Healthy Elderly People Research Articles

A Systematic Review of Thirty-One Assessment Tests to Evaluate Mobility in Older Adults.

Assessments of gait, balance, and transfer in elderly people play a valuable role in maintaining healthy aging and preventing a decline in mobility. Several evaluation tools have been proposed; however, clinicians should select the most accurate ones wisely, based on numerous criteria. This systematic review aims to identify all applicable elderly mobility assessment tests and show their measurement properties with as much detail as possible. Initially, a broad search was performed. Articles were screened based on their titles and abstracts, and only studies published in English were considered. Based on our inclusion and exclusion criteria, 31 assessment tests evaluating the mobility of healthy elderly people were found. Then, further searches were completed to identify the measurement properties of each test. These characteristics include the origin and year of establishment, several practicality factors, and validity. The analysis of our outcomes illustrates the similarities and differences between the identified tests.

Factors associated with health-related quality of life (HRQoL): differential patterns depending on age.

The aims of this study were: (1) to analyze age differences in health-related quality of life (HRQoL) between the young old (aged 65-84) and the oldest old (aged 85 and over), and (2) to investigate three types of predictors: (a) physical health [Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living, comorbidity, use of medication], (b) global cognitive ability and (c) psychosocial factors, specifically personality traits, social support and emotional functioning (positive and negative affect and life satisfaction), which may influence the HRQoL of both the young old and the oldest old. A cross-sectional study was conducted with 257 healthy community-dwelling elderly people. HRQoL was assessed using the SF-36 Health Survey. Functional and health status, global cognitive ability and psychosocial variables were also assessed. Age differences were found in HRQoL, with the oldest old scoring lower for this variable. Multiple stepwise hierarchical linear regression analyses revealed that, in relation to the physical health component, use of medication, BADL and positive affect had the greatest influence among the young old (65-84), whereas among the oldest old, neuroticism and the BADL were the most influential factors. As regards the mental health component, neuroticism, use of medication and positive affect were the main predictor variables among the young old, while neuroticism and negative affect had the greatest influence among the oldest old group. The oldest old had a poorer HRQoL in both dimensions measured (physical and mental). There appear to be differences between the determinants of HRQoL for young old and oldest old adults, suggesting that these associations change with age.

Evaluating depression in cognitively healthy elderly people by using Mini-Mental State Examination.

We examined a method for evaluating depression with the Mini-Mental State Examination in cognitively healthy elderly people and employed the projective perspective. In MMSE three groups-normal, depressed tendency, and depressed-completed the Mini-Mental State Examination (MMSE) and a Japanese version of the 15-item Geriatric Depression Scale. The Mini-Mental State Examination evaluated individuals' writing based on a sentence, the number of written words, and sentence content; it also assessed their copying of drawn figures. In the depressed group, the proportion corresponding to the characteristics of (i) to (iii) was higher than in the other two groups: (i) the calculation score was 0 or 1; (ii) subjects scored above the median in sentence writing relative to similar subjects with the same language and clinical setting; and (iii) subjects expressed feelings in their writing. One point was given for each characteristic, and we calculated the sum. Depressed subjects had a score ≥2. This evaluation method can differentiate depressed subjects with high accuracy (sensitivity: 77.8%, specificity: 76.4%) without placing an extra burden on the subjects.

Natural Language Processing for the Identification of Silent Brain Infarcts From Neuroimaging Reports.

