Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 we...Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 were followed up in 2021.General and abdominal obesity were assessed,and serum C-reactive protein(CRP)levels were measured at baseline.Depression status was assessed at baseline and at follow-up.Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms,as well as the relationship between obesity and CRP levels.The associations of CRP levels with the geriatric depression scale,as well as with its three dimensions,were investigated using multiple linear regressions.Results General obesity was associated with worsening depression symptoms and incident depression,with an odds ratio(OR)[95%confidence interval(CI)]of 1.53(1.13-2.12)and 1.80(1.23-2.63),especially among old male subjects,with OR(95%CI)of 2.12(1.25-3.58)and 2.24(1.22-4.11),respectively;however,no significant relationship was observed between abdominal obesity and depression.In addition,general obesity was associated with high levels of CRP,with OR(95%CI)of 2.58(1.75-3.81),especially in subjects free of depression at baseline,with OR(95%CI)of 3.15(1.97-5.04),and CRP levels were positively correlated with a score of specific dimension(life satisfaction)of depression,P<0.05.Conclusion General obesity,rather than abdominal obesity,was associated with worsening depressive symptoms and incident depression,which can be partly explained by the systemic inflammatory response,and the impact of obesity on depression should be taken more seriously in the older male population.展开更多
Introduction:Older adults are prone to high levels of depression due to their deteriorating physical functions and shrinking social networks after retirement.Volunteering as an important social activity is essential f...Introduction:Older adults are prone to high levels of depression due to their deteriorating physical functions and shrinking social networks after retirement.Volunteering as an important social activity is essential for alleviating depression by building social network.This paper aims to examine the effect of volunteering on depression among older adults by using China Longitudinal Aging Social Survey(CLASS 2018)data.Methods:This study uses descriptive analysis and chi-square tests to show differences in demographic factors of older adults’volun-teerism participation,followed by bivariate correlation analysis to examine the correlation between the vital vari-ables.Afterward,stratified linear regression analysis is used to research the significant level and impact between volunteering and degree of expertise,frequency,and variety of participation.Results:8,459 older adults are included in study.The research reveals that older adults who are younger,live in urban areas,are married,or have a higher degree of education tend to have fewer depressive symptoms.Meanwhile,participation in volun-teering(OR=0.90,95%CI:0.8,1.1,p<0.001),as well as that demands specialized skills(OR=0.51,95%CI:0.30,0.2,p<0.001),more frequency of participation(OR=1.85,95%CI:1.53,2.18,p<0.001),and a wider variety of activities(OR=0.21,95%CI:0.12,0.29,p<0.001),all have a positive influence on depression levels.Discussion/Conclusion:Older adults who participate in voluntary services have lower depression symptoms and should be encouraged to use their professional skills and increase participation frequency and variety in this process.This article suggests that governments should help older adults participate in voluntary services by time bank which will further strengthen social ties,rebuild social networks and alleviate depression symptoms of older adults.展开更多
This study examined factors related to the psychological well-being of older adults and built and verified a model for predictingpsychological well-being. The participants were 350 older adults aged over 60 years who ...This study examined factors related to the psychological well-being of older adults and built and verified a model for predictingpsychological well-being. The participants were 350 older adults aged over 60 years who lived in South Korea and were active in thelocal community. The model proposed in this study was found to be suitable. Depression, self-efficacy, and social support had adirect effect on the psychological well-being of older adults, while depression, activities of daily living (ADLs), and self-efficacy hadan indirect effect. Self-efficacy and social support mediated the relationship between depression and psychological well-being, andself-efficacy mediated the relationship between ADLs and psychological well-being. It is necessary to develop and implement aprogram that can help alleviate depression and improve self-efficacy and social support among older adults in order toenhance their psychological well-being. Additionally, to establish a model that predicts the psychological well-being of olderadults, a study is needed to verify the model not only in Korea but also in other countries.展开更多
This study aims to be the first to use meta-analysis to explore the relationship between meaning in life(MIL)and mental health issues among older adults.A meta-analysis was conducted using six databases,resulting in 1...This study aims to be the first to use meta-analysis to explore the relationship between meaning in life(MIL)and mental health issues among older adults.A meta-analysis was conducted using six databases,resulting in 16 studies with 5,074 participants in total.The“metacor”and“forestplot”packages in R-Studio were used for data analysis.The total effect was calculated using a random-effects model,with I2=86%in the heterogeneity test.The results showed a moderate negative correlation between MIL and mental health issues among older adults,with an average effect of−0.37.Five potential moderating variables were examined:the conceptualization of MIL(value vs.purpose),region(Asian vs.Western countries),residence status(community vs.nursing home vs.hospital),types of mental health issues,and evaluation methods(clinical vs.non-clinical).The first four had no significant moderating effect.The mean correlation coefficients between mental health issues and value/purpose were−0.49/−0.33;the mean correlation coefficients in Asian countries and Western countries were−0.48 and−0.34;the mean correlation coefficients among participants living in community/nursing home/mixed status were−0.33/−0.40/−0.40;the mean correlation coefficients between MIL and depression/others were−0.37/−0.35;however,the negative relationship between MIL and mental health issues was stronger when non-clinical evaluations(self-report only)were used.Specifically,the mean correlation coefficient for non-clinical evaluations was−0.42 and for clinical evaluations was−0.29.This study is the first meta-analysis to identify the negative correlation between older adults’MIL and mental health issues.Significant moderating effects of evaluation methods were found.展开更多
Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health...Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.展开更多
