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  • 1.

    【2hr】Aging and Others Pain Processing: Implications for Hospitalization

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    机译 衰老和其他人的疼痛处理：对住院的影响
    摘要：Objectives. While self-pain perception has been widely investigated in aging, the perception as well as memory of pain in others has received little attention. Methods. The study was designed as a cross-sectional behavioral study in which a group of 41 younger and a group of 41 older adults evaluated a series of valenced and pain-related pictures and were later required to recall them. Results. We found that older adults judge the stimuli as being less intense compared to their younger counterparts. However, older adults remembered a larger number of pictures with individuals expressing pain compared to pictures with individuals who have neutral or positive facial expressions. Conclusions. Older adults may underestimate emotional intensity in others, but they seem to remember painful information in others as well as younger adults. These data are discussed in terms of theories of pain perception and implications for hospitalization.
  • 2.

    【2hr】Factors Associated with Insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria

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    机译 尼日利亚老年医学中心老年患者失眠的相关因素
    摘要：Background. Insomnia is a form of chronic sleep problem of public health importance which impacts the life of elderly people negatively. Methods. Cross-sectional study of 843 elderly patients aged 60 years and above who presented consecutively at Geriatric Centre, University College Hospital, Ibadan, Nigeria. The World Health Organization Composite International Diagnostic Interview was used to diagnose insomnia. We assessed the following candidate variables which may be associated with insomnia such as socidemographic characteristics, morbidities, and lifestyle habits. Statistical analysis was done with SPSS 17. Results. The point prevalence of insomnia was 27.5%. Insomnia was significantly associated with being female, not being currently married, having formal education, living below the poverty line, and not being physically active. Health complaints of abdominal pain, generalized body pain, and persistent headaches were significantly associated with insomnia. Conclusion. The high prevalence of insomnia among elderly patients in this setting calls for concerted effort by healthcare workers to educate the elderly on lifestyle modification.
  • 3.

    【2hr】Predictors of Inpatient Utilization among Veterans with Dementia

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    机译 老年痴呆症患者住院使用的预测指标
    摘要：Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the P < 0.15 level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia (n = 296) and their caregivers found marital status to predict hospitalization in the multivariate logistic model (B = 0.493, P = 0.029) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (B = 1.048, P = 0.007, B = 0.040, and P = 0.035, resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with ClinicalTrials.gov .
  • 4.

    【2hr】Prevalence and Determinants of Fall-Related Injuries among Older Adults in Ecuador

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    机译 厄瓜多尔老年人跌倒相关伤害的患病率和决定因素
    • 作者：Carlos H. Orces
    • 刊名：Current Gerontology and Geriatrics Research
    • 2014年第-1期
    摘要：Objectives. To estimate the prevalence and determinants of fall-related injuries in the previous year among adults aged 60 years or older in Ecuador. Methods. The prevalence of fall-related injuries was estimated using cross-sectional data from the first national survey of Health, Wellbeing, and Aging study. Logistic regression models were used to examine the associations between participants' demographic characteristics and fall-related injuries. Results. Of 5,227 participants with a mean age of 72.6 years, 11.4% (95% CI, 10.3%–12.7%) reported a fall-related injury in Ecuador, representing an estimated 136,000 adults aged 60 years or older. Fall-related injuries were more frequently reported among older adults residing in the most urbanized and populated provinces of the country. After controlling for potential confounders, self-reported race as Indigenous (OR 2.2; 95% CI, 2.11–2.31), drinking alcohol regularly (OR 2.54; 95% CI, 2.46–2.63), subjects with greater number of comorbid conditions (OR 2.03; 95% CI, 1.97–2.08), and urinary incontinence (OR 1.83; 95% CI, 1.79–1.87) were factors independently associated with increased odds of sustaining fall-related injuries. Conclusions. Fall-related injuries represent a considerable burden for older adults in Ecuador. The present findings may assist public health authorities to implement fall prevention programs among subjects at higher risk for this type of injury.
  • 5.

    【2hr】Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score

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    机译 老年髋部骨折和住院服务：使用ASA评分预测住院费用
    摘要：Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status.
  • 6.

    【2hr】Relationship-Based Care and Behaviours of Residents in Long-Term Care Facilities

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    机译 长期护理机构中基于关系的护理和居民行为
    摘要：Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents' agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers' RBC use and residents' agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (P from 0.03 to 0.003). However, many other components of RBC were not associated with residents' behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents' behaviours.
  • 7.

