Related Factors In Elderly Patients Research Articles

Rate of Correct Inhaler Usage and Related Factors in Elderly Patients With Chronic Obstructive Pulmonary Disease

Poor disease control in patients with chronic obstructive pulmonary disease (COPD) is associated with suboptimal inhaler use. This study was designed to explore the accuracy of inhaler use and related factors in elderly patients with COPD. A cross-sectional survey design was used to recruit patients with COPD from a medical centre in southern Taiwan who were over 65 years old and used inhalers regularly. All of the data as well as information on inhaler use accuracy were collected using a self-designed questionnaire and inhaler operation checklist. Multivariable logistic regression was used to analyse significant correlates of correct inhaler operation. The average age of the 150 participants was 75.0 years (SD = 7.5) years. Most used one type of inhaler only (86.0%). The rate of accurate inhaler operation was 40.7% (n = 61) for the sample, with dry powder inhalers associated with the highest accuracy (64%) and pressurized metered-dose inhalers associated with the lowest accuracy (1.6%). Multivariate logistic regression analysis showed that using a soft mist inhaler (adjusted odds ratio, AOR = 23.29; 95% confidence interval, 95% CI [2.84, 191.07]), using a dry powder inhaler (AOR =15.60, 95% CI [1.99, 122.26]), and higher satisfaction with the inhaler were positively and independently associated with accurate inhaler use (AOR = 1.94, 95% CI [1.09, 3.44]). Important factors related to inhaler use accuracy include inhaler type and level of patient satisfaction with their inhaler. Healthcare professionals should regularly confirm that older patients are able to use their inhalers correctly and are satisfied with their inhalers.

Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment.

To investigate the incidence of falls in elderly aged 65 years and above among outpatients and inpatients, and to analyze its related factors and identify prevention strategies. A retrospective analysis was conducted on 451 patients aged 65 years and above who received comprehensive geriatric assessment in outpatients and inpatients from the Department of Geriatrics in the Second Xiangya Hospital from March 2021 to March 2022. According to whether there had been at least one fall in the past year, the patients were divided into a fall group and a non-fall group. Data were collected from the We-Chat applet of comprehensive geriatric assessment. A t test and chi-square test were performed to compare the difference between the two groups. Logistic regression analysis was then conducted to identify factors associated with falls. (1) The incidence of falls among the outpatient and inpatient was 28.8%. (2) The rate of light, moderate, and heavy dependence on daily living ability and decreased mobile balance ability were higher in the fall group than those in the non-fall group. The average calf circumference in the fall group was significantly lower than that in the non-fall group. (3) The prevalence of diabetes and eye diseases in the fall group was significantly higher than that in the non-fall group. (4) The percentage of insomnia and suspicious insomnia cases in the fall group was higher than that in the non-fall group. The mean scores for dysphagia, frailty, and incontinence were higher and the mean malnutrition score was lower in the fall group than in the non-fall group. (5) Multiple logistic regression analysis showed that frailty, insomnia, and malnutrition were independent influencing factors of fall (OR = 1.955, 1.652, 10.719, P = 0.044, 0.041, 0.025, respectively). The incidence of falls among outpatients and inpatients aged 65 years and above is high. Frailty, insomnia, and malnutrition are the main factors influencing falls in these patients.

Frailty Status and Related Factors in Elderly Patients in Intensive Care for Acute Conditions in China.

Objective: Frailty is a complex age-related clinical disorder characterized by the decreased physiological capacity of multiple organ systems, leading to increased susceptibility to stressors. Because the clinical manifestations of frailty are heterogeneous, accurately diagnosing the degree of frailty and its predisposing factors is important. We investigated the prevalence of frailty and the related risk factors in elderly patients in emergency departments (EDs) in China using a clinical frailty scale (CFS) and a comprehensive geriatric assessment (CGA) tool.Methods: Elderly patients who were scheduled to be discharged from the acute ward of an ED within one week were recruited. They were asked to complete a set of surveys using CGA forms, comprising a CFS, a Nutritional Risk Screening 2002 form, laboratory tests for albumin level and body mass index, a Mini-Cog test for cognitive status, Barthel's activities of daily living index, an instrumental activities of daily living (IADL) assessment, a Geriatric Depression Scale-15 (GDS-15) assessment and a Cumulative Illness Rating Scale-Geriatric assessment.Results: Frailty prevalence in the recruited elderly patients was 33.33%. Frail elderly patients (CF≥5) also had more comorbidities, higher depression scores, and nutritional risks along with lower body mass indices, weight, quality-of-life scores and physical function scores. Cognitive impairment, depression, and education level were found to be the main impact factors on frailty.Conclusion: Frail elderly patients had greater cognitive problems and higher levels of depression besides physical dysfunction, which further aggravates frailty in older patients.

