• Title/Summary/Keyword: Elderly Patients

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Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

The Nutrition Assessment and Care for the Elderly in Japan

  • Sugiyama, Michiko;Nishimura, Akio;Koyama, Hideo
    • Journal of Community Nutrition
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    • v.2 no.1
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    • pp.12-26
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    • 2000
  • In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.

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Analysis of Influencing Factors on the Outpatient Prescription of Antipsychotic Drugs in the Elderly Patients (노인환자의 항정신병 약물 원외처방 내역에 미친 영향 요인 분석)

  • Dong, Jae Yong;Lee, Hyun Ji;Lee, Tae Hoon;Kim, Yujeong
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.4
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    • pp.268-277
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    • 2021
  • Background: Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. Methods: Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)'s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. Results: A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year's old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient's characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. Conclusion: This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients' and medical institutions' characteristics, is needed.

The Effect of Preoperative Nutritional Status on Postoperative Outcome in Elderly Patients (노인 환자의 수술 전 영양상태가 수술 후 임상경과에 미치는 영향)

  • Kim, Min Young
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.292-299
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    • 2019
  • Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

Health Perception and Family Support as Influencing Factors on Depression in Hospitalized Elderly Patients (건강지각과 가족지지가 입원 노인환자의 우울에 미치는 영향)

  • Lee, Sun-Ok;Kim, Moon-Jeong
    • The Korean Journal of Health Service Management
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    • v.9 no.4
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    • pp.145-155
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    • 2015
  • Objectives : The purpose of this study was to test the influencing effects of health perception and family support on depression in elderly patients. Methods : Two-hundred forty-nine hospitalized geriatric patients were recruited in B city, South Korea. They were asked to complete a questionnaire, and 214 data sets were included in multiple regression analysis. Results : Subjects perceived a higher level of depression. Influencing factors of depression were hospitalization experience (t=3.476, p=.001), health perception (t=-3.310, p=.001), education (t=2.684, p=.008), economic satisfaction (t=2.579, p=.011), satisfaction with allowance (t=2.262, p=.025), and family support (t=-2.200, p=.029). The model was statistically significant explaining 36.3% of the variance (F=21.257, p<.001). Conclusions : In dealing with depression, nurses in elderly care facilities should be more concerned about patients with hospitalization experiences. Interventions to improve health perception should be provided to elderly patients, and educational programs on how to support patients are needed for the families of patients.

Approaching Knowledge, Attitudes, and Practices Model for Elderly with Dementia Who are Suspected to Have Hearing Impairment in Korea

  • You, Sunghwa;Han, Woojae
    • Journal of Audiology & Otology
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    • v.24 no.1
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    • pp.40-47
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    • 2020
  • Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

Approaching Knowledge, Attitudes, and Practices Model for Elderly with Dementia Who are Suspected to Have Hearing Impairment in Korea

  • You, Sunghwa;Han, Woojae
    • Korean Journal of Audiology
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    • v.24 no.1
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    • pp.40-47
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    • 2020
  • Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

Adherence to Antidepressants in Korean Elderly Patients with Major Depressive Disorder (주요우울장애 노인 환자의 항우울제 복약이행도 연구)

  • Kyeong Ju Lee;Yu Jeung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.62-69
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    • 2023
  • Objective: Adherence is an important component in the treatment of various diseases, and poor adherence to antidepressants in patients with major depressive disorder is common. Non-adherence can be more prevalent in elderly patients with multiple morbidity and polypharmacy, resulting in negative treatment outcomes. The purpose of this study was to analyze adherence to antidepressants in Korean elderly patients with major depressive disorder. Method: A retrospective study was conducted using the Korean National Health Insurance claims database, and the subjects of this study were patients aged 65 or older who received at least one prescription of antidepressant monotherapy for the treatment of major depressive disorder between January 1, 2020 and June 30, 2020. Adherence was measured using the proportion of days covered at 6 months after the initial antidepressant prescription date. Logistic regression analysis was used to identify factors associated with adherence. Results: A total of 416,766 patients were finally included in the study. Over half of patients were non-adherent (52.67%) to antidepressants. According to the multivariate logistic regression analysis, national health insurance or medical aid, taking selective serotonin reuptake inhibitors or selective norepinephrine reuptake inhibitors, and having comorbidities were significantly associated with greater rates of adherence in the study subjects. The highest adherence rate was observed in patients taking vortioxetine. Conclusion: There was a considerable rate of non-adherence in Korean elderly patients with major depressive disorder. Health care professionals should try to improve adherence in elderly patients with major depressive disorder.

Does Age Influence the Poor Prognosis after Aneurysmal SAH Surgery in Elderly Patients?

  • Sim, Jong-Eun;Kim, Hyung-Dong;Song, Young-Jin;Noh, Seung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.357-362
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    • 2006
  • Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.

Factors Influencing the Burden Felt by Main Family Caregivers of Elderly Patients with Brain and Spinal Diseases (뇌.척추질환 노인 환자 주 가족수발자의 부담감에 영향을 미치는 요인)

  • Park, Hee-Kyung;Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.22 no.4
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    • pp.389-398
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    • 2011
  • Purpose: This study of this study was to identify factors influencing the burden of main family caregivers who take care of elderly patients with brain and spinal diseases. Methods: This was conducted as descriptive research and data were collected from 255 main family caregivers who were taking care of elderly patients with brain and spinal diseases from 4 hospitals in Daegu and Gyeongbuk Province. Stepwise-multiple regression was used to identify the influencing factors of burden felt. Results: As the score of burden felt by the main family, economic, social, physical, interdependent and emotional burdens were high in order. Factors influencing burden felt by main family care givers taking care of elderly patients with brain and spinal diseases were changed relation with patient after hospitalization, daily life ability, marital status, education and family caregiver's personality (explanatory power of 24.6%). Family caregivers felt a heavier burden when their relation with the patient was changed negatively or when the patient's activity of daily living was low. Conclusion: Based on these results, we need to develop coping measures and interventional programs for reducing the burden felt by the main family caregivers of elderly patients with brain and spinal diseases.