Symptoms In Elderly People Research Articles

Effect of horticultural therapy on static, dynamic balance and gait speed among institutionalized older adults with cognitive impairment.

Although horticultural therapy has been used successfully to reduce neuropsychiatric symptoms in elderly people with cognitive impairment, we do not yet know how it affects balance. The aim of our study was to determine the acceptability and effect of a 12-week horticultural therapy on balance and walking speed among institutionalized older adults with cognitive impairment. This mixed-methods controlled trial included 23 participants. Subjects in the experimental group (n=13) participated in a 60 min horticultural therapy programme twice a week for 12weeks in addition to the institution's usual social activities. Subjects in the control group (n=10) participated in the institution's usual social activities. Static and dynamic balance were measured with the Performance Oriented Mobility Assessment scale. In addition, gait speed was measured. Qualitative data were collected through a semi-structured interview with participants of the experimental group. At the end of the intervention period, the experimental maintained their baseline performance on the static balance, while the control group showed a decline. The gait speed of the experimental improved, while that of the control group did not change. In dynamic balance, no changes were demonstrated. The results of our qualitative data analysis indicate that horticultural therapy increases the possibility of social interactions, encourages older people to engage in conversation. As a conclusion, horticultural therapy should be more widely included in programmes for older people with cognitive impairment.

Integrated care program for patients with dementia and behavioural disorders in the home setting.

Introduction: Behavioural symptoms involve suffering and functional worsening of people with dementia, overburden their caregivers and increase emergency department visits, hospitalizations and early institutionalizations.
 Objectives And Who It Is For: To evaluate the results of an interdisciplinary intervention to improve the control of behavioural symptoms in elderly people with dementia receiving chronic care at home.
 Who We Involved And Engaged With: Representatives of general practitioners, home care specialists, geriatricians, psychiatrists, healthcare managers, and patients and families voice through claims and suggestions. The first pilot was adapted considering patients’ needs and acceptance.
 Materials And Methods (What We Did): before-after quasi-experimental study with own individual as control. Inclusion criteria: admission to the Home Medicine section between 06/01/2021 and 09/30/2022, age older than 64 years; and major cognitive impairment with behavioural disorders of complex management for the attending physician; or need for adequacy of psychotropic drugs during the transition of care for having suffered an acute confusional syndrome during hospitalisation. Exclusion criteria: history of psychosis or life expectancy of less than six months.
 Intervention: Provision of care by a health care team coordinated by a geriatrician via telemedicine, the home follow-up physician and a health and social care counsellor (comprehensive gerontological assessment). The geriatrician agreed on tailored interventions together with the patient's relatives or caregivers.
 The main outcome variable was changes in the score of the behavioural disorders subscale of the NPIq questionnaire administered by the geriatrician. The consumption of psychotropic drugs, standardised by defined daily doses (DDD) according to WHO, was also analysed.
 Results: 81 persons were included (72% women), mean age 89.5 years. Seventy percent lived in a private home and the remainder in care homes. At baseline, they had the following mean (SD) symptom intensity scores of: delirium 1.1 (2.7), hallucinations 1.3 (2.6), agitation-aggression 2.6 (4.3), depression 0.9 (2.9), anxiety 1.1 (3.0), euphoria-denial 0.1 (1.0), apathy 0.6 (2.3), disinhibition 0.3 (1.7), irritability 1.0 (2.7), motor disturbances 0.9 (2.7), nocturnal behaviours 2.2 (3.8), appetite-ingestion 0.3 (1.6), total intensity 12.5 (13.7). At baseline, 42.0% were taking benzodiazepines, mean DDD 19.9/100 patients. 
 After the intervention there was an average decrease of -7.6 points in the total NPIq scale (95%CI -10.0 to -5.1; p<0.001) and 50% of those taking benzodiazepines had discontinuation or dose decrease. without significant changes in other psychotropic drugs (only an increase in donepezil and memantine).
 Learnings: The integrated management program of elderly with dementia and behavioural disorders improved behavioural symptoms with decreased doses of BZD after the intervention.
 Next Steps: For scientific purposes, to perform a randomised controlled clinical trial. For local managerial purposes, to scale up the initiative to all eligible persons.