SARS-CoV-2 Omicron variant; psychological effect and influencing factors in elderly patients

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant appeared in South Africa for the first time. The high prevalence of its mortality in elderly patients has caused an increase in anxiety triggered by this disease in aged people. Objectives: The aim of this study is to evaluate the anxiety related-COVID-19 in the SARS-CoV-2 Omicron variant and its related factors in elderly patients who are candidates for cataract surgery. Patients and Methods: This descriptive-analytical study was conducted on 159 over 65 years old patients who are candidates for cataract surgery. Easy and accessible sampling methods were employed to select samples. Demographic characteristics sheet and the Corona Disease Anxiety Scale (CDAS) questionnaire were filled out by them. Fisher’s exact test, Mann-Whitney U and binary logistic regression tests were conducted for data analysis. Results: The results showed that out of 159 patients, 57.9% were female, with a mean age of 73.09 ± 9.64 years. The anxiety level of 70.4% of patients was mild or non-anxiety and 29.6% was moderate or severe. The correlation between anxiety related to COVID-19 with age, gender, vaccination status and history of being infected by COVID-19 was significant (P<0.05); however, the correlation with the job, place of residence and marital status were not significant (P>0.05). Conclusion: We concluded that older age, female gender, non-vaccinated and having no history of being infected by COVID-19 are the most influential factors that increase anxiety triggered by COVID-19 in elderly patients.

Arterial Endothelial Function and Related Factors in Elderly Patients With Essential Hypertension and Abdominal Obesity

Abstract Background To investigate arterial endothelial function and related factors in elderly patients with both essential hypertension and abdominal obesity. Methods A total of 658 elderly patients (≥60 years old) with essential hypertension and 64 elderly subjects without hypertension were recruited. Hypertension and obesity were defined based on blood pressure (≥140/90 mm Hg) and waist circumference (male ≥90, female ≥85 cm), respectively. Endothelium-dependent dilatation (EDD) of anterior tibial artery induced by reactive hyperemia was examined by high-resolution vascular ultrasound. Pearson correlation analysis, factorial analysis, and multiple linear regression analysis were undertaken to examine the related factors of EDD. Results Factorial analysis showed that hypertension and abdominal obesity were influence factors of EDD, but there was no interaction between them. From normotensive without abdominal obesity, normotensive with abdominal obesity, hypertensive without abdominal obesity, to hypertensive with abdominal obesity, a gradual decline in EDD was observed (9.37 ± 1.11%, 8.59 ± 0.99%, 7.70 ± 0.30%, and 6.75 ± 0.26%, respectively, P < 0.05). In elderly hypertensive patients with abdominal obesity, EDD correlated with waist circumference (r = −0.139, P < 0.05), systolic blood pressure (r = −0.245, P < 0.05), pulse pressure (r = −0.287, P < 0.05), and fasting glucose level (r = −0.131, P < 0.05). Multivariate linear regression analysis revealed that EDD was associated with pulse pressure (β = −0.280, P < 0.001) and waist circumference (β = − 0.141, P = 0.009). Conclusions In elderly patients with essential hypertension and central obesity, EDD is impaired, and negatively correlated with pulse pressure and waist circumference.

