Elderly Individuals Research Articles

Association of hypertension and long-term blood pressure changes with new-onset diabetes in the elderly: A 10-year cohort study.

To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China. A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression. By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005). Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.

Effects of Blood Lead Levels

Lead exposures among school-age children are a major public health issue. Although the harmful effects of lead exposure during the first years of life are well known, there is not as much understanding of the effects of low levels of lead exposure during later childhood. To review the effects of blood lead levels (BLLs) <10 µg/dL in school-age children and adolescents. We searched Medline, Embase, Global health, CINAHL, Scopus, and Environmental Science Collection databases between January 1, 2000, and May 11, 2023. We included peer-reviewed English-language articles that presented data on the effects of BLLs <10 µg/dL in individuals ages 5 through 18 years. Data on country, population, analytic design, sample size, age, BLLs, outcomes, covariates, and results were extracted. Overall, 115 of 3180 screened articles met the inclusion criteria. The reported mean or median BLL was <5 µg/dL in 98 articles (85%). Of the included articles, 89 (77%) presented some evidence of an association between BLLs <10 µg/dL during school age and detrimental outcomes in a wide range of categories. The strongest evidence of an association was for the outcomes of intelligence quotient and attention-deficit/hyperactivity disorder diagnoses or behaviors. Few articles controlled for BLLs at age <5 years, limiting conclusions about the relation between later BLLs and outcomes. BLLs <10 µg/dL in school-age children and adolescents may be associated with negative outcomes. This review highlights areas that could benefit from additional investigation.

Polyphenol Treatment of Peripheral Blood Mononuclear Cells from Individuals of Different Ages.

Human peripheral blood mononuclear cells (PBMCs) have been largely utilized to assess the cytotoxic, immunomodulatory, and anti-inflammatory properties of both synthetic and natural compounds. Within the latter category, polyphenols from dietary sources have been extensively analyzed. PBMCs represent a feasible in vitro model to study polyphenol hallmarks and activity according to quantitative and qualitative differences in immune responses in individuals of different age. In this chapter, we propose a method for PBMC treatment with polyphenols and analysis designed on age-dependent qualitative and quantitative variability in immune cell performance.

Quantifying age-specific household contacts in Aotearoa New Zealand for infectious disease modelling.

Accounting for population age structure and age-specific contact patterns is crucial for accurate modelling of human infectious disease dynamics and impact. A common approach is to use contact matrices, which estimate the number of contacts between individuals of different ages. These contact matrices are frequently based on data collected from populations with very different demographic and socio-economic characteristics from the population of interest. Here we use a comprehensive household composition dataset based on Aotearoa New Zealand census and administrative data to construct a household contact matrix and a synthetic population that can be used for modelling. We investigate the behaviour of a compartment-based and an agent-based epidemic model parametrized using these data, compared with a commonly used contact matrix that was constructed by projecting international data onto New Zealand's population. We find that using the New Zealand household data, either in a compartment-based model or in an agent-based model, leads to lower attack rates in older age groups compared with using the projected contact matrix. This difference becomes larger when household transmission is more dominant relative to non-household transmission. We provide electronic versions of the synthetic population and household contact matrix for other researchers to use in infectious disease models.

Getting Help During Active Pain Crises in Sickle Cell Disease: Patient and Caregiver Perspectives in Canada

Plain Language Summary What is this summary about? This is a plain language summary of an article originally published in Patient Preference and Adherence. This study aimed to identify the notable symptoms and impacts of sickle cell disease from the point of view of individuals living with sickle cell disease and their caregivers. The study also sought to understand the factors involved in individuals living with sickle cell disease’ and caregivers’ decisions and preferences if and when they seek care during a pain crisis. This summary describes: the symptoms experienced by adolescents and adults living with sickle cell disease and their severity; the treatments they and their caregivers prefer to use when they are experiencing a pain crisis; and the factors that go into deciding when and whether individuals living with sickle cell disease and their caregivers should seek outside help -- to go to a hospital, for example - during a pain crisis. What were the results? Individuals living with sickle cell disease undergoing an acute pain crisis and their caregivers consider many factors when deciding whether to seek care at a medical facility. These include: The intensity of their symptoms If the facility has a treatment plan for them already in place If the facility has long wait times If the facility has an understanding and compassionate staff The individual's age and ability to manage their daily responsibilities Racial bias, shown in the actions and lack of empathy of Emergency Department staff toward individuals living with sickle cell disease, frequently factored into the individuals' and caregivers’ decision-making and hinders their ability to get the treatment needed during a pain crisis. What do the results mean? There is a need for a unified care team at medical facilities that treats all individuals living with sickle cell disease with the same high level of empathy and treatment quality and for a strong support system for individuals living with sickle cell disease outside of the hospital or clinic. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here

Late-life dietary folate restriction reduces biosynthesis without compromising healthspan in mice.