    【2hr】Senescent Remodeling of the Innate and Adaptive Immune System in the Elderly Men with Prostate Cancer

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    机译 老年男性前列腺癌的先天和适应性免疫系统的衰老重塑。
    摘要：Despite years of intensive investigation that has been made in understanding prostate cancer, it remains a major cause of death in men worldwide. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer in the elderly men is becoming a disease of increasing significance. Aging is a progressive degenerative process strictly integrated with inflammation. Several theories have been proposed that attempt to define the role of chronic inflammation in aging including redox stress, mitochondrial damage, immunosenescence, and epigenetic modifications. Here, we review the innate and adaptive immune systems and their senescent remodeling in elderly men with prostate cancer.
  • 8.

    【2hr】The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

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    机译 宠物和动物辅助疗法对老年人健康的益处
    摘要：Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.
  • 9.

    【2hr】The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the Oldest Old

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    机译 简化的急性生理学评分III在预测最老的老年人的手术和ICU死亡率方面优于简化的急性生理学评分II和急性生理学和慢性健康评估II。
    摘要：Elderly patients in the USA account for 26–50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the “Oldest Old” is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student's t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the “Oldest Old” population.
  • 10.

    【2hr】Predicting Delirium Duration in Elderly Hip-Surgery Patients: Does Early Symptom Profile Matter?

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    机译 预测老年髋关节手术患者Deli妄的持续时间：早期症状简介是否重要？
    摘要：Background. Features that may allow early identification of patients at risk of prolonged delirium, and therefore of poorer outcomes, are not well understood. The aim of this study was to determine if preoperative delirium risk factors and delirium symptoms (at onset and clinical symptomatology during the course of delirium) are associated with delirium duration. Methods. This study was conducted in prospectively identified cases of incident delirium. We compared patients experiencing delirium of short duration (1 or 2 days) with patients who had more prolonged delirium (≥3 days) with regard to DRS-R-98 (Delirium Rating Scale Revised-98) symptoms on the first delirious day. Delirium symptom profile was evaluated daily during the delirium course. Results. In a homogenous population of 51 elderly hip-surgery patients, we found that the severity of individual delirium symptoms on the first day of delirium was not associated with duration of delirium. Preexisting cognitive decline was associated with prolonged delirium. Longitudinal analysis using the generalised estimating equations method (GEE) identified that more severe impairment of long-term memory across the whole delirium episode was associated with longer duration of delirium. Conclusion. Preexisting cognitive decline rather than severity of individual delirium symptoms at onset is strongly associated with delirium duration.
  • 11.

    【2hr】Active Aging: A Global Goal

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    机译 积极老龄化：全球目标
    摘要：
  • 12.

    【2hr】Health-Related Quality of Life Measures for Physically Active Elderly in Community Exercise Programs in Catalonia: Comparative Analysis with Sedentary People

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    机译 加泰罗尼亚社区锻炼计划中与体育活动老年人相关的健康生活质量衡量标准：与久坐不动人士的比较分析
    摘要：Objective. To evaluate Health-Related Quality of Life (HRQoL), medication used, and Stock of Health Capital (SHC) in physically active elderly participants in Community Exercise Programs (CEPs) compared to a sedentary group. Methods. EuroQol standardized instrument was completed by physically active elderly (n = 2,185) who participated in CEPs. Common items were compared to HRQoL data of 1,874 sedentary elderly people, taken from the Catalan Health Survey 2006 (CHS'06). Visual Analogue Scale (VAS) outcomes and medication used were assessed through parametric statistics. Dimensions of health conditions were compared, between sedentary people and physically active elderly participants in CEPs. SHC results were obtained combining the EuroQol scores and Life Expectancy (LE) values. An economic value of €34,858.70 was assigned to these years of LE. Results. Physically active subjects had better HRQoL values (75.36 in males and 70.71 in females) than CHS'06 sedentary subjects (58.35 in males and 50.59 in females). Medication used was different between physically active subjects (1.89 in males and 2.87 in females) and CHS'06 sedentary subjects (4.34 in males and 4.21 in females). SHC data for physically active elderly (€465,988.31/QALY in males and €522,550.31/QALY in females) were higher than for CHS'06 sedentary subjects (€363,689.33/QALY in males and €346,615.91/QALY in females).
  • 13.

    【2hr】Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

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    机译 影响残疾人和非残疾人老年人的生活质量的因素：多元对应分析的结果
    摘要：Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors) on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT) survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA) was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS).” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people's life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network's nodes, are likely to play an important role in this relationship.
  • 14.

