• Title/Summary/Keyword: frailty

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The Motor-cognitive Training on Cognition and Physical Performance in the Older Adults with Mild Cognition Impairment : A Literature Review

  • Jung, Jihye;Kim, Yong-Seong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.493-502
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    • 2021
  • Objective: Older adults with mild cognitive impairment (MCI) are more likely to progress to dementia. Motor-cognitive training is applied as a dual-task to improve the cognitive and physical functions of older adults with MCI. The purpose of the study was to know the recent trends in motor training types and outcome measures used for motor-cognitive training in older adults with MCI. Design: Aliterature review Methods: This literature review was conducted in Pubmed, MEDLINE® and Google Scholar with the following key words: older adults, mild cognitive impairment, motor-cognitive training, cognition, and dual-task. The 7 studies were found with the search tool and all studies were randomized controlled trials. Results: In motor-cognitive training in older adults with MCI, 6 studies applied aerobic exercise. And 3 out of 6 studies also applied strengthening exercises. One study applied dual tasks without aerobic exercise. In the 6 studies, overall cognitive and executive function were used as outcome measures, and physical function was evaluated as gait performance. Memory and physical frailty were also used as measurement tools. As a result of all studies, when motor-cognitive training was applied, cognition and physical performance showed significant results. Conclusions: A recent five-year study applied mainly aerobic exercise and strength training to older adults with MCI and found it to improve cognitive and physical performance.

Effects of Resistance Exercise on Bone Health

  • Hong, A Ram;Kim, Sang Wan
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.435-444
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    • 2018
  • The prevalence of chronic diseases including osteoporosis and sarcopenia increases as the population ages. Osteoporosis and sarcopenia are commonly associated with genetics, mechanical factors, and hormonal factors and primarily associated with aging. Many older populations, particularly those with frailty, are likely to have concurrent osteoporosis and sarcopenia, further increasing their risk of disease-related complications. Because bones and muscles are closely interconnected by anatomy, metabolic profile, and chemical components, a diagnosis should be considered for both sarcopenia and osteoporosis, which may be treated with optimal therapeutic interventions eliciting pleiotropic effects on both bones and muscles. Exercise training has been recommended as a promising therapeutic strategy to encounter the loss of bone and muscle mass due to osteosarcopenia. To stimulate the osteogenic effects for bone mass accretion, bone tissues must be exposed to mechanical load exceeding those experienced during daily living activities. Of the several exercise training programs, resistance exercise (RE) is known to be highly beneficial for the preservation of bone and muscle mass. This review summarizes the mechanisms of RE for the preservation of bone and muscle mass and supports the clinical evidences for the use of RE as a therapeutic option in osteosarcopenia.

Aortoesophageal Fistula after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

  • Nitta, Masakazu;Tamakawa, Taro;Kamimura, Natsuo;Honda, Tadayuki;Endoh, Hiroshi
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.172-175
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    • 2019
  • Although thoracic endovascular aortic repair (TEVAR) has grown to become the standard of care to treat blunt thoracic aortic injury (BTAI), the long-term effects of TEVAR are still unclear. We here present a 72-year-old man with BTAI due to a traffic accident. He successfully underwent TEVAR and was transferred to another rehabilitation hospital 2 months after the accident. However, 1 month later, he underwent gastroscopy with fever and hematemesis and was diagnosed with aorto-esophageal fistula (AEF). After being re-transferred to Niigata University Medical and Dental Hospital, we tried to convince him to undergo surgical treatment, but he strongly refused. He received palliative care and died due to rupture of the aortic pseudoaneurysm 3 days after the hospital transfer. Fatal complications like AEF may occur after TEVAR, so clinicians need to carefully follow patients who underwent TEVAR.

Family Business and Risk Management: Perspectives of SMEs Entrepreneurs in Indonesia

  • TAN, Jacob Donald;SUGIARTO, Sugiarto;BUDHIJONO, Fongnawati
    • The Journal of Asian Finance, Economics and Business
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    • v.8 no.5
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    • pp.851-861
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    • 2021
  • This study aims to explore the specific risks in family small-medium enterprises (SMEs) and explain how they manage these risks to sustain and expand. In Indonesia, family business composes around 95 percent of all businesses and contributes about 80 percent to the country's economy. SMEs contribute approximately 57.8 percent to the nation's gross domestic product. Risk management poses challenges to the family business's survival, as family members do not take actions on risk. The assessment of risk is difficult and family businesses lack the ability to determine risk management priorities, including risk management review processes to evaluate risk, thus leading to family business failures. Applying the case study approach, in-depth semi-structured interviews were conducted in seven family SMEs comprising fifteen informants. Additionally, a focus group discussion consisting of three experts is conducted to reaffirm the findings from the interviews, observations, and field notes. The research identified the specific risks and how the family owners strategize to safeguard against these risks such as cash flow deficiency, operations dysfunction, cultural frailty, disharmony, transgenerational entrepreneurship failure, political uncertainty, and unprofessionalism. Comprehending these risks and their strategic decisions elucidated in this research could enable the family owners and key non-family professionals to work hand-in-hand to thrive over the family business risks together. Further avenues of research regarding family business risk management are also suggested in this study.