Prevalence of anxiety and depression and related factors in elderly patients with metabolic syndrome

Objective To investigate the prevalence of anxiety and depression in elderly patients with metabolic syndrome (MS) and its related factors. Methods A total of 672 subjects aged 60 or over undergoing health check-up in two Nanjing community health service centers from November 2015 to October 2016 were enrolled in the study. The basic information and the history of hyperlipidemia, hypertension and diabetes were collected by questionnaire survey; the results of physical examination and biochemical testing were documented. The prevalence of anxiety and depression were investigated by the Hospital Anxiety and Depression Scale (HADS). According to MS diagnostic criteria, the subjects were divided into MS group (n=181) and non-MS group (n=491). The HADS scores of two groups were compared and the influencing factors related to anxiety and depression were analyzed. Results The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index(BMI), levels of fasting blood glucose (FBG), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) were higher and high density lipoprotein cholesterol (HDL-C) was lower in MS group than those in non-MS group (all P<0.05). The prevalence rates of anxiety and depression in MS group (30.9% and 34.8%) were significantly higher than those in non-MS group (20.2% vs. 25.1%, χ2=8.655, 6.288, P=0.003, 0.012). Multivariate logistic regression analysis showed that obesity (BMI≥28 kg/m2), high FBG (≥7.0 mmol/L), hypertension [blood Pressure≥140/90 mmHg (1 mmHg=0.133 kPa)] were the independent risk factors for anxiety in MS patients (OR=3.987, 2.827, 2.375, respectively, all P<0.05); obesity (BMI≥28 kg/m2), high FBG(≥7.0 mmol/L), smoke, high TC (≥5.2 mmol/L), hypertension (≥140/90 mmHg) were the independent risk factors for depression in MS patients (OR=7.718, 3.233, 2.071, 1.932, 1.910, respectively, all P<0.05). Conclusion Elderly patients with metabolic syndrome are prone to anxiety and depression, and obesity, high FBG, hypertension and other factors are the risk factors for anxiety and depression. Key words: Metabolic syndrome; Anxiety; Depression

Factors related to intentional and unintentional medication nonadherence in elderly patients with hypertension in rural community.

PurposeWe assessed medication nonadherence, categorized as intentional or unintentional, and related factors in elderly patients with hypertension, correlating the data with measurement of blood pressure as the final target of medication adherence and other possible influencing factors, such as lifestyle.Patients and methodsSubjects were aged ≥65 years, resided in a rural area, and were taking antihypertensive drugs. The survey was conducted in July 2014. Participants were divided into the following three groups: “Adherence”, “Unintentional nonadherence”, and “Intentional nonadherence”. Individual cognitive components, such as necessity and concern as well as self-efficacy and other related factors, were compared according to adherence groups. The interrelationships between those factors and nonadherence were tested using structural equation modeling analysis.ResultsOf the 401 subjects, 182 (45.6%) were in the adherence group, 107 (26.7%) in the unintentional nonadherence group, and 112 (27.9%) in the intentional nonadherence group. Necessity and self-efficacy were found to have a significant direct influence on unintentional nonadherence behaviors (necessity β=−0.171, P=0.019; self-efficacy β=−0.433, P<0.001); concern was not statistically significant (β=−0.009, P=0.909). Necessity was found to have significant direct and indirect impact on intentional nonadherence (direct β=−0.275, P=0.002; indirect β=−0.113, P=0.036). Self-efficacy had no significant direct effect on intentional nonadherence though it had the only significant indirect effect on intentional nonadherence (direct β=−0.055, P=0.515; indirect β=−0.286, P<0.001). Concern had no significant influence on intentional or on unintentional nonadherence (direct β=0.132 0.132, P=0.151; indirect β=−0.006, P=0.909).ConclusionUnintentional nonadherence should be regularly monitored and managed because of its potential prognostic significance. Interventions addressing cognitive factors, such as beliefs about medicine or self-efficacy, are relatively difficult to implement, but are essential to improve medication adherence.