Many developing countries like Nigeria lack policy for the care of the older adults and this creates major challenges for the elderly population. The traditional family institution and community support that used to b...Many developing countries like Nigeria lack policy for the care of the older adults and this creates major challenges for the elderly population. The traditional family institution and community support that used to be safety nest are being adversely affected by westernization. This development might have adverse effect on life satisfaction among the older adults. This hospital based cross-sectional study was designed to determine the association between support and life satisfaction among older adults. A total of 128 subjects participated in the study out of which 28.9% were satisfied with life. Expectation of support was mainly from the family, less from the community and very low from the government. The level of support received from all sources generally fell short of expectations. Marital status and source of livelihood were significantly associated with life satisfaction. There is inadequate social support from the government and support from family and community fell below expectations. Expectations of support were the most strongly correlated with life satisfaction. Support for older adults must be addressed in order to meet their expectations and improve their level of satisfaction with life.展开更多
Cognitive impairment(CI)is a type of syndrome in which acquired and persistent cognitive impairment is at the core,leading to decreased daily life and work ability,and may be accompanied by mental and behavioral abnor...Cognitive impairment(CI)is a type of syndrome in which acquired and persistent cognitive impairment is at the core,leading to decreased daily life and work ability,and may be accompanied by mental and behavioral abnormalities.With an ageing population,the incidence of CI disease continues to increase,and the socio-economic burden is growing,making it a social problem that poses a serious health risk to the global population.At the same time,it also poses serious challenges to the field of nursing.This special issue of the International Journal of Nursing Sciences aims to publish original research papers,case reports,as well as systematic and literature review manuscripts on CI care in older adults.展开更多
Objectives:This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City,Bengkulu,Indonesia.Methods:A cross-sectional study was conducted in 333 older...Objectives:This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City,Bengkulu,Indonesia.Methods:A cross-sectional study was conducted in 333 older adults with hypertension,who were selected using multistage sampling method.Data were obtained by face-to-face interview with structured questionnaires.The questionnaires used in this study included the Health-Promoting Lifestyle Profile II(HPLP II),Hypertension Knowledge-Level Scale(HK-LS),Self-Rated Abilities for Health Practices Scale(SRAHP),Barriers to Health-promoting Behaviour Scales(BAS),Benefits to Health-Promoting Behaviour Scales(BES),Multidimensional Scale of Perceived Social Support(MSPSS)and Situational Influences Questionnaire(SIQ).Data were analysed by using multiple linear regressions.Results:The mean and standard deviation(Mean±SD)of each questionnaire were as follows:HPLP II,2.55±0.19;HK-LS,11.83±3.00;SRAHP,2.00±5.87;BAS,27.89±2.70;BES,34.29±2.29;MSPSS,60.35±8.12;and SIQ,47.71±6.66.According to the multiple linear regression model,36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables,namely,education,knowledge,self-efficacy,perceived barriers,social support and situational influences(adjusted R^(2)=0.369).Conclusions:High and good-quality education will increase the level of health-promoting behaviour,whereas barriers,such as expense and time requirement,can decrease it.Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour.Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.展开更多
Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Agi...Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.展开更多
Background:Resistance exercise has numerous,well-documented benefits on the health and functional performance of older adults.However,little information exists on the affective responses to resistance exercise in this...Background:Resistance exercise has numerous,well-documented benefits on the health and functional performance of older adults.However,little information exists on the affective responses to resistance exercise in this population.As affective responses can predict continued exercise behavior,examining if and how they differ between resistance exercise intensities and frequencies in older adults may provide important data to improve resistance exercise prescription.Methods:We monitored the affective responses of older adults when performing high-velocity,low-load(HVLL)or low-velocity,high-load(LVHL)resistance exercise once or twice weekly.A total of 40 moderately to highly active,but resistance-exercise naïve,older adults(60-79 years)completed 1 of 4 randomly assigned progressive resistance exercise conditions:HVLL once weekly(HVLL1:n=10),HVLL twice weekly(HVLL2:n=10),LVHL once weekly(LVHL1:n=10),or LVHL twice weekly(LVHL2:n=10).The Physical Activity Affect Scale,Felt Arousal Scale,Feeling Scale,rating of perceived exertion,Visual Analog Scale,and the Physical Activity Enjoyment Scale were used to assess enjoyment and affective responses.Results:The results from Physical Activity Enjoyment Scale(out of 35)suggest that all exercise conditions were largely and similarly enjoyable to older adults(HVLL1:30.9±2.4;LVHL1:31.9±3.6;HVLL2:30.9±3.5;LVHL2:30.2±3.7)despite greater fatigue(p=0.033;ηp^2p=0.22)and perceived workload(p=0.042;ηp^2=0.20)in LVHL(results from Visual Analog Scale).Conclusion:Moderately to highly physically active older adults may tolerate higher intensities of resistance exercise performed once or twice weekly without experiencing a negative impact on enjoyment.However,the role that supervision and social interaction played in shaping the participants’responses is unclear.展开更多
Objective To examine the association of atherosclerotic cardiovascular disease(ASCVD)and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged≥65 years,from one cen...Objective To examine the association of atherosclerotic cardiovascular disease(ASCVD)and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged≥65 years,from one center(2016–2018)underwent clinical,laboratory assessments and the Montreal Cognitive Assessment(Mo CA).Using regression analysis,the relationship between ASCVD and its risk factors was evaluated in subjects with and without cognitive impairment(MoCA score<26).Results Older age(b=-1.3 per 5 years,95%CI:-1.7 to-0.9,P<0.001),history of stroke(b=-1.6,95%CI:-3.0 to-0.3,P=0.01),and myocardial infarction(MI;b=-2.2,95%CI:-3.6 to-0.8,P=0.003)were independently associated with lower MoCA scores,whereas more education(b=1.5 per 3 years,95%CI:1.1 to 1.9,P<0.001),higher body mass index(BMI;b=0.5 per 3 kg/m^2,95%CI:0.0 to 1.0,P=0.04),higher estimated glomerular filtration rate(eGFR;b=0.8 per 15 U,95%CI:0.1 to 1.4,P=0.03),left ventricular ejection fraction(LVEF;b=0.4 per 5%,95%CI:0 to 0.8,P=0.04)and statin use(b=1.3,95%CI:0.3 to 2.3,P=0.01)were associated with a higher MoCA score.Cognitive impairment was independently associated with older age(OR=1.51 per 5 yrs,95%CI:1.28 to 1.79,P<0.001),less education(OR=0.55 per 3 years,95%CI:0.45 to 0.68,P<0.001),lower BMI(OR=0.78 per 3 kg/m^2,95%CI:0.62 to 0.98,P=0.03)and higher levels of high sensitivity c-reactive protein(hsCRP;OR=1.08 per 1 mg/L,95%CI:1.02 to 1.15,P=0.01).Conclusions Beyond age,cognitive impairment was associated with prior MI/stroke,higher hsCRP,statin use,less education,lower eGFR,BMI and LVEF.展开更多
