create age-friendly cities in India.The realization of the needs and demands of older people,the Indian government should give attention to promote and implement more age-friendly communities all over the country.This initiative till now taken in 3 states,i.e.,Delhi,Udaipur,and Kolkata-which involved in age-friendly community initiatives collaborated with WHO.In this era of a rapid aging sphere,the communities have to enhance in such a manner where the older population can meet their needs quickly without any conflicts and problem.To conclude,the government and policymaker should emphasize the policies into practices to build age-friendly communities across the country and make better living conditions for“allages”.For timely action and productive recommendation,it is an urgent need on the part of the government,policymakers,researchers,social workers to develop and enhance the community’s facilities,which can gain confidence and wellbeing of the elderly in India.
文摘With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.
文摘This was an advanced male(87-year-old)with refractory chronic eczema for over 40 years,based on his allergic constitution,accompanied with chronic kidney disease due to primary hypertension(CKD,phase 3).It was so difficult to tolerate the severe itching that the glucocorticoids(GC)had to be applied to it,but some new-onset respiratory symptoms,such as cough,dyspnea after exertion etc.,occurred to this patient.Some classical IPA images were found on his pulmonary CT scanning,which were further comfirmed by the positive findings of GM-test,and then a final diagnosis of IPA was accordingly established.Unfortunately,a persistent fever emerged after starting an antifungal therapy to the patient,and his IL-2 level was detected to be superhigh.As a response to allergic fever,GC was carefully given intravenously again to treat it,and it turned out to be totally improved since then;suggesting that systemic thinking(integrated with the other clinical evidences)is essential to diagnose IPA,and GC can also be used to improve its symptoms with the existence of antifungal therapy.
文摘What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,occurred with an accelerated episode of cough,productive sputum and a dropping down to 86%in SatO₂due to a cold weather.A diagnosis of pulmonary encephalopathy(PE)was made on the basis of the subsequent agitation and delirium,and the sedatives,such as quatiepine and haloperidol,had to be given for her mental excitation respectively,but she still pulled out indwelling needle herself and refused to any infusion therapy.As an alternative,a vaporized therapy integrated with tea herb drinking had to be applied to relieving her agitation,being designed as the vaporization of the inhaled oxygenation by means of high-flow oxygenation device(HFOD),with an ampoule of ambroxol mixed into the inhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles when being infected.We thought that a better efficacy would be achieved for hypercapnic encephalopathy due to AECOPD if we concentrate on a good ventilation of small airway through the vaporized therapy.
文摘Neurosurgical treatment for psychiatric disorders features a long and controversial history.This article explores a“spectrum of psychosurgery”,describing how old-fashioned and controversial prefrontal lobotomy gradually evolved into modern day,mainstream scientific deep brain stimulation(DBS).We focus on the rise,fall and possible re-emergence of psychosurgery as a therapeutic intervention today.We journey through historic indiscriminate use of prefrontal lobotomy,which evoked stern criticism from both public and professionals,through to the development of modern day DBS-performed for patients suffering from severe,treatment resistant symptoms of obsessive-compulsive disorder(OCD),epilepsy and movement disorders.We hope this article will provide a basis for understanding the availability of existing treatment options and potential future opportunities,whilst simultaneously challenging any public/professional preconceptions of psychosurgery,which may indirectly be obstructing patient care.Additionally,we carried out a qualitative survey displayed in WordCloud Format,capturing the intellection of 38 mental health professionals working for North West Boroughs NHS Healthcare Foundation Trust,on“psychosurgery”,“prefrontal lobotomy”and“DBS”,which may well reflect wider public opinion.In summary,the article provides a brief,yet comprehensive overview of the controversial history of psychosurgery,present-day practice,and future trends of neurosurgery for psychiatric disorders.
文摘Population ageing is an issue of worldwide importance.People are living longer due to advances in education,technology,medicine,food distribution,and public health.While the COVID-19 pandemic has significant global impacts,in many countries the elderlyface threats and challenges that are unique and disproportionately severe.One such threat is that aging results in a decline in immune function,meaning elderly bodies respond more slowly and less effectively to external threats like COVID-19.Responses at individual,family,community and societal levels should take into account the heightened vulnerability of older adults during this pandemic.
基金Lanzhou Science and Technology Bureau Program Funds(2017-RC-16,2018-1-110)Gansu Science and Technology Fund Grant(ID:17ZD2FA009)National Science and Technology Ministry(ID:2017ZX09101001).
文摘Parkinson’s disease(PD)is a complex fatal chronic neurodegenerative disease most common in elderly people.The early genome-wide association studies(GWAS)found that the minor allele variant of PARK16 rs708730 polymorphism is a significant protective factor for PD in Caucasian populations.However,these results cannot be repeated by the following studies in Caucasian populations and other populations.We considered that the inconsistency of the findings may be caused by the small-scale samples or the heterogeneity among different populations.Therefore,in this study,we synthesized the previous related GWAS studies through three authoritative sources,and used the large-scale samples(10,645 PD cases and 30,499 controls)to reevaluate the association between rs708730 polymorphism and PD.The results showed that there is no association between them in Asian ancestry population.While,in European ancestry population,we found that the minor allele variant(G)of rs708730 polymorphism is significantly associated with a decreased risk of PD.Collectively,our findings further verified the association of rs708730 with PD and show its genetic heterogeneity among different populations,which can help to develop a better understanding of the PD’s pathogenesis.
文摘Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.
