Elderly Asian Research Articles

W1465: Colonoscopy for CRC Screening in Asymptomatic Elderly African Americans, Hispanics and Asian Americans

W1465: Colonoscopy for CRC Screening in Asymptomatic Elderly African Americans, Hispanics and Asian Americans

Respect and Empathy in Teaching and Learning Cultural Medicine

Respect and Empathy in Teaching and Learning Cultural Medicine

Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians

To evaluate the correlation between body mass index (BMI), body composition, and all-cause mortality in an elderly Asian population. A prospective observational cohort study with 3.5-year follow-up. The Korean Longitudinal Study on Health and Aging Project for elderly residents in Seongnam City, Korea. Eight hundred seventy-seven subjects aged 65 and older for whom baseline body composition data was available. BMI, waist circumference, and body composition of each subject was evaluated. Body composition was examined using bioelectrical impedance analyses of measures, including lean mass (kg), fat mass (kg), and fat proportion (%). In addition, lean mass index (LMI, kg/m(2)) was calculated by dividing lean mass by the square of height. Participants were divided into three groups: Group 1 (<25th percentile), Group 2 (25-75th percentiles), and Group 3 (> or =75th percentile) for BMI, waist circumference, body composition, and LMI. In the fully adjusted Cox proportional hazard model, BMI, waist circumference, and fat composition were not correlated with mortality, but higher lean mass and LMI were considered predictors of lower mortality when comparing Group 3 and Group 1 (in lean mass, relative risk reduction of 84%, 95% confidence interval (CI)=45-96%, P=.004; in LMI, relative risk reduction of 69%, 95% CI=12-89%, P=.03). The present study indicates that the recommendation of low BMI as a means of obtaining a survival advantage in the elderly is not supported. Instead, higher lean mass and higher LMI are associated with better survival in the elderly Asian population.

Angiographic no-reflow and six-month mortality in elderly (≥ 75 years old) Asian patients undergoing primary percutaneous coronary intervention: A single center experience from 1998 to 2007

We sought to report the incidence of angiographic no-reflow and clinical outcomes of elderly patients who have undergone primary percutaneous coronary intervention at a tertiary institution in Singapore over a period of 10 years. A total of 141 patients (60% male) aged 75 or above underwent primary PCI between 1998 and 2007. Their average age was 80+/-5 years. Cardiogenic shock complicating STEMI on presentation accounted for 15% of the patients. At baseline, 103 (73%) patients have impaired TIMI flow grade (TIMI 0-2), and 38 (27%) have normal flow (TIMI 3). At the end of the procedure, 44 (31.2%) patients had no-reflow phenomenon (TIMI 0-2), whereas 97 (68.8%) achieved normal antegrade flow. Post-procedure corrected TIMI frame count was analyzable in 66% (n=93) of the patients. Post-procedure corrected TIMI frame count was>28 in 37.6% (n=35) of patients. In-hospital, 30-day and six-month mortalities were 20.6, 25.5% and 27.7%, respectively. Multivariable analysis showed that age 80 or above, low systolic blood pressure and final TIMI 0-2 flow independently predicted six-month mortality. We found that one-third of the treated patients developed no-reflow phenomenon. Six-month mortality was 27.7%, most were cardiac deaths that occurred during index hospitalization.

Attitudes and Behavior of Elderly Asian Indians towards Health and the Impact of Nutrition Education Program on Dietary Knowledge and Behavior

Attitudes and Behavior of Elderly Asian Indians towards Health and the Impact of Nutrition Education Program on Dietary Knowledge and Behavior

East Asian Attitudes toward Death— A Search for the Ways to Help East Asian Elderly Dying in Contemporary America

The art of dying well has been a quintessential subject of ethicoreligious matters among the people in the West and the East. Most of us wish to die at home; however, about 50% of Americans die in acute care hospitals. Furthermore, immigrants from East Asian cultures feel more uncomfortable near death, because their physicians are not familiar with their traditions.This article is written to help American physicians understand the unique aspects of East Asian Confucian Ethics for the better care of the dying elderly. Western attitudes toward death are briefly reviewed and the six East Asian concepts related to death are elaborated from Confucian Chinese philosophy. To widen the horizon of bioethics and to embrace the Confucian wisdom of dying well, three pearls of wisdom from classical Confucianism are proposed: the relational autonomy of family, Confucian creative self-transformation, and the unity of transcendence and the human being.

