Clinical interventions in aging
-
Observational Study
Frailty and nutritional status in older people: the Mini Nutritional Assessment as a screening tool for the identification of frail subjects.
Frailty is a condition characterized by reduced resistance to low-level stress events, resulting from the progressive decline of multiple physiological systems observed with aging. Many factors can contribute to the pathogenesis of frailty, and nutritional status appears to play a key role. The objective of the study was to investigate the relationship between nutritional status, evaluated using Mini Nutritional Assessment (MNA), and frailty among older people. ⋯ Malnutrition contributes to the development of frailty. MNA can generate vital information to help identify a substantial part of both frail and pre-frail patients at low cost and care.
-
This study aimed to explore the physician's knowledge and identify the perceived barriers that prevent family medicine physicians from engaging in deprescribing among older patients. ⋯ The study identified several factors affecting family medicine physician's deprescribing behavior. The use of theoretical underpinning design helped to provide a comprehensive range of factors that can be directed when defining targets for intervention(s).
-
Sympathovagal imbalance is a common underlying disorder in hypertension and diabetes. This study characterized autonomic nervous system function, indicated by heart rate deceleration capacity (DC) and deceleration runs (DRs), in patients with type 2 diabetes mellitus (T2DM), with or without concomitant essential hypertension. ⋯ Compared with healthy subjects, T2DM patients with or without essential hypertension have lower DC and DRs. DC and DRs correlate negatively with blood glucose and insulin resistance index.
-
The purpose of this article was to examine the relative importance of patients' self-advocacy and perceived physicians' advocacy for impacting patients' satisfaction in terms of physician communication and physician-patient relationship. We also examine the influence of physicians' emotional support and patients' demographic as well as health characteristics on patients' satisfaction. ⋯ These findings raise questions about consumer empowerment among older adults and underscore their desire for and appreciation of physicians' advocacy. Findings are discussed in the context of power imbalance between elderly patients and their doctors.
-
Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI) of remifentanil can reduce emergence cough effectively, and sex-related differences in effect-site concentration (Ce) of remifentanil have been evaluated in young patients. In this study, we determined the Ce of remifentanil for preventing emergence cough following extubation in male and female elderly patients and evaluated the sex-related difference. ⋯ The remifentanil requirement for preventing emergence cough was lower in female than in male elderly patients, indicative of sex-related differences in Ce of remifentanil. Sex should be considered when using remifentanil TCI for preventing emergence cough in elderly patients.