Background: The Elderly Posyandu (integrated healthcare center) at the Sinoa Community Health Center in Bantaeng has an important role in maintaining the quality of life of the elderly in the ...community. Apart from providing health services, this smallest service unit will also facilitate various non-medical activities so that the elderly have a place to work and be active.
Purpose: This is the researchers' idea to examine whether there is an influence of the Elderly Posyandu program on the quality of life of the elderly in the Sinoa sub-district, Bantaeng.
Methods: This study used a quantitative method with a cross-sectional design. The population of this study was 210 elderly with a total sample of 136 elderly selected by means of proportional stratified random sampling. Data collection was carried out by means of interviews using a questionnaire. The collected data were analyzed using the path analysis test.
Results: Results of path analysis, where the independent variable (predictor) is the Elderly Posyandu variable include extension (X1) and elderly gymnastics (X2), the mediation variable is the elderly health (Y), and the dependent variable (response) is the quality of life of the elderly (Z), show that periodic medical check-up (X3) through the elderly health variable (Y) has the greatest indirect influence on the quality of life of the elderly in the Sinoa sub-district, Bantaeng.
Conclusion: Posyandu management for the elderly is very important because it will affect the quality of life of the elderly. The management in question includes the elderly Posyandu program.
Background Many physicians are reluctant to treat elderly glioblastoma (GBM) patients as aggressively as younger patients, which is not evidence based due to the absence of validated data from ...primary studies. We conducted a meta-analysis to provide valid evidence for the use of the aggressive combination of radiotherapy (RT) and temozolomide (TMZ) in elderly GBM patients. Methods A systematic literature search was conducted using the PubMed, EMBASE and Cochrane databases. Studies comparing combined RT/TMZ with RT alone in elderly patients ( greater than or equal to 65 years) with newly diagnosed GBM were eligible for inclusion. Results No eligible randomized trials were identified. Alternatively, a meta-analysis of nonrandomized studies (NRSs) was performed, with 16 studies eligible for overall survival (OS) analysis and nine for progression-free survival (PFS) analysis. Combined RT/TMZ was shown to reduce the risk of death and progression in elderly GBM patients compared with RT alone (OS hazard ratio HR 0.59, 95% confidence interval CI 0.48-0.72; PFS: HR 0.58, 95% CI 0.41-0.84). Evaluable patients were reported to tolerate combined treatment but certain toxicities, and especially hematological toxicities, were more frequently observed. Limited data on O6-methylguanine-DNA methyltransferase (MGMT) promoter status and quality of life were reported. Conclusion The meta-analysis of NRSs provided level 2a evidence (Oxford Centre for Evidence-Based Medicine) that combined RT/TMZ conferred a clear survival benefit on a selection of elderly GBM patients who had a favorable prognosis (e.g., extensive resection, favorable KPS). Toxicities were more frequent but acceptable. Future randomized trials are warranted to justify a definitive conclusion.
Abstract One of the leading causes of morbidity and premature mortality in older people is frailty. Frailty occurs when multiple physiological systems decline, to the extent that an individual's ...cellular repair mechanisms cannot maintain system homeostasis. This review gives an overview of the definitions and measurement of frailty in research and clinical practice, including: Fried's frailty phenotype; Rockwood and Mitnitski's Frailty Index (FI); the Study of Osteoporotic Fractures (SOF) Index; Edmonton Frailty Scale (EFS); the Fatigue, Resistance, Ambulation, Illness and Loss of weight (FRAIL) Index; Clinical Frailty Scale (CFS); the Multidimensional Prognostic Index (MPI); Tilburg Frailty Indicator (TFI); PRISMA-7; Groningen Frailty Indicator (GFI), Sherbrooke Postal Questionnaire (SPQ); the Gérontopôle Frailty Screening Tool (GFST) and the Kihon Checklist (KCL), among others. We summarise the main strengths and limitations of existing frailty measurements, and examine how well these measurements operationalise frailty according to Clegg's guidelines for frailty classification — that is: their accuracy in identifying frailty; their basis on biological causative theory; and their ability to reliably predict patient outcomes and response to potential therapies.
We estimate the causal effects of acute fine particulate matter exposure on mortality, health care use, and medical costs among the US elderly using Medicare data. We instrument for air pollution ...using changes in local wind direction and develop a new approach that uses machine learning to estimate the life-years lost due to pollution exposure. Finally, we characterize treatment effect heterogeneity using both life expectancy and generic machine learning inference. Both approaches find that mortality effects are concentrated in about 25 percent of the elderly population.
The following article presents the theoretical model of strength and vulnerability integration (SAVI) to explain factors that influence emotion regulation and emotional well-being across adulthood. ...The model posits that trajectories of adult development are marked by age-related enhancement in the use of strategies that serve to avoid or limit exposure to negative stimuli but by age-related vulnerabilities in situations that elicit high levels of sustained emotional arousal. When older adults avoid or reduce exposure to emotional distress, they often respond better than younger adults; when they experience high levels of sustained emotional arousal, however, age-related advantages in emotional well-being are attenuated, and older adults are hypothesized to have greater difficulties returning to homeostasis. SAVI provides a testable model to understand the literature on emotion and aging and to predict trajectories of emotional experience across the adult life span.