P-232 Social Connection Disadvantage, Cardiometabolic Conditions and Mortality Among Elderly Asian Americans, White and African Americans

P-232 Social Connection Disadvantage, Cardiometabolic Conditions and Mortality Among Elderly Asian Americans, White and African Americans

Assessing Medication Consultations, Hypertension Control, Awareness, and Treatment Among Elderly Asian Community Dwellers Research and Reports

To describe blood pressure (BP) and medication-related findings of a pharmacist-conducted hypertension (HTN) monitoring program. Retrospective post hoc analysis. Community site. Multiethnic, community-dwelling, Asian older adults. Medication consultation/BP records from 1998-2005 were reviewed. Participants' mean baseline BP readings were classified using guidelines from the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) and stratified into three groups: < or =70, 71-79, and > or =80 years of age. Medication consultations were grouped into: lifestyle/general medication review, adherence assessment, non-HTN medication consults, and specific consults, which included pharmacist-provided, medication-related recommendations. Participants with specific consults and subsequent self-reported changes in HTN therapy were identified. Their mean BP readings at six months, before and after the self-reported changes, were assessed for differences, using paired t-test, P < or =0.05 was significant. Baseline HTN treatment/awareness rates, age-stratified HTN control, number/types of HTN medications used, adherence problems, consultations provided, BP changes in participants who self-reported changes in medication therapy. Among 414 participants (averaged 74.2 +/- 8.5 years of age, 34.1% male), baseline HTN rate, awareness rate, and treatment rates were 51.9%, 37.9%, and 24.9%, respectively. Baseline BP worsened with increasing age. Overall, 258 participants received 651 consultations. The most prevalent non-adherent behavior reported was self-adjustment of medication dosing. Among 65 participants who received HTN medication-related advice, 52/65 (80%) reported changes in medication therapy and showed significant improvement in BP at six months before and after the self-report. HTN awareness/treatment rates were low in the entire population. HTN control was worst among the oldest individuals. Implementing initiation or adjustments in medication therapy can potentially improve BP control.

Disparities in self-reported activities of daily living and instrumental activities of daily living disability among Asian American subgroups in the United States: Results from the National Health Interview Survey 2001–2003

Background The purpose of this study was to compare disability and functional limitations among elderly Asian American subgroups using datasets from the National Health Interview Survey 2001−2003. Methods This retrospective cross-sectional study analyzed whether activities of daily living (ADL) and instrumental ADL (IADL) disabilities were different among Asian American subgroups in the United States using data retrieved from the 2001−2003 National Health Interview Survey. For comparing all Asian American subgroups, χ 2 analysis was applied for the bivariate comparisons. Results Rates of 7.1% and 12.2% for ADL and IADL disability, respectively, within Asian American group were found. The elder Chinese subgroup accounted for the highest ADL and IADL disability (11.6% and 17.3%, respectively, p < .05). Being female, not married, and older was associated with higher ADL and IADL disability ( p < .05). Conclusions The findings of the study highlight the intergroup variability among the elder Asian American subpopulations.

Grandparenting Responsibility Among Elderly Asian Americans

ABSTRACT This study examines whether Asian American grandparents who reside with grandchildren take on responsibility for most of the basic needs of their grandchildren. We use data from the 2000 U.S. Census, which asked about grandparent responsibility for the first time. Younger grandparents, grandparents without disabilities, and grandmothers are more likely to be responsible for their grandchildren. Those who immigrated at age 65 or older are less likely than native grandparents to be responsible for their grandchildren, and Asian Indians are less likely than Japanese grandparents to take on this responsibility. Householders are much more likely than non-householders to be responsible for their grandchildren, but there are not many distinctions to be made among householders since there is a generally high degree of involvement among these grandparents. Future studies should look more closely at grandparents who are not householders.

