Mccabehawkins8453
Assess the association between depression among new long-term care residents (<3 months stay) with dementia and functional mobility decline.
A multi-site prospective cohort study was carried out among 26 participants diagnosed with dementia. Functional mobility was measured by Timed-Up-and-Go (TUG) and 2-Minute walk test (2MWT) at baseline, and 60-day post-baseline while participants received usual care. Linear mixed models were applied to examine the association between depression and functional mobility decline.
Residents experienced a statistically significant decline in functional mobility in as soon as 60 days. Each additional year of age was associated with a 2% increase in TUG. The interaction between depression and time spent in LTC was statistically significant. Age and time living in LTC were significantly associated with functional mobility decline in new residents with dementia.
Further work determining why residents with dementia experience decline in functional mobility at an accelerated rate is needed.
Further work determining why residents with dementia experience decline in functional mobility at an accelerated rate is needed.
This study investigated the relationship between social activities and frailty during the restriction on outings due to COVID-19.
A cross-sectional study.
This study was conducted in City Nishinomiya of Prefecture Hyogo, in Japan. A mail survey was carried out among women aged 65 years or older in May 2020. A population of 293 women aged 65 years or older living in the community was recruited for the study and 213 of them were analyzed.
The survey included questions on sex, age, height, weight, and social activity. Social activity consisted of participation in social organizations and their frequency, as well as frequency of interaction with family and friends. The survey also asked if regular social activity had been impeded by COVID-19.
A significant association was found between frailty and hindered interaction with friends (β 0.176,
= .014). Multivariate linear regression analysis confirmed that this association was also significant in Model 1 (β 0.158,
= .025), and Model 2 (β 0.148,
= .034).
No association between being hindered in social activity and frailty was found in older women living in the community during the restriction on outings due to COVID-19.
No association between being hindered in social activity and frailty was found in older women living in the community during the restriction on outings due to COVID-19.
Medical Assistance in Dying (MAiD) is an end-of-life option for Canadians accounting for 2% of all deaths in Canada in 2019. Adults over 80 years old represent a significant proportion of these deaths, yet little is known about how they compare with their younger counterparts.
This study retrospectively reviewed our tertiary care institution's MAiD database to compare MAiD recipients <65, 65-80, and >80 years of age. Extracted data included basic demographics, illness characteristics, functional status, social living arrangements/contacts, and outcomes of MAiD assessments.
Of 267 patients assessed for MAiD, 38.2% were over 80. Compared to the younger groups, those over 80 were more likely to be female, to live alone, and to be widowed; however, they did not self-identify as 'socially isolated'. The majority fit into the illness categories of malignancy, cardiopulmonary or neurologic diseases, but those over 80 were more likely to have other more chronic/subacute conditions leading to the MAiD request.
Older adults accessing MAiD are distinct in that they tend to be increasingly frail and without a predominant underlying diagnosis as compared with younger adults, but rather have an accumulation of losses resulting in global functional decline and subsequent loss of autonomy and independence.
Older adults accessing MAiD are distinct in that they tend to be increasingly frail and without a predominant underlying diagnosis as compared with younger adults, but rather have an accumulation of losses resulting in global functional decline and subsequent loss of autonomy and independence.
The University of Calgary Cumming School of Medicine Annual Geriatrics Update Clinical Pearls Course (Geriatrics Update) is a one-day, continuing medical education (CME) course designed to enhance geriatrics competency for family physicians (FPs), given increasing population age and complexity. We aimed to evaluate how the course meets FPs' perceived learning needs and identify modifications that may better support FPs.
Descriptive data from 2018-2019 course evaluation surveys including demographic data, evaluations, and narrative feedback from participating FPs. Semi-structured phone and video-conferenced interviews with FPs were thematically analyzed each year.
Evaluation surveys had high response rates of FPs (52 or 61% in 2018; 39 or 58% in 2019). Most FP respondents (84% in 2018 and 82% in 2019) intended to make practice changes. FPs were significantly (
=.001) more confident on course objectives after the course in both years. All interviewees (n=20) described fulfilled perceived and unperceived learning needs and planned to return. The Geriatrics Update course is the primary source of Geriatrics CME for 60% of interviewees.
Iterative evaluation of Geriatrics Update identified that the course is well received, and often FPs primary source of geriatric CME. Interviews provided additional context and descriptive feedback to improve course delivery and better meet FP learning needs.
Iterative evaluation of Geriatrics Update identified that the course is well received, and often FPs primary source of geriatric CME. Interviews provided additional context and descriptive feedback to improve course delivery and better meet FP learning needs.
The aim of this cross-sectional study was to assess the effects of past occupational activity on muscle strength and respiratory function among retirees.
