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210条结果
  • 机译 特定领域认知中的个体差异和轻度认知障碍和痴呆的风险
    摘要:Intraindividual variability among cognitive domains may predict dementia independently of interindividual differences in cognition. A multidomain cognitive battery was administered to 2305 older adult women (mean age 74 years) enrolled in an ancillary study of the Women's Health Initiative. Women were evaluated annually for probable dementia and mild cognitive impairment (MCI) for an average of 5.3 years using a standardized protocol. Proportional hazards regression showed that lower baseline domain-specific cognitive scores significantly predicted MCI (N = 74), probable dementia (N = 45), and MCI or probable dementia combined (N = 101) and that verbal and figural memory predicted each outcome independently of all other cognitive domains. The baseline intraindividual standard deviation across test scores (IAV Cognitive Domains) significantly predicted probable dementia and this effect was attenuated by interindividual differences in verbal episodic memory. Slope increases in IAV Cognitive Domains across measurement occasions (IAV Time) explained additional risk for MCI and MCI or probable dementia, beyond that accounted for by interindividual differences in multiple cognitive measures, but risk for probable dementia was attenuated by mean decreases in verbal episodic memory slope. These findings demonstrate that within-person variability across cognitive domains both at baseline and longitudinally independently accounts for risk of cognitive impairment and dementia in support of the predictive utility of within-person variability.
  • 机译 埃及一家大学医院的老年医疗患者的心理健康问题和社会人口统计学相关性
    摘要:Background. Depression and cognitive impairment are two common mental and public health problems especially among elderly. In this study, we determined the prevalence of these problems and their associations with sociodemographic factors among hospitalized elderly in Egypt. To achieve this, 200 elderly medical inpatients were included in this cross-sectional study. Methods. Comprehensive geriatric assessment was done for every participant. Sociodemographic variables were assessed by interviews with patients and their family members. Depressive symptoms were screened for by the 15-item Geriatric Depression Scale (GDS), and the presence of depressive symptoms was defined as a GDS score of ≥6. Cognitive impairment was assessed by the Mini-Mental State Examination (MMSE) Scale, and cognitive impairment was defined as a MMSE score of ≤23 out of a total score of 30. Results. The prevalence of both depressive symptoms and cognitive impairment was 72% and 30%, respectively. Significant associations were noticed between each of depressive symptoms and cognitive impairment, and low income and advancing age (P < 0.01), respectively. Other associations were insignificant. Conclusions. The findings of this study may be an alarm for health authorities and staffs involved in elderly care to increase their awareness of social and mental health problems among the elderly.
  • 机译 不明原因的跌倒在骨科病房的跌倒相关伤害患者中很常见:UFO研究(老年患者的不明原因的跌倒)
    摘要:To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65–101). Falls were defined “accidental” (fall explained by a definite accidental cause), “medical” (fall caused directly by a specific medical disease), “dementia-related” (fall in patients affected by moderate-severe dementia), and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.
  • 机译 评估神经退行性疾病患者的血小板指数:帕金森氏病患者的平均血小板量增加
    摘要:Platelets induce chronic inflammation which is a key step in atherosclerosis and may be involved in the progression of neurodegenerative diseases (NDD). We aimed to measure the mean platelet volume (MPV) and platelet count (PLC) in NDD patients. The present study was designed to investigate the platelet function by measuring MPV and PLC in NDD. A total of 182 outpatients with Alzheimer's (AD) or Parkinson's diseases (PD) were included. The control group consisted of 104 healthy subjects. Platelet count was similar between groups. MPV values of PD patients were higher than those of AD patients and controls (P < 0.001). MPV correlated negatively with Heohn and Yahr scale (HYS) score (P < 0.001). Increased MPV in patients with PD may point to a platelet dysfunction. High-grade inflammation presents with low levels of MPV as seen in PD patients with high HYS scores.
  • 机译 积极促进老龄化:重要老龄化计划的成果
    摘要:Active aging is one of the terms in the semantic network of aging well, together with others such as successful, productive, competent aging. All allude to the new paradigm in gerontology, whereby aging is considered from a positive perspective. Most authors in the field agree active aging is a multidimensional concept, embracing health, physical and cognitive fitness, positive affect and control, social relationships and engagement. This paper describes Vital Aging, an individual active aging promotion program implemented through three modalities: Life, Multimedia, and e-Learning. The program was developed on the basis of extensive evidence about individual determinants of active aging. The different versions of Vital Aging are described, and four evaluation studies (both formative and summative) are reported. Formative evaluation reflected participants' satisfaction and expected changes; summative evaluations yielded some quite encouraging results using quasi-experimental designs: those who took part in the programs increased their physical exercise, significantly improved their diet, reported better memory, had better emotional balance, and enjoyed more cultural, intellectual, affective, and social activities than they did before the course, thus increasing their social relationships. These results are discussed in the context of the common literature within the field and, also, taking into account the limitations of the evaluations accomplished.
