Journal of Geriatric Medicine

Journal Information
EISSN : 2630-5259
Current Publisher: Bilingual Publishing Co. (10.30564)
Total articles ≅ 34
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Akemi Hirano, Yusuke Suzuki, Toshio Hayashi, Koichiro Ina, Joji Onishi
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2712

Abstract:
Background: Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers, and the accumulation of everyday stressors reportedly promotes the induction of inflammatory markers. However, few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose: This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods: Participants were elderly caregivers living together with elderly Alzheimer’s-type dementia patients. We performed logistic regression analysis, with levels of adrenaline, noradrenaline, and dopamine (indicators of catecholamine) as dependent variables.Results: Caregiver BMI had a significant impact on adrenaline levels (OR: 0.792; 95%CI: 0.654-0.960) and noradrenaline levels (OR: 1.210; 95%CI: 1.009-1.451), whereas age had a significant impact on dopamine levels (OR: 1.162; 95%CI: 1.019-1.324).Discussion: While caregiver BMI significantly impacted adrenaline and noradrenaline levels, the mechanism underlying these relationships is unclear. One possibility is that obesity (BMI) and a rise in sympathetic nerve activity contributed to hypertension. Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion: There is a need to identify factors which increase BMI in caregivers. Future studies aimed at gaining a better understanding of the lifestyle habits of caregivers and intervention studies aimed at reducing their BMI are warranted.
Maria Laquaglia, Marina Celly Martins Ribeiro de Souza, Carolina Marques Borges
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2907

Abstract:
A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States. The present ecological exploratory study uses secondary aggregate data from the fifty United States. The purpose of this study is to address the disparities in Alzheimer’s in minority populations in the US and explore influencing factors. The “minority” populations considered were African American and Latino populations, and the “majority” population was referred to as “white”. The prevalence rates of Alzheimer’s disease were one-and-a-half times greater, and twice as greater in older Latinos and African Americans respectively, compared to older whites in the investigated time period. The data was extracted from the United States Census Bureau, the CDC National Center for Health Statistics, and the Behavioral Risk Factor Surveillance System (BRFSS) Dataset. The major results from this study showed that being over 65 years old (p=.009), with a below-average median household income (p=.024), history of stroke (p=.029), and being a part of the Latino population (p=.036), are significantly associated with Alzheimer’s mortality rates in the United States. These findings show an association between Alzheimer’s mortality rates and being a part of a minority population in the United States. By identifying disparities in access to Alzheimer’s healthcare and at-risk communities, more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s education and resource allocation for minority populations.
Joice Anu
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2614

Abstract:
Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization. Hourly rounding® is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs. This helps with positive fall prevention outcome. This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit. The implementation of the intervention took place in a long-term care facility located in Dallas, Georgia. The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission. Twenty staff members were included in the sample, age 18 years and 60 years. The unit has 41 residents who were included in the pilot case study design. Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database. Competency checklist was completed prior to implementation and post implementation to evaluate staff understanding of the main tenets of the 4 P’s (potty, pain, possession, and position). For this project, descriptive statistics was used to help determine fall rates. Minitab was used to analyzed data and to determine if it was clinically significant. In the ten weeks following the hourly rounding implementation, participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet. The results indicated that it is statistically significant and with a P-values = -<0.0001 and t-value = -5.81.Keywords: Rounding and education; fall risk; fall reduction; older adult patients; quality improvement; fall prevention; fall and fall related injury.
Akemi Hirano
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2986

