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Yang Y, Gong J, Yang B, Chen C, Deng X, Chen K, Zhao Y, Cai X, Li J, Zhou J. Post-discharge nutritional management for patients with coronary heart disease and frailty: a qualitative study. BMC Geriatr 2024; 24:268. [PMID: 38504183 PMCID: PMC10949777 DOI: 10.1186/s12877-024-04885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Frail elderly patients experience physiological function and reserve depletion, leading to imbalances in their internal environment, which increases the risk of coronary heart disease recurrence and malnutrition. However, the majority of these patients, who primarily have a low level of education and lack self-management skills, face difficulties actively dealing with obstacles during the transition period after their discharge from hospitalization. Therefore, it is necessary to understand and discuss in depth the nutrition management experience of discharged elderly patients with coronary heart disease and frailty (ages 65-80 years old) and to analyze the promoting and hindering factors that affect scientific diet behavior during the discharge transition period. METHODS Fifteen elderly patients with coronary heart disease and frailty who had been discharged from the hospital for 6 months were interviewed using a semistructured method. The directed content analysis approach to descriptive research was used to extract topics from the interview content. RESULTS All participants discussed the problems in health nutrition management experience of discharged. Five topics and ten subtopics were extracted, such as ①Weak perceptions and behaviors towards healthy eating (personal habit solidification, negative attitudes towards nutrition management), ②Lack of objective factors for independently adjusting dietary conditions (reliance on subjective feelings, times of appetite change), ③Personal hindrance factors (memory impairment, deficiencies in self-nutrition management), ④Expected external support (assistance care support, ways to obtain nutritional information), ⑤Lack of continuous nutrition management (interruption of professional guidance, avoidance of medical treatment behavior). CONCLUSIONS Nutrition management after discharge places a burden on elderly patients with coronary heart disease and frailty. According to the patients' physical conditions, we should develop a diet support system that is coordinated by individuals, families and society.
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Affiliation(s)
- Yifei Yang
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jing Gong
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Binxu Yang
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Chan Chen
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xintong Deng
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Kejun Chen
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yingying Zhao
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xusihong Cai
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jingjing Li
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jing Zhou
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
- School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China.
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Pronk AC, Wang L, van Poelgeest EP, Leeflang MMG, Daams JG, Hoekstra AG, van der Velde N. The impact of cardiovascular diagnostics and treatments on fall risk in older adults: a scoping review and evidence map. GeroScience 2024; 46:153-169. [PMID: 37864713 PMCID: PMC10828261 DOI: 10.1007/s11357-023-00974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/07/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND We aimed to summarize the published evidence on the fall risk reducing potential of cardiovascular diagnostics and treatments in older adults. METHODS Design: scoping review and evidence map. DATA SOURCES Medline and Embase. ELIGIBILITY CRITERIA all available published evidence; Key search concepts: "older adults," "cardiovascular evaluation," "cardiovascular intervention," and "falls." Studies reporting on fall risk reducing effect of the diagnostic/treatment were included in the evidence map. Studies that investigated cardiovascular diagnostics or treatments within the context of falls, but without reporting a fall-related outcome, were included in the scoping review for qualitative synthesis. RESULTS Two articles on cardiovascular diagnostics and eight articles on cardiovascular treatments were included in the evidence map. Six out of ten studies concerned pacemaker intervention of which one meta-analyses that included randomized controlled trials with contradictory results. A combined cardiovascular assessment/evaluation (one study) and pharmacotherapy in orthostatic hypotension (one study) showed fall reducing potential. The scoping review contained 40 articles on cardiovascular diagnostics and one on cardiovascular treatments. It provides an extensive overview of several diagnostics (e.g., orthostatic blood pressure measurements, heart rhythm assessment) useful in fall prevention. Also, diagnostics were identified, that could potentially provide added value in fall prevention (e.g., blood pressure variability and head turning). CONCLUSION Although the majority of studies showed a reduction in falls after the intervention, the total amount of evidence regarding the effect of cardiovascular diagnostics/treatments on falls is small. Our findings can be used to optimize fall prevention strategies and develop an evidence-based fall prevention care pathway. Adhering to the World guidelines on fall prevention recommendations, it is crucial to undertake a standardized assessment of cardiovascular risk factors, followed by supplementary testing and corresponding interventions, as effective components of fall prevention strategies. In addition, accompanying diagnostics such as blood pressure variability and head turning can be of added value.