Colon cancer represents one of the most common cancers diagnosed in older adults worldwide.The standard of care in resected stage II and stage III colon cancer continues to evolve.While there is unequivocal evidence t...Colon cancer represents one of the most common cancers diagnosed in older adults worldwide.The standard of care in resected stage II and stage III colon cancer continues to evolve.While there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer,data regarding its use in patients with stage II colon cancer are less clear.Further,although colon cancer is a disease that affects older adults,there is considerable debate on the value of adjuvant chemotherapy in the aging population.In particular,many older patients are undertreated when compared to their younger counterparts.In this review,we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer,discuss representation of older adults in trials and the specific challenges associated with the management of this subpopulation,and highlight the role of comprehensive geriatric assessments.We will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.展开更多
Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls ...Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.展开更多
Temporal envelope is a low frequency amplitude modulation conveying segmental and suprasegmental information during speech perception.Unfortunately,we seldom find ourselves in completely quiet listening environments a...Temporal envelope is a low frequency amplitude modulation conveying segmental and suprasegmental information during speech perception.Unfortunately,we seldom find ourselves in completely quiet listening environments and noise,commonly found in the surrounding environment,obscures both the fine structure cues and partly the temporal envelope cues in speech.Available temporal content of speech emanating from noise is often enough to convey required information in normal hearing individuals.However,the case is different in older adults(with and without hearing loss) who lack such capabilities due to the impairment in temporal processing.This calls attention of a researcher to delineate the importance of temporal enhancement of speech in improving speech perception.There are many temporal envelope strategies available in the literature,but each one has its own lacunae.An envelope enhancement by a deep band modulation(DBM) is found to be beneficial for those individuals who have had a temporal processing impairment.The reason could be attributed to the 15 dB enhancement in the temporal envelope bandwidth between 3 and 30 Hz,extracted from each channel,which significantly increases the modulation depth such that masking of a consonant by a vowel is minimized.Additionally,output of deep band modulated speech is rescaled such that its duration increases and it provides relatively easy access to the word of the lexicon.Thus,in the near future,with more experiments related to DBM algorithm,it can be utilized in the rehabilitative devices to lessen the impact of the temporal processing impairment.展开更多
BACKGROUND Blink and masseter reflexes provide reliable,quantifiable data on the function of the central nervous system:Delayed latencies have been found in patients with neurocognitive disorder(ND)and type 2 diabetes...BACKGROUND Blink and masseter reflexes provide reliable,quantifiable data on the function of the central nervous system:Delayed latencies have been found in patients with neurocognitive disorder(ND)and type 2 diabetes mellitus(T2DM),but this has not been studied in patients with both pathologies.AIM To investigate if older adults with ND plus T2DM have prolonged latencies of blink and masseter-reflex and if they were associated with disease progression.METHODS This cross-sectional study included 227 older adults(>60 years)from Colima,Mexico.Neurocognitive disorder was identified by a neuropsychological battery test,and T2DM identified by medical history,fasting glucose,and glycosylated hemoglobin.Latencies in the early reflex(R1),ipsilateral late(R2),and contralateral late(R2c)components of the blink reflex were analyzed for all subjects,and 183 subjects were analyzed for latency of the masseter reflex.RESULTS In 20.7%of participants,ND was detected.In 37%,T2DM was detected.Latencies in R1,R2,and R2c were significantly prolonged for groups with ND plus T2DM,ND,and T2DM,compared with the control group(P<0.0001).The masseter reflex was only prolonged in older adults(regardless of T2DM status)with ND vs controls(P=0.030).In older adults with ND and without T2DM,the more the cognitive impairment progressed,the more prolonged latencies in R2 and R2c presented(P<0.01).CONCLUSION These findings suggest that blink and masseter reflexes could be used to evaluate possible changes in brainstem circuits in older adults with ND and T2DM.展开更多
Depressive disorders are recognized as one of the most common mental health conditions across different age groups.However,the risk factors associated with depression among older people from low-and middle-income coun...Depressive disorders are recognized as one of the most common mental health conditions across different age groups.However,the risk factors associated with depression among older people from low-and middle-income countries remains unclear.This study aims to identify socio-demographic,health and psychosocial-related factors associated with depression in Chilean older adults.A cross-sectional study was carried out in a representative sample of 1,765 adults aged≥60 years participants from the Chilean National Health Survey 2016–2017.Depres-sion was assessed with the Composite International Diagnostic Interview(CIDI-SF).Associations between the exposure variables and depression were investigated using Poisson regression analyses.The mainfindings indi-cated that women showed higher likelihood of depression than men(Prevalence Ratio(PR)=2.6[95%CI:1.40;4.89]).An increased likelihood of depression was found in older adults with chronic pain,multimorbidity(≥2 diseases),previous diagnose of depression,high perception of stress,financial stress,and difficulties for social par-ticipation.In women,higher likelihood of depression was found for those with the frailty phenotype(PR:8.53[95%CI:1.68;43.32]),rheumatoid arthritis(PR:2.41[95%CI:1.34;4.34]),insomnia(PR:2.99[95%CI:1.74;5.12])and low self-rated well-being(PR:4.94[95%CI:2.26;10.79]).Men who were divorced(PR:7.10[95%CI:1.44;34.90])or widowed(PR:10.83[95%CI:3.71;31.58]),obese(PR:5.08[95%CI:1.48;17.42])and who had asthma(PR:7.60[95%CI:2.31;24.99])were associated with higher odds of depression.The currentfindings may have clinical implications for the early identification of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.展开更多
BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for hi...BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications.The underrecognition of catatonia in older patients is also frequent,and research in this population is scarce.AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings.METHODS Following the PRISMA guidelines,MEDLINE,EMBASE,and PsycINFO databases were searched from inception to December 2021,with a strategy aimed at identifying all articles published on catatonia in older adults.Titles and abstracts were scanned and selected independently by two authors.Papers investigating issues related to catatonia and/or catatonic symptoms in older people,with English abstracts available,were included.References of selected articles were revised to identify other relevant studies.RESULTS In total,1355 articles were retrieved.After removing duplicates,879 remained.Of the 879 identified abstracts,669 were excluded because they did not meet the inclusion criteria.A total of 210 articles underwent full text review,and 51 were eliminated for various reasons.Fourteen more articles were selected from the references.Overall,173 articles were reviewed:108 case reports,35 case series,11 prospective cohort studies,6 case-control studies,3 retrospective cohort studies and 10 reviews.We found several particular aspects of catatonia in this population.Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.Older patients,compared to younger patients,have a higher risk of developing catatonia with benzodiazepine(BZD)withdrawal,in bipolar disorder,and in the general hospital.Age,together with other risk factors,was significantly associated with the incidence of deep venous thrombosis,neuroleptic malignant syndrome poor outcome,other complications and mortality.Treatment with BZDs and electroconvulsive therapy is safe and effective.Prompt treatment of its cause is essential to ensure a good prognosis.CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.The risk of developing catatonia in some settings and conditions,as well as of developing complications,is high in this population.Symptomatic treatment is safe and effective,and timely etiologic treatment is fundamental.展开更多
Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People'...Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People's Republic of China using a translated Gerotranscendence Scale and demographic information.Results:The community-dwelling older adults had an overall intermediate level of gerotranscendence.One-way analysis of variance and multiple linear regression analysis showed that sex,living arrangements,regular activities,and religious affiliation influenced the gerotranscendence perspective of the community-dwelling older adults(p<0.05),but that living arrangement and gerotranscendence perspective were not significantly correlated.The covariates clarified about 38.8%of the variation in gerotranscendence perspective.Conclusions:Our findings suggest that sex,regular activities,religious affiliation,and living arrangement influence gerotranscendence.These findings can guide the planning and implementation of better practices in elderly care by nurses and other healthcare professionals.展开更多
Objectives:To describe the quality of life(QOL)of adults≥60 years of age in communities in Beijing and explore demographic,clinical,and psychological factors associated with QOL.Methods:This was a cross-sectional stu...Objectives:To describe the quality of life(QOL)of adults≥60 years of age in communities in Beijing and explore demographic,clinical,and psychological factors associated with QOL.Methods:This was a cross-sectional study.A total of 363 older adults were recruited,in which 313 completed the questionnaires.Depressive symptoms were measured with the Self-Rating Depression Scale(SDS)and QOL was analyzed with the 36-item short form(SF-36).The t-test and Mann-Whitney U tests were used to compare QOL by gender and age group.Factors associated with QOL were determined using multiple linear regression.Results:Among 313 older adults,depressive symptoms were observed to be prevalent to the extent of 16.6%.Overall,participants had higher QOL in the domains of social role functioning and emotional role functioning,with lower QOL in the domains of physical functioning and general health perceptions.There were no significant differences in QOL between women and men.However,there were significant differences between different age groups,with older adults having better mental QOL than younger adults.Better physical QOL was associated with less depressive symptoms,having a partner,and younger age(R2=28.7%).Better mental QOL was associated with less depressive symptoms,less chronic disease,and older age(R^(2)=34.7%).Conclusions:With aging,physical QOL was lower and mental QOL was better.Less depressive symptoms,having a spouse or partner,and young-old age assert positive influence on physical QOL of the older adults;and less depressive symptoms,no chronic disease,and older age assert positive influence on mental QOL.展开更多
Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medica...Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.展开更多
基金supported by the National Key R&D Program of China[2020 YFC2003000]。
文摘Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 were followed up in 2021.General and abdominal obesity were assessed,and serum C-reactive protein(CRP)levels were measured at baseline.Depression status was assessed at baseline and at follow-up.Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms,as well as the relationship between obesity and CRP levels.The associations of CRP levels with the geriatric depression scale,as well as with its three dimensions,were investigated using multiple linear regressions.Results General obesity was associated with worsening depression symptoms and incident depression,with an odds ratio(OR)[95%confidence interval(CI)]of 1.53(1.13-2.12)and 1.80(1.23-2.63),especially among old male subjects,with OR(95%CI)of 2.12(1.25-3.58)and 2.24(1.22-4.11),respectively;however,no significant relationship was observed between abdominal obesity and depression.In addition,general obesity was associated with high levels of CRP,with OR(95%CI)of 2.58(1.75-3.81),especially in subjects free of depression at baseline,with OR(95%CI)of 3.15(1.97-5.04),and CRP levels were positively correlated with a score of specific dimension(life satisfaction)of depression,P<0.05.Conclusion General obesity,rather than abdominal obesity,was associated with worsening depressive symptoms and incident depression,which can be partly explained by the systemic inflammatory response,and the impact of obesity on depression should be taken more seriously in the older male population.