  • 机译 Gerontechnology:在照顾认知障碍的老年人时提供帮助—非正式照料者的满意度和接受度的对照研究的中间结果
    摘要:The incidence of cognitive impairment in older age is increasing, as is the number of cognitively impaired older adults living in their own homes. Due to lack of social care resources for these adults and their desires to remain in their own homes and live as independently as possible, research shows that the current standard care provisions are inadequate. Promising opportunities exist in using home assistive technology services to foster healthy aging and to realize the unmet needs of these groups of citizens in a user-centered manner. ISISEMD project has designed, implemented, verified, and assessed an assistive technology platform of personalized home care (telecare) for the elderly with cognitive impairments and their caregivers by offering intelligent home support services. Regions from four European countries have carried out long-term pilot-controlled study in real-life conditions. This paper presents the outcomes from intermediate evaluations pertaining to user satisfaction with the system, acceptance of the technology and the services, and quality of life outcomes as a result of utilizing the services.
  • 机译 不同生活阶段单腿站立平衡的变化
    摘要:The ability to maintain a one-leg standing position and the relation between plantar two-point discrimination and standing time on one leg were assessed. Participants were 1,241 apparently healthy people aged 2–92 years. Participants were asked to stand on one leg with eyes open (EO group) or closed (EC group) for up to 120 seconds. Coefficients of determination (COD) between subjects' ages and results for both groups were calculated by quadratic and cubic functions. The slope of the tangent line drawn against the resultant curve was calculated by a differential formula. COD for the quadratic function were 0.65 (EO) and 0.33 (EC); age at maximum values in both groups was 37 years. COD for the cubic function were 0.77 (EO) and 0.52 (EC); maximum values were at ages 30 (EO) and 28 (EC) and minimum values at ages 88 (EO) and 77 (EC). The ability to remain standing on one leg with eyes closed appears to begin deteriorating in the late 20s. Age and plantar two-point discrimination distance had a significant positive correlation, and the two-point discrimination distance and standing time on one leg had a significant negative correlation. Decreased plantar sensation appears to be related to the decline in duration of one-leg standing.
  • 机译 马来西亚第三中心老年糖尿病患者的跌倒患病率及其相关因素
    摘要:The purpose of this study is to determine the prevalence of falls and its associated factors among elderly diabetes type 2 patients attending a tertiary center in Malaysia. We conducted a cross-sectional study among 288 elderly diabetes type 2. The data collected includes data on sociodemographic, diabetes history, comorbid diseases, drug use, and activity of daily living (Barthel's index). The patient also was examined physically, and balance and gait assessment was carried out. Prevalence of falls among elderly diabetes was 18.8%. Female gender (OR: 2.54, P < 0.05), age group more than 75 (OR: 2.97, P < 0.05), retinopathy (OR: 2.19, P < 0.05), and orthostatic hypotension (OR: 2.87, P < 0.05) were associated with higher risk for falls. High balance and gait score was associated with reduced risk of fall in elderly diabetes (OR: 0.89, P < 0.05). In conclusion, the factors that are associated with higher risk for falls among elderly diabetes were female sex, age group more than 75, presence of retinopathy, and orthostatic hypotension. Those who had higher balance and gait score were found to be less likely to fall compared with those with lower score.
  • 机译 有和没有唐氏综合症的智障成人死亡率的临床预测指标
    摘要:Background. Mood, baseline functioning, and cognitive abilities as well as psychotropic medications may contribute to mortality in adults with and without Down Syndrome (DS). Methods. Population-based (nonclinical), community-dwelling adults with intellectual disabilities (IDs) were recruited between 1995 and 2000, assessed individually for 1–4 times, and then followed by yearly phone calls. Results. 360 participants (116 with DS and 244 without DS) were followed for an average of 12.9 years (range 0–16.1 years as of July 2011). 108 people died during the course of the followup, 65 males (31.9% of all male participants) and 43 females (27.6% of all female participants). Cox proportional hazards modeling showed that baseline practical skills, seizures, anticonvulsant use, depressive symptoms, and cognitive decline over the first six years all significantly contributed to mortality, as did a diagnosis of DS, male gender, and higher age at study entry. Analysis stratified by DS showed interesting differences in mortality predictors. Conclusion. Although adults with DS have had considerable improvements in life expectancy over time, they are still disadvantaged compared to adults with ID without DS. Recognition of potentially modifiable factors such as depression may decrease this risk.