In recent years the life expectancy in elderly patients with CML has approached that of the age-matched population and is similar to younger patients. In this study, we characterized and assessed the ...outcome of patients 75 years and older diagnosed with CML.
A multicenter, retrospective study of consecutive patients diagnosed in Israel and the Moffitt cancer center in Florida, United States (MCC) with CML at the age of ≥ 75 years. The 1- and 5-year overall survival (OS) were calculated. Event-free survival (EFS) was defined as death, progression, or a switch to 2nd line treatment due to intolerance or resistance to 1st line therapy. We estimated the median OS of the whole cohort at the time of CML diagnosis, hereafter termed expected OS, using the life expectancy according to the central bureau of statistics (CBS). The expected and the observed median OS were plotted using Kaplan-Meier curves and were compared using Log-rank analysis. The study was approved by the local Institutional Review Boards.
A total of 123 patients aged ≥ 75 years were diagnosed with CML between 2000 and 2022. The median age was 79 (range: 75 - 100) years. The median observed OS for the whole cohort was 48.5 (2.2-195) months compared to a median of 112 (27.6-150) months expected OS. OS and EFS were compared between patients receiving Imatinib vs. 2nd generation TKIs as 1st line treatment. OS was worse (71 months vs. not reached, P=0.021) for the group treated with imatinib in 1st line. EFS was similar between these groups (15 vs. 18 months, P=0.535).
According to the observed OS, life expectancy was shortened in elderly patients with CML. Noteworthy, compared to patients receiving 2nd generation TKI in 1st line treatment, patients receiving Imatinib had worse OS but similar EFS. An explanation of this result could be due to physician discretion due to comorbidities or insurance issues.
Modern society is experiencing an accelerated increase in the number of elderly people, to the detriment of children and young adults, in the context of declining birth rates, high adult mortality ...and increasing life expectancy due to advances in medicine. Cardiovascular diseases are becoming more common in the general population, representing the leading cause of death, being responsible for a third of the total number of deaths worldwide, and heart failure is the most common cause of hospitalization in patients over 65 years. Depression is one of the most common mental illnesses, presents different clinical pictures, which vary from person to person and in relation to age, being shown that there are somatic disorders due to depression, including cardiovascular disease.
We studied 127 patients hospitalized in the Geriatrics Department of the Calarasi County Emergency Hospital, diagnosed with heart failure (HF), being divided into 2 groups: the first group, which included 63 patients with heart failure with mildly reduced ejection fraction and the second, which included 64 patients with heart failure with preserved ejection fraction.
The main risk factor present in the studied patients was dyslipidemia, which is present in 90% of patients with a mildly ejection fraction and in 88% of patients with a preserved ejection fraction. Hypertension was also present in 75% of patients in the first group and in 63% of those in the second group. Depression was present in 67% of patients with mildly reduced ejection fraction and in 64% of those with preserved ejection fraction. The degree of depression was higher among women, 11% of those with HF with mildly reduced ejection fraction and 14% of those with preserved ejection fraction had major depression. The degree of depression increases with age, patients over 80 years presented predominantly moderate-severe depression (41% of patients in the first group, and 50% in the second). Patients with NYHA class III heart failure had predominantly moderate-to-severe depression: 50% of patients with mildly reduced ejection fraction and 67% of those with preserved ejection fraction.
Depression is an important independent risk factor for heart failure in the elderly patients. Due to the fact that the symptoms of the two pathologies are often similar, the diagnosis of depression can be difficult to make, which is why it should be investigated in all patients with heart failure. It is important to understand the peculiarities of the polypathology of the elderly, which often poses problems for the diagnosis and treatment of the clinician.
to determine the prevalence of three independent, disability-free and operationally defined frailty phenotypes and the associated risk of mortality in a community-dwelling older people cohort over 74 ...years of age.
observational, prospective and population-based design. Bio-psycho-social variables were assessed using a range of standardised instruments. The physical frailty phenotype (PFP), mental frailty phenotype (MFP) and social frailty phenotype (SFP) were operationally defined using a deficit accumulation model that excluded disability. Logistic regression analyses explored associations of the frailty phenotypes with sex, age and marital status, and a Cox proportional hazard regression analysis was performed to evaluate the association between frailty phenotypes and mortality.
of the eligible individuals, 82% (n = 875) participated. The prevalence of any frailty phenotype in an individual was 38.8%; 17.3% exhibited the PFP, 20.2% exhibited the MFP, and 8.9% exhibited the SPF. Older and female were more likely to exhibit the PFP, and widowhood was associated with the SFP. The hazard ratios of mortality were 3.09 (95% CI = 1.54-6.17) for the PFP and 2.69 (95% CI = 1.01-7.25) for the SFP.
three different disability-free frailty phenotypes were differentially related to the socio-demographical characteristics of sex, age and marital status and independently predicted risk of mortality.
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