Educational needs for the development of a simulation module of home visiting care for the frail elderly (시뮬레이션 기반 허약노인 방문간호 교육 요구도)

  • Ahn, Junhee;Yang, Youngran
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.1
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    • pp.68-79
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    • 2021
  • Purpose: This study aimed to identify the educational needs of nurses and nursing students for the development of a simulation module of home visiting care for frail, elderly people. Methods: Focus group interviews were conducted with 15 home visiting nurses working in public health centers and 14 nursing students who experienced home visiting from September 10 to October 10, 2018. Results: Bloom's taxonomy of learning objectives, namely, cognitive, affective, and psychomotor domains was used as a framework for data analysis. The defined educational needs for each domain were as follows: "understanding frail, elderly people" for the cognitive domain; "intervention for mental health" and "building a therapeutic relationship" for the affective domain; and "nursing skills", "health education for healthy lifestyles", "referral to the community resource connection", "protection for visiting nurses" for the psychomotor domain. Conclusion: Based on the findings of this study, a simulation module of home visiting care for frail, elderly people can be developed and used for nursing students and nurses to strengthen the capacity for home visiting care.

Association between Hand Grip Strength and Gait Variability in Elderly: Pilot Study (노인의 악력과 보행 가변성 간의 연관성: 예비연구)

  • Lee, Do-Youn;Lee, Yungon;Shin, Sunghoon
    • PNF and Movement
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    • v.20 no.1
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    • pp.125-134
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    • 2022
  • Purpose: The aim of this study was to establish an association between grip strength and gait variability in the elderly. Methods: The participants in this experiment (n = 20) were aged 65 or older. Power grip and lateral pinch forces were obtained in grip strength tests, and spatiotemporal gait parameters were collected from IMU sensors during 6 min actual walking to test the gait of participants. The collected gait parameters were converted to coefficient of variation (CV) values. To confirm the association between grip strength and gait variability, a partial correlation analysis was conducted in which height, weight, and gait speed were input as controlling variables. Results: Grip power showed a significant negative correlation with the stride length CV (r = -0.52), and the lateral pinch force showed a significant negative correlation with the stance CV (r = -0.65) and swing CV (r = -0.63). Conclusion: This study reveals that gait variability decreases as grip strength increases, although height, weight, and gait speed were controlled. Thus, grip strength testing, a simple aging evaluation method, can help identify unstable gait in older adults at risk of falling, and grip strength can be utilized as a non-invasive measurement method for frailty management and prevention.

The art of diabetes care: guidelines for a holistic approach to human and social factors

  • Muhammad Jawad Hashim
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.218-222
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    • 2023
  • A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

Statistical Analysis of Clustered Interval-Censored Data with Informative Cluster Size (정보적군집 크기를 가진 군집화된 구간 중도절단자료 분석을 위한결합모형의 적용)

  • Kim, Yang-Jin;Yoo, Han-Na
    • Communications for Statistical Applications and Methods
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    • v.17 no.5
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    • pp.689-696
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    • 2010
  • Interval-censored data are commonly found in studies of diseases that progress without symptoms, which require clinical evaluation for detection. Several techniques have been suggested with independent assumption. However, the assumption will not be valid if observations come from clusters. Furthermore, when the cluster size relates to response variables, commonly used methods can bring biased results. For example, in a study on lymphatic filariasis, a parasitic disease where worms make several nests in the infected person's lymphatic vessels and reside until adulthood, the response variable of interest is the nest-extinction times. Since the extinction times of nests are checked by repeated ultrasound examinations, exact extinction times are not observed. Instead, data are composed of two examination points: the last examination time with living worms and the first examination time with dead worms. Furthermore, as Williamson et al. (2008) pointed out, larger nests show a tendency for low clearance rates. This association has been denoted as an informative cluster size. To analyze the relationship between the numbers of nests and interval-censored nest-extinction times, this study proposes a joint model for the relationship between cluster size and clustered interval-censored failure data.

Relationship between diet quality and sarcopenia in elderly Koreans: 2008-2011 Korea National Health and Nutrition Examination Survey

  • Na, Woori;Kim, Jiyu;Chung, Bong Hee;Jang, Dai-Ja;Sohn, Cheongmin
    • Nutrition Research and Practice
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    • v.14 no.4
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    • pp.352-364
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    • 2020
  • BACKGROUND/OBJECTIVES: Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008-2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. RESULTS: The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003-3.254, P < 0.05). CONCLUSIONS: This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

Efficient Techniques to Secure User Data in the Secure OS for a Multi-user Environment (다중 사용자 환경을 위한 보안운영체제의 효율적인 사용자 자원 보호 방법)

  • Ahn, Sun-Il;Han, Sang-Yong
    • The KIPS Transactions:PartC
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    • v.12C no.7 s.103
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    • pp.999-1006
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    • 2005
  • The Secure OS is an operating system which adds security functions to the existing operating system, in order to secure a system from sorority problems originated from inherent frailty of applications or operating systems. With the existing Secure Oses for it is difficult to set an effective security policy securing personal resources in a multi-user environment system. To solve this problem in this paper we present two Techniques to secure user data efficiently in the RBAC-based Secure OS for a multi-user environment. Firstly we utilizes object's owner information in addition to object's filename. Secondly we make use of meta symbol('$\ast$'), which is able to describe multiple access targets. In addition this paper gives some examples to show advantages from these techniques. And these features are implemented in an solaris-based Secure OS called Secusys.