• Title/Summary/Keyword: Elderly(>70 years)

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Impact of Treatment Type on Overall Survival in Elderly Brazilian Women with Breast Cancer

  • Bello, Marcelo Adeodato;de Menezes, Raquel Ferreira;de Sousa Silva, Brunna;da Silva, Rafael de Carvalho;Cavalcanti, Rousiane Silva;da Costa Moraes, Thayane de Fatima;Tonellotto, Fabiana;de Aguiar, Suzana Sales;Martucci, Renata Brum;Bergmann, Anke;Thuler, Luiz Claudio Santos
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4769-4774
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    • 2016
  • Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.

Prevalence of peripheral arterial disease(PAD) used by edinburgh claudication questionnaire among the elderly people in rural communities (일부 농촌지역 노인들에서 Edinburgh 파행 설문지를 이용한 말초동맥질환 유병률)

  • Son, Ji-Yeon;Kim, Gui-Yeon;Lee, Jong-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.364-372
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    • 1995
  • Peripheral arterial disease(PAD) is a major health problem in the elderly population, so prevalence of PAD is investigated using Edinburgh claudication questionnaire. Subjects were over 65 years old in the kyeongsan county. The prevalence of PAD was 9.0% in total population(8.5% in men, 9.3% in women). definite claudication was 3.9%, atypical claudication was 5.1%. and, grade 1 was 4.4%, grade 2 was 4.6%. The prevalence of PAD was increased with age but not statistically significant. There was no difference of PAD by gender and smoking. PAD was significantly associated with systolic blood pressure positively. But, unexpectedly, PAD was significantly associated with BMI negatively. PAD are important elderly health problem in the our country. So the etiology and preventive methods of PAD will be researched on our country population.

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Health Status of Dependent Older People and Pattern of Care among Caregivers: A Case Study of Hong Ha Health Promoting Hospital, Lampang, Thailand

  • Wicha, Sumitra;Saovapha, Benjaporn;Sripattarangkul, Sirirat;Manop, Natchapan;Muankonkaew, Thanakrit;Srirungrueang, Supha
    • Asian Journal for Public Opinion Research
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    • v.5 no.3
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    • pp.228-249
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    • 2018
  • In 2015, the population of elderly people in Thailand was 16% of the total population and is predicted to be over 20% by 2021 and nearly 28% by 2031. The increase of the elderly population in Thailand has also increased the proportion of dependent elderly people, and caring for them poses many challenges for both families and the government. This descriptive method research aimed to survey the health status of dependent older people in the rural community of Lampang province in northern Thailand. The participants consisted of 62 older people and 62 primary family caregivers from Hong Ha Health Promoting Hospital, Lampang, Thailand (totaling 124 people). The researchers assessed the health status of older people and their activities of daily living (ADL). In addition, researchers assessed the health status and stress of caregivers. All the participants were interviewed about their experiences with caregiving. The results showed that most of the older respondents were female with an average age of 78.15 years. Based on the ADL assessment, 50 of the 62 older persons were homebound while the rest were bedridden. The majority of older people had chronic or long-term conditions that required hospitalization from time to time. Their frequent health problems included oral disorders such as tooth decay or caries/gum disease/no teeth, reduced sight, psychological disorders, knee pain and risk of falling, low BMI, risk of malnutrition, and urinary leakage and incontinence (58.06%, 66.13%, 62.90%, 70.97%, 38.71%, 66.13%, and 37.10%, respectively). Usual care provided by the family members included personal hygiene care, food preparation and feeding, medication management, housekeeping and organizing necessary equipment, supply of needed equipment, prevention of falls, helping with travel for medical checkups and treatment, and providing companionship. Families experienced shortages of medical supplies, daily use equipment, lack of employment, inadequate income, and difficulty accessing health care services due to lack of transportation. Some caregivers experienced caregiving stress related to a lack of social interactions as well as routine caregiving activities. Families need different types of support in order to promote the well-being of older people and caregivers. This highlights the need for a community participation model for the care of older people in order to reflect sustainable long-term outcomes.