Abstract:
背景: COVID-19の世界的な広がりは、家族介護者のストレスレベル、介護者の負担、燃え尽き症候群を大幅に増加させることが報告されています。したがって、家庭での健康を改善し、COVID-19感染を防ぐ方法を考案する必要があります。この研究は、認知症患者の高齢介護者の健康関連の生活の質に対する自由時間の影響を調べることを目的とした。方法:介入群では、介護者は患者の世話を続けながら、週に2回30分ごとに自由時間を取っておきます。自由時間中、介護者は家で自由に時間を過ごし、好きなことをすることができました。対照群は通常のケアのみを受けた。介入期間は6ヶ月でした。結果: SF-36の活力サブスケールスコアは、参加者の半数以上(57.1%)がベースラインと比較してこのサブスケールのランクに改善または変化がないことを示したにもかかわらず、介入群で有意に減少しました。ランク検定(有意ではありません)。考察:介護者は、毎日の介護が肉体的疲労の蓄積をもたらし、精神的な余裕がほとんどないことを示しました。介護者も自由時間を確保することが困難であり、活力の向上を妨げている可能性があります。結論: COVID-19感染を防ぐために、介護者のストレスを軽減し、彼らの生活の質を改善することができる在宅プログラムを開発する必要があります。
Daxu Peng, Qingchen Liu, Xiuyang Cao, Guanwen Deng
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2892

Abstract:
Aim. Postoperative delirium (PD) is a common complication of surgery in elderly patients, but its pathophysiological mechanism remains unclear. In order to clarify the role of intraoperative hypotension and fluctuation of blood pressure in the development of PD, we conducted a follow-up study in elderly patients with intraoperative hypotension and fluctuation of blood pressure. Methods. Patients who underwent hip surgery in 2018-2019 were selected. One day before the operation, the mentality of patients were evaluated by Mini-mental State Examination (MMSE), and the sex, age, height and weight of the patients were recorded. Radial artery puncture was performed in all patients before anesthesia, intraoperative SBP, MAP and DBP were recorded, and the surgical events of the patients was recorded. The markers associated with PD (TNF-α, IL-6 and S-100β ) were determined before and after surgery. Perioperative delirium(PD) was assessed by the prevailing standard of assessment, Confusion of Consciousness Assessment (CAM).. Cognitive assessment was evaluated using the Mini-mental State Examination (MMSE). In addition, the timing and type of delirium were recorded. Result. There were 158 patients which were accorded with the inclusion criteria came into the study. The results of our data showed that delirium occurred in 41 patients (25.9%) during the first week after surgery. In the comparison between the PD group and the non-PD group, it was found that the patients with postoperative delirium were older, lower body mass index and higher MMSE score before operation. Intraoperative blood pressure is low, usually more than 30% lower than preoperative blood pressure. The levels of TNF- α, IL-6 and Smur100 β were higher after operation. Conclusion. The increased incidence of postoperative delirium may be related to intraoperative hypotension and intraoperative blood pressure fluctuation. The pathophysiological mechanism may be that hypotension causes low cerebral perfusion, which in turn causes local inflammation in the brain. In addition, postoperative delirium is also more likely to occur in older patients with lower body mass index.
Arundhati Guha Thakurta, Rauf Iqbal
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2674

Abstract:
Ageing work force is one of the leading causes behind the reduction in the rate of growth of the labour force in construction industries. Construction industry is a major source of employment worldwide after agriculture, and generally the primary one in urban areas. Manual material handling in construction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body. Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty. To analyze the level of exertion, ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce. 20 male construction workers in the age group of i) 20 to 30 years (golden age group); ii) 50 years and above were selected from a local construction site in Mumbai. Demographic data like age, height, weight, BMI, body fat, waist hip ratio and risk assessment by questionnaires study comprising QEC, NMQ, VAS, and LEFS were collected. Compared to the golden age group, the elderly subjects were found to feel uncomfortable to their lower back, knee and calf due to the immoderate forces and motions applied to their lower limbs during their daily work. Muscle pliability and proper coordination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures. For elderly workers, age related limitations become an additional factor to maintain their normal work life.
Mi-Mi Zhou, Si-Yuan Jing, Yue Chen
Journal of Geriatric Medicine, Volume 3; doi:10.30564/jgm.v3i1.2934