A total of 205 community-dwelling older adults participated in the study. Age (≥60 years) and cessation of professional activity (retirement) constituted the inclusion criteria. The International Standardized Classification of Occupations (ISCO-08) was used to stratify the participants into white- or blue-collar groups. Forced vital capacity (FVC), forced expiratory volume (FEV) in the first second, inspiratory vital capacity (IVC) parameters, and hand grip strength were tested.
Statistically significant differences in IVC and FVC scores were found in white- and blue-collar workers after adjusting for sex and age (ANCOVA). White-collar men had significantly higher IVC as compared to blue-collar men.
Blue-collar male workers may be prone to deteriorating respiratory function in older age. It is vital to promote physical activity and educate blue-collar workers about the need to use respiratory protective equipment.
Blue-collar male workers may be prone to deteriorating respiratory function in older age. It is vital to promote physical activity and educate blue-collar workers about the need to use respiratory protective equipment.
To determine the feasibility of conducting an RCT on the potential effectiveness of memantine hydrochloride in prolonging safe driving in mild AD.
A placebo-controlled, double blind randomized trial was conducted. Forty-three individuals ≥60 with mild AD met screening criteria and were randomized. Driving ability was measured by a standardized on-road driving test. Outcomes were driving capacity at 6 and 12 months and completion of the 12-month intervention.
Of 43 participants randomized, 59% of the memantine group and 52% of the placebo group completed the on-road test at 12 months (
= .66). All 13 memantine group participants maintained their driving status at 12 months, whereas only 8 of the 11 placebo group participants did (
= .040, OR = 4.45).
Results provide the framework for designing a rigorous multisite clinical trial of memantine effect on maintaining driving capacity in mild AD.
Results provide the framework for designing a rigorous multisite clinical trial of memantine effect on maintaining driving capacity in mild AD.
LIM and SH3 domain protein 1 (LASP1), highly expressed in a variety of tumors, is considered as a novel tumor metastasis biomarker. However, it is unknown which signaling pathway works and how the signal transduces into cell nucleus to drive tumor progression by LASP1. The aim of this study is to explore the essential role of LASP1 in TGF-
1-induced epithelial-mesenchymal transition (EMT) in lung cancer cells.
The gene and protein levels of LASP-1 were successfully silenced or overexpressed by LASP-1 shRNA lentivirus or pcDNA in TGF-
1-treated lung cancer cell lines, respectively. Then, the cells were developed EMT by TGF-
1. The cell abilities of invasion, migration, and proliferation were measured using Transwell invasion assay, wound healing assay, and MTT assay, respectively. https://www.selleckchem.com/products/didox.html Western blotting was used to observe the protein levels of EMT-associated molecules, including N-cadherin, vimentin, and E-cadherin, and the key molecules in the TGF-
1/Smad/Snail signaling pathway, including pSmad2 and Smad2
A retrospective cohort study was performed in patients aged 18 years or older with pneumonia who underwent chest CT within 24 hours of admission between April 2014 and March 2019. We measured the thickness, area, and volume of the pectoralis major and minor muscles at the level of the aortic arch. Factors associated with mortality were examined using logistic regression analysis.
A total of 483 patients (mean age 77 ± 14 years, 300 men (62%)) were included, and fifty-one patients (11%) died during admission. In univariate analysis, decreased thickness, area, and volume of the pectoralis major and minor muscles were associated with higher in-hospital mortality. Multivariate analysis with adjustment for age, gender, serum albumin, and A-DROP revealed that thinner pectoralis major and minor muscles were independent factors of poor prognosis (odds ratio 0.878, 95% confidence interval (CI) 0.783-0.985,
=0.026 and odds ratio 0.842, 95% CI 0.733-0.968,
=0.016, respectively). Approximately 25% of the patients died when the pectoralis minor muscle thickness was 5 mm or less, and no patients died when it was 15 mm or more.
The pectoralis muscle mass may be an independent prognostic factor in hospitalized patients with pneumonia.
The pectoralis muscle mass may be an independent prognostic factor in hospitalized patients with pneumonia.
To evaluate the cost-effectiveness of [
Lu]Lu-DOTA-TATE versus relevant comparators for the treatment of neuroendocrine tumours located in the gastrointestinal tract (GI-NETs) and the pancreas (P-NETs).
A three-state partitioned survival model was developed to perform a cost-utility analysis of [
Lu]Lu-DOTA-TATE versus standard of care (high dose Octreotide LAR), everolimus and sunitinib. Effectiveness data for SoC, everolimus and sunitinib were obtained from published Kaplan-Meier survival curves. Given a lack of head-to-head effectiveness data, matching adjusted indirect comparisons (MAICs) were performed to population-adjust [
Lu]Lu-DOTA-TATE survival data based on prognostic factors and derive estimates of relative effectiveness. Health state utilities were estimated from real-world evidence. Drug acquisition costs were taken from nationally published sources (BNF, NICE), and administration costs were based on treatment protocols in [
Lu]Lu-DOTA-TATE studies, combined with nationally published unit costs (PSSRU, DoH reference costs).