Folate is a vitamin required for cell growth and is present in fortified foods in the form of folic acid to prevent congenital abnormalities. The impact of low-folate status on life-long health is poorly understood. We found that limiting folate levels with the folate antagonist methotrexate increased the lifespan of yeast and worms. We then restricted folate intake in aged mice and measured various health metrics, metabolites, and gene expression signatures. Limiting folate intake decreased anabolic biosynthetic processes in mice and enhanced metabolic plasticity. Despite reduced serum folate levels in mice with limited folic acid intake, these animals maintained their weight and adiposity late in life, and we did not observe adverse health outcomes. These results argue that the effectiveness of folate dietary interventions may vary depending on an individual's age and sex. A higher folate intake is advantageous during the early stages of life to support cell divisions needed for proper development. However, a lower folate intake later in life may result in healthier aging.

Providing nutritional guidance to elderly individuals in a São Paulo social initiative among the COVID-19 crisis

Providing nutritional guidance to elderly individuals in a São Paulo social initiative among the COVID-19 crisis

Clinical Application of Different Doses of Hydromorphone Slow-Release Analgesia in Lumbar Fusion in Elderly Patients.

The aim of this study is to examine the analgesic efficacy of varying doses of hydromorphone hydrochloride in conjunction with absorbable gelatin sponge for postoperative pain management in elderly individuals undergoing lumbar fusion surgery. Additionally, the study aims to assess the sustained release analgesic properties of this combination and to determine the optimal dosage of hydromorphone hydrochloride for effective pain relief. A total of 113 elderly patients (aged≥65years old) meeting the criteria for 1-2-level posterior lumbar fusion surgery at Ganzhou City People's Hospital between July 2022 and August 2023 were randomly assigned to four groups: group A (0.2mg hydromorphone hydrochloride 1ml), group B (0.3mg hydromorphone hydrochloride 1.5ml), group C (0.4mg hydromorphone hydrochloride 2ml), and group D (0.9% normal saline 2ml) for standard anesthesia induction and maintenance. Prior to suturing the incision, gelfoam was utilized to administer epidural analgesia to each group. Following the surgical procedure, an intravenous analgesia pump was utilized for pain management. The baseline infusion rate was set at 0.5ml/h. Patient-controlled analgesia (PCA) was administered at a dose of 2ml, with a lockout interval of 20min, allowing the patient to self-administer as needed. Pain relief was assessed using the visual analogue scale (VAS) prior to surgery, as well as at 1day and 3days post-operation. The frequency of PCA requests within the initial 48-h postoperative period, the remedial analgesia with dezocine, postoperative adverse reactions, and duration of hospitalization were documented for analysis. The VAS scores of groups B and C were found to be significantly lower than those of group D 1day after the operation. Additionally, VAS scores at 3days post-operation, remedial rate of dezocine and PCA follow-up times at 48h in groups A, B, and C were significantly lower compared to group D (P<0.001). There was no statistically significant difference between group B and group C in VAS scores at 1day and 3days post-operation, as well as PCA follow-up times at 48h post-operation (P<0.001). Furthermore, the VAS scores of groups B and C were lower than those of group A at 1day and 3days post-operation (P<0.05). The PCA frequency of group C was also lower than that of group A at 48h post-operation (P<0.05). The combination of hydromorphone hydrochloride and absorbable gelatin sponge epidural analgesia has been shown to enhance postoperative pain management. A dosage of 0.4mg of hydromorphone hydrochloride may be considered an appropriate analgesic dose, as it can provide effective pain relief without eliciting adverse reactions. ChiCTR.org.cn(ChiCTR2200064863). Registered on October 20, 2022.

Evaluation of nutritional status and malnutrition screening tests of elderly individuals living in nursing homes

Evaluation of nutritional status and malnutrition screening tests of elderly individuals living in nursing homes

Age Is Just a Number? The Impact of Age on Abdominoplasty Outcomes: A Single Surgeon Experience.