Urban-rural disparities of depression symptoms and its influencing factors among the elderly aged ≥65 years old in Anhui Province from 2019 to 2020

Objective: To analyze the difference in depression symptoms and influencing factors between urban and rural elderly people aged ≥65 years old in Anhui Province. Methods: Based on the data from a survey of 68 communities in Anhui Province that implemented the National Elderly Psychological Care Project from 2019 to 2020, the current status of depression symptoms in the elderly was evaluated using the Patient Health Questionnaire-9 (PHQ-9). The difference in the detection rate of depression symptoms between urban and rural elderly people with different characteristics was compared by using the χ2 test. The logistic regression model was used to analyze the relevant factors of depression symptoms in urban and rural elderly people. Results: A total of 15 532 elderly people aged≥65 years old were included in the survey. The detection rate of depressive symptoms was 7.12%, which was higher in rural areas (9.08%) than in urban areas (6.48%). Logistic regression showed that chronic diseases were risk factors for depressive symptoms in elderly people from both urban and rural areas. Positive attitudes towards aging and good mental resilience were protective factors for depressive symptoms in elderly people. Having hobby (OR=0.64, 95%CI: 0.45-0.91), good relationship with children (OR=0.56, 95%CI: 0.41-0.76), good relationship with spouse (OR=0.51, 95%CI: 0.37-0.71), and having at least 6 friends (OR=0.48, 95%CI: 0.32-0.71) were the protective factors for depressive symptoms in urban elderly people. A good relationship with neighbors (OR=0.58, 95%CI: 0.41-0.82) and having 1-2 friends (OR=0.40, 95%CI: 0.25-0.64) were the protective factors for depressive symptoms in rural elderly people. Women (OR=1.49, 95%CI: 1.06-2.10) and higher education level (OR=1.81, 95%CI: 1.19-2.74, compared with illiterate/semi-illiterate in primary school; OR=2.94, 95%CI: 1.82-4.76, compared with illiterate/semi-illiterate in junior high school and above) were the risk factors for depressive symptoms in rural elderly people. Conclusion: There are differences between urban and rural areas in depressive symptoms among elderly people in Anhui Province. The detection rate of depression symptoms among rural elderly people is higher, and the influencing factors of depressive symptoms between urban and rural elderly people are also different, which should be treated specifically in the implementation of intervention measures.

Chronic conditions and depressive symptoms in middle-aged and older Chinese adults: Roles of perceived social support and area of residence

BackgroundMany studies have shown that having noncommunicable chronic diseases (NCDs) is strongly associated with depressive symptoms in elderly people; however, the mechanisms of this association are not fully understood. This study aims to investigate whether perceived social support (PSS) mediates the effect of NCDs on depressive symptoms and whether these relationships differ depending on where middle-aged and elderly people live. MethodsThe study population was from the psychology and behavior investigation of Chinese residents (PBICR). A total of 8732 people aged 45 and older were included in the hypothetical modulated model. Perceived Social Support Scale (PSSS) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate PSS and depressive symptoms. ResultsNCDs were positively related to depressive symptoms (β = 0.81, p < 0.01) and indirectly mediated through PSS (β = 0.08). Residency moderated the relationship between NCDs and PSS (β = −0.16, p < 0.01) and between NCDs and depressive symptoms (β = 0.29, p < 0.01). Specifically, the effect of NCDs on PSS and depressive symptoms was greater in rural middle-aged and older adults. ConclusionsNCDs raise the risk of depressive symptoms in middle-aged and older Chinese, with PSS playing a partially protective role. In addition, the area of residence moderated the connection between the number of NCDs and PSS, NCDs, and depressive symptoms in middle-aged and older adults.