Elderly South Asian Canadian Immigrant Men

The experiences of elderly South Asian (SA) men who have immigrated to Canada provide unique insights to men's health and illness behaviors and beliefs. In this article, we describe the connections between masculinity, culture, and health among a cohort of 14 SA immigrant men. The findings indicated that participants' health behaviors were closely aligned to those of western men. However, a fine-grained analysis revealed how complex cultural connections informed and influenced many men's health behaviors and beliefs. Based on the study findings, recommendations for the future design of healthcare services targeted to SA men are made.

Poverty Among Elderly Asian Americans in the Twenty-First Century

ABSTRACT This article examines the risks of poverty among elderly Asians living in the United States. Using data from the 2000 US Census, the analysis examines differences in poverty status by marital status, household structure and nativity. The article, addressing the “model minority” thesis among Asian Americans, shows how it fails to control for heterogeneity within this population. The analysis finds that Asian elders benefit from co-residence, and while we cannot test for the presence of filial piety among the Asian population this finding is consistent with other studies that show extended family living represents a response to poverty rather than preference. Marked differences are seen among Asian elders in poverty when controlled by specific ethnicity among US nationals or by national origin among migrants to the United States further supporting the high level of heterogeneity within Asian populations.

Prognostic predictors of technique and patient survival in elderly Southeast Asian patients undergoing continuous ambulatory peritoneal dialysis

The population of elderly patients entering chronic dialysis programmes is increasing. Elderly patients are susceptible to malnutrition and have multiple complicating disorders in addition to uraemia. Selecting appropriate dialysis modality is particularly critical in elderly patients. Continuous ambulatory peritoneal dialysis (CAPD) has many advantages to elderly patients; however, the clinical outcome varies for elderly CAPD patients. In comparison with Westerners, Southeast Asians have a small body mass index and may be more suited to CAPD therapy. To identify the prognostic predictors in elderly Southeast Asian patients, this historical cohort study analysed 144 patients aged > or = 65 years at initiation of CAPD. A group of haemodialysis (HD) patients aged > or = 65 years was utilised as the control group. Survival curves for patient and technique were derived from Kaplan-Meier analysis and were further analysed by Cox-Mantel log-rank test. To elucidate the impact of individual factors on patient survival, various significant univariables were further subjected to multivariate analysis. No significant increase existed for relative risk of technique failure in elderly patients compared with younger patients. This analytical data indicates that CAPD was as good as HD for elderly uraemic patients regarding to the patient survival. Diabetes, dependent patients, low albumin levels and previous HD history were significant poor prognostic factors for survival of elderly CAPD patients. In conclusion, CAPD is an effective modality of renal replacement therapy for Southeast Asian elderly patients. The technique survival was not affected by patient age.

The Impact of Globalization on Asian Elderly: Suggestions for a Korean Research Agenda

The Impact of Globalization on Asian Elderly: Suggestions for a Korean Research Agenda

Results of Total Elbow Arthroplasty in the Treatment of Distal Humerus Fractures in Elderly Asian Patients

Distal humerus fractures in elderly patients are difficult to treat as these fractures are often complicated by varying degrees of comminution intra-articular involvement and osteoporosis. We retrospectively reviewed the results of primary total elbow arthroplasty in the treatment of distal humerus fractures in seven patients followed for a minimum of 1 year. Between July 2000 and June 2002, seven patients with distal humerus fractures were treated electively with total elbow arthroplasty using the semiconstrained Coonrad-Moorey elbow replacement prostheses. The Mayo Elbow Performance Score was used to assess the outcomes. The mean age of our patients was 72.9 years. The mean duration of postoperative hospitalization stay was 7.6 days. The average length of follow up was 24.9 months. Six of these patients had no pain, and one patient had mild pain. The mean arc of flexion was 88.6 degrees. Six elbows had excellent results, while 1 elbow had good result. The mean Mayo score was 94.3 points. One elbow developed blisters postoperatively but resolved with dressings and antibiotics. Our review suggests that total elbow arthroplasty can give good to excellent short term results when used in the treatment of distal humerus fractures in elderly Asian patients.

