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.
The purpose of this paper is to reduce the reverse-causality and overestimate bias of analysis on how health affected middle-aged and elderly worker's early retirement. From the Korean Longitudinal Study of Ageing(KLoSA) panel data, I researched 1,049 people who were 45-52 years old in 2006. To eliminate the reverse-causality problem, I used the health data which is surveyed before retirement. To reduce bias, I controlled the health status when retirees worked. The main results are as follows. First, the worsened health still affects the hazard of early retirement, with reducing the endogeneity problem. Second, chronic illness is one of the strong predictors of early retirement to self-employed, and self-reported bad health is the main health predictor of wage workers. These results give two implications; first, the impact magnitude of the health indicator depends on employment type. Each employment type has different flexibility of working hours. It seems that the flexibility can reduce early retirement hazard with health problems. Self-employed, who has more flexibility of working hours can work until they have to stop working due to the serious health problem or doctor's advice. Second, to promote middle-aged and elderly workers to keep working, the long-term health policy which decreases chronic illness is needed.
This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.
Sohn, Bongyeon;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Kim, Ki-Bong
Journal of Chest Surgery
/
v.51
no.5
/
pp.322-327
/
2018
Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.
Lee, Joon Seok;Kim, Kyung Hwan;Choi, Jae Woong;Hwang, Ho Young;Kim, Ki-Bong
Journal of Chest Surgery
/
v.51
no.6
/
pp.367-375
/
2018
Background: It is unclear whether mitral valve (MV) repair for degenerative mitral regurgitation (MR) provides the same advantages in the elderly that it does in the general population. Methods: From 1994 to 2016, 188 elderly patients (mean age, $68.3{\pm}5.50years$) underwent MV repair (n=153) or MV replacement (n=35) for primary degenerative MR. Early and long-term outcomes were compared before and after propensity score matching (PSM). Results: Before PSM, there was a significant difference in operative mortality (p=0.011). Overall survival and freedom from cardiac-related death (CRD) at 5, 10, and 15 years were significantly higher in patients who underwent MV repair (p=0.039 and p=0.007, respectively). In the multivariable analysis, MV replacement was an independent risk factor of CRD. After PSM, operative mortality was not significantly lower in patients who underwent MV repair (p=0.125). Overall survival and freedom from CRD at 5, 10, and 15 years showed no significant difference between the 2 groups in the PSM cohort (p=0.207, p=0.47, respectively). There was no significant difference in freedom from reoperation before or after PSM (p=0.963 and p=0.575, respectively). Conclusion: MV repair for primary degenerative MR might be a valid option in the elderly population if successful repair is possible.
The change of sleep pattern is one of the most often altered normal physiological functions in elderly people. Besides normal change of sleep, insomnia and sleep apnea syndrome (SAS) are (one of) the main complaints. In addition, parasomnia is also frequent in this age group. Several parasomnias frequently found in the elderly are reviewed. Periodic limb movements in sleep (PLMS), restless legs syndrome (RLS), and REM sleep behavior disorder are the most frequent parasomnias in old age. Most parasomnias could be diagnosed by polysomnography, and be treated easily. Therefore, early and precise diagnosis and management for parasomnia in aging people are needed.