Efforts to Deal with Menopausal Symptoms in Elderly People with Yard Management

Menopause is a phase commonly experienced by women in their old age, which is in the form of the last menstrual bleeding. Symptoms of menopause must be understood by every woman as it is not impossible that they can experience depression while going through it. If the condition is not overcome or left alone, it will cause serious problems. Yard management can be an alternative to overcome menopause problems. In this research, this solution of yard management was offered to the partner audience, namely members of Aisyiyah Ranting Barenglor. The purpose of this service is to provide an understanding of menopause symptoms earlier. The solution offered was carried out by providing knowledge about yard land optimization as well as training on yard management so that it becomes more beautiful and comfortable to see. This activity was carried out at Aisyiyah Ranting Barenglor, North Klaten. The implementation of this activity is carried out through: 1) counseling on understanding of menopause symptoms and yard management, and 2) training on the cultivation of vegetable plants in polybags. Results showed that there was an increase in knowledge and understanding of menopausal symptoms by 29% and an increase in participants' knowledge and skills about yard utilization management by 33%. The enthusiasm and motivation of the participants really supported this activity allowing this activity to run smoothly

Individual-specific functional connectivity improves prediction of Alzheimer’s disease’s symptoms in elderly people regardless of APOE ε4 genotype

To date, reliable biomarkers remain unclear that could link functional connectivity to patients’ symptoms for detecting and predicting the process from normal aging to Alzheimer’s disease (AD) in elderly people with specific genotypes. To address this, individual-specific functional connectivity is constructed for elderly participants with/without APOE ε4 allele. Then, we utilize recursive feature selection-based machine learning to reveal individual brain-behavior relationships and to predict the symptom transition in different genotypes. Our findings reveal that compared with conventional atlas-based functional connectivity, individual-specific functional connectivity exhibits higher classification and prediction performance from normal aging to AD in both APOE ε4 groups, while no significant performance is detected when the data of two genotyping groups are combined. Furthermore, individual-specific between-network connectivity constitutes a major contributor to assessing cognitive symptoms. This study highlights the essential role of individual variation in cortical functional anatomy and the integration of brain and behavior in predicting individualized symptoms.

Negative symptoms and associated factors in older people with schizophrenia

IntroductionThe evolution of schizophrenia with age remains poorly studied. The prevalence of negative symptoms in elderly people with schizophrenia is even less described in the literature.Objectivesto evaluate the prevalence of remission of negative symptoms in the elderly and to study the sociodemographic and clinical variables associated with this remission.MethodsThe sample consisted of 83 subjects aged 55 years and over, followed at the psychiatry department "G" of the Razi hospital in Tunis and suffering from schizophrenia according to the DSM5 criteria. Global remission was defined as a score below 4 on the seven negative symptom items of the PANSS. A questionnaire was administered to each patient to collect epidemiological and anamnestic data.Results59% of the sample showed remission of global negative symptoms. 84% and 60% were in remission on the emotional and cognitive subscales, respectively. The existence of remission was correlated with lower PANSS global score, more preserved cognitive functioning, later age of onset, more family and social support, and the absence of a concomitant somatic illness.ConclusionsThis study showed that measures to optimize treatment of positive symptoms and cognitive functioning may have an impact on negative symptoms. Similarly, quality of social network in later life impacts the level of negative symptoms.Disclosure of InterestNone Declared

Longitudinal study on the Emotional Support Mechanism of the Mental Health of Empty Nesters

