The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2021
Effectiveness of a On-site Medicalization Program for Nursing Homes With COVID-19 Outbreaks.
Nursing homes are highly vulnerable to the occurrence of COVID-19 outbreaks, which result in high lethality rates. Most of them are not prepared to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. ⋯ A coordinated on-site MP of nursing homes with COVID-19 outbreaks achieved a higher SOPC rate, and a reduction in referrals to hospital, thus ensuring rigorous but also humanistic and gentle care to residents.
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2021
Proteome-Wide Analysis using SOMAscan Identifies and Validates Chitinase-3-Like Protein 1 as a Risk and Disease Marker of Delirium Among Older Adults Undergoing Major Elective Surgery.
Delirium (an acute change in cognition) is a common, morbid, and costly syndrome seen primarily in aging adults. Despite increasing knowledge of its epidemiology, delirium remains a clinical diagnosis with no established biomarkers to guide diagnosis or management. Advances in proteomics now provide opportunities to identify novel markers of risk and disease progression for postoperative delirium and its associated long-term consequences (e.g., long term cognitive decline and Alzheimer's disease [AD]). ⋯ Our identification of CHI3L1/YKL-40 in postoperative delirium parallels reports of CHI3L1/YKL-40 and its association with aging, mortality, and age-related conditions including AD onset and progression. This highlights the type 2 innate immune response, involving CHI3L1/YKL-40, as an underlying mechanism of postoperative delirium, a common, morbid, and costly syndrome that threatens the independence of older adults.
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J. Gerontol. A Biol. Sci. Med. Sci. · Oct 2020
Ascertainment of delirium status using natural language processing from electronic health records.
Delirium is underdiagnosed in clinical practice, and is not routinely coded for billing. Manual chart review can be used to identify the occurrence of delirium, however, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) has the capability to process raw text in electronic health records (EHRs) and determine the meaning of the information. We developed and validated NLP algorithms to automatically identify the occurrence of delirium from EHRs. ⋯ NLP-CAM demonstrated a sensitivity, specificity and accuracy of 0.919, 1.000 and 0.967, respectively. NLP-mCAM demonstrated sensitivity, specificity and accuracy of 0.827, 0.913 and 0.827, respectively. The prevalence analysis of delirium showed that the NLP-CAM algorithm identified 12,651 (9.4%) delirium patients, the NLP-mCAM algorithm identified 20,611 (15.3%) definite delirium cases and 10,762 (8.0%) possible cases.
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J. Gerontol. A Biol. Sci. Med. Sci. · Oct 2020
Randomized Controlled TrialLong-term Effects of Calcium β-Hydroxy-β-Methylbutyrate and Vitamin D3 Supplementation on Muscular Function in Older Adults With and Without Resistance Training: A Randomized, Double-blind, Controlled Study.
The primary aim of this study was to determine whether supplementation with calcium β-hydroxy-β-methylbutyrate (HMB) and vitamin D3 (D) would enhance muscle function and strength in older adults. Older adults over 60 years of age with insufficient circulating 25-hydroxy-vitamin D (25OH-D) levels were enrolled in a double-blinded controlled 12-month study. Study participants were randomly assigned to treatments consisting of: (a) Control + no exercise, (b) HMB+D + no exercise, (c) Control + exercise, and (d) HMB+D + exercise. ⋯ HMB+D + no exercise resulted in significant increases in the functional index compared with those observed in the control + no exercise group at 3 (p = .03), 6 (p = .04), and 12 months (p = .04). Supplementation with HMB+D did not further improve the functional index within the exercising group. This study demonstrated the potential of HMB and vitamin D3 supplementation to enhance muscle strength and physical functionality in older adults, even in individuals not engaged in an exercise training program.
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J. Gerontol. A Biol. Sci. Med. Sci. · Oct 2020
Impact of Combined Lifestyle Factors on All-Cause and Cause-Specific Mortality and Life Expectancy in Chinese: The Singapore Chinese Health Study.
To examine the impact of combined lifestyle factors on premature mortality and life expectancy in Chinese adults. ⋯ A healthier lifestyle is associated with a substantially reduced risk of mortality and a longer life expectancy in the Chinese population. Our findings highlight the necessity of coordinated actions targeting combined lifestyle factors in reducing the overall burden of diseases and premature deaths.