Genome-Wide Association Analyses on Blood Pressure Using Three Different Phenotype Definitions

  • Park, Ji-Wan;Uhmm, Saan-Yong;Shin, Chol;Cho, Nam-H.;Cho, Yoon-Shin;Lee, Jong-Young
    • Genomics & Informatics
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    • v.8 no.3
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    • pp.108-115
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    • 2010
  • Hypertension is the most prevalent disease worldwide and is itself a risk factor for cerebral, cardiac, and renal diseases. The inconsistency of candidate genes suggested by previous genomewide association studies (GWASs) may be due to not only differences in study design and genetic or environmental background but also the difference in the power of analysis between continuous traits and discrete traits. We analyzed 352,228 single nucleotide polymorphisms (SNPs) in 8842 unrelated Koreans obtained from Ansan and Ansung cohorts. We performed a series of GWA analyses using three different phenotype models; young hypertensive cases (278 subjects) versus elderly normotensive controls (680 subjects); the upper 25% (2211 hypertensive cases) versus the lower 25% of the SBP distribution (2211 hypotensive controls); and finally SBP and DBP as continuous traits (8842 subjects). The numbers of young hypertensive cases and elderly normotensive controls were not large enough to achieve genomewide significance. The model comparing the upper 25% subjects to the lower 25% of subjects showed a power that was approximate to that of QTL analysis. Two neighboring SNPs of the ATP2B1 gene, rs17249754 (SBP, p=$2.53^{-10}$; DBP, p=$1.28{\times}10^{-8}$) and rs7136259 (SBP, p=$1.30{\times}10^{-9}$; DBP, p=$6.41{\times}10^{-8}$), were associated with both SBP and DBP. Interestingly, a SNP of the RPL6 gene, rs11066280, revealed a significant genomewide association with SBP in men only (p=$3.85{\times}10^{-8}$), and four SNPs located near the MAN2A1 gene showed a strong association with DBP only in elderly men aged 60-70 years (e.g., rs6421827, p=$4.86{\times}10^{-8}$). However, we did not observe any gene variant attaining genomewide significance consistently in the three phenotype models except for the ATP2B1 gene variants. In general, the association signal with blood pressure was stronger in women than in men. Genes identified in GWASs are expected to open the way for prevention, early diagnosis, and personalized treatment of hypertension.

Effect of Combined Exercise on Lung Function, Blood Vitamin D, Calcium and Bone Metabolism Hormones in Elderly Women (복합운동이 여성노인의 폐기능, 혈중 비타민 D, 칼슘 및 골대사호르몬에 미치는 영향)

  • Ki, Min-Jae;Ha, Soo-Min;Kim, Jung-Sook;Koh, Su-Han;Kim, Ji-Sun;Kim, Do-Yeon
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.4
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    • pp.699-710
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    • 2020
  • The purpose of this study was to investigate the effect of combined exercise on lung function, blood vitamin D, calcium and bone metabolism hormones in elderly women who are over 65 years by dividing them into a combined exercise group(n=13), control group(n=17). The combined exercise program included 60-minutes sessions 3times each week. Aerobic exercise intensity was 40-50%HRR(RPE 12-13) for 1-4 week, 50-60%HRR(RPE 13-14) for 5-8 week, and 60-70%HRR(RPE 14-15) for 9-12 week and resistance exercise intensity was set at OMNI-RES 3-4 for 1-4 week, OMNI-RES 5-6 for 5-8 week, OMNI-RES 7-8 for 9-12 week. As a result, lung function indicated that FEV1 showed an interaction effect between group and time and FVC/FEV1 levels significantly increased in combined exercise group. Blood vitamin D showed an interaction effect between group and time, also, significantly increased in combined exercise group and control group. Calcium showed an interaction effect between group and time, and significantly decreased in control group. Bone metabolism hormones indicated that both calcitonin and osteocalcin showed an interaction effect between group and time, osteocalcin significantly decreased in control group. For the following this conclusion, elderly women can be improved their lung function through 12 weeks combined exercise and also mitigate the blood vitamin D but there was no meaningful results of calcium and bone metabolism hormones.