Abdominoplasty is among the most popular aesthetic procedures in plastic surgery worldwide. Common indications include prior massive weight loss, surgical or not, with remaining skin excess and post-pregnancy women looking to restore their youthful abdominal contour. Aging of the worldwide population results in a greater number of older patients interested in aesthetic procedures. Identifying the impact of age on abdominoplasty outcomes is crucial in ensuring the safety of care and determining sub-optimal patients that might not benefit from the procedure. Medical records of all abdominoplasty patients operated by the senior author were screened for appropriate patients. Patients were excluded from the study if the mandatory follow-up time was not met or in instances of incomplete medical records. Patients were further stratified into 5 age groups based on age and compared using pre-operative, intra-operative and post-operative characteristics. Further regression analysis was performed to estimate the risk of complications for each individual age group, in an unadjusted and adjusted model. Six hundred and seventy-three patients were included in the study. Statistically significant differences were noted between the groups in respect smokers, prior bariatric surgery, and hypertension, diabetes mellitus and dyslipidemia (p values <0.01). Seroma rates, were greatest in the oldest age group (P value = 0.039). Odds ratio of 3.3 was calculated for seroma development in patients aged greater than 60. In a multivariate analysis, the risk diminished and was found to be statistically insignificant. Abdominoplasty is a safe procedure in all age groups. Increased rates of specific complications must be assessed in relation to potential confounders that exist between different age groups. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Risk Factors Associated with Advanced Colorectal Neoplasia in Adults Younger than Age 45.

Colorectal cancer (CRC) is rising in young adults between ages 20 to 49 years. CRC screening is endorsed for average-risk individuals beginning at ages 45 to 49 years. Targeting screening for individuals <45 years may be warranted if risk factors for advanced neoplasia can be identified. To identify factors associated with advanced colorectal neoplasia in adults aged <45 years. Individuals ages 18 to 44 years who underwent colonoscopy at Cleveland Clinic between 2011 and 2021 with ≥1 advanced neoplasm (AN) were included. Patients with inflammatory bowel disease or inherited CRC syndromes were excluded. Demographics, comorbidities, family history of CRC, and colonoscopy indication were obtained. Patients with a normal colonoscopy constituted the control group. A multivariable logistic regression model was used to investigate the relationship between clinical variables and the presence of advanced colorectal neoplasia. In all, 13,006 patients were included, of which 651 (5%) patients had AN: 404 (62%) with tubular adenoma ≥10mm, 29 (4.5%) tubular adenoma with high-grade dysplasia, 210 (32%) tubulovillous adenomas, 27 (4%) traditional serrated adenomas, 82 (13%) sessile serrated lesions ≥10mm, 7(2%) sessile serrated lesions with dysplasia, and 29 (4.4%) patients had a CRC. Factors associated with AN were older age (means 38.5 vs. 36.6y), history of smoking, diabetes, non-White race, higher body mass index (29.9 vs. 28.5kg/m 2 ), and lower vitamin D (27.6 vs. 32.2 ng/dl), all P <0.001. In the reduced multivariable model, factors associated with AN included tobacco use (OR 2.026 (current vs. never, P <0.0001), age (OR increase by 1.06 per year, P <0.0001), male gender (OR 1.476, P <0.0001), family history of CRC (OR 3.91, P <0.0001), aspirin use (1.31, P =0.035), and diabetes (OR 2.106, P 0.001). Increasing age, male gender, exposure to tobacco, family history of CRC, diabetes, and aspirin use were independently associated with advanced neoplasia in adults younger than 45. Targeted early screening to young adults with these risk factors may be justified. Large collaborative prospective studies are needed to validate our findings.

Impact of an Epstein-Barr Virus Serology-Based Screening Program on Nasopharyngeal Carcinoma Mortality: A Cluster-Randomized Controlled Trial.

