ObjectiveTo systematically review the correlation between sleep quality and social support of the elderly.MethodsDatabases including PubMed, MEDLINE, The Cochrane Library, Springerlink, ProQuest, CMB, CNKI, VIP, and WanFang Data were searched to collect studies on the correlation between sleep quality and social support of the elderly from January 1996 to January 2020. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 studies involving 2 427 elderly people were included. The meta-analysis showed that the combined correlation coefficient between sleep quality and social support was -0.40 (95%CI −0.54 to −0.26). The correlation between sleep quality and social support of the elderly varied with the year of publication and sample size, however without regular change. The correlation coefficient of the elderly from institutions (hospital or pension institutions) was higher than that of the community (−0.33 vs. −0.26); the correlation coefficient of the elderly with health problems was higher than those without health problems (−0.32 vs. −0.25); the results measured by non-random sampling method were higher than those measured by random sampling (−0.37 vs. −0.23); and the results measured by Pittsburgh sleep quality index (PSQI) and social support rating scale (SSRS) were higher than those measured by PSQI and perceived social support scale (PSSS) (−0.30 vs. −0.13).ConclusionsThe higher the level of social support of the elderly in China, the lower the score of PSQI, and the better the sleep quality, in which there are differences in different sample sources and physical conditions.
Objective To evaluate the safety and efficacy of laparoscopic-assisted gastrectomy (LAG) comparing with conventional open gastrectomy (COG) in elderly patients with gastric cancer. Methods Databases included PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP were searched to collect the case-control studies about LAG versus COG for elderly patients with gastric cancer, and the searched time was from inception to May 2017. Then meta-analysis was performed by using RevMan 5.2 software. Results Finally, ten case-control studies included 1 522 patients were enrolled. There were 757 patients in observation group (underwent LAG) and 765 patients in control group (underwent COG). Results of meta-analysis showed that: the observation group was associated with less intraoperative blood loss ［MD=–121.12, 95% CI was (–179.93, –62.31), P<0.000 1］, more harvested lymph nodes ［MD=1.62, 95% CI was (0.60, 2.65), P=0.002］, shorter time to the first ambulation ［SMD=–2.58, 95% CI was(–4.58, –0.58), P=0.01］, shorter the postoperative intestinal function recovery time ［SMD=–0.85, 95% CI was (–1.20, –0.51), P<0.000 01］, shorter the time of oral intake ［MD=–0.90, 95% CIwas (–1.27, –0.52), P<0.000 01］, shorter hospital stay ［MD=–4.03,95% CI was (–5.62, –2.44), P<0.000 01］, lower incidences of overall postoperative complications ［OR=0.49, 95% CI was (0.38,0.64), P<0.000 01］, surgical-related complications ［OR=0.54, 95% CI was (0.39, 0.74), P=0.000 1］, incision relatedcomplications ［OR=0.42, 95% CI was (0.22, 0.81), P=0.010］, and respiratory complications ［OR=0.60, 95% CI was (0.38, 0.95), P=0.03］, but there was no significant difference on the operative time ［MD=8.36, 95% CI was (–10.97, 27.69), P=0.40］ and incidence of anastomotic fistula ［OR=0.60, 95% CI was (0.27, 1.31), P=0.20］. Conclusions The available evidences suggest that LAG is equally safe and feasible compared with COG, it has a significant advantages in reducing intraoperative blood loss and ensuring the number of lymph node dissected during surgery, with less trauma, shorter postoperative hospital stay, lower overall postoperative complications rate, and other short-term efficacy advantages.
ObjectiveTo analyze the effects of alcohol consumption on oral flora of middle-aged and elderly men from the core area of southwestern China, and explore the relationship between excessive-alcohol-consumption-related flora and alcohol-related cancer.MethodsFrom March to June 2018, saliva samples of target subjects were collected for 16S ribosomal RNA gene sequencing, and a questionnaire survey which took drinking history of each participant as the target variable was conducted. According to the amount of alcohol consumed, the subjects were divided into non-drinking group, moderate-drinking group, and excessive-drinking group. The microbial analysis of α diversity, analysis of group difference of oral flora abundance, bacterial function prediction, and receiver operating characteristic (ROC) curve model prediction were carried out.ResultsA total of 59 subjects were included. There were 23 cases (39.0%) in the non-drinking group, 23 cases (39.0%) in the moderate-drinking group, and 13 cases (22.0%) in the excessive-drinking group. The average age was (61.90±8.85) years. Excessive drinking increased the abundance of oral flora (P<0.05), and could change the abundance of specific genus such as Peptostreptococcus and TM7［G-6］ (P<0.05) and regulate cancer-related pathways (P<0.05). ROC analysis found that a panel of three genus oral bacteria such as TM7［G-6］ might effectively distinguish the non-drinking group from the excessive-drinking group (area under curve=0.915).ConclusionsGenus of Peptostreptococcus and TM7_［G-6］ are the potential oral flora biomarkers for the excessive-drinking of target subjects. Some excessive drinking-related flora are closely related to oral cancer.