    【2hr】Active Ageing in CIS Countries: Semantics Challenges and Responses

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    机译 独联体国家的积极老龄化：语义挑战和对策
    摘要：Although the CIS countries are connected together by the legacy of breaking away from the Soviet Union, they have had a distinctive transition course and are rather diverse in terms of the population ageing challenges and policy responses in place. The commonality is that a comprehensive national strategy on ageing is lacking, and many of necessary reforms were put aside owing to political uncertainties, lack of societal consensus, and financial instability. The notion of active ageing is associated with the term “accelerated ageing,” which is understood to be an individual living a life under harsh living conditions or a society experiencing rapid increases in the relative number of older persons, and therefore it carries a negative connotation. Yet, in the same spirit as the European Year for Active Ageing and Solidarity between Generations 2012, the CIS countries have initiated sectoral programmes towards enhancing employment of older workers, social participation of older people in the society in a wider sense and also measures promoting health and independent living of older persons.
  • 15.

    【2hr】Effects of a Behavioral Program on Exercise Adherence and Exercise Self-Efficacy in Community-Dwelling Older Persons

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    机译 行为计划对社区居住老年人的运动依从性和运动自我效能的影响
    摘要：Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.
  • 16.

    【2hr】Delirium in Australian Hospitals: A Prospective Study

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    机译 澳大利亚医院的妄：一项前瞻性研究
    摘要：Objectives. Australian data regarding delirium in older hospitalized patients are limited. Hence, this study aimed to determine the prevalence and incidence of delirium among older patients admitted to Australian hospitals and assess associated outcomes. Method. A prospective observational study (n = 493) of patients aged ≥70 years admitted to four Australian hospitals was undertaken. Trained research nurses completed comprehensive geriatric assessments using standardized instruments including the Confusion Assessment Method to assess for delirium. Nurses also visited the wards daily to assess for incident delirium and other adverse outcomes. Diagnoses of dementia and delirium were established through case reviews by independent physicians. Results. Overall, 9.7% of patients had delirium at admission and a further 7.6% developed delirium during the hospital stay. Dementia was the most important predictor of delirium at (OR = 3.18, 95% CI: 1.65–6.14) and during the admission (OR = 4.82; 95% CI: 2.19–10.62). Delirium at and during the admission predicted increased in-hospital mortality (OR = 5.19, 95% CI: 1.27–21.24; OR = 31.07, 95% CI: 9.30–103.78). Conclusion. These Australian data confirm that delirium is a common and serious condition among older hospital patients. Hospital clinicians should maintain a high index of suspicion for delirium in older patients.
  • 17.

    【2hr】It Is Always on Your Mind: Experiences and Perceptions of Falling of Older People and Their Carers and the Potential of a Mobile Falls Detection Device

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    机译 始终在您的脑海中：老年人及其护理者跌倒的经验和看法以及移动式跌倒检测设备的潜力
    摘要：Background. Falls and fear of falling present a major risk to older people as both can affect their quality of life and independence. Mobile assistive technologies (AT) fall detection devices may maximise the potential for older people to live independently for as long as possible within their own homes by facilitating early detection of falls. Aims. To explore the experiences and perceptions of older people and their carers as to the potential of a mobile falls detection AT device. Methods. Nine focus groups with 47 participants including both older people with a range of health conditions and their carers. Interviews were audio recorded, transcribed verbatim, and thematically analysed. Results. Four key themes were identified relating to participants' experiences and perceptions of falling and the potential impact of a mobile falls detector: cause of falling, falling as everyday vulnerability, the environmental context of falling, and regaining confidence and independence by having a mobile falls detector. Conclusion. The perceived benefits of a mobile falls detector may differ between older people and their carers. The experience of falling has to be taken into account when designing mobile assistive technology devices as these may influence perceptions of such devices and how older people utilise them.
  • 18.

    【2hr】Validation of Geriatric Care Environment Scale in Portuguese Nurses

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    机译 葡萄牙护士老年护理环境量表的验证
    摘要：The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α = .919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.
  • 19.

    【2hr】Elders Life Stories: Impact on the Next Generation of Health Professionals

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    机译 老年人的生活故事：对下一代医疗专业人员的影响
    • 作者：Tracy Chippendale
    • 刊名：Current Gerontology and Geriatrics Research
    • 2013年第-1期
    摘要：The purpose of this study was to pilot an enhanced version of the “Share your Life Story” life review writing workshop. The enhanced version included the addition of an intergenerational exchange, based on the content of seniors' writings, with students planning careers in the health sciences. The researcher employed a mixed methods design. Preliminary results using descriptive analysis revealed an increase in positive images of aging and a decrease in negative images of aging among the five student participants. Qualitative results revealed six themes that illuminate the hows and whys of the quantitative results as well as additional program benefits. Feedback from students and seniors helped to refine the intergenerational protocol for a larger scale study.
  • 20.

    【2hr】Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

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    机译 厄瓜多尔老年人跌倒的患病率和决定因素：SABE I调查的分析
    • 作者：Carlos H. Orces
    • 刊名：Current Gerontology and Geriatrics Research
    • 2013年第-1期
    摘要：The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.
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