BackgroundSilent brain infarction (SBI) is defined as the presence of 1 or more brain lesions, presumed to be because of vascular occlusion, found by neuroimaging (magnetic resonance imaging or computed tomography) in patients without clinical manifestations of stroke. It is more common than stroke and can be detected in 20% of healthy elderly people. Early detection of SBI may mitigate the risk of stroke by offering preventative treatment plans. Natural language processing (NLP) techniques offer an opportunity to systematically identify SBI cases from electronic health records (EHRs) by extracting, normalizing, and classifying SBI-related incidental findings interpreted by radiologists from neuroimaging reports.ObjectiveThis study aimed to develop NLP systems to determine individuals with incidentally discovered SBIs from neuroimaging reports at 2 sites: Mayo Clinic and Tufts Medical Center.MethodsBoth rule-based and machine learning approaches were adopted in developing the NLP system. The rule-based system was implemented using the open source NLP pipeline MedTagger, developed by Mayo Clinic. Features for rule-based systems, including significant words and patterns related to SBI, were generated using pointwise mutual information. The machine learning models adopted convolutional neural network (CNN), random forest, support vector machine, and logistic regression. The performance of the NLP algorithm was compared with a manually created gold standard. The gold standard dataset includes 1000 radiology reports randomly retrieved from the 2 study sites (Mayo and Tufts) corresponding to patients with no prior or current diagnosis of stroke or dementia. 400 out of the 1000 reports were randomly sampled and double read to determine interannotator agreements. The gold standard dataset was equally split to 3 subsets for training, developing, and testing. ResultsAmong the 400 reports selected to determine interannotator agreement, 5 reports were removed due to invalid scan types. The interannotator agreements across Mayo and Tufts neuroimaging reports were 0.87 and 0.91, respectively. The rule-based system yielded the best performance of predicting SBI with an accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 0.991, 0.925, 1.000, 1.000, and 0.990, respectively. The CNN achieved the best score on predicting white matter disease (WMD) with an accuracy, sensitivity, specificity, PPV, and NPV of 0.994, 0.994, 0.994, 0.994, and 0.994, respectively.ConclusionsWe adopted a standardized data abstraction and modeling process to developed NLP techniques (rule-based and machine learning) to detect incidental SBIs and WMDs from annotated neuroimaging reports. Validation statistics suggested a high feasibility of detecting SBIs and WMDs from EHRs using NLP.

Comparison of the internal hip abduction moment and the pelvic kinematics during single-leg standing between people with knee osteoarthritis and healthy elderly people

Purpose: A high external knee adduction moment (KAM) during walking is known as the risk factors for progression of knee osteoarthritis (KOA). Recent studies demonstrated that contralateral pelvic drop increased the KAM during walking and single-leg standing. Thus, stabilizing pelvis in the frontal plane is one of the goal for conservative treatments for KOA. In addition, internal hip abduction moment (HAM) explaining hip abductor muscle strength of the stance limb play a role in stabilizing the pelvis. However, few studies investigated HAM and pelvic kinematics during single-leg standing in people with KOA. Single-leg standing is convenient method to assess movement of the pelvis in the frontal plane, such as in the Trendelenburg test. The purpose of the present study was to compare the HAM and the pelvic kinematics during single-leg standing between people with KOA and healthy elderly people. Methods: Nine healthy elderly people (healthy group; age: 61.0 ± 9.0 years, height: 157.0 ± 9.3 cm, weight: 57.3 ± 11.2 kg) and 10 patients with KOA (KOA group; age: 67.8±8.9 years, height:152.8±6.9 cm, weight: 56.8±15.1 kg, K/L grade: 2-3) were recruited for this study. These subjects performed the single-leg standing trials. Subjects stood on two force platforms. They lifted one lower limb off the force plate 'as fast as possible' following a sonic cue, and held the posture. The onset of lift-off point was defined as the time when the vertical component of the ground reaction force became less than 10 N. All data were recorded until 3000ms following the lift-off. The data were collected with a six-camera motion analysis system and two force plates that were temporally synchronized and sampled at 200Hz and 1000Hz, respectively. Helen Hays marker set was used. The peak HAM and peak KAM during the single-leg standing were determined using the SIMM6.0.2 software. The maximum and minimum value of the lateral tilt angle of the pelvis during single-leg standing trials were calculated using the custom Matlab code. The contralateral pelvic elevation was denoted as a positive angle. We compared peak HAM, peak KAM and pelvic tilt angle between groups using unpaired t test. The level of significance was set at 0.05. Results: able 1 shows all kinematics and kinetic data (mean and SD) and statistics. There was no significant difference between groups for peak HAM and peak KAM. Maximum value of the pelvic tilt angle was not significant difference between groups. Minimum value of the pelvic tilt angle was greater in KOA group than in healthy group (p<0.05). Conclusions: People with KOA reduced the contralateral pelvic drop during single-leg standing. In addition, there was no difference peak KAM and peak HAM in KOA group compared with healthy group. People with KOA probably adapted their pelvic kinematics to prevent the increase of peak KAM during single-leg standing. Since hip abductor muscle play a role in stabilizing pelvis, hip abductor muscle strengthening exercises might be effective for rehabilitation program for KOA.

