• Title/Summary/Keyword: elderly mortality

Search Result 211, Processing Time 0.025 seconds

The Effects of Protein and Supplements on Sarcopenia in Human Clinical Studies: How Older Adults Should Consume Protein and Supplements

  • Young Jin Jang
    • Journal of Microbiology and Biotechnology
    • /
    • v.33 no.2
    • /
    • pp.143-150
    • /
    • 2023
  • Sarcopenia is a condition in which muscle mass, strength, and performance decrease with age. It is associated with chronic diseases such as diabetes, cardiovascular disease, and hypertension, and contributes to an increase in mortality. Because managing sarcopenia is critical for maintaining good health and quality of life for the elderly, the condition has sparked concern among many researchers. To counteract sarcopenia, intake of protein is an important factor, while a lack of either protein or vitamin D is a major cause of sarcopenia. In addition, essential amino acids, leucine, β-hydroxy β-methylbutyrate (HMB), creatine, and citrulline are used as supplements for muscle health and are suggested as alternatives for controlling sarcopenia. There are many studies on such proteins and supplements, but it is necessary to actually organize the types, amounts, and methods by which proteins and supplements should be consumed to inhibit sarcopenia. In this study, the efficacy of proteins and supplements for controlling sarcopenia according to human clinical studies is summarized to provide suggestions about how the elderly may consume proteins, amino acids, and other supplements.

Do Elderly Patients Need Dialysis? (노인 환자에게 투석이 필요한가?)

  • In O Sun
    • The Korean Journal of Medicine
    • /
    • v.99 no.4
    • /
    • pp.165-168
    • /
    • 2024
  • Initiating dialysis at an advanced age is both a clinical challenge and an ethical dilemma, because the benefits in older adults with advanced chronic kidney disease may be offset by high rates of dialysis-related morbidity. Geriatric conditions, such as aging, frailty, functional impairment, and cognitive impairment, significantly influence the prognosis of elderly patients. Therefore, it becomes important to provide patients and families with prognostic information regarding timing of initiation, which is further complicated by the competing mortality risk. Shared decision-making by clinicians and patients can yield better clinical outcomes and quality of life. Through this approach, patients can opt for the most appropriate treatment based on their personal values, which often entails conservative management.

Radical Oncological Surgery and Adjuvan Therapy in Non-Small Cell Lung Cancer Patients over 70 years of Age

  • Demirci, Nilgun Yilmaz;Ulger, Sukran;Yilmaz, Ulku;Aydogdu, Koray;Yilmaz, Aydin;Erdogan, Yurdanur
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.11
    • /
    • pp.4711-4714
    • /
    • 2015
  • Background: The incidence of lung cancer increases with age. Approximately 50% of non-small cell lung cancer (NSCLC) patients are over 70 years old. Because of the increasing elderly population, treatment approaches in this age group continue to be studied similar to groups of young people. Materials and Methods: In the current study, 26 patients who underwent radical surgery and adjuvan chemoradiation at Ataturk Chest Diseases and Chest Surgery Training and Research Hospital were evaluated retrospectively. Results: Of 21 patients (81%) were male and the average age was 74.4. Lobectomy was performed in 18 cases, pneumonectomy in 3, sleeve lobectomy in 3 and bilobectomy in 2. There was no perioperative or early period mortality. Overall survival was 24.5 months. Conclusions: From our study, lung cancer surgery and adjuvant therapy can be performed safely with low morbidity in the elderly.

Control of Influenza: Live Vaccine Development

  • Seong, Baik-Lin
    • Proceedings of the PSK Conference
    • /
    • 2002.10a
    • /
    • pp.149-150
    • /
    • 2002
  • Despite various efforts on improving vaccines and antivirals, influenza epidemics continue to afflict many people, causing widespread morbidity and mortality in the young and the elderly. Since the discovery of the unusual 'cap-stealing'mechanism of transcription, significant advances were made on molecular aspects of influenza gene regulation. This provides new insights for developing new antiviral compounds. Reverse genetic technologies have also been advanced for generating recombinant chimeric viruses suitable for designing live vaccine. (omitted)

  • PDF

Respiratory Review of 2010: Pneumonia (호흡기내과 의사를 위한 폐렴 리뷰)

  • Kim, Yun-Seong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.68 no.6
    • /
    • pp.319-327
    • /
    • 2010
  • Pneumonia represents a spectrum of diseases that range from community-acquired to health care-associated pneumonia. Despite advances in diagnosis, antimicrobial therapy, and supportive care, pneumonia remains an important cause of morbidity and mortality, particularly in elderly patients and in those with significant comorbidities. Community-acquired pneumonia (CAP) is the leading cause of death from infectious disease in Korea. This article provides a synopsis of recent studies regarding various types of pneumonia, with a focus on CAP.

Consideration on assumption and transition of mortality model for Korea - Discussion on the kinds of Lee-carter - (우리나라 사망력 모형의 변천과 가정 고찰 - Lee-Carter 류를 중심으로 -)

  • Oh, Jinho;Kim, Soon-Young
    • The Korean Journal of Applied Statistics
    • /
    • v.31 no.5
    • /
    • pp.637-653
    • /
    • 2018
  • Rapid aging of the population affects population structure and population aging. Consequently, developed countries have focused on population aging as a major issue in regards to pension sustainability finances as well as health and the elderly welfare system. Mortality projections that result from population structure changes and population aging are increasingly important. This paper compares six mortality models using KOSTAT's life table from 1970 to 2016. The models are rooted in the Lee-Carter (LC) model (Lee and Carter, Journal of the American Statistical Association, 87, 659-671, 1992) and have been modified and improved on the assumptions of the LC model. We examined the improvement process and the check assumption by models in order to find a suitable mortality model for Korea. Korea shows rapid aging and declined mortality rate by age; therefore, it is desirable to estimate and predict mortality from LL&LC-ER models by combining LC-ER, LL, and LC-ER models that reflect the phenomena and modify age-specific mortality patterns without major changes in expected life expectancy.