Study on the related factors for mineral metabolism in elderly patients with maintenance hemodialysis

Objective To investigate the present state of mineral metabolism and its related factors in elderly patients with maintenance hemodialysis (MHD), in order to improve the quality of life and survival rate in elderly patients with MHD in Xinxiang. Methods Clinical data of 466 patients with treatment of MHD for over 3 months in 4 hospitals in Xinxiang district were enrolled from January 2012 to August 2013 in this study, and the patients were divided into the elderly group (n=159, aged ≥60 years) and the non-elderly group (n=307, aged<60 years). The evaluation indexes for mineral metabolism were determinated, such as serum levels of calcium, phosphorus, intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP). The present state of mineral metabolism and its relationships with anemia, dialysis ages, adequacy of dialysis, malnutrition and inflammatory factors were analyzed in elderly patients with MHD. Results Among 466 patients, the serum levels of calcium, phosphorus and iPTH in MHD patients were (1.95±0.34) mmol/L, (2.54±1.38) mmol/L and (409.5±345.6) ng/L respectively, and their control rates were 34.3%, 20.4% and 25.5% respectively. And in patients with hemodialysis three times a week, the control rates were 50.8%, 31.4% and 32.2% respectively. The serum levels of phosphorus, iPTH, ALP, albumin and transferrin saturation were lower in elderly group than in non-elderly group (all P<0.01), and the serum levels of pre-albumin, hemoglobin and feritin were lower in elderly group than in non-elderly group (all P<0.05). But the serum levels of calcium and C-reactive protein (CRP) were higher in elderly group than in non-elderly group (all P<0.05). Conclusions The elderly patients with MHD exhibit unique clinical manifestations of abnormal mineral metabolism, and low bone transformation osteopathy is the main manifestation. The micro-inflammation, malnutrition and anemia are more severe in elderly patients than in non-elderly patients. Key words: Hemodiafiltration; Renal osteodystrophy; Calcium metabolism disorders; Phosphorus; Parathyroid hormone

Nursing diagnosis "impaired walking" in elderly patients: integrative literature review

The impaired walking nursing diagnosis has been included in NANDA International classification taxonomy in 1998, and this review aims to identify the defining characteristics and related factors in elderly patients in recent literature. Integrative literature review based on the following guiding question: Are there more defining characteristics and factors related to the nursing diagnosis impaired walking than those included in NANDA International classification taxonomy in elderly patients? Search conducted in 2007-2013 on international and Portuguese databases. Sample composed of 15 papers. Among the 6 defining characteristics classified at NANDA International, 3 were identified in the search results, but 13 were not included in the classification. Regarding the 14 related factors that are classified, 9 were identified in the sample and 12 were not included in the NANDA International taxonomy. This review allowed the identification of new elements not included in NANDA International Taxonomy and may contribute to the development of taxonomy and nursing knowledge.

Analysis and prevention of nosocomial infection related factors in elderly patients with cardiovascular disease

Objective To explore the related factors of nosocomial infection in elderly patients with cardiovascular disease.Methods From January 2011 to December 2012 in our hospital,2530 cases of elderly cardiovascular patients were selected for study objects to observe effects of the related factors of nosocomial infection to elderly patients with cardiovascular disease.Results 248 patients from 2530 cases with cardiovascular disease developed nosocomial infection,the proportion was 9.8％.The nosoeomial infection rate of patients aged over 70 years was 15.4％,the nosocomial infection rate of those aged under 70 years was 6.7％; the nosocomial infection rate of the patients with heart functional class Ⅰ-Ⅱ was 6.1％,the nosocomial infection rate of the patients with heart functional class Ⅲ-Ⅳ was 15.8％; the nosocomial infection rate of the patients with the implementation of invasive diagnosis and treatment measures was 19.7％,the nosocomial infection rate of the patients without the implementation of invasive diagnosis and treatment measures was 6.7％,the nosocomial infection rate of the patients with prophylactic use of antibiotics was 13.7％,the nosocomial infection rate of the patients without prophylactic use of antibiotics was 8.2％.The logistic regression analysis showed that the patients' age,cardiac function,prevention of the use of antibiotics and the implementation of invasive treatment measures were significant.Conclusion The main factors affecting nosocomial infection in elderly patients with cardiovascular disease were the age of patients,cardiac functional grading,antibiotic prophylaxis and invasive treatment measures. Key words: Elderly; Cardiovascular; Nosocomial infection; Related factors; Prevention

Between spiritual wellbeing and spiritual distress: possible related factors in elderly patients with cancer

Objective this article describes the assessment of the spiritual wellbeing of elderly patients with cancer submitted to chemotherapy and possible predictive factors of the spiritual distress diagnosis. Methodology this is a methodological study for clinical validation of a nursing diagnosis, using interviews to assist in completing the form. Results 45 elderly patients participated in this study, Catholics, mostly female, diagnosed with breast cancer, average age of 70.3 years. The prevalence of spiritual distress was of 42%; 24.4% of the elderly patients were under anti-depressant medication. A significant association was noted between spiritual distress, anti-depressant medication and level of education; an increase (not significant) was acknowledged at the start of the treatment. Conclusion these results emphasize the relevance of clarifying this diagnosis and the responsibility of nurses to provide spiritual care to patients. Interventions should be planned appropriately every time a nursing diagnosis is identified as a complex answer and for which pharmacological treatment is not sufficient.