Effects of different intensities of strength and endurance training on some osteometabolic miRNAs, Runx2 and PPARγ in bone marrow of old male wistar rats.

Bone tissue is known as a living dynamic and complex organ in response to physical activity and mechanical loading such as exercise training; thus, the purpose of this study was to determine the effect of different intensities of strength and endurance training on expression of some osteometabolic miRNAs and runt-related transcription factor 2 (Runx2) and peroxisome proliferator-activated receptor γ (PPARγ) in bone marrow of old male Wistar rats. To this end, a total number of 50 male Wistar rats (aged 23months, 438.27g) were obtained from Pasteur Institute of Iran. The rats were randomized into five groups (10 rats/per group) including moderate endurance training (MET), high-intensity endurance training (HET), moderate-intensity resistance training (MRT), high-intensity resistance training (HRT), and control (CON). The four training groups completed 8weeks of a training program, 5days a week, according to the study protocol. To evaluate miR-133a, miR-103a, miR-204, and other adipogenic and osteogenic genes such as RUNX2 and PPARγ via real-time PCR, total RNA including mRNA and miRNA was isolated from the bone marrow. The statistical analysis was then performed using two-way analysis of variance (ANOVA). No significant differences in miR-133a (p = 0.197), miR-103a (p = 0.302), miR-204 (p = 0.539), RUNX2 (p = 0.960), and PPARγ (P = 0.872) were observed between the intervention groups and the control one. Furthermore, there were no significant differences in bone force (p = 0.641), fracture energy (p = 0.982), stress (p = 0.753), module (p = 0.147), and elongation (p = 0.292) variables between the intervention groups and the control group. Investigating molecular and cellular changes in the bone after such exercises in longer time could provide clearer results about the beneficial or harmful effects of these types of exercises in healthy and passive elderly people.

Relationship between the severity of iron overload in peripheral blood CD4+ T cells and the key transcription factors of RORrt, IRF8, STAT3 for cell proliferation and differentiation in elderly patients with myelodysplastic syndrome

Objective To investigate the effects RORrt(RORrt), IRF8(IRF8)and STAT3(STAT3)in peripheral blood CD4+ T cells on the cell proliferation and differentiation in elderly patients with iron-overload myelodysplastic syndrome(MDS). Methods A prospective case-control study was conducted.Twenty-two elderly hospitalized patients(12 males and 10 females)aged 60-78 years with iron-overload MDS from Jan.2017 to Dec.2018 were enrolled and considered as the observation group.Twenty MDS patients without iron overload hospitalized in the same period were selected as the non-iron overload group, and 26 healthy elderly people were considered as the healthy control group.Peripheral blood monocytes(PBM)were prepared and resident CD4+ T cells were sorted by flow cytometry.The mRNA and protein expression levels of transcription factors of RORrt, p-STAT3 and IRF8 were detected by quantitative real time polymerase chain reaction(qRT-PCR)and Western blotting. Results In peripheral blood CD4+ T cells, the mRNA expression level of RORrt and p-STAT3 were higher and that of IRF8 was lower in the iron-overload group than in the non-iron overload group and the healthy control group(42.634±18.613 vs.21.289±15.158 and 22.520±9.896; 29.710±9.689 vs.12.355±4.681 and 9.818±3.845; 19.293±8.258 vs.23.785±12.498 and 69.619±23.768, P<0.01). In peripheral blood CD4+ T cells, the protein expression level of RORrt and p-STAT3 was higher, and that of IRF8 was lower in the iron overload group than in the non-iron overload group and healthy control group(P<0.01). Conclusions The abnormalities of the mRNA and protein expression levels of transcription factors of RORrt, IRF8 and p-STAT3 in CD4+ T cells play a fundamental role in the pathogenesis of iron overload MDS in elderly patients. Key words: Myelodysplastic syndrome; Antigens, CD4; Interferon regulatory factors