文摘Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflammatory markers.However,few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose:This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods:Participants were elderly caregivers living together with elderly Alzheimer’s-type dementia patients.We performed logistic regression analysis,with levels of adrenaline,noradrenaline,and dopamine(indicators of catecholamine)as dependent variables.Results:Caregiver BMI had a significant impact on adrenaline levels(OR:0.792;95%CI:0.654-0.960)and noradrenaline levels(OR:1.210;95%CI:1.009-1.451),whereas age had a significant impact on dopamine levels(OR:1.162;95%CI:1.019-1.324).Discussion:While caregiver BMI significantly impacted adrenaline and noradrenaline levels,the mechanism underlying these relationships is unclear.One possibility is that obesity(BMI)and a rise in sympathetic nerve activity contributed to hypertension.Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion:There is a need to identify factors which increase BMI in caregivers.Future studies aimed at gaining a better understanding of the lifestyle habits of caregivers and intervention studies aimed at reducing their BMI are warranted.
文摘A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States.The present ecological exploratory study uses secondary aggregate data from the fifty United States in the year of 2019.The purpose of this study was to address the disparities in Alzheimer’s in minority populations in the US and explore associated factors.The“minority”populations considered were African American and Hispanic populations,and the“majority”population was referred to as“white”.The data were extracted from the United States Census Bureau,the CDC National Center for Health Statistics,and the Behavioral Risk Factor Surveillance System(BRFSS)Dataset.The prevalence rates of Alzheimer’s disease are greatest in both older Hispanic(12.2%)and African Americans(13.8%),compared to older whites(10.3%)in the investigated time period.Our results showed that being over 65 years old(p=.009),with a below-average($62,843)median household income(p=.024),history of stroke(p=.029),and being a part of the Hispanic population(p=.036),were significantly associated with Alzheimer’s mortality rates in the United States.By identifying disparities in access to Alzheimer’s healthcare and at-risk communities,more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s education and resource allocation for minority populations.
文摘On the basis of the basic model of the kinetic theory of aging of living systems,mathematical modeling of various characteristics of aging of mankind,state,generation,human body,organs and cells has been carried out.These results are compared with experimental and calculated data of other authors.The analysis of the works presented here and those carried out earlier gave reason to believe that the basic mathematical model of the evolution of aging of living dynamic systems of various hierarchical levels and nature is the invariant differential equation of the kinetic theory of aging,as a manifestation of the fractality property of living systems.
文摘Ageing work force is one of the leading causes behind the depletion in the growth rate of the labor force in construction industries.Construction industry is a paramount source of employment worldwide after agricultural industry explicitly in urban areas.Manual material handling in construction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body.Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty.To analyze the level of exertion,ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce.20 male construction workers in the age group of i)20 to 30 years(golden age group);ii)50 years and above were selected from a local construction site in Mumbai.Demographic data like age,height,weight,BMI,body fat,waist hip ratio and risk assessment by questionnaires study comprising QEC,NMQ,VAS,and LEFS were collected.Compared to the golden age group,the elderly subjects were found to feel more discomfort in their lower back,knee and calf regions of lower limb due to immoderate forces and motions tolerated by their lower limbs during their daily work.Muscle pliability and proper coordination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures.For elderly workers,age related limitations become an additional factor to maintain their normal work-life.
文摘The aim of the study was to identify the impact of COVID-19 lockdown on continuation of treatment among the OPD geriatric patients.Quantitative research study has been conducted.A descriptive research design and convenience sampling technique were used to pick a total of 100 samples,(n=100).Self-structured socio demographic questionnaire and self structured interview method were used to collect the data in November 2020 at tertiary care hospitals,Bhubaneswar,Odisha,India.The collected data were analyzed through descriptive and inferential statistics.Comparison of three categories of COVID-19 pandemic factors affecting in availing OPD services reveals that the psychological factor has more effect(73%)followed by hospital related factors(68%)and the availability of public transportation and resources(62%)has less effect in availing OPD services among patients during COVID-19 pandemic.Application of chi square test reveals that there is no significant relationship of intensity of COVID-19 pandemic factors affecting in availing OPD services among patients with selected socio demographic variables.These findings suggest that facility for sanitization of hospital premises,facility for social distancing in registration counter,waiting area and other areas of hospital are not quite satisfactory.Factors like availability of public transport,availability of healthcare personnel’s in OPD,adequacy of treatment facility,cost of medical services,availability of diagnostic services,are highly affecting geriatric patients in availing OPD services during COVID-19 pandemic and need to be taken care.
文摘Background:Epidemiological studies have demonstrated associations between higher levels of vascular risk factors in midlife and later development of dementia,particularly Alzheimer’s disease(AD).However,in elderly subjects with dementia,some studies have shown that these associations may decrease or even reverse.Therefore,the study aimed to find the association between late life cardiovascular risk factors and neurodegenerative dementia in general and AD in particular.Methods:It is a retrospective case control study using electronic medical records that included elderly patients that were reviewed in Ahmadi hospital geriatric clinic,Kuwait,from the period of 1/7/2019 to 1/2/2020.Two hundred and three(203)elderly patients with neurodegenerative dementia(study group)were recruited for this retrospective study and compared to two hundred and one(201)controls with normal cognition for the presence of vascular risk factors.Results:The study included 404 subjects.Age ranged from 60 to 107 years(mean age 78.79,±8.13 SD).AD was found to be the most prevalent type of dementia in the study group,as 49.3%(100/203)of the demented patients were diagnosed with AD.No significant statistical association was found between vascular risk factors and dementia(P>0.05),except for obesity which showed a negative association(P<0.001).Regarding AD,no statistical significance was found between AD and diabetes,hyperlipidemia,smoking nor atrial fibrillation.On the other hand,the authors found obesity and hypertension more prevalent in the normal cognition group(negative association with P value<0.001,0.05 respectively).Conclusions:The results of the study support an emerging concept that,while elevated levels of vascular risk factors in midlife increase the risk of development of dementia and AD later in life,once dementia begins,these associations may be diminished or reversed in the elderly.