Purpose: The aim of this study was to compare the clinicopathological characteristics and postoperative prognosis of two age groups with gastric cancer in order to establish the proper treatment strategy in these groups of patients. Materials and Methods: Among patients with gastric cancer who underwent a gastrectomy between 1990 and 1996 at the Department of Surgery, Kyungpook National University, the clinicopathological characteristics, including the postoperative survival, of patients younger than 40-years old were compared with those of patients over 69-years old. Results: During that period 1,125 gastric cancer patients underwent a gastrectomy. Among them, 111 patients ($9.9\%$) were less than 40-years old, and 96 patients ($8.5\%$) were over 69-years old. In the young group, 79 patients ($71.2\%$) had a poorly differentiated adenocarcinoma, and 59 patients from the elderly group ($61.5\%$) had a well- or moderately differentiated adenocarcinoma (P<0.05). Curative surgery was performed for 88 ($79.3\%$) patients in the young group and 78 ($81.3\%$) patients in the elderly group. This difference was not statistically significant. There was no statistically significant difference in the 5-year survival rates between the young and the elderly ($66.3\%\;vs.\;47.2\%$) groups, but the 5-year survival rate of the young group was significantly higher than that of the elderly group after a curative resection ($83.2\%\;vs.\;53.3\%$; P<0.05). Also the 5-year survival rate of the elderly group was significantly higher than that of the young group after a non-curative resection ($20.4\%\;vs.\;4.6\%$; P<0.05). Conclusions: For young patients, more efforts are needed to detect gastric cancer in its early stages so that a curative surgery can be performed. However, for the elderly, surgical treatment is recommended at any stage because of the relatively high survival rate, even after non-curative surgery.
Jung, NamKyo;Park, Se Jin;Kwon, Soon-Hyun;Jun, Jongarm;Yu, Jaehak
Journal of Platform Technology
/
v.9
no.3
/
pp.36-43
/
2021
Stroke disease is one of the leading causes of death worldwide, and in particular, it is the most important causative disease that causes disability in the elderly. Since stroke disease often causes death or serious disability, active primary prevention and early detection of prognostic symptoms are very important. In particular, it is necessary to detect and accurately predict stroke prognostic symptoms in daily life and prompt diagnosis and treatment by medical staff. In recent studies, image analysis such as computed tomography (CT) or magnetic resonance imaging (MRI) is mostly used as a methodology for predicting prognostic symptoms in stroke patients. However, this approach has limitations in terms of long test time and high cost. In this paper, we experimented with clinical data on how stroke disease affects foot pressure in elderly in walking. Experiments have shown that there is a significant difference in * p < .05 in 12 cells between the stroke elderly and the normal elderly during walking. As a result, it is significant that we found a significant difference in the gait patterns in daily life of the stroke elderly and the normal elderly.
The purpose of this study was to identify nutrition quotient for elderly (NQ-E) and to investigate factors affecting NQ-E of the elderly using welfare center and senior citizen's center in Changwon city. A self-administered questionnaire was conducted between June 2021 and early August 2021 for 320 elderly (≥65 years, male, n=52, female, n=268). As a result of the survey, the mean NQ-E score was 61.12, which was within the medium-high grade. The scores of balance, moderation, and dietary behavior factors were within the medium-high grade, while diversity factor was within the medium-low grade. According to the results of the Pearson's correlation coefficient analysis, NQ-E showed positive correlations with the 'with family' (p<0.01), 'education level' (p<0.01), 'health functional foods consumption' (p<0.01), 'monthly household income' (p<0.05), 'nutrition education experience' (p<0.05), 'reading nutrition labeling of health functional foods' (p<0.01), 'perception of the efficacy of health functional foods' (p<0.01), and 'the number of times of leisure activities per week' (p<0.01) and negative correlations with the 'gender' (p<0.05), 'age' (p<0.01), 'smoking' (p<0.05), and 'social frailty' (p<0.01). As a result of multiple regression analysis, 'gender' (p<0.05), 'perception of the efficacy of health functional foods' (p<0.05), 'the number of times of leisure activities per week' (p<0.05), and 'social frailty' (p<0.05) were found to be factors affecting NQ-E. Based on the results of this study, customized services by characteristic, nutrition education, and counseling for the elderly should be implemented and the development of various programs and continuous support of the community are necessary so that the elderly can carry out social exchange.
The burden of valvular heart disease (VHD) is increasing with age, and the elderly patients with moderate or severe VHD are notably common. When to operate in asymptomatic patients with VHD remains controversial. The controversy is whether early surgical intervention should be preferred, or a watchful waiting approach should be followed. The beneficial effects of early surgery should be balanced against operative mortality and long-term results. Indications of early surgery in each of the VHD will be discussed in this review on the basis of the latest American and European guidelines.
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