Journal of Geriatric Medicine

Journal Information
EISSN : 2630-5259
Published by: Bilingual Publishing Co. (10.30564)
Total articles ≅ 35
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Patrícia De Castro Rodrigues, Julia Carvalho Galiano, Virginia Fernandes Moça Trevizani, Fania Cristina Santos
Journal of Geriatric Medicine, Volume 3; https://doi.org/10.30564/jgm.v3i2.3663

Abstract:
Introduction: Locomotion is a determinant of intrinsic capacity ofolder people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome (LoS). Knowledge on locomotiveproblems and sarcopenia, and their interface with quality of life, in theoldest old in the literature is scarce.Objective: To evaluate the correlation between LoS and sarcopenia andtheir influence on quality of life in oldest old.Methods: A cross-sectional study of an observational, descriptive andanalytical epidemiological survey in independent older adults aged 80and over from São Paulo, Brazil and who participated in the third waveof the LOCOMOV Project, was carried out. Sociodemographic data,comorbidities, functioning in activities of daily living, physical functioning,quality of life, and presence of sarcopenia and LoS were assessed. Thestatistical analyses included the Test-for-Comparing-Two-Proportions,Pearson's Correlation Coefficient, the chi-Square test and Student´s t-test.Results: Thirty oldest old with a mean age of 89.1 years were evaluated.The prevalence of LoS was high (53.3%) and correlated significantly withchronic pain (p-value 0.024), worse performance on the SPPB and Gaitspeed (p-value <0.001). Sarcopenia was not correlated with LoS, but worsequality of life on the physical domain was significantly associated with LoS(p-value <0.001) regardless of the presence of sarcopenia.Conclusions: LoS was highly prevalent among the oldest old studied andnegatively impacted their quality of life, regardless of the presence ofsarcopenia.
Alessandro Amorim Aita, Corina Satler, Henrique Salmazo Da Silva, Isabelle Patriciá Freitas Soares Chariglione
Journal of Geriatric Medicine, Volume 3; https://doi.org/10.30564/jgm.v3i2.3602

Abstract:
The maintenance of high cognitive performance in old age has increasinglybecome a public health interest due to associations between cognition,well-being, longevity, and autonomy. The objective of the researchis to investigate cognitive, physical, and psychological trajectories ofneurotypical older adults (NOAs) and high performing older adults(HPOAs). An exploratory study to investigate 21 NOAs and six HPOAs(mean age 71, SD = ± 3.59), followed up for one year. The older adultswere submitted to physical fitness, quality of life, anxiety, depression,RAVLT, ACE-R, and Stroop tests, being assessed at three moments:baseline, six months after the cognitive (MEMO) or stimulation (Stimullus)interventions, and six months after the multimodal interventions, whichcould be physical or psychopedagogical interventions (health educationlectures). Nonparametric statistical tests (Mann-Whitney and Wilcoxon)were performed with p≤0.05. The results demonstrated that the cognitivemeasures were good predictors of cognitive performance and we observedpositive correlations between cognitive and mood measures. The olderadults with high performance had a lower prevalence of depressivesymptoms. There were gains in global cognitive performance, mood, and inphysical fitness variables associated with multimodal interventions, evidentin the neurotypical group
Jianbo Hong, Mi Mi Zhou, Weisheng He, Yue Chen
Journal of Geriatric Medicine, Volume 3; https://doi.org/10.30564/jgm.v3i2.3818

Abstract:
What methods would you choose apart from increasing sedatives foragitation in an advanced patient with hypercapnic encephalopathy dueto AECOPD? This is a 94-year-old female who suffered from COPD forover 30 years, occurred with an accelerated episode of cough, productivesputum and a dropping down to 86% in SatO₂ due to a cold weather. Adiagnosis of pulmonary encephalopathy (PE) was made on the basis of thesubsequent agitation and delirium, and the sedatives, such as quatiepineand haloperidol, had to be given for her mental excitation respectively, butshe still pulled out indwelling needle herself and refused to any infusiontherapy. As an alternative, a vaporized therapy integrated with tea herbdrinking had to be applied to relieving her agitation, being designedas the vaporization of the inhaled oxygenation by means of high-flowoxygenation device (HFOD), with an ampoule of ambroxol mixed into theinhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles whenbeing infected. We thought that a better efficacy would be achieved forhypercapnic encephalopathy due to AECOPD if we concentrate on a goodventilation of small airway through the vaporized therapy.
Weisheng He, Mi Mi Zhou, Yue Chen
Journal of Geriatric Medicine, Volume 3; https://doi.org/10.30564/jgm.v3i2.3472

Abstract:
It has been reported that a 92-year-old female had got a bruise superficialwound on her right leg one and a half years ago, developing into refractoryskin ulcer due to improper management before. A prepared cream, mixedroyal jelly with berberine for dressing change, was made on the scenethrough the crush of berberine tablets, working with fresh royal jelly.Topical dressing change with the cream was done every 3 days, and twomonths later, such the ulcer became clean and was covered fully with freshgranulation tissue. This kind of cream consists of the ingredients of TCMpurely, free of antibiotic, and being quite effective clinically, also helpfulfor proper use of antibiotic.
Samira Olyani, Hadi Tehrani
Journal of Geriatric Medicine, Volume 3; https://doi.org/10.30564/jgm.v3i2.3889

Abstract:
In last decade, COVID-19 outbreak was one of the major crises encountered the world(1). During the COVID-19 pandemic, Iranian people have been advised to stay at home and far away others. If it is essential to leave their residence, people have been urged to avoid gathering and maintain physical distance from others. Community disconnectedness for older adults was primary prevention specially for elders with comorbidities (2). For the first time, most of Iranian older adults were experiencing an unwanted and prolonged separation from others.
Mi-Mi Zhou, Si-Yuan Jing, Yue Chen
Journal of Geriatric Medicine, Volume 3; https://doi.org/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.
Arundhati Guha Thakurta, Rauf Iqbal
Journal of Geriatric Medicine, Volume 3; https://doi.org/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.
Daxu Peng, Qingchen Liu, Xiuyang Cao, Guanwen Deng
Journal of Geriatric Medicine, Volume 3; https://doi.org/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.
Maria Laquaglia, Marina Celly Martins Ribeiro de Souza, Carolina Marques Borges
Journal of Geriatric Medicine, Volume 3; https://doi.org/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; https://doi.org/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.
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