基金supported the China National Social Science Fund Item[20ZDA076].
文摘Introduction:Older adults are prone to high levels of depression due to their deteriorating physical functions and shrinking social networks after retirement.Volunteering as an important social activity is essential for alleviating depression by building social network.This paper aims to examine the effect of volunteering on depression among older adults by using China Longitudinal Aging Social Survey(CLASS 2018)data.Methods:This study uses descriptive analysis and chi-square tests to show differences in demographic factors of older adults’volun-teerism participation,followed by bivariate correlation analysis to examine the correlation between the vital vari-ables.Afterward,stratified linear regression analysis is used to research the significant level and impact between volunteering and degree of expertise,frequency,and variety of participation.Results:8,459 older adults are included in study.The research reveals that older adults who are younger,live in urban areas,are married,or have a higher degree of education tend to have fewer depressive symptoms.Meanwhile,participation in volun-teering(OR=0.90,95%CI:0.8,1.1,p<0.001),as well as that demands specialized skills(OR=0.51,95%CI:0.30,0.2,p<0.001),more frequency of participation(OR=1.85,95%CI:1.53,2.18,p<0.001),and a wider variety of activities(OR=0.21,95%CI:0.12,0.29,p<0.001),all have a positive influence on depression levels.Discussion/Conclusion:Older adults who participate in voluntary services have lower depression symptoms and should be encouraged to use their professional skills and increase participation frequency and variety in this process.This article suggests that governments should help older adults participate in voluntary services by time bank which will further strengthen social ties,rebuild social networks and alleviate depression symptoms of older adults.
基金support from the National Research Foundation of Korea(NRF-2017R1C1B5076621).
文摘This study examined factors related to the psychological well-being of older adults and built and verified a model for predictingpsychological well-being. The participants were 350 older adults aged over 60 years who lived in South Korea and were active in thelocal community. The model proposed in this study was found to be suitable. Depression, self-efficacy, and social support had adirect effect on the psychological well-being of older adults, while depression, activities of daily living (ADLs), and self-efficacy hadan indirect effect. Self-efficacy and social support mediated the relationship between depression and psychological well-being, andself-efficacy mediated the relationship between ADLs and psychological well-being. It is necessary to develop and implement aprogram that can help alleviate depression and improve self-efficacy and social support among older adults in order toenhance their psychological well-being. Additionally, to establish a model that predicts the psychological well-being of olderadults, a study is needed to verify the model not only in Korea but also in other countries.
基金This research was funded by a research Grant 32171076 from National Social Sciences Foundation of China20BSH139 from National Social Sciences Foundation of China.
文摘This study aims to be the first to use meta-analysis to explore the relationship between meaning in life(MIL)and mental health issues among older adults.A meta-analysis was conducted using six databases,resulting in 16 studies with 5,074 participants in total.The“metacor”and“forestplot”packages in R-Studio were used for data analysis.The total effect was calculated using a random-effects model,with I2=86%in the heterogeneity test.The results showed a moderate negative correlation between MIL and mental health issues among older adults,with an average effect of−0.37.Five potential moderating variables were examined:the conceptualization of MIL(value vs.purpose),region(Asian vs.Western countries),residence status(community vs.nursing home vs.hospital),types of mental health issues,and evaluation methods(clinical vs.non-clinical).The first four had no significant moderating effect.The mean correlation coefficients between mental health issues and value/purpose were−0.49/−0.33;the mean correlation coefficients in Asian countries and Western countries were−0.48 and−0.34;the mean correlation coefficients among participants living in community/nursing home/mixed status were−0.33/−0.40/−0.40;the mean correlation coefficients between MIL and depression/others were−0.37/−0.35;however,the negative relationship between MIL and mental health issues was stronger when non-clinical evaluations(self-report only)were used.Specifically,the mean correlation coefficient for non-clinical evaluations was−0.42 and for clinical evaluations was−0.29.This study is the first meta-analysis to identify the negative correlation between older adults’MIL and mental health issues.Significant moderating effects of evaluation methods were found.