Curry Consumption and Cognitive Function in the Elderly

Curcumin, from the curry spice turmeric, has been shown to possess potent antioxidant and antiinflammatory properties and to reduce beta-amyloid and plaque burden in experimental studies, but epidemiologic evidence is lacking. The authors investigated the association between usual curry consumption level and cognitive function in elderly Asians. In a population-based cohort (n = 1,010) of nondemented elderly Asian subjects aged 60-93 years in 2003, the authors compared Mini-Mental State Examination (MMSE) scores for three categories of regular curry consumption, taking into account known sociodemographic, health, and behavioral correlates of MMSE performance. Those who consumed curry "occasionally" and "often or very often" had significantly better MMSE scores than did subjects who "never or rarely" consumed curry. The authors reported tentative evidence of better cognitive performance from curry consumption in nondemented elderly Asians, which should be confirmed in future studies.

Prevalence of Hepatitis C–Related Cirrhosis in Elderly Asian Patients Infected in Childhood

Approximately 20% of hepatitis C virus (HCV) patients develop cirrhosis from infection after about 20 years. The proportion of patients developing cirrhosis for longer than 30 years after infection is unknown. Our objectives were to determine the prevalence of HCV-related cirrhosis in a population of Asian patients who were infected in childhood 20 to 80 years ago and compare this with the prevalence of cirrhosis in Caucasian patients referred to the same hospitals. Retrospective analyses were performed of all patients who had detectable HCV-RNA levels and who attended local hospitals in northeast London between 1992 and 2003. Factors implicated in the development of cirrhosis were examined by multivariable analysis. A total of 143 adult Asian patients who had been infected with HCV for many decades were compared with 239 Caucasian patients. The prevalence of cirrhosis increased with age. Of Asian patients aged 61-80 years (n = 55) 78% had cirrhosis, whereas 25% of Caucasian patients aged 61-80 years (n = 55) had cirrhosis. Multivariable linear analysis revealed that fibrosis progression and age were similar in both groups and the difference in the prevalence of cirrhosis was not explained by any unique Asian characteristic other than prolonged infection. The prevalence of cirrhosis in patients with chronic HCV increases with increasing duration of infection. In Asian patients infected at birth, infection for over 60 years causes cirrhosis in 71% of infected individuals. Because relationship between the severity of fibrosis and age in Asian patients is similar to that seen in Caucasian patients it is likely that similar rates of cirrhosis will be seen in other patients who are infected for more than 60 years.

Susceptibility of Elderly Asian Immigrants to Persuasion With Respect to Participation in Research

Familism, respect for authority, and a sense of shame/pride are cultural characteristics that might influence research participation of Asian Americans. We compared 79 elderly Asian immigrants, most of whom immigrated from China or Hong Kong, with 58 elders who were not Asian and mostly not immigrants. Responding to hypothetical situations presented on a self-administered questionnaire, the Asian group professed to be more likely to be influenced by a request from a son/daughter, landlord, physician, or advertisement (p<0.001) and by a monetary incentive (p=0.05). Multivariate adjustment for potential confounders attenuated the strength of these relations, but except in the case of the monetary offer, differences remained statistically significant. Within the Asian group, multivariate logistic regression modeling indicated that years lived in the US was associated with more likelihood of refusing requests to participate in research. We conclude that acculturation or assimilation into American society may build resistance to pressure to participate in research. Our findings also suggest that elderly Asian immigrants may need additional protections to achieve truly informed consent.

Improving mental health services for Latino and Asian immigrant elders.

Given the changing demographics of the aging population in the United States, it is likely that professional psychologists will encounter elderly clients from diverse backgrounds in their practice. Asians and Latinos represent the 2 fastest growing groups of elderly immigrants. This article offers information and practical suggestions to assist clinicians working with elderly Asian and Latino immigrant clients. Specific recommendations for enhancing assessment and treatment efficacy with these populations are also provided.

Successful Electroconvulsive Treatment of Depression Associated With a Marked Reduction in the Symptoms of Tardive Dyskinesia

This report describes improvement of tardive dyskinesia (TD) in a patient who received electroconvulsive therapy (ECT) for depression. The patient, an elderly Asian male, was treated for major depression with ECT and showed a rapid improvement of TD that may have been caused by any number of drugs or combination of drugs. We discuss the possibility of improving TD by treating the depression with ECT.