Abstract:
The dosing of anti-Parkinson drugs is considered as the optimal control of the symptoms of PD, and increasing the dose of drugs is a common method to treat the aggravate state of PD. However, this is a case of PD elderly patient who had nephritic syndrome, with an increase in the dose, the symptoms did not get improved,but a series of other adverse effects appeared.
Imelda Rahmayunia Kartka, Mulya Ulfa
Journal of Geriatric Medicine, Volume 2; doi:10.30564/jgm.v2i3.2330

Abstract:
Background: An elderly was closed to some medical problem, especially hypertension. Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest person to the patient. One important aspect of family nursing is the family itself. To achieve good treatment outcomes, implementation of evidence-based nursing is needed. The purpose of this study is to present the implementation of evidence-based nursing to an eldelry in a family bu using coconut water to reduce high blood pressure and progressive muscle relaxation therapy to reduce pain intensity in hypertensive patients, as well as acupressure therapy in stopping smoking that is applied 1 week each other. Method: In the implementation, complementary therapy is applied to hypertensive patients by given young coconut water and progressive muscle relaxation therapy, and acupressure therapy in an effort to stop smoking. Results: showed significant results in the reduction of high blood pressure before being given an intervention was TD: 200/100 mmHg and after being given the intervention obtained TD: 140/80 mmHg and decreased pain intensity in hypertensive patients using relaxation therapy, as well as a decrease in the number of cigarettes smoked with acupressure therapy for 1 week. Conclusion: The application of complementary therapy carried out showed improvement in elderly patients suffering from hypertension and smoking behaviour, therefore, the application of evidence based nursing in providing nursing care is recommended. Suggestion: Complementary Nursing Case Study this is expended to be a reference material to improve health services and provide an overview in carrying out complementary nursing care to families, especially an elderly with comprehensive cases of hypertension (bio, psycho, social and spiritual).
Satish Kr Gupta
Journal of Geriatric Medicine, Volume 2; doi:10.30564/jgm.v2i3.2393

Abstract:
The coronavirus disease 2019 (COVID-19) pandemic presents a major challenge to societies all over the world. This new virus threat both socially as well as economically regarding health and safety of human being irrespective of age, race or social status across the world. This expository paper focuses on the impact of COVID-19 upon elderly and importance of social distancing and isolation for elderly people. This paper also explores the scenario of COVID-19 in India and the measures that government bodies are taking to contain and mitigate it. Role and responsibilities of families and caregivers to keep away the elderly disease-free, spirited and mentally fit. Those in isolation or quarantine need special care: telephonic counselling, digital contact with family and ensuring adequate nutrition is vital. The study is primarily based on secondary data including books, journals, newspapers, and other governmental reports.
Lori Suet Hang Lo, Linda Yin King Lee, Irene Yuen Fung Wong, Yuen Yan Lai, Hoi Tong Au, Tsz Ying Wong, Chui Ping Chueng, Wai Lam Shek, Choi Yi Wong, Hoi Lam Chan, et al.
Journal of Geriatric Medicine, Volume 2; doi:10.30564/jgm.v2i3.2469

Abstract:
Globally, in-home drug-storage compliance is often unsatisfactory, especially among older adults, and can lead to negative health outcomes. This study used a cross-sectional and descriptive design to examine in-home drug-storage compliance among older adults. Convenience sampling was used to recruit 117 older adults in Hong Kong. An in-home drug-storage checklist was used to assess the in-home drug-storage environments (light, temperature, and humidity) and drug-storage methods (drug safety, packaging, information, and expiration) of each older adult. The findings showed that Hong Kong older adults’ overall compliance rate in drug storage was 87.25%, and their compliance rate for drug-storage methods (84.59%) was lower than that for drug-storage environments (97.02%). Older adults who were of advanced age, who were less educated or who lived alone demonstrated lower in-home drug-storage compliance. This indicates the need to revise existing health-education strategies to encourage in-home drug-storage compliance. Healthcare professionals should assess older adults’ drug-storage compliance to identify less compliant subgroups and deliver specific drug-storage support as required. Family members should also be involved in this process.
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