Clinical Features and Prognostic Factors in Elderly Koreans with Advanced Non-Small-Cell Lung Cancer in a Tertiary Referral Hospital

  • Kim, Seo Woo;Kim, Mi Yeon;Lee, Yoon Pyo;Ryu, Yon Ju;Lee, Seok Jeong;Lee, Jin Hwa;Chang, Jung Hyun;Shim, Sung Shine
    • Tuberculosis and Respiratory Diseases
    • /
    • v.75 no.2
    • /
    • pp.52-58
    • /
    • 2013
  • Background: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Methods: Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. Results: The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <$18.5kg/m^2$. The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Conclusion: Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.

Open Heart Surgeries in Septuagenarians. (70세이상 환자에서의 개심술)

  • 김형수;이원용;지현근;김응중;홍기우
    • Journal of Chest Surgery
    • /
    • v.32 no.11
    • /
    • pp.1017-1022
    • /
    • 1999
  • Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

  • PDF

Clinical Results of Cardiovascular Surgery in the Patients Older than 75 Years

  • Kim, Dong Jin;Park, Kay-Hyun;Isamukhamedov, Shukurjon S.;Lim, Cheong;Shin, Yoon Cheol;Kim, Jun Sung
    • Journal of Chest Surgery
    • /
    • v.47 no.5
    • /
    • pp.451-457
    • /
    • 2014
  • Background: The balance of the risks and the benefits of cardiac surgery in the elderly remains a major concern. We evaluated the early and mid-term clinical results of patients aged over 75 years who underwent major cardiovascular surgery. Methods: Two hundred and fifty-one consecutive patients, who underwent cardiac surgery at Seoul National University Bundang Hospital between July 2003 and June 2011, were included in this study (mean age, $78.7{\pm}3.4$ years; male:female=130:121). Elective surgery was performed in 112 patients, urgent in 90, and emergency in 49. Results: Early mortality was 12.7% (32/251). Follow-up completion was 100%, and the mean follow-up duration was $2.8{\pm}2.2$ years. Late mortality was 24.2% (53/219). There were 283 readmissions in a total of 109 patients after discharge. However, the reason for readmission was related more to non-cardiac factors (71.3%) than to cardiac factors. The overall survival estimates were 79.2% at the 1-year follow-up and 58.4% at the 5-year follow-up. Patients who underwent elective surgery had a lower early mortality rate (elective, 4.5%; urgent, 13.3%; emergency, 30.6%) and better overall survival rate than those that underwent urgent or emergency surgery (p<0.001). Conclusion: The timing of cardiac surgery was found to be an independent risk factor for early and late mortality. Thus, earlier referral and intervention may improve operative results. Further, comprehensive coordinated postoperative care is needed for other comorbid problems in aged patients.

Life Expectancy and Causes of Death for the elderly of Korea, USA, and Japan (한미일 노인의 기대여명과 사망원인)

  • 박경애
    • Korea journal of population studies
    • /
    • v.22 no.2
    • /
    • pp.97-119
    • /
    • 1999
  • 한국, 일본, 미국의 생명표, UN의 인구연감, WHO의 세계보건통계연감 등 공식통계를 활용하여, 한국 노인의 기대여명 및 사망원인별 사망력을 미국 및 일본과 비교하여 파악하고 있다. 한국 노인의 기대여명은 미일보다 빠른 속도로 증가하고 있는데, 1970년대 중반 이후는 미국처럼 여자보다 남자 노인의 기대여명 증가가 빠르면서, 남녀 노인의 기대여명 차가 감소하고 있다. 1997년 현재 65세시 기대여명은 남자 13.64세, 여자 17.26세로 남녀간 3.62세 차이를 보이며, 출생후 남자 72%, 여자 88%가 65세까지 생존한다. 노인의 주요 사인은 미일과 마찬가지로 순환기계질환 및 악성신생물인데, 순환기계질환중 한일은 뇌혈관질환이, 미국에서는 허혈성 심장질환이 노인의 주된 사망원인이 된다. 한국 남녀 노인의 연령층과 상관없이 허혈성 심장질환 및 폐렴 사망률은 미일보다 낮고, 뇌혈관질환, 고혈압성질환, 위암, 간암, 결핵, 당뇨병, 정신 및 행동장애, 간질환 및 교통사고 사망률은 미일보다 높다. 대부분의 사망원인에서 남자사망률이 여자사망률보다 높지만, 한국의 고혈압성 질환, 간암, 폐암 및 간질환에 의한 성별 사망률 격차가 미일보다 크며, 한미일 모두 75세 이상 노인의 정신 및 행동장애에 의한 여자 사망률보다 남자사망률보다 높게 나타난다. 사망원인 생명표 작성결과를 보면, 1997년 현재 한국의 65세 남성과 여성은 순환기계질환 제거시 각각 3.47년과 2.7년을, 악성신생물 제거시 각각 3.87년과 1.58세의 기대여명 증가를 예상할 수 있고, 일본에 비해 특정 사인을 제거시 상대적으로 많은 기대여명 증가를 기대할 수 있는 사망원인은 남자 노인의 간질환 및 교통사고를 들 수 있다.

  • PDF