  • 机译 衰老综合症
    摘要:
  • 机译 老年人的冷漠:从评估到治疗
    摘要:
  • 机译 营养与痴呆
    摘要:
  • 机译 WHO-5作为老年人冷漠早期筛查的有效性
    摘要:Aim. The objective of our study has been to evaluate the WHO-5 as a new early screening instrument for apathy in a group of elderly persons. Methods. The WHO-5 was compared to the Geriatric Depression Scale (GDS-15). The GDS contains five items measuring well-being and ten items measuring depression. The internal validity of the WHO-5 (total score being a sufficient statistic) was evaluated with both parametric and nonparametric item response theory models. The external validity of the WHO-5 and the GDS was evaluated by ROC using depression as index of validity. Results. The item response theory analyses confirmed that the total score of the WHO-5 is a sufficient statistic. The ROC analysis shows an adequate sensitivity (61%) and specificity (84%). The GDS15 and its two subscales obtained low sensitivity (25–42%), but high specificity (90–98%). Conclusion. The WHO-5 was found both internally and externally valid when considering decreased positive well-being to be an early indication of apathy reflecting that the wind has begun to be taken out of the “motivation sail.”
  • 机译 墨西哥瓜达拉哈拉大都市区60岁以上人口的认知障碍和抑郁症患病率
    摘要:Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.
  • 机译 管理性医疗保险中认知完好的老年白人妇女的教育水平和骨密度测试的关联
    摘要:Objectives. To examine associations between having bone density tests and level of education among white elderly women in managed Medicare. Method. Data from the ninth through twelfth cohort (2006–2009) of the Medicare Health Outcome Survey (HOS) of managed Medicare plans were analyzed; 239331 white elderly women were included. Respondents were grouped by education level and the percentages of respondents who had lifetime bone density testing done among each group were analyzed. Results. 62.7% of respondents with less than a high school education reported previously taking a bone density test. This was lower than the 73.8% for respondents who completed high school and the 81.0% for respondents with more than a high school education. When potential confounding factors such as age, body mass index, marital status, smoking history, year of HOS survey, and region were factored in, the odds ratios of having a bone density test when compared to respondents with less than a high school education were 1.61 and 2.39, respectively, for those with just a high school education and more than a high school education (P < 0.001). Conclusion. Higher education was independently associated with greater use of bone density test in these elderly white women.
  • 机译 再论唐氏综合症中的甾醇脂质代谢:唐氏综合症与选择性降低血清甾醇水平相关
    摘要:Over the past 15 years, insights into sterol metabolism have improved our understanding of the relationship between lipids and common conditions such as atherosclerosis and Alzheimer's Disease (AD). A better understanding of sterol lipid metabolism in individuals with Down Syndrome (DS) may help elucidate how this population's unique metabolic characteristics influence their risks for atherosclerosis and AD. To revisit the question of whether sterol lipid parameters may be altered in DS subjects, we performed a pilot study to assess traditional serum sterol lipids and lipoproteins, as well as markers of sterol biosynthesis, metabolites, and plant sterols in 20 subjects with DS compared to age-matched controls. Here we report that the levels of nearly all lipids and lipoproteins examined are similar to control subjects, suggesting that trisomy 21 does not lead to pronounced general alterations in sterol lipid metabolism. However, the levels of serum brassicasterol were markedly reduced in DS subjects.
