Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Sep 2011
Comparative StudyHealthcare services for Japanese elderly long-staying in Thailand from the perspective of the patient and healthcare providers: a survey study.
Long-stay refers to a long visit abroad by retired middle-aged and older people. This study describes the attitudes/opinions of elderly Japanese long-staying subjects and healthcare providers in Thailand. Two cross-sectional questionnaire surveys were conducted in Chiang Mai Province, Thailand. ⋯ Healthcare providers agreed with the Thai government policy promoting long-stays. The most recognized obstacle in caring for Japanese long-stay elderly was the language barrier. More research on Japanese elders staying abroad is needed to promote effective communication between Japanese elderly and other ethnic healthcare professionals.
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Arch Gerontol Geriatr · Sep 2011
Comparative StudyPlace of death for the elderly in need of end-of-life home care: a study in Japan.
To investigate factors affecting the place of death of patients receiving home care services, we performed a retrospective cohort study using 252 elderly Japanese patients. During a 3-year period, 40 patients died at home (78.4 ± 12 years olds), and 59 patients died at hospitals (77.6 ± 13.4 years olds). Patient profiles, including their demographic characteristics, comorbidities, as well as formal and informal care levels were evaluated. ⋯ Thus, dying at home may be associated with cases of malignancy compared to other diseases in Japan, and it may be associated with a greater need for home visiting nurses. In conclusion, the nature of the patient's disease and the presence of visiting nurses influenced the decision regarding the patient's place of death. More study is necessary to better understand the end stages of death at home.
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Arch Gerontol Geriatr · Sep 2011
Multicenter Study Comparative StudyFive-year survival of patients after out-of-hospital cardiac arrest depending on age.
Patient's age belongs to the independent prognostic factors of patients after out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the influence of age on 5-year survival in professionally cardio-pulmonary resuscitated patients with "primary cardiac" etiology OHCA. In this analysis of prospective multi-centric study, from April 1, 2002 until August 31, 2004, a total of 560 patients were included (aged 16-97 years) from the East Bohemian region, for whom a professional cardio-pulmonary resuscitation for OHCA was attempted. ⋯ Of the subgroup <70 years, 29 patients (10%) survived to year 5 (58% from the 50 patients surviving to day 30), and in the subgroup ≥ 70 years, we had 4 patients surviving to year 5 (2%) (29% from the 14 patients surviving to day 30), respectively (Fisher's exact test; comparison in the all resuscitated patients: p < 0.001, in the population surviving to day 30: p = 0.071). In conclusion, there was a trend towards a worse outcome in 5-year survival following OHCA in the patients aged ≥ 70 years. Nevertheless, these data support that prognosis OHCA of elders is not associated with universal dismal outcome.
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Arch Gerontol Geriatr · Sep 2011
Comparative Study Controlled Clinical TrialThirst in the elderly with and without heart failure.
Elderly patients with heart failure (HF) may be troubled by thirst, despite the fact that elderly have an impaired ability to sense thirst. The present study was undertaken to compare the intensity of thirst in patients with and without HF and to evaluate how this symptom relates to the health-related quality of life and indices of the fluid balance. Forty-eight patients (mean age 80 years) admitted to hospital with worsening HF (n = 23) or with other acute illness (n = 25) graded their thirst and estimated their health-related quality of life (HRQoL). ⋯ There was no statistically significant relationship between thirst and HRQoL, which was low overall. Serum sodium and urine color did not differ significantly between the groups, but the urine of the HF patients had a lower sodium concentration and osmolality. We conclude that elderly patients with worsening HF have considerably increased thirst and, hence, intense thirst should be regarded as a symptom of HF.
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Arch Gerontol Geriatr · Sep 2011
Comparative StudyRelationship between body composition and age, menopause and its effects on bone mineral density at segmental regions in Central Southern Chinese postmenopausal elderly women with and without osteoporosis.
We aimed at evaluating the relationship between lean mass and fat mass with age, menopausal age (MA) and years since menopause (YSM) and their effects on bone mineral density (BMD) at segmental regions in postmenopausal elderly women with and without osteoporosis. After using a dual-energy X-ray absorptiometry (DXA) methodology to measure body composition and BMD at posteroanterior spine and hip in 244 postmenopausal elderly non-osteoporotic (Non-OP) women (65.5 ± 4.3 years) and 298 postmenopausal elderly osteoporotic (OP) women (67.1 ± 4.4 years), we found that in postmenopausal elderly Non-OP women, there was no correlation between lean mass with age, MA, and YSM, as well as no correlation between fat mass with age (all, p > 0.05); leg fat (LF) mass (r = 0.187; p<0.01), whole body fat (WF) mass (r = 0.151; p < 0.05), and trunk fat (TRF) mass (r = 0.141; p < 0.05) were positively correlated with MA; LF (r = -0.131; p < 0.05) and WF (r = -0.127; p < 0.05) were negatively associated with YSM; WF and whole body lean (WL) mass were the most important body composition components influencing BMD at the third lumbar spine (L3), total first to fourth lumbar spine (L1-4) and hip, respectively; TRF was the most significant determinant of BMD at both L2 and L4. In postmenopausal elderly OP women, there was no relationship between body composition with MA (p > 0.05); Trunk lean (TRL) mass (r = -0.183; p < 0.05), leg lean (LL) mass (r = -0.136; p < 0.01), and WL mass (r = -0.162; p < 0.01) were negatively correlated with age; TRL mass (r = -0.132; p < 0.05), LL mass (r = -0.152; p < 0.01), WL mass (r = -0.170; p < 0.01) were also negative with YSM; WF was the most important factor influencing BMD at lumbar spine and hip. These data suggest in postmenopausal elderly Non-OP women, fat mass (TRF, LF, and WF) was more related with MA; WF and WL mass were the most important body composition components influencing BMD at L1-4 and hip, respectively; in postmenopausal elderly OP women, body composition was not correlated with MA; lean mass (TRL, LL, and WL) was more age-related negatively; WF mass was the most significant factor affecting BMD at lumbar spine and hip.