Background: With the gradual decline of the physiological functions of elderly people, "big events" in social roles and social relations such as widowhood, retirement, disability, etc. will have a major negative impact on their mental state, make them show mental depression and other conditions, people with severe symptoms may even choose to commit suicide. Objectives: Whether living alone or living only with a spouse is significantly related to the depression tendency of elderly people; Whether the high frequency of intergenerational meetings will alleviate the depression tendency of elderly people who live alone or only with their spouse; Whether social interaction will relieve the depression tendency of elderly people who live alone or only with their spouses; Whether there are significant urban-rural differences in the relationship between different living patterns and the depression tendency of the elderly, as well as the relationship between "visit home often", social interaction and depression tendency of the elderly. Methods: Taking mental depression as an example, this article uses the CHARLS data and OLS regression model to analyze the correlation between different living patterns and depression tendency in urban and rural areas, and introduce the interaction effect analysis of intergenerational meeting frequency variable "visit home often" to explain its mechanism. Results: The elderly people living alone or living only with a spouse do have a high tendency to depression, and the depression tendency of living alone is more obvious; “visit home often” can effectively reduce the depression tendency of elderly people living alone or living only with a spouse. Social interaction has a weaker influence on the mental depression of elderly people; The elderly people living alone or living only with a spouse in rural areas have a higher tendency to depression. And "visit home often" is more obvious to reduce the mental depression of the elderly living alone or living only with a spouse in urban areas. Main Contribution to Evidence-Based Practice: The article puts together the recent evidence about the effect of empty nest on depression symptom in Elderly People；compares the impact of urban-rural differences；explores the mechanism of intergenerational frequency of interaction between residential patterns and depression.

Mediating role of functional limitations in the association of urinary incontinence with depressive symptoms among middle-aged and older adults: The English Longitudinal Study of Aging

ObjectiveTo investigate the association of urinary incontinence with depressive symptoms, and to explore the mediating effect of functional limitations on this association. MethodsThis cross-sectional study included 7039 adults aged 50 and over from the English Longitudinal Study of Aging (Wave 8). Urinary incontinence was defined as whether the participants experienced urinary incontinence in the past 12 months. Depressive symptoms were assessed based on the Center for Epidemiologic Studies-Depression Scale. Functional limitations included disability of activities of daily living, instrumental activities of daily living, mobility and large muscle groups limitation of the participants. Logistic regression based on Karlson/Holm/Breen (KHB) method was applied to estimate the association of urinary incontinence with depressive symptoms and explore the mediating effect of functional limitations. ResultsUrinary incontinence was significantly associated with increased risk of depressive symptoms after controlling covariates (odds ratio = 1.75, 95 % confidence interval: 1.45–2.11). Functional limitations explained 36.96 % of this association. ConclusionUrinary incontinence might be associated with an increased risk of depressive symptoms among middle-aged and older adults and functional limitations partially mediate this association. Improving physically functional capacity might play an important role in preventing and managing depressive symptoms in elderly people with urinary incontinence.

Longitudinal Causal Inference of Cognitive Function and Depressive Symptoms in Elderly People

Objective: the association between depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) and subsequent cognitive function (Mini-Mental State Examination [MMSE]) is equivocal in literature. To examine the causal relationship between them, we use longitudinal data on MMSE and CESD and causal inference to illustrate the relationship between two health outcomes.&#x0D; Method: Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Participants included 3050 noninstitutionalized Mexican Americans aged 65 and older followed from 1993-2001. Cognitive function and depressive symptoms were assessed using the MMSE and CESD at baseline and at 2, 5, and 7 years of follow-up. Independent variables were sociodemographics, CESD, medical conditions. Marginal structural causal models were employed to evaluate the extent to which cognitive function depend not only on depressive symptoms measured at a single point in time but also on an individual’s entire depressive symptoms history.&#x0D; Discussion: our results indicate that if intervention to reduce 1 points of depressive symptoms were made at two years prior to assessing cognitive function, they would result in average improvement in cognitive function of 0.12, 95% CI [0.06, 0.18],P&lt;.0001. Conclusion: The results suggest that health intervention of depressive symptoms would be useful in prevention of cognitive impair.

Physical exercise as a non-pharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials.

Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.

Effects of Hearing Impairment, Quality of Life and Pain on Depressive Symptoms in Elderly People: A Cross-Sectional Study.