Correlation between hypocalcemia and acute exacerbation of chronic obstructive pulmonary disease in the elderly

ABSTRACTIntroduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important disease of hospitalized elderly patients, who often have electrolyte imbalances. This study was performed to analyze total serum calcium levels in elderly patients with AECOPD and identify the correlation between hypocalcemia and AECOPD.Methods: 153 elderly patients with AECOPD served as the observation group, and 115 healthy elderly people undergoing physical examinations served as the control group. Differences in the corrected serum calcium, albumin (ALB), and neutrophil/lymphocyte ratio (NLR) were analyzed between the observation and control groups before and after treatment. The incidence of hypocalcemia was compared among patients at different ages and with different pulmonary function classifications before treatment. The relationship between hypocalcemia and respiratory infection was analyzed. Differences in the pretreatment NLR, ALB, logarithm of the serum C-reactive protein level (LogCRP), and hospital stay were compared between patients with and without hypocalcemia.Results: The corrected serum calcium level (P < 0.001), NLR (P = 0.001) and albumin level (P < 0.001) were significantly different among the pretreatment group, post-treatment group, and control group. The serum calcium level, LogCRP, and NLR were significantly lower after than before treatment (P < 0.05). Significant differences in the incidence of hypocalcemia were found among patients of different ages (P = 0.002). The respiratory infection rate (P < 0.001), hospital stay (P < 0.001), NLR (P = 0.007), and LogCRP (P < 0.001) was higher in patients with than without hypocalcemia. However, the albumin level was lower in patients with than without hypocalcemia (P < 0.001).Conclusions: In elderly patients with AECOPD, hypocalcemia may be related to the disease progression, respiratory infection rate, and hospital stay of patients with AECOPD.

Correlation between atherogenic index of plasma and renal function change in the elderly patients with hypertension

Objective To observe the abnormality of lipid metabolism and renal function change in elderly patients with hypertension, and to evaluate the relationship between atherogenic index of plasma(AIP) and glomerular filtration rate(GFR). Methods From July 2015 to June 2017, in Quzhou People′s Hospital, 182 elderly patients with hypertension were selected as observation group, and 192 elderly healthy people with normal blood pressure were selected as control group.The total cholesterol(TC), triglyeride(TG), high density lipoprotein cholesterol(HDL-C) were detected, and the AIP=1og[TG/HDL-C]was calculated.The GFR was estimated by Cockcroft-Gault equation.The relationship between the estimated GFR (eGFR) and the blood lipid parameters was analyzed. Results The eGFR of the observation group and control group were (84.94±19.49)mL·min-1·(1.73m2)-1, (154.91±20.44)mL·min-1·(1.73m2)-1, respectively, the difference between the two groups was statistically significant (t=11.27, P<0.01). The AIP of the observation group and control group were (0.68±0.03), (-0.22±0.02), respectively, the difference between the two groups was statistically significant (t=3.43, P<0.01). There was a negative correlation between AIP and eGFR in the elderly patients with hypertension(r=-0.845, P<0.01). Conclusion The fact shows that abnormality of lipid metabolism in the elderly patients with hypertension is present.AIP can be used as a plasma marker of atherosclerosis and could be used as a useful and important parameter for clinical observation in the elderly hypertensive patients with renal impairment. Key words: Hypertension; Atherogenic index of plasma(AIP); Dyslipidemias; Glomerular filtration rate

健常高齢者および若年者の歩行中の障害物跨ぎ動作における側方の姿勢安定性 ─3 軸加速度計を用いた検討─

健常高齢者および若年者の歩行中の障害物跨ぎ動作における側方の姿勢安定性 ─3 軸加速度計を用いた検討─

Relation between cognitive and cerebello-thalamo-cortical functions in healthy elderly people: Evidence from the Yakumo Study