ObjectivesTo examine the cognitive performance among the elderly and associated influencing factors.MethodsUsing data from the six issues of Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 1998 to 2011, selecting adults aged 80 years or above, multilevel hierarchical model was utilized to estimate the trend of the elderly's cognitive performance and its influencing factors.ResultsA total of 128 cases were studied. The descent in MMSE was not significant with the growth of age (P=0.834). Female's MMSE scores were lower than male's (P=0.011) and descended quicker (P=0.015). Furthermore, ADL status and level of leisure activity were significantly related to the cognitive performance of both male and female (P<0.05).ConclusionsParticipation in leisure activities were the crucial protective factor for cognitive performance. It's recommended that measures be taken respectively for elderly males and females, and policies be stressed to enhance their cognitive performance, thus to guarantee their healthy aging.
ObjectiveTo investigate the clinical effect and prognosis of laparoscopic complete mesocolic resection (CME) in the treatment of elderly patients with stage Ⅲ right colon cancer.MethodsClinical data of 280 elderly patients (aged 60 years or older) who underwent stage Ⅲ right hemicolectomy in the First Hospital of Lanzhou University from 2010 to 2015 were collected. Among them, 160 patients underwent laparoscopic CME treatment were set as the observation group, and 120 patients underwent conventional laparotomy were set as the control group. The mean operative time, intraoperative blood loss, postoperative first anal exhaust time, number of lymph nodes dissection, number of positive lymph nodes, length of hospital stay and postoperative complications were compared between the two groups. The postoperative local recurrence rate, distant metastasis rate, 3-year cumulative survival rate and postoperative recurrence risk factors were analyzed.ResultsThere were no statistically significant differences between the observation group and the control group in operative time, number of lymph node dissection, number of positive lymph nodes and postoperative distant metastasis rate (P>0.05). The amount of intraoperative blood loss, postoperative anal first exhaust time, days of hospitalization, and postoperative recurrence rate in the observation group were less or shorter or lower than those in the control group, with statistically significant differences (P<0.05). The 3-year survival rate in the observation group was higher than that in the control group (log-rank χ2 =11.865, P=0.001), and the disease free survival in the observation group was also higher than that in the control group (log-rank χ2=7.567, P=0.006). Logistic regression was used to analyze the cases of postoperative recurrence in the two groups, and it was found that the degree of tumor differentiation, vascular invasion and lymph node metastasis were independent risk factors for postoperative tumor recurrence.ConclusionLaparoscopic CME in the treatment of elderly patients with stage Ⅲ right colon cancer is effective, it is safe and feasible, which can effectively prolong the survival time of patients.
ObjectivesTo investigate and analyze the activities of daily living status and influencing factors for the elderly of long-term care in Shangrao City of Jiangxi Province, and provide a basis for Shangrao City to carry out long-term care insurance for the elderly. MethodsCluster sampling was used to investigate the elderly aged 60 and over in 12 counties (cities, districts)of Shangrao, including the elderly general demographic characteristics and activity of daily living survey. ResultsA total of 1 087 elderly people were surveyed, with an average age of 77.75±8.12 and a total 70.6±21.4 score of activity of daily living. Comparing different age groups, the elder age group had a worse activity of daily living (P<0.001). Those with a higher education level had relatively poor activity of daily living (P<0.001), and those with spouse also had poor activity of daily living (P<0.05). Multiple linear regression analysis showed that age (P<0.001), education level (P<0.001), marital status (P<0.05) and income level (P<0.05) were important factors affecting the scores of activity of daily living of the elderly. ConclusionsAge, education level, marital status, low-income situation, chronic disease, and household registration are the main risk factors affecting the score of the long-term care of the elderly in daily life. The establishment of a long-term care insurance system should be based on chronic diseases, age, marital status and other factors to determine the corresponding long-term care standard scoring system and compensation standards.