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Affiliation(s)
- Anouschka C Pronk
- Department of Internal Medicine, Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
| | - Liping Wang
- Department of Internal Medicine, Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
| | - Eveline P van Poelgeest
- Department of Internal Medicine, Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands.
| | - Mariska M G Leeflang
- Department of Epidemiology and Data Science Section of Methodology, Amsterdam University Medical Centres, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Joost G Daams
- Medical Library, University of Amsterdam, Amsterdam, The Netherlands
| | - Alfons G Hoekstra
- Computational Science Lab, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
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Cilhoroz BT, Heckel AR, DeBlois JP, Keller A, Sosnoff JJ, Heffernan KS. Arterial stiffness and augmentation index are associated with balance function in young adults. Eur J Appl Physiol 2023; 123:891-899. [PMID: 36564497 DOI: 10.1007/s00421-022-05116-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Arterial stiffness and pulsatile central hemodynamics have been shown to affect various aspects of physical function, such as exercise capacity, gait speed, and motor control. The aim of this study was to examine the potential association between arterial stiffness and balance function in healthy younger men and women. METHODS 112 participants (age = 21 ± 4 years, n = 78 women) underwent measures of arterial stiffness, pulsatile central hemodynamics, balance function and physical fitness in this cross-sectional study. Postural sway was measured in triplicate while participants stood on a foam surface with their eyes closed for 20 s. The average total center of pressure path length from the three trials was used for analysis. Measures of vascular function were estimated using an oscillometric blood pressure device while at rest and included pulse wave velocity (PWV), augmentation index (AIx), and pulse pressure amplification. Measures of physical fitness used as covariates in statistical models included handgrip strength determined from a handgrip dynamometer, lower-body flexibility assessed using a sit-and-reach test, estimated maximal aerobic capacity (VO2max) using heart rate and a step test, and body fat percentage measured from air displacement plethysmography. RESULTS The results from linear regression indicated that after considering sex, mean arterial pressure, body fat, estimated VO2max, handgrip strength, and sit-and-reach, PWV (β = 0.44, p < 0.05) and AIx (β = - 0.25, p < 0.01) were significant predictors of postural sway, explaining 10.2% of the variance. CONCLUSION Vascular function is associated with balance function in young adults independent of physical fitness. Increased arterial stiffness may negatively influence balance, while wave reflections may be protective for balance.
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Affiliation(s)
- Burak T Cilhoroz
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Andrew R Heckel
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Jacob P DeBlois
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Allison Keller
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kevin S Heffernan
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA.
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Pleiss A, Jurivich D, Dahl L, McGrath B, Kin D, McGrath R. The Associations of Pulse Pressure and Mean Arterial Pressure on Physical Function in Older Americans. Geriatrics (Basel) 2023; 8:geriatrics8020040. [PMID: 37102966 PMCID: PMC10137340 DOI: 10.3390/geriatrics8020040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Background: We sought to examine the associations of pulse pressure (PP) and mean arterial pressure (MAP) on physical function in older Americans. Methods: Our analytic sample included 10,478 adults aged ≥65 years from the 2006–2016 Health and Retirement Study. Handgrip strength, gait speed, and standing balance were collected using relatively standard protocols. PP and MAP were calculated from blood pressure measurements. Results: Older Americans with any abnormality in PP had 1.15 (95% confidence interval (CI): 1.05–1.25) greater odds for slowness and 1.14 (CI: 1.05–1.24) greater odds for poorer standing balance. Persons with any abnormality in MAP had 0.90 (CI: 0.82–0.98) decreased odds for weakness and 1.10 (CI: 1.01–1.20) greater odds for poorer standing balance. Those with low PP had 1.19 (CI: 1.03–1.36) greater odds for slow gait speed, while persons with low MAP had 1.50 (CI: 1.09–2.05) greater odds for weakness and 1.45 (CI: 1.03–2.04) greater odds for slowness. Older Americans with high PP had 1.13 (CI: 1.03–1.25) greater odds for slowness and 1.21 (CI: 1.10–1.32) greater odds for poorer balance, whereas those with high MAP had 0.87 (CI: 0.80–0.95) decreased odds for weakness. Conclusions: Cardiovascular dysfunction, as observed by PP and MAP, may help to explain some of our findings.