  • 机译 阿尔茨海默氏病的血脂异常和血脑屏障完整性
    摘要:Background. Blood-brain barrier (BBB) dysfunction may have a significant role in the pathogenesis of Alzheimer's disease (AD). Modifiable factors associated with BBB function may have therapeutic implication. This study tested the hypothesis that dyslipidemia is associated with BBB impairment in mild-to-moderate AD. Methods. Thirty-six subjects with AD were followed for 1 year. Fasting CSF and plasma were collected with clinical assessments at baseline and 12 months. BBB impairment was defined as CSF albumin index ≥9. Independent t-tests and linear regression assessed the relationship between plasma lipoproteins and BBB integrity. Results. Dyslipidemia was prevalent in 47% of the population, and in 75% of those with BBB impairment. Subjects with BBB impairment had significantly higher mean plasma triglyceride and lower HDL cholesterol (TG, P = 0.007; HDL, P = 0.043). Plasma triglycerides explained 22% of the variance in BBB integrity and remained significant after controlling for age, gender, ApoE-4 genotype, blood pressure, and statin use. Conclusion. Dyslipidemia is more prevalent in AD subjects with BBB impairment. Plasma triglyceride and HDL cholesterol may have a role in maintaining BBB integrity in mild-to-moderate Alzheimer's disease.
  • 机译 脂肪调节非肥胖老年人的肌肉减少症与身体功能之间的关系
    摘要:It is intuitive to think that sarcopenia should be associated with declines in physical function though recent evidence questions this assertion. This study investigated the relationship between absolute and relative sarcopenia, with physical performance in 202 nonobese (mean BMI = 26.6 kg/ht2) community-dwelling older (mean age = 73.8 ± 5.9 years) adults. While absolute sarcopenia (appendicular skeletal mass (ASM)/ht2) was either not associated, or weakly associated with physical performance, relative sarcopenia (ASM/kg) demonstrated moderate (r = 0.31 to r = 0.51, P < 0.01) relationships with performance outcomes in both males and females. Knee extension strength (r = 0.27) and leg extension power (r = 0.41) were both related to absolute sarcopenia (P < 0.001) in females and not in males. Strength and power were associated with relative sarcopenia in both sexes (from r = 0.47 to r = 0.67, P < 0.001). The ratio of lean mass to total body mass, that is, relative sarcopenia, is an important consideration relative to physical function in older adults even in the absence of obesity. Stratifying these individuals into equal tertiles of total body fat revealed a trend of diminished regression coefficients across each incrementally higher fat grouping for performance measures, providing further evidence that total body fat modulates the relationship between sarcopenia and physical function.
  • 机译 郊区环境中的流动性和主动老龄化:深度访谈和基于人的GPS跟踪的发现
    摘要:Background. Governments face a significant challenge to ensure that community environments meet the mobility needs of an ageing population. Therefore, it is critical to investigate the effect of suburban environments on the choice of transportation and its relation to participation and active ageing. Objective. This research explores if and how suburban environments impact older people's mobility and their use of different modes of transport. Methods. Data derived from GPS tracking, travel diaries, brief questionnaires, and semistructured interviews were gathered from thirteen people aged from 56 to 87 years, living in low-density suburban environments in Brisbane, Australia. Results. The suburban environment influenced the choice of transportation and out-of-home mobility. Both walkability and public transportation (access and usability) impact older people's transportation choices. Impracticality of active and public transportation within suburban environments creates car dependency in older age. Conclusion. Suburban environments often create barriers to mobility, which impedes older people's engagement in their wider community and ability to actively age in place. Further research is needed to develop approaches towards age-friendly suburban environments which will encourage older people to remain active and engaged in older age.
  • 机译 HSD17B1中的多态性:唐氏综合症女性的早发和阿尔茨海默氏病的风险增加
    摘要:Background/Aims. Genetic variants that affect estrogen activity may influence the risk of Alzheimer's disease (AD). In women with Down syndrome, we examined the relation of polymorphisms in hydroxysteroid-17beta-dehydrogenase (HSD17B1) to age at onset and risk of AD. HSD17B1 encodes the enzyme 17β-hydroxysteroid dehydrogenase (HSD1), which catalyzes the conversion of estrone to estradiol. Methods. Two hundred and thirty-eight women with DS, nondemented at baseline, 31–78 years of age, were followed at 14–18-month intervals for 4.5 years. Women were genotyped for 5 haplotype-tagging single-nucleotide polymorphisms (SNPs) in the HSD17B1 gene region, and their association with incident AD was examined. Results. Age at onset was earlier, and risk of AD was elevated from two- to threefold among women homozygous for the minor allele at 3 SNPs in intron 4 (rs676387), exon 6 (rs605059), and exon 4 in COASY (rs598126). Carriers of the haplotype TCC, based on the risk alleles for these three SNPs, had an almost twofold increased risk of developing AD (hazard ratio = 1.8, 95% CI, 1.1–3.1). Conclusion. These findings support experimental and clinical studies of the neuroprotective role of estrogen.

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