• 제목/요약/키워드: Elderly frailty

검색결과 83건 처리시간 0.018초

Impact of Adjuvant Chemotherapy in Elderly Breast Patients in Taiwan, A Hospital-Based Study

  • Lee, Hsiu Chuan;Chen, Wei Yu;Huang, Wen Tsung;Cheng, Kuo Chen;Tian, Yu Feng;Ho, Chung Han;Tsao, Chao Jung;Feng, Yin Hsun
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4591-4597
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    • 2016
  • Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

디지털 중량제어기술을 활용한 고령친화운동기구의 인간공학적 분석 (Ergonomic Analysis for the Aging-Friendly Exercise Device Utilized on the Digital Load Control Technology)

  • 김보건;장영관;하종규;백준영
    • 한국산학기술학회논문지
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    • 제22권3호
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    • pp.252-260
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    • 2021
  • 노쇠의 관리를 위해 근력운동의 중요성이 강조되고 있고 다양한 운동기구들이 개발되어지고 있다. 최근에는 전자기 저항을 디지털 중량으로 변환하여 제어하는 디지털 중량제어기술이 주목을 받고 있으나 국내에서 고령자를 대상으로 하여 디지털 중량제어기술 기반 운동기구의 효과성과 안전성을 검증한 보고는 전무하다, 따라서, 본 연구는 디지털 중량제어기술을 활용한 고령친화운동기구의 인간공학적 분석을 통하여 이후 개발방향의 지표 제시를 목적으로 하였다. 총 20명의 성인 남녀 (연령: 62.40 ± 2.09 세) 를 대상으로 적용 가능한 운동강도를 분류하기 위하여 운동기구의 부하를 레벨화하였고, 세가지 실험대상 동작시의 근 활성도와 심박수를 측정하였다. 또한, 국제 표준 ISO 9241-11에 준거한 설문지를 활용하여 소프트웨어부와 기기부의 안정성, 조작성, 효율성, 만족도 등을 평가하였다. 그 결과, 운동 부하, 근활성도, 심박수가 일관되게 증가하는 결과를 통해서 현장에서 적용 가능한 3단계의 운동 강도를 분류할 수 있었다. 모니터 사이즈의 확대, 메뉴의 한글화, 기구의 소형화, 소음의 최소화가 필요한 것으로 나타났다. 이러한, 결과들을 고려할 때 향후 신제품 개발시에는 기구 크기, 표시부, 소음의 보완을 통한 고도화된 고령친화운동기구 개발의 필요성이 시사 되어 진다.

Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
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    • 제16권2호
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    • pp.128-148
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    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.