Relations between cognitive and cerebello-thalamo-cortical functions in healthy elderly people (65–75 years old) were examined by longitudinal behavioral data. Based on the individually calculated cognitive decline ratio in D-CAT (digit cancelation test) and in LMT (Logical Memory Test) during the period of 11 years, participants were classified into the Decline and the Maintain groups and group differences in the postural tremor measures (Quotient of Romberg) were compared. Significant group differences were shown in the postural tremor measure in D-CAT that reflects prefrontal function, but it was not the case in LMT. These results strengthened our previous findings that suggest a strong relation between the cerebello-thalamo-cortical function and the prefrontal cortex function using behavioral measures. Findings provide evidence that to strengthen postural function such as physical exercise is effective for slowing cognitive decline with age.

Reader response: Sauna bathing reduces the risk of stroke in Finnish men and women: A prospective cohort study

The article by Kunutsor et al.1 evaluated the correlation between sauna bathing patterns and risk of stroke. The study population was made up of healthy elderly people without a known history of stroke, at an average (SD) age of 62.7 (6.5) years. People at this age, especially accompanied with other cerebrovascular risk factors, are very likely to have major cervical or intracranial vessel stenosis.2,3 In the event of a heated situation such as sauna, hypoperfusion or even ischemic stroke may be induced due to large fluid loss and severe vessel stenosis.4 People with or without vessel stenosis could have a different intracranial hemodynamic correlation with sauna bathing. It is understandable that vascular evaluation may be difficult to achieve, as the research is a community-based study. However, the status of intracranial vasculature, which could be an important variable of the relationship between sauna and risk of stroke, should be included into the analysis.

Executive Functions, Episodic Autobiographical Memory, Problem-Solving Capacity, and Depression Proposal for a Structural Equations Model.

The executive functions play an important role in storing and recovering autobiographical memories, especially episodic memories. These types of memories provide information about solutions and experiences from the past that can be utilized as examples in the present when seeking solutions to any problem. In addition, a close relationship between depression and the executive functions has been widely recognized. This study aims to elaborate a structural equations model that empirically supports the relationships among the executive functions, episodic autobiographical memory, and the adaptive capacity to solve problems, taking into account the depressed mood state. In all, 32 healthy elderly people, 32 patients with Parkinson disease, 32 with amnestic mild cognitive impairment, and 32 with Alzheimer disease were evaluated. Structural equation models were estimated to test the effects among the constructs. The final model shows adequate fit indexes, thus revealing that an individual's problem-solving capacity will depend on the capacity to access the episodic autobiographical memory, which in turn will depend on the maintenance of executive functioning. In a parallel way, the mood state, and specifically depression, will play a modulator role because when there is depressive symptomatology, some capacities that depend on executive control can be diminished.

Odour and salt taste identification in older adults: evidence from the Yakumo study in August 2014

Background: This study examined the relationship between olfactory function and taste function. A personal function test was calculated from the Yakumo study database, and the odour stick identification test and salt taste identification test were administered to healthy elderly people. The participants were community dwellers who voluntarily participated in the Yakumo Study and had managed everyday life by themselves. Totally, 358 people (152 male, 206 female) participated in Yakumo–cho inhabitant’s examination of 2014. The average age of 152 male was 65.2±9.4 years old (40–80 years old). We used Sal save (product made in Advantec Co. Ltd.) for an examination of taste. We used Smelling stick (product made in Daiichi Kogyo Co. Ltd.) for olfactometry. In addition, the average age of 206 female was 63.7±10.6 years old (40–85 years old).The results showed that the performance score on odour identification test was better in female participants than male participants. The results of the salt taste identification test showed that the recognition of salt density was lower in female participants than in male participants. Because taste and olfactory cognitive abilities decline with age, the development of meals for the elderly requires a new approach. Meals for the elderly should be healthy, with a strong fragrance and a light taste of salt.