基金financed by the Flinders University College of Business,Government and Law Large Project Grant[Grant Number:100031.21].
文摘Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.
文摘Many developing countries like Nigeria lack policy for the care of the older adults and this creates major challenges for the elderly population. The traditional family institution and community support that used to be safety nest are being adversely affected by westernization. This development might have adverse effect on life satisfaction among the older adults. This hospital based cross-sectional study was designed to determine the association between support and life satisfaction among older adults. A total of 128 subjects participated in the study out of which 28.9% were satisfied with life. Expectation of support was mainly from the family, less from the community and very low from the government. The level of support received from all sources generally fell short of expectations. Marital status and source of livelihood were significantly associated with life satisfaction. There is inadequate social support from the government and support from family and community fell below expectations. Expectations of support were the most strongly correlated with life satisfaction. Support for older adults must be addressed in order to meet their expectations and improve their level of satisfaction with life.
文摘Cognitive impairment(CI)is a type of syndrome in which acquired and persistent cognitive impairment is at the core,leading to decreased daily life and work ability,and may be accompanied by mental and behavioral abnormalities.With an ageing population,the incidence of CI disease continues to increase,and the socio-economic burden is growing,making it a social problem that poses a serious health risk to the global population.At the same time,it also poses serious challenges to the field of nursing.This special issue of the International Journal of Nursing Sciences aims to publish original research papers,case reports,as well as systematic and literature review manuscripts on CI care in older adults.
基金The authors would like to express gratitude to the elders in Bengkulu City,Indonesia for their participation in this study,the Boromarajonani College of Nursing Nopparat Vajira(an affiliated institution of Kasetsart University and the Institute of Health Science Tri Mandiri Sakti for their support,as well as the Directorate General of Higher Education and the Ministry of Research,Technology and Higher Education of The Republic of Indonesia for the funding.
文摘Objectives:This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City,Bengkulu,Indonesia.Methods:A cross-sectional study was conducted in 333 older adults with hypertension,who were selected using multistage sampling method.Data were obtained by face-to-face interview with structured questionnaires.The questionnaires used in this study included the Health-Promoting Lifestyle Profile II(HPLP II),Hypertension Knowledge-Level Scale(HK-LS),Self-Rated Abilities for Health Practices Scale(SRAHP),Barriers to Health-promoting Behaviour Scales(BAS),Benefits to Health-Promoting Behaviour Scales(BES),Multidimensional Scale of Perceived Social Support(MSPSS)and Situational Influences Questionnaire(SIQ).Data were analysed by using multiple linear regressions.Results:The mean and standard deviation(Mean±SD)of each questionnaire were as follows:HPLP II,2.55±0.19;HK-LS,11.83±3.00;SRAHP,2.00±5.87;BAS,27.89±2.70;BES,34.29±2.29;MSPSS,60.35±8.12;and SIQ,47.71±6.66.According to the multiple linear regression model,36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables,namely,education,knowledge,self-efficacy,perceived barriers,social support and situational influences(adjusted R^(2)=0.369).Conclusions:High and good-quality education will increase the level of health-promoting behaviour,whereas barriers,such as expense and time requirement,can decrease it.Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour.Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.
基金supported by National Natural Science Foundation of China[82025030,81941023,81872707,81273160 and 81573247]National Science and Technology Planning Project[2018YFC2000300]NIH/NIA P30AG028716。
文摘Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.
基金This study was funded by Cybex International as part of a funded PhD.
文摘Background:Resistance exercise has numerous,well-documented benefits on the health and functional performance of older adults.However,little information exists on the affective responses to resistance exercise in this population.As affective responses can predict continued exercise behavior,examining if and how they differ between resistance exercise intensities and frequencies in older adults may provide important data to improve resistance exercise prescription.Methods:We monitored the affective responses of older adults when performing high-velocity,low-load(HVLL)or low-velocity,high-load(LVHL)resistance exercise once or twice weekly.A total of 40 moderately to highly active,but resistance-exercise naïve,older adults(60-79 years)completed 1 of 4 randomly assigned progressive resistance exercise conditions:HVLL once weekly(HVLL1:n=10),HVLL twice weekly(HVLL2:n=10),LVHL once weekly(LVHL1:n=10),or LVHL twice weekly(LVHL2:n=10).The Physical Activity Affect Scale,Felt Arousal Scale,Feeling Scale,rating of perceived exertion,Visual Analog Scale,and the Physical Activity Enjoyment Scale were used to assess enjoyment and affective responses.Results:The results from Physical Activity Enjoyment Scale(out of 35)suggest that all exercise conditions were largely and similarly enjoyable to older adults(HVLL1:30.9±2.4;LVHL1:31.9±3.6;HVLL2:30.9±3.5;LVHL2:30.2±3.7)despite greater fatigue(p=0.033;ηp^2p=0.22)and perceived workload(p=0.042;ηp^2=0.20)in LVHL(results from Visual Analog Scale).Conclusion:Moderately to highly physically active older adults may tolerate higher intensities of resistance exercise performed once or twice weekly without experiencing a negative impact on enjoyment.However,the role that supervision and social interaction played in shaping the participants’responses is unclear.