Correlates of depression in type 2 diabetic elderly patients: A correlational study

Objectives This aim of this study was to investigate depression and related factors in elderly patients (⩾65 years) with type 2 diabetics. Methods The study utilized a descriptive-correlational design. Convenience sampling was applied to enroll 156 subjects, aged ⩾65 years from diabetic outpatient clinics at three hospitals in Kaohsiung. This study applied the Personal Resource Questionnaire 2000 (PRQ 2000), Taiwan Geriatric Depression Scale (TGDS), and a form for demographic data. Results (1) The mean index score for depression level was 26, indicating that study subjects had a low level of depression. The social support index score was 76. (2) Significant differences in TGDS scores existed for diabetes duration, diabetes complications, and treatment type. (3) Social support and regular exercise were significantly and negatively correlated with depression. (4) Social support and diabetes complications were significant correlates of depression and accounted for 25.9% of variance in depression. Conclusion Analytical results may assist nurses in understanding depression and related factors for diabetic patients aged ⩾65. Therefore, this study could form a basis for caring older people with diabetes, and provide a reference for further research.

Depression and related factors in elderly patients with occlusion stroke.

The purpose of this study was to examine depression and the related factors in elderly stroke patients. Purposive sampling was used to recruit 106 participants from the outpatients department (OPD) of a teaching hospital in Taipei. The major findings of this study were: (1) Twenty-nine stroke survivors (27.4%) and eight stroke survivors (7.5%) were classified as having mild depression and moderate to severe depression, respectively. (2) There was no significant difference or correlation between the depression score and demographic characteristics, chronic illness condition, or disease characteristics. The depression scores in " worrying about nothing " were significantly lower than the depression scores in " worrying about disease " (t = -4.03, p =.03). (3) There was no significant correlation between the depression score and the Mini-Mental State Examination score, or the Barthel Index score. (4) Social support and depression were negatively correlated (r = -.306, p =.001). (5) Multiple regression analysis revealed that " worrying about disease, " " worrying about family, " and informational support from family, relatives and friends accounted for 22.1% of the variance in depression. The implications for clinical practice and further studies are suggested.

Inverse association between daily activity and sleep activity and related factors in elderly patients with chronic obstructive pulmonary disease and bronchial asthma

To test the hypothesis that both daily activities and sleep quality may be mutually disturbed in elderly subjects with chronic obstructive pulmonary disease (COPD) or bronchial asthma (BA) and to determine factor(s) that relate to deterioration. Elderly subjects with chronic airflow obstruction (group R; n = 60), consisting of COPD and BA, were compared with subjects without respiratory symptoms (group C; n = 53). Both daily activities and sleep quality were assessed by force-gravity (GF) measurement using an accelerometer. The night study showed that both total sleeping period and frequency of GF in group R were increased significantly compared with group C. Subjects with BA showed fewer movements differing from those in COPD subjects. The daytime study indicated that the frequency of GF was greater in group C than in group R, suggesting reduced daily activities in group R. Subjects with BA showed more movement than COPD subjects. Hypercapnia was a significant factor causing COPD subjects to move more frequently during sleep and a decrease in peak flow rate was a significant factor in the reduction of movement during the day in subjects with BA. It is assumed that elderly subjects with COPD or bronchial asthma require a longer sleep period than subjects without respiratory symptoms because of the deterioration of sleep quality in the former group and the sleeping pattern differs between subjects with COPD and BA. Hypercapnia is considered a possible factor disturbing sleeping quality in COPD, whereas decreased peak expiratory flow rate is a factor reducing daytime activities in subjects with BA.