Cerebral micro‐bleeding identification based on a nine‐layer convolutional neural network with stochastic pooling

SummaryCerebral micro‐bleedings are small chronic brain hemorrhages caused by structural abnormalities of the small vessels. CMBs can be found from individuals with stroke at memory clinics and even healthy elderly people. CMBs indicate hemorrhage‐prone pathological states. Research shows that CMBs are associated with an increased risk of future ischemic stroke, intra‐cerebral hemorrhage (ICH), dementia, and death. Considering that CMBs severely influence people's life, it is necessary to identify the CMBs in an early stage to prevent from further deterioration and to help people live a healthy life. In this paper, we proposed using CNN with stochastic pooling for the CMB detection. CNN has good performance in image and video recognition, recommender system, and nature language processing. Based on the collected subject, the experiment result shows that the six‐convolution layer and three fully‐connected layer CNN, nine‐layers in total, achieved sensitivity, specificity, accuracy, and precision as 97.22%, and 97.35%, 97.28%, and 97.35% in average of ten runs, which shows better performance than five state‐of‐the‐art methods.

Slower Reorientation of Trunk for Reactive Turning while Walking in Hemiparesis Stroke Patients

We examined the behavioral characteristics of reactive turning in hemiplegic stroke patients when they were informed of the turning direction just before turning was required at an unpredictable time. Eleven stroke patients and 20 healthy elderly control people were asked to initiate a turn as soon as a visual cue to inform them of the turning direction was activated unpredictably using a foot switch. Both the segmental reorientation and stepping type when turning 90° while walking were measured. The results indicated preserved segmental reorientation of the head and pelvis in stroke patients. Stroke patients showed delays in pelvic turning but not in head turning. Their delayed pelvic movement might be due to motor dysfunction and the time taken to ensure stability when deciding when to turn.

Peningkatan Edukasi bagi Lansia Sehat dan Produktif

Lack of knowledge of the elderly in maintaining health in facing old age causes many health problems in the elderly. The goal to be achieved in mentoring is that the elderly in the Posyandu Lansia (Integrated Healthcare Center for the Elderly) of the Kauman village of Yogyakarta can improve their health knowledge of the elderly as an effort to live healthily, so as to increase the life expectancy of the healthy and productive elderly people. The end of the mentoring is expected that all elderly participants can find out what is happening to the health of the elderly as an effort to live a healthy life. The material presented in this activity includes knowledge about healthy elderly people, diseases and risk factors that occur in the elderly, as well as nutrition and healthy food for the elderly by using case study methods, consultation for healthy living, and the practice of maintaining physical health. Other activities carried out in increasing knowledge in realizing healthy elderly people are by increasing awareness of the elderly to carry out health checks including blood pressure, blood sugar levels, uric acid, and cholesterol and elderly exercise. The results obtained are knowledge and skills for healthy and productive living procedures for the elderly.

Identification and features selection of elderly people based on accelerations of smartphone

In this study, we record 3-axis accelerations during various measurement tests with a smartphone, extract features from the accelerations, and then identify young people and the elderly people, as well as healthy elderly people and care-requiring preliminary group for the features by random forests of machine learning. We also perform the selection of the features specific to the elderly people. For the measurement tests, each subject conducts normal and fast 10m walking, chair standing and sitting test, alternate step test, and balance test with 3 kinds of standing position holding. The subjects are 23 young people and 25 elderly people who can walk independently. As a result, the accuracies in all the measurement tests are 78% or more using selected features, and 91% or more in the alternate step test in particular. Moreover, the amplitude and the dispersion of the acceleration, the frequency component, and the period time are selected as the characteristic peculiar to the elderly people.

The Characteristics of Adjustability of Grasping Force in Healthy Elderly People

The Characteristics of Adjustability of Grasping Force in Healthy Elderly People

Evaluation of Oral Functions in Healthy Elderly People: Survey by Questionnaire of Relationship between Swallowing Function and Devising Food Modifications

Evaluation of Oral Functions in Healthy Elderly People: Survey by Questionnaire of Relationship between Swallowing Function and Devising Food Modifications