基金funded by grants from Beijing Healthcare Committee Fund (19-8)Research Foundation of Beijing Friendship Hospital+1 种基金Capital Medical University (yyqdkt 2017-6)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201838)。
文摘Objective To examine the association of atherosclerotic cardiovascular disease(ASCVD)and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged≥65 years,from one center(2016–2018)underwent clinical,laboratory assessments and the Montreal Cognitive Assessment(Mo CA).Using regression analysis,the relationship between ASCVD and its risk factors was evaluated in subjects with and without cognitive impairment(MoCA score<26).Results Older age(b=-1.3 per 5 years,95%CI:-1.7 to-0.9,P<0.001),history of stroke(b=-1.6,95%CI:-3.0 to-0.3,P=0.01),and myocardial infarction(MI;b=-2.2,95%CI:-3.6 to-0.8,P=0.003)were independently associated with lower MoCA scores,whereas more education(b=1.5 per 3 years,95%CI:1.1 to 1.9,P<0.001),higher body mass index(BMI;b=0.5 per 3 kg/m^2,95%CI:0.0 to 1.0,P=0.04),higher estimated glomerular filtration rate(eGFR;b=0.8 per 15 U,95%CI:0.1 to 1.4,P=0.03),left ventricular ejection fraction(LVEF;b=0.4 per 5%,95%CI:0 to 0.8,P=0.04)and statin use(b=1.3,95%CI:0.3 to 2.3,P=0.01)were associated with a higher MoCA score.Cognitive impairment was independently associated with older age(OR=1.51 per 5 yrs,95%CI:1.28 to 1.79,P<0.001),less education(OR=0.55 per 3 years,95%CI:0.45 to 0.68,P<0.001),lower BMI(OR=0.78 per 3 kg/m^2,95%CI:0.62 to 0.98,P=0.03)and higher levels of high sensitivity c-reactive protein(hsCRP;OR=1.08 per 1 mg/L,95%CI:1.02 to 1.15,P=0.01).Conclusions Beyond age,cognitive impairment was associated with prior MI/stroke,higher hsCRP,statin use,less education,lower eGFR,BMI and LVEF.
文摘Colon cancer represents one of the most common cancers diagnosed in older adults worldwide.The standard of care in resected stage II and stage III colon cancer continues to evolve.While there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer,data regarding its use in patients with stage II colon cancer are less clear.Further,although colon cancer is a disease that affects older adults,there is considerable debate on the value of adjuvant chemotherapy in the aging population.In particular,many older patients are undertreated when compared to their younger counterparts.In this review,we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer,discuss representation of older adults in trials and the specific challenges associated with the management of this subpopulation,and highlight the role of comprehensive geriatric assessments.We will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.
基金supported by the Swedish Research Council(Grant number 2011-2976)DS is supported by an Australian National Health and Medical Research Council(NHMRC)R.D.Wright Biomedical Career Development Fellowship(Grant number GNT1123014).
文摘Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.
文摘Temporal envelope is a low frequency amplitude modulation conveying segmental and suprasegmental information during speech perception.Unfortunately,we seldom find ourselves in completely quiet listening environments and noise,commonly found in the surrounding environment,obscures both the fine structure cues and partly the temporal envelope cues in speech.Available temporal content of speech emanating from noise is often enough to convey required information in normal hearing individuals.However,the case is different in older adults(with and without hearing loss) who lack such capabilities due to the impairment in temporal processing.This calls attention of a researcher to delineate the importance of temporal enhancement of speech in improving speech perception.There are many temporal envelope strategies available in the literature,but each one has its own lacunae.An envelope enhancement by a deep band modulation(DBM) is found to be beneficial for those individuals who have had a temporal processing impairment.The reason could be attributed to the 15 dB enhancement in the temporal envelope bandwidth between 3 and 30 Hz,extracted from each channel,which significantly increases the modulation depth such that masking of a consonant by a vowel is minimized.Additionally,output of deep band modulated speech is rescaled such that its duration increases and it provides relatively easy access to the word of the lexicon.Thus,in the near future,with more experiments related to DBM algorithm,it can be utilized in the rehabilitative devices to lessen the impact of the temporal processing impairment.
文摘BACKGROUND Blink and masseter reflexes provide reliable,quantifiable data on the function of the central nervous system:Delayed latencies have been found in patients with neurocognitive disorder(ND)and type 2 diabetes mellitus(T2DM),but this has not been studied in patients with both pathologies.AIM To investigate if older adults with ND plus T2DM have prolonged latencies of blink and masseter-reflex and if they were associated with disease progression.METHODS This cross-sectional study included 227 older adults(>60 years)from Colima,Mexico.Neurocognitive disorder was identified by a neuropsychological battery test,and T2DM identified by medical history,fasting glucose,and glycosylated hemoglobin.Latencies in the early reflex(R1),ipsilateral late(R2),and contralateral late(R2c)components of the blink reflex were analyzed for all subjects,and 183 subjects were analyzed for latency of the masseter reflex.RESULTS In 20.7%of participants,ND was detected.In 37%,T2DM was detected.Latencies in R1,R2,and R2c were significantly prolonged for groups with ND plus T2DM,ND,and T2DM,compared with the control group(P<0.0001).The masseter reflex was only prolonged in older adults(regardless of T2DM status)with ND vs controls(P=0.030).In older adults with ND and without T2DM,the more the cognitive impairment progressed,the more prolonged latencies in R2 and R2c presented(P<0.01).CONCLUSION These findings suggest that blink and masseter reflexes could be used to evaluate possible changes in brainstem circuits in older adults with ND and T2DM.