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Association between ApoA1 Gene, Plasma Lipid Profile, hsCRP Level, and Risk of Arterial Stiffness in Thai Elderly. Adv Prev Med 2022; 2022:4930033. [PMID: 35873099 PMCID: PMC9303502 DOI: 10.1155/2022/4930033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction. Apolipoprotein A1 (ApoA1) gene polymorphism is linked to high-density lipoprotein cholesterol (HDL-C) levels. Variations in this gene, along with dyslipidemia and inflammation, may increase the risk of vascular stiffness. This study aimed to investigate the link between ApoA1 rs670 genetic variations, various biochemical parameters, and the risk of arterial stiffness in older people. Methods. This population-based cross-sectional study included 355 participants (≥60 years) who completed a demographic and lifestyle information questionnaire. Clinical and anthropometric examination, biochemical analysis, and ApoA1 rs670 genotyping by real-time PCR were performed. The cardio-ankle vascular index (CAVI) was used to assess arterial stiffness. Results. Age, BMI, waist circumference, SBP, LDL-C, and high-sensitivity C-reactive protein (hs-CRP) were associated with high CAVI (≥9) among older people. The mean CAVI (8.19 ± 2.78) for the ApoA1 rs670 AA genotype was lower than that of the GG genotypes (8.94 ± 1.00,
). These results are supported by HDL-C (OR = 0.47, 95% CI: 0.24–0.93;
) and high hs-CRP (OR = 0.30, 95% CI: 0.16–0.57;
) levels together with adjusted ORs of both variables. Conclusion. ApoA1 rs670 genetic variations involved in the synthesis, transport, and processing of HDLs, hypertension, and inflammation are linked to arterial stiffness. Further studies are required to clarify these mechanisms.
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Oh DS, Choi JD. Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E650. [PMID: 33466699 PMCID: PMC7828767 DOI: 10.3390/ijerph18020650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/21/2023]
Abstract
The aim of this study was to demonstrate the effects of motor imagery training on balance and gait abilities in older adults and to investigate the possible application of the training as an effective intervention against fall prevention. Subjects (n = 34) aged 65 years and over who had experienced falls were randomly allocated to three groups: (1) motor imagery training group (MITG, n = 11), (2) task-oriented training group (TOTG, n = 11), and (3) control group (CG, n = 12). Each group performed an exercise three times a week for 6 weeks. The dependent variables included Path Length of center of pressure (COP)-based static balance, Berg Balance Scale (BBS) score, Timed Up and Go Test (TUG) score, which assesses a person's mobility based on changes in both static and dynamic balance, Falls Efficacy Scale (FES) score, which evaluates changes in fear of falls, and gait parameters (velocity, cadence, step length, stride length, and H-H base support) to evaluate gait. After the intervention, Path Length, BBS, TUG, velocity, cadence, step length, and stride length showed significant increases in MITG and TOTG compared to CG (p < 0.05). Post hoc test results showed a significantly greater increase in BBS, TUG, and FES in MITG compared with TOTG and CG (p < 0.05). Our results suggest that motor imagery training combined with functional training has positive effects on balance, gait, and fall efficacy for fall prevention in the elderly.
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Affiliation(s)
- Dong Sik Oh
- Department of Physical Therapy, Division of Health Science, Hanseo University, Seosan 31962, Korea
| | - Jong Duk Choi
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Daejeon 34520, Korea;
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