Long-term Combined Exercise has Effect on Regional Bone Mineral Density and Cardiovascular Disease Risk Factors of the Elderly with Osteoporosis (장기간의 복합운동이 골다공증 노인의 신체부위별 골밀도와 심혈관질환 위험요인에 미치는 영향)

  • Choi, Pil-Byung
    • 한국노년학
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    • v.31 no.2
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    • pp.355-369
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    • 2011
  • The purpose of this study was to find the effects of long-term combined exercise on regional bone mineral density(BMD) and cardiovascular disease(CVD) risk factors in the elderly with osteoporosis(OP). For the purpose, the subjects of this study were separated by two groups with thirty-one elderly women, who the first group was combined exercise group(CEG, n=16) and second group was non exercise group(CON, n=15). The combined exercise program was made up of warm-up (10min), work-out (aerobic; 30~45min/HRR 40~60%, resistance; 1RM * 50-70%, 8-10 * 2set ~ 10-15 * 1set), and cool-down (10min). Exercise group of the inspection have been trained 5 times a week for 1years. The results : At first, the variables of regional BMD were significantly different to pelvis, spine, trunk and T-score in two groups. At second, the variables of CVD risk factors were significantly different to SBP and DBP as well as TC, TG, LDL-C and HDL-C in two groups. As results of these conclusion, this study have positively effect shown that CEG was superior to CON in regional BMD(pelvis, spine, trunk and T-score), blood pressure(SBP, DBP) and plasma lipids(TC, TG, and LDL-C). Especially, the long-term combined exercise was provides a striking overall health quality of life with improving BMD and reduced CVD risk factors in the elderly with OP. In the future, other researches should deal with specific measures that reduction in mortality due to chronic disease and improvement quality of life for the development of programs in multiple researches of osteoporosis and chronic diseases.

Factors Affecting National Health Insurance Mass Screening Participation in the Disabled (장애인의 국민건강보험 건강검진 수검에 영향을 미치는 요인)

  • Park, Jong-Hyock;Lee, Jin-Seok;Lee, Jin-Yong;Hong, Ji-Young;Kim, So-Young;Kim, Seong-Ok;Cho, Byong-Hee;Kim, Yong-Ik;Shin, Young-Soo;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.511-519
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    • 2006
  • Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

Critically Ill Patients with Pandemic Influenza A/H1N1 2009 at a Medical Center in Korea

  • Choi, Eun-Young;Huh, Jin-Won;Lim, Chae-Man;Koh, Youn-Suck;Kim, Sung-Han;Choi, Sang-Ho;Kim, Won-Young;Kim, Won;Kim, Mi-Na;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.28-35
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    • 2011
  • Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

Seasonal Food Intake Status of the Long-lived Elderly People in Kyungpook Sung-Ju (경북 성주지역 장수노인의 계절별 식품섭취 상태)

  • 백지원;구보경;김규종;이성국;이혜성;이연경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.4
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    • pp.691-700
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    • 2000
  • The purpose of this study was to estimate food intakes of the long-lived elderly and to obtain the data for establishing dietary guidelines that may be recommended for the general population for the sake of longvity. The subjects of the study were 224 elderly people of age over 85 years living in Kyungpook Sung-Ju area who have no problem in daily living. The food consumption survey was carried out seasonally by the repeated 24-hr recall method for one year. The subject group for this study was composed of 58 males and 166 females, the average age being 87 years old. Food intakes of the winter were more than any other seasons. The mean daily total food intake per capita was 594.4g, 513.5 g (86.4%) from plant foods and 79.3 g(13.3%) from animal foods. The sequence of high intakes of food groups were cereals, vegetables, fruits, fishes, legumes and meats. Boiled white rice, beef soup, soybean paste soup, soybean paste stew, broiled yellow croaker, kimchi, ra myon and broiled noodles were consumed most frequently. In conclusion, the subjects consumed much more plants foods than animal foods and consumed more natural and seasonal foods than processed foods and also showed food habits of eating small meals. Dietary habits of eating small meals containing abundant amount of fresh plant foods might partially contribute to the longevity of the subjects.

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The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.