Reduction of the incidence of depression and improvement of quality of life (QOL) of elderly people have become important subjects. Various factors are related to depressive symptoms in elderly people, and sensory impairment is a key to health, QOL, and depressive symptoms. In this cross-sectional study, a visual acuity test and audiometry were used to examine the relationships of visual and hearing impairment and other factors with depressive symptoms in elderly people. A group of 490 community-dwelling people aged over 65 years old underwent vision and hearing tests, the Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination (MMSE), and questionnaires on social isolation, QOL, and physical condition. Logistic regression analysis was used to examine factors affecting CES-D. Multivariate logistic regression analysis indicated that hearing impairment, pain score, and satisfaction with human relationships and activities of daily living (ADL) were independent predictors of CES-D scores. Satisfaction with human relationships and ADL can reduce depressive symptoms in elderly people. Hearing impairment, pain, and social contact are also important. Therefore, improvement of social networks, interpersonal relationships, ADL, and hearing impairment may be effective in improving these symptoms in elderly people.

Relationship between sleep duration and depressive symptoms in middle-aged and elderly people in four provinces of China

Objective: To explore the relationship between sleep duration and depressive symptoms in middle-aged and elderly people. Methods: A total of 11 931 middle-aged and elderly people aged ≥55 years who participated in the baseline survey of the "Community Cohort Study of Specialized Nervous System Diseases" in China from 2018 to 2019 were selected to obtain basic information about their lifestyle, food intake frequency, disease history, sleep duration. The body height and weight were measured, and body mass index (BMI) were calculated. The subjects with depressive symptoms were screened with the Geriatric Depression Scale (GDS-30). Restricted cubic spline model and multivariate logistic regression model were used to analyze the relationship between sleep duration and depressive symptoms. Results: Among the middle-aged and elderly people aged ≥55 years, 17.79% reported sleep duration less than 7 hours, 16.84% reported that their sleep duration ≥9 hours, and the detection rate of depression symptoms was 7.95%. After adjusting for factors such as region, age, gender, the restricted cubic spline results showed the U-shaped relationship between sleep duration and the risk for depressive symptoms, the results of multivariate logistic regression analysis showed that the risk for depressive symptom in middle-aged and elderly people aged ≥55 years with sleep duration ≤5 hours, 6 hours, and ≥9 hours were 1.749(95%CI:1.279-2.392), 1.284(95%CI:1.021-1.615) and 1.260(95%CI:1.033-1.538) times higher compared with the counterparts with sleep duration 7-8 hours, the risk for depressive symptom in women with sleep duration ≤5 hours, 6 hours and ≥9 hours were 2.115 (95%CI:1.473-3.038), 1.605(95%CI:1.213-2.123) and 1.313(95%CI:1.011-1.705) times higher, respectively, compared with counterparts with sleep duration 7-8 hours, the risk for depressive symptoms in 55-64-year-old middle-aged and elderly people with sleep duration ≤5 hours and ≥9 hours were 1.806 (95%CI:1.014-3.217) and 1.478 (95%CI:1.060-2.061) times higher compared with counterparts with sleep duration 7-8 hours, and the risk for depressive symptoms in elderly people aged 65-74 years with sleep duration ≤5 hours was 2.112 (95%CI:1.327-3.361)times higher compared with counterparts with sleep duration 7-8 hours, the differences were all significant (P<0.05). There was no statistically significant association between sleep duration and depressive symptoms in men and in elderly people aged ≥75 years (P>0.05). Conclusion: Insufficient or prolonged sleep was independently associated with depressive symptoms in middle-aged and elderly people, showing a U-shaped relationship, especially in women and in middle-aged and elderly people aged 55-64 years.

Association of 25(OH)D Serum Level with Degree of WOMAC Index in Elderly Female Patients with Knee Osteoarthritis at KPKM FK UIN Jakarta

Background. Osteoarthritis (OA) is a chronic, progressive, degenerative disease which incidence increase with age dan occured majority in female. Pain in OA occurs due to accumulative process of degradation, repairment, and inflammation that causes symptoms of pain accompany with decrease in joint activity and function. These symptoms in elderly people, count about 9,8% of Indonesian population in 2020 which is muslim in majority, often causing complaints of difficulties to perform certain movements in shalat. Vitamin D is a nutritional factor which is known from several research wouldinhibit progressive joint destruction and relief of painful symptoms. And may have an important role to prevent the progressive process of the disease, thus promising to help the elderly to perform the shalat without knee joint problems. Objectives. The research’s objective was to determine the association between 25(OH)D serum level and the degree of WOMAC index of pain, stiffness, and functionality of knee OA in elderly female patients at Public Health Clinics (KPKM) Faculty of Medicine, Syarif Hidayatulloh State Islamic University of Jakarta (FK UIN Jakarta). Methods. The research used analytic Cross-Sectional design, with 106 elderly female as respondents, whose pain degree, stiffness, and functionality were measured using the WOMAC questionnaire of Knee OA and 25(OH)D serum level wasexamine. Results. Chi Square Fisher statistical analysis showed that there is no significant statistical association found (p 0,689) between 25(OH)D serum level and the degree of WOMAC index of knee OA in elderly female patients at KPKM FK UIN Jakarta. Conclusion. There is no significant statistical association found between serum vitamin D level and degree of WOMAC index of knee OA in elderly female patients at KPKM FK UIN Jakarta

Depressive symptoms in elderly people participating in University of the Third Age and residents of Nursing Homes: the role of optimism and acceptance of passing

The elderly age group needs particular support in preventing development of depressive symptoms, among others, due to the prospect of passing. This group is heterogenous in terms of characteristics of ways of spending leisure time, which, as an important aspect of everyday life affecting the quality of interpersonal relationships and well-being, might be related to the level of their depressive symptoms. The aim of this study was to find out whether participation in University of Third Age (UTA; leisure time spending directed at personal development) activities versus being a Nursing Home resident (NH; leisure time spending, directed at compensation of difficulties associated to the aging process) may differentiate elderly people in terms of the level of depression taking into account their optimism and acceptance of passing. The study was paper-pencil questionnaire-based, conducted on a sample of people above the age of 59: participants of UTA (N=48) and NH (N=54). In the UTA group, consistently for all levels of acceptance of passing, the higher the level of optimism, the lower the depressive symptoms. However, for the NH group, the higher the acceptance of passing, the lower the role of optimism in predicting depressive symptoms.

Analysis of the Effects of Coordination Program Viva 2 Parkinson (CoVi2) on Dynamic Balance, Muscle Parameters, and Symptomatology in Older Adults Diagnosed With Advanced Stages of Parkinson's Disease

There is evidence to suggest that assisted cycling can effectively improve the motor function of patients with Parkinson's disease (PD) and an assisted cycling intervention is more beneficial for those with more advanced PD. Therefore, the aim of this study was to investigate the influence of an intervention with a coordination program at MOTOmed Viva 2 Parkinson on dynamic balance, muscle parameters, and symptoms in elderly people diagnosed with advanced stages of PD. We studied 4 elderly people with PD in advanced stages. We evaluated PD symptomatology using the adapted Spanish version of the MDS-UPDRS (Movement Disorder Society Unified Parkinson's Disease Rating Scale); dynamic balance was evaluated by means of the Timed Up and Go (TUG) and the MOTOmed Viva 2 Parkinson system stores data about muscle tone, symmetry, coordination, and spasms, in each of the sessions undertaken. We found that a 21-minute coordination training in 13 sessions with the MOTOmed device demonstrates positive effects on muscle tone, spasms, coordination, symmetry, and balance in older adults diagnosed with advanced stages of PD.

A enfermagem frente às manifestações clínicas da depressão em idosos que sofreram abandono: revisão integrativa da literatura

Objetivo: Mapear o processo de enfermagem, com ênfase nas intervenções de enfermagem, do cuidado ao idoso em contexto de abandono e acometido a depressão. Métodos: Este estudo consiste numa Revisão Integrativa da Literatura. Foi realizada pesquisa nas bases de dados Scientific Electronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), utilizando-se a combinação de descritores em idioma português segundo consulta aos Descritores em Ciências da Saúde (DeCS). Para apoiar a análise dos dados, foi utilizado o software IRAMUTEQ e para o processamento de dados utilizou-se a Classificação Hierárquica Descendente (CHD). Resultados: A qualidade de vida não está restrita somente ao físico, mas também ao social. Verificou-se a prevalência de sintomas depressivos em idosos que foram institucionalizados e com isso perderam a convivência com a comunidade. Dessa forma o abandono favorece a aquisição de sintomas depressivos no idoso, por conta do sentimento de solidão. Considerações finais: Há poucas referências correlacionando o processo de enfermagem com a população idosa acometida de quadros de transtorno psicológico. Sendo necessário o desenvolvimento de estudos visando promover intervenções de enfermagem ao cuidado do idoso.

Association Between Upper-Extremity Health Condition and Depressive Status in an Elderly General Population.

Background: This study was designed to investigate whether psychological status is associated with upper-extremity health status in an elderly general population. Methods: Using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand (QuickDASH-JSSH), we evaluated 200 Japanese elderly people (76 men, 124 women; mean age, 71.6 years, 60-98 years) to assess their upper-extremity-specific health status. Each had completed a self-administered questionnaire including gender and dominant hand items. As an indicator of hand muscle function, we measured their bilateral hand grip. Study participants were assessed for depressive symptoms using the Geriatric Depression Scale Short-Japanese Version (GDS-S-J). Statistical analyses were applied to clarify associations between self-assessed upper-extremity dysfunction and screening results for depressive symptoms in an elderly general population. Results: Those reporting no complaint of an upper extremity were 72 (36 men and 36 women) (36.0%). The GDS-J score was found to have significant positive correlation with age (r = 0.20, P= 0.0045) and the QuickDASH score (r = 0.25, P = 0.0004). The GDS-J score was found to have significant negative correlation with dominant grip (r = −0.15, P = 0.04) and non-dominant grip strength (r = −0.21, P = 0.004). For all participants, multiple regression analysis revealed the QuickDASH score as associated with the GDS-J score. Conclusion: Self-administered upper-extremity health condition as assessed using QuickDASH is correlated with depressive symptoms in elderly people. Objective pathophysiology and subjective illness behavior must be identified in daily clinical practice. A biopsychosocial approach must be used when advising and treating patients.

447 - Risk factors associated with sleep disturbance in a general elderly Japanese population: The Arao Cohort Study

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.

Thymic rejuvenation via FOXN1-reprogrammed embryonic fibroblasts (FREFs) to counteract age-related inflammation.

Age-associated systemic, chronic inflammation is partially attributed to increased self-autoreactivity, resulting from disruption of central tolerance in the aged, involuted thymus. This involution causally results from gradually decreased expression of the transcription factor FOXN1 in thymic epithelial cells (TECs), whereas exogenous FOXN1 in TECs can partially rescue age-related thymic involution. TECs induced from FOXN1-overexpressing embryonic fibroblasts can generate an ectopic de novo thymus under the kidney capsule, and intrathymic injection of naturally young TECs can lead to middle-aged thymus regrowth. Therefore, as a thymic rejuvenation strategy, we extended these 2 findings by combining them with 2 types of promoter-driven (Rosa26CreERT and FoxN1Cre) Cre-mediated FOXN1-reprogrammed embryonic fibroblasts (FREFs). We engrafted these FREFs directly into the aged murine thymus. We found substantial regrowth of the native aged thymus with rejuvenated architecture and function in both males and females, exhibiting increased thymopoiesis and reinforced thymocyte negative selection, along with reduced senescent T cells and autoreactive T cell–mediated inflammation in old mice. Therefore, this approach has preclinical significance and presents a strategy to potentially rescue decreased thymopoiesis and perturbed negative selection to substantially, albeit partially, restore defective central tolerance and reduce subclinical autoimmune symptoms in elderly people.