文摘Depressive disorders are recognized as one of the most common mental health conditions across different age groups.However,the risk factors associated with depression among older people from low-and middle-income countries remains unclear.This study aims to identify socio-demographic,health and psychosocial-related factors associated with depression in Chilean older adults.A cross-sectional study was carried out in a representative sample of 1,765 adults aged≥60 years participants from the Chilean National Health Survey 2016–2017.Depres-sion was assessed with the Composite International Diagnostic Interview(CIDI-SF).Associations between the exposure variables and depression were investigated using Poisson regression analyses.The mainfindings indi-cated that women showed higher likelihood of depression than men(Prevalence Ratio(PR)=2.6[95%CI:1.40;4.89]).An increased likelihood of depression was found in older adults with chronic pain,multimorbidity(≥2 diseases),previous diagnose of depression,high perception of stress,financial stress,and difficulties for social par-ticipation.In women,higher likelihood of depression was found for those with the frailty phenotype(PR:8.53[95%CI:1.68;43.32]),rheumatoid arthritis(PR:2.41[95%CI:1.34;4.34]),insomnia(PR:2.99[95%CI:1.74;5.12])and low self-rated well-being(PR:4.94[95%CI:2.26;10.79]).Men who were divorced(PR:7.10[95%CI:1.44;34.90])or widowed(PR:10.83[95%CI:3.71;31.58]),obese(PR:5.08[95%CI:1.48;17.42])and who had asthma(PR:7.60[95%CI:2.31;24.99])were associated with higher odds of depression.The currentfindings may have clinical implications for the early identification of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.
文摘BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated,even though its classification has evolved in recent years.Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications.The underrecognition of catatonia in older patients is also frequent,and research in this population is scarce.AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings.METHODS Following the PRISMA guidelines,MEDLINE,EMBASE,and PsycINFO databases were searched from inception to December 2021,with a strategy aimed at identifying all articles published on catatonia in older adults.Titles and abstracts were scanned and selected independently by two authors.Papers investigating issues related to catatonia and/or catatonic symptoms in older people,with English abstracts available,were included.References of selected articles were revised to identify other relevant studies.RESULTS In total,1355 articles were retrieved.After removing duplicates,879 remained.Of the 879 identified abstracts,669 were excluded because they did not meet the inclusion criteria.A total of 210 articles underwent full text review,and 51 were eliminated for various reasons.Fourteen more articles were selected from the references.Overall,173 articles were reviewed:108 case reports,35 case series,11 prospective cohort studies,6 case-control studies,3 retrospective cohort studies and 10 reviews.We found several particular aspects of catatonia in this population.Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.Older patients,compared to younger patients,have a higher risk of developing catatonia with benzodiazepine(BZD)withdrawal,in bipolar disorder,and in the general hospital.Age,together with other risk factors,was significantly associated with the incidence of deep venous thrombosis,neuroleptic malignant syndrome poor outcome,other complications and mortality.Treatment with BZDs and electroconvulsive therapy is safe and effective.Prompt treatment of its cause is essential to ensure a good prognosis.CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology.The risk of developing catatonia in some settings and conditions,as well as of developing complications,is high in this population.Symptomatic treatment is safe and effective,and timely etiologic treatment is fundamental.
基金This research was supported by Hunan Province Department of Education Fund(No.:14C0984).
文摘Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People's Republic of China using a translated Gerotranscendence Scale and demographic information.Results:The community-dwelling older adults had an overall intermediate level of gerotranscendence.One-way analysis of variance and multiple linear regression analysis showed that sex,living arrangements,regular activities,and religious affiliation influenced the gerotranscendence perspective of the community-dwelling older adults(p<0.05),but that living arrangement and gerotranscendence perspective were not significantly correlated.The covariates clarified about 38.8%of the variation in gerotranscendence perspective.Conclusions:Our findings suggest that sex,regular activities,religious affiliation,and living arrangement influence gerotranscendence.These findings can guide the planning and implementation of better practices in elderly care by nurses and other healthcare professionals.
基金This project was supported by the Research project of Beijing University of Chinese Medicine,Beijing,China(No.2013-JYBZZ-JS-142).
文摘Objectives:To describe the quality of life(QOL)of adults≥60 years of age in communities in Beijing and explore demographic,clinical,and psychological factors associated with QOL.Methods:This was a cross-sectional study.A total of 363 older adults were recruited,in which 313 completed the questionnaires.Depressive symptoms were measured with the Self-Rating Depression Scale(SDS)and QOL was analyzed with the 36-item short form(SF-36).The t-test and Mann-Whitney U tests were used to compare QOL by gender and age group.Factors associated with QOL were determined using multiple linear regression.Results:Among 313 older adults,depressive symptoms were observed to be prevalent to the extent of 16.6%.Overall,participants had higher QOL in the domains of social role functioning and emotional role functioning,with lower QOL in the domains of physical functioning and general health perceptions.There were no significant differences in QOL between women and men.However,there were significant differences between different age groups,with older adults having better mental QOL than younger adults.Better physical QOL was associated with less depressive symptoms,having a partner,and younger age(R2=28.7%).Better mental QOL was associated with less depressive symptoms,less chronic disease,and older age(R^(2)=34.7%).Conclusions:With aging,physical QOL was lower and mental QOL was better.Less depressive symptoms,having a spouse or partner,and young-old age assert positive influence on physical QOL of the older adults;and less depressive symptoms,no chronic disease,and older age assert positive influence on mental QOL.
文摘Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.