Objective To explore the efficacy of endovascular therapy in elderly patients with acute ischemic stroke. Methods The acute ischemic stroke patients who received endovascular therapy between January 2020 and January 2023 were retrospectively enrolled. According to age, patients were divided into the elderly group (≥ 80 years old) and other age groups (<80 years old). The baseline data, green channel data, nerve function deficit, recanalization and complication information were collected, and the patients were followed up. Modified Rankin Scale (mRS) was used to evaluate patients prognosis at 3 months after onset. Score less than or equal to 2 points was defined as good prognosis and over 2 points was defined as poor prognosis. Results A total of 138 patients were included, and 7 patients were lost to follow-up. Finally, 131 patients were included. Among them, there were 50 cases in the elderly group and 81 cases in the other age group. There were statistically significant differences in age, hypertension, atrial fibrillation, and vascular recanalization between the elderly group and the other age group (P<0.05). There was no statistically significant difference in the other baseline data, complications, 3-month prognosis, or mortality between the two groups (P>0.05). The results of multivariate logistic regression analysis showed that the National Institute of Health Stroke Scale score at admission [odds ratio (OR)=1.150, 95% confidence interval (CI) (1.033, 1.281), P=0.011], pulmonary infection [OR=2.933, 95%CI (1.109, 7.758), P=0.030], and hypoproteinemia [OR=3.716, 95%CI (1.226, 11.264), P=0.020] affected the mRS score at 3 months after onset. Conclusions Among the patients with acute ischemic stroke undergoing endovascular therapy, there is no difference in the occurrence of complications or short-term prognosis between elderly patients and other age patients. However, the attention should still be paid to reducing the occurrence of complications in patients, strengthening their nutritional support, and thereby improving their prognosis.
Objective To summarize the tumor characteristics and the research progress in diagnosis and treatment of elderly patients with breast cancer. Methods To combine the literature review and clinical guidelines, to introduce tumor characteristics, the advance of diagnosis and therapy and expert consensus in elderly breast cancer. Results Compared to the patients in other age group, the elderly patients with breast cancer have special physiological and psychoical characteristics, meanwhile aged patients frequently together with basic disease, the strategy of clinical diagnosis and treatment and prognosis are very different from young and middle-aged patients. Conclusion For the elderly patients with breast cancer, we should formulate the corresponding treatment plan on the premise of the comprehensive evaluation of patients’ life expectancy, with the disease, the degree of benefit, treatment tolerance and other factors.
To observe the effects of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and postoperative cognitive dysfunction (POCD) of elderly patients, we collected 80 elderly patients undergoing selective coronary artery bypass graft under cardiopulmonary bypass. The Mini Mental State Examination (MMSE) was applied to test the cognitive function. The SjvO2, Da-jvO2 and CEO2 were used for the analysis of the cerebral oxygen metabolism. We found that POCD was related to disequilibrium of cerebral oxygen metabolism. Ultrasound-guided SGB before surgery reduced the incidence of POCD because of the improvement of cerebral oxygen metabolism.
ObjectiveTo explore the feasibility and application value of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients.MethodsThe clinical data of patients who underwent LPD from August 2016 to July 2019 were retrospectively analyzed. The patients were allocated into the elderly group (≥65 years old) and non-elderly group (<65 years old). The early surgical outcomes and postoperative complications of the two groups were compared.ResultsIn this study, 69 cases of LPD were collected, including 42 cases in the elderly group and 27 cases in the non-elderly group. Compared with the non-elderly group, the proportion of patients complicated comorbidities was higher (P<0.05), albumin level was lower (P<0.05), and American Society of Anesthesiologists classification was higher (P<0.05) in the elderly group. There were no significant differences in the intraoperative conditions, postoperative recovery, and postoperative complications between the two groups (P>0.05), and there were no significant differences in the pathological results of postoperative malignant tumor between the two groups (P>0.05).ConclusionsFor elderly patients with over 65 years old, LPD is a safe and feasible surgical procedure for clinical practice. Meanwhile, early surgical outcomes are satisfactory, postoperative complications are not increased, and tumor cure effect can be achieved.