Screening for nasopharyngeal carcinoma (NPC) has shown an improvement in early detection and survival rates of NPC in endemic regions. It is critical to evaluate whether NPC screening can reduce NPC-specific mortality in the population. Sixteen towns in Sihui and Zhongshan cities, China, were selected; eight were randomly allocated to the screening group and eight to the control group. Residents age 30-69 years with no history of NPC were included from January 1, 2008, to December 31, 2015. Residents in the screening towns were invited to undergo serum Epstein-Barr virus (EBV) viral capsid antigen/nuclear antigen 1-immunoglobulin A antibody tests; others received no intervention. The population was followed until December 31, 2019. Nonparametric tests and Poisson regression models were used to estimate the screening effect on NPC mortality, accounting for the cluster-randomized design. The trial is registered with ClinicalTrials.gov (identifier: NCT00941538). A total of 174,943 residents in the screening group and 186,263 residents in the control group were included. NPC incidence and overall mortality were similar between the two groups. A total of 52,498 (30.0% of 174,943) residents participated in the serum EBV antibody test. The overall compliance rate for endoscopic examination and/or biopsies among baseline and ever-classified high-risk participants was 65.9% (1,110 of 1,685) and 67.6% (1,703 of 2,518), respectively. A significant 30% reduction in NPC mortality was observed in the screening group compared with the control group (standardized NPC-specific mortality rate of 8.2 NPC deaths per 1,000 person-years versus 12.5; adjusted rate ratio [RR], 0.70 [95% CI, 0.49 to 0.997]; P = .048). This benefit was most evident among individuals age 50 years and older (RR, 0.56 [95% CI, 0.37 to 0.85]; P = .007) compared with those younger than 50 years (RR, 0.96 [95% CI, 0.64 to 1.46]; P = .856). In this 12-year trial, EBV antibody testing resulted in a significant reduction in NPC mortality.

The Relationship between E-Health Literacy and Educational Participation Motivation among Elderly Individuals: The Chained Mediating Effects of Self-Identity and Social Capital.

Aims/Background In light of the increased utilization of digital technology among the elderly population, understanding the relationship between e-health literacy, self-identity, social capital, and educational participation motivation has become crucial. This study aims to investigate these relationships and explore the mediating effects of self-identity and social capital on the elderly population. By shedding light on these aspects, the study seeks to contribute to the existing knowledge base and inform intervention strategies to enhance the elderly individuals' overall well-being and engagement with digital health resources. Methods A questionnaire survey was conducted in a sample consisting of 578 elderly participants. Data of the surveyed variables were analyzed. Mediating effect analysis methods were employed to explore the mediating roles of self-identity and social capital in the relationship between e-health literacy and educational participation motivation among the elderly individuals. Results The results revealed a significant positive correlation between e-health literacy, self-identity, social capital, and educational participation motivation among elderly individuals. Furthermore, self-identity and social capital were found to play significant mediating roles between e-health literacy and educational participation motivation. Specifically, self-identity and social capital acted as complete mediators, with a mediating effect value of 0.61, between e-health literacy and educational participation motivation. Additionally, the chained mediating effect of self-identity and social capital was also significant. Conclusion This study demonstrated that e-health literacy and educational participation motivation are closely intertwined, with self-identity and social capital acting as the mediators in this association, in the elderly population, providing valuable guidance for enhancing the health and quality of life and offering insightful references for the development and implementation of relevant policies.

The Efficacy of a Home-Based, Augmented Reality Dual-Task Platform for Cognitive-Motor Training in Elderly Patients: A Pilot Observational Study.

This study introduces a novel home-based dual-task platform incorporating augmented reality (AR), COGNIMO, aimed at simultaneously enhancing cognition and physical abilities. The purpose of this study was to assess the effectiveness of this intervention in enhancing cognitive and physical abilities in elderly individuals with subjective cognitive decline, mild cognitive impairment (MCI), and mild Alzheimer's dementia. A 12-week observational study enrolled 57 participants aged 60-85 years. Primary outcomes included changes in cognitive scores (Korean Mini-Mental State Examination, 2nd edition [K-MMSE-2] and Korean-Montreal Cognitive Assessment [K-MoCA]), while secondary outcomes measured physical parameters and depression scores between baseline and week 12 in the active and the control groups. Of 57 participants, 49 completed the study. The active group (≥12 sessions) exhibited significant improvement in K-MoCA compared to the control group (<12 sessions) (p=0.004), while K-MMSE-2 score changes showed no significant difference (p=0.579). Positive correlations between training sessions and K-MoCA changes were observed (r=0.31, p=0.038), emphasizing a dose-response relationship. Subgroup analyses revealed a distinction in cognitive changes, particularly in the MCI group. The COGNIMO platform showed positive effects on cognitive function in MCI patients, suggesting potential benefits for this population. The study highlights the potential of AR-integrated home-based interventions for cognitive enhancement in elderly individuals, underlining the need for further trials in the future.

Association between nighttime sleep duration and quality with low back pain in middle-aged and older Chinese adults

BackgroundThis study aims to investigate the association between sleep duration, sleep quality, and the risk of low back pain (LBP) among middle-aged and elderly individuals in China. MethodsUtilizing data from the China Health and Retirement Longitudinal Study spanning 2011 to 2020, we categorized sleep duration into long, medium, and short categories, and sleep quality into good, fair, and poor levels. LBP status was determined based on self-reported information by participants. Multivariable logistic regression analysis was employed to assess the relationship between sleep duration, sleep quality, with the risk of LBP. ResultsA total of 6750 individuals were included in the longitudinal study. After 9 years of follow-up, the prevalence of LBP was 25.69 %. In the fully adjusted model, compared to individuals with medium sleep duration, those with short sleep duration had a 28 % increased risk of developing LBP (OR = 1.28, 95%CI: 1.12, 1.46). Additionally, when compared to individuals with good sleep quality, those with fair and poor sleep quality had a 35 % (OR = 1.35, 95%CI: 1.19, 1.54) and 33 % (OR = 1.33, 95%CI: 1.12, 1.58) increased risk of LBP, respectively. Joint analysis of both factors revealed that individuals with poor sleep quality and short sleep duration had the highest risk of LBP. ConclusionAmong middle-aged and elderly individuals in China, short sleep duration and poor sleep quality were associated with an increased risk of LBP. Future studies should further explore the mechanisms underlying this association and validate the findings through randomized controlled trials.

Exposure of cumulative atherogenic index of plasma and the development of prediabetes in middle-aged and elderly individuals: evidence from the CHARLS cohort study

BackgroundThe impact of dynamic changes in the degree of atherosclerosis on the development of prediabetes remains unclear. This study aims to investigate the association between cumulative atherogenic index of plasma (CumAIP) exposure during follow-up and the development of prediabetes in middle-aged and elderly individuals.MethodsA total of 2,939 prediabetic participants from the first wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. The outcomes for these patients, including progression to diabetes and regression to normal fasting glucose (NFG), were determined using data from the third wave. CumAIP was calculated as the ratio of the average AIP values measured during the first and third waves to the total exposure duration. The association between CumAIP and the development of prediabetes was analyzed using multivariable Cox regression and restricted cubic spline (RCS) regression.ResultsDuring a median follow-up period of 3 years, 15.21% of prediabetic patients progressed to diabetes, and 22.12% regressed to NFG. Among the groups categorized by CumAIP quartiles, the proportion of prediabetes progressing to diabetes gradually increased (Q1: 10.61%, Q2: 13.62%, Q3: 15.65%, Q4: 20.95%), while the proportion regressing to NFG gradually decreased (Q1: 23.54%, Q2: 23.71%, Q3: 22.18%, Q4: 19.05%). Multivariable-adjusted Cox regression showed a significant positive linear correlation between high CumAIP exposure and prediabetes progression, and a significant negative linear correlation with prediabetes regression. Furthermore, in a stratified analysis, it was found that compared to married individuals, those who were unmarried (including separated, divorced, widowed, or never married) had a relatively higher risk of CumAIP-related diabetes.ConclusionCumAIP is closely associated with the development of prediabetes. High CumAIP exposure not only increases the risk of prediabetes progression but also hinders its regression within a certain range. These findings suggest that monitoring and maintaining appropriate AIP levels may help prevent the deterioration of blood glucose levels.

Nicotinamide mononucleotide supplementation rescues mitochondrial and energy metabolism functions and ameliorates inflammatory states in the ovaries of aging mice.

Noninvasive pharmacological strategies like nicotinamide mononucleotide (NMN) supplementation can effectively address age-related ovarian infertility by maintaining or enhancing oocyte quality and quantity. This study revealed that ovarian nicotinamide adenine dinucleotide levels decline with age, but NMN administration significantly restores these levels, preventing ovarian atrophy and enhancing the quality and quantity of ovulated oocytes. Improvements in serum hormone secretion and antioxidant factors, along with decreased expression of proinflammatory factors, were observed. Additionally, a significant increase in the number of ovarian follicles in aging individuals was noted. Scanning electron microscopy data indicated that NMN significantly alters the density and morphology of lipid droplets and mitochondria in granulosa cells, suggesting potential targets and mechanisms. Transcriptomic analysis and validation experiments collectively suggested that the beneficial effects of NMN on aging ovaries are mediated through enhanced mitochondrial function, improved energy metabolism, and reduced inflammation levels. Our results suggest that NMN supplementation could improve the health status of aging ovaries and enhance ovarian reserve, offering new insights into addressing fertility challenges in older women through assisted reproductive technology.

Sarcopenia and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Narrative Review

The primary objective of modern medicine is to extend human life expectancy. Currently, the majority of hospital patients across various clinical settings are elderly or advanced-age individuals, often with multiple comorbidities and age-related alterations in peripheral tissues. One such alteration is sarcopenia, a progressive decline in muscle mass, strength, and function, which significantly increases the risk of disability and mortality in older adults. Sarcopenia is associated with numerous adverse outcomes, and its underlying mechanisms are the subject of ongoing research. This narrative review discusses the epidemiology, pathophysiology, and diagnostic criteria for sarcopenia. It also examines the connections between sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD), highlighting potential treatment approaches for the coexistence of these two pathologies.

Individual and joint exposure to air pollutants and patterns of multiple chronic conditions.

Existing research on the detrimental effects of air pollution and its mixture on multiple chronic conditions (MCC) is not yet fully recognized. Our objective was to examine if individual and joint exposure to air pollution is associated with the incidence and patterns of MCC. Totally 10,231 CHARLS 2015 participants aged over 45 years and 1,938 without MCC were followed up in 2018 and 2020. Residential-levelcumulative personal exposure concentrations of PM1, PM10, PM2.5, CO, O3, NO2, SO2, NO3-, Cl-, NH4+, and SO42- at the residential level were determined utilizing a spatio-temporal random forest model with a spatial resolution of 0.1° × 0.1°. In the cross-sectional and longitudinal research, logistic regression, cox regression analysis, and quantile g-computation were utilized to estimate the single and joint effect with MCC and its patterns, respectively. Interaction analyses and stratified analyses were also performed. A correlation was observed between the prevalence of cardiovascular illnesses and the presence of all 11 major air pollutants. PM2.5, PM10, NH4+, NO3-, CO, and SO42- are associated with an increased frequency of respiratory disorders. An increase of PM2.5, PM1, PM10, NO2, and SO2 (a 10µg/m3 rise), CO (a 0.1mg/m3 rise), and PMCs (Cl-, NH4+, NO3-, and SO42-) (a 1µg/m3 rise) corresponded to the HRs (95% CI) for developing MCC of 1.194 (95% CI: 1.043, 1.367), 1.362 (95% CI: 1.073, 1.728), 1.115 (95% CI: 1.026, 1.212), 1.443 (95% CI: 1.151, 1.808), 3.175 (95% CI: 2.291, 4.401), 1.272 (95% CI: 1.149,1.410), 1.382 (95% CI: 1.011, 1.888), 1.107 (95% CI: 1.003, 1.222), 1.035 (95% CI: 0.984, 1.088), and 1.122 (95% CI: 1.086, 1.160), respectively. SO2 was the predominant contributor to the combined effect (HR: 2.083, 95% CI: 1.659-2.508). Gender, age, drinking, and health status could modify the effects of air pollutants on MCC patterns. Long-term exposure to air pollution is correlated to the incidence and patterns of MCC in middle-aged and elderly Chinese individuals. Preventive methods are essential to safeguarding those susceptible to MCC.

COGNITIVE FUNCTION OF THE ELDERLY IN PALEMBANG CITY NURSING HOMES: AN EPIDEMIOLOGICAL STUDY

Elderly refers to individuals who have reached the final stage of life, namely 60 years old and above. Physiologically, the elderly will experience various declines in body functions. The decline in cognitive function is among the most common in the elderly. The incidence of cognitive decline in the elderly in Indonesia is relatively high, which is as much as 32.4%, and is most vulnerable at the age of 65 years. Cognitive impairment can cause older adults to have difficulty in doing daily activities (bathing, dressing, washing, cooking), managing finances, getting lost on the road, and other disturbances that make the elderly less independent and confident, then tend to withdraw from social activities. The disturbances can also lead to anxiety disorders and depression. This study aims to determine the profile of cognitive function in the elderly at Palembang Nursing Homes. This cross-sectional study involves all elderly individuals in Palembang City Nursing Homes who meet the inclusion-exclusion criteria. The Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina) was used to assess cognitive function. In this study, as many as 69 elderly (87.34%) had experienced a decline in cognitive function. Then, the dominant characteristics in the group that experienced a decrease in cognitive function were &gt;90 years old (100%), women (91.38%), college graduates (100%), never worked (100%), had a history of stroke (92.86%), did not remember or did not know about cognitive impairment history in the family (93.33%). Delayed recall was the aspect that experienced the most disruption (96.2%). This study has revealed that the prevalence of cognitive impairment in Palembang Nursing Homes is exceptionally high. Therefore, it is imperative to implement routine screenings to identify early cognitive impairment